"Defiance" is diagnosis of child therapist

Discussion in 'General Parenting' started by crazymamawoman, Jun 26, 2007.

  1. crazymamawoman

    crazymamawoman New Member

    We met with the therapist today without difficult child and he said that we've allowed her to be defiant by not disciplining her. He said even though we don't give in to her demands, she's still "winning" because she argues and fights for several hours. He advised that we sit with her against the wall holding her still until she calms down.

    After everything I've read here, I'm really second guessing this. Should we go to another doctor? Our insurance only lets us see someone with a referral from our regular pediatrician.
     
  2. smallworld

    smallworld Moderator

    Run, don't walk to another doctor. You should ask your pediatrician for a referral to a neuropsychologist and a child psychiatrist OR a multidisciplinary team at a children's or university teaching hospital.
     
  3. Steely

    Steely Active Member

    Ditto what smallworld said.....

    I had a psychiatrist once tell me that my difficult child did not have outlets for his anger, and if I just let him break some dishes when he was mad than he would be fine. Huh??????? I conceded to this doctors advice, gave my son some "dishes", and my son proceeded to wreck not just his "dishes", but the entire house. He became completely out of control.
    We warrior moms have to go with our gut. I knew this psychiatrist was wrong at the time, but I went with his advice because he was the "professional". Go with your intuition - if you think this is crazy advice - then it is.
     
  4. Big Bad Kitty

    Big Bad Kitty lolcat

    In case you still have a doubt in your mind...

    I third that motion. Get to another doctor ASAP. That's just crazy.

    Best of luck, and many prayers your way.
     
  5. Sara PA

    Sara PA New Member

    Does you child respond well to being physically restrained? That was one sure way to keep things going in our house. Even now when my son is upset he doesn't like being touched, let alone held down.

    It seems like your child gets "stuck" on something rather than whatever it is the therapist thinks she is doing. More like obsessive than manipulative.
     
  6. Allan-Matlem

    Allan-Matlem Active Member

    Hi,
    I don't think a situation where your kid is ' loosing ' and you ' winning ' would improve things. I don't believe that we can break kids into submission , they will resist even more. Even behaviorists , and I am not , say that honey catches more flies than vinegar so use positive reinforcements. personally I prefer workingwith -problem solving approaches like that of the explosive child , not a doing to approach.

    I think the starting point has to be - relaxing the environment , putting behaviors into basket c = ignoring in the time being and trying to bond , connect in one and one time , using dialog questions to direct conversation , you listen , she speaks. Try to focus on perspective taking, empathy , addressing concerns - what's the problem first and then look at solutions. It is easier to talk about non emotive issues first , stories , new s items, your experiences , video story etc what she thinks, what the kid in the story thinks , how could they solve the problem. Avoid saying NO , we set limits also when we reach mutually satisfying agreements. This is not a quick fix , it is a process ,but helps the relationships and promotes various cognitive skills that may be lacking. I recommend getting the latest edition of the book , the explosive child and trying to find out what is getting in your child's way. Greene says kids do well if they can , not kids do well if they want to. Defiance can be explained as pure choice or a learning disability in areas for eg frustration tolerance , flexibility and adaptability

    I hope this helps
    Allan
     
  7. witzend

    witzend Well-Known Member

    Well, I wouldn't do that, but I would put her in her room and refuse to interact with her until she stopped. You don't say how old she is, so it's hard to know what time period we are talking about.

    Believe me when I say that M was totally defiant from about age 6 on. Things got better when he was about 10 or so and we got a therapist who said essentially the same thing about him, and recommended time outs. We thought he was a total A S S to suggest it. But he explained to us that the point of the time out was to end the discussion/argument. There wasn't usually going to be a resolution, because really, the discussion was just over, period.

    The recommendation was to get a timer, and timeout lasted as many minutes as he was old. Three years old, three minutes, etc. The timer started when he went into his room. He had to stay in there and be quiet - not interact with us in any way - for the time set. If he started kicking the wall or hollering at us, the timer stopped. I might quietly go to his door and say "The timer will start again when you are quiet." When he was quiet, the timer would start again. When it went "ding", he could come out. What he could not do when he came back out was take back up where he started. If it was an important issue, he could have a calm discussion at a later time, but acting out brought him back to time out. Most times, there was no valid reason to revisit the issue as we had made our decision before the hissy fit started.

    I know that people pooh-pooh time outs, but it's the way you use the time out that makes it work, not the time out. Your difficult child and you both need to know what the time out is there to accomplish. The time out is about ending the craziness. It's not about punishment, it's not about bringing the argument down a notch. It's about your child knowing that you will not engage in their acting out anymore. You have a great head start by not giving in. Try the timer. We never thought it would work, but it kept the peace in our house. M still had his problems, believe me, but I would never have made it through my marriage or as his mother (I seriously would have walked out) if it weren't for the time outs.
     
