Viewing Time

2. Viewing Time This presentation will take one hour to complete.

3. Target Audience This program is designed for primary care physicians. Other health care professionals working with patients and their families may also find this program of interest.

4. Faculty Disclosure It is the policy of Children’s Hospitals and Clinics of Minnesota to ensure balance, independence, objectivity, and scientific rigor in all its educational programs. Our faculty have been asked to disclose to our program audience any real or apparent conflicts of interest related to the content of their presentations. They have also been requested to let you know when any products mentioned in their presentations are not labeled for the use under discussion or are still under investigation.

5. Faculty Disclosure Karen Arrett, MD has disclosed no actual or apparent conflict of interest in relation to this educational activity. During this educational activity Dr. Arrett will not be discussing the use of any commercial or investigational product not approved for any purpose by the FDA.

6. A Pediatrician’s Review of Two Commercially-Available Parenting Programs: Parenting with Love and Logic and Total Transformation Karen Arrett, M.D. Pediatrician, Partners in Pediatrics, Brooklyn Center, Minnesota

7. A Pediatrician’s Review of Two Commercially-Available Parenting Programs: Parenting with Love and Logic and Total Transformation A lecture and discussion on parenting styles, and an evaluation of the philosophy and techniques of two parenting programs that may be of benefit to parents and their children.

8. Program Objectives Upon completion of this program, participants should be able to: Understand the philosophy and technique utilized in the Parenting with Love and Logic Resources. Understand the philosophy and technique utilized in the Total Transformation Program. Describe three parenting styles.

9. Disclaimer Children’s Hospitals and Clinics of Minnesota accepts no responsibility for the materials presented through these Grand Rounds seminars. Each professional presenter assumes all responsibility for maintaining confidentiality or obtaining authorization, in accordance with all applicable laws.

10. Accreditation Children’s Hospitals and Clinics of Minnesota is accredited by the Minnesota Medical Association to provide continuing medical education for physicians. Children’s Hospitals and Clinics of Minnesota designates this educational activity for a maximum of 1 AMA Category 1 CreditTMtoward the AMA Physician’s Recognition Award. Each physician should only claim credits for the time that he or she actually spent in the activity.

11. Receiving CME Credit To receive CME credit, you must view the entire program and complete the evaluation form at the end.

13. A Pediatrician’s Review of Two Commercially Available Parenting Programs Parenting with Love and Logic The Total Transformation Karen Arrett M.D.

14. Pediatricians have a place in guiding children to healthy and successful lives.

15. Pediatricians and behavioral medicine 15% of practice is behavioral Pediatricians are expected to be experts ADHD, Autism, ODD, Anxiety, Depression, School refusal and school failure, OCD Pediatricians receive little training in behavioral pediatrics,

16. Pediatrics, March 2003 Child Disobedience and Noncompliance: A Review Larry Kalb and Rolf Loeber PhD University of Pittsburgh Dept. of Psychiatry

17. Parent training Parent training programs well researched interventions for noncompliant children. Parent training programs have been shown to be effective at reducing child behavior problems including noncompliance in the first 3 years after treatment. Treatment effects can generalize to other behaviors such as aggression and also improves behavior in sibling of the target child for up to 1 year of follow up.

18. Resources are available Parenting with Love and Logic The Total Transformation

19. LOVE AND LOGIC

20. What is Love and Logic • A parenting philosophy that primarily teaches character • Formula • The child makes a mistake • The adult responds with empathy instead of anger • The child learns from the consequences of his actions

22. Theory behind Love and Logic Success for children of all ages rests on a balance of unconditional compassion, firm behavioral limits and logical consequences The primary goal is to reduce behavior problems, increase motivation, and build assets which contribute to life long responsibility and resiliency.

