Mad River Behavioral Health: March 2019

The Purpose of Behavioral Programming

Our dedication is to the whole child. Our interest extends to the child’s family, neighborhood, school, and community. Each child’s well-being is contingent on the well-being of the extended network surrounding and supporting their growth.

Our interest in the whole child includes their well-rounded and well-balanced development. We must attend to each area of need and support carefully weighted, balanced, and multi-dimensional growth: music, art, sports, friendship, family, hobbies and interests, academic achievement, ethical and spiritual well-being. No one area can be allowed to consume our attention at the expense of another area. We must remain flexible and responsive to the child’s needs. We must nurture each child’s strengths and carefully attend to their weaknesses.

Elements of Character, Development, and a Healthy Lifestyle:

Honesty

Creative Well-being

Cooperation / Teamwork

Physical Well-being

Work

Emotional Well-being

Loyalty

Intellectual Well-being

Enthusiasm

Ethical Well-being

Determination

Spiritual Well-being

Curiosity / Inquisitiveness

Community Well-being

Playfulness

Filial Well-being

Optimism

Social Well-being

Resourcefulness

Caring & Compassion

Growth is a dynamic process; a process leading toward resilience, a process leading toward a healthy and productive adult participant in society.

Leadership initiates the process.

Leadership is the beacon toward which the children grow. Leadership is the example or model we provide. What does our model look like? How do we nurture a carefully weighted and balanced lifestyle in our own lives and in the lives of the children we serve?

How do we nurture resilience? How do we nurture a sense of community in which growth and resilience will flourish?

The purpose of programming is to create a sense of community that will nurture, protect, and celebrate the children.

“I was seeing in a sacred manner the shape of all things in the Spirit and the shape of all shapes as they must live together like one being and I saw the sacred hoop of my people was one of many hoops that made one circle wide as daylight and as starlight. And in the center grew one mighty flowering tree to shelter all the children of one mother and one father and I saw that it was Holy.”

~ Black Elk

Kenneth H. Little, MA

603-726-1006

KenLittle-NH.org

Open & Honest Communication

Raising children requires open and honest communication. The only way children will ever participate in an open and honest dialogue is if they feel safe to speak openly and honestly.

If you as a parent create any sensation of fear, even the slightest amount, if you are angry, harsh, critical, or punitive, you are creating a sizable obstacle to effective communication with your children. All problem solving and all skill development requires safety and trust.

Children may forgive our transgressions, but they will not necessarily forget.

Now, with that said, I have never met a parent who did not lose their sense of calm at least every now and then. So, what do we as parents do when we make parenting mistakes?

The first step is always to take a step back, take some time to consider what went wrong and to regain a sense of calm. It may take a while to figure out what went wrong, but once we do regain our composure we will want to go back to our children and apologize for our loss of self-control, to take ownership and responsibility for the error, and to remove any sense of responsibility from the children.

Whatever they may or may not have done, it's not their fault or responsibility that we lost control.

The next step is to repair the relationship.

Different people tend to do different things after a fight or argument. Somethings will bring people back together, healing any hurt feelings. Somethings leave the relationship damage unresolved. Each infraction left unresolved diminishes the relationship more and more over time. As parents, it's best if we can heal hurt feelings and resolve relational problems as they occur. Our children will need us most during adolescence. It's best to have a strong and intact relationship going into this stage of life.

There are many ways for parents to keep their head in the right place. A proactive parenting plan will help you keep stay calm more often and safeguard a strong, trusting relationship with your children.

Printable PDF

Kenneth H. Little, MA

603-726-1006

KenLittle-NH.org

Trust & Faith

Parenting requires two key elements: trust and faith. It's very important that parents
trust their children and have faith in their innate goodness and capacity, while
continuously working to develop the required skills, ability, and character.
With constructive proactive parenting the likelihood is very high that your children
will turn out to be the good, capable, successful adults they were born to be.

Believe this. Believe in your child’s natural goodness and innate ability from birth on.

