See also The Therapeutic Pause Technique for Teaching Skills

The Therapeutic Pause technique can be useful for setting limits on behavior, ensuring that children cooperate with demands, or for enforcing rules.  It can also be used when a parent has to deny something that the child wants, and the child refuses to accept it.

Uncooperative behaviors usually are attempts to gain control of a situation, resulting in a power struggle between the parent and the child.  Some children have more of a need for control than others.   Other children have excessive needs for control, finding it difficult to trust anyone or anything that is not entirely predictable or subject to his will.

But the plain fact is that parents have to “control what child has control of.”  To maintain this control, they sometimes cause their children to feel bad, and the result of children’s bad feelings can sometimes be quite unpleasant.

The Therapeutic Pause technique minimizes unnecessary frustration and intrusion into the child’s body space.  It doesn’t eliminate uncomfortable feelings however.  Instead of using coercion (coercion is defined here as any form of inducement, incentive, “reinforcer,” threat, or punishment used to motivate a child to cooperate), the parent seeks to control elements that interfere with the child’s cooperation.  When the parent can or will not give the child what he wants, the parent controls elements that interfere with the child’s acceptance (coping) of the situation.

ControllingInput

One of the most important things to control is the amount of “input” the child deals with after he has been asked to do something.  This is necessary whenever a child processes information slowly or has difficulty dealing with a lot of sensory or language information at one time.  This is why the continuation of prompting (i.e. cajoling, reminding, directing, or threatening) and other forms of sensory or language input can actually have a detrimental effect on cooperation.  The increased input can actually slow down or interfere with the child’s thinking.

While it may seem counter-intuitive, it is usually better to make the demand, set the limit, or whatever, once – without repeating.   After the parent makes the demand, he or she waits for the child to initiate the steps required.  This can take quite a while sometimes, depending on what is going on inside the child’s head.  Sometimes, the motor planning required (initiation and execution of the actions in sequence) can take the child a seemingly inordinate amount of time to “process.”  Sensory input (especially language), can interfere with the process, and it can also force the child to being the mental processing all over again.

How long should you wait, and when should you repeat what you’ve said?

The rule of thumb is: don’t repeat yourself unless you are sure the child has actually forgotten what you’ve said.   Most uncooperative behavior is to avoid something – indicating that the child has not forgotten.  In this case, repeating not only interferes with mental processing – it undermines your authority.

Just make sure that when you give directions you do so when you have the child’s undivided attention and that you do so in a manner where you can be sure he understands.  You shouldn’t have to repeat yourself after that.

There may be times when due to attentional or working memory issues, a child cannot execute the full series of actions required and can get lost.  Even in such a case, it is better not to be too direct about prompting.  Instead, do as little as possible in assisting your child think for himself.  Allow time to refocus, and use non-specific cues (e.g. “Remember what you were doing?”  …or a look or gesture that asks the same thing – but that doesn’t require the child to process spoken language).

Sometimes, the parent has to wait until the child accepts the demand.  More often than not, uncooperative behavior is what the child does to avoid negative feelings such as frustration, disappointment, anger, etc.  When the Therapeutic Pause technique is used, the assumption is that the demand or limit is fair, attuned (based on an empathic and sensitive understanding of the child’s needs and perspective), and within the child’s ability to deal with it.  When this is the case, the parent remains emotionally available for the child when demonstrations of empathy are needed.  Hugs, sympathetic statements (e.g., “I know, you really wanted that ice cream.”  “It’s hard to wait.”), soothing tones of voice are all available – but should not be overdone.  The parent has to allow the child to come to acceptance mostly on his own – and the parent should allow the child to learn from his feelings.

Avoidmaking deals” or offering unnecessary choices

A lot of the time, making deals and offering choices are really attempts to bypass negative feelings for both parent and child.  Parents do this when the child’s reaction to negative feelings is uncomfortable for them, or when they feel the child cannot handle the negative feelings.

It is often helpful to “reframe” the situation: some lessons in life are just plainly difficult!  Uncomfortable feelings go along with difficult realities.  By using the Therapeutic Pause strategy, the child is allowed to come to terms with the reality and the feelings in the presence of the most compassionate people available – his parents.

This is not a blanket rule.  It is a value decision.  Sometimes, a child needs help to realize that there are other choices, or that first something else has to happen and then he can have what he wants.  Children with disabilities or who are upset may have trouble thinking of those things.

It’s the attitude that makes the difference.  When parents make deals or offer unnecessary choices, they do it with a certain urgency that has the unintended effect of communicating to the child that “this is really as bad as you think it is!”  We don’t want children to be afraid of feeling bad.  We want children to eventually understand that negative feelings are unavoidable sometimes, but they are always temporary and they are not life-threatening (you wouldn’t know it by the way some children overreact).  Therefore, when parents do offer choices or soothing words – they have to communicate in a sympathetic, but ‘matter-of-fact’ manner.  The child is allowed to reject the choices, but the parent should not struggle too much to come up with something else in hopes of avoiding an unpleasant situation.

An uncooperative child can be expected to do whatever he can to avoid negative feelings or to skirt demands, limits, and rules.  He may try to go do something else that he wants, or he might engage in the type of behavior that is punishing to the parents (e.g. whining, arguing, screaming, hitting, breaking, etc.).  These behaviors can have the effect of dropping or changing parental demands, which merely encourages more of the same.

ControllingAccess

Access to distractions, unauthorized alternative activities and the like can also interfere with cooperation.  Therefore, it is important that parents not allow the child to do anything else but what he’s been asked to do.  Venting and other unpleasant behaviors are seen as part of the process of a child accepting his choices and are allowed (within limits), but going and doing something else is not.  Children feel safer and are happier when they know their parents will rein in their unwise and inexperienced choices.

On the other hand, attempting to take something out of a child’s hands or physically preventing them from doing something can be problematic – especially with bigger children.  The struggle can make the problem worse or end up hurting someone.

In order to avoid this, the parent prevents access to anything further.  The child will eventually want something else or try to do something else.  The parent prevents that – before whatever it is gets started.  Here are some examples of how this works:

Mom asks junior to put on his shoes and junior refuses.  She does however prevent his leaving the house until he puts his shoes on.
Dad asks junior to clean up his room, but he takes no action.  He shuts the TV off and doesn’t allow him to play with anything else or leave the room. 
When the child realizes what is happening, the child could react with protest behavior.  The parent continues to stop the action until the child accepts the demand or limit.

So here is a brief review of the steps:

  1. Make sure you have the child’s undivided attention before giving a direction, setting a limit, or making any type of demand.
  2. Tell the child what you want in a manner you are sure he can understand.  Check for his understanding.
  3. Stop the Action until the child cooperates.
  4. Continue on after he cooperates without undo congratulations or thanking.   Be sure to show you’re pleased – just don’t overdo it.  The child is just doing what he is supposed to do.