Category: teens

Five-minute wisdom for parenting troubled children and teens

Five-minute wisdom for parenting troubled children and teens

Five-minute wisdom for parenting troubled children and teens
6 votes

From many years of  counseling parents, I’ve found the following parenting wisdom quickly helps parents understand, clarify priorities, and take the next steps.

You are not alone. All families experience the same fears no matter what the child’s challenges: guilt, anger, frustration, failure, and mental and physical exhaustion.

There is a way. The steps to finding peace in the home are the same for all families.

You can start now. You can improve behavior without having a diagnosis, and the techniques work for the majority of difficult children.

There is reason for HOPE. They have the capacity to do better. With support and treatment, difficult children improve.

Have realistic expectations: They may not be ready for adulthood, and may need extra support into their 20’s… but that’s OK. There’s time to catch up with their peers.

Plan ahead for a crisis, brainstorm options for an effective response and create a checklist. We can’t think clearly in a tension-filled moment.

GOOD Things to do for Your CHILD or TEEN

Pay attention to STRENGTHS not weaknesses. Always find something great about them.

Guide them to their gifts. Give them ample opportunity to do what they are already good at.

GOOD Things to do for YOU

o Be your own cheerleader. Silently think, “I can handle this;” “I’m the one in control.

o Regularly talk through your feelings with others who understand and won’t judge.

o Get a life, maintain personal interests, and set thoughts of the child aside without guilt.

o Commit to doing the best you can, and accept that this enough – plan to let go someday.

You’ve done a good job when they are able to take responsibility for their own care. This is a monumental personal achievement!

KEYS to CALM

In a neutral patient voice, give directions or requests . You will need to repeat yourself, calmly, several times. Your voice should not communicate strong emotions. Tone of voice, not words or volume, is what creates a bad response.

Don’t rush calm. Give the child plenty of time to unwind and settle. Calm is more important than quick.

Ensure there’s a calm place to go – a time-out space, even for you.

Get an appropriate therapy animal – a calm and durable creature unlikely to be harmed.

Reduce chaos in your home: noise, disorder, family emotional upheavals, the intrusive stimulation of an always-on TV, etc.

Ideas for MANAGING resistance

You want your child to be resistant to the negative things they’ll face in life. It represents willpower, and is a strength to cultivate.

o Be quiet and LISTEN. If you respond, address how they feel, not what they say.

o Use reverse psychology-ask them to do something you don’t want them to do, so they can defy you and do the opposite.

o Choose your battles. Let them think they’ve won on occasion.

o For an ODD child, give multiple instructions at once, including things they do and don’t want to do. It becomes too much work to sort out what to defy.

o Actively ignore – Stay in the vicinity but don’t respond, look away, act like you can’t hear. They eventually give up. Works best for ages 2 – 12.

o Mix it up – Be unpredictable. Give a reward sometimes but not all the time. Try new ways to use incentives or set boundaries and structure.

DON’T make these Nine COMMON Parenting MISTAKES

1. Treat your home like a democracy, let your child have an equal say in decisions.

2. Find fault with them and tell them about it repeatedly. If they do something positive, it’s not good enough.

3. Pretend your child has no reason for their behavior. Ignore his or her needs or challenges. Are they being bullied? Are they having a hard time sleeping? Is your home too chaotic?

4. Make rules and only enforce them once in a while, or have consequence come later.

5. Don’t treat your child appropriately for his or her age. Make long explanations to a 3-year-old about your reasoning. Assume a teen wants to be just like you.

6. Expect common sense from children who are too young (5), or from young adults with a long track record of not showing common sense.

7. Keep trying the same things that still don’t work. Repeat yourself, scream, show how frustrated you are with them.

8. Jump to conclusions that demonize the child. “You are manipulative and deceitful,” “You don’t listen to me on purpose,” “I’m tired of your selfishness…”

9. Make your child responsible for your feelings. If you lose your cool, insist they apologize.

Problem SYMPTOMS, not problem children

– Does not show common sense and is not influenced by reason and logic;

– Has no instincts for self-preservation, and poor personal boundaries;

– Has no well-adjusted friends; has friends who are risky or troublesome;

– Doesn’t respond to rewards and consequences;

– Has limited character strengths: honesty, tolerance, respect for others, self-control;

– Does not make plans they can realistically achieve, hangs on to fantasies;

– Acts younger than their peers. Will not be ready for adulthood by 18;

– Lives in the here and now; doesn’t think about the past or future;

– Does not notice their effect on others.

