Transforming the Difficult Child: The Nurtured Heart Approach

by Howard Glasser, Jennifer Easley

Transforming the Difficult Child brings to life a new way of shifting intense children to a solid life of success. The Nurtured Heart Approach puts a refreshing spin on both parenting and teaching and reveals new techniques and strategies that create thoroughly positive behaviors. This is the newly updated 2016 revision.

Genres: Parenting, Nonfiction, Psychology, Self Help, Counselling, Family, Teaching

272 pages, Paperback

First published January 1, 1998

Reviews

[Jackie · Rating 5 out of 5]

Not only has this book helped me understand the psychology of oppositional behavior, which I have been observing in my son for 14 years, it has provided the key to unlocking the mystery of how to parent this child. Since I started reading this book, I have stopped feeling so hopeless and frustrated when trying to parent him because I now know the best way to deal with him. The book has altered my perspective and I'm now seeing and commenting on good things he is doing, rather than the wrong. I think he is feeling all the positive energy...that he has been needing all along. This feels like a much better parenting approach...of all children. Really grateful to have stumbled across this book!

[Ellis Amdur · Rating 4 out of 5]

There is Pollyanna sweetness to this book that drives me up the wall (hence, the 4 star rating). BUT, it is, nonetheless, a wonderful resource for families who have children with behavioral problems. The approach focuses on kids earning points to get privileges, but NOT gold stars that are meaningless. Points are used so that the child becomes responsible for earning all the good things in life through good behavior. It has the best way of imposing consequences that I’ve ever seen, taking into account the requirements, legal and otherwise, that face a 21st century parent. Finally, this approach is a great way to start when the parents have had difficulty with anger in their own right. Most parents with anger difficulties are frustrated, unskilled, or feel profoundly incompetent to change their miserable situation with their kids, whom they, nonetheless, love. This approach gives the parents a “toolbox” so that they know what to do. They learn to set limits and discipline, and give their kids something up-to-now lacking – real guidance and leadership. Again, the tone can easily make the reader thing that this book is a “liberal,” – let the children have their way – type of book, but read on. It is quite the opposite. It offers parents a chance to be really strong, really clear on values, and openly loving at the same time. In particular, this will prove very useful for parents of children who have the justifiably controversial diagnoses of ADHD, Oppositional-Defiant Disorder, Intermittent Explosive Disorder - these diagnoses that are all-to-often - adjectives that describe kids who don't conform to others' wishes, in school or home. Before I would ever allowed my child to receive any medication for so-called behavioral disorders, I would definitely use the information in this book - I've used it to work with a number of parents with very beneficial effects.

[Tryn · Rating 4 out of 5]

This is a book that one frazzled parent recommends to another. A friend recommended it to me and I recommended it to my sister and another friend, when they called to chat about kids. I’ve read a lot of parenting books over the years, but this is the most practical, confidence-inspiring one I’ve encountered so far. The title, however, is misleading and probably steers too many parents away who would actually benefit from reading it. The very practical, specific advice in this book would be helpful for any parent raising any child. I don’t consider any of my children “difficult” but what I learned in this book is useful to me on a daily basis. It really comes down to the energy we give to our children. Children seek out our energy. If they don’t get enough of it, they will demand it with bad behavior. We can give them our energy in a positive form or a negative form—light or dark. When we affirm and appreciate them, we strengthen them internally. When we strategically place the rope like the trainers for Shamoo do when teaching a killer whale to jump, then we help them to experience success built upon success.

I’ve been hesitant to use praise and rewards with my children because I do not want them to be focussed on those things, but this book shows me how to use them in appropriate ways that are more about appreciation and earning privileges. I need to read this book again.

[The Badger · Rating 4 out of 5]

Nurtured Heart definitely works, but it seems to be an offshoot of Parent Child Interaction Therapy (PCIT) and the Child Adult Relationship Enhancement (CARE) approach. While Nurtured Heart is expensive and time consuming to teach to all staff members in a school or facility, CARE can be taught in a couple one-hour staff meetings. Nurtured Heart is aimed at educators, but fails to take into account the other people children see during their usual day: the custodian, the clerk, the bus driver, their PARENTS! PCIT and CARE make sure these people are also trained.

