To all who have worked on a child psych unit....

We use a sticker system for rewards. If they get all their stickers, they get a ticket they can cash in for prizes. Sometimes this works, sometimes not.

Exercise! Keep groups down to 30 min or less. Do physical activity after every group (speedball, jumping jacks, duck duck goose).

When someone is melting down, you can use distraction. One nurse we have has a persona "Mr Crabby" and she brings bubbles to the patients room. "Mr Crabby says we need to wash our hands. When you brush your teeth, Mr Crabby will blow bubbles over your bed for a few minutes."

Stick to firm limits.

When you have a group of kids getting out of control, say in a normal tone, "Johnny is doing well sitting quitely." You'd be surprised how quick kids ears perk up and they start settling down. Then you say, "Ben is also doing an excellent job sitting quitely." And so on...the kids want to hear their name praised.

It takes time to learn what is going to work for that kid too. And sometimes nothing works except time out and an IM.