Healing Parenting for Kids with Emotional and Behavioural Disorders
♥ What is Therapeutic Parenting?
“Therapeutic parenting is healing parenting. The parent provides the therapeutic environment and follows the directives of the professional therapist. The parent’s priority is the healing of the child. They are committed to providing the tight structure and powerful nurturing necessary for the child to heal. They dedicate a minimum of six months to a year full-time commitment to caring for the child. They do not work outside the home during this time. Ninety percent of the healing is done at home. The other ten percent is done in the therapist’s office.” (Thomas, 1997)
Therapeutic parenting is a form of parenting to build or repair a bond with a child who is unattached and/or emotionally disturbed. It is a form of parenting that goes above and beyond what the average parent goes through with a healthy, secure child.
♥ Therapeutic Practices We Use and Teach at The RADish Ranch
The following practices are the main body of the therapeutic treatment and approaches that we use. Each child and family receive a tailored approach and program consistent with their needs, setting, and family life.
Felt Safety. Felt Safety is the feeling of safety; not just being told that you are safe, but the feeling that comes with an environment and people that will keep you physically, emotionally, and mentally safe.
We practice this by using line-of-vision supervision and the 6-foot rule (having your child within 6 feet at all times), door alarms on bedroom doors at night, tight structure in all aspects of daily life, and a simplified routine, environment, and schedule.
First Year of Life Attachment Cycle. The four stages of this cycle are: 1. Baby has a need; 2. Baby asks for need to be met (cries); 3. Need is met by caregiver with love and nurturing; 4. Baby develops trust. Children who experienced trauma during their first year of life had this cycle broken and have learned that they must rely on themselves in order to be safe and grow.
We re-do this cycle with children by requiring them to ask for their needs to be met and giving the caregiver the opportunity to say yes, meet the need, and provide love and nurture.
Brain-Based Behaviour Intervention (3BI). 3BI is a program used to deal with any defiant, destructive, disrespectful, or limit-testing behaviour. It promotes brain growth, self-image, attachment & connection, life skills, and self-esteem.
We use brain shifters to help the child think more clearly – jumping jacks, brain jumps, brain boosters, strong sitting (yoga-like mindfulness pose), and mini-trampoline jumping. We teach the child to take responsibility for their actions and give back with an act of kindness to the person they have been defiant, destructive, or disrespectful to.
Play and Connection. Play and connection are absolutely necessary for a child to heal, attach, and thrive. It is a big part of our work with children with RAD and their parents.
We teach Theraplay techniques to parents to use during connection time with their child.
We use and teach Bruce Perry’s 6R program to promote connection, attachment, and brain growth.
We teach parents to implement daily snuggle time: a time when parents rock their child, sing them songs or tell stories, and feed them sweet milk treats. It is a time of heart-to-heart connection that is imperative to healing.
We use and teach a daily structured playtime for the child to promote brain development, Felt Safety, body control, and imagination.
We teach and encourage 12 hugs a day from parent to child to promote connection, healing, acceptance, and bonding.
The 3 Jobs of Parents. “A parent’s job is to love their child, keep them safe, and teach them about life.”
We have parents model this with empathy and connection, and firm, consistent boundaries.
The 6 Jobs of Strong Kids. “My job is to be respectful, responsible, and fun to be around, and to do my chores and work fast and snappy, right the first time, the adult’s way.”
Children are instructed in these 6 Jobs in all aspects of life; being respectful to adults, peers, property, and settings; being responsible for hygiene, chores, schoolwork, and belongings; being fun to be around by sharing, being kind, and showing empathy and compassion to others; and by doing their chores, jobs, and/or work fast and snappy, right the first time, the adult’s way to prepare them for school, the work force, and future relationships.
Five Things a Child is in Charge Of. “I am in charge of my brain, my feelings, my strong, my thoughts, and my 6 Jobs.”
Children with Reactive Attachment Disorder feel the need to be in charge of everything and everyone in order to be ‘safe’, however, in order to heal they need a loving caregiver to be in charge of them and their surroundings. We teach children the 5 areas in which they need to gain self-control in before their brains will be strong enough and ready to make bigger choices and be in charge of decision making.
We believe in focusing on a child’s emotional, mental, behavioural, and physical health.
The following excerpts are from Foster W. Cline’s book, Uncontrollable Kids, from Heartbreak to Hope and were written by Deborah Hage (deborahhage.com). They give great insight into therapeutic parenting and the techniques that are used.
It has been slightly abridged to shorten the page, but the full version is amazingly written and well worth reading!
