Working with Aggressive Children

1. Working with Aggressive Children Lilly Landikusic LMFT, Founder and Director, EMPOWERMENT COUNSELING SERVICES Talon Greeff MMHC, Director of Residential Care, UTAH YOUTH VILLAGE This training and additional resources can be found at www.utahparenting.org

2. Overview • Introduction • Stories • Dynamics of aggression • Youth issues • Pre-blowup • Home environment • Setup youth for success • Avoiding power struggles • During the blow-up • Steps for calming • Things you should do • Post-blowup • Writing assignments • Other Behavioral Techniques • Conclusion

3. Introduction • Cody, 8 year-old boy, attacked sister and mother • Charlie, 15 year-old girl, verbally abusing parents and siblings, threats, constantly pushing limits using anger • State mental hospital teen who was severely developmentally delayed 9:40

4. Dynamics of Aggression • Research demonstrates that adjudicated youth feel they have little or no control over their lives • Often feel they cannot make any decisions • Many youth have been moved “on a whim” • They are frustrated and angry at “the system” • They blame their parents, case managers, foster parents, school teachers, judges and anyone else they believe is responsible for their unhappiness • Research also shows that they feel there are two ways they can take control of their lives: passive resistance or physical aggression

5. Other Dynamics of Aggression • They may have seen aggression modeled by their family members and mimic it • They may have experimented with aggression as a behavior and continue to use it • They may have a physiological problem and it may be more difficult for them to manage emotions • Progress in this area requires a longer view—immediate consequences often do not provide immediate change 9:45

6. Youth Issues • Poor communicators, tend to be less verbal • Lower than average intellectual functioning • Have “anger issues” • Difficulty with change • Difficulty with relationships or attachment We can help any youth with aggression even those who are severely lower functioning

7. Pre-Blowup • Home setup • Systems to share power • Use family meetings to setup rules and give feedback • Use a manager system for youth leadership in the home • Weekly family activities • They are not earned, everyone gets to participate equally • Purpose is to build relationships by having fun together • Weekly one on one time with an adult • Have fun, demonstrate a sense of humor

8. Pre-Blowup • Home setup • Adequate sleep for youth or child • Reasonable, enforced bedtimes • Medication as necessary • Take time to put children to bed with calming routines • Story time • Back rubbing • Melatonin has been used with success • Home routines and “rhythm” • Develop an accepted schedule • Relaxed, home rhythm, allow small disturbances 9:50

9. Pre-Blowup • Setup youth or child for success • Assess medication • Observe child or youth • Determine baseline and record on calendar • Document youth behavior on kitchen calendar • Give clear, short instructions when a child is frustrated or upset • Put your irreplaceable things away or in storage, help you stay calm

10. Pre-Blowup • Be clear in how you will handle aggressive behavior • Have a clear plan worked out with your spouse and case worker • Be able to describe it to the youth or child • Clear rewards and consequences for taking a time-out or for refusing to take a time-out • Suggestion: Shorten time-out if taken immediately • Suggestion: Assign a chore for refusing to take a time-out • Suggestion: Take away privileges for refusing to complete a chore

11. Pre-Blowup • Practice necessary skills or behaviors daily • Practice negative consequences, like time-out • The youth should quickly do the time-out • Practice “controlling emotions” • Deep breathing • Counting • Thinking about consequences • Steps to practicing skills with youth • Avoid power struggles by giving choices • Prepares child and parent for aggressive situations 9:55

12. Steps for Practicing with Youth • Describe the behavior you are teaching • Give a reason using an if/then statement • Demonstrate the behavior for the child • Have the child engage in the behavior and practice three times • Reward

13. Avoiding Power Struggles • Based in giving and explaining choices • For example, if a youth says you can’t make them clean their room. Your response would be, “I understand it’s not fun to clean your room and you have a choice. You can choose not to clean your room keeping you from watching TV or you can clean your room and watch TV sooner. It’s up to you” • Let the youth know they have the choice and emphasize it’s up to them. We cannot literally force anyone to do anything. We wouldn’t want to do that because then learning doesn’t take place. 10:00

14. Steps to Avoiding Power Struggles • Youth says, “I won’t…You can’t make me… No..,” • Empathy statement, “I would be more fun to watch TV • Explain that youth has a choice, “You have a choice.” • Explain the negative choice and its consequence, “You can choose to not do your chore now and lose TV”

15. Steps to Avoiding Power Struggles • Explain the positive choice and its consequence, “Or you can get right on the chore and watch TV when you are done.” • If necessary, give youth time and return to see what the choice is, “You need to get started in the next five minutes.” • If the youth makes the positive choice then praise and reward. If not, then impose a negative consequence such as turning off the TV. 10:05

16. Things to Remember • Do not walk on eggshells or let child/youth train you to accommodate their behavior • You will do the work, either now or later • Have low tolerances with small consequences, if you consequate interrupting, name calling and yelling then you will deal with less physical aggression • Negotiating is ok, as long as it is not bribe or blackmail • Bribe is a reward which comes before the behavior

