HELP FOR PARENTS WITH STRONG-WILLED, OUT-OF-CONTROL CHILDREN AND ADOLESCENTS

Education and Counseling for Individuals Affected by Oppositional Defiant Disorder and ADHD

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Oppositional Defiant Husband


What you have described is the behavior of my husband who is 45 yrs old. We have been married 25 years. He does the opposite of what he is asked -- not just by me -- but his associates. Can this information help me deal in a better way with him, especially his temper and denial of any mistakes on his part. No counseling has never worked. Counselors in his mind are idiots.

Thanks,

J.

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Hi J.,

Great question. And the surprising answer is "Yes ...it will help with an oppositional, defiant spouse."

A significant number of mother's who join Online Parent Support state that they feel as though they are raising two children -- their child and their husband. The really cool (and unforeseen) benefit to this program is that the material will work on anyone (e.g., child, spouse, coworker, parent, etc.). Most people don't believe me when I say this, because it all "sounds too good to be true" -- and the old adage is "if it sounds too good to be true, then it probably is."

This is where I put my money where my mouth is. If it doesn't work -- email me and I'll give you a refund.

Do I have magic bullets? No. I just have a lot of experience in dealing with the oppositional, defiant personality.

Dealing with difficult people is really confusing and often troubling (unless you know how they think and what motivates them).

Mark

My Out-of-Control Husband

She has started to hit and kick us...

We started your program with our 3-year-old daughter 2 weeks ago, and when we ignore her she screams at us “...talk to me ...look at me” and she has started to hit and kick us.

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I would suggest you start making a concerted effort to "catch your daughter being good." When she cooperates, is helpful, or shows kindness, make sure you praise her, and give her a smile and a hug. Be specific with your praise, such as "I really like the way you played quietly while I was talking on the telephone," or "Honey, I'm so proud of the way you put your toys away!" This is providing intensity when “things are going right.”

The other side of this equation is that you need to wear your poker face when she whines, complains, or begs. If you repeatedly nag or lecture her, you are giving her exactly what she wants -- your intensity. When kids are acting out in order to get intensity, I always tell parents, "Don't get mad -- get boring." Eventually your daughter will learn that good behavior gets rewarded by praise and approval, while crying and whining get a consequence (usually in the form of a time out). Of course if she does something aggressive or destructive, you'll need to put her in a longer time out or give her a stiffer consequence, but administer the consequence calmly, in a businesslike, matter of fact way. Remember that if you let her get you upset and you start yelling or lecturing, she's gotten exactly what she wanted…your intensity.

Also, make sure you do special activities with her individually, apart from any other children.

==> Here are a ton of tips re: temper tantrums.

Mark

Teens Who Run Away

"16 year old daughter refuses to come home …don’t know where she is staying …skipping school …has a foul mouth lately …has a boyfriend that is doing same as she is."

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When parents begin to implement appropriate discipline for broken house rules, some children may respond by threatening to runaway from home if they do not get their way. If this occurs, defuse the situation, but do NOT threaten or challenge your child.

For example: “Daughter, you know that I cannot control you. And if you really want to run away from home, I cannot stop you. I cannot watch you 24 hours a day, and I can’t lock you up in the house. But no one in the world loves you the way I do. That is why we have established these house rules. Because I love you, I cannot stand by and watch you hurt yourself by __________ (e.g., not going to school, using drugs or alcohol, destroying house property), and running away from home will not solve the problem. You and I know it will only make matters worse.”

When your child runs away…

Teens who run away are not bad. They have made a bad decision. They got themselves caught up in pressures that they felt the need to escape from. Instead of facing their problem and solving it, they chose to run from it. We need to teach our teen how to face their problems, even if the problem is us. When they have the right tools to fix some of the things that may be going on in their lives, the pressure lessens, and there is no more need for them to escape.

Every teen either has tried or knows another teen who has run away.

I haven't met a teen yet who didn't know of someone's experience of running away. This can be a real problem, considering most teens will glamorize the experience.

Parents of teens who run away are not bad parents. You cannot lock them in. As much as you would like to build a wall around them, it is their choice whether or not to walk out the door.

If your teens runs:
  • Call the Police, IMMEDIATELY! Don't wait 24 hours, do it right away.
  • Ask investigators to enter your child into the National Crime Information Center (NCIC) Missing Persons File. There is no waiting period for entry into NCIC for children under age 18.
  • Get the name and badge number of the officer you speak with.
  • Call back often.
  • Call everyone your child knows and enlist their help.
  • Search everywhere, but do not leave your phone unattended.
  • Search your teens room for anything that may give you a clue as to where he went.
  • You may also want to check your phone bill for any calls they may have made recently.
  • Call the National Runaway Switchboard 1-800-621-4000. You can leave a message for your child with them.

When your teen comes home:

Take a break from each other. Do not start talking about it right away. Your emotions are too high at this point to get anywhere in a conversation. Go two separate directions until you both have gotten some rest.

Ask and Listen. Why did they leave? You may want to evaluate a rule or two after speaking with them, but do not do so while having this talk. Tell them you are willing to think about it, and you will let them know.

Tell them how you felt about them going. Let them know that they hurt you by leaving. Let them know that there isn't a problem that can't solve. If they ever feel that running away might solve something, have them talk to you first. You could always offer other choices, so they can make a better decision.

Get some help. If this isn't the first time or you have problems communicating when they get back, it's time to ask for help. This could be a person that your child respects (e.g., an aunt or uncle), or you may want to seek professional help.

Kids & Cussing

My son will not do what he is told and everyday is a fight... help. He also has a foul mouth, swearing, ect... what can I do to get him to stop?

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While there are many ways parents can help children avoid bad language, there is no substitute for avoiding it yourself.

Most children under 3-years-old won't comprehend that certain words are unacceptable. Often, ignoring the offense may be the best defense when dealing with the very young. But after their third birthday, they're more likely to understand that some words are naughty. So take action. Get down on your knees, look your child directly in the eye, and tell him, “That's a word that we don't use in our family.” Make the words - not the child - the culprit to give him a chance to move away from the behavior.

