Encouraging Healthy Autonomy in Your Teen
Posted by FamilyFirst Psychological Services
“They are trying to grow up too fast!” is a complaint that we often hear from parents about their young teenagers. Parents often end up in our offices because their efforts to make and enforce rules with their teens have backfired, and everyone is unhappy. While parents are generally just trying to keep their adolescents safe, teens tend to see parents’ efforts as overly strict, rigid and unfair. On the other end of the spectrum, some families end up consulting us because their teens are overly dependent and not making appropriate progress towards independence.
One important thing for parents to keep in mind is that teens are supposed to be growing up, and in fact they don’t have very much time to bridge that gap between losing the last of their baby teeth and choosing their first semester college courses. Further, by the time they get to the end of that process, most parents actually want their teens to be operating relatively self-sufficiently. They want their kids to know their own strengths and weaknesses and be able to make good, healthy decisions on their own. So, as the parent of a young teen, what can you do to help promote the kind of healthy autonomy that is likely to support your child on their path to being an independent, competent adult? Here are a few tips:
1. Include your teen. Research on adolescent development indicates that teens thrive when parents solicit input from them on family rules, even though parents still can opt to make the final decisions. Encourage your teen to tell you their reasons for wanting a certain privilege, and listen seriously to them while they do so. This practice in advocating for themselves can go a long way towards enabling teens to appropriately identify and assert their own needs later on in life. Further, teens who feel like their parents at least acknowledge their point of view (even if their parents don’t agree) are more likely to listen to their parents in return.
2. Pick your battles. Giving your adolescents control over some areas of their lives (e.g. clothing choices) can help reduce conflicts in other, arguably more important areas (e.g. curfew). Remember that teens’ drive to grow up can’t be squelched, any more than an infant’s drive to get mobile and explore the world can. The best parents can do is to try to “direct the flow” of this normative (though arguably difficult!) developmental process.
3. Give your teen responsibilities. If your son or daughter is going to ultimately be able to take care of themselves, they need to be in the habit of doing so before they are packing their bags to leave home. Teens can help with the family laundry, cook dinner once/week, take care of a younger sibling, wash the car, take out the trash… the list is almost as endless as parents’ own chore lists.
4. Find meaningful activities for your teen. Although many of our kids’ lives are very full, teens often complain that much of their time is spent on activities that don’t feel particularly worthwhile or important to them. Many adolescents are not great at delayed gratification, which makes schoolwork (leading to the distant vision of more of the same in college) not terribly fulfilling to them. Teens can gain a great deal of competence as well as personal gratification by helping others — volunteer work is a particularly powerful venue for building a sense of self and gaining important life skills.
Kathleen Boykin McElhaney, Ph.D.
Licensed Clinical Psychologist
Draw Your Lines in the Sand
Posted by FamilyFirst Psychological Services
Find it hard to say no? You’re not alone. At one time or another, we all fall victim to our own ill-defined limits. Whether it is something small, such as lending something that is not returned right away, or something more serious, such as inappropriate remarks from a peer, asserting boundaries can be tricky. That task is much harder when you do not know what your personal boundaries are. Let us break boundaries down, and take it one piece at a time.
First, consider with whom you have boundaries. Does anyone have an all access pass? Hopefully not. Even those with whom we share the closest relationship, at some point, we have a boundary. However, those boundaries vary greatly from person to person. For example, we have different limits that we place on our immediate family versus strangers. Here is a list of different people to consider when defining your personal boundaries:
• Spouse/Partner
• Children
• Parents
• Siblings
• Extended family (e.g., aunts, uncles, cousins)
• Close Friends
• Co-workers
• Acquaintances
• Strangers
Second, there are different types of personal boundaries. Think about it, there are many different ways your “comfort zone” can be breached, right? A stranger stands too close to you in the grocery line, an acquaintance asks a question that feels a little too personal, or a co-worker questions your religious beliefs. These are examples of physical, emotional, or spiritual boundaries. The next step in defining your personal boundaries is by understanding what type of boundaries you have. Below is a sample list of types of boundaries:
• Physical
– How much physical contact are your comfortable with?
– Consider the range of possible physical contact, from no contact to the most intimate types of touch.
• Emotional
– How emotionally close are you comfortable with a person being?
