Behavioral Consult

Dissuading parents from using corporal punishment

Publish date: January 16, 2019

Specific strategies

We can’t just count on words and a handout to counter reflexes to hit, although these have some proven benefit. We have to convince parents to take action on other invisible health conditions such as high cholesterol or blood pressure, prescribing difficult changes in family diet and exercise. While these are also challenging they are not fraught with similar emotion. Parents resorting to hitting are more likely to be depressed, stressed, or have their own histories of ACEs. While we need to advise parents in practical strategies, we need to do this while attending to their strong feelings, family loyalty, frustration with the child’s misbehavior, and personal context, not just the facts about adverse outcomes.

Dr. Barbara J. Howard

Knowing that this is complex, I always leave advice about corporal punishment to the latter part of a visit. It is wise to ask permission to address this topic which some families think is none of our concern. One might say, ”I would like to help you manage this behavior. May I suggest some things that have evidence for helping?” To be effective, we need to lower defensiveness by praising parts of parenting they are doing well, then focusing on one challenging behavior.

Before it must come eliciting a specific example (What would s/he have to do to get hit? How did it work?), empathy with their pain (That sounds really [upsetting, frustrating, embarrassing]), problem solving (What have you tried so far? What has worked best?), and connecting to family opinions (What do your parents/partner say about this? How would your/his or her parents have handled this when you/he or she were growing up?).

Often advice for daily irrevocable special time and quick attention to desirable bits of behavior are first steps to breaking negative parent-child cycles. When a behavior requires intervention, eye contact at child level, acknowledgment of the child’s point of view, brief explanation of why a behavior is not okay, and an age- and offense-relevant consequence (removal of toy, time out, chore card, loss of privileges) have best evidence for reducing misbehavior over time. Letting them know that smaller consequences work better than larger ones is a relief for both child and parent!

The new AAP policy article has references for parenting programs, videos, and handouts – all good ideas. But parents are more likely to make the effort to use these resources when you develop understanding of their situation without judging them, explain reasons for choosing noncorporal discipline, provide evidence-based alternatives, and offer return visits to support them in changing their ways.

Dr. Howard is assistant professor of pediatrics at Johns Hopkins University, Baltimore, and creator of CHADIS (www.CHADIS.com). She reported no other relevant disclosures. Dr. Howard’s contribution to this publication was as a paid expert to MDedge News. Email her at pdnews@mdedge.com.