How does CPS differ from anger management programs?

In placing primary emphasis on training children to manage their anger, many existing programs are quite explicit in targeting an “identified patient” (the child) and lose sight of the transactional nature of the child’s interactions with the world. Moreover, such training typically takes place in the therapist’s office outside of the contexts in which the child is having difficulty. The child is then sent back into the “real world,” armed with new skills so as to be the primary agent of change. We don’t think that’s a particularly realistic treatment approach. In the CPS model, training involves all relevant interaction partners; in other words, there is no identified patient. Thus, the training takes place in the environments where the child is having the greatest difficulty and everyone learns the skills.

Can CPS be implemented in tandem with contingency management procedures? In other words, can the two models be used together?

In a few research studies, the two models have been combined, and with good results. However, as a matter of practice, we generally stay away from combining the two models. The two models are often incongruent with regard to philosophies and explanations for oppositional episodes, which can leave adults feeling quite confused. Confusion tends to make people head for familiar ground – imposing their will.

My background is in learning theory, and the CPS model is making me a little uneasy. You seem to be saying that oppositional episodes do not cause a child to learn that adults will capitulate to his or her wishes. Does this mean that you think no learning is occurring? How can this be?

In its focus on antecedent events, cognition and situational specificity, learning theory is actually the central theoretical underpinning of the CPS model. What we question is the automatic assumption that a child has learned that challenging behavior is an effective means of seeking attention or coercing adults into capitulating. Thus, we also question the automatic premise that what a child needs to be taught is that his challenging behavior will not attract attention (adults typically teach this lesson by withdrawing reinforcement, otherwise known as ignoring, or time-out, or suspension from school) and that adults will not even discuss the concerns that caused the child to become frustrated in the first place (thereby ensuring that capitulation will not occur).

In actuality, there are many other things a child could have learned from his or her repeated challenging episodes. He might have learned that when he becomes frustrated, his adult interaction partners often become frustrated as well, and that this compounds his initial frustration. He might also have learned that his adult interaction partners become highly inflexible and rigid themselves when he becomes frustrated, and aren’t exactly sure how to proceed in a manner that will effectively reduce his frustration. He most certainly has learned that punishment is often the end result of these episodes, and that the punishment doesn’t seem to be making things any better. It follows that there are many alternative things a child could be taught; for example, that adults are able to respond to his frustration in a manner that reduces agitation, resolves frustrations in a mutually satisfactory manner, teaches lacking thing skills, and makes things better.

What do you tell parents or teachers who want to know how to tell the difference between when a child’s behavior is manipulative and when it is driven by a lack of skill?

We don’t know anyone who can reliably distinguish between the two patterns – especially at times when reliable distinctions are most important (with a frustrated child in front of you!). The children with whom we work typically lack the requisite skills (forethought, planning, impulse control, organization) for competent manipulation. There’s really no risk in using CPS even with children who are “convincingly manipulative” because a mutually satisfactory solution requires that both the child’s and the adult’s concerns be addressed. We often ask ourselves, “Why is this child going about getting his or her concerns addressed or needs met in such an apparently manipulative or indirect fashion?” The answer that usually applies: “Because the more direct route to having his concerns addressed or needs met has historically been blocked (by adults imposing their will).”

What are the most common problems you see in therapists trying to implement this model?

We find that, early on, many therapists attempting to implement CPS don’t feel completely comfortable assessing the lagging thinking skills found on the Pathways Inventory and continue to describe children’s difficulties using diagnoses. Remember, a diagnosis gives no information about the specific thinking skills a given child may be lacking and therefore does not point therapy in a direction as it relates to what skills are to be trained. Clinicians new to this approach are often too eager to jump to intervention – usually because they want to be responsive to the family’s level of distress but also because they are excited to have some practical tools to offer – and therefore completely bypass the assessment of lagging thinking skills. But there is a danger in introducing intervention strategies before the parents have been convinced of the existence of cognitive skills deficits and signed on to their new role. So long as a parent still believes that a child is willfully misbehaving, that parent will have no rationale for practicing CPS. Finally, we find that many therapists have been trained to be good and empathic listeners and are therefore reluctant to be as directive in therapy as the CPS model demands.

How can I become certified in CPS as a clinician?

We do not formally certify clinicians or trainers, but we do offer Advanced Training Seminars for clinicians as well as a wealth of other resources to learn the CPS model (click here).