If your child persists in using such language, show him you mean business with disciplinary action outlined in the My Out-of-Control Child eBook. For a four-year-old, that may mean calling a short time-out or taking away a favorite toy. Kids a little older may benefit from time spent in their rooms.

My Out-of-Control Child

Teens & Drugs


Moms & dads can help through early education about drugs, open communication, good role modeling, and early recognition if problems are developing. If there is any suspicion that there is a problem, parents must find the most appropriate intervention for their child.

The decision to get treatment for a child or adolescent is serious. Moms & dads are encouraged to seek consultation from a mental health professional when making decisions about substance abuse treatment for children or adolescents.

Parents and families must be informed consumers and should be involved in their child's recovery. Here are some important things to consider:

· Addicted or drug-abusing individuals with co-existing mental disorders should have both disorders treated in an integrated way. Because addictive disorders and mental disorders often occur in the same individual, individuals should be assessed and treated for the co-occurrence of the other type of disorder.

· Counseling (individual and/or group) and other behavioral therapies are critical components of effective treatment. In therapy, teens look at issues of motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding behaviors, and improve problem-solving skills. Behavioral therapy also facilitates interpersonal relationships and the teen's ability to function in the home and community.

· Effective treatment must attend to the multiple needs of the individual -- not just the drug use. Any associated medical, psychological, social, and cognitive problem must be addressed.

· Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification safely manages the acute physical symptoms of withdrawal associated with stopping drug use. While detoxification alone is rarely sufficient to help addicts achieve long-term abstinence, for some individuals it is a strongly indicated precursor to effective drug addiction treatment.

· No single treatment is appropriate for all teens. It is important to match treatment settings, interventions, and services to each individual's particular problems and needs. This is critical to his or her ultimate success in returning to healthy functioning in the family, school, and society.

· Recovery from addiction can be a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Addicted individuals may require prolonged treatment and multiple episodes of treatment to achieve long-term abstinence and fully restored functioning. Participation in self-help support programs during and following treatment often is helpful in maintaining abstinence. Moms & dads should ask what aftercare treatment services are available for continued or future treatment.

· Remaining in treatment for an adequate period of time is critical for treatment effectiveness and positive change. Each person is different and the amount of time in treatment will depend on his or her problems and needs. Research shows that for most individuals, the beginning of improvement begins at about 3 months into treatment. After this time, there is usually further progress toward recovery. Length of stay in a residential program can range from 8 to 18 months, depending upon the individual's willingness and commitment.

· Treatment does not need to be voluntary to be effective. Strong motivation can facilitate the treatment process. Sanctions or enticements in the family, school setting, or juvenile justice system can increase significantly both treatment entry and retention rates and the success of drug treatment interventions.

I felt my only solution was to ask her to move out...

I am a mother of three children and I run a daycare from my house. I have a sixteen year old daughter who I have always referred to as having intense anger Issues. Over the years I have felt I dealt with my children fairly assertively and mildly indulgent I got 63 on your test. My son is 14 my other daughter is 8. All my children have been expected to do certain things around the house and have been issued consequences for inappropriate behaviours. My kids are good kids the two older ones each have outside jobs. Pay for most of their things they need. They are all good students and respect curfews and most rules in our home. Now the problem my husband and I have is with my sixteen yr old when she is presented with something she does not agree with she becomes extremely intense very quickly at times without much warning. She swears and becomes physical at times. I have tried the poker face response and have a problem with my other children seeing her react this way. They see that she is getting away with it all though she usually receives a consequence afterwards and frankly accepts it well. But my other kids find her intensity scary. She has been diagnosed recently as bipolar. After a recent incidence I felt my only solution was to ask her to move out which she has done. The house is so much less tension as we all seemed to be walking on glass constantly. I would love to have her back. What would you suggest be the best solution on doing this without making her thinks she has control.

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I’m assuming that - since your daughter has recently been diagnosed with bipolar – she is seeing a Child & Adolescent Psychiatrist who is in the process of trying to find the right dosage and combination of medications to treat her symptoms. This process will take a year or two. Once she is stabilized from a medical standpoint, she should be much less impulsive and explosive. So, proper medication is key here.

Recent research suggests that kids and teens with bipolar disorder don't always have the same behavioral patterns that adults with bipolar disorder do. For example, kids who have bipolar disorder may experience particularly rapid mood changes and may have some of the other mood-related symptoms listed below, such as irritability and high levels of anxiety. But they may not show other symptoms that are more commonly seen in adults.

Because brain function is involved, the ways people with bipolar disorder think, act, and feel are all affected. This can make it especially difficult for other people to understand their condition. It can be incredibly frustrating if other people act as though someone with bipolar disorder should just "snap out of it," as if a person who is sick can become well simply by wanting to. Bipolar disorder isn't a sign of weakness or a character flaw; it's a serious medical condition that requires treatment, just like any other condition.

Although there's no cure for bipolar disorder, treatment can help stabilize a person's moods and help the person manage and control symptoms. Like other teens with long-lasting medical conditions (such as asthma, diabetes, or epilepsy), teens with bipolar disorder need to work closely with their doctors and other medical professionals to treat it. This team of medical professionals, together with the teen and family, develop what is called a “treatment plan.” Teens with bipolar disorder will probably receive medication, such as a mood stabilizer, from a psychiatrist or other medical doctor. A psychologist or other type of counselor will provide counseling or psychotherapy for the teen and his or her family. Doctors will watch the symptoms closely and offer additional treatment advice if necessary.

