1. Working with Aggressive Children Lilly Landikusic LMFT, Founder and Director, EMPOWERMENT COUNSELING SERVICES Talon Greeff MMHC, Director of Residential Care, UTAH YOUTH VILLAGE This training and additional resources can be found at www.utahparenting.org

2. Overview Introduction Introduction Stories Stories Dynamics of aggression Dynamics of aggression Youth issues Youth issues Pre-blowup Pre-blowup Home environment Home environment Setup youth for success Setup youth for success Avoiding power struggles Avoiding power struggles During the blow-up During the blow-up Steps for calming Steps for calming Things you should do Things you should do Post-blowup Post-blowup Writing assignments Writing assignments Other Behavioral Techniques Other Behavioral Techniques Conclusion Conclusion

3. Introduction Cody, 8 year-old boy, attacked sister and mother Cody, 8 year-old boy, attacked sister and mother Charlie, 15 year-old girl, verbally abusing parents and siblings, threats, constantly pushing limits using anger Charlie, 15 year-old girl, verbally abusing parents and siblings, threats, constantly pushing limits using anger State mental hospital teen who was severely developmentally delayed State mental hospital teen who was severely developmentally delayed 9:40

4. Dynamics of Aggression Research demonstrates that adjudicated youth feel they have little or no control over their lives Research demonstrates that adjudicated youth feel they have little or no control over their lives Often feel they cannot make any decisions Often feel they cannot make any decisions Many youth have been moved “on a whim” Many youth have been moved “on a whim” They are frustrated and angry at “the system” 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 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 Research also shows that they feel there are two ways they can take control of their lives: passive resistance or physical aggression

5. Other Dynamics of Aggression They may have seen aggression modeled by their family members and mimic it 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 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 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 Progress in this area requires a longer view—immediate consequences often do not provide immediate change 9:45

6. Youth Issues Poor communicators, tend to be less verbal Poor communicators, tend to be less verbal Lower than average intellectual functioning Lower than average intellectual functioning Have “anger issues” Have “anger issues” Difficulty with change Difficulty with change Difficulty with relationships or attachment Difficulty with relationships or attachment We can help any youth with aggression even those who are severely lower functioning

7. Pre-Blowup Home setup Home setup Systems to share power Systems to share power Use family meetings to setup rules and give feedback Use family meetings to setup rules and give feedback Use a manager system for youth leadership in the home Use a manager system for youth leadership in the home Weekly family activities Weekly family activities They are not earned, everyone gets to participate equally They are not earned, everyone gets to participate equally Purpose is to build relationships by having fun together Purpose is to build relationships by having fun together Weekly one on one time with an adult Weekly one on one time with an adult Have fun, demonstrate a sense of humor Have fun, demonstrate a sense of humor

8. Pre-Blowup Home setup Home setup Adequate sleep for youth or child Adequate sleep for youth or child Reasonable, enforced bedtimes Reasonable, enforced bedtimes Medication as necessary Medication as necessary Take time to put children to bed with calming routines Take time to put children to bed with calming routines Story time Story time Back rubbing Back rubbing Melatonin has been used with success Melatonin has been used with success Home routines and “rhythm” Home routines and “rhythm” Develop an accepted schedule Develop an accepted schedule Relaxed, home rhythm, allow small disturbances Relaxed, home rhythm, allow small disturbances 9:50

9. Pre-Blowup Setup youth or child for success Setup youth or child for success Assess medication Assess medication Observe child or youth Observe child or youth Determine baseline and record on calendar Determine baseline and record on calendar Document youth behavior on kitchen calendar Document youth behavior on kitchen calendar Give clear, short instructions when a child is frustrated or upset Give clear, short instructions when a child is frustrated or upset Put your irreplaceable things away or in storage, help you stay calm Put your irreplaceable things away or in storage, help you stay calm

10. Pre-Blowup Be clear in how you will handle aggressive behavior Be clear in how you will handle aggressive behavior Have a clear plan worked out with your spouse and case worker Have a clear plan worked out with your spouse and case worker Be able to describe it to the youth or child Be able to describe it to the youth or child Clear rewards and consequences for taking a time-out or for refusing to take a time-out Clear rewards and consequences for taking a time-out or for refusing to take a time-out Suggestion: Shorten time-out if taken immediately Suggestion: Shorten time-out if taken immediately Suggestion: Assign a chore for refusing to take a time-out Suggestion: Assign a chore for refusing to take a time-out Suggestion: Take away privileges for refusing to complete a chore Suggestion: Take away privileges for refusing to complete a chore

11. Pre-Blowup Practice necessary skills or behaviors daily Practice necessary skills or behaviors daily Practice negative consequences, like time-out Practice negative consequences, like time-out The youth should quickly do the time-out The youth should quickly do the time-out Practice “controlling emotions” Practice “controlling emotions” Deep breathing Deep breathing Counting Counting Thinking about consequences Thinking about consequences Steps to practicing skills with youth Steps to practicing skills with youth Avoid power struggles by giving choices Avoid power struggles by giving choices Prepares child and parent for aggressive situations Prepares child and parent for aggressive situations 9:55

