PMT Parent Management Training ( Barkley) vs CPS Collaborative and Pro-active Solutions (Greene)

This is part of an email discussion about using PMT – Parent Management Training and CPS – Collaborative and Pro-active Solutions as treatment models for kids with challenging behavior. I reached out to some Prof whom name I mistakenly mistook as someone who was an SDT advocate – Self Determination Theory . I discontinued the discussion because he was conflating autonomy with independence and structure with control , implying that he did not or did not want to understand what SDT was all about .

Thanks for your quick response.  I apologize for asking some more questions . You write 'In my opinion there is more than one way to increase autonomy in children – and CPS and PMT are two of the ways. Some children need more external “controls” to help them develop autonomy whereas other do not. Thus, both can be effective in this regard. No mystery here – there are multiple pathways to any one outcome as many of us have written over the years.

I can appreciate that some kids need more structure , but one can do that without being controlling. From what I know about SDT , and I think you have done much research on the SDT model , using extrinsic motivation and controlling parents places the locus of control with the parents and this  impacts negatively on autonomy and on intrinsic motivation. So can you refer me to the literature or give me an explanation to solve this mystery.

I think part of the issue here is the word “controlling” – while it is true that the parent remains the parent and has a responsibility to do so, in PMT the parent collaborates with the child in identifying targets for change and in selecting reinforcers for consequences. This is a process, and the child is involved at each and every step. Developmentally, I believe most of us think that external “control” is needed to achieve “internal” control. The key here is to use what you refer to as “control” to instigate the behaviors – to prompt them, occasion them, and consequate them  - as the child is able to gain control of his or her behavior, the external contingencies are removed. Kohn greatly overstates what actually goes on in PMT – PMT done well helps the child become autonomous.      

'With both treatments we want families to get along better and the children to flourish – both can accomplish this goal.' 

Again my difficulty – PMT is based on parental authority and getting compliance, CPS is more of a working with, collaborative approach so getting along and children flourishing can mean different things to different families. A consensual and more democratic relationship or more of a conditional and  controlling environment – and that imho impacts on autonomy and IM.  Maybe all parents share  the long-term goals of better relationships and flourishing children , the short-term goals of compliance using contingencies , rewards and consequences and praise  to enforce behavior means that their emotional needs of unconditional acceptance are not being met. So my comment about the Alice in Wonderland was if the goals and parenting philosophies are so different  we must know what we want from our research -  to measure compliance and that kids are less trouble now  or are we meeting their emotional and developmental needs of autonomy, competence , relatedness  and also a commitment to the values underlying behavior.

In my opinion, the problem with your position is that your assumptions are wrong – PMT is not solely based on “parental authority and getting compliance” as you suggest.  There is much more to it – you might wish to read Russell Barkley’s manual and books on PMT where he does a good job of talking about the processes involved. By the way, I also think that the child’s “emotional needs of unconditional acceptance” is grossly overblown. I am not sure where your support for “unconditional acceptance” is coming from and whether it is a “need.” I can see how if you really believe this, you would think that PMT is as you suggest. Again, it is not and children do not have a need or unconditional acceptance – where is the evidence for this? If it exists I am unaware of it.  

About Alfie Kohn you say :  Much of it is not grounded in science and it needs to be desperately evaluated before it is promulgated the way it has been.  From what I understand and have read it is heavily based on SDT so could you briefly elaborate here

A place to start here is a scientific review of SDT – might you provide me with that? All things, in my opinion, do not need to fit in the SDT model to be valid and clinical useful – thank goodness for that!    

Self Determination Theory ( based also on Punished By Rewards , A.Kohn)

Non-traditional progressive approaches to parenting and education focus on " working with " children are informed by the Self Determination theory, a theory about human motivation, development and well-being. SDT does not see motivation as a unitary phenomenon, with differences only in magnitude. The question is not how to motivate people, but how are people motivated. If they are more intrinsically motivated identifying with the inherent value of the activity and find it interesting and enjoyable, they will be more engaged, persistent, and this will impact positively on their well-being. When the motivation is extrinsic as when they feel coerced, controlled or pressured into doing something or do not find value in what they are doing, people are less motivated, unengaged, less persistent and this impacts negatively on well-being. 40 years of research shared also by Alfie Kohn in the book Punished by Rewards has shown in the many domains of life when people's needs for autonomy (not to be confused with independence), competence and relatedness are met - people are self- determined, intrinsically motivated and experience a sense of vitality and well- being.  Autonomy is not independence, but the feeling that my actions and words are volitional expressions of intentional choice and are endorsed at the highest level of reflection, and connected to my inner being. Competence is the feeling that one is competent to act affectively in the world and make a contribution to others. Relatedness is the feeling a sense of belonging to a group, a community, caring for others and being cared for.

