Think:Kids program for kids with serious challenges

In this column, I am happy to announce that we are developing a relationship with Massachusetts General Hospital’s Think:Kids program. This program, also known as the Collaborative Problem Solving model, has grown out of the work of Stuart Ablon, Ph.D., and is designed to help children, families and care providers deal more effectively with challenging behaviors.

Children who frequently shut down, become defiant or explosive may respond to traditional behavioral strategies such as limit setting, time-outs and other consequences and rewards.  Unfortunately, many children are not able to respond to these approaches. In fact, some get worse and enter a spiraling process of escalating behaviors and loss of functioning. Often these children end up in more restrictive situations like specialized schools, residential programs and hospitals and are prescribed medications to reduce these behaviors.

Effect of the Think:Kids Collaborative Problem Solving model on restraints/seclusions at Yale-New Haven Children’s Hospital Inpatient Psychiatry Unit

The Think:Kids Collaborative Problem Solving model emphasizes that children do well if they can, and if they are not doing well, it may not be because they won’t but because they can’t. It is our job as adults to help figure out what is getting in the way and to support the child in succeeding.

Often children with serious challenges have specific lagging abilities in processing information, language comprehension, regulating emotions, being flexible and other key areas. By approaching children differently, we create opportunities for empathetic relationships that can dramatically reduce challenging behaviors.

A number of institutions in Oregon have successfully utilized this approach to reduce or eliminate restraining kids, and our providers have observed many occasions where the need for psychiatric medications were reduced or eliminated as well.

The basic tenants of this approach are described at the following websites:

The Division of Child and Adolescent Psychiatry at OHSU Doernbecher is dedicated to serving children and families in the Northwest through compassionate clinical care, broad-based research and innovative training of future health care providers. In the months ahead, our faculty will share research outcomes and clinical advice that we hope readers will find informative and helpful.

Ajit Jetmalani, M.D.
Head, Division of Child and Adolescent Psychiatry
OHSU Doernbecher Children’s Hospital