12. Steps for Practicing with Youth 1. Describe the behavior you are teaching 2. Give a reason using an if/then statement 3. Demonstrate the behavior for the child 4. Have the child engage in the behavior and practice three times 5. Reward

13. Avoiding Power Struggles Based in giving and explaining choices Based in giving and explaining choices For example, if a youth says you can’t make them clean their room. Your response would be, “I understand it’s not fun to clean your room and you have a choice. You can choose not to clean your room keeping you from watching TV or you can clean your room and watch TV sooner. It’s up to you” For example, if a youth says you can’t make them clean their room. Your response would be, “I understand it’s not fun to clean your room and you have a choice. You can choose not to clean your room keeping you from watching TV or you can clean your room and watch TV sooner. It’s up to you” Let the youth know they have the choice and emphasize it’s up to them. We cannot literally force anyone to do anything. We wouldn’t want to do that because then learning doesn’t take place. Let the youth know they have the choice and emphasize it’s up to them. We cannot literally force anyone to do anything. We wouldn’t want to do that because then learning doesn’t take place. 10:00

14. Steps to Avoiding Power Struggles 1. Youth says, “I won’t…You can’t make me… No..,” 2. Empathy statement, “I would be more fun to watch TV 3. Explain that youth has a choice, “You have a choice.” 4. Explain the negative choice and its consequence, “You can choose to not do your chore now and lose TV”

15. Steps to Avoiding Power Struggles 5. Explain the positive choice and its consequence, “Or you can get right on the chore and watch TV when you are done.” 6. If necessary, give youth time and return to see what the choice is, “You need to get started in the next five minutes.” 7. If the youth makes the positive choice then praise and reward. If not, then impose a negative consequence such as turning off the TV. 10:05

16. Things to Remember Do not walk on eggshells or let child/youth train you to accommodate their behavior Do not walk on eggshells or let child/youth train you to accommodate their behavior You will do the work, either now or later 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 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 Negotiating is ok, as long as it is not bribe or blackmail Bribe is a reward which comes before the behavior Bribe is a reward which comes before the behavior

17. During the Blowup Stay about 10 feet away from the youth Stay about 10 feet away from the youth De-escalation begins with delivery of a consequence De-escalation begins with delivery of a consequence Youth may tantrum to avoid a consequence Youth may tantrum to avoid a consequence Deliver one consequence, additional chores or lose privileges for a day 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 Don’t pile consequences on or think that delivering a consequence will result in compliance Steps for calming down youth Steps for calming down youth 10:10

18. Steps for Calming the Youth 1. Express empathy or praise 2. Describe behavior you need them to stop Yelling Yelling Swearing Swearing Stomping around Stomping around 3. Describe what you want them to do Short instructions Short instructions Pleasant voice Pleasant voice Don’t expect compliance but praise approximations Don’t expect compliance but praise approximations 4. Repeat first three steps until youth calm down Allow time for them to calm down

19. During the Blowup Only discuss the child’s behavior, not the issue or situation that began the blow-up Only discuss the child’s behavior, not the issue or situation that began the blow-up Ignore any “baiting” Ignore any “baiting” “You’re nicer to the other kids” “You’re nicer to the other kids” “You are so unfair” “You are so unfair” “You don’t know what it’s like nowadays” “You don’t know what it’s like nowadays” Monitor your own behavior Monitor your own behavior Remove any audience Remove any audience Explain how youth can resolve the situation Explain how youth can resolve the situation 10:15

20. During the Blow-up Know when to restrain Know when to restrain Hurting self or others Hurting self or others Severe property damage Severe property damage Know how to restrain Know how to restrain Don’t restrain if you cannot, will make situation worse Don’t restrain if you cannot, will make situation worse Add charges to youth Add charges to youth Plan for support Plan for support It is your job to manage your youth in your home It is your job to manage your youth in your home Lean on resources for necessary help Lean on resources for necessary help

21. During the Blow-up Know when to call the police Know when to call the police Teenager assaults parent Teenager assaults parent “You need to put the knife down in 5 seconds or I will have to call the police” “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 Youth needs to learn that familial violence is unacceptable Inhibits parents ability to deliver and enforce consequences Inhibits parents ability to deliver and enforce consequences Severe property damage Severe property damage Take youth property as consequence, youth cannot be allowed to damage home to get property back Take youth property as consequence, youth cannot be allowed to damage home to get property back Damage the youth cannot fix, repair or make restitution Damage the youth cannot fix, repair or make restitution Severe potential harm or damage Severe potential harm or damage Stealing a car Stealing a car Taking a weapon Taking a weapon 10:20

22. Things you Should Do Track youth who are aggressive Track youth who are aggressive Avoid blocking exits or areas of travel Avoid blocking exits or areas of travel Appear relaxed and calm Appear relaxed and calm Slouch Slouch Lean against a wall Lean against a wall Break eye contact Break eye contact Remain about 10 feet away—no closer! Remain about 10 feet away—no closer! Remember—you are in charge and in control Remember—you are in charge and in control It is a matter of time It is a matter of time You don’t need to convince them you are in charge You don’t need to convince them you are in charge

