PROFESSIONAL COUNSELLOR - Mental Health Academy

THE PROFESSIONAL COUNSELLOR03 2007FEATUREBehaviour Modification with ChildrenSteve and Jan have come to counselling regardingtheir 5 year old daughter, Kim, who screams when shedoesn’t get her own way. She is starting school nextyear and her parents are concerned with how she isgoing to fit in and what will happen if she doesn’t gether own way.A précis of the session is as follows. For ease ofwriting the Professional Counsellor is abbreviated to‘C’.In the first session C gathered information fromSteve and Jan about their discipline techniques andwhat they have done in the past when Kim screams.Jan said that they have tried everything and nothingworks. C asked Jan to expand on this - what exactlyhave they tried and what happened.Jan said that over the last year she has triedignoring Kim’s behaviour but she found it actually gotworse. C asked Jan if she ever gave in to Kim insteadof ignoring her and she said she did but only aboutonce a week.Jan said that she tried sending her to her roomevery time that she screamed and that Kim’s screamingstopped after being in her room for a few minutes butit didn’t stop the screaming actually occurring. C askedJan what Kim was doing when she was let out of herroom and Jan said that she was just playing with hertoys.Steve said he had had enough and although hedisliked hitting Kim he felt it was a last resort. Steveexplained that Kim would just scream for longer if hehit her. Both Jan and Steve were very distressed aboutKim’s behaviour.C didn’t want the parents to feel as if they hadfailed but needed to tactfully point out why theirprevious attempts at stopping Kim’s screaming hadbeen unsuccessful. So C talked to Steve and Jan abouthow she felt that she could help change Kim’sbehaviour and emphasised that the parents had madea positive step by seeking professional help and howit showed commitment to their daughter and herupbringing.C then explained to Steve and Jan that she wasgoing to use similar techniques to what they had usedpreviously but would modify them slightly. C alsoexplained that she would highlight for them thereasons why their previous attempts were unsuccessfulso that they could reuse the techniques for otherproblems that arose.C began by explaining that Kim was screamingbecause she was getting some sort of reward forscreaming. That reward may be just receiving attentionwhether it is negative or positive attention. So basically8Steve and Jan had to ensure that Kim received noreward for behaving in this way.C then explained that when Jan had ignored Kim’sscreaming but gave in to her once a week then Kimwas actually still being rewarded for screaming. Thatis, she was getting what she wanted, even if it wasonly once a week. C explained to Steve and Jan thatthis was enough for Kim to continue screaming. Shewill continue to scream if she knows there is a chancethat she will get her own way, even if onlyoccasionally.C also talked about time-out as punishment andexplained that sending a child to a room full of toys ismore of a reward than a punishment. So if Kim isasked to do something she doesn’t want to do, shejust screams and gets to go to her room and play withher toys.Also if Kim is hit for screaming then she may stillbe receiving attention for the screaming. Even if theattention is negative some children see this as betterthan no attention at all. C then asked Steve and Jan toconsider what they do when Kim is quiet and playingwith her toys or watching TV. They responded bysaying that they try not to disturb her so that she willstay quiet. C then explained that in essence what theywere doing was ignoring Kim when she was good and“Even if theattention isnegativesomechildren seethis as betterthan noattention atall.”giving her attention (even if itis negative) when she wasbad.C then spoke to Steve andJan about setting up abehaviour modificationprogram for Kim. The aim ofthe program is to reduce thebehaviour of screaming.The first step of theprogram was for Steve and Janto record Kim’s behaviourbefore they tried to change it.They kept a daily tally ofevery time Kim screamedwhen she didn’t get her ownway. It was not necessary for the parents to tell thechild that they were recording her behaviour. Cinformed Steve and Jan that they would need tocontinue to record Kim’s behaviour while they weretrying to change it.Session two was held after Steve and Jan hadcollected the two week baseline and it was now timeto try and change Kim’s behaviour. The first step indoing this was to not reward or reinforce Kim’sscreaming in any way. C explained to Steve and Janthat they had two options on how to change Kim’s