Child and Adolescent Counseling: Understanding …...Child and Adolescent Counseling 3 Light...

Child and Adolescent Counseling 1

Light University Online

Child and Adolescent Counseling: Understanding Children and

Their Issues

CACO 501

Module 3



Module Three

Table of Contents

Emotional Coaching with Kids Gary Sibcy, Ph.D. ............................................................................................................................................................ 3

Angry, Defiant, and Violent Kids Tim Clinton, Ed.D and Gary Sibcy, Ph.D. .......................................................................................................... 16

Family Systems: Understanding and Breaking Generational Patterns David Stoop, Ph.D. ..................................................................................................................................................... 24

ANGER, AGGRESSION, AND DYSFUNCTION



Description Using a three session role-play scenario, Dr. Sibcy highlights the importance of emotional coaching in raising and working with kids. Emphasizing the five cognitive skill deficits, Dr. Sibcy explains how to help kids build problem solving skills, enhance language processing, tolerate negative emotions, and develop empathy for others. Students will learn how time-banking and compliance interactions are important to raising emotionally healthy kids and be taught three different pathways out of the collaborative problem solving skills model.

Learning Objectives:

1. Identify why certain consequences may not work for some kids based on their cognitive skill set.

2. Be able to implement time-banking and effective compliance

interactions with kids as emotional coaching skills.

3. Be able to implement five skills that will enhance problem solving and build the cognitive skill set of the child.

EMOTIONAL COACHING WITH KIDS

VIDEO

Gary Sibcy, Ph.D.



Introduction

There is no doubt about it—many parents become frustrated and overwhelmed by

parenting. This lesson will help relieve some of the frustration by understanding why kids

may not respond to the consequences they are given. Students will learn the importance of

time-banking and its ability to help a child regulate emotion. Various other emotional

coaching techniques are presented throughout this course to help the parent, develop a

child’s cognitive skill set.

I. Session One

A. Situation Analysis

Global statements (i.e. Always, never)

Define terms (i.e. Going ballistic, flipping out)

B. Why Consequences May Not Work for Children

Tactile sensitivity Pediatric bipolar disorder – Sensory profile Secure base system

“Children listen more to your mood and behavior than what you say.” --Gary Sibcy



Compliance issues Preventative measure vs. consequence of behavior

II. Session Two

A. Five Core Cognitive Skills Deficits

Motivational problems

Skill deficits

B. The FIVE core cognitive skills deficits

Executive skill deficits

1. Rooted in frontal lobe of brain

2. Problem solving

Cognitive flexibility

1. Black and white thinking 2. Catastrophizing 3. Difficulty in transitions

Language processing

1. Ability to label internal states



2. Prefrontal cortex

Emotional regulation

1. Tolerate negative feelings

2. Mood changes

Social skills

1. Ability to start and end relationships

2. Empathy

C. Time-banking

Positive versus negative investments/deposits Balance/ Imbalance

Floor time with kids (15 minutes each, 3 to 4 times/wk)

1. Don’t give commands

2. Don’t ask intrusive questions 3. The adult schedules it 4. Don’t remove it



III. Session Three

A. Building Cognitive Skills

Affective dysregulation

Most effective in environments that are mild to moderately frustrating

Compliance interaction

B. Five Goals of Compliance Interactions

Take the concern seriously

Take the child seriously

Prevent meltdowns

1. During meltdowns, the child develops negative beliefs about self and

others when they are really angry

2. Meltdowns prevent child from using cognitive skill set

Work on cognitive skills

Create secure base use

1. Adult concern only

2. Work on cognitive skills

3. Drop expectations



3. FIVE cognitive skills

i. Empathy –Getting child’s concerns out on the table

ii. Asserting your concerns

iii. Respectful

iv. Invite the child to collaborate

v. Collaboration Bibliography Clinton, T. & Sibcy, G. (2006). Loving your child too much: Staying close to your kids

without overprotecting, overindulging, or overcontrolling. Nashville, TN: Integrity Publishers.

