Biography 
Dr. Greene is the author of The Explosive Child, co-author ofTreating Explosive Kids: The Collaborative Problem Solving Approach, and has a new book, Lost at School: Why Our Kids with Behavioral Challenges Are Falling Through the Cracks and How We Can Help Them.                           

Nanci - The Balanced Mind Foundation  
We are delighted to welcome Ross Greene, PhD as our guest for today’s chat. Dr. Greene, would you like to make any opening remarks? 

Ross Greene PhD  
Not really...thanks a lot for inviting me to this! I'm happy to answer any questions people might have. 

Nanci - The Balanced Mind Foundation  
Before we start taking questions, could you talk a little about your new book? In particular, the concept of Collaborative Problem Solving and Plans A, B and C? I realize that is probably broader than what can be covered in a session but it might help give our members a 'sneak peak' to the book. 

Ross Greene PhD  
Well, a lot of folks have been asking about how the model I described in The Explosive Child could be applied in schools. Kids with behavioral challenges tend to be misunderstood anyway, and school is an especially challenging place to address their needs. But I've implemented the CPS model in many schools, so I know it can be done. The book -- Lost at School -- is about how to do it. 

mamax3  
Dr. Greene, what recommendations might you have for kids who struggle in a classroom with 20+ kids but do well in a smaller setting? 

Ross Greene PhD  
The challenge, as always, is to figure out what skills a kid might be lacking and what problems are reliably and predictably precipitating the kid's challenging episodes. So, in the circumstance of kid doing better in a smaller setting, I'd try to figure out what it is about the larger setting that seems to be getting in the kid's way and whether there are solutions that might help the kid stay in the larger setting. But it's different for every kid. I've come across a lot of kids who could have stayed in a larger setting but ended up getting moved to a smaller setting because no one figured out what lagging skills and unsolved problems were making life difficult for the kid in the larger setting. 

lp  
What is the difference between anxiety and stress? How do they relate to emotion regulation skills and what "other skills" are there that relate to an explosive child. 

Ross Greene PhD  
You can find the entire list of lagging skills I look for by logging on tohttp://www.lostatschool.org/  (I'm not self-promoting, just want people to know where to find it). Click on the ‘What's Different’ tab. As for the difference between anxiety and stress...hmmm...I think both may be too vague for me to sink my teeth into. I find it a lot more productive to focus on very specific skills (for example, difficulty organizing one's thoughts, difficulty moving off of one's original idea or solution, etc.) and very specific unsolved problems (for example, getting homework done, being in the same room with one's brother, etc.). 

chickie  
Hi Dr. Greene. What is a good strategy for introducing homework when a child is resistant without making things overwhelming? Or should homework be dropped? 

Ross Greene PhD  
Well, in the parlance of Collaborative Problem Solving, just dropping it would be "Plan C." And just making him do it -- often this results in a full-blown challenging episode...that's "Plan A." But trying to figure out what it is about the homework that's getting in the child's way and trying to come up with a solution that would address the child's concern...that's "Plan B." And that's what I spend my waking hours trying to help people learn how to do well. 

momwithbpteen  
I'm a special education teacher and a mom of a 13 yr old son with BP. I'm very worried because the teachers in our schools are not educated about Bipolar kids (my son had early onset). I have to bring in educational books and videos to meetings and to the school counselors/teachers to inform them. It's quite disheartening. Can you enlighten me on what can be done to push for better educating our teachers??? 

Ross Greene PhD  
As a teacher, you probably understand that most educators don't receive a whole lot of training in dealing with kids with social, emotional, and behavioral challenges. So, because there are a lot of such kids in our classrooms, teachers are at a bit of a disadvantage...a lot of the kids are presenting with difficulties that are poorly understood, and school discipline tends to be set up to respond to such difficulties in a very reactive, emergent, punitive way. 

So we've got a lot of work to do to help educators learn about kids with behavioral challenges and provide them with the tools to deal with such kids more effectively. It's something I'm spending a lot of time doing these days and, of course, Lost at School is my attempt to disseminate the information on a wider scale. 
But, just as an example, the entire town of Sanford, Maine -- all seven public schools, the police department, etc. -- is in the midst of being trained in the CPS model. Between January (when the project started) and the end of last school year, discipline referrals at the junior high school had already been reduced by 58 percent!

