School Violence: Tips for Parents to Help Children Cope

In the aftermath of the shootings at Sandy Hook School, parents may be concerned about what they should be doing to help their children cope and make sense of this tragedy. Parents can help by listening to their fears and reassuring them that they are safe.

• Find out what your children already know about the event.

• Allow children to express their feelings and fears but don't force the discussion.

• Keep explanations simple and age appropriate. Younger children may lack the language skills to fully express their feelings but can express themselves through drawings and play activity.

• Limit exposure to news coverage of the event.

• Reassure your children that they are safe. Explain that you and the adults in their life do everything they can to keep them safe. Review their school's safety procedure with them and let them know that you have confidence in their school's ability to protect them. Reassure them that these events are not a frequent occurrence.

• Help children gain a sense of control. Doing something to help others may help them feel more empowered. For example, participating in a prayer vigil for the victims or any event that assists people in need reminds them that most people are good and care for others.

• Maintain a normal routine. Having a regular schedule and consistency is reassuring to children.

Most children are resilient and will manage this without significant problems. Parents should stay alert to any signs of continued distress such as nightmares, sleeplessness, excessive worrying or refusal to go to school. In those cases parents should seek advice from a mental health professional.

School Refusal

Written by: Angela Lacalamita, MA, LCPC


School anxiety, refusal and avoidance are increasingly becoming a problem with children/adolescents. Researchers estimate that 2-5% of school age children suffer from anxiety related school refusal. School refusal encompasses a broad spectrum of behaviors to include:

• prolonged absence from school

• sporadic attendance

• skipping classes

• emotional or behavioral difficulty in an attempt to refuse school

• physical complaints of illness without medical explanation (somatic) when faced with having to attend school

There are numerous factors that may influence school refusal. Generally, youth refuse school to avoid academic situations that cause distress (i.e. homework or other school related situations), escape social or evaluative situations (i.e. peer groups or tests), to gain attention from a person in which the child has an emotional attachment toward, to obtain rewards outside of the school setting (i.e. sleeping in, or video games). Many children that display school refusal also display other emotional or behavioral difficulty to avoid school settings i.e., running away, substance use, noncompliance, temper tantrums and aggression. If left untreated, school refusal can lead to significant difficulty with a child’s social, emotional and educational development.

The long-term outcome for children who refuse school is not well established, primarily due to an inconsistent definition.  Regardless of the terminology used, school refusal may be a precursor to disturbances later in life if left untreated. If your child is experiencing difficulty in attending school, a comprehensive evaluation from a mental health professional will reveal the reasons behind the school refusal.

The following are tips that can help your child manage school related anxiety or other stressful situations.

• Relaxation Training: a combination of progressive muscle relaxation and breathing exercises can be helpful. Diaphragm breathing is achieved by inhaling through the nose and exhaling through the mouth for a set number of times. Progressive muscle relaxation is a technique in which a muscle group is isolated and contracted for five seconds and then released. This technique can begin by starting with the feet and gradually work up to the head or vice versa.

• Gradually introduce school to your child in small degrees. Eventually this will help them realize there is nothing to fear and that nothing bad will happen (generally for younger children just beginning school).

• Have your child identify the positive aspects of going to school: being with friends or learning a favorite subject.

• Have your child identify any negative thoughts they may be having. Encourage your child to replace the anxious (negative thoughts) with supportive and calming statements, i.e., “I can handle this.”, “I have done this before.”

• Arrange a meeting with your child’s counselor for support and direction.

• Establish routines: Having a routine offers predictability, improves transitions to school and reduces anxiety. The morning routine prior to school should be the primary focus. It can be a benefit to have regular routines for all parts of the day to limit any behavioral difficulty.

• Learn about your child’s anxiety disorder and research the treatment options.

Dependent Adult Children

Written by: Angela Lacalamita, MA, LCPC

One of the many challenges with parenting is setting limits with your adult children. As parents you want to protect your children from the disappointments and challenges that life may bring. Supporting your children through their early developmental stages is crucial to their growth and development. However, when you begin to continuously rescue them from their problems and/or overlook their lack of contribution to the household, you are potentially fostering dependent children. Protecting your adult children from the challenges and struggles that life brings may prevent them from developing the necessary skills to care for themselves and become self-sufficient. How do you know when to say “No “?  When do you allow them to experience some consequences for their actions?  One way to know the answer to this question is to ask yourself the following questions: Am I beginning to feel resentment, burden and anger for everything I am doing for my child? Am I beginning to feel emotionally and physically exhausted? Am I scared to say “No”? Is your adult child beginning to make demands or use guilt when they are not being given what they want? Are you putting you own happiness and opportunities aside for your child? If you have answered “ Yes ” to any of these questions, you may want to explore ways in which you can motivate and foster your adult child’s independence. 

Protecting your children is only a small part of parenting. It also involves preparing your children for adulthood. When is it the appropriate time to foster independence? Once your children graduate from school or decide to no longer pursue an education, is the time for them to work toward becoming self-reliant. This does not mean that you have to ask them to leave your household. However, they should be working toward autonomy. At times, a variety of reasons contributes to adult children returning home. Allowing your children to return home is acceptable as long as steps are taken to encourage their independence, i.e. contributing to a fair share financial and household responsibilities. If your adult child is becoming dependent, you may have to motivate them and/or force them to become independence. Here are some things to consider.

