When Hindy was five, I asked my pediatrician for a referral to evaluate her for ADHD.

“You’re not going to get a definitive diagnosis of ADHD at this point,” the pediatrician told me. “But you should know that anxiety often presents in young children with the same symptoms as ADHD. The anxious child acts out not because she is impulsive, but because she feels wound up all the time, so any little provocation puts her over the edge.”

I took Hindy to a behavioral therapist, who recommended that we get a mobile play therapist to come to the house twice a week and work with Hindy in her natural environment, giving her the skills to navigate real-life interactions. But the therapist didn’t “get” Hindy. When Hindy would start to act out, the therapist would announce, in a shrill voice, “That’s unacceptable! We need to take a time-out!” Then, Hindy would start to kick and slam doors and cry uncontrollably.

In the less unsuccessful sessions, Hindy would insist on being the one to choose which game to play and decide how the game would go. When there was a moment of downtime, she “made” the therapist sit in her little chair so she could do the therapist’s hair…. After one of the sessions, the therapist said to me, “Hindy seems to have a need to control the people around her.” As if my preschooler was some kind of control freak.

I was very upset. I wasn’t a professional, or even an experienced mother, but I knew that what Hindy needed was security, not control. The reason she tried so desperately to control others was that she felt out of control herself!

Thankfully, the mobile therapist had to discuss her cases with her supervisor, and the supervisor realized that the shidduch wasn’t working. When I called the supervisor to discuss my concerns, after about three months of this torture, she recommended something called parent-child interaction therapy (PCIT). I felt a little offended, thinking she was blaming me for Hindy’s behavior. When I looked into the program, it seemed hopelessly scripted and artificial to me. But at that point, I was willing to try anything. And I liked the idea that PCIT would give me skills to deal with Hindy instead of bringing another stranger into the picture, which would make Hindy even more anxious. Plus, it was covered by insurance.

The PCIT program took about three months to learn, and involved two aspects: special play time known as child-directed interaction (CDI), whose goal is to foster a loving and nurturing bond between parent and child, and parent-directed interaction (PDI), in which effective discipline strategies are implemented.

After an initial evaluation with Hindy, I went alone for a session to learn PCIT techniques. Then, for about six weeks, I took Hindy along once a week and played with her in the therapist’s office, while the therapist sat behind a one-way window coaching me through an earbud.

Besides that, every day at home, I had to spend five minutes playing with Hindy, with no distractions or interruptions. During this special play time, I had to focus on interacting with her using the five categories whose acronym is “PRIDE”: praise the child’s actions (“Wow, you’re building so carefully!”), reflect upon the child’s statements (if the child says, “I love Lego,” say, “You do love Lego” or “Lego is fun!”), imitate the child’s play, and enjoy the shared time. For these five minutes of CDI, I was not supposed to utter any criticism, commands, or questions.

The results of the special play time were remarkable, and were not long in coming. Hindy started trusting me much more, and I felt more loving and positive toward her. We became a team — she sensed that I was on her side, instead of constantly reprimanding her, and she began listening to me much faster when I tried to calm her.

After about six weeks of CDI, I added the parent-directed interaction portion of PCIT. This began with a “listening game,” with the therapist coaching, first in person and then in the earbud. The listening game started with easy commands during special play time, followed by praise when Hindy complied: “Please put the blue block on top of the tower,” and then, “You did a great job!” Time-out was also explained then — if she wouldn’t listen to a play command, she’d need a time-out for not listening to Mommy.

After two sessions of this, I began giving her direct commands to clean up after special play time. The command had to be worded unequivocally: “Please put the doll in the bin,” not “Can you put the doll in the bin?” or “Let’s put the doll in the bin.”

I learned exactly how to deal with Hindy’s misbehavior each step of the way. First, I gave a direct command. If she didn’t listen, I would say, “If you don’t put the doll away, you’ll need to have a time-out.” If she didn’t listen after a few seconds, I would tell her to go to our designated time-out chair. If she didn’t go, I would pick her up from behind, under her arms, and take her there. If she got up from the chair before I told her she could, she would have to go into a time-out zone where she could see me but could not come out, such as behind a baby gate or a couch.

After we mastered the listening game, I began giving her one or two direct commands during the day, always followed by praise for listening, or time-out for non-compliance. The commands had to be stated unemotionally, and phrased in the positive: “Please put your feet on the floor,” instead of “Stop jumping on the couch.” Aside from those few direct commands, I made sure to word all other instructions to her as indirect suggestions: “How about you get into pajamas?” or “Let’s go to bed now, okay?” This way, she wasn’t “not listening” if she didn’t comply immediately. Soon, I was able to use direct commands whenever I needed Hindy to do something.

