What Every Parent Wants

 

Parents want lots of things for their kids.

But when they call me, there is astounding similarity in what they want. Parents arrive, hope in hand. They sit on my couch and describe children of different ages, issues, gender, and problem settings. Yet every parent wants the same thing. Improbable, but true.  How can this be?

 

paris girls chalk

 

CONNECT

Parents yearn for their young children to connect better —  with them at home, and with others outside the home.  They pray for smoother interactions between their child and other kids, between their child and other adults.  They wish their child could …

Get through a play date without a knock down/drag out, friend-goes-home-early;

Feel brave enough to say hello on the playground;

Handle teacher correction without feeling she’s “mean;”

Be able to tell a teacher what one feels and needs;

Have as many loving moments at home as challenging ones;

Enjoy mutually satisfying parent-child interactions.

COPE

What else do they want? Without exception, every parent who comes to my office wants “coping skills for my child.” After many years, I noticed this word mentioned in EVERY intake — not just many or most. Parents yearn for their child to acquire skills that can be remembered, applied and activated in troubling times. For their children to learn to handle a situation without aggression, withdrawal, meltdown, a freak out, or “bad choices.”

THRIVE

My new patient paperwork concludes with this question:

“Say you run into someone six months from now, someone who knows your family well but hasn’t seen you in a while. Somehow, things have gotten better. What would you like to be able to say?”

In the hopeful answers to this question, the same word keeps cropping up: THRIVE. “He is just thriving” or “She’s thriving now in every way …” Parents want their child to feel success, joy, light, achievement and resilient self-esteem – to thrive on every level of development.

So, parents want their children to connect and cope better, so ultimately they can thrive.  Over my 20 years as a child psychologist, I see those aspirations as intertwined. But perhaps not as you’d expect.

 

With preschool & primary graders,

child coping is a joint venture between adult & child.

They learn and practice these skills with YOU

and apply them in the world.

 

Wait … don’t kids learn to cope in the therapy room?

They learn it in every room. Young children are developing their “coping systems” – a complex blend of neurological, physiological and emotional and social mechanisms for reacting and responding to challenge. Part temperament and genetics, part modeling, part impulse control, part emotional regulation. A tall order for the young ones I see.   Very hard to do alone.  We adults actually help or hinder children’s coping through our interactions with them.

Adult-child interactions literally build kids’ brains, fortifying the neural groundwork for either calm, confident problem solving or alarmist, defensive/offensive or escapist problem solving.  What’s the difference? Asking for help versus throwing a chair; greeting an unfamiliar child versus hiding behind your leg; expressing the thought “This is too hard” versus running out of the classroom.

 

To help children connect, cope & thrive,

I teach adults to facilitate their child’s coping

through brain-building interactions styles.

 

At some point in the process of child therapy  most parents mention to me, “It kind of seems like you’re training us …”   Down the road, many parents also share a common disclosure, admitting somewhat sheepishly but with deep pride: “I noticed he really started to change when I started to change. I had no idea ….”

Child therapy is composed of direct child intervention AND parent guidance.   Parent workshops go straight to parent guidance.   Workshops pump parents full of information that lower the temperature of child problems.

For instance, parents learn why yelling never works.  We think the louder we yell, the more kids will remember the lesson next time. Right? Wrong. Yelling activates the threat center in the limbic system in the brain, taking blood and oxygen away from the thinking cortex. Yelling literally incapacitates the child’s cortex from problem solving. Thinking goes off line. Good coping doesn’t get rolling like that.

You can learn to help your child Connect, Cope & Thrive via child therapy or a parent workshop.  Or, you try to apply these few concepts and see if things improve:

Child coping starts at home in every interaction you share.

Your own calm coping is the best model for your child’s coping.

If your child’s “upset elevator” goes up, keep yours down.

 

Promote your child’s coping through calm connection that models the cool you want them to achieve. Remember, you are building his or her brain in these early years.  Parents are the most important part of child therapy.

 

Dr. Beth’s Parent Workshops & Saturday Seminars resume September 2014 including:  Savvy Solutions for Your Challenging Young Child; You & Your Anxious Child; and The Child-Sight Model: Change Your View and What You Think, Say and Do. Visit DrBethKids.com for details. 
 
