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What the Heck Were You Thinking?
Adoption, Foster Care and Cognitive Behavior Therapy

Inability to manage strong feelings can cause foster and adopted children and teens to act out in inappropriate ways. Cognitive Behavioral Therapy may help these children gain control of their behavior.

By Pamela Lowell

The inability to manage strong feelings can cause foster and adopted children and teens to act out in inappropriate ways. Ways that aren't good for us or them. How can we help this population develop the ability to tolerate the strong emotions that can sometimes arise from conflicting thoughts and feelings?

Obviously, many of the kids who come to us have experienced multiple loss and trauma. That's how they come in the door. One reason they display difficult behaviors is because certain memories can be re-triggered from a circumstance that reminds them of that original loss. They may not even be conscious of what that memory is, but it brings up similar feelings.

As a family therapist, one of the best ways I know to work with problem behaviors is through Cognitive Behavioral Therapy. Basically this means that feelings trigger thoughts, and those thoughts influence behaviors. We can't control our feelings, nor should we try (because feelings are not good or bad, they just are) but we can control the meaning we assign to our feelings. And by getting a handle on our thoughts, we can manage our behaviors.

After a particularly "difficult" incident you might try asking them questions to help process the event in a different way:

  1. What were you FEELING before you acted out? Mad? Jealous? Scared? Frustrated? What signals were you getting from your body that you were feeling that way? Heart beating fast? Clenched fist?
  2. What THOUGHT was connected to the feeling? OR What were you saying to yourself at the time? Hitting makes me feel better? Lying will get me out of this situation? There was a thought there, help them find it.
  3. What "BEHAVIOR" was connected to the thought? What did you do? Actually hit the person? Throw something? Scream? Did it get you what you wanted?
  4. If not what could you have told yourself about that feeling to change your behavior and not get you into trouble? In other words what would be a more positive thing for you to think?

For example I once worked with a foster teen who would throw things when she got upset. She told me, "I was angry. (Feeling) My heart was beating fast. I have to throw things--it calms me down. (Thought)" But the last time she was angry she threw her mp3 player against the wall! (Behavior) It was not an effective way of dealing with her emotions--she lost something valuable to her and was grounded for a week. She also knew she'd have to face adverse consequences from her foster parents and/or the school if she continued to throw things when angry.

I asked her what thought that might be more helpful when she was feeling angry: "When my heart is beating fast I know I'm getting angry. If I throw something I'm going to get in trouble. What else can I do?"

We came up with a list of behaviors (at least 10) that she could do instead of throwing things that might actually calm her down and not get her in trouble (like listen to music, shoot baskets, tell someone how she feels, do some deep breathing, distract herself, etc.). She knows she can't control whether or not she gets angry, but now she has some tools to deal with that strong emotion.

When any of us behave irrationally or explosively, we are letting our emotions control us--instead of being in control of our emotions. Since teenagers usually resist anybody or any "thing" controlling them, they really relate to this concept. We can also remind them about past times when they did a good job of controlling their emotions. There are circumstances where they probably wouldn't act that way (like in front of a boy or girl they are trying to impress!)

All of us have trouble at times managing our emotions. But we can learn how to control our thoughts and our behavior-it might take a little work, but in the end it will definitely get us more of what we want. That's an offer many kids (and adults) find difficult to refuse.

Pamela Lowell is a social worker and national presenter in the area of ambivalence and permanency issues for foster and adopted teens. She recently published the award-winning children's novel Returnable Girl, about a teen in foster care who lies, steals and throws things when she's upset.
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