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Parenting a Child Who Has Intense Emotions: Dialectical Behavior Therapy Skills to Help Your Child Regulate Emotional Outbursts and Aggressive Behaviors
by Pat Harvey, LCSW-C and Jeanine A. Penzo, LICSW 2009 (New Harbinger Publications: Oakland, CA) All rights reserved. [224 pages]
[Answer 18 of 25 questions to receive 8 hours of Continuing Education credit]

Chapter 1: Emotional Intensity and Your Child's Feelings (p. 9-30)
1. Which question would NOT help parents recognize worrisome behaviors in their child?

a. Asking our child why he behaves the way he does.
b. Is our child unable to differentiate between situations, responses, causes, and effects?
c. Does our child respond to events in an extreme way?
d. Does our child reach a high level of intensity very quickly?
e. Does our child have trouble prioritizing what is important, and is he overwhelmed by choices?
f. Does our child take a long time to return to a calm state after an upsetting incident?

2. Our feelings come from our
a. behavior.
b. thoughts.
c. temperament.
d. circumstances.

3. What thought could have helped Jane have better feelings about getting her two young children ready for school?
a. "Here we go again. This will be one of those days when Jackie won't get ready for school by herself."
b. "Why can't Jackie just do this herself like she did yesterday?"
c. "Jackie is taking too much time to get ready. She is doing this on purpose."
d. "Okay, Jackie needs some help getting ready for school. If I help her, she will get ready faster."

Chapter 2: Effective Parenting (p. 31-62)
4. Which is NOT true?
a. Reminding yourself that your child is doing the best he can helps you feel less angry, less disappointed, and less frustrated with your child.
b. Accepting that your child needs to do better means that he is not doing his best right now
c. Your child wants to do better because he seeks your approval and would rather live in a house that is free of tension and anger.
d. When a parent tells his child that he cannot have a friend over for the weekend, and the child responds by saying, "You never let me have any fun," a wise parent will refrain from arguing, quietly allowing the child to have this different point of view.

5. Effective parents will describe a child's behavior in a non-evaluative manner, and then describe the consequence of that behavior. Which is NOT an example of this?

a. "You asked your mother after I already had told you No. You are so manipulative.
b. "I appreciate it when you take out the garbage."
c. "You have really worked hard on this school project. I hope you are proud of this accomplishment."
d. "Thank you for cleaning up your room."

6. Which is NOT true about validation of your child's feelings?"
a. Sometimes validation can just be sitting quietly and listening to your child.
b. Acknowledging that your child is angry right now could increase the chances of him being angry next time because he will think you are endorsing his bad behavior
c. Validation can help de-escalate emotional situations.
d. Validation helps a parent to remain calm in the face of a child's emotional behavior.

Chapter 3: Understanding What Your Child is Telling You (p. 65-84)
7. Your child comes home from a friend's house and responds in an angry manner when you ask if she had a good time. When you ask her what's wrong, she yells, "Nothing!" Then she goes to her room.
At this point, as her parent, what should you NOT do?
a. Let he be alone for awhile in her room. Don't take her silence personally.
b. Don't rush to her door to ask her again what's wrong.
c. When she calms down, tell her you would be glad to listen to her if something is bothering her.
d. If she denies being upset, give her a consequence for lying to you.

8. In the story of ten year old Ricki coming home quiet and brooding from school, all of the following responses by her mother, Penny, are effective parenting EXCEPT
a. Penny notices right away that something is bothering Ricki. Penny remains calm and makes no demands on Ricki.
b. Penny tells Ricki she is not a loser and reminds Ricki of several of her accomplishments.
c. Penny tells Ricki she has right to feel sad about not being invited to the sleepover.
d. Ricki yells and slams her bedroom door shut. Penny waits for awhile, then tells Ricki she will listen whenever Ricki wants to talk about what is bothering her.

9. If your child tells you that she hates her best friend, which would be an effective parental response?
a. Tell your child that hatred is a sin.
b. Give her a consequence for her bad attitude.
c. Acknowledge her feelings, knowing that they are probably temporary.
d. Talk with her about ways she can change her bad feelings.

