Big Bend Therapy, LLC

04/23/2019

This is an excellent article. The website has a lot of great information also.

During adolescence, the brain goes through a massive and magnificent redesign. This is to give children the neural firepower to make the transition from dependent little people to independent, productive, happy adults. It’s an exciting time, but it doesn’t always feel this way. Adolescence can b...

04/11/2017

Have you heard about the show called “13 Reasons Why”? It’s currently on Netflix and a lot of teenagers are watching it. The show follows some students in high school. One of their classmates has recently committed su***de, and this classmate leaves behind a series of cassette tapes detailing different events that led her to kill herself. I haven’t finished the series, so I cannot say whether the writers of this show deal with the topic well, but I am for anything that gets teens thinking about the aftermath of su***de and those that are left behind.

Su***de is a topic that strikes great fear in parents. The teen years are filled with overwhelming emotions, minimally developed coping skills and impulsive behavior. It’s a dangerous mix that can make kids feel like su***de is a way out. The one thing I always tell clients that are having suicidal thoughts is that su***de is a permanent solution to temporary problems.

First, here are some su***de prevention resources parents and teens can use:
1. 211 Big Bend—This is the Big Bend Hotline that is answered 24/7 by trained counselors. It is anonymous. They can listen or provide resources. All you have to do is dial 2-1-1.
2. National Su***de Prevention Lifeline--Call 1-800-273-8255. It is also answered 24/7 by trained counselors and is anonymous.
3. 911—If you feel that your teen’s life, or the life of someone you know, is in danger, call 9-1-1. The police officer that responds will evaluate the person and see if they need to be taken in for mental health treatment.
4. TMH Behavioral Health Center—They have an adolescent floor that can help stabilize a teen that is in imminent danger of su***de.

Second, parents can help teenagers by emphasizing that feelings are temporary. Things that seem so important today probably won’t matter much next week. Ask them if they will still be upset or worrying about whatever is currently bothering them in one month. Don’t minimize their distress or feelings, but help them gain some perspective that things usually do get better with time.

Third, if you are worried that your teen might be struggling with suicidal thoughts, ask them directly if they are. You will not be giving them ideas by asking them outright. It is important to be direct and take seriously whatever answer they give you. If they say yes, seek help from a licensed therapist or one of the above resources right away.

It really does take a village, and hopefully we can all work together to keep teens safe.

04/04/2017

Own your behavior and your choices. Parents should say this to their children often. When something goes wrong, kids can give parents a whole list of reasons why it’s anyone’s fault but theirs. It can be easy to get sucked into the vortex of the blame game. You know you are starting to get sucked in when you are hearing a very long story leading up to why your child did what he or she did. Or you are hearing lots of kids’ names in the story other than your own child’s.

So how can parents help kids own their behavior?

First, listen. Listen to their long drawn out stories and explanations of all the injustices that have been done to them. Be sympathetic. Say something like, “I can see how upset and mad you are,” once they have finished. Show them that you do understand how they are feeling. But do not get sucked in and get upset by the other players’ behaviors. This is what your child wants. If you are mad at others, you won’t be mad at them. It also helps to remember that your child is giving you one side of the story and using everything he or she has to convince you that they have suffered a serious injustice.

Second, ask, “What could you have done differently? What will you do differently next time?” Help them focus on their own behavior. Emphasize to them that they can only control their own behavior and choices. Do not focus on all the other kids in the story; only focus on your child and his or her actions. If you focus on the other people in the story, you are helping send the message that it’s someone else’s fault.

Last, say something like, “In this family, we own our behavior and our choices. I’m glad to hear you take responsibility for your part in what happened today.”

I hope this helps you raise strong, responsible children!