• Impose household rules for curfew, telephone and TV use and chores. Give them the choice of following the rules or leaving.

• Require working children to contribute part of their salary for room and board. If you do not need the money, then consider saving it for your child to use when they are on their own.

• Helping your child financially should be contingent on their efforts toward developing independence. If you are helping them financially, consider paying off past debts as opposed to providing living expenses.

• Set a time limit on how long children can remain at home before you tell them to leave. If you tell your child that he or she needs to leave, it is very important that you follow through.

• You have the right to say, “No, I have changed my mind” about a previous promise.

• Set limits on how much time you spend helping your child resolve any problems. If your child asks for advice, encourage them to offer ideas.

• Be aware that your child may be angry and possibly reject you. He or she will most likely come around later.

Parental bonding makes for happy, stable child

Parental bonding makes for happy, stable child

The Five Stages Of Grief

The Five Stages Of Grief

Suicide Prevention

Mental Health America: Suicide

Recovering from Divorce

Written by: Angela Lacalamita, MA, LCPC

Marriage is a union by which two people who love each other legally and/or religiously commit to one another.  When you marry your intentions are to spend your golden years and the rest of your life with your partner.  The furthest thing from your mind is the possibility of divorce.  If divorce were to have crossed your mind, you more than likely disregarded the thought and believed wholeheartedly that your marriage would be different. Like many people, you may not have anticipated your marriage becoming another divorce statistic. An unfortunate and disappointing occurrence is that nearly half of marriages, 50%, will result in divorce.  Even more startling is that the likelihood of divorce increases to nearly 60% for second marriages.

Divorce can be an emotionally devastating ordeal and recovery at times can be difficult. As with any loss, you may experience a variety of emotions.  Feelings of anger, sadness, failure, loss among other emotions are quite common. Although divorce recovery is one of the most painful and stressful experiences once can endure in life, it also can be an opportunity to get your life back on track and discover a new life that is filled with happiness. Below are some ways to help you in your process of healing.

Work through your negative feelings.The intense feelings such as sadness, depression, and anger can be painful.  Understand that all of the feelings and emotions that occur following divorce are normal. Try to remember that these feelings do not last forever and work toward accepting them. Once you have been able to work through these emotions, you are more likely to move toward positive changes in your life.

Identify and spend time with the people in your life who can be supportive. 

It is imperative that you be allowed to speak your mind as often as you need to. Supportive, non-judgmental and loving people that allow you to express your emotions, allow you to heal. Surrounding yourself around those who will allow you to vent and not try to “fix” things can help you gradually work through your emotions.

Reflect on what happened in the relationship. Part of the healing process is for you to come to terms with what occurred in the relationship. This is a crucial part of healing so that you can gradually come to terms with the divorce and be able to move forward in developing new relationships. Sometimes this is the hardest part of healing for it requires you to examine your role. Blaming your ex or yourself will be of no benefit. Understanding how you played a role in the dynamics which contributed to the divorce can help you in future relationships. You don’t want to recreate a similar relationship in the future, so being honest with yourself is very important.

Engage in Self- Care. The stress and pain when going through life transitions such as divorce can be overwhelming. You must take care of yourself. Begin by reconnecting with old friends, develop new friendships and involve yourself in activities that are healthy and reduce stress. Get a massage or participate in an activity that you desired to participate in or have placed aside.  

Try to remember that the stages of divorce recovery are complex and different for each person. Allow yourself whatever amount of time you need to recover. If you are confused and hurting, the above approach can help your journey through the divorce process be easier, less traumatic and be on the path of a new life.  

Bullying

Bullying

Potential treatment for cognitive effects of stress-related disorders, including PTSD

Potential treatment for cognitive effects of stress-related disorders, including PTSD

iPhone/iPad Apps Can be Helpful in Treating Stress and Anxiety

Written by Laura Piuca Hinkes, L.C.S.W.

It is well documented that deep breathing exercises can reduce the body's response to stress and help manage anger and anxiety. Though breathing is a natural reflex, many of us fail to properly breathe. We tend to take shallow breaths and let our breathing become rapid when we are stressed, which only heightens our stress and anxiety. Deep breathing can be easily learned and should be practiced consistently to avoid returning to a less effective breathing style. As we increasingly become tech savvy, we are depending more and more on our smart gadgets to get us through the day- to get directions find recipes, do our shopping. It makes perfect sense that we can use apps  to improve our well being. Apps for the iPhone and iPad such as Breathe2Relax or Long Deep Breathing are easy to use, free or very inexpensive. They demonstrate how to properly conduct deep breathing exercises and allow you to personalize the application by choosing the music and graphics. You can also adjust the duration of time you inhale and exhale during the exercises.  Using these apps during stressful times of your day or at bedtime can help develop a routine where you pay more attention to your stress levels and dedicate some time to take care of yourself.

Of course these apps are not intended to replace professional therapy but are merely an adjunct to the work you do in your therapist's office.

