The Kazdin Method for Parenting the Defiant Child With No Pills, No Therapy, No Contest of Wills Book and disk - 2008 - 1st Edition

Details

• Title The Kazdin Method for Parenting the Defiant Child With No Pills, No Therapy, No Contest of Wills
• Author Alan E. Kazdin
• Binding Book and Disk
• Edition number 1st
• Edition 1
• Pages 288
• Language EN
• Publisher Houghton Mifflin, Orlando, Florida, U.S.A.
• Date January 8, 2008
• ISBN 9780618773671

Your four-year-old’s tantrums have become more frequent and intense; they have started to dominate the life of your household. He’s not just yelling and screaming anymore — now he throws things, hits, and kicks, too. The bedtime tantrum is the most predictable one, and the one that disrupts home life the most, but he has also taken his show on the road. You’ve been late to work recently because he melts down in the morning when you leave him at daycare. After other spectacular public performances at the supermarket, restaurants, and family gatherings, none of which you handled very well, you are sure that others see you as an incompetent parent — and you are starting to wonder if they might be right. And, deeper than that, it frightens you to feel the situation slipping beyond your control. You’re losing your confidence that you can govern your child, your household, and when you lose your temper, yourself.
***

You want your nine-year-old to work with you, not against you. You’re not asking for blind compliance, but more cooperation would be nice. Right now, she seems to fight you every step of the way, from getting up for school in the morning through homework and dinner and computer or TV time. Sometimes she insists on complete freedom and autonomy; sometimes she acts as if you have to do everything for her. She bickers incessantly with her sister, too. Is it asking too much for you to have a little peace around the house? You’re tired of laying down the law, trying to understand her point of view, and using every other strategy that hasn’t worked. Frankly, you are fed up with your own child. You find yourself wistfully wondering why you weren’t one of the lucky ones who got a nice, easy kid to raise.
***

Your thirteen-year-old gives you nothing but attitude. On a couple of occasions, he has stolen something or committed an act of vandalism, the most worrisome pieces of a larger pattern of defying authority. You tell yourself that he’s going through a phase, that he’s just a normal preadolescent, but you fear that he may be heading toward serious trouble. You have tried to talk to him in every way you can think of — punishing, explaining, begging, crying — but nothing works. Your spouse says you are exaggerating, but you feel it’s time to face the seriousness of what’s happening to your family. Your child has a good heart, but that doesn’t keep you from feeling always a little on edge, not knowing when the next crisis will develop.

***

Should you be addressing these problems now, before they lead to more serious ones? Or should you wait to see if a particular problem resolves itself? Perhaps you’ve gone online, Googled “tantrum” or “defiant child,” and found that your child’s behavior fits a dire-sounding label. Perhaps you’re more concerned than your spouse is, or vice versa, and it’s becoming a bone of contention between you — two devoted parents who find themselves disagreeing about what’s wrong, how serious it is, how to put it right, or whether to try to fix it at all.
The tangle of confusion, frustration, fear, and anger inside you turns spending time with your child into a wearisome, long-running confrontation, even a chore that you secretly dread, and that feels very wrong to you. You’ve become a character you don’t really recognize, or recognize all too well as the kind of parent you never wanted to be: a frequently irate, sometimes out-of-control shouter who spends altogether too much time ineffectively nagging, threatening, punishing, and even hitting the very child you love as much as you have ever loved or could ever love anyone. You feel off-balance, strange to yourself. You need a better way to be a parent, but you haven’t gotten much useful help from the models you may have turned to: the way your parents, bless their hearts, did it; the many ways the child- rearing manuals suggest you do it; the way Supernanny does it on TV. With professional experts of all kinds promising that their way works, with friends and friends of friends telling you stories about how so-and-so’s kid was turned around by a new parental strategy or miracle diet or whatever, it’s hard to figure out what actually will work for you and your child.

