Teens and OCD

At least 1 in 200 kids and adolescents in the United States have Obsessive Compulsive Disorder (OCD). Understanding the special impact that the disorder has on their lives is important in helping them get the right treatment. Some common issues with OCD in kids and adolescents are as follows:

1. Anger Management Problems: This is because the moms and dads have become unwilling (or are unable!) to comply with the youngster's OCD-related demands. Even when moms and dads set reasonable limits, children and adolescents with OCD can become anxious and angry.

2. Disrupted Routines: OCD can make daily life very difficult and stressful for children and adolescents. In the morning, they feel they must do their rituals right, or the rest of the day will not go well. In the evenings, they must finish all of their compulsive rituals before they go to bed. Some children and adolescents even stay up late because of their OCD, and are often exhausted the following day.

3. Other Mental Health Problems: Children and adolescents with OCD are more likely to have additional mental health problems than those who do not have the disorder. Sometimes these other disorders can be treated with the same medicine prescribed to treat the OCD. Depression, anxiety disorders and trichotillomania (compulsive hair or skin picking) may improve when a youngster takes anti-OCD medicine. On the other hand, Attention-Deficit Hyperactivity Disorder (ADHD), tic disorders, and disruptive behavior disorders usually require additional treatments, including medicines that are not specific to OCD.

4. Physical Complaints: Stress, poor nutrition, and/or the loss of sleep can make kids physically ill.

5. Problems at School: OCD can affect homework, attention in class, and school attendance. If this happens, you need to be an advocate for your youngster. It is your right under the Disabilities Education Act (IDEA) to ask for changes from the school that will help your youngster succeed.

6. Problems with Self-Esteem: Children and adolescents worry that they are "crazy" because their thinking is different than their friends and family. Their self-esteem can be negatively affected because the OCD has led to embarrassment or has made them feel "bizarre" or "out of control."

7. Social Relationships: The stress of hiding their rituals from peers, times spent with obsessions and compulsions, and how their friends react to their OCD-related behaviors can all affect friendships.

Experts agree that cognitive behavior therapy (CBT) is the treatment of choice for children with OCD. Working with a trained CBT therapist, kids and adolescents with OCD learn that they are in charge, not OCD.

Using a CBT strategy called exposure and response prevention (ERP), youth can learn to do the opposite of what OCD tells them to do, by facing their fears gradually in small steps (exposure), without giving in to the rituals (response prevention). ERP helps them find out that their fears don't come true and that they can get used to the scary feeling, just like they might get used to cold water in the swimming pool.

Here is an example:

Imagine a teen that repeatedly touches things in his room to prevent bad luck. Using ERP, the teen would learn to leave his room without touching anything. He might feel very scared at first, but after some time, the anxiety goes away as he gets used to it. He also finds out that nothing bad happens.

At first, ERP may sound scary to many kids and teens. They may not be ready to try it. It is important to find a CBT therapist who is experienced in working with kids with OCD. An experienced therapist will be able to get your youngster ready for ERP by making it kid-friendly.

When youth understand how the therapy works, they may be more willing to deal with the initial anxiety experienced during ERP because they know the anxiety will increase and then go down over time. Moms and dads need to be involved in their youngster's treatment as well, under the therapist's guidance.

Medicines should only be considered when there are moderate to severe OCD symptoms. Both cognitive behavioral therapy (CBT) and medicine effectively treat OCD in kids and adolescents. Their use is supported by the treatment guidelines of the American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP).

Antidepressants are usually the first kind of medicine that a doctor will try. Your doctor might refer to these medicines as SSRI's, which stands for "Selective Serotonin-Reuptake Inhibitors", or TCA's, which stands for "Tricyclics." Here are some names of each of these kinds of medicines:

SSRI's-

• citalopram (Celexa®)

• escitalopram (Lexapro®)

• fluoxetine (Prozac®)

• fluvoxamine (Luvox®)

• paroxetine (Paxil®)

• sertaline (Zoloft®)

TCA's-

• clomipramine (Anafranil®)

OCD medicines control and decrease symptoms, but do not "cure" the disorder. OCD is usually well controlled when the right treatment is in place, but symptoms can often return when the youngster stops taking the medicine.

All OCD medicines work slowly. It is important to not give up on a medicine until it has been taken at the right dose for 10 to 12 weeks. Studies have also shown that improvement of childhood OCD can continue for at least a year after starting medicine.

Only four OCD medicines have been approved by the FDA for use in kids:

• clomipramine (Anafranil®)
• fluoxetine (Prozac®)
• fluvoxamine (Luvox®)
• sertaline (Zoloft®)

But, doctors can prescribe any OCD medicines to kids if they feel it is needed.

The best dose of OCD medicine should be determined on an individual basis. Kids should start at a lower dose than adolescents, but OCD symptoms often need to be treated with higher, adult-sized doses. If a youngster has difficulty swallowing pills, a liquid or other version may be available. The following dose ranges may be necessary:

• fluvoxamine (Luvox®): 50-300 mg/day

• sertaline (Zoloft®): 50-200 mg/day

• clomipramine (Anafranil®): 50-200 mg/day

• citalopram (Celexa®): 10-60 mg/day

• paroxetine (Paxil®): 10-60 mg/day

• fluoxetine (Prozac®): 10-80 mg/day

• escitalopram (Lexapro®): 10-20 mg/day

No two kids respond to OCD medicines in the same way. In general, clomipramine (Anafranil®) is usually not given first because of its side effects.

Factors that may guide the medicine choice can include:

• a good response to a certain drug by other family members

• cost or availability

• potential for side effects

• presence of other disorders

In the largest youngster OCD treatment study to date (POTS)1, remission (the absence of any major symptoms) occurred in about 1 in 5 kids on medicine and in more than half of those with medicine and CBT. In addition, many more kids had improvement (but not full remission). Some kids will have no response at all to some medicines, but it does not mean that other medicines will not help.

