About Central Florida Behavioral Health Network (CFBHN)
CFBHN is a not for profit 501 (c ) (3) community services network incorporated in 1997 as a collaboration of substance abuse providers in Hillsborough County. Currently CFBHN contracts with fifty-two provider organizations to offer a full array of mental health and substance abuse services in eleven counties to an estimated 95,000 plus individuals. The geographic areas served spans from Pasco in the north, throughout the Tampa Bay area and south from Desoto to Lee counties. The range of services includes acute care, residential treatment, housing, medical, outpatient and recovery support services. Substance abuse prevention services are also provided to over 785,000 at risk children.
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Consultant Services
CFBHN offers expertise through consultation in many areas, including specialized clinical areas such as suicide prevention, developing co-occurring capabilities, organizational development, quality improvement, and network administration. Please contact us for more information or to request a consultant in these or other areas.
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OUR MISSION:
CFBHN is a not-for-profit organization of community providers, stakeholders and consumers incorporated to ensure and enhance an array of behavioral health and other human services for the citizens of the communities served.
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Core Functions
•Network Management
•Strategic Planning
•Quality Improvement
•Financial Management
•Information Management
•Provider Services
I recently had to deal with this netowrk- they were very helpful and very informative
http://cfbhn.org/
Wednesday, January 26, 2011
Friday, January 07, 2011
Bipolar in Children and Teens
Bipolar Disorder in Children and Teens (Easy to Read)
An easy-to-read booklet on Bipolar Disorder in children and teens that explains what it is, when it starts and how to get help.
Does your child go through intense mood changes?
What is bipolar disorder?
Who develops bipolar disorder?
How is bipolar disorder different in children and teens than it is in adults?
What causes bipolar disorder?
What are the symptoms of bipolar disorder?
Do children and teens with bipolar disorder have other problems?
How is bipolar disorder diagnosed?
How is bipolar disorder treated?
Medication
Therapy
What can children and teens expect from treatment?
How can I help my child or teen?
How does bipolar disorder affect parents and family?
Where do I go for help?
I know a child or teen who is in crisis. What do I do?
Contact us to find out more about bipolar disorder
Does your child go through intense mood changes?
Does your child have extreme behavior changes too? Does your child get too excited or silly sometimes? Do you notice he or she is very sad at other times? Do these changes affect how your child acts at school or at home?
Some children and teens with these symptoms may have bipolar disorder, a serious mental illness. Read this brochure to find out more.
What is bipolar disorder?
Bipolar disorder is a serious brain illness. It is also called manic-depressive illness. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or "up," and are much more active than usual. This is called mania. And sometimes children with bipolar disorder feel very sad and "down," and are much less active than usual. This is called depression.
Bipolar disorder is not the same as the normal ups and downs every kid goes through. Bipolar symptoms are more powerful than that. The illness can make it hard for a child to do well in school or get along with friends and family members. The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide.
Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives.
Who develops bipolar disorder?
Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime.
How is bipolar disorder different in children and teens than it is in adults?
When children develop the illness, it is called early-onset bipolar disorder. This type can be more severe than bipolar disorder in older teens and adults. Also, young people with bipolar disorder may have symptoms more often and switch moods more frequently than adults with the illness.
What causes bipolar disorder?
Several factors may contribute to bipolar disorder, including:
Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
Abnormal brain structure and brain function.
Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.
The causes of bipolar disorder aren't always clear. Scientists are studying it to find out more about possible causes and risk factors. This research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.
What are the symptoms of bipolar disorder?
Bipolar mood changes are called "mood episodes." Your child may have manic episodes, depressive episodes, or "mixed" episodes. A mixed episode has both manic and depressive symptoms. Children and teens with bipolar disorder may have more mixed episodes than adults with the illness.
Mood episodes last a week or two—sometimes longer. During an episode, the symptoms last every day for most of the day.
Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels.
Children and teens having a manic episode may:
Feel very happy or act silly in a way that's unusual
Have a very short temper
Talk really fast about a lot of different things
Have trouble sleeping but not feel tired
Have trouble staying focused
Talk and think about sex more often
Do risky things.
Children and teens having a depressive episode may:
Feel very sad
Complain about pain a lot, like stomachaches and headaches
Sleep too little or too much
Feel guilty and worthless
Eat too little or too much
Have little energy and no interest in fun activities
Think about death or suicide.
Do children and teens with bipolar disorder have other problems?
Bipolar disorder in young people can co-exist with several problems.
Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs.
Attention deficit/hyperactivity disorder, or ADHD. Children with bipolar disorder and ADHD may have trouble staying focused.
Anxiety disorders, like separation anxiety. Children with both types of disorders may need to go to the hospital more often than other people with bipolar disorder.
Other mental illnesses, like depression. Some mental illnesses cause symptoms that look like bipolar disorder. Tell a doctor about any manic or depressive symptoms your child has had.
Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, like drive too fast or spend too much money. Some young people with bipolar disorder think about suicide. Watch out for any sign of suicidal thinking. Take these signs seriously and call your child's doctor.
How is bipolar disorder diagnosed?
An experienced doctor will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child's mood and sleeping patterns. The doctor will also ask about your child's energy and behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if an illness other than bipolar disorder is causing your child's symptoms.
How is bipolar disorder treated?
Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in a similar way they treat adults. Treatment can help control symptoms. Treatment works best when it is ongoing, instead of on and off.
1. Medication. Different types of medication can help. Children respond to medications in different ways, so the type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them.