The Method

There is a way to establish what actually does work. It’s called science. To most people as they go about their daily lives, “science” means subjects such as the discovery of water on Mars, how birds spread influenza, and what trans fats do to our bodies. All of these are important and consistently newsworthy, without doubt, but science has also been quietly pressing forward in the effort to understand child development, child-rearing, parent- child interaction, and aall sorts of other matters that affect your child’s social, emotional, and behavioral adjustment.
Within the extensive research on human behavior in geeeeeneral, a great deal tells us specifically about the behavior of children. You may be surprised to hear that scientists have studied the most effective way to give a command to a child, or that they have rigorously compared the effectiveness of rewarding good behavior and punishing misbehavior. There are even studies that tell us very specific things like, for instance, the most effective way to speak to a child when asking her to do something she’d prefer not to do: brush her teeth, wear a jacket, get off the phone, or go to bed on time. Obviously, very few parents have the time or training to get up to speed on the latest research in psychology, not to mention child development and neurobiology and all the many related fields. But they can benefit profoundly from what researchers have discovered.
In this book, I present a method for changing your child’s behavior that is based on good science — on what we currently know about children’s behavior from the results of sound, well-conducted studies. I do not offer impressionistic beliefs or unsupported opinions about childhood. I’ll be telling you something about the research and basic principles that underlie this approach, so you get a sense of why it works, but my emphasis will be on what to do and how to do it.
One great virtue of the method is that the same principles and techniques apply to the full range of situations for children and adolescents. I’m talking about everything from the milestones of normal child development — eating, toilet training, sleeping in one’s own bed, not having tantrums — all the way to potentially more serious behavior problems like fighting or stealing. The method has been demonstrated to be effective even in those more difficult situations in which there are other problems in the home, such as when parents have physical or mental health problems, or engage in drug use or domestic violence. As long as you are committed to systematically taking this approach to changing the behavior of your child, even an imperfect and partial application of the method produces results.
First, you must shift your own focus of attention. As parents we tend to be experts on what we want our kids not to do. For example, I want him to stop whining, talking back, and ignoring me. I will teach you to focus more positively on what you do want your kids to do — When it’s bedtime, I want her to go directly, quickly, and quietly to bed — and give you the tools to methodically reinforce that behavior until it replaces the behavior you don’t want.
You’ll learn how to build up the behaviors you want: how often your child must practice the good behavior in order for it to “take,” how to set up situations so that the behaviors you’d like to see are much more likely to occur, how to create more chances to practice, how to praise most effectively, how to set up and give rewards that work, how to get from the desired behavior never happening to seeing it happen a lot, how to troubleshoot and improve a program that’s not working well enough. I will have much to tell you about the details, because they can make all the difference between success and failure.
When you commit to positively reinforcing the behavior you want, you can be kinder to your child while being more systematic. We tend to fall into a trap of believing that getting serious about behavior problems means getting negative: more punishment, tougher standards, “zero tolerance.” But positive reinforcement requires a very different kind of effectiveness from a parent: better praise, more purposeful rewards, greater attentiveness to a child. It draws you and your child closer together as it makes you a more effective parent.
Parents who use my method often find great relief in discovering that getting down to business doesn’t have to mean bearing down even harder on their children. Being more effectively gentle and positive with your child doesn’t mean being spineless. The reverse, in fact, may be true. Flying off the handle, perpetual anger, shouting, hitting — those are the truer signs of a defeated, ineffective parent. Positive reinforcement tends to calm a household because it offers clear, attainable objectives for parents and children alike to aim for in shaping behavior.
My method does not require a lifelong commitment. The program you’ll set up for changing your child’s behavior works like a frame you place around a growing plant to train it up straight and healthy. The plant is better behavior, and once it can stand on its own, you’ll take down the frame. You will not be awarding points or keeping track of rewards forever. In fact, most parents find that such concentrated interventions take effect very quickly and can be largely discontinued after a relatively short time, like a month or two. The intention here is that you build the frame of this method around your child’s changing behavior, but once the desired behavior takes deeper root and gains in vigor, you quickly scale down the frame and then take it down entirely.
Where the Method Comes From

