Managing Defiance with Self-regulation Training

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  • 1. Managing Defiancewith Self-regulation Training
    Brad Chapin MS, LCP, LMLP
    Mathew Penner MSW, LMSW
  • 2. Overview
    Opposition and Defiance
    Managing it with a Solid Framework
    Self-regulation Training
    Strategies
  • 3. Defiance and Opposition
    Can we “cure” it?
    Or a better question may be…should we?
    Are there times in your life where being oppositional or defiant was the best course of action?
  • 4. A World Without Defiance?
  • 5. On an Individual Level
    Learned helplessness
    Dependence vs.Independence
    Victimization – bullying, domestic violence
    Low Self-esteem
    Powerlessness
  • 6. Manage it vs. Destroy it
    Oppositional and Defiant behavior is healthy
    Conflict is a natural part of communication
    Conflict can create growth
    We can learn from conflict
  • 7. So What’s the Problem?
  • 8. Where it can go Wrong
    Intensity
    Aggression
    Becomes destructive
    Timing
    A time and a place for it
    Planning/Process
    How to approach the situation
    Consideration of others involved
    Pros and Cons
    Cost/benefit
  • 9. Behavior on a Continuum
    Moderate
    Dependent,
    Helpless,
    Victim
    Aggressive, Hurtful, Antisocial
  • 10. Disruptive Behavior Disorders
    Oppositional Defiant Disorder
    Conduct Disorder
    Disruptive Behavior Disorder NOS
    Antisocial Personality Disorder
    Reserved for Adults
  • 11. Oppositional Defiant Disorder
    A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present: (1) often loses temper (2) often argues with adults (3) often actively defies or refuses to comply with adults' requests or rules (4) often deliberately annoys people (5) often blames others for his or her mistakes or misbehavior (6) is often touchy or easily annoyed by others (7) is often angry and resentful (8) is often spiteful or vindictive B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. C. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.
    • Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association
  • What Else Can Look LikeOppositional Defiant Disorder?
    Autism Spectrum
    Anxiety
    Depression
    Bipolar Disorder
    Trauma History
    Developmental Issues
  • 12. Types of Defiance
  • How Do Children Develop Extreme Defiance?
    Bio-psycho-social explanation
    Bio = Biological reasons
    Psycho = Psychological
    Social = History, Environmental
    Within the Psychological domain we explore the “why” behind the behavior
    What MOTIVATES defiance?
  • 22. Behavioral Reasons for It to Get Out of Control
    The child has LEARNED that extreme defiance “works”
    He throws a fit and ends up getting his way
    Learned by example
    Over time this behavior is strengthened through success
    Risk/Reward or Cost/Benefit
  • 23. Cognitive Reasons for It to Get Out of Control
    “I have to get you before you get me.”
    “Everyone is against me.”
    “The more I push, the more I get.”
    “I’ve been hurt so much already that I don’t care what happens to me.”
    “I have no control. I will do what it takes to have control.”
  • 24. Things that Don’t Seem to Work
    What things have you tried that didn’t seem to work very well?
    Have you ever “won” an argument?
    What about power struggles?
    How do your own actions influence the situation?
    STUDY LINK:
    http://www.aera.net/uploadedFiles/News_Media/News_Releases/2010/AERA%20Factsheet-3%20April8-2010.pdf
  • 25. What Can We Do?
    Set up a simple and Consistent set of expectations
    Learn to manage ourselves
    Use our skills and supports
    Self-regulation Skill Training
    Physical
    Emotional
    Cognitive
  • 26. “Know Thyself”
    Socrates - 469 BC – 399 BC
    Benjamin Franklin wrote in his 1750 Poor Richard's Almanac that "There are three things extremely hard: steel, a diamond, and to know one's self.“
  • 27. “Know Thyself”
    How do you think about children who are oppositional or defiant?
    What perceptions do we form about others?
    What do we attribute their behavior to?
    What do we think about our own ability to manage these types of behaviors?
    How do we respond under stress?
  • 28. Having a Solid Framework
    Gives you guidance when you get stuck
    Helps you evaluate new interventions/activities
    Helps the Team Communicate
    Prevents Confusion
    Helps provide Consistency
  • 29. Self-regulation Training Framework
    Cognitive-behavioral Psychology
    Provides Evidence Base
    Self-Regulation
    Strategies
    Physical, Emotional, Cognitive
    Regulation Skill Domains
    Academic Performance Emotional Control Motivation
    Aggression/Violence Executive Function School Safety
    Anger Impulse Control Self-efficacy
    Anxiety Learned Helplessness Self-esteem
    Attention Locus of Control Social Interaction
    Attribution LongevitySuccess
    Cognitive Flexibility HappinessTrauma
    Depression Oppositional Defiance Well-being
    © 2010 ChapinPsychological Services, LLC
  • 30. Self-regulation & Violence
    School Safety
    Violence & Aggression
    Victim/Perpetrator
    What are the connections?
