Emotional Rescue

This article appeared in the Winter 2015 issue of SSA Magazine.

Researchers say a better understanding of emotion regulation can improve interventions for youth in foster care

A growing body of research has shown that learning to regulate emotions—to manage feelings of anger, sadness or even joy—is a key part of human development. Research also suggests that this capacity is frequently impaired among children who have suffered from maltreatment, abuse or poor caregiving.

And yet such findings have had little influence in child welfare systems, says Curtis McMillen, a professor at SSA, adding that interventions that do address emotion regulation often rely on outdated science. For example, dialectical behavior therapy (DBT), a popular and effective approach incorporates a theory of emotion, but one based on research that is 25 years old. “It’s a terrific intervention,” he says, “but it is not based on the science we have today.”

In “An Emotion Regulation Framework for Child Welfare Intervention and Programming” in the September 2014 Social Service Review, McMillen, Colleen Cary Katz, PhD ’14, an assistant professor at Hunter College, and Emily Claypool, AM ’13, a social worker at the Infant Welfare Society in Chicago, survey the research on the topic and suggest how it could improve the child welfare system.

McMillen says the survey, which took into account more than a hundred studies, had its start from what he heard from foster parents he worked with in St. Louis. These foster parents, who cared for especially difficult children, struggled with what struck them as extreme emotional immaturity. A simple request to pick up a dirty towel might set off a 45-minute tantrum.

“It made fostering these kids unpleasant,” McMillen says. “We weren’t having much success with emotional outbursts. The behavioral therapy we were using didn’t do much good.” When he studied the research on emotion regulation, he says, he learned so much that he decided that the information might help others too.

Scientists say emotional episodes typically begin with a change in an individual’s environment that threatens a personal goal, provoking an emotional reaction. Individuals with a high capacity for emotion regulation can quickly recognize the goal at stake and reframe threats and identify new strategies. This capacity, which involves what is known as “executive functioning,” arises in a child’s preschool years and develops through adolescence. Responsive parenting by caregivers who engage a child’s emotions (rather than dismiss them) and provide examples of their own efforts to regulate emotion can help this development.

Researchers have found that many children entering the child welfare system have a diminished capacity to regulate emotion, and they have identified links between deficient emotion regulation and a range of poor outcomes. Substance abuse, for example, may be seen as an effort to suppress unwanted emotion. Anxiety can be understood as a disorder in which individuals regularly perceive threats to their personal goals and cope poorly with the resulting fear.

How can an understanding of emotion regulation improve child welfare services? The authors suggest three ways. First, they say it can enrich existing approaches such as behavioral therapies and attachment theory. In cognitive therapy, for example, clinicians might work with children to challenge notions that emotions are bad or that they invariably last for a long time. Second, the authors say child welfare programs might import existing clinical protocols. They cite ten examples, including affect regulation training, acceptance and commitment therapy and mindfulness-based cognitive therapy.

Third, research on emotion regulation could serve as the basis for new programs and interventions. The authors list a range of “clinical targets” that could serve as goals for these interventions, such as the ability to recognize the unhelpful thinking that can arise during emotional episodes, new behavioral habits during moments of emotional crisis, and a willingness to express what one wants from others during moments of high emotion.

The authors admit that an emotion regulation approach has shortcomings. Researchers do not agree on many of the details of emotion regulation. “Global measures” of emotion regulation, they say, may be too general. “When people measure it, it seems to be correlated to so many important things. It may be we haven’t related to something very specific and what we’ve measured is your general ability to get along in the world,” McMillen says.

For McMillen, the most surprising result of the study was how it changed his own views of emotion. Indeed, he says a better understanding of emotion regulation can help people in many different circumstances, and not just in social work. “I have a completely different angle on it than I had before,” he says. “I’m more sympathetic toward the person who’s emotionally upset. It’s easier for me to understand them.”

McMillen, J. Curtis, Colleen Cary Katz, and Emily J. Claypool. “An Emotion Regulation Framework for Child Welfare Intervention and Programming. Social Service Review 88 (3):443-68.