Catch 22: School Exercises Better Prepare Kids for Danger?

A few weeks ago our family’s nightly dinner discussion became centered around my 10-year-old son explaining what it was like to experience a school lock down exercise earlier that day. As he “in a matter of fact way” told his story about a teacher instructing him and his classmates to hide; I couldn’t help but notice a tinge of fear in his voice. Was his fear more projection on my part? Possibly my own fears and anxieties coming into fruition, due to concern for the welfare of my boy and the overall reality of the world we now must live in? This shocking authenticity proclaiming that “I’m here to take your life! I’m here for your children and to deprive you of the very freedom that you hold dear!” The freedom that so many sacrificed and gave their all for; only to replace it with fear for our lives, distrust and vigilance. Was my boy overtaken with this same fearfulness? or “to him” was this simply a certainty that we all must live with? A realism that will soon become a “normal” part of an ordinary day in the life of a child "similar to the cold war air-raid exercises of the 1950s?" The only difference being the cold war attacks did not occur, but legitimate terrorism "more recently" has occurred and "in 2001"on a mass scale. The words I heard on the news days before regarding the San Bernardino attacks echoed through my mind “terrorist attacks are usually done and over before the police arrive.” “We have three options which are to run, hide, or fight.” It makes sense for our schools to break down our children’s options to only two of those choices which are to “run and hide.”

When pondering the overall effects that these modern world threats may have on our children we must understand a few relevant points. Our kids tend to break the world down to its simplest form. They look at things two dimensionally in terms of good or evil, friend or foe. After listening to my child describe ISIS, I realized it sounded more like the dark side in the Star Wars films. Regardless of all the complexities involving human nature, my son was absolutely correct! The difference “of course” being that Star Wars is a fantasy science fiction and fundamentalist terrorism as well as homegrown terrorism along with the deadly promises that both embody are about as real as it can possibly get.
I believe that the effect of the "terrorism threat" on our children can be compared to exposure to other types of violent threats that occur within the backdrop our society. The majority of human beings “children included” are resilient. In time children begin to habituate to specific situations and conditions. In other words, once they become used to lockdowns and the overall threat of attack, the fear or “anxiety” is incorporated into their everyday lives and they eventually learn to adapt “somewhat like the soldier who learns to adapt and survive in the wartime theatre; who learns to sleep at night with bombs detonating in in the backdrop.” In this day and age learning to be prepared for potential threats of violence is an absolute necessity. This does not necessarily mean that children who are warned about the dangers of terrorism and better prepared for it will constantly struggle with anxiety or trauma. Nor does it mean that they’ll have to contend with mental illness throughout their lives. When children become clinically anxious or traumatized, it’s usually associated with direct or continual exposure to violent acts and images or physical abuse and/or neglect, which is not necessarily correlated with learning self-defense or being taught where to run and hide when you’re being targeted by predators. However, it’s probably not a good idea to allow children to view graphic, violent images of the atrocities associated with terrorism or to let them watch overly violent television shows meant for mature audiences. Allowing our children to incessantly play violent video games on a continual basis is also not a good idea. These vehicles can become preoccupations and are known to produce genuine anxiety and fear in our children and sometimes aggression. 

Please do not misinterpret what is being said here. The world has changed and it is a very different world that we are raising our children in. We need to face this fact. These changes do indeed affect our children’s emotions and thinking as well as the forming of their beliefs and ideologies. But, let us not associate the teaching of preventive measures, preparation and vigilance and proper informative discussions with them about terrorism, violent threats and safety as direct causation for our children to become overly anxious, traumatized, insecure and significantly unstable. Being made ready is a good thing and it saves lives. The limiting of preventative measures such as lockdown exercises and failure to explain these very real threats to our children would leave them ill-equipped and more exposed to danger. I believe that It is better to be educated and informed than not prepared.