Every kind of drug has potential side effects. These side effects must always be weighed against the benefit. Some common side effects of OCD medicines include:

• a heightened sense of energy

• inability to sit still

• nausea

• sleepiness or insomnia

In general, the other drugs are safer than clomipramine (Anafranil®) which has its own side effects, including:

• concentration problems

• drowsiness

• dry mouth

• problems with urination

• racing heart

• weight gain

For all antidepressants in kids and adolescents, the FDA has issued "black box warnings" about suicidal thoughts and urges. The highest risk period for this is when starting or increasing the dose of the medicine. However, a recent study found no increase in suicidal thoughts in groups of kids with OCD who were studied.

These drugs appear very safe with long-term use and side effects reverse when they are stopped. There is no current evidence that they do permanent damage to the body.

It is important to know that if the first medicine does not improve OCD, another one should be tried. Trying several OCD medicines may be needed. Many people have better results if CBT is added to drug treatment. If the combination of one drug and CBT don't work, adding a second or third medicine can also be tried.

Many doctors suggest that OCD treatment should continue for at least one year, even after the symptoms have stopped. Unfortunately, OCD drugs do not "cure" the illness. When medicine is stopped, symptoms often return within a few weeks to months. If they return, most patients will respond well after starting to take the medicine again.

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

Children Who Abuse Their Pets

Child and teen motivations for the abuse of pets have not been studied extensively. However, case reports and a child interview study (using the Cruelty to Animals Assessment Instrument) suggest a number of developmentally related motivations.

Why Children and Teens Abuse Pets—

• Animal phobias (that cause a preemptive attack on a feared animal).
• Attachment to an animal (e.g., the youngster kills an animal to prevent its torture by another individual).
• Curiosity or exploration (i.e., the animal is injured or killed in the process of being examined, usually by a young or developmentally delayed child).
• Forced abuse (i.e., the youngster is coerced into animal abuse by a more powerful individual).
• Identification with the youngster's abuser (e.g., a victimized youngster may try to regain a sense of power by victimizing a more vulnerable animal).
• Imitation (i.e., copying a parent's abusive "discipline" of animals).
• Mood enhancement (e.g., animal abuse is used to relieve boredom or depression).
• Peer pressure (e.g., friends may encourage animal abuse or require it as part of an initiation rite).
• Post-traumatic play (i.e., reenacting violent episodes with an animal victim).
• Rehearsal for interpersonal violence (i.e., "practicing" violence on stray animals or pets before engaging in violent acts against other people).
• Self-injury (i.e., using an animal to inflict injuries on the youngster's own body).
• Sexual gratification (i.e., bestiality).
• Vehicle for emotional abuse (e.g., injuring a sibling's pet to frighten the sibling).

Research on the abuse of pets reveals the following:

• A youngster harming - or killing - a family pet is a precursor to some very serious violent behavior. Research in psychology and criminology shows that kids and teens who commit acts of cruelty against animals don't stop there – many of them move on to their fellow humans.
• Acts of cruelty toward animals are the first signs of violent pathology that includes human victims.
• Animal abuse is not just the result of a minor personality flaw in the abuser, but a symptom of a deep mental disturbance.
• Kids who abuse animals most likely are repeating a lesson learned at home from their moms and dads or guardians. They are reacting to anger or frustration with violence.
• Kids who harm family pets are at risk for other kinds of acting-out behavior and need immediate help.
• Domestic abuse is directed toward the powerless; animal abuse and youngster abuse often goes hand and hand.
• Police records indicate that a history of cruelty to animals is one of the traits that regularly appear in its computer records of adult violent criminals. Violent and aggressive criminals are more likely to have abused animals as kids.
• The youngster's violence is directed at the only individual in the family more vulnerable than himself — an animal.
• What also goes along with torturing animals is setting fires. If you smell smoke, you'd better take it seriously.

Here are some “red-flag” behaviors that a youngster may exhibit towards a pet:

1. Chasing after an obviously scared pet
2. Intentionally feeding pets harmful substances
3. Intentionally putting an animal in danger such as throwing it out the window or kicking it onto a busy street
4. Locking pets inside enclosed spaces
5. Taking pleasure in watching a pet who is in pain
6. Tying strings or chords on pet’s neck, limbs or paws
7. Violently lashing out at a pet after being reprimanded by an adult

Once detected, it is advisable that moms and dads step-in and immediately correct the behavior before it worsens.

What Parents Can Do About the Abuse of Pets—

One of the most powerful tools we have for preventing cruelty to pets is education. It is important to plant the seeds of kindness in kids early, and to nurture their development as the youngster grows. Kids not only need to learn what they shouldn't do, but also what they can do. When kids see that their pets are happy and loving, it will make the youngster feel good, too. This in turn will help the kids care for their pets' feelings.

Kids need proper education, too. Please urge your local schools to integrate humane education into their curricula. To help you, your local shelter may have outreach programs, education materials, camps, etc.

Every youngster is unique, and grown-ups should use caution and careful thought when discussing cruelty with kids. In general, kids under the age of four simply should not be exposed to cruelty. Two-year-olds can begin to learn that their actions make others (including pets) happy and sad. With two- and three-year-olds, discuss their own experiences and how they would feel if they were treated the way they treat their pets or other pets in their immediate lives. Help them relate not only the ways they would feel hurt, but also the ways they would feel happy.

With all kids under six or so, you may wish to help guide their hands so they can learn how to pet and hold their animal companions. Kids do not have fine control over their movements and impulses—they will want to treat their pets with love, but will need a little help from you to do it correctly.