Photo credit: by Beth Onufrak

Parents: Why a Workshop?


question marksSo, you’ve been concerned about your young child
for quite some time. You’re not sure if you need a child psychologist … maybe, maybe not. Starting therapy is not like signing him up for soccer! It’s a larger decision. Some friends say get help now; others say, “it’s just a phase.” You and your spouse may not even be on the same page about your child.

A few new good ideas would be soooo nice. So you read articles, blogs, posts, tweets … but none seem to address the specific issues in your life with your child. You’d love specific parenting advice, some face-time with an expert, and the support of other struggling parents like you. A safe place where you wouldn’t have to worry about judgment. And it would be great to “test drive” a therapist before signing up for care.

That’s when a workshop may be “just what the doctor ordered.”

people link

Workshops are one of my favorite clinical activities. For one, I can talk with grownups and don’t have to sit criss-cross applesauce on the carpet! More importantly, they serves my deep need to help more than one child per hour. Workshops serve my growing drive to get basic, customized, high-quality information to parents of young kids in a cost-effective format.

And these days, cost-effective things are more needed than ever! Workshops extend child psychology services in an affordable, comfortable, helpful way so people don’t have to forestall something this important. That being, helping your child connect, cope, and thrive.

For many years – 13 to be exact – I resisted the notion of holding parent workshops. How could I ever help children I’ve never met … especially when each child is so unique? Then it hit me. Week after week, along with the customized advice I dispense, a set of core principles and “prescriptions” kept coming in handy.

For any given child & family, about 50% of my interventions are singular and customized; the other 50% come from foundational elements of pediatric mental health & balanced parenting. These common elements are pervasively, predictably helpful across a wide range of diagnostic conditions, family circumstances and child problems. From these elements, the content of my Parent Workshops was born.

In the hot Phoenix summer of 2013, I launched my first workshops. Feedback from the initial sessions revealed what parents really need. In addition to facts, approaches & strategies, they craved something else as well. They needed the opportunity to …

    • step away from their busy lives
    • reflect deeply about their children
    • absorb new ideas while out of the house, and
    • receive laughs, tissues & high-fives from other parents.

Workshop attendees found encouragement through another week of tantrums. And cheers after sharing a breakthrough. Some of the best moments occurred as I listened in the circle. And whadya know … I actually helped children I had never even met. Several, in fact, in a few hours time. As Mr. Rogers used to sing, “It’s such a good feeling …”

Workshops resume next month.
Dr-copy.Beth-Kite-Story-3-PRINTSavvy Solutions for Your Challenging Young Child will run Wed. nites, March 5th thru April 2nd and Thurs. mornings, March 6th thru April 3rd.

Workshops in development include: My Child & Me and ADHD and You & Your Anxious Child.

For details and registration, visit the Workshops tab on my website at DrBethKids.com. If you’re a Phoenix local in the Valley of the Sun, take a look or tell a friend. If you live elsewhere, look into parent workshops near you – for facts and friendship, solutions and support.


The Brain Bridge: From Play to Clean-Up

 

Imagine your sleeping child … rosy cheeks, languid limbs, lost in dreamland. And you have to wake her up. You know it will a challenging transition to the waking world. Instinctively, you know — the journey from sleep to wakefulness is a colossal transition between brain states. So you offer a gentle nudge, a tender stroke, a soft whisper. You know gentle brain transitions keep everyone happy.

Moving from play to clean-up is a brain transition, tooA shift from flexible fantasy to order and organization. The enormity of this shift and effort it requires often elude us. “OK, playtime is over, time to clean-up”  we rattle off, expecting an immediate shift. The resulting push-back tells us an earthquake has just erupted, the young child’s resistance like the rumble of tectonic plates! It’s a very strenuous brain shift for young kids, especially those age 7 and under.