23. The rules of Love and Logic Rule #1 Adults set firm limits in loving ways without anger, lecture or threats

24. Rule #2 When a child causes a problem the adult hands it back in loving ways

25. Parenting styles Helicopter Parent-This parent hovers over children and rescues them from the hostile world in which they live Drill Sergeant-this parent commands and directs the lives of their children Consultant Parent-This parent provides guidance and consultant services for their child

26. Helicopter Parent Provides messages of weakness and low personal worth Protects the child from any possible negative feelings Rescues child from natural consequences, Makes decisions for the child

27. The Result

28. The Drill Sargeant

29. Shares personal feelings about own performance and responsibilities • Provide and help explore alternatives and then allows the child to make his or her own decision • Provides time frames in which child may complete responsibilities • Models doing a good job, finishing cleaning up and feeling good about it • Makes sure the child owns the problem, helps the child explore solutions to his or her own problems • Uses many actions but very few words • Allows child to experience life’s natural consequences Models doing a good job, finishing, cleaning up and feeling good about it Uses many actions but very few words Allows child to experience life’s natural consequences The Consultant Parent UsesLove and Logic Techniques • They give messages of personal worth and strength • Provide and help explore alternatives and then allows the child to make his or her own decision • Provides time frames in which child may complete responsibilities

30. Techniques Enforceable statements Choices Empathy then consequences Diffusing arguments Guiding children to solve their own problems

31. Enforceable Statements • No Threats • No Anger • No Frustration • No Warnings

32. Ineffective Techniques vs. Enforceable Statements “Don’t You Talk to Me in that Tone of Voice!” “You sound upset; I’ll be glad to listen when your voice is as soft as mine.” “I want that lawn cut now. I’ve asked you five times” “I’ll be taking you to your soccer game just as soon as the lawn is cut.” “Do your homework right now!” “Feel free to join us for some television once your studying is done.” “You two be nice to each other and stop that fighting!” “You guys are welcome to come back as soon as you work that out.”

33. Improves Parent/Child Relationship PROVIDE CHOICES • Avoid Power Struggles           • Children get  to practice making decisions    • Children learn from mistakes          Builds Child’s Self-Confidence!

34. Allow a short time to decide,  otherwise decide for them    •   Ensure that the child lives with the consequence of the decision      •   Be careful not to turn choice into a threat  • Allow the consequences to do the teaching        HOW TO PROVIDE CHOICES Provide Two Choices You Can Live With   Avoid lectures Important to be calm and non threatening   

35. Words to Use • You are welcome to _______ or _____      • Feel free to ______or ______     • Would you rather ________ or _______     • What would be best for you _____ or ____

36. McDonald’s 6:00 p.m. “I’m Hungry”

37. Diffusingarguments

38. How Kids Pull You into the Argument “It’s not fair!” “I hate you!” “You don’t care!” “Dad wouldn’t do that!”

39. Diffusing Arguments “I love you too much to argue with you.” “Nice Try.” “I know.”

40. CONSEQUENCES Natural Delayed Anticipatory

41. This must really hurt.” • “This is so sad.” • “That is really hard.” • “I am sorry you feel • that way.” Consequences with Empathy

42. Church

43. Love and Logic One-Liners Phrases which help parents avoid conflict and provide empathy.

44. I know        Nice try    I love you too much to argue      I will love you wherever you live      That seems drastic One-LinersAnyone Can Use

45. Use genuine compassion and understanding   Avoid sarcasm  Delivery is Important Keep repeating the same or other one-liners

46. Guiding children to solve their own problems Express empathy Send the power message-what are you going to do? Offer choices – would you like some suggestions ? Have child state the consequences of the choice – will that work for you? Give permission to solve or not- let me know how that works out for you

47. Tools Books CD’s DVD’s Presentation guides Conferences Phone support Free resources on the website www.loveandlogic.com

48. Specialty items Calming the chaos

49. Ease of use Easy to order Many items also available at book stores or Amazon.com Entertaining Easy to read Able to quickly implement techniques

50. How a pediatrician can use Recommend resources Recommend conferences Give presentations Model in office Use techniques in discussions with patients Handouts free and online Use with own children, in the workplace and spouse.