Dr. Thomas Cordier is an author and public speaker on mental health topics. He is also a researcher and psychotherapist specializing in cognitive-behavioral treatment aspects. His book entitled, "An Introduction to the Interpersonal-Cognitive-Behavioral Therapy Treatment System (I-CBT): A Recie for Mental Health Treatment Success" is curently available worldwide. He has extensively researched the efficacy of an interpersonal, integrative approach to cognitive-behavioral-therapy (CBT) and created a model and manual that is easily comprehensible regardless of the patient's age or learning abilities. Dr. Cordier created the interpersonal-cognitive-behavioral treatment program (I-CBT and the I-CBT Family Systems Program at the New England Center for Cognitive Behavioral Therapy (NECBT) and the NECBT Cordier Institute for I-CBT. http://www.NECBT.com

WHAT TYPE OF PARENT ARE YOU?

Parenting….it is one of the toughest jobs in the world. It is also one of the most rewarding! When we parent, we have to make so many on the spot decisions, deal with lack of sleep, worry, and have so much thrown at us all at once. How we deal with the stressors, behavioral concerns, etc. can have so much impact on our children. It is so important to learn what style you use and whether it is effective. In the parenting seminars we teach at NECBT, we talk about four common parenting styles – Authoritarian, Authoritative, Permissive and Uninvolved. In teaching these seminars, I really think we need to add a fifth – The Helicopterer.

First, let’s define the first four styles:

Authoritarian – Strict rules, high demands but unresponsive to children, punishment and explanations such as “because I said so!”

Authoritative – Establishes rules for conduct but more democratic. Parents are responsive to their children and work toward helping their children become responsible and self-controlled.

Permissive – Parent is lenient and responsive, indulgent with few demands. Low expectations for their child’s self-control. They avoid confrontation with their children. They are more like a friend

Uninvolved – Few demands, sometimes neglectful, sometimes rejecting or emotionally or physically abusive, not involved in children’s lives.

Helicopter Parenting is yet another style – and I think this may be a new style that is not healthy.  Helicopter Parenting is defined as “A parent who takes an overprotective or excessive interest in the life of their child”. This is the total opposite of an uninvolved parent. This is a hyper-involved parent! Why is this so bad? It sounds pretty good to be protective and interested….doesn’t it?

Here are some of the qualities of a helicopter parent:

• Manages most if not all of their children’s activities
• Believes everything their child tells them without clarification
• Frequently confronts other children, parents and teachers on their child’s behalf
• Basically, solve all of their child’s problems without allowing them to solve them on their own.

Here are some of the negative consequences for the children of helicopter parents:

• Anxiety and fear
• Inability to solve problems
• Learn avoidance as a way of coping
• Inability to deal with friendship issues
• Inability to develop social skills through unstructured play
• Inability to self-sooth or calm themselves

Some of you may remember when kids were sent outside to play “until the streetlights came on”.  In my childhood, we were allowed to go out and explore, make new friends, fight and make up with friends, learn and discover how to work within groups of friends, deal with whatever came up. There is something to be said for learning self-sufficiency, making our own mistakes and figuring out what to do to fix them, and feel the struggles as well as the sense of accomplishment when we came out of them through the use of our own devices.  I acknowledge we are in a different time; however, we as parents can learn how to let go a bit and help our kids make some of their own decisions, process with them their mistakes, and help them to become self-sufficient, confident and responsible. It’s kind of like having them on an invisible rope tied around their waist – you let the rope out occasionally and, when needed, pull it back a bit. It is allowing them to explore and discover, fall down occasionally, and being there to help them get back up again.

The good news is that we are able to help helicopter parents (as well as any parent!) through teaching I-CBT skills and a different, more effective way to get the behaviors they want from their kids through our Family Systems Treatment Method which includes Parent Management Training. We can also empower their children in individual and group therapy to help themselves learn how to challenge their irrational thinking, calm themselves and come up with more functional, rational thinking.

Let go a bit Helicopterers! Imagine a more rational, calm household with children who exhibit increased self-sufficiency. Sounds better, doesn’t it?

Bonnie Lillis, LPC

Clinical Director

Tips for Parents who have Children Diagnosed with ADHD

Any parent who has a child that has been diagnosed with ADHD can use help managing their lives! The following tips may offer assistance:

STRUCTURE - Children with ADHD need structure to function successfully.