[Kit · Rating 1 out of 5]

this book let me down. parents don't pick up books like this when the traditional parenting tactics of time out work, and this book is just a dressed up version of it, with a good dollop of parental shaming for seeking help with a child's ADHD thrown at the end.

[Danielle Sullivan · Rating 4 out of 5]

So I have one kid who's autistic and one kid who definitely has sensory issues and may very well be diagnosed with more things when she is older. They are good kids, but the younger especially is a tough kid. A lot of defiance, a lot of testing, control issues, high anxiety, many screaming tantrums that can last an hour, etc. I'm autistic with spd and anxiety too, so we all ended up triggering and exhausting each other, and the older the kids got, the worse it was all getting. I have read a lot of parenting books and am familiar with a lot of different approaches, willing to be as flexible as I can, and very willing to learn about and work with neuroatypical brains/behaviors, but I was at the end of my rope last year, right before she turned 3 years-old, and feeling very hopeless about being able to parent her at all, much less parent her successfully. Nothing I tried worked, a lot of what I tried made things worse, and I was just exhausted and burned out all the time. It was affecting our whole family, and I felt lucky if we made it 5 hours without an hour-long tantrum over something unexpected and insignificant.

I can no longer remember how I heard of this book, and I know I wasn't expecting much from it because it's pretty old at this point, and parenting approaches change quickly. But it totally saved our lives. I implemented some of the simpler suggestions, like using fewer words and gentle, but direct command-form language, right away, and they worked! It was amazing! She started doing the things I asked her to do at least some of the time! Over time, I was able to change how I was responding to the tantrums and other challenges, and we saw huge progress in my daughter's ability to talk through issues, and tell me what was making her anxious, instead of just immediately tantruming. Since we listen to her and try to work with her to solve the issue once we know what it is, she's begun to have more trust that we're on her side and will help her, and since she feels more connected, her overall behavior is so much better. I would not have been able to make these changes without this book, and I'm really grateful for it.

All that said, this book is really aimed toward much older children, so a lot of it we could not apply to our situation. The suggestions for the behavior reward charts seem really overly complicated, and definitely wouldn't work for anybody under 10, I don't think. A lot of the book is pretty repetitive, too, which is helpful at times, but mostly felt frustrating. So the book is, mechanically, not great, but the content and philosophy is top notch, and I do recommend it to anyone with a child with behavioral issues of any kind.

[Isabel · Rating 4 out of 5]

Not sure the Shamu analogy has the same connotation that it did in the pre-Blackfish days, but there's a lot that does still seem to apply since the 2013 update.

I have started using the positive focus and video tape moments with my students. It occurs to me that this really is rewarding and worthwhile for all kids. And really, all adults. What can it hurt to honestly tell someone that they're doing things well? Plus it is affirming to take time to focus on what is going well in my class instead of losing sight of that in constant battle with things that are a bit--ah--off.

I take issue with the idea that filling out the little eval sheets is only 30 seconds of effort on behalf of teachers. The reality is that it's a LOT of effort for the kid to remember to share the sheet and even more effort if the teacher has to get involved with reminders, etc. I feel pretty ADHD myself in the course of a day teaching 7th graders. Little "low effort" sheets like the on described are surprisingly difficult to deal with in the hustle and bustle of the classroom.

Still, if I could figure out a way to work it in to my day, I'd love to do this with about 6 or 7 students in my class. I believe, as Glasser says, that the number of kids needing this kind of intervention is only going to increase, so I really appreciate his giving me a possible "tool" to work with my kids. He is totally right that at the moment, mainstreaming is often very exclusionary. It bothers me to think that this is happening in my classroom and I really hope that with the NHA, I can start to turn this around and make all of my kids active, engaged learners in our classroom community.

[Dey · Rating 4 out of 5]

Main concept: our kids want our energy. If they can’t get it in a positive way, they’ll take negative. We unintentionally end up rewarding bad behaviour by giving more energy to it. Think about asking your kid to put on pajamas: if they do it, you say thanks and move on to the rest of getting ready for bed. That’s pretty low energy and you are moving towards separation. But if kiddo doesn’t put on pajamas? Maybe yelling, wrestling the kid into the pjs - which is much higher energy.

