Behavioral Health Treatment and Therapy Tips

Think

Kanfer & Schefft (1988) suggest six thinking rules for therapists:
1. Think behavior (instead of problems)
2. Think solution (instead of causes)
3. Think in small steps (instead of long-term deficits)
4. Think flexible (instead of continuing to do the same thing)
5. Think positive (instead of focusing on deficits)
6. Think future (instead of past)

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Hypersensitivity

Hypersensitivity is the result of the central nervous system becoming "over" stimulated when presented with sensory input. For example, a child who is hypersensitive to sound may become easily distracted, irritable, or hyperactive when in a situation where the auditory input is overwhelming. Many people are sensitive to sounds (or other sensory inputs) that the majority of people are not even aware of. For example, the flickering of flourescent lights can cause sensory overload in many people.

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Standing At Desk

One highly effective behavior management technique for children with ADHD in school is to simply place a firm hand to the child's back when they are becoming fidgety. It helps the child to calm and refocus without calling attention to behavior.

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Psychologist

A psychologist can have a variety of background academic experience. Clinical psychologists have studied and trained in emotional and behavioral health issues. They are trained in evaluation and treatment of mental health disorders. Many psychologists have a doctorate in clinical psychology, but some do not have a college degree. It is important to check credentials. Psychologists also work in schools, specifically with behavior problems. They may administer intelligence tests, aptitude tests, and achievement tests to evaluate student progress, potential, or choice of career.

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Transitions

Warn the child in advance when transitioning to give plenty of time for the child to adapt. For example, instead of simply saying "Time to stop. Clean up.", you can say, "You have 5 minutes before we go to lunch." Then give a second warning, "You now have 2 minutes before we go to lunch. Start thinking about what you have left to do." Finally, "You now have 1 minute before lunch. Finish up what you are doing and stop." For more ideas on working with children with ADHD, visit ADHD.

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Medication

Did you know that medication used to treat Attention Deficit Disorder should not be used if the child is also suspected as having Bi-Polar Disorder? ADHD medication will actually aggravate Bi-Polar symptoms.

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ADD/ADHD and Classroom Assignments

Children with ADD/ADHD often have difficulty keeping up with their peers on classwork and assignments. To help:
1. Allow extra time to complete projects,
2. Shorten assignment to level of child's
attention, and,
3. Modify assignments so child succeeds (less problems, partially done projects.
CAUTION: Be aware of how much less the child is doing than others. Allowing a child to fall too far behind the rest of the children may cause the child to be retained and make the problem worse. Visit ADHD for a more detailed explaination of ADHD.

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Behavior Plans

Set up a behavior contract with the child with ADD/ADHD. Work on one behavior at a time. Have the child identify the behavior and assist the child in selecting an alternative, more appropriate behavior to replace the misbehavior with. All misbehaviors must be replaced with another behavior, not just simply taken away. Then, help the child reach the goal on the first try. Success breeds success. Failure breeds failure. Make sure the plan works! To learn more about writing behavioral plans in an online course, visit Behavior Management: Winning the Battle!

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Breaks

Children with ADD/ADHD benefit from breaking their work into sections by providing a 'short break' between activities. A good rule of thumb is 20 minutes of work time followed by a 5 minute "active" break. The 5 minute break time should be spent playing jump-rope, running in place, bouncing a ball, blowing bubbles, playing jacks, or some other active movement.

It is ironic that most schools do will not allow this simple behavior management procedure since even the average adult's attention span is only 20 minutes. A 5 minute break will increase learning and lessen misbehavior by ridding the body of stress and tension through the generation of blood! To learn more about working with ADHD, visit ADHD.

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Holding Therapy

Holding therapy is a technique that is sometimes used in the treatment of Attachment Disorders. The goal of holding therapy is to help the child develop inner control of emotions and to encourage ego development and trust. Holding therapy is never used as punishment. Is it effective? The judges are still out on the effectiveness of this treatment and recent publicity on Holding Therapy being improperly done resulting in the death of a child will probably keep the treatment in a bad light for awhile. As a therapist who has used holding therapy, I have found it to be extremely useful in the treatment of attachment disorders.

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ADD/ADHD Help

To teach a child to cognitively restructure their ADD/ADHD behavior, first have them identify the task at hand (I am supposed to write my spelling words). Next, teach the child specific tasks related to the assignment (I need to read each word and sound it out carefully. I am to use my best handwriting and to write slow. When I am done, I need to recheck my work to be certain I haven't missed anything.)

Giving them cognitive structure for their tasks will help them complete their tasks in a more efficient and timely manner.

