This episode of “Mad in the Family” focuses on a non-drug method to bringing out the best in challenging children, particularly those diagnosed with “ADHD.” It is called the Nurtured Heart Approach® and its essence is that, in the words of our guest, “the same intensity that drives people crazy is actually the source of a child’s greatness.” He is the approach’s creator, family therapist Howard Glasser. Glasser has been called “one of the most influential living persons working to reduce children’s reliance on psychiatric medications” and is the author of the bestselling book, Transforming the Difficult Child and more than a dozen other books.
Howard Glasser: “Kids read our energy differently than we suspect.”
Glasser is also the Founder of the Children’s Success Foundation, whose mission is to advance the work of the Nurtured Heart Approach by conducting training programs to support parents in building Inner Wealth® in their children, educators in formally implementing the approach in school systems, and therapeutic professionals to meet the unique mental health needs of “intense” children. A frequent keynote speaker at conferences on treatment and education, he currently teaches certification trainings on his method, as well as in Dr. Andrew Weil’s program at the University of Arizona’s School of Integrative Medicine.
- How he developed the Nurtured Heart Approach. As a new therapist working with “problem” children and families, he diligently applied all the accepted techniques he had learned in school, only to find they often didn’t work well. Through observing the interactions between parents and children, he developed the approach organically. But he was reluctant to share it with colleagues or even give it a name, in part because the precepts “flew in the face of everything I’d ever studied.”
- How the approach was codified and spread. Word got out and he was asked to speak to groups about it. After the first presentation, he ran into a colleague who told him he and his staff were all using the new method and it was working. Eventually he started a center and began to teach it. The people they trained had the same positive results. Oftentimes, children entered treatment unmedicated and, using the Nurtured Heart Approach, the majority of them wound up never needing to be put on drugs.
- Nurtured Heart 101. It is based on three “stands”: 1: Absolutely No! I refuse to energize negativity. 2. Absolutely Yes! I will super-energize experiences of success. As he says, “I am going to wait till the next moment when that problem isn’t happening…. [Then]I am going to be very deliberate, purposeful …. in calling a child out” for good behavior. 3: Absolutely Clear! I will set clear limits and provide clear, un-energized consequences. Together, he says, the three stands provide “a methodology … to create a resolute new milieu. …How do we refine what we’re saying to inspire [the child] in an energetically congruent way?”
- The traditions behind Nurtured Heart. The approach is not an outgrowth of a particular school of psychology. Though Glasser himself studied with people trained under Jung and Freud, his approach is more intuitive and based on his personal spiritual philosophy, which evolved when he lived on an ashram in his 20s. Namely: “seeing the greatness in another being, seeing the beauty.”
- How Nurtured Heart differs from behavioral interventions. Rather than having a goal of managing a child’s behavior through a system of negative and positive reinforcement, it’s about building a relationship that brings out the “greatness” in the child. Here, the reward “is us”: our attention and interaction. Directing our energy not to the moments when things are going wrong, but when they are going right, and “going way beyond ‘thank you’ or ‘good job.’” The adult points out the specific things the child is doing well (self-control, for example), why they value that behavior, and what it says about the child’s intrinsic abilities.
- A demonstration of the type of words and energy used when interacting with someone in the moment, using Nurtured Heart’s Stand 2. Glasser calls positive attention to Miranda’s preparation and interviewing skills in a way that is spontaneous, sincere, and specific, resulting in her immediately feeling appreciated. Similarly, he explains, “I want to spark a fire in kids, have them feel like they’ve been heard and seen for who they are.”
- The key concept of Inner Wealth®, “a growing sense of my value…my worth,” and how to build it in challenging children so they can flourish. One technique is to help the child see the big picture of what could have gone wrong in a given situation, but didn’t due to their making positive choices and using their inner resources. Glasser is working with the University of Arizona on a survey attempting to objectively define and measure Inner Wealth before and after using Nurtured Heart.
- Useful metaphors. He holds that parents are like toys in that they feature unlimited actions and emotions. We tend to be boring if our children behave but exciting when they don’t, because only then do we fully engage with them. Therefore, we need to mimic the type of toy kids find most compelling: a video game. Video games have strict rules for success and failure, which set off bells and whistles when the player plays well, allowing him or her to achieve higher and higher scores. When a player fails, there are no warnings or second chances: It’s game over. But after the game resets, it starts again immediately, with new chances to succeed.
- The concept of Reset and how to get a child’s attitude and behavior back on track. Unlike a classic “time out,” which forces the child to pause, a reset “unplugs” the adult, briefly turning off “the faucet” of the relationship until the child is again behaving in a way we can praise. That need not be anything special; it could be simply calming down or coming close to a “line” set by the adult but not crossing it. Glasser notes that this technique is particularly useful in classroom settings to help smart, challenging kids channel their energy.
- Using Nurtured Heart Approach with children labeled with ADHD or other behavior-based diagnoses. He doesn’t think the symptoms reflect pathology in the child or the parents. Rather, they reflect a lack of good tools for dealing with intensity, which is seen as an enemy. Often kids just don’t know how to direct their energy, which leads to being referred for psychiatric treatment. However, 90% of kids in his practice stopped showing these symptoms within six weeks of employing the Approach, as confirmed in a University of Arizona study.
- How Nurtured Heart is being implemented in various health and social systems in parallel with ongoing studies of its effectiveness. For example, the New Jersey system of care has been introducing it in its work with trauma-impacted kids in the foster care system and in residential treatment programs. Rutgers University will soon produce a SAMHSA-funded report on a five-year study of outcomes of using the
Approach with such children.
- Pushback on the Approach, such as the idea that kids with an ADHD diagnosis need to be medicated. He believes medication might work in the short term, but the problems they are designed to treat have still not been addressed. He urges parents to see that the very traits that lead families to see a doctor about their child’s behavior are actually “a gift” that can be channeled in more constructive ways.
- The Children’s Success Foundation, a clearinghouse of information, research, and training on Nurtured Heart. Through the Foundation, parents and various types of practitioners from around the world can receive in-person or online training, and/or do online coursework for using Nurtured Heart in regular and special education, social services, the juvenile justice system, and with underserved populations. It is looking to collaborate further with institutions.
- Where parents can find more information about Nurtured Heart. Glasser has written more than 15 books and online classes are available 24/7 at the Children’s Success Foundation, including a weeklong Certification Training Intensive.