ADHD: Disorder or Difference?

The word “disorder” conjures up images of illness, disease and serious disabilities. All parents want to see their child as the smartest, most capable and best liked boy or girl on the block. So why would they want to have a label attached to them that often coveys just the opposite–such as slow learner, under-achiever or Attention Deficit Hyperactivity Disorder?

What a difference one word can make. Suppose we changed the last D in ADHD from “disorder” to “difference.” We could then say that a child with ADHD has some significant differences in his cognitive ability, emotional sensitivity and activity level when compared to other children. This difference is probably inherited. His “skill set” is different from 95% of the children in his class.

I believe that, as a society, we have created a monster with ADHD, and it has fueled our perception that medicating our children can solve all their problems-and ours.

Unfortunately, the environment in which he spends most of his time is geared toward the other 95%. However, we then could look at helping him to adapt successfully to this environment, using his own set of strengths rather than helping him to cope with this environment due to his weaknesses. We then might say that this child may need psychostimulants and/or psychological intervention to enable him to concentrate on boring tasks and control spontaneity in a highly regimented environment.

The above in some ways reflects the ongoing debate about whether ADHD is a valid mental health condition that requires appropriate medical and psychological intervention OR that ADHD is a mythical disease state, manufactured by the medical community in order to make huge profits and is promoted by educational bureaucrats and abusive parents desiring to tranquilize unruly kids. I believe that, as a society, we have created a monster with ADHD. We perceive it as a diagnosis that will forever change or even taint the course of our child’s life. And we are no longer surprised by the number of school-age children who are now diagnosed with ADHD. In fact, we have come to regard it as a norm, and it has fueled our perception that medicating our children can solve all their problems—and ours.

The facts, as in most debates, point to the truth being somewhere in the middle of these perceptions. ADHD is a condition worthy of future study to provide answers to scientific questions that will result in more accurate diagnosis and more effective methods of treatment. In the meantime, ADHD left untreated leads to a higher likelihood of depression, suicide and substance abuse later in life. ADHD appropriately treated leads to a higher likelihood of success in life because it can help the child properly channel his increased sensitivity, creativity and high energy.

On a more personal level, as a parent of a son who was diagnosed with ADHD at the age of five, I can identify with parents who may lean toward either the denial or victim mentality. When my wife and I were concerned about our son’s behavior and emotional well-being, the last thing I thought of was that he had ADHD. Sometimes, I was probably a bit on the overprotective side. But on the whole, once our whole family accepted that he was a child with an attention deficit hyperactivity difference who needed medication, along with psychological support (provided by us at home), the situation turned around completely. He responded well to the medication, and the crisis of emotional turmoil was over. Over the years, we continued to provide consistent structure (as best we could) and encouragement as well as teaching him how to relax, learn necessary social skills and how to “stop and think.” It all paid off. He has been off medication since middle school. He graduated with honors from a highly regarded university and is now pursuing a successful career in TV and film. He has a great sense of humor and lots of friends.

I encourage parents not be afraid of the diagnosis, give it undue weight and importance or use the label as a crutch for your child. Instead, I believe we need to accept it as the first step in turning a difficult situation around to a positive direction. Helping a child with ADHD succeed requires a team approach that often needs to continue over many years. That team includes the family, health professionals, teachers and, of course, the child. Children may need medication, but treatment guidelines indicate that psychological interventions are also important. In some cases, psychological interventions may be sufficient to bring about desired results. In other cases, they address symptoms medication alone does not help and may also actually reduce the dosage of medication necessary to achieve desired results.

Effective psychological interventions include parent education, behavior modification, home-school contracts, cognitive behavioral therapy, social skills training, relaxation training and mental exercises to improve cognitive functioning. Recent research indicates that many or all of these interventions may be most effective when implemented at home with the parents and the child working as a team. Not only does this approach appear to improve the short-term effectiveness of the interventions, it also results in positive parenting techniques and an open and supportive parent/child relationship that becomes a way of life that is consistent and enduring over time.

So, ADHD can be perceived as a label to be dreaded, used as an excuse to avoid difficult situations or it can be perceived as the identification of the problem underlying a child’s difficulties at home and at school which can be successfully addressed. On the one hand, it is a curse. On the other, it is an opportunity to make things better. The basic tenet of cognitive behavioral therapy is that how we think determines how we feel, which then determines how we behave. If we want to change how we feel and how we behave as the result of those feelings, we need to change how we think. ADHD: Think of it as an opportunity.

