by Psychguy29 » Tue Apr 05, 2011 5:40 pm
I am a therapist currently working with a child with MID, ADHD, ODD, encopresis and enuresis. He is 16 years old and also has grown to the point where restraint and timeouts are no longer an option. His thoughts are extremely scattered and his rages are out of control. When I first arrived the parents notified me that it once took 3 police officers to hold him down. We found that many of his problems were context-dependent, only occurring in the house, with exception to his noncompliance, which also occurred a bit at school. I have set up a token economy (trophies because that's whats he likes to earn playing online with his PS3) which reinforces in hourly intervals for 5 categories (no verbal aggression, physical aggression, cooperation, respecting physical space and using self-control card). I also put a large wipe-off board next to this token trophy case outlining the day to make it nice and predictable. Every time he receives 5 trophies per category he receives $3.00. This has been working nicely. Also, we've been instructed by the psychologist to ignore any verbal aggression, keep a neutral tone and minimal eye contact. She was right. He required "us" to argue until he had a fit of rage. Without us having a verbal back-and-forth he simply walked to his room and we reinforced the first calm thing he did or said. The child/teen will not argue if there is nobody to spar with. This is by no means an easy fix and will probably take lots of blood, sweat and tears but the parents say Im their last hope before they institutionalize him. Hope this "behaviorist stance" helps a bit.