Your PRIORITIES in Order

1. You and your primary relationship(s)

2. Basic needs and responsibilities: housing, clothing, food, income, health

3. Your challenged child or teen.

How parents spend their time when a child has a mental illness. Make the slices equal in size–too much for one, too little for others.
Time spent on all the important things better supports the child and the family they depend on.

 

 

 

 

Therapy types explained: DBT, CBT, CPS, and others

Therapy types explained: DBT, CBT, CPS, and others

Therapy types explained: DBT, CBT, CPS, and others
3 votes

The fantastic news about the brain is that it can heal itself by talking with someone! And there is ample evidence to back this up.

The therapist or psychologist who works with your child or teen will use a type of therapy or “modality” based on their symptoms or diagnosis, because some work better for mood disorders, some work better for defiant children, some work better for borderlines, and so forth. (In thought disorders like autism and schizophrenia, talk therapy has limits. Those on the autism spectrum need specialized interactions due to their processing issues. Those on the schizophreniform spectrum need medication to think logically before starting

Therapy models. Each type of therapy follows a model, and five are covered in this article. Your child’s therapist must be trained and practiced in any model they use. Why? It’s a matter of quality control. A therapist who has fidelity to a model (adheres to protocol) will help the most people most of the time, because that model has data to prove that the majority will benefit–the ones in the center section of the Bell Curve. (Therapists include psychiatrists, psychologists, and psychotherapists with MSW (Masters in Social Work), LCSW (Licensed Clinical Social Worker) and other licensure.)

Therapy models

CBT – cognitive behavioral therapy
CBT works when the child can examine their own feelings and make sense of them—the “cognitive” part. They learn to understand what affects them and why. The therapist will guide your child to create a list of options for themselves for when they face the next stressful situation that pops up in their lives. CBT helps a person think their way out of the confusion and have plans in place for appropriate actions. It works for mood disorders and anxiety, and some thought disorders if person has ‘insight’ (able to notice when they are behaving or thinking irrationally). CBT is one of the most widely used therapeutic models because it works for people who are relatively stable but enduring a difficult life situation (divorce, medical illness, job loss, and other big stressors).

DBT – dialectical behavioral therapy
DBT is unusual in that it can help anyone for any reason! The term “dialectical” describes how a patient learns to hold two opposing truths in their mind and respond effectively to the discomfort and emotions this causes. DBT is the one therapy model that can work for people with borderline personality disorder, who are considered the hardest to treat. It also helps those with mood dysregulation, those who’ve thought about or attempted suicide, or those with uncontrollable and negative responses to the world, such as oppositional defiant disorder. DBT relies less on personal self-examination and analysis, and instead concentrates on self calming, tolerating stress without overreacting, accurately perceiving the nature of a conflict, and communicating with others appropriately. Anyone can benefit from DBT. Notice how commonly people hear bad news and immediately expect the worst, then act to address the worst possible outcome? Does your child do this, only to extremes?

EMDR – eye movement desensitization and reprocessing
The goal of EMDR therapy is to help a person process extremely distressing memories of trauma and mitigate their torturous subconscious influence so children and adults can adapt and cope when memories are triggered in the future. EMDR is used for people with PTSD (physical, sexual, or emotional abuse) and other traumas such as from war, accidents, and major disasters. The therapy process uses rhythmic stimuli as a distraction during the precise moments when the person relives the traumatic memory—eye movement back and forth (by following a swinging object or a therapist’s hand), clapping, or listening to tones switching from ear to ear through headphones. The person does not have to talk about the horrible memory, so EMDR is less stressful—so important for a trauma survivor! EMDR works but there are no acceptable explanations. It is based on a belief that the memory and associated stimuli of the event must be processed to remove it from “an isolated memory network” where it creates havoc.

