 | | | Margie Ryerson, MFT, is a marriage and family therapist in Orinda and Walnut Creek. She can be reached at 925-376-9323 or margierye@yahoo.com
| | | | | | Two very loving and concerned parents called me about their six year old son, "Adam." They wanted to bring him in for therapy because he was increasingly uncooperative and difficult to handle at home. As I questioned them further, I found out that Adam performed well in his first grade class at school and obeyed his teacher. He had friends and activities that he enjoyed, and he was healthy and bright.
I set up an appointment to meet with Adam's parents and explained that we could accomplish much more in a shorter period of time if I met with them directly and bypassed seeing Adam. When a child is acting out only with his parents, we can more easily narrow down the approach for treatment. Play therapy, art therapy, and other child-oriented therapies work well in certain instances, but this situation called for some parental re-grouping.
Some children respond well to discipline and parental limits and persuasion. Others are strong-willed and enjoy having a sense of their own power as they challenge parental authority. Adam definitely was determined to get his way whenever possible. He refused to come to the dinner table, he refused to stay in his room for time-outs, he refused to go to bed, take a bath, or get ready for school. And this is just a partial list.
Adam's parents had tried carrying him back and forth to his room for time-outs and then holding the door closed. They literally had to dress him and carry him to the car for school, hold him down for baths, and drag him to the dinner table. Naturally, his parents were concerned that if they were having this many problems with Adam now, what would it be like when he became an adolescent?
Adams' parents had made a few well-intentioned mistakes in their efforts to reform their son's behavior. For instance, they tended to overdo positive reinforcement; if Adam came to the dinner table when he was called, they made a big fuss over him. It cheapens the currency if you do somersaults whenever your child does something that is normal and expected. They also spent a great deal of time and energy trying to persuade Adam to cooperate. No wonder Adam felt in control of his parents rather than vice-versa.
The first thing we implemented was a much-needed behavioral plan. To begin with, his parents charted three expected behaviors. If Adam complied with one, he received a sticker. Five stickers added up to a small privilege, such as staying up a half-hour later on a weekend night. Ten stickers resulted in a local ice-cream outing. Twenty stickers yielded a small prize. It is important to start small and to keep it simple. Otherwise the child will continue to feel too powerful if parents cater to his natural desire for bigger and better rewards.
More importantly, Adam's parents agreed to change their own behavior. They would no longer repeat their instructions several times, nag, over-explain, or show anger and frustration. They were to remain calm, firm, and detached from Adam's negative behavior. They would make sure their body language wasn't giving them away. In other words, even if they were seething inside, they would adopt serene facial expressions and postures. In this way, Adam would no longer be able to derive power and satisfaction from manipulating his parents' emotions.
If he wouldn't get dressed for school in the morning, he would either be late for school or have to go partially dressed. If he screamed and kicked in the car, his parents would ignore him and act calm. Either way, his refusal to cooperate needed to become his problem and not his parents'. Adam's teacher was informed of the behavioral plan and cooperated by giving him tardies and consequences if he arrived late to school.
If Adam didn't come to dinner when he was called, the family ate without him and made sure to enjoy themselves and laugh with his younger sister. If he became hungry later on, he could only have plain crackers and carrots to eat. Yes, this wasn't a well-balanced diet, but his nutritional needs needed to be subordinated for awhile.
Over a lengthy period of time, Adam's parents calmly but firmly dealt with his resistance to baths and bedtime. Gradually, as Adam didn't receive the "reward" of upsetting his parents, but could qualify for a real reward if he complied with them, he became more cooperative.
As Adam succeeded with the behavioral plan, his parents next adopted a positive incentive plan. Now Adam could also earn stickers for helping out at home with chores and with his little sister.
This process was not a short one; it took over a year for Adam's behavior to turn around at home. Happily, Adam is now entering third grade and is flourishing both in school and at home. Luckily for Adam, he has parents who worked hard to give him the training and structure he needed to become an emotionally healthy child.
|
Lamorinda Weekly, Moraga CA