10. Which of the following would help children express their feelings?
a. Parents who acknowledged and accepted their child's feelings, not reacted against them.
b. Parents who selectively share their own feelings with their child, taking care not to overwhelm
c. Parents who attend to their children just as much when they are calm and pleasantly engaged as when they are having intense reactions.
d. All of the above.

Chapter 4: Responding When Your Child is Overwhelmed by Emotions (p. 85-97)

11. Which of the following would NOT decrease the possibility of an emotional outburst in a child?
a. Having dinner at about the same time every night.
b. Having bedtime around the same time each night.
c. As a consequence for breaking a rule, always taking away something the child enjoys.
d. Having your child complete a chore by a certain time that day.
e. Having a place for your child to go and be quiet and undisturbed.
f. Providing activities that are soothing and enjoyable such as listening to music, drawing or painting, exercising, or taking a warm bath.

12. Which would NOT help a parent remain calm when a child is having an emotional outburst?
a. The parent remembering that when he was a child, he never would have treated his own parents this way.
b. The parent speaking slowly to the child in a soft tone and low voice.
c. The parent taking slow, deep breaths.
d. The parent thinking to himself, "I can help my child calm down if I remain calm."

Chapter 5: Teaching Your Child to Manage Feelings (p. 99-111)
13. Which is NOT true?
a. Children can learn self-awareness by alternately tensing and relaxing their body, or by breathing in and out, and then describing these sensations in their own words.
b. Children can learn to make connections between experiences and feelings, such as, "When someone yells at me, I feel angry," or "When I do well on a test in school, I feel proud."
c. When a child's emotions are escalating, one of the best calming activities at that moment is for the child to talk about what is bothering him. Talking will almost always help him feel better right away.
d. The best time to use a calming activity is before the child escalates her emotions.

14. How do parents find out what is an effective calming activity for their child?
a. Ask your child what he likes to do when he feels upset.
b. Observe what your child does to calm down when he is upset.
c. Make a chart with your child of what helps him calm down when he is only a little upset, and what helps him calm down when he is really upset.
d. All of the above.

Chapter 6: Behavioral Principles and Intense Behaviors (p. 115-134)
15. If a child whines because he wants a cookie, and the parent gives him the cookie,
a. the child will most likely whine the next time he wants something.
b. the child will most likely stop whining right after he gets the cookie.
c. both a. and b.

16. A reinforcer is a consequence that increases the probability that a behavior will occur again. A reinforcer can be something that a child likes, or taking away something that a child dislikes. For a reinforcer to be effective, all of the following are true EXCEPT:
a. The reinforcer should occur immediately after the desired behavior so the child links the desired behavior to the reinforcer.
b. Parents should choose a different reinforcer if the one they are using is not effective.
c. Intermittent reinforcement is highly effective because the child never knows when his behavior will result in a reward, so he continues the behavior in the likelihood he will eventually be rewarded.
d. Parents should view reinforcers as "bribes" since their children are not old enough to be intrinsically motivated.

17. Parents have a child who is often overwhelmed in social situations and tends to grab things from other children. The parents decide to help their child learn more effective social behaviors. They tell their child that if he plays with other children for 15 minutes without grabbing anything out of their hands, then he will get a special snack. After their child learns to do this, they then tell him if he does not grab anything for 30 minutes, then he will be given money to save to buy a favorite toy. And when the child can sit with other children and not grab anything at all from them, he will be allowed to have a friend come over for the weekend to play.
The parents are using the behavioral strategy of
a. shaping.
b. reinforcing.
c. natural consequences.
d. a. and b.

18. Which is NOT true?
a. Unlimited punishment should be used for really bad behaviors, like hitting another child and causing him to bleed.
b. Although both reinforcement and punishment are effective parenting strategies, reinforcing a desired behavior is more effective than punishing an undesirable behavior. For example, it is more effective to reinforce your child when he is being calm than punishing him for yelling and cursing.
c. It is effective for parents to reinforce an opposite, desirable behavior. For example, parents who have a child who tends to yell may reward their child when he uses a softer voice.
d. When using time-out, it is effective to allow the child to come out after he becomes calm, not before he becomes calm.

