Therapeutic Interventions

1. Engage in daily affectionate, nurturing, and playful contact with the child. (1, 2)

2. Verbalize the advantages of implementing positive discipline at an early age.

1. Instruct the parents to initiate a strong bond with their baby through loving interaction (e.g., holding, rocking, talking, making eye contact,) and providing for essential needs (e.g., food, clean diaper, warmth).

2. Assign the parents to schedule daily playtime when they devote full attention to the child; turn off the television or radio and engage in an exclusively child-centered activity.

3. Advise the parents to provide a sense of security in the young child by establishing age-appropriate limits (e.g., bedtime, mealtime, play areas, clean up routine).

3. Structure the environment to ensure the young child's safety. (5, 6)

4. Identify the developmental stages of the child. (7, 8)

5. Read literature and/or attend a parenting class to learn effective parenting strategies for young children. (9, 10)

4. Brainstorm with the parents a list of characteristics they hope their child will develop (e.g., honesty, empathy, self-confidence, social skills); discuss the benefits of encouraging these traits when the child is very young because young children desire to emulate and please their parents.

5. Assign the parents to childproof their home by removing fragile or dangerous items and providing a safe eating, sleeping, and play area for the child.

6. Instruct the parents to combine a verbal inhibition (e.g., "No touch," when child pulls on glasses) with physical management (e.g., hold the child's hands) to teach the child not to engage in an inappropriate behavior.

7. Discuss the developmental stages of early childhood with the parents as outlined in current literature (e.g., Touchpoints by Brazelton).

8. Assist the parents in determining if their child's behavior is within normal developmental limits (or assign the "Charting Our Child's Developmental Stages" activity from the Parenting Skills Homework Planner by Knapp).

9. Assign the parents to read literature about implementing strategies of positive discipline with their young child (e.g., Love and Logic Magic for Early

6. Verbalize an awareness of the problems created by being an overprotective parent. (11, 12, 13)

7. Set age-appropriate limits using strategies of positive discipline. (14, 15, 16)

Childhood by Fay and Fay or The Gesell Institute's Child Behavior by Ilg and Ames).

10. Refer the parents to a positive parenting class (e.g., Parenting Young Children by Dinkmeyer, McKay, and Dinkmeyer, Becoming a Love and Logic Parent by Fay, Cline, and Fay, or The Parent Talk System by Moorman and Knapp).

11. Assign the parents to listen to the audiotape, Helicopters, Drill Sergeants, and Consultants (Fay) to recognize the advantage of allowing their child to solve some problems alone or with limited assistance.

12. Teach the parents how over-protective parenting can contribute to the child's feelings of inadequacy and dependency (e.g., child relies on parents rather than developing problemsolving abilities); encourage them to allow age-appropriate tasks and responsibilities.

13. Assign the parents to watch the Finding Nemo video (Walt Disney Pictures) with their child and note examples of how an overprotective parent can interfere with the child's normal maturation and development.

14. Role-play with the parents the use of "I" statements (e.g., "I feel . . . when you . . . because . . .") (see Parent Effectiveness Training by Gordon).

15. Instruct the parents to use "Controlled Choices" (see Parent Talk by Moorman) to

Teach the child appropriate behavior through modeling and defining what is expected. (17, 18)

9. Initiate reinforcement strategies to help the child develop responsible behavior. (19, 20)

limit options according to the child's maturity and decisionmaking abilities (e.g., "Would you like hot dogs or grilled cheese?" versus "What would you like to eat?").

16. Advise the parents to use a short timeout when the child's behavior becomes defiant, or overly emotional, requiring that the child remain away until a cooperative attitude has been established.

17. Instruct the parents to model a desired behavior for their child and verbally refer to the action (e.g., "When I come home I put my boots in the closet and hang my coat on the hook.").

18. Assign parents to use the "Next time . . ." technique (see Parent Talk by Moorman) to help the child replace inappropriate with appropriate behavior (e.g., "Next time you need my help please ask for it in a polite tone of voice.").

19. Assign the parents to teach responsible behavior by asking the child to act responsibly (child asked to turn off the television), using misbehavior as a learning opportunity (child refuses to complete the task), imposing a consequence to teach a more appropriate behavior (no television until tomorrow), allowing the same opportunity to act responsibly (next day the child is allowed to watch a favorite show and then turn off television) (see "The Four Steps to Responsibility" in

10. Utilize logical consequences to re-direct inappropriate behavior. (21, 22, 23)

11. Promote the child's efforts to become self-reliant using encouragement and support. (24, 25, 26)

Parenting with Love and Logic by Cline and Fay).