12/01/2016

Dating violence in teenage relationships happens, and it happens often. The statistics are startling. One study said that 1 out of 5 teenagers experiences some type of violence in dating relationships. It can be hard for teens to recognize the signs of an unhealthy relationship because they are new to dating relationships. Many teens equate jealousy with love, but that is not true. JEALOUSLY IS NOT LOVE!
Here are some common warning signs of potential violence in a relationship:
• Checking texts, emails, or social networks without permission
• Telling a partner what to wear or not wear
• Telling a partner to delete pictures or posts he/she finds objectionable
• Extreme jealousy or insecurity
• Belittling comments or put-downs
• Possessiveness
• Telling a partner who she/he can spend time with
• Telling a partner what to do
• Pushing a partner to do sexual things that she/he is not comfortable with

These behaviors are all attempting to control or manipulate. If you are involved in a relationship that you are concerned about, there are some great websites that have useful information. On the website Loveisrespect.org you can take a quiz to determine how healthy your relationship is. There is also a lot of material and information to help you become more informed about potential violence in relationships.

It’s important for teens to understand that their partner won't change this type of behavior. It will usually just get worse. Being the “perfect” girlfriend or boyfriend will not alter an partner's jealous or controlling behavior. This type of behavior is usually only helped by years of therapy and a desire to be different.

All people deserve to be in healthy relationships that are free from abusive, controlling behavior. Helping teens to recognize the warning signs early on will help them develop healthy boundaries and expectations for all future relationships.

11/03/2016

Anxiety. It’s one of the most common mental health issues I see in my practice. Nervousness, dread, avoidance of situations, fears—everyone has experienced these at some point. But when these feelings interfere with daily life and daily functioning, it becomes an issue that needs to be treated. The Anxiety and Depression Association of America states that anxiety disorders affect 1 in 8 children (ADAA.org), and a lot of these children go undiagnosed (as high as 80% per the ADAA).

How do you know if your child is experiencing a high degree of anxiety? Here are some of the symptoms you might see: stomachaches, headaches, trouble sleeping (either trouble falling asleep or staying asleep), excessive fears, excessive shyness, excessive worrying, avoidance of school or social situations.

When a child experiences anxiety, the solution is usually to try and avoid whatever is causing the anxiety. Scared to sleep by yourself? Sleep with your parents. Scared of the dark? Sleep with all the lights on. Scared to go to school? Be “sick” so you can stay home. Avoidance, however, is not an effective or long lasting solution to anxiety. And sometimes you cannot avoid what is making you feel anxious.

What can you do to help your child cope with anxiety? There’s been a lot of research in this area and there are numerous things that have been found to be effective. It’s important to note, however, that these techniques and coping skills will not make anxiety go away completely. The goal of mental health treatment regarding anxiety is to reduce it enough so that the child can improve the ability to function in daily life. There is no magic wand to wave to make anxiety disappear completely (unfortunately).

Here are some things that do help:
1. Relaxed breathing--This is a coping technique that helps slow down the adrenaline rush that fuels anxiety. Breathing deeply with your belly (and not shallowly with your chest) helps calm an anxious mind by inducing the relaxation response. You need to practice this type of breathing when you’re calm for it to be effective when you feel anxiety starting to rise. Even young children can learn how to do this effectively. Here’s how: breathe in through your nose to a slow count of 4, hold for 1 count, then breath slowly out to a count of four. Put your hands on your belly to make sure it is rising and falling as you breathe. Practice at night before you go to bed. It will help relax you too!
2. Mindfulness—Developing a mindfulness practice helps gain control of a brain that lives in excessive worry and what ifs about the future. Being present in the here and now calms an anxious mind. There are numerous apps that can help develop such a practice. Even elementary aged children can learn to practice mindfulness.
3. Weighted blankets—There is new research that sleeping with a weighted blanket helps improve sleep quality. The thinking behind this is the weighted blanket feels like a swaddle or womb. Our brain feels safe so it can relax allowing sleep to happen more easily.
4. Positive thoughts—I wrote an entire page about this coping skill a few weeks ago, so scroll through them to read about it. Attacking your thoughts is one of the most effective ways to reduce anxiety.
5. Practice gratitude—At the end of the day, think of at least three specific things that you are grateful for that happened that day. Try to be as specific as possible. Have your child say them out loud to you before bed. Research has shown that when people with anxiety start practicing gratitude, it helps subtly shift their world view to one that is more positive and optimistic.

