Calming the Explosive Child
Since long before psychologists got involved, the conventional wisdom of parenting held that children should be seen and not heard, and punishments awaited kids who broke the rules. Of course, not all parents took a hard line, and in the 1960s, in a landmark of child psychology, psychologist Diane Baumrind described three types of parents. The authoritarian parent values absolute obedience above all else. A child must stay in his or her place, order is paramount and there is no give and take—the parent is always right. A permissive parent is the opposite—the parent is accepting, doesn’t punish, affirms all the child’s desires, consults with the child about family rules and never exercises authority. (Baumrind later divided this category into two: permissive-indifferent and permissive-indulgent.) Finally, there is the authoritative parent, one who directs the child in a rational manner, encourages give and take, and values both autonomy and discipline but still displays firm control when parent and child differ.
It’s that third style most psychologists have long recommended, and it’s what parent training is supposed to cultivate, particularly in treating so-called defiant children—those who have oppositional defiant disorder (ODD), conduct disorder or other issues, including attention deficit/hyperactivity disorder, which Greene lumps into the “explosive child” category. The treatment concept is largely based on Defiant Children: A Clinician’s Manual for Parent Training, by Russell Barkley, first published in 1987. Parents are advised to learn to issue commands effectively, set up systems of rewards with points or tokens and use time-outs when a child seriously violates rules. For the parents of troubled children, social workers at group homes, teachers and juvenile detention workers, this method has been the recommended approach, and sometimes it’s effective. Studies have shown that parents seem to feel better about their child after attending a parent-training program, and they rely less on critical or violent discipline. Even indicators of child behavior improve with parent training, depending on which of the many versions is used.
Still, many parents don’t fully comply with parent training, and studies showing the effectiveness of the method obviously include only those families that stuck with the program. Moreover, although most parent-training studies record statistically significant improvements, there are few clinically significant changes—concrete alterations the family can recognize and enjoy apart from what may register on a clinician’s lab tests. Finally, there’s not much information on what happens to the child and parent after treatment is complete, because studies tend to end after an initial 12 weeks of therapy.
In devising his alternative to parent training, Greene was influenced by developmental psychology and neuropsychology, both of which emphasize the development of cognitive skills crucial for handling life’s social, emotional and behavioral challenges. Kids who explode really do have a sort of learning disability, Greene believes: He suggests that just as no one would expect a kid with dyslexia to start reading if he were given a sticker every time he got an answer right and a time-out when he got it wrong, it’s unrealistic to think a child lacking the skills to deal with his frustration is going to behave perfectly given those same rewards and consequences.
With CPS, parents start by empathizing with the child as they gather information about why he isn’t meeting expectations. And even though a more authoritarian approach might seem easier and faster, says Greene, over the long haul it sucks up more energy and time than figuring out the real issues and dealing with them beforehand. “When adults solve problems collaboratively with kids, both learn a lot of skills the kids—and sometimes the adults—had been lacking,” Greene says. “Many children don’t have the language to articulate their concerns and can’t take another person’s concerns into account. That’s something CPS teaches them to do.”
In a 2004 paper in the Journal of Consulting and Clinical Psychology, Greene and Ablon described the results of a study involving 47 children who met the criteria for oppositional defiant disorder—they were all extremely disobedient and hostile toward authority figures—and who also had signs of juvenile bipolar disorder or major depression. The researchers randomly assigned half to a treatment consisting of traditional parent training—setting limits, rewards and consequences—and half to CPS for 10 weeks. Both sets of children improved, showing fewer signs of ODD. But those on CPS also had improved relationships with their parents post-treatment (relationships in the other families deteriorated) and were significantly better behaved. And these benefits seemed to persist well beyond the end of the initial study period. “At four months post-treatment, the kids who had received CPS continued to improve,” says Greene. “The ones who’d had parent training started to lose their gains.”