23. Post Blow-up Wait a significant time, usually several hours or until the next day, and have the youth practice what they should do instead of blowing up Wait a significant time, usually several hours or until the next day, and have the youth practice what they should do instead of blowing up It should be a neutral time that is convenient for you and the youth It should be a neutral time that is convenient for you and the youth Keep the practice short and resist lecturing Keep the practice short and resist lecturing The youth should practice three times The youth should practice three times Have a reward for practicing that is used quickly. Reduce the consequence, candy bar, extra time out of bed Have a reward for practicing that is used quickly. Reduce the consequence, candy bar, extra time out of bed 10:25

24. Post-blowup Apply consequence that is reasonable, not punishing Apply consequence that is reasonable, not punishing Suggestion: youth lose privileges for half a day, lose privileges for a full day Suggestion: youth lose privileges for half a day, lose privileges for a full day Do a combination of consequences like a major chore, several role-plays and written assignments Do a combination of consequences like a major chore, several role-plays and written assignments Teach with the consequence—teach a skill that will help the youth avoid blowing up in the future Teach with the consequence—teach a skill that will help the youth avoid blowing up in the future

25. Writing Assignments and Other Techniques Have youth fill out worksheet on SODAS Have youth fill out worksheet on SODAS Complete Aggression Log or calming down worksheet Complete Aggression Log or calming down worksheet Practice emotional regulation techniques Practice emotional regulation techniques Counting to ten Counting to ten Thinking about consequences Thinking about consequences Thinking about what you want Thinking about what you want Thinking about something pleasant Thinking about something pleasant Thought-stopping/Taking a minute Thought-stopping/Taking a minute Time self out Time self out Put pleasant things in your room Put pleasant things in your room Sing positive song to yourself Sing positive song to yourself Develop a positive saying to repeat to yourself Develop a positive saying to repeat to yourself 10:30

26. SODAS SITUATION: One sentence describing the situation SITUATION: One sentence describing the situation OPTIONS: List at least three options available OPTIONS: List at least three options available DISADVANTAGES: List at least three disadvantages for each option DISADVANTAGES: List at least three disadvantages for each option ADVANTAGES: List at least three advantages for each option ADVANTAGES: List at least three advantages for each option SOLUTION: Pick one of the options SOLUTION: Pick one of the options

27. Calming Down Worktable Things that make me angry How I can tell I am getting angry – Body signals How I can calm down Telling me no My face feels hot, I start to talk fast Take a deep breath before speaking

28. Other Behavioral Techniques Differential reinforcement of incompatible behavior Differential reinforcement of incompatible behavior Focus on teaching skills that make it impossible to do the negative 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 You cannot yell if you are speaking in a normal voice Differential reinforcement of other behavior Differential reinforcement of other behavior Focus on teaching and rewarding skills rather than providing a negative consequence for a 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 Rewarding a youth for being sensitive to others’ needs makes it less likely you will need to provide a negative consequence for hitting 10:35

29. Differential Reinforcement of Incompatible Behavior It is easy to get frustrated with problem behavior and apply a negative consequence It is easy to get frustrated with problem behavior and apply a negative consequence Focus instead on reinforcing positive behavior Focus instead on reinforcing positive behavior It is a simple concept: praise and reward behavior that is the opposite of the behavior you don’t want to see It is a simple concept: praise and reward behavior that is the opposite of the behavior you don’t want to see The trick is to reward the good behavior that prevents them from doing the bad behavior The trick is to reward the good behavior that prevents them from doing the bad behavior You cannot yell if you are using a normal voice, so praise a normal voice You cannot yell if you are using a normal voice, so praise a normal voice You cannot be hitting if you are touching softly, so praise touching softly You cannot be hitting if you are touching softly, so praise touching softly Singing instead of yelling Singing instead of yelling Complimenting others instead of complaining Complimenting others instead of complaining Praise and reward a strength that makes it impossible for the youth or child to do the problem behavior Praise and reward a strength that makes it impossible for the youth or child to do the problem behavior

30. Differential Reinforcement of Other Behavior Identify the problem behavior Identify the problem behavior Identify the skill or behavior that the youth have or you would like them to have 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 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 Reinforce the behavior or skill you want to have rather than the problem behavior Breathing deeply Breathing deeply Complimenting Complimenting Any of the emotional self-regulation techniques Any of the emotional self-regulation techniques 10:40

31. Conclusion Working with aggressive youth and children can be frustrating Working with aggressive youth and children can be frustrating Have a long-term view and track the progress so you can see it 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 Modeling patience, polite asking and sensitivity to others helps youth learn more quickly Everyone can learn and change Everyone can learn and change This training and additional resources can be found at www.utahparenting.org

32. Contact Information Presenters: Talon Greeff MMHC, Director of Residential Care, UTAH YOUTH VILLAGE (801) 272-9980 Lilly Landikusic LMFT, Founder and Director, EMPOWERMENT COUNSELING SERVICES (801) 604-1134