20. Ask the parents to assign one new responsibility each month (e.g., leaving pacifier in the bedroom, putting on own coat) for which the child is reinforced (or assign the "Helping My Child Develop Responsible Behavior" activity from the Parenting Skills Homework Planner by Knapp).

21. Brainstorm with the parents a list of situations in which they could allow their preschooler to learn from the consequences of poor decisions (e.g., kicks sister and earns a timeout, doesn't pick up toys and loses them for one day).

22. Assign the parents to allow the child to experience the consequences of an irresponsible personal choice (e.g., fooling around at bedtime leads to losing bedtime story) and to reassure the child by saying, "Next time you'll have a chance to make a different choice."

23. Help the parents design several logical consequences to deal with chronic misbehavior (e.g., wandering off at the store results in riding in the stroller, throwing a temper tantrum results in a timeout).

24. Advise the parents to use the empowering statement, "I think you can handle it," when the preschooler is asking for too much assistance and to exclaim:

12. Verbally recognize and affirm the child's positive qualities. (27, 28)

13. Refrain from personal criticism while directing the child toward positive, desirable behavior. (29)

14. Grant specific freedoms and privileges consistent with the

"You did it!" when the child has successfully mastered a challenge.

25. Assign the parents to use "Act as if' in response to "I can't language" (see Parent Talk by Moorman) to encourage the preschooler to make an effort despite fear of failure, (e.g., "Act as if you knew how to draw that tree.").

26. Ask parents to use the "Check Yourself' technique (see Parent Talk by Moorman) (e.g., "Check your backpack to make sure you have what you need for school.") to help the child develop the ability to prepare successfully for upcoming events.

27. Instruct the parents to affirm the child's positive assets and qualities whenever possible (e.g., "You're a good helper. You like different kinds of food.").

28. Council the parents to deal with negative behavior by separating the deed from the doer (e.g., "Biting is not allowed") and directing the child toward more positive behavior (e.g., "Use your words to tell others how you feel.").

29. Encourage the parents to regularly refer to an ongoing list of the child's emerging positive characteristics as an encouragement for both themselves and the child.

30. Council the parents to wait until the necessary self-control

child's demonstrated level of maturity and self-control. (30)

Report a reduction in power struggles resulting from strategies designed to enlist the child's cooperation. (31, 32, 33)

16. Express awareness that all behaviors have a social purpose and all misbehavior is goal oriented. (34, 35)

is acquired before granting specific privileges (e.g., allow walking independently in the store only when staying close to the parent has been demonstrated).

31. Instruct the parents to use the "broken record" technique by repeating the same phrase until the child complies (e.g., "It's time for you to take your nap." "It's time for you to take your nap.") to avoid arguing about a parental directive.

32. Assign the parents to use age-appropriate choices (e.g., "You may wear your red shirt or your green shirt. Turn off the television or I will.") to share control with the preschooler and direct the focus toward the choice.

33. Direct the parents to avoid power struggles with their preschooler by making a result desired by the child contingent upon a behavior desired by the parent (e.g., "You may watch television after your toys have been picked up.").

34. Teach the parents the four goals of children's misbehavior: attention, power, revenge, and overcoming feelings of inadequacy; determine how they may be reinforcing misbehavior by their reactions and brainstorm more appropriate responses (see Children: The Challenge by Dreikurs and Stoltz).

List and implement activities designed to maintain a strong couple-centered family environment. (36, 37)

Seek support, encouragement, and respite from co-parent, family, and friends. (38, 39)

35. Assign the parents to involve the child in reciprocal activities that encourage a healthy self-esteem and a feeling of belonging (e.g., one-to-one chats, high fives, daily greetings, reciprocal smiles).

36. Assign the parents to read The Seven Habits of Highly Effective Families (Covey) to learn strategies for attaining a positive family atmosphere.

37. Brainstorm with the parents ideas for strengthening their marriage and maintaining a couple-centered family (e.g., support each other during child interactions, keep a weekly date night).

38. Brainstorm with the parents a list of support people who can be relied on to babysit, console, listen, and help out in case of emergency or burn out.

39. Discuss with the parents the importance of cooperation in the co-parenting process and offer to mediate any current roadblocks.

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