Wright, H. N. (2005). Helping your kids deal with anger, fear, and sadness. Eugene, OR:

Harvest House Publishers.



Study Questions

1. As parents, what is the importance of defining such phrases as “going ballistic” or “flipping out?” Why is it that certain consequences may not work for certain children? Why do motivational techniques work with some children but not others?

2. Describe each of the FIVE core cognitive skills. What are the deficits? Define and describe each.

3. What is time-banking? Why is it important? What is affective dysregulation? Why is it important and who is more likely to provoke it in kids, the parent or therapist?

4. Why is compliance interaction so important? What are the FIVE goals of compliance interaction? Describe each. What are the THREE different pathways to secure base use? Which should be used more often?

5. What are the FIVE skills needed to build cognitive skills in children? Describe each.

Soul Care Notes

Lamentations 3:22-25 Job 23:13-17 Ecclesiastes 1:1, 2 Acts 15:7 Ephesians 4:15



Use of attachment theory in the treatment of Oppositional Defiant Disorder By Gary Sibcy, Ph.D. Licensed Clinical Psychologist & Licensed Marriage and Family Therapist, Piedmont Psychiatric Center

Assistant Professor of Graduate Counseling, Liberty University

Every year, an untold number of parents seek professional help for their children because of unmanageable behavioral problems. Many of these children are diagnosed with a condition called Oppositional Defiant Disorder (ODD). In the majority of cases, parents are taught new discipline strategies, from stickers and behavioral charts to power assertive techniques like removing privileges, time-outs, and groundings. While these approaches can have benefit, they frequently miss the mark and leave parents feeling confused and defeated. In some cases, these approaches only exacerbate the problem by leading to an escalation of conflict and increased acting-out behavior. Recent research on attachment theory and the healing power of the parent-child relationships offers a new way of thinking about treating children and adolescents with behavioral problems, especially those children with Oppositional Defiant Disorder. Oppositional Defiant Disorder consists of three main features:

1. Defiance. These children refuse to comply with requests. "No" is their favorite word, and parents become locked into a pattern in which they battle the child over just about everything. Such battles are out of proportion to what is developmentally appropriate.

2. Anger and irritability. Touchy, easily annoyed and argumentative, oppositional defiant children throw temper tantrums and refuse to accept responsibility for their behavior.

3. Negativity. Such children are gifted at putting a negative spin on life. And they have a knack for spreading this negativity to the rest of the family. Many parents complain that it is almost impossible to please their defiant child.



Attachment Theory and ODD Below are five key factors involved in an attachment relationship. As you read,

notice that according to attachment theory, the quality of a parent-child relationship plays a critical role in shaping a child's way of thinking, feeling and behaving. When the attachment relationship becomes threatened, disrupted or disturbed, it creates a context for behavioral problems to appear. Unless the relationship is repaired, primarily rule-based, power-assertive parenting techniques that focus mostly on punishments like spankings, time-outs, or removal of privileges will lose their effectiveness because the angry, defiant child will essentially ignore them or intentionally try to sabotage them.

Proximity seeking. When a child becomes upset, he will seek proximity/closeness to the caregiver.

Safe haven. As a child gets closer to the caregiver—either physical or emotional—the child feels a sense of peace, confidence, comfort and calm. It is in this relationship that the child learns to manage negative emotions and problem-solving.

Secure base/exploration. A child who knows the caregiver is readily available, uses this sense of security as a base from which to explore the world, and develops an sense of self-confidence and creativity. Notice that self-confidence begins with confidence in another person.

Attachment Wounds lead to very strong emotional reactions. These feelings are

often acted-out in misbehaviors like defiance, temper tantrums, and clingy, controlling actions.

Separation or threat of separation. Anything that the child perceive as a

threatens to the attachment relationship leads to intense emotions like anger and/or anxiety.