Mark

My Out-of-Control Teen

Help for Drug-Addicted Son

Update on the situation here. My son (who decided to move out with friends) came home today and asked my husband if he could come home. My husband told him that we would have no problem if the kid that we had last year came home but not the kid he has become. Mark I really had a good kid up until last summer of 2008. He was always appreciative and respectful now I have this monster. All of Chris's friends that he had hate the new group he started hanging around with they call this group the kids that are going no where. Chris started smoking drugs with this bunch. Chris told my husband that he doesn't see the problem with him having this habit. The reason he left was because we would not tolerate this behaviour, I am not going to change it is against my values and my morales to have a kid sitting there doing drugs. This kid choose this live style not me. It was like he choose to lose.

What steps do I do here, I don't want him home if it is going to be the same old thing. He ran away in March and came back 6 weeks later and we had him do a contract with the rules. No smoking dope, no skipping school, showing respect to us. He came home lasted 2 days, and he was telling me that he was staying out all night on a Sunday night and I would see him Monday night, I told him that if he left he would have consequences he told me that he was out for the night and that it was none of my business where he was going. I locked up the house the next day left a note on the door he could come back home on Saturday when my husband and I were home and discuss the situation. We were have a roof put on that day, he asked the roofer for the ladder and got in through the bathroom window. He left me a note saying well I told you I was only going out for 1 night and I would be home and I will see you on Saturday. This kid had decided he was running the show here, my house and I was taking orders from him. He came home on Saturday and kept up this behaviour. He got kicked out of his co-op program. This kid had won the leadership award at school and the engineering award, MPV 3 years in a row in soccer. My husband as me to please hold on until after June so that the kid would get his credits for school and I bit my tongue. By July I had a real monster here and that's when he stole the car, stole money from us etc. and I started to use your techniques and it was working until the one day he was getting to aggressive and then I told him that if he hated it here that he should work out a plan to leave and that is when he called his friend's mother and asked her if he could still move in with her and she said I will sent my son over with the truck to get your stuff and off he went. The next week there was a t-shirt that was knotted up and left at my door step I opened the t-shirt and inside the knot was sharp pieces of glass, the same week my car was keyed.

Mark, my father was a violent alcholic and so was my husband's dad. We hating living at home, just hated it. I don't want round 2. What do you do to get someone to realize that you are not going to change but they need to?

My brother thinks that when he talks to me that it just gives him more fuel for the fire, to say yes that is why I don't live there with them. That keeps him going for another few weeks. When I see him or talk to him on the phone I just keep it to 30 seconds and no more. I figure why give him more fuel for the fire. I think this was another one of his acts to con us. I don't want it to go back to what it was before he left.

Any advice. I am open to anything and even criticism if I am taking a hard approach.

A.

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Hi A.,

Your son has a huge risk of alcoholism and drug addiction given his heredity. I think it's safe to say that he will either have to stay clean and sober -- no use whatsoever -- or he will continue his decline.

I have worked with both adult and teen alcoholics/drug addicts since 1994. The one thing that continues to disturb me greatly -- even after 14 years of working with these clients -- is the unfortunate fact that most must hit several hard bottoms over the course of several years (if not decades) before they can finally agree that their chemical abuse/dependence is a real problem that needs to be addressed. Then, and only then, will the client pursue sobriety.

The insidiousness of drug abuse (i.e., what makes it so dangerous) is that the "drug" becomes the most important thing in the person's life ...more important than health ...more important than family and friends ...more important than getting an education ...more important than work ...sanity ...God ...and even life.

Your son does not see his use of chemicals as a problem. Thus he is not going to stop using them any time soon. So you can say, "Once you start rehab, we will consider letting you come home -- but until that time, you must live elsewhere."

Mark Hutten, M.A.

My Out-of-Control Teen: Help for Parents

Teen Cutting & Suicidal Threats


How do I deal with my 14 year old daughter's "unspoken" threats to hurt herself/commit suicide? She has never said anything to me, but I know from reports to her school guidance counselor, her comments/poetry on my space, and having heard from her friend's and their parents. She knows I am aware because of school, parent, and child services involvement. However, when I try to discuss it or when it is brought up by the school, parents, or others she denies it (e.g. that she said or did anything self-destructive, or that she want to die). She has been cutting herself for some time and acting out in many other ways. This self destructive behavior and comments have been going on for nearly a year and continue to escalate with each passing week. My gut instinct based on my knowing her, tells me she is doing this to manipulate people (especially me, but also friends for attention) and situations, but I am also concerned about the underlying emotional factors that are driving this behavior. She refuses to participate in any type of counselling and will not talk to me or any adults about it. I have been told by the school and the authorities that until she does something drastic that there is nothing they can/will do. Can you provide any advice/resources?

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Hi J.,

Re: cutting.

Please review the page on cutting: MyOutOfControlTeen.com/cutting

Re: threats of suicide.

Hormones, problems at school, feelings of inadequacy and emotional development can all play a part when an adolescent threatens suicide. Sometimes they are looking for attention, and sometimes they have every intention of following through with their threats. Regardless of the motivation, however, you should never treat it as an empty threat. When your adolescent threatens suicide, you should act quickly and ask questions later.

The most important thing to do when your adolescent threatens suicide is to keep her in your line of sight. Even if you are absolutely certain that your adolescent is crying out for attention -- and therefore has no intention of following through -- you will never forgive yourself if your suspicions are wrong.

Realize that you cannot handle this yourself, no matter how close you are with your adolescent. Threats of suicide mean that you need an expert's assistance in the matter, regardless of the time or circumstance. You might consider calling a psychiatrist and making an emergency appointment. This might be difficult if you don't live in a large city, but most psychiatrists will arrange emergency visits.

Here’s more info on teen suicide:

1. Anti-social behaviors are not good indicators of suicide risk as once thought. Suicide is equally common among popular kids as it is among unpopular kids.

2. Movies, music, books and web sites do not lead to suicide. Often these media get blamed when a suicide occurs because certain types of music or web sites are found among the deceased possessions. In reality suicidal people tend to seek these things out rather than be led astray by them. A sudden and extreme interest in these things can be a precursor to a suicide attempt.