Kids who are between about four and six often begin to understand basic moral concepts, such as fairness. These kids can learn to be kind to pets because the pets "deserve" it. Kids may discuss injuries they have had themselves, but do not introduce discussions about other types of injuries. Try to limit discussions of animal cruelty to the simple fact that pets can be hurt; do not describe how they can be hurt (e.g., starvation, physical abuse, etc.).

With most kids who are six to ten years old, you can begin to discuss why someone might be mean to an animal (as long as you make sure the youngster always keeps in mind that it is wrong to hurt pets). In addition, do not let discussions of animal cruelty satisfy the morbid curiosity some kids of this age may have. Kids of this age often form some of their earliest memories and impressions about the state of the world beyond their families. It is very important that grown-ups filter what these kids perceive! Even if kids witness violence as a "bad example" or as a way NOT to act, they are still witnessing violence, and can be strongly affected by it.

Many kids between 10 and 14 are exploring their self-image and reflecting upon their relationships with others. Studies indicate that kids of this age are still strongly affected by violence, so discussions about animal cruelty should still be kept free of details about the violence. Nonetheless, the issue can be raised directly—if delicately—with most of these kids. Grown-ups should make it clear that they do not condone violence in their own thoughts and behavior. Kids of this age are finely attuned to the words and actions of adults, and still rely on them as role models.

Moms and dads, educators, and trusted adults can also discuss with 10- to 14-year-olds how they would act if their peers or friends treated pets cruelly. By couching the advice in terms of what you would do if you were in a given situation, you can help kids overcome peer pressure and follow what they know is right. These kids may encounter others abusing pets—knowing that they are in the right and will be supported for standing up to it is very important at this age of strong peer pressure.

Again, with all kids – even older teens – keep in mind the importance of modeling appropriate behaviors. Our kids do emulate us, even if they wouldn't admit it. If we treat pets cruelly or as unfeeling machines, our kids will probably think that this is right or, at least, normal. The more a youngster identifies with an adult, the greater an impact that person will have on the youngster-in both good ways and bad ways.

Kids who know of animal cruelty should tell a grown-up about it. Make sure kids know who they can trust—such as moms and dads, educators, police, etc.—and nurture their trust so they can tell you.

It's vital that children who hurt pets receive intervention — including counseling and a ban on contact with animals — to prevent their violence from continuing. It's also crucial that animal guardians protect their dogs and cats from abuse and other dangers by keeping them indoors and never leaving them outdoors unattended.

Although vandalism may represent costly and psychologically significant destructiveness, smashed windshields and graffitied walls do not feel pain or cry out when they are damaged. Pets, however, do express their distress when they have been abused, and their distress calls out for attention. This article has provided an overview of the under-reported and under-studied phenomenon of pet abuse in childhood and adolescence. Addressing cruelty to animals as a significant form of aggressive and antisocial behavior may add one more piece to the puzzle of understanding and preventing youth violence.

==> Help for Abusive Children and Teens

How to Settle Arguments Between Siblings

As close as brothers and sisters can be, they can also be fierce rivals. It is common for sibs to be playing peacefully one moment and arguing or fighting the next. Sibs learn to interact and get along with others by first learning how to live peacefully with a brother or sister.

A youngster who has sibs is taught from firsthand experience how to see another person’s point of view, how to settle disputes, how to compromise, and how to show affection and not hold a grudge.

Some situations require a parent’s intervention. You’ll know it’s time to mediate when:

1. You know the argument has gone too far when your youngster is already bawling, screaming, or throwing a fit. He can neither reason nor be reasoned with fairly in this frustrated condition.

2. You’ll easily recognize when an argument is going nowhere (e.g. “Did, too!” “Did not!” “Did, too!” “Did not!”). Don’t let it reach boiling point, and don’t bother asking who started it. Since children have short attention spans, at this point, they’ve probably even forgotten how the fight started.

3. Since they can’t express themselves clearly, children sometimes resort to hitting to release their frustration. Whether it’s a “harmless nudge” or an “innocent push,” moms and dads should intervene. Otherwise, children might conclude that physical aggression is a valid way to solve problems.

4. When the dialogue has veered from the issue and has become an exchange of cruel and disrespectful remarks (e.g. “You’re retarded!”) and maybe even bad words, it’s time to draw the line.

5. If one youngster is bigger or older than the other and is getting physical, it’s time to intervene. Intervening between two siblings is one way of teaching older children to practice tolerance toward their younger siblings.

The “Kid-of-the-Week” Method for Mediating Sibling Arguments--

1. Line up your children and, one by one, take their individual pictures.

2. Make a little frame that will hold the picture and add a magnetic strip to the back so that it will stick to the refrigerator.

3. On the frame in easy-to-read letters write these words: “Kid of the Week.”

4. Put the pictures in a hat, randomly select one and slip it in the frame. This youngster will be the first Kid of the Week. Select a second one and this will be the next kid of the week. Keep doing this until you run out of kids.

5. Now the problem is solved. Whoever is Kid of the Week gets first option on whatever is up for debate. If there is ever an argument over who gets to sit where, who gets to go first, or who gets to use the TV remote, just ask the question: Who is Kid of the Week? They will know and the problem is solved.

6. If you have more than two kids the next choice goes to the next Kid of the Week and on down the line. Just make sure you keep the pictures in order and rotate them at the beginning of the week. Trust me – your children will make sure you do this.

7. You may want to do more than just settle arguments. Whoever is Kid of the Week also has additional responsibilities. For example, Kid of the Week has to empty the garbage cans, help clean up the kitchen, and be the first to carry out other chores when needed. Use Kid of the Week to teach that “with privileges come responsibilities.”

8. Implement Kid of the Week and have fun with it. It's a great teaching tool and it settles a multitude of arguments. The only other thing you will need to do is figure out a way to keep them from gloating: "Ha, ha, I'm kid of the week!"

