Wednesday 23 September 2009

Is ADHD Behavioral Therapy The Answer ?

This video looks at various options for Treatments for ADHD and explains why ADHD behavioral therapy is the best solution.

Wednesday 9 September 2009

Fix Behavior With A Problem Child?

When parents say that nothing works with their children and they despair of ever being able to fix behavior, they should read James Lehman's article on tough case kids, he should know as he was one himself !

"My Kid Will Never Change."
When You've Hit a Wall with Your Child's Behavior


My Kid Will Never Change.When Youve Hit a Wall with Your Childs BehaviorHave you ever listened to parenting advice, all the while thinking, “That won’t work with my child—nothing does. He’s too difficult; no one can get through to him.” If you’ve ever felt this way, stop what you’re doing and read this article. We sat down and talked to James Lehman, who explains how to get through to “hard case” kids—and how to manage their behavior effectively. (The good news? There is hope—and room to make some real changes that work.)



Let me be clear: kids don't behave because they like their parents; kids behave because it's in their best interests to behave.


Q: James, what is your response to parents who say, “My child is really tough. He’ll never change.”



James: I understand that parents get frustrated and exhausted trying to deal with kids who can be really resistant and difficult. But I know from experience that that doesn't have to be the case—there are other ways of solving the problems of acting out, defiance, attitude, and lack of motivation in children. I think when a parent says, “My child will never change,” one of the things they’re saying is, “My parenting style will never change; I don’t think there’s anything new I can teach my child. And because I'm stuck where I am, he's going to stay stuck where he is.”

If your parenting style isn't working and you don't change it, it's probably going to continue not working. That’s just a given. But if your parenting style develops and you learn different ways to coach, teach and set limits on your child, I believe that eventually you will see change.


Q: So is there any one thing a parent should be doing to help their child change?



James: In my opinion, people change for a variety of reasons, some of which can be hard to understand. The idea that it takes a certain amount of input, or that there’s one thing you should do in order for your child to change, is not really a logical one. It’s not like you can just wave a magic wand a certain way and get your child to behave. The truth is, different kids need different amounts of support. I think that it's important for parents to understand the concept that knowledge is cumulative in kids. In other words, one bit of knowledge doesn't create one bit of change. Rather, it takes a lot of bits of knowledge to create one bit of change. Really, the idea that kids won't change is out of context with how they learn. If the approach you’ve been using isn’t working, try another one—trust me, you can learn more effective ways to solve the problem of inappropriate behavior. That’s something I’ve helped parents do my entire career—and I have seen true change happen over and over again.


Q: James, the first step for many parents is getting their child to listen to them. How do you go about doing that when you have a “hard case” kid who never listens to anyone—and especially not to his or her parents?



James: I think that this is another instance where parents have to look at their own skill base—and not at their kid’s. Understand that your child’s capacity to listen will be influenced by his age, his peer group, the setting in which you are having a conversation with him, and the issue at hand. And if your child is really angry and frustrated about something and you're trying to reason with him, he's not going to listen, plain and simple. Just accept that going into it.



I often ask parents to envision what might have to happen in order for their child to listen to them. What would be an ideal place for a talk? Most parents can describe the setting: it's quiet, there are no distractions, everyone is calm, and they have a chance to really share their ideas with their child. I think all of these elements have to be in play in order to have any kind of discussion with your child.

Here’s another crucial thing to remember: kids will listen to something—and comply— when it’s in their best interests to do so. Let me be clear: kids don't behave because they like their parents; kids behave because it's in their best interests to behave. So parents who compromise about household rules in order to get their kids to do what they want are missing the point. Instead of trying to get your child to like you in order to behave, what you have to do is get your child to like his life, his privileges, his friends, and his independence. Because all those things that matter to us, also matter to our kids—and are incentives for them to try harder.