Dr. Robert Myers is a clinical psychologist with 25 years of experience working with children and adolescents with Attention Deficit Hyperactivity Disorder and learning disabilities, and is the creator of The Total Focus Program. Dr. Bob has been a talk show host on KIEV and KORG in Southern California and has also appeared as a guest on many radio and television talk shows nationally and as a regular columnist for Parents and Kids Magazine. Dr. Myers earned his PhD from the University of Southern California.

The Lost Children: When Behavior Problems
Traumatize Siblings

Q: What do the other children in the family experience when they have a brother or sister who’s hostile or acts out chronically?

James:
It’s traumatizing when something hurtful happens to you, and you can’t control it, you can’t stop it, you can’t predict how hurtful it’s going to be, and you can’t predict when or whether it’s going to happen. Children who grow up with a chronically defiant, oppositional sibling grow up in an environment of trauma. They don’t know when they’re going to be verbally abused. They don’t know when their things are going to be broken. They don’t know when there’s going to be a major breakdown in the kitchen, and someone’s going to be restrained as they’re yelling and screaming. Often, acting out kids target their siblings as sources of power. It makes them feel powerful to say mean or abusive things or to hurt their siblings. They like that feeling of power, so they do it over and over again.

Several things happen in the mind of a child who lives with this kind of trauma. First, the siblings of acting out kids become used to witnessing outbursts, and it has a negative effect on them in the long run. These are people who grow up willing to accept higher levels of abuse in their marriages and their friendships. They become desensitized to disrespect and abuse. They become numb to how it really feels to be called a name. They tolerate higher levels of disrespect and abuse in other areas of their life once they become adults. Their ability to be assertive also diminishes.

It’s also important to have a “safety plan.” Just as families are encouraged to have a plan of action if there’s a fire (where to meet, how to get out, what to do), I have always encouraged families to sit down and talk about how they can help the acting out child.

They learn not to assert themselves. They learn how to avoid people and situations, and it can hamper their social skills. In our world, a certain degree of assertiveness is necessary to communicate in a way that gets your needs met, and these kids don’t learn how to do that.

I’ve worked with the siblings of kids who act out in my practice, and they are, by and large, nice kids, but they have a lot of problems asserting what the problem is with their sibling and confronting it. They make a lot of excuses for their sibling’s behavior and abuse. They tend to defend him to outsiders, and it develops a very unhealthy social persona in them.

Q: The child with the behavior problem tends to get most, if not all of the attention in the family. What effect does this have on the other children?

James:
My experience is that this manifests itself in two ways. One is that the sibling becomes what is called a “lost child.” This is a child who avoids family situations. When a family discussion starts to get a little heated, this kid disappears into his room. As things get more complex and as he gets older, he stays in his room more. He avoids conflict and confrontation. In emotionally charged situations such as dinnertime, the lost child will tend to avoid dinner because the acting out child uses it as a forum for his aggression. The lost child will tend to say he’s not hungry or his stomach hurts. Anything to get away from the tension and abuse.

On the other end of the spectrum, kids will develop higher levels of attention-seeking behavior that we call “adaptive responses.” For example, a child who’s adapted to a calamitous situation at home shows his adaptive response in school by hiding out. He doesn’t raise his hand. He doesn’t get involved in group activities. He uses an avoidance adaptation in school that makes him stand out as if there’s something socially wrong with him, and it’s how he’s adapted at home. Some kids will act out even more than the hostile sibling, although this is rare.

An adaptive response to trauma means avoidance of anxiety and hyper arousal—in other words, watching out for trouble, listening very carefully to catch wind of tension, always remaining on high alert for hostility so that they can catch the pain before it comes.

Q: What should parents do to minimize the negative effects of the acting out child on the other children in the family?

James:
The first thing parents have to do is make every effort to make the sibling safe. And that leads to them not holding the acting out, abusive kid accountable. No matter what he does.

If parents are afraid of backtalk because it makes them feel powerless, it’s very likely that they’ll tell the defiant child to stop doing it, and the child will say, “I don’t have to listen to you.” The parent feels as though there’s nothing they can do about it, and that leads to them not hold the child accountable because they don’t want to be embarrassed and feel powerless. Inevitably, parents stop setting the limits. The result is the other children in the family wonder who’s really in control, and they identify the acting out kid as the person in charge. As the defiant child acquires more power, the siblings challenge him less and give in to him more.

