A chat with Ross Greene, PhD
“CHALLENGING BEHAVIOR IS THE RESULT of lagging skills and unsolved problems,” says Ross W. Greene, PhD, associate clinical professor of psychiatry at the Harvard Medical School. “Rewarding and punishing doesn't teach the skills challenging kids lack or solve the problems durably,” he adds. Greene’s books—The Explosive Child and Lost at School—describe Collaborative Problem Solving (CPS), the model of care he originated to help children with emotional, social, and behavioral challenges.
Greene’s research focuses on inflexible/easily frustrated/explosive children, long-term outcomes in socially impaired children with ADHD, and student-teacher compatibility. He has authored numerous articles, chapters, and scientific papers on school and home-based interventions for children with disruptive behavior disorders. His research has been funded by the U.S. Department of Education, the National Institute on Drug Abuse (NIDA), and the Stanley Medical Research Institute.
Greene received his doctorate in clinical psychology from Virginia Tech in 1989 after completing his internship at Children's National Medical Center/George Washington University Medical Center in Washington, DC. Prior to his appointment to the Harvard faculty, he served as visiting assistant professor on the clinical psychology faculty at Virginia Tech and as assistant professor in psychiatry and in pediatrics at University of Massachusetts Medical Center. He lectures throughout the world and consults extensively to general and special education schools, inpatient and residential facilities, and systems of juvenile detention.
Greene spoke with CHADD members about the CPS model during an online chat.
Not really that much different than the mistakes of parents who don't have ADHD! Having unrealistic expectations... worrying too much about what other people will think... worrying too much about how their child looks compared to others... relying too heavily on imposed consequences for things imposed consequences don't fix... not listening carefully enough to what kids are trying to tell us... not taking kids' concerns into account... relying too heavily on imposition of adult will to solve problems rather than solving problems collaboratively... being a little too confident that we adults always know what's best.
I understand about being proactive instead of reactive, but there are still a number of times when my sons do get explosive. What would you suggest for helping them cope better with their anger and processing afterward when things have calmed down?
As you've mentioned, the best way to help kids learn to cope with frustration is to proactively solve the predictable problems precipitating their frustration. Then they get practice at the thinking involved in dealing with frustration under more optimal circumstances. But it may also be a good idea to discuss—proactively—the best courses of action if unexpected problems cause unexpected explosions. This is a good ongoing topic for proactive discussions as well.
Is it better to reward good behavior or punish bad behavior? What types of "privileges" should be taken away?
I don't rely on either. The trend "out there" is to emphasize the positive. But if you believe as I do that challenging behavior is the result of lagging skills and unsolved problems... and if you believe, as I do, that rewarding and punishing doesn't teach the skills challenging kids lack or solve the problems durably... then all of a sudden rewarding and punishing is replaced by problem-solving (preferably of the collaborative variety) and the teaching of skills. If all that is a little unfamiliar, you may want to pick up a copy of The Explosive Child, where I've gone into much greater detail.
When my thirteen-year-old daughter is asked to do something she does not like to do, such as brushing teeth or doing homework, she automatically explodes and screams mean things at family members. She goes from 0-60 in a second. We have tried to work on this for years—everything from positive reinforcement to negative consequences—and nothing has helped. The farthest we have gotten is now she readily apologizes for it about half the time. Any suggestions?
Yes, lots! My suggestion—it's a predictable one—is that you learn how to solve these very predictable problems proactively, rather than relying on consequences to get the job done. My experience is that consequences—punishment or failing to receive a reward—cause a lot of explosions. The approach I describe in my books should help. It involves understanding what's getting in the way for the child on each problem and trying to address those factors so they're not getting in the way anymore. That's how explosions are reduced—by solving the problems that are causing them.
My son is turning thirteen and his anger seems to have increased. Could this be related to puberty?
I've always felt that “puberty” isn’t specific enough to help me understand changes in a kid's behavior, whether it's in the positive or negative direction. More specific concerns could include things like "You guys won't let me do what other kids do," or "You're always telling me what to do," or "I think it's time for me to start making my own decisions." These are concerns we could actually discuss and potentially address. But there's not a whole lot we can do about puberty!
How do I explain to my six-year-old girl, in a positive way she will understand, why some of her classmates' parents will not allow her to have play dates with their children? The parents are disapproving of her behavior and do not want their children to imitate it or to have their feeling hurt by something she might say or do.
I’m lacking some information that would help me answer this question in a highly specific way. Without dismissing the concerns of the other parents, I'm wondering if their concerns about how your daughter will act are on-target. I'm wondering if there's any problem-solving that could be done so that your daughter doesn't do the things the other parents are concerned she might do. I'm wondering if the play dates might require more adult supervision. I'm wondering if the other parents are open to such ideas. In short, I'm wondering about whether there are lots of things that could be done to help the play-date situation before anything needs to be said to your six-year-old daughter.