19. Which is an effective way to get a child to do his homework?
a. Write up a contract with your child in which he will be allowed to do something he enjoys doing only after his homework has been completed.
b. A child is doing his homework and manipulates his parents to sit with him by throwing a tantrum when they get up, and then working quietly on his homework when they sit back down with him. The parents decide to reward him for each hour he works on his homework without his parents sitting with him.
c. The child is not required to have perfect behavior, but is required to make progress toward better behavior. It is effective for parents to give prompts to a child who begins to misbehave, and then reinforce the child if he calms down within two minutes of receiving the prompt. It is also effective for the parents to give reinforcement for whole days without an outburst.
d. All of the above.

Chapter 7: Maintaining Expectations, Limits, and Routines (p. 135-144)
20. Which is NOT true?
a. Parents should not have a specific bedtime for young children. They will fall asleep on their own.
b. Parents will be more successful in getting their children to bed if they give them a calming activity beforehand and not rush their child.
c. If requiring a chore to be done right away results in a negative response, parents can give their child a time when the chore has to be done, and they can remind her that she cannot do other activities until that chore is finished.
d. If a routine is a struggle for a child to complete, parents can reward their child on those days when she completes the routine without causing difficulties.

21. When a child does not immediately comply with parental expectations, parents can avoid power struggles by
a. calmly giving prompts about their expectations.
b. not standing over their child waiting for compliance, but walking away and asking her to complete the expectation within a short time period.
c. calmly reminding their child of the reward she will earn when the expectations are met.
d. All of the above.

Chapter 8: Decreasing Tantrums, Aggression, and Other Problem Behaviors (p. 145-156)
22. Jason is an 8-year-old boy who has explosive temper tantrums. His parents practiced all the right responses when he was younger: (1) Not giving in to his demands. (2) Calmly ignoring the tantrums. (3) Reinforcing positive behaviors, such as making polite requests, and developing a contract for tantrum-free days. (4) Distracting him or trying to calm him before the tantrums escalated.
However, even after all these appropriate parental responses, Jason continues to explode and sometimes resorts to breaking things and hitting or pushing his siblings.
Which of the following additional parental responses would NOT be helpful?
a. Jason's parents decide to spend individual, uninterrupted time with him and his siblings (fifteen minutes) at least five times a week.
b. His parents acknowledge and validate Jason's feelings and his siblings' feelings, even when the children are misbehaving.
c. His parents make a contract with Jason that for each hour he is tantrum-free he receives a sticker, and after earning so many stickers he receives a reward.
d. Fifteen minutes into his tantrum, Jason's parents threaten to lock him in his room with no dinner if he continues with his outburst.
e. After each outburst, Jason must engage in a calming activity.
f. Jason's parents reassure him that they love him even though they don't like his tantrums.

23. Which is NOT true?
a. Children threaten to hurt themselves because they want attention.
b. Children cut themselves because they want to alleviate emotional pain.
c. If your child hurts another child while they are playing together, it is appropriate for you to calmly remove your child from the play area.
d. If you are at the playground with your child, and he refuses to come to you after several prompts, it may be effective to tell him he will not return to this playground if he does not come right now.

Chapter 9: School-Related Difficulties (p. 157-170)

24. What can parents do with a child who refuses to go to school?
a. They can ask their child if there is anyone bothering them at school.
b. They can meet with their child's teacher(s) and find out if the teacher has any helpful observations.
c. They can develop a contract and reinforce their child on the days she goes to school without incident.
d. All of the above.

Chapter 10: The Impact of Intense Emotions on the Entire Family (p. 173-185)
25. Which is NOT true?
a. A child who has intense emotions should never be dismissed from doing chores whenever that child's siblings are also doing chores.
b. Parents should work hard to spend individual time with each of their children.
c. When other siblings are jealous of a child who has intense emotions, parents should accept and understand their feelings.
d. Parents should recognize the uniqueness of each of their children.