Counseling/PCIT not going well

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    • #189644

      My 7-year old son has ADHD and we started counseling in August. Our main goal in counseling was to help him with his emotional dysregulation – he had started over the summer having these explosive outbursts 2-3x per week with yelling, throwing things, slamming doors, etc. It was really distressing and we were desperate to get him (and us) some help with this behavior.

      Due to COVID, the counseling is all-virtual. Our son hasn’t been able to connect well with his counselor and is still hiding under our table/avoiding participating in the sessions and takes a lot of time to warm up and participate each session. We are several months in now, and have yet to touch on these anger episodes, instead, our counselor wants to focus on him listening to us/obeying. Whenever we bring it up that the ourtbursts/anger is what we really need help with, she keeps saying “we’ll get to that”. It has felt very one-size-fits-all and not tailored to what our family needs. We just recently found out the type of therapy our therapist has been doing with us is PCIT (she never shared that PCIT was what we were doing, until finally I asked if there was a certain model we are following). We have spent these first few months doing “special play time” with him where we give him a lot of targeted praise/descriptive commenting, etc (which is nothing new – we were already doing those things when we played with him). That part of it was OK and something we enjoyed. Then last month, our counselor has had us change that play time to “listening practice”. We give him commands and then follow a chain of consequences if he doesn’t follow through with the commands – leading to time-outs (something that hasn’t worked well for our family when we’ve tried it in the past). He now no longer wants to do this special play time with us and it’s distressing to him. It also doesn’t sit right with me to be having a fun time drawing together and then have to command he use a certain color marker or draw a certain thing, or command he build a certain thing with legos and punish him for not doing that. I get that he needs to be able to follow directions/obey us, but it seems like such a silly thing to command him to do and punish him for. That’s just not the kind of mom I want to be and I feel like it has been eroding his trust in us. It usually leads to a big outburst, and so instead of helping him with these outbursts, it seems that the counseling causes outbursts and gives him no coping skills to help calm back down. He has been crying and not wanting to do the sessions with her, where she has us do this listening practice while she watches. I feel like crying too! I am ready to throw in the towel with this counselor, but I have read such great things about PCIT and am wondering if we just have a bad counselor? Is this how PCIT usually goes? Do we stay the course so we can say that we tried this? Will it get better/easier as we move through this model of therapy? It gives me a lot of anxiety to think about continuing with this counselor/PCIT.

      He has been having less emotional outbursts as we experimented with medication the last couple of months and we have figured out that a lot of it was due to the meds he was on. I still think our family needs help with managing these outbursts when they do happen, and its frustrating to not be getting it. We have read “The Explosive Child” and that really resonated with me, but it doesn’t seem to jive well with the type of parenting that PCIT is suggesting we do. In general, I am drawn to parenting books/styles that focus on connection/compassion/empathy, so I really loved “The Explosive Child”.

      I appreciate any thoughts/feedback anyone can give… thank you for reading this.

    • #189793
      Penny Williams

      PCIT can be great for kids with ADHD, with the right counselor as your guide. You need someone experienced with ADHD and behavior issues. Some of what you’ve been doing in PCIT is great (the play) but some I advise against, like time-outs. Expecting a child with ADHD to listen to avoid consequences or punishment is futile. Especially at age 7 when he has little to no self-regulation yet. I lean heavily on Ross Greene’s work and approach, as well as Mona Delahooke.

      We’ve actually had a great experience with a trauma-focused therapist. We all experience some traumas in life and kids with differences experience trauma more (trauma isn’t just abuse or victimization, it’s the way something is experienced by the individual).

      I’ve also begun interweaving my coaching work with polyvagal theory — realizing that behavior is driven by how we process everything around us and is physically driven as well. Understanding the autonomic nervous system helps us understand our kids so much better.

      Your parenting mindset is also a big piece of the puzzle.

      ADDitude Community Moderator, Parenting ADHD Coach, Podcaster & Author, Mom to teen w/ ADHD, LDs, and autism

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