Working with children when they are at their worst

I teach explosive children in a children's psychiatric assessment unit. There are 8 beds on the unit and I have a very small classroom. Here's an example of how I work with children when they are at their worst. Jasper is an explosive 11 year old boy who is verbally offensive and physically abusive. He's hard to like. Let me be crystal clear. He's very hard to like. But does that change how I treat him? Absolutely not. I had a couple days to develop a relationship with Jasper before this incident.

Here's what happened.

I was quickly finishing my lunch in my classroom before taking my 5 students, who are inpatients on a children's psychiatric assessment unit, swimming. As I scarfed down the last bite of my sandwich, I heard some yelling.

When I walked towards the crowd of students and staff, I could hear one of the staff yell at Jasper to go to his room. Jasper yelled back, stating that no one could tell him what to do. As I walked closer, Jasper spotted me. He walked straight at me and reported in a mostly calm and collected manner that, "Curtis made a joke about me wearing speedos and that was mean". He then promptly walked to his room and sat on the floor in his doorway.

I walked to the nurse's station where most of the staff was collecting when someone told me that Jasper had hit Curtis. As I polled the crowd, their expressions all said the same thing: "There's no way Jasper can go swimming now." I stated that I needed a minute to work with Jasper and Curtis before all of us would go swimming.

I walked over to Jasper who was still sitting on the floor sulking. In order to talk with him (rather than down on him) I sat on the floor with my legs crossed, just like him and said, "You look sad, what's up?"

Jasper looked up at me and barked, "If he ever makes fun of me like that again, I'm going to fucking kill him. I mean it. I'll fucking kill him."

My response was three simple words, "I believe you." It is tempting to argue with Jasper and tell him that he isn't allowed to kill anyone, but I knew this wasn't the hill I wanted to die on right now -- there was a more important problem that I need to address so I prioritized my attention and mostly ignored this threat. (If you are familiar with Ross Greene's approach than this is what Plan C looks like) It's also important to note that while it is true that I did believe Jasper felt like killing Curtis, I did not believe for one second that he could or would actually do it.

"Do you remember what you said to me before you came to sit over here?"

"No."

"Jasper, I was impressed."

He looked up at me and was surprised to hear me talking about something I was impressed with. He stopped crying, wiped a tear and asked, "What do you mean?"

"Jasper you came over to me only moments after the heat of the moment and with a very calm tone, no swearing or yelling, you gave me an accurate description of what happened. I am impressed."

He looked down again but didn't say anything.

"Jasper there's one other person in this unit that you should have said that to."

"Joe, there's no other adult here that I could have said that to. You are the only one who helps me instead of giving me trouble."

(Now this isn't exactly true, but it is Jasper's perception so it is his reality. And again, this isn't the problem I wanted to address right now, so I chose to use Plan C and ignored it).

"Jasper, I wasn't talking about an adult. Jasper, I'm going to say something really strange. Are you ready?"

He looked up and said, "Sure".

"I think you should have said it to Curtis."

He stared at me.

I waited.

He stared some more.

I waited.

He still just stared at me.

I waited longer. I could tell he was thinking, in fact I could almost see the smoke coming out of his ears. He was really perplexed by my suggestion. I'm usually pretty good at wait-time, but even I couldn't take this staring contest any longer, so I broke the silence. "What do you think about that, Jasper?"

"Well... huh... that's an interesting idea."

His reaction told me that he honestly had never even considered this as an alternative to hitting. "How can we fix this problem?"

"He could say sorry, but sorry won't make the pain go away. You know for me words hurt a thousand times worse than physical pain. I have a swing at home and none of my friends can swing on it because it hurts their nuts, but I can swing on it all day because I have an abnormal tolerance for physical pain, but words stab me in the heart. They hurt so bad."

It took every ounce of self-control not to laugh at his explanation, but I was able to hold back. "I believe you, Jasper. I can see that Curtis's words hurt you. And you're right, an apology won't take away the hurt. But an apology will do something different. It will plant the seed of a new feeling called forgiveness that, if you let it, will grow larger than the hurt. But remember, 'sorry' is not a word -- it does not come from your mouth, it comes from your heart. People also like it when others ask if we are ok. It's kind of weird, but even when we are hurting, it makes us feel better to know that other people care. Have you ever noticed that?"

"Yeah, I have."

"Jasper, if Curtis apologized to you and you could tell that he really meant it, would that help to solve this problem?"

"Yes, and I think I would like him to ask me if I'm ok."

"Cool. Let's do that in a minute, but first, we have one more problem that we need to solve."

I could see some of the excitement rush out of Jasper's expression as he hung his head again. It looked like he was preparing himself for trouble.

"Jasper, you hit Curtis."