Children should take the fewest number and smallest amounts of medications as possible to help their symptoms. A good way to remember this is "start low, go slow". Always tell your child's doctor about any problems with side effects. Do not stop giving your child medication without a doctor's help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.
2. Therapy. Different kinds of psychotherapy, or "talk" therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members.
What can children and teens expect from treatment?
With treatment, children and teens with bipolar disorder can get better over time. It helps when doctors, parents, and young people work together.
Sometimes a child's bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms.
You can help treatment be more effective. Try keeping a chart of your child's moods, behaviors, and sleep patterns. This is called a "daily life chart" or "mood chart." It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working.
How can I help my child or teen?
Help your child or teen get the right diagnosis and treatment. If you think he or she may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice.
If your child has bipolar disorder, here are some basic things you can do:
Be patient
Encourage your child to talk, and listen to him or her carefully
Be understanding about mood episodes
Help your child have fun
Help your child understand that treatment can help him or her get better.
How does bipolar disorder affect parents and family?
Taking care of a child or teenager with bipolar disorder can be stressful for you too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time.
If you are taking care of a child with bipolar disorder, take care of yourself too. If you keep your stress level down you will do a better job. It might help your child get better too.
Where do I go for help?
If you're not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency.
I know a child or teen who is in crisis. What do I do?
If you're thinking about hurting yourself, or if you know someone who might, get help quickly.
Do not leave the person alone
Call your doctor
Call 911 or go to the emergency room
Call a toll-free suicide hotline: 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline. The TTY number is 1-800-799-4TTY (4889).
Contact us to find out more about bipolar disorder.
National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279
E-mail: nimhinfo@nih.gov
Web site: www.nimh.nih.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. TR-08-6380
An easy-to-read booklet on Bipolar Disorder in children and teens that explains what it is, when it starts and how to get help.
Does your child go through intense mood changes?
What is bipolar disorder?
Who develops bipolar disorder?
How is bipolar disorder different in children and teens than it is in adults?
What causes bipolar disorder?
What are the symptoms of bipolar disorder?
Do children and teens with bipolar disorder have other problems?
How is bipolar disorder diagnosed?
How is bipolar disorder treated?
Medication
Therapy
What can children and teens expect from treatment?
How can I help my child or teen?
How does bipolar disorder affect parents and family?
Where do I go for help?
I know a child or teen who is in crisis. What do I do?
Contact us to find out more about bipolar disorder
Does your child go through intense mood changes?
Does your child have extreme behavior changes too? Does your child get too excited or silly sometimes? Do you notice he or she is very sad at other times? Do these changes affect how your child acts at school or at home?
Some children and teens with these symptoms may have bipolar disorder, a serious mental illness. Read this brochure to find out more.
What is bipolar disorder?
Bipolar disorder is a serious brain illness. It is also called manic-depressive illness. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or "up," and are much more active than usual. This is called mania. And sometimes children with bipolar disorder feel very sad and "down," and are much less active than usual. This is called depression.
Bipolar disorder is not the same as the normal ups and downs every kid goes through. Bipolar symptoms are more powerful than that. The illness can make it hard for a child to do well in school or get along with friends and family members. The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide.
Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives.
Who develops bipolar disorder?
Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime.
How is bipolar disorder different in children and teens than it is in adults?
When children develop the illness, it is called early-onset bipolar disorder. This type can be more severe than bipolar disorder in older teens and adults. Also, young people with bipolar disorder may have symptoms more often and switch moods more frequently than adults with the illness.
What causes bipolar disorder?
Several factors may contribute to bipolar disorder, including:
Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
Abnormal brain structure and brain function.
Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.
The causes of bipolar disorder aren't always clear. Scientists are studying it to find out more about possible causes and risk factors. This research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.
What are the symptoms of bipolar disorder?
Bipolar mood changes are called "mood episodes." Your child may have manic episodes, depressive episodes, or "mixed" episodes. A mixed episode has both manic and depressive symptoms. Children and teens with bipolar disorder may have more mixed episodes than adults with the illness.
Mood episodes last a week or two—sometimes longer. During an episode, the symptoms last every day for most of the day.
Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels.
Children and teens having a manic episode may:
Feel very happy or act silly in a way that's unusual
Have a very short temper
Talk really fast about a lot of different things
Have trouble sleeping but not feel tired
Have trouble staying focused
Talk and think about sex more often
Do risky things.
Children and teens having a depressive episode may:
Feel very sad
Complain about pain a lot, like stomachaches and headaches
Sleep too little or too much
Feel guilty and worthless
Eat too little or too much
Have little energy and no interest in fun activities
Think about death or suicide.
Do children and teens with bipolar disorder have other problems?
Bipolar disorder in young people can co-exist with several problems.
Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs.
Attention deficit/hyperactivity disorder, or ADHD. Children with bipolar disorder and ADHD may have trouble staying focused.
Anxiety disorders, like separation anxiety. Children with both types of disorders may need to go to the hospital more often than other people with bipolar disorder.
Other mental illnesses, like depression. Some mental illnesses cause symptoms that look like bipolar disorder. Tell a doctor about any manic or depressive symptoms your child has had.
Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, like drive too fast or spend too much money. Some young people with bipolar disorder think about suicide. Watch out for any sign of suicidal thinking. Take these signs seriously and call your child's doctor.
How is bipolar disorder diagnosed?
An experienced doctor will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child's mood and sleeping patterns. The doctor will also ask about your child's energy and behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if an illness other than bipolar disorder is causing your child's symptoms.
How is bipolar disorder treated?
Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in a similar way they treat adults. Treatment can help control symptoms. Treatment works best when it is ongoing, instead of on and off.