3. Peer pressure is at its most influential during the teen years and things like bullying and exclusion by peers can cause teens to see death as the only way out or as a way of gaining attention from peer groups that ignore them.

==> My Out-of-Control Teen: Help for Parents

4. Statistically speaking suicide is the second leading cause of death among teenagers, a close second to automobile accidents. Some experts feel that many car accidents are actually suicides and that the rates are so close that suicide may actually be the leading cause of death in teens.

5. Suicide clusters, multiple suicides within a closed community or peer group, often occur and are not fully understood by experts. When a suicide occurs at your school or in your community it is wise to seek help for friends who have threatened suicide or attempted suicide in the past as cluster victims are not always known to one another.

6. Suicide pacts are a youth phenomenon and are almost non-existent in other age groups. Experts feel that peer pressure may be in part to blame since it is at its most influential during the teen years. If a friend ever pressures you to commit suicide or to aid them in their attempt seek help immediately.

7. Suicide threats should always be taken seriously. Even threats veiled as jokes can mask a sincere desire to harm oneself. Always seek help for a friend who threatens suicide or repeatedly jokes about killing themselves.

8. The reasons why suicide is so prevalent among teens is still a mystery but experts do have some ideas as to why teenagers are at a greater risk. The three most common factors considered to account for the high suicide rate among teens are; an immortality complex in which teens don't appear to grasp the finality of death, reactive-immaturity in which the psyche is thought to not yet have developed enough maturity to control emotional reactivity to negative or hurtful occurrences, and broad hormonal fluctuations that can lead to irrational thought processes and bouts of depression.

9. There is no such thing as a failed suicide attempt; these are really desperate cries for help. Often people think that somebody who tries to commit suicide but survives is only seeking attention but in reality suicide survivors are 12x more likely to eventually die from suicide than teens who threaten suicide but do not ever act on the threat. People who have attempted suicide and survived are at a high risk to eventually take their own life.

10. While clinical depression is common among suicidal people of all ages it is less common in teens. Suicidal teens are more likely to be reacting to social and environmental pressures when they become suicidal than they are to be suffering from a true mental illness. For this reason suicide is often harder for experts to predict in teens.

Hope this helps,

Mark Hutten, M.A.


 

==> My Out-of-Control Teen: Help for Parents

Son used his step mom's credit card to purchase an online gaming membership...

Mark, we just found out that my 16 y.o. son used his step mom's credit card to purchase an online gaming membership. His bio mom caught him stealing checks from her husband a year ago. The credit card theft is a felony here in Texas. How should I handle this with him?

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When a teen has been caught stealing, a parent's reaction should depend on whether it's the first time or there's a pattern of stealing. When there’s pattern of stealing, it's recommended that parents follow through with stricter consequences. For example, when a teen is caught stealing, the parent can take the teen back to the store and meet with the security department to explain and apologize for what happened.

The embarrassment of facing up to what he or she did by having to return a stolen item makes for an everlasting lesson on why stealing is wrong.

Further punishment, particularly physical punishment, is unnecessary and could make the teen angry and more likely to engage in even worse behavior.

If it's a first-time offense, some stores and businesses may accept an apology and not necessarily press charges. However, some stores press charges the first time around. And there's often little sympathy for repeat offenders.

Kids of all ages should know that stealing is a crime and can lead to consequences far worse than being grounded, including juvenile detention centers and even prison.

If a teen steals money from a parent, the teen should be offered options for paying back the money, like doing extra chores around the house. It's important, however, that a parent does not “bait” the teen by leaving out money in the hopes of catching the teen in the act. That could damage the sense of trust between a parent and teen.

Mark Hutten, M.A.

Advice regarding helping our son adopt better sleep, nutrition, and academic habits...

Mark,

You may not be able to offer any specific advice on our issue, but I have to bring this up – we are at our rope’s end.

Our son, R___, is having a tough time focusing on his academics. He is 16, a junior in public high school, Port Orange Florida. He is in the IB (International Baccalaureate) program. Over the past year and a half his grades have steadily decreased: his current reporting period (4 week) GPA is 1.7 a solid “D.” He is an avid an accomplished soccer player, but at the rate he’s going he will be on academic suspension. His outlook for college is at best, not good – despite the fact that he definitely seems to want to go to college. (We are beginning to wonder if the IB program is just too hard for him, although says he really wants to do it.)

We’ve just subscribed to OPS. We’ve read your online material, in particular advice to one parent regarding a similar situation in which you made the following points:

(1) Let him do his own work – that’s his job, his teachers are his bosses.
(2) His sleep habits are poor – he stays up late – often past midnight, as late as 1:00. Wakeup is a chore taking 3-5 attempts.

Adding to this is the following:

(3) He has very poor nutrition habits. My wife has tried may times to prepare healthy meals – he will have no part of them, but drinks energy drinks, eats bagels and cream cheese, pizza, an occasional ham and cheese sandwich, never vegetables.

(4) He is hearing impaired – his acuity in the higher frequencies is significantly impaired. He has aids, but refuses to wear them (we suspect it may be a question of vanity, and refusal to acknowledge the impairment).

We have tried urging him to do his homework. That has not worked. Recently we have tried incentivizing him with money for good performance – his grades have just gotten worse (down to the current GPA).

My wife tends to have an authoritarian parenting style; I tend to have an indulgent style – so there is polarization in our approach – which may be making things worse.

Based on what I’ve just read (your advice to a parent in a similar situation minus the hearing and nutrition problems) we will likely follow your advice, and

(1) Remove the TV from his room
(2) Do the one reveille call in the morning – perhaps even with a real bugle.

We are also considering restricting his social life (going out on weekends, but no weekend sleepovers), but we would like your opinion.

Bottom line: If you have ANY specific advice regarding helping our son adopt better sleep, nutrition, and academic habits, we would SINCERELY appreciate it.

Many thanks in advance for any specific help,

Desperately yours,

H.

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Hi H.,

Re: sleep.