However, if a parent does tell a kid, “Stop that. It’s not acceptable” and turns around and walks away, and the kid says, “Screw you,” the siblings don’t see him as powerful; they see him as primitive. That’s the important thing. If the parent holds the child with the behavior problem accountable and takes away his “power,” the siblings see the parent as in control and see the kid as out of control. Most important, the parent reduces the environment of trauma for the siblings. Instead of wondering when the pain and chaos will erupt next, they will know the parent is in control and nothing will erupt.

It’s also important to have a “safety plan.” Just as families are encouraged to have a plan of action if there’s a fire (where to meet, how to get out, what to do), I have always encouraged families to sit down and talk about how they can help the acting out child. Do this without the child being present.

I have taught parents to say this: “If Johnny starts acting out, I’m going to deal with him. I’d like you go to your room for five minutes. The best thing you can do to help Johnny when he’s acting out is to leave him alone. Don’t feed into him. Don’t fight with him. Just let me know.” When parents set up this structure, the siblings have a plan for what to do when this kid starts to melt down. When they know what to do, it reduces their feeling of panic and helps them to ease the trauma.

The plan should be framed as how can we help Johnny. Parents should say openly, “We’re going to help Johnny by holding him responsible for his behavior and setting limits. But Johnny doesn’t always respond to that, and sometimes it takes us a while. The best way you can help Johnny is to stay out of it and go inside.”

Remember that trauma comes from not feeling that you have any control over the situation. If the children have a plan for what to do, then it’s not traumatizing because they have some control. The situation may be annoying and frustrating for them, but it’s not traumatizing.

James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.

How to Keep the Violence Out of Your Home

Fifteen minutes with Grand Theft Auto–San Andreas and Josh (age 14, under the persona of CJ in the game) has killed ten gang members and made off with over $100,000 dollars. He pulls another “Baller” out of his car and cuts him in half with a chainsaw. Then another. Slices into him again for good measure. He grabs a bazooka and blows away the guy in the back seat. There’s blood everywhere. He’s on fire today. He buys two prostitutes with his chump and gets a lap dance.

Sam, Josh’s 12-year-old brother is scanning channels in the next room. He lands on a rerun of The Sopranos. Josh looks up just in time to see Christopher Moltisanti put a bullet in the brain of a Hollywood screenwriter. Gray matter splatters all over the place. Awesome.

Violence has always been a part of American culture and civilization in general.

If you don’t want your child to become desensitized to violence, you need to re-sensitize him to the values of your home.

It’s an undisputed fact that the more violence kids are exposed to, the more desensitized they become to it. But it’s not the violence that’s the problem for families now. It’s the delivery systems used to bring that violence into the home.

It used to be that you could manage your home to keep the violence outside. You only had three channels anyway. You could turn off the TV. There wasn’t a lot of violent music and talk on the radio. In those days, all we had was music about puppy love, lost love and love for the open road. We didn’t have a lot of music about hurting, abusing or killing people.

The delivery systems that bring violence into the home have changed and multiplied. 200 plus channels on TV, and the higher you climb on the remote, the more violence you see. Rap music downloaded and embedded in your kid’s ears via I-pod. Satellite radio with no restrictions. Video games with a parental rating system and little else to guide you on the content. The way violence is delivered into the home has changed and that’s a very difficult thing for families to manage. Meanwhile, our kids are becoming ever more desensitized to the images and sounds of people being mutilated and degraded. The more brutality they see, the less they feel it.

The challenge for parents today is to establish the separation between what’s going on inside their home and outside their home. The delivery systems of violence—especially sadistic violence–into the home have to be minimized. There’s a difference between a football video game where people are being tackled, hit and knocked down, and a game where people are being machine-gunned, stabbed and dismembered. Parents have to cut down on the delivery of sadistic, senseless violence into their home using whatever technology and empowerment they have at their disposal.

If you don’t want your child to become desensitized to violence, you need to re-sensitize him to the values of your home. Keep the inside of the home separate from the outside. Here’s an effective way to do it. Instead of saying, “You can’t listen to rap music,” say, “You can’t listen to rap music in our home.” Instead of saying, “You can’t play violent video games,” tell your child, “You can’t play violent video games in our home.” Instead of giving your child unrestricted access to all 200 plus channels on TV, use the parental controls and say, “You can’t watch violent movies in our home.” You have every right and the power to establish these rules, and you should do so if you’re concerned about your child’s exposure to violence.