1. Medication. Different types of medication can help. Children respond to medications in different ways, so the type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them.
Children should take the fewest number and smallest amounts of medications as possible to help their symptoms. A good way to remember this is "start low, go slow". Always tell your child's doctor about any problems with side effects. Do not stop giving your child medication without a doctor's help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.
2. Therapy. Different kinds of psychotherapy, or "talk" therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members.
What can children and teens expect from treatment?
With treatment, children and teens with bipolar disorder can get better over time. It helps when doctors, parents, and young people work together.
Sometimes a child's bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms.
You can help treatment be more effective. Try keeping a chart of your child's moods, behaviors, and sleep patterns. This is called a "daily life chart" or "mood chart." It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working.
How can I help my child or teen?
Help your child or teen get the right diagnosis and treatment. If you think he or she may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice.
If your child has bipolar disorder, here are some basic things you can do:
Be patient
Encourage your child to talk, and listen to him or her carefully
Be understanding about mood episodes
Help your child have fun
Help your child understand that treatment can help him or her get better.
How does bipolar disorder affect parents and family?
Taking care of a child or teenager with bipolar disorder can be stressful for you too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time.
If you are taking care of a child with bipolar disorder, take care of yourself too. If you keep your stress level down you will do a better job. It might help your child get better too.
Where do I go for help?
If you're not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency.
I know a child or teen who is in crisis. What do I do?
If you're thinking about hurting yourself, or if you know someone who might, get help quickly.
Do not leave the person alone
Call your doctor
Call 911 or go to the emergency room
Call a toll-free suicide hotline: 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline. The TTY number is 1-800-799-4TTY (4889).
Contact us to find out more about bipolar disorder.
National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279
E-mail: nimhinfo@nih.gov
Web site: www.nimh.nih.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. TR-08-6380
Monday, January 03, 2011
Parenting a Defiant Child- I see me in this article do you?
Parenting Patterns to Avoid with Defiant Children ( this may not be what I agree with - it has some good points to it- so take what you can and digest it out- I have highlighted somethings in blue that I think stand out for me)
Parents can inadvertently contribute to a child's defiance and negativity by being too intrusive and by constantly imposing their own agenda. With a baby, for example, parents may overstimulate him by talking too loudly, tickling too many times, and bouncing him around too much. In attempting to cope with all that stimulation, the baby protests with fussing or crying.
With a toddler, a parent who doesn't read the child's cues and who constantly insists that the child do things the parent's way can contribute to a defiant child's rigidity. For example, an eighteen-month-old is playing with a jack-in-the-box and is focused on figuring out how to open the latch to get Jack to pop out of the box, when he is suddenly interrupted by his father. Dad, thinking the child can't do it, tries to move his son's hand forward on the latch. The child defiantly shoves dad's hands away. Hurt, the father inadvertently intrudes on his son by putting an alphabet book on top of the jack-in-the-box, muttering, "Let's do something else." The toddler, trapped with both hands under the jack-in-the-box and the book, tumbles everything over and begins a tantrum, banging his head on the floor. His world has been invaded by his father. A power struggle develops, as the toddler digs in his heels even further the more his father takes over.
With a school-age child, parents may unknowingly intrude and overload him by the way they boss him around - even when doing something potentially enjoyable together. An eager father may try to coach his daughter in soccer. Rather than letting her experiment with different ways to kick the soccer ball and perhaps setting up ingenious games, the father insists on instructing, ordering, and demanding too much. He gets impatient and angry when the child doesn't want to do it daddy's way. The whole enterprise disintegrates into a struggle between an irritable dad and an ever more defiant child.
Parents sometimes contribute to a defiant child's rebellion by getting the child involved in too many activities. Actually, the number of activities is less important than the way in which parents get involved. If the activities are fun and spontaneous, and the child is learning through discovery, parents find that their child has lots of energy. On the other hand, if the child is feeling bossed around and controlled, it can dampen even the most energetic child's enthusiasm. (If you have had a controlling, intrusive boss at work, then you know how such an attitude can rob you of your motivation and desire to participate and excel.)
In general, parents who are very rules-oriented or rigid are more apt to set up monumental power struggles with the defiant child. When they also often take the child's behavior personally, seeing his negativity as aimed directly at them instead of as an attempt to organize his world, the situation is compounded. "He's just doing that to make me angry," such parents tell me. There is nothing wrong with having rules and standards of conduct for your child, of course, but too many arbitrary rules and regulations can drive a defiant child into doing precisely the opposite of what you are demanding of him.
These struggles, I have found, are often played out around certain recurrent issues. The parent insists that homework be done at a certain time or in certain ways. "You have to do your homework before dinner, in your room, at your desk with the radio off and the door closed!" Such rigid rules almost inevitably set up a nightly struggle that exhausts everyone. Another incendiary issue is clothes. The child may want to wear an old cotton shirt and comfortable, worn jeans to school, while the parent insists on a newer, stiffer shirt and pants. "You're not going to leave my house looking like that," parents will say. The child's response, of course, is "I won't wear that junky stuff you want me to wear!" And another battle is under way.
Even more important for the child's response than parents wanting their way is the style by which they try to get their way. When it comes to homework, cleaning up toys, or respecting other people, parents can persuade, negotiate, and set limits in a calm, empathetic, and supportive way. In contrast, an "in your face," domineering attitude is sure to set up or intensify the child's defiance.