• Providing meals, bath, homework and bedtime as closely as possible at the same time every day can be helpful.
• These kids also benefit by doing their homework in the same place every day.
• Allowing them to do something physical after school instead of sitting down immediately to start their homework can help them to focus.
• Having them break down their work into small manageable “bites” can often be the answer to decreasing their sense of being overwhelmed.
• Giving them 25-30 minute increments for homework or tasks then a 5-10 minute break can also be very effective.
• At home you need to check their homework and ensure they have put it into their book bag. Often they will have completed their homework but forget to turn it in. They will need your patience and your help to stay organized as this is often very challenging for them. Providing a check list for chores, routines and homework can also help your child improve their organization.

PREDICTABILITY- ADHD children need predictability or they tend to get anxious, antsy or act out.

TRANSITIONS - Transitions can be difficult. To decrease their anxiety, provide them with a simple, succinct explanation ahead of time and rehearse the transition with them when appropriate.

BRIEF EXPLANATIONS - Keep your words brief. When our explanations are too long, these kids will often tune out as it is difficult for them to continue concentrating. They often are uncomfortable admitting this at home and school. This leads to moving forward with insufficient information, thus leading to trouble.

HELP WITH SHORT-TERM MEMORY - Most people don’t understand that ADHD kids may have short-term memory problems – you may think that they are not listening but they really are! This is why they don’t recall the directions. What will increase their success is giving them no more than 2 step directions and showing them exactly what you want to do. They learn visually so it is helpful for them to have a picture of the activity. Check off lists can also be helpful with pictures for children who are younger.

RELAXATION - ADHD children frequently act impulsively. They need you to help them slow down, take some deep breaths and look at the consequences of their behavior before just plunging in.  Since they can be anxious it is helpful to teach them relaxation skills:

·         Deep breathing (slowly)

·         Give the whole family the opportunity to have a “calm half hour” when no one talks, no electronics, and everyone does something quietly. This teaches them it is okay to not always be on the go; and relaxation actually feels good!

·         Recognize when your child may be over-stimulated.  

·         Planning less activities in a row or introducing calming activities can go a long way to help your child self regulate.

·         Help your child find some activities that are self soothing is also important.

NOTICE WHAT THEY DO WELL - As with all children, it’s important to notice when they are doing things well and to provide an enthusiastic response.  Children with ADHD often develop a poor sense of self-esteem as adults are correcting them quite a bit. They often feel that they can do nothing right (“Lower your voice, can’t you settle down? Why do you always have to be moving? Why aren’t you paying attention to me? Why can’t you ever do your homework without a scene?”).

COGNITIVE BEHAVIORAL THERAPY - Sometimes therapy can help them to develop a greater belief in themselves as well as provide support to parents who are often feeling frustrated and overwhelmed. Cognitive Behavioral Therapy is a key component to your child’s success as it helps them learn that what they think determines how they feel. Learning how to challenge their thoughts can give them an invaluable tool for handling their emotions. Since impatience is often a product of having ADHD, many children can benefit by learning good anger management skills which help them in developing healthy relations and self-control.

HELP THEM TO LEARN HOW TO DO OTHER THINGS WELL - Creating a behavior program where two behaviors are targeted and the child earns a point for each time the target behavior is executed is essential. These points lead up to a reward which increases their incentive to change their behavior. Rewards can be material, extra time with you, choosing what they will have for dinner, staying up later, or having a friend over are a few suggestions. It is essential to ignore the behavior you do not want and reinforce the behavior you do want enthusiastically!

HELP THEM LEARN GOOD SOCIAL SKILLS - In addition, they can use some assistance with social skills. They tend to interrupt peers when they are talking – they are sometimes concerned that they will forget what they want to say! They may need your help in understanding how they represent themselves to others. Rehearsing effective communication, friendship skills, how to handle being bullied, manners and how to decrease their impulsivity, etc., is a way for your child to feel more confident. Help your child to be able to pick out their strengths and state them to themselves often. This helps them to develop positive self-talk.