The probability of a good outcome declines as parents implement parenting plans and
methods that are based in fear, anxiety, anger, and mistrust. For example, if you
believe that children are inherently sneaky and dishonest, you are likely to parent
them in a way that increases their sneakiness and dishonesty. Similarly, overly
restrictive parenting designed to increase child obedience and safety often inspires
increased rebellion and risky behaviors.

Trust

I often hear parents say to a child who has made a mistake -- "you broke my trust".
This in my view is a deep parental mistake, more akin to shaming than guiding and
correcting. Under what circumstances does a parent think create illusory conditions
of trust based on the expectation that their child will never make a mistake?

Mistakes are expected, not surprises. Trust your children to make mistakes as they
grow up.

Children are born with natural goodness and abilities, not as perfect beings. Life is a rigorous and demanding practice-to-mastery activity. Mistakes are an expected part of life. When a child makes a mistake, it will be more reasonable and honest for a parent to say, "ah, that was expected. Let's see if we can figure out what went wrong." Mistakes are an expected part of growing up, not betrayals of trust. It's much more reasonable and accurate to trust that children will make mistakes, understanding that this is a very ordinary part of growing up.

Smile at the mistakes and reassure them.

Faith

Have faith in your children. Believe in them, that they are essentially good and
capable. Children make mistakes. They will need coaching and corrective guidance
on life skills, but this does not make them bad. "Bad" behaviors are much more
accurately seen as expected mistakes.

This is not an exercise in semantics.

How you feel about children in general will leak out all over your children. Many
parents (and teachers) that I've worked with over the years have expressed the belief
that children are essentially "bad", that they are liars and are always "up to no good",
trying to get away with some bad behavior. This is a belief, a basic assumption about
children and human beings. It's not a fact.

While it may apply to a very few, most children are not inherently "bad". If you believe that children are basically bad, this belief will be infused into every parent-child interaction: it will be in your eyes, in your tone of voice, in the conclusions you jump to, and in the way you talk with your child after events. Your child will gradually internalize your beliefs over time and have increasingly bad behavior as a result.

This parenting approach is a self-fulfilling prophecy.

The parent believes it and interacts with their children accordingly who then internalize the belief and ... act it out in the real world.

My strongest possible recommendation is for you to question your beliefs about
children and work continuously to develop a belief in their inherent ability and
goodness. They do not misbehave intentionally as an expression of "being bad"
humans. Children are inherently "good'. Think of misbehavior events as “just a mistake”, not a catastrophic indicator that they will grow up to be felons or failures.

Note: there are a very few children who do certain things that are indicators of a much
larger problem. This is rare. I have worked with these children. They do need extra
help. It's unlikely that your child is this child. I'll do a post on red flags another time,
but just as an example, cruelty toward animals is an example of a child in significant
distress. If you are concerned, consult with your child's medical doctor first. If you
are still concerned speak with a clinical specialist.

Even if your child is in a high-risk category, your belief in their essential goodness
and ability to overcome can have a significant constructive impact on future outcomes
while in the opposite direction, your belief that they are inherently bad is more likely
to cement their destructive future fate.

Printable PDF File

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

The Great Adventure!

When my wife and I brought our first son home from the hospital, all packed into the warm winter snugly fleece in his little car seat, I carried him into our apartment and placed him, still in the car seat, in the center of the kitchen floor ... very much like a bag of groceries.

We stood there looking down at him. I looked at my wife. "Now what?"

Groceries, I know what to do with. You unpack them and put them away. An infant was a whole new and anxiety producing adventure for me. My wife -- a pediatrician in training -- seemed a wee bit more confident, but not as much as I would have liked.

Although I had been working with children as a mental health professional for over 5 years, I had no direct parenting experience at all, had never changed a diaper in my entire life. I began rummaging through his bag of things. Where is the owner's manual? How do you turn this thing on, off; change its settings?

I had no idea ... none.

I'm sure there must be parents who are completely skilled and confident about parenting from the very start; people who transition seamlessly into parenting. However, I'm not one and I've never met one. For my self and the parents I know and have worked with, parenting is a struggle.

Deciphering the Difficulties

Figuring out how and why you get stuck in a parenting ordeal can be a very difficult task. The answers are not always as obvious as one might think.

