05

Parenting “Difficult” Teens

by Bryan Jaffe

“NIGHTMARE WOULD BE PUTTING IT MILDLY,”
Christine said of raising her twenty-two-year-old daughter Michele, who is diagnosed as having ADHD and oppositional defiant disorder (ODD). “For a long time I wasn’t sure what would happen. I was afraid she was going to end up in jail or worse.” Molly faces a similar situation with her fifteen-year-old son Thomas, who also has ADHD and exhibits characteristics of ODD and/or a conduct disorder (CD).

Parents of children and teens with ADHD already know that they face additional challenges and hurdles, and defiant children with ADHD can make those challenges feel like a minefield.

ImageMichele’s story

While Michele was growing up, her parents embodied two very different philosophies. Her mother believed that more structure and harsher consequences would “set her straight,” while her father felt that she needed the freedom to figure out who she was with as little interference as possible.

“It was horrible,” Christine said. “There we were giving her two completely different messages when we really needed to work together. I worried that she was going to get herself into a situation she might not be able to get out of. My husband felt she should be free to explore and deal with whatever consequences resulted from her actions.”

Christine’s fears were realized one night when, at age sixteen, Michele snuck out of the house to go to a party she had been forbidden to attend. She also took her mother’s car keys and “stole” the car.

“The phone rang and woke us up. It was after eleven and we couldn’t figure out who would be calling at that hour,” Christine said. When she picked up the phone, she learned not only that Michele had snuck out and taken the car, but that she had been pulled over by the police, who confiscated several ounces of marijuana and put Michele in jail.

“I was ready to go down, bail her out, and pretty near kill her myself at that point,” Christine recalled. “I had tried so hard to keep her from making these mistakes and to keep her safe, and nothing worked. My husband refused to let me go and bail her out, and said if I did that, Michele would never learn that her actions had consequences.” After a heated disagreement, Christine and her husband John decided they would post Michele’s bail in the morning.

“It was the scariest night of my life,” Michele said of her stay in jail. “I was in there with some really bad, scary looking people. I didn’t belong with them! And I couldn’t believe my parents didn’t come for me right then and waited until the morning!” Looking back, she acknowledges that it was probably the right thing to do, because it gave her a very strong image of what she wanted to avoid.

“I never wanted to go back there. There were a few times where I was about to do something stupid,” she said, “and I thought back to that night, which stopped me.” After the arrest, Michele was evaluated again, by a new psychiatrist, and diagnosed with ODD in addition to her ADHD. “It was rough,” Michele said of the process. “It was a whole new way of doing things, and it led to a lot of arguments still. But I knew I had to make it work somehow, or I might end up back in jail or worse.”

The real breakthrough for Michele came when she found what has turned out to be her calling. She had never achieved much in the way of academic success and considered a report card of straight Cs cause for celebration, but she had always excelled at art projects. She spoke with her parents at length, explaining that she wanted to transfer to an academy for students with artistic abilities. Her parents recalled that her art and music teachers had often told different stories than the “Michele never behaves or listens in class” they usually heard in teacher conferences.

They reached an agreement to try it out semester by semester. If she did not live up to her end of things, Michele would be pulled out of the academy and returned to her public school. But this never became an issue. While it was not always easy going, and problems did crop up as a result of her tendency toward defiance, Michele was able to focus most of her energy into something she loved, and did not want to risk losing. She is now working full-time creating graphic images and designs for an advertising company.

Thomas’s story

Molly is still where Christine was seven years ago. She has no idea what the outcome will be in her situation with Thomas.

“As far back as kindergarten [Thomas’s] teachers were telling us he had difficulty with his attention,” Molly recalled. “We had an idea of where this might be going, having had a friend whose son had ADHD, so we took him for an evaluation early on.”

Thomas was diagnosed with ADHD and put on a treatment plan. But he continued to struggle in school, which Molly attributed at the time to the school’s failing to provide adequate accommodations.

“I didn’t realize at the time that these were behavioral problems that would lead where they have today,” Molly said. “He was never happy with his situation, in school or at home. He would always say he was bored because he could not do what he wanted.”

Despite continuing to struggle in school and exhibiting oppositional and defiant behavior, Thomas continued to move up from grade to grade, until his eighth grade year of middle school. That is when Molly says everything fell apart.

“He had no interest in his classes or his work, he was only interested in impressing his peers,” Molly said. “[Thomas] was sent to an alternative school after he assaulted another student and threatened to kill him, and he actually did well there. It was highly structured, and there were small goals to meet each day and consequences.”