MOVEMENT IS KEY - Children with ADHD sometimes learn kinesthetically which means they like motion. When their body is occupied it is easier for them to focus (for example, chewing gum, squeezing a squishy ball, using clay, swinging their foot back and forth, etc.).  They require a lot of physical exercise which helps them to ground their energy, decrease overstimulation and hyperactivity. Getting a mini trampoline works well when they need to get their energy out when the weather is inclement. If enrolling them in sports, they do best in a sport such as soccer, hockey, or lacrosse which has continuous movement. Playing baseball may be more difficult as it may be difficult for them to wait their turn.

ADVOCATE FOR THEM IN SCHOOL - Parents play a very crucial role as their child’s advocate in the school system. When your child is diagnosed with ADHD they are entitled to modifications at school which enhances their ability to learn. The law that provides them with the right to modifications is called “The American Disabilities Act” (ADA). Unless they have any learning disabilities they are not qualified as “Special Ed” but rather “Other Health Impaired” under what is called a “504 plan”. Schools will rarely tell you about this option unless you bring it up. Possible modifications:

• Taking tests in a room other than the classroom so there will be fewer distractions
• Getting more time to take a test since their attention may wander. This can also provide them some extra time to check their work as they often rush through to finish, increasing their chances to make careless mistakes.
• They can check in with the school social worker/psychologist at the beginning and the end of the day to process any problems that may have come up.
• They can be allowed to chew gum, use a squishy ball, have a wiggle seat, get up for a sensory break, leave the room for a stretch break or drink of water, bring papers to the office for a teacher, have a classroom job and have the teacher give them a subtle cue when they are off task.

After school activities that allow for expending energy and making friendships are pivotal to their success.

MEDICATION? - You may want to consider options to treat the child’s ADHD with medication. You will need to consult with a good Child Psychiatrist. After the diagnosis is made it is often permissible to obtain the medication from your primary care physician. However, a mental health professional is required to diagnose your child.

Children with ADHD have many gifts such as well developed intuition, sensitivity, creativity, intellectual prowess and unique ways of looking at the world. They can teach us a great deal from their perspective!

Andrea Schear, LCSW

The Erosion of Self-Esteem and Creation of Negative Body Images

What is your body image? How we think about how we look can either positively or negatively impact our self esteem or how we feel about ourselves. Our body image is formed out of every positive and negative experience we have had. Mine started at a young age when my mother complained that she had to buy me “chubbies” instead of wearing the hand-me-downs of my sisters. It has continued to take hits from classmates, friends and most of all from what I call the “tyranny of the media”. Think about all of the images you are bombarded with on a daily basis – the ones that show the perfect bodies, the beautiful faces, and even their seemingly perfect lives. This does not even include the sexualization of women based on their so-called perfection…..and that message can have us question whether we are attractive if we don’t look "perfect".

What I find so disturbing is that children and teens are so impressionable. Our children are literally attacked by images through social media, Youtube videos, magazines, movies, television shows and especially commercials. Here are some disturbing facts, taken from www.nationaleatingdisorders.org.

·         42% of 1st-3rd grade girls want to be thinner (Collins, 1991).

·         In elementary school fewer than 25% of girls diet regularly. Yet those who do know what dieting involves and can talk about calorie restriction and food choices for weight loss fairly effectively (Smolak, 2011; Wertheim et al., 2009).

·         81% of 10 year olds are afraid of being fat (Mellin et al., 1991).

·         46% of 9-11 year-olds are “sometimes” or “very often” on diets, and 82% of their families are “sometimes” or “very often” on diets (Gustafson-Larson & Terry, 1992).

·         Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives (Neumark-Sztainer, 2005).

·         35-57% of adolescent girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives. Overweight girls are more likely than normal weight girls to engage in such extreme dieting (Boutelle, Neumark-Sztainer, Story, &Resnick, 2002; Neumark-Sztainer&Hannan, 2001; Wertheim et al., 2009).

