Working with High Risk Children and Adolescents: Collaborative and Strength-Based Interventions

Module 1: Paradigm Shift – Understanding the “Why”

• The Myth of Motivation: Dr. Muth debunks the idea that “kids do well if they want to” and explores the philosophy of “kids do well if they can.”
• The Neurobiology of “Bad” Behavior:
  • The role of the amygdala and prefrontal cortex in dysregulation.
  • Fight/Flight/Freeze responses in clinical settings.
• Strength-Based Profiling: Moving beyond diagnostic labels to map the child’s assets, resilience factors, and “islands of competence.”

Module 2: Risk Assessment & Crisis Management

• Triage and Assessment:
  • Differentiating between suicidal ideation, non-suicidal self-injury (NSSI), and aggression/conduct issues.
  • Assessing lethality, intent, and access to means.
• Safety Planning 2.0: Moving beyond the “contract for safety.” Creating dynamic plans that include specific coping skills, identified support people, and environmental restrictions.
• Legal & Ethical Considerations: When to breach confidentiality, duty to report, and navigating consent with minors.

Module 3: The Collaborative Toolkit – Integrated Interventions

• Collaborative & Proactive Solutions (CPS):
  • Dr. Muth reviews the “Plan B” conversation structure to solve problems collaboratively rather than unilaterally.
• Motivational Interviewing (MI) for Adolescents:
  • “Rolling with Resistance”: How to sidestep power struggles when a client is defensive.
  • Using “Change Talk” to increase intrinsic motivation for safety.
• Solution-Focused Techniques:
  • The Miracle Question and Exception Finding: Identifying times when the problem isn’t happening to build on success.
• Narrative Approaches:
  • Externalizing the problem (e.g., “fighting The Rage” vs. “being an angry kid”) to reduce shame and defensiveness.

Module 4: Engaging the System – Families and Schools

• Parent Coaching with PACE:
  • Using Dr. Dan Hughes’ Playfulness, Acceptance, Curiosity, and Empathy (PACE) model to help parents co-regulate rather than police behavior.
• Addressing Caregiver Burnout: Validating the exhaustion of raising a high-needs child while teaching parents to manage their own triggers.

Module 5: Advanced Case Application & Synthesis

• Complex Case Studies: Reviewing real-world scenarios presented by Dr. Muth involving dual diagnoses (e.g., ASD + Trauma, ADHD + ODD).
• Selecting the Right Tool: Discussing when to use CPS vs. MI vs. rigid safety protocols based on the client’s current state of regulation.
• Troubleshooting: “What if the child refuses to talk?” Strategies for non-verbal engagement and building safety without words.

Module 6: Closing & Sustainability

• Review of Key Concepts: Rapid recap of the integrated toolkit.
• Self-Care for the Therapist: Managing countertransference and vicarious trauma when working with aggression and high-stakes risk.
• Q&A