Parenting a Child Who Has Intense Emotions --
Dialectical Behavior Therapy Skills to Help Your Child Regulate Emotional Outbursts & Aggressive Behaviors

by Pat Harvey, LCSW-C and Jeanine A. Penzo, LICSW

This book addresses the Continuing Education content areas of:
1. Counseling Theory/Practice and the Helping Relationship, particularly,
    A. "principles and techniques of counseling and their application in professional counseling settings." Counselors will learn how to help their
        parent-clients apply the skills and techniques of Dialectical Behavioral Therapy (DBT) to children who don't control their intense emotions.
    B. "information on the use of the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V); diagnosis and
        treatment of mental disorders." This book targets especially children who have a diagnosis of Disruptive Mood Dysregulation Disorder.
          This diagnosis is appropriate when
          (1) Severe recurrent temper outbursts manifested verbally (e.g., verbal rages) and/or behaviorally (e.g., physical aggression toward people or
                property) that are grossly out of proportion in intensity or duration to the situation or provocation.
          (2) The temper outbursts are inconsistent with developmental level (e.g., the child is older than you would expect to be having a temper tantrum).
          (3) The temper outbursts occur, on average, three or more times per week.
         (4) The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by others
               (e.g., parents, teachers, friends).
          (5) The above criteria have been present for 1 year or more, without a relief period of longer than 3 months. The above criteria must also be
                present in two or more settings (e.g., at home and school), and are severe in at least one of these settings.
          (6) The diagnosis should not be made for the first time before age 6 years or after age 18.
                Age of onset of these symptoms must be before 10 years old.
          (7) There has never been a distinct period lasting more than 1 day during which the full symptom criteria, except duration, for a manic or
                hypomanic episode have been met.
          (8) The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental

2. Human Growth and Development, particularly, "the nature and needs of individuals at all developmental levels; normal and abnormal human
   behavior". Counselors will learn how to teach children ways to acknowledge their strong emotions without losing control. This will promote
   individual self-esteem during the developmental years.

3. Social and Cultural Foundations, particularly, "social mores and interaction patterns." This book seeks to improve a child's social favor through
    self-control and the constructive response to one's strong emotions.

Counselors will learn these skills in helping their parent-clients who have children with intense emotions:

1. How to identify children who have intense emotions. They are children who:
   (1) are unable to differentiate between situations, responses, causes, and effects.
   (2) respond to events in an extreme way.
   (3) reach a high level of intensity very quickly.
   (4) have trouble prioritizing what is important.
   (5) are overwhelmed by choices.
   (6) take a long time to return to a calm state after an upsetting incident.

2. How to help parents respond effectively to children who:
   (1) take too long in getting ready for school, or refuse to go to school.
   (2) have trouble completing their homework.
   (3) express themselves with too much anger.
   (4) throw tantrums.
   (5) act inappropriate around other children.
   (6) who might be a danger to others or themselves.

3. How to use dialectical behavior skills to teach parents:
   (1) that their child is doing the best he can, while at the same time, helping their child to do better.
   (2) to describe their child's behavior in a non-evaluative manner, and then describe the consequence of that behavior.
   (3) that they should validate their child's feelings.
   (4) to attend to their child as much as when their child is calm as when he is intense.
   (5) how to promote calming activities for their child.
   (6) how to use reinforcers for promoting appropriate behavior.
   (7) how to use punishment and natural consequences effectively.
   (8) how to use contracts with their child to promote appropriate behavior.
   (9) how to maintain expectations, limits, and routines.

4. How parents can remain in control over their own emotions:
   (1) by speaking to their child slowly in a soft tone and low voice.
   (2) by knowing that validating their child's emotions is not an endorsement of their child's inappropriate behavior.
   (3) by taking slow, deep breaths.
   (4) by exercising proper self-care.