·         Even among clearly non-overweight girls, over 1/3 report dieting (Wertheim et al., 2009).

·         Girls who diet frequently are 12 times as likely to binge as girls who don’t diet (Neumark-Sztainer, 2005).

·         Of American elementary school girls who read magazines, 69% say that the pictures influence their concept of the ideal body shape. 47% say the pictures make them want to lose weight (Martin, 2010).

·         The average American woman is 5’4” tall and weighs 165 pounds. The average Miss America winner is 5’7” and weighs 121 pounds (Martin, 2010).

·         The average BMI of Miss America winners has decreased from around 22 in the 1920s to 16.9 in the 2000s. The World Health Organization classifies a normal BMI as falling between 18.5 and 24.9 (Martin, 2010).

Do these statistics disturb you as much as much as they do me?

Bottom line (no pun intended), we are allowing the media to erode the vulnerable self-esteem of our children and teens. Here are some things to think about to help our children, and us – think of it as putting on strong armor so that these messages don’t sink in as negative attacks.

Myth: I want to look like a magazine model in real life. 

Fact: Even models don’t look like their pictures in real life.  There are many tricks to “doctoring” pictures.  Some techniques include airbrushing, computer alterations, special lighting to cast shadows in just the right places, even black and white photography, especially on “muscular” men, so that the definition of muscles is greater.  All types of media trick us into thinking that there are people who look far more “perfect” than any person really ever does.

Fashion models are actually thinner than 98% of women. Why would we allow this low percentage of people regulate how the rest of us feel?

So, how can we fight this? One way is to have a radical acceptance of our body and to develop an attitude of gratitude for what our body actually accomplishes. Here are some of those marvelous accomplishments we take for granted every day:

•         Fights off infection

•         Allows you to move

•         Rewards you with the sight of a sunset

•         Heals the bruises

•         Expresses emotions

•         Creates another human being

•         Defends you and heals you from attack

•         Gives you pain to inform you that something needs to be cared for

•         Releases you from pain

•         Allows you to hear the sound of laughter

•         Refreshes you after a night’s sleep

•         Allows you to touch, hear, smell, see, laugh, cry, scream, and live!

Finally, we are much more than what we look like. We are strong, loving, intelligent…you can name the adjectives for yourself. As for your body - respect it, love it and become comfortable living in and with it! You are so worth it!

Bonnie Lillis, LPC, CI-CBT

New Groups for Children and Adults

Group Therapy at NECBT can be effective for all ages.

Here at NECBT are in the midst of some exciting developments in the arena of Group Therapy.

While we have long been holding an ongoing Children’s Group to help our child patients develop Social Skills and work on their Emotional Intelligence, we are now introducing new groups into our repertoire!

Children’s Yoga, while previously incorporated into our Children’s Group, will now be its own separate entity. Children’s Yoga, once only offered every other week, will be offered for patients within our practice on a weekly basis every Monday at 4:45 pm.
Our Yoga Teacher, Mandee Morris, has completed her Children’s Yoga Training with KAY (Kidding Around Yoga), and makes the practice much more than just slow-movement and breathing. The class is fun as well as useful in guiding children toward mindfulness and our I-CBT based rational thinking.

Is your Child or Teen struggling with Anxiety this School Year?

The 2014-2015 school year is now in full swing. Children and teens are working on assignments, preparing for the first tests of the new year, and also trying to balance different extracurricular activities such as sports, music, theater, and scouts, just to name a few. It is important for our young people to be well-rounded and to be exposed to different experiences. However, on occasion, children and teens can become overwhelmed and anxious in the midst of everything going on in their lives.

Here at New England Center for Cognitive Behavioral Therapy & Psychiatry, we know that Anxiety comes in all different shapes and sizes. It can emerge in different circumstances, and at different times for every child or teen.

In some cases, a child or teen may have Social Anxiety brought on by the pressures to fit in with their peers at school. Other children may find that their Anxiety is brought on by test-taking and a fear of failure.

There are many different types of Anxiety, and they are each characterized by different symptoms.