Traditional approaches are informed by behaviorism and focus on" doing to " children with extrinsic motivators - rewards, punishments, praise, criticism, helping parents be more assertive, consistent and contingent in order to get compliance.

The consequences of autonomous motivation are that performance, wellness, interest and engagement are greater and can be maintained over a long period of time. Controlled or external motivation is doing something to get something else, to avoid punishment or negative feelings when the person feels pressured, demanded of, and obliged.  In the short term, a promise of reward or a threat of punishment are very powerful motivators but in the longer term they undermine intrinsic motivation, performance and well-being.

People are often involved in tasks which are often not inherently interesting or enjoyable, yet they identify with the underlying value and purpose of the activity. This is called identified and integrated regulation. One would be willing to subject oneself to a security check at the airport because one identifies with the value and purpose of the check.  You could be motivated to change your life style because of your health issues, learn new skills or mathematics because they would be necessary for a dream job, or you may even believe that it is important to know mathematics or change your life style. People may have even assimilated and integrated the goals and values into their personalities, yet while they see value, they   have no interest in changing a life style or learning mathematics for its own sake and they don't find mathematics or the different life style pleasurable. Externally regulated behavior is the least autonomous and is performed to get a reward, praise, avoid punishment and negative consequences, comply with a demand. Introjected regulated behavior comes from a sense of ‘‘ought-to,” shame, ego, or other social pressures associated with a task. It is " internally " controlling. This form of regulation is brought about by contingent self- esteem and by a desire not to seem incapable in the eyes of classmates, or to receive approval positive regard from parents or teachers. It is internal like the drive for " perfectionism " or being a "work alcoholic ". While this is internally driven, introjected behavior has an external perceived locus of causality, or not coming from one's true inner -self, like externally regulated behavior. Since the causality of the behavior is perceived as external, the behavior is considered non-self-determined. Intrinsic regulation is characterized as a belief that the learning task is stimulating and interesting, that accomplishment in and of itself is worthwhile, and that studying and knowing new things is pleasurable.

The process of becoming more autonomously and intrinsically motivated is called internalization. Internalizing the value and relevance of a task or behavior occurs when the basic needs for autonomy, competence and relatedness are supported.