It may be impossible for moms and dads to be around all the time to mediate, but proper conflict resolution needs to be modeled as much as possible. This means that in the end, all parties involved must be willing to compromise and to give in to the other’s needs and wants.

==> Discipline for Defiant Teens

How To Ground Your Child

As most parents know, grounding is a technique effective with school-age children and teenagers and involves restricting the child to a certain place, usually home or his room, as punishment.

But, unfortunately, most parents do not know the proper way to use grounding, and instead, ground too long – or not long enough. The result: grounding totally loses its effectiveness, and the parent complains, “I’ve tried everything with this child –and nothing works!”

How To Ground Your Child - 20 Tips for Parents:

1. Age appropriate groundings are a vital consideration. Little kids who are put in 'time out' are in effect being grounded. At this age, time outs and groundings need to be timed in minutes. The rule of thumb for time outs, groundings or withholding of privileges should be commensurate with age, but only up to a certain point. Kids under about six years of age should be given incremental time outs in minutes. Time outs should last no more than about one to two minutes per year. Between the ages of six to ten, you can start to ground kids to the yard or house for a few hours to a day at a time.

2. Be prepared to alter your routine in order to enforce the grounding. This may mean making small sacrifices and inconveniencing one or more members of your family. Making small sacrifices now will reap benefits in the future for you and your youngster. So, if grounding your daughter means that one parent stays home with her and misses the family’s Saturday pizza night, so be it.

3. Be ready to take extra steps to enforce the grounding if need be. If your child leaves the house and goes to the party anyway, go and get him. This action lets him know that you mean business. Don’t worry about embarrassing your child, since his friends probably already know that he’s supposed to be grounded anyway.

4. Consider reprieves, but only for good behavior, and often only if the grounding was initially too ‘over-the-top’. Prepare to apologize as well, and be sincere, because in a fit of anger, parents often make the punishments too harsh, then cool down and realize they made a mistake.

5. Good things to ground children from are: sugary snacks or candy, television, computer, video games, IPod, cell phone, special events (e.g., going to a friend's house, after school party, trip to McDonald's or some other junk food venue, etc.).

==> Parenting Techniques for Difficult Teens

6. Grounding for a week or longer is difficult to follow through with. Within a week's time, many activities take place. Mothers/fathers must constantly decide whether each activity is included in the grounding. It's also difficult to simply follow through at all on a long grounding. Parents who take away the driver's license for a month often shoot themselves in the foot. For one thing, this means that the parents need to provide transportation to work, school and other events that are not included in the grounding.

7. Grounding must be done in small increments of time (i.e., minutes, hours, or days). Then, if kids defy the grounding, it is increased in small amounts as well. If the original amount of grounding time is large (e.g., 2 weeks), moms and dads risk escalating their youngster’s defiance rather quickly. CASE EXAMPLE: Talking on the phone instead of doing homework. Normal Consequence: Cell phone taken away for one day and evening. First Escalation: Cell taken away for one additional day/night. Second Escalation: Three days. Third Escalation: Four days.

8. If your child retaliates by destroying your stuff or making a mess, then it is appropriate to add to the grounding. However, it should be O.K. for a youngster to discharge his anger through screaming and yelling, but it is never acceptable for him to take his anger out on someone else or his property.

9. Try to give a definite date for the end of the grounding. Prisoners almost always know when their sentences will end, when they have committed far worse crimes. Knowing when the grounding will end will be reassuring to the youngster, while still being effective.

10. Be calm whenever you impose any kind of punishment and avoid any form of aggression. Keep in mind that grounding should be a removal of privilege not an administering of harm.

11. Kids should not be grounded from school field trips or special interest group activities, sports practices, Boy Scout camping trips, youth group functions, band concerts, choir presentations, sports events in which they participate.

12. Never withhold meals or other necessities from a youngster during grounding.

13. Kids should not be grounded from visiting relatives. For example, they should be permitted to go on outings with grandparents (otherwise, you are punishing the grandparents, too). Find something else to withhold.

14. Lift the grounding when your youngster must go to someone’s home (e.g., to be watched while you are at work). Continuing the grounding is difficult for the ‘caretaking adult’ to follow through with. It may cause some tensions that will only have an adverse affect on the desired outcome of the punishment.

15. Make sure that you know whether or not the child’s disobedience was deliberate. Believe it or not, often what seems to be a knowing disobedience is actually something a youngster thought was O.K., and being punished for that could take him by surprise and teach him that you are just waiting to take away his things. Sometimes, kids even forget things, and the proper way to deal with forgetting a chore is to have the youngster do an extra chore for payment.

16. Make sure the punishment fits the crime. Example: If a youngster keeps on imitating fights seen on TV and uses knives, forks, or anything else that is dangerous, then TV restriction is a good course of action.

17. Make sure the situation the youngster is being grounded from is something she really sees as punishment. If she doesn’t seem to care whether or not she goes to her grandfather’s birthday party, ground her on another day when she’ll miss going out with her friends. If your youngster enjoys spending time alone in her room, restricting her to her room will serve to reward her instead of punishing her. Try taking a privilege away instead, or require her to spend some time outside her room.

18. Once you have grounded the youngster, prepare for him to protest, scream, and throw a fit. If that happens, ignore him, and he will soon realize you will not listen to his whining.

19. Only on the rarest occasions should your child be grounded from playing with other kids. If they get into trouble together, or if the youngster is a threat or danger to your youngster, then it would be acceptable to ground your child from seeing the other child.

20. There is a point at which the grounding has the opposite effect from the desired correction (i.e., the point of saturation). For the first few days of grounding, the youngster often feels a certain remorse for the behavior. Whether they admit it or not, most kids understand why they were grounded, if it was an appropriate grounding. After a few days to a week, children begin to get bored and restless. Resentment begins to set in and what was initially effective, corrective discipline backfires.