17. During the Blowup • Stay about 10 feet away from the youth • De-escalation begins with delivery of a consequence • Youth may tantrum to avoid a consequence • Deliver one consequence, additional chores or lose privileges for a day • Don’t pile consequences on or think that delivering a consequence will result in compliance • Steps for calming down youth 10:10

18. Steps for Calming the Youth • Express empathy or praise • Describe behavior you need them to stop • Yelling • Swearing • Stomping around • Describe what you want them to do • Short instructions • Pleasant voice • Don’t expect compliance but praise approximations • Repeat first three steps until youth calm down Allow time for them to calm down

19. During the Blowup • Only discuss the child’s behavior, not the issue or situation that began the blow-up • Ignore any “baiting” • “You’re nicer to the other kids” • “You are so unfair” • “You don’t know what it’s like nowadays” • Monitor your own behavior • Remove any audience • Explain how youth can resolve the situation 10:15

20. During the Blow-up • Know when to restrain • Hurting self or others • Severe property damage • Know how to restrain • Don’t restrain if you cannot, will make situation worse • Add charges to youth • Plan for support • It is your job to manage your youth in your home • Lean on resources for necessary help

21. During the Blow-up • Know when to call the police • Teenager assaults parent • “You need to put the knife down in 5 seconds or I will have to call the police” • Youth needs to learn that familial violence is unacceptable • Inhibits parents ability to deliver and enforce consequences • Severe property damage • Take youth property as consequence, youth cannot be allowed to damage home to get property back • Damage the youth cannot fix, repair or make restitution • Severe potential harm or damage • Stealing a car • Taking a weapon 10:20

22. Things you Should Do • Track youth who are aggressive • Avoid blocking exits or areas of travel • Appear relaxed and calm • Slouch • Lean against a wall • Break eye contact • Remain about 10 feet away—no closer! • Remember—you are in charge and in control • It is a matter of time • You don’t need to convince them you are in charge

23. Post Blow-up • Wait a significant time, usually several hours or until the next day, and have the youth practice what they should do instead of blowing up • It should be a neutral time that is convenient for you and the youth • Keep the practice short and resist lecturing • The youth should practice three times • Have a reward for practicing that is used quickly. Reduce the consequence, candy bar, extra time out of bed 10:25

24. Post-blowup • Apply consequence that is reasonable, not punishing • Suggestion: youth lose privileges for half a day, lose privileges for a full day • Do a combination of consequences like a major chore, several role-plays and written assignments • Teach with the consequence—teach a skill that will help the youth avoid blowing up in the future

25. Writing Assignments and Other Techniques • Have youth fill out worksheet on SODAS • Complete Aggression Log or calming down worksheet • Practice emotional regulation techniques • Counting to ten • Thinking about consequences • Thinking about what you want • Thinking about something pleasant • Thought-stopping/Taking a minute • Time self out • Put pleasant things in your room • Sing positive song to yourself • Develop a positive saying to repeat to yourself 10:30

26. SODAS • SITUATION: One sentence describing the situation • OPTIONS: List at least three options available • DISADVANTAGES: List at least three disadvantages for each option • ADVANTAGES: List at least three advantages for each option • SOLUTION: Pick one of the options

27. Calming Down Worktable

28. Other Behavioral Techniques • Differential reinforcement of incompatible behavior • Focus on teaching skills that make it impossible to do the negative behavior • You cannot yell if you are speaking in a normal voice • Differential reinforcement of other behavior • Focus on teaching and rewarding skills rather than providing a negative consequence for a behavior • Rewarding a youth for being sensitive to others’ needs makes it less likely you will need to provide a negative consequence for hitting 10:35

29. Differential Reinforcement of Incompatible Behavior • It is easy to get frustrated with problem behavior and apply a negative consequence • Focus instead on reinforcing positive behavior • It is a simple concept: praise and reward behavior that is the opposite of the behavior you don’t want to see • The trick is to reward the good behavior that prevents them from doing the bad behavior • You cannot yell if you are using a normal voice, so praise a normal voice • You cannot be hitting if you are touching softly, so praise touching softly • Singing instead of yelling • Complimenting others instead of complaining • Praise and reward a strength that makes it impossible for the youth or child to do the problem behavior

30. Differential Reinforcement of Other Behavior • Identify the problem behavior • Identify the skill or behavior that the youth have or you would like them to have • You can use shaping and chaining to build on a strength • Reinforce the behavior or skill you want to have rather than the problem behavior • Breathing deeply • Complimenting • Any of the emotional self-regulation techniques 10:40

31. Conclusion • Working with aggressive youth and children can be frustrating • Have a long-term view and track the progress so you can see it • Modeling patience, polite asking and sensitivity to others helps youth learn more quickly • Everyone can learn and change This training and additional resources can be found at www.utahparenting.org

32. Contact Information Presenters: • Talon Greeff MMHC, Director of Residential Care, UTAH YOUTH VILLAGE (801) 272-9980 • Lilly Landikusic LMFT, Founder and Director, EMPOWERMENT COUNSELING SERVICES (801) 604-1134