A Wiley Website with Info about our Brand New Counseling and Psychotherapy Videos

This spring and summer Rita and I have been working with John Wiley & Sons to produce DVDs to go with our textbooks Clinical Interviewing and Counseling and Psychotherapy Theories in Context and Practice. The Clinical Interviewing DVD is out and the Theories DVD will be available soon. There’s a new website with information about this at: http://lp.wileypub.com/SommersFlanagan/

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John reading the new textbooks to his twin grandchildren (who look quite excited about learning how to do psychotherapy).

 

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Parenting Advice: Don’t Say it More than Three Times

A Visit to the Mall

Here’s what a parent of a 5-year-old and a 2-year-old explained when she came in for a consultation:

Parent: My friend invited me and my two kids to meet her and her two-year-old at Bellevue Square for dinner and shopping. I knew better. This friend makes me feel insecure. We met for dinner at this nice café and there’s nothing there my kids will eat. After a while, they start running around the café. I settle them down and we walk around to shop and my five-year-old son is running way ahead and I keep trying to get him to get back with us and he won’t listen. We eventually get to a pet store and my two-year-old is climbing on stuff and my five-year-old is knocking on the pet-cage glass right where it says “Don’t knock on the glass” and he won’t stop. Finally, I drag them both to a bench and make them sit there and I yell at them and they start crying and I’m humiliated and have to carry them both outside to the car and yell at them some more. I was one of those parents you see who has out-of-control children and then goes berserk.

Consultant: So, eventually your kids started listening to you? [Focusing on how the negative behavior sequence finally stops can be revealing.]

Parent: Yes. Because they knew it was over.

Consultant: When you tell that story it reminds me of how kids can sometimes almost read our minds and know when something is really important to us and know when they can take advantage of us by not listening. But then when we somehow make it clear that the fun and games are over, suddenly they get it and cooperate.

Parent: I felt so uncomfortable with my friend and her potty-trained little girl and I couldn’t even come close to controlling my kids. And later that night, when I was talking about it to my 5-year-old, I apologized for yelling and losing my mind and I asked him why he didn’t listen to me and he said, “I listened, I just didn’t do what you said.” I couldn’t believe it!

Consultant: That’s amazing. So, he really did know what was going on.

Parent: He did and he still didn’t cooperate.

Consultant: Can I share some ideas with you?

Parent: Yes. I’d love some ideas!

Consultant: We used to have a parent educator here who taught a class called, “They only listen when I yell . . . and other parenting myths.” The point of the class was exactly what you’ve been talking about. It’s not that our kids only pay attention when we yell, it’s that they only comply when they know we’re completely serious. Tell me, how many times did you have to ask your five-year-old to cooperate before he finally did?

Parent: It had to be twenty times. I was trying to get him to sit down at the café, to come back to us when we were shopping, to stop knocking on the glass at the pet shop, and he would sometimes partly respond and sometimes not at all, until the end, when he sat on the bench and started crying.

Consultant: Here’s what I’m thinking. You already said you set yourself up with this dinner with this friend and her practically perfect two-year-old. I’ll bet somewhere inside you were really wanting to avoid a confrontation with your kids and the embarrassment that goes with it. And they sensed you were a little bit afraid to confront them and afraid to give out firm consequences and so they just chose not to listen or cooperate.

Parent: I know. I know. I don’t even take my two-year-old grocery shopping any more because it’s too much. And obviously they knew I didn’t really want to follow through with any consequences. But what can I do?

Consultant: I have two ideas and the first one will sound really weird.

Parent: Just tell me.

Consultant: This is crazy, but you need to start looking forward to when your children have tantrums or misbehave.

Parent: That is weird.

Consultant: I know, but unless you look forward to it, with confidence that you can handle whatever they do, they’ll sense your dread and fear and they’ll be the ones who are confident they can do whatever they want—like run ahead in the mall and knock on the pet store glass cages—because they sense you’re afraid to stop them.

Parent: Okay. I get it. But I don’t know how I can look forward to a meltdown in the mall.

Consultant: And that’s exactly why we need to develop a nice and clear and practical plan for the next time this sort of thing happens. You need a very simple plan for limit-setting with your children. Because if you have to ask them to cooperate twenty times, they know they don’t have to pay any attention or respect to you—until the twentieth time when you’re yelling and screaming. The plan should have one or two warnings and then a small consequence. For example, in the mall situation, it might have been embarrassing, but the first time your kids didn’t respond to your requests to sit down or walk with you, you could have given a clear warning, something like, “Okay, if you don’t walk with me, then we’ll go outside and spend some time on the bench until you’re ready to come back in.” Then, the second time one of them didn’t cooperate, you’d calmly collect them and take a brief timeout on the bench or in your car. Then, if it happened a third time, you could turn to your friend and say, “I’m sorry, but it looks like my kids aren’t cooperating right now and so I need to take them home.” I know that might have felt embarrassing and awkward, but it would communicate very clearly to your children that you are a serious mom who’s confident in her limits and decisions.