Stern voice, expressions of displeasure and threatened consequences are simply not effective ways to inspire clean-up.  Young kids need a bridge, a navigable, appealing bridge from the tragically sad end of play to the brutally unappealing work of cleanup. We grown-ups can build that bridge in thin air.

bridge with frame

What is a Brain Bridge? It’s a development-wise, brain-smart style of engagement that helps young children shift (body, mind, & soul) from one activity to another. Such as, from play to your next agenda item! The Play-CleanUp Bridge links the right hemisphere and the frontal lobes. This notion vastly over-simplifies brain function, but the general concept is instructive. So, what do those brain areas have to do with play and clean-up?

Play lights up the right hemisphere. Not this brain area exclusively, but significantly. The right hemisphere, which delights in symbols, fantasy, imagery, creativity and spontaneity lends a lot of support to imaginative play.

Clean-up requires the frontal lobes and their activities called Executive Functions. From only a few of their names, you’ll detect their relevance to clean up: Response Inhibition (stopping one’s play), Task Initiation (starting to clean up), Working Memory (remembering 2+ step directions), Sustained Attention (resisting getting sidetracked). These behaviors take SKILL power, not just will power. Brain specialists say the frontal lobes require 18 to 20 YEARS to fully develop!  And we want clean up done (with cooperation, no less) in ten minutes?

So let’s build a Brain Bridge. The work of cleanup is simplified by incorporating the spirit of play. Your young child has been reveling in her right hemisphere. Join her there for best results.

1)  Celebrate first.  Wrap things up with joyful concluding remarks! Comment on your child’s play and how fun it has been. And get down on eye level instead of towering overhead.

2)  Give a countdown with fingers. Time is a total abstraction to the young child, let alone its passage. Make it visual. Say you have 5 minutes left and show fingers. Not just 5 fingers but 4, 3, 2, 1 and zero fingers as you sit nearby. Add the encouragement, “You can have a lot of fun in 5 minutes!” 

3)  Talk to the toys. This highly effective back-door brain route sneaks messages to the frontal lobes and bypasses the volatile limbic system. Address the toys:  “Guys, I’ve got some kinda sad news – it’s almost clean-up time. I know you’ve had fun with Brandon, but you can play with him again tomorrow.”

 Advise the toy to obey your child.  “T-Rex, in a minute Brandon is going to put you in the bucket … I know you’re sad to get picked up.  But it’s important you listen to him, because he knows it’s clean-up time. You can do it, T-Rex.”  If the child says, “T-Rex can’t understand you!”  just reply, “I know, I’m pretending.”  And co-pretending will resume.

4)  Make piles. To kids, picking up a toy-strewn floor is akin to cleaning up the planet. Help this job look do-able. Cluster like-items into separate piles for your child. Describe what you’re doing. Teach these skills by being your young child’s frontal lobes, modeling skills to come.

5) Thank the toys for the fun we’ve had.  Farewell play-talk borrows lightness from the imagination, facilitates emotional coping and supports cooperation. (Dr. Dan Siegel would say it integrates the left & right hemispheres too, which helps kids self-regulate.)

6)  Describe each item & action: Bye yellow chopper, curly ribbon.  Is your child using one hand or two?  Do toys drive or dance into their buckets? Cleaning up can take 150 separate behaviors. Describing them gives your child credit and celebrates objects as they get put away.

7)  Meet them halfway. A.k.a., give it to them on a silver platter. Hand your child the toy.  Point to where it goes. And hand him the next thing. Soon you’ll hear “I can do it myself!”

8)  Add pretend media.  Narrate like a fascinated radio host or a Monster Truck announcer. Tell America how fast Megan is cleaning up.  Want to grow your child’s executive function skills? Then keep this task appealing with joy and fun in your voice.

9)  Invite “Searching Eyes.”  When items go unnoticed, say “Use your searching eyes to see if anything is hiding from you.”  (Note: This is the opposite of “You missed that one.”  Why demean and deflate when your child is working so hard?)  Exclaim, “You found it! That puzzle piece couldn’t hide from you!”  Searching and finding fills a child’s heart with achievement and pride.

10)  Give a Praise Re-cap. Crouch down, arm around your child, and gaze upon the cleaned-up landscape. Recall each thing put away. “Amazing! You put away all the books, markers, frogs, snakes & lizards. What an excellent cleaner-upper today. You really know how to do it.”