Nanci - The Balanced Mind Foundation  
That's a tremendous result! 

cello  
We have tried collaborative problem solving with our son only to have him be unable to follow through on his end of the agreement. We feel betrayed by his lack of commitment. Any suggestions on what we might be doing wrong or how to address this? 

Ross Greene PhD  
That's usually a sign of a few possible ways in which Plan B can go awry.

 Sometimes it means that the kid's concern wasn't well-understood in the first place (so the solution didn't really address it).

 Sometimes, it's a sign that the kid had other concerns about the problem, but didn't articulate them (maybe because the issue had never been discussed before so he needed more time to think about it). 

 And, often, it's a sign that the original solution wasn't as REALISTIC and MUTUALLY SATISFACTORY as we may have thought it was. It's important not to agree to solutions that one of the two parties (the kid or the adult) can't actually do, and even more important to make sure that the solution truly addresses the concerns of both parties. 

The reality is that with Plan B -- as in real life -- the first solution seldom solves the problem durably. So I could just as easily have called the model "Progressive Problem Solving" or "Incremental Problem Solving"...the goal, of course, is to learn from the solutions that didn't quite get the job done so as to inform future solutions that will. 

teddyone  
Dr. Greene - The Explosive Child book is wonderful! Do you have any advice on motivating a bp child to get out the door on a school morning when he starts to hate school? Also, any advice on how to help a bp child to respond when they are shut down? Yelling to get their attention seems to escalate the child. 

Ross Greene PhD  
You're going to notice that my answers tend to have a common them to them. If a child is balking at going to school, we need to figure out why...if we don't understand why, then the problem (whatever it is) won't get solved and he'll still have trouble getting out the door on school mornings. 

This goes without saying, but yelling to get a child's attention tends not to be an effective strategy. But we need to realize that the child is shut down for a reason (and a good one at that).  The idea is to figure out what's causing the child to shut down...what specific problem...and to discuss and try to resolve the problem PROACTIVELY....so you don't find yourself trying to intervene once he's already shut down. 

Little by little...one problem at a time...the child should be shutting down less often because the problems causing him to shut down are better understood and there are solutions in place to address his concerns. 

Nanci - The Balanced Mind Foundation  
I think it's actually helpful for us to see how the same general approach can apply in different situations. Often we are so close to the issues, so burned out, that we lose objectivity and the ability to step back and look at the bigger picture. 

Ross Greene PhD  
Yes, that's why the more "micro" level of analysis...lagging skills and, especially, unsolved problems...tends to be helpful to people. If what we're working on is too vague, we won't end up working on much of anything!

Nanci - The Balanced Mind Foundation  
Thanks Dr. Greene, you're doing a great job of answering all of our questions! 

jf  
Can you address how CPS might be adapted for children with Asperger’s and/or non-verbal learning disabilities? My son seems to have trouble with the approach, thinking that everything is negotiable and there are no definitive rules/expectations. It seemed to increase his argumentativeness. 

Ross Greene PhD  
Well, what you'll notice about me is that generic descriptions -- in this case, Asperger's or NLD -- don't give me much information about a kid.

So I need to move beyond the generic descriptions and get to specific lagging skills. Kids with Asperger's disorder, NLD, and other diagnoses on the autism spectrum, tend to be very black-and-white thinkers. The question for jf is "Why has your child come to the conclusion that everything is negotiable and there are no expectations? And how can we work on that?” But it depends a little on what you mean by "definitive expectations/rules." If your child is having difficulty meeting an expectation or abiding by a rule, then you have a problem to solve. In Collaborative Problem Solving, you have three options: Plan A, Plan B, and Plan C. 

