Transcript Working with Aggressive Children

MAZCAN Enterprises
Understanding and
Managing Physically
Aggressive Youth
Training Summary
 This training is designed to assist counselors in
understanding and managing physically aggressive
behaviors in children and youth.
 Clinicians will be equipped with the ability to better
assist the youth severed by utilizing techniques that
will be covered in this training.
Objectives
 Clinicians will learn that approaches with managing
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children with aggressive behaviors depend on the child’s
developmental stage.
Clinicians will be able to define aggression in children
and youth.
Clinicians will develop a greater understanding of the
factors that contribute to aggressive behaviors in
children.
Clinicians will learn a variety of techniques that will
assist them in managing aggressive behaviors.
Clinicians will learn some resources and some strategies
for self-care to assist them in dealing with aggressive
behaviors of children.
Why children explode
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Many children are not
able to comply with
expectations because of
developmental delays.
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They lack the skills they
need to be successful.
Youth Issues
 Poor communicators, tend to be less verbal
 Lower than average intellectual functioning
 Have “anger issues”
 Difficulty with change
 Difficulty with relationships or attachment
Dynamics of Aggression
 Research demonstrates that adjudicated youth feel
they have little or no control over their lives
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Often feel they cannot make any decisions
Many youth have been moved “on a whim”
 They are frustrated and angry at “the system”
 They blame their parents, case managers, foster
parents, school teachers, judges and anyone else they
believe is responsible for their unhappiness
 Research also shows that they feel there are two ways
they can take control of their lives: passive resistance
or physical aggression
Other Dynamics of Aggression
 They may have seen aggression modeled by their
family members and mimic it
 They may have experimented with aggression as a
behavior and continue to use it
 They may have a physiological problem and it may
be more difficult for them to manage emotions
 Progress in this area requires a longer view—
immediate consequences often do not provide
immediate change
Crisis Prevention Planning
 Takes place early in a
case
 Considers child’s past
and experiences
 Includes input from the
child, caseworker, and
others involved in child’s
care
Gender Differences
Girls internalize their
victimization
 Cry
 Shut down
 Become emotional
Boys externalize their
victimization
 Be come aggressive, fight
 Verbally Disrespectful
 Non -Compliant
Skill Building
 Let the youth know, trouble is addictive.
 Group Work:
 Let them choose worlds
 World One: Peaceful World: people live together,
they care about each other.
 World Two: Violent World: People die, use drugs are
homeless
Skill Building Continued
 Make it interesting using cognitive behavioral
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approach.
Promote mutual aid- when youth helps other youth
with problems, they are helping themselves at the
same time.
Help develop anger and impulse control.
There are good ways/bad ways to deal with anger).
Ask questions like: What sports player handles a bad
call well and how?
Pre-Blowup
 Setup youth or child for success
 Assess medication
 Observe child or youth
Determine baseline and record on calendar
 Document youth behavior on a calendar
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Give clear, short instructions when a child is frustrated or
upset
Put your irreplaceable things away or in storage, help you stay
calm
Steps for Practicing with Youth
 Describe the behavior you are teaching
 Give a reason using an if/then statement
 Demonstrate the behavior for the child
 Have the child engage in the behavior and practice
 Reward
5 Steps to Problem Solving
Define the
problem
Evaluate the
Results
Obtain a
Commitment
Brainstorm
Alternatives
Choose a
Solution
Things to Remember
 Do not walk on eggshells or let child/youth train you
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to accommodate their behavior
You will do the work, either now or later
Have low tolerances with small consequences, if you
consequate interrupting, name calling and yelling
then you will deal with less physical aggression
Negotiating is ok, as long as it is not bribe or
blackmail
Bribe is a reward which comes before the behavior
During the Blowup
 Stay about 10 feet away from the youth
 De-escalation begins with delivery of a consequence
 Youth may tantrum to avoid a consequence
 Deliver one consequence, additional chores or lose privileges
for a day
 Don’t pile consequences on or think that delivering a
consequence will result in compliance
Steps for Calming the Youth
 Express empathy or praise
 Describe behavior you need them to stop
 Yelling
 Swearing
 Stomping around
 Describe what you want them to do
 Short instructions
 Pleasant voice
 Don’t expect compliance but praise approximations
 Repeat first three steps until youth calm down
Allow time for them to calm down
During the Blowup
 Only discuss the child’s behavior, not the issue or
situation that began the blow-up
 Ignore any “baiting”
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“You’re nicer to the other kids”
“You are so unfair”
“You don’t know what it’s like nowadays”
 Monitor your own behavior
 Remove any audience
 Explain how youth can resolve the situation
During the Blow-up
 Know when to call the police
 Teenager assaults a peer and/or professional
“You need to put the knife down in 5 seconds or I will have to call
the police”
 Youth needs to learn that familial violence is unacceptable
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Impact on the family
 Sadness
 Guilt
 Helplessness
 Hopelessness
 Disappointment
Things you Should Do
 Avoid blocking exits or areas of travel
 Appear relaxed and calm
 Slouch
 Lean against a wall
 Break eye contact
 Remain about 10 feet away—no closer!