When you build a Brain Bridge, you respect your child’s mind and, in the process, your child’s spirit. And that benefit extends long after the last lizard is put away.

*   *   *   *   *

References: The Whole Brain Child by Dan Siegel & Tina Payne Bryson; Smart But Scattered by Peg Dawson & Richard Guare; The Family Coach Method by Lynne Kenney.


“You’re Taking Your Child to a Shrink?”

You’ve wondered and waited ~ with your worries and wishes.  You’ve hoped this was “just a phase” in your young child’s life. Time after time, you’ve reassured yourself, “He’ll outgrow this; he’s young” or “she has so much time.”  In talks with your partner, you’ve raised your concerns … and talked yourself out of them as the weeks and months (or years) passed. There have been periods when he blossomed and was doing just fine. Times when those problems seemed far behind her.

Then the difficult days return … An event occurs, a moment arrives when it’s all too clear – you cannot manage this yourself. You are out of ideas. You begin to ask around, look online, make some calls. Make an appointment with dread and hope, shaky nerves and eager heart. Nearly every parent who seeks child treatment describes these phases. Now that you’ve made that call, you wonder what (or whether) to tell family & friends. The reactions of others can be a gnawing concern:

what

“I’m not even mentioning this to my mother, she’d have a cow.”

“I can just hear my dad now … ‘MY grandson is not crazy!’ ”  

“We’re not telling our friends, they wouldn’t get it – she’s an angel at other people’s houses.”  

You are not alone if this story sounds like yours. In fact, you are entirely typical. You may feel wary of following your plan while anticipating disapproval from others. It is hard to seek outside help. So hard that many families put it off a little longer. A good number of parents arrive moist-eyed and shake my hand confessing, “We should have been here two years ago. We knew things were getting bad, but we just weren’t ready.”  

How do you know when it’s time?  The following benchmarks may tell you: When you have tried countless strategies, but the problem keeps worsening; when you’re starting to worry about the safety of your child and those she plays with;  when the problem is hampering friendships, school, and family life; when your child doesn’t seem to enjoy “being a child;” when there are more “bad” days than good and his or her self-esteem appears to be suffering.

How do you select a child mental health provider? At local community mental health centers, staff assign a therapist to match your needs.  If you select a health insurance provider or elect to private pay, your choice will be more personalized.

checklist

    • Ask trusted people.  You’d be surprised how many parents have struggled behind the scenes just like you. Many have a favorite provider they count upon.
    • Look online.  More and more providers have websites and social media presence.  How do they describe their practices? Check out their Facebook business page posts. What do they Tweet?  How do you like  their material?
    • Call for an initial inquiry.  Do you feel comfortable interacting with the office staff?
    • Understand medication vs. therapy.  Medication is prescribed by psychiatrists, physicians & nurse practitioners. Therapy is provided by psychologists, counselors, & social workers
    • Ask if a parent-only intake is possible.  Not all providers can offer this. However, such an intake allows coverage of sensitive topics you don’t wish to discuss in front of your child.

O.K., so you’ve made an appointment. Or you’ve begun the process and feel ready to tell people.What do you say?  I offer these suggestions:

We’ve found a provider who specializes in young children.

We need “new ideas” to address a big problem that just isn’t going away.  

We want to help our child now before the problem grows so we can have “better days” together. 

After meeting your therapist, assess how you feel. Provider-family “fit” is very important! But a degree of unease is natural until you all settle in. Be open to sharing information. Providers cannot truly help your child or family without the “full picture.” Know that any personal information you share is entirely in service of your child. Also, be ready to change yourself! Providers help young children by giving their grown-ups “new ideas.”

Seeking help for your young child is a step of courage.  And it can make a world of difference! Intervention with young children sweeps stones off the path of development before they become boulders. Begin early so the only thing weighing upon his young shoulders is sunshine. happy20sun


“You can tell me anything, I’m a puppet!” Why Play Therapy Works

Criss-cross applesauce, a spunky boy sits on the whimsical playroom carpet, eyes wide, mouth agape. He’s listening to my impulsive puppet Freddy exclaim, “I get so mad, I want to kick him in the leg!”  Freddy elaborates: “Why won’t he just play my game, my way, every time?”  It’s no longer any surprise. Nine times out of ten the amazed child replies, with visible relief, “THAT’S JUST HOW I FEEL!”


