Conscious Discipline: A Constructive Approach to Behavior Modification for Children

August 24, 2020 Mark Wilhelm

“Discipline is not something you do to children; it is something you develop within them.” — Dr. Becky Bailey

As many parents would attest, few things about raising children are easy. On top of the substantial commitments of time and resources that children require, parents must also determine how best to guide their children as they learn, grow and develop as individuals. Providing discipline can be a significant part of this process, which leaves parents with the additional task of deciding how they ought to do it.

The old adage “spare the rod, spoil the child” suggests that punishment (and in this case, corporal punishment) is a necessary component of discipline for children. However, modern psychologists have discovered that punishment is not as effective at changing behavior as once thought. For example, studies presented by the American Psychological Association have found that punishments like “time-outs” can be effective at reducing defiant and violent behavior, but reasoning with children is most effective for milder forms of misbehavior. In addition, reasoning proved more effective at reducing violent and defiant behavior in the long-term than punishment.

It’s with this knowledge that Dr. Becky Bailey, at the time a professor of early childhood education at the University of Central Florida, created “Conscious Discipline” in 1996. Conscious Discipline is a social-emotional learning program for parents, educators and mental health professionals that emphasizes behavior modeling and problem solving rather than punishment for misbehavior. According to a report by the The Harvard Graduate School of Education, Conscious Discipline has been shown to reduce aggression, hyperactivity and conduct problems among children.

Anna Harmless and Melissa Lawson, two school-based providers at our Putnam County office, have begun utilizing components of Conscious Discipline in their work with youth, parents and educators. In this blog post, they explain the basic science underlying Conscious Discipline and why it can be an effective, constructive alternative to punishment-based discipline.

Brain States and Behavior: The Science Behind Conscious Discipline

According to the Conscious Discipline model, anyone who wants to modify a child’s behavior must first understand a few things about the way the human brain functions.

The tenets of Conscious Discipline are based upon a simplified neuropsychological model of the brain. This model does not tell us everything about the way our brains work, but it can help us predict how a person will feel and behave in certain situations. “Dr. Becky Bailey did a lot of research on the human brain, and she found that we have three different ‘brain states,’ “ Melissa explains. These states are:

The Survival State: This is the most basic or “primal” of our brain states, which is activated when we perceive a threat to our well-being. When our brain is in the Survival State, we look for ways to fight or flee from the perceived threat, and we are incapable of thinking clearly and rationally.
The Emotional State: This state is typically triggered when something upsets us and causes us to feel anger, fear, sadness, or another negative emotion. In this state, we tend to revert to ingrained patterns of behavior and are not good at thinking critically or considering other people’s opinions.
The Executive State: This state makes full use of our prefrontal cortex, allowing us to think through conflicts and find logical, constructive solutions. It is the optimal brain state for problem-solving and learning, but it is only accessible when we are in a state of emotional calm.

The main problem with “traditional” or punishment-based discipline is that it keeps children in the Emotional or Survival Brain States—neither of which are conducive to learning. “I’ve been doing therapy at Cummins for seven years now, and I have seen traditional discipline fail so many times,” Anna explains. “The child is already thinking, ‘I’m bad. I’m sad. I feel bad.’ So if we punish them by taking something away, that just reinforces the child’s inner voice. We want to help the child calm themselves and express themselves instead.”

Melissa adds, “Ideally, we want children to develop their executive functioning skills so they can problem-solve and learn to cope with their emotions in a healthy way.” Therefore, the primary goal of Conscious Discipline is to teach children how to work through problems using their Executive Brain State.

Behavior Modeling and Problem Solving: Conscious Discipline in Action

As we’ve said, Conscious Discipline teaches that children must be engaged in their Executive Brain State in order to truly learn from disciplinary action. This is all well and good if the child is calm and collected at the moment discipline is required—but what if they are misbehaving due to emotional turmoil? How can we help move the child out of the Emotional or Survival Brain States so they will be receptive to instruction?

This brings us to another important concept of Conscious Discipline: behavior modeling. Humans, and especially human children, intuitively imitate the behavior of other humans. It’s one of the primary ways we learn how to think, act and socialize with others. With this in mind, Conscious Discipline teaches that adults can help shift children into their Executive Brain State by modeling calm, thoughtful, non-aggressive responses to problems and conflicts. Melissa explains further,

“Dr. Bailey calls this ‘downloading your calm’ onto the child. If you’re approaching the child in a calm state, you can help them get to that calm state with you, whether it’s through affection or just recognizing how they’re feeling and reflecting it back to them. You can say, ‘You seem upset. Is this why? OK, we’re going to breathe, and I’m going to teach you how you can calm down and help yourself feel better.’ Once they’re calm, that’s when you can solve the problem together and teach them a skill they can use for the rest of their life.”

