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  • Seeking Professional Help for an Angry Child

    IMAGE At what point does a child's normal outburst of anger turn into an indicator of future violence, aggression, and hate?
    When children consistently demonstrate behaviors, such as intense anger, frequent loss of temper, extreme irritability, impulsiveness, and frustration, it should be taken seriously and not dismissed as a "phase they will outgrow." This complex and troubling issue needs to be examined and understood by parents, teachers, caregivers, employees, and other adults.

    Warning Signs

    Something was different about Blake. Bedtime, mealtime, play time, it didn't matter. Everything turned into an episode.
    "He was my first child, so I thought we just weren't doing something right," says Blake's mom. "Family and friends were quick to offer suggestions. I read every book on discipline and my husband and I exhausted every behavior strategy we knew."
    Ever since Blake was 18 months old, daily activities such as getting dressed, eating breakfast, playing with toys, and going to school often resulted in an emotional meltdown. The behavior varied, but was frequently characterized by screaming, hitting, head banging, and throwing whatever object was within reach. He was kicked out of two preschool programs and was constantly in trouble during his first few years of elementary school. As a consequence of his behavior, he was frequently isolated from his peers and labeled as a discipline problem.
    "We were afraid of our own son. One time when he was seven he became so enraged over going to bed that he grabbed his cat by the neck and threw him across the room." After seven years of constant turmoil, Blake's parents decided to seek professional help.

    Warning Signs That Professional Help Is Needed

    • Explosive temper tantrums or "meltdowns"
    • Extreme irritability or impulsiveness
    • Physical aggression
    • Fighting
    • Threats to self or others
    • Attempts to hurt self or others
    • Use of weapons
    • Cruelty toward animals
    • Fire setting
    • Destruction of property and vandalism
    • Panic
    Whenever these behaviors are observed in children, help from a qualified mental health professional, such as a child therapist, psychologist, or psychiatrist should be sought immediately. Early treatment can make a difference.

    Seek Help Sooner Rather Than Later

    According to counselor Dr. Kay Schrader, parents should seek help from a mental health professional when they find that normal behavior management strategies are not effective in teaching the child appropriate ways to express anger. She suggests parents request help when they realize that the expression of anger can't be pulled into an acceptable range or that peers are rejecting the child because of the behavior.
    Early intervention is important to the success of treatment, says Dr. Schrader. The longer the behavior is untreated, the more entrenched it becomes, and the harder it is to treat.
    Research shows that the future for children who cannot control their expression of anger is likely to be unhappy, unproductive, and destructive if they don't receive early, ongoing, comprehensive treatment. Without treatment, they have difficulty adjusting to the demands of adulthood, holding a job, and building and maintaining healthy relationships. This downward spiral may lead to violent behavior resulting in legal consequences.

    Selecting a Therapist

    Parents can request a referral from their physician, school counselor, or call the number on their insurance card for approved providers. Ask about the therapist's training, education, experience, and philosophy. Therapy is hard work. Therefore, it is important that you and the therapist are working toward the same goal and have a relationship based on mutual respect and trust. Specialized training in the areas of child development, anger management , and parenting skills is especially beneficial.

    Methods of Treatment

    Treatment depends on the unique characteristics of the child and the severity of the behaviors. It is common for the therapist to begin by requesting information from other medical specialists, the child, family, teachers, and caregivers. Understanding the root of the anger and the factors contributing to the inappropriate behavior will provide direction toward the most effective treatment.
    Skill building in the areas of problem solving and anger management, behavior therapy, and psychotherapy are common methods used by professionals to help children express and control their anger more appropriately.
    Medication is another means of treatment, especially when it is determined that the child's uncontrolled outbursts of anger are associated with attention problems, inability to tolerate frustration or change, psychiatric disorders, or extreme mood instability. Because medications are often accompanied by side effects, the therapist, family, and child must agree that this is the best option for improvement.
    In extreme cases, the treatment may involve removing the child from the home and/or school environment to provide more structure and intense intervention. It is very important that the family and school personnel continue to be involved in therapy so they can provide the necessary support when the child returns to her home environment.

    Helping the Family

    Most therapists work with other family members as well as the child with the identified problem. The child's behavior imposes great stress on the relationships within the family. Also, parenting a difficult child requires more advanced parenting skills than most parents ever have to learn.

    Working With the School

    Responding to pressures at school—academic frustration, peer pressure, teasing, social rejection, isolation—is a challenge for any child, especially one who has difficulty controlling anger. Parents and teachers must work together to provide mutual support for the child. Consistency is important.
    If a mental health professional has diagnosed your child with an emotional disability, the school is required to provide assistance if the disability affects school performance. An IEP (Individualized Education Plan) will be developed to determine what support is necessary to help the child succeed in school. The therapist, school counselor, special education teacher, classroom teacher, parents, and child should all have input into the IEP. The teacher may be asked to use specific behavior management strategies with the child to support the treatment plan. When parents and educators work together, they improve the child's opportunity to succeed in school, both academically and socially.

    Your Child's Future

    Treatment is often a long process because establishing new attitudes and habits takes time, but the investment is worth it. Treatment offers hope for a bright, productive future.

    RESOURCES

    American Academy of Child and Adolescent Psychiatry http://www.aacap.org

    National Network for Child Care http://www.nncc.org

    References

    Hughes R. Helping children deal with anger at friends. Ohio State University website. Available at: http://fcs.osu.edu/hdfs/yc/index.htm . Accessed March 3, 2008.

    Hughes R. Helping children deal with anger at parents. Ohio State University website. Available at: http://fcs.osu.edu/hdfs/yc/index.htm . Accessed March 3, 2008.

    Massey M. Early Childhood Violence Prevention. ERIC Digest. Clearinghouse on Elementary and Early Childhood Education. October 1998.

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