Plan A increases the likelihood of challenging behavior. Plan C means you've dropped the expectation. It's only with Plan B that you're trying to understand why the child is having difficulty meeting a particular expectation and trying to work toward solutions that address his concerns. 

psychgirl  
What are the major differences (observations of behaviors) between a student with Bipolar, ADHD, MOOD that can help educators understand these disorders and better address their social/emotional needs? 

Ross Greene PhD  
Ah, now I'm going to be a little controversial. I apologize in advance! I don't think your goal is to understand the disorders. If I tell you that a kid has ADHD, I really haven't told you anything about his lagging skills or about the problems that are reliably and predictably precipitating his challenging episodes. Same for any other disorder. I've found that our over-emphasis on diagnoses makes it HARDER -- MUCH HARDER -- to understand challenging kids and figure out what it is that we need to do to help them. 

jake  
Dr. Greene: Do multiple very early psychological traumas (prematurity, multiple moves in first weeks of life, ultimately adoption overseas) result in the same kind of explosive behavior often seen in children with Bipolar Disorder? Do you recommend the same kinds of interventions for these children? What role to medications and talk therapy play in these children when we think the issue is not biochemical and the trauma was preverbal. 

Ross Greene PhD  
I warned you about all my answers starting to sound the same, yes?! We really can't do anything about a child's premature birth (once he or she is born)...nor about the multiple moves in the first weeks of life, or the fact that he or she is adopted...the best we can do is figure out what skills the kid is lacking now, what problems are precipitating challenging moments now, and get to work on them!  As for meds, there are some things meds do well and other things meds don't do well at all. The important thing is to know the difference...otherwise, we run the risk of depriving a kid of medicine for things that medicine helps with (hyperactivity, impulsiveness, mood enhancement, short fuse) or putting a kid on medicine for things medicine doesn't do well at all (the teaching of lagging skills and the collaborative solving of problems).

Nanci - The Balanced Mind Foundation  
Here are a few questions that are a little broader in scope, focusing on working with the school system. 

Fritzy  
How do you get your school to adapt the Collaborative Problem Solving? My school wants proof it works. 

Ross Greene PhD  
There are many studies going on right now in schools that will provide lots of evidence for the fact that the CPS model is effective in schools. There are already published studies documenting the effectiveness of the model (albeit not in schools). I'm hoping the new book helps...and I'm hoping that the recognition that what's being done now isn't terribly effective will help folks in schools try something new. 

annelise  
What can be done when a school presses charges against a child, landing the child in the juvenile justice system? How can this be prevented in the future so the (non-criminal and unstreet-wise) child doesn't end up at a juvenile detention home? 

Ross Greene PhD  
In Maine, some people actually try to get the kid into the juvenile detention system because they feel that's the place for the kid to receive the best care (the entire juvenile detention system in Maine is implementing the CPS model). Of course, schools tend to press charges when they're not sure what else to do about behaviors they've had difficulty understanding and addressing for a long time. 

The way this can be prevented is for us to do the hard work of making sure schools understanding kids with social, emotional, and behavioral challenges better and provide them with practical, realistic, effective tools to meet these kids' needs better than we do now. I'm an optimist...I think it's possible, and I've seen it happen in a lot of places already.

Sean  
Dr. Greene - 1st thank you for your work - with the use of CPS model and its positive effects - it has worked for our child both in our home and at school- do you have examples of where this can be expanded into the larger community like the WrapAround approach - or is CPS a one on one approach? 

Ross Greene PhD  
Thanks, Sean. My project in Sanford, Maine is the first in which I've examined whether CPS can be applied in an entire community. It's going really well...and there are tentative plans to expand the community-wide intervention to other towns and municipalities. So, no, CPS is not merely for one-on-one interactions. In fact, it's not solely applicable to adult-child interactions either. 

Nanci - The Balanced Mind Foundation  
So all of us stressed out parents can use this with our spouses? :-) 

Ross Greene PhD  
My experience is that having one's concerns heard and understood and working toward mutually satisfactory solutions serves adults well, too! Even spouses! And with some of the problems we're facing these days, it seems like CPS is just what the doctor ordered! 

judy  
Is there a specific type of therapist we should be looking for to assist us in using Collaborative Problem Solving? 