Predictably, when he returned to his traditional school, Thomas’s struggles resumed. After a tumultuous school year, he went to a summer camp and almost made it through the summer, before sneaking off with a friend during a camp trip and getting caught smoking marijuana.

With high school looming, Molly wanted to move Thomas into an alternative school environment like the one he attended in eighth grade that seemed to work for him.

“I communicated to him that a normal school environment was not working for him,” Molly said. However, Thomas wanted to stay where he was, with his friends, and told Molly that she could not make him go. He said he would run away if she tried. He then proceeded to run away twice in the next couple of weeks. The first time, the police brought him back after a few days.

“The second time he ran away, I got a call from the police that he had shoplifted some electronics and food and stolen someone’s bicycle to use as a getaway vehicle,” Molly said. “He was arrested after a couple of days.”

With this going on, Molly’s parents, who she said blamed her for Thomas’s behavioral problems, began to become more involved with the situation. They undermined much of what Molly had tried to do to get control of the behaviors. Her parents invited Thomas to stay with them if he was unhappy at home. They do not impose the kind of structure Molly has been working to implement.

“My husband and I are seeing a psychologist now who specializes in how to handle difficult children, but my mother refuses to see him,” Molly said. “He is living with them now because I’ve placed boundaries and they won’t.”

Because the family members are not on the same page and working together, Molly said she will never be able to make any structure work because her parents will continue to undermine her efforts. She has tried to explain the problem to her mother, but has been rebuffed and told she’s “a horrible parent.”

“My mother is enabling this behavior by not placing boundaries or consequences,” Molly said. “He’s been there for a few weeks and occasionally goes to school, and continues to skip class when he does go. He’s stopped taking his ADHD medications since living there.”

Molly does not see a resolution to this situation. Short of moving to another state, far from her parents, she is not sure how to keep Thomas away from them and at home.

For her part, Molly admits that she wishes she had come to terms with these behaviors earlier on. “Had I sought out help earlier, and not had my blinders on, maybe things wouldn’t have escalated to this point,” Molly said. “For anyone else, I would tell them don’t just depend on medication and accommodations. If there are problems that keep happening, find help.”

Molly hopes she can avoid a repeat of this pattern with her younger child, who has displayed similar behavioral challenges. She is applying the psychologist’s treatment plan for her daughter and feels it is making an impact.

“What we have in place now is to focus on two behaviors we want to work on,” Molly said. “Just two. And we write them down, post them up, set small, reachable goals, and follow through. Rewards are given daily and should be tangible. Consequences are given as needed, but before that, if the child is getting off track, there should be a warning to try and steer things back on track.”

No easy answers

There are no easy answers for parents who live with defiant teens, but there is hope. Having the right treatment plan in place with a professional who specializes in treating children with difficult behaviors is a key component of the best chance at success. In addition, rules and boundaries must be set, and consequences must be felt. Finally, catching the issues as early as possible, before they take root and grow larger, can go a long way toward preventing the problem from reaching a seemingly impossible point.

Parenting children who rebel at every turn is a daily battle, and even having a treatment plan in place will not guarantee smooth sailing. As Molly’s experience so painfully demonstrates, it is absolutely essential for a defiant teen to get the same message from all important adults in his or her life. Defiant teens can be very skilled at finding weaknesses in even well-structured environments, so ensuring that parents and all caregivers are on the same page is essential.

Hope and Help for Parents

What can a parent do when faced with defiant behavior above and beyond what even most parents of children with ADHD must face?

A starting point can be found in the NRC’s information sheet 
What We Know #5B, Coexisting Conditions: Disruptive Behavior Disorders. Basic advice offered includes: obtaining parent training, family therapy, and a system known as Collaborative Problem Solving. The fact sheet offers some resources for parents and lists some books that can help parents take the first steps towards reducing such behaviors.

One book that is of particular help is Your Defiant Teen by Russell A. Barkley, PhD, Arthur L. Robin, PhD, with Christine M. Benton. This book speaks specifically about teens and has a narrower focus than books that focus on defiance in children of various ages. Your Defiant Teen sets out a ten-step program for parents to institute and recommends finding a professional familiar with the system who can work with parents to implement treatment.



Bryan Jaffe is a writer-editor for the National Resource Center on ADHD: A Program of CHADD. An abridged version of this article appeared in the November edition of NRC News.

This article originally appeared in the February 2012 issue of Attention magazine. Copyright © 2012 by Children and Adults with Attention-Deficit Hyperactivity Disorder (CHADD). All rights reserved. No portion of this article may be reproduced without written permission from CHADD.
Posted in: 2012, February