Why is my child always worse with me? I always hear "she's a bit hyper, but not that bad" from the camp or daycare. We use 1-2-3 Magic and are very consistent with expectations and consequences.
I'm not sure why your daughter is worse with you, but there are lots of possibilities. It could be that 1-2-3 Magic, with its emphasis on consequences, is not the ideal match for your daughter. It could be that camp and daycare are more structured or more active than home and that these factors make it easier for your daughter to conform to behavioral expectations. Challenging behavior, I find, is very specific to certain situations. The "magic" is in trying to figure out what it is about the conditions under which a child is (and isn’t) behaving adaptively so as to start working on whatever it is that’s contributing to challenging behavior.
How can I help my daughter be more aware of her anxiety and anger building before she explodes? She just reacts without any thought process.
I'm not sure the main goal is to have your daughter be more aware of her building anxiety and anger before she explodes. That's a very "emergent" approach to things. My usual approach is much more proactive and involves having parents (and teachers) make a list of the "unsolved problems" (some people call them triggers or antecedents) that are setting the stage for challenging behavior, then to start using CPS with the child so as to understand the concerns that are setting anxiety and anger in motion on each unsolved problems and to get each problem durably solved. Once the problems precipitating explosions are solved, your child won't need to be aware of her building anxiety and anger. Solved problems won't cause her to feel those things…and she’ll have had lots of practice at solving problems that pop up in the future.
My nine-year-old son, who was diagnosed with inattentive ADD last month, has no self-esteem and does not want to try new activities, such as sports. I have been trying for years to build up his confidence, but to no avail. Do you have any suggestions?
You know, self-esteem is another one of those concepts that I like to get greater specificity on in individual kids. So I'd need to know the specific areas in which you feel your kid has low self-esteem... then I'd assume he had some legitimate reasons for not feeling so competent in those realms... then I'd want to gather some information from him on each realm in which he wasn't feeling so competent or confident... then I'd want to start collaborating on solutions for how to address whatever is getting in his way.
Those are the basic ingredients of CPS, and they apply to low self-esteem and not wanting to try certain things as much as they do to homework and teeth-brushing and sharing and all the other things we hope will go well (but often don't).
How do you begin to discipline when your child has already learned to back you down with screaming?
Screaming usually occurs in the heat of conflict. Collaboratively and proactively solving the problems that are causing conflict occurs outside the heat of the conflict. If the problems are solved in a way that works for both parent and child, then I'd expect far less (or no) screaming and far less (or no) backing down.
What recommendations do you make to parents dealing with children who are out of control and refuse to listen or cooperate? I usually have to angrily send my son to his room and not let him come down until he has settled down and is ready to have a conversation. He is sent upstairs multiple times a day.
This question, like some of the others, refers mostly to what is being done in the heat of the moment. There aren't any really great things to do in the heat of the moment. Punishment usually makes the heat of the moment hotter. Meaningful discussions aren't likely in the heat of the moment.
The good news is that the problems that cause people to find themselves in the heat of the moment are highly predictable—homework, getting along with siblings, screen time, diet, waking up in the morning, going to bed at night, boredom—so they can be resolved PROACTIVELY. Indeed, these problems are so predictable that I've made a list of them on an instrument called the ALSUP (Assessment of Lagging Skills and Unsolved Problems). It can be downloaded from livesinthebalance.org, the website of my nonprofit. By the way, the Lives in the Balance website has tons of resources—including streaming video of people actually using the CPS model and audio programming on a variety of topics related to CPS—for people interested in learning more about the model.
My six-year-old son becomes remorseful immediately after reacting to situations with inappropriate anger. How can I make him feel better without using ADHD as an excuse?
I don't know if his ADHD is the reason he's responding to situations with inappropriate anger, so it should be easy to remove it as an excuse. If you're really interested in explaining to your son why he gets angry sometimes, I'd suggest helping him appreciate (at a six-year-old level) the skills that are involved in handling anger well, letting him know how you're going to be helping him with those skills, helping him identify the unsolved problems that are reliably making him angry, and working with him to solve those problems collaboratively. Once those problems are solved, he won’t have much inappropriate anger to be remorseful about anymore.
My husband and I read The Explosive Child and we use CPS with our son. It is very similar to our natural parenting choices. We see a beautiful, creative child whose emotions are very close to the sleeve. He appears to be managing strong feelings better. His father and I are seeing the growth at home. At school, however, he still has explosions. What are some effective strategies for educating educators?
Well, I don't have a sound-bite answer for that question! But that's why I wrote my most recent book, Lost at School. Many schools and school systems are using it for summer reading, and a lot have already used it for book study groups. So it seems to be having an impact. I find that most educators are very eager for a better understanding of their challenging students and equally eager for more effective tools for helping them.
Visit help4adhd.org, the website of CHADD’s National Resource Center on ADHD, to download What We Know Sheet # 7S: “Behavioral Treatment for Children and Teenagers with ADHD.” Visit chadd.org to read the full transcript of this chat (members only).
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