Realize this. You can tell your child about the standards in your home, but don’t be surprised if they watch and listen to violent music, games and programming outside the home. Here’s why. The forbidden is always very alluring to kids. This is something parents need to know and understand. A kid can know something is forbidden, but doesn’t always understand that it’s hurtful. For example, take speeding on the highway. People know going over sixty five is forbidden. But they don’t realize it’s hurtful. They just think they can drive safely, that their car’s made for it, that the highway’s safe, that they’re good drivers. They don’t understand the potential for hurt there. It’s the same with kids. They know certain things are forbidden. But they don’t know how it’s really going to hurt them. They don’t know why it’s forbidden, and if you explain it to them, the explanation may or may not stick with them. Most of the time, it doesn’t, because the allure of the forbidden outweighs logic with kids.

But kids do understand values when you establish them. So you need to demarcate areas where unacceptable things are not going to happen. State firmly and clearly that you are not going to do this in our home, and then uphold it.

Establish a policy of zero tolerance for violence in your home. Say this to your kids: “There’s no excuse for abuse.” Establish this as a cardinal rule in your home now, before you discover your kids being hurtful with one another. If you do have a problem with a child who hurts you or his siblings, now is definitely the time to establish this policy. If this kid gets violent in your home, call the police. If he hits his siblings, press charges. If he hits you, call the police. Go to court. Call it what it is: domestic violence. Just because you’re the child’s parent doesn’t give him the right to destroy your home and to hit other kids.

When you control the delivery systems of violence in your home and establish a zero tolerance policy, your kids can internalize that structure and understand that your home and family is not a place for violent images or behavior. They learn to separate fantasy from reality. Remember: reality is in the home. This is how we talk to each other here. This is how we treat each other at home. This is what we listen to. This is what we watch. These are the games we play. These are our family values and our family standards. Reinforce this with your kids consistently, and they will learn to make good choices outside the home and live their own lives that way. They will learn that violence is wrong and they won’t become desensitized to it.

James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.

Out of Control Behavior: Should I Medicate My Child?

The recent death of a four-year-old Massachusetts girl from an overdose of medications for ADHD and bipolar disorder has brought the issue of medicating children for behavior problems to the forefront of public consciousness. While this sad case shows the extreme end of the issue, it reminds us of the fork in the road many parents face daily. We have a behavior problem. Should I medicate my child? The question of medication is a complicated one, and many parents have understandable reservations on medical, moral or spiritual grounds. This month in Empowering Parents, James Lehman takes a candid, straight-ahead look at what medication can and cannot do for your child.

James Lehman:
It’s natural for parents to look to the medical system when they are faced with out-of-control behavior. If the child is diagnosed as having some medical condition — Attention Deficit Hyperactivity Disorder (ADHD), for example, or depression — the parents may breathe a sigh of relief. “At last! We know what’s wrong, and there’s medication for it.”

Unfortunately, a diagnosis and medication aren’t always a solution. Medications that target behavior problems are at best a shot in the dark and at worst can have many undesirable side effects and alter the child’s personality. Often, the medication that works on one child won’t work on the next one, so a period of trial and error may have to take place, requiring patience from the parent and the child. Even the diagnoses can be slippery when it comes to adolescents. Depression, which can be treated medically, can look like Oppositional Defiant Disorder, which cannot be treated medically.

Parents need to know that medications aren’t meant to change specific behaviors. What they may do is rebalance some chemicals in the brain to give the child who is taking them a longer fuse or a little more flexibility in thinking about a situation. Kids who are acting out often turn to a fight-or-flight response. If a medication is working well, it won’t change this tendency toward “fight or flight,” but it may give these kids a little extra time to consider the best thing to do.

If you and your doctor determine that medication is the best choice for your child, be observant as your child starts the medication. Look for signs of behavior change. It is possible that they may occur. More likely what you may find is an increased receptivity to alternate problem-solving techniques. A longer fuse or more patience, for example. Then realize that the pills don’t teach the actual problem-solving techniques; it’s up to the adult to teach them and up to the child to learn them.

If a medication is working well, parents should see an increase in ability to focus on tasks such as homework and chores. Conversely, a child who simply becomes lethargic or unemotional is probably not benefiting from the medication, because he is not receptive to learning new problem-solving skills and may need a different medication, a different diagnosis or even a different approach to the problem.

For some young people, psychoactive medications can mean the difference between being functional and doing the work of growing up, and being a constant behavior problem, with all the consequences that implies. I’ve also seen children and teenagers be put on medication who didn’t need it. Their problem didn’t have a medical basis. They needed to learn problem-solving skills, and their parents were not properly trained to teach them these skills.