  8. Allan-Matlem

    Allan-Matlem Active Member

    Hi,
    I am one of those parents who don't like TOs but for some they work. I think the Nutured Heart approach of TOs as short as a few secs , followed by positive affirmations is better than 1 min per age. I agree the important step is that the child perceives it not as punishment but helping to calm down and change gears. I prefer the word ' chill out time ' and giving a child a ' comfort corner ' with a book , CD etc that she can calm down

    Allan
     
  9. kris

    kris New Member

    time outs can be effective. they were for both of mine when they were young....prior to my son's difficult child phase. once his depression started & he started raging restraining him was out of the question. any form of touch drove him crazy. if your child has sensory issues in general or rage related starting off with-physical restraint will probably exacerbate the situation.

    with-o a profile that give age/diagnosis/medications if any it's hard for us to advise you re: alternative.

    kris
     
  10. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    in my opinion see a Child Psychiatrist with the MD) and/or a neuropsychologist. I would have been out the door pronto. Unfortunately, there are bad apples. I start with the Big Guns==the Doctor of Psychiatry and the Psycologist who does intensive evaluations (NeuroPsychs). in my opinion I wouldn't bother with a non-MD therapist or even a regular Psycologist. Or experience with so many of them were very bad. If your child has a disorder, in my opinion, time outs alone are rarely effective. You need to find out exactly what is going on. I seriously doubt it's your parenting. Most of us have been told that if we were "better" parents our kids would behave. It's not always true. My son, who is on the autistic spectrum, refused to stay in time outs. He got much better once we treated the Autism Spectrum Disorders (ASD). JMO
     
  11. busywend

    busywend Well-Known Member Staff Member

    Get a new doctor. neuropsychologist referral is my advice.

    Please do a profile. As Kris said - it is harder for us to recall who you & difficult child are and what your story is if we do not have a signature.
     
  12. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Really its hard to say if the therapist is right or wrong because we cant know your child through a message board. Your therapist has a more hands on working knowledge of your child.

    There are kids who defiant because they are hard kids to parent. They dont mesh well with our parenting personalities. My older two kids really did want to please us. My oldest was so laid back and calm it wasnt funny. He only had to be told what was the right thing to do and he did it. He didnt want to break the rules. He rarely got in trouble. My middle one could be naughty but it was usually impulsive type stuff. He learned from his mistakes. Then along came the baby. He seemed hardwired to defy us. It was his mission in life to thwart authority. He is this way today. Nothing changed him.
     
  13. helpmehelphim

    helpmehelphim New Member

    We heard this same exact thing from a few different therapists. I completely agree with- Smallworld...I would run, not walk to someone other than a therapist. I can say that now after spending so much time getting the type of advice that you just received and feeling that same confusion that you address in your post.

    All therapists have different approaches and different philosophies that they adhere to. Some follow Piaget, Freud, etc., etc. Some are behaviorists and some are not. Some believe in approaches that work with the child to help them learn and others believe in behavior modification among other things. I found the most important thing to do is find a professional that matches my own parenting philosophy. That philosophy has changed a great deal for me over the the last few years. When my son's illness didn't mesh with- my parenting then I changed my parenting...not everyone goes that route, but I decided that he needed different things and that it was important for me to meet him where he was at the time and go from there. He has gotten much better. That's an individual decision.

    We have a wonderful psychiatrist where we live near Raleigh, NC that just the other day said to me, "when a child is drowning, that's not the time to teach them to swim". That's how I feel about it right there...when the child is able to feel calm and secure, then we can teach them better how to deal and cope (which will decrease the defiance in our own experience). There are different ways of helping them get to that state...many different ways.

    I understand what you are saying completely. You know what you are comfortable with in terms of treatment for your child. If you believe that what is going on is truly motivational (child is not motivated enough to do well) then you know that. That wasn't our experience at all. My son was totally motivated to do well (although people thought he wasn't because his behavior was different) and being strict, punishing, having too high expectations couldn't motivate him because it wasn't for lack of motivation...there were cognitive and emotional issues at play that had to be addressed so that he could have a chance.
     
  14. Nancy

    Nancy Well-Known Member Staff Member

    What part of Ohio are you in? I may have a referral for you if you are up north.

    Nancy
     
  15. crazymamawoman

    crazymamawoman New Member

    Thanks, everyone. If it would help with advice, here is a brief synopsis of Parent Assessment form:

    -----------------------

    Introduction to difficult child


    difficult child has a great sense of comedic timing and she often keeps the entire family laughing. She is musical, making up songs with lyrics and love to sing and dance. She is affectionate to both parents and her sister, often giving impromptu hugs and kisses.


    Family History

    difficult child lives with her parents, Dad(48) and Mom(44) and sister,(10). Parents have been happily married for 14 years. The family’s values are Judeo-Christian based and they commit to regularly volunteering for the church and school events. Parents believe in teaching their children responsibility, empathy and activism.

    Medical History
    difficult child was born 8/9/2000 after an uneventful pregnancy. The mother took 100mg Effexor from months 4 through 7 of the pregnancy at the advice of her OB/GYN. Delivery was induced 2 weeks early due to the baby’s larger size. difficult child weighed 8lbs 4oz and was 21” long. Mother experienced postpartum depression and was placed on Effexor 150mg and advised that she could breastfeed. difficult child was breastfed until the age of 20 months.

    difficult child has/had no developmental delays and was fully immunized according to the AAP timetable including optional varicella.
    She has no record of hospitalization or emergency care.

