The parents must have dealt with their own past abuse issues: If the adopting parent was abused in the past, it is crucial that s/he have found resolution to this issue prior to the placement. If this has not occurred, the child’s acting out behaviors will quickly become intolerable to the parent. If the placement occurs before the parent has found resolution, it is important that the parent enter therapy as soon as possible.
Have a thorough psychiatric or psychological assessment on a yearly basis as long as symptoms persist: Any underlying psychiatric conditions have to be considered so that the correct therapeutic approach can be determined. Medications may also be necessary if the child has other existing conditions such as attention deficit disorder or an obsessive compulsive disorder.
Continue with professional therapy for the child and the parents as long as the behaviors persist: Aggressive and sexualized behaviors require on-going professional intervention. Parents can use techniques at home which support the therapy, but they cannot provide the therapy themselves nor can they create the desired change in the child without professional support. As well, the parents need the help of the therapist to learn how to deal with their own feelings about these types of negatives behaviors and to learn how to deal with the high level of stress that is the result of living with a violent or sexually intrusive child.
Be prepared to have the child removed from the home when the behaviors are escalating: Adoptive parents often hesitate to have a child taken from the home as they are afraid they will not be able to get him back, or they are afraid the child will perceive it as rejection. However, a child who is going through a cycle of severe acting out is not safe to live with for other children, for the pets, or for the parents. Family members are at risk of being harmed, and all of the family is at risk of becoming unstable. Escalating events of aggressive or intrusive behaviors are beyond the ability of a family to manage so other living situations must be utilized. If the child cannot return home for the forseeable future, the parents can still maintain an on-going relationship with her and perhaps include her in significant family events such as birthdays and holidays.
Stay in charge: A child who has experienced abuse have often been in pseudo adult roles and expects to be the adult in the new family She may be skilled at eroding parental authority and control. It is important to gently, but firmly and consistently, remind the child that the parent is in charge and is the final authority on all decisions. A democratic family orientation can evolve over time, but will not likely be in the best interests of the child until the emotional issues are resolved.
Use all of the techniques in the attachment section: These techniques are equally useful for children who are violent and or/sexual. The Feet technique, points, time-out, and helping the child cope with isolation are particularly useful.
Talk about boundaries: A boundary is a psychological bubble that surrounds each of us. It helps us to feel that we have enough individual space both physically and emotionally. Children who have been abused have often lost these bubbles and may not recognize them in others. The parents can help the child develop her own bubbles and learn to recognize others by talking about them. For example, if the child is sitting too close to a sibling, and the parent knows this will lead to a fist fight, the parent can intervene early by stating “Oh Robbie, look, you moved into David’s bubble. Move over a bit so you both have room for your bubbles,” or “Kathy, I love cuddling with you, but you’re sitting so close that my bubble is getting squished. Can you move over an inch so both our bubbles have room.”
Always have a tape player with earphones and a hand held computer game in the car: Boredom and transitions are often triggers for aggressive behaviors. Let the child listen to favorite tapes while going to and from places to keep him distracted and occupied. The tapes will have to be changed frequently to keep him interested. The hand held games will also keep the child busy and are more suitable for a teen. Buy the same for the siblings.
Do not hit back: This sounds simple, but living with an aggressive or overtly sexualized child may eventually trigger an outburst in even the most sweet tempered of parents. This is best avoided by prevention. Get the child into respite, or to a daycare, or over to a grandparent’s house, or somewhere else so that the parent gets a break when the tension has been intense for a period of time. If the parent does hit the child, it is important that she take a breath, give herself time out, and then face what happened openly with the child, the family, and the support services. The child needs to see the parent take responsibility and implement measures to prevent it from happening again. If it does happen again, it is very important that the parents seek help to consider whether the child can safely remain in the home at the present time.
Teach the child about choices: When the child is aggressive or sexual, talk to her about what other behavior she could have chosen to do when she had the triggering feeling (anxious, mad, irritated, bored, aroused, etc.). The child may try to wiggle and twiggle her way out of this conversation, but using a calm tone and a supportive demeanor, the parent should run through the list of alternative behaviors each time a situation arises. Timing is crucial with this. At the beginning of the placement, it may be important to wait until things have settled down, but after the child knows the routine, this conversation should be held as soon as possible after an incident occurs. The parent must also be careful that he is in control of his feelings and is able to move beyond his own anger at whatever the child has just done.
Teach the child how to apologize: When it is appropriate, have the child face his victim, say what he has done, and apologize. This is not easy. It may take months of practice before the child is able to even look at his victim without laughing or spitting or hitting, but it is important to try to get to this point. Primary consideration must be given to the victim, and if she is not willing to participate willingly, do not use this technique.
Role model how to apologize: When the parent makes a mistake or a misjudgment or overreacts to a situation, it is important that she apologize for her behavior in an appropriate manner so that the child can see the adult being accountable for her actions and acting in a responsible manner.
Protect the pets: Violent or sexually intrusive children may harm the family pet. The child may do so in ways that do not leave marks and are not obvious to the rest of the family. It is best not to have any kind of household pet but if the animal was already in the home prior to the placement, make sure that the child is never alone with it.
