The Behavioral Therapist Detective: Here’s How We Solve the Case
How It Starts…
I regularly get questions from parents about how to manage their child’s behavior. We welcome such questions and look forward to working with parents to help improve the situation. I might hear something like, “my child is having lots of tantrums and is really hard to manage” or “my child won’t do anything I ask!” These are, in fact, difficult situations and worth reaching out to somebody like me for answers. I believe I can speak for all the therapists at Community Psychiatric Centers when I convey that this is our job. This is what we do, so we welcome the opportunity to help children control their impulses and parents feel more confident in managing their kids.
To Help, We Become Detectives
As the famous detective, Sherlock Holmes, often exclaimed, “you know my methods, Watson.” Yes, Behavioral Therapists have methods too, and they begin similarly: gathering clues (i.e. information), which we call collecting ‘data.’ We can’t get enough data or clues, and the clues can’t be too specific.
So, we may drive you crazy by asking lots and lots of questions. Not to mix characters, but another famous detective, Jack Webb, was known to say “just the facts, Ma’am.” We’re the same way – the more facts we have, the better we’ll be able to help. We want lots of facts, then we’ll put those pieces together to solve the case, so to speak. To the extent that if we don’t have adequate facts we are feeling our way in the dark. Therefore, we are not using the most effective strategies, wasting valuable time, and it’s a whole lot harder to ‘solve the case.’
What Do We Need to Know?
To help develop effective strategies for your child, there are various factors or aspects, we need to consider. It all starts with these three. They are considered the cornerstone of our detective work to determine the ‘what’ of the behavior:
We need to know as much as possible about each of these aspects. They would include how often the behavior occurs, how intense is it (what it looks like), and how long it lasts. If we know those three things, we’re well on our way to knowing the ‘what’ of the behavior.
As With Any Good Detective, We Need to Determine ‘Why?’
Now that we know the ‘what’ of the behavior, to gain some insight into ‘why’ the behavior is occurring, we ask:
- How long has the behavior been going on?
- What is the trigger for the behavior?
- Is there any pattern or predictability for the behavior?
Once we have these questions answered, we’ll have a much better understanding of why the behavior manifests. We’d learn, for example, whether there is a predictable event or person that tends to trigger the tantrum. If the tantrum occurs every time or only at certain times of the day or in specific situations? Has this been going on for years, or only the past few weeks? Does the tantrum occur 5x per day, or once per week? Does the tantrum persist for one minute or 30 minutes? Is the behavior very intense with subsequent destruction of property, or only mild emotion and sobbing? When does the tantrum not occur?
‘How?’ or What’s Been Tried to Alleviate the Behavior?
Next, we need to know the ‘how?’ We need to know what’s been tried, and what each intervention ‘looks like.’ For example, if we hear that you’re utilizing time-out, we’d need to know precisely how time-out is used. Same for loss of privilege, ignoring the misbehavior, or trying to talk to the child and problem-solve. Knowing the specifics is vital since there are, for example, dozens of ways to implement time-out.
Regarding predictability or a pattern of behavior, we often find there are two or three specific situations that are proving to be difficult, such as the morning routine, or bedtime, or specific chores. So, we’ll break down each of those situations accordingly to get these questions answered.
Once we know the answers to these questions, it’s simply “elementary” as quoted from our friend, Detective Sherlock Holmes, to fit the pieces together and determine more effective ways of intervening.
The Behavioral Therapist’s Role
It’s important to note that entire chapters can be written about each of these facts, or clues (i.e. frequency, intensity, duration, triggers, predictability…), and the answers help to drive the planning of specific strategies. This reflects the complicated job of a detective, er, I mean a Behavioral Therapist. There is a lot of data to gather and analyze from which to determine a game plan. It takes training and experience to effectively pull it all together.
There are many famous detectives who are fun to watch as they gather evidence and solve the case (maladaptive behavior). This is dating myself, but we can recall the aforementioned Sherlock and Webb, and who can forget Columbo, Marlowe, Reacher, Perry Mason (okay, so Mason was not a detective, and Reacher wasn’t either, but they sure could solve the case).
A behavioral therapist’s job is no less fun and challenging in gathering all the information and ultimately putting the pieces of the puzzle together. However, in our situation, given that kids and situations are ever-changing, the solving of the ‘case’ is also an evolving process and does not always involve a one-time concluding event. In that respect, when working with a behavioral therapist at Community Psychiatric Centers, it’s not as simple as Professor Plum using the candlestick in the library. Actually, before writing this post, I didn’t realize the abundance of detective references; we sure enjoy solving mysteries, don’t we? In any case, our Behavioral Therapists will continue to monitor the situation and modify the plan as things evolve.
Diagnosis Plays a Part
Our Behavioral Therapists will recommend effective intervention strategies that may focus on the trigger (modifying the approach to the child) or the behavior (finding an effective consequence). Not to complicate the matter even further, but a child’s diagnosis also comes into play. When a child has autism, we may focus more on the triggers, and modify how we approach the child. Alternatively, we may focus more on consequences for a neuro-typical child who tends to be oppositional.
Yep. After we gather the information, we come up with some hypotheses regarding what is fueling the problematic behavior, and the best ways to intervene. Next, we experiment with some different approaches to test the hypotheses.
So How Does the Detective Process Relate to You, as the Parent?
The same pieces of data that help us, also help you. The more aspects you’re aware of, the better you’ll be able to provide this information to a behavioral therapist and also use that information yourself to make more informed decisions on how to manage your child. Think of it this way: say you notice that your child tends to get emotional and tantrum daily. These last for approximately 5 minutes. The tantrums happen upwards of 3/5 days per week, directly after school when redirected from playing a game to doing homework, especially if there is math homework. Okay, so this is an easy one, and pretty ‘elementary’, but it makes a good point. Having this information is vital to experiment with some different approaches based on your hypothesis.
These experiments may include modifying the trigger by changing the time of homework (later in the afternoon), working with the teacher to modify the math homework (so the harder math work is completed in the classroom), helping to improve your child’s math skills so they are less math-averse, beginning homework with any subject besides math (using what’s called ‘behavioral momentum to get the math done), or talking with your child to see how they want to handle this conundrum and see if they have any good ideas. You can also deal directly with the behavior by using a sticker chart for homework completion to increase motivation, or taking away computer time if your child tantrums. So, there are lots of options, but all these options are based on the evidence you’ve gathered as a parent-detective.
I hope this post has helped to uncover the clues necessary for effective behavior management. We reviewed the importance of the following steps:
- Identifying a trigger for a misbehavior
- Determining the frequency of the misbehavior
- Noting the intensity of the misbehavior
- Timing how long it lasts, or the duration
- Assessing if there is any predictability or pattern to the behavior
- Journaling what’s been tried
- Noting how it has been tried
- Develop a hypothesis as to what’s fueling the behavior problem
- Test the hypothesis with different approaches
As you gain comfort and confidence in collecting these clues, you’ll find yourself becoming an increasingly effective and efficient parent-detective. You will be able to make the necessary adjustments to manage whatever behavioral problem comes your way. However, it’s always helpful to get professional assistance, from a trained and experienced behavioral therapist-detective, who can guide you along the way. Feel free to contact me in that respect at DrC@cpcwecare.com. Happy detecting!!