Category Archives: Parenting

Fear, Anxiety, Loathing, and Today’s Workshop for the Thriving Institute

Even though I’m a Montana Grizzly, being back in Bozeman is always nice. Today, Rita is insisting that we go out to Burger Bobs before my evening workshop for the Thriving Institute. To be honest, Burger Bobs sounds a little heavy for my pre-workshop meal. I’m nervous, but I guess we’ll see if that’s a mistake or not.

For those in attendance (or those not in attendance), here’s the ppts for tonight. They’re like, “amazing” or at least I hope you think so.

Thrive Anxiety Beast 2019

Anybody feeling anxious? Or like a beast?

Spidey

 

Understanding and Taming the Anxiety Beast in Your Child

Nora Twirl

I’m feeling a little nervous about going back to Bozeman this coming Thursday, November 14. This time, instead of continuing on with my latest streak of suicide and happiness presentations, the focus is on something I love even more: Parenting. I’m nervous because I obviously need help and support for coming up with titles to my talks. Somehow I’ve claimed that I’ll be taming beasts this Thursday. Looking back, I’m wondering why I made up such a grandiose sounding title. Ugh. Help wanted.

Despite my own anxiety, I’ll be presenting on behalf of Thrive, a very cool parenting education and children’s support organization in Bozeman. The event is called the Thriving Institute.

Location: Bozeman Public Library

Time: 6pm to 8pm

You can register online at: allthrive.org

Check out the fancy flyer here! Thriving Institute – Understanding and Taming the Anxiety Beast in Your Child

In anticipation of Thursday’s talk, I’m re-posting a blog from last year. It’s about children and anxiety, and it’s got an accompanying podcast. Here’s the re-post!

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Facing fear and anxiety is no easy task. It’s not easy for children; and it’s not easy for their parents. Here’s a short piece of historical fiction that captures some of the dynamics that can emerge when you’re helping children face their fears.

“I’m scared.”

My nephew turned his pleading fact toward me. He was standing on the diving board. I was a few feet below. We had waited in line together. Turning back now meant social humiliation. Although I knew enough to know that the scene wasn’t about me, I still felt social pressure mounting. If he stepped down from the diving board, I’d feel the shame right along with him. My own potential embarrassment, along with the belief that he would be better served facing his fears, led me to encourage him to follow through and jump.

“You can do it,” I said.

He started to shake. “But I can’t.”

Parenting or grand-parenting or hanging out with nieces and nephews sometimes requires immense decision-making skill. I’d been through “I’m scared” situations before, with my own children, with grandchildren, with other nephews and nieces. When do you push through the fear? When do you backtrack and risk “other people” labeling you, your son, your daughter, or a child you love as “chicken?”

This particular decision wasn’t easy. I wanted my nephew to jump. I was sure he would be okay. But I also knew a little something about emotional invalidation. Sure, we want to encourage and sometimes push our children to get outside their comfort zones and take risks. On the other hand, we also want to respect their emotions. Invalidating children’s emotions tends to produce adults who don’t trust themselves. But making the decision of when to validate and when to push isn’t easy.

I reached out. My nephew took my hand. I said, “Hey. You made it up here this time. I’ll bet you’ll make the jump next time.” We turned to walk back. A kid standing in line said, “That’s okay. I was too scared to jump my first time.”

Later, when the line had shrunk, my nephew wanted to try again. “Sure,” I said. “I’ll walk over with you.”

He made the jump the second time. We celebrated his success with high-fives and an ice-cream sandwich.

Like all words, the words, “I’m scared” have meaning and provoke reactions.

Sometimes when parents hear the words, “I’m scared” they want to push back and say something like, “That’s silly” or “Too bad” or “Buck-up honeycup” or something else that’s reactive and emotionally invalidating.

The point of the story about my nephew isn’t to brag about a particular outcome. Instead, I want to recognize that most of us share in this dilemma: How can we best help children through their fears.

Just yesterday I knelt next to my granddaughter. She was too scared to join into a group activity. She held onto my knee. We were in a public setting, so I instantly felt embarrassment creeping my way. I dealt with it by engaging in chit-chat about all the activity around us, including commentary about clothes, shoes, the color of the gym. Later, when she finally joined in on the activity, I felt relief and I felt proud. I also remembered the old lesson that I’d learned so many times before. In the moment of a child’s fear, my potential emotional pain, although present, pales in comparison to whatever the child is experiencing.