==> Parenting Techniques for Difficult Teens

MODIFIED GROUNDING—

Many moms and dads use grounding as a discipline technique with their teenagers. However, when parents ground their teenagers for long periods (e.g., several weeks or more) it often loses its effectiveness because there is typically little incentive for teenagers to behave well during the grounding. Also, when parents ground teenagers for a long period of time, they often give in and reduce the length of grounding because of the restraints it places on the whole family. When this happens, teenagers learn their mother/fathers won't follow through with the grounding they impose.

The modified grounding procedure described below involves brief and intense grounding, but the teen is allowed the opportunity to earn his way off grounding by completing a job assignment. This technique is most appropriate for older kids (e.g., 12-17 year olds).

Points to consider when using modified grounding:

1. After your teen has completed the assigned job(s), he should come to you so that his performance can be checked. If the job has been done well, it is important to briefly praise your teen for the job performance and inform him that the grounding is over. If the job has not been completed satisfactorily, briefly provide feedback to your teen on the aspects of the job that have been done well and those that need additional work. Be specific in what additional work needs to be done. Try to handle corrective feedback in a matter-of-fact manner without nagging, lecturing, or becoming upset.

2. Grounding is severe and means staying in one's own room (or an assigned room) except for attending school, eating meals, or performing chores. During grounding there should be no television, no video games, no radio or tape players, no other games/toys, no visitors, no telephone calls, no snacks, no reading materials except school books, and no outside social activities. If a family outing is scheduled, a sitter should be used so that the grounded teen remains at home while the moms and dads and other family members can still go on the family outing.

3. Sit down with your teen and develop a list of 10-15 jobs that often need to be done around the home. Do not sit down with your teen to start this procedure at a time when your teen is about to be punished. Choose a time when your teen is behaving well to discuss the technique and to create a list of jobs. These jobs should not be chores that the teen is expected to do on a regular basis. These jobs should take a significant amount of time to complete (e.g., at least 1-2 hours). The jobs should also be things that your teen is capable of doing. Examples of such jobs include washing the windows in the house, cleaning out the garage, and cleaning the bathroom.

4. After a list of jobs has been created, your teen should be told that when he misbehaves to the degree that grounding is necessary, this new discipline technique will be used. Immediately after the misbehavior has occurred, the teen will be told he is grounded and an index card will be picked at random. The teen will be completely grounded until that job has been completed to the parent's satisfaction. For particularly significant misbehavior, more than one card can be drawn.

5. It is critical that you not nag your teen about the jobs to be done. The rules of grounding should only be explained to your teen once.

6. Write each individual job on a separate index card. This description should include a very detailed description of exactly what is required to do the job satisfactorily. For example, cleaning the garage would involve removing all objects from the garage, removing cobwebs on the ceilings, sweeping the floor, hosing/scrubbing the floor, and replacing objects in an organized and neat fashion. If some jobs are relatively brief, it is possible to combine jobs together so that all cards have a job assignment that will take approximately the same total time to complete.

7. Remember to frequently praise and give teenagers positive feedback when they are behaving well. As with any punishment technique, grounding will only be optimally effective when there is a positive and loving relationship between mothers/fathers and their teenagers.

Using the modified grounding procedure, your teen earns his way off grounding. Therefore, your teen basically determines how long the grounding will last. Grounding may last anywhere from just a few hours to several days. If the grounding lasts more than several days, it is important to check to make sure your teen is being appropriately grounded (e.g., they're not sneaking television/radio).

==> Parenting Techniques for Difficult Teens

How to Conduct Successful Family Meetings

Family meetings help busy families stay connected, improve communication, self-esteem, emotional support and problem solving. Another advantage of family meetings is that they eliminate the need for nagging. If a solution is not followed during the week, the person who notices this can simply write the item on the agenda again. At the next meeting, the family can discuss the consequences of not following the agreed-upon rules until a consensus is reached on that.

Family meetings are good times to set house rules. You are relaxed and the kids are more receptive. Spur-of-the-moment rules ("You're grounded!") made when you are angry are likely to be unfair and un-followed.

Getting together to sort out discipline problems is a valuable way for moms and dads and kids to express their concerns. Discipline problems that involve one youngster should be handled privately, but there are times when all the kids get a bit lax in the self-control department and the whole family needs a reminder.

Suppose your house is continually a mess. Call a family meeting and invite suggestions from the kids on how to keep the house tidy. Use a chalkboard to make it more businesslike. Write down the problem and propose solutions. Put together a "kids want/parents want" list in order to set goals. To avoid “chore wars,” assign each youngster a room to tidy-up. Then you will know who is responsible and who to compliment.

Formulate house rules for happier living. Arriving at a general consensus is better than voting, which has winners and losers. Try a suggestion box and have the kids write their suggestions on little cards. You'll learn a lot about your living habits that way. One father got a suggestion from his teenage daughter: "Dad, please ask me to help instead of demanding that I help."

You can use family councils to help a youngster solve a problem. Develop a share-and-care atmosphere. Make the meeting fun. Besides your living room, try other meeting places (e.g., family picnic at the park). “Meetings” shape family behavior and are a forum in which to foster family communication.

Important Tips for Successful Family Meetings—

1. The first meeting sets the tone. Plan for it! Have a short fun game, a nice refreshment, and positive comments or rewards.

2. After meetings are a well-accepted routine, do not use the Family Meeting time only to resolve conflicts, but also to work out schedules, talk about good news, and to plan for fun, making sure all meetings are sprinkled with a healthy amount of humor, praise and rewards.

3. Allow the kids a chance to talk. If you are raising allegations against them, give the kids a chance to explain themselves or provide reasoning for their actions. Make sure the meeting does not turn into a lecture by promoting the kid's ability to speak and be heard.

4. At the first meeting remind everyone to contribute to the conversation, listen to others and to be supportive, not critical.