"Actually, I hit him twice." (I find this fascinating because when an adult yelled at Jasper that he wasn't allowed to hit others and that he needed to go to his room, he denied hitting anyone. And yet when Jasper sees the adults less like punishers and more like teachers he is prepared to correct me and admit that he hit Curtis not once but twice).

"How do we make this right?"

"I could apologize... but remember words hurt way worse than physical pain. They aren't the same."

"Jasper, do you remember your friends on the swing? What if Curtis is less like you and more like your friends? What if he is the opposite to you and he has an abnormal tolerance to words but physical pain hurts a thousand times worse?"

He stared again, but this time I could really tell that a light bulb had just turned on. "Well, I suppose that could be possible. I think I should say sorry."

"Remember, 'sorry' isn't a word."

"Actually, at this point, I'm feeling pretty bad about what I did. I want to apologize and mean it."

"What else could you do?"

"I could ask him if he's ok."

"I bet he would like that. You ready to try it?"

"Yes."

"Ok. You wait here and I'll get Curtis."

I walked over to Curtis where he was talking with another adult and still rubbing his head. "Curtis, can I talk with you about how we can make things right?"

"Sure." Curtis was quite calm. He's a little more reasonable and a little less explosive than Jasper.

"I think we have a couple problems here."

"Yeah, I shouldn't have made that joke."

"No, you probably shouldn't have, but Jasper shouldn't have hit you, either."

"No, he shouldn't have. You know I was just kidding around. I see Jasper joking around with others all the time and I just thought he could take it, but I guess I was wrong."

"Yeah, it's tough isn't it. I know that I've had times where I thought someone would appreciate my jokes but then realized they were hurt by them. It's not easy getting a read on how others will respond. So how can we make this right?"

"I could apologize."

"Really? That's interesting, because I was talking to Jasper and he's feeling really terrible about hitting you and he wants to apologize, too."

"Really?"

"Yeah, really. You want to go talk with him with me?"

"Sure."

When we came together I asked who wanted to go first and they both tried to start. Noticing that they cut each other off, they both offered to let the other go first. It was pretty cute.

Curtis started, "Jasper, I'm sorry about that joke I cracked. I thought you were a jokester so I thought you would take it."

Jasper replied, "Yeah, I am a jokester but there's a funny thing about me, I can give jokes but I can't seem to take them very well."

At this point, I actually laughed a little because of how accurate Jasper's self-reflection truly was. I said, "Looks like you found something we need to work on together."

"Yeah, I guess I did," answered Jasper.

"So are you ok?" asked Curtis.

"Yeah. And I'm sorry for hitting you, Curtis. Are you ok?"

"Yeah, I'll be ok."

I could tell that both boys meant it and that both had planted the seeds of forgiveness. I could tell that we were ready to move on so I asked, "you boys ready to go swimming?"

Both boys said yes, and we all went swimming.

***

When I got back from swimming, I had a couple staff members who were a little unsure as to why I let Jasper go swimming. Here are some of the arguments I made for why punishing Jasper would have been at best unhelpful and at worst harmful towards our ultimate goals for him:

• It was a lot of work to get Jasper to think about more than just himself and to empathize and apologize. Can you see how all this hard work would have been destroyed had I then punished Jasper by not letting him go swimming? Invoking the punishment would have encouraged Jasper to revert to thinking only about how this situation affected him. I'll put it another way: Punishing Jasper by taking away swimming forcibly isolates him from his peers, in front of his peers, and isolating a child who struggles with social skills is like banning books from a child who struggles to read.

• Punishment ruptures relationships.There is a very good chance that Jasper would grow to resent Curtis because had Curtis not cracked the joke, Jasper could have gone swimming. There is also a good chance that Jasper would resent me for invoking the punishment. Can you see how rupturing relationships with punishments is one of the last things Jasper needs? He already has very few meaningful relationships, let's not make things harder for him than he already has it.

• Punishment teaches Jasper a lesson: You can get your way with people who are weaker than you are by hurting them. Can you see that Jasper understands this lesson already all too well? Can you see that Jasper's working model for relationships is already built on a foundation of coerciveness, manipulation and power? Can you see how punishment would only perpetuate this vicious cycle? It's time to drop the archaic strategy that says when kids do bad things, we should do bad things to them.

• Jasper doesn't have a lot going for him. He tells us that he hates himself and that he wants to die. He's already in a psychiatric assessment unit. Jasper experiences life as punishment everyday. How will taking more things away from him help?

• Some people fear that by letting Jasper go swimming, we are teaching him and others that hitting is ok. This is a fear that is mostly fabricated by a deeply disturbing, distasteful and distrustful view of the nature of children. Not one of the children who witnessed Jasper hit Curtis would have said that going swimming made hitting Curtis right. Not one. They all understood that Jasper has difficulties working with others and that he is still learning how to navigate his day without explosions. If I punish Jasper, it does indeed teach everyone a lesson, and that is that you are only accepted when you are acceptable, and this is a recipe for disaster for children who have learned to see themselves as unacceptable on a daily basis. 

