Jennifer Wilke-Deaton, MA, LPA is a scheduled keynote presenter at the MHBFSA Annual Conference scheduled October 20 and 21, 2005 in Frankenmuth, MI.  Ms. Wilkes-Deaton is an expert in family service delivery and the development of innovative parenting strategies.  Her handbook Creative Parenting Skills, was developed to assist professionals in teaching effective parenting strategies to consumers.

As a practicing clinician, I hear many complaints and experience a barrage of referrals for children with behavioral problems (many of them not clinically significant).  I often experience feelings of frustration with our mental health and educational systems (of which I am a part) on a daily basis.  We as professionals, as well as many exhausted parents, have a common core problem.  “How do we help these kids, when we feel like we have tried everything?”  So often we look to parents and teachers in these children’s lives and point the finger of blame, which leads to a great sense of disempowerment.  So, how do we help people feel desire, develop drive, and sustain effort when they simply experience failure after failure with these children?

I have some concerns regarding our approaches to parent training and classroom management over the past 15-20 years.  One of which is that we seem to be creating secondary gain-driven and poorly centered (self-aware) children who often carry these values into adulthood.  We have taken the demand for K.I.S.S. (keep it short and simple) techniques and have unintentionally fueled the development of relatively severe and difficult to stabilize behavioral problems (e.g. Oppositional Defiant Disorder and Conduct Disorder) and perhaps even more rigid personality characteristics. 

Firstly, many of the behavioral programs in schools, homes, psychiatric units, detention facilities, and counseling centers are based on obtaining secondary gain (tangible or external rewards).  We have developed many different kinds of token economies, point systems, leveling systems, and other behavioral purchasing plans over the past several years (Lieberman, 2000; Ayllon, 1999; Alyord, 1998), which generally work for a short period of time and then ultimately fail or become open to manipulation or “cheating” by the target population. Token economies are actually a fantastic program for daycare, pre-school, and grade school settings, but should only be used to help establish the practice of classroom rules and scheduling.  Point systems, which are often utilized in residential settings and therapeutic detention sites, are based on the gains/losses concept of behavioral management.  Unfortunately, these types of systems are more often based on losses rather than gains.  Earning-based systems are much more effective in developing positive self-esteem and intrinsic desire, but are also very complicated and difficult for parents to manage on a daily basis.  It is unfortunate that these types of programs have been divvied out to families and school systems without the proper theoretical understanding and guidance of application.  I find that programs like these have excellent intentions, but are generally underdeveloped, over-generalized to a large person-base (rather than individualized), and used as a failing mainstay for the long-term treatment of clinically significant negative behaviors.

A broad concern is that point systems utilize reinforcements (i.e. poker chips, points, rocks, buttons, etc.) that are in no way connected to the behaviors at hand.  Research has been very specific about the importance of immediate feedback as a necessity to adjust and develop healthy and efficient cognitions.  The process of immediate and relatable feedback can actually help develop hardwire neural connections in the brain.  People using these systems have the basic understanding that feedback must be given to the individual, but what they are missing is that not only does the feedback from the environment need to be immediate but also related to the initiating behavior (Kagan, 2001; Mesulam, 1997; Beatty, 1995; Benton, 1968).  How, for example, do 100 points earned over several hours or days, used to purchase stickers or balloons from a “store” have anything to do with developing positive communication or self-regulation? 

If you know children whose behaviors are being managed by a point system or token economy, you also know that the thought of losing a representative point can frequently provoke anxiety, create lying responses, and even aggressive behaviors (exactly the opposite of what we are trying to achieve).

My second area of concern is that due to the demands for short-term and brief interventions, we as clinicians have become more advisors than counsel to our clients.  It is our responsibility, and a necessary component of effective and long lasting behavioral treatment, to challenge individuals to create individual solutions to their needs.  By removing this component of cognitive challenge, we also remove the opportunity to nurture positive independent thought and effective problem-solving skills.  Many of the children and families that I have worked with have been in and out of the revolving door of treatment for years.  Several of the families I have helped have a history of successful achievement of their therapeutic goals during the duration of therapy.  Often, these people will return to therapy within months or weeks, because they do not know how to independently apply skills or utilize resources without immediate direction from an outside source (i.e. therapist, case manager, school counselor, or social worker).

This is likely due to the approach of giving a laundry list of reinforcers and consequences to families and schools, rather than individualizing plans and promoting healthy mistakes, recognition, and recovery. 

In my intensive after school program we made a distinction between “coping skills,” which are effective de-escalation and prevention tools easily accessed by individuals, and “coping skills-schmoping skills,” which are things people have been told they should use but are not necessarily effective for that individual’s needs or matching their abilities.  For example, for one child “taking deep breaths” or “counting to 10” may be something they do well and can access without a great deal of assistance, but for others these types of skills may be nearly impossible to utilize.  Therefore, the goal is to find what works with each person individually and develop those skills specifically, so that they do not require the constant reminder of, “Now what are you supposed to do when you feel angry?” Remember that we all make mistakes, and that these mistakes are a way of identifying areas that need to change.

Also, many of the techniques that we incorporate into behavioral plans are not specific to the environmental factors that are occurring at the time (impacts from home, other classroom disruptions, etc.) For example, Joey has a problem with the use of foul language.  Time-out may be effective and appropriate if he initiated the behavior himself, but if the rest of the students in the classroom initiated the use of foul language time-out only serves to isolate Joey rather than develop positive communication in that classroom setting.  Time-out as it is being practiced currently by many parents (to be discussed later) is an effective method of removing a child from harming themselves or other people, but does not meet the needs of all behavioral problems in all settings.  In fact, the effort of adults should be focused on the prevention of triggering the incident in the first place to avoid punishment, which is often a short-lived solution to the problem. We need to focus on parent-training that teaches the basic concepts and building blocks of individualized positive parenting (and yes, teachers parent too).  We need to train the concepts and give them the opportunity to practice and gain feedback from professionals and other parents, so that they are able to apply these skills to a multitude of behaviors and settings.

My goal for this Creative Parenting-Skills Handbook is to assist professionals in their ability to teach, allow the practice of skills, and then trouble-shoot difficulties for anyone working with children that have behavioral concerns (either clinically or not clinically significant).  It is important to set a goal for yourself, as a professional, of focusing on empowering the disempowered, reassuring the fearful, and supporting those that need assistance.  These people working with children also need immediate feedback and feel a sense of self-worth and efficacy when trying and making mistakes.  In doing this, you will experience greater openness not only to initial and ongoing treatment, but also to one’s comfort in asking for assistance rather than advice if things become difficult.  I refer to this as “getting boosters.”  The following book includes the basic structure of effective parenting, and as the weeks of treatment go on you will find that you develop more positive parenting skills on a more stable base of building blocks.  Rather than starting to train parenting late in the process of well-practiced negative behaviors and frustrated parenting, which constitutes an unstable foundation, we should focus on going back to the basics to avoid the constant and frequent repairs.  I wish you the best of luck with these individuals and know that you will experience great success.