Understanding Autism and Tantrums

Written by Angela Lacalamita, MA, LCPC

It is expected that if you have young children they will experience temper tantrums. However, parents of children with autism and disorders on the autism spectrum scale are often faced with more severe tantrums and meltdowns.  Many parents describe feeling isolated, defeated, overwhelmed and even unable to leave their home due to the frequency and severity of the tantrums. Generally, children will experience tantrums if they are tired, hungry or upset. As we learn about our children’s mood and behaviors, we gradually learn to predict when they may experience difficulty. However, with autistic children, tantrums often are unpredictable. One reason they occur is due to their inability to understand the message being communicated. At times, this occurs in situations where the child is asked to shift their attention from one activity to something else. Children who do not suffer from developmental disabilities may struggle with tantrums when asked to shift from something enjoyable, watching their favorite movie to something that is not preferred, preparing for bed.  However, autistic children can easily experience difficulty even when the shift is to another pleasant activity.  Autistic children’s inability to understand and recognize that the new activity can also be enjoyable can result in tantrums. Another reason why autistic children experience tantrums is related to difficulty with transition. These types of tantrums are often related to the child’s inability to understand the message entirely. For example, telling an autistic child that you are going to take him or her for ice cream, may result in a tantrum when it is time to leave. The child’s inability to make a connection between ice cream and time to leave may have been interpreted as something else.

For autistic children, tantrums are a way of expressing themselves. Escalation occurs when their needs/wants are not being met. Tantrums though, are not just related to an autistic child’s inability to understand the message. They are also in part related to the parent’s inability to understand the message the child is attempting to convey. For example, a parent may offer an autistic child some cookies as a snack however; the child desires ice cream and proceeds to have a meltdown. A parent may try to offer other options however; the child does not have the ability to communicate his or her desire for ice cream.

One technique to help reduce tantrums is to implement visual aids. Giving an autistic child a visual aid for each transition (i.e. a visual aid of the car when you indicate it is time to leave and another visual aid of the restaurant at the time you are driving) can reduce the likelihood the child will misunderstand the message. Visual aids that represent time, along with periodic reminders, can also help an autistic child comprehend that the time for the activity is coming to an end.  Another technique that can be helpful is using sequential visual aids (i.e. using 3 pictures on a strip). Sequential visual aids can help autistic children learn not only natural progressions but also visually see each task being completed and what remains.

Significant research supports that music is beneficial for autistic children. Since language acquisition is processed in the left cerebral hemisphere of the brain and music is processed on the right cerebral hemisphere, researchers believe that autistic children are able to comprehend language by the brain shifting to using the right cerebral hemisphere. Providing directions to an autistic child using a melody can help the child comprehend the request being made. Using techniques that are more understandable, such as music can reduce the pressure the child may feel and also make the activity more enjoyable. Providing directions while snapping fingers, tapping your foot or changing the pitch in your tone as you speak can help a child not only comprehend what is being asked but also predict what may be asked in the future. 

Researchers Studying How Exercise Affects The Brain

Researchers Studying How Exercise Affects The Brain

What Are Antidepressants?

What Are Antidepressants?

Strategies to Manage Caregiver Stress

If you are a caregiver, you are not alone. The National Alliance for Caregiving and AARP, estimate that more than 65 million people, 29% of the U. S. population provides care for a chronically ill, disabled or aged family member. Over the next several years, this number is expected to increase significantly.  With the rising costs of long-term care and increasing budget cuts with agencies that provide assistance, it may be unrealistic for some to avoid taking on the role of a caregiver for a family member. In addition to the stress of providing care, caregivers often experience additional challenges. Balancing the pressure of work, child care and relationships can be quite difficult and result in significant strain on a marriage or family. If you are going to care for a family member, it is imperative that you develop effective strategies to manage the level of stress. 

1.) Find a support group for those who are also caregivers. Utilize any community resources or hospitals to locate groups that may be taking place in your community. It helps to talk to others who are experiencing similar challenges.

2.) Self-Care. Get adequate sleep, nutrition and exercise. It is very important that you have the physical and emotional energy necessary to provide care.

3.) Utilize resources such as family, friends professional or community agencies to assist you. There are a number of non for profit social service agencies or government agencies that may be able to provide you some assistance. 

4.) Take care of your emotional well-being. Caregivers are at risk for burnout, stress, and clinical depression. Monitor your mental and emotional health.  See a therapist if you begin to see signs of prolonged sadness, anger, resentment, sleeplessness, alcohol or drug abuse, and anxiety. Also, make sure you get enough time to interact with your friends and enjoy your hobbies. 

5.) Be realistic with what you can give and don't give in to guilt. Feeling guilty is normal, Remember that you are doing all that you can. Ask for help from your family or friends. You don't have to feel guilty about asking for help.

Emotionally Intelligent Relationships

Written by: Angela Lacalamita, MA, LCPC

Over the years I have counseled many couples for a number of reasons. Some of the presenting problems have varied from restoring romance, parenting issues to infidelity. Although these couples presenting problems were different, a similar challenge experienced in these relationships was the lack of emotional intelligence. When we hear of emotional intelligence we may think of leadership skills or personal development. When introduced in the 1990’s emotional intelligence was seen as a powerful key in one’s personal success. If you used emotional intelligence, you were seen as being at the head of your class. The same core concepts which are the biggest predictor of personal excellence, leadership and performance in the workplace, are also critical in creating and maintaining successful marriages/relationships. Emotional intelligence is a unique set of tools that helps us develop the ability to recognize, manage our emotions and use reason and problem solving skills when faced when obstacles or conflict. It also provides us the ability to understand and effectively respond to others emotions. The critical skills in emotional intelligence (anger management, stress tolerance, decision making, assertiveness and social awareness) to name a few, are fundamental in maintaining healthy and successful relationships.  Even through moments of conflict, couples that use emotional intelligence are able to maintain self-control and refrain from using negative communication patterns. These couples ability to remain mutually respectful, emotionally connected and resolve conflict in a healthy manner are a few of the key factors that increases relationship satisfaction and likelihood of success. Here are a few tips to help you add emotional intelligence to your relationship: 

1. Be aware of your emotions. Manage any stress, anger or other negative emotions you may be experiencing. Emotional awareness can help prevent you from displacing your feelings or from negatively interpreting your partner’s comments or actions. The ability to manage negative emotions can help prevent a discussion from escalating and reduce the likelihood that you will say something that cannot be taken back.