If you’d like to hear more about how to help children cope with their fears, you can listen to Dr. Sara Polanchek and me chatting about this topic on our latest Practically Perfect Parenting Podcast. Here are the links.

On iTunes: https://itunes.apple.com/us/podcast/practically-perfect-parenting-podcast/id1170841304?mt=2

On Libsyn: http://practicallyperfectparenting.libsyn.com/

And follow us on Facebook: https://www.facebook.com/PracticallyPerfectParenting/

 

 

Interested in Exercise for Treating Depression in Adolescents? Check out the DATE study!

Half Marathon 2019

Common sense, clinical intuition, non-experimental research studies, and most sentient beings all support the likelihood that physical exercise can reduce depressive symptoms.

But, to the best of my knowledge, only one, very small, randomized controlled study of exercise for treating major depressive disorder in youth has ever been conducted. This study was nicknamed the DATE study (the Depression in Adolescence Treated with Exercise study by Hughes, Barnes, Barnes, DeFina, Nakonezny, & Emslie, and published in 2013 in a journal called, Mental Health and Physical Activity).

A brief review of the DATE study provides a glimpse into the potential of exercise as an intervention for treating depression in youth.

The DATE study randomized youth ages 12 – 18 years into an aerobic/cardio group (n = 16) vs. a stretching group (n =14). Although participants exercised independently and were given a variety of exercise alternatives (they could use Wii or Jazzercize, that’s right Jazzercize), both groups were involved in 12 weeks of rigorously monitored three times weekly exercise treatment protocols.

The results were statistically and clinically significant, with the aerobic condition showing remarkably fast responses and achieving a 100% response rate (86% complete depression remission). The stretching group improved more slowly, but also had a significant positive response (67% clinical response rate; 50% complete depression remission).

Now you might be thinking, that sounds pretty good, but how do those results compare with response rates from established medical treatments, like Prozac?

The authors shared that information. They reported that documented response rates in comparable fluoxetine (Prozac) studies with youth, showed, on average, about a 52% (Prozac) and 37% (placebo) response rate. Just to be clear, let’s put those results in order of which treatment looks best:

  1. Aerobic Exercise = 100% response rate
  2. Stretching = 67% response rate
  3. Prozac = 52% response rate
  4. Placebo – 37% response rate

But the authors didn’t stop there.

They noted that although Prozac shows beneficial treatment effects, clients who take Prozac and other antidepressants commonly experience uncomfortable side effects and occasional health-threatening adverse events. How do you suppose the exercise and stretch groups compared?

No big surprise here: They experienced ZERO side effects and ZERO adverse events.

In summary, the DATE study authors reported that, compared to antidepressant medication treatment with adolescents, exercise resulted in (a) a faster response rate, (b) a better response rate, (c) fewer relapses (n = 0) at six and 12 month follow-ups, and (d) zero side effects or adverse events (Hughes et al., 2103).

But here’s the kicker. Who exactly were these researchers?

This is my favorite part. The researchers were extremely high level and prestigious academics who primarily conduct pharmaceutical research. One of them was the guy responsible for the clinical studies that led to FDA approval of Prozac for treating youth with depression (Graham Emslie). The two biggest names on the study have repeatedly been funded by Eli Lilly, GlaxoSmithKline, Pfizer, and many more. The DATE study was funded by NIH.

Sadly, the DATE study hasn’t been replicated. I can’t find any new RCTs on exercise for  depression among adolescents. When I told this to Rita, she just quipped, “That’s probably because the authors were murdered by pharmaceutical companies in some back alley.”

I hope not. Because, to summarize, the DATE study supports the systematic use of exercise in youth with depressive symptoms OVER and INSTEAD OF antidepressants.

Who knew?

Just about everyone.

Inspiring Cooperation in Your Children

Moose

**Photo courtesy of the amazing Dudley Dana**

As Ella Fitzgerald and Louis Armstrong sang in 1957, it’s “Summer time and the living is easy.”

In fact, if you’re a parent living on planet Earth (or the Missoula valley) and you’re trying to regulate your children’s access to electronic devices, the living may not be easy; it may be infuriating.