    Mental/Emotional History
    Paternal mental family history includes alcoholism (paternal grandfather.) Maternal mental family history includes diagnosesd general anxiety/panic disorder (mother), depression (mother) and suicide (paternal grandmother, paternal great uncle). Mother has been effectively controlling her depression and Generalized Anxiety Disorder (GAD) with Effexor 150mg. Paternal grandfather exhibited symptoms of Pedophilia and Narcissistic Personality Disorder. Neither sister nor difficult child have been diagnosed with any mental/emotional disorder.

    Social History
    difficult child has generally played well with others, although she has a tendency to demand the authoritative role. She is popular at school and often invited to the social functions of her peers.

    Scholastic History
    difficult child does well academically in public schools and is expected to attend the ASP/Gifted program this fall.

    Assessment History
    difficult child began having extreme tantrums at the age of 16 months. Unlike her sister’s “terrible twos”, difficult child's tantrums would last for up to an hour and involved head banging, kicking, hitting and throwing. The parents expected the tantrums to dissipate somewhat by age 3 but the extreme tantrums continued until approximately age 5. The tantrums lessened in frequency to approximately 4-5 per week but became more intense. Frequency of tantrums is currently 2-4 per week with each tantrum lasting 20 minutes to 2 hours.

    difficult child has been examined by her pediatricians (she sees various doctors at the practice). psychiatrist recommended counseling and evaluation with a child psychologist. The parents have looked at the nutritional and sleep needs of the child to determine if they affect her behavior. They have also encouraged difficult child to participate in sports as an outlet for her energy.

    Discipline
    The discipline philosophy of the parents is to use real-life consequences to enforce behavior until the intrinsic rewards motivate the child. The parents have never spanked the children and used time-outs in the toddler and early school age years.
    --------------------------------

    The example the therapist latched on was when I told him that when I put difficult child in her room and tell her to cool down, she screams NO and comes running back out. I walk her back in and tell her that she must stay there until she calms down. The therapist said that she's "winning" when she comes out and that she's gotten used to getting what she wants.

    I have to say, I felt terrible after that meeting. husband is working all the time so basically it's MY fault since I'm the one disciplining her 99% of the time.

    Now I'm really confused.
     
  16. helpmehelphim

    helpmehelphim New Member

    It's so difficult when we take our kiddos to people that we trust will give us the information that we need. What this professional says is based on his/her training and knowledge set. I wouldn't be comfortable hearing the professional talk about a kid "winning" when the reason that I've taken the kiddo is that they are having trouble coping with- certain life circumstances and if they were "winning" they wouldn't even be there. It's a mindset. To me, it is not helpful.

    I would change professionals. I would interview the professional first as well. I would go with information in hand about the types of parenting that I value (I take books with- me about the approaches that I need acknowledged and they can either agree or not but it cuts to the chase of what I need with- my kiddo). We are hiring them to do an important job. I've fired them before (I quit seeing one that I was using myself). There are good therapists, not so good and all kinds in between.

    I reject the assumption that parenting causes behavioral disorders. Parenting can certainly help with- the environment but it's not going to take the place of Occupational Therapist (OT), Speech Language Pathologist (SLP), psychiatrist, therapist, medication, etc. or the biggie, maturity and time (sometimes it takes much longer for certain kiddos to mature than others).
     
  17. TerryJ2

    TerryJ2 Well-Known Member

    How old is your difficult child? The Holding Technique really only works when they're pretty young. My son is 10 and we're way past that.
    I understand what the dr was saying about how the child is still winning by raging for so long, but I like Witzend's idea better, where the child must leave the area. I noticed that our son calms down much more quickly because A) there's no audience, and B) we are not exacerbating the situation by trying to force him into either a conversation or argument.
    Obviously, feeding into rages is a component, but I think your dr is missing other factors. Is that ALL that was offered? Clearly, it's not normal for a kid to do that (or none of us would be here!) Sounds like a limited vision cheap shot to me. I agree with-the others that you need another opinion and concrete suggestions.
     
  18. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I disagree that the child is "winning." Of course, they are all different, but I used to rage and it kind of would spiral out of control in less than a second. I felt horrible about it afterwards, but couldn't seem to stop the rages from happening. Afterwards, I'd sit in my room and think about how I didn't deserve to live because I hurt the people I loved. I didn't express this often to my parents, but it's how I felt. I don't know if raging behavior nets any winners. If my parents had tried to restrain me, I think the out-of-control feelings would have escalated beyond control. At any rate, that's just my experience.
     
  19. guest3

    guest3 Guest

    jeepers does this guy want you to have the police involved>?

    Hope you find a new doctor soon.
     
  20. witzend

    witzend Well-Known Member

    Thanks for the info. Not everyone will see it unless they are looking at that particular post. You might try adding a profile signature, which you can do under the link of "my stuff".

    I think that a 3-5 minute "time out" "Chill out" "Calm Time" would be just fine. I would advise against it being in a corner or anywhere in the same room as others. In her room alone, not as a punishment, but so that she can compose herself and disengage.
     
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