 Remember—you are in charge and in control
 It is a matter of time
 You don’t need to convince them you are in charge
Basic Relaxation
 Deep Breathing
 Count Backwards from 10
 Imagery- Think of a fun place or a joke
 Know physical signs when you are angry
 Talk to yourself’ Say:
 “I’m not going to feed into this negativity.”
 “She’s trying to make me look stupid.”
Response Examples
 Fogging: Play down the significance of an insult.
Deflect things.
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Insult: “you’re stupid”
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Response: “Yeah, I am.”
 Play a game: I try to make you upset but you don’t
let it phase you. Make it fun. If you keep your cool
you win, if you don’t you loose.
Interactive Examples
 Equip youth with skills to use in society, in the
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world.
Exercise: We are going to call your teacher, your
employer and tell them to insult you.
Questions:
Will you keep your calm or will you loose it?
How will it impact you as a student or employee?
How will that impact your life?
Effective Communication
 Youth can insult better than give compliments.
 Communications allows you to make friends,
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establish relationships and ask for help.
Show youth the difference between being assertive
and aggressive.
Ask basic questions to test assertive IQ
What if you ordered a hamburger at a restaurant and
it was raw in the middle?
What if waited for a friend at 8 pm and they came at
8:45?
Social Problem Solving
 Identify the problem
 What do I want to happen?
 Evaluate the consequences
 Apply the problems)
Social Problem Solving
 If someone stares at you it’s usually 1 of 3 things:
 He likes your hat
 He thinks he knows you
 He doesn’t like how you look
 Hostile Attributions:
 Misinterpreting neutral situations or statements.
 Teach them what is neutral vs. what’s provocative.
 This is necessary to keep them out of trouble.
Developing Empathy
 Empathy is a deterrent to anti-social behavior
 Morality allows youth to reason in moral terms
 Law of the jungle- I’ll do because if not I will get my
butt kicked
 Making deals-You take care of me , I’ll take care of
you. What’s in it for me attitude.
 Trust /Caring- Concerned about what others think.
Seeing things from the same perspective
Empathy Exercises
 Measure their empathy and thought process.
 Youth stands outside of a store, they notice a lady
double parks in front of the store and leaves her keys
inside of the car.
 Ask the youth what would you do?
Empathy Exercises
 Have youth name moral and immoral people
 Public figures and people in their personal lives
 Ask them: How do you want to be remembered?
 Talk about divorce, separation or relationship of
parents
 Encourage youth to volunteer
 Crime reenactment role playing activity
 Have them demonstrate how they victimized
something else
Group Work
 Be careful of group
 Take charge from the
members
 Work with co-therapist
 Always make your group
short 45 minutes
start
 Have a pre planned
agenda
 Establish rules, limits,
time, cursing
confidentiality group is a
safe place
Group Work
 FIRST: Pair into groups only 2 a pair
 Have them spend 5 minutes interviewing their
partner
 Introduced your partner
 Hit Parade: Each person bring a song or a CD have
them play it and share how does that song represent
them and “their story.”
Group Work
 Go into the group expecting wise cracks and disorder
 Place a chair in the front of the room-Allow them to
entertain
 Do something impulsive-Run to the window when 3
or more children act out.