I’ve taken pages of notes, and have started implementing the techniques with both kids (1 who compulsively attacks boundaries, one who is super compliant). Only 2 days in and seeing much better behaviour, plus acting out (temper tantrums and meltdowns) not lasting as long.

It does require me to pay more attention than I had been, and that lack of attention has been a big part of the problem. So having targets to hit each hour for giving them neutral or positive feedback helps me stay focused. (Neutral observations don’t set off kids defenses - have you ever said “no, not really” to a compliment? - while letting them know you are really seeing them.)

So far, we aren’t doing the suggested earning credits for privileges. I’m simply not organized enough for that.

I’m happy to share my notes with anyone.

[Mistiemae1 Downs · Rating 5 out of 5]

I was given this book to read after finally visiting a child psychologist to get help dealing with my very intense, difficult son. I was extremely skeptical and resistant at first, but after implementing just the first step of the Nurtured Heart Approach, I saw instant improvement in my child. This in turn gave me confidence that I needed to continue on my parenting journey in a positive, heartfelt direction.

Do not be put off by the title. Though the book is specifically geared towards the "difficult" child, the results you will see with an average child are just as wonderful! We have four children and implemented the ideas across the board. I am now sure that each of my children is getting the attention they need from me each day.

The Nurtured Heart Approach itself is divided into simple, easily implementable steps that any dedicated parent can do with just a few minutes each day. Each chapter will give the reader additional information and encouragement for each step along the way. There are also chapters and an appendix relating to crossing the boundary from home to school, where many intense children struggle most.

[Carla · Rating 3 out of 5]

I didn't get through the whole book, although these types of books are difficult for me to complete. I liked the overall concept of changing how you interact with your child to make it more nurturing and supportive, but some of the suggested reward system is just too complicated. We tried it a bit when our daughter was younger and we all basically lost interest. There are too many parameters to track and too many tally points to mark up and count. A simpler system based on the same concept would likely work better.

[Jenny · Rating 3 out of 5]

The first part of the book, which talked about acknowledging positive behaviors and not reacting emotionally to negative behaviors, made a lot of sense. The consequence system (e.g. time-outs, delivered neutrally) seemed like a reasonable strategy for many, although we haven't had much luck with time-outs in our house. The reward points system seemed waaay too complicated and I don't really like the notion that all things other than what's needed for life are privileges that can only be earned according to the reward points system.

[Ashley Case · Rating 3 out of 5]

Dnf. This just wasn't the book to help my situation, but that doesn't mean it won't help someone else. I gave up on page 123 when it was talking about a points system that definitely won't work around here. Everything up until that point was already implemented or not something useful for my child. I have done a lot of parenting classes and read several books about it, (foster parent training and domestic adoption classes) so maybe this was too much of a repeat for me.

[Limeminearia · Rating 1 out of 5]

“These other books often encourage parents to go along with giving their children demoralizing psychiatric diagnoses like ADHD, Oppositional Defiant Disorder, Autism Spectrum Disorder, Anxiety Disorder and even Bipolar Disorder. This usually leads to the psychiatric medicating of children and, in many cases, to a lifetime career as a “mental patient” with ever-increasing psychiatric diagnoses and drugs.”

No.

Also beware any book that promises “miracles” and says it will work for any child.

[Carey Cavanaugh · Rating 5 out of 5]

Doesn't matter what kind of child you have. This is an incredible philosophy that respects and finds successes in children.

[Molly Ricks · Rating 4 out of 5]

I've been reading this book slowly, implementing each step as I learn about it. I've actually seen a big difference in behavior in both of my boys so far.

[Brenda Schenck · Rating 3 out of 5]

Have begun using this approach at work with all students and have decided to commit to it for the school year to see how it goes.

[Alli Todd · Rating 5 out of 5]

This is a book I will definitely re-read!

[Rich · Rating 4 out of 5]

Excited to Implement the Nurtured Heart Approach!

“Transforming the Difficult Child” offers a powerful, practical approach to supporting challenging behaviors. The Nurtured Heart Approach aligns seamlessly with our successful PBSIS programming, reinforcing positivity and firm boundaries. The strategies are clear, effective, and empowering for both educators and students.