Provide a separate bedroom: A child with these issues requires her own bedroom in order to ensure that she does not have an opportunity to terrorize the siblings or damage their belongings. The siblings should be allowed to have a lock on their door and be assured that they have room in their home in which they do not have to cope with the violent or sexual behavior of the acting out child.
Teach the child how to recognize, label, and cope with feelings of frustration, boredom, disappointment, excitement, anticipation, anxiety and fear: These feelings are often the main triggers for acting out behaviors. Both the adoptive parents and the child need to learn the early warning signs that the child displays when he is experiencing one of these. It is equally important that the child and parents learn to label the feelings and then find a fast way to intercede before the feelings escalate into negative behaviors. Many self-help books have pictures of faces that demonstrate the feelings and these pictures can be placed on the refrigerator or a notice board so that the child can learn to identify the look with the word or feeling. It is also helpful to learn to predict situations in which the child is likely to experience one of these feelings. Talk to him about it ahead of time. For example, “Ricky, we are going to the movies today and we will have to wait in the line up for a long time. You might feel bored while are waiting. What toys do you want to take with you to play with while we are waiting?” If you have just returned from a long car trip and everyone is tired and crabby, be aware that these type of feelings can lead to violent or sexual behaviors and take precautions before it happens. The parents can also talk to the child about it. For example “Jill, I know you are excited and tired from going to the fair today. Sometimes when you have these feelings, you behave inappropriately. What can we do together to make certain it doesn’t happen today?” It is not up to the child to devise a means of intercepting her own behaviors, but it may increase her motivation if she is included in the process. This also keeps the issue out in the open and makes everyone more careful. And, do not relax the parental guard just because the child appears to be participating in the process.
Meet regularly with teachers: The parents, child, and teacher should meet at least once a month to discuss how the child is behaving and what strategies each party is finding most useful to prevent or resolve negative behaviors. A part of each of these meetings should not include the child. These face to face meetings also ensure that the parents are aware of what is happening at school as well as reducing the child’s opportunity to make false allegations against the teacher or the parents.
Consider impact of peer relationships and the school experience: At the regular meetings, find out from the teacher whether the child has any friends and if so, what kind of influence they are. Violent and sexually intrusive children are often socially ostracized and lonely and this increases their overall level of stress, frustration, and rage. They may seek out peers who are functioning in equally negative ways and this almost always leads to an increase of acting out behaviors in the community. Or, the child may be so lonely that he is retreating into a fantasy world. This too, often leads to increased acting out. It may be necessary to consider home schooling to reduce the child’s daily stress. This can be difficult for the parent who desperately needs a break from the child, but it should be considered.
Place siblings and the acting out child in different schools: The siblings will generally be embarrassed by the reputation the child has in the school. The child may feel overwhelmed and ashamed of his inability to have friends or to get as good grades as the siblings. Separate schools allows the siblings to have an environment where they are not subjected to the impact of an acting out child and the child can have an environment where he is not compared to his better behaved siblings.
Include third parties: Aggressive and sexually intrusive children can be skilled at blaming others and presenting themselves as victims of mean parents. It is important to avoid this by always including the third party in discussions. For example, if grandma is starting to hint that mom is too strict with Johnny, then mom and grandma need to sit down together and talk about how grandma arrived at this belief. Once mom and grandma have thoroughly discussed this, then include Johnny. This can be done without blaming Johnny or accusing him of lying, rather, the concerns and how grandma and mom have resolved them can be presented to Johnny.
Plan what will be done when the child is caught in a negative behavior: The actual consequences for a negative behavior can be worked out either ahead of time or later. However, the way in which the parent will respond at the moment of catching the child in a negative scenario should be well considered. For example, the parents may agree that the child will be sent to his room and nothing more will happen until both parents have had an opportunity to calm down and discuss the event, or until the therapist has become involved, or until the police arrive. The child will often initiate an event for the sole purpose of provoking the parents and so it is important that the child very quickly learn that the parents will not respond in an equally violent or rageful or hysterical manner, but that they will respond in a well thought out, calm manner.
Use respite care: A family cannot live with the daily stress of a violent or sexually intrusive child without taking a break. Make arrangements with the local social services for respite services from a licensed foster home that specializes in caring for children with this type of problem. It is also important that the siblings have a break from the stress and have an opportunity to have quality time with the parents.
Join, or create, an appropriate support group: The parents need an outlet where they can vent their anger and frustration and exhaustion without fear of being evaluated. They need to be able to say that they hate their child to people who understand that they love the child more than anything. This can only come from peers. That is, parents who also have adopted violent or sexually intrusive children.
Do not let the child rule the lives of the parents: The child can become the focus of all of the parental attention and energy. It is crucial to the marriage and the stability of the family that the parents continue to have other interests and maintain a social life. If the parent is afraid to go out because the aggressive teen will leave the house, or burn it down, while they are gone, they should go out anyway. The parents cannot function as prison guards and are entitled to have their adult time away from the house.
Source: Handout for NYSCCC 2003 conference workshop presented by Brenda McCreight, PhD, May 9, 2003, Albany, NY. Reprinted with permission of the author.