Loss or extended separations. Situations like

divorce, death, illness, moving, parental depression, etc, can not only trigger anger and anxiety, but also in deep feelings of sadness, despair, and grief.

More on Attachment Wounds

Attachment theory says that we all need at least three things to feel secure: safe people, safe places, and safe beliefs. Attachment wounds occur when something threatens the security of any of these three. There are many kinds of events that can lead to attachment wounds in children. In most cases, parents are not intentionally trying to threaten the security of the attachment relationship. Nonetheless, wounds can still occur when families experience things like (1) intense marital conflict, marital separation, or divorce; (2) physical illnesses of a parent that may require hospitalization or that render the parent physically or emotionally unavailable to the child; (3) parent depression or



alcoholism; (4) family financial problems; (5) moving the family from one community to another; and (6) poor parenting practices, ranging from chaotic, neglectful, inconsistent parenting to overly rigid, angry, critical, styles.

These kinds of situations trigger a child’s strongest emotional reactions of anger, anxiety, or depression. But children are not usually very skilled at verbally expressing these feelings, even for the most verbally gifted. Imagine an eight year old saying something like, “Mother, dear, when you and father argue, I feel angry and scared because I feel like I’m the one who makes you argue.” For children who develop ODD, they are especially sensitive to changes in their environment and they expend a great deal of effort trying to control things around them. They are also prone to act-out their feelings in misbehavior, anger outburst, and stubbornness. When they act this way, parents—who are already stressed-- usually respond with frustration, anger, and heavy-handed parenting practices. They also develop very negative mindsets about their children, often feeling “worn down” and “drained” by their child. They may even want to avoid being around their child as much as possible. Most ODD kids become increasingly angry and vindictive when faced with this kind of parenting as they misinterpret their parents’ anger and emotional avoidance as a threat to the attachment bond. So the problem worsens, leading to a vicious downward spiral and both child and parents become stuck in an endless power struggle. Emotional Bank Accounts

Another way of understanding how attachment wounds effect parenting is through

the metaphor of emotional bank accounts. All close relationships need a certain amount of emotional resources to help us effectively handle the inevitable conflict, stress, and tension inherent in close relationships. We call these resources “emotional bank account.” We make deposits into this account whenever we intentionally take the time to emotionally connect with a loved one. For example, a father spending time with his son passing ball or letting his daughter show him her favorite dolls are examples of making emotional deposits. When dad does things that place stress on the relationship, like having his son finish his homework before going outside to play or making his daughter go to bed early because of her misbehavior, this requires a withdraw on the same account. The key is to make sure that you never make too many withdraws on the account. Once you do the overdraft charges begin adding up and continue depleting the capital in the account. Children with behavior problems require parents to make many more withdraws on the account. Overdraft charges on the account come in the form of increased acting-out, resulting in a vicious cycle, like the one described above. Banking Time

To keep the account from going bankrupt, it is crucial that parents find away of

balancing the emotional bank account with their child. Of course it would easy to make deposits if children would “behave.” However, most ODD children are determined to act-out when their emotional bank accounts are overdrawn. So I encourage parents to use a procedure called “Banking Time.” It’s a way of making emotional deposits into an over drafted account with a difficult child. As these positive experiences add up, you will find



that your child is more motivated to please you and you will find that discipline techniques work more effectively. Below, Dr. Sibcy briefly describes how to use the Banking Time procedure.

Each parent is asked to set aside 15 to 20 minutes every day for playtime with their

child. This act alone carries a great deal of significance because many parents live such time-starved lives that they hardly have time to sit-down to dinner, let alone make time to play. Parents may refer to Time Banking as “special time” when talking to their children. There are several important things to keep in mind when doing Time Banking with children:

1. In order for Banking Time to be effective, parents must commit to do it on a consistent basis; we suggest a minimum of 3 to 4 sessions per week. This adds a component of predictability to the parent child relationship. This, in itself, is curative because children—even chaotic ones—seek predictability in relationships. The fact that many parents find this difficult suggests that the inability to find and make predictable time and space for their child is an important issue to address and therapist should problem solve with parents about ways to “make time” for this activity.