Of course, if the adult is upset by the child’s misbehavior, then it may be difficult for them to respond to it constructively. As a result, Conscious Discipline also requires adults to monitor their own brain states and regulate themselves appropriately. “There’s a lot of mindfulness work that the adult has to do,” Anna says. “Overall, it’s a self-regulation program to help adults first so the adults can help the children.”

For adults and children both, this means breaking free from any maladaptive disciplinary practices they may have learned in the past. “Family culture is huge in the way the world works and the way our children learn, but a lot of people don’t even think about the concept of family culture,” Anna continues. “We want people to understand how they learned what they learned about parenting and being a part of a family. We’ve been able to help some parents realize, ‘Wow, I didn’t like how it felt when I was punished as a kid. Maybe I don’t want to cause my own child to feel that same negativity.’ “

When exercised appropriately, Conscious Discipline inverts the focus of child discipline by teaching the child what to do instead of what not to do. According to Melissa, the most difficult part of the whole process is not getting carried away with our emotions: “The hardest part for kids and adults is noticing the reaction they’re having, calming down, and getting out of that Emotional or Survival State. then they’ll be able to process and work through the problem in their Executive State.”

If you’d like to learn more about Conscious Discipline, we encourage you to visit ConsciousDiscipline.com, where you can learn even more about how the program works and access free resources for working on discipline with children!

If you’d like to learn more about behavioral health challenges that children may face, we recommend watching our video on trauma and student mental health below, which we recorded last year with Cummins’ Michelle Freeman and Jessica Hynson!

How IAPRSS and Cummins BHS Are Advancing Peer Recovery Support Services in Indiana

August 11, 2020 Mark Wilhelm

When someone is working toward recovery from substance use disorder (or SUD), support from loved ones and treatment professionals is a must. In particular, behavioral health workers like therapists, counselors and life skills specialists can offer invaluable guidance and assistance for anyone who is working to overcome addiction. However, sometimes a recovering person can benefit most from the support of an individual who has their own lived experience with SUD.

This is where peer recovery support services can be helpful. Peer recovery support services (also called “peer recovery services” or “peer support services”) are behavioral health services that supplement clinical treatment for substance use disorder. These services are delivered by peer recovery coaches or peer recovery specialists, individuals who are themselves in long-term recovery from substance use. According to the Substance Abuse and Mental Health Services Administration, peer recovery services have been shown to improve relationships with treatment providers, increase satisfaction with treatment, decrease criminal justice involvement, reduce relapse rates, and improve access to social supports.

In a nutshell, peer recovery support adds to SUD treatment services by extending care beyond the doors of a clinical facility. Peer recovery coaches rely on shared understanding and respect to support their clients’ recovery on an informal, day-to-day basis. In many cases, a peer may serve as a bridge to other individuals and supports that can help a person stay invested in their recovery for the long term.

As a strong advocate of peer recovery services, Cummins Behavioral Health has been working with the Indiana Association of Peer Recovery Support Services (or IAPRSS) to promote their implementation throughout our state. In this blog post, we speak with IAPRSS Director Justin Beattey about what his organization does and how it’s working to improve peer recovery services throughout Indiana.

Justin Beattey and IAPRSS: Advocates for Peer Recovery Support in Indiana

Justin Beattey isn’t an advocate for peer recovery support just because it sounds good on paper; on the contrary, he has witnessed the good it can do firsthand.

“I am a person in long-term recovery from mental health concerns, substance use issues and the criminal justice system,” Beattey explains. “I’ve had several go-arounds with treatment since I was a teenager. All of my engagements with treatment were very provider-focused, by which I mean the provider pretty much told me, ‘This is what you need to do.’ My last go-around with treatment was when I connected with peer support, and that was the first time I ever had anyone ask me, ‘What do you want to do, and how do I help you do that?’ “

IAPRSS works to advance the profession of peer recovery support in two main ways: by supporting peer professionals as well as the organizations that employ them. For peer recovery coaches and specialists, this primarily means providing professional development assistance and community support. “For example, we have a once-a-month peer professional support group for peers to get together and talk about their profession and what’s going on in their work,” Beattey says. “And we also meet with peers individually to help them map out how they want to grow professionally—how to strengthen current skills and where to make improvements.”

For behavioral health organizations, IAPRSS provides varying levels of consultation related to peer recovery support services. “Sometimes it’s helping an organization figure out policy and procedure, plan out workflow, create job descriptions, advertise those jobs—everything related to building out that program,” Beattey says. “For other organizations, it’s just talking through what ideas they have and what other organizations are doing.”