When these struggles become entrenched and parents come to me for help, I see several different types of responses. I see parents (often, but not always, a mother) who feel defeated, frustrated, angry, and depressed by the running battles. They feel guilty and are embarrassed by their child's behavior - what they see as his horrible manners, his rudeness, his sloppiness. Feeling helpless and angry, they rage at the child, throwing temper tantrums themselves. Another reaction I see from parents (often fathers) is a punitive, "You-won't-get-away-with-this" stance. This father is a law-and-order kind of guy who expects to be obeyed. He may punish the child frequently, often physically, hoping to force or scare him into better behavior.
"If you don't sit straight at this table, you're going to your room for an hour," he may roar at the dinner table each night at his slumping child, who merely stares back in defiant silence. "All right, that's it! Go to your room, and I don't want to see your face until seven o'clock!" As this scene is repeated over and over again about major and minor issues, a fierce duel between parent and child develops. The parent tries to intimidate or scare the child into backing down. While this approach may frighten some children into obedience (although the parent will have sacrificed the child's goodwill and respect in the process), the defiant child only digs in deeper. Open negativism turns into stony passive resistance. His grades suffer. He may get headaches and stomachaches. He may use more primitive mechanisms to battle back. At the extreme, he might even begin wetting or defecating in bed. But often he will still refuse to give in. As the battles between parent and child rage on, the whole family begins to suffer. By the time such a parent reaches my office, he is often so enraged that he is willing to sacrifice anything not to lose face. Mortified at the prospect of appearing weak and impotent, he forgets that his adversary is just a child. "I don't care what happens," I hear from such parents frequently, "he will not be a spoiled brat!"
There is yet another worrisome parental pattern that I sometimes see among parents of defiant children. They become so drained of energy in the power struggles, and so angry at their child that, without meaning to, they inadvertently become less nurturing and empathetic. There is less love and understanding in the family as a whole, and sometimes between the parents as well. Parents tell me, "I love Joey deeply. Because I love him so much, I get frustrated and withdraw like that." Unfortunately, children pick up on this response. One eight-year-old child told me, "I know my parents love me, but they hate everything I do." As the special nurturing care in the family erodes, not infrequently children will tell me, "I wish I were never born" or "Sometimes I think it's better not to be alive." Or the child may simply wall himself off more and more in a defiant corner, refusing to be a part of the family. A parent's lack of nurturing, added to overintrusiveness, is a double whammy that very few children, especially those with a defiant nature, can deal with. Most often this double whammy intensifies the child's difficulties.
How Parents Can Help the Defiant Child
The most important way to help your defiant child is to become aware of his underlying insecurities and vulnerabilities and be as soothing as possible. Underneath the child's defiance is his inability to let you know directly how much he needs you and how much he depends on you for comfort and security. The only response he knows is to act defiantly (hardly a way to win friends!). Therefore, you want to first gain your child's trust and confidence and somehow slip under his defiance so that you can offer him what he needs.
Establishing Trust and Security
Establishing trust and security is not easy, of course. For example, when you ask your eight-year-old how school went and he replies, "Don't ask all the time! Why do you care?" it's hard to see his underlying vulnerabilities. It is easier to be soothing with a highly sensitive child who is clingy and frightened than with a defiant child. The defiant child, with his constant need to be the boss and his ongoing power struggles with you, makes life more difficult. Yet, it is crucial to remember that this child is just as prone to being overwhelmed and overloaded as the highly sensitive child. The defiant child uses bossiness and defiance in an attempt to feel secure. To protect himself, he shuts out part of the world - including his parents at times. Your goal is to provide tender, loving care in spite of his negativity and defiance.
At first such a child may not trust you completely. He is not sure whether your attempts to soothe will be comforting or upsetting. He is so accustomed to taking charge, and so fearful of intrusions, that he feels he can trust only himself. You have to convince him that you can be comforting. Review in your mind the kinds of experiences that tend to be soothing for him. Which kinds of sounds help him relax and which are upsetting? Does he like light or firm touch? Does he prefer soft music boxes or rhythmic beats? Is he sensitive on certain parts of his body - his feet, perhaps, or his head, or his mouth? If he is a baby, what kinds of rocking motions does he like? Fast? Slow? In an older child, does he like to run fast or just putter along? Does he like you to be laid-back with him or very focused on him and very enthusiastic? Over time, by watching and playing with your child, you can build a profile of his likes and dislikes. Then you can use that profile to adapt your approach in trying to calm and comfort him.
Start slowly and gradually. With a sixteen-month-old, for example, who pushes your hand away or turns his back when you try to play with him, sit just outside his "boundary," so you don't intrude. Find some way to relate to him - working down the ladder of development, if need be. That is, if you can't get him to brighten up by talking to him, try using gestures - point at the block tower he is building and put one of your blocks right at his "boundary." Maybe he will reach out and take it. But if he still responds with irritation - pushing your block away, for example - back off and go down one developmental level. Try just exchanging some attention: see if you can exchange a smile and a flirtatious glance with him. See if he'll respond with a little grin. As you do this day in and day out, you should start seeing him loosening his "boundary" and begin relating to you in more complex ways. From exchanging glances, you can move up to exchanging gestures (you hand him a block, he accepts it and adds it to his tower while you clap softly and smile), and then to exchanging words (you say, "That's a great tower!" he says, "Want more blocks!"). Soon, he will learn to be more flexible and will be relating to you at whatever developmental level he has reached.