I did not set out to specialize in helping parents improve their children’s behavior. I started down the road that led to this method when somebody gave me a problem to solve and I turned to the research for help.
That occurred back in the early 1970s, when I was a graduate student at Northwestern University. The director of a local clinic that treated children who had emotional problems asked whether I could help his clients. The one I remember best was Sharon, a fifteen-year-old girl who had terrible, destructive tantrums whenever anyone said no to her or there was even the slightest unexpected change in her routine.
When told we would be breaking for lunch, for instance, Sharon would blow up. She threw things, swore with amazing virtuosity, and shouted at the top of her voice. The predictable pre-lunch tantrum could be controlled by announcing to her sixty and then thirty minutes before lunch that lunch was coming, but if the clinic’s staff forgot to do this, the tantrum was inevitable.
After consulting with researchers around the country, I created a program for Sharon and other clients at the clinic by adapting techniques on learning and behavior that had proved effective in treating adults. The program did not produce overnight miracles, but it did bring about gradual transformations with clear, lasting effects. We could see and measure the changes and, more important, others working with our clients and their families saw the changes. In the case of Sharon, we entirely eliminated her tantrums in about three weeks, step by step, by instituting a system of rewards for small positive changes in her behavior. She reached the point where she would smile mischievously instead of blowing up when we interrupted her. And once we ended the programs, the improved behaviors continued. The programs were temporary; the changes endured.
The treatment did not make any attempt to get at a root cause of behavior — to determine, say, the ultimate cause of Sharon’s rages. We proceeded upon the idea that if you can help the child in the short term to change her behavior, over time you will change the child. The research tells us that building up a better response to replace tantrums, if the new behavior is repeated often enough, will in effect rewire that child’s brain so she doesn’t jump to rage as the default coping strategy for difficult situations.
Sharon’s was an extreme clinical case, but I also wanted to bring the research to bear on the more everyday behavior problems that all parents have to deal with. I was appalled by the unending stream of bad “expert” advice to often desperate parents, who understandably snatched at anything that looked like a tool and rarely had the training to tell what was based on good science and what was not. So I began conducting parenting classes in which we discussed and practiced techniques for changing behavior that parents could use at home. Often the behaviors we addressed were utterly normal ones, like getting a child to eat certain foods, using the toilet, getting ready for school, doing homework, practicing a musical instrument, playing nicely with a sibling, respecting property, and not teasing or hurting a pet. The programs did not always succeed, especially at first, but we constantly evaluated whether change was happening and whether it was happening fast enough. We would adjust the program, measure our progress, and adjust again.
I also began working with schools, and when I moved from Chicago to take a job at Pennsylvania State University, I applied what I had learned to help children in local schools there. There were many challenges — such as a memorable five-year-old girl who would self-induce vomiting whenever she was mad, thoroughly disrupting the class every time she did it. (She actually turned out to be an easy case.) But as the research on behavior made the leap from the laboratory to meaningful application to the lives of real people, and as the body of that research built up, we had more equipment with which to face those challenges. The accumulating studies began to show conclusively that what many of us do as parents — from harsh punishment to endlessly explaining to a child why his behavior is wrong — may not work at all and can even make our children’s behavior problems worse by giving attention to them.
We began teaching parents to “catch their children being good,” instead of unwittingly reinforcing unwanted behaviors by shouting, hitting, explaining, or otherwise attending to them. And the developing body of scientific research began to show conclusively that small, temporary changes in what parents do at home have large, lasting effects in changing children’s behavior at home and at school.
After a decade at Penn State, I moved to the University of Pittsburgh School of Medicine, where, in addition to continuing my research and directing an inpatient service, I continued training parents to change their children’s behavior at home over the long term. My colleagues and I also used federal grants to study the techniques we taught, refining them and making them more effective.
In 1989, I took a position at Yale University and moved my clinic there. It continues as the Yale Parenting Center and Child Conduct Clinic, which I direct. I am also the John M. Musser Professor of Psychology and Child Psychiatry, and for four years I directed a large research and clinical operation at the Child Study Center at the Yale Medical School. At the Yale Parenting Center and Child Conduct Clinic, the most hands-on of these responsibilities, my staff and I see families of children from ages two to sixteen and apply programs to change child behavior in the home and community. Five days a week, every week, we work with parents who need help with their children. Some families bring us children who are referred by the schools, other mental health services, or law enforcement agencies. These are children with severe problems. But at least half of the parents who come to us face less severe difficulties. They just want our help in stopping their children from arguing or teasing so much, or in getting their children to do homework, to take more responsibility, or to not melt down so often. And we know how to help them. We can help families break the cycle that pits defiant child against exhausted parent until one or both gives way.