Children and Adolescent Programs at NECBT

The 2014-15 school year has begun. At this time of year, children and teens may find themselves feeling anxious or depressed, either from the new added stressors from school, or even from social situations in which they feel uncomfortable. In some cases, families may be discovering for the first time that a child has symptoms associated with ADHD. Others may simply need help learning how to better manage their stress. At NECBT, we can help children, teens, and their families get on the right track this school year.

Treating children can be challenging. In fact, a child’s brain is not fully developed until his or her mid-twenties. At New EnglandCenter for Cognitive Behavioral Therapy our philosophy for treating children and adolescents is to highly involve the parents and/or guardians. We have had a lot of success with this approach to children’s therapy. Parents are taught the same I-CBT used in individual session as well as how to use evidence based reinforcement techniques to encourage preferable behaviors.  Parents are then better equipped to handle their child’s behaviors outside the office setting. 

For more about I-CBT, a hybrid of Cognitive Behavioral Therapy and Emotional Intelligence developed by American Psychotherapist Thomas A. Cordier, please see last week’s post here.

NECBT's Behavioral Parent Training Starts 9/17! Sign up now!

NECBT's next Behavioral Training for Parents and Professionals will be starting on Wednesday, September 17th! 
NECBT’s Behavioral Training is part of the three-tiered system of our Children and Adolescent Programming here at NECBT. Parents of children age 17 and younger who are currently patients at NECBT are required to attend this 10-week seminar to learn how to help reinforce the I-CBT treatment that children are learning in individual sessions. However, Behavioral Training is a great learning opportunity for anyone who works with children, and we are opening up our course to the public as well. 

As the school year starts, being a part of this unique training can equip parents and professionals with the skills and techniques that can make the new school year successful for everyone involved!

Behavioral Training is specifically designed for parents, teachers, and administrators looking to learn strategies to help improve children’s behavior in home, school, and social environments.

Medication Management at NECBT

I-CBT, combined with medication, can help get patients back on track.

Here at NECBT, we consider ourselves a therapy-focused organization. In most cases, we would prefer to approach Mental Health without the use of pharmaceuticals. However, we do understand that at times medication is necessary for individual patients, depending on the nature and the severity of their condition. With this in mind, we offer a Medication Management program that is in line with our philosophy: Medication only when absolutely necessary.

Playing Team Sports to Improve Mental Health

Participating in team sports can improve mental health.

To honor the U.S. World Cup 2014 team who, in spite of their Tuesday loss to Belgium, played inspiringly throughout the tournament, this week's blog post examines the mental health benefits of playing team sports.

It is no secret that there are many mental health benefits to exercise and physical activity. Medical professionals and the media frequently offer studies and information linking physical activity to improved mood. According to this 2013 article by Treacy Colbert, “physical activity stimulates brain chemicals that make you feel happier and more relaxed.” Colbert also notes that with regular exercise, individuals gain more confidence in their abilities, which with steady and gradual improvements, can contribute to improved self-esteem.
It is likely that you have heard runners talk about the “runner’s high” that they get from a boost in endorphins during and after a long run, or that you know someone who participates in a regular practice of yoga, tai chi, or martial arts--activities known for helping to improve one’s focus and relieve stress. An increasing level of research, however, is now showing that while exercising alone is extremely valuable to one’s overall mental health, participating in team or club sports provides additional benefits.

NECBT's Behavioral Training for Parents and Professionals

NECBT's Behavioral Training brings families together.

NECBT's Behavioral Training for Parents and Professionals class will be starting on Thursday July 10^th! As mentioned in last week’s entry, NECBT’s Behavioral Training is part of the three-tiered system of our Children and Adolescent Programming here at NECBT. All parents of children age 17 and younger are required to attend this 10-week seminar to learn how to help reinforce the I-CBT treatment that children are learning in individual sessions. However, Behavioral Training is a great learning opportunity for parents of patients of all ages. 

Behavioral Training is specifically designed for parents, teachers, and administrators looking to learn strategies to help improve children’s behavior in home, school, and social environments.