– This can be harder to define because it is an abstract idea, meaning that it is not something we can easily define.
Helpful questions for considering your emotional boundaries are:
• How much personal information are you comfortable with this person knowing?
• At what point do you start to find it more difficult to trust this person with personal information?
• How comfortable are you in allowing this person to see you emotionally upset?
• Financial
– How much money, if any, would you be willing to lend this person?
– How much money, if any, would you be willing to borrow from this person?
• Religious/Spiritual
– Would you be comfortable sharing your beliefs with this person?
– Would you be comfortable participating in religious/spiritual exercises/activities with this person?
• Privacy
– How much access to personal information/accounts are you comfortable giving to this person?
– How much access to personal spaces are you comfortable giving to this person?
The next step to defining personal boundaries is to explore what your limits are across boundary type and person. In other words, when with a stranger, what are your physical, emotional, spiritual boundaries? How about with a close family member? Consider making a chart that you complete to define the boundaries you have with the different people you encounter in your life.
The quickest way to asserting boundaries is to know what your boundaries are to begin with.
Amie Allain, Ph.D.
Licensed Clinical Psychologist
Developing Resiliency for Our Fast-Paced Ever Changing World
Posted by FamilyFirst Psychological Services
We live in an ever-changing world. As soon as we buy a new computer or cellular phone, there is an update. Our environment, our economy, our health, our family situations are frequently in flux. Our children start new schools, get new teachers and coaches, join new social groups, and must navigate new demands from all of these sources. Learning to be resilient, or flexible under the influence of change, is a vital capacity to nurture given our fast-paced, variable world. But how does one go about nurturing the capacity of resilience?
According to Joan Borysenko, Ph.D., there are five key tips for developing resiliency. The first is an acceptance of reality that allows for an optimization of future possibilities. If we are overly optimistic we may not plan for the possibility of change. Being realistic about this possibility provides an opportunity for us to problem solve and be proactive. People who are overly optimistic may actually be protecting themselves from a thought they find intolerable. Resilient people are able to tolerate the difficult “what ifs”, because they believe in their abilities to adapt to new situations, even difficult ones. Appropriate realism does not mean we become fretters, it just means we are open to what may come our way and we believe in our capacity to deal with it.
Nurturing a social network also helps to encourage the development of resiliency. Cultivating allies and mentors to provide support during challenging times enhances our hardiness during these times. Feeling safe and having a deep belief that life is meaningful is a third key to resilience. Feeling safe can include a sense of spirituality or a religious belief, but it can also just mean feeling safe in one’s own ability to handle life’s challenging situations. Having this sense of self-efficacy allows us to navigate life’s winding roads. Resilient people are also highly creative and adaptable. This is the capacity to make lemonade out of lemons. Dr. Borysenko tells the story of looking into a nearly empty refrigerator with three wilted carrots and half an onion, and deciding that you will make a great soup.
Finally, resilient people have taken care of their “physical plant”. They exercise, eat right, and get adequate sleep. They practice mindfulness, being fully aware of the present moment without judgment, to enhance emotion regulation, focus, and the capacity to cope. They are aware of ‘burnout’ and take steps to keep their bodies running optimally.
The brain signature of resilience, according to Dr. Dan Siegel, is a moving toward rather than away from challenging situations. Increasing our capacity to tolerate the moving toward that which is difficult because we believe in our ability to deal with whatever life has in store for us, is what we mean by resilience. And resilience is a critical competence for us to develop as we navigate the 21st century.
Marcia Kaufman, Ph.D.
Licensed Clinical Psychologist
(Portions of this blog were taken from a lecture by Joan Borysenko, Ph.D. at the conference of The National Institute for the Clinical Application of Behavioral Medicine, December, 2011.)
Enjoying the Season by Focusing on the Present
Posted by FamilyFirst Psychological Services
As the holiday season approaches, many of us begin to feel stressed, overwhelmed and exhausted. In the face of shopping lists to work through, travel itineraries to plan, and seemingly endless school functions to attend, we often lose sight of the potential for joy, celebration and re-connection with loved ones that this season is supposed to bring. Thus, the holiday season is an especially good time of year to practice “living in the moment”. Although this advice often sounds trite and worn out, in fact it is based on very sound psychological principles that can help reduce stress, boost your mood and improve your outlook on life.
