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Child Therapy Techniques - The Center for Practical Tools for Child and Adolescent Therapists

Dr. David A. Crenshaw, Director  

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Dr. Crenshaw is co-editing a series of books for Guilford.  Please click here for his Guilford books and ordering information.

 Rosie, first NY trial dog and what you can do to support Rosie's Law

"Heartfelt Feelings" Coloring Cards

Certified translations in 8 languages

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Dr. Crenshaw's book Bereavement: Counseling the Grieving throughout the Life Cycle is so successful that it is now in its third printing and earned an average customer rating of 4.0 out of 5 starsfrom Amazon.com      

Read Dr. Crenshaw's articles in Play Therapy magazine by clicking on title: "Should I Be Worried?"  "Selective Mutism" "Preverbal Trauma" "No Time or Place for Child's Play" "Sounds of Silence" "Symbolism of Windows and Doors in Play Therapy" "The Wonder of It All" "Rosie Goes to Court"  "Secrets Told to Ivy"  with permission of Play Therapy Magazine.  

Two New Poetry Books By David A. Crenshaw (click on titles for details)       The Vision of the Heart  and A Place of Healing and Hope

Books below are available in paperback at 20% discount. To order click on the book images below or simply call 1-800-462-6420.  Code # 4W9CAPBK.  If you want to read reviews first, click on book title under the book image.

Child and Adolescent Psychotherapy: Wounded Spirits and Healing Paths,

Therapeutic Engagement of Children and Adolescents

Understanding and Treating the Aggression of Children: Fawns in Gorilla Suits

Understanding and Treating Aggressive Children: Fawns in Gorilla Suits

Handbook of Play Therapy with Aggressive Children

 

Evocative Strategies in Child and Adolescent Psychotherapy

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David A. Crenshaw, Ph.D., ABPP 205 Dogwood Court Poughkeepsie, NY 12601

Phone:  (845) 489-8661

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Copyright © 2004-2015 by David A. Crenshaw, Ph.D., ABPP. All rights reserved.

Should I Be Worried?  Understanding My Child’s Anger

By David A. Crenshaw, Ph.D., ABPP

     “He is usually a caring and sensitive child, but when he explodes in rage he is like a monster.” The frustrated mother was describing her 8-year-old son Michael, a second grader who is liked by his teachers and his classmates — except when he has a “meltdown”. During a meltdown, Michael is like a different child and it is scary to the other children. Both his parents and teachers are worried.

     Michael is typical of children who display a pattern of impulsive-reactive aggression as described by psychologist Ross Greene in his book The Explosive Child. These children acquire various diagnostic labels when they are evaluated by mental health professionals — ADHD, Oppositional/Defiant Disorder, or Disruptive Behavior Disorder. As Greene explains, however, the two primary features shared by such children, regardless of diagnostic labeling, are low frustration tolerance and inflexibility. These children are not exhibiting a character flaw or a moral weakness, but simply manifesting subtle neuro-developmental deficits related to difficulties in emotion and impulse regulation. Until neurological maturation enhances the ability of these children to self-regulate in a more reliable and consistent manner, they tend to be overwhelmed by their strong emotions and often experience emotion in an all-or-none manner. Either the child feels nothing at all, or experiences anger as red-hot rage — with nothing between. In other words, they have not developed the capacity for modulation.
Greene advocates an active teaching approach, which I strongly endorse.

Tools for Modulation

    Verbal mediation is a crucial tool for modulating anger. Children who have developed the capacity to identify, label and verbalize their feelings are more skilled at modulating emotions. Children have to be taught a language for their feelings by parents and teachers, as they tend to have significant difficulty finding words to express their emotional states. A respected colleague explained that children who are aggressive tend to experience emotion “like a wind blowing through their system.” In other words, the feelings are non-descriptive and undifferentiated, leaving kids unable to identify or share them. Even highly verbal children often have a limited vocabulary when it comes to emotional states.

     One of the most effective interventions for a child who explodes in rage is to teach her/him an expanded vocabulary for dealing with feelings. The vocabulary should include not just “angry” and “mad”, but words that capture the various levels of intensity — such as “irritated”, “annoyed”, “furious”, and “enraged”. This approach is based on the technique of scaling. For children who do not know how to modulate their anger, teaching them a vocabulary that expresses degrees of intensity helps them understand that emotions do not have to be experienced in an all-or-none way.

    Another way to convey the concept of scaling and degrees of anger is through the use of an anger thermometer like this one:

 

 
   
   

Anger Thermometer
     The child can be helped to find words to express anger at a low level (blue zone), at the mid level (yellow zone), and at the high level (red zone). This tool can be used to help children process anger after a situation that has triggered a meltdown. Parents and/or teachers can not only help children find words to express their anger in each zone but can teach problem solving skills that play a crucial role in developing self-regulation. Children can be asked, for example, what choices they might have for expressing low level anger if they notice they are only irritated or annoyed. Obviously, if children don’t notice the signs of building anger until it is in the red zone, their choices are going to be limited because for most kids it is too late. When they reach the meltdown point, they are unable to reason or to think clearly, and at that point, all the parent or teacher may be able to do is to try to keep the children safe.

     It is helpful to focus kids on the early signs of anger build-up. Do they notice their voices rising, their hearts racing, the clenching of their teeth or fists? The earlier these signs are noticed, the more likely it is that children will be able to head off a meltdown. Since a sense of personal control is important to children, it can be helpful to frame early detection skills as ways they can maintain control of their anger.

     The self-calming skills often cited by children as helpful are: 1) walk away; 2) use distraction to get your mind off it: 3) count to ten; 4) take three deep breaths; 5) use coping statements, like, “I can handle this,” or “I am in control here”; 6) rationalization statements, like, “I didn’t want to go to the party anyway”; and 7) displacement into physical activities like a vigorous game of basketball with friends.


Additional Tips for Parents and Teachers

     Perhaps the most effective way parents and teachers can help children develop constructive ways to express anger is to set a good example. If a teacher or a parent is always yelling, it will be hard to motivate the kids to work on their own anger management issues. Conversely, if we model remaining calm even when under stress, and demonstrate that there are constructive ways to cope with the inevitable frustrations that arise in daily life, children will want to imitate such behaviors and eventually, if they are attached to us, will internalize adaptive coping behaviors.

     We need to be careful about the way we think and talk about anger in children. Even the most furious, enraged child is not angry all the time. Some children are angry at home, but not at school — or vice versa. Some kids only become aggressive if they are humiliated. If we think of kids as monsters or demons, they have an uncanny way of living up to our expectations.

     It is helpful if we can identify the triggers and the specific contexts that lead to meltdowns and then help the child be aware of these triggers and ways to cope when provocations are unavoidable. If the child’s rage poses a risk to others or her/himself, a mental health evaluation by a licensed psychologist, social worker, or child psychiatrist experienced in problems of aggression in children is recommended.

 

Text Reprinted with permission of Westchester Parent Magazine (Feb/06)  Photos were not part of original article.

 

 

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