5. Create a procedure that begins and ends the Family Meeting on a positive note. Moms and dads can say something positive about every youngster, and at the end of the meeting, every youngster can say something positive about the other person on their left, for example.

6. Discuss all the materials that you wanted to discuss. If you are there to discuss certain misbehavior by one of the kids, do this concisely. Do not beat around the bush, as this can aggravate the kids, making them more difficult to speak to about it.

7. Don't let the desire to solve problems get you into a situation where sensitive matters are brought out in front of everyone. The Family Meeting is a public forum, and not the place to "gang" up on moms and dads, children, or solve multiple conflicts. This can get out of control quickly, and respect for moms and dads and children alike is extremely important.

8. In most families, discussions of chores usually take up a good deal of meeting time, at least at the beginning. To get started with this, it is helpful to use a meeting to make a list of all the jobs that need to be done daily, weekly, and monthly. Be sure to include in this list all the jobs the adults do that might otherwise be taken for granted, such as earning money, paying the bills, and shopping for groceries. One way to divide up the chores is to ask for volunteers to take responsibility for each one. After you reach agreement on this, someone can write up an individual job list for each family member. Trading job assignments is another way to divide up chores. For example, one youngster may hate taking out the trash but would be willing to do laundry. Trading can be good, but moms and dads should make sure that no one is taken advantage of in this process. Another way to assign chores is to rotate them systematically among family members each week or month, or distribute them randomly at each meeting. There are many creative solutions, and whatever system your family agrees to is the one that will work the best. Whatever system you use, you can expect some aspect of chores to keep reappearing on the family meeting agenda. This ongoing negotiation, although time-consuming, is important to the success of the family unit.

9. It is important to have a written agenda. If something is eliminated, moms and dads need to meet with the youngster and explain why (e.g., some things are personal, some things are ridiculous, some things are argumentative, etc).

10. It's helpful to use the Family Meeting to discuss consequences for certain behaviors; children will often come up with penalties parents would think were too strict. While moms and dads are still in charge, letting children pick their "punishment" to a certain degree is helpful.

11. Maintain order in the meeting by having the adults speak first. This will set the stage for what the meeting is going to be about. State clearly what you are going to be talking about and in what order things will be spoken about. Make sure the group knows that only one person is permitted to speak at a time to prevent confusion and agitation.

12. Meetings work best if no one adds any items to the agenda once the meeting has started. In order for meetings to run smoothly, there needs to be a chairperson and a secretary. These responsibilities should change each week so that each member of the family has a chance to participate in the leadership; as soon as kids are old enough to do these jobs, they should have their turn.

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13. Mom and dad should be the co-moderators for meetings in the beginning. Share the moderator duties with kids as you go along.

14. Moms and dads listen for and acknowledge the feelings that are expressed, ask open-ended questions to clarify the problem, and then brainstorm solutions with the entire family.

15. Moms and dads model making an action plan and help kids set a specific goal to continue positive experiences or address problems identified this week.

16. Moms and dads offer praise, encouragement and support for the good things that each person mentions.

17. Prohibit arguing in the meeting by snuffing it out before it begins. If you see a disagreement begin to develop, do what you can to resolve it right away.

18. Pick a day when all can attend. This may take some discussion but be firm and in the end, just pick a date. Sacrifice might be necessary, but promise short meetings and stick to it.

19. Set a scheduled time for meetings, post it where everyone will see and stick to the time. If moms and dads are committed to the project, it will have more impact.

20. Some families have discovered the importance of starting and ending on time. Unfinished items can be carried over to another meeting, even if it needs to be the next day. In any case, meetings should have a definite end; it's fun to end with a special dessert or a short game, if time permits.

21. Sometimes moms and dads report that their kids are at first resistant to the idea of family meetings, thinking that this is merely a new trick to get the kids to do what the moms and dads want. When this occurs, parents should restrict the agenda items of the first few meetings to pleasant topics that are not emotionally charged, such as planning a family trip or discussing how to celebrate an upcoming birthday.

22. Strive for consensus rather than always voting. It is worth finding solutions that everyone is happy with, even when this requires more time. Consensus means that each solution should have 100 percent agreement among all family members before the next agenda item is taken up. When consensus is hard to reach on a specific issue, the chairperson can ask if everyone agrees to end the discussion, but to have that issue be first on the agenda at the next meeting. Perhaps it is possible to reach consensus on a compromise.

23. Talk about the activities for the days and week ahead. Briefly discussing what everyone has ahead of them is a great way to help children stay informed and to actually understand what others in the family do. Children tend to be self-focused, which is part of their "age and stage." This becomes increasingly important as kids grow older and participate in numerous activities. This skill will also help them learn organization skills, all important for the future.

24. The chairperson's job is to see that each agenda item is addressed in order, to ensure that no one interrupts the person speaking, and to keep the discussion on the topic at hand. The secretary writes down the decisions reached.

25. The magic number of rules for comfortable meetings seems to be 5. Having too many rules is just like too many cooks in a kitchen. Confusion is the result. It will weigh the meeting down, and someone will have to be the "enforcer." This is common even in the corporate world. After 5 rules, even adults seem to mentally clock out. Add more rules over time, as things come up. Keep it Simple!

26. The Nuts and Bolts of the Meetings can bog everyone down. Keep agenda items brief, remembering it is the process that's important. Listening to others, contributing to decisions, having fun are all time important.

27. There will be pouting! Ignore the pouting that may occur when some don't get their way. Expect it. It will go away largely on its own as they see that everyone at one time or another "loses" part of their requests and desires as compromises are born.

28. Try to eliminate the "That's not fair!" complaint. Fairness will often appear to be for the goodness of all, not necessarily the individual. Ii think this word is highly over used. We need to teach our kids how to accept things that are not fair because they're going to run into it a lot!! "Fair" is subjective. Giving in is an important trait, family members need to know that sacrificing their personal desires and "vote" sometimes is normal and right. You can keep your opinion, even though the family may feel the need to not act on it.