You can follow the same strategy with a preschooler. If your child is lining cars up in a row, come in as close as you sense he will let you. Offer to help him make his line of cars longer. Keep your motions slow and relaxed. Try to remember to use voice tones that he is comfortable with. If he is sensitive to touch, be respectful of that. You probably don't want to muss his hair or pinch his cheek, for example, if he doesn't like being touched on the head or around the face. Be especially cautious about trying to control his body with grabs or unwelcome hugs. It's better to let him know you are available through a warm look and outstretched arms, gesturing your interest in hugging him and seeing if he'll meet you halfway. Wherever possible, let him be the boss.
With an older child, the same principles apply. Approach him slowly. Make sure your movements and voice tone are as relaxing to him as possible. For example, your eight-year-old is sorting through his baseball collection and reciting batting averages. "Cal Ripken batted .280 last year," he says as you enter his room. You sit down on the edge of his bed, respectful of his "boundary" and say quietly, "Oh, I didn't know that." Your goal is to establish a calm relationship on his terms. Let him boss you around. If your child is playing Nintendo, ask if you might play together and let him assign you to your role.
Even more than with most children, the general goal with the defiant child is to be warm, soothing, and respectful as much as possible. Meet his inflexibility with flexibility. For example, you're helping tie his shoes. He pulls his foot away - "Not so tight, stupid. It hurts my foot!" Instead of saying, "Don't talk to me that way!" you could take a deep breath and say, "I guess your foot is a bit sensitive," as you tie his shoe one more time. "Is this way better?" At another point (when he isn't feeling so finicky) you can raise the more general issue of why he gets so mad at you and calls you "stupid" whenever you're not "perfect." Here, you can help him reflect on the fact that maybe he is being extra hard on you. As you help him see this pattern and encourage him to become more flexible, remember that he is probably being harder on himself, calling himself "stupid" or worse. For this reason, a defensive strategy ("You can't talk to me like that!") and then blowing up with anger over his "spoiled, insensitive" behavior (understandable though that response may be) not only doesn't work, but actually strengthens the child's defiance. Whatever your child is doing to you, he is probably doing worse to himself. When you come down on him too hard, you may only intensify his own self-criticism and probably even self-hatred. Empathy and flexibility, coupled with quiet explanations, help him see that he is being hard on both you and himself.
Setting Limits
Firm limits also need to be implemented. Being empathetic doesn't mean always giving the child what he wants. But when he is being refused another helping of ice cream, or punished for kicking his sister or trying to scratch his mother, the limit setting needs to be done in a firm but very gentle (and I stress "gentle") manner. Gentle limits coupled with empathy and flexibility will gradually help your child be less critical of you and himself.
Expand the child's dialogue about what comforts and what bothers him. For example, say he doesn't like the way you put his shirt on. So you try again, only this time you ask him to help direct you so that you are exchanging lots of words and gestures and, at the same time, following his general guidelines. This tends to ease the tension. Trying too hard to get it "right," or putting the shirt on him in a rough or annoyed fashion, will start a battle. As you build his trust and confidence in you, he begins to see you as a colleague who can help him, rather than as an adversary out to get him.
In response to such advice, parents tell me they fear they will "spoil" or overindulge their child and worsen his angry, demanding behavior by being so understanding. I tell them that parents can't spoil a child by helping him to feel more secure. They spoil him by not setting limits. Underneath a spoiled child is a child who thinks, "I can't get the boundaries I need. I have to push more and more and more because nothing works." But you need to set limits on his aggression, not on his need for comfort and security. You don't set limits and soothe at the same time. And you need infinite patience - not an easy thing to accomplish.
In setting limits, take advantage of your child's debating skills to hash out rules, rewards, and punishments in advance together. Try to avoid surprises and avoid throwing a tantrum yourself.
Also, it is best to try to avoid situations where the family becomes so stressed and exhausted that the parents stop nurturing each other and a great deal of anger develops in the family. Under those circumstances, one parent commonly tries to overprotect the child in an anxious, hovering way, unsettling the child with his or her needy intrusiveness. And the other parent, feeling deprived and jealous, often becomes overly punitive with the child. It's only when parents have their own needs met that they can be truly gentle and collaborative in setting the required limits.
Encouraging Self-Awareness
As your child gets older, help him to become aware of his own sensitivities and tolerance level. Help him to see what he does and what he doesn't do when he gets overloaded. Urge him to verbalize his feelings and develop a reflective attitude toward his sensitivities. That way, he eventually learns to prepare himself for challenging situations. Because this child is so sensitive to feelings of embarrassment and humiliation, his needs must be respected. But, at the same time, see if you can build in some humor, as well. Shared jokes about his perfectionism and critical attitude, if done in a warm and accepting manner, allow him to become aware of his sensitivities. Help him acknowledge some of his tyrant-like and greedy tendencies. "I guess more is always better," you may tease gently. Or you could jokingly ask him how he thinks you should be tortured for being so imperfect!
While empathizing with such a child is difficult, it can be made even harder by his aversion to being patronized. You may find, for example, that comments like "I know it must be hard" when said in an exhausted tone of voice will not have the desired effect. On the other hand, using both empathy and humor to help your child verbalize his anger and outrage may prove especially helpful. For example, if he is glaring at you and muttering under his breath, complaining that the soup is still too cold or too hot, a remark like, "Gee, I guess you're ready to fire me" or "I guess you think I'd better practice my cooking a little bit more" will respect your child as an intelligent, though outraged, individual and is more effective than a patronizing "I know how sensitive your little tongue is."
Parents benefit from self-awareness as well. Sometimes parents feel some embarrassment and guilt toward defiant or stubborn aspects of themselves. Without being aware of it, they may see pieces of themselves in their child and, if they hate that part of themselves, they will often take that hatred out on the child, rather than be aware of its origins. All of us have negative characteristics that we aren't proud of. These hidden "truths" often resonate with characteristics in our children that we don't like. It's as if all the "bad elements" in the collective family psyche hang out together. Being aware of these patterns allows us to take a more supportive and empathetic posture with our children, rather than an overly critical one.