♥ Therapeutic Parenting Techniques
Proactive Techniques
Proactive techniques involve creating a home environment and relationship with difficult children so that being respectful, responsible, and fun to be around is a desirable goal for them. The parents must set a tone that is positive and makes valued behaviors worthwhile. There are several creative ways of doing this. One is planning family activities to maximize positives and minimize negatives, which help the children be enthusiastic about the activities rather than apprehensive and defensive. Another way is for the parents to speak in loving ways, avoiding sarcasm and anger, so that the children will want to bond to them. The parents must spend a great deal of one-on-one time with each child to develop a parent-child bond: game-playing, cuddling, rocking, and occasionally feeding a bottle to an unattached child are all part of the life of a therapeutic parent.
Tight control of television time is another proactive trait. Even so-called “good” programs are detrimental to kids, especially those with problem behaviour, and it is not necessarily the content of the shows that is at fault. It is the passive watching that wrecks the kids. The TV does not relate, does not answer questions, and does not reward creative thinking. No matter if the show is Sesame Street, Reading Rainbow, Where in the World Is Carmen Sandiego, or some other highly acclaimed educational program, children simply sit and watch. They are not engaging in reciprocal smiles, eye contact, movement, or touch. None of the interactions essential to bonding are present. They might learn all about how high technology works, but they never get the chance to make a tin-can telephone with their parents or playmates! Therefore, proactive parents eliminate TV watching until unattached children have demonstrated good behavior over several months. (Yes, months – not a few days or a week.) Filling the TV time with fun time when earned gives children another incentive to work on their behavior.
Sincere encouragement is important as well. Proactive parents get excited when children are “caught” doing something right, rather than when they do something wrong. Bad behavior is dealt with matter-of-factly, while the pizzazz is saved for the good behavior. Squealing with delight when children brush their teeth and ignoring them when they don’t focuses on the positives in their personalities. The parents have to be aware of opportunities for such reinforcement, for they come unannounced: you might see a proactive parent suddenly grab a child in a hug and swing her around because she walked by another child and didn’t hit him. “Wow! Did you see what you just did? You walked by Jim without punching him!”
Because unattached children are by definition self-centered, developing reciprocal relationships is art of the therapeutic parents’ job, too. These children must learn to trust others to take care of them, and reciprocally, they must learn that they must take care of others. This is essential to the success of therapy. Participating in joint activities, doing chores, paying back those they hurt through their thoughtlessness are all learning tasks for unattached children. Therapeutic parents must provide many opportunities for disturbed children to interact in a reciprocal way.
All of these techniques sound child-centered, and I guess they are. However, concentrating on the child like this will burn out any therapeutic parent or couple. Therefore, the parents must be taken care of, too. Time off for the parents is important, and they must have some arrangement for someone else to watch the children periodically. The relief may come from family or from the program that the parents are involve with, but it must come. In addition, the parents must be sure to take care of themselves during family activities. When they choose to participate in something fun for the children, it must also be fun for them. On the other side of the coin, when the child’s negative behavior requires a response, the parents must ensure that they feel good about themselves and the child, despite the child’s reaction to the consequences of his behavior. In this way, the parents will be able to continue caring for the child, and the child will trust that the parents will be there for him.
Reactive Techniques
When children do not take advantage of the enjoyment life has to offer and make poor behavior choices, therapeutic parents must react to the choices. there are a number of ways for parents to demonstrate being “sad for” the child because of her behavior, rather than “mad at” her. These are the reactive techniques.
Reactive techniques can be seen as ranging along a scale from non-intrusive (ignoring behavior) to extremely intrusive (one-minute scolding). Underlying all reactive discipline techniques is consequencing, which is the concept of having children experience either a real-world or a simulated real-world consequence of their behavior.
As the techniques become stronger in response to escalating negative behavior, the parent must remember that intrusive techniques can quickly become abusive techniques. During proper training in these techniques, parents will spend a lot of time discussing the slender line which divides discipline that makes the child confront and want to change her behavior from punishment that serves to satisfy the parent’s anger. One common understanding is that when a parent becomes angry, discipline is no longer therapeutic and should not be attempted, at least until the parent is no longer overwrought. (This is a major reason why I keep telling parents that they must take care of themselves first, so that they can be therapeutic with their children.) Another important point that therapeutic parents agree on is that techniques which are not working should be changed, not applied with increased vigor.
Naturally, the least-intrusive reactive technique is simply to ignore all behavior that can be ignored, such as sloppy dressing and careless schoolwork. Of course, such behavior has its consequences: unkempt kids are not invited on family outings and poor schoolwork gets poor grades. The parents are not oblivious to what the child is doing, but they don’t react to it when the behavior occurs. Later, misbehavior can be dealt with by the parents or the therapist, as they usually point to a larger problem.
The next step up the intrusiveness scale is a simple touch to remind children that the parent is present and is aware of their behavior. Very often, the parent need only rest her hand lightly on the child’s shoulder to help the child become more thoughtful. If the child is out of reach, a smile accompanied by raise eyebrows can be effective.
