Tag: adhd

Popular Psychology

Childrens Therapist: Yep That’s Me!

by Torey C. Richards, LMHC2 Comments on Childrens Therapist: Yep That’s Me!

Preschool girl listening to teacher in classroomI like to share with my readers whenever anything changes or happens that I think is appropriate for you to know and recently I got a new job title, childrens therapist.

It’s funny how the universe works. Sometimes the more you try to avoid doing or dealing with something, the more you end up on a collision course to face it head on. That’s how I feel right now. I’ve been working in the field of counseling and psychology since 2006 and started off working with adults. In 2010 I started working with teenagers in an inner-city high school and absolutely loved it.

Around the same time I was offered an opportunity to work with younger kids, but cringed at the idea of doing therapy with kids who had trouble verbalizing and processing. Things such as play therapy were very foreign to me and when I started doing some in-home counseling I started seeing a few kids that were between the ages of 10 and 12. I quickly referred them out feeling both uncomfortable and unprepared to work with kids that young.

Well recently I changed jobs. I was looking to work more with clients and wanted to work with adults, but ended up landing a job as a childrens therapist within the last two weeks. I already have 10 clients, ranging from the ages of 4 to 14.  A four year old! Supposedly he has ADHD, and that may be the case, but I’ve met his parents and I am sure that their parenting skills aren’t the best so maybe with some parent training they’ll learn hoow to deal with him better and help shape him so that he doesn’t get stuck with the diagnosis of ADHD if it isn’t really appropriate.

I’m also being used in the capacity of a licensed evaluator to evaluate and diagnose kids who aren’t on my case load and have been giving the responsibilty of working with all the kids that are referred to the program through the department of juvenile justice.

It’s a bit overwhelming, challenging and exciting because there is so much I have to learn so that I can help these kids and their parents, especially the younger ones that traditional talk therapy doesn’t work with.

Earlier this week I was sitting with a 10 year old girl and we were doing pretty good. We were doing traditional talk therapy and she seemed to be doing fine with it and I remember thinking, “this isn’t so bad”, but about halfway through it she asked “can we color”. I was thrown off for a second, but then laughed to myself as I remembered she was a kid and told her “yes we can color”. And so we colored, and talked and it was pretty cool!

I have my first child who just turned 6 months over the weekend and here I am being thrown into the role of a childrens therapist. It’s like the universe had this whole thing set up and sometimes that’s just the way I think life works. At the same time, it’s forcing me to get out of my comfort zone, something I am always telling clients to do and I have so much I have to learn that I feel like a student again.

I have read this great book I have talked about before called The Boy Who Was Raised As a Dog: And Other Stories From a Child Psychiatrists’ Note Book by Bruce Perry. It is a book that talks about the horrific effects of childhood trauma, some intentional, and some unintentional in the form of neglect and ignorance.

As I revisit that book, it helps me put into focus the importance of the work I can do with these children. Yes, many of them have genetic predispositions to things like ADHD and mood disorders, but a lot of them are being raised by people and in environments that are causing them to respond a certain way.

It is my job if I can, to help correct this through therapy and parent education so that these kids have the best opportunity possible to turn into healthy children and eventually successful adults.

In the book, there is one story about a boy who was being raised mostly by a mother who had some type of mental disorder so while she took care of the child, he basically stayed alone in his crib without any interaction for 6 to 8 hours a day. He learned not to cry because no one was coming to help him. He grew up with unable to have feelings for other people and as an older teen, eventually murder two girls, raped their dead bodies and then stomped on them. Even in prison he showed no remorse and blamed the girls for not allowing him to do whatever he wanted to do. He didn’t even have any regrets other than getting caught.

Some of the kids I’ve seen, the parents have already written them off as bad apples and just want them put on medication so that they don’t have to deal with them. I can see that if these kids aren’t shown love, support, guidance and limitations, they will grow up to be criminals or in the very less, incapable of having healthy relationships with anyone.

Also, they have already gave me some great blog ideas. I’ve already unfortunately diagnosed some of them with ADHD, mood disorder, anxiety disorder, conduct disorder, oppositional defiant disorder and pervasive developmental disorder.

These may just be another stop on my journey to become the best overall therapist I can be, but I am going to cherish and learn from every moment and experience and do the absolute best I can to make a difference in each childs life.   I’ll keep you guys posted along the way.

Popular Psychology

The Basics of Behavior Modification Techniques

by Torey C. Richards, LMHC4 Comments on The Basics of Behavior Modification Techniques

Behavior modification techniques have at times been controversial.

Many people believe that they don’t work in the long run, but I know when done correctly, they can be an effective tool to curve undesired behavior and increase desired ones.

A Very Brief History

Behavior modification is largely derived from tenets of a psychological approach known as operant conditioning created by B.F. Skinner, which proposes that behavior can be shaped by reinforcement or lack of reinforcement.

Behavior modification techniques have been used successfully with adults and children to help with conditions such as attention-deficit/hyper-activity disorder (ADHD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), pervasive developmental disorders, phobias, and many others.