A defiant child can also learn to choose certain physical activities to decrease his oversensitivity and overload. Many of the same physical exercises I describe for the highly sensitive child are also helpful for the defiant child: jumping with joint compression, large muscle movements, and rhythmic actions in space (such as swings or spinning games). Be sensitive to the particular patterns of sensations that comfort your child. Again, the most important thing to remember as you develop a program of physical activity is that the defiant child needs to be the boss. Let him direct how fast mommy is swinging the "airplane," or how many times in a row he wants to jump on daddy's tummy.
As a parent of a defiant child - you do get worn out and frustrated even more so when you are a single parent-seek help seek others to step in- it will benefit you and your child
Read more on FamilyEducation: http://life.familyeducation.com/behavioral-problems/anger/40422.html#ixzz1A06xx7tk
Parents can inadvertently contribute to a child's defiance and negativity by being too intrusive and by constantly imposing their own agenda. With a baby, for example, parents may overstimulate him by talking too loudly, tickling too many times, and bouncing him around too much. In attempting to cope with all that stimulation, the baby protests with fussing or crying.
With a toddler, a parent who doesn't read the child's cues and who constantly insists that the child do things the parent's way can contribute to a defiant child's rigidity. For example, an eighteen-month-old is playing with a jack-in-the-box and is focused on figuring out how to open the latch to get Jack to pop out of the box, when he is suddenly interrupted by his father. Dad, thinking the child can't do it, tries to move his son's hand forward on the latch. The child defiantly shoves dad's hands away. Hurt, the father inadvertently intrudes on his son by putting an alphabet book on top of the jack-in-the-box, muttering, "Let's do something else." The toddler, trapped with both hands under the jack-in-the-box and the book, tumbles everything over and begins a tantrum, banging his head on the floor. His world has been invaded by his father. A power struggle develops, as the toddler digs in his heels even further the more his father takes over.
With a school-age child, parents may unknowingly intrude and overload him by the way they boss him around - even when doing something potentially enjoyable together. An eager father may try to coach his daughter in soccer. Rather than letting her experiment with different ways to kick the soccer ball and perhaps setting up ingenious games, the father insists on instructing, ordering, and demanding too much. He gets impatient and angry when the child doesn't want to do it daddy's way. The whole enterprise disintegrates into a struggle between an irritable dad and an ever more defiant child.
Parents sometimes contribute to a defiant child's rebellion by getting the child involved in too many activities. Actually, the number of activities is less important than the way in which parents get involved. If the activities are fun and spontaneous, and the child is learning through discovery, parents find that their child has lots of energy. On the other hand, if the child is feeling bossed around and controlled, it can dampen even the most energetic child's enthusiasm. (If you have had a controlling, intrusive boss at work, then you know how such an attitude can rob you of your motivation and desire to participate and excel.)
In general, parents who are very rules-oriented or rigid are more apt to set up monumental power struggles with the defiant child. When they also often take the child's behavior personally, seeing his negativity as aimed directly at them instead of as an attempt to organize his world, the situation is compounded. "He's just doing that to make me angry," such parents tell me. There is nothing wrong with having rules and standards of conduct for your child, of course, but too many arbitrary rules and regulations can drive a defiant child into doing precisely the opposite of what you are demanding of him.
These struggles, I have found, are often played out around certain recurrent issues. The parent insists that homework be done at a certain time or in certain ways. "You have to do your homework before dinner, in your room, at your desk with the radio off and the door closed!" Such rigid rules almost inevitably set up a nightly struggle that exhausts everyone. Another incendiary issue is clothes. The child may want to wear an old cotton shirt and comfortable, worn jeans to school, while the parent insists on a newer, stiffer shirt and pants. "You're not going to leave my house looking like that," parents will say. The child's response, of course, is "I won't wear that junky stuff you want me to wear!" And another battle is under way.
Even more important for the child's response than parents wanting their way is the style by which they try to get their way. When it comes to homework, cleaning up toys, or respecting other people, parents can persuade, negotiate, and set limits in a calm, empathetic, and supportive way. In contrast, an "in your face," domineering attitude is sure to set up or intensify the child's defiance.
When these struggles become entrenched and parents come to me for help, I see several different types of responses. I see parents (often, but not always, a mother) who feel defeated, frustrated, angry, and depressed by the running battles. They feel guilty and are embarrassed by their child's behavior - what they see as his horrible manners, his rudeness, his sloppiness. Feeling helpless and angry, they rage at the child, throwing temper tantrums themselves. Another reaction I see from parents (often fathers) is a punitive, "You-won't-get-away-with-this" stance. This father is a law-and-order kind of guy who expects to be obeyed. He may punish the child frequently, often physically, hoping to force or scare him into better behavior.
"If you don't sit straight at this table, you're going to your room for an hour," he may roar at the dinner table each night at his slumping child, who merely stares back in defiant silence. "All right, that's it! Go to your room, and I don't want to see your face until seven o'clock!" As this scene is repeated over and over again about major and minor issues, a fierce duel between parent and child develops. The parent tries to intimidate or scare the child into backing down. While this approach may frighten some children into obedience (although the parent will have sacrificed the child's goodwill and respect in the process), the defiant child only digs in deeper. Open negativism turns into stony passive resistance. His grades suffer. He may get headaches and stomachaches. He may use more primitive mechanisms to battle back. At the extreme, he might even begin wetting or defecating in bed. But often he will still refuse to give in. As the battles between parent and child rage on, the whole family begins to suffer. By the time such a parent reaches my office, he is often so enraged that he is willing to sacrifice anything not to lose face. Mortified at the prospect of appearing weak and impotent, he forgets that his adversary is just a child. "I don't care what happens," I hear from such parents frequently, "he will not be a spoiled brat!"