The child I have in mind speaks to the puppet, and he’s not alone.  Freed by genuine understanding and clear acceptance, the child opens his heart. He pours out his own troubles to the boy, girl, dragon, wolf, octopus, skunk, or chipmunk on my hand.  “I know, last night I kicked my brother,”  he offers, commiserating with the puppet.  “I hate time out.”  Another child reveals, “I did that in school and got sent to the principal. It was the worst day EVER.”

Now, I have a nice degree on the wall, with all the rights and privileges thereunto appertaining.  But puppets are my co-therapists and their credentials seem to surpass mine.  Children tell the puppets far more than they tell me alone.  Why is this?

The answer is simple: Puppets give safe distance.   No child wants to see a therapist who fixates on her problems, nor feel there’s something wrong with herself. In my playroom, it’s the puppet who has the problem. And to a much greater extent than the child.  That’s the secret.  If a child is here for anxiety, Puppet Miranda has hilarious, unreasonable terrors.  The boy here for anger meets puppet Pedro, who mentions unmentionable aggressive thoughts … the very thoughts children harbor and sometimes enact.  The boy can hardly believe Pedro feels the same way.  And before he knows it, we are talking.  Other puppets join us, supportive “voices of reason.”  Four-way conversations ensue between the troubled puppet, the helper puppet, the child … and oh yeah, me.

Puppets help bring the child’s problem comfortably into the room. They often speak for the child, making her feel not so alone and not so BAD.  Puppets are but one of many play therapy tools. But for me and many child providers, they open the door.  Puppets are exceptional delivery vehicles for Cognitive Behavioral Play Therapy, described above.  CBPT helps children try on new thoughts and rehearse new behaviors.  And guess who models those — yes, the puppets.

There are many models of play therapy, including directive (didactic in style), non-directive (following in style), and familial (incorporating parents).  One expressive mode is Sand Tray therapy, using miniature toys children select and arrange in sand.  Sand Tray helps children heal from trauma, abuse, and emotional damage too painful to speak aloud.  Regardless of the mode, play therapy provides stand-in symbols (toys, materials) to represent feelings and people, events and things, wishes and fears.  The child’s imagination creates a buffer and a flexible “space” to explore tough stuff.  Therapeutic play allows the freedom to approach and retreat from uncomfortable ideas, memories, and feelings.  Children open up about burdens such as obsessions and compulsions, low self esteem, wishes that one was “never born,” despair, rage and shame.  Play gets inner feelings “out on the table” so we can deal with them together.

So puppets are one tool of the play therapist.  The puppet-child connection is unsurpassed in early childhood psychotherapy. Children often bond with their puppets friends, proudly believing they themselves are the helpers. One child brought a nugget of puppy chow to nurture a chronically anxious puppet. “Worry Wolf,”  she entreated, “you have GOT to get hold of yourself!”  She then rattled off an expert list of self-calming tips for emotional regulation.  Well-remembered and expertly modeled.  Parents bring their children for follow-up visits, amazed with progress. In a hush, they whisper, “He’s been talking about Freddy nonstop for two weeks.”

Good.  Freddy sends a tangible and memorable message out the door – long outlasting the single hour with me.  I ought to put him on the payroll.

#parenting  #playtherapy  #puppets  #self-regulation  #angermanagement #child psychology


To Do or Not To Do

I have a child in mind who is running through the house, tracking mud along the journey, jumping on the couch, scrambling up on a countertop, dropping clothes in the hallway, making tsunamis in the tub.

And into his little ears comes a reprimand (or two or three) passed down through The Ages: “Cut that out, now you behave yourself.”  “Stop it.”  “Don’t do that!”

These phrases are ingrained in the sub-conscious minds of most adults. They fly out of our mouths like pre-recorded messages.  Actually, we do have “recordings” in our minds, for better or worse, from parental words spoken to us.  These are often the first words we spout forth, even without thinking – they are part of us.

