10/7/2010
1
Group Therapy for Parents of
Children With Difficult Behavior
1: Welcome /
Understanding Difficult Behavior (P...
10/7/2010
2
Session Format
Brief Review / Update
New Information Presented
Discussion
Assumptions
Everybody pretty much do...
10/7/2010
3
Assumptions
Our perception of what causes a problem behavior
always guides what we do about it.
“He’s got a di...
10/7/2010
4
Introducing the Inflexible/Explosive Child…
Dr. Ross Greene of Harvard has spent a lot of time
working with th...
10/7/2010
5
Executive Functions?
Yes! Executive Functions!
Shifting Cognitive Set (“Shifting Gears”):
The ability to shift...
10/7/2010
6
Executive Functions?
Yes! Executive Functions!
Working Memory:
The ability to “hold that thought” until the br...
10/7/2010
7
Sensory Processing Problems
In order to accurately perceive the world:
1. Your senses have to pick up the “sig...
10/7/2010
8
What about ADHD, ODD, and the Rest of
the Alphabet Soup?
Problems with Executive Functions are (arguably) the
...
10/7/2010
9
Further Reading / Resources
Websites
Ross Greene / Collaborative Problem Solving
http://www.livesinthebalance....
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Parenting_Session01.pdf

  1. 1. 10/7/2010 1 Group Therapy for Parents of Children With Difficult Behavior 1: Welcome / Understanding Difficult Behavior (Part One) Housekeeping Introductions Confidentiality Agreements Billing Slips Bathrooms Questions Other
  2. 2. 10/7/2010 2 Session Format Brief Review / Update New Information Presented Discussion Assumptions Everybody pretty much does the best they can with what they’ve got. Parents Kids Professionals (Teachers, Counselors, Doctors, Etc.) Behavioral Problems start when the demands of the environment overwhelm the kid’s ability to cope or adapt.
  3. 3. 10/7/2010 3 Assumptions Our perception of what causes a problem behavior always guides what we do about it. “He’s got a disorder…” “She’s just a brat…” “I’m a bad parent…” “He had too much sugar/caffeine/insert foodstuff here…” Caution! We’re about to start talking about various kinds of problems/disorders Beware “Med Student Syndrome” – When talking about various disorders, it’s easy to image you have them all! Remember – Let the doctors and specialists do the diagnosing! Also Remember – It’s ok to ask your doctor or therapist (or other professional) about these things, and/or to call their attention to something that worries you. They, after all, are here to Help!
  4. 4. 10/7/2010 4 Introducing the Inflexible/Explosive Child… Dr. Ross Greene of Harvard has spent a lot of time working with this population—and has written a book: Parenting the Explosive Child (highly recommended). He tells us: If the child could change, the child would change. The child’s (mis)behavior is best understood as the result of lagging cognitive skills or abilities. If we can help them get the skills that they need, these kids’ behavior will improve. BUT – before we can intervene to teach any skills, we need to understand what skills they lack, and what cognitive deficits they have to deal with! Cognitive Deficits— “Thinking Problems” – Typical of the Inflexible/Explosive Child Easily and quickly overwhelmed when a situation demands adaptability Trouble thinking through ways to resolve frustrating conflicts Lower frustration tolerance and more intense feelings of frustration than most others of his/her age Tends to think in concrete, black-and-white terms Trouble with “Executive Functions” Trouble with Sensory Processing
  5. 5. 10/7/2010 5 Executive Functions? Yes! Executive Functions! Shifting Cognitive Set (“Shifting Gears”): The ability to shift from one mind-set to another. An explosive child has trouble shifting from their own agenda to their parent’s agenda through understanding and adaptation. In a similar way, some adults are known to have similar problems shifting from a “work” mindset, where they are the boss, to a “home” mindset, where they have to respond more empathetically and sensitively to other family members. Executive Functions? Yes! Executive Functions! Organization and Planning: The anticipation of problems and the selecting, monitoring, and adjustment of strategies in response to problems. A child who wants to watch television a few more minutes before coming in to dinner must efficiently – within a few seconds – organize and plan a coherent response to a parent who is expecting rapid compliance. This is why some parents say that their explosive child do just fine unless something doesn’t go their way.