  • 31. Assumptions of the Framework
    Children will do well if they can (Green & Ablon, 2006).
    One must be physically calm to effectively engage in problem-solving and learning (Goleman, 1998, Macklem, 2008 ,Yerkes & Dodson, 1908).
    Human beings have little control over their environment, but a great deal of control over their responses to their environment (Ellis, 1962).
    The relationship is likely the most important variable when trying to help someone change (Hubble, Duncan & Miller, 1999).
  • 32. Assumptions of the Framework
    Cognitive-behavioral psychology works (Beck & Fernandez, 1998; Butler, Chapman, Forman & Beck, 2006).
    Effective Self-regulation is critical for success and happiness (Baumeister, Heatherton, & Tice, 1994; Duckworth & Seligman, 2005; Masten & Coatsworth, 1998).
    In order to be effective, we need to meet children where they are currently functioning (Greene, 2006; Bailey, 2001).
    Do not assume that children have learned anything about how to regulate their own behaviors in a healthy way.
  • 33. Cognitive-behavioral Psychology Works
    Cognitive-Behavioral Psychology
    Over 400 Random, Clinical studies
    Easy to Use
    Natural to implement – probably doing some of it already
    De-mystifies psychology
    High emphasis on education
    Stresses monitoring and outcomes
  • 34. Cognitive-Behavioral Psychology in a Nutshell
    Behavioral
    Setting up consistent limits with consequences
    Rewarding positive behaviors
    Cognitive
    Understanding that beliefs and perceptions dictate our emotional and behavior responses
    Change beliefs to change behavior
  • 35. What is the Goal?
    Self-Regulation
    Age
    External
    Regulation
    Age
  • 36. Self-regulation
    Broadly defined
    Skill-building
    Scaffolding
    Learning to regulate one’s own Physical, Emotional, and Cognitive processes in healthy, pro-active ways to be successful
    Healthy, adaptive and “appropriate” responding to internal and external events
  • 37. Three Functional Categories of Self-regulation Skill Training
    Physical
    Emotional
    Cognitive
  • 38. Physical Regulation
    When Physical response is triggered:
    Lower Brain is in command
    Higher thinking not engaged
    Body is ready for action
    Performance requiring thought is compromised
    Learning is decreased
    Problem-solving is decreased
    Yelling, screaming, pushing, hitting, kicking, biting, throwing things, spitting, “shutting down”, etc.
    People can get hurt
    http://www.youtube.com/watch?v=trPuXkbTpok
  • 39. Physical Regulation
    Goals of Physical Strategies:
    Moderate the Fight/Flight/Shut-down ; Autonomic system
    Move back “up” from the brain-stem
    Return body to baseline
    Physical Strategies include:
    Repetitive movements
    Stretching
    Change of physical position
    Breathing
    Relaxation
    Distraction
    Biofeedback
    Can take advantage of Imagination and Visualization – Suggestion, Association
  • 40. Physical Training
    Do:
    Remove Stimulation
    Practice and Prevention
    Reduce Stress
    Give Space
    Calming Exercises
    Rhythmic Repetitive Movements and Stretching
    Do Not:
    Try to teach
    Argue
    Lecture
    Win
    Prove a point
  • 41. My Physical Strategies
    Break into small groups and identify as many activities as you can to address Physical Regulation
    Goals of Physical Strategies:
    Moderate the Fight/Flight/Shut-down ; Autonomic system
    Move back “up” from the brain-stem
    Return body to baseline
    Physical Strategies include:
    Repetitive movements
    Stretching
    Change of physical position
    Breathing
    Relaxation
    Distraction
    Biofeedback
    Can take advantage of Imagination and Visualization – Suggestion, Association
  • 42. Emotional Training
    Goals of Emotional Strategies:
    Accurately identify emotions; our own and those of others
    Own and accept responsibility for our feelings
    Expressing feelings in healthy, appropriate ways
    Emotional Strategies Include:
    Labeling
    Expression training
    Responsibility for feelings
  • 43. My Emotional Strategies
    Break into small groups and identify as many activities as you can to address Emotional Regulation
    Goals of Emotional Strategies:
    Accurately identify emotions; our own and those of others
    Own and accept responsibility for our feelings
    Express feelings in healthy, appropriate ways
    Emotional Strategies Include:
    Labeling
    Expression training
    Responsibility for feelings
  • 44. Cognitive Training
    Goals of Cognitive regulation:
    Problem-solving skills
    Engaging higher cortical areas of the brain
    Planning and organization skills
    Insight and Understanding
    Forming healthy beliefs about ourselves and the world around us
    Cognitive Strategies include:
    Specific training to problem areas
    Ex. – Collaborative Problem Solving for Conflict Resolution
    Insight-oriented teaching to promote understanding
    Learning about his/her own patterns of behavior
  • 45. Cognitive Training
    Common beliefs:
    “I have to get you before you get me.”