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Behavior Intervention and Autism

There are many differing behavioral treatments for Autism. For example, Lovass' Behavioral Intervention uses 'Discreet Trial' methodology to teach a child appropriate behavior, Gentle Teaching and TEACCH focus correcting a child's behavior by following the child's agenda and building on positive behaviors that are already there.

No one behavioral intervention is superior to another, they simply all take a different approach. It is important, then, to research the various interventions before deciding on any given one.

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Using a Timer with ADD/ADHD

To help a child with ADD/ADHD organize their worktime better:
1) Use a timer for longer assignments,
2) Teach the child to pace him/herself according to the time left on the timer,
3) Break down large assignments into parts, and
4) Require fewer correct responses.

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ADD/ADHD and Completing Taks

A child with ADD/ADHD needs to think through the consequences of his/her actions (If I do well on this assignment, I get an extra half hour of television tonight. If I do not do well on this assignment, I will have to do extra homework instead of watching television.)

To assist the child, put the steps in pictures, or visual form for the child to check off one by one. For example, items on the check list might be:
Check to see if my name is on the paper
Check my spelling
Check to make sure I answered all the questions.

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Counselor

A counselor is a general term used to describe a variety of individuals with very differing backgrounds. There are family counselors who may or may not be licensed, guidance counselors, which typically work in schools and have a bachelor or master's degree, Christian counselors, that follow a religious oriented course of therapy, and indigenous counselors in a variety of roles.

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Using a Timer

Set a timer for a minute or two more than the child with ADD/ADHD is capable of attending and challenge child to attend until timer goes off. Reward the child lavishly if they attend until the timer goes off. Do not reprimend if the goal is not met, simply say something like, "Oh, that's too bad. Let's try again tomorrow!"

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ADD/ADHD and Peer Help

An effective strategy for helping a child with ADD/ADHD complete classroom tasks is to assign another student as a monitor/model. The pair can be called "Spelling Buddies" or something like that. It is important, however, that the child with ADD/ADHD not always be the one receiving the extra help. In other words, it is necessary to find a time when the child with ADD/ADHD is the "helping" student instead of the one always receiving the help. This helps foster self-esteem, personal responsibility, and social acceptance.

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Learning to Control Anger: Part 3

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Stopping Aggression

Look for signs of stress building up in the child before the child blows a fuse and becomes aggressive or acts out. Then, teach the child to recognize his/her own signs. Last, teach the child coping skills to overcome the stress (e.g., going to another area, getting help from an adult, or using a calming strategy such as putting on head phones or listening to music).

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Pleasant Imagery

Pleasant Imagery - One way to lessen our anger and relax is to keep in mind a pleasant thought. Because I enjoy gardening, I like to envision myself going into a beautiful garden and admiring the flowers. You will have to come up with an imagery that allows you the same pleasantry as my imaginary garden does.

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The Senses

Check the child's environment for sights, sounds, smells, and visual contact that might be distracting the child. Really look and listen. Sometimes we, as adults, become immune to common noises such as air conditioners or buzzing from overhead lights that children with ADD/ADHD cannot tune out.

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Self-defeating Thoughts

Often, what and how, a child feels about him or herself is the result of feelings that have arisen from an accumalation of many experiences. These feelings generalize into one "umbrella" feeling that becomes that, more or less, consumes all other feelings. The child then automatically falls into the umbrella feeling even when the new situation the child is not necessarily related.

For example, a child may think "I am no good at math so I cannot do my homework." or "Everyone thinks I'm stupid." When, in actuality, the child may be good at multiplication, but struggling with division. Or, the child had some bad experiences where members of his/her peer group were calling him/her names, but the child also has numerous other friends that like him/her very well.

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Electroencephalogram

One of the most standard tests is called an electroencephalogram (E.E.G), a test which measures electric impulses in the brain. An E.E.G is typically conducted by a neurologist, which is a doctor that can perform various tests to determine brain or nerve damage. Upon reading the E.E.G, the neurologist can determine if there is nerve or brain damage. The quality of an E.E.G. depends upon the competence of the technician making the brain recording and the skill of the physician interpreting the results.

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All or Nothing

Changing self-defeating thoughts requires cognitive restructuring of thought processes in the brain. One way to help your child do this is to talk the child through the experience. For example: if the child says, "Everyone thinks I'm stupid." You respond with, "What makes you think that?". The child might say, "Because everyone was laughing when I answered a question wrong in class." You then say, "How did that make you feel?" The child says, "Terrible!" You say, "Okay, let's think of some reasons the other kids might have been laughing and write them down."

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Discreet Trial: What Is It?