First, consider the alternatives to “living in the moment”. One alternative is to focus on the past. While there can be some value in reflecting on the past and taking stock (how else would we make New Year’s resolutions?!), too much dwelling on the past can foster feelings of regret and sadness that can in turn promote depression. If you find yourself constantly thinking thoughts that begin with “if only I had…” or “I wish that I could have…” it may be time to try focusing on the present. A second alternative to living in the moment is focusing on the future. Again, there is some value in anticipating what challenges may be ahead of us and planning accordingly. However, a singular focus on the future tends to promote feelings of anxiety and distress, and can lead to feeling overwhelmed and helpless. If you are often playing various possible scenarios over and over (“what if this happens…” “what if that happens….”), consider working more on focusing on the moment that you are in.
This holiday season, try to actively savor something that you might otherwise hurry through. Take a break from your “to do” list and focus on what your senses are telling you about where you are and what is going on around you. Be an objective observer of your environment, and stop to notice what you see, hear, smell, taste and feel. If you are baking treats for a child’s school function, take a few minutes to luxuriate in that smell of fresh-baked holiday goodies. If you are wrapping a gift for your work gift-swap, take time to notice the way that the wrapping paper sparkles and how the ribbons curl just so. Appreciate the warmth of your sweater, the sparkling lights on your neighbor’s porch, and the sweet smell of pine as you pass the display of wreathes outside of the grocery store. If you find yourself becoming overwhelmed with tasks, stop, close your eyes, and breathe. Focus on the fact of your breathing, being sure to breathe deeply into the bottom part of your lungs, engaging your diaphragm. Counting as you breathe will help you to breathe more deeply, and also help you to focus on what you are doing as opposed to what you have to do.
In short, the best way to get more enjoyment out of your holiday season is to focus a bit more on the present moment – and perhaps a bit less on the present(s) on your list.
Kathleen Boykin McElhaney, Ph.D.
Should an Eye Exam Be on Your Child’s Back To School List?
Posted by FamilyFirst Psychological Services
Vision plays an important role in successful academic performance. Vision is the ability to understand what one sees, and is a learned process. A large portion of learning happens visually in traditional classroom settings. When I ask parents about their child’s vision I often get responses such as “His routine eye exam was 20/20.” It is important to understand that a routine eye exam only measures how well one can see the eye chart, meaning certain sizes of letters that can be seen at 20 feet. It does NOT detect other vision problems that can interfere with learning. Specifically, a typical routine eye exam can’t detect problems with eye movement control (needed for tracking along lines as one is reading/writing), focusing near (needed for copying from the board), maintaining visual focus (needed to keep up with the material being learned and prevents the eyes from fatiguing), eye teaming (needed for the eyes to work together), and depth perception (needed to accurately judge distances of objects).
It is important to identify the symptoms that could signal a possible vision problem. Some of these are listed below:
• Frequent loss of place when reading
• Takes much longer doing homework than expected
• Skips words or repeats lines when reading out loud
• Has short attention span when reading and doing schoolwork
• Reverses letters such as b’s and d’s
• Omits or substitutes small words like “of” for “for”
• Frequent eye rubbing or blinking when reading or doing schoolwork
• Problems catching or hitting balls
• Clumsiness with physical activities
• Avoids reading
• Complains of eyes being tired easily
• Poor posture when working close
• Complains of blurring or double vision when reading or writing
• Squints when doing near work
• Poor reading comprehension
• Fails to recognize the same word in the next sentence
• Holds books or other homework materials very close when reading/working
Many students’ visual abilities are under-developed and thus not up to the level needed to face the learning demands of classroom situations. If your child has a history of struggling with reading and learning, a comprehensive eye exam by a Developmental Optometrist is warranted.
Such an examination will determine whether poor visual skills are interfering with the learning process. Lastly, the above listed symptoms could also be indicative of other learning challenges that can be assessed in a comprehensive psychoeducational evaluation. Refer to our test services page for more information.