The important thing is to experiment and find what works best for your child. You will probably use different techniques at different times depending on the situation. And if you feel that your child needs more intensive intervention, seek professional help through your medical doctor or a licensed therapist.

10/24/2016

Instead of telling children with hyperactivity and attention problems to sit still, perhaps we should encourage them to wriggle at will.

10/18/2016

Practicing positive self-talk will improve your mood and emotions. Self-talk is the internal dialogue we all have that constantly “talks” to us evaluating situations and encounters with others. These thoughts are so automatic that we sometimes don’t recognize or even “hear” them.

Imagine the following scenario: a middle school girl walks into the cafeteria and looks over at a table full of girls she would like to sit with. One of the girls at the table looks at her and then all the girls at the table start laughing. How the middle school girl thinks about this situation will determine her feelings and reaction. She could think, “Someone at that table must have told a funny joke,” in which case she would go about her business and her emotions would not be affected. Or she could think, “Oh no, they are looking at me and laughing. Something must be wrong with how I look or how I’m dressed,” in which case she would feel sad, upset and anxious. It is the same scenario in each case. It is only the thought that changes how she feels.

What we say to ourselves largely dictates our emotional reactions and feelings. Because these thoughts are so automatic, we tend to think that our emotions are a necessary reaction to something; that they are outside of our control. But this is not true. The truth is you are largely responsible for how you feel. Your thoughts come before your feelings. Changing your thoughts will change your feelings and ultimately help you have more control over your actions.

The first step is to recognize the thoughts you are having. The next time you have a strong emotional reaction, take a step back and try to determine what you were thinking right before your reaction. Being able to recognize your negative internal dialogue will help you identify the connection between your thoughts and your actions. Remember that just because this thought exists in your head does not mean it is true! We have a lot of thoughts that are irrational and not based in truth at all.

The next step is to counter your negative self-talk with positive, accurate statements. This step involves practice, practice, practice. For my overachieving adolescent clients, I often ask them to say to themselves, “I am enough.” For my worrier clients, I often ask them to say, “I can handle this.” Some clients find it helpful to have a mantra that they repeat anytime they begin to hear this negative self-talk. One client would always say to herself, “I have enough time and energy to handle all the things I need to get done today,” when she felt stressed out and overwhelmed. The important thing for positive self-talk is for it to be an accurate statement that counteracts the negative, inaccurate one. Repeat these positive statements to yourself whenever you “hear” the negative thoughts.

It does take a lot of practice to both recognize the negative statements, and remember to counteract them with positive ones, but over time, you will find that you are more in control of your emotions and reactions. And you will probably feel happier overall.

10/12/2016

Learning to handle negative emotions is critical for children, but parents tend to teach avoidance rather than acceptance.

10/03/2016

Let's talk about teens and stress. Stress is one of the most frequent mental health issues I see with adolescents. In fact, a recent study by the American Psychological Association found that teens report experiencing stress levels higher than adults (APA, Stress in America, August 2013). The same study found that teens also minimize the psychological and physical effects of such stress, not understanding the impact it can have on their lives. This combination of increased stress and decreased understanding of its effects is worrisome. When teens are stressed they can resort to unhealthy behaviors in an attempt to cope. Such behaviors can include drug and alcohol use, increased sexual activity and self harming behaviors such as cutting. In addition, teens report increased levels of anxiety, depression, negative thoughts and sleep difficulties as a result of such stress.

If you have adolescents in your life, I am sure you have heard them exclaim that they are stressed out. Adults, however, can underestimate the level of stress their children are experiencing. In addition, parents may not be aware of the consequences that such stress can have. Teens, while identifying being stressed out, often think there is nothing they can do about it.