Discreet Trial is a method of working with children using a strong cognitive-behavioral approach. Introduced by Lovaas in the 1970s, it became a household word for families with a child with Autism. During the 80s, Discreet Trial sort of disappeared, only to re-surface with strength today.

Discreet Trial involves a very systematic approach to teaching and learning. "Tasks" are presented in repetition to the child over a set time period. Correct responses are strongly reinforced, while consequences for non-compliance are also reinforced. For example, to teach a young child to "sit", the child would be instructed to "sit" repeatedly over a predetermined time period. If the child sat, s/he would be rewarded. If not, there would be a consequence.

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Learning to Control Anger: Part 1 of 3

There are three basic steps to learning to control anger: 1) recognizing anger cues, 2) moving the anger from the limbic system in the brain (where emotions arise) to the frontal cortex (where you can more rationally deal with them), and 3) learning to use anger reducers.
First, it is important to recognize that everyone gets angry and it is important to let children know it is okay to get angry. It is when we get caught up in anger patterns that are unnecessary or unhealthy for us or someone else that anger needs to be managed.
The first step in controlling anger is to know when we are getting angry. Much of the time we really do not realize we are becoming angry until we are well into the anger pattern. Steps two and three are addressed in related tips.

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Psychotherapist

A psychotherapist is someone trained in the treatment of emotional or behavioral disorders. They may or may not have a masters degree or doctorate. It is important to check into a psychotherapist's credentials, training, and background to determine if they have the necessary experience to address your specific problem. They typically are not licensed to dispense medications.

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Hyposensitivity

Hyposensitivy is the result of the central nervous system being "under" stimulated by sensory input. Many people mistakenly assume that children who are hyperactive are overstimulated, when in reality, their hyperactivity is related to not being stimulated enough. A child lacking sensory input to kinesthetic movement may twirl, spin, bump into things, plow into people, hug too hard, or show other means of gaining sensory input.

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Psychiatrist

A psychiatrist is a licensed physician who diagnoses and treats emotional and behavioral disorders. A fully trained psychiatrist has special training in the field of mental health, has completed an internship and residency, and must pass an examination through a board certified in psychiatry. Psychiatrists are licensed to prescribe medications such as tranquilizers, sedatives, stimulants, antidepressants, and other psycho-medications.

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Count to 10

Counting to 10 - Remember the old saying that if you get angry you should count to 10? Well, there is something to the idea. Using language helps keep us in the frontal cortex of our brain where we can rationally deal with our anger, rather than the limbic system where we have little control over our emotions. By counting, we function from the frontal cortex and also keep our mind off of worse case scenarios which worsen the problem.

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Standing at Desk

If you have a child with ADHD in the classroom that is constantly in trouble for 'standing' instead of 'sitting' at his or her desk, why not just let him or her stand? Standing does not disrupt the classroom process and the child who is standing is most likely doing so because of some need. For more positive behavior management techniques, please visit 101 Positive Pointers For Preventing Problem Behavior in Young Children.

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Helping the Child with ADD/ADHD

Sometimes children with ADD/ADHD cannot help being impulsive and/or hyperactive because they are too stimulated by the sights, sounds, smells, and textures of our environment. To help, provide a quiet, "time-away" space so the child can "escape" when needed. Teach the child to go to the quiet place when becoming over-stimulated and before misbehavior esculates. Visit ADHD for a list of articles on ADHD. You can also find a "How To" e-book on working with ADHD by clicking here.

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Choosing a Therapist

There are many types of mental health professionals, including psychiatrists, psychologists, counselors, therapists, and social workers. Choose the type of therapist that best meets your need. In general, psychiatrists are the most expensive, but also the most comprehensive service you can get. They can prescribe medications and provide specialized treatment.

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Teaching Social Skills

Teach problem solving thinking during the teachable moment and in structured social lessons (social situations where alternative behaviors can be discussed and taught). For example, show pictures of children doing inappropriate behavior and have the class discuss the situation and alternative behaviors the child could have done that would be acceptable.

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Recognizing Anger Cues

Our body gives us important cues that we are becoming angry. Learning to recognize those cues can help us control our anger.

Think about how you respond to anger. Do you get red faced? Does your heart race? Do you clench your fists? How about feeling a sudden rise in temperature? Everyone reacts differently to anger situations, so it is important to pay attention to how your body reacts the next time you are in an anger situation. Write your response down and you will be ready to move on to step 2 of the anger control process.

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Teach Self Consequences

Teach Self Consequences - This technique is particularly helpful for children and teenagers who often do not "think out" the consequences of their actions. You simply fill in the blanks to this statement: "If I _____, then _____ will happen." ("If I run into the back of the slow driving car in front of me, then I will most likely be arrested."). By logically thinking through the situation, we are able to better control our anger.