Parent: It wouldn’t have been half as embarrassing as the way things turned out.

In this case, we developed a very simple limit-setting system. It involved three steps:

1.  The first time the children misbehave, give a clear warning.

2.  The second time the children misbehave, take them into a brief and boring timeout from the fun.

3.  The third time the children misbehave, the fun activity ends.

In addition to these three steps, we discussed managing the children’s physical needs by checking if they were hungry, tired, sick, or hurting and planning in advance for outings. We also discussed how she could review with her children, in advance of the outing, exactly what she expected and exactly what would happen (brief public timeout, followed by a disappointing trip back home) if misbehavior occurred. Finally, we suggested that she set up some practice outings where she could quickly and effectively implement the consequences without the pressure of a friend looking on. The purpose of these outings was to practice the plan and demonstrate to her children exactly what would happen if and when public misbehavior occurred.

Overall, this procedure is consistent with what we know from the science of behavioral psychology. As Kazdin (2008) states: “Here’s a rough rule of thumb to go by: if you say it twice (the initial instruction plus one reminder), that’s reminding; if you say it three or more times, you’re nagging and nagging can undermine [your credibility and power]” (p. 172). In addition to Kazdin’s good advice, we like to emphasize to parents that most children are amazingly intuitive—like dogs, they can sense their parents’ fear.

Give Information and then Back-Off: A Choice Theory Parenting Assignment

Parent Homework Assignment 8-1 — From How to Listen so Parents will Talk . . . http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_8?s=books&ie=UTF8&qid=1341892854&sr=1-8&keywords=how+to+listen+so+parents+will+talk+and+talk+so+parents+will+listen

Choice Theory Communication Skills Training: How to Provide Information and Then Back Off, Instead of Trying Too Hard to Control Your Child’s Decision Making

As a loving parent, if you’re concerned about your children’s behaviors, you’ll probably have a strong and nearly irresistible impulse to tell them how to live their lives. After all, you’re the adult and they should listen to your excellent advice. You may feel the urge to say:

  • You need to clean your room now because being disorganized and undisciplined is a bad habit that will make your life miserable.
  • Alcohol and drugs are illegal and so if you go out and behave illegally, I’ll call the police and have you ticketed.
  • You need to start caring about your grades at school and that means scheduling time for homework and studying for tests.
  • Swearing is unacceptable in this house and if you do it again, I’ll wash your mouth out with soap.

Unfortunately, as you may recall from your own childhood, when parents are bossy and insistent about how things should be, children often become more stubborn and resistant. Then parents begin to nag and lecture and the pattern of advice-giving and advice-rejection deepens. This assignment is designed to help you communicate important information to your children without starting an all-out power struggle or negative nagging pattern. The following suggestions are appropriate only if the situation isn’t dangerous and you don’t need to jump in and directly and forcefully protect your children:

1. Ask permission. If you have a strong opinion that you’d like your child to hear, try asking permission to share it. Say something like, “Can I share my opinion on this with you?” Then, either your child will say “yes” and you can share your opinion or she’ll say “no” and then you’ll need to accept her boundary (in response to a “no,” you might say, “Okay. Thanks for being honest with me. Let me know if you change your mind” and then walk away).

2. Express your intention not to express your opinion. You could try telling your child, “I have an opinion on this, but I trust that you can work it out, or that you’ll ask me for help if you need it. So I’m going to try to keep my mouth shut for now.” This gives your child the message that you’re trying to respect his ability to work out his own problems. You can also add humor into this or other power-sharing techniques by adding: “You should really appreciate this, because you know how hard it is for me to keep my mouth shut and not give you advice.”

3. Provide your information or opinion and then back off.  If you can’t resist giving your opinion, just do it and then back off and let your child consider your input. The key to this strategy is patience. Undoubtedly, you’ll provide excellent advice and then your child will look like she’s not considering your advice and so you’ll have the urge to repeat your advice over and over until you see action. Instead of falling into this pattern, try saying, “Look. I’ve got an opinion, which you probably already know. But instead of staying quiet, I’m just going to say it and then let you make your own decision on how to handle your situation. It’s your life. You have to make your own decisions. But I love you and can’t stop myself from telling you what I think, so here it is.”