Maria Kanakos, Psy.D. Posted by FamilyFirst Psychological Services Summer is a time when everyone takes a good look in the mirror to see how their bodies are going to fare in their bathing suit for their beach trip vacation. Whether it is fine-tuning for a more sculpted look or heading to the gym for a complete overhaul, our goal is the same – challenging ourselves to improve our fitness. It is just as important to take that assessment of ourselves psychologically in the mirror and to make necessary adjustments. How fit do we look when we are trying to see how well we measure up to our ideal? Here are a few things to ask yourself when you are sizing yourself up psychologically: 1. Are you exercising your heart? Are you controlling stress enough in your life to be showing a soft heart to your family? Friends? Self? Do you feel tender when you are talking with others or short-fused? If you feel short-fused a lot, it is probably a sign that you need to slow down and prioritize connecting over accomplishing. Rather than getting our hearts over-wrought with adrenalin over things not being perfect, let’s exercise the part of us that communicates how much people mean to us and get excited about relationships. 2. Crunches: Instead of asking if you are doing enough crunches, a mental health assessment requires you to ask the opposite- Am I crunching too much? Are you crunching time to get more out of the day and finding that you can’t crunch anymore? Are you or your family suffering because of it? How about taking something off your plate that will allow you to crunch less and enjoy more. Can you delegate something you already do and find benefits from it? Can the kids help cook and learn life skills while they are helping out? Have you left enough down time in your day to self-care or do you drop in bed at the end of the day without refueling psychologically? Reserve 10 minutes a day to exercise your right to do what you love to do. 3. How are your pectorals? It may be more important to ask yourself how you are exercising those pectorals, rather than how they look when not being exercised. Ideally, those pectorals are being used to hug and be hugged. Are you incorporating enough touch in your life to feel renewed? If not, try reaching out when you feel most stressed and allow tactile healing to relax you. Touch can bring about endorphins that provide a sense of well-being and peace that resembles the effects of physical exercise. 4. Your backside: Psychologically, we usually need more, rather than less when thinking about our backside. Who has your back in terms of support that you need? Do you have a weekly sitter that allows you to take a date night? Do you have enough help in the home to help you accomplish your household tasks? The next time your birthday comes around, skip the request for cologne or perfume and ask for a home organizer for a few hours or a carpenter for a half day to help you take some things of your to-do list. When you start your get-fit program for psychological health, stretching will likely be part of it. Behavioral changes require stretching to reach your personal best. Like developing physical muscles, each change you make will help you grow your confidence to live your life more consciously so that you can feel great in the summer, however you might look. Virginia DeRoma, Ph.D. Posted by FamilyFirst Psychological Services Summer packs high expectations for fun through family vacations. With these plans come great hopes for relaxing times, strengthened family bonds, and memories of both adventure and discovery. Few intend to live out their favorite National Lampoon vacation. My recent debacles with travel have reminded me that even the best-laid plans can turn into infamous memories of the sort we don’t expect. These unexpected deviations from the ideal trip can turn our plan for stress-reduction into an exercise in stress management. When obstacles occur, think of these experiences as deviations from your destinations, rather than vacation spoilers, and challenge yourself manage the stress instead of letting it manage you. Here are a few “unexpected” deviations in my planned family travel for 2011 and reminders of the importance of regrouping: 1. Transportation May Fail You: As I nestled in for my trip to Europe, after waiting for hours on the plane for a repair, I was informed that our family of five would have to deboard as it would be impossible for us to make our connection to Europe. Further, there was not space on any other day to accommodate us for the kids’ spring break. We arrived home at 10pm, held a quick family meeting, and by midnight we had recasted a plan for an alternative destination that we could drive to in the U.S. A few phone calls later, we had lined up a place to stay with friends who we hadn’t seen in years and we can’t imagine having had a better spring break than how we spent it. 2. Illness May Befall You: The day that we arrived on the plane to that rescheduled trip to Europe, my youngest child became violently ill. Prior to becoming ill, his flexibility changed to insistence on having his own way and he was misinterpreting feeling bad for being hungry (although nothing appealed to him to eat and when he did eat what I gave him, he indicated that it tasted funny). While it isn’t unusual for children to behave oddly after being on an overnight flight (with so many fun games on flights abroad, it is difficult to get kids to sleep on a flight), his change of disposition made me suspect that he was sick. Although I gave him