Lagging Skills and Unsolved Problems

I spent the day learning about Ross Greene's approach for working with children. We talked a lot about how children will be successful when they can and it is our job to first identify the lagging skills and unsolved problems that are causing difficulty. 

One of the tools Ross Greene's approach uses is the Assessment of Lagging Skills and Unsolved Problems. Using this tool, I wrote a sample case formulation or what could be an Individual Program Plan based on Ross Greene's approach.

Sample Case Formulation

or

Individual Program Plan

A summary of some key lagging skills, perhaps those that are contributing to challenging behaviour most often or maybe those on which caregivers can most easily agree:

Nolan has difficulty managing his emotions in response to frustration so as to think rationally... isn't very good at appreciating how his behaviour is affecting others and recognizing how he's coming across... and difficulty empathizing with others, appreciating another person's perspective or point of view.

Emphasize that these lagging skills are especially problematic in the conditions (unsolved problems) in which they are demanded by the environment. Specify some of these conditions:

Nolan tends to run into difficulty when these lagging skills are demanded. So he has a lot of trouble shifting from computer time during language arts to putting the computer away and going to physical education. It's very hard for him to learn cooperatively with his classmates... he often has difficulty compromising on ideas with others without pushing his ideas on others and getting very frustrated. And then he can't figure out why others are mad at him. When playing floor hockey, Nolan has difficulty negotiating the interpretation of the rules with his peers such as offsides, goals and high sticking. Has difficulty coping and forgiving others for wronging or hurting him by accident without getting very angry.

Underscore that challenging behaviours occur in response to these unsolved problems, that the manner in which the adults are presently going about trying to solve them is making things worse and solving no problems durably, and that the unsolved problems are highly predictable:

These unsolved problems cause Nolan to become quite frustrated, and that's when he is likely to exhibit challenging behaviours, like crying, hitting, isolating himself from others and swearing. When we remind Nolan of how we expect him to act - or reprimand or punish him for not meeting those expectations - it only makes things worse... and doesn't help Nolan solve any of the problems over which he's becoming upset. Fortunately, since his unsolved problems are highly predictable, we don't need to try solving them in the heat of the moment.

Check to ensure that there is a consensus and that the case formulation (or Individual Program Plan) accurately summarizes the deliberations of the group:

Does this sound like a good summary of what we've been saying about Nolan?

Point out that the goal of intervention is to solve these problems collaboratively so they no longer precipitate challenging behaviour and so that lagging skills are taught, at least indirectly:

Our goal is to begin solving some of these problems with Nolan's help, so that he's involved in helping us understand what's getting in the way for him and he's also involved in coming up with solutions that will work for him and for us. Once the problems are solved, they won't set in motion challenging behaviour any more. And if we solve the problems collaboratively, then Nolan will start to learn some of the skills he's lacking.

***

I see all this as an important shift in mindset. It is so tempting to focus on a child's behaviour and to theorize, hypothesize and develop stories around why those behaviours are occurring, but none of this is helpful in supporting the child develop the skills they need to better navigate their day. Instead, we are far better off using our limited time, effort and resources to identify the skills children lag along with the situations and unsolved problems that are demanding these lagging skills.

Once we identify the lagging skills and unsolved problems, we jump into Ross Greene's approach for working with children.

Ross Greene is coming to Calgary

Ross Green

WHO: Ross Greene

WHAT: Collaborative Problem Solving Advanced Training

WHEN: May 9-11

WHERE: Calgary, Alberta. Executive Royal Inn.

WHY: Because children will be successful when they can, we need to move away from "doing things to" children and move towards a "working with" approach.

HOW: For more information on registration check out this page.

Here are a couple posts I've written about Ross Greene's book Lost at School:

Ross Greene's approach for working with children

Ross Greene's Lost at School

Alfie Kohn's interview with Ross Greene

Here are all of my posts on rethinking discipline.

Solving Problems Collaboratively: The Ross Greene Approach

Ross Greene's book Lost at School has played a critical role in how I frame my conversations and interactions with students who are having a hard time navigating through their day. It's important to note that this requires a shift from "doing things to" kids to "working with" kids. At best the former can get us temporary compliance while the latter can bring authentic engagement.

To do this, I find myself using Ross Greene's three steps to Ross Greene's approach for working with children:

1. Empathy
2. Identify the Problem
3. Invitation to solutions

Empathy

Children have to believe that we care about them before they will care about what we have to say, and one of the best ways to express empathy is to suspend our judgement and listen to the child. This might be as simple as asking "What's up?" While the child is offering their answer, you might find it helpful to clarify their concerns by echoing what you hear them say by saying, "I'm hearing you say..."