As you probably already know, if you express your opinion you may get a strong emotional response (e.g., “I’m fifteen years old and I can make my own decisions!”). Although this seems weird, if you give lots of advice, your children may see your ideas and opinions as evidence that you don’t believe they’re competent to make their own decisions. This is why you should always express your advice with love and concern; avoid sounding as if your main goal is to control your child’s behavior.

Finally, if the situation is dangerous or potentially so, skip the less direct parenting recommendations listed above and instead think strategically about how to deliver direct advice that will be heeded. You’ll probably need to use a more direct approach than is described here, and you may need to consult with a professional.

More assignments like this and more are in the book, How to Listen so Parents will Talk — http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_8?s=books&ie=UTF8&qid=1341892854&sr=1-8&keywords=how+to+listen+so+parents+will+talk+and+talk+so+parents+will+listen

A Guide to Limit-Setting with Your Kids: Montana Parenting Homework Part 3:

A Practical Guide to Setting Limits

This guide is adapted from: How to Listen so Parents will Talk and Talk so Parents will Listen (Wiley, 2011)

Unfortunately, children are not born knowing how to deal with frustration, anger, and disappointment. This means it’s our job to teach them how to deal with these difficult and sometimes unpleasant emotions.

One way to teach your child about how to handle frustration and other difficult emotions is through limit-setting. If you let your child do whatever she wants anytime she wants to, she’ll have trouble learning how to cope with frustration. This can happen if you always give your children whatever they want.

Many parents mistakenly think that when they set limits, they need to be mean or especially tough. Don’t make that mistake. Good limit-setters are firm, but kind and compassionate. Try to be the kind of boss you’d like to have yourself.

An effective limit-setting strategy includes the following:

1. Set a clear limit or clear expectation.

2. If your child appears upset or resistant, show empathy for your child’s frustration, disappointment, or anger.

3. Repeat the limit in clear language (you could also have your child repeat the limit or plan back to you).

4. Give your child a reasonable choice or timeline (this is especially important with strong-willed children; see the following for examples).

5. Show more empathy by joining in with your child’s unhappiness (this might include telling a story, if there’s time).

6. Enforce the limit on time and with a logical consequence.

7. Stay positive and encouraging.

A Limit-Setting Example

1. Set a clear limit: “Dinner will be ready in five minutes, so it’s time to turn off your computer game.”

2. Show empathy by using feeling words: “I know it’s hard to stop doing something fun and you’re feeling very upset.”

3. Repeat the limit: “But you know it’s time to stop playing computer games.”

4. Give a choice and a timeline: “Either you can stop playing in the next two minutes, or I’ll unplug the computer.”

5. Show more empathy by joining in with your child’s unhappiness: “I hate it when I have to stop doing something I love.”

6. Enforce the limit on time and with a logical consequence. (Say what you’ll do and then do what you said: If you said it will be two minutes, wait two minutes and enforce the limit; don’t wait three minutes or one minute).

7. Stay positive and encouraging: “Even though I had to turn off your computer in the middle of your game tonight, I’m sure you’ll be able to plan for this and turn it off yourself tomorrow.”

Remember, although it’s your job to teach your child how to become more responsible and how to cope with the frustrations of life, you won’t be able to do this perfectly; no one does this perfectly. Just keep the principles in this homework assignment in mind and practice them when you can.

[The book can be found at: http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_9?ie=UTF8&qid=1341756323&sr=8-9&keywords=How+to+Listen+so+parents+will%5DImage

 

Montana Parenting Homework, Part II: Backward Behavior Modification

Parent Homework Assignment 9-1

Backward Behavior Modification

One amazing thing about parenting is how easy and natural it is to do things backward. For example, imagine your 7th-grader comes home with a report card that has five A’s, one B, and one C. If you’re like most parents, you’ll take a quick look and say something like, “Why’d you get that C?” or, “How can you raise that B to an A?”

Even though these questions make excellent sense, they’re in direct violation of a very basic principle of human behavior. That principle is: Whatever you pay the most attention to will tend to grow and whatever you ignore will tend to shrink. Despite this powerful principle, our human and parental tendency is almost always to pay close attention to the F’s and C’s in life, while only offering a passing glance at the A’s.

Another version of the same problem happens with parents who have two or more children. Your children may coexist very nicely together 60 percent of the day and fight like cats and dogs for the other 40 percent. Unfortunately, in that situation the natural tendency is to give almost all your attention to your children when they fight and very little attention to them when they’re playing nicely.

