Collaborative Problem Solving

BY CHAD STEELE, M.ED., LMHC, AMS-C II

When children fail to meet adult expectations, adults need a plan. Collaborative Problem Solving (CPS) offers an innovative approach to respond to children and adolescents with social, behavioral, and emotional challenges. The model, developed by Think:Kids, a program of the Psychiatry Department of Massachusetts General Hospital, is based on the belief that children with challenging behaviors lack the skill, not the will, to solve problems, handle frustrations, and be flexible.

This evidence-based approach puts forward two beliefs: that such challenging behaviors are the result of underdeveloped thinking skills (rather than attention-seeking, manipulative, limit-testing, or poor motivation), and that the best way to meet these challenges is through teaching the necessary skills (instead of the imposition of adult will or reward and punishment approaches). The mindset behind CPS is acknowledgement, rather than confrontation.

CPS lays out three options to respond to behavioral challenges in children:

• Plan A: When adults impose their authority/will to make a child meet their expectations (these are “my” rules, “my” orders. For example, an adult orders a child to take out the trash). A reward may be offered or punishment/ consequences may be threatened if the expectation (taking out the trash) is not met. Plan A is based on the idea that basic consequences can teach lessons.

• Plan B: When adults work together with children to solve problems in mutually satisfactory and realistic ways. (The adult asks why the child hasn’t taken out the trash, and they discuss options for accomplishing the task.)

• Plan C: When adults drop their expectations, at least temporarily, when Plan A is unsuccessful. (The adult takes the child’s stress into account, recognizes the child has homework, and either takes out the trash or let’s the chore wait.) Plan C reduces challenging actions by the child, but does not focus on the relationship between child and adult.

Plan B is the heart of the Collaborative Problem Solving model. The plan takes into account the child’s reasoning for his or her actions (the trash wasn’t taken out because of homework), addresses the adult’s concerns (the trash needs to go out because the garbage pickup is soon), and helps the child work on problem-solving skills with the adult to assess potential solutions and choose one that is both realistic and mutually satisfactory (arrives at a way in which the trash is out on time and the child completes his/her homework). Plan B gives the child the first opportunity to initiate the mutually beneficial solution. For example, an adult might ask a child, “Do you have an idea that will get both of our needs met?”

Plan B enables children with behavioral issues to become more competent. Unlike Plan A, the child has a vested interest, and unlike Plan C, the child does not have to take action on his or her own. (If a child cannot figure out simple tasks such as how to take out the trash on time and complete homework, how can we expect them to navigate social, school or work situations in the future?) Plan B addresses all of these issues. However, the adult reserves the right to choose any of the plans when there is an unmet expectation.

Plan B offers versions for specific situations, but all are collaborative.

• Proactive Plan B (described above) works best with the proper assessment of a child’s lagging skills in problem situations or unmet situations.

• Emergency Plan B is used in a crisis.

• Spontaneous Plan B is when a child catches an adult off guard with a request.

The objective of Collaborative Problem Solving plans A, B, and C is to decide which is going to best help a child at a certain time, in certain circumstances. Behind most challenging behaviors, there are problems to be solved and skills to be learned, and CPS advocates not letting any challenging episodes go to waste. Just like the recognition that children with learning disabilities require a different way of teaching, children with behavioral challenges require a more adaptive approach to improve their behaviors.

Since its introduction a decade ago, Collaborative Problem Solving has been shown to be an effective approach to solving such challenges. In 2015, the national assault rate in a child and psychiatric unit was 5 percent; at Centra it was 3.5 percent, well below average.

Today, as a result of implementing CPS at Centra, the inpatient unit assault rate is .3 percent. CPS also has reduced the use of restraints and seclusion in units across the country. Where it is used in schools, CPS has led to reductions in detentions, suspensions, injuries, teacher stress, and alternative school placements.

Its success lies in a variety of factors. Instead of seeing children as manipulative or starving for affection, CPS encourages professionals to consider five categories of skills: language and communication, attention and working memory, emotion and self-regulation, cognitive flexibility, and social thinking skills. Through CPS, professionals take into account skills that are lagging and are able to offer a more compassionate approach to a child’s behavioral challenges. With the underlying mantra that kids do well if they can, CPS offers an effective way to solve problems, build relationships, and instill confidence in children with behavioral challenges.

Chad Steele, M.Ed., is a licensed mental health counselor and certified anger management specialist with the Child & Adolescent Psychiatric Program at Centra Virginia Baptist Hospital.