Often with parenting, we find ourselves too close to an issue within our families to figure out a solution. Although we may know what we need to do, we may find it challenging to follow through. This was the case for Miranda and her husband, Mark. Even though Miranda herself is a family therapist with a thriving practice, she knew she needed expert guidance to get her family on a better path. So Miranda and Mark contacted EFC.
“All good therapists have a therapist,” says Miranda. Recognizing that her family’s issues were beyond her scope was the first vital step in restoring family harmony.
Miranda and Mark have three daughters: Dawn, Olivia and the baby, Emily. It’s a busy, busy life. Mark works full-time (before and during Corona) and Miranda keeps her practice active, working part-time while providing the lion’s share of the childcare. But sibling tensions and conflicts crept into the family’s life in late 2019, escalating after baby Emily was born, with big-sister Dawn often in conflict with Olivia, two years her junior. Miranda found herself too often refereeing these pint-sized conflicts – and getting caught up in power struggles with her 5-year-old daughter.
As a therapist, Miranda knew she had to address the pattern of escalating conflict. Trained in attachment parenting, which promotes positive parenting and peer attachment, she found herself without adequate resources to “do the discipline piece.” She knew she needed to set boundaries within her daughters’ secure attachment, but she didn’t know how.
As a “spirited” child, Dawn can be headstrong and determined – qualities that will serve her well in adult life, Miranda notes, but that can make the unpredictable conditions of everyday life challenging. For example, when Dawn created a game or pretend-play scenario, she tolerated no interruption – and utterly rejected participation by her little sister. Miranda knew that she had to help Dawn learn how to self-regulate, to de-escalate conflicts and to better manage her own distress. They tried a bunch of techniques, but Dawn’s outbursts persisted – and increased.
“When she was in that out-of-control place, we didn’t know how to get her back – or what consequences to put in place”
It felt to Miranda as if the family centered around Dawn, which she knew wasn’t good for Dawn, her younger daughters, or for the marriage. Both parents found themselves tailoring their actions and activities to prevent Dawn’s meltdowns. The secure attachment Miranda and Mark prized was “really important,” Miranda says, “but that alone wasn’t doing it.”
“When she was in that out-of-control place, we didn’t know how to get her back – or what consequences to put in place,” Miranda says. That’s when she reached out the EFC, and was matched with Imani Williams, a therapist in the Parent-Child Interaction Therapy (PCIT) program.
Imani introduced an evidence-based set of strategies to help Dawn and her parents cope with Dawn’s outbursts – and eventually, help her to become more cooperative and responsive to her parents’ requests. As its name suggests, the PCIT experience focuses on two main elements, child-directed interactions and parent-directed interactions. Each is designed to nurture parent-child connection and establish clear, neutral boundaries and expectations. The process itself is not time-limited, although most families complete the training in four to eight months, with clinician visits three times a week. (In-person visits have been suspended due to the novel Coronavirus; digital visits and telephone calls help us continue to support our clients.)
Before getting into the disciplinary nuts and bolts, Imani helped Miranda and Mark “lay a good foundation.” They were taught to set aside daily Special Time for their two older daughters: five minutes a day for each child, when the parent’s attention is only on the one child, without any sort of correction, direction, distraction or expectation – just being together in a low-key, non-confrontational moment. During Special Time, the child leads the interaction, and the parent’s task is to follow: to affirm, reflect, and connect with their child – or children, in Miranda and Mark’s case. Imani visited the family at home three times a week to monitor their progress; seeing them interact at home gave her insights into family dynamics when she wasn’t visiting.
“It doesn’t sound like a lot, but it's a lot to schedule in” for both of the older girls, Miranda recalled. “It’s a very structured way to play, and doing it daily was a challenge. But it’s there to make sure the relationship is strong and secure.”
Things started to shift when Imani taught the family how to use a dedicated time-out chair, an approach that empowers the child to take charge of her own feelings – and develops her ability to recover, acknowledge the challenge, and rebound appropriately. It also permits parents to establish a safe physical and emotional distance from their child, so everyone can take a breath and calm down.
Before PCIT, when Miranda would ask Dawn to pick up her blocks, for example, Dawn would simply refuse. If Miranda pressed her, she’d throw the blocks or pitch a tantrum. Miranda felt like she didn’t have a recourse. What’s more, she felt herself get escalated and triggered with each conflict. Imani taught the family how to use a time-out chair, reinforcing the lessons on her frequent visits. Essentially, once a child goes to the time-out chair, she must sit for a few minutes (generally, in tune with a child’s age – 3 minutes for a three-year-old, for example), until her emotions have settled. Then, she must be able to sit quietly for 5 seconds – a blink that can seem an eternity to a frustrated child – after which, she is invited to return to the activity and carry out the parent’s original request. Parents are tasked with recognizing their child’s success when the child is calm enough to return. (Another protocol addresses reluctant chair-sitters.)
Once the family mastered time-outs, conflicts diminished. Now, on the rare occasion when Dawn is resistant, Miranda mentions the timeout chair, and “nine times out of ten, she does what’s asked. I don’t feel powerless, and she knows there are consequences.”
“With this specific protocol, we all together learned” how to manage and defuse conflict, Miranda says today. Especially helpful in the home setting was giving Dawn the chance to practice her newfound skills with her one-time nemesis, Olivia. As a bonus, Olivia learned to use the same tools, and both girls better understand that their actions have consequences. Mark wanted in, too. He requested that Imani train him on his day off in how to use the time-out chair.
“With this specific protocol, we all together learned” how to manage and defuse conflict”
“I know parents need a time-out, too,” says Miranda. “But Dawn would follow me and hit me. I felt enraged and powerless. I’m so far from a perfect parent, but I’m relatively emotionally healthy, I have a healthy marriage and enough financial resources. I was dealing with things in myself I’d never seen before.”
“It gave me more empathy for people living with more stressors,” says Miranda. “Made me grateful that it was all right here in Durham.”
The Exchange Family Center serves and supports Durham County residents with free resources, strategies and techniques to help families better understand, anticipate, and address interpersonal issues and family conflicts.