Children and adolescents with anxiety disorders often act out or react with anger to treatment. In particular, the prospect of doing exposure and resisting compulsions or safety behaviors can engender not only fear but also anger, resistance, and defiance. This can take the form of tantrums, threats of harm to self or others when parents insist on treatment, overt treatment refusal, and refusal to participate in other activities of daily living such as school. This can be difficult for clinicians and families to manage, and can lead to both treatment dropout and conflict at home. This workshop will present practical strategies that clinicians can use to deal with children’s anger, and suggestions for how to present these strategies to parents. Topics covered will include managing tantrums, what to do when a child refuses to participate in treatment or school, and managing verbal and physical aggression toward others.
At the end of this session, participants will be able to:
- manage patient tantrums and threats and effectively coach families on managing these types of behaviors at home.
- utilize rewards, consequences, and parent training to help families overcome treatment refusal.
- work with parents and the school system to deal to treat school refusal.
Presentation level: Intermediate/Advanced.
Hanley, G. P., Piazza, C. C., Fisher, W. W., & Maglieri, K. A. (2005). On the effectiveness and
preference for punishment and extinction components of function-based interventions.Journal of Applied Behavior Analysis, 38, 51-65.
Wilder, D. A., Chen, L., Atwell, J., Pritchard, J., & Weinstein, P. (2006). Brief functional analysis and treatment of tantrums associationed with transitions in preschool children. Journal of Applied Behavior Analysis, 39, 103-107.
Williams, C. D. (1959). The elimination of tantrum behavior by extinction procedures. Journal of Abnormal and Social Psychology, 59, 269-269.
Dr. Alison Alden earned her Ph.D. from Northwestern University in Evanston, IL, where she focused on researching and treating anxiety. She also completed a post-doctoral fellowship at Northwestern Memorial Hospital. She has extensive training and experience in cognitive behavioral therapy for anxiety, OCD, and mood disorders, and integrates mindfulness and dialectical behavior therapy (DBT) into her practice. Dr. Alden has published several research articles and book chapters on anxiety, depression, and emotion regulation, and has presented talks and posters to state and national professional organizations. She has also taught in Northwestern University’s School of Continuing Studies. Dr. Alden is a member of the Anxiety and Depression Association of American (ADAA), and was the recipient of the highly competitive ADAA Career Development Leadership Program award in 2014.
Dr. Julieanne Pojas received her doctorate and masters’ degree in clinical psychology from Midwestern University in Downers Grove, Illinois. As a licensed clinical psychologist, she specializes in the treatment of anxiety and related conditions. She is trained in cognitive-behavioral therapy and exposure response prevention. Dr. Pojas has received specialized training and certification from the Behavior Therapy Training Institute (BTTI) at the International Obsessive Compulsive Foundation.
Dr. Pojas has experience working in a variety of clinical settings in Illinois and California treating a culturally diverse population. She believes in providing culturally appropriate treatment. She has done several talks training mental health professionals and educating parents about mental health topics. Dr. Pojas is a member of the Anxiety and Depression Association of American (ADAA), the International OCD Foundation (IOCDF), and the Asian American Psychological Association (AAPA).