Pediatricians Review of Two Parenting Programs PowerPoint Presentation

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Viewing Time This presentation will take one hour to complete.

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Target Audience This program is designed for primary care physicians. Other health care professionals working with patients and their families may also find this program of interest.

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Faculty Disclosure It is the policy of Children’s Hospitals and Clinics of Minnesota to ensure balance, independence, objectivity, and scientific rigor in all its educational programs. Our faculty have been asked to disclose to our program audience any real or apparent conflicts of interest related to the content of their presentations. They have also been requested to let you know when any products mentioned in their presentations are not labeled for the use under discussion or are still under investigation.

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Faculty Disclosure Karen Arrett, MD has disclosed no actual or apparent conflict of interest in relation to this educational activity. During this educational activity Dr. Arrett will not be discussing the use of any commercial or investigational product not approved for any purpose by the FDA.

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A Pediatrician’s Review of Two Commercially-Available Parenting Programs: Parenting with Love and Logic and Total Transformation Karen Arrett, M.D. Pediatrician, Partners in Pediatrics, Brooklyn Center, Minnesota

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A Pediatrician’s Review of Two Commercially-Available Parenting Programs: Parenting with Love and Logic and Total Transformation A lecture and discussion on parenting styles, and an evaluation of the philosophy and techniques of two parenting programs that may be of benefit to parents and their children.

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Program Objectives Upon completion of this program, participants should be able to: Understand the philosophy and technique utilized in the Parenting with Love and Logic Resources. Understand the philosophy and technique utilized in the Total Transformation Program. Describe three parenting styles.

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Disclaimer Children’s Hospitals and Clinics of Minnesota accepts no responsibility for the materials presented through these Grand Rounds seminars. Each professional presenter assumes all responsibility for maintaining confidentiality or obtaining authorization, in accordance with all applicable laws.

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Accreditation Children’s Hospitals and Clinics of Minnesota is accredited by the Minnesota Medical Association to provide continuing medical education for physicians. Children’s Hospitals and Clinics of Minnesota designates this educational activity for a maximum of 1 AMA Category 1 CreditTM toward the AMA Physician’s Recognition Award. Each physician should only claim credits for the time that he or she actually spent in the activity.

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Receiving CME Credit To receive CME credit, you must view the entire program and complete the evaluation form at the end.

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A Pediatrician’s Review of Two Commercially Available Parenting Programs Parenting with Love and Logic The Total Transformation Karen Arrett M.D.

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Pediatricians have a place in guiding children to healthy and successful lives.

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Pediatricians and behavioral medicine 15% of practice is behavioral Pediatricians are expected to be experts ADHD, Autism, ODD, Anxiety, Depression, School refusal and school failure, OCD Pediatricians receive little training in behavioral pediatrics,

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Pediatrics, March 2003 Child Disobedience and Noncompliance: A Review Larry Kalb and Rolf Loeber PhD University of Pittsburgh Dept. of Psychiatry

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Parent training Parent training programs well researched interventions for noncompliant children. Parent training programs have been shown to be effective at reducing child behavior problems including noncompliance in the first 3 years after treatment. Treatment effects can generalize to other behaviors such as aggression and also improves behavior in sibling of the target child for up to 1 year of follow up.

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Resources are available The Total Transformation Parenting with Love and Logic

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LOVE AND LOGIC

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What is Love and Logic A parenting philosophy that primarily teaches character Formula The child makes a mistake The adult responds with empathy instead of anger The child learns from the consequences of his actions

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Theory behind Love and Logic Success for children of all ages rests on a balance of unconditional compassion, firm behavioral limits and logical consequences The primary goal is to reduce behavior problems, increase motivation, and build assets which contribute to life long responsibility and resiliency.

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The rules of Love and Logic Rule #1 Adults set firm limits in loving ways without anger, lecture or threats

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Rule #2 When a child causes a problem the adult hands it back in loving ways

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Parenting styles Helicopter Parent-This parent hovers over children and rescues them from the hostile world in which they live Drill Sergeant-this parent commands and directs the lives of their children Consultant Parent-This parent provides guidance and consultant services for their child

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Helicopter Parent Provides messages of weakness and low personal worth Protects the child from any possible negative feelings Rescues child from natural consequences, Makes decisions for the child

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The Result

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The Drill Sargeant

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The Consultant Parent Uses Love and Logic Techniques They give messages of personal worth and strength Provide and help explore alternatives and then allows the child to make his or her own decision Provides time frames in which child may complete responsibilities Shares personal feelings about own performance and responsibilities Provide and help explore alternatives and then allows the child to make his or her own decision Provides time frames in which child may complete responsibilities Models doing a good job, finishing cleaning up and feeling good about it Makes sure the child owns the problem, helps the child explore solutions to his or her own problems Uses many actions but very few words Allows child to experience life’s natural consequences Models doing a good job, finishing, cleaning up and feeling good about it Uses many actions but very few words Allows child to experience life’s natural consequences

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Techniques Enforceable statements Choices Empathy then consequences Diffusing arguments Guiding children to solve their own problems

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Enforceable Statements No Threats No Anger No Frustration No Warnings

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Ineffective Techniques vs. Enforceable Statements “Don’t You Talk to Me in that Tone of Voice!” “You sound upset; I’ll be glad to listen when your voice is as soft as mine.” “I want that lawn cut now. I’ve asked you five times” “I’ll be taking you to your soccer game just as soon as the lawn is cut.” “Do your homework right now!” “Feel free to join us for some television once your studying is done.” “You two be nice to each other and stop that fighting!” “You guys are welcome to come back as soon as you work that out.”

