Recently in Therapy Category

Probably more than you've ever wanted to know about parent coaching, therapy, magic, and apples & giraffes, too.  Thanks to interviewer Nicole Basham!

Click here to read the interview.

On his travel blog, Rick Steves once explained the 'secret' of the Oracles at Delphi, saying this:

Two thousand five hundred years ago, movers and shakers from throughout the ancient world went to Delphi to get advice from the Delphi priests. The priests weren't in cahoots with the gods. They just interviewed everyone who came to them, thinking that they were. Because of that, the priests knew what the competition was up to (politically, militarily and so on) and could give divine-quality advice.

I was reminded of this explanation the other day, when I realized that I often repeat conversations from client to client.  Mr & Mrs Smith might be in my office today for help with, say, bedtime troubles.  The suggestions I offer to them come from different sources: some I probably got from a book, some from a friend, maybe one I 'invented', and without a doubt a few came from previous clients.  Then the next week the Smiths come back and tell me which ideas worked/didn't work for them, and invariably they'll tell me a new solution that they themselves invented, or heard from a friend, or read in a magazine... and I promptly add it to my trusty bag of tricks. 

Anyway, I'm no oracle, and I don't think my advice is divine quality (!!!) but I can surely identify with the strategy.  I am constantly listening and learning and sharing what I learn.

When our kids are sick and we don't know what's wrong or how to deal with it, we usually go to the doctor.  We don't feel conflicted about seeking that professional's help, and we don't wait until things are so bad that our child is comatose.  But for some reason, with behavioral/emotional/relationship challenges, people can be reluctant to seek help, often waiting until the problems worsen and get cemented in place.  John Gottman says that, on average, couples wait 7 years before they seek the help they need.  I think that parents do better, and seek help much sooner, but it is so important to remember that therapy can be supportive at any stage, and can help improve relationships by resolving minor challenges before they become a major problem. 

When a child has behavior problems, parents come in to my office, and say that they worry that "x" behavior might be a sign of something very serious.  I understand that fear, I really do (I'm a parent, too.)  But, it's not just when something's terribly wrong that we can get help from a professional.  Even when "everything's fine," it's possible for a professional to help parents identify and improve the small hangups in their daily life.   A skillful child & family therapist can help parents tweak a particular area, and--via the magic of the parenting relationship--even if the parents had little to do with creating the problem, they can still be largely responsible for fixing the problem.

So what is a small area of your daily life that you'd love to see get better?  Bedtime?  Transitions?  The dinner table?  A difference of opinion between you & your spouse about how to handle something?  Homework?  Mornings?  Chores?  I encourage you to seek out a supportive, non-judgmental therapist who specializes in kids/families/parenting.  Please feel free to email or call me if I might be of help! 

Who has time to read an entire parenting book these days?  It's amazing how much time & energy it takes to chew through a 350 page epic on how you "should" parent.  Even the really good books are tough to get through.  It's made me particularly appreciative of brevity, so to that end here are just 3 thoughts/comments that I frequently say in my role as a parent coach & therapist.  It's a little like a 15 minute parent coaching session, or a super, super condensed parenting book.  ;^)

1. It's our job as parents to help prepare our kids for the real world.  We parents typically want to protect our kids from the evils and heartbreaks that exist out there.  That's normal and healthy and generally encouraged.  But.  Our other very important job is to help our children acquire the skills, habits, resources, and strength to be able to handle the problems of the world on their own.  We can't protect them forever, so we'd better equip them.  Start now. 
2. Kids intuitively know that they are half-mom and half-dad.  When kids hear/see/perceive criticism from one parent to another, they internalize it and file it away under "things about MYSELF that aren't good."  While I say this one more to parents who are divorcing, it's also true for married parents.  Every couple has conflict (it's healthy, actually) but the way we handle that conflict is so important.
3. The single best way to get your kid to change is to let them see you changing.  I say this one so often that I joke I'm going to embroider it on a pillow one day.  But it speaks to the power of role modeling, the power of acknowledging that-even though we're the parent-we're still not perfect, and it also sends the message that in your family's home-everyone is committed to growing.  Such a powerful and positive message!

