Steve and Jan have come to counselling regarding their 5 year old daughter, Kim who screams when she doesn’t get her own way. She is starting school next year and her parents are concerned with how she is going to fit in and what will happen if she doesn’t get her own way.

Steve and Jan have come to counselling regarding their 5 year old daughter, Kim who screams when she doesn’t get her own way. She is starting school next year and her parents are concerned with how she is going to fit in and what will happen if she doesn’t get her own way.

A summary of the session is as follows

For ease of writing the Professional Counsellor is abbreviated to ‘C’.

In the first session C gathered information from Steve and Jan about their discipline techniques and what they have done in the past when Kim screams. Jan said that they have tried everything and nothing works. C asked Jan to expand on this — what exactly have they tried and what happened.

Jan said that over the last year she has tried ignoring Kim’s behaviour but she found it actually got worse. C asked Jan if she ever gave in to Kim instead of ignoring her and she said she did but only about once a week.

Jan said that she tried sending her to her room every time that she screamed and that Kim’s screaming stopped after being in her room for a few minutes but it didn’t stop the screaming actually occurring. C asked Jan what Kim was doing when she was let out of her room and Jan said that she was just playing with her toys.

Steve said he had had enough and although he disliked hitting Kim he felt it was a last resort. Steve explained that Kim would just scream for longer if he hit her. Both Jan and Steve were very distressed about Kim’s behaviour.

C didn’t want the parents to feel as if they had failed but needed to tactfully point out why their previous attempts at stopping Kim’s screaming had been unsuccessful. So C talked to Steve and Jan about how she felt that she could help change Kim’s behaviour and emphasised that the parents had made a positive step by seeking professional help and how it showed commitment to their daughter and her upbringing.

C then explained to Steve and Jan that she was going to use similar techniques to what they had used previously but would modify them slightly. C also explained that she would highlight for them the reasons why their previous attempts were unsuccessful so that they could reuse the techniques for other problems that arose.

C began by explaining that Kim was screaming because she was getting some sort of reward for screaming. That reward may be just receiving attention whether it be negative or positive attention. So basically Steve and Jan had to ensure that Kim received no reward for behaving in this way.

C then explained that when Jan had ignored Kim’s screaming but gave in to her once a week then Kim was actually still being rewarded for screaming. That is, she was getting what she wanted, even if it was only once a week. C explained to Steve and Jan that this was enough for Kim to continue screaming. She will continue to scream if she knows there is a chance that she will get her own way, even if only occasionally.

C also talked about time-out as punishment and explained that sending a child to a room full of toys is more of a reward than a punishment. So if Kim is asked to do something she doesn’t want to do, she just screams and gets to go to her room and play with her toys.

Also if Kim is hit for screaming then she may still be receiving attention for the screaming. Even if the attention is negative some children see this as better than no attention at all. C then asked Steve and Jan to consider what they do when Kim is quiet and playing with her toys or watching TV. They responded by saying that they try not to disturb her so that she will stay quiet. C then explained that in essence what they were doing was ignoring Kim when she was good and giving her attention (even if it is negative) when she was bad.

C then spoke to Steve and Jan about setting up a behaviour modification program for Kim. The aim of the program is to reduce the behaviour of screaming.

The first step of the program was for Steve and Jan to record Kim’s behaviour before they tried to change it. They kept a daily tally of every time Kim screamed when she didn’t get her own way. It was not necessary for the parents to tell the child that they were recording her behaviour. C informed Steve and Jan that they would need to continue to record Kim’s behaviour while they were trying to change it.

Session two was held after Steve and Jan had collected the two week baseline and it was now time to try and change Kim’s behaviour. The first step in doing this was to not reward or reinforce Kim’s screaming in any way. C explained to Steve and Jan that they had two options on how to change Kim’s behaviour — they could use either planned ignoring or time out.

C then highlighted what each was and explained that if they use planned ignoring they must NEVER give into the child and that the screaming will probably increase for a short time before decreasing. On the other hand if they use time-out then they must always put the child in time-out whenever she screams and again must never give in.

Steve and Jan decided that they would try planned ignoring first. C then gave them the following step by step guide on how to ignore Kim’s screaming.

Step 1. Look away from your child or turn your back on the child within 5 seconds.

Step 2. Move away from your child (at least 3 feet). Leave the room if you can.

Step 3. Maintain a neutral expression on your face. No smiling or looking upset. Keep in mind that if your child detects that they are getting to you then they have your attention and the chances of the screaming worsening is increased.

Step 4. Ignore everything your child says. Do not enter into any conversations with them. You can tell them at the outset that you are going to ignore their screaming.

Step 5. Begin ignoring as soon as your child engages in the unwanted behaviour. The sooner you can cut of the supply of attention that maintains the unwanted behaviour, the better the results.

C advised Steve and Jan to back up the planned ignoring of the screaming with labelled praise of Kim’s behaviours which they like. This can be used to tell a child exactly what it is a parent likes about the child’s behaviour e.g., “Kim, I really liked the way you were quiet when I was on the phone” or “Kim I really like the way you are playing quietly”. The idea of this is that Kim will prefer to behave in ways which receive parental attention or rewards.

When Steve and Jan implemented the program they found that for 2 weeks Kim’s screaming did increase but they continued to ignore it and in the third week the behaviour started to decrease.

A final session was set for 4 weeks after Steve and Jan began to change Kim’s behaviour. The final session was designed to iron out any problems which may have occurred. A common problem when introducing a behaviour modification program is that other problem behaviours may surface. In the final session C also explained to Steve and Jan that the program they implemented was designed to decrease an undesirable behaviour but programs can also be introduced to increase a child’s desirable behaviour.

Examples of behaviours a parent may want to increase could be time spent on homework or a child picking up all their toys. Programs designed to increase a child’s desirable behaviour use rewards and reinforcers including star charts. This visual aspect to behaviour change can help increase a child’s self esteem as they are given responsibility to choose which way they want to behave. If they choose the appropriate way then they receive a reward.

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