Parents as therapists

There are two proven models of therapy that are taught to parents to practice with their children in the home. Like the other models, they don’t work for every child, but they work for most children with a certain range of behaviors, rages, resistance, and physical violence, which can be caused by ODD, ADHD, and depression/bipolar disorders.

CPS – collaborative problem solving
CPS can be learned by anyone to manage an intensely frustrated child who goes into uncontrollable fits or tantrums, and the parent can do nothing to calm them down. The fits may last hours, and must run out of steam on their own. Afterwards, the child is often remorseful. Why? Their brain is “chronically inflexible” and has difficulty with the unexpected, switching from one situation to another or one plan to another. Using CPS, a parent doesn’t enforce rules per se, but negotiates with child so that they together come up with a win-win solution. This is very counterintuitive! The parent does not give away their authority, but offers the child an acceptable choice. For example, if a child can’t get a red jacket because there aren’t any in their size, and they must have red (!), the parent asks the child if they want to order one and wait 2 weeks, or if they will accept another color. This seems fair to the child because they have a say, and much easier on the parent because the child accepts the outcome they’ve chosen.

PMT – parent management training
PMT refers to a proven intensive educational program for parents to teach them skills for managing extremely difficult children, especially those with ODD. PMT helps parents assert consistency and predictability at home and in school, and promote positive social behavior in their child. The parents are also trained to change their own behavior towards their child, and taught how to analyze different home/school situations, “then apply moment-to-moment positive reinforcement or punishment” (called interventions) based on what is happening. The punishments are humane, such as taking time outs. It is hard on the parents, but works for children with serious behavior problems in addition to ODD: Conduct disorder, ADHD, and autism spectrum disorders.

What makes a good therapist? Because multiple models are out there, a really skilled therapist will figure out which model your child needs once they get to know them, and they will apply parts of different models depending on your child’s individual challenges. That same skilled therapist will also be a cheerleader for your child, helping them feel good about themselves (and you), helping them discover their talents, and helping them to stay committed to their need for self-care. This is the very definition of a good therapist! Therapy is hard to take for anyone, but your child will trust a good therapist if they feel they have their best interests. Chemistry is important. If your child doesn’t like the therapist or make progress, it’s worth spending the time to find someone else who’s a better match. If the therapist has professional ethics; they will recognize they are not a fit and recommend someone else.

I know of a 10-year old child whose therapist dragged out appointments for a year with zero progress or results. From the start, the child didn’t like her and simply refused to talk with her. And this child, now 11, refuses any therapy because “it’s boring and a waste of time.” What an unfortunate consequence!

How you know you have a good therapist. A good therapist will be able to discover something valuable that brings light on your child’s situation after the very first session. They should ask you for background information about your child, and listen to you when you talk about recent problematic situations. They cannot talk to you about your child’s therapy, but they can encourage you to partner with them, and should recognize your need (your family’s need) for your child to function as normally as possible. You can ask to have therapy together with your child if its appropriate. If the therapist can’t connect meaningfully with your child after a few weeks, ask them about this. If you have any doubts about the therapist, share them, and expect to have a thoughtful, respectful explanation.

Which therapy is best for your child?

Seek a therapy provider with knowledge of all of them, and with experience treating children and teens. Ask about a specialty when you make the initial contact, and ask about a model you think fits your child’s behaviors (based on their descriptions). You can get a one-time assessment from a therapist for an opinion on which model to use. The best way to find a good therapist is through personal referrals: your child’s doctor or psychiatrist, support groups, school counselors, and other parents.

What to do when they stop listening

What to do when they stop listening

What to do when they stop listening
4 votes

You don’t have to feel this frustrated.

At some point in their development, all kids stop listening. It’s frustrating but normal. There are lots of good advice for getting normal children and teens to listen, or at least follow the rules and directions given by the parent.But it’s different when your child has serious behavioral disorder, and when their behaviors are extreme or outright risky. Your priority may be to prevent destructive behavior and family chaos when they hate you, blame you, or are willing to take extreme risks. Then who cares about the dishes or homework?

First things first, avoid upsetting yourself.

Avoid repeating things over and over, raising your voice, or expressing your frustration. It really matters.  This stresses you as much as it stresses them. Children and teens with disturbances have a hard time tracking, and it may be pointless to expect them to listen. Your child or teen is overwhelmed by brain noise and does not hear even hear you.