Instead of giving in to your child and trying to be his friend, communicate that it's his responsibility to listen to you—and that he'll be held accountable if he doesn’t. The relationship between responsibility, accountability and consequences can’t be stressed enough here. The message should always be: “You're responsible and I'm going to hold you accountable.” And let him know there are going to be consequences if he doesn’t comply with the rules.



I also believe that parents have to say something worth listening to. Kids don't listen to preaching. Kids don't listen to labeling. And they don't listen to name calling or blaming, either. I think it’s helpful to talk to your child in a direct, matter-of-fact way. Don’t personalize what is happening; just stick to the facts. Try to define the problem in a way that is solvable. “It’s your responsibility to take out the garbage. If you don’t, there will be consequences.” And let him know he’ll be rewarded if he is able to meet his responsibilities consistently. This is how you hold your child accountable.


Q: What are some tips for getting through to your child, especially if that child is a hard case?



James: Again, I think if your child sees it's in his best interests to respond to you, hard case or not, he's going to find a way to respond. To give you an example, we often see kids with behavior problems really getting along with teachers who are highly structured. That’s because the structure the teacher has set up makes it clear that it's in the child’s best interests to behave. Sometimes that's because the teacher doesn't take any playing around and sets limits right away; sometimes it's because the teacher gives consequences and rewards that the child finds meaningful. Remember, there always has to be interplay between structure that's clear, and rewards that are meaningful. And if you find the right combination, your child will respond to you—whether or not he's a hard case.

I also think that with hard cases, you have to be very clear about who you are. I don't think you have to be hard yourself, but you have to be able to clearly define what you expect from your child. And let them know that you're going to hold them accountable. I think kids who are hard cases often don't see what's in it for them. They might think, “So what’s in it for me if I clean my room? What's in it for me if I do my homework?” I think the answer is to have a structure where you can show them what the consequences and rewards are. So they know what’s going to happen if they don’t finish their assignment or mow the lawn. It’s clear to them what they’ll get as a reward—and what might be taken away as a consequence.



I also believe there is a lot of legitimacy in giving kids more independence when they do things more independently. So you can say things like, “You can stay up half an hour later because you’ve shown me that you can be responsible with your reading homework.” That actually motivates your child to act more independently. And when I say independently, I don't mean defiantly—I just mean independently. In other words, they're able to meet their responsibilities without a lot of prodding or threatening or following up from you.


Q: What if you have a child who doesn't seem to respond to consequences?



James: If your child doesn't respond to consequences, then you simply haven't discovered things that are consequential to him. Don't forget, a consequence can be a reward, too. Too many parents use the term “consequences” when they mean punishments. Many kids become very resistant to the idea because of what they think it means. Instead, parents have to learn to use the carrot and the stick—not just the stick.



So again, once a child sees it's in his best interests, a lot of things will change. Here's a great example: Let’s say you have a kid who hasn’t worked hard in school, isn’t really committed to anything and is kind of lazy around the house, perhaps a little mouthy sometimes. And then one day he wants to get his driver’s permit. Oh man, do things change! All of a sudden, that same child is apologetic when he makes a mistake. He's interested in doing the things you want him to do—and he's willing to do his chores and homework. All because he wants to drive that car.



You might not have a car to use as a reward with your child, but there are other things that might work. In my opinion, parents have to develop a motivational system—a “motivational package,” if you will. That means that you should always have a menu of rewards on hand. And I think that list should come from your child. When times are good, I recommend that you sit down and say, “Hey, I'm making a menu of things we could do that you might enjoy. Can you help me out?” And by the way, you should also have a menu of consequences. It’s a mistake to have only one consequence that you use all the time. Instead, have a consequence system that allows you to have choices. So it's not the same old, “Go to your room.” If you have a list of consequences, you can give your child and yourself a little more elbow room. Remember, consequences that are task-oriented are the most effective because they promote learning and change.


Q: What about parents who say, “I don’t know how to motivate my child—he doesn’t care about anything?”