Many parents allow their children to stay up late on weekends to watch TV and play video games...

BIG mistake!

...then to make matters worse, they allow their children to sleep in on Sat. and Sun. mornings...

Another BIG mistake!

Why? Because it takes until the middle of the school week (i.e., approx. Wednesday) for the child to make up for sleep deficits (i.e., they get only about 4 -5 hours of sleep Sunday night since they have to get up on Monday morning for school...

...then the weekend comes, and the cycle starts all over.

Don't make these mistakes.

Also, he should only get one wake-up call. You are clearly taking the responsibility AWAY from him by nagging him to get up. As long as you nag -- he'll sleep.

Re: nutrition.

You have bigger fish to fry than this one. This should go in the "pick your battles carefully" file.

Re: academic habits.

I think you know where I stand on this issue since you've already read the recommendations.

Final point: I'm a bit concerned that you are rushing through the program. The academic biz is in Session #4 / Week #4 -- you just signed-up yesterday!

Rushing things WILL be the kiss of failure - I promise.

Mark

My Out-of-Control Son

Oppositional Defiant Disorder [ODD] in Adults


Dear Mark

I have just signed on for your e-course. My son has recently been diagnosed with ODD and thank God I have an answer to the challenge (understatment of the year!) that it has been trying to understand what was going on with him. He is only eight years old but I have had nightmares about what would become of his future and of my sanity!

The thing is the more I read about the disorder for my son, the more pieces fall in place for the troubles I have had and am still having with my husband and marriage. He is sooooo much like our boy in nearly every way. At the same time, all that I read on the subject pertains to children and teenagers. Although he would probably have a fit if he knew I was even thinking it about him, i desperately need to know if adults can suffer from the disorder as well?

Regards,

J.

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Hi J.,

Re: ...i desperately need to know if adults can suffer from the disorder as well?

Absolutely. And the good thing is: You can use many of the parenting strategies that you will be using with your son with your husband.

It is very common for a mother to feel as though she is raising two children -- her child and her husband. This topic leads to a discussion about co-dependency on the mother's part (which I don't have time to get into right now).

Maladaptive behaviors are serious enough when the adult cannot maintain employment or constantly moves from job to job, has trouble with "significant other" relationships (possible multiple divorces), or has a strong dependence on alcohol, substances or negative habits.

Although we're talking about adults here, young people can engage in similar behaviors when they have trouble in school, have difficulty making and keeping friends, and rely on fancy toys or video games to synthetically alter their mood.

Mark

Teachers Triggering Temper Tantrums in Students


Mark-

I’m a middle school teacher. Actually I purchased your ebook to help me understand – and cope with – some of my unruly students. It has been an immense help. One question: How do you deal with a student who – out of the clear blue – slips into a temper tantrum?

Thanks,

M.

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Hi M.,

When a youngster reportedly has 'temper tantrums' in school, one of the first questions I always ask is whether this is also happening in the home. If it is, then is it only happening when homework or school-related matters arise, or is it happening in other situations as well? Thinking about under what conditions the kid loses control can help us determine where to start looking, what accommodations might be needed, and what other assessments and/or interventions might be needed.

Suppose that the kid is not having 'temper tantrums' at home, but is having them in school. While it is still possible that it is the kid's disability that is the primary contributor the problem (e.g., a kid with depression may "explode" in school when asked to concentrate or produce for long periods of time), we also need to look closely at how the school is handling the kid. Have they made enough accommodations? If there's a plan in place, have they followed it?


==> My Out-of-Control Teen: Help for Parents

In my experience, it seems that in some cases, school personnel have been responsible for triggering a temper tantrum or pushing the kid past his or her limits. Consider the following (and unfortunately true) example where a teacher knows a kid has Oppositional Defiant Disorder and that one of the kid's symptoms is that he "has to" finish something he is reading. On a particular day, the teacher instructs the class to put their books down as it is time to do another activity. The kid with ODD doesn't comply, and the teacher cues him again to put the book down and start the next task. The kid with ODD continues reading and tries to leave the room to go finish the book. The teacher refuses, blocks the doorway, and tries to take the book away. The kid with ODD "explodes," and swings at the teacher.

In the preceding example, one could argue that we should hold the youngster responsible for his behavior and that he has to learn that no matter what, he cannot take a swing at people. And on some level, I'd agree with that. The problem with the school disciplining the kid for it, however, is that such consequences may not reduce the likelihood of it happening again if the youngster's compulsion is that severe, and it fails to discipline the teacher who failed to respect the youngster's limits. If teachers "get in the face" of youngsters who are known to have behavior problems, then aren't they as responsible for what happens as the youngster?

In my opinion, when it comes to school, the teachers, as the adults, have the responsibility to manage themselves so that they don't engage in an escalating pattern with the youngster. And one of the most effective ways to help school personnel recognize the limits and what to do in particular situations is staff development. Teachers are often concerned that they will lose their authority with the class if they don't "discipline" an out-of-control child. The reality is that their "discipline" is often punitive and escalates a bad situation into a full-blown "temper tantrum."

Even when teachers are not provoking or causing the youngster's problems, they may be the youngster's last hope of restoring themselves to a calmer state. Learning how to stay calm, recognize the signs of impending explosions, and helping the youngster make a graceful exit so that they can calm themselves are important skills. Realizing that you are not "rewarding the youngster for misbehavior" if you allow them to switch to an activity that is inherently interesting to them and that helps them focus and calm themselves is also important. Maintaining your empathy for an explosive kid can make all the difference.


 

==> My Out-of-Control Teen: Help for Parents

Son getting excitement from the meltdowns...

Thanks Mark. I'm really excited about this program, and just watching the videos I did yesterday and doing the quiz has made me realize it's going to help immensely. My teens aren't out of control yet, but one of them certainly is an intense child and displays many of the traits you speak about. The explanation of that type of child getting excitement from the meltdowns is something I've thought for a long time but didn't know how to put in perspective. I am looking forward to this program and have already learned and implemented some of your ideas.

