What to Know Before Taking Your Child to a Behavioral Therapist

Image Source: Thinkstock
Image Source: Thinkstock

When I read one brave mother’s account of the difficult decision to enroll her child in behavioral therapy after dealing with uncontrollable tantrums, I felt decidedly uncomfortable.

Not because I have a child who is regularly smacking me in the face (although, let’s be clear, it has happened before), but because so many of the comments on the article seemed to mirror my own experience.

“I was told she’ll outgrow it once she starts school. It actually got worse when she started school. She would behave at school and then explode at home!” one mother commented.

“I am currently going through the same thing with my 4 year old. He is excellent in school but when he gets home it’s tantrum central. Not all the time but a good bit of time. I’m calling tomorrow to make an appointment for him,” said another.

Um, is someone watching my life? That is exactly the issue that our own family has been having, and it really got me wondering — could our own family benefit from behavioral therapy to take my child’s behavior from out-of-control to manageable?

There is no shame in admitting that, as a parent, I don’t automatically know all the answers. If you’ve been struggling with a child’s behavior too and don’t know where to turn or where to go next, Carnigee Truesdale-Howard, PsyD, ABPP, a Clinical Psychologist with Beaumont Hospital, who has practiced pediatric psychology for 12 years, has provided me with a checklist to determine when behavioral therapy might be needed.

1. First off, what the heck is behavioral therapy?

“Behavior therapy is a way to decrease or extinguish undesired or maladaptive behavior through retraining or learning other new behaviors,” Truesdale-Howard says. She explains that there are different types of behavioral therapies such as classical conditioning, operant conditioning, aversion, exposure, systematic desensitization, and applied behavioral analysis (ABA).

Essentially, the type of behavioral therapy that a therapist will use depends on the behavior you want to change or the diagnosis behind the behavior. “For example, systematic desensitization is used for individuals with anxiety,” she notes. In her own practice, Truesdale-Howard utilizes “operant conditioning,” which uses rewards and punishments to change maladaptive behaviors. Potty-training charts, anyone?

In a nutshell, Truesdale-Howard thinks that any behavior that needs changing in your child can benefit from behavioral therapy. It’s not a shameful thing at all, but just another tool in your parenting toolbox.

2. Understand that high-achieving kids may struggle with behavior problems at home.

Because so many of the comments, along with my personal experience, mentioned having trouble with children who act completely different at home versus at school, I asked Truesdale-Howard specifically about the issue. What’s going on with that behavior shift?

“There could be many reasons as to why some children behave differently at school and at home,” she says. But she then went on to note that children who are especially “Type A” kids — those high-achieving, good students — or children with anxiety may expel so much of their mental energy at school that once they get home, all hell breaks lose. “When at home, they can let their guard down and they feel more relaxed and safe to make mistakes and may be less stressed at home.”

3. Behavioral therapy will improve your relationship with your child.

“All children, teens, and adults can benefit from behavioral therapy,” says Truesdale-Howard firmly. Although she notes that the parent will be doing the work of changing their own behaviors (monitoring their tone, being consistent, having realistic expectations, etc.) and that the relationship might be “strained” in the process, ultimately, “implementing behavioral therapy techniques will and can strengthen the parent-child relationship.”

4. What’s the role of the parent when a child is undergoing behavioral therapy?

“The parent has an extremely important role,” Truesdale-Howard says. “The parent essentially is role modeling and is in charge of implementing those behavioral strategies that were discussed in the office. I always tell parents that the change does not necessarily occur in my office, the change occurs in the environments in which the behavior is occurring or in the moments when the parents are following through with the behavior plan.”

When we mentioned it, my husband brought up his concern that enrolling a child in behavioral therapy might be reinforcing the child’s thought that they are “bad” or that something is wrong, especially if the behavior has attention-seeking origins. Is that a concern at all?

“It is a concern that many parents have, but can easily be managed by helping the child to differentiate the behavior from themselves. I often tell kids that they are great and wonderful children, but it is the behavior that is unacceptable or needs to change. I also help families think about taking their car to the mechanic for a tune-up. Nothing is wrong with the car, but it just needs an adjustment, and all of us need help sometimes,” Truesdale-Howard explains.

5. Most kids want to change their behavior, too.

“Most kids recognize that their behavior leads to unfavorable results and they can begin to feel bad and guilty about that. So teaching them new ways to manage or change their behavior leads to an improved self-esteem and better parent-child relationships,” Truesdale-Howard notes.

It’s a bit sobering to realize that our kids might be just as frustrated as we are — without the tools and knowledge that adults have to control their behavior, isn’t it?

6. Behavioral therapy isn’t forever.

When I asked Truesdale-Howard what she wanted parents to understand most about behavioral therapy, she responded quickly: “That it works and that therapy can be short-term.”

According to Truesdale-Howard, the key to success with behavior therapy is consistency and follow-through. “Also that sometimes the behavior will get worse before it gets better, but this means that change is occurring and you are on the right track,” she explains. “Keep working with your therapist!”

7. Behavioral therapy isn’t just about the kids.

Finally, Truesdale-Howard offers up some tough love to parents struggling with their child’s behavior. “If you want to see behavior change in your child, be ready to change your own behaviors as a parent,” she says simply.

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