The key thing to remember is this: With or without medication, many young people who have behavior problems are best treated by creating very structured situations in which to learn appropriate behaviors. Generally, school is a structured environment, so a child may perform better and cooperate better at school where things are more structured. Behavioral change is hardest to measure in the unstructured environment of home. You can teach problem solving skills by starting small and setting limits and offering coaching around one problem you want your child to change at home. Focus in on one thing: doing spelling homework, doing one nightly chore, or talking nicely to your sister. Coach your child toward success with this one thing. Then move on to the next behavioral issue.

As parents, it’s important that we manage our expectations around medication. It can help your child to focus and accept another way to work through is behavioral issue. But it will not solve the problem. Only you and your child, working in a structured, problem-solving environment, can do that.

James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.

Is It a Phase?

Q: Why do parents tend to dismiss inappropriate behavior as “a phase?”

James: When a child is between 18 months and two years old, they’ll start to walk away and say “no” to their parent. The child is practicing a new skill. Parents call it a phase because eventually, the “no” goes away and the child starts to operate within the guidelines of the family. When parents see things they can’t explain, they call it a phase. Parents are very prepared to tolerate phases. But they’re not prepared to tolerate inappropriate behavior. So they label it a “phase” because that makes it easier for them to accept it.

Parents tolerate phases in adolescents in order to accommodate their kids. The sort of phase we’re talking about starts at around age twelve. There’s more testing of authority and testing of limits. You hear, “I just wanna talk to my friends.” “I just wanna stay in my room.” Kids spend more time instant messaging and wanting a cell phone. Parents see this correctly as a phase. And at first, they accommodate this. Most parents who are secure about their parenting will understand this and accept it. We see enough of this in our culture—on TV and in magazines—for parents to understand that this is something adolescents and pre-adolescents go through.

What tends to happen, though, is that some kids start to violate family norms, and parents tend to deny that this is separate from the phase. Saying “This isn’t fair,” and stomping off to your room a couple of times is a phase. Calling your mother filthy names is not. Saying “I only wanna talk to my friends about this. They’re they only ones who understand,” is a phase. Getting high on drugs or alcohol is not.

Q: If the behavior is inappropriate, does it matter whether or not it’s a phase?

James: No, it doesn’t. I think the most important thing parents need to know about phases is it’s important to the child as well as the parent to maintain appropriate standards and boundaries through the phase. So, we set up situations where the child can act out the need for independence or act out the challenge of authority without being destructive, abusive to others or self-abusive. So parents can say, “If you don’t like what’s going on, feel free to go to your room. Feel free to say what you don’t like.” Parents should even accommodate this by giving kids time to say it. I think one of the most effective techniques is to tell your kids that at 7 pm, we’ll sit down and talk about the things you think aren’t fair. And then we’ll go from there. Because then when the kid starts to escalate, you can say, “Save it for seven o’clock.” That way, you have a problem-solving time set aside.

But if the kid starts to call his mother and father all these disrespectful names or call his sister or brother foul, sexual names, I think that’s not a phase. That’s abusive behavior. And it needs to be stopped.

The task of adolescence is individuation. And sometimes adolescents are so uncomfortable with this task that they’ll use hostility and abuse to accomplish that. Parents have to maintain the standards during those times. There’s no excuse for abuse. That’s not a phase. Deal with it as a violation of family rules. Not as a moral issue, not as something to panic about. It’s a violation of family rules, and this is how we have to deal with it. Parents should have clear sets of consequences for this so they can manage it.

Q: How do you know when to address a certain behavior, instead of hoping the child grows out of it?

James: If it’s hurting the person who’s doing it or hurting other family members, people in society, teachers and other students in school, it needs to be addressed. Adolescence is a phase where you start out as a dependent child. It’s called the “latency age, “and you end up as an adult, usually in college. Adolescence doesn’t end with adolescence. That phase of development lasts into the early twenties, and there are different earmarks for the different parts of that phase. For instance: “I can only talk about this with my friends.” “I wanna look hot.” “I’ve gotta look cool.” And then you’ll see a slow shift to the next phase where they want to date and be popular. Then you’ll see a slow shift to the next phase where they individuate themselves from other teenagers. So, at age twelve, it’s me and all teens. At age seventeen, it’s me and my group.