Reinforcing Positive Behavior 

Reinforcing consequences are anything a person receives as a result of their behavior, that increases the likelihood of that behavior occurring again.

For example, if a child gets a laugh from a parent when they swear, they are more likely to do it again. Or if they get praise for bringing home good grades, they are more likely to continue trying to bring home good grades.

Reinforcers, as the name suggest, reinforce behavior. Some good behaviors, some bad behaviors.

We use reinforcers all the time, often without realizing it. As the saying goes, we teach people how to treat us, because we often reinforce their behavior towards us, good or bad.

When people, especially children hear the word consequence, they usually assume that it is something negative, but consequences can also be positive.

Positive reinforcers are consequences a person wants to receive. They are used in behavior modification to increase desired behavior, usually through a reward system.

Behavioral contracts can be used to outline details of the reward system. As an example, a reward could be one hour of video games per day if all homework assignments for that day are complete, or all chores are done.

Sometimes negative behavior is also unintentionally rewarded. As an example, if a child yells enough and the parents gets annoyed and gives in to the child’s demands, that child is being reinforced to yell whenever he/she doesn’t get their way.

In these cases, the unwanted behavior needs to be stopped through what is called “extinction”.

Extinction

Extinction is basically stopping an undesired behavior by removing it’s rewards. Examples of rewards for undesired behavior include getting what they want after:

  • pleading
  • crying
  • throwing a tantrum
  • yelling
  • withdrawing

Time-out is one of many effective techniques used to extinguish undesired behaviors by removing the person from any rewards.

As I stated before, the saying “we teach people how to treat us” comes back to this, even as adults.

In a relationship, if our partner is being insensitive to our needs, yet we cling to them more and shower them with attention, then we are rewarding their behavior.

Negative Consequences for Behavior

Penalties, punishment and negative reinforcement are all forms of negative consequences.

Penalties are when someone loses something as a result of a behavior, such as the removal of a favorite toy or a privilege.

A punishment is when someone receives a consequence for a behavior that they don’t want, such as a spanking.

Negative reinforcers include the withdrawal of a privilege or addition of extra chores/assignments.

Differences Between Negative Reinforcement and Positive Reinforcement

Punishment, penalty and negative reinforcement usually result in minimal effort on part of the person to achieve the desired behavior.

Positive reinforcement is the only method that will encourage people to give voluntary, extra, enthusiastic effort to achieve the desired behavior.

The key to behavior modification is to use negative consequences as necessary, but to focus more on positive reinforcements.

The Five B’s of Effective Parenting

Lastly, the five B’s are very important when it comes to using behavior modification techniques with effective parenting:

  1. Be positive– try using positive consequences more than negative
  2. Be specific– be specific what behaviors are being punished or rewarded
  3. Be certain– your child should know without a doubt what to expect from you        based on their behavior.
  4. Be consistent– if you don’t apply rules consistently, your child can never be certain of what to expect
  5. Be immediate– act immediately when your child deserves a positive or negative reinforcer.

When used correctly, behavior modification techniques are positive tools and great ways for kids to learn in a rather safe environment about consequences.

They learn that in life, often there are no right or wrong decisions, but they have to be able to deal with the consequences (positive or negative) of their decisions.

Popular Psychology

A Quick Glimpse at ADHD in Teenage Girls

by Torey C. Richards, LMHC2 Comments on A Quick Glimpse at ADHD in Teenage Girls

As I wrote in a previous post, attention deficit/hyperactivity disorder is 2 to 4 times more common in boys than in girls and thus often doesn’t get discussed much when it comes to teenage and adolescent girls.

In her article Calm Down, Boys, Adolescent Girls Have ADHD Too, Mary Bates discusses how ADHD goes unrecognized in girls because they often don’t present with the stereotypical hyperactivity and attention deficit that boys usually present with and because diagnosing ADHD in itself can prove difficult because teenagers can be impulsive, inattentive and disorganized, but not noticeably hyperactive.

Kathleen Nadeau, a clinical psychologist in Silver Spring, Maryland, and coauthor of Understanding Girls with AD/HD states that girls are less likely to be hyperactive and impulsive, but instead may appear “spacey,” unfocused, inattentive, have trouble staying organized and/or remembering directives or homework.

It wasn’t too long ago that ADHD was two separate disorders, ADHD and ADD (attention deficit disorder), but now they are almost always diagnosed as ADHD with a sub-type of either predominately attention-deficit, predominately inattentive or combined.

Since girls often present with different symptoms, they are often diagnosed five years later than boys or go un-diagnosed altogether, thus missing out on proper treatment for their disorder. “A 16-year-old girl who runs stop signs and can never find her homework might not be a rebel- she could have ADHD” Bates says.

Treatment for ADHD includes stimulant medications, school and family counseling. Families can try ignoring minor annoyances while creating a point or contract system (“Wash the dishes now and I will leave you alone while you play your video games”). ADHD is not a curse, many successful and brilliant people today and in history have ADHD, just look at Michael Phelps.