James: I think parents should set goals with their children to motivate them. So a goal might be, “If you can clean your room for three days, then you get an extra half hour of computer time.” Now your child is working toward something reachable. But remember, the incentive has to be something your child wants. Things that tend to work with kids these days are cell phones, computers, video games, and television. These are all “carrots” we can use to give our kids the incentive to behave and be responsible.

By the way, I think for many kids with motivational problems, the right approach is, “We will give you half an hour on the computer; that's our gift to you. Every member of the family gets it. And if you want more, then we need to see you trying harder and keeping up with your responsibilities.” I tell parents to limit time on the computer because I think a great opportunity is being missed here: you are squandering your chance to offer it as a reward. By limiting your child’s computer time, he has to put forth some effort to earn more. Be sure to clearly define what a child must do—and for how long—in order to earn that extra time.



And incidentally, it’s also been my observation that if you can't motivate your child, something will someday. What I mean by that is that it’s important to know that there are other catalysts in your child’s life besides you—and that’s a good thing. I’ve seen teens who are slobs clean up their act when they get a girlfriend. Certainly kids go back and get their GED's when they find out they need a high school diploma to get anywhere in life. So you are not the only change agent in your child’s life—but you are the most influential one.


Q: James, what would you say to parents who feel like their child is hopeless—and that nothing will work for them?



James: I would say that I understand—I think there are children who certainly make you feel hopeless when you're trying to parent them. Believe me, I’ve worked with some entrenched, out-of-control kids over the years. But by using that system of responsibility, accountability and consequences, I saw many, many of those kids turn their lives around and go on to become successful adults. So in my mind, there's always hope—but you have to be willing to work at it to create real change.




"My Kid Will Never Change." When You've Hit a Wall with Your Child's Behavior reprinted with permission from Empowering Parents. For more information, visit www.empoweringparents.com



James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.

Wednesday 2 September 2009

Difficult Child?

What happens if you have a difficult child who says all the time 'I don't care '? How can you leran to motivate them? James lehamn has written a really helpful article which shows that behavior modification is the key to solving problem behavior with a difficult child.

Motivating Underachievers Part I:
When Your Child Says "I Don't Care"


Motivating Underachievers Part I: When Your Child Says I Dont CareAre you facing the new school year with dread because you have an unmotivated or underachieving teen or pre-teen? Is your child’s answer to everything, “I don’t care” or “It doesn’t matter?” In Part I of this two-part series, James Lehman, MSW explains why your child does have motivation—and how you can coach them to better behavior.


Once you realize that your adolescent is motivated to do nothing, it will become obvious to you right away that he actually puts a lot of energy into doing that “nothing.”


The first thing to understand about teens and pre-teens who seem to have no motivation is this simple truth: It's impossible to have no motivation. Everybody is motivated—it just depends on what they’re motivated to do. I think it's helpful to see that rather than being unmotivated, these kids are actually motivated to not perform and to resist their parents. In other words, they’re motivated to do nothing.


Parents often think that if they can find a new way to encourage their child, he or she will magically start achieving more. I don't think it's like that at all. In fact, I think the problem is that these kids are motivated to resist, withdraw and under-perform. In effect, instead of acting out, they’re acting in.


Think of lack of motivation as an action problem—and the action is to resist. These kids are making excuses; they’re pushing their parents away. At school, they’re motivated to resist studying and homework. They're also motivated to resist their teachers. Look at it this way: these kids are motivated to say “I don’t care,” either with their words or with their actions. They’re saying those words; they’re telling you what they’re doing—they’re not caring.


How Can Parents Motivate Their Teen or Pre-teen?

