Helping Difficult Children Stay Off Medications

The Basic Problem

Many of my colleagues in the treatment world have told me that, prior to finding an approach that works to shift a child’s intensity to greatness, they felt they had no choice but to recommend psychiatric evaluation (which usually led to a prescription for psychiatric drugs) for difficult children. They felt they had no recourse; they couldn’t ignore the dangers inherent in the child’s accelerating poor choices. Most relevant here is that in retrospect, they felt that it boiled down to simply being faithful to their training…which, it turns out, is often a setup for failure with difficult children.

Hopefully things have improved now, but even with my history of having gone to a top school to earn my degree in clinical psychology, guided by highly inspired and brilliant professors, I came away with a repertoire of methods that ran me into a wall when actually working with clients.

The Reality of The Situation

I found that at that place where the rubber meets the road – where I was working directly with children and families, giving them my best professional advice – things got worse for them instead of better. I ended up burned out because the methods I was given either didn’t have the impact needed or put the children and their families I was trying to help at risk for escalating problems and further treatment, including medications. This is a story I hear from many other clinicians to this day.

Certainly when we wring our hands in frustration and see no rays of light ahead for a client, we feel ethically bound to recommend attempts to provide relief, including psychiatric evaluations. What most people do not know is that a child and family innocently sent for a behavioral evaluation with a medical professional most often winds up with a prescription in hand that very day.

Doctors surely are trying their best to help, but in the current environment, their repertoire of solutions for children with challenging behaviors tends to be limited to medication 1, 2 or 3. When our tool of choice is a hammer, everything looks like a nail. Psychiatry’s tool of choice is medications.

So let me explain why, in my opinion, most treatments fail with these children. I’m speaking as someone who, when I first began to use the method I developed to counsel very difficult children, was rumored to be able to “cure ADHD.” That method has been greatly refined over 15+ years. We’ll come back to that later.

The Medical Model

Most treatment paradigms are still based on a medical model at the core: they are pathology-based and problem-oriented. All the theories and philosophies of treatment when I was a student believed that by simply getting to the bottom of a problem by talking it through, by facilitating understanding, by getting to the core of the emotions and by uncovering the depths of the currently twisted dynamics, that blessed relief will occur.

This sounds so right in theory, but in practice, this type of exploration – the path of trying to find the mystical “why” – actually rewards the very problem you are trying to solve.

When things are going right, we are relatively low-key, even boring. Even highly loving parents and teachers typically are limited to a few short praises when things are going well: comments like ‘thank you!’ and ‘good job!’ On the other hand, most adults can wax poetic in great detail over most anything negative. It is remarkably easy for any child with a little more life force, intensity, sensitivity and neediness to conclude that adults are so much more interesting, animated, available, connected – offering juicier relationship – when things are going wrong.

In the end, what happens is this: negative behaviors earn kids what’s tantamount to a terrific broadband connection with the people who matter most to them: their parents and teachers. Positive behaviors elicit something akin to dial-up.

Let’s Get Better Broadband

No one wants to go back to dial-up – we all want better broadband. What happened for you the last time you lost your Internet connectivity? Did you scramble to try to get connected again? When most kids act out, this is what they’re doing. (Exceptions would be the tiny minority of difficult children who actually need medications to function well and be safe.) They accidentally discover that the best broadband is available when things are going wrong and it simply becomes habitual, and for some kids, perpetual. It’s all about energy.

Those kids who get best at playing with that energy – at eliciting intense connectivity through negative behaviors – are often the ones who end up in a psychiatrist’s office being evaluated and prescribed drugs that could create a brain chemical imbalance where none exists. The child is actually adapting spectacularly to her world by doing what she’s doing. If we want to change this dynamic without medicating the child, we have to recognize that by pouring energy into the problem, we are responding in a completely upside-down way.

Encouraging Positive Behavior

How do I know this is true? When you change the flow of energy by bringing it on when things are not going wrong – when things are going right – the most challenging children quite suddenly become much more interested in making positive choices. This is how the approach I developed works, and it reliably pulls even the most challenging children into greatness.

