When children consistently demonstrate behaviors, such as intense anger, frequent loss of temper, extreme irritability, impulsiveness, and frustration, it should be taken seriously and not dismissed as a phase. This complex and troubling issue needs to be examined and understood by parents, teachers, and other caregivers.
Take Blake, for example. Bedtime, mealtime, play time, it didn't matter. Everything turned into an episode.
"He was my first child, so I thought we just weren't doing something right," says Blake's mom. "Family and friends were quick to offer suggestions. I read every book on discipline and my husband and I exhausted every behavior strategy we knew."
Ever since Blake was 18 months old, daily activities such as getting dressed, eating breakfast, playing with toys, and going to school often resulted in an emotional meltdown. The behavior varied, but frequently included screaming, hitting, head banging, and throwing whatever object was within reach. He was kicked out of 2 preschool programs and was constantly in trouble during his first few years of elementary school. As a consequence of his behavior, he was frequently isolated from his peers and labeled as a discipline problem.
"We were afraid of our own son. One time when he was 7, he became so enraged over going to bed that he grabbed his cat by the neck and threw him across the room." After 7 years of constant turmoil, Blake's parents decided to seek professional help.
Warning Signs That Professional Help Is Needed
Professional help may be needed if your child has:
- Explosive temper tantrums or meltdowns
- Extreme irritability or impulsiveness
- Demonstrated physical aggression
- Been involved in fights
- Made threat to self or others
- Attempted to hurt self or others
- Used weapons
- Shown cruelty toward animals
- Set fires
- Destroyed and vandalized property
- Panic attacks
Whenever these behaviors are observed in children, help from a qualified mental health professional, such as a child therapist, psychologist, or psychiatrist should be sought right away. Early treatment can make a difference.
Seek Help Sooner Rather Than Later
Parents should seek help from a mental health professional when they find that normal behavior management strategies are not effective in teaching the child appropriate ways to express anger. Ask for help when your child's expression of anger can't be pulled into an acceptable range or when your child's peers are rejecting your child because of the behavior.
Early intervention is important to the success of treatment. The longer the behavior is untreated, the more instilled it becomes, and the harder it is to treat.
Without treatment, your child may become depressed, and eventually have difficulty adjusting to the demands of adulthood like holding a job, and building and maintaining healthy relationships. This downward spiral may also lead to violent behavior resulting in legal consequences.
Selecting a Therapist
Parents can request a referral from their physician, school counselor, or call the number on their insurance card for approved providers. Ask about the therapist's training, education, experience, and philosophy. Therapy is hard work. Therefore, it is important that you and the therapist are working toward the same goal and have a relationship based on mutual respect and trust. Specialized training in the areas of child development, anger management, and parenting skills are especially important.
Methods of Treatment
Treatment depends on the unique characteristics of the child and the severity of the behaviors. It is common for the therapist to begin by requesting information from other medical specialists, the child, family, teachers, and caregivers. Understanding the root of the anger and the factors contributing to the inappropriate behavior will provide direction toward the most effective treatment.
Skill building in the areas of problem solving and anger management, behavioral therapy, and psychotherapy are common methods used by professionals to help children express and control their anger more appropriately.
Medication is another means of treatment, especially when it is determined that the child's uncontrolled outbursts of anger are associated with depression, attention/impulsivity problems, inability to tolerate frustration or change, psychiatric disorders, or extreme mood instability. Because medications often result in side effects, work with your child's doctor to determine the best medication to meet your child's needs.
In extreme cases, the treatment may involve removing the child from the home and/or school environment to provide more structure and intense intervention. It is important that the family and school personnel continue to be involved in therapy so they can provide the necessary support when the child returns home.
Helping the Family
Most therapists work with other family members as well as the child with the identified problem. The child's behavior imposes great stress on the relationships within the family. Also, parenting a difficult child requires more advanced parenting skills than most parents ever have to learn.
Working With the School
Responding to pressures at school—academic frustration, peer pressure, teasing, social rejection, isolation—is a challenge for any child, especially one who has difficulty controlling anger. Parents and teachers must work together to provide mutual support for the child. Consistency is important.
If a mental health professional has diagnosed your child with an emotional disability, the school is required to provide assistance if the disability affects school performance. An Individualized Education Plan (IEP) will be developed to determine what support is necessary to help the child succeed in school. The therapist, school counselor, special education teacher, classroom teacher, parents, and child should all have input into the IEP. The teacher may be asked to use specific behavior management strategies with the child to support the treatment plan. When parents and educators work together, they improve the child's opportunity to succeed in school, both academically and socially.
Your Child's Future
Treatment is often a long process because establishing new attitudes and habits takes time, but the investment is worth it. Treatment offers hope for a bright, productive future.
American Academy of Child and Adolescent Psychiatry
Kid's Health—Nemours Foundation
Canadian Academy of Child and Adolescent Psychiatry
Canadian Pediatric Society
6 ways to help an angry child. Ask Dr. Sears website. Available at: http://www.askdrsears.com/topics/parenting/discipline-behavior/7-ways-help-angry-child. Accessed October 24, 2017.
A child's anger can be a warning. Psychology Today website. Available at: http://www.psychologytoday.com/blog/family-secrets/201201/childs-anger-can-be-warning. Published January 26, 2012. Accessed October 24, 2017.
Anger overload in children: diagnostic and treatment issues. Great Schools website. Available at: http://www.greatschools.org/gk/articles/anger-overload/. Published May 19, 2016. Accessed October 24, 2017.
Last reviewed October 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 12/7/2015