The New York Times published an article yesterday about the FDA's recent criticism of the use of antipsychotic drugs in children.  (For example: Risperdal, Zyprexa, Seroquel, Abilify and Geodon.)  Prescriptions for the drugs (for kids) are increasing, and despite their designation as anti-psychotic meds, they are also being prescribed for non-psychotic problems like ADHD!  The side effects are serious and numerous--including fatalities (Risperdal alone has resulted in 31 child deaths since its introduction.)   John Grohol at psychcenter.com said this about these "off-label" prescriptions:

The data don't support such prescriptions, and the long-term data is virtually non-existent. Docs (and parents pushing the docs) should stop reaching for every possible new drug to help children when, especially for a disorder like ADHD, there are powerful, fast non-drug treatments available (such as psychotherapy).

I'm glad to see an increase in scrutiny in the use of these medications.  Behavioral, psychological, attentional problems--they aren't just a chemical problem--and the further we can move away from the mindset of "pill=solution," the better.

Read the original NYT article here.
Read John Grohol's take on it here.

Once upon a time, on a Monday, a man was walking down a road.  All of a sudden, out of nowhere, he found himself at the bottom of a big, dark place.  It was scary!  After several hours, he figured out that he had fallen into a very large pothole.  He wasn't able to get out on his own--actually it required a lot of help to get out, but eventually he did get out.  It was awful.

The very next day--Tuesday, the man was walking down the road and fell into the pothole again.  This time he immediately recognized where he was, but he still couldn't get out.  He needed help again.

Wednesday, when the man fell in the pothole for the 3rd time, he remembered how to get out, and--with much hard work--was able to get out on his own.  Whew!

On Thursday, the man was walking down the street again.  As he approached the pothole, he remembered his previous falls.  He even saw the pothole when he got close... but unfortunately he fell in anyway.  But he knew the way out pretty well this time, and got out quickly.

On Friday, the man saw the pothole from a good distance away.  He felt so proud of himself for spotting it, and while it took a lot of effort, he did manage to walk around it safely, and didn't fall in for the first time in a long time!  Hurrah!

On Saturday, the man took a different road.

I love this story (it's not mine, and I have no idea where it came from) as a metaphor for life change.  I imagine the potholes as arguments or really bad habits that we find ourselves sucked into without meaning to go there!  One of the first steps to change is always awareness, then hard work, and finally comes success.  Eventually, living our lives the way we want to--having our relationships look like we want them to--stops being a ton of effort, and we find ourselves on a smooth path with no (okay, few) potholes.

Here's to having a smoother path before you this week!

Do you worry about your child's shyness?  Do other people label your child shy?  Do you wonder if shyness is a problem?

Shyness isn't always a problem.  Really!  Humans come in all different temperaments, and thank goodness for that.  American popular culture tends to favor social, outgoing people, but (a) other cultures send different messages, and (b) neither way is "right or wrong".  Rather, it is FAR more important that your child feel comfortable the "just way they are," to quote Mr. Rogers. 

Developmental Stages & Shyness
First of all, consider your child's developmental stage.  Young toddlers go through stages of separation anxiety, but so do older kids, it just looks different.  The most prominent period for this (later) is when children start kindergarten.  This is a huge transition for kids, and results in shyness, or regression, or a host of other behavioral changes.  It's normal.  In those situations parents need to continue to support and love their child, talking about the changes and your child's feelings and how to cope.  Things will get better with time.  

A second period of developmental shyness is normal around the early stages of puberty, too.  Body changes are accompanied by greater pressures from peers, and emotional and hormonal shifts.  It's a tough time, and shyness is often part of the picture.  Again, just keep supporting, loving, talking, and teaching and things will get better with time.

Introverts & Extroverts
An extrovert is someone who 'gets their energy' from interacting with others.  An introvert is someone who gets their energy from within, from being alone.  Which one is your child?  A shy child might be a perfectly happy and content introvert, with no need for fixing or changing.   
Is your child happy?  Do they think their shyness is a problem?  

I encourage you to ask them!  In a non-confrontational way--perhaps when it's just the two of you in the car going somewhere--bring up the topic of shyness.  For example: "John, did you have a good time yesterday at Dan's birthday party?  If your son says "No," talk a little about why he didn't have a good time.  Perhaps he himself felt that his feelings of shyness kept him from enjoying himself.  If you son says "yes," you might say "You know, I noticed when I picked you up that you were playing by yourself in the back room."  Perhaps this will spark a conversation.  But simply, your goal is to find out whether your child themselves thinks that shyness is a problem.