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PROVIDE CHOICES  Avoid Power Struggles           Children get  to practice making decisions    Children learn from mistakes          Builds Child’s Self-Confidence!           Improves Parent/Child Relationship

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HOW TO PROVIDE CHOICES Provide Two Choices You Can Live With     Allow a short time to decide,  otherwise decide for them         Ensure that the child lives with the consequence of the decision        Be careful not to turn choice into a threat  Allow the consequences to do the teaching        Avoid lectures Important to be calm and non threatening

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Words to Use You are welcome to _______ or _____      Feel free to ______or ______     Would you rather ________ or _______     What would be best for you _____ or ____

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McDonald’s 6:00 p.m. “I’m Hungry”

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Diffusing arguments

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How Kids Pull You into the Argument “It’s not fair!” “I hate you!” “You don’t care!” “Dad wouldn’t do that!”

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Diffusing Arguments “I love you too much to argue with you.” “Nice Try.” “I know.”

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CONSEQUENCES Natural Delayed Anticipatory

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Consequences with Empathy This must really hurt.” “This is so sad.” “That is really hard.” “I am sorry you feel that way.”

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Church

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Love and Logic One-Liners Phrases which help parents avoid conflict and provide empathy.

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One-Liners Anyone Can Use I know        Nice try    I love you too much to argue      I will love you wherever you live      That seems drastic

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Delivery is Important Use genuine compassion and understanding     Avoid sarcasm       Keep repeating the same or other one-liners

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Guiding children to solve their own problems Express empathy Send the power message-what are you going to do? Offer choices – would you like some suggestions ? Have child state the consequences of the choice – will that work for you? Give permission to solve or not- let me know how that works out for you

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Tools Books CD’s DVD’s Presentation guides Conferences Phone support Free resources on the website www.loveandlogic.com

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Specialty items Calming the chaos

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Ease of use Easy to order Many items also available at book stores or Amazon.com Entertaining Easy to read Able to quickly implement techniques

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How a pediatrician can use Recommend resources Recommend conferences Give presentations Model in office Use techniques in discussions with patients Handouts free and online Use with own children, in the workplace and spouse.

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The Total Transformation

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The Total Transformation A Parent training program developed by James Lehman MSW in 2004 Designed to help parents teach their children problem solving skills Described as a step by step program to help parents understand and manage disrespectful, obnoxious and abusive behavior in children

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Philosophy Aimed at children with more challenging problems Change faulty thinking Stop blaming and excuses Focus on the behavior response desired and the behavior elicited Give consequences Try to help kid see that their way of solving problems creates more problems for them

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Causes of obnoxious behavior Not caused by parent saying the wrong thing Behavior is compensatory for child’s poor problem solving skills This behavior is not mental illness The behavior is learned and rewarded, and generated by extreme self centeredness

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Characteristics and practices of the child with abusive behavior Victim stance Injustice Uniqueness One way boundaries Concrete transactions Pride in negativity Anger with an angle One way training One way role models Wishing Put offs Casing Dishonesty False apology Turn around Partialization

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Ineffective techniques Bottomless pockets Over negotiator Screamer Ticket puncher Savior Martyr perfectionist

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Parenting roles that lead to accountability A culture of accountability in the home Training and coaching role Problem solving role Limit solving role

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27 transformation tools Accept no excuse for abuse Direct statements Disconnect Stop the show Consequences Be an empowered parent Honesty Values Family as a business Identify Single issue focus Selective attention Redirect the interest Choose your fights

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Cueing Strategic recognition and affection Harmless humor Esteem Basic direction Compliance Transition time Responsible love and concern Replacement and reciprocity Don’t hold your breath Act as if Role modeling

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Trigger management The trigger management process Diminish the potential-avoid risky situations Manage the situation-escape risky situations Identify the trigger thought-example it is not fair

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The Alternative Response Step 1- investigate Step 2- confront Step 3- identify Step 4- challenge Step 5 declare Step 6-probe Step 7- choose Step 8- consequences and amends

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Tools Audio program Supplemental programs Phone support Empowering Parents e-newsletter www.thetotal transformation.com

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Legacy Publishing has sold over 85,000 units 10-15% return rate Approved by the National Association of Social Workers for 6 CEU’s

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How a pediatrician can use Recommend as a resource for their patient’s families View the program to become knowledgeable about the philosophy and techniques of the program and discuss the specifics with the family in response to specific behavior problems

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The Luxury of Primary Care Time and repeated encounters!!! Long lasting impact on the lives of our young patients Rare to make fantastic or rare diagnoses Psychosocial and behavioral problems are every day

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Comments and Questions

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To receive CME credit, please click the “CME EVAL” button below, and complete the form Thank you for viewing this presentation!

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Thank you for viewing this presentation! Please return to the Medical Education web portal to take the CME Evaluation for this activity