Ross Greene PhD  
If they don't have expertise or training in the CPS model, then you're looking for an open-minded one at the very least. Family therapists are often well-qualified to do things that are somewhat similar to CPS even if they aren't familiar with the model. 

phyllis  
Dr. Greene - how do you know when to go from basket B back to basket C? In other words, if our daughter is showing stress during the process of learning and staying with "homework-schoolwork productivity", is making progress yet at the expense of irritability at home, eating disorder (over eating) popping up, when do you back down into just leaving it alone? Not pushing the homework? (ohhh... this is indeed complicated.) 

Ross Greene PhD  
Well, there are certainly times when you'd decide to drop an expectation, possibly because you have bigger fish to fry and want the kid to be "available" for the problems you really do want to be working on. But what you've described sounds to me like whatever solution is in place for homework isn't working very well right now and should be revisited. That doesn't necessarily mean moving to Basket C (I now call it Plan C)...it may mean a return visit to Plan B to get a handle on why the current solution isn't working. 

Momof2
We use your 3 basket method only for our 16 year old bipolar daughter. Our 14 year old non-bipolar daughter sees this as unfair. She thinks her sister gets away with more bad behaviors.  We have tried to explain this.  Can you give us an explanation that she might accept?

Ross Greene PhD  
You could try to explain it...or you could use Plan B with your 14-year old non-bipolar daughter, too! With this model, no one is "getting away with anything." We all have things we need to work on...concerns that need to be heard, validated, and addressed...problems that need to be solved...skills that need to be taught. So my bet is that your 14-year old would respond well to Collaborative Problem Solving, too.

jerrypb  
Many of the residential schools that accept children (12-18+) with BP hold fast to CBT, talking about how "research shows" that this model works best. Many of these look down at psychotherapy/play therapy. My child has been substantially helped over the last 7 years by psychotherapy and is now "disallowed" from pursuing it while at his residential school. What's your position on psychotherapeutic help for kids with mood disorders? 

Ross Greene PhD  
"Psychotherapeutic help" is a bit vague for me...but I sure would hate to deprive a kid of a treatment that's been working for them. 

Deb  
Can CPS and DBT (dialectic based therapy) be used concurrently? 

Ross Greene PhD  
There are certainly some similarities between the two models. I wouldn't see why not.

cmd  
Dr. Greene, How can I help my child see the "big picture"? He gets stuck on a negative thought and can't get around it. Example would be "If I'm late and miss 2 hours of school, I'll be counted as absent anyway so why bother going?" Can't understand or doesn't care that the work will be waiting for him when he returns. 

Ross Greene PhD  
Tough question to answer through this format, but I'll try. In one respect, your kid is right (about the being counted absent part). I'd need to hear more about what he's thinking along those lines, and this would help me determine what part of the "big picture" he was missing. That would be accomplished through the Empathy step of Plan B. Sounds like you have some legitimate concerns as well...i.e., the work will be waiting for him when he returns. 

The third step of Plan B would involve you and your son trying to come up with a solution that works for both of you. But that won't happen unless your son's perspective is well-understood so you can take it into account. Hope that helps! 

Nanci - The Balanced Mind Foundation  
We are just about at the end of our hour so this will be our last question. 

Chaos  
My son has been turned away from two mental health centers and a third just stopped his therapy cause she was short term and they didn't get along she even called him a nice cuss word to his face...and he doesn't go to school and here in NY I have tried all that I know and he is still just on meds with no therapy no support anywhere. Where do I turn for help? 

Ross Greene PhD  
A very tough situation...not knowing the resources that might be available in your area, I'm not positive where to direct you. So let me suggest that you log on to http://www.lostatschool.org/, click on the contact tab, fill out the form, and let me and my colleagues know exactly where you live, and we'll see if there's anyone we know of who can help. 

Nanci - The Balanced Mind Foundation  
Dr. Greene, thank you so very much for your time and expertise. You fielded a tremendous array of questions and shared so much valuable information with our members. We all appreciate the work that you do on behalf of our children. 

Ross Greene PhD  
My pleasure! Thanks for having me!