2. It is crucial that they not make banking time sessions non-contingent on their child’s behavior. Let them know that your child cannot earn “special-time” and they cannot lose it either.” For parents who object to special time because the feel that it could reinforce negative behavior is if it were contingent on the negative behavior. For example, if the child misbehaves and then the parent says, “let’s go do a special time.” But because these sessions are planned in advance, it makes them non-contingent. Placing contingencies on special-time can, in fact, damage the relationship.

3. Parents should allow their child to take the lead; letting their child select the activity, as long as it is within reason--television and violent video games should not be used.

4. During the banking time session, parents are asked to not ask intrusive questions and to not give commands. Inform parents that this is a time to follow their child’s lead, which is a powerful way of communicating to a child that he or she is loved. Plus, research shows that parents of ODD children often ask more questions and give more commands to their children, even during play activities. Intrusive questions and commands interfere with children’s play and they increase the odds that the child will become more oppositional.

5. Instead parents, parents should work on two skills: observing and describing. Parents are asked to observe their child’s play and to



describe what they see, much like a sportscaster describes a baseball game: “Ryan pushes the car across the floor and it crashes into a pile of paper wades.” Kids love this because when adults attend to their play, they feel important and liked. This is the message parents are trying to send, and children are more apt to accept it in form of special attention than when we just say it.

6. Encourage parents to look for something special and unique about their child during the banking time session. The idea is that they are looking for positive things about their child that they may have not noticed before.

7. Also, encourage parents to send some positive messages to their child during the sessions. The key is that these messages be very specific and tied to behavior. For example, “I like the way you said thank you,” or “I like it when you take turns like that.” Avoid generalized statements such as “You’re such a good boy.”

8. Special time is not for teaching skills and it is not a time for moral instruction. There are plenty other occasion in day-to-day life that parents may teach and instruct, but not during banking time session. Keep in mind that while normal house rules apply, parents should handle minor misbehavior by not paying attention to it and avoiding eye contact, and if necessary, terminating the banking time session.

9. Ask parents to keep a log of their banking time sessions. The log should include when they did it, what they did, and for how long. Also, have parents record what positive discovery they made about their child.

10. Counselors should review these logs with parents. It is crucial that you review the parents’ feelings and thoughts about the banking time sessions. The banking time sessions are helpful not only because they help children feel better about their parents, but it helps parents become more positive, open, and flexible in their thinking about their defiant child. However, some parents may find it extremely difficult to discover anything positive about their child. This should be processed very sensitively and carefully with the parent. Keep in mind, that parents who hold excessively negative views of their child are likely to be poor candidates for teaching punishment-based or power-assertive parenting procedures because they are likely to misuse these practices and severely damage the parent child relationship.

11. Also, many parents will have difficulty finding time and space to do the banking time sessions. This difficulty is usually symptomatic of the family’s difficulties with structure and time. The counselor should



take a supportive, problem-solving stance with the parents to help them find ways to implement banking time sessions. It is of utmost importance, however, that the therapist not bypasses the use of banking time. Underscore for the parent the importance of finding time and how it can repair the parent-child relationship.

12. Some parents, especially those who are resistant to using time-banking sessions, are likely to have a history of being neglected or maltreated as a child. In some cases, the best way of dealing with this resistance is to encourage the parent to discuss their own history of being parented. Inquire about how they were parented, how their parents “made time” for them, and how they felt as a child. Be sure to ask for very specific examples about how their parents related to them, thus avoiding the tendency to produce idealized images of their parents that are not rooted in real experiences. By remaining sensitive and supportive, the counselor is likely to help the parent make linkages between the way they were parented and their current parenting practices. By becoming more aware of these feelings, many resistant parents become more open and sensitive to their child’s feelings and his or her need to be connected with.