Way back in 1998-2000 I had a biweekly Missoulian parenting column. One of the most popular columns I ever wrote was about a popular and challenging phenomenon among children in 1999. It started . . .

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Here’s a quick parenting quiz.

Question: “How do you spell opportunity?”

Answer: “P-O-K-E-M-O-N.”

As if you didn’t know, Pokemon paraphernalia – the movie, action figures, and yes, Pokemon trading cards – are red hot items among many grade-school children.  Some adults question whether Pokemon obsessions are healthy.  Others contend that Pokemon monsters are evil.  Still others fuel their children’s Pokemon desire through unchecked spending.

When parents ask for my professional opinion about the Pokemon phenomenon, I put on my psychologist face.  I cradle my chin in my hand and look upward in a sort of reflective way.  Then I slowly speak Latin (not bothering to mention that I’m using ½ of my Latin vocabulary).  I say,

“Carpe Diem!”

Then, just in case the person I’m talking with speaks even less Latin than I do, I repeat myself in English.

“Seize the day!”

This is a precious moment in history.  We have at our fingertips – thanks to Pokemon monsters – frequent, repeating, and unparalleled parenting opportunities.

It doesn’t matter whether your child is into Pokemon, Furbys, Heavy Metal music, whining, or chocolate, limit-setting issues will undoubtedly arise.  And limit-setting is absolutely essential.  Parents must set limits — because their children won’t.

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Here’s the new question: If Pokemon monsters were all-the-rage and immensely challenging back in 1999, what monstrosities are plaguing Montana parents THIS SUMMER??

Cell phones and other electronic devices!

Even though your children’s relationships with their electronic devices is filled with crazy-making energy for parents, I deeply believe that my carpe diem advice from the 1990s still stands. All this points to using knowledge about your child, limit-setting, and logical consequences to transform the pain of dealing with electronic devices into the pleasure of having well-adjusted children.

If you want to take advantage of your child’s obsessions, consider making a short list of mutually agreeable rules (based on your family values or principles). For example:

  • Tell your child that rule violations will result in a warning or consequence
  • Follow-through and use empathy as appropriate
  • Remember that children need to learn from mistakes
  • If your child throws a fit or behaves aggressively, NEVER give in

Here’s an electronic device limit-setting example:

Let’s say you’ve talked with your son or daughter and decided that everyone in your family needs time free from all electronic devices. You make it clear that there will be no phones (or other devices) during family meals, during family chores, and during the hour before bedtime. The agreed upon consequence for violating this rule might be something like loss of phone privileges for 6 hours (if you make the consequence small, it will be easier for you to enforce and easier for your child to comply without completely freaking out). Then, if your child violates the rule, you can either give a warning-reminder (“I notice your phone is out. Please put it away or I will put it in our family phone lock-box”) or simply remind your child of the house rule and put the phone in the lock-box.

The cool thing about giving your children warnings is that it gives them a chance to change or improve their behavior. If, upon being warned, your child puts the phone away, you can praise the excellent decision-making by saying something like, “I noticed you put your phone away when I gave you the warning.” If your child makes a poor decision and temporarily loses phone privileges, then you can be empathic and encouraging, “I’m sorry you lost your phone for a while. That’s must feel upsetting. I bet you’ll make a better choice next time.”

Rather than droning on about the virtues of limit-setting to teach your children well, I’m stopping here to point out yet another fantastic opportunity.

The featured Practically Perfect Parenting episode of this week is creatively titled, Inspiring Cooperation in Your Children. And so, for more fun and entertaining information on this parenting topic, you can go to one of the following links.

On Libsyn: https://practicallyperfectparenting.libsyn.com/

On Apple: https://podcasts.apple.com/us/podcast/practically-perfect-parenting-podcast/id1170841304

As always, feel free to comment, share, like, or shun this blog and the accompanying podcast.

Using Therapeutic Storytelling with Children: Five Easy Steps

Books

Everybody loves a good story.

Good stories grab the listener’s attention and don’t let go. I’ve been reading and telling stories for as long as I can remember. Whether its kindergartners, clients, or college students, I’ve found that stories settle people into a receptive state that looks something like a hypnotic trance.