Our counselors are especially excited for the upcoming staff training, and I can’t wait to see the impact this approach will have in our district. A must-read for anyone looking to transform behavior through strength-based practices!

⭐️⭐️⭐️⭐️/5

[Janelle Kuntz · Rating 5 out of 5]

Unfortunate title but excellent book for learning how best to parent kiddos with intense, big feelings....."orchid" kids. Repetitive at times but probably necessary to drill these concepts into the parent brain. The Nurtured Heart Approach is just a great philosophy to adhere to for all relationships.

[Megan Ivey · Rating 4 out of 5]

There is a wealth of good advice in this book, though a lot of it is hard to follow. The last chapter of the book talks about medication for kids with ADHD. It made me angry that they seem to believe kids who have ADHD could be cured with positive reinforcement alone. Some kids’ lives are greatly improved with medication and no one should make those decisions based off of advice from a book.

[Madelyn · Rating 2 out of 5]

This book is extremely hard to read. I went slow and tried implementing what he recommended. I get the idea. Theory of it makes sense. Not sure it’s entirely doable. Especially with multiple kids.

[Hayley Anderson · Rating 3 out of 5]

I genuinely believe that positive reinforcement is an excellent parenting strategy and I agree with much of what this book said, and I will definitely implement it in my life parenting a "difficult child." I'm only giving it three stars though, because it was very repetitive, carried on with weird metaphors, etc when it could have used that time to visually summarize key points, give specific examples, etc.

Here's the general idea. We want to give all our energy to our children when they are doing something desirable, even if it's something as basic as "not hitting in the last ten minutes." Like really dig deep and recognize our children in moments of basicness (is that a word?). We do not want to water the weeds. Especially difficult children who have learned they can get the most energy out of us when they misbehave, so we are instead training them in reverse.

This should happen 10-20 times a day, and for a child with behavioral problems it needs to be very specific. "Good job playing nicely" isn't going to cut it. More like "I see you're lining up all the blue blocks. I love your focus and concentration. You've been playing so peacefully and calmly. That shows me how your can keep yourself engaged and work hard at a task." That's not a line specifically from the book, but that's the idea. You can also try to see when a child is getting upset and praise them for remaining calm before they act out to try and prevent drama. "I can see it made you mad when your sister took the last cookie. You're showing great self control so far by not hitting or using mean words. You are regulating your emotions nicely."


The advice given on the limit setting is a little more fuzzy to me. If a rule is broken, you simply say "time for a reset" and you turn your attention away until the child has cooled off, and if they need to clean up a mess you have them do that after, if they don't comply, time for another reset. This sounds great in theory but in practice is difficult depending on the issue at hand (hitting, running away from me with my phone, leaving the house without permission, etc).


There was also no advice on transitions. This is a common difficulty among children with behavioral concerns and I was really hoping for a chapter or two with some tips.

There was a good section (though with some weird tangents and metaphors) about school and making it work with the teacher.

Overall worth a read if you need a more specific positive approach to parenting if the basics aren't cutting it, and you realize the traditional parenting methods are actually reinforcing your child's negative behaviors. But hopefully you've been blessed with children who don't require you read a zillion parenting books 😂

Quick add. Some people have issue with the title of the book. But I think that's because they haven't experienced a child that fits that terminology. When a child hits you, siblings, classmates, and teachers, and is consistently disciplined for it, but carries on with the behavior, that child is difficult. A child who maybe once in a blue moon is aggressive, is just a child. I have no problem with the title- some children have behaviors that are difficult to manage. This book is meant for kids with ADHD and ODD, though the author doesn't love those labels. Difficult isn't "bad." A beloved game or a book can be difficult. It doesn't mean it can't be enjoyed and won with the right tools, though!!

[Catherine Gillespie · Rating 3 out of 5]

I read Transforming the Difficult Child: The Nurtured Heart Approach after seeing it recommended as a resource for calm and effective parenting (particularly about getting kids through their homework without fuss, although the book is more comprehensive than just that!). It took me a bit to get past the title. I don’t refer to my children as “difficult,” nor do I find that title helpful even in kids who are difficult. The authors use the term “intense” in a couple of places, and I wish they would have stuck with that in the title too. In fact, I think the title could be off-putting to parents like me whose kids are basically great but sometimes have bad behavior. That said, the authors note that their methods are applicable to all kids, not just “difficult” ones.

