Adult Treatment Planner

Objectives and Interventions

• Provide information on the marital relationship, child behavior expectations, and style of parenting.
  • Engage the parents through the use of empathy and normalization of their struggles with parenting and obtain information on their marital relationship, child behavior expectations, and parenting style.
• Identify specific marital conflicts and work toward their resolution.
  • Analyze the data received from the parents about their relationship and parenting and establish or rule out the presence of marital conflicts.
  • Conduct or refer the parents to marital/relationship therapy to resolve the conflicts that are preventing them from being effective parents.
• Complete recommended evaluation instruments and receive the results.
  • Administer or arrange for the parents to complete assessment instruments to evaluate their parenting strengths and weaknesses (e.g., the Parenting Stress Index [PSI] or the Parent-Child Relationship Inventory [PCRI]).
  • Share results of assessment instruments with the parents and identify issues to begin working on to strengthen the parenting team.
  • Use testing results to identify parental strengths and begin to build the confidence and effectiveness level of the parental team.
• Express feelings of frustration, helplessness, and inadequacy that each experiences in the parenting role.
  • Create a compassionate, empathetic environment where the parents become comfortable enough to let their guard down and express the frustrations of parenting.
  • Educate the parents on the full scope of parenting by using humor and normalization.
  • Help the parents reduce their unrealistic expectations of their parenting performance.
• Identify unresolved childhood issues that affect parenting and work toward their resolution.
  • Explore each parent's story of his/her childhood to identify any unresolved issues that are present and to identify how these issues are now affecting the ability to effectively parent.
  • Assist the parents in working through issues from childhood that are unresolved.
• Decrease reactivity to the child's behaviors.
  • Evaluate the level of the parental team's reactivity to the child's behavior and then help them to learn to respond in a more modulated, thoughtful, planned manner.
  • Help the parents become aware of the "hot buttons" they have that the child can push to get a quick negative response and how this overreactive response reduces their effectiveness as parents.
  • Role-play reactive situations with the parents to help them learn to thoughtfully respond instead of automatically reacting to their child's demands or negative behaviors.
• Identify the child's personality/temperament type that causes challenges and develop specific strategies to more effectively deal with that personality/temperament type.
  • Have the parents read The Challenging Child (Greenspan) and then identify which type of difficult behavior pattern their child exhibits; encourage implementation of several of the parenting methods suggested for that type of child.
  • Expand the parents' repertoire of intervention options by having them read material on parenting difficult children (e.g., The Difficult Child by Turecki and Tonner; The Explosive Child by Greene; How to Handle a Hard-to-Handle Kid by Edwards).
  • Support, empower, monitor, and encourage the parents in implementing new strategies for parenting their child, giving feedback and redirection as needed.
• Verbalize an understanding of the impact of their reaction on their child's behavior.
  • Use a Parent Management Training approach beginning with teaching the parents how parent and child behavioral interactions can encourage or discourage positive or negative behavior and that changing key elements of those interactions (e.g., prompting and reinforcing positive behaviors) can be used to promote positive change (e.g., Parenting the Strong-willed Child by Forehand and Long).
  • Teach the parents how to specifically define and identify problem behaviors, identify their reactions to the behavior, determine whether the reaction encourages or discourages the behavior; generate alternative constructive reactive behaviors.
• Implement parenting practices that have been proven to be effective.
  • Teach the parents how to implement key parenting practices consistently, including establishing realistic age-appropriate rules for acceptable and unacceptable behavior, prompting of positive behavior in the environment, use of positive reinforcement to encourage behavior (e.g., praise), use of clear direct instruction, time out and other loss-of-privilege practices for problem behavior, negotiation, and renegotiation (usually with older children and adolescents).
  • Assign the parents home exercises in which they implement and record results of implementation exercises; review in session, providing corrective feedback toward improved, appropriate, and consistent use of skills.
  • Ask the parents to read parent-training manuals (e.g., Parenting through Change by Forgatch) or watch videotapes demonstrating effective parenting techniques (see Webster-Stratton, 1994).
• Verbalize a sense of increased skill, effectiveness, and confidence in parenting.
  • Support, empower, monitor, and encourage the parents in implementing new strategies for parenting their child, giving feedback and redirection as needed.
  • Train the parents or refer them to structured training in effective parenting methods (e.g., 1-2-3 Magic by Phelan; Parenting with Love and Logic by Cline and Fay).
  • Educate the parents on the numerous key differences between boys and girls, such as rate of development, perspectives, impulse control, and anger, and how to handle these differences in the parenting process.
  • Have the children complete the "Parent Report Card" (Berg-Gross) and then give feedback to the parents; support areas of parenting strength and identify weaknesses that need to be bolstered.
• Partners express verbal support of each other in the parenting process.
  • Assist the parental team in identifying areas of parenting weaknesses; help the parents improve their skills and boost their confidence and follow-through.
  • Help the parents identify and implement specific ways they can support each other as parents and in realizing the ways children work to keep the parents from cooperating in order to get their way.
• Decrease outside pressures, demands, and distractions that drain energy and time from the family.
  • Give the parents permission to not involve their child and themselves in too numerous activities, organizations, or sports.
  • Ask the parents to provide a weekly schedule of their entire family's activities and then evaluate the schedule with them, looking for which activities are valuable and which can possibly be eliminated to create a more focused and relaxed time to parent.
• Develop skills to talk openly and effectively with the children.
  • Use modeling and role-play to teach the parents to listen more than talk to their child and to use open-ended questions that encourage openness, sharing, and ongoing dialogue.
  • Ask the parents to read material on parent-child communication (e.g., How to Talk So Kids Will Listen and Listen So Kids Will Talk by Faber and Mazlish; Parent Effectiveness Training by Gordon); help them implement the new communication style in daily dialogue with their children and to see the positive responses each child had to it.
• Parents verbalize a termination of their perfectionist expectations of the child.
  • Point out to the parents any unreasonable and perfectionist expectations of their child they hold and help them to modify these expectations.
  • Help the parents identify the negative consequences/outcomes that perfectionist expectations have on a child and on the relationship between the parents and the child.
• Verbalize an increased awareness and understanding of the unique issues and trials of parenting adolescents.
  • Provide the parents with a balanced view of the impact that adolescent peers have on their child.
  • Teach the parents the concept that adolescence is a time in which the parents need to "ride the adolescent rapids" (see Turning Points by Pittman; Preparing for Adolescence: How to Survive the Coming Years of Change by Dobson) until both survive.
  • Assist the parents in coping with the issues and reducing their fears regarding negative peer groups, negative peer influences, and losing their influence to these groups.
• Increase the gradual letting go of their adolescent in constructive, affirmative ways.
  • Guide the parents in identifying and implementing constructive, affirmative ways they can allow and support the healthy separation of their adolescent.
• Parents and child report an increased feeling of connectedness between them.
  • Assist the parents in removing and resolving any barriers that prevent or limit connectedness between family members and in identifying activities that will promote connectedness (e.g., games, one-to-one time).
  • Plant the thought with the parents that just "hanging out at home" or being around/available is what quality time is about.