Nowadays, mostly we see children and teens entranced with their electronic devices, television, and movies. Although it’s nice to see young people in a calm and focused state, the big problem with devices (other than their negative effects on sleep, attention span, weight, brain development, and nearly everything else having to do with living in the real world), is that we (parents, caretakers, and concerned adults), don’t have control over the electronic stories our children see and hear.

Storytelling is a natural method for teaching and learning. Children learn from stories. We’re teaching when we tell them. We might as well add our intentionally selection of stories to whatever our children might be learning from the internet.

Way back in 1997, Rita and I wrote a book called Tough Kids, Cool Counseling. One of the chapters focused on how to use therapeutic storytelling with children and teens. Although the content of Tough Kids, Cool Counseling is dated, the ideas are still solid. The following section is good material for counselors, psychotherapists, parents, and other adults who want to influence young people.

In counseling, storytelling was originally developed as a method for bypassing client resistance. Stories are gentle methods that don’t demand a response, but that stimulate, “thinking, experiencing, and ideas for problem resolution” (Lankton & Lankton, 1989, pp. 1–2)

Storytelling is an alternative communication strategy. For counselors, it should be used as a technique within the context of an overall treatment plan, rather than as a treatment approach in and of itself. For parents and caregivers, stories should be fun, and engaging . . . and told in a way to facilitate learning.

Story construction. Even if you’re an excellent natural storyteller, it can help to have a guide or structure for story construction and development. I like using a framework that Bill Cook, a Montana psychologist, wrote about and shared with me. He uses the acronym S-T-O-R-I, to organize the parts of a therapeutic story.

S: Set the stage for the story. To set the stage, you should create a scenario that focuses on a child living in a particular situation. The child can be a human or an animal or an animated object. The central child character should be described in a way that’s positive and appealing. Because much of my work back in the 1990s involved working with boys who were angry and impulsive, the following story features a boy who has an arguing problem. Depending on your circumstances, you could easily feature a girl or a child who doesn’t have a particular gender identity.

Here’s the beginning of the story.

Once upon a time there was a really smart boy. His name was Lancaster. Lancaster was not only smart, he was also a very cool dresser. He wore excellent clothes and most everyone who met Lancaster immediately was impressed with him. Lancaster lived with his mother and sister in the city.

In this example, the client’s name was Larry. If it’s not too obvious, you can give the central character a name that sounds similar to your client’s name. You may also develop a story that has other similarities to your client’s life.

T: Tell about the problem. This stage includes a problem with which the central character is struggling. It should be a problem similar to your client’s or your child’s. This stage ends with a statement about how no one knows what to do about this very difficult and perplexing problem.

Every day, Lancaster went to school. He went because he was supposed to, not because he liked school. You see, Lancaster didn’t like having people tell him what to do. He liked to be in charge. He liked to be the boss. The bad news is that his teachers at school liked to be in charge too. And when he was at home, his mother liked to be the boss. So Lancaster ended up getting into lots of arguments with his teachers and mother. His teachers were very tired of him and about to kick him out of school. To make things even worse, his mother was so mad at him for arguing all the time that she was just about to kick him out of the house. Nobody knew what to do. Lancaster was arguing with everyone and everyone was mad at Lancaster. This was a very big problem.

O: Organize a search for helpful resources. During this part of the story, the central character and family try to find help to solve the problem. This search usually results in identifying a wise old person or animal or alien creature as a special helper. The wise helper lives somewhere remote and has a kind, gentle, and mysterious quality. In this case, because Larry (the client) didn’t have many positive male role models in his life, I chose to make the wise helper a male. Obviously, you can control that part of the story to meet the child’s needs and situation.

Because the situation kept getting worse and worse and worse, almost everyone had decided that Lancaster needed help—except Lancaster. Finally, Lancaster’s principal called Lancaster’s mom and told her of a wise old man who lived in the forest. The man’s name was Cedric and, apparently, in the past, he had been helpful to many young children and their families. When Lancaster’s mother told him of Cedric, Lancaster refused to see Cedric. Lancaster laughed and sneered and said: “The principal is a Cheese-Dog. He doesn’t know the difference between his nose and a meteorite. If he thinks it’s a good idea, I’m not doing it!”