The use of Time-Banking is one of a series of techniques counselors use to help heal, restore, and revitalize the parent-child relationship. In many cases, counselors observe a forty to sixty percent reduction in symptoms when parents consistently and effectively use it. The strengthened parent-child relationship also becomes the basis for more effective discipline procedures— giving effective commands, setting firm limits, using contingency management packages, administering punishments like time-out and response-cost systems. The relationship also becomes the basis modeling and teaching moral values and prosocial behavior. The key to attachment parenting is understanding that a parent’s relationship with a child is the most powerful resource they have for teaching them how to live, love, and grow in the Lord.



Description Ten percent of children are reacting to their parents and authorities with anger and defiance. Many parents are frustrated from trying everything but finding nothing that really works to correct their child’s behavior. In this lesson, Dr. Clinton and Dr. Sibcy explain why children react with anger and defiance and what can be done to change their hearts and ultimately, their behaviors. They discuss why so many discipline strategies are ineffective and share several relationship strategies that work.


1. Understand the biblical foundation for parenting. 2. Recognize what attachments are and what role they play in angry and

defiant children, as well as understand the characteristics, prevalence and pathways to anger and defiance.

3. Realize the importance of relationships vs. rules in parenting, as well as identify discipline strategies that are ineffective and prescribe effective strategies.

ANGRY, DEFIANT, AND VIOLENT KIDS

VIDEO

Tim Clinton, Ed.D. and Gary Sibcy, Ph.D.



Introduction

The Bible says that children are a heritage and gift from the Lord. If this is true, then why

are so many parents stressed out and ready to “throw in the towel” on discipline? The

problem is that many parents are focused on changing a behavior rather than changing

their child’s heart. Students will discover why so many children are angry and defiant and

what can be done to change their behavior patterns through corrective relationships.

Students will explore the prevalence and pathways of defiance, as well as the biblical

answers and solutions.

I. Introduction

A. Psalm 127 B. Deuteronomy 6:6-7 C. Coaching Concept

D. Ephesians 6:1-4

A. Proverbs 22:6

B. Proverbs 22:15



C. Scriptural Examples

David & Absalom Jacob & Joseph The prodigal son

D. The Absence of Parents

E. The Connection between the Way Kids Respond to Parents and to God

II. Anger & Defiance in Children

A. Characteristics

Negative

Hostile

Temper tantrums

Argue



Blame

Easily annoyed and annoy others

Spiteful

Vindictive

B. Prevalence

C. Beginning

Transitions

Family stressors

D. Differences between Strong-Willed and Defiant

E. ADHD

F. Pathways Difficult temperament

Family stressors



Attachments

III. The Role of Attachments in Angry & Defiant Children

A. Seek Proximity/Closeness

B. Safe Haven

C. Secure Base/Exploration

D. Separation Creates Anxiety/Anger

E. Perceived Loss of a Relationship

IV. Parental Patterns of Response

A. Coercion Ineffective commands

Repeat commands

Threats

Acquiesce or aggress



B. Negative View of the Child V. Treatment Strategies

A. Floor Time

B. Special Time Results

1. Learn language

2. Learn needs

C. Empathy

Get their story right.

Communicate to them that you understand.

They believe you understand.

A change of heart precipitates a change of behavior. Rules without relationship lead to

rebellion.



D. Problem Solving

Defining the problem

Helping child figure out what to do Anticipating the consequences of their solution

E. Boundaries Limits

Love

Discipline is about an act; punishment is about a person. The quality of one’s relationship

will determine the effectiveness of one’s discipline strategies.



Study Questions

1. What are the characteristics of angry and defiant children? How does defiance differ from being strong-willed?

2. How prevalent is angry defiance among children? What usually triggers it?

3. What is meant by “attachments?” How do they relate to anger and defiance among children?

4. What can be done to improve the parent/child relationship? Why are relationships so important in regard to discipline?

