It takes a lot of work. N.B. - Acute tantrums and their aftermath are NOT an appropriate time for therapeutic Holding Time. Holding Time is a very powerful technique which can work well for children who have been through the adjustment period and can express their feelings, but Holding Time is supposed to be Bonding Time, not Behavior Control Time. By the same token, you don't want to deny the child a chance to cuddle because they had a tantrum and ruined your outing. That would be punishing, and Extinction isn't about punishment.
Cuddles are precious.
Get 'em when you can. Copyright Terry Dolittle Teri Dolittle is the adoptive mom to a son with special health care and developmental needs adopted from Romania at the age of 3, and the birthmother of a daughter with mild neurological issues and learning differences. She worked as a Physician Assistant in neurology before returning turning to study Maternal and Child Health issues as a graduate student, and has been studying and writing about special needs adoption issues since 1992.