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The San Mateo CBT Clinic provides therapy for anxiety disorders in children, teens, and adults. Jonah Lakin PsyD is a licensed clinical psychologist specializing in Cognitive-Behavioral Therapy (CBT) for Obsessive-Compulsive Disorder (OCD), panic disorder, phobia, Generalized Anxiety Disorder (GAD),  social anxiety disorder/social phobia, agorophobia, emetophobia (fear of vomiting), illness anxiety disorder, trichotillomania (hair pulling), & excoriation (skin-picking).

San Mateo CBT Clinic blog about anxiety treatment

Anxiety Blog. Describes CBT principles involved in treatment for anxiety disorders in children and adults. Conditions discussed include: Obsessive-Compulsive Disorder (OCD), panic disorder, phobia, Generalized Anxiety Disorder (GAD),  social anxiety disorder/social phobia, agorophobia, emetophobia (fear of vomiting), illness anxiety disorder, trichotillomania (hair pulling), & excoriation (skin-picking).

Why Parent Coaching is Critical in the Treatment of Children

Jonah Lakin

Does suggesting parent coaching mean you think parents are the problem?

Some parents are hesitant to come into therapy when their child is struggling with depression, anxiety or behavioral problems. They sometimes tell me, “my kid has something wrong with him - why would you need to have sessions with me?”

First, let’s get something out of the way up front: that a parent could benefit from parent coaching does not mean that the parent is causing the issue. Most parents I see are incredibly caring and want the absolute best for their children. I never suggest coaching because I blame the parents or see them as the problem.

In fact, while our minds have a tendency to want to identify the source of a problem, I don’t find that information very useful. Instead, I like to focus on how to move forward. I think about it like this: “Ericka is having trouble with anxiety. What are all the methods I can use to ensure that she overcomes these problems as rapidly as possible?”

To that end, regardless of who or what “caused” the problem, parental responses can help resolve it. 

A primary reason for that is that - to a certain extent - parents can determine the everyday lives of their children. I have very little control over the environments of my adult clients; they determine how they spend their time and what they do or don’t do. Parents, on the other hand, influence every one of their children's activities. By working with parents, I am able to rapidly address problems with children that could take years without the active participation of their parents. 

I’ve tried all kinds of things to get my child to be good.  We talk through it every day.  Why would parent coaching help?

I often see children hitting or swearing at their parents. Parents come in feeling exhausted, beaten down, and sometimes hopeless. They tell me the awful things they’ve gone through and the multitude of techniques they have already tried. While parents usually have several behaviors they want addressed, they almost always request that I speak to the child and help the child understand why what they’re doing is wrong. 

I think the impulse to explain the “goodness” or “badness” of a child’s behavior to them in the hopes that they will choose to be “good” comes from a belief that the problem behaviors are the result of the child's moral compass being off. This may, in fact, be true. But it's often the case that when I speak to the child, I get a slightly different story about why they misbehave. 

They sometimes feel bad about the swearing or hitting, and may say, “I don’t know why I do it.” But when we look closer, it turns out that these behaviors often get them things they want. For example, they may kick and scream and swear at their parents until their parents, exhausted and out of ideas, give in and get the child the Playstation they were screaming for. 

Now, the child has two choices moving forward. They can choose to scream and swear, which they know is wrong but may result in them getting a Playstation. Or, they may choose not to scream and swear, which they know is what they’re supposed to do but definitely will not get them that Playstation. This is simply not a moral issue. 

Consider the situation for yourself. Let’s say you got into work 10 minutes late this morning, and learned that the company started a new incentive today: all employees who were on time will be entered into a raffle to win $1,000. The odds of winning are 1/10. Entering the raffle is done on the honor system. 

Even though you know that lying is wrong, would you consider doing it in the moment for $1,000?  Ten minutes isn't a big deal, you’re usually on time, and you’ve been working so hard.  I think if we are being honest, you might take the chance. In this case, the problem isn’t simply a lack of morality, but that incentives in the environment are structured in a way that lead you to be more likely to lie.

Your child is often similarly responding to incentives in their environment. Therefore, when I meet with parents, my goal is to identify any possible incentives your child has for their problematic behavior and ensure that we remove them. Likewise, we want to add consequences for problematic behaviors. 

Consider what you would do if the company told you, “the $1,000 raffle entry is on the honor system, but if anyone is found to be lying, they will be terminated immediately.” Now you’re probably thinking, “it’s not worth the risk. Jenkins saw me come in late; what if he says something?” Your behavior changes based on consequences and incentives; your child is no different. 

Parents will often say that they do punish their children by yelling at them or by giving time-outs. In this case, there may be some other incentive that isn’t obvious. For example, sometimes a child likes getting yelled at because it gives them one-on-one time with a parent. Similarly, time-outs can be rewarding for a child because it’s time away from siblings who tease him. We need to take a very careful look at the environment, to better understand how it may be influencing the child. 

Let’s take a look at a different kind of problem, like anxiety. Consider you have a child that is fearful of social situations. You do your best to encourage him to go to a birthday party, but given how much he seems to suffer, you decide it’s better to let him miss the party because it will be so awful for him. Even though you only intended to alleviate his discomfort, you’ve unintentionally increased his likelihood that he misses future parties, because he was rewarded by escaping the anxiety he had about this one. 

It’s important to remember that you didn’t make your child swear at you, and you didn’t make them anxious. But you can strongly influence their behavior and anxiety going forward. Even parents who have excellent discipline plans and read up on parenting strategies can use coaching to understand how to respond to their individual child. 

What does getting parent coaching mean about me as a parent?

Consider this: when you were growing up, did you ever have a class on how to parent an anxious child? Did anyone ever teach you behavioral principles and what to do when they don’t seem to work? How about a college class on “how to parent your depressed and irritable teen?” Probably not. There is nothing to feel ashamed about regarding getting some help; in fact, that you’re willing to get some help for your child means you are a supportive parent. You wouldn’t beat yourself up if you struggled to write software code if no one ever taught you how. So why beat yourself up for not knowing every possible thing there is to know about dealing with anxious, angry children?

Parents have many questions to consider: “What kind of challenge is appropriate for my child? What will be too hard, and what will be too easy? My kid has tantrums once a month, is that normal? How do I know if I have the right reward or consequence? I try to put him in time-out, but he just runs away.” All of these questions and concerns can be addressed and resolved relatively quickly in parent coaching with a trained psychologist.

- Dr. Lakin