Conventional and traditional approaches to parenting and teaching set kids up for escalating patterns of progressively difficult behavior. Adults are simply trying as hard as they can with normal methods, and when problems emerge, out come the lectures and strident measures of correction. Lots of energy flows, and that just deepens the pattern.

I Get Attention When Things Go Wrong

And there it is; therein lies the problem with traditional treatments and interventions in schools and in homes. They so strive to engage with the child at the point of the problem, and because of this, they inadvertently wind up so often making matters worse: further entrenching this child’s basic impression that they get more – more and better energy, connection, and relationship – when things go wrong.

For example: I’ve met so many school counselors, who get called into a classroom in the midst of a problem. The expectation is that the counselor will take the child to his office for a discussion to resolve the issues and document the incident. And school counselors are so well trained and such caring, kind, compassionate people! They get the child to their office to talk, and the issues might seem to be ironed out and the child prepared to do better in class from then on. All might seem rosy. But guess who’s back in the counselor’s office because of the same or greater problems the next day, if not sooner?

That time with the counselor further imprints the child’s deepening impression that ‘better broadband’ – sweeter relationship – through negativity is the way to get great one-on-one time with that caring, kind and compassionate counselor. Before you know it, the school is pushing for an evaluation and medications because the child is continuing to be disruptive and end up in the counseling office.

The Setup Is For Failure

It’s a setup to fail. Our philosophies of parenting, education and treatment end up guiding and propelling us in a direction that brings us to the cliff of seeing no other alternatives. Without an approach that flips the conventional wisdom on its head, we will keep losing these challenging children to the ethics of pathology and where that road ultimately leads.

Thousands of social workers, counselors, psychologists, coaches and therapists are already consciously daring to exit the realm of normal approaches. They have found an alternative that truly strengthens children from the inside out; that refuses to be problem- and pathology-oriented; and that refuses to energize negativity. This approach folds in a novel and effective inroad to limit-setting.

The Alternative: Show Gratitude For Good Choices

Those who have dared to explore this approach have found that once the pattern is reversed and great connection is restored through energized appreciation and gratitude for a child’s good choices, good can go to great. Once that channel is open, it’s easy to appreciate a child like this: “Kimberly, I appreciate that you didn’t argue when I said no to your request. You are showing me your wisdom, power and control in following that rule and for choosing to be respectful.”

Things shift fast when children are noticed for the great qualities that are always already there. They light up. They begin seeing that an even higher caliber of ‘broadband’ is available for doing what’s right. Then, the icing on the cake: if parents, teachers, and treatment professional are really daring, they take positive acknowledgements to the level of greatness: “And Kimberly, these are all qualities of your greatness that I see in you.”

Manifesting Greatness Through Positivity

Talk about better broadband. This is where to find it: in what’s going well, and in what’s not going wrong. Shining the gift of adult attention there demonstrates to children of all intensity levels that this is where the good stuff lives. They start acting out greatness to achieve that relationship they crave, instead of challenging and rule-breaking.

We all want better connection in some ways – call it oneness, intimacy or closeness. Watch what happens when you consistently demonstrate to a child that it’s truly available through positivity. You’ll see children who are thriving – children we’d never think to submit for psychiatric evaluation or a prescription for medications to control their behaviors. The fire of their intensity becomes something we’d never dream of putting out.

For more on the approach I created to help challenging children step into their greatness, including a free e-course, go to www.childrenssuccessfoundation.com.

Photo Credits

Four filled pill bottles on a shelf – Microsoft Office Clipart Collection

Young boy showing thumbs up sign – Microsoft Office Clipart Collection

A version of this article appears at Mad In America

Guest Author Bio

Howard Glasser
Howard Glasser is a revolutionary psychologist, creator of the Nurtured Heart Approach, and author of the best selling book on the topic of ADHD, Transforming the Difficult Child. As the Executive Director of the Children’s Success Foundation, he writes books on his approach and offers live certification training and online courses to parents, educators, and mental health professionals on how to create communities in which all children flourish.