Cognitive-Behavioral Therapy for Impulsive Children

Phillip C. Kendall (1992)

Description of Treatment:

Initial tasks are psychoeducational and similar to tasks used in school

Middle sessions shift emphasis to interpersonal play situations and appropriate use of problem-solving steps.

Final series of sessions deal with the child’s particular behavior problems and involve role playing of alternative solutions to specific problematic situations.


Components of Program:

Session 1: Getting Started

Purpose: Give the child an initial exposure to the problem solving process that will enable the child to:

1. See how the steps can be sued to “STOP and THINK” before attempting to solve problems
2. Cope with those inevitable mistakes that everyone makes
3. Provide self-reinforcement for thinking and reflecting as an active problem-solver.
4. Acquaint child with the STOP and THINK dollars (points), reward menu and the contingencies.

Session 2: Following Directions

Purpose: Give child skills that can be effectively used in problem-solving during future sessions. The purpose is twofold:

1. To provide practice materials that directly attack the target area of carefully following direction
2. To serve as a foundation for later sessions as the child learns to self-instruct or self-direct himself/herself to “STOP and THINK”.

Session 3: Multiple Tasks

Purpose: Continued opportunities to rehearse and use the problem-solving steps.
Tasks are more verbal, and may require more advanced thinking for some children.

Session 4: Arithmetic

Purpose: For the child to learn to apply the self-directed steps to grade-appropriate
mathematical questions to solve them in a logical and reflective manner.

Session 5: Which is less? Which is more?

Purpose: Use similar tasks as presented in the first four sessions with a greater
emphasis on the relationship between SAYING the steps and DONG the steps.

Session 6: Word Search

Purpose: Self instructions are implemented to facilitate and improve the focusing and
use of a strategy by reducing the haphazard, fast, trial-and-error approach and
practicing the well-thought-out, systematic approach. This session provides experience
in using the cognitive-behavioral strategy as:

1. A tool for approaching problems
2. A tool for solving more abstract puzzles.

Session 7: Bring Your Own

Purpose: The purpose is three-fold:
1. To provide the opportunity for the application of the verbal self-instructional problem-solving to each child’s specific weakness.
2. To provide the opportunity to make a direct link between the problem-solving skills and their use in schoolwork
3. To help children see the application of the STOP and THINK procedure on materials form outside the therapy/workbook focus.

Session 8: Checkers

Purpose: Apply the self-instructions to a situation bridging the workbook-type task and
the social situation. In addition, as the therapist-child relationship develops, the
therapists has the opportunity to further inquire about the personal dilemmas of the

Session 9: Cat and Mouse

Purpose: Further facilitate the transition of the training to interpersonal situations.

Sessions 10 to 12: Dealing with Emotions

Purpose: These sessions deal with the recognition of “feelings” in the area of
interpersonal behaviors

Sessions 13 and 14: The Consequences of Behavior

Purpose: The child learns to generate not only the alternate ways to handle
hypothetical social situations, but also to think about the consequences of the various
alternatives. The purpose of these sessions is to:

1. Encourage the child to cope with problems or situations which involve the inhibition of impulses
2. Help the child examine ways he/she could modify his/her behavior in social situations
3. Help the child to consider the consequences of his/her actions
4. Help the child to approach interpersonal situations in a self-controlled manner

Sessions 15 and 16: Role Plays

Purpose: The child works to find the best solution to a role-played social problem.

Session 17: You’re the Expert

Purpose: Allows the child to own the ideas, put them into his/her own frame of reference, and make a commercial to tell other kids about STOP and THINK.

Session 18: Let’s Review

Purpose: To provide an opportunity for the individual child to review the areas in need of special practice.

Sessions 19 and 20: Making the Commercial

Purpose: To allow the child to be the expert and demonstrate for others the new skills
he/she has learned.

ADHD Characteristics

ADHD Developmental Course

Causes of ADHD

DSM-IV Diagnosis of ADHD

Treatments for ADHD

Medication Information

Description of Stop & Think

Stop & Think for ADHD

Efectiveness of Stop & Think
Pragmatic Issues of Stop & Think

ADHD Resources

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