“Mom time” or “dad time” is slightly more intrusive than touch, because the child is brought in close after misbehavior and is held or cuddled on the parent’s lap. The goal of this is to make the child feel loved and valued while giving him a chance to regroup and choose better behavior. This may last for a few minutes, or it may go on for as long as it takes to read a couple of short storybooks. When that is finished, the child is given a consequence or sent off with a big hug to try again.
“Mom time” can be extended, if need be, into “line-of-vision supervision,” in which the child is within the parent’s sight at all times. Some therapeutic parents call this “the umbilical cord.” The first effect is that the child is confronted with her behavior: she is told that until she is able to make good decisions – what to say, where to go to the bathroom, how to handle objects – she needs to be close to someone who can make good decisions for her. The second is that the child gets the chance to observe other people making good decisions. This modeling is an important part of the child’s learning how to make such decisions. Line-of-vision supervision can be very tiring for the parent, for with unattached children it can go on for weeks or months.
Having “practice sessions” is another technique which is minimally intrusive. The goal of this technique is to get the child to enjoy cooperating, so the parent can be silly and use pizzazz. Practice sessions are held at the parent’s convenience, and not necessarily when an infraction occurs. The parent starts with an unusual request, such as “Run to the door and put your nose to the doorknob.” (This is sometimes done in a Simon Says game situation.) Once the child is cooperating on the silly things, the parent can make a command about what the child needs to practice: “Go flush the toilet.” “Wipe your nose.” “Get in the car and buckle your seat belt.” The child’s response to the command is typically, “I didn’t use the toilet,” or some such objection, to which the parent says, “I know. this is just a practice session, so that when you need to do it you will know how.”
If the child refuses to follow the command, the parent lets it pass, but the next time the child asks the parent to do something, the parent repeats the command. Very often, dinnertime is the next opportunity to get compliance. When the child asks, “Please pass the milk,” the parent replies with a gentle smile, “Please go flush the toilet.” The child might get mad, but not to worry. Sometimes anger is what the child need to change his behavior, and he is the one who needs to get mad, not the parent.
Another technique that can be fun for parents is the “double bind.” This paradoxical technique allows for, and sometimes encourages, oppositional behavior in a way that keeps the parent in charge. In essence, the parent tells the child to do what she is going to do anyway. If she does it, the parent is in control. If the child doesn’t do it, she has made the right choice.
For example, the parent might say, “Go clean up your room; but first, whine and cry.” The child might actually declare that she can pick up her toys without whining and crying, and then go clean her room. Or, the child will whine and cry, and then go clean her room. Either way, the parent has won. Other situations also lend themselves to this technique: “It’s your turn to do the dishes, but dawdle around for a while before you start.” “Feel free to not study for tomorrow’s spelling test. Your dad and I are just as capable of loving a bad speller as a good one.” “Keep practicing your cursing. If you’re going to do something, you might as well do it until you’re the best at it!”
Parents can use this technique in conjunction with others. For instance, parents might use pizzazz for good behavior with a double bind: “Wow! Did you see what you just did? You walked by Jim without punching him! I bet that was an accident – you meant to hit him and you forgot. Walk by and try it again. I want to know if I saw what I think I saw.”
One of the beauties of the double bind is that parents can give children permission to make bad choices. Then, when the kids do make a bad choice, parents are ready for it and don’t get sucked into an angry response. Since many children display negative behavior just to enrage their parents, parental permission to behave poorly often robs them of the reason to do so.
Sometimes the best response to continued bad behavior is for a parent to declare, “You are draining my energy. Which chore do you want to do to fill me back up?” Next, the parent lists some of the things that need to be done and has the child choose one. This creates a win-win situation: the parent is taken care of, and can continue loving the child without being blocked by anger. The child feels good for doing something right, and therefore entitled to his parent’s approval. Of course, there must be a way to check that the chore was done properly; assigning a chore without proper follow-up is signing a death warrant for winning control and subsequent trust.
Having a child who has made a poor behavior choice go to a “think-it-over” spot is often effective. Instead of the parent confronting the child over misbehavior, the child confronts herself. Whenever the child’s behavior needs attention, the parent tells her to sit in a designated spot (in whatever position works) util she can say or write what happened, how she felt, how she behaved, and how she will handle the same situation in the future. If the child is so non-compliant that she cannot sit, or the parent doesn’t want the hassle of making sure she is sitting, so she can be sent to her room and allowed out as soon as the mission is accomplished. Or, the child may be required to simply sit with no directions as to what to think. At the end of the allotted time, the parent lets her get up, gives her a hug, tries to get a reciprocal smile, gives her a “good luck” message, and sends her off to try again.
“How wonderful it is that nobody need wait a single moment before starting to improve the world” Anne Frank