When an adult and a child enter into a conversation, the disparity in age by definition creates an imbalance of power. Despite conventional wisdom, this is not the time to increase your adult power; on the contrary, I've found it quite necessary to reduce my adult power and ensure that the child feels like I am not trying to enter into a power struggle by imposing my will on them.

Because I believe that children should experience their successes and failures not as reward and punishment but as information, I find it very helpful to start off my conversation with "I'm not mad..." or "You're not in trouble". Sometimes I find it helpful to add "I'm a teacher, not a punisher. I'm here to help you learn, not punish you".

Because empathy is not a word, it's a feeling, this step will require more time and effort than it takes to simply say "I care". Our best intentions are always trumped by the child's perception; that is, we often may find ourselves ready to move on to the next step before the child is convinced we are in fact empathetic.

Identify the Problem

The key to this step is understanding that there are usually two problems that need to be identified and eventually solved - one is the adult's problem and the other is the child's problem. Adults are great at identifying the problem we want to solve, but we aren't all that great at identifying the problem that concerns the child. Our problems can be obvious, but I've found that a child's problem can be quite elusive until we actually take the time and effort to engage them in a conversation about what truly is troubling them.

The child must feel like you care about solving their problem as much as you care about solving your own.

Invitations to Solutions

Adults are great at unilaterally imposing solutions in search of a problem and not so great at remembering that there are two problems that need a solution that is mutually satisfactory and durable. One way to initiate this with a child is to say, "I wonder if there's a way..."

Don't get discouraged when the first attempt at the solution fails. These things take time, effort and collaboration. Solutions can fail for a couple different reasons:

• Sometimes kids suggest unsustainable solutions. 
• Sometimes adults suggest unsustainable solutions.
• Sometimes kids feel compelled to agree to solutions that are not really satisfactory to them.
• Sometimes even good solutions need practice or minor adjustments.

For some kids, all this is totally unnecessary, but for kids who lag the necessary social, emotional and behavioral skills to get through their day without explosions, Ross Greene's approach for working with children gives them a chance.

Kids don't go bad -- they get lost

There's a big difference between believing "kids will do well if they can" and "kids will do well when they want to".

If we believe kids do well when they want to, we will likely engage in manipulative schemes filled with rewards and punishments. The problem with rewards and punishments is that the kids who have the most troubling behaviours are those who have already had their share of bribes and threats. It should be more clear now than ever that doubling the dose of carrots and sticks isn't working.

In short, this form of discipline is broken.

If we believe kids do well if they can, then we understand this isn't a motivation problem -- it's a lagging skills problem. When a child has trouble reading, we engage in teaching them the reading skills they need in order to read -- and so, when a child has trouble behaving, we engage in teaching them the emotional, social and thinking skills they need in order to behave.

If a kid is illiterate, we figure out what skills they are lagging and we teach them those skills. We don't see illiteracy as a motivational problem, we see it as a lagging skills problem. And yet, when we see a kid misbehaving, conventional wisdom tells us to bring in the reinforcements in an effort to spur on their motivation to behave.

It's time we taught behaviour like we teach literacy. It's time we saw misbehaviour for what it truly is -- a lagging skills problem.

Kids don't go bad -- they get lost.

And it's our job to help them find themselves.

For more on this, I totally recommend Ross Greene's book Lost at School.

Ross Greene's Lost at School

Dr. Ross Greene

I am reading Dr. Ross Greene's book Lost at School and I am fascinated by how progressive and practical the Ross Greene approach is for helping teachers to help the most troubled students.

At the heart of Ross Greene's philosophy is that kids will do well if they can. The point being is that we all aspire to be successful, but sometimes we lack the skills in order to be so.

Some of the hardest children to like are the ones who need us the most. They need us because they lack the necessary emotional, social and thinking skills necessary to navigate their home and school environments successfully.

Far too often, the conventional wisdom around troubled kids is that they lack the motivation to be successful -- or in other words, too often our philosophy is built around the misassumption that kids will do well only when they want to. When misbehaviour is framed as a motivation problem, we assume that it makes perfect sense to bring in the reinforcements which include rewards and punishments and bribes and threats.

If rewards and punishments worked, we would have solved misbehaviour a long time ago. But alas, this flavour discipline is broken -- we need a new narrative.

I'm looking forward to using Greene's Assessment for Lagging Skills and Unsolved Problems (ALSUP) as a means for identifying the underlying lagging skills that are creating unsolved problems.

While it is true that many adults feel absolutely certain that they know exactly how to solve misbehaviour problems, most adults do not spend the necessary time and effort collecting information to establish the underlying causes of misbehaviour. Hence why so many adult interventions for misbehaviour are solutions in search of problems.

Because I teach in an inpatient children's psychiatric unit, I can see Collaborative Problem Solving becoming an important part of my work with children.

If you have any experience using any of Ross Greene's work in your interactions with children, I would love to hear from you.