  6. 6. 10/7/2010 6 Executive Functions? Yes! Executive Functions! Working Memory: The ability to “hold that thought” until the brain has a chance to think something through. If children are unable to hold a thought long enough to think through possible solutions to the problem (“My Mom wants me to come in for dinner, but I want to watch television for a few more minutes”), they are likely to respond with their first impulse (“No, I’m not coming and you can’t make me!). This, of course, only makes the situation worse. Executive Functions? Yes! Executive Functions! Separation of Affect (“Putting Aside Feelings”): The ability to “shelve” an emotional response long enough to think through various solutions to problems. The inability to separate affect from thought can help to explain the rigid, self-centered thinking patterns, lack of empathy and social tact, and the inability of these miserable children to achieve insight into their condition. The reasoned statement,“I got angry today after Ms. Robinson called me in from recess early so I could catch up on some missed assignments” becomes “Ms. Robinson is a mean teacher. I hate her and I never want to go back to her class” without the ability to separate affect.
  7. 7. 10/7/2010 7 Sensory Processing Problems In order to accurately perceive the world: 1. Your senses have to pick up the “signal” (or, if you like, the “stimulus”). 2. Your nerves have to carry the signal to your brain 3. Your brain has to accurately decode/make sense of the signal Of course, problems can occur at any point in this process! Examples of Sensory Processing Problems Auditory (Hearing) •Responds negatively to unexpected or loud noises •Holds hands over ears •Cannot walk with background noise •Seems oblivious within an active environment Body Position •Continually seeks out all kinds of movement activities •Hangs on other people, furniture,objects, even in familiar situations •Seems to have weak muscles, tires easily, has poor endurance •Walks on toes Visual (Seeing) •Prefers to be in the dark •Hesitates going up and down steps •Avoids bright lights •Stares intensely at people or objects •Avoids eye contact Movement •Becomes anxious or distressed when feet leave the ground •Avoids climbing or jumping •Avoids playground equipment •Seeks all kinds of movement and this interferes with daily life •Takes excessive risks while playing, has no safety awareness Taste and Smell •Avoids certain tastes/smells that are usually part of kids’ diets •Routinely smells nonfood objects •Seeks out certain tastes or smells •Does not seem to smell strong odors Touch •Avoids getting messy in glue, sand, finger paint, tape Is sensitive to certain fabrics (clothing, bedding) •Touches people and objects at an irritating level •Avoids going barefoot,especially in grass or sand •Has decreased awareness of pain or temperature
  8. 8. 10/7/2010 8 What about ADHD, ODD, and the Rest of the Alphabet Soup? Problems with Executive Functions are (arguably) the defining characteristic of ADHD, and are associated with many other behavioral disorders diagnosed in kids. Sensory Processing Disorders can be mistaken for ADHD Sensory Processing Disorders often Co-Occur WITH ADHD, Autistic Spectrum Disorders, and other behavioral disorders We’ll talk more about the commonly diagnosed behavioral disorders next time! Further Reading / Resources Books Armstrong,Thomas. (2010). Neurodiversity: Discovering the Extraordinary Gifts of Autism,ADHD, Dyslexia, and Other Brain Differences. Cambridge, MA: Da Capo Lifelong Books. Ayres,A. Jean. (2005). Sensory Integration and the Child— Understanding Hidden Sensory Challenges: 25th Anniversary Edition. Los Angeles, CA: Western Psychological Services. Greene, Ross. (2010). The Explosive Child: A New Approach for Parenting Easily Frustrated, Chronically Inflexible Children. New York: Harper Paperbacks.
  9. 9. 10/7/2010 9 Further Reading / Resources Websites Ross Greene / Collaborative Problem Solving http://www.livesinthebalance.org/ http://www.ccps.info/ Sensory Integration / Sensory Processing http://www.sensory-processing-disorder.com/ http://www.sinetwork.org/

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