 Celebrate unification
 Always get the toughest member to buy in to your
objective
The “C.A.K.E.” Model
Paper
• Create a
mind map or
other
illustrations
T-Shirts
• On the front
how the
public sees
them
• On the back
how they see
themselves
Calming Down
Work Table
• Have them
answer
specific
questions
about their
behavior
Calming Down Worktable
Things that make
How I can tell I
How I can calm
me angry
am getting angry –
down
Body signals
Telling me no
My face feels hot, I Take a deep breath
start to talk fast
before speaking
Youth Connections
 First Establish a connection with the youth.
 Youth feel counseling doesn’t offer them anything.
 Advocate to them to take control of their own lives
(youth in foster care and residential institutions)
 Identify what motivates them
 Sell them on the idea to work at changing their lives
i.e.: we need people like you, going to school, getting
a job etc.
Clinical Strategies
 Make treatment interesting, almost fun, teens have a
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problem with boredom
Use reverse psychology when appropriate
In the school setting integrate ways to get youth
interested
We want them to feel that we understand their pain
and hurt.
Convince them that counseling is useful and they
have an alliance.
How to respond to youth silence
 “I cant believe that you can be so silent.”
 “How can you do that?”
 “ I know that you may think that this is stupid, but
lets make a deal to meet and talk 3-4 times about
anything.”
Techniques for Resistant Youth
 Joining Techniques: Admire their bravado: “I can’t
believe how tough you are.” Be interested.
 Boasting Component: Priming and pumping
information from youth. Tell them how “great” place
a positive spin each time they provide you with
information.
Techniques for Resistant Youth
 Find a way to make yourself useful.
 Talk to them about their world. i.e. how to shave, do
their hair etc. This will build trust.
 Try to be a resource to the youth.
 Be able to take advice from them, allow them to offer
you something.
 Use their friends to their advantage. Invite the friend
to the next meeting- Best friend will become a junior
shrink. (let them know it’s a one time deal).
Writing Assignments and Other Techniques
 Have youth fill out worksheet on SODAS
 Complete Aggression Log or calming down
worksheet
 Practice emotional regulation techniques
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Thinking about consequences
Thinking about what you want
Thinking about something pleasant
Thought-stopping/Taking a minute
Put pleasant things in your room
Sing positive song to yourself
Develop a positive saying to repeat to yourself
S.O.D.A.S.
 SITUATION: One sentence describing the situation
 OPTIONS: List at least three options available
 DISADVANTAGES: List at least three disadvantages
for each option
 ADVANTAGES: List at least three advantages for
each option
 SOLUTION: Pick one of the options
Other Behavioral Techniques
 Differential reinforcement of incompatible behavior
 Focus on teaching skills that make it impossible to do the
negative behavior
 You cannot yell if you are speaking in a normal voice
 Differential reinforcement of other behavior
 Focus on teaching and rewarding skills rather than providing a
negative consequence for a behavior
 Rewarding a youth for being sensitive to others’ needs makes it
less likely you will need to provide a negative consequence for
hitting
Differential Reinforcement of Other Behavior
 Identify the problem behavior
 Identify the skill or behavior that the youth have or
you would like them to have
 You can use shaping and chaining to build on a
strength
 Reinforce the behavior or skill you want to have
rather than the problem behavior
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Breathing deeply
Complimenting
Any of the emotional self-regulation techniques
Appropriate Expressions of Anger
 Relaxation Techniques
 Problem Solving
 Letter to nowhere
 Journal
 Physical activity
How Meaning is Conveyed
 7% is in words that are
spoken.
 38% of meaning is in the
WAY words are spoken.
 55% of the meaning is in
facial expression.
Self-Care
 Stay in touch with supportive friends
 Exercise
 Use support groups
 Keep a sense of humor
 Forgive yourself
Conclusion
 Working with aggressive youth and children can be
frustrating
 Have a long-term view and track the progress so you
can see it
 Modeling patience, polite asking and sensitivity to
others helps youth learn more quickly
 Everyone can learn and change
Questions and comments
Thank You All!
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