Parenting a Child with Intense Emotions Using Dialectical Behavior Therapy (DBT)

All parents must weather the occasional tantrum in the mall, melt down over dinner, and foot stomping when denied a request. But what if tantrums and melt downs are the norm, not the exception for your child? And what if they escalate into aggression and dangerous behaviors like cutting, binging, threatening and throwing things and refusing to respond to limits and expectations?

Parents usually seek out Pat Harvey after years of difficult behaviors. Often they have tried multiple therapists and numerous treatments, with little or no improvement in their children's out-of-control behavior. Pat Harvey LCSW-C, co-author with Jeannine Penzo LICSW of the book "Parenting a Child Who Has Intense Emotions: Dialectical Behavior Therapy Skills to Help Your Child Regulate Emotional Outbursts and Aggressive Behaviors" has developed a talent for connecting with parents and helping them learn how to apply DBT principles and skills to parenting their children.

Effective Parenting:

It's not uncommon for parents of children with intense emotions to react to their child out of anger and later regret it. Or, in an attempt to enforce a rule in the face of opposition parents might react severely, escalating the situation even further. Despite a parent's best efforts to respond effectively, heat-of-the-moment responses often intensify the situation and leave parents feeling inadequate and like "bad" parents. Years of feeling blamed when they have been doing their best increases parental self-judgment.

In their book, Harvey and Penzo do not focus on being a "good" parent or having "good" children. In fact, they focus on removing judgmental language from the act of parenting altogether. Instead, they recommend parents focus on being effective and doing what works in any given situation. Effective parenting requires parents to accept that both they and their children are doing the best that they can. This means letting go of past mistakes and failures and letting go of judgments as they learn new skills.

Effective parenting also involves learning skills designed to improve a parent's ability to listen, understand and accept their child. The intent of these skills is to communicate that a child's emotions and thoughts are meaningful, understandable and authentic. Validating a child can decrease intense emotions and increase communication, which allows parents to identify the right problems to solve and propose strategies that fit their child's ability level and personality. Validation does not mean that a parent agrees with the child or that their behavior was ok. It does communicate that the parent understands the child's behavior in the context of the child's life.

Skills to Respond to Your Child's Feelings and Behaviors:

DBT involves sharing information and teaching specific concrete skills. With this model, parents learn to understand and respond to their children's emotions and behaviors. To increase acceptance and improve interactions, parents are taught the story of emotion, from the source of an emotion to the function of emotions. It emphasizes understanding what makes a particular child vulnerable to intense emotion, his or her triggers and the beliefs that influence an emotional response. Parents learn to observe how intense and negative emotions affect their child's body and how these emotions result in problematic behaviors. Improved understanding allows parents to intervene early and respond to their child's emotion with greater acceptance. It enables parents to be more effective in helping their child feel more in control and better about him/herself.

At the same time, parents are taught to respond to their child's behaviors with greater effectiveness. They are trained in the four DBT Skills modules, mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance. In these modules they learn how to focus their attention, effective strategies for coping with interpersonal conflict, how to regulate painful emotions and skills to deal with the pain and distress that are a part of life. They are also taught skills aimed specifically at improving their child's behaviors such as how to shape their child towards constructive activities, how to use punishment minimally though effectively and to use contracts and positive reinforcement to maintain limits and expectations.

Families often report feelings of hope after initial sessions. The combination of information, specific skills and a non-judgmental approach appears to generate optimism. Ultimately the goal is to allow families to live meaningful and enjoyable lives. Although family life may differ from parent's initial vision, with this treatment many have described an increase of calm in their lives and a closer relationship with their children.

Reference:

Harvey, P and Penzo, J.A., 2009, Parenting a Child Who Has Intense Emotions: Dialectical Behavior Therapy Skills to Help Your Child Regulate Emotional Outbursts and Aggressive Behaviors, California: New Harbinger.