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Monthly Archives: August 2013

Dear Cathi,

I worry about my daughter, Claire. She seems to keep things bottled up inside. Her teachers always tell me how “easy going” she is, letting slights just roll off her shoulders. From our point of view, she is hurting inside but just doesn’t know how to express it. For example, her friends seem to walk all over her, bossing her around, and Claire says nothing and goes along with their wishes. But then, out of the blue, every month or so, Claire loses it, crying and screaming in a fit of rage. These episodes usually happen at home with us in reaction to something very small. My husband and I are so taken off guard by her behavior that we just don’t know what to do or say to help her. What do you suggest we do? These monthly explosions are pretty scary and upsetting for all of us.




Dear Mia,

I am sure it is very painful for you and your husband to see Claire holding feelings inside without a pathway for expressing them. You see that the feelings are building up inside her like a pressure cooker but you feel you can’t do anything to help her manage the stress in advance. As you can imagine, the process of becoming more comfortable with anger and then expressing it in a healthy fashion is a complicated one. Let’s think about the steps involved:

Step One: Claire must recognize she is having feelings in reaction to others in the moment.
Claire: “My friend, Paige, just told me to go get her pencil sharpened for her. I don’t like that.”

Step Two: She must develop an ability to identify and label what those feelings are.
Claire: “I feel annoyed when Paige bosses me around.”

Step Three: Claire needs to trust her feelings and what she would like changed in response to them
Claire: “My annoyance tells me I don’t want to be bossed around anymore”

Step Four: Claire needs to use words to express her feelings.
Claire: “Paige, I don’t like when you ask me to do things for you that you can do yourself. You need to get your own pencil sharpened.”

Wow! That’s a tall order for anyone; never mind a child.
So, as a parent, how can you help her master this complex process?

1. Help Claire understand her feelings
Claire needs your help in understanding that anger is an acceptable emotion to feel. You can help her understand that when emotions stay inside for a long time, they may come out in ways that are less healthy. You may want to ask her, “What happens if you keep your feelings inside for a long time without letting anyone know?” Her list may include:
a. I may feel sad inside.
b. I might explode down the road.
c. I can’t get what I need.
d. It’s hard for others to understand how I feel

2. Help Claire develop a larger, more detailed vocabulary of feelings
I can’t stress enough the value for children of understanding their own feelings. To help Claire learn more about her feelings, you might start by teaching her a “Feeling of the Week”. Begin with simple ones, like mad, sad, and glad and move on to more challenging ones like frustrated, disappointed, and confused. You might post the word on the fridge. Use the feeling word regularly in sentences throughout the week and highlight it aloud when you see her exhibiting the feeling.

3. Express your own feelings clearly and openly
Claire will learn a lot by watching and listening to you. Your expression of feelings gives her permission to express her own. Don’t be afraid to say things to her like, “I am frustrated with my boss when he watches me like hawk. I am going to meet with him tomorrow to talk with him about the things he is doing that make me uncomfortable.”

4. Let Claire know that she can talk to you about her feelings
When Claire does come home and tell you about her day, listen quietly to her feelings. Stay calm and neutral as she describes to you the events in her life. This will allow her to explore her feelings at her own pace. You might say things like, “Tell me what happened” or even “I’m listening”. Sometimes you might need to inhibit your natural responses. If you say things like, “I hate that your friend treats you that way!”, you might unwittingly fuel Claire’s feelings of uncertainty and shut down, rather than open up, lines of communication.

5. Experiment with Role Playing
You might begin by demonstrating for Claire how you might express anger in a particular situation. Then allow Claire to give you feedback on how you did. Allow her to give it a try. Role-playing might allow Claire a forum to practice responses in advance of difficult situations. Another role-play is to stage a pretend argument with your child. Role-play an argument. Give points for using good conflict resolution skills like staying on point, using words without attacking, listening to the others’ position.

Throughout the rehearsal, expressing feelings with words helps Claire beef up her “anger management muscles”. As she becomes more comfortable and aware of her own feelings, she is developing healthy ways to convey them. Claire frees herself from the destructive cycle of store/explode/store and allows her to be open and spontaneous with others.

I look forward to an update on how she is doing!



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As parents, we are very tuned in to our child’s social and emotional development. There is almost nothing more difficult than watching your child experience discomfort or anxiety. So many children with social skills deficits feel alone, frustrated and angry. They want friends. They aren’t aware, for the most part, what it is they are doing to cause their peers to shy away. Some of the indicators that your child is struggling with social skills look like this:

- Jenna didn’t get invited to a single birthday party last year
- My son can’t cooperate with other kids
- My daughter always likes to be the boss
- Steve thinks people are teasing him when they are just joking around
- I wish Beth could see how other kids see her

So what now? Perhaps your pedicatrician, school guidance counselor or just your own intution, leads you to believe that your child needs some extra help. With all of the treatment options for social skills that have emerged over time, it can be confusing to make a decision about what will be effective.

Social skills training groups vary tremendously in their ability to help children not only learn, but also transfer skills from a group to a home and school environment. For many children, learning new social skills is like learning a foreign language. Similarly to acquiring a new language, it’s important that the kids are immersed in the thinking and culture of interpersonal skill building. In addition, the skills need to be practiced inside and outside of group in order for new friendship skills to take hold.

There are a few key elements that the research on social skills training reveals as critical for real and sustained friendship building to take place:

(1) Real Change Requires Real Time.
For many, learning social skills does not come naturally. Like learning a new language, acquiring social skills takes time and practice in order to sustain long-term, systemic change. Having conducted social skills groups for over 17 years, we generally notice a self-esteem boost in the first couple of months of group, but the lasting skill changes don’t begin to take hold until about the sixth month of weekly group meetings.

(2) Parent Involvement is Critical.
Repetition and rehearsal are key factors in transferring learned skills to a child’s natural environment. Parents need to be taught the same skills that the kids are working on so that learning and practice continues at home. When parents participate in this way, they help deepen a child’s understanding and help move learned skills into the child’s “muscle memory” (where behaviors become more natural and automatic). Children acquire the necessary skills exponentially more quickly and deeply when parents and clinicians are all on the same page.

(3) Social Skills Must Be Practiced in Between Sessions.
A cognitive-behavioral therapeutic model stresses the need for practice in order to reinforce skills learned during group. This way, children are encouraged to practice the skills acquired in a variety of social settings outside of group, which “cements” these social skills for life.

(4) Focus on Specific Skills.
A well-structured, comprehensive social skills group must cover several common areas of weakness in children who struggle with making and maintaining friends:

- Reading social cues accurately
- Active listening
- Making a good first impression
- Developing good eye contact
- Improving communication and conversation skills
- Facilitating social entry
- Coping effectively with teasing and bullying
- Enhancing self-esteem
- Managing stress
- Developing anger control

(5) Groups Need to Be Carefully Formed.
It can be challenging to group children together appropriately for maximum benefit, but it is a crucial step in the process. Some of the factors include the children’s age, gender, social and emotional development and treatment goal objectives.

(6) Licensed Clinicians are a Must.
It is very important to have a group run by a licensed clinician who has had the proper training to help actualize goals set for your child. This is not only a factor for the therapist leading the children’s group, but for the parent group leader as well.

There are realistic benefits to many therapy groups. Groups instill hope in children who otherwise might feel alone. They offer a feeling of acceptance that may not be found in other social settings. However, in order to be truly “friendship changing,” it’s important that a social skills group has the critical elements we have outlined above.

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