But what if they are refusing to listen?  That’s a different issue.  They ARE listening, and they are definitely communicating back to you.  This is resistance and defiance.  (see Managing resistance – tips and advice )

Things to do when they stop listening

Use technology: texting and email.

This mother should be texting her daughter instead

This approach is so simple and so effective that therapists encourage high-conflict parent-teen pairs to communicate exclusively using email and texts, even if the parties are in close proximity, like at home together! Think about this. You are using their chosen medium; you can keep it brief and concise; both you and your child have time to reflect on your response. Your conversation is documented, right there for both of you to track. No one is screaming or repeating themselves.Word of caution
Watch what you write. Don’t use emotionally charged words or tone. Be sure to read texts and emails over and over before sending! “The Journal of Personality and Social Psychology 2006 revealed that studies show e-mail messages are interpreted incorrectly 50% of the time.”

Move somewhere closer or farther, change your body language
Instead of communicating with your voice, use your body. For some children and teens, an arm around their shoulders calms them quickly. Or try standing calmly and quietly. Or put some distance between you and your child’s personal space, even if it means stopping and getting out of the car and taking a short walk. Experiment to see what works for your situation.

Use a third-party
Maybe you are the wrong person to carry the message and settle a tense situation. Don’t be too proud to admit that, for whatever reason, your child will not listen to you no matter how appropriately you modify your approach. So use a substitute or third-party. Is there another person who has a better rapport and can convince your child to complete a chore, do homework, leave little sister alone—a spouse, a grandparent, a teacher or counselor, a therapist? What about a friendly animal, live or stuffed? For young children, you can bring out Kitty and ask her to tell Joey that mommy and daddy only want him to do this one simple chore.

Draw a picture, make a sign

As a young child, I recall my parents hounding me for something, I don’t even remember what.  Then they’d ask, “What do you want me to do, draw a picture?” Well, yes in fact, I understood pictures and they didn’t frighten me as much as my parents yelling at me. Pictures and signs work, put them up where the family can see them (and your troubled child won’t feel singled out).  Maybe a funny comic gets a point across in a non-threatening way.  Some sign ideas: “It’s OK to be Angry, not Mean,” “STOP and THINK,” “Our family values Respect and Kindness,” “This is a smoke-free, drug-free, and a-hole free home.”

Time outs for you
.
Take your own sweet time to calm down and think things through what to say when you’re challenged by your offspring. Consider how you’ll respond to swearing. Put him or her on hold. Don’t return texts or email right away, “I’m busy and I’ll reply in 30 minutes.” Be specific on time, then follow through, or they might learn to blow you off with the same casual phrase, expecting you to forget. 

A Precaution

Watch your tone of voice
From infancy, we are wired to pick up emotions in the voice—it’s literally in our brain.  Your tone is very powerful and can be calming or destructive. Think about asserting strength and caring in your voice without lecturing. Be assertive but forgiving. Be firm and not defensive. Don’t get caught apologizing for upsetting your child or justifying your rules. 90% of parents know the right thing to say, but its common to say it the wrong way.

Is your child bullying you with their behavior?
I’ve observed child verbally bully and abuse their parents. This is not communicating and not negotiable. You have options for standing up to this without making things worse. Temporarily block their email or calls, or ignore and let them go to voicemail. Declare bullying unacceptable. Pull rank and apply a consequence. You cannot let their harassment continue because they will use it on others.
About that mean-spirited voicemail or email.
When you get an ugly message, tell yourself you are hearing from a scared, frightened person, and you’re the one whose feelings they care about the most. See this as a good thing. They are trying to communicate but it’s mangled and inappropriate. You want them to stay in contact and engage with you even if its negative. When a disturbed child stops communicating is when you must worry.  It hurts, but your hurt will pass.  You can handle it.  They will still love you , and some day they will show you.  Be very patient.
If the things they communicate hurt.
It is best that you take your feelings out of the picture and seek other sources of affirmation and support—this can’t come from your child. If they write “I hate you,” maybe they are really saying “you make me mad because you are asking me to do something I can’t handle now.”

Good luck out there,
–Margaret

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