D.

Online Parent Support

Risperdol and the treatment of ODD...

Hello Mark, What do you know about Risperdol and the treatment of ODD?

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In choosing drugs for ODD, look for drugs that have been proven safe in children, have no long term side effects, and have been found in research studies to be effective in extremely aggressive children and adolescents or in Comorbid conditions which children with CD often have. Each drug has certain problems that need to be watched for. The current medical literature suggests three basic principles when using psychiatric drugs in children:

1. Start low
2. Go slow, and
3. Monitor carefully

Start low means that you do not start any of these drugs at the usual dose, or the maximum dose. When you have pneumonia, it can be a real emergency. You want to give people plenty of medicine right away, and if there are problems, then you reduce it. Unfortunately, many people use this same strategy in the medical treatment of ODD. The problem is that big doses can cause big problems, and when the problems affect your mind and personality, this usually means trouble for the person taking the medicines. So start with the lowest dose possible. For example, if you use a drug called Clonidine, for a boy about 60 lb., know that the dose that will probably work for most boys that size is two pills a day. If you gave him that to start out with, you might win and it would work. But if he happens to be sensitive to that drug, he could have big problems. Although they would be reversible problems, it would probably make most children and adolescents and or parents never want to take the drug again. So what do you do? Start with a half of a pill a day, about 25% of the usual dose. That way if the child is sensitive to the drug, it causes little problems. Many children respond to drugs at very low doses, far below the usual recommendations.

Re: go slow. ODD is not an acute illness. Less than 10% of the people I see with this need to be treated very quickly. Most people whom I see with this problem have had it for years. As a result, there is no need to increase the dose quickly. By going slowly, it is a lot easier to manage any side effects because things don't happen suddenly. Also, it is easier to find the lowest effective dose.

Re: monitor. For each of the medical treatments for ODD, there are specific side effects, which need to be checked regularly. Some common ones are monitoring weight so that people are gaining weight, watch for tics, watch for depression, checking blood pressure and pulse, checking blood tests and EKGs, and making sure parents know what the side effects are of the different medications. In this way, if there is a problem, you can pick it up early and avoid the horror stories, some of which are true, about the medical treatment of this problem.

The following are drugs which have been tested in adults and children who are violent and aggressive for a variety of reasons – from ADHD to brain damage, to Conduct Disorder, and of course ODD:

Atypical Antipsychotics—These drugs were first used for schizophrenia, and that is how they got this name. They are now commonly used for many conditions where people are not psychotic. As you can see, these are not benign medications. All of them can have serious side effects. As a result, they are not used for small problems.

Risperidone (Risperidal)—This drug was initially developed to be a safer drug for adult schizophrenia. It was then found to be effective in children with schizophrenia and other psychoses. Then it was found to be helpful in some children with Tic disorders. Based on those findings it has been used in Conduct Disorder and aggression. These studies are probably the most exciting news for the medical treatment of CD in 20 years. Risperidone is called Risperidal and comes in a variety of sizes; .25mg, .5 mg, 1mg, 2mg and liquid. It also helps Tourettes and psychosis. Usually this is given twice a day. This drug usually shows an effect within hours of a dose. There are more studies done on this drug than all the other atypical antipsychotics combined.

Olanzapine (Zyprexa)—This drug was recently approved for mania in adults. It has been studied less in children. However the early reports are positive. The usual dose is about 5-15 mg a day. It comes in 2.5 mg, 5mg and 10 mg. It is also called Zyprexa. It is more expensive than Risperidone and in adults is associated with more weight gain. This can be given once a day.

Quetiapine (Seroquel)—This drug is a little different than the above drugs as it seems to cause very little problems with things like tremor and stiffness. In adolescents it can lower the blood pressure so the dose has to be increased slower. The dosage range is 200-800 mg a day. There are only a few articles on its use in children and adolescents, but these have been quite positive for mood disorders. I do not know of any study on using in CD. It comes in a 25mg and 100 mg size and has to be given twice a day. It is called Seroquel.

Mark Hutten, M.A.

He wants to take 2 days off of school next week to go hunting...

Hi,

I have been applying your techniques for about 5 weeks now and can say that things have definitely gotten better. We have had a couple moments but otherwise have been much happier and getting along great. I have read the emails regarding the poor grades and how I should let my son (14 yrs) take ownership of his grades and treat school like it's his job. I completely understand that and agree that the concept should work. I've been fighting with him for 4 years and gotten nowhere so it's obvious that I can't control the outcome. He thinks he can never do good enough for me. So I have told him that it is his job now and his future and he is in charge of it. He only has to live up to his own expectations.

Here's my question...he wants to take 2 days off of school next week to go hunting, a once a year opportunity. He says he will take care of making up all of the work that he will miss for those days ahead of time. I don't know if I should have a say in this or not if I am giving him the control. He has assignments that he missed and can't make up so I don't feel he should be taking time off. But since I've just given him the control and ownership should I let him prove to himself that he can take care of it and that I trust him to do it? The past assignments were missed while I was trying to be in control. Are these two separate things? Where do I draw the line and do I ever step in? Or do I completely give him the control? I understand missing school is not something that is acceptable but there are times when I can see exceptions. If he were pulling all A's and B's I wouldn't have a problem with it at all. I am just really confused about turning the ownership over at this point and where that leaves me with this decision.

Please help.

C.

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Hi C.,

This is a great question. Fortunately, the answer is an easy one.

"Schooling" takes place on multiple stages -- not just in the classroom. So this hunting trip will be much more of a learning experience for him than sitting in class. This is a wonderful opportunity to take education to a new, exciting level.

Let him go ...forget about the make-up work (that's his job).

Mark

P.S. As a former teacher, I would want him to go on the trip. And I would have him take pictures so he could give a report to the class regarding the trip.