But STOP & DON’T are the least effective words to change children’s behavior. My job is to look through a child’s eyes, listen through a child’s ears.  A child may hear:

“Anthony, stop that right now or there’ll be no XBox when we get home.”

I usually hear the following translation:

“Anthony, cease this action right now, even though you are physically activated and completely engrossed in it. Calm yourself down, generate a list of other things you could do, select an alternative acceptable behavior, and re-route your mental and physical energy into that. Otherwise, you will lose a privilege several hours from now, long after this moment has passed.”

In psycho-babble, we are asking him to deploy his emotional and physical self-regulation skills and use executive functions.  OK, let’s switch to plain old English!  Only telling him STOP/DON’T asks him to take control of his body and emotions, suppress a strong impulse, and make a measured decision about what to do instead.   All of which require his frontal lobes … which are still growing.

Grown-ups can act as a child’s frontal lobes. Tell him what TO DO instead of what NOT to do.*   It’s an extra thinking step —  in an already busy day — but it yields the best results in the now and promotes learning for next time.  It’s teaching.  And it’s loving. It keeps YOU calm. Best of all, it’s effective.

Your effort to convert STOP/ DON’T responses into DOs will pay off.  The trick: imagine what your child would be doing if she were not doing this behavior.

    • If his shoes were not on the couch, his sneaker feet would be on the floor.
    • If she were not running through the house, she’d be using her quiet walking feet.
    • If he weren’t squeezing the family cat, he’d be using soft hands.
    • If she weren’t hitting brother in the car, her hands would be on her own side touching her own things.
    • If he weren’t scribbling, he’d be drawing slowly and carefully.

Sometimes the STOP/DON’T moment is urgent – like hurting or breaking. The first reasonable DO conversion might be “please come here by me.” There you can explain what needs to stop and what else your child can do.

“DO commands” do the initial work for you child’s frontal lobe – they tell her what to do instead. In my experience, children are more likely to comply with constructively phrased, friendly but firm DO commands.   Begin with “You may” to add an element of courtesy and authority, a respectful and effective combination.  Follow with praise for any amount of effort, however small, and generously describe any response going in the right direction.  DO commands are teaching moments.

    • “You may make small waves under the water; thank you for trying little waves.  Ooh, that’s a little one!”
    • Walk slowly and carefully with that cup of juice, please.  Excellent trying! You are really watching that cup.”
    • Hug me with gentle arms, please – oh, that feels so good, thank you for being gentle! “
    • “You may move over here [point] away from sissy to make your building.  Good job starting to move your stuff.”

DO commands readily lead into detailed praise.  When you notice spontaneous displays of DO behaviors you’ve been teaching, give a specific praise! Add lots of description. I call this “Positive Noticing,” detecting and commenting upon cooperative DOs that occur even without your prompting. Quite simply, “catch ’em being good.”

Try some DO commands.  They have changed the lives of many families in my care!  Make a list on your fridge converting your most frequent STOP/DON’T commands to DOs.  The extra thought will pay off as your child advances in self-control and emotional regulation.

* These ideas are drawn from the Parent-Child Interaction Therapy (PCIT) treatment model developed by Sheila Eyberg Ph.D., University of Florida, with whom Dr. Onufrak trained in her doctoral studies.


Welcome to A Child in Mind!

No matter what day it is, I always have A Child in Mind … one returning today, one who visited yesterday, one whose words still circle through my thoughts, one whose message will only unfold to me a few days from now.  Every day, I am a student of the young children who entrust their hearts to me.  And it is one fascinating, demanding class!  My office playroom is the classroom in which I will spend my career, criss-cross applesauce.

I am Dr. Beth Onufrak, a clinical child psychologist in private practice.  Young children are my exclusive service population, ages 3-8. These are my reflections upon what children reveal in the course of a clinical day. Children’s inner needs, worries, wishes, contemplations – are all wrapped up in “behavior.”  Behavior can express or obscure these inner feelings and needs.  This blog presents the lessons children teach me about what they feel, need, and do.  It adds research findings that guide my work. My aim is to help parents, teachers, caregivers, and pediatric professionals interpret child needs and respond with solutions.