I have been meeting with a single Mother who has temporarily lost custody of her son. We had developed a pretty tight plan of action, things that Mom really needs to work on to begin the process of getting her life in order so she might be able to regain custody of her son.

Mom has accomplished none of these action items over the past few months.

I queried Mom about this, what she thought might be preventing her from following through on the action steps we had designed.

There could be many reasons, but I've had an inkling for some time that she's just exhausted, ashamed; that on some level she believes herself to be a bad parent. I have wondered if perhaps, she might not be relieved in some ways that she no longer has custody, that she is no longer responsible for parenting her son. Could it be that she secretly believes that her son is better off without her?

So I asked.

Figuring out what's going on, working and what's not working and why, is a very difficult path. It really does require that parents dig into themselves to try to understand what's going on, what's driving the process in the way that it is. It's extremely hard work.

More to come soon.

© 2019 Kenneth H. Little. All rights reserved.

The Spirited Child

I see spirited children often. I love their natural energy. Their parent(s) always look a bit tattered, ruffled, and strained.

Most parents would say, I think, that they want their children to have some "get-up-and-go", a bit of "fire in their belly", some internal tenacity. These are admirable traits and characteristics that will serve children well as they learn how to refine, harness, and direct their energies as they move toward adulthood.

They will very likely clash with the world during this process.

It is better to guide these children gently forward rather than to try to break them of their natural tendencies.

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

From Parent to Child

When children first come whooshing out into the world they are fully reliant on their parent(s) for all of their needs and well-being. As soon as the umbilical chord is cut, however, the very long and gradual process of separation and individuation begins.

Parenting from here on out, every minute of it, is fully about preparing -- incrementally -- the child to occupy a successful, healthy role in the adult world to the best of their abilities. With each passing moment children grow, change, move inexorably toward adulthood. Ready or not, adulthood will arrive.

Children are not well prepared by overly involved, overly controlling parents. Children are not well prepared by under involved, neglectful parents. Children are best prepared by collaborative parents who gently and gradually ween them off parental control and into self-management.

To be continued.

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

Parenting Ethics: Do No Harm, Do Good

In the medical community "nonmaleficence" is the ethical obligation not to inflict harm. In medical ethics, the physician's guiding maxim is “First, do no harm.”

The opposite is beneficence (do good); provide benefits to persons and contribute to their welfare. Refers to an action done for the benefit of others.

"Nonmaleficence means non-harming or inflicting the least harm possible to reach a beneficial outcome. Harm and its effects are considerations and part of the ethical decision-making process ..."

Clearly, parenting should come with the same sort of ethical guidance. A parents first obligation to their children is to inflict no harm; or at least to inflict the least amount of harm possible to reach the beneficial outcome.

1) Nonmaleficence - do no harm
2) Beneficence - do good

Evidence-Based Parenting

The research on parenting provides a reasonably clear set of guidelines on what is harmful and what is helpful.

Evidence-based parenting is the most effective approach.

Do the leg work. Do the research.

Successive Approximations ... Toward Success

A brief talk with a colleague this morning prompted me to write this short essay. She was describing to me how frustrating it is to walk out into the living room and realize how much mess has accumulated while your children sit and giggle watching youtube videos, apparently oblivious to the carnage surrounding them.

I know this feeling. It can be infuriating. The urge to scream can be powerful.

But First, Ask ... is this an emergency?

Take a step back. Evaluate. Is this an emergency? Is anyone gushing blood or on fire? If yes, it's an emergency -- stay calm, think clearly, take action. If no one is gushing blood or on fire, there is no emergency -- stay calm, think clearly, delay taking action. Emergency or not, stay calm - think with a clear head.

Own the Problem

First, always own the problem. If the family is not functioning as desired, responsibility falls to the leadership. The family leaders are responsible for creating the necessary systems and structures and for providing the support and training needed to facilitate the desired outcome. Consider for a moment, if your knee-jerk reaction is to blame the children ... you are committing a fundamental attribution error. Your children have always existed within your family culture.

