Question: Dear Center for Anxiety, Thank you so much for your insightful columns. I really enjoy reading your pieces and feeling the relief of not being the only one who struggles. Still, I never thought that I would be the one to write in, but here I am.
My husband and I are at our wits end with my 14-year-old son. His behavior was never great, but a “parenting expert” told us to go easy on him, so we tolerated it. We were probably what you would call “enabling” parents. Not bad parents, but we did not discipline consistently. Now, he is a teenager and a complete terror. He walks around the house angry at everyone. He yells at me, he curses at his 5-year-old sister, and he rarely if ever does anything around the house. Last week, my husband asked him to help take down the Succah and he completely lost it. I won’t narrate the whole story here, but it was really scary. I just don’t know what to do. After speaking it over with a chavrusa, my husband has started a campaign of being very tough with him, but we haven’t seen any results. Of course, this is after ten years of letting our son do whatever he wanted on what now seems like bad advice. We really are lost, and worse, we are heart-broken. What should we do?
Lost and Heart-broken
Dear Lost and Heart-broken,
The picture you paint is one that is truly, very painful. However, the first step here is to recognize that self-blame is typically not helpful. Could you as parents have done a better job? Of course! But, parenting in the 21st century is hard for many people. If you are trying to grow and do better, you are already ahead of the game and on a great path, and you can right the ship – your son is still young and it’s not at all too late.
Another point to emphasize up front is that while there are plenty of “parenting experts” who should not be in business, and there are plenty of mixed-messages and misinformation out there in the world, there really are some great, reliable, approaches that can dramatically improve your child’s behavior as well as your relationship with your child. To this end, it is important to discriminate between folk wisdom and psychological science – it’s one thing to speak about what we “think” may work, and another to speak about what we “know” is effective.
To illustrate, we want to mention two approaches – both which we offer in-house at the Center for Anxiety – for parents in contemporary psychology that have significant research and clinical support.
Parent-child interaction therapy, or PCIT, is an incredibly effective approach to help develop effective, loving, parenting with children between ages 2 and 7. The approach has been shown to be helpful for children with significant behavioral problems (such as ODD, [oppositional-defiant disorder] and severe ADHD) and can also be helpful for any parent seeking to improve the quality of their relationship and communication with their child. In PCIT, parents and children come into sessions together and engage in play and other activities. A therapist sits behind a one-way mirror, and provides live feedback to parents in how to interact with their children. Therapy focuses on specific skills, including how to discipline effectively and without rupturing relationships, and the program follows a clear set of steps toward improved parent-child interaction. Treatment is usually 12-20 weeks long and remarkably effective – in most clinical trials PCIT helps > 90% of participants overall, and 100% of people who complete the program.
A second approach that has strong research support and can be applied to children ages 2-17 is the technique known as parent management training, or PMT (everything has an acronym!). Parent management training, which aims to help parents manage, is more of your typical reward and punishment, behavior charts and prizes approach. However, while most of us have tried these parenting strategies ad-hoc with mixed success, when managed systematically these techniques can be extremely powerful. Practitioners of PMT show a 75-80% effectiveness rate, and that applies just as well in high-risk cases involving violence and delinquency. PMT is effective for older children, and does not require the child to be present at therapy sessions, as treatment is conducted with parents only. So it is a very good option for parents of teens.
Suffice it to say, you can make big changes going forward if you take the right approaches and use them consistently and methodically. Moreover, you are not alone. Since January, 2017 we have serviced nearly 300 new Frum families with these and other concerns, and results from our in-house research program show that people can and do change. So there is there is definitely help out there that really works.
All our best,
Center for Anxiety
David H. Rosmarin, PhD, ABPP, is an Assistant Professor in the Department of Psychiatry at Harvard Medical School, part-time, and a board-certified clinical psychologist. He also directs the Center for Anxiety which has offices in Manhattan, Brooklyn, Monsey, and Boston. Gabriel Hoffnung, PhD is a postdoctoral fellow at the Center for Anxiety’s Monsey office. He combines a strong background in neuropsychology with a staunchly behavioral approach to provide treatment to adults, adolescents and children in both English and Yiddish.
Readers are encouraged to write in their questions and concerns, and each month 1-2 letters will be published along with our responses. Submissions should be sent in via email to [email protected] with “Lakewood Scoop Question” in the Subject line of the message. To protect anonymity, names and other identifying details will be changed prior to publication. Questions are welcome about any topic related to mental health and treatment. We look forward to hearing from you!