But eventually Lancaster got tired of all the arguing and he told his mom “If you buy me my favorite ice cream sundae every day for a week, I’ll go see that old Seed-Head man. Lancaster’s mom pulled out her purse and asked, “What flavor would you like today?”

After hiking 2 hours through the forest, they arrived at Cedric’s tree house late Saturday morning. They climbed the steps and knocked. A voice yelled: “Get in here now, or the waffles will get cold!” Lancaster and his mom stepped into the tree house and were immediately hit with a delicious smell. Cedric waved to them like old friends, had them sit at the kitchen table, a served them a stack of toasty-hot strawberry waffles, complete with whipped cream and fresh maple syrup. They ate and talked about mysteries of the forest. Finally, Cedric leaned back, and asked, “Now what do you two want . . . other than my strawberry waffles and this pleasant conversation?”

Lancaster suddenly felt shy. His mom, being a sensitive mom, looked up at Cedric’s big hulking face and described how Lancaster could argue with just about anyone, anytime, anywhere. She described his tendency to call people mean names and mentioned that Lancaster was in danger of being kicked out of school. Of course, Lancaster occasionally burst out with: “No way!” and “I never said that,” and even an occasional, “You’re stupider than my pet toad.”

After Lancaster’s mom stopped talking, Cedric looked at Lancaster. He grinned and chuckled. Lancaster didn’t like it when people laughed at him, so he asked, “What are YOU laughing about?” Cedric replied, “I like that line. You’re even stupider than my pet toad. You’re funny. I’m gonna try that one out. How about if we make a deal? Both you and I will say nothing but “You’re even stupider than my pet toad” in response to everything anyone says to us. It’ll be great. We’ll have the most fun this week ever. Okay. Okay. Make me a deal.” Cedric reached out his hand.

Lancaster was confused. He just automatically reached back and said, “Uh, sure.”

Cedric quickly stood up and motioned Lancaster and his mom to the door, smiling and saying, “Hey you two toad-brains, see you next Saturday!!”

Searching for helpful resources can be framed in many ways. For counselors, you might construct it to be similar to what children and parents experience during their search for a counselor. Consistent with the classic Mrs. Piggle Wiggle book series, the therapeutic helper in the story has tremendous advantages over ordinary counselors. In the Lancaster example, Cedric gets to propose a maladaptive and paradoxical strategy without risk, because the whole process is simply a thought experiment. Depending on your preference and situation, you can use whatever “treatment” strategy you like.

R: Refine the therapeutic intervention. In this storytelling model, the initial therapeutic strategy isn’t supposed to be effective. Instead, the bad strategy that Cedric proposes is designed for a core learning experience. During the fourth stage (refinement) the central character learns an important lesson and begins the behavior change process.

Both Lancaster and Cedric had a long week. They called everyone they saw a “stupid toad-brain” and said, “You’re even stupider than my pet toad” and the results were bad. Lancaster got kicked out of school. That morning, when they were on their way to Cedric’s, Lancaster got slugged in the mouth for insulting their taxi driver and he was sporting a fat lip.

When Lancaster stepped into Cedric’s tree house, he noticed that Cedric had a black eye.

“Hey, Mr. Toad-Brain, what happened to your eye?” asked Lancaster. “Probably the same thing that happened to your face, fish lips!” replied Cedric.

Lancaster and Cedric sat staring at each other in an awkward silence. Lancaster’s mom decided to just sit quietly to see what would happen. She was felt surprisingly entertained.

Cedric broke the silence. “Here’s what I think. I don’t think everyone appreciates our humor. In fact, nobody I met seemed to like the idea of having their brain compared to your pet toad’s brain. They never even laughed once. Everybody got mad at me. Is that what things are usually like for you?”

Lancaster muttered back, “Uh, well, yeah.” But this week was worse. My best friend said he doesn’t want to be best friends and my principal got so mad at me that he put my head in the toilet of the boys’ bathroom and flushed it.”

Cedric rolled his eyes and laughed, “And I thought I had a bad week. Well, Lanny, mind if I call you Lanny?”

“Yeah, whatever, Just don’t call me anything that has to do with toads.”