Take a step back. Clear your head.
Consider the problem carefully, where is the breakdown?
Consider potential solutions - what needs to be changed or re-organized?
Convene a family meeting, include all stake holders.
Explain the problem and your vision of the desired outcome.
Invite members to problem solve - on how to get from the current situation to the desired outcome.
Brainstorm, Try-storm, Generate a list of potential solutions.
Evaluate potential solutions for goodness of fit.
Pick the best. Agreeable to all.
Agree to implement on a trial basis.
After a short trial period, evaluate outcome.
If the problem is solved, carry on.
If the problem is not solved, return to step 1.

Successive Approximations

Understand this term. Successive approximation describes a process of gradually refining outcomes to come closer and closer to the envisioned standard. At first family members may not be skilled in accomplishing the tasks as required. For example, vacuuming may be disorganized, the dish washer may be loaded incorrectly, etc. All tasks and activities start out sloppy and improve with practice and training over time.

In the illustration above, step 4 represents the desired outcome. It's fairly tight, precise, on target. Step 1 represents the not very precise first approximation. With training and practice outcomes improve through the steps. The 4 steps illustrated above is more symbolic than actual. When it comes to raising children, the are many, many more steps in achieving success.

Set-backs and Regressions

It's important to expect set-backs and regressions. The process of improvement looks more like a stock market graph that a straight line. The are periods of growth followed by regressions and set-back as each family member navigates various struggles and challenges, and experiences of success. During easier times, expect performance improvement. During tough times, expect regression, performance decline. Teach and practice regrouping skills, the ability to bounce back from adversity.

Be Supportive

Encourage and re-assure. Practice leads to mastery. Failure is not a disaster, but an opportunity to be supportive, evaluate what went wrong, and to make improvements over time. Failures are opportunities to practice regrouping skills.

Crafting an Effective Family Culture

I think for most parents, myself included, figuring out how to be the best possible parent, figuring out how to help our children become the best possible version of themselves that they can be ... is central to our existence as parents.

In my mind, this purpose is an all-consuming obligation.

The whole purpose of this blog is directed toward fulfilling this purpose. In this essay I offer thoughts on developing a constructive family culture. I use the word constructive to describe a family that adds value to their children. Not all families do this. In fact, many diminish their children either subtly or in crushing torrents.

Family culture describes the rules, norms, values, customs, traditions, and leadership style of a family that guides and informs the way people behave on an individual basis and interact with each other.

This essay is not prescriptive, an instruction on how to make a specific family culture. It is a thinking tool designed to promote thought on this important topic.

Each interested family will need to create, craft, or construct its unique internal culture. All families have an internal culture, but not all families have a well thought out, intentionally constructed family culture. Some family cultures are functional and adaptive. Some family cultures are dysfunctional, maladaptive. Many family cultures are accidental. Most family cultures are not optimized around success and well-being.

Personally and professionally, I think the goal of family, the sole purpose, is to provide an environment in which each member is enlarged, enhanced, made better and stronger because of the family culture.

At least, this is the ideal that I'd like to see families moving toward. I do know that there are many families within which members are diminished and that stress and frustration and difficulty rob the family of its vital energy. Sometimes, life gets hard. But I think that the goal has to always to be to move back toward a family culture that is enriching. During times of heavy stress it is not unusual or unexpected for family members to regress. Being able to regroup quickly and effectively is an important life skill.

Words I use to describe what I view as an enriching family culture:

Inclusive
Collaborative
Kind
Generous
Trusting
Fair, and
Supportive

What does your family culture look like? What do you want it to look like? Crafting a family culture is an on-going process. Sit down with family members and begin by writing down a few words that describe your family culture. Make a list. Talk it over. Think and refine. Once you have a list of words that describe how it is, talk it over and write out a list of words that describe what you want it to be.

Create a plan to transform your family from the way it is to the way you want it to be.

Kenneth H. Little, MA / 603-726-1006 / KenLittle-NH.com

"Sex, Drugs, and Rock 'n Roll"

Why Do Kids Start Smoking; and other unhealthy, self-destructive behaviors? What can parents do? How to develop a constructive parenting plan that will reduce the risk?

