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My book "Therapeutic Parenting" and "When Love Is Not Enough" by Nancy Thomas provide the background and context for these specific techniques. It is not advisable to use these techniques without reading the books as these suggestions could easily be misunderstood and misapplied if not used in the context of a whole therapeutic philosophy and regimen.
Respite is for the sake of the parents when a child's behaviors and attitudes have worn them out and they need time away to regain the energy necessary to keep the child in their home. Respite, therefore, is beneficial to the parents by definition. It is respite for them.
Respite has the potential, however, to be very therapeutic and beneficial with an oppositional defiant and reactive attachment disordered child as well. Done right and done well the child will see that the source of all goodness and light is her parents. If she wants to have all the good things that life can offer she will not engage in behaviors which wear them out, necessitating that she go elsewhere in order for them to have a good time. She will see that respite is so unfun that she will want to stay at home and have fun times with her parents.
In order for this to happen, respite providers must be emotionally distant and the tasks assigned must be physically demanding. The respite provider needs to keep in mind several principles in order to have a frame of reference that will enable her to be effective:
- The child is abusive to her parents, not abused by her parents; the perpetrator, not the victim.
- The child does not need sympathy. In fact, sympathy will feed her pathology. The parents need empathy and support for sticking with a very difficult child.
- The parents are wonderful, warm, loving parents and competition from the respite provider for the child's good will is counterproductive to her living at home in a good way.
- The respite provider is not the child's pal, friend or confidant.
- The child is not a guest in the home. The child is there to work on the behaviors that cause her to be in respite, not have a vacation.
Therefore, these are the guidelines for effective respite:
- No television, computer, game boy, Nintendo, etc.
- When the family wants to engage in those activities then the child can stay in her room.
- Appropriate room toys would be cards, books, puzzles, a collage assignment, latchhook.
- Time must be spent addressing the behavior that caused the child to be sent to respite. If she is there because she refused to go to her room then she needs to practice going to her room - regardless of what her behavior is at the time. If she did a bad job on a chore then she needs to practice doing the chore. Even if the floor is mopped, if that is what she needs to work on then she can keep re-mopping the floor. If she is in good spirits and cooperative, that is great. However, it does not negate the need to work on her life. Having a good attitude in respite does not earn her any privileges. Privileges come from parents for good attitude and behavior at home!
- Meals consist of non-sugar cereal for breakfast and peanut butter and jelly sandwiches, milk/juice, and fruit for lunch. Dinner can be what the family eats only if her behavior and attitude have been exceptional. No eating out or commercial food, like pizza.
- Respite providers must not promote any bonding with the child and will avoid all of the bonding interactions such as eye contact, touch, movement, smiles and sweet food.
The final arbiters of what constitutes good respite for a particular child and what is good for family unity are the parents. Any questions regarding what the child can and cannot do need to be addressed to them.
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