With hands flailing and curly brown hair flopping in all directions, a 5-year-old girl sits herself down in the middle of a supermarket aisle, forcing busy shoppers to maneuver their carts around the frenzied roadblock. “But I want cookies!” she screeches. A woman leans over the child, cheeks flushed with embarrassment, and hisses, “Don’t make a scene!” (Too late.) It’s a hypothetical scene that is all too familiar for many people — both parents and supermarket observers — parents allowing children to get out of hand and suddenly not being able to to quell their raging tantrums. But, such parents might say, such behavior is relatively normal, right? Staff reporter Stephannie Furtak investigates.
As a result of such thinking, said Alan Kazdin, director of the Yale Parenting Center and Child Conduct Clinic, many parents do not believe their child’s behavior is severe enough to warrant stereotypical psychological care.
“A couple of years ago, there was pressure from the community and around the country asking if we could help people with normal parenting problems: tantrums, toilet training, teen attitude,” Kazdin said. But many people are turned off by the stigma that is attached to terms like therapists and clinic, he explained.
For this reason, what was formerly only known as the Child Conduct Clinic — a center affiliated with the Yale Child Study Center that provided health services for severely aggressive and antisocial children — became the Yale Parenting Center in 2005. Now the clinic is no longer only for children with medically-diagnosed disorders — but for all parents looking for advice on how to handle their kids.
“We’re here to serve the people,” Kazdin said simply. “There’s a lot that psychology has understood about how to make child-rearing easier.”
Kazdin, who is also a professor of psychology at Yale, fine-tuned over 30 years of research and data into a system that is now a household name in the field of psychology: “the Kazdin method.” Officially titled Parent Management Training, Kazdin’s technique, used at the Yale Parenting Center, emphasizes positive reinforcement as a key approach to changing a child’s problem behaviors.
The method was originally developed to combat severe aggressive and antisocial behavior in children — one of the most pricey mental health problems in the United States, costing society 10 to 15 thousand dollars a year, Kazdin said.
“These children are so expensive,” he said, “because they get into so much trouble.”
The PMT program, which can take anywhere from six to 12 weeks, involves weekly sessions with a therapist. Each session focuses on teaching parents a specific skill — everything from praise and rewards to punishments and time-outs.
What surprises many people, therapist Erin Carrubba said, is that for almost the entire duration of the program, parents are the only ones involved in the therapy sessions.
“We work mostly with the parents,” therapist Bernadette Lecza said, “teaching them things to change their child’s behavior at home.”
The key to PMT is teaching parents how to use the techniques in a directed way so that the child can identify which good or bad behavior produced the specific consequence.
Lecza recalled a family she worked with last spring that had a lot of success with PMT. The parents of a 4-year-old boy came to the Parenting Center concerned that their son, who was prone to tantrums, would not be ready for kindergarten in the fall.
“We took it one step at a time,” Lecza said. “First, we worked on having him follow directions without crying.”
She taught the parents how to use praise and small rewards whenever their son listened and did what he was told, even if he misbehaved in other ways. For example, if he turned off the TV without tears, John* was rewarded with specific praise (“Thank you for following directions without crying”) and a treat (a cookie), even if he showed reluctance and stomped his feet.
After about two weeks of constant positive reinforcement, John was able to handle disappointing situations without tears. When anger and talking back replaced crying as John’s method of dealing with unpleasant circumstances, Lecza simply told the parents to change the plan so that respectful speech would be rewarded.
This step-by-step process of eliminating problem behaviors continued until John’s conduct significantly improved by the end of the sessions.
“The parents … just needed a tool to help them,” Lecza said.
While the Yale Parenting Center has helped many families like John’s in the past, Carrubba acknowledged that the recent economic crisis is causing many families to put psychological services on the back burner.
In addition to losing clients, the Center is also struggling to find its own funding.
“The clinic is facing some economic strain,” she said. “Our grants are running out. We’re just trying to come up with ideas to keep the clinic going.”
Additionally, as a clinic that operates on a sliding scale based on what each family can afford, the Parenting Center loses money faster than it makes it.
Kazdin maintained, however, that he has never considered patenting his methods for profit.
“This is science,” Kazdin said. “It should get out there and help everyone.”
The average child does not receive the psychological services they need — an issue amplified by the current state of the economy, he said. As a result, one of the long-term objectives of the Parenting Center to train other therapists in PMT nationwide, Kazdin said, so that as many people as possible can benefit from the system.
“We just wanted to have treatments that would make a difference,” Kazdin said.
*Name has been changed to protect the client’s privacy.