2. Maintain a positive attitude and refrain from negative interpretations. Managing negative feelings at times can be challenging. However dwelling on the negative aspects of your partner’s actions can easily consume you and lead to you believing that your partner’s motives are always negative. Spend some time identifying your partner’s positive characteristics. Identify the characteristics that attracted you to your partner. Remember that it is the behavior you more than likely are unhappy with and not your partner’s character.

3. Recognize how your partner feels. Validation is an important tool in building intimacy and reducing anger and resentment. You don’t have to agree with your partners view however be able to respect, acknowledge and relate to the feeling. Use the speaker listener technique. Paraphrase what you hear and focus on the message being sent. When speaking to your partner, only speak for yourself and talk about your thoughts, feelings and concerns using “I” statements.

Regardless of the type of relationship you are involved in, all relationships require work and dedication. Developing an emotionally intelligent relationship does not happen overnight. However, applying these skills can significantly improve a relationship and reduce the destructive patterns and behaviors that lead to relationship difficulty.

When Worrying is a Problem

Written by Laura Piuca Hinkes, LCSW 

Everybody worries from time to time. However, when it begins to consume you, lead to avoidance, distract you from important areas in life and inhibit your ability to problem solve, it's time to take some action. People who suffer from chronic worry experience a variety of symptoms, some symptoms include:

• Difficulty concentrating
• Difficulty controlling the worrying
• Muscle tension
• Feeling nervous
• Fatigue
• Restlessness
• Irritability
• Sleep disturbance

Chronic worriers may try to distract themselves or push worrisome thoughts out of their head only to have the worries creep back in. It would be more helpful to learn to postpone worrying. In this strategy you create a “worry period” where you set aside a time (say 20 minutes) and a place for worrying, preferably the same time and place daily. During the day when a worry or anxious thought arises write it down on your worry list and tell yourself you will attend to it later during your worry period. Postponing worrying in this way can help because it interrupts our tendency to dwell on what is worrying us but doesn't have the expectation that we have to suppress these thoughts. 

How often do we spend time worrying about things we have no control over?  You can ask yourself if there is something you can do to solve the problem. If for example, you are worrying about paying bills, brainstorm all the possible solutions. You could call your creditors, cut back on expenses or get a second job. Try to focus on the things you have the power to change rather than those that are beyond your control.

But what about all those things I have no control over? The truth is we have to accept that there is a certain amount of uncertainty in our lives. Dwelling on all the things that could go wrong doesn't make our life more predictable. Do you tend to predict that bad things will happen when there is just as much likelihood that the outcome will be positive or at least neutral?  People who's tendency is to worry all the time tend to have a pessimistic view of their world. If you tend to assume the worst and focus only on the negatives this will increase your worrying and anxiety. You can focus on ways to retrain your thoughts to be more positive. When plagued with a worried thought challenge the thought with these questions:

• What is the evidence that the thought is true? That it is not true?

• Is there a more positive, realistic way of looking at the situation?

• What's the probability that what I'm afraid of will actually happen?

• If the probability is low, what are some more likely outcomes?

• Will worrying about it help?

• If someone else had this worry what would I tell them?

Talking with someone may help you sort out some possible solutions. It can be especially helpful to talk with a counselor who is impartial. Many counselors use Cognitive Behavior Therapy to help individuals see how negative thinking can affect our lives and how they can discover healthier patterns that will decrease their worry and anxiety.

Treatment of Obsessive-Compulsive Disorder (OCD)

Written by Angela Lacalamita, MA, LCPC

What is Obsessive-Compulsive Disorder (OCD)? OCD is an anxiety disorder that results in obsessive thoughts and/or compulsive behaviors. Obsessions are defined as recurrent, uncontrollable, intrusive thoughts or mental pictures that produce anxiety, fear or worry. Compulsions are repeated actions aimed to reduce the anxiety, fear or worry. People that suffer from OCD will try to control their obsessive thoughts by checking things over repeatedly or perform rituals. Some common obsessions may include: fear of getting a disease/ contamination or unreasonable fear or worry that if things are not perfect, something terrible will occur. Common compulsions may include repeated hand washing or showering, repeatedly checking the stove, door locks, electrical outlets, the need to perform a task a certain number of times or saving things/ hoarding items that may not have value.

OCD can progress to a point where it can significantly interfere with one’s ability to function productively in social, family, work and academic settings.  Dependent on the severity of the symptoms, it could potentially result in one becoming homebound.

What causes OCD? Researchers have not confirmed the exact cause of OCD. However, biological and environmental factors play a significant role. Biological factors point to the neurotransmitters serotonin and dopamine. Experts believe that there are insufficient levels of the neurotransmitter serotonin and over activity of dopamine. More recent studies that have used brain imaging have discovered over activity in certain parts of the brain. Another contributing factor is having a genetic predisposition to OCD due to a family member having OCD or another anxiety disorder. Environmental factors such as stress and/or life transitions can potentially trigger OCD in those who may be psychologically prone.