Getting the Word Out

Discovery has been my job, and I love it. I’ve spent more than three decades refining my method — thirty-plus years of research, grants, scholarly conferences, clinical applications, follow-up studies, all the routines of scientific scholarship. I’ve written or coauthored forty-four books and almost six hundred articles, chapters, and papers. But they were addressed almost exclusively to other professionals in my field. Now it’s time to get the word out as widely as possible to the people who need it most.
The scientific evidence that demonstrates what works best in changing children’s behavior is overwhelming. That wasn’t true when I first began working with children, but it is now. There’s always more vital research to be done, but scientists have to think beyond research, too. How do we get this technology — because that’s what a scientifically supported method that produces reliable results amounts to, a technology — into the hands of people so that they can put it to use? I’m both sobered and motivated by recalling that children are still being crippled and killed by polio half a century after researchers discovered a vaccine for it. Research must go hand in hand with dissemination if it’s going to help people. Misbehavior isn’t as scary as polio, but it’s far more pervasive than polio ever was. (And sometimes it’s pretty scary in its own right. Children’s misbehavior at its worst — conduct disorder, a psychiatric diagnosis for extreme aggressive and antisocial behaviors — is a fantastically expensive, widespread, persistent problem affecting millions of families.) Scientists, including me, have not worked hard enough to ensure that their relevant findings reach beleaguered parents. I wrote this book to distill that scientific expertise in the form of practical help you can use to address behavior problems in your own home.
My job is made more complicated by the sheer volume of advice and therapeutic approaches, much of it misguided, that’s already out there. Parents who come to my clinic often have a mishmash of good and bad and irrelevant parenting lore already floating in their heads. Sometimes they have tried other treatments, including some that superficially resemble methods that actually work, and those treatments have not helped much.
I feel for these parents. They’re looking for workable solutions in a field with insufficient quality control. There are over 550 therapies for children and adolescents. Over 90 percent of them haven’t been tested with any scientific rigor. We simply don’t know if they work or don’t work. But there’s no public outcry of What’s the basis for this? There are no hoops through which a therapy must pass to get on the market, no equivalent of the Food and Drug Administration’s approval process for a new drug. What’s out there might work, but it’s often being used in place of things that are known to work. And a few widely accepted treatments have actually been proven to make behavior worse.
This is the fault of the mental health professions, not of parents, who make what sense they can of the tsunami of seemingly authoritative information constantly coming at them. I’m doing what I can to effect change in my profession from within. As president of the American Psychological Association, which has over 150,000 members, one of my main goals is to encourage the recent turn in clinical work toward greater accountability to scientific standards.
But there’s still a lot of poor advice out there. For instance, one parenting book that’s been in circulation for years says that if a brief time-out doesn’t work, keep upping the ante and make it longer, even going to a so- called monster time-out lasting four hours or more. But the research shows us that more intense punishment does not lead to greater change in behavior. If you are giving more and longer timeouts, it means your strategy is failing. The answer is not to escalate — just the opposite, in fact. If you’re giving more and longer time-outs, this should tell you that you need to do more to positively reinforce good behaviors to replace the unwanted behaviors.
Speaking of time-outs, plenty of experts explain that you give a child a time-out so that he can think about how he got into trouble. This is a complete misunderstanding of time-out, which is not about thinking at all. We know this because animal research proves that time-out works with all sorts of mammals that do not have our cognitive power. In a time-out, we simply withdraw attention for a brief period. Getting a child to think about things is really good for lots of reasons but not as a way to change the child’s behavior. Getting the child to do things differently, on the other hand, will change behavior and the child’s thoughts about it.
One widely read author assures readers that if children can tell us they are angry, they will not kick us or otherwise express their aggression in unacceptable ways. This is an outdated view not supported by evidence. A large body of scientific work tells us that talking about aggression will not reduce aggressive behavior. In fact, talking about aggression sometimes actually increases aggression. In any case, it will certainly not help a child develop nonaggressive solutions to behavior problems. The whole approach is based on misguided psychology derived from an old hydraulic model, which treated the human psyche like a steam engine that must release pressure in order to function smoothly.
But ideas discredited by science can continue to circulate for years, even decades. Some of the advice — about punishment, for instance — is actively harmful. Some of it is basically benign; it may not hurt, except to the extent that it gets in the way of finding and applying more effective solutions. Often, the advice offers fine general tools for living but not direct paths to addressing your concerns about your child’s behavior. In addition to teaching practical skills, this book will equip you to read the parenting advice with an informed critical eye.
Perhaps the greatest danger posed by bad advice is that it discourages parents from pursuing solutions that really do work. Some of the bad advice out there looks superficially like the good, evidence-based advice. All kinds of experts tell you to praise your child, or set up a point chart, or use time-outs instead of harsher punishments. But most of them don’t pay any attention to the good research on how to make these strategies effective. Nor do they systematically connect the strategies to the real reason why they work, which is that they encourage reinforced practice (of which I’ll have more to say in chapters 1 and 2) to occur. Success and failure are determined in the details, and scientists have studied those details with an exactitude that I want you to be able to take advantage of. If you happen across mediocre, impressionistic advice that’s not based on good science, and you try it, and it fails to change your child’s behavior, you may decide that praise or point charts or time-outs don’t work at all. And that would be a tragedy, because when done right, they work very well indeed.
This book is all about doing it right. My main goal is to put the science at your disposal in a practical, efficient way that you can use to improve your child’s behavior.
So, Relax