    “Everyone is against me.”
    “The more I push, the more I get.”
    “I’ve been hurt so much already that I don’t care what happens to me.”
    “I have no control. I will do what it takes to have control.”
  • 46. My Cognitive Strategies
    Break into small groups and identify as many activities as you can to address Cognitive Regulation
    Goals of Cognitive regulation:
    Problem-solving skills
    Engaging higher cortical areas of the brain
    Planning and organization skills
    Insight and Understanding
    Forming healthy beliefs about ourselves and the world around us
    Cognitive Strategies include:
    Specific training to problem areas
    Insight-oriented teaching to promote understanding
    Learning about his/her own patterns of behavior
    © 2010 ChapinPsychological Services, LLC
  • 47. Specific Scenario
    What about the other Complicating Factors?
    Crowded classroom with lots of eyes and ears
    Pressure of completing the “task at hand”
    Academic standards
    Lack of other adults
    Our own upset and other internal factors
    The child’s unknown history /abilities
  • 48. Johnny
    10-year-old boy
    Often disruptive in class with frequent anger outbursts
    When angry, he stays agitated for over an hour and continues to struggle in class
    Can be triggered by other students or the teacher
    believes that “things have to be a certain way or else” and it is obvious that he does not believe he has control over his actions and he believes that others “make” him angry and can be openly defiant
    Grades are C’s and D’s and cognitive abilities are average for his age
    Single-parent home with similar behaviors being reported at home
  • 49. Johnny’s Baseline Assessment
    © 2010 ChapinPsychological Services, LLC
  • 50. Creating an Individualized Planfor Change
    Complete baseline assessment
    Select Physical, Emotional and Cognitive Strategies to match child’s interests and behaviors
    Engage child, team and parents if possible
    Sell the change
    - Simple
    - Just a few meetings
  • 51. Create Your Plan
    Get into groups
    Develop a plan to help Johnny increase his ability to Self-regulate
    Use Physical, Emotional, and Cognitive Strategies
  • 52. Don’t Forget Self-Assessment
    What baggage did you bring to the party?
  • 53. 2 Physical Strategies
    My Warning Signs
    Melting Freeze
  • 54. My Warning Signs
    One of the first steps in diffusing emotional upset is successful recognition of the physical changes that take place in the body.
    © 2010 ChapinPsychological Services, LLC
  • 55. Melting Freeze
    Children who do not regulate well have difficulty calming down physically when they are upset.
    © 2010 ChapinPsychological Services, LLC
  • 56. 3 Emotional Strategies
    You Can’t Make Me Laugh
    Emotional Overflow
    Free Emotional Expression
  • 57. You Can’t Make Me Laugh
    Children struggling with self-regulation often do not understand the power they have over their own emotions.
    © 2010 ChapinPsychological Services, LLC
  • 58. Emotional Overflow
    Children struggling with self-regulation often let their emotions build up inside them to a level that becomes impossible to contain.
  • 59. Free Emotional Expression
    Children who struggle with self-regulation often have difficulty expressing the feelings they have in healthy ways
    © 2010 ChapinPsychological Services, LLC
  • 60. 2 Cognitive Strategies
    Defiance Trap
    The Domino Effect
  • 61. Defiance Trap
    Children struggling with self-regulation often have difficulty complying with rules and limits. A critical part of self-regulation is understanding that one’s own actions can dictate the amount of freedom they are granted by parents, teachers and others in authority.
    © 2010 ChapinPsychological Services, LLC
  • 62. The Domino Effect
    Those who struggle with self-regulation often have difficulty understanding the fact that they can control their own emotional and behavioral outcomes for events that take place in their lives
    © 2010 ChapinPsychological Services, LLC
  • 63. Additional Tips
    Use Natural Consequences when you can
    Be Strengths-based
    For strategies, use things that you and the child are interested in
    Programs like Challenge Software can engage children quickly
    Understanding goes a long way
  • 64. Collaborative Information
    Psych Challenge Blog
    http://psychchallenge.blogspot.com
    Email
    Brad.chapin@cpschallenge.com
    Facebook – search Challenge Software
    Twitter id = chapin55
    Challenge Software Program for Children
    Online tool for teaching Self-regulation www.cpschallenge.com
    © 2010 ChapinPsychological Services, LLC www.cpschallenge.com brad.chapin@cpschallenge.com