There is yet another worrisome parental pattern that I sometimes see among parents of defiant children. They become so drained of energy in the power struggles, and so angry at their child that, without meaning to, they inadvertently become less nurturing and empathetic. There is less love and understanding in the family as a whole, and sometimes between the parents as well. Parents tell me, "I love Joey deeply. Because I love him so much, I get frustrated and withdraw like that." Unfortunately, children pick up on this response. One eight-year-old child told me, "I know my parents love me, but they hate everything I do." As the special nurturing care in the family erodes, not infrequently children will tell me, "I wish I were never born" or "Sometimes I think it's better not to be alive." Or the child may simply wall himself off more and more in a defiant corner, refusing to be a part of the family. A parent's lack of nurturing, added to overintrusiveness, is a double whammy that very few children, especially those with a defiant nature, can deal with. Most often this double whammy intensifies the child's difficulties.
How Parents Can Help the Defiant Child
The most important way to help your defiant child is to become aware of his underlying insecurities and vulnerabilities and be as soothing as possible. Underneath the child's defiance is his inability to let you know directly how much he needs you and how much he depends on you for comfort and security. The only response he knows is to act defiantly (hardly a way to win friends!). Therefore, you want to first gain your child's trust and confidence and somehow slip under his defiance so that you can offer him what he needs.
Establishing Trust and Security
Establishing trust and security is not easy, of course. For example, when you ask your eight-year-old how school went and he replies, "Don't ask all the time! Why do you care?" it's hard to see his underlying vulnerabilities. It is easier to be soothing with a highly sensitive child who is clingy and frightened than with a defiant child. The defiant child, with his constant need to be the boss and his ongoing power struggles with you, makes life more difficult. Yet, it is crucial to remember that this child is just as prone to being overwhelmed and overloaded as the highly sensitive child. The defiant child uses bossiness and defiance in an attempt to feel secure. To protect himself, he shuts out part of the world - including his parents at times. Your goal is to provide tender, loving care in spite of his negativity and defiance.
At first such a child may not trust you completely. He is not sure whether your attempts to soothe will be comforting or upsetting. He is so accustomed to taking charge, and so fearful of intrusions, that he feels he can trust only himself. You have to convince him that you can be comforting. Review in your mind the kinds of experiences that tend to be soothing for him. Which kinds of sounds help him relax and which are upsetting? Does he like light or firm touch? Does he prefer soft music boxes or rhythmic beats? Is he sensitive on certain parts of his body - his feet, perhaps, or his head, or his mouth? If he is a baby, what kinds of rocking motions does he like? Fast? Slow? In an older child, does he like to run fast or just putter along? Does he like you to be laid-back with him or very focused on him and very enthusiastic? Over time, by watching and playing with your child, you can build a profile of his likes and dislikes. Then you can use that profile to adapt your approach in trying to calm and comfort him.
Start slowly and gradually. With a sixteen-month-old, for example, who pushes your hand away or turns his back when you try to play with him, sit just outside his "boundary," so you don't intrude. Find some way to relate to him - working down the ladder of development, if need be. That is, if you can't get him to brighten up by talking to him, try using gestures - point at the block tower he is building and put one of your blocks right at his "boundary." Maybe he will reach out and take it. But if he still responds with irritation - pushing your block away, for example - back off and go down one developmental level. Try just exchanging some attention: see if you can exchange a smile and a flirtatious glance with him. See if he'll respond with a little grin. As you do this day in and day out, you should start seeing him loosening his "boundary" and begin relating to you in more complex ways. From exchanging glances, you can move up to exchanging gestures (you hand him a block, he accepts it and adds it to his tower while you clap softly and smile), and then to exchanging words (you say, "That's a great tower!" he says, "Want more blocks!"). Soon, he will learn to be more flexible and will be relating to you at whatever developmental level he has reached.
You can follow the same strategy with a preschooler. If your child is lining cars up in a row, come in as close as you sense he will let you. Offer to help him make his line of cars longer. Keep your motions slow and relaxed. Try to remember to use voice tones that he is comfortable with. If he is sensitive to touch, be respectful of that. You probably don't want to muss his hair or pinch his cheek, for example, if he doesn't like being touched on the head or around the face. Be especially cautious about trying to control his body with grabs or unwelcome hugs. It's better to let him know you are available through a warm look and outstretched arms, gesturing your interest in hugging him and seeing if he'll meet you halfway. Wherever possible, let him be the boss.
With an older child, the same principles apply. Approach him slowly. Make sure your movements and voice tone are as relaxing to him as possible. For example, your eight-year-old is sorting through his baseball collection and reciting batting averages. "Cal Ripken batted .280 last year," he says as you enter his room. You sit down on the edge of his bed, respectful of his "boundary" and say quietly, "Oh, I didn't know that." Your goal is to establish a calm relationship on his terms. Let him boss you around. If your child is playing Nintendo, ask if you might play together and let him assign you to your role.