Before we get started, I think it’s important to establish some perspective. Your child is most likely perfectly normal, which is to say that she is wonderful in many ways but occasionally misbehaves (and the research shows that even the very best-behaved kid listens only about 80 percent of the time).
Kids are people, and people respond to the method of positive reinforcement this book teaches; it works. Our research shows that about 80 percent of even the most serious cases of child conduct disorder respond well to my method, and chances are good that even the very worst moments you confront with your child fall far short of the threshold that all of these serious cases exceed.
And take heart, too, in the knowledge that kids aren’t as fragile as we sometimes make them out to be. Stop worrying that you have somehow inflicted permanent “psychological scars” on your child with less-than-perfect parenting — which is, of course, the only kind there is. Think, instead, of your child’s behavior as a complicated bundle of habits and routines. It’s never too late to change those habits and routines by reinforcing different ones, and when you improve your child’s behavior, you give both your child and yourself a chance to feel better about everyone involved. Change the behaviors; the feelings will follow.
I intend this book as a resource you can use to build a better family life. It explores how both parents and children see the world and themselves, and how both children and parents often come to express that self-conception in troublesome behavior. Such behavior can drift into a self- perpetuating destructive pattern, but the cycle can be interrupted and the troublesome behavior changed, bringing greater harmony to the family. I have distilled the science into practical guidance — sample dialogues between parents and child, for instance, and explanations for why one dialogue has been shown to be effective while another has not. I keep foremost in mind the necessity of answering practical questions like, If I want to start applying these methods today, what exactly do I do? or What exactly should I say? The scientific research has clear and often surprising things to say about even the most common and typically unquestioned practices we all employ, from explaining to nagging to punishing. So keep an open mind. Help is here, and it’s the best help science can offer.

Copyright © 2008 by Alan E. Kazdin and Carlo Rotella. Reprinted by permission of Houghton Mifflin Company.