During this period, it’s important for parents to understand that if kids gravitate toward a negative subculture, there’s a problem there. In other words, if kids start hanging out with kids who get high all the time, they’re getting high, and they’ll lie to you about it. But worse than that, they’re seeking a subculture that doesn’t expect anything else out of them, except that they get high. If you hang out with people who play soccer, they expect you to practice. They expect you to stay healthy. They expect you to show up for games. They expect you to be a team player. There’s a cluster of expectations that kids in other groups have. If you’re part of the chess team, there’s an expectation cluster. If you’re part of the honor society, there’s an expectation cluster. If you’re part of a church group, there’s an expectation cluster. When kids gravitate toward groups that don’t have any other expectations for them, except that they’re juvenile delinquents or they shoplift or they get high, parents should take alarm at that.

Q: So, if you’ve got a situation that is violating family norms, what’s the best way to address it with your child?

James: If you want to talk to kids about these things, I think first you want to choose a time when things are going well. Not when they’re going badly. And you want to choose a neutral setting. It shouldn’t be at the dinner table. It shouldn’t be in the kid’s room. It shouldn’t be in your bedroom. Pick some place quiet in the living room, where there aren’t other kids around. Begin by telling your kids what you see. Not what you think or what you feel. What you see. “I see your grades going down. I found cigarette rolling papers in your room. I see that you’re not hanging out with the kids who play soccer anymore, and you used to love soccer. And I’m wondering what’s going on. What do you see?” And ask the kid what they see. That should start a discussion, and it should be an interview format, in which the parent is conducting an interview, not a sharing conversation like they would with one of their friends. This isn’t, “I feel, you feel.” This should be an interview: “This is what I see going on. What’s up?”

The kid may turn away. The kid may say, “None of your business.” The kid may run a lot of excuses. But the parent has to calmly keep the focus on what they’re seeing and what they want to change. And how they can be helpful. Again, the kid may not change, but the parent has planted the seed and met their obligation. And they can have those conversations once or twice a week.

Your kids are going to accept a much wider range of differences than you will as a parent. For a lot of those, you just have to have it established with your kids that these are the rules, and whoever your friends are, this is how you have to behave, and this is what’s appropriate in our home. “You can have friends with nose rings and eye rings, but you’re not going to have any of those. And as long as we don’t have to fight about that, there’s no problem.”

James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.

Is It a Phase?

Q: Why do parents tend to dismiss inappropriate behavior as “a phase?”

James: When a child is between 18 months and two years old, they’ll start to walk away and say “no” to their parent. The child is practicing a new skill. Parents call it a phase because eventually, the “no” goes away and the child starts to operate within the guidelines of the family. When parents see things they can’t explain, they call it a phase. Parents are very prepared to tolerate phases. But they’re not prepared to tolerate inappropriate behavior. So they label it a “phase” because that makes it easier for them to accept it.

Parents tolerate phases in adolescents in order to accommodate their kids. The sort of phase we’re talking about starts at around age twelve. There’s more testing of authority and testing of limits. You hear, “I just wanna talk to my friends.” “I just wanna stay in my room.” Kids spend more time instant messaging and wanting a cell phone. Parents see this correctly as a phase. And at first, they accommodate this. Most parents who are secure about their parenting will understand this and accept it. We see enough of this in our culture—on TV and in magazines—for parents to understand that this is something adolescents and pre-adolescents go through.

What tends to happen, though, is that some kids start to violate family norms, and parents tend to deny that this is separate from the phase. Saying “This isn’t fair,” and stomping off to your room a couple of times is a phase. Calling your mother filthy names is not. Saying “I only wanna talk to my friends about this. They’re they only ones who understand,” is a phase. Getting high on drugs or alcohol is not.

Q: If the behavior is inappropriate, does it matter whether or not it’s a phase?

James: No, it doesn’t. I think the most important thing parents need to know about phases is it’s important to the child as well as the parent to maintain appropriate standards and boundaries through the phase. So, we set up situations where the child can act out the need for independence or act out the challenge of authority without being destructive, abusive to others or self-abusive. So parents can say, “If you don’t like what’s going on, feel free to go to your room. Feel free to say what you don’t like.” Parents should even accommodate this by giving kids time to say it. I think one of the most effective techniques is to tell your kids that at 7 pm, we’ll sit down and talk about the things you think aren’t fair. And then we’ll go from there. Because then when the kid starts to escalate, you can say, “Save it for seven o’clock.” That way, you have a problem-solving time set aside.

