Most days I think about how dog training has influenced my therapeutic style. If you are a client, you have probably heard some of my favorite dog stories.

I often talk about how I forgot my training and turned my dog Sadie into a frightened mess of fur whenever a thunderstorm rolled through. It was pretty cute when she was a puppy and would cuddle up next to me for protection. I’d pet her and say whatever silly dog stuff you say to your dog when she’s scared. Now, she weighs well over 60 pounds and when she gets too close between her fur, dog breath, and weight—it’s not quite as cute.

Let’s take a look at what I did wrong with Sadie and see what lessons I can learn.

I recently ran across a Behavioral Intervention Plan (BIP) for an elementary school girl. Behavioral Intervention Plans are often a good idea and can be used to teach students to focus better, reduce their oppositionality, follow rules more often, and become more cooperative. These plans usually emphasize positive interventions (such as rewards and attention) although they also employ negative consequences judiciously, when called for.

The original idea behind BIP’s was grounded in something called learning theory. In brief, learning theory proposes that kids will do more of what they are rewarded for and less of what they aren’t. They’re also likely to engage in disruptive behaviors less often if those behaviors result in a loss of something the child likes or if the behavior is followed by a mildly unpleasant consequence.

However, some of the BIP’s that I’ve seen in recent years seem to have lost their original grounding in learning theory. The school girl I mentioned (we’ll call her Nicole) had been failing to follow rules, blurting out inappropriate comments in class, banging her head, arguing with the teacher, and sometimes trying to leave the classroom when she shouldn’t. Here are some relevant snippets from Nicole’s BIP:

Parents worry a lot about their kids nowadays. Life has become more complex and the world seems to deliver a constant stream of unpredictable stressors, challenges, calamities, toxins and traumas. Parents naturally want to help their kids overcome these difficulties and succeed in life. In other words, they want their kids to feel happy, secure, and competent.

So naturally, many parents feel quite upset when they see their kids experiencing distress. At those times, they feel highly motivated to help their kids calm down. To accomplish that goal, these parents will often:

• Explore what may be bothering their kids

• Reassure their kids that everything will be alright

• Hug their kids to help them calm down

• Talk with their kids for as long as it takes to help them feel better

• Find ways of making their kids feel better by giving them things they want (e.g., ice cream, money, etc.)

Generally speaking, one or more of these strategies will, in fact, result in both kids and their parents feeling better. There can’t be any problem with that can there? Well, actually there is.

We have been writing this blog for a few years. When we started, we decided to call the blog Anxiety and OCD Exposed. It’s been a long time since we have discussed why we decided on that title so we thought that new readers might want some explanation.

The term “exposed” may bring up a lot of different thoughts such as:

• Finding out that a politician was cheating on his wife
• Discovering a dumping ground of toxic waste
• The feeling of your hands when you forget to wear gloves in cold weather
• A politician taking opposite positions in the same campaign
• Not noticing the piece of toilet paper stuck to your shoe
• The most effective treatment for anxiety and OCD

Research says that overall the best treatment for anxiety and OCD is a method called exposure. When people are afraid or anxious about something, they tend to avoid it. The more they avoid what they fear, the more fearful they become.

Exposure helps people face their fears in a gradual way. Most people find that after being exposed to their fear or OCD triggers, over a period of time, their anxiety decreases. The goal of exposure is not to eliminate all anxiety, but to make anxiety manageable.

I’m pretty sure that I came out of the womb as a cognitive behavioral therapist. Well, maybe a behavioral therapist—I guess I wasn’t using language those first few months. But, I’ve always been acutely aware of how rewards, lack of rewards, and thinking all interact and influence feelings and behavior.

In my early training, I considered myself a radical behaviorist. I still do pretty much. I believe that the words we use and the thoughts we think can be considered verbal behavior. But, those beliefs are much more complex than what I wish to discuss today.

When children are afraid of something, adults often reassure them. Many kids are afraid of the dark or of monsters under the bed. This fear usually starts sometime around preschool and is a great way to delay bedtime or to keep a loved one hovering around the bedside.

Many millions of parents, with good intentions, have said to their scared kids, “Don’t worry, there’s nothing to be afraid of.”

Most scared kids willingly accept their parents’ reassurance. They might get an extra hug or a night light or one more bed time story. Gradually, they outgrow their fears. But some kids don’t easily grow out of their fears. They may just be prone to anxiety or sometimes they get too much attention from their caring parents.

These kids’ fears may get them extended routines of reassurance such as long rigid rituals that must be performed each night before they sleep. And many exhausted parents give up and extend an invitation to their frightened children to sleep with them in their beds.

Kids don’t generally develop anxiety disorders all on their own. Oh sure, genes and biology have some influence, but these factors largely just predispose kids in the direction of acquiring problems with anxiety. The wrong messages can push both anxiously disposed kids as well as otherwise normal kids in the direction of struggling with anxiety for the rest of their lives.

If you’re a parent or someone who cares about kids, you just might want to know what type of messages instill insecurity. I’ll start by laying out three common mistakes that parents make; in other words, the kinds of messages you “don’t” want to give them:

It’s report card time here in New Mexico and I am getting lots of phone calls from parents who have recently had parent teacher conferences. By far, the biggest referral I get is for kids who are suspected of having attention deficit disorder (ADD or ADHD).

Almost 20 years ago, I began collecting material for my dissertation which was about the relationship between ADHD, empathy, and perspective taking (the ability to understand that other people have thoughts and feelings). At that time, I was curious to learn more about a disorder that appeared to be increasing within the population. The majority of researchers believed that ADHD was, in most cases, related to genes or a problem during the pregnancy or birth.

Like most professionals, states require psychologists to keep up with current research through continuing education. Yesterday, I attended a lecture on the differential diagnosis of ADHD and or Bipolar disorder in kids. Not surprisingly, the water is muddied by the similarity of some of the symptoms and the fact that most kids with Bipolar Disorder have other problems such as ADHD, Learning Disabilities, Opposition Defiant Disorder, among others.

Another problem the presenters mentioned was that today there are 40 times more kids diagnosed as bipolar than in the mid-1990’s. Thus, the presenters raised the questions as to whether we are seeing more kids with bipolar, are we better at spotting this diagnosis, or are we over-diagnosing kids with bipolar disorder? Additionally there are troubling concerns that only a few research teams are responsible for most of the research on this topic.

Last week Chuck wrote a blog about what questions you should consider asking your therapist. He was talking about the importance of feeling mutual trust within the therapeutic relationship. Today, I want to continue a discussion of the therapeutic relationship.

The other day, I was sitting on a curb in Santa Fe waiting for a parade. Beside me were a bunch of little kids. There was a long wait and finally a few firemen marched by. That was the parade. When the firemen reached the bandstand, there were several speeches, and then they started to put flowers down in front of the bandstand in honor of 9-11 firefighters who died.