A lot of the referrals that I get at my practice are about kids who are acting out, who have some kind of behavioral issue. These issues can range from non-compliance and disrespectful behavior to verbal and or physical aggression to acting out in the community. Parents are usually looking for some kind of treatment for their child because someone told them that therapy would be helpful. I’m a little more skeptical than that. Therapy has its place, but I don’t think it’s all that effective with most kids. And besides, these behavioral issues are probably not because there’s something wrong with the child, but rather there’s an issue in the interaction between child and the parent. That would be the good news. Trying to get inside of a kid’s head and fix something that’s wrong with them is pretty hard, and we don’t always have the right tools for that. So, when I get these referrals I will typically tell parents to leave their kids at home and invite them in to meet with me. Why? Because it usually has much more to do with us (parents) than them (kids).
While our children are always special to us, as a group they are much more alike than they are different. This is especially true where their behavior is concerned. I have found that across the developmental spectrum we can make predictions about kids that are pretty accurate. Because this is true, I make three assumptions about children before I ever meet them. In treatment I start with these assumptions but I always leave open the possibility that I might be wrong.
I will outline the first assumption here, and assumptions 2 and 3 in the next entry.
Assumption 1: There’s probably nothing wrong with your child.
This is a hard sell to the parent who is dealing with a child who is acting out, but it really is likely that what that child is doing falls within the range of what is normal for his/her age. The behavior can likely be explained within the context in which it is happening. We have to remember that children are very reactive to their environment.
For example, a common complaint of parents is that their child will not get ready in the morning before school. Many parents will identify that their children are too distracted to effectively prepare themselves and need constant redirection and reminders. In reality, it is more likely that the child’s behavior is designed to start and maintain interaction with the parent. Even if that interaction is negative, the child is still in control of it, and that is sufficient for the child to pursue that course. This is called “Secondary Gain”. I will usually direct these parents to withdraw their interaction and simply make an expectation of completion, with a mild consequence if they do not. Once this is in play, the “distracted” behavior will usually evaporate. What appeared to be a distraction is often behavior designed to gain an interaction with parents.