According to Beattey, one of IAPRSS’ primary goals is to improve the quality of all peer recovery services provided across the state:

“We want to help ensure that consistency is provided throughout Indiana, because a lot of organizations have kind of had their own understanding of peer support. Some organizations really understand it, and others don’t so much just because they haven’t been educated on it. We’ve been able to use organizations like Cummins as examples of what good, robust peer recovery programs should look like, and also how to properly support peers through effective supervision.”

How IAPRSS and Cummins Are Raising the Bar for Peer Recovery

As Beattey hinted at above, one of the prevailing issues with the peer recovery profession is a lack of standardization across different organizations and programs. Because there are no external regulations on peer recovery services, organizations that provide peer services are left to determine their own guidelines and best practices. In response, IAPRSS has been working to develop universal standards to help all peer recovery support programs effectively serve their clients.

“We used a grant from Indiana’s Division of Mental Health and Addiction to create a peer infrastructure advisory board for the state,” Beattey explains. “We gathered a lot of industry leaders and created a ‘think tank,’ for lack of better wording, and one of the things we did is create some standardized documentation.” These include ready-to-use guidelines covering professional standards for peer recovery coaches, supervision of peer recovery professionals, and ethical standards for peer recovery support services.

Once these standards were agreed upon and documented, Beattey and IAPRSS made sure to get the word out in the peer recovery community. Beattey says, “We worked throughout the state doing town hall discussions about peer recovery support to get the community as a whole educated on what peers are—that they’re not sponsors, they’re not counselors or therapists, they’re just people who are going to provide person-centered recovery support based on the individual’s needs. And what was more important than just creating standards was making sure we educated the community on them.”

Throughout the whole process, IAPRSS has collaborated closely with Cummins and other behavioral health organizations that are operating successful peer recovery programs. This process has been invaluable for determining best practices of peer recovery support, as Beattey explains:

“It’s been incredibly important for us to maintain regular communication with behavioral health providers to have real-time updates on what’s happening in the peer support profession. Cummins has been a great partner, because they have had no qualms about reaching out to me and letting me know what’s working well for them. This provides us with real-life examples, so rather than saying, ‘We think this is how peer support should be done,’ we’ve been able to say, ‘Well, this is what’s working great at Cummins, or this is what’s not working great at Cummins—this is what needs clarification.’ And that has helped me advocate for peer support services with other organizations, because I can say that it’s not just IAPRSS thinking this, it’s Cummins thinking this, as well.”

At Cummins Behavioral Health, we believe strongly in the value of peer recovery support services for individuals who struggle with substance use disorder. We are thrilled to be working with IAPRSS and doing our part to help peer recovery support services grow and flourish throughout Indiana!

If you’d like to learn about some of the other addiction treatment services that Cummins BHS provides, we recommend reading our blog posts on virtual IOT and adolescent IOT below!

How Behavioral Health Providers Can Serve Our Veterans’ Mental Health Needs

August 5, 2020 Mark Wilhelm

Service members of the U.S. Armed Forces fill an extremely important role in our society. They are the frontline defenders of our country and all its citizens, and for that, they deserve our deepest respect and appreciation. Unfortunately, the nature of their work puts them at a significantly elevated risk of sustaining injuries both physical and psychological.

One study conducted by the RAND Corporation in 2008 found that approximately 18.5% of veterans who served in Afghanistan and Iraq later suffered from PTSD or depression. The same study also found that only half of veterans who need treatment for these conditions seek help, and only half of those who receive treatment get minimally adequate care. This gap in treatment is especially concerning given the fact that suicide rates for veterans are 50% higher than for members of the general population.

In theory, all veteran health care needs are addressed by the Office of Veterans Affairs (or “the VA”), but in reality, this is not always the case. To begin with, not all veterans are eligible to receive care from the VA, with one common disqualifier being discharge from service under other than honorable conditions. In addition, not all veterans live near a VA hospital, which means they must travel long distances for medical or behavioral health appointments. For these reasons and more, community behavioral health providers have a duty to offer high-quality care to veterans and service members.

Like with any consumer population, it’s essential that veterans receive behavioral health care that is sensitive to their unique experiences and needs. To learn more about these needs and how providers can meet them, we spoke with Cummins’ Matt Baker, a Peer Recovery Specialist and Armed Forces veteran, and Melissa Bush, a Licensed Therapist who also comes from a military family. In this blog post, Matt and Melissa explain what kind of behavioral health issues veterans may face, what barriers to treatment stand in their way, and how care providers can give them the treatment they need and deserve.