The consequence of violating this basic principle is:

  • Your 7th-grader feels his efforts are underappreciated and becomes less motivated.
  • Your children, sensing that they can get more of your attention by fighting than from playing together nicely, may begin fighting even more.

Our first point with this homework assignment is to reassure you that it’s perfectly natural to pay more attention to “bad” behavior than “good” behavior. But, it’s equally true that even though paying too much attention to bad behavior is natural—it’s not helpful because it can become a reward for bad behavior.

Our second point is that you should work very hard to:

Pay more attention to your children when you like what they’re doing than you do when you don’t like what they’re doing.

Or, better yet, try this:

When giving out consequences, be boring, but when giving out rewards, be passionate.

I had this lesson driven home to me many years ago. While doing therapy with teenagers who were in trouble for delinquent behavior, they started telling me how much satisfaction they got from making their parents angry. When I asked about this, they said things like, “I love it when my dad’s veins start sticking out of his neck” or “It’s cool when I can get my mom so mad that she spits when she talks.”

Keep these images in mind the next time your child does something that gets under your skin. Then, instead of a long lecture complete with bulging veins and spitting, be short and boring. Use a monotone to say something like: “I don’t like it when you do that.”

Then, when your child comes home on time, or gets an A, or plays nice with her brother, or makes an intelligent comment about virtually anything—that’s when you should launch into a passionate and positive lecture—complete with bulging veins and spittle.*

*These rules may not hold perfectly for your unique child. For example, some teens may not like much positive attention. That’s why you’re the best judge of whether a particular parenting strategy will work with your child. We’re also kidding about the spittle; that’s hardly ever a good thing to see.

To look at the book this blog is based on, go to: http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_1?ie=UTF8&qid=1341534736&sr=8-1&keywords=how+to+listen+so+parents+will+talk

 

American Parenting—In Honor of Independence Day

It’s too dry this year to set off fireworks in Montana and so instead I’ll be blogging about parenting in honor of Independence Day.

The surge in interest and media coverage of Tiger parenting and French parenting this past year has been a great thing. It’s not that I think American parents should go out and adopt either of these styles (although I like Asia and France), but the more we talk and learn about parenting, the better. To keep parenting in the focus for both my blog readers (Hi Rylee:), every day this week I’ll be posting a blog on American parenting. Actually, this is more about Montana parenting.

 Montanans embrace values of independence, generosity, honesty, and hard work. In the spirit of these values—especially the hard work value—every day this week I’m featuring a different “Homework Assignment for Parents.” These assignments are adapted from the book How to Listen so Parents will Talk and Talk so Parents will Listen.

If you like these homework assignments, feel free to use them. If you like them a lot, go to the Amazon page and “Like” the book (thanks for doing that). And, of course, if you love what you’re reading you can buy the book at Amazon too. http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_6?s=books&ie=UTF8&qid=1341322827&sr=1-6&keywords=how+to+listen+so+parents+will+talk+and+talk+so+parents+will+listen

Here’s Parent Homework Assignment installment #1.

Creating Special Family Times

Special time for families can be formal (as described in the Special Time Tip Sheet) or less formal.

This homework assignment is for parents who want to work on creating spontaneous special time for family connection.

Idea 1: Be a keen observer of what your child loves. This can be as simple as noticing when and why your child smiles. If you watch for these happy or joyful moments, you’ll undoubtedly be able to generate ideas for how to help create more happiness and joy.

Idea 2: Ask yourself a few questions to get in touch with how you might create more special times. These questions might include:

1. ‘‘What do you and your child naturally do for fun together?’’

2. ‘‘When do you and your child find yourselves enjoying each other?’’

3. ‘‘What would be a fun or interesting activity that you and your child could do together?’’

4. ‘‘What does your child like to do on his or her own or with his or her friends?’’ ‘‘Is it possible for you to be involved in any of these . . . even as a supportive person to create the situation?’’

5. ‘‘Do you play any family games together with your child?’’

6. ‘‘What did you do for fun when you were younger?’’ ‘‘Is there any way to smoothly (without big expectations) introduce your child to something you love to do? (for example, playing cards, fly-fishing, second-hand shopping, arts and crafts, etc.)

Idea 3: Every once in a while drop everything and focus on your child. Although it’s not healthy for you to ‘‘be there’’ for your child and cater to his or her every desire, it is important to occasionally stop whatever you’re doing to give your child your undivided attention. This might involve turning off the television, closing your laptop, putting down the newspaper, or powering down your telephone. The point is that you want to give your child the clear message that she or he is your number one priority. This message will help you put a deposit in your child’s emotional bank account.