this feedback, he insisted that he was just starving and that I just needed to feed him the “right thing” to fix his disposition. I reinterpreted the right thing to be going to the hotel for an early check-in and giving him some bed-rest. Within an hour of check-in, his gastro-intestinal virus greeted us. Rather than getting pulled into power struggles with exhausted, sick kids about whether or not they are/might be sick or what they think they need, trust your own instincts about what might be going on with them and usher them to a place of rest. Insist on some down time when it is needed. If my son had gotten his way, we would have been sitting in one of the nice restaurants where he wanted to solve his “hunger problem,” instead of the comfort of his own bathroom-away-from home. 3. Costs May Surprise You: If events that you had planned begin eating into your budget, remember that laughing is low-cost and fun can be free. On the nights that we opted out of spending another expensive night out on food and ate in, we had had some fabulous family fun playing cards. Serious smiling is a great alternative to spending. Virginia M. DeRoma, Ph.D. Posted by FamilyFirst Psychological Services In recent years there has been increasing concern among parents who seek our services regarding their children and the amount of time that they spend on the computer. Parents often have particular worries about time spent on the internet, whether it be on social media websites, online gaming, or participating in virtual worlds (e.g. Second Life). Concerns range from questions such as: how much time is too much? what websites are appropriate vs. inappropriate? how can I protect my child from internet predators? and how do I think about the virtual relationships with others that my child develops online? Some parents become concerned that their child is “addicted” to the computer or the internet. Unfortunately this phenomenon of concern over computer or internet “addiction” is so new that psychology has not quite caught up with the times. Physicians, psychologists and educators are all currently struggling to understand what is healthy vs. unhealthy for children (and adults) when it comes to use of the computer and the internet, so that helpful guidance can be offered to parents. One way to evaluate your child’s relationship to the computer and/or the internet is to fall back on the general criteria that mental health professionals use in order to determine whether a behavior is abnormal and therefore in need of intervention. 1. First, is the behavior atypical? Ask around and talk to your pediatrician: Is the amount of time that your child spends on the computer and /or on the internet typical for his or her age? Are the activities that your child seeks out on the computer age appropriate? The website Common Sense Media has good age-by-age guidelines for both computer games and internet websites: www.commonsensemedia.org. 2. Second, is the behavior maladaptive? Does amount of time spent on the computer interfere with your child’s daily functioning and/or responsibilities? Does he/she neglect homework, friends, and/or family in order to spend time on the computer? Is his or her mood adversely affected by time on the computer? Does he or she lose sleep and/or skip meals to spend time on the computer? Is he/she engaging in activities on the computer or internet that puts him/her at risk (e.g. giving out personal information, sending inappropriate pictures)? 3. Thirdly, is the behavior distressing? This question is often difficult to answer when it comes to assessing any particular childhood behavior or activity from a mental health perspective. There are a range of behaviors that are not particularly distressing to the child, but instead are distressing to others around him or her. When thinking about this criteria, consider the amount of conflict your child’s relationship with the computer/internet is causing in your household, as well as the extent of negative feelings that you or your child may have about this issue. If you have serious concerns about your child’s mental health, including internet or computer addiction and possible related issues such as mood dysregulation, academic underachievement, and/or poor social skills, consult your pediatrician or a mental health professional. Kathleen Boykin McElhaney, Ph.D. Posted by FamilyFirst Psychological Services This blog addresses the frequent concerns that parents bring up pertaining to the content of the video games their children are playing. As mentioned in a previous blog (Posted November 2010) written by Dr. Kathleen McElhaney, parenting in the digital age is challenging. While controversial, several studies have linked exposure to violence in TV shows and video games to elevated aggressive and non-controlled behavior, especially in children. Parental involvement and media education can help reduce the negative effects that video games with sophisticated content have on our children. Below is a list of things that parents are highly encouraged to do to reduce this risk. • Check packaging for the content rating of the video game before your child plays. The content rating is set by The Entertainment Software Rating Board (ESRB). These ratings are based on a number of factors including level of violence, sexual themes, and controversial/stronger language found in a game. Ratings range from EC (Early childhood), which indicates content suitable for children as young as three years of age to ratings of AO (Adults only), which contains