Once you realize that your adolescent is motivated to do nothing, it will become obvious to you right away that he actually puts a lot of energy into doing that “nothing.” He puts a lot of energy into resisting you, to withdrawing from you, to making complaints. When you talk to an adolescent who's an underachiever, what you hear are a lot of errors in thinking. “I can't; it’s too hard; it doesn't matter; I don’t care.” In fact, “I don’t care” is their magic wand and their shield—it takes off pressure and makes them feel in control all at the same time. The words “I don’t care” empower them. When they start feeling anxious about their place in life, it soothes them to say it doesn’t matter; they use it like a soporific or a drug. “I don’t care” also helps them deal with their anxiety. Fear of failure? “I don’t care.” It's hard to do? “I don’t care.” It dismisses everything.


Frankly, you can't make your child care. Let’s be honest, the old saying, “You can bring a horse to water, but you can't make him drink” is true. But understand that while we can’t make our kids drink, we can certainly try to make them thirsty.


9 Ways to Get through to Your Underachieving Child or Teen


Look at What Your Child Likes: Look for things that can be used as rewards for your child. Make a point of observing what your child likes and enjoys now. And don't take his word for it; he'll tell you he doesn't care about anything; that “nothing matters.” But look at his actions—if he watches a lot of TV, plays on the computer, if he likes video games or texting, you know what he likes. Ask yourself: does he like going to the movies? Does he like going fishing? Does he like taking walks? Take an inventory of the things he enjoys and write it all down on a piece of paper. (While I usually recommend that parents sit down with their kids and draw up this list together, in the case of kids who tend to withhold, I don’t think it’s a good idea. Don't ask a child who uses passive aggressive behavior; because he won’t tell you—remember, withholding is his way of maintaining control.) Later, you can use these things as incentives.


Take the Goodies out of His Room: I think underachieving kids should not have a lot of goodies in their rooms. Look at it this way: their room is just a place for them to withdraw. If you have a child who holes up in his bedroom, the computer should be in the living area—and if he's going to use it, he should be out there with other people. He also shouldn’t have a TV or video games in his room, and if he’s not performing, don’t let him have his cell phone, either.


I also want to be clear and state that it’s important to realize that there's a difference between being motivated to do nothing and being completely withdrawn. A child who won’t attend to his work or do his chores is different from someone who's depressed. If your child won't come out of his room, doesn’t seem to care no matter what you take away, and is often isolated and withdrawn, you have to take that seriously and seek professional help.


Make Sure everything is Earned Each Day: I think that you have to hold unmotivated kids accountable. Make sure everything is earned. Life for these guys should be one day at a time. They should have to earn video games every day. And how do they earn them? By doing their homework and chores. They earn their cell phone today and then start over tomorrow. Let me be clear: for these kids, Mom should hold the phone.


Have Conversations about What Your Child Wants: When times are good, I think you should talk to your child about what he would like to have some day. Try to sneak in different ideas to get your child to think about how he will achieve what he wants in life. Sit down with your child and say “So what kind of car would you like to have? Do you like Jeeps?” Try to get him to talk about what he'd like. Because later on you can say, “Look, I care about you and I want you to get that Jeep—and you're not going to get it by not doing your homework."


As a parent, I'd be talking this way to your child from pre-adolescence. You can say things like, “Just think, some day you're going to have your own place. What kind of place would you like?” That's the type of thing you use to motivate adolescents because that's what is real to them: they want to get an apartment, they want to have a girlfriend or boyfriend, they want to get a car. So have conversations about what it takes to attain those things. And don’t forget, it’s a mistake to give your teen or pre-teen lectures when you want them to do something—instead, make them see that completing their responsibilities is in their best interests, because it leads to the life they’d like to have in the future.


Don’t Shout, Argue, Beg or Plead: Personally, I think if you’re shouting, you're just showing your frustration—and letting your child know that he’s in control. Here’s the truth: when people start shouting, it means they've run out of solutions. With kids who are underperforming, I think you have to be very cool. Arguing, pleading, and trying to get your teen to talk about how they feel is not very effective when they’re using withholding as a relationship strategy.


In my opinion, you can try almost anything within reason for five minutes. So you can negotiate, you can reason, you can ask your child about their feelings. It’s fine to say, “Is something wrong?” Just be aware that a chronic withholder will be motivated not to answer you.