Online Parent Support

Teens & Salvia: The New Drug of Choice


Hi Mark,

Things have been going better over this way with our 15 year old daughter. We've taken your advice and are trying to refine the techniques. Thanks for your previous help.

I do have a question and wondered if you had any insight. My daughter left a note from her boyfriend that she received at school laying by the computer last night. I found it this morning. He was talking about them experimenting with something called salvia.

I've been doing some research on this and it seems it is legal here in Indiana. I've discovered it is a hallucenogenic herb. Scary stuff.

From this note and the exchange of IMs I read this morning before I left for work, she seems to be struggling with this and does not want to do it. He stated he was going to try it and it was okay if she didn't.

A couple of days ago she asked about spending some time with this boyfriend and we did the "yes, but..." She fulfilled the but and now has our permission to spend time with him tonight. She is going to a friend's home after school today so I won't see her until she gets in tonight at her curfew.

Know anything about this salvia and its use with teenagers these days? What do you advise I do here?

Thanks,

G.

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Salvia divinorum, a green, leafy plant native to the Mazateca region of Mexico, provides its users with a short but intense hallucinogenic experience. A member of the mint family, it is not among the ornamental garden plants sold under the name Salvia at local nurseries.

The high is unlike that from LSD or psychedelic mushrooms, users say, nor is it anything like the experience of smoking marijuana. Salvia is not currently controlled by federal law, but dozens of states have moved to outlaw cultivation and sale of the plant, which is currently freely available for purchase on the Internet.

As an herb with psychedelic properties, Salvia divinorum is of pharmaceutical interest because of its uncommon affinity for opium/endorphin receptors—specifically the kappa opioid receptor. Most drugs with classical “psychotomimetic” properties, like LSD and MDMA, are highly selective for the 5-HT(2A) serotonin receptor.

Salvia is not one of these. Like ibogaine, another hallucinogenic shrub with a weak affinity for kappa opiate receptors, Salvia’s active ingredient--Salvinorin A--causes psychoactive effects not usually associated with stimulation of the brain’s internal opioid system. Previous research had identified a few such compounds, such as enadoline, which produced similar hallucinogenic effects.

The pharmaceutical industry has already taken a look at the kappa-opioid agonists in the ongoing search for new painkillers, and has so far discovered the usual psychedelic trap of too many unpredictable side effects for a commercial medication.

Classified as an “atypical” psychedelic, the salvia high is intense, dream-like, and short-lived, tapering off after about 30 minutes. An ounce of salvia in leaf form sells for as little as $40, but more concentrated liquid extracts sell for as much as $60 per gram.

Salvia’s addictive potential is low to nonexistent. No hallucinogen such as LSD or peyote has ever been found to be addictive in the classical sense.

Nonetheless, fearing that the inexpensive plant might become “the next marijuana,” as an Associated Press report put it last month, 24 states have passed, or are considering, legislation to restrict access to salvia. Elsewhere, sale of the drug has been restricted in Spain, Italy, Sweden, Belgium, Australia, and other countries. In the AP article, a Florida state legislator alleged—with unintended irony: “As soon as we make one drug illegal, kids start looking around for other drugs they can buy legally. This is just the next one.”

There are many reasons why Salvia divinorum is not likely to be “the next one.” According to drug expert Rick Doblin of the Multidisciplinary Association for Psychedelic Studies (MAPS), salvia “tastes terrible” and is “not going to be extremely popular.” The popular drug information site EROWID describes salvia as “more scary than fun” for many users, concluding that, whether smoked or swallowed, the plant is “aversive for many who try it.” Like ibogaine, salvia is no party drug. It can result in confusion, dizziness, depersonalization, and all the other hallmarks of a “bad trip.”

A related question is the extent to which kappa opioid receptor boosters might reduce the craving for addictive drugs. Ibogaine has been touted for having precisely this effect on heroin addicts and others. However, an early study of kappa opioid receptor-active compounds did not find any reduction in self-administration of cocaine.

The National Institute of Drug Abuse (NIDA) is studying salvia. The Drug Enforcement Administration (DEA), citing salvia as a “drug of concern,” is evaluating it.

My Out-of-Control Teen

Physically Abusive Daughter


Hello Mark,

What do I do when my daughter hurts me? When she does not like what I say she punches, has gone after me with scissors, pens and whipped me with coat hangers and throws things at me.

How do you handle this? Help

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Hi T.,

Although aggressive behavior such as hitting, screaming, and even biting is not seen as all that unusual from a youngster of one or two years of age, the same conduct in kids merely a year or two older is often seen as cruel and problematic. Controlling feelings and emotions is, however, a learned skill and can be very difficult to master (even for some adults!).

Staying calm and collected not only requires a fair amount of self-control and discipline, but also a basic understanding of appropriate social behavior and morality. Most kids under the age of five or six have a minimal comprehension of what exactly is socially acceptable, at least beyond pleasing Mom or Dad. Even then, some kids may find it difficult to control their temper and yet there is often a difference between a youngster who is deceptively ‘acting out' (which is rare, and often due to an unstable or unsafe home environment) and one who is simply trying to be assertive.

The majority of kids do not recognize their own strength or even the full consequences of their actions; and in a world where they are often being told what to do, where to go and how to behave, it does not seem all that unreasonable that they may sometimes need to speak out and be heard. Those school-aged kids who continue to act obnoxiously or aggressively may have never experienced the opportunity of being truly listened to in a loving environment. Listening, on the part of moms & dads involves not only hearing your kid's jokes and laughter, but perhaps more importantly hearing about those hurt, angered and unhappy emotions as well. So often, kids are not allowed to speak negatively, complain, or offer a difference of opinion and thus their feelings continue to build up until one day they may unintentionally vent or lash out. It is important to remember that hearing your kids out does not mean submitting to their every whim or desire.