“Well Lanny, the way I see it, we have three choices. First, we can keep on with the arguing and insulting. Maybe if we argue even harder and used different insults, people will back down and let us have things our way. Second, we can work on being really nice to everyone most of the time, so they’ll forgive us more quickly when we argue with them in our usual mean and nasty way. And third, we can learn to argue more politely, so we don’t get everyone upset by calling them things like ‘toad brains’ and stuff like that.”

After talking their options over with each other and with Lancaster’s mom, Cedric and Lancaster decided to try the third option: arguing more politely. In fact, they practiced with each other for an hour or so and then agreed to meet again the next week to check on how their new strategy worked. Their practice included inventing complimentary names for each other like “Sweetums” or “Tulip” and surprising people with positive responses like, “You’re right!” or “Yes boss, I’m on it!”

As seen in the narrative, Lanny and Cedric learn lessons together. The fact that they learn them together is improbable in real life. However, the storytelling modality allows counselor and client the opportunity to truly form a partnership and enact Aaron Beck’s concept of collaborative empiricism.

I: Integrating the lesson. In the final stage of this storytelling model, the central character articulates the lesson(s) learned.

Months later, Lancaster got an invitation from Cedric for an ice cream party. When Lancaster arrived, he realized the party was just for him and Cedric. Cedric held up his glass of chocolate milk and offered a toast. He said, “To my friend Lanny. I could tell when I first met you that you were very smart. Now, I know that you’re not only smart, but you are indeed wise. Now, you’re able to argue politely and you only choose to argue when you really feel strongly about something. You’re also as creative in calling people nice names as you were at calling them nasty names. And you’re back in school and, as far as I understand, your life is going great. Thanks for teaching me a great lesson.”

As Lanny raised his glass for the toast, he noticed how strong and good he felt. He had learned when to argue and when not to argue. But even more importantly, he had learned how to say nice things to people and how to argue without making everyone mad at him. The funny thing was, Lanny felt happier. Mostly, all those mad feelings that had been inside him weren’t there anymore.

At the end of this story (or whatever story you decide to use), you can choose to directly discuss the “moral of the story” or not. In many cases, leaving the story’s message unstated is useful. Or you might ask the child, “What do you think of this story?”

Letting the child consider the message provides an opportunity for intellectual stimulation and may aid in moral development. Although it would be nice to claim that therapeutic storytelling causes immediate behavior change, the more important outcome is that storytelling provides a way for an adult and a child to have pleasant interactions around a story . . . with the possibility that, over time, positive behavior change may occur.

The Pediatric Sleep & Wellness Conference in Seattle and The Suicide Prevention and Intervention in Bozeman: Informational Flyers Flying

In the coming weeks I’m honored to be able to present on two of my favorite topics: Parenting and Suicide Assessment.

These two upcoming events (in Seattle, April 27 and in Bozeman, May 16 and 17) have nice landing urls for information and registration.

If you happen to be in one or both of these areas, I’d be happy to see you. Please let me know, so we can say a real, non-virtual hello.

The links.

Seattle: https://pediatrictrainingacademy.com/conference/?fbclid=IwAR0ov1b6RgqIY3qHRG7qPAC2Nf9PyHpkbI5fOodtp8umUUTMbDW2sh9v438

Bozeman: https://www.byep.org/saw

Boze Coop

Happy Wednesday! JSF

 

Bozeman Workshops on Parenting

I’m just about to hit the road to Bozeman to provide a short class and evening presentation for Thrive and the Big Sky Youth Empowerment Program (BYEP). These are two fantastic organizations and I’m honored to make the trip and spend time talking about youth and how parents can move toward being the parents they want to be.

The 1:30pm presentation is titled, “Strategies and Techniques for Influencing and Motivating Children and Teenagers” and the powerpoints are here: Thrive Bozeman Motivation 2019

The 6:00pm workshop is at the Bozeman Public Library and is titled, “Transforming Explosive Tantrums Into Cooperation: Strategies for Helping Children (and Caretakers) Achieve Emotional Regulation.” Yep. . . that’s a mouthful. Here’s the powerpoint: Thrive Bozeman Explosive Solutions 2019

I also have a summary handout for participants here: Thrive Explosive Handout 2019

If you want more information about Thrive and BYEP and the cool and important work they do, you can find Thrive information here: https://allthrive.org/

And BYEP here:  https://www.byep.org/

Okay. Now, on to the important stuff: Go Griz!

Hatches B