What are the treatment approaches for OCD?  The American Psychological Association recommends that that use of SSRI medication (selective serotonin reuptake inhibitors) and/ or cognitive behavioral therapy be used in treating OCD. Experts maintain that the use of SSRI’s is an effective approach in manipulating the serotonin level in the body, thus allowing it to be available for other nerve cells. Another approach to treating OCD is through the use of the different treatment approaches within Cognitive Behavioral Therapy (CBT). One effective approach in treating OCD is using Exposure and Response Prevention. This approach is aimed at reducing the intrusive thoughts, images or impulses through repeated exposure to the obsession. The exposure is used to learn more effective thinking patterns and develop adaptive coping skills to manage the anxiety. The response prevention refers to making the decision to resist the compulsion. With gradual and repeated exposure, the individual becomes less anxious resulting in reducing and refraining from engaging in compulsive behavior.

Cognitive behavioral therapy in conjunction with a SSRI medication seems to offer the best long results. Treatment results vary by individual; however most individuals can significantly reduce their symptoms and regain control of their lives. 

Challenges of ADHD and School

Written by: Deborah Miller-Lunsford, LCSW

Many adolescents with ADHD experience significant problems managing school, both in terms of social and academic successes.  Both parents and adolescent can become frustrated and angry leading to a great deal of stress at home.  One of the first steps is to get a formal diagnosis from counseling professional.  With that in hand, the next step is to engage the teachers and school support staff in identifying your child’s needs. Together you can develop strategies for academic success.

There are two different types of attention deficit disorders.  ADHD refers to hyperactivity and impulsivity while ADD refers to those who are primarily inattentive and easily distractible.  According to the American Psychiatric Association, however, the correct diagnostic term for both types is ADHD.  Because these symptoms can be mild to severe, parents see varying levels in skill and maturity impairment.

Our school system is not ideally designed for the ADHD child (unable to provide enough individual attention) so the child often experiences a host of challenges.  Here are some of the more common school problems that your ADHD child is likely to experience.

Restlessness: 

The hyperactive child is often restless, getting up and down from his/her seat disrupting classmates and irritating the teachers.  There can be lots pencil tapping, leg and foot moving and general bouncing around in the desk.

Short Attention Span and Distractibility:

The AD/HD child often has trouble following teacher’s lectures, participating in small group projects and performing well on tests.  The child with short attention span often finds him/herself with a wandering mind. This can result in failing to complete tasks as well as irritating project partners.

Impulsiveness:

This impulsivity can be evidenced by the child blurting out answers in class or making impulsive and incorrect responses on tests and class assignments.  Speaking before thinking is often a real problem for this child.  These statements can often resemble insults but are really just the result of not thinking before speaking. Nevertheless, this can result in the child having difficulty in the social aspects of school.

Procrastination:

Most of us have put off an unpleasant task until the last minute.  With ADHD, kids often wait until the very last minute to begin an assignment and then don’t have enough time for completion.  This can be particularly true of the “long term” research assignments/projects.  These kids just don’t anticipate how much time it will take them to properly complete all the steps and get it ready to hand in on time.  They frequently turn in poor quality incomplete assignments or they don’t get the work done at all.

Trouble Shifting Attention from One Situation to Another:

The child’s ability to shift attention from one task to another is often impaired.  Transition time, when students are switching classes or topics, often results in not turning in assignments at the end of class, forgetting to pack up everything needed to complete homework assignments, etc.  Kids can “over focus” on what they are doing which makes it difficult to switch gears and move smoothly and swiftly from one task to another.

Forgetfulness:

This is a big one!  It applies to almost any activity but it is evidenced in school by forgetting to turn in assignments, permission slips, bring home books, etc.  Homework can become a challenge when the needed materials are “in my locker.”

These are just a few of the more common complaints associated with AD/HD kids and the classroom.  Fortunately there are resources available to teach kids, their parents and teachers positive coping skills.  Structure, consistency and organization are key factors.  Finding an experienced therapist who can guide you is a good place to start.  In addition, you can find several good books that are easy to read and are encouraging for everyone.  Edward M. Hallowell, M.D., John J. Ratey, M.D., and Daniel G. Amen, M.D. are just a few of the recommended authors.  They are excellent resources to assist you with your challenges. 

The most important thing you can do as a parent of an ADHD child is to love them.  I encourage you all to Stop, Breathe and Think before responding.  

Understanding Self -Injurious Behaviors

Statistics vary as to the number of individuals who engage in self-injurious behaviors. Conservative estimates are that about 1% of the general population will self-injure. What is self- injury? Self-injury is defined as deliberate self-harm to one’s body. It can include cutting, bruising, burning, excessive body piercings/tattoos and fracturing bones. Of the above mentioned, most commonly seen is cutting, particularly in youth.  Although there is research suggesting that self-injury rarely represents a suicidal gesture, self-injurious behaviors should always be taken seriously. It can be a strong predictor for future suicide or suicidal attempts (often within 1 year of the self-injurious behaviors) and also lead to accidental death. Contrary to popular belief, self-injurious behaviors are not always a means of gaining attention. Even if the goal was to obtain attention, self-injurious behaviors communicate distress and a need for help. Primarily self-injury serves the purpose of expressing and managing painful thoughts and emotions such as anger, sadness or anxiety. Self-injurious behaviors can also be a means of distraction or a means to gain a sense of control due to feeling powerless in other areas in life. Several effective treatments are available to assist those who self-injure. Treatment strategies may include:

• Counseling using Dialectical Behavior Therapy (DBT): DBT is a form of treatment that assists people in identifying, labeling and expressing emotions. One of the many goals is to learn ways to better tolerate distress and acquire new coping skills through techniques such as mindfulness. One of the several goals in DBT is to be able to identify and reduce stress and tension before incidents of self-injury.