“It Matters to Me.” I think parents have to be very clear and tell their children that what they do matters to them. Personalize it by saying, “It matters to me. I care about you. I want you to do well. I can't make you do it and I won't force you. But it matters to me and I love you.”


By the way, when I tell parents to personalize it by saying “It matters to me,” that doesn’t mean you should take it personally. Taking something personally means believing that your child’s inappropriate behavior is directed at you. It’s not—in reality, it’s their overall strategy to deal with the stresses of life. The concept of “It Matters to Me” helps because relationships can be motivating, but your child is his own person. It's no reflection on you if he doesn't want to perform. You just have to set up the scenario and enhance the probability that he's going to do what he needs to do. But don't take it personally, as if somehow you have to make him do it. The truth is, you can't.


Stop Doing Your Child’s Tasks for Him: “Learned helplessness” is when people learn that if they don’t do something, someone will step in and do it for them—and it’s a very destructive pattern. When kids and teens use this shortcut, they don't learn independence. In fact, in families where this occurs, many times you'll find that the kids weren’t allowed to be independent very much. Perhaps they had to do things a certain way and all the choices were made for them. Eventually, they gave up; they surrendered.


Regardless of why your child might have an attitude of learned helplessness, as a parent, it’s important to stop doing things that he needs to do for himself. Don’t do his homework—let him do it. You can be available for help if necessary, but don’t take on his tasks. I believe one of the most important things an adolescent has to learn is independence, and if you take on his responsibilities, you’re robbing him of this chance to develop.


Learn How to Be a Coach: Let’s face it: it's often sports coaches who get the most out of our kids. It’s their job to help kids want to improve their skills. So the coach learns a little bit about each of his players. A good coach is not constantly saying, “You’re great, you’re the best, you’re a superstar!” Rather, they always keep their athletes looking forward by complimenting them on the specifics of their progress: “Nice layup, Josh. You positioned your hands better that time. Keep it up.” I think parents need to learn more about the Coaching parenting style. Always keep your child looking forward. Comment on his or her progress instead of telling them how great they are when they haven’t put forth much of an effort. Kids see through flattery and false praise just like adults do—and it usually backfires.


Set Deadlines and Use Structure: Tell your child clearly when to do chores and schoolwork—and when you want them done by. I think it's important to schedule these kids, to give them structure. “Do your chores from 3 p.m. to 4 p.m., and then you'll have free time until dinner. And during free time, you can do whatever you want to do.” There are other ways to motivate your child by saying, “If you can accomplish this in X amount of time, we'll go to your cousin’s house on Saturday” or “I’ll take you to the boat show this weekend.” Remember, not everything that your child likes to do costs money, so add those activities into the equation.


I think it’s important for parents to realize that being an underachiever gives your child a sense of control and power, because then he doesn't have to worry about the anxiety of failure or meeting challenging responsibilities. He doesn't have to compete with other kids. He doesn't have to deal with people's expectations. In fact, a large part of underachieving has to do with managing other people's expectations. That’s because once you start to achieve, people expect more of you. Kids feel this quite powerfully and they don't have much defense against it. So you'll often see that when people start expecting more of these kids, they fall apart.


For me, it's not about who's to blame; it's about who's going to take responsibility. A kid who's an underachiever is motivated to do less—or to do nothing—because it gives him a sense of power and it gets him out of the stress of having to meet responsibilities. Your job as a parent is to help him by coaching him to meet those responsibilities in spite of his anxiety, fear or apathy.


In Part II of our series on Underachievers, James will talk specifically about ways you can motivate your child in school. Stay tuned to learn how you can get your underachieving child on track for the school year—no matter what his or her issue is.




Motivating Underachievers Part I: When Your Child Says "I Don't Care" reprinted with permission from Empowering Parents. For more information, visit www.empoweringparents.com



James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.