Collaborative Problem Solving
I've been an RN since 1985, and have worked most of that time in hospital psychiatry. I've noticed that in my nursing career I've always "jumped into into the deep end of the swimming pool" ; and true to form, since 2006
I've settled in the area of child/adolescent psychiatry. The good news is that there are truly enlightened therapies available for kids with mental health issues. I've been especially grateful in these years to learn about Dialectical Behavioral Therapy, and also about Collaborative Problem Solving (CPS), the subject of this article
Understanding Explosive Behavior
For parents, teachers and other caregivers, persistent or recurring violent and explosive behaviors are stressful to deal with. One common response is to view these behaviors as conscious, intentional or manipulative - a power struggle to be won, behaviors to be suppressed or defeated. Another is undue sympathy and identification with a child, leading to capitulation on the part of adults
Collaborative Problem Solving identifies a different way to understand and deal with these behaviors. Children's explosive behaviors, it observes, have to do with basic human cognitive skills a child has not successfully learned yet - and what happens when the child is called upon by his or her situation, environment or caregivers to use these still unlearned skills
In the course of childhood children gradually learn to understand and use language, recognize and communicate needs and wishes, recognize and tolerate various kinds of emotions and situations. Children can use any
skill they truly have - but only have those skills they've learned.. When environment, circumstances or caregivers call on skills a child does not
yet have, internal conflict and pressure arise. If in a child's experience
these become overwhelming, it truly doesn't know what to do. It's from this point exactly, if no effective external help is provided, that explosive behaviors ensue
Collaborative Problem Solving
I met Collaborative Problem Solving through a nursing continuing education course, which used the text "Treating Explosive Kids" by Dr Ross Greene and Dr Stuart Ablon. I find this among the most useful, compassionate and intelligent applications of science I've experienced. Here's an overview of the approach from the CPS website Think : Kids :
"Collaborative Problem Solving (CPS) is an approach to understanding and helping children with behavioral challenges that was first articulated by Dr. Ross Greene in his book, The Explosive Child (1998 ; 2001 ; 2005 ; 2010), then described in a book for mental health clinicians by Dr. Ross Greene and Dr. Stuart Ablon (Treating Explosive Kids, 2006), and then for educators in Dr. Greene's book Lost at School (2008, 2010)
The CPS model views behavioral challenges as a form of learning
disability or developmental delay - in other words, behaviorally challenging kids are lacking crucial cognitive skills, especially in the domains of flexibility, frustration tolerance, and problem-solving. It seeks to create fundamental changes in interactions between kids with behavioral challenges and their adult caregivers by having caregivers engage kids
in solving problems collaboratively rather than by using motivational procedures. While studied primarily in children with oppositional defiant disorder, it has been suggested for behavior management in youth with a variety of behavioral challenges, including youth with bipolar disorder, attention deficit hyperactivity disorder (ADHD), Asperger's disorder, and conduct disorder, and has been implemented and studied in many settings including families, schools, inpatient psychiatry units, and residential and juvenile detention facilities"
Neither punitive nor permissive, the CPS approach seeks to identify external and internal triggers to explosive behaviors : on the one hand the situations and circumstances in which they typically happen for the child, as observed by adult caregivers ; and on the other the child's perceptions. The child's account and understanding of what happened, or typically happens are elicited, with an important emphasis on validation. Questions are asked and the child's perceptions restated as needed until his or her own experiences are not only seen, but the child feels that they're seen. The child's concerns - what he or she fears, needs or hopes for - are elicited in such a way that the child feels they're understood, and will be included in any solution
That a child feels seen and accepted in his/her perceptions and concerns, opens the door for introducing the concerns of adults in a way the child can understand. The remaining process to be worked out is a collaborative one, addressing the concerns of all parties. By discerning what cognitive skills may be lagging for the child, adults do not challenge them unduly, but support their proper development. The approach is not only scientific and effective, but humane and kind
Helping Kids with Explosive Behavior Problems :
Core Readings in Collaborative Problem Solving
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