Even more than with most children, the general goal with the defiant child is to be warm, soothing, and respectful as much as possible. Meet his inflexibility with flexibility. For example, you're helping tie his shoes. He pulls his foot away - "Not so tight, stupid. It hurts my foot!" Instead of saying, "Don't talk to me that way!" you could take a deep breath and say, "I guess your foot is a bit sensitive," as you tie his shoe one more time. "Is this way better?" At another point (when he isn't feeling so finicky) you can raise the more general issue of why he gets so mad at you and calls you "stupid" whenever you're not "perfect." Here, you can help him reflect on the fact that maybe he is being extra hard on you. As you help him see this pattern and encourage him to become more flexible, remember that he is probably being harder on himself, calling himself "stupid" or worse. For this reason, a defensive strategy ("You can't talk to me like that!") and then blowing up with anger over his "spoiled, insensitive" behavior (understandable though that response may be) not only doesn't work, but actually strengthens the child's defiance. Whatever your child is doing to you, he is probably doing worse to himself. When you come down on him too hard, you may only intensify his own self-criticism and probably even self-hatred. Empathy and flexibility, coupled with quiet explanations, help him see that he is being hard on both you and himself.
Setting Limits
Firm limits also need to be implemented. Being empathetic doesn't mean always giving the child what he wants. But when he is being refused another helping of ice cream, or punished for kicking his sister or trying to scratch his mother, the limit setting needs to be done in a firm but very gentle (and I stress "gentle") manner. Gentle limits coupled with empathy and flexibility will gradually help your child be less critical of you and himself.
Expand the child's dialogue about what comforts and what bothers him. For example, say he doesn't like the way you put his shirt on. So you try again, only this time you ask him to help direct you so that you are exchanging lots of words and gestures and, at the same time, following his general guidelines. This tends to ease the tension. Trying too hard to get it "right," or putting the shirt on him in a rough or annoyed fashion, will start a battle. As you build his trust and confidence in you, he begins to see you as a colleague who can help him, rather than as an adversary out to get him.
In response to such advice, parents tell me they fear they will "spoil" or overindulge their child and worsen his angry, demanding behavior by being so understanding. I tell them that parents can't spoil a child by helping him to feel more secure. They spoil him by not setting limits. Underneath a spoiled child is a child who thinks, "I can't get the boundaries I need. I have to push more and more and more because nothing works." But you need to set limits on his aggression, not on his need for comfort and security. You don't set limits and soothe at the same time. And you need infinite patience - not an easy thing to accomplish.
In setting limits, take advantage of your child's debating skills to hash out rules, rewards, and punishments in advance together. Try to avoid surprises and avoid throwing a tantrum yourself.
Also, it is best to try to avoid situations where the family becomes so stressed and exhausted that the parents stop nurturing each other and a great deal of anger develops in the family. Under those circumstances, one parent commonly tries to overprotect the child in an anxious, hovering way, unsettling the child with his or her needy intrusiveness. And the other parent, feeling deprived and jealous, often becomes overly punitive with the child. It's only when parents have their own needs met that they can be truly gentle and collaborative in setting the required limits.
Encouraging Self-Awareness
As your child gets older, help him to become aware of his own sensitivities and tolerance level. Help him to see what he does and what he doesn't do when he gets overloaded. Urge him to verbalize his feelings and develop a reflective attitude toward his sensitivities. That way, he eventually learns to prepare himself for challenging situations. Because this child is so sensitive to feelings of embarrassment and humiliation, his needs must be respected. But, at the same time, see if you can build in some humor, as well. Shared jokes about his perfectionism and critical attitude, if done in a warm and accepting manner, allow him to become aware of his sensitivities. Help him acknowledge some of his tyrant-like and greedy tendencies. "I guess more is always better," you may tease gently. Or you could jokingly ask him how he thinks you should be tortured for being so imperfect!
While empathizing with such a child is difficult, it can be made even harder by his aversion to being patronized. You may find, for example, that comments like "I know it must be hard" when said in an exhausted tone of voice will not have the desired effect. On the other hand, using both empathy and humor to help your child verbalize his anger and outrage may prove especially helpful. For example, if he is glaring at you and muttering under his breath, complaining that the soup is still too cold or too hot, a remark like, "Gee, I guess you're ready to fire me" or "I guess you think I'd better practice my cooking a little bit more" will respect your child as an intelligent, though outraged, individual and is more effective than a patronizing "I know how sensitive your little tongue is."
Parents benefit from self-awareness as well. Sometimes parents feel some embarrassment and guilt toward defiant or stubborn aspects of themselves. Without being aware of it, they may see pieces of themselves in their child and, if they hate that part of themselves, they will often take that hatred out on the child, rather than be aware of its origins. All of us have negative characteristics that we aren't proud of. These hidden "truths" often resonate with characteristics in our children that we don't like. It's as if all the "bad elements" in the collective family psyche hang out together. Being aware of these patterns allows us to take a more supportive and empathetic posture with our children, rather than an overly critical one.
A defiant child can also learn to choose certain physical activities to decrease his oversensitivity and overload. Many of the same physical exercises I describe for the highly sensitive child are also helpful for the defiant child: jumping with joint compression, large muscle movements, and rhythmic actions in space (such as swings or spinning games). Be sensitive to the particular patterns of sensations that comfort your child. Again, the most important thing to remember as you develop a program of physical activity is that the defiant child needs to be the boss. Let him direct how fast mommy is swinging the "airplane," or how many times in a row he wants to jump on daddy's tummy.
As a parent of a defiant child - you do get worn out and frustrated even more so when you are a single parent-seek help seek others to step in- it will benefit you and your child
Read more on FamilyEducation: http://life.familyeducation.com/behavioral-problems/anger/40422.html#ixzz1A06xx7tk
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