There are many causes of stress for teens. But school work, home work, and the pressure of making good grades and keeping up are usually the stressors teens list first. The environment of school in general, with the unwritten social codes of behavior, dress and peer relationships, can cause a great deal of stress to teens. The pressure to attend college (to get into a good college) add to this already stressful load. Most teens are also active in extracurricular activities, sports, jobs, and community service activities, leaving them very little time to do anything else.

What can we as adults do? Ask how they are doing. And then, listen to what they say. Help them talk through how they are feeling and what areas of life are causing the most stress. Talk to them about what stress is and what they can do about it. Help them to lead a balanced life of some obligations, but also some free time. Be on the lookout for increased mental health distress. And last, try to model good stress management yourself.

What can teens do? The number one thing teens should do is to schedule some time to do something they enjoy (for no reason other than the sheer joy they experience doing it). Most of their lives are over programmed. They need some time to decompress. In addition, they can work to develop healthy coping skills through mindfulness training, relaxed breathing, challenging negative thoughts, accepting less than perfection (accepting "good enough"), exercising regularly and trying to get enough sleep.

Coping with stress and developing appropriate stress management skills should be an ongoing conversation with your child as they grow and their challenges change. Good luck, parents!

09/26/2016

Let's talk about parenting skills. Parenting is something that most of us are dealing with on a daily basis. Yet we often feel lost, like we don't know what we are doing. I am going to simplify parenting down to three important fundamentals. They are the three legs that hold up your parenting stool.

The first leg is consistency. Do what you say you are going to do. If you put your child on restriction for one week, he or she better stay on restriction for one week. If you tell your child no, you better stick with it. You will reduce a lot of arguing if you are consistent. On the flip side, if you find yourself arguing with your child often, I suggest you take some time and examine how consistent you are being as a parent. This principle sounds easy, but it can be very difficult to execute in the here and now of parenting day to day.

The second leg of your parenting stool is consequences. There must be consequences when your child makes a poor choice. I suggest that parents have a list of consequences that have been thought out beforehand so you won't be trying to think these up on the spur of the moment when you are probably angry and frustrated. Even better, draw up a family rules chart with your child including the list of consequences for breaking those rules. Then when a rule is broken, you can just point to the chart and let them know which consequence they will be getting. One thing I always suggest to parents is not to paint yourself into a corner and issue some extreme consequence when you are upset. This goes back to the first leg of consistency because you want to follow through with whatever consequence you have given. But it is perfectly acceptable to say to your child, "I am upset and angry right now. You will have a consequence, but I need some time to decide what that will be, and I don't want to make that decision right now with how I'm feeling."

The third and final leg of your parenting stool is the most important. It is the one thing that research shows is the MOST effective way to change behavior. This is positive reinforcement. Better known as commenting on the good. When you see your child doing something right, tell them. Catch them in the act of doing something well, and comment on it. But, to be effective, the comment must be specific. Saying "good job" is not what I mean. Telling your child he played well when he knows he didn't is not what I mean. Here are some examples of how to be specific:
Thank you, Susie, I like when you get ready for school quickly, and we leave on time.
Good job, Johnny, I like when you do what I tell you to do.
Susie, I like how you came right in from school and started on your homework. That's showing some real initiative!
Johnny, I've noticed that you've checked in your phone to me for the last two nights without me asking. Thank you for being so responsible.
As parents we are used to correcting all the time. It takes time and practice to get in the habit of commenting on the good you see. But if you take the time to do it, you will see an increase in behavior that you like.

If you use these three fundamentals to form the basis of your parenting, you will feel more confident as a parent and you will be getting the best our of your child. Good luck out there, parents. You are doing hard work!

09/19/2016

Thank you to everyone who took the time to like my page, share my page, say kind words about me or encouraging words to me. I so appreciate all the love and support. For those wanting a little more information, my therapy practice focuses on children, adolescents, families and couples using an attachment based counseling focus (I will explain more about attachment in a later post). I am a Licensed Clinical Social Worker and an adoption competency certified therapist. Thank you for helping to spread the word about my practice!