Stay tuned for more about shyness.

If your child takes medication for ADHD, are regular electrocardiograms necessary? Well, it depends on whom you ask, apparently. The American Heart Association says yes, and the American Academy of Pediatrics says no.

For more details, visit today's post on this topic on the "On Parenting" blog, written by Nancy Shute--it's an excellent blog, by the way, one that I look forward to reading each week myself.

As an MSSW first-year intern, I worked at a residential treatment facility for teenage male sex offenders. I didn't ask for that job, and it was really-really challenging, but I definitely learned an enormous amount there. This is one of my favorite stories from that time.

I worked with a psychiatrist who was a super smart guy. He was completely dedicated to the kids, but not terribly patient with the interns. One day I made the mistake of complaining to him. One of the kids had just interacted with me in a sexually inappropriate way, and I was feeling gross and uncomfortable and just icky all over. I tried to evaluate the interaction in a professional, clinical way, but mostly just came up with the conclusion that the kid was "wrong" and not working his treatment program appropriately. So when I ran into the psychiatrist, I described the kid's behavior, probably in such a way that I highlighted how "bad" and resistant to treatment the kid was. ("Bad kid, bad!")

The Dr looked at me, and immediately said: "Good for him!"

What!?

Oh my goodness. I was just a wee bit offended and righteous. But, thankfully the doctor didn't care, and his desire to educate me prevailed. Here's what he taught me that day:

We really must view a child's behavior as communication, and communication is good. That doctor wanted me to be able to recognize that a child in a treatment center for a sexual offense, who hits on a staff member, is sending a message loud and clear. And the doctor wanted me to get the correct message. The message wasn't: "I'm a bad kid." Rather, the message I needed to get was: "I'm not done learning and growing. I need more help with healthy relationships." (*)

To be clear: I'm not saying that the behavior itself is good-or even okay. Rather, I'm saying that if we look at it as a communication, then we can find the good behind the behavior. There IS good behind the behavior, and our kids NEED us to choose this perspective. So, we can look at the kid as though they are intrinsically "good," and that their "bad" behavior is a communication of need. Compare this with assuming that a "bad" behavior is a reflection of a "bad" child. Which of these perspectives will allow us to be more loving and helpful to the child as they grow? Which perspective discourages growth?!

Our kids need us to look behind their behavior. They need us to assume the best, and help them grow and learn.

So, parents, when could you say "Good for him/her!" about your child?

(*) It's also possible that the child's message included either (a) "Are you safe? Can I trust that you won't be unhealthy with me even if I try to be unhealthy with you?" or (b) "I know that you are safe, and that's why I can trust you with this communication-that I am still not safe."

Therapy is good stuff. Kids usually LOVE going, and parents love the progress they see. You want your kid to get what they need and their health (physical and mental) is a top priority. But, money doesn't grow on trees and you want to make sure that you're maximizing your time, money and energy.

So, here are a few tips from a therapist on how to get the most out of your child's therapy.

• Have a "grown-ups only" meeting with your child's therapist every month or two.
• The more you and the therapist talk, the better you'll both be able to help the child.
• Have both parents participate/attend.
• Ask for homework. (Homework is like getting an extra session per week, for free!)
• Do the homework. ;^)
• Show up early. Use the 5 minutes you're sitting there to talk with your kid about your week, your goals, your feelings, the homework. It helps transition to "therapy-time." Plus, Murphy's law guarantees that the one time you show up late for a session, will be the time when something deep, meaningful, and difficult will come up. Those few minutes make a difference!

And my best tip:

Participate in family therapy. Children are deeply affected by their parents. I tell every parent I work with two things:

1. The single most effective thing that you can do to get your child to change is to let them see you changing.
2. You are probably the most motivated 'client.' Children, whether due to age or inexperience with the world or something else, don't usually know that their world/emotions/interactions/relationships can be changed, and that talking about these things can help them change.

There are many more (whole books have been written, in fact) but this is short list will get us started!