1. MENTAL DISORDERS and MANAGING POWER STRUGGLES Bernard A. Yates, LCSW-C July 16 and 17, 2009 byates2@bcps.org

2. Objectives To look at the mental disorders that affect our students To understand how these conditions impact the child in stressful situations To learn ways of dealing with students and assist them in managing difficult situations

3. Introduction Know your child. Know the diagnosis the treating professional has given the child. All behavior has a goal. Know yourself and your buttons.

4. Goals of Misbehavior Attention Avoidance Control or Power Revenge Expression of Hopelessness

5. POWER STRUGGLE An interaction With the goal of gaining control of the situation Win-lose interaction Each partner utilizes different tools –Student: disrespect, arguments, etc. –Teacher: Authority, orders

6. A look at diagnoses A diagnosis is not a clear description of the problem All children exhibit symptoms along a continuum. The diagnosis could be inaccurate or misleading.

7. ADHD Symptoms Difficulty attending to class work –Over attends to stimuli Easily distracted Impulsive, acts without thinking Is accustomed to being “in trouble” and is defensive when corrected Goal of misbehavior: Attention

8. ADHD in a Power Struggle Effect on Interaction Defensive when confronted (perception) External locus of control Negative attention- seeking Overwhelmed by the work Your Response Use calming techniques Reinforce who is responsible Teach positive ways of getting attention Teach “chunking”

9. Depression Symptoms Low Mood, sadness Irritability Poor motivation Withdrawn Goal of Misbehavior: Avoidance or expression of anger

10. Depression in a Power Struggle Effect on Interaction Difficulty Motivating self Hopeless feelings Catastrophic thinking Your Response Relationship may be the key Feelings are not facts Challenge thinking

11. Bipolar Disorder Symptoms Vacillation from highs to lows Possible psychosis Delusional thinking, Grandiosity “Rules do not apply to me” Goal of Misbehavior: Power or Control

12. Bipolar Disorder in a Power Struggle Effects on Interaction Highs are silly or rage Believe their grandiose thinking Can look antisocial Can be paranoid Your Response Do not negotiate Set firm limits and enforce consistently Know your feelings Know who is treating the student

13. Anxiety Disorders, Including OCD Symptoms Worry/stress about anticipated events Avoidance is the cornerstone. Often looks oppositional Student really is “stuck” Can look like ADHD Goal of Misbehavior: Avoidance

14. Anxiety in Power Struggle Effects on Interaction Fight or Flight Stuck on negative thought High Stress level – watch for aggression Your Response Do not impose physical closeness Feelings are not facts; give choices Calm first and then problem solve

15. PTSD Post Traumatic Stress Disorder Symptoms Hyper vigilance Easily startled Can become aggressive in a panic Sexual abuse can complicate relationship Goal of Misbehavior: Escape or Avoidance

16. PTSD in a Power Struggle Effects on Interaction Panic can lead to flight or aggression Child feels very unsafe Child may be seeking a physical/sexual confrontation Your Response Express limits verbally, avoid physical Bring child to a safe place to process –Only when calm Be aware of child’s goal

17. Attachment Disorders Symptoms Wide range of severity, from mild to severe Skewed relationships: Avoidant, Ambivalent, Disorganized Inhibited and Disinhibited Extreme need for Control Goal of Misbehavior: Control

18. Attachment Disorders in a Power Struggle Effects on Interaction Will attempt to “split” staff Approach/Avoidance Negative cycle of behavior Your Response Be aware of your feelings Keep boundaries clear Set clear limits and consequences without showing emotion

19. ODD AND CONDUCT DISORDER Are descriptions of behavior and not clear statements of what drives the behavior. ODD is most likely based in Anxiety with the goal of controlling the present situation. CD is most likely caused by untreated Depression and ADHD with the goal of power.

20. Teacher responses Set clear limits and consequences ahead of time. Consistently enforce consequences without getting angry. ODD wants a good relationship with you while CD simply wants power. Know your emotions and buttons.

21. Conclusion Know your student. Know yourself and your buttons. Power Struggles, Successful Techniques for Educators Allen N. Mendler, Ph.D. Discipline Associates