But if the kid starts to call his mother and father all these disrespectful names or call his sister or brother foul, sexual names, I think that’s not a phase. That’s abusive behavior. And it needs to be stopped.

The task of adolescence is individuation. And sometimes adolescents are so uncomfortable with this task that they’ll use hostility and abuse to accomplish that. Parents have to maintain the standards during those times. There’s no excuse for abuse. That’s not a phase. Deal with it as a violation of family rules. Not as a moral issue, not as something to panic about. It’s a violation of family rules, and this is how we have to deal with it. Parents should have clear sets of consequences for this so they can manage it.

Q: How do you know when to address a certain behavior, instead of hoping the child grows out of it?

James: If it’s hurting the person who’s doing it or hurting other family members, people in society, teachers and other students in school, it needs to be addressed. Adolescence is a phase where you start out as a dependent child. It’s called the “latency age, “and you end up as an adult, usually in college. Adolescence doesn’t end with adolescence. That phase of development lasts into the early twenties, and there are different earmarks for the different parts of that phase. For instance: “I can only talk about this with my friends.” “I wanna look hot.” “I’ve gotta look cool.” And then you’ll see a slow shift to the next phase where they want to date and be popular. Then you’ll see a slow shift to the next phase where they individuate themselves from other teenagers. So, at age twelve, it’s me and all teens. At age seventeen, it’s me and my group.

During this period, it’s important for parents to understand that if kids gravitate toward a negative subculture, there’s a problem there. In other words, if kids start hanging out with kids who get high all the time, they’re getting high, and they’ll lie to you about it. But worse than that, they’re seeking a subculture that doesn’t expect anything else out of them, except that they get high. If you hang out with people who play soccer, they expect you to practice. They expect you to stay healthy. They expect you to show up for games. They expect you to be a team player. There’s a cluster of expectations that kids in other groups have. If you’re part of the chess team, there’s an expectation cluster. If you’re part of the honor society, there’s an expectation cluster. If you’re part of a church group, there’s an expectation cluster. When kids gravitate toward groups that don’t have any other expectations for them, except that they’re juvenile delinquents or they shoplift or they get high, parents should take alarm at that.

Q: So, if you’ve got a situation that is violating family norms, what’s the best way to address it with your child?

James: If you want to talk to kids about these things, I think first you want to choose a time when things are going well. Not when they’re going badly. And you want to choose a neutral setting. It shouldn’t be at the dinner table. It shouldn’t be in the kid’s room. It shouldn’t be in your bedroom. Pick some place quiet in the living room, where there aren’t other kids around. Begin by telling your kids what you see. Not what you think or what you feel. What you see. “I see your grades going down. I found cigarette rolling papers in your room. I see that you’re not hanging out with the kids who play soccer anymore, and you used to love soccer. And I’m wondering what’s going on. What do you see?” And ask the kid what they see. That should start a discussion, and it should be an interview format, in which the parent is conducting an interview, not a sharing conversation like they would with one of their friends. This isn’t, “I feel, you feel.” This should be an interview: “This is what I see going on. What’s up?”

The kid may turn away. The kid may say, “None of your business.” The kid may run a lot of excuses. But the parent has to calmly keep the focus on what they’re seeing and what they want to change. And how they can be helpful. Again, the kid may not change, but the parent has planted the seed and met their obligation. And they can have those conversations once or twice a week.

Your kids are going to accept a much wider range of differences than you will as a parent. For a lot of those, you just have to have it established with your kids that these are the rules, and whoever your friends are, this is how you have to behave, and this is what’s appropriate in our home. “You can have friends with nose rings and eye rings, but you’re not going to have any of those. And as long as we don’t have to fight about that, there’s no problem.”

James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.

The Disneyland Daddy: A Case Study

Vicki is the single mother of Alex (12), Ryan (8) and Jessica (6). To make ends meet, she works two jobs—as a receptionist during the week and part-time catering on weekends. She has been divorced from Mike, a supervisor for a building contractor, for two years. Her relationship with Mike is strained at best, hostile at worst.

Mike gets the kids every other weekend and every Wednesday. The kids love going to Dad’s because there are “no rules.” They get to do pretty much whatever they want. Weekends are filled with video games, trips to the mall, pizza and movie outings. And candy. Lots and lots of candy. Wednesday nights are TV nights. The kids never do their homework on Wednesday nights because, after a long day, Mike wants to kick back. He doesn’t want to have to deal with questions about homework. Vicki resents Mike’s free-for-all parenting and calls him “The Disneyland Daddy.”

