NESCA Clinical Staff Trained in Collaborative Problem Solving

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NESCA Director Dr. Ann Helmus reported that In mid-July, 2008, her group's entire clinical staff of neuropsychologists and other specialists successfully completed two days of intensive training in the "collaborative problem-solving approach" to treating so-called "explosive kids", that is, children who have been labeled as unmotivated or even willfully oppositional or defiant, and given to uncontrollable emotional outbursts. This ground-breaking technique builds upon the philosophy that in terms of meeting parental, academic or social expectations, "children do well if they can," and that if they can't, it's because something--an unsolved problem or lagging cognitive skill--is getting in their way.

NESCA (Neuropsychology & Education Services for Children & Adolescents), a private pediatric neuropsychology practice in Newton, Massachusetts, recently arranged for its entire clinical staff to undergo two days of intensive, high-level training in Collaborative Problem Solving, a technique that promises to help families reach durable solutions to recurring behavioral problems arising out of a wide range of "real world" circumstances.

Collaborative Problem Solving was originally developed as a tool to the treatment of so-called "explosive kids", that is, children who had been labeled as unmotivated or even willfully oppositional or defiant, and given to uncontrollable emotional outbursts. A ground-breaking technique, CPS builds upon the insight that in terms of meeting parental, academic or social expectations, "children do well if they can," and that if they can't, it's because something--an unsolved problem or lagging cognitive skill--is getting in their way.

Conducted at NESCA by Dr. Stuart Ablon (http://www.thinkkids.org or http://www.explosivechild.com), director of the Psychotherapy Research Program in the Department of Psychiatry at Mass. General Hospital, an instructor in Psychiatry at Harvard Medical School and co-author, with Ross Greene, Ph.D., of the bestselling parenting guide, The Explosive Child, the program introduced our staff to the new and far more positive construct that such children actually have lagging skills--learning disabilities, in effect, or developmental delays--in the areas of flexibility/adaptability, frustration tolerance and problem solving, and that given tools to cope more effectively with changing circumstances, social or academic challenges or other "triggers" of maladaptive behavior, they will become both happier and better regulated emotionally.

Collaborative Problem Solving recognizes that "children do well if they can," and that failures to meet expectations relate to cognitive deficits, unsolved problems or both. The technique aims through a form of structured dialog and therapist-mediated communication to equip parents and children with the means to meet each others' needs without meltdowns, around such frequent triggers as transitions, homework and screen time. It also leads to durable solutions to recurring problems, reducing household tension and strengthening parent-child relationships.

Dr. Ablon says "the collaborative problem solving (CPS) model, as applied to challenging kids, sets forth two major tenets: first, that these challenges are best understood as the byproduct of lagging cognitive skills (rather than, for example, as attention-seeking, manipulation, limit-testing, or signs of poor motivation); and second, that these challenges are best addressed by teaching children the skills they lack (rather than through reward and punishment programs and intensive imposition of adult will)."

He continued, "While challenging kids let us know they're struggling in some fairly common ways (screaming, swearing, defying, hitting, spitting, throwing things, breaking things, crying, withdrawing, and so forth), they are quite unique as individuals when it comes to the mix of lagging cognitive skills that set the stage for these behaviors. This means that prior to focusing on the teaching of cognitive skills, one must first identify those skills that are lagging in each individual child or adolescent.

The teaching of these skills may be accomplished in a variety of ways, but primarily through helping challenging children and their adult caretakers learn to resolve disagreements and disputes in a collaborative, mutually satisfactory manner."

Dr. Ablon finds the CPS model applicable to diverse human interactions, but especially those that can result in conflict. So, he says, "CPS can be applied to interactions between classmates, siblings, couples, parents and teachers, employees and supervisors, and nations. All people benefit from learning how to identify and articulate their concerns, hear the concerns of others, and take each others' concerns into account in working toward mutually satisfactory solutions."

NESCA Director Dr. Ann Helmus adds, "CPS promises to be extremely effective in helping us to deal with some of the thorniest real-life issues faced by many, if not most typical families, not just those with explosive kids, so we have begun to integrate these techniques into many of our recommendations and therapies."

For additional information about Collaborative Problem Solving, go to: http://www.thinkkids.com or http://www.explosivechild.com.

Please also visit NESCA online, at http://www.NESCA-newton.com.

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Todd Helmus

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