The information in this program outline is provided by the program representative and edited by the CEBC staff. The Think:Kids program has been rated by the CEBC in the area of: Disruptive Behavior Treatment (Child & Adolescent).

• Types of Maltreatment: Does not target any specific kind of maltreatment
• Target Population: Children and adolescents with a variety of behavioral challenges, including both externalizing (e.g., explosions, meltdowns, tantrums) and internalizing (e.g., implosions, shutdowns, withdrawal).  The children and adolescents carry a variety of psychiatric diagnoses, including Oppositional Defiant Disorder, Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, Mood Disorders, Bipolar Disorder, Autism Spectrum Disorders, etc.

Think:Kids teaches an approach for helping children with behavioral challenges where through training, support and clinical services, the understanding that challenging kids lack the skill, not the will, to behave well is promoted. Specifically, skills related to problem solving, flexibility, and frustration tolerance are emphasized. Unlike traditional models of discipline, this approach avoids the use of power, control, and motivational procedures and instead focuses on teaching at-risk kids the skills they need to succeed.

Not long ago, kids who had trouble reading were thought of as lazy or dumb. Today, people recognize that these kids have a learning disability that simply requires a different method of teaching. Think:Kids aims to accomplish a similar shift in perspective and practice with behaviorally challenging kids. Rather than try to motivate these kids to behave better, this approach teaches skills through a process of helping adults and kids learn how to resolve problems collaboratively.

The goals of Think:Kids are to:

• Pursue high priority adult expectations.
• Reduce challenging child behavior.
• Create (or restore) a helping relationship between the adult and the child.
• Clarify what crucial thinking skills need to be taught to the child and start teaching them.
• Solve chronic problems so they don’t keep coming up.
  

The essential components of Think:Kids include:

• Assessment of the specific thinking skill deficits and unsolved problems that are setting the stage for the challenging behavior. There are five main areas of thinking skill deficits:
• Executive Functioning
• Language Processing
• Emotion Regulation
• Cognitive Flexibility
• Social Skills
• Delineation of the three specific and unique options for responding to unsolved problems/unmet expectations and what each accomplishes:
• Plan A – Imposition of adult will
• Plan B – Solve the problem collaboratively
• Plan C – Drop the expectation (for now, at least)
• Successfully engage in proactive problem solving in a collaborative manner in order to solve problems durably, pursue adult expectations, reduce challenging behaviors, teach skills, and create or restore a helping relationship.

Think:Kids was designed with a child component that addresses the following presenting problems and symptoms:

• A range of internalizing and externalizing behaviors, including (but not limited to) physical and verbal aggression, destruction of property, self-harm, substance abuse, tantrums, meltdowns, explosions, implosive behaviors (shutting down), crying, pouting, whining, withdrawal, defiance, and oppositionality.

Age range: 3 – 21

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Caregivers, educators, and other supports are essential to the success of the approach.  Caregivers, teachers, etc. are taught the approach, and are given opportunities to practice the approach with the child, so that they can intervene outside the context of the clinical setting. Caregivers are introduced the approach through various means such as parent training workshops, written materials, and video and online trainings. Individual sessions with a therapist provide the opportunity for more intensive work.  Typically, these sessions involve the parents as well as the child and are used to practice and troubleshoot the problem solving process.  Parent groups can also occur and these can take the form of a more open-ended support group facilitated by a certified mentor (typically a parent who has utilized the approach with their own child(ren) and have gone through the Think Kids’ mentor certification process) or a time-limited psychoeducational multifamily parent group.  These groups tend to be either monthly or biweekly.  School staff typically learn the model via single or multi-day workshops and through follow-up training and consultation.

Think:Kids was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

• Challenging, oppositional or defiant behavior from the child as well as other social, emotional and behavioral challenges.

Think:Kids was designed to be conducted in a group setting; but has not been tested for use in a group setting.

Recommended group size:

Approximately 12 people

Testing References:

Recommended Intensity:

Typically family therapy once/week for approximately 1 hour. In the sessions, the child/adolescent is the identified patient, but the parents are heavily involved in the sessions so that they can get better at doing the approach with their child on their own. The approach can also be delivered by educators in a school system (often via a school mental health person or an administrator, but sometimes directly by the classroom teacher) and in a therapeutic milieu, again via clinical staff or directly by line staff.

Recommended Duration:

8 – 12 weeks

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home
• Community Agency
• Foster Home
• Hospital
• Outpatient Clinic
• Residential Care Facility
• School

Think:Kids includes a homework component:

Delineation and prioritization of unsolved problems, reduction of imposition of adult will, practice of problem solving process.

Think:Kids has materials available in a language other than English:

French

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

The typical resources for implementing the program are:

Trained personnel. Parent support groups and multifamily psychoeducational groups require a room big enough to hold the number of families (anywhere from a couple of parents up to 12 or so). Therapy sessions are conducted in typical therapeutic settings, such as a residential facility, inpatient unit, outpatient clinic, or private practice settings, and require the typical clinical set-up.

Program can be implemented by any of the following trained individuals: a certified parent mentor (parent, grandparent, child care provider), a school mental health provider, or a clinician (any mental health clinician such as a licensed psychologist, master’s level psychotherapist, licensed social worker, etc.).

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:

• Beth Edelstein, Director of Outreach and Support Programs
  Think:Kids at Massachusetts General Hospital
  info@thinkkids.org
  phone: (617) 643-6300

Training is obtained:

Onsite, local (in Boston), video/phone consultation.

Number of days/hours:

Ranges from 1 day introductory session to more intensive (2-3 day) advanced sessions as well as hourly consultation and supervision.

Additional Resources:

There currently are additional qualified resources for training:

There are many certified trainers throughout North America who teach the model as well. The list is available at http://www.thinkkids.org/map/.

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being