• Group therapy will allow for a healthy expression of emotions and allow people to share their experiences and decrease any shame that may be associated with self-injurious behaviors. 

•  Family therapy addresses any history or family dynamics that may be related to the self-injurious behaviors. Family members will learn to communicate more directly and openly with each other.

• Medications: Antidepressants or anti-anxiety medication may be used to reduce the initial impulsive response to stress.

If you know someone struggling with self-injurious behaviors, be supportive, encourage them to talk about their feelings and don’t expect them to simply stop self-injuring. A variety of alternative coping strategies will be necessary before one will be able to stop using self-injury as a coping method. Try not to judge or criticize for this may increase the risk of self-harming behavior. Encourage them to talk to a mental health professional so that the underlying causes of the self-injurious behaviors can be explored and healthier coping strategies are developed.

Teen Substance Abuse

Written by: Angela Lacalamita, MA, LCPC

A dangerous trend that has been on the rise with adolescents is snorting, injecting and smoking bath salts. Bath salts are similar to “Spice” or “K2” (herbal incense) in which adolescents appear to be drawn to the attractive packaging and assume that the products are a safe alternative to street drugs since they are commonly sold over the counter. This could not be further from the truth. Parents, teachers, and lawmakers need to be made aware that the potential for these drugs to harm the lives of our children is quite significant and little is known about the long term effects. Doctors at poison centers all over the country have reported that bath salts mimic the effects of methamphetamine resulting in extreme anxiety, confusion, paranoia, hallucinations, delusions, elevated heat rate and blood pressure. Since the use of bath salts is shown to raise blood pressure and reduces blood supply to the heart there is an increased risk for heart attacks and strokes. If you suspect your adolescent is using bath salts or other substances please contact a mental health professional for assistance. Immediately seek medical attention for your child if you begin to see any of the following side effects:

• Elevated heart rate
• Euphoric feeling
• Elevated blood pressure
• Bloodshot eyes
• Pale skin
• Extreme anxiety
• Panic attacks
• Vomiting
• Hallucinations or paranoia
• Seizures

Postpartum Depression/Anxiety

By Laura Piuca Hinkes, LCSW

Women today may feel that our culture expects them to be “supermoms” who can cradle a baby with one arm and manage a Fortune 500 company with the other. For many new mothers their experience is anything but super. As many as 50% of mothers experience some form of “baby blues” and a smaller group experience a more serious condition known as Postpartum Depression/Anxiety.

Symptoms of Postpartum Depression include:

• Changes in sleep and/or eating
• Feelings of hopelessness and worthlessness
• Irritability and sadness
• Excessive crying
• Difficulty concentrating
• Lack of interest in or feelings for the baby
• Thoughts of suicide

Symptoms of Postpartum Anxiety include:

• Excessive worry
• Racing thoughts
• Feelings of dread and panic
• Fear of being alone with the baby

A woman who is used to being competent and in charge in her pre-baby life may feel helpless and incompetent when faced with the sleepless nights and around the clock demands of a new born. Some women are reluctant to tell anyone what is happening inside of them for fear of being judged as a bad mother.

Various factors can play a roll in the occurrence of postpartum depression/anxiety. Some authorities believe postpartum depression/anxiety is caused by a drop in the level of maternal hormones after delivery. Others blame it on a difficult and prolonged labor and delivery or that it can simply come about from exhaustion and a new mother's tendency to over do it. Some women are genetically more vulnerable to postpartum depression/anxiety.

Women with postpartum depression/anxiety need not suffer alone. Speaking with your physician can be your first step. There are community and online support groups. Counseling and/or medication can be very effective. If you are a mother having thoughts of hurting yourself or your baby or if you know someone who is feeling this way, seek immediate assistance through your physician or nearest emergency room.

Quick Facts on Bipolar Disorder

Bipolar disorder consists of recurrent episodes of depression, mania and/or mixed symptoms. These episodes cause extreme shifts in mood, energy and behavior that interfere with normal healthy functioning. Approximately 2.5 million Americans are affected by bipolar disorder. Causes of bipolar disorder can include biochemical, genetic and environmental factors.


A common sign is mood swings between emotional highs (mania) and lows (depression). During a manic phase, symptoms may include: 

• Racing thoughts 

• Poor judgment 

• Tendency to be easily distracted 

• Agitation 

• Rapid speech 

• Euphoria 

• Increased drive to achieve goals 

• Decreased need for sleep 

• Sadness 

• Hopelessness 

• Anxiety 

• Irritability 

Bipolar disorder can be difficult to detect. Some people may go for quite a while before they are correctly diagnosed. The reason for this has to do with the dual nature of the disorder. When someone is feeling manic they are full of energy and usually feel good. They are "high on life" and seldom seek treatment. By contrast, they often seek treatment when they fall into a major depressive episode. At that time, they describe only depressive symptoms. Therefore, it is common for the individual to be incorrectly diagnosed with depression instead of bipolar disorder. Bipolar disorder also shares many of the signs and symptoms associated with other illnesses such as anxiety disorders, further complicating diagnosis. If you suspect that someone you know is suffering from bipolar disorder, contact a mental health professional. During low phases of bipolar, symptoms may include: 

Symptoms of bipolar disorder may appear as early as age 5. More typically, symptoms usually appear around the age of 20. Symptoms may also become more evident later in life, between the ages of 40 and 50. Bipolar disorder symptoms often appear for the first time during or around big life changes that can trigger a mood episode.