Many educators are aware that punishment, consequences and threats are counterproductive. Making children suffer is unlikely to help children become ethical, compassionate decision makers and generates anger, defiance, and a desire for revenge, it models the use of power rather than reason and ruptures the important relationship between adult and child. Carrots in the form of rewards, incentives and praise, turn out to be no more effective than sticks at helping children to become caring, responsible people or lifelong, self-directed learners. So why do rewards fail.? When anything is presented as a prerequisite for something else -  do this task and you can get that – the task comes to be seen as less desirable. Rewards are usually experienced as controlling and we don't like it when the things we desire are used as levers to control our behaviors. There is a tendency to associate any success to the reward and without the reward the person would not have done the task. The message the child infers is, “This must be something I wouldn’t want to do; otherwise they wouldn’t have to bribe me to do it or praise me when I do it or the activity itself is not worth doing for its own sake , so the only reason I am doing it is for the reward.” Thus Rewards reduce interest and intrinsic motivation in the task. Extrinsic motivation co-opts intrinsic motivation and this is most profound when rewards are stopped, as kids have no longer a reason to do the task. Kids who were invited to play with another child so that they could get access to his toys or were offered cookies for playing with the child, were less interested in playing with the other child on future occasions. Studies showed when kids were received a reward for evaluating puzzles or an unknown drink, those who did not receive a reward developed a taste for the drink and did not want to stop playing with the puzzles, while those who were offered the reward stopped playing as soon as they received the reward and when offered free drinks at a later date, those who were paid to drink, did not take up the offer while those who did not receive the reward took the free drinks. Students, meanwhile, become less excited about learning once they’ve been given a grade or some other reward. The focus is now on extrinsic performance goals rather than finding interest, purpose and meaning in the learning. Kids will only learn for a test and if work is graded. This leads to avoiding challenging tasks and has a negative effect on creative thinking, long-term retention, and internalization. Awards for attendance to counter increasing absenteeism have the opposite effect. While attendance increases at the beginning because of the chance of getting award, the effect wears off and when the awards are no longer given, attendance decreases. Even when awards for attendance were given unexpectedly for good attendance, attendance thereafter decreased. Giving kids an award for attendance instead of helping them find good reasons to want to come to school not only reduces interest but has also gives the unintended message that they are better than the norm and this gives them a license to miss school in the future. Just like praising a kid for effort gives a message that he is a loser so does giving an award for something expected like attendance. Rewards are addictive -The problem with rewards is that they are addictive and kids become very dependent on them. The only reason why kids do or do not do things is to get a reward or avoid punishment. Because kids are so unmotivated we repeatedly need to offer rewards which again reduces interest in the task. The problem is also that when rewards co-opt intrinsic motivation and preclude intrinsic satisfaction, the extrinsic needs become stronger in themselves. Thus people develop stronger extrinsic needs as substitutes for more basic, unsatisfied needs. They end up behaving as if they were addicted to extrinsic rewards. The claim that we need to use rewards because a task is uninteresting or kids are unmotivated is just fueling the situation and the last thing we should be doing is giving rewards because they undermine interest. Promising a reward to someone who is unmotivated or demotivated is like offering salt water to someone who is thirsty, it's not the solution, it's the problem.  Rewards do motivate. Rewards motivate kids to get more rewards. Rewards impact negatively on achievement Groups that were rewarded if they were successful at solving a puzzle, writing a poem or doing something creatively did worse than those who received no reward. When people put off doing something — which often happens when a task seems unappealing — a reward offered for finishing early either didn’t help or actually led to increased procrastination. Rewards interfere with moral and spiritual development, commitment to values.  A number of studies, for example, have shown that children are apt to become less concerned about others’ well-being if they were rewarded earlier for helping or sharing. When the rewards stop, people usually return to the way they acted before the program to promote being generous and sharing began. Children whose parents make frequent use of rewards tend to be less generous than their peers. A child promised a treat for being generous and acting responsibly has been given every reason to stop doing so when there is no longer a reward to be gained. Rewards promote cheating to get more rewards. Kids learn to ask what will I get or with punishments, what will be done to me, instead of asking what kind of person do I want to be, does my behavior reflect my values?. Rewards ignore reasons. Instead of helping children find meaning and reasons why they should do certain things or behave, their motivation becomes the reward. Instead of dealing with underlying problems we give rewards which only get temporary compliance and only compensate for lagging skills. Rewards don't teach skills. Rewards punish. The carrot becomes the stick when kids don't get the reward. Rewards punish because they are experienced as controlling. Rewards rupture relationships -They focus on individualism; create competition and conflict between kids where complaints of unequal treatment and playing favorites are common. It interferes with efforts to promote collaboration, cooperative learning and a sense of community which improves the quality of learning. Rewards also interfere with a genuine and trusting relationship with a teacher where a kid feels safe to be open, expose his vulnerability, admit mistakes and ask for help when problems develop. It is the judgmental nature of rewards and praise that encourages kids to try and impress and curry favor with the person handing out the rewards. Rewards are a tool for ' doing to ' kids, control and manipulation through seduction, rather than ' working with ' kids in an unconditional way. Kids feel valued and accepted only if they behave as they are told and do well in school.

A discussion focusing on informational feedback and encouragement for future progress is much better than praise or a reward. Rewards like those given on computer games are experienced as informational revealing kid's level of competence and future opportunities available to improve competence support intrinsic motivation. Perceived competence only helps intrinsic motivation when the kid feels autonomous.  Children are likely to become enthusiastic, lifelong learners when the focus is on competence and not performance and competition as a result of being provided with an engaging curriculum; a safe, caring community in which to discover and create; and a significant degree of choice about what and how and why they are learning.

An introduction to Collaborative and Pro-active solutions

Collaborative and Pro-active solutions , originally known as the Collaborative Problem solving approach was created by Ross Greene , and can be accessed through his books and non-profit organization Lives in the Balance. CPS can be described as a model of care in which adults work with children in a respectable and compassionate way , to improve cooperation and solve problems that give rise to challenging behavior and in the process facilitate the acquisition of important life skills . The focus is not on behaviors , but the underlying problems and lagging skills that give rise to those behaviors. Unlike other models which are informed by behaviorism , CPS does not believe that challenging behavior is caused by passive, permissive , inconsistent parenting,  or parents not being firm , assertive ,consistent or contingent enough , rewarding good behavior and punishing bad behavior. Challenging behavior occurs when the demands placed on kids outstrip their skills to react in a flexible , adaptable way and problem solve. These lagging skills  can be viewed as a developmental delay in the general domains of flexibility/ adaptability, frustration tolerance, and problem solving . The mantra of CPS is that children do well if they can and not children do well if they want to. Kids prefer to do well than not to do well , we don't have to bribe them to wanna behave and succeed .Only kids that have been rejected and have had their concerns ignored so long  by adults and have lost hope of any adult taking their concerns seriously seem not to care any more. It might be appropriate to bribe a kid to overcome a refusal to  participate in a worth while and beneficial activity. Rewards might appear to work, but they just compensate for the lagging skills , don't teach skills and get in the way of dealing with problems because for  sure a reward won't fix a problem. Rewards undermine intrinsic motivation and any impact is only short-term. In fact the CPS process itself  is rewarding for child, in  that the child and his concerns are taken seriously and problems get in the way of his success are being solved. If the CPS model is concerned about lagging skills , how does it differ from other approaches that teach lagging skills in a top down manner and use rewards to reinforce these skills. ? These approaches focus on teaching skills in order to fix the child , so his behaviors are appropriate. CPS believes that skills must be taught in the context of unsolved problems. The child does not always exhibit lagging skills except in situations, conditions where the expectations and demands placed on him outstrip his skills to behave adaptively. Secondly , we don't want a situation typical of traditional ' doing to " approaches where all the unsolved solved problems in the child's world never get solved because we were too busy fixing  the child.  CPS is not trying to fix the kid so he meets adult's expectations but to solve the problem from the child's as well as the adult's perspective .