content suitable for those individuals ages 18 and up. Parents need to take these ratings seriously and avoid assuming that a younger child can “handle” what will be displayed on the screen. For detailed content rating descriptions visit www.esrb.org I encourage parents to look more closely at the types of games their children are playing and set appropriate limitations and restrictions for accessing particular games. Despite the growing technology in today’s world, our duty as good parents is to stay in control of and monitor our children’s exposure to what they see on the screens! Maria Kanakos, Psy.D. Posted by FamilyFirst Psychological Services Given my work as a clinical psychologist, I try my best to stay up on the latest research across several areas, so that I can help parents make well-informed decisions regarding their children’s treatment. Recently, I was tuned in to NPR and was intrigued to hear a Dutch researcher being interviewed with regard to a study about the role of diet in Attention Deficit/Hyperactivity Disorder in children. I turned up the volume and listened carefully, hoping to hear something that would prove interesting and useful for my clients. The statement that the researcher went on to say astounded me. In no uncertain terms, the researcher concluded that a majority of children with ADHD symptoms were exhibiting those symptoms as a result of dietary sensitivities. I waited for the typical caveats that researchers are obligated to provide regarding limitations of their results. I waited for the interviewer to ask some pointed questions regarding the nature of the research that led to these conclusions. However, neither was forthcoming. ( If you are curious, you can read the transcript of the interview on NPR – the study was discussed on All Things Considered on March 12, 2011. A response evaluating the conclusions to this study, put out by CHADD, can be found here:www.chaddleadershipblog.blogspot.com/2011/03/elimination-diets-for-adhd-not-ready.html Given the age we live in, parents have access to an astounding amount of information, which is both extremely helpful and also potentially enormously overwhelming. It can be very difficult to sort through claims that are made and posted on the internet or via other news media regarding a particular disorder and/or treatment. Here are a few guidelines to help parents and other concerned individuals to be informed consumers of psychological research: 1. How was the sample selected for the study? How representative was this sample of the population that was intended as the focus of research? For example, studying children who have AD/HD – Combined Type may not yield results that are applicable to children with other forms of AD/HD. When in doubt, consult nationally known organizations for the latest information regarding a given treatment. Examples of reliable websites include the American Psychological Association website (www.apa.org), the NIMH website (www.nih.nimh.gov) and for AD/HD, the CHADD website (www. chadd.org ).
Licensed Clinical Psychologist
Mirror, Mirror, on the Wall…
Licensed Clinical Psychologist
Believe It or Not, Travel with Kids Can be Fun
Licensed Clinical Psychologist
Internet “Addiction”: When Should Parents be Concerned?
Licensed Clinical Psychologist
Posted May 9, 2011
Parents: Screen the Screens!
• Set limits on how often and how long your child is allowed to play video games
• To ensure adequate monitoring of what your child is playing, do not install game equipment in child’s bedroom
• Supervise your child’s internet use as there are some video games available for playing on-line
• Monitor all media exposure including video games, television shows, movies, and Internet
• Be open with your child as to the rating of a video game he/she is interested in and use it as an opportunity to share your thoughts, feelings, and concerns about what he/she will observe if exposed to a particular game.
• You may not be able to control what kinds of video games your child is exposed to when he/she is at a friend’s house, but you can ask them about what they played and observed during a particular video game. This way, you can discuss how they feel and/or interpret what they saw.
• Good parenting entails sharing information you learn with other parents so that they too stay informed on the pros and cons of certain video games.
Licensed Clinical Psychologist
Posted 4-19-11
Researching the Research: How to Understand and Evaluate Psychological Studies
2. How were variables defined and measured? For example, if the researchers report “improvement” in symptoms, what constituted improvement and where did this information come from? Studies that rely on reports from individuals that know that the individuals are participating in a treatment study, and that know what type of treatment was given, are considered less reliable. These reports may be inadvertently biased by beliefs that the treatment is working. Studies that include reports from raters that are “blind” to the conditions of the study are more reliable.
3. Who was compared in the study? Was there an experimental group and a control group? Was there a “placebo control”? Often individuals participating in a treatment study improve by virtue of being involved in a study, and not due to the treatment itself. Thus, it is very important to compare a treatment to other comparable types of interventions, not just to no treatment.
Kathleen Boykin McElhaney, Ph.D
Licensed Clinical Psychologist
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