Major Depression in Children & Adolescents

Major depression has increased significantly over the years. Recent studies suggest that by the time adolescents reach the end of their teen years, 20 % will have will have had depression. Depression impacts adolescents regardless of gender, social background, income level, or race, though some reports indicate that teenage girls report suffering from depression more often than teenage boys.


Depression affects a young person’s thoughts, feelings, behaviors and body. It can lead to emotional and behavioral problems. If depression is left untreated, it can lead to academic failure, substance use and even suicide. 

Some signs of depression often include:
The most common treatments used to treat depression are counseling and/or use of medication. Cognitive behavioral therapy, a specific type of therapy has been shown to significantly reduce symptoms of depression. The use of anti-depressant medication has also been shown to be effective in treating depression. However these medications may have serious side effects in children and adolescents and should be discussed with a medical doctor.  If you suspect your child or adolescent suffers from depression, seek assistance from a mental health professional or speak to your pediatrician. If you suspect your child is having suicidal thoughts, contact 911 immediately.


- Hopelessness
- Sadness or bouts of crying
- Loss of interest in activities which were previously enjoyable
- Academic difficulty
- Suicidal thinking
- Irritability
- Difficulty concentrating or remembering things
- Lack of energy
- Changes with appetite and/or sleep
- Aches and pains such as headaches or stomach aches that don’t seem to go away

Child Abuse Changes The Brain

Read The Article

Child Abuse Changes The Brain, study finds
Maltreated kids, like soldiers, adapt to become hyper-aware of danger

Body Image & Eating Disorders In Men & Women

Body image and eating disorders in men | womenshealth.gov

5 Tips for Managing Symptoms of ADHD

1. Set specific behavior goals and monitor your child’s progress toward the goal. Applying consequences and rewards using a behavior chart can help motivate the behavior changes. For example, a child may have a goal of sitting for 15 minutes at a time to do homework. Parents should track whether the child has met the goal. Short amounts periods of time can help the child complete assignments more easily and improve their level of confidence. 

2. When giving directions, it is helpful to keep them short and simple. Complicated or long directions for children with AD/HD can result in the child easily losing focus and forgetting what you have asked them to complete. If long directions are needed provide written directions.

3. Provide a homework assignment notebook where your child is required to write assignments in and obtain teachers signatures indicating that he/she has everything needed to complete the assignments. Once the assignments are completed, parents should check them and also sign the assignment book indicating that all of the homework has been completed.

4. Create a written schedule for the child to follow. This would include a morning and after school routine. Specific directions such as: Make your bed, make your breakfast, brush your teeth and organize your backpack can reduce forgetfulness.  If possible parents should check to ensure their child has everything necessary for the school day.

5    5. Offer feedback between compliments. If you need to let your child know that they have done something incorrectly, find something positive he/she has done and begin with the positive comment first.

Controlling Anger Before it Controls You

Written by : Angela Lacalamita, MA, LCPC

It is often thought that anger is an unhealthy emotion. However, anger is a feeling that is normal, healthy and serves the function of letting us know when all is not right in our world. When anger is felt too intensely, too frequently or expressed using aggression is when anger becomes a problem. There are numerous reasons why we become angry. The most common reasons for feeling anger are related to our personal worth, needs and basic convictions. Maybe you have felt invalidated by a spouse during a disagreement or by an employer by having received a poor performance review. Regardless of the setting, if we perceive that we are not being acknowledged, or feel as though our needs are unmet, we experience anger. Another contributing factor to anger is related to our values, beliefs or convictions being challenged or ignored.  Think of the number of times you responded with anger when a social issue or topic went against what you firmly believe. Even though you recognized that you were not able to control what others were thinking or how they were behaving, you still reacted with anger.

Managing the way you express anger requires some effort to think and behave in a different fashion. One approach to managing anger is to identify the problem causing the conflict, the feelings associated with the conflict and deciding whether to resolve the conflict or let it go. If you decide to let it go, then you have to let it go completely. Not letting the issue go completely may place you at risk of the anger resurfacing and boiling to a point where you react in an unhealthy fashion.  A second approach to managing anger involves using direct commands to stop thinking the thoughts that are fueling your anger. Some examples are “I need to control my anger before it controls me” or “I need to control my anger because there are no benefits to exploding. “  A third approach in managing anger is visualizing yourself dealing with the event contributing to your anger in a calm, assertive and non- aggressive fashion.   

No matter how hard we try, unexpected events or challenges will occur in life which will contribute to feelings of anger. Eliminating anger is not a realistic expectation. However using these approaches will help you manage your anger before it controls you and begins to negatively impact your life.