Once we had the listening part down pat, it was time to introduce “house rules.” I presented these one at a time, at a calm, neutral time. “Hindy, I loved how nicely you were playing with Shua this morning. You’re getting so good at being nice to other kids! But sometimes people forget to be nice. So we’re going to make a rule in our house that there’s no hurting. If you hurt someone, you’ll need to take a time-out. For the next few days, if you hurt, I’ll remind you of the no hurting rule. After that, hurting would get a time-out right away.”

For the next two or three days, any time Hindy smacked Shua, I’d very matter of factly label the behavior: “That’s hurting. That would be an automatic time-out.” On the day that I was ready to enforce the rule, I would inform Hindy that hurting would result in a time-out. When she broke the rule, I would say, as if reporting on traffic conditions, “That was hurting. Please go take a time-out.” After a minimum of three minutes, at a time when she had been calm for at least five seconds, I would “catch” her sitting nicely and praise her for it: “You’re sitting nicely, you can come out now. Remember, no hurting.”

During the first few days of enforcing a rule, there were typically quite a few time-outs, but those quickly decreased. “As soon as you have fewer than two time-outs a day for a particular rule, you can introduce another one,” the PCIT therapist told me.

Along with instituting automatic time-outs for not listening or for breaking a house rule, I kept up special play time and praised positive behavior effusively, while paying as little attention as possible to negative behavior and ignoring anything that did not demand intervention. To my surprise, Hindy was receptive, even eager, each time I presented her with a new rule, and the time-outs were hardly the aggressive confrontations I initially imagined they would be. Because the system was clearly explained in advance and the consequences were totally predictable, Hindy hardly made a fuss when I directed her to the time-out chair. On my end, because I knew exactly how to respond, I didn’t feel angry when I imposed the time-out, and I didn’t feel emotionally drained in the aftermath.

If Hindy needed a time-out, I gave it, and as soon as it was over, I was able to hug her and tell her how wonderful she is and continue playing with her — because I’d never gotten sucked in to a power struggle or an emotional confrontation. In fact, there were very few confrontations taking place altogether; if she flung her cereal, I’d simply say, “Please clean it up.” I knew she’d listen, and if she didn’t, I knew what to do next. There was no more lecturing, no more feeling at a loss for how to respond. The resentment didn’t build up anymore; I just dealt with the behavior and then went back to enjoying my kids.

Watching PCIT work in real time, I realized that although the program seemed artificial and technical to me, for Hindy, these scripted protocols were actually a gift, because they took the guesswork out of her life and dramatically reduced her anxiety. In addition, the special play time we shared each day established the tone of the relationship as essentially positive, something I had never managed to achieve before.

Previously, mothering Hindy had been about survival. Although I had forced myself to stay calm when dealing with her, inside I had been in a state of war. I must get this child to behave! I need to have a life! But now that I had a formula for successfully dealing with her explosions, I finally felt at peace. Now, discipline was something that occasionally happened; warm, positive interaction was our state of being.

Another side benefit of PCIT was that it gave me very clear guidelines for how to spend one-on-one time with a child, so I started to give each of my kids “PRIDE” time, which did wonders for them, too. I had always wanted to spend “quality time” with my kids, but I had always been too stressed and exhausted to figure out when and how.

Today, I realize that it’s not enough to force myself to speak calmly to my kids when I’m upset — I have to work at eliminating the emotional negativity from within, because when a mother is stewing on the inside, the children feel it, and the entire home suffers. I’ve also learned not to attach any emotion to Hindy’s misbehavior — she isn’t out to get me, she just needs to learn skills. And I trust myself more to help her learn those skills.

Hindy is still a high-strung, anxious child, and we still have a lot of work to do with her. But today, baruch Hashem, we’re able to deal with her issues in the context of a loving, relaxed home environment where we can focus primarily on her positive qualities: her energy, her empathy, her creativity, her leadership skills, and her problem-solving abilities.

She makes life cuckoo sometimes, but she has so much to give as well. One day she’ll make an amazing head counselor. She’s great at thinking out of the box, and whenever she solves a problem for me — finds my keys, gets her siblings excited about cleaning their room, entertains the neighborhood kids on Yom Kippur –– I say, “What would I do without Hindy? Everyone needs a Hindy!”

Recently, the baby wasn’t feeling well and refused to eat anything I offered. I was wondering what to do, when Hindy showed up with a tomato, because she knows that her little brother likes tomatoes. When the baby started eating the tomato, Shua piped up, “Everyone needs a Hindy!”

(Originally featured in Mishpacha, Issue 646)