Mother: I love how much Kovi and I have in common. I wouldn’t want to give him meds to change that!

Kovi: I never realized I have so many red thoughts all day. 

Father: I’ve been disciplining Kovi for his actions all this time. I didn’t realize his poor behavior starts with his thoughts.

After Kovi’s evaluation, I call his parents.

“Therapy, maybe, but not medication,” Miriam says as soon as she gets on the phone.

Aaron clears his throat. “Do you think Kovi needs medication?” he asks.

“I’m a therapist,” I explain. “I cannot offer a diagnosis. I certainly cannot write a prescription. What I can do, though, is evaluate Kovi’s symptoms and treat them through therapeutic interventions.”

“What do you mean, symptoms?”

“Based on your report and my observations, Kovi presents with poor impulse control. He also has no social ‘filter.’ He says whatever comes to mind.”

Aaron asks, “Can you treat that in therapy?”

“I can teach Kovi some techniques to improve his impulsivity and social skills. If he can’t seem to master these skills with therapy alone, other approaches may be warranted. Your pediatrician can refer Kovi to a doctor for evaluation and direction in terms of diagnosis and medication. Some kids do well with therapy only, but some kids need a combination of meds and therapy.You’re the parents; the starting point is your call.”

Like his mother, Kovi arrives for his first session with a bang. “I can park my bike here, right?” he asks, jamming the bike against the wall. “It’s not that fancy here.”

“Did you bike here on your own?” I ask.

“Yeah, my mother had a party.”

“Nice. Are there perks to having a mother who’s an event planner?”

Kovi smirks. “We get leftovers sometimes. You should see these awesome custom cakes she brings home.”

“You know, Kovi,” I say, “when a pastry chef is working for one of your mother’s parties, he’ll start by sifting the flour.” I show Kovi a standard flour sifter and pour flour slowly through it. In a minute, the flour is all in a bowl, and we can see that the sifter has strained out four red jelly beans.

I point to the jelly beans. “Those represent ‘red’ thoughts,” I explain. “ ‘Red’ thoughts are thoughts that should be sifted out of your speech. If you think a red thought, try to change it to a green thought.” I dump a mixture of red and green jelly beans into the bowl as I explain. Then I read Kovi some sentences and he has to pick out a bean of the corresponding color: “Your haircut is weird!” (red) “Nice haircut!” (green)

Kovi trades in his red beans for green ones as he practices changing each red thought to a green one. I teach Kovi why this is important: because thoughts lead to feelings, which lead to actions. “Green thoughts lead to actions that make other people comfortable. Red thoughts lead to actions that make other people uncomfortable.”

Kovi and I spend several sessions identifying his thoughts and categorizing them as red or green. Then we practice changing the reds to greens to help Kovi improve the outcome of his thoughts.

Originally featured in Family First, Issue 563. D. Himy, M.S. CCC-SLP, is a speech-language pathologist in private practice for over 15 years. She is the creator of the Link-It reading comprehension and writing curriculum for elementary school students and directs continuing education programs for speech-language pathologists and educators.