5. Define and describe both effective and ineffective discipline strategies.



Description As Dr. Stoop suggests, everyone has a dysfunctional family. Yet, there is a clear distinction between healthy and unhealthy family dynamics and generational patterns are the centripetal force behind these dynamics. This lesson defines generational patterns and how they work. How sameness is maintained across the generation is explained and a plan on how to break the patterns is provided.


1. Define generational patterns and recognize the many different patterns that exist throughout family systems.

2. Identify how generational patterns work, including the various factors

involved in maintaining sameness throughout the generations.

3. Be able to implement a plan for how to break the generational patterns in one’s own family and be able to teach others how to do the same.

FAMILY SYSTEMS: UNDERSTANDING & BREAKING GENERATIONAL PATTERNS

VIDEO

David Stoop, Ph.D.



Introduction

As Exodus reveals, the sins of the fathers are passed down unto the third and fourth

generations. Unfortunately, these unhealthy generational patterns are still plaguing

families and wreaking havoc on relationships. Even though positive patterns do exist,

negative cycles seem to prevail. Students will be introduced to the factors responsible for

keeping these negative patterns alive and be given practical skills useful for breaking

generational sin.

I. Healthy Versus Unhealthy Families

A. Exodus 20:5 B. Research has shown that a dysfunctional pattern typically lasts four

generations before somebody says “I am going to stop this thing.” C. Types of Generational Patterns

Alcoholism

Addiction

Abusive patterns

Sexual abuse/ molestation

Favoritism in family

Can you think of positive patterns?



II. What Maintains the Sameness over the Generations

A. Homeostasis

Every family tries to maintain sameness

Circular communication Understanding cause and effect Homeostasis is maintained through

1. Placing blame

2. Being critical

3. Negative feedback loops

B. People must do more than make a vow to stop the generational sin.

III. Healing One’s Past A. Isaiah 51:1-2—Joseph stopped it and he looked back.

Verse 1—Look to where you come from

Verse 2—Look to your ancestors



B. Nehemiah 9 Professing sin of the fathers Never honor what is not honorable; Give worth to what is worthy

C. Accepting Truth of the Past Find the balance of the good and the bad

Look at past objectively and honestly

IV. Accepting the Past

A. Gain a clear picture of one’s past. B. Feel the emotions that were never felt. C. Ask why.

D. Set healthy limits with one’s parents.

Modeling for one’s own children Forgiveness

“The day my life began was the day I forgave my father.”



Bibliography Stoop, D. & Masteller, J. (2004). Forgiving Our Parents, Forgiving Ourselves: Healing Adult

Children Of Dysfunctional Families. Ventura, CA: Regal Books. Stoop, D. (2004). Making Peace With Your Father. Ventura, CA: Regal Books. Stoop D. (2005). Forgiving the Unforgivable. Ventura, CA: Regal Books.



Study Questions

1. According to research how many generations will a dysfunctional pattern typically last? Read Exodus 20:5. Make a list of some of the generational patterns in one’s own family. Are there any that were never really noticed before?

2. What maintains sameness over the generations? What is homeostasis? How is it maintained?

3. Define circular communication. Define negative feedback loops. What is the importance of Isaiah 51:1-2 and Nehemiah 9? According to Dr. Stoop, who should people honor and when?

4. Which family member is most likely to tell the objective and honest truth about the family?

5. List and describe the FOUR ways to accept and overcome one’s past. What is the importance of forgiveness in this process?

Soul Care Notes

Psalm 127:3-5 Exodus 20:5 Isaiah 51:1-2 Nehemiah 9 2 Timothy 1:5

Child and Adolescent Counseling: Understanding …...Child and Adolescent Counseling 3 Light...

Documents

Transcript of Child and Adolescent Counseling: Understanding …...Child and Adolescent Counseling 3 Light...