29. Try to keep the agendas of your family meetings centered around issues that have a tangible effect on you, such as issues of noise, use of the TV or the family car, help with chores, and messes in the common areas of your home.

30. Close the meeting on a positive note. Perhaps end it with ordering pizza or going out for a snack. This will help the kids associate the family meetings with positive things rather than boring or disciplinary things. If discipline is necessary, still try to do what you can to make the end of the meeting positive. Be lenient if you can or allow the youngster a chance to apologize in exchange for a lighter sentence. However, to ensure the apology is heartfelt, do not tell the youngster beforehand that there will be a lighter sentence.

Family meetings should:

• be balanced by containing some rules, some firmness, some fun
• be pleasant
• be short
• be uninterrupted by the world
• contain structure but not be weighed down heavily by it
• have a direction, purpose and easily determined focus (no one should leave the meeting thinking "Huh? What was this about?”)
• involve everyone, stressing sharing, taking turns, and listening to others

Examples of common topics of family conflict are:

• Borrowing other's possessions with or without permission
• Division of chores
• Interrupting others
• Leaving lights on and other family budget matters
• Showing respect for others (e.g., entering bedrooms without knocking, picking up after yourself, monopolizing electronic game time/TV/music/phone/computer)
• Use of the bathroom

Use the 'Go Around' method for discussions. Go around the circle, giving each family member the opportunity to respond to the topic:

Topic 1: Something that made you feel good this week.

Topic 2: Something that bothered you this week.

Topic 3: Something that you want to work on or accomplish next week.

Topic 4: Your schedule for the week. What meetings, appointments, tests, special events or projects you have this week.

 

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

Using “Rewards” To Shape Behavior

Kids behave according to the pleasure principle: behavior that is rewarding continues; behavior that is unrewarding ceases.

While you don't have to go to the extreme of playing behavioral scientist, you can invent creative ways to motivate desirable behavior with rewards.

To work, a reward must be something your youngster likes and truly desires. Ask some leading questions to get ideas:

• "If you had ten dollars, what would you buy?"
• "If you could go somewhere with a friend, where would you like to go?
• "If you could do some special things with your parents, what would they be?"

Granting a reward is a discipline tool to (a) set limits and (b) get jobs done. The best reward is one that is a natural consequence of good behavior: "You're taking really good care of your bicycle …let's go to the bike shop and get you a battery-operated headlight." The natural consequences of good behavior are not always motivating enough in themselves. Sometimes it's necessary to fabricate a reward.

Reward Charts—

Reward charts are a helpful way to motivate young kids. They see their progress and participate in the daily steps toward the reward. The reward chart stands out as a testimony of good behavior for all to see. Reward charts work because they are interactive and fun. Even the business world uses performance charts as profit motivators. Throughout life, many kids will be surrounded by performance charts, so they may as well get used to seeing them in their home.

In making reward charts, consider these tips:

• Charts can contain positive and negative entries, reminders of both types of behaviors. For example, you can use daily charts to correct poor eating habits. The youngster puts a happy face sticker on the chart every morning he drinks all his orange juice and a sad face sticker on the chart on mornings he doesn’t. If the happy faces outnumber the sad faces at the end of the week, the youngster gets to choose where he wants to go for lunch Saturday afternoon.

• Construct the chart so that the youngster has a visual image of closing in on the reward. You may get the best results from a "connect the dots" chart. Have the youngster draw a picture of what he wants. Then outline the periphery of the picture with dots several inches apart. With each day of successful behavior (e.g., each time he remembers to feed the dog) the youngster connects another dot. When all the dots are connected, the youngster collects the prize.

• Display the chart in a high visibility location (e.g., on the refrigerator). Giving the chart a high profile and high visibility gives the youngster easy access, serves as a frequent reminder of the desired behavior, and lets him proudly exhibit his progress.

• Keep the time until the prize is collected short. Frequent, simple rewards keep motivation high. For ages 2 - 3, use end-of-the-hour rewards. For ages 4 - 5, use end-of-the-day rewards. For ages 6 – 12, use end-of-the- week rewards. A month is an unreachable eternity for any youngster.

• Remember that novelty wears off quickly for kids. So change charts frequently.

• Make the chart interactive: connecting dots, pasting on stickers, drawing different colored stars, etc. (just something more interesting than a check mark).

• Work with your youngster. Let your youngster help construct the chart and make daily entries.

Creative Rewards— 

Besides charts, design your own clever motivators:

• Ask the youngster to do a task. Set a timer. If the task is done before the timer rings, your youngster gets a reward. To decide the amount of time to give the youngster, figure out your youngster's "best time" to do that task and add 5 minutes.

• Ask your youngster to play quietly alone or with a sibling for a short time (maybe 30 minutes). Check on your youngster frequently (every 2 to 5 minutes, depending on the youngster's age) and give a reward or a token for each few minutes they were quiet or playing well. Gradually increase the intervals (go from checking your youngster's behavior every 2 to 5 minutes to checking every 30 minutes), but continue to give rewards for each time period your youngster was quiet or played well.

• Because his 7-year-old's toy of the month was a train, a father chose a new railroad car as a weekly reward for the youngster keeping his room picked-up. And he related the reward to the behavior: "When you show me you can keep your room picked-up, then we'll add a new car to your train set." He used periodic reminders: "Let's keep your room as sharp as your train set.”

• In a short time (about an hour) put a mark on a chart or on your youngster's hand each time you see her performing a good behavior. For example, if you see your youngster playing quietly, solving a problem without fighting, picking up toys or reading a book, you would mark the chart. After a certain number of marks, give your youngster a reward. You can also make negative marks each time a bad behavior occurs. If you do this, only give your youngster a reward if there are more positive marks than negative marks.