Why does it matter? "Isn't risky behavior during adolescence normal?" "I did it and I'm fine, what's the big deal?"

Ingesting, inhaling, injecting drugs and alcohol can impact brain development during the adolescent years, a time of rapid brain growth. Even small differences in neurological development can cause lasting problems well into adulthood.

"Altered brain development due to exposure of neurotoxins during adolescence, particularly alcohol, could set the stage for cognitive problems into adulthood, conferring functional consequences throughout life."(3)

It is best if the brain is well protected from birth until age 25. Drugs, alcohol, tobacco (other*) all pose significant risks to healthy brain development.

Below is a list of risk factors for smoking cigarettes. They are similar to the reasons why kids start other unhealthy activities. There are some that are not preventable, like poverty. Kids grow up in the families they grow up in. Don't be re-assured by high and moderate socio-economic status (SES). While low SES is associated with smoking, high SES is associated with alcohol and marijuana* use.

"Young adults with the highest family background SES were most prone to alcohol and marijuana use."

Hold on, wait right there. The literature on marijuana use during adolescence indicates that it is not benign.

"The literature ... provide strong evidence that chronic cannabis abuse causes cognitive impairment and damages the brain, particularly white matter, where cannabinoid 1 receptors abound."

Ages 12 to 25 are the important years. Young people are most likely to start using destructive substances during these years.

" ... by 26 years of age, nearly all people who are going to use tobacco have already begun, so the focus of primary prevention with young people really spans the ages of 12 to 25 years."

Relatively low SES,
Relatively high accessibility and availability of tobacco products,
Perceptions by adolescents that tobacco use is normative, that is, usual or acceptable behavior,
Use of tobacco by significant others and approval of tobacco use among those persons,
Lack of parental support,
Low levels of academic achievement and school involvement,
Lack of skills required to resist influences to use tobacco,
Relatively low self-efficacy for refusal,
Previous tobacco use and intention to use tobacco in the future,
Relatively low self-image, and
Belief that tobacco use is functional or serves a purpose.

You can see that the age range of concern is between 12 and 25, but most parents do not activate to address adolescent concerns until it's too late, often not until after-the-fact. The point at which parents will need to begin preparing their children to reduce the risk -- at the very latest -- is prior to age 12.

A well-designed, proactive parenting plan will begin work on preparing children for adolescents beginning at birth, but if you start late, age 8 is good. A pro-active parenting plans lays out the pathway toward the desired outcome for each child.

To get a sense of what this plan might look like, flip each of the risk factors listed above into its positive opposite whenever possible.

High or Low SES is hard to alter.
Accessibility and availability? Reduce.
Perceptions by adolescents? Teach facts: only about 8% of high school students smoke, etc.
Parents, aunts, uncles, grand parents, etc., stop using and disapprove.
Increase parental support.
Support and facilitate academic achievement and school involvement.
Increase peer-pressure resistance skills ("Go along to get along", compliance and conformity, is not a constructive lesson for children).
Increase child's belief in their effectiveness in refusing.
Address faulty ideas supporting intention to use.
Enhance self-esteem, self-image, self-worth constructively.
Nurture belief that substance use serves no constructive purpose.

There are critical skills children need to be taught and parents will need to have developed a relationship with their children that supports open discussion. Any parenting practices that impinge on open discussion are counter-productive.

Additional Reading

Socioeconomic Status and Substance Use Among Young Adults: A Comparison Across Constructs and Drugs

Social, Environmental, Cognitive, and Genetic Influences on the Use of Tobacco Among Youth

The effect of alcohol use on human adolescent brain structures and systems

Adverse Structural and Functional Effects of Marijuana on the Brain: Evidence Reviewed

Mad River Behavioral Health

The Purpose of Behavioral Programming

Open & Honest Communication

Trust & Faith

The Great Adventure!

Deciphering the Difficulties

The Spirited Child

From Parent to Child

Parenting Ethics: Do No Harm, Do Good

Successive Approximations ... Toward Success

Crafting an Effective Family Culture

"Sex, Drugs, and Rock 'n Roll"

Additional Reading

Navigating the Maze: Essential Strategies for Conflict Resolution

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