Friday, October 31, 2008

Anxious Children: What Treatment is Best?

Anxious Children: What Treatment is Best?

The New England Journal of Medicine has recently published a large research study looking at what treatment works best for children with anxiety disorders, medication or cognitive behavioral treatment. This study has been described in detail by Lindsey Tanner of the Associated Press. Sertraline (Zoloft), a selective_serotonin_reuptake_inhibitor, and cognitive behavioral therapy were found to be equally effective on their own. However, when a combination of sertraline and therapy were used together, the reduction of symptoms of anxiety in the children was much greater. The implications of this study are that a combination of medical and psychological treatment is the most effective treatment for children who have struggled with significant anxiety that has affected their day-to-day functioning and relationships with other people.

This study is quite significant and will no doubt increase the use of SSRIs with children. Insurance companies and national associations will use these results to promote the use of medication as the crucial component of helping children cope with anxiety. Even though cognitive behavioral treatment is just as effective as medication on its own, taking a pill is much quicker and more cost-effective to administer. Many parents will chose to take the "quick fix" approach and ignore that these children actually need to learn life-skills as well.

I strongly encourage parents to deeply self-reflect before giving their anxious child a pill. Before you jump to medicating your child, be sure that the anxiety is not just a situational feeling. We all become anxious from time to time. Many times, this anxiety goes away when the situation changes. Also, be sure that you are teaching some of the basics of cognitive behavioral therapy (e.g., relaxation, reinterpreting events). We all have to learn to overcome our fears through lots of hard work. In order for children to become strong adults, it is a wonderful skill to how to manage fears through positive self-talk, brief relaxation (i.e., deep breathing, visualizing a safe place), and persistence. If we give too much power to medication, our children will be less inclined to learn the success principles that are so important in life.

Of course there are times when medication is indicated (e.g., persistent symptoms of anxiety over time that are greatly affecting performance and relationships) and the decision to medicate is a personal one made on case-by-case basis. However, even if medication is utilized, the children on medication still need to be taught how to effectively overcome the challenges that they will face throughout their lifetime. The medication may "cut the edge" off the symptoms of anxiety which could help the child be more able to learn. The medication will not teach such skills as assertion, prioritization of life's goals, and reinterpreting stressful events (e.g., calling someone up on the phone, entering a group of people) as "no big deal." The more that children are taught how to manage fears and stressors, the better off they will be.

To learn more about children and anxiety, go to my recommended resources page by clicking here.

Tuesday, October 28, 2008

Helping Kids Cope: When The Economy Hits Home

Helping Kids Cope: When The Economy Hits Home
Watch my recent interview on CNN about now to help children understand and cope with the current economic crisis. To view the interview click here. You may also view the interview on my blog at:

Sunday, October 26, 2008

Keeping the Dream Alive: An Inspiring Story

Keeping the Dream Alive: An Inspiring Story

Ken Mink is a basketball player at Roane State Community College in Harriman, Tenn. This in itself is not necessarily news since there are thousands of basketball players in our country. The astonishing part of this story is that this man is 73-years-old!!!! How many of you play basketball at 50? 40? 30? 20? He plays at an age where he is fully qualified for the full payment of social security, when any bus will give him a discount rate as a senior, and when many people his age are having to physically struggle just to go to the grocery store. He plays basketball on a college team!! If he isn't breaking the age barrier, I do not know who does. Jim Litke, AP sport's writer, has written that Ken Mink has achieved his long-standing dream of playing basketball on a college team. He played college ball in his 20s but was unable to play for his entire eligibility period. He kept his dream alive throughout the years and now he is back. This is a lesson for all of our children, and even for us, that it is important to keep your dreams alive no matter what your age. With vision, persistence, and hard work, dreams can and will come true. For the full text of Jim Litke's story click here.