When Mike drops off the kids at Vicki’s apartment on Sunday night, they are wound up, bubbling about all the things they did with Dad over the weekend and not wanting the fun to end. Within minutes, excitement turns to disrespect, when Vicki asks them to help with chores and get to their homework. They talk back, act out and tune their mother out. Sunday nights with mom turn into screaming matches and tears. The anxiety always spills over into Monday morning, when she has to get the kids out of bed and get to work on time.

In her own words, Vicki’s life is “a wreck.” Her priority is to get the bills paid and provide for her kids. In doing so, she feels she is losing control of them at light speed. How can Vicki get back in control, when her parenting efforts are undone weekly by Mike?

Mike doesn’t have effective parenting skills and tries to make up for it with deep pockets. He’s also perfectly happy that the kids go back to their mother’s and act out because it’s gratifying for him. It’s a way to act out his bad feelings toward his ex-wife. Vicki feels cheated, betrayed and resentful about her income disparity with Mike and for having to carry the whole workload of raising the children.

What they both need to understand is that in divorce situations, kids develop a sort of “extra sensory perception” about statements that reflect resentment, anxiety or jealousy. They already feel caught in the middle between their parents, and this heightened sensitivity to their parents’ words makes it even more so.

Can Vicki stop the disrespect and chaos in her home and can Mike learn to be a responsible, effective parent? Yes. But here’s what has to happen.

The simple fact is this: When the kids come back from Dad’s, they need a structure to come home to, not a “mommy” to come home to.

• 1.) The hard pill for parents, especially mothers, to swallow, is that they have to manage their feelings of resentment and anxiety. Kids do sense when daddy returns them that mom is resentful. This raises their anxiety and contributes to the acting out. One way to manage the resentment is talking about it straightforwardly. I recommend that mom sit down and talk with the kids when things are going well. She can acknowledge to them that sometimes she has a hard time when they return because daddy’s able to give them things that she’s not. So when they return home, there should be a half hour transition time, where they just go to their rooms and unwind and unpack and have a snack. They don’t talk about the visit with daddy. They don’t talk about the chores. They don’t do anything. They just unwind. After that half hour of transition time, that’s when she meets with the kids and sets up the structure for the night (homework, chores and TV time before bed) and the week (getting up, getting to school on time).

• 2.) Mom needs to have a structure in the home with rules and very clear expectations. She needs to establish a culture in the home that says, “You’re accountable to me.” What happens at Dad’s house is irrelevant. Mom needs to say this: “You’re not at your father’s anymore. The rules here are these.” Then turn around and walk away. Mom can establish a structure by saying, “It’s eight o’clock. You need to start getting ready for bed. If not, there’ll be no TV tomorrow night.” Or “If not, I’m taking your cell phone.” The clearer that structure is and the more it’s backed up by expectations, responsibilities and accountability, the better the chances the kids will respond to it. The simple fact is this: When the kids come back from Dad’s, they need a structure to come home to, not a “mommy” to come back to.

• 3.) At the same time, mom can set up a reward structure. The kids who do their homework on Wednesday nights when they’re at Dad’s get something extra. It doesn’t have to be something that costs a lot of money. It can be extra computer time, extra phone time or staying up half an hour later the night they get back. There’s also a much easier way to get the kids to do their chores. Give them a certain amount of time to complete a task. If they get it done, they get a reward. For example, if Ryan does the dishes within 15 minutes after supper, he gets an extra half hour on the computer that evening. Vicki should set the limits and make it the kids’ responsibility to meet them. Why? Because they can do it. Kids show us this every day. Why do you think they go home and act out, then go to school the next day and behave themselves? It’s because they can manage different environments effectively.

• 4.) I think the “Disneyland Daddy” in this case needs to be challenged to take responsibility. If these parents are involved in family therapy or counseling, accelerating Mike’s responsibility needs to be part of the structure. I’ve known families who have worked out an arrangement in therapy that if the child is acting out, the father has to come over and help restrain him. It puts some responsibility back on the father and discourages him from creating the problem. I’ve seen divorced parents make agreements that if the child comes home and is acting out, he goes back to the father’s and stay an extra night. This can only happen if mothers are empowered through the divorce decree and custody arrangement or through regular or court-ordered family therapy. But it’s important for mothers in these situations to have that empowerment, so that the family has a structure for the co-parenting task.

James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled teens and children for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.