10 Ways to Show Your Children That You Care

Written by Angela Lacalamita, MA, LCPC

1. Listen to what your children are saying and validate what they are feeling.

2. Acknowledge and praise their positive behaviors.

3. Be encouraging and supportive.

4. Forget your worries for a moment and spend individual time with them.

5. Be consistent when holding them accountable.

6. Appreciate your children’s individuality.

7. Allow them to make some decisions, so that they can learn and grow.

8. Empower them to take a stand against what is wrong.

9. Be realistic with your expectations and don’t expect perfection.

10. Always love them, no matter what.

Tips to Improve Your Connection With Your Spouse or Significant Other significant other

Read The Article: How Can I Improve Intimacy in My Marriage?

Yoga May Help Prevent Adolescent Mental Problems

Read The Article: Yoga May Help Prevent Adolescent Mental Problems

Improving Your Self-Esteem

By Angela Lacalamita, MA, LCPC

Our view of ourselves is an inherent factor in our psychological wellness. If our self-esteem is compromised many areas in our lives are impacted. Maintaining a healthy self-esteem also protects us from life's unexpected challenges or obstacles. Developing a positive self esteem is one of many things we can do to work toward leading a fulfilling way of life. Some tips for developing a positive self-esteem are:

1) Challenging our inner critic. We all will experience positive and negative self talk. Becoming aware of when you are beginning to use negative self talk and challenging yourself when it occurs can be helpful. When you begin to say to yourself, "I can't", stop and ask yourself the following: How can I handle this?” or “How is this possible?”

2) Use positive statements or affirmations of your desired outcome or goal. They should be short, believable and focused on what you want to accomplish. By repeating them over and over again, you will begin to open up the possibility of using more positive self talk.

3) Surround yourself around with positive people who supports your dreams and goals. If you are surrounded by people who are increasingly negative, you gradually begin to follow suit.

At first, these skills may seem uncomfortable. However, as you practice them, they will become easier over time. Challenge those thoughts and beliefs that are contributing to your low self-esteem. You will build confidence and learn to value yourself.

Is It Depression or Just A Bad Mood?

By Erika Krull, MS, LMHP

Depression is a common problem for people across the world. About 10 percent of the U.S. population over 18 has depression. Women report depression twice as often as men, though it’s not clear if this really shows how many men and women really have depression. And if you have already had depression once, you are at a higher risk of relapsing. It’s a good thing to consider whether you are dipping into clinical depression or just have a low moment.

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Stress Reduction Tips

Our lives are filled with numerous responsibilities. At times life may feel like a juggling act. Balancing career, family, and friends, along with the other areas in life which require our attention, can be quite stressful and overwhelming. Here are some tips to bring some balance to your daily routine and reduce stress:


Reframe the event that is contributing to the stressStress is determined by how you perceive a particular event. Reframe your response byacknowledging that the stressful event is not within your control and that you are in control of how you respond to the event.

DistractionFocus on something else to prevent the thoughts that are contributing to the stress.

Think Positively & Recite These Statements to Yourself
Develop positive affirmations to recite to yourself during times of stress. For example, My life is good and I will not allow this stress to impact me! or I can get passed this too!

Take a Mental VacationVisualize a place in which makes you feel happy and where you would want to be, for example, a beach in the Caribbean.

Count to 10 (or Count to Whatever Number It Takes to Reduce the Stress)

Get Up & Leave the Stressful Situation If PossibleTalk a walk, go to lunch.

Deep BreathingThe key to deep breathing is to breathe deeply from the abdomen, getting as much fresh air as possible into your lungs. When you take deep breaths from the abdomen, rather than shallow breaths from your upper chest, you inhale more oxygen. The more oxygen you get, the less tense, short of breath, and anxious you feel. Breathe by pushing out with stomach muscles to bring oxygen and energy into your body. Exhale and let go of the stress.

Scream Out Loud If You Can
Letting your emotions out can be helpful.


Exercise or Participate In Yoga/Tai Chi for Stress Relief
Yoga involves a series of both moving and stationary poses, combined with deep breathing. Not only can yoga reduce stress but it also can improve flexibility, strength, balance, and stamina. If you practice yoga on a regular basis, you can improve how you respond to stress. Since injuries can happen when yoga is practiced incorrectly, it’s best to learn by attending group classes, hiring a private teacher, or at least following video instructions.

Challenging intolerance of uncertainty: The key to anxiety relief

Ask yourself the following questions and write down your responses. See if you can come to an understanding of the disadvantages and problems of being intolerant of uncertainty. 

• Is it possible to be certain about everything in life?

• What are the advantages of requiring certainty, versus the disadvantages? Or, how is needing certainty in life helpful and unhelpful?

• Do you tend to predict bad things will happen just because they are uncertain? Is this a reasonable thing to do? What is the likelihood of positive or neutral outcomes?

• Is it  possible to live with the small chance that something negative may happen, given its likelihood is very low?

Adapted from: Accepting Uncertainty, Centre for Clinical Interventions

Why You Keep Worrying

You have mixed feelings about your worries. On one hand, your worries are bothering you - you can't sleep, and you can't get these pessimistic thoughts out of your head. But there is a way that these worries make sense to you. For example, you think:

- Maybe I'll find a solution.- I don't want to overlook anything.
- If I keep thinking a little longer, maybe I'll figure it out.- I don't want to be surprised.- I want to be responsible.You have a hard time giving up on your worries because, in a sense, your worries have been working for you.Source: The Worry Cure: Seven Steps to Stop Worry from Stopping You
by Robert L. Leahy, Ph.D.by Robert L. Leahy, Ph.D.by Robert L. Leahy, Ph.D.