• To keep fighting between siblings to a minimum, you can use a "good behavior candle." The object is to burn the candle all the way down so that both children can get a reward. As soon as they get home from school, you can light the candle. The candle stays lit until a fight or argument occurs. The child who initiated the argument has to blow out the candle. The sooner the candle burns down (e.g., the fewer arguments), the sooner the children get a reward. Since kids don't like to delay gratification, they're more motivated to avoid arguing with one another.

• Write a short list of good behaviors on a chart and mark the chart with a star each time you see the good behavior. After your youngster has earned a small number of stars (depending on the youngster's age), give her a reward.

The Cons of Using Rewards—

Some child development experts describe “rewards” for good behavior as “bribes.” These experts do not believe parents should offer rewards when a child behaves well. Small rewards, such as stickers, can be helpful in teaching young children to complete tasks. These however, can cause dependence on outside motivators rather than learning internal motivation and developing a sense of pride for “a job well done.”

Rewards may narrow goals for children and may take away opportunities for children to choose to do something because it is “the right thing to do.” Although rewards have been compared to adults receiving a paycheck, adults work for more than just a paycheck. Adults feel satisfaction for a job well done; they work for knowledge and for personal growth. When children receive rewards for a job well done, they are taught to work just for a paycheck.

In any event, rewards are a way to entice your children toward goals you've made for them. The ultimate goal is self-discipline (i.e., they behave well because they want to, or because they know you expect good behavior). They shouldn't expect a prize each time they behave well.

Be as creative as you like with your reward system. Spell out the types of behavior and chores that will be rewarded. Consistency is the key here. As your children grow up and House Rules evolve, so can the rewards.

Here a partial list of rewards that may be used in a “reward system”:

1. Going for a picnic
2. Going horse-back riding
3. Going on a trip to the zoo
4. Going out for hamburgers or pizza
5. Going outside at night
6. Going roller skating
7. Going someplace alone with dad or mom
8. Going to a beach
9. Going to a movie
10. Going to the park or playground
11. Having a special desert like ice cream
12. Playing a game with parent(s)
13. Playing an educational computer game
14. Playing with friends
15. Riding on a bicycle with dad or mom
16. Sitting in the front seat
17. Spending the night at a friend’s house
18. Staying up late (e.g., midnight)
19. Swimming
20. Watching a video

Note: As with all parenting techniques, using a “reward system” may work well for Jack -- but not so great for Jill.

==>  My Out-of-Control Child: Help for Parents of Defiant Kids

How to Withhold Privileges

Losing privileges is one of the few behavior shapers you never run out of. Children will always want something from you. For this behavior modification technique to have a good chance of preventing recurrence of misbehavior, the youngster must naturally connect the withdrawal of privileges to the behavior.

Here are some good examples:

• “If you choose to ride your bike over to your friend’s house without asking permission, you also choose to lose your bike for 2 days.”
• “Since you dawdled and missed the morning carpool, you can walk to school.”
• “You get caught driving drunk and you lose your license.”

Here are some bad examples:

• “Since you decided to come home late for supper, you cannot watch any TV tonight.” (What does withholding television have to do with being home in time for supper? ...the child wonders.)
• “If you keep picking on your sister, you will not go over to your friend’s house to play basketball later.” (Not much of a connection here either.)
• "If you refuse to do your homework, you will get out there and pick up sticks in the yard."

Withholding privileges can work if it is part of a “pre-agreed upon” behavior management strategy decided on during a family meeting. Moms and dads state the behaviors they expect from their children and announce that part of the fun of being a parent is granting privileges to the children so they can have some fun too. But if the children don't hold up their end of the bargain, the parents cannot grant those privileges. So, being home in time for supper gets you the privilege of a half-hour of video games rather than the ‘video game time’ being an inalienable right of every citizen in the household.

Losing privileges is an effective form of discipline used to show kids that all privileges come with responsibilities and must be earned; therefore, when your youngster misbehaves, you can use the withholding method by temporarily removing an object or activity (e.g., video game, playing with friends). Before taking away the valued object or activity, explain to your youngster what you are doing and the reason for your action.

The amount of time the object or activity should be withheld solely depends on the level of misbehavior. Parents will want to “make the punishment fit the crime.” For example, if your child violates curfew by 30 minutes, “one-day grounding” would make sense because (a) there is an easily understood connection between “not coming home” (violation) and “being grounded at home” (consequence), and (b) being grounded one day for every 30 minutes the child is late seems reasonable by most standards.

Here are a few additional things to keep in mind when you use this withholding technique:

o  Be aware of what your youngster can and cannot do. Kids develop at different rates. They have different strengths and weaknesses. When your youngster misbehaves, it may be that he simply cannot do what you are asking or he does not understand what you are asking.

o  Be sure you can follow through on your promise.

o  Choose something that your youngster values that is related to the misbehavior.

o  For kids younger than 6 or 7 years, withholding privileges works best if done right away. For example, if your 5-year-old misbehaves in the morning, do not tell him he can't watch TV that evening. There is too much time in between, and he probably will not connect the behavior with the consequence.

o  Learn from mistakes—including your own. If you do not handle a situation well the first time, do not worry about it. Think about what you could have done differently, and try to do it the next time. If you feel you have made a real mistake in the heat of the moment, wait to cool down, apologize to your youngster, and explain how you will handle the situation in the future. Be sure to keep your promise. This gives your him/her a good model of how to recover from mistakes.

o  Never take away something your youngster truly needs (e.g., a meal).

o  Once you make a rule or promise, stick to it.

o  Work toward consistency. Try to make sure that your rules stay the same from day to day. Kids find frequent changes confusing and may push the limits just to find out what the limits are.

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