Behavioral Health Challenges of the Military Lifestyle

When we think about current and former members of the Armed Forces, it’s important to remember that not all service members are the same. On top of the personality differences that make every individual unique, a veteran’s experience in the military is also affected by their time and place of service, which branch of the military they served in, and what role(s) they filled. For these reasons, no two veterans will have identical mental health needs.

“Veterans are just like the rest of the population when it comes to mental health care needs,” Matt says. “I’ve worked with vets who have major depressive disorder, schizophrenia, personality disorders, generalized anxiety disorders—you name it, veterans suffer with it.”

However, there’s no denying that military service members are exposed to a large amount of stress in the line of duty. “The military experience is very high-stress by nature,” Melissa says. “If you think about boot camp, for example, it’s a very stressful environment. Some of us who have not gone through that experience are not sure we could make it out the other side.” It’s not surprising, then, that post-traumatic stress disorder is a well-known concern among veterans.

A lesser-known problem that some veterans may struggle with is the concept of “moral injury.” As Melissa explains, “Moral injury is the idea that I have this moral code or this person that I believe myself to be, but I’ve been in a high-stakes situation, and in the context of that situation, I’ve acted in a way or saw others act in a way that doesn’t fit with my moral code.” This experience of behaving or witnessing behavior that is contrary to our personal ethics can be traumatizing in its own right.

Unfortunately, the stigma of mental illness is especially prominent in the Armed Forces, which have organizational cultures that value resilience and team cohesion. According to Matt, this can pose a large barrier to treatment for service members and veterans:

“I don’t want to come across sounding negative in any way toward our military or the way we’re trained. I loved my time in the service. I’m proud of my time in the service. But my personal view is that it’s almost an indoctrination that civilians go through when becoming a service member. Starting with basic training, you’re torn down and built back up into this idea of what a service member is and what they represent. You’re a member of a team first and foremost, and an individual second. Mission success is the objective above anything else. So if a service member becomes injured or suffers some kind of mental health issue, then they’re no longer effective as part of that team. It’s perceived as a weakness, and that can cause a lot of chaos in that individual’s life. There’s loss of identity, loss of purpose, loss of belonging. It’s hard to break through that wall that’s been built up, that culture, to get through to the individual and get them to buy-in to the fact that we want to help.”

The Basics of Culturally-Competent Care for Veterans

Given what we know about the veteran population and their mental health needs, there are several steps a behavioral health professional can take to provide them with the best possible care.

First and foremost, providers should be sure that they are asking about military service in their initial assessments with clients. “One of the big factors for providers to know is that this is a population that tends to be under-identified,” Melissa explains. “Have they ever served? Are they currently serving? Have they ever been deployed? Did they see combat? Do they have any close family members or loved ones who are in those same categories? Part of the assessment should be asking these questions to get an idea if there’s more there that needs to be explored.”

Since every service member’s experience in the Armed Forces is unique, providers should also be careful not to assume they know how a veteran feels about the military or the time that they served. “You can’t just assume that all veterans are proud of their service,” Melissa says. “The time they served, the experience they had while serving, the circumstances of their discharge—you need to ask those personal questions to assess how they identify.”

Once this has been done, therapists and counselors should focus on building a relationship of respect and trust just as they would with any consumer. “It all starts with the relationship between the client and the provider,” Matt says. “Sitting down and talking with this person, getting on their level, being empathetic, and digging through the wall that’s going to be put up automatically. Because most veterans are going to be respectful, but they’re not going to want to open up.”

According to Matt, providers may find it easier to build trust and engagement with veterans if they implement a few simple techniques during treatment:

“First of all, providers should understand some of the different language that veterans use. Time is the first one. When you schedule an appointment, try scheduling for ‘1300’ instead of 1:00 PM. Instead of going to lunch, veterans go to ‘chow.’ They may use some derogatory terms for the combatant they fought—understand those. Also, it may sound bad, but you shouldn’t give a vet too many choices. Just tell them what time they need to be somewhere and what to expect, and they’ll be there. That’s a part of the military culture that we come from. Finally, a good way to approach treatment is to lay out the treatment plan like a mission. Sit down with the vet, set the objective, and educate them on it. I think that’s a good approach to get them to buy-in.”

At Cummins Behavioral health, we believe that all people deserve access to exceptional mental health care. Our duty to serve our communities extends to the service members and veterans living within them, especially considering the sacrifices they have made to safeguard our own well-being. That’s why we’re committed to providing the best culturally-competent care possible for our veteran population!

Interested in learning about therapeutic best practices for other behavioral health consumer populations? You might enjoy our blog posts on African American mental health and women’s mental health below!