Standard behavior modification approaches are designed to support adults in guiding energetic children with attention deficit disorder (ADHD or ADD) toward choices that will maintain harmony in homes and classrooms.
The Nurtured Heart Approach® (NHA), created by therapist Howard Glasser in the late 1990s, is often considered “behavior modification.” But it is really a revolutionary way of building positive adult-child relationships.
Instead of trying to modify behavior and exert control, NHA transforms the child by altering the way his parents relate to him. Eventually, it changes the way the child relates to himself and the world.
Testimonials are not difficult to find. Says one mother: “My husband and I were desperate to find an approach that worked for our high-energy six-year-old boy. No form of discipline made him listen to us or follow rules. We tried the NHA, and it transformed my son into a well-behaved, considerate boy who listens to his parents. I consider this a miracle.”
A Brief History of NHA
In the early- to mid-1990s, Howard Glasser was working as a family therapist in private practice in Tucson, Arizona. Many families came to him seeking help managing their challenging children. All his training and focus went toward trying to help these families, but the tactics his training had taught him didn’t improve his clients’ situations.
Disillusioned and frustrated, Glasser started to work on new ways of working with these children, guided by his own history of being an exquisitely difficult child himself. Through a process of intuition, trial, and error, he created an approach that, for years, didn’t have a name. Word traveled quickly as he seemed to “cure” young people with ADHD. Interns trained in his methods at a family therapy center he opened in Tucson and it became more effective than professionals in improving the behaviors of challenging children.
Eventually, Glasser started to formalize his methods, which enabled him to teach it as a unified approach. And he came up with a name. He wrote his first book with therapist Jennifer Easley, Transforming the Difficult Child, which — more than a decade later — remains a top seller on Amazon.
Since its inception, the NHA has been adopted by hundreds of thousands of families, thousands of teachers and administrators, dozens of schools, and dozens more school systems and child welfare systems.
A multi-year University of Arizona research study on this approach is nearly complete at this writing. It looks at whether the NHA reduces children’s ADHD symptoms of impulsivity, hyperactivity, and inattention, reduces parental stress, and increases a sense of competency among parents of children with ADHD. Early results are promising.
Some of the most compelling evidence for the approach’s effectiveness comes from parents: “Our son has always been intense, but as he approached four he was starting to act out in increasingly difficult and physical ways. Within 48 hours of [using NHA and] reinforcing his positive behaviors and de-energizing his negative behaviors, he was a different child. I fell in love with my son all over again.”
NHA in a Nutshell
The overarching impetus of the NHA is that the intensity that goes awry and that eventually becomes symptomatic and diagnosable is the energy source that fuels a child’s greatness. Instead of having a child run laps to burn off intensity or placing him in activities meant to channel that life force, you can use specific ways of relating to the child that transform that intensity into fuel for the child’s innate greatness. From that place, the child is drawn to make good choices, use wisdom and self-control, and to be compassionate and collaborative.
The NHA sets up the transformation by creating a paradigm shift for the adult. It carries the adult learner through a series of contentions, intentions, and techniques to engineer this shift. The principles of NHA are:
Stand One: Refuse to Energize Negativity
Children learn at an early age that they get a lot more “juice” from adults when things are going wrong. Naturally intense children will work that dynamic to obtain the biggest possible dose of focused, emotionally vivid connection from adults. Stand One begins to flip that dynamic: simple refusal to connect in an energized way with the child around challenging behaviors. It is crucial to establish this first stand before the other two, but it becomes effective only when it is used alongside the second Stand.
Stand Two: Purposefully Energizing Success
This Stand is about finding and acknowledging positive and neutral behaviors — any behaviors that don’t involve breaking rules. It flips the dynamic of energy for negative behaviors into energy for positive and neutral behaviors. As the child comes to expect to be rewarded with connection and appreciation for not acting out, he shifts.
Mastering this Stand entails a consistent appreciation and commitment to remember to state appreciation in moments when a parent thought nothing worth remarking on what was happening. What is appreciatively expressed to the child is never BS. It comes from truth-based recognition, based on what has been there all along.
Stand Three: Clear Rules and Consequences
The third Stand is: Be clear about the rules of your household or classroom, stating them in a “No…” format (“No hitting,” “No lying,” “No teasing,” “No leaving a mess”). This brings a greater clarity than so-called “positive rules”: “Keep your hands to yourself” or “Be kind” or “Clean up after yourself.”
Adults who have raised challenging children know that if the line between rule followed and rule broken isn’t perfectly clear, the child will test and push to figure out where the line is. You may end up with a lot of rules, but that’s OK. It leaves more room for Stand Two appreciations where the rules are not being broken: “Billy, I love that you chose to not argue when the game with your brother didn’t go your way. I saw you were upset and you handled those feelings so powerfully and wisely by deciding not to fuss.”
When a rule is broken, the NHA uses an un-energized “reset” as a consequence. This is a form of time-out where the adult temporarily disconnects from the child, giving zero reactivity to the rule-breaking behavior and saying, “Billy, reset.”
The adult watches carefully for the next moment when something is going right or the rule-breaking is dwindling or stopping, and goes back to Stand Two: “Thanks for resetting. I see that you aren’t pushing your sister any more, and that shows me you are using your self-control and thoughtfully expressing kindness.”
A Truth-Based Approach
The NHA may seem overly positive at first. What’s true is that it is based in absolute truth of the moment. Either a rule is being broken, or it isn’t. If a rule isn’t being broken, actively offer energized, positive acknowledgement and appreciation. If a rule is being broken, it’s time for a reset and a new chance for success.