Aside from releasing pent up emotions, kids who behave aggressively may also do so because they have been rewarded for the conduct. Moms & dads may have hoped to raise a youngster who is strong and able to stand up for him- or herself in rough situations. More commonly, moms & dads may have inadvertently reinforced the aggressive behavior through attention. Indeed, even nagging or punishing kids for acting aggressively can make it more likely that they will act that way in the future. Imagine, if you will, a youngster quietly piecing a puzzle together or even playing a video game. He/She has almost completed the puzzle/game but cannot get the final pieces/play to come together. Throughout this quiet half an hour the parent has been around but has said absolutely nothing. Nothing, that is until the youngster becomes obviously frustrated and throws the puzzle/game across the room and begins screaming or swearing loudly. At this point the parent intervenes by reprimanding the youngster and sending him/her to their room. It would appear that the parent has done everything appropriate in this situation, except for the fact that the only attention this youngster received during the time period was negative. If this is commonly the case, the youngster may begin to feel that any attention is better than no attention and as a result may continue to act out disruptively in daily activities. When dealing with aggressive kids, it is worth the effort to praise even the smallest attempt at proper behavior, while paying very little if any attention to negative conduct. Praise can be a very strong motivator.

It is also important to remember that behavior can be very difficult to change and that it takes a lot of patience. Turning an aggressive youngster into a non-aggressive youngster will not happen overnight, and the odd outburst may even occur once the behavior has seemed to restore itself.

In dealing with aggressive kids, regardless of their age, here are a few suggestions to consider:

· STAY AS CALM AS POSSIBLE—No matter how agitated, upset, or aggressive your youngster becomes, it is much easier for them to relax if you are also at least somewhat calm. Despite your own concern, do not try to rationalize with them until they have calmed down. Try sending them into their room, or if you have to take yourself out of the situation and stay in your own bedroom or bathroom. If they become overly violent or aggressive you may need to take drastic measures. Call the police if necessary, but stay calm. The more aggravated your youngster sees you become the more power he or she has gained over you and the more likely he will be to repeat the behavior.

· REWARD GOOD BEHAVIOR—Although some moms & dads may see rewards as a form of bardering or bribery, it does not have to be that extreme. It also can work really well for older kids who in no other way seem to want to stop their aggressive tendencies. Offering your kids well-deserved praise, a play at the park, or an opportunity to play at a friends house for proper conduct can work wonders. The key is to inform them of what is first expected, to reward them soon if not immediately after they obey, and to always withhold any and all rewards if they do not obey. So for example, if your youngster has made it through a shopping trip without any yelling, crying, or hitting, you may want to stop at the park with them on the way home as a thank you. Offering them the park the next day is already too late as it gives them the chance to act inappropriately in the mean time. For rewards to work effectively they also cannot be given to your kids if they have not done what was expected of them. Toys can be used as well, but they are not advised and it is always best to start off small otherwise your youngster may be asking for things each and every time he or she behaves. The best kind of reward is praise. Kids need to know their moms & dads are proud of them.

· KNOW YOUR YOUNGSTER'S TEMPERAMENT—Everyone is born with a unique temperament or personality. Some people tend to be more reserved or timid, while others are always outgoing and spontaneous. Similarly, some kids tend to be more outwardly assertive and aggressive and others less so. Knowing your youngster's personality allows you the advantage of foresight. If your youngster does not do well with unexpected occurrences, try to keep his or her day routine. Use the insight.

· KNOW THE TRIGGERS—Whether it be rush hour traffic or spilled juice, everyone has those things that really aggravate or irritate them, and kids are no different. While they may not be as great at expressing what upsets them, things like a late meal, a missed soccer game, or even a forgotten bedtime story can really agitate kids and make them angry. Knowing that your youngster becomes easily upset under certain circumstances allows moms & dads or care-givers to avoid or work around these situations -- or at the very least, be prepared for them. It might be helpful to keep a journal to figure out what times of day or what occurs prior to each time your youngster becomes upset. If mornings are difficult for your youngster, perhaps allow them some extra time to wake up or do not ask a whole lot form them at this point in time. If not being allowed to purchase a toy from the store usually sends them into a tantrum, warn them ahead of time or if possible just leave them at home.

· EXPRESS YOURSELF—Be sure to give your kids the chance to see all of your own personal emotions. Modeling appropriate behavior should not be equated with hiding your feelings or fears from them. It is important for your kids to see that you are also human, and that it is possible to have the esteem and self-control to act rationally even when feelings may not be.

· BE A ROLE MODEL—This is perhaps the hardest part of being a parent or caregiver. Role-modeling your own behavior can be difficult even in the easiest of times, but particularly if arguing or fighting is a common occurrence in your household. Nevertheless, you should not expect from others that which you cannot put forth yourself. Even the odd volatile joke or sarcastic remark can be misinterpreted by kids, so watch not only your actions but also your words. Being a role model not only involves controlling your own emotions, but also teaching your kids how to express theirs — both good and bad— appropriately. Modeling support and compassion for others is an important beginning place, so you may want to volunteer some of your time. Simply bring your neighbor some fresh cut flowers or a fruit basket to say "hello". Visit sick kids in the hospital. Work at the food bank with your kids over the Christmas holidays. Be the kind of person that you would like your youngster to grow up to be.

· AVOID PHYSICAL PUNISHMENT—It can be very easy to become angered and even outraged at a misbehaving youngster, especially an older one who probably should know better. Just be cautious of how you express your feelings, because the kids are always watching and learning from you. Yelling or hitting an already angered and destructive youngster seems only to up the anti. If you expect your kids to act responsibly and calmly, be sure to do so yourself. And remember, even a ten or twelve year-old girl or boy is still a youngster. Kids do not form intent the same way adults do and often have little desire to hurt or upset you. They merely need to express themselves and have not yet learned to do so in a socially acceptable manner.

· UNCONCERNED KIDS— As a final note, if your youngster tends to be destructive often and does not seem to benefit from appropriate parental intervention, or actually seems to enjoy harming others, please seek professional advice.

Mark Hutten, M.A.

My Out-of-Control Teen: Help for Parents

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