Idea 4: Speak up about your positive feelings. In the harried pace of American life, it’s easy to forget to add in the little positive expressions to the people you love. To counter this forgetful tendency, you should make a commitment to say ‘‘I love you’’ to your child every day. Perhaps even more important are spontaneous statements about how you ‘‘like’’ your child. Try that out. When you see something you like about your child’s personality or behavior, just say, ‘‘I like who you are’’ or ‘‘I like it when you do that.’’ Saying you like your child can convey even more important meaning to them than saying ‘‘I love you.’’ In addition, be clear about wanting to spend time with your child by saying things like, ‘‘I want to spend some time with you,’’ and then schedule it if you need to.

These are four simple ideas for creating special time in your family. Take a minute to think about these ideas and then improve on them by creating new and better ideas that fit your family and help you intentionally have more fun and more special times together.

http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_6?s=books&ie=UTF8&qid=1341322827&sr=1-6&keywords=how+to+listen+so+parents+will+talk+and+talk+so+parents+will+listen

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Is Solution-Focused Therapy as Powerfully Effective as Solution-Focused Therapists Would Have Us Believe?

[This Blog is adapted from a previous blog posted on psychotherapy.net]

Solution-focused therapy is very popular. But is it effective?

Beginning in the 1980s, solution-focused therapy hit the mainstream and many mental health providers (and third-party payers) continue to sing the praises of its brevity and effectiveness. For example, in a 2009 book chapter Sara Smock claimed, “. . . there are numerous studies, several reviews of the research, and a few meta-analyses completed that showcase [solution-focused therapy’s] effectiveness.”

Really?

Solution-focused counseling and psychotherapy has deep roots in post-modern constructive theory. As Michael Hoyt once famously articulated, this perspective is based on “the construction that we are constructive.” In other words, solution-focused therapists believe clients and therapists build their own realities.

Ever since 2003, my personal construction of reality has been laced with skepticism. That was the year President George W. Bush included 63 references to “weapons of mass destruction” in his State of the Union address (I’m estimating here, using my own particular spin, but that’s the nature of a constructive perspective). As it turned out, there were no weapons of mass destruction, but President Bush’s “If I say it enough, it will become reality” message had a powerful effect on public perception.

From the constructive or solution-focused perspective, perception IS reality. Remember that. It applies to the solution-focused therapist’s view of solution-focused therapy effectiveness.

I recall hearing many presenters tell me that solution-focused therapy is powerful and effective. Or maybe it was powerfully effective. And I recall reading books and articles that similarly referred to the power and effectiveness of solution-focused therapy. Now we could just take their word for it, but I still can’t help but wonder: “What does the scientific research say about the efficacy of solution-focused therapy anyway?”

Here’s a quick historical tour of scientific reality.

  • In 1996, Scott Miller and colleagues noted: “In spite of having been around for ten years, no well-controlled, scientifically sound outcome studies on solution-focused therapy have ever been conducted or published in any peer-reviewed professional journal.”
  • In 2000, Gingerich & Eisengart identified 15 studies and after analyzing the research, they stated: “. . . we cannot conclude that [solution-focused brief therapy] has been shown to be efficacious.”
  • In 2008, Johnny Kim reported on 22 solution-focused outcomes studies. He noted that the only studies to show statistical significance were 12 studies focusing on internalizing disorders. Kim reported an effect size of d = .26 for these 12 studies [this is a rather small effect size].
  • In 2009, Jacqueline Corcoran and Vijayan Pillai concluded: “. . . practitioners should understand there is not a strong evidence basis for solution-focused therapy at this point in time.”

Now don’t get me wrong. As a mental health professional and professor, I believe solution-focused techniques and approaches can be very helpful . . . sometimes. However, my scientific training stops me from claiming that solution-focused approaches are highly effective. Although solution-focused techniques can be useful, psychotherapy often requires long term work that focuses not only on strengths, but problems as well.

So what’s the bottom line?

While in a heated argument with an umpire, Yogi Berra once said: “I wouldn’t have seen it if I hadn’t believed it!” This is, of course, an apt description of the powerful confirmation bias that affects everyone. We can’t help but look for evidence to support our pre-existing beliefs . . . which is one of the reasons why even modernist scientific research can’t always be trusted.  But this is why we bother doing the research. We need to step back from our constructed and enthusiastic realities and try to see things as objectively as possible, recognizing that absolute objectivity is impossible.

Despite strong beliefs to the contrary, there were no weapons of mass destruction. And currently, the evidence indicates that solution-focused therapy is NOT powerfully effective.

 

The place to click if you want to learn about psychotherapy, counseling, or whatever John SF is thinking about.