Resources For Families and Educators

Considering the Risks That Lead to Self-harm or Suicidal Thoughts and behavior

Depression, prior suicide attempts, psychiatric disorders, intense anxiety, and addiction are common risk factors for suicide.

While our last post discussed developmental factors that play a role in healthy personality development, this article discusses the disorders of personality, which are personalities that due to how they are formed, may lead to various interpersonal and emotional difficulties. Afterward is a brief overview of risk factors for personality disorders in childhood and adolescence. At the end of the article, a brief discussion of various treatments will be discussed.

As parents of children who are undergoing neuropsychological evaluations or as test takers ourselves, we often wonder what our intellectual capacity says about us or our child. Intellectual capacity, our very ability to think, learn, plan, and understand ideas, can bring up all sorts of emotions and questions. Moreover, questions arise when trying to make meaning from a 2-3 digit number like an IQ that often holds an over-ascribed meaning. Scores could feel daunting, like an assigned grade. For example, if a child receives an IQ of 90 a parent might think that could explain why their child is struggling in school, but that is not necessarily the case. Performance on a single assessment or measure of intellectual ability is only part of the picture and means very little without other sources of information.

Have you ever been scared in your own home? Children and teens exhibiting defiant behavior consistently can be emotionally draining for themselves and others around them. There's a range between the usual independence-seeking behavior of teens and out-of-control defiant behavior. It's normal to exhibit oppositional behaviors at certain stages of an adolescent’s development.

Often, referrals are made to see children and teens with difficulty expressing their emotions and sentiments (with peers and adults). This impacts their social-emotional well-being and may affect social interaction skills. The challenges can sometimes be psychological and/or attributed to neurodevelopmental differences such as language processing, attention, and emotional regulation.

We often like to think of our sense of self as whole, believing that there is only one ‘me.’ However, certain schools of thought have begun to challenge this notion.

Executive functioning is a term used to describe a set of mental skills that center around starting, sustaining, and completing goals.

Social-Emotional Skills When Working with Children and Teens in Therapy

Often, referrals are made to see children and teens with difficulty expressing their emotions and sentiments (with peers and adults). This impacts their social-emotional well-being and may affect social interaction skills. The challenges can sometimes be psychological and/or attributed to neurodevelopmental differences such as language processing, attention, and emotional regulation. In therapy with children and teens, there are many avenues to address the building of social-emotional skills, such as:

One of the major tasks of childhood is to consolidate a personality. A personality, as defined by the American Psychological Association (APA) loosely “refers to the enduring characteristics and behavior that comprise a person’s unique adjustment to life, including major traits, interests, drives, values, self-concept, abilities, and emotional patterns.” Judging from this long description, consolidating a personality is no simple task. It is something children (and adults!) develop over time as they grow in psychological and physical maturity.

Play is at the core of children’s lives. It is how children express themselves, connect with others, and make sense of the world. Play is so important for children’s development that the American Academy of Pediatrics (AAP) describes it as “essential to the social, emotional, cognitive, and physical well-being of children beginning in early childhood.” Through play, children can share their fears, frustrations, wishes, and dreams with others, as they cannot yet directly verbalize their thoughts and feelings.

Nowadays, the internet is an ever-constant presence in both parents' and children’s lives. Never before has technology allowed us to be so immersed in the lives of others around the world. Social media, online spaces where individuals can post, share, and respond to content (written, photo, video), has become a virtual meeting site where people can keep in touch with friends, stay abreast of current events, and build communities. What occurs on sites such as TikTok, YouTube, Twitter, Instagram, Facebook, and Tumblr can be just as important, if not more important, than what occurs in the non-virtual world.

Mentalization is a term clinicians and researchers use to describe the process by which parents can reflect on their child’s thoughts, feelings, and motivations, and then communicate these feelings back to their child. It is a process we all engage in, and one that relies on our ability to use imagination, empathy, and communication to work effectively. It also requires the parent to reflect on their emotional states and own history to ensure that they can effectively sort out what their child is thinking and feeling, and what the parent is thinking and feeling.

Please note that this is a continuation of the prior blog post titled: “Identifying and Preventing Escalating Behaviors in Children”
In the first half of this blog post, we discussed ways to prevent an escalation of behavior and emotion in your child. However, due to the fact that no caregiver, child, or environment is perfect, there may be times when no amount of prevention or early intervention will be enough to stop an escalation in its tracks. This post will briefly review the final four stages of Colvin’s (2004) Escalation Cycle: 4) Acceleration, 5) Peak, 6) De-Escalation, and 7) Recovery.

Children often experience ‘big emotions,’ getting caught up in joy, sadness, anger, and fear in strong, often intense, ways. When overwhelmed by these feelings, our children ‘act out,’ and escalate emotionally and behaviorally. Although we should expect our children to act out at times as they learn to regulate their emotions and problem-solve, sometimes these escalations can lead to problems academically, socially, and personally. Every child experiences and expresses their emotions differently but the escalation pathway often follows similar patterns and is described in the Escalation Cycle, as shown below.

Cognitive Distortions are exaggerated or irrational negative thought patterns that can influence your emotions. These cognitive distortions are commonly referred to as thought traps because they often have a habitual nature and are hard to break out of, especially in moments of distress. Cognitive distortions don't have a single root cause but are commonly associated with mental health struggles such as depression and anxiety along with exposure to traumatic events or abuse.

Year Into What Was Unexpected

A year ago this time the office doors closed suddenly to seeing patients and families in person. The loom and gloom of this impending virus was felt strongly for 2 weeks prior to March 14, 2020. Trusted colleagues and patients and our practice were becoming increasingly concerned about being in a work space together in close proximity. It was a sense of unabating and rapidly increasing worry that things were not safe and out of control.

When our children feel bad, we might often want to make them feel better instantly. Paying attention to what we say is important because invalidating feelings could ultimately lead to our children feeling worse. Actually, invalidating the feelings of our family members could be especially damaging to their mental health.

The Report

The current U.S. Surgeon General, Dr. Vivek Murthy, released an extensive advisory report on social media and youth mental health. While social media may offer benefits, there are clear indicators that social media can also pose a risk of harm to the mental health and well-being of children and adolescents. Social media use by young people is nearly universal, with up to 95% of young people ages 13-17 reporting using a social media platform and more than a third saying they use social media “almost constantly.”

Call to Action

Dr. Vivek Murthy’s advisory comes as a call to action urging policymakers, researchers, parents, children, technology companies, and those in the mental health community to gain a better understanding of how social media impacts our community, how to optimize social media usage and how to create a safe online environment. Most social media platforms are designed for kids above the age of thirteen, but recent data shows that 40% of kids between the ages of 8-12 use these platforms often. Growing bodies of research acknowledge the potential harm of social media use during critical stages of development on mental health outcomes. The surgeon general’s report goes on to state that, at this time, there is not yet enough evidence to determine if social media is sufficiently safe for children and adolescents. That is a strong statement that highlights the need for a more in-depth understanding of how social media is affecting our young people's mental health.

What is the Harm?

The Jump (Highschool to College)

There are so many concerns for all parents regarding their child transitioning from high school to college. Parents of students with disabilities may especially wonder how their child will keep up with an increased workload. College could be the perfect storm of increased freedom, lack of supervision, and many new demands. Parents know how much support they give their children, and wondering where that support might come from once they leave home is worrying.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects many people globally. It has been connected to higher rates of failure in academic settings, a higher likelihood to be unemployed, and could make developing and maintaining relationships difficult. However, on the bright side, researchers have long wondered if ADHD has a strength: Enhanced creativity.