Book Excerpt: How to Discipline a Defiant Child

My job is made more complicated by the sheer volume of advice and therapeutic approaches, much of it misguided, that's already out there. Parents who come to my clinic often have a mishmash of good and bad and irrelevant parenting lore already floating in their heads. Sometimes they have tried other treatments, including some that superficially resemble methods that actually work, and those treatments have not helped much.

I feel for these parents. They're looking for workable solutions in a field with insufficient quality control. There are over 550 therapies for children and adolescents. Over 90 percent of them haven't been tested with any scientific rigor. We simply don't know if they work or don't work. But there's no public outcry of What's the basis for this? There are no hoops through which a therapy must pass to get on the market, no equivalent of the Food and Drug Administration's approval process for a new drug. What's out there might work, but it's often being used in place of things that are known to work. And a few widely accepted treatments have actually been proven to make behavior worse.

This is the fault of the mental health professions, not of parents, who make what sense they can of the tsunami of seemingly authoritative information constantly coming at them. I'm doing what I can to effect change in my profession from within. As president of the American Psychological Association, which has over 150,000 members, one of my main goals is to encourage the recent turn in clinical work toward greater accountability to scientific standards.

But there's still a lot of poor advice out there. For instance, one parenting book that's been in circulation for years says that if a brief time-out doesn't work, keep upping the ante and make it longer, even going to a so- called monster time-out lasting four hours or more. But the research shows us that more intense punishment does not lead to greater change in behavior. If you are giving more and longer timeouts, it means your strategy is failing. The answer is not to escalate — just the opposite, in fact. If you're giving more and longer time-outs, this should tell you that you need to do more to positively reinforce good behaviors to replace the unwanted behaviors.

Speaking of time-outs, plenty of experts explain that you give a child a time-out so that he can think about how he got into trouble. This is a complete misunderstanding of time-out, which is not about thinking at all. We know this because animal research proves that time-out works with all sorts of mammals that do not have our cognitive power. In a time-out, we simply withdraw attention for a brief period. Getting a child to think about things is really good for lots of reasons but not as a way to change the child's behavior. Getting the child to do things differently, on the other hand, will change behavior and the child's thoughts about it.

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