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Deep Belly Breaths

Deep Belly Breaths - Most of us spend a good part of our day breathing incorrectly. Pay attention to how you normally breath. Do you take shallow breathes from the upper part of your lungs or do you breath deeply? If you breath correctly, you will notice your mid-section rising and falling with each breath you take. This not only helps to reduce anger, but actually pumps necessary oxygen throughout the body and brain, helping us to better control our actions.

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ADD/ADHD and Recess

One of the most common mistakes school personnel make when dealing with children with ADD/ADHD is to take away the child's free time play or recess. Children with ADD/ADHD need to vent anxiety, hyperactivity,
anger, or frustration in appropriate ways (e.g., kicking a ball, running, jumping, and yelling). Taking away these activities may actually increase the hyperactive behavior, therefore, taking away an active period the child physically needs should not be used as a behavior management option. To learn more about behavior management through an online course, visit Behavior Management

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Parental Rights in Treatment or Therapy

Authors of ethics literature have identified parental rights in therapy or treatment of their children. These include the parents' right:
1. To have a legal responsibility to provide for their child's welfare.
2. To access information that pertains to their child's welfare.
3. To seek therapy and/or treatment services for their child.
4. To be involved in therapeutic decision making and goal setting for their child -- right to give permission for treatments.
5. To release confidential information concerning their child.

(Prout, H. T. & Brown, D. T., (1999). Counseling and psychotherapy with children and adolescents, NY:John Wiley & Sons.

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Social Worker

A social worker is someone who may or may not have training in social work. There are many types of social workers, including clinical social workers, psychiatric social workers, and others. Many social workers hold a master's degree or doctorate in family and psychology related issues. Some are licensed. A social worker trained in an accredited school will hold a M.S.W. degree or D.S.W. A licensed social worker will typically have a L.C.S.W. behind their name. This means they have gone through state licensing requirements and testing.

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Definition of SI

Sensory Integration is the neurological process of organizing information through the nervous system. The nervous system consists of the spinal cord and brain. Sensory input comes from exposure to our environment through our senses of sight, sound, smell, taste, and touch.

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Short Term Vs Long Term Goals

Assist the child with ADD/ADHD to meet short term goals of attending & build on that time. For example, if the child can only attend for two minutes, extend
that time to three and help the child meet that
goal before expecting longer attention.

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Neurologist

A neurologist is a doctor that can perform various tests to determine brain or nerve damage. One of the most standard tests is called an electroencephalogram (E.E.G), a test which measures electric impulses in the brain.

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Medication and Autism

Some experts approach Autism from a biochemical viewpoint with treatment including medications such as antidepressents (Prozac, Zoloft), antibacterial (Nystatin), or Seretonin (a natural chemical in the brain) .

Although each of these chemical treatments have proven mildly to maximally effective in some cases, none of them have proven to be the "all-out cure" for Autism.

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Learning to Control Anger: Part 2

Step 2 of learning to control our anger involves changing the part of the brain we use when we are angry. Emotions such as anger, love, hate, and fear, are centered in a middle section of the brain called the limbic system. The frontal lobes, or cortex area of the brain controls abstract thought, reasoning, and problem solving, which is where we an control our anger. To control anger, then, we must work from the frontal lobe, or cortex area instead of the limbic area of the brain. To find out more about how to do that, read the tips on this site associated with anger management.

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Using Language

Language is often the key to controlling anger. Because language is centered in the frontal cortex of the brain and emotions are centered in the middle part of the brain, called the limibic system, language helps move us from the emotion part of our brain to the thinking part of our brain. The old saying of "When angry, remember to count to 10 first before acting" actually has merit. Young children do this naturally if you watch them at play. They talk out loud to themselves often as they work through frustrating and difficult situations.

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Cognitive Approach to ADD/ADHD, Impulsivity, Hyperactivity

Sometimes children with ADD/ADHD seem to act without thinking. This is called impulsivity and is a common problem among children with ADD/ADHD. But children can be taught to give themselves self-cues to cognitively "slow down". For example, for a child who tends to rush through his/her school work and ends up with a messy, half-completed assignment, the child can be taught to self-monitor by having them "think" through the situation ahead of time using a series of questions, such as: Did I put my name on the paper? Did I use my best handwritting? Did I answer all of the questions?

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Alternative Treatments for Autism

Although there is no known cause or cure for Autism, some alternative treatments have shown some success. These include: Cranialsacral Treatment, Brushing, Rhythms Entrainment, Aroma Therapy, and Music or Art Therapy.

Before chosing any alternative treatment for Autism, it is important to research them in detail.

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