Wednesday, October 22, 2008

The Economic Crisis and the Mood Swings of Parenting and School

The Economic Crisis and the Mood Swings of Parenting and School

Due to the typical calendar year of school, and the nature of seasons, parents and children go through cycles of excitement, hope, boredom, and discouragement. However, most of these individuals are not aware that these cycles are normal and predictable. Let me be a bit more specific. At the start of the school year, most parents and children are excited for the year to begin. New clothes are bought, new teachers are met, a new binder is organized, and friends whom you have not seen for the entire summer are seen again. However, after period of time, the reality of the school year sets in. The newness wears off. Some boredom and discouragement sets in. This happens between the middle of October until the holidays. The holidays give a positive boost to many people because there are things to look forward to during the holiday break. In January, most children and parents are excited for school to begin. However, they are probably not as excited before. From the latter part of January until spring break, boredom and discouragement is at its all time high. This is the longest stretch of the year without something exciting. Once the weather becomes nice and spring break hits, positive feelings are again on the rise because summer vacation is near. There is lots of planning regarding what to do for summer activities. Once school is out the excitement is peaked. However, during July some of the boredom again sets in. As the school year approaches, this cycle repeats itself. I am articulating this to you because it is important to put all of yours and your child's emotions in context. You are more affected by these cycles than you may realize. As a psychologist, I have years of data on this cycle. I know when my busy times will be. I can almost predict how people will be. This year will be more intense. The economic crisis and election are added stressors that we have not had for some time. Because of these, you may find yourself having more intense ups and downs than in past years. I encourage you to keep these cycles in mind and realize that we are going into a period of the year where it is common to experience boredom and discouragement. The issues in our country have made these cycles even more apparent. If you are feeling discouraged, please have faith that the cycles will swing to the positive. At this time, you need to be strong and hold on. Pretty soon the cycle will pull you to a more positive state of mind.

Friday, October 17, 2008

Sat on CNN - Economic Crisis and Children

Please join me tomorrow morning (Saturday, October 18th) on CNN at 8:00 am (Central Time). I will be talking about the effects of the current economic crisis on children. I will be covering the following:

Seven tips for talking to your child about the economic crisis
Over the past several weeks, people have become increasingly concerned about and impacted by the current economic crisis. Parents are worried. We are all worried. Many changes to people’s living situations and lifestyles are now taking place. When parents are worried, the children soak this up like a sponge. Like adults, children respond to financial stress in diverse ways. Many children are fine and show little impact. However , there are many other children who respond by becoming more withdrawn, shy, anxious, and clingy. Other children have responded by becoming more active, impulsive, and even aggressive. T o ensure that your child weathers the storm of these days of hardships in a positive way parents are encouraged to do the following:
  • Be aware that children will be impacted by the current challenges in our country, some more than others. Those who are affected may not show signs of anxiety in an obvious way. Your child may be affected and if this is the case, more support is necessary.
  • Hang out with your child as much as possible. If you are extremely busy, even a little time is better than no time. Just knowing you are there will be a source of comfort. When you are with your child, you do not necessarily have to do something structured. Just being with your child is wonderful in itself.
  • Talk to your child honestly about what is currently happening. There is no need to go into complete detail about everything. Just, briefly explain. If your child wants to know more, then explain as much as the child developmentally can understand.
  • Offer to be there for him or her. Tell your child that you would love to talk if he/she has concerns of their own.
  • Emphasize resilience. Tell your child that he/she will be fine. Explain that many families throughout the history of the world have faced hardships and have done well.
  • Be a good listener. Don’ t try and fix your child’s feelings. Just listen and acknowledge the feelings shared.
  • Keep your family routine as consistent as possible. Keep your dinner and play times the same. Keep the child in their school if at all possible. Children do best when their routine is not drastically altered.

If you feel that your child’s emotions or behavior are greatly impacting daily functioning, then it may be time to seek professional help. Parents are encouraged to first consult the natural caregivers in their child’s life such as the teacher, school counselor, or family physician. These professionals see all types of children on a regular basis and will have a good sense of if more specialized help is needed. These professionals also will have ideas regarding to whom to turn for help.

Times are tough and listening to all the negativity around us can be quite the bummer. But, rather than giving up, stay positive and find that inner strength to hold on. With patience and persistence the good times will soon be upon us again.

Monday, October 13, 2008

Does Your Child Need Residential Treatment?

Sometimes children and adolescents demonstrate behaviors and emotions of concern that cannot be managed at home. These youth may be in need of residential treatment. This can be a very emotional idea for parents to consider. I am actually a true believer of residential care since I began my career in a hospital based program in the 1980s (Capistrano By The Sea Hospital in Dana Point, CA). I saw wonderful and positive changes take place in the participating youth. This program is no longer in existence due to the budget cuts of managed care. In place of hospital programs, therapeutic schools have filled the void. There are now a variety of outstanding programs that are tailored to individual needs. If you are seeking residential care for your child, I recommend that you hire an educational consultant to help you find the appropriate program. Educational consultants are professionals who spend their career investigating/evaluating programs and providing placement services to parents. The first place to look for a possible educational consultant is to contact My mentor and former boss at Capistrano By The Sea (Larry Stednitz, PhD) is now an educational consultant with this organization. Dr. Stednitz, Lon Woodbury, MA (director), and colleagues do a remarkable job in placing the young person in the right program. These professionals are all certified by the Independent Educational Consultants Association.