Education and parenting is very much about creating structure  either by using Plan A , imposing adult will , Plan B – collaborating with children and Plan C – putting certain expectations for the time being on the shelf. CPS does not conflate structure with control , so structure , boundaries , values, guiding principles, expectations  of a family or school are worked out together in discussion with children. Problems are solved the same was, collaboratively using Plan B so the kid is a fully invested participant, solutions are more durable, and (over time) the kid -- and often the adults as well -- learn the skills they were lacking all along. Plan B is comprised of three basic ingredients. The first ingredient – called the Empathy step – involves gathering information from the child so as to achieve the clearest understanding of his or her concern or perspective on a given unsolved problem. The second ingredient (called the Define Adult Concerns step) involves entering into consideration the adult concern or perspective on the same unsolved problem. The third ingredient (called the Invitation step) involves having the adult and kid brainstorm solutions so as to arrive at a plan of action that is both realistic and mutually satisfactory…in other words, a solution that addresses the concerns of both parties and that both parties can actually perform. Plan B is best done pro-actively. After listing a child's lagging skills in the context of unsolved problems ( the lagging skill is to ensure that we are wearing the right lenses , that children do well if they can and not children do well if they want to) , we prioritize and select problems 2 or 3 problems that are high priority like safety or problems that are causing the most disruption, to work on . We Plan C other problems by putting them in the meantime on the shelf. Dropping some of our expectations is important to reduce conflict and negative interactions and create a calmer atmosphere that allows for building of connection and trust. Plan B is more successful when there is connection and a good feeling between parent and child. Plan A is when the parent in a unilateral way imposes his will on the child. Plan A , the use of power  increases the likelihood of challenging episodes and won’t solve any problems durably.

The CPS model is recognized as an empirically-supported, evidence-based effective treatment. The question " effective for what " needs to be asked. It goes beyond targeting behaviors , a parents' need for discipline and control. It meets the criteria of Self Determination theory that children's well-being is supported when their  needs for autonomy – feeling self-directed and intrinsically motivated  , competence and relatedness are supported. This means that all children, not only challenging kids deserve to be taken seriously, treated in a respectable, compassionate manner and their needs addressed. The child's autonomy is supported because his perspective and concerns are important, and need to be articulated . The child is part of the solutions , generating choice rather than choosing solutions which the adult has laid out. Parents report that they feel it is the first time they have been heard as kids are now listening to their concerns. The process teaches both adult and child many skills in an indirect way. They both learn to articulate concerns and perspective, listen to others , empathy ,take perspectives of others, seeing how your behavior impacts on others ,conflict resolution , problem solving –clarifying concerns, define a problem and try to find mutually satisfying , realistic solutions that requires skills such as planning, foresight , hindsight etc. The approach promotes communication , connection , belonging , caring for others and feeling that you matter. Boundaries and limits are important for children. Parents and teachers are actually setting boundaries in a collaborative way when their concerns are being addressed by the mutually satisfying solution. The model promotes socio-moral learning and commitment to values as  kids learn to set their own boundaries and take into account how their behavior impacts on others.  In a sense Plan A can be viewed as the adult being the authority figure and imposing his will on children. For sure there will be times and situations that demand this, of course with an explanation, but children are more likely to accept parents' decisions because they know that parents take into account their concerns when making decisions that affect them. Leadership and being authoritative are expressed using Plan B and not Plan A. One's authority  is not derived from one's status as the authority figure but because of one's personality and leadership qualities that enable one to work with people, guide them, solve problems in a collaborative way, influence and inspire them. CPS enables our children and even more so the challenging ones to be the catalyst and source of enormous emotional growth, empowerment and leadership. In fact the research ( Greene 2004)  shows that parents who were trained in using CPS felt that they were much better at setting boundaries than parents who received PMT – Parent management that helps parents achieve compliance by being  more assertive and contingent . CPS is simple but not easy to do , but these skills are always being learned on the way. Education is a process , but the journey of consensual living is worth the effort and commitment .