Once I got past the title, I found some helpful information. Some of these ideas have been in other books I’ve read–putting energy into positive affirmation rather than giving attention only to negative behaviors, etc–but this book gave detailed examples that helped me think through how to implement the ideas with my elementary-aged kids.

{Read my full review here}

[Derek Jones · Rating 4 out of 5]

Some children don't respond to traditional parenting well. They have some combination of low attention, low empathy, attraction to risk, and high energy that makes them an exhausting and sometimes embarrassing undertaking. I've attended Dr. Glasser's classes, which cover much of the same material here in this book, and he does a great job of pointing out that these personality attributes don't have to be negative -- but they do have to be managed differently.

The techniques do work! However, with any unconventional approach that gives real results (like various diets), the problem is in sustaining the system, which (because traditional parenting hasn't been working) doesn't feel "normal", which can then lead to lapses and "refresher courses" every so often. Still, like diets, this doesn't mean it's not worth doing. They are effective, but not simple.

[Aspidistra · Rating 4 out of 5]

What I mostly got from this book was a better understanding of the emotional dynamics between parent and child when a child is acting out. It helped me to see some counterintuitive ways that I could help my child (and myself) gain self-control. This is not a book specifically for adoptive parents, but many adoptive parents of older children may find it helpful.

The book recommends eventually instituting a very structured points system for helping a child to gain privileges or treats from good behavior. I think this would work well for many kids, but it was too complicated and too punitive for mine. Nevertheless, we have adopted some of these methods in a more informal way with great success.

[Janis · Rating 5 out of 5]

Can I just say 'wow!' I have read many parenting books and have felt they all had merit, but never successfully implemented the ideas presented. This book, while just read and not implemented yet, has the most promising premise for parenting I have ever read. While written for parents of 'difficult' children, I think it would work for any child and possibly any adult that you interact with often. How can you go wrong with focusing on the positives, no matter how small? We all need positive reinforcement, and this book has the answers for how to do it. Finally! I'm still a little intimidated by the process--any change is difficult--but I actually feel a lot of hope for helping all my children to succeed in life.

[Sandi · Rating 4 out of 5]

I don't agree with everything in the book, but it has made a big difference in how I correct my 11 yo son's behavior and his response to correction. I would recommend it for every parent of an Autistic child for sure, and for parents of difficult children as well. I wish it were possible for teachers to adapt this model in public schools, but it is so different that I don't think it would work with all children in class and would take so much time of the regular classroom teacher, but I think it would give them something to think about as far as dealing with difficult children. Special Ed teachers would benefit from reading this book.

[Chris Zable · Rating 4 out of 5]

Recommended by Rachel Gollub.

The upshot of this book is, give as much of your praise and energy as you can to your kids when they're doing what you want, and as little energy as possible when they aren't. We're applying this in our family and, I think, seeing some positive results. Four stars instead of five because the book is very booster-ish and pleased with itself, and because I could have used more details on what to do with unwanted behaviors than just "ignore them" (e.g. when my kid is tantruming in a public place I can't just turn my back) and on how to build the skills needed for positive behaviors.

[James Andersen · Rating 4 out of 5]

I give this book 4-stars, not five, only because it is somewhat hard to read, but the message of the content is great! If its content weren't so repetitive, which might allow the book to be just one-third its size, I would definitely give the book 5-stars. Regardless of the flaw, the book is well worth your read. A child's well-being, after all, is at stake!

I might add, the book's title is a bit misleading because the book isn't necessarily about difficult children, but rather about parents who ought find a better way to deal with certain childlike personalities. Once the parents are properly addressed and trained by the book, you see, the child is no longer "difficult." ;)

[April · Rating 5 out of 5]

Out of desperation i bought this book.. Wasnt even sure if it would work. My son is 9 and I really thought he would scoff at the techniques this book teaches you. I can say it is honestly working. Its not easy to remain calm and consistent but this approach makes complete sense and he actually looks forward to earning points. I find that when i slip into my old ways of giving in and also yelling- his behavior also reverts. But if u stick withthe concept you WILL see a difference fast. I wish i started this years ago.