What to do when a 12-year-old boy has defeated behavior management program (Kazdin method)?

Question

I am in a six year relationship with a woman who has two kids, a 15-year-old girl and a 12-year-old boy.

We have moved a lot. The child's father has been incarcerated for most of the child's life. He has only female friends and is highly socially anxious. We recently learned that he had been exploring gay porn online for many months and assume he is gay.

He has been treated with stimulant medication for ADHD on and off since he was 8, and this school year he has gone from "forgetting" to do much of his schoolwork (which has been his excuse for years) to actively refusing to participate when his "screen time" was curtailed after he began failing many subjects.

We have tried many behavior charts and behavior management programs over the years, most recently the Kazdin method. All attempts have failed. The child is now in personal counseling and his mom and sister are also seeking treatment for depression and other issues. His mother has some ADD and possible borderline personality issues but is seeking treatment. He is willing to forgoe rewards that he values highly rather than comply with small parental requests, and he is not fazed by having straight F's on his report card - in fact he seems to be punishing us for attempting to set limits with him.

I think the child hates me as the unwanted step-parent who constantly attempts to support his mom's behavior management programs by reminding her that she is not adhering to her own agenda (she often fails to monitor his compliance with chore charts, and he often lies about having no homework or about having completed his chores).

I find myself in the untennable position of sitting back and watching this cycle repeat endlessly in a negative downward spiral. Due to my poor relationship with the child I now feel that any attention I show him can backfire. If he is bad and thows a rock through our window I want to punish him, but I think he is doing it to get negative attention and I find myself doing that at times.

Rarely, he will begin to do his homework and I will say something encouraging, and it seems to mean very little him, and he stops doing his homework. There are no certified Kazdin therapists in our area and I have not been successful in reaching anyone at their office for specific advice. What does a person do when a child has beaten his parents at behavior management?

Answer 1

Realistically, there is only one way to treat this young man and that is to love him, completely and without reservation, forever.

It's not easy to diagnose your family's problems from a single 425 word description, but certain tells jump out of your story.

I'm sure you love the kid, or else you wouldn't be here. His mother and sister love him, too. But you all have to convince the boy of that, and you have to keep reinforcing that conviction every day and every hour. In the long run this is much more important than getting his behavior under control.

You must have noticed that when he does something constructive, like beginning his homework, and you express admiration and encouragement, he reacts very negatively. Also he is willing to forgo rewards that he values highly rather than comply with small parental requests. These are classic tells for a child who is afraid to be loved.

The problem is that if he admits that he needs love and approval then there is something you and his mother can withhold when he fails to meet your expectations. And he feels sure he cannot meet your expectations -- probably because he is gay, but also because you and his mother want him to be better than his parents, but you're kinda convinced he won't be. And he might be going crazy (most 12-year-olds think this). And he was very good and took all his meds but he still has ADHD.

Look at his life from his point of view. His father is in jail. The boy doesn't know how this happened. How does he know that he won't end up in jail too? Then nobody will love him. That would be agony. Better not to need love from anyone.

His mother suffers from ADHD and depression and who knows what else. Obviously you and she think this is a big deal; she's getting treatment. What if he inherits these afflictions from his mother? Then nobody will love him. That would be agony. Better not to need love from anyone.

Obviously he is an unsatisfactory person in his parent's eyes. Why else would he need a regimen of medication? Saying he has ADHD and needs treatment is just another way of saying he is unworthy and naughty. What if he never learns how to be good? Then nobody will love him. That would be agony. Better not to need love from anyone.

What if he is gay? OMG what if his father, you and his mother reject him because he is gay? What if you try to cure him of being gay? Good luck with that; you couldn't even cure his ADHD. Then nobody will love him etc. etc.

Are you beginning to get a sense of the constant unremitting terror that dominates every moment of this young man's life?

Normally the love between parents and children is so strong that parents can get away with controlling the children's behavior by withholding approval. This lever is unavailable to you; not because of the boy's overwhelming need to misbehave, but because of his fear of the love.

Of course I could be way off. As I said, 425 words is very little to go on. If my answer doesn't make sense to you, or leaves you with a 'so what' or 'blah' reaction, then I'm sorry I couldn't be of more help. But if my answer makes you uncomfortable, then I am probably close to the truth.

I don't envy you your task. You must bind your family together and teach them that membership is unconditional and inalienable. First, you have to convince yourself. Believe that the mutual acceptance and affection within the family is much more important than the interaction between the family and the rest of the world.

Answer 2

If there is a biological underpinning to his (mis)behavior, you won't necessarily be able to address it through behavior modification.

As an example of this, a friend of mine was once sitting alone in a classroom and was approached by a substitute teacher who was training to be a clinical psychologist. After a half an hour this substitute instructor came out excited, and was sharing with everyone how he had stumbled on a person with some rare psychological disorder in the classroom. The people he told knew my friend, so when they went to the classroom they immediately called the hospital because he was actually in diabetic shock.

Biological roots can include genetic predisposition, age related factors, or environmental factors.

I understand you are trying Kazdin's method, which I am not familiar with. It looks to me like you have tried a combination of methods in the past, because Kazdin specifically says "no drugs", but you specifically state that he has taken his medications dutifully.

The drugs given to children to control ADD are psychoactive in nature, and often interfere with memory formation. It is not unheard of for ADD symptoms to disappear when a child is taken off the medications that are supposed to be controlling the behaviors.

Furthermore, any psychoactive drug risks causing depression, the physiology of which is not yet well understood. Example: recent studies of the chemical action of SSRI's have found that they don't do what experts thought they did for years, explaining why their effects are unpredictable.

At 12 years old, exploring gay porn doesn't make him gay. All it makes him is curious. It's normal for kids to explore and compare their bodies during puberty. Porn is not a suitable or healthy way for him to pursue this, but it's not an unexpected behavior. Catastrophizing it is as big a mistake as letting it continue, IMHO.

Again, at 12 years old, with the onset of puberty, it is not unheard of for boys to become exceptionally assertive or aggressive. That is one of the known side effects of testosterone. Starting to explore porn, becoming aggressive about refusing to do what is requested, both coinciding the normal timeframe for onset of puberty, suggests but does not prove a correlation.

I have known parents who are very frustrated over their child's irresponsibility at home, and worried about their behavior elsewhere. However, in work situations where they are treated responsibly as members of a team accomplishing a task, you would believe that they were about 5 years older than their chronological age based on their behavior. In my opinion (which along with $0.50 will get you a really bad cup of coffee), some of their problems arise because they are treating a responsible adolescent as if they were an irresponsible child, and the child resents that. I don't know enough to say this is the case, but the question needs to be asked.

Are there activities that you can enjoy together with him where he can be free to be himself and you can participate together in more of a peer relationship? Volunteer at a cable TV station, for example? This really helped me with my daughter during the teen years. When she excelled at that, and ultimately moved into the technical director's role, we joked that she liked it because she was supposed to tell her dad (cameraman) where to go.