Therapy
Man
Therapy Man Therapy™ provides men
approaching crisis, and the people who care about them, a
place to go and learn more about men’s mental health,
examine their own mental health, and consider a wide array
of actions that will put them on the path to help, treatment
and recovery, all within an easy-to-access online portal at
www.mantherapy.org. Visit this page to take the 18-point
head test, find local resources, and learn valuable tips
about topics like fighter jets, how to make guacamole, and
what to do when you or someone you care about is in a
crisis. How To Encourage
Someone To See A Therapist Here are some steps you can take to tell your loved one about the benefits of seeking therapy. Show Support Misconception about mental health and therapy has intensified stigma in society. Your loved one may be aware that they need help, but may be afraid to seek it if they think you will judge or treat them differently. Therefore, it is essential to use non-stigmatizing language when talking with them about their mental health. Assure them that you will support them through the therapy process. Demi Lovato is one of the most vocal celebrities about her mental health issues. She mentioned on multiple occasions how important it was for her to have people around that really care about her wellbeing. She credits her support group for being able to go through everyday life. Demi asks for advice from her loved ones and asks them to let her know when they feel something’s off: "So whether it's with my management team or with my friends, every choice that I make, I run by people. And that's what's really helped me—vocalizing what you need." Be Sensitive To Timing And Place Talking to someone about mental health requires emotional sensitivity as well as physical sensitivity. The “where” and “how” the topic is presented may determine how a person reacts to your suggestions. Your loved one may not be as bold as Kesha when she shared her condition and struggles with the world while receiving an award. Don’t start this delicate conversation in front of other people or where others can hear as this may cause discomfort. And avoid grouping up in an intervention-style conversation as people do on TV shows. Allow the person struggling to decide whether they want others to know. This way, they feel respected and in control of their own treatment. Also: Avoid talking to someone when they are in a bad mood, tired, have tight deadlines at work or if they’re doing something important. They may dismiss you or disregard the weight of the topic. Approach the person when they’re in a good mood, relaxed and undistracted. Try as much as possible to keep the conversation private, friendly and relaxed. Prepare For Resistance Not all people who hear about therapy will be willing to try it out. You need to be prepared to make your case if your loved one resists your suggestion. Here are some ideas that you can use to highlight the importance of therapy:
Offer To Help You can try to embolden someone to go to therapy, but unless you are willing to offer meaningful support, it’s not going to encourage them. Some people do not know where to start when seeking help. Guide them in finding a suitable therapist in the area, depending on their preferences. You can contact offices on their behalf or research various professionals, their credibility and reviews. Some people are scared of seeing a therapist alone or signing up for group therapy. Offer to go with them until they’re comfortable. You can sit in the waiting room during their first few sessions. Make sure to assure them that you won’t ask prying questions about the counseling unless they want to share. Seeking therapy is one of the best
steps that a person with a mental health condition can take.
However, it’s an effort that requires great strength
and courage. Share your suggestions as openly as possible
and leave them to make the decision that best suits their
needs. Above all things, assure them of your continued love
and support throughout the process. Find instant
support & online therapy Choose your own listener Want to connect with a listener based on life experience or affiliation? Browse or search our listener community to find the right listener or online counselor, someone with whom you feel comfortable chatting. Whether you want listening or online counseling about life, love, relationship problems, stress, depression help, or you just need to vent about your problems, we have an active listener or therapist for you to vent to via anonymous chat. Get online therapy in your anonymous, private room 7 Cups respects your privacy. Our bridging technology connects you one-on-one to a listener or online therapist while remaining completely anonymous. Our friendly Noni bot will welcome you to your private room where you can get settled and learn a bit more about how you can feel better. Your listener will join you in just a few seconds for a confidential chat. Connect & Talk to strangers Learn & grow with the community. Chat with supportive people in group support rooms who have overcome similar challenges. Engage in guided discussions or lighthearted banter. Join conversations about issues and struggles that matter to you in our community forum. Follow positive, kind people you meet at 7 Cups and post about how you are taking care of yourself to your own support network. Stay emotionally fit and grow with us Make emotional wellness a daily habit by following your growth path. Reminders and progress along your path can help you get support from trained volunteer listeners and do simple activities on your own to relax, on a regular basis, giving you more control over your own well being. What is a Growth Path? Do you need help with your life? 7 Cups is an on-demand emotional health and well-being service. When you need to chat we connect you to a real listener or therapist when you want someone to talk to. When you may not feel ready to chat, you can try simple activities to help boost your mood. Whatever step you take first - chatting one-on-one, doing solo activities, watching short videos, reading self-help guides, forum posts, and uplifting feed posts, or participating in group discussions - starts you on a path that will encourage and support you as you take steps daily to become stronger. There are many ways to receive support online -- therapy, counseling, coaching, and guidance are among them. New technologies, like those provided through 7 Cups, allow us to offer affordable, convenient, flexible, accessible counseling to fit your individual needs. What is Online Therapy? Online therapy is mental health counseling provided via the Internet. Sometimes it is called e-therapy, distance therapy, telehealth, or Internet therapy. Online therapy can be done by texting, video chatting, voice messaging or audio messaging with licensed therapists online. What about Video Chat Therapy? While video chat therapy does allow for more accessibility, it does not eliminate some of the key challenges that traditional therapy faces. More and more clients are now opting for message therapy as an even more convenient and affordable solution. Consider how Online, Message-Based Psychotherapy has the ability to improve upon traditional office-based counseling services Traditional
Therapy Online
Therapy Location Must find a local Counselor
or Therapist Can find an expert on your
issue, not necessarily based on
geography Accessibility Must meet in therapist or
counselor’s office Can connect with your
therapist from home, work, or wherever is
convenient for you. Availability Bound to the therapist or
counselor’s schedule, and often meet once per
week. Can chat with your therapist
anytime--when you truly need it--and, as often as
you’d like. Affordability Often very expensive,
traditional therapy can be as much as $200 per
session, and upwards of $800/month. Significantly cheaper: you
pay as little as $37.50/week, or $150 for the whole
month of unlimited contact with your
therapist. Visibility Requires face to face
interaction, which can be challenging for some
people. Allows anonymity, and can be
accessed privately, without others knowing that you
are receiving therapy. Effectiveness Equally as effective, but
given that it is harder to access, and there are
more barriers, remaining consistently in treatment
can be challenging. Studies have demonstrated the
effectiveness of online therapy. It gives the added
bonus of allowing people to take their time to
explore their thoughts, and put them into
words. Why Clients & Therapists Often Prefer Text-Based Psychotherapy:
Source: www.7cups.com/
Parents Guide to
Getting Good Care Does My Child Need Help? We all worry about our kids. Sometimes our worries are about whether they are developing in a healthy way. (Should he be talking by now?) Or about whether they are happy—we don’t like to see them sad or suffering. And sometimes we worry because a child’s behavior is causing problems for him—or for the whole family. One of the challenges of parenting is knowing when a worry should prompt action. How do you know when to get help for a child who is struggling? Keep in mind that there is a lot of variation in how kids develop, and a broad range of behavior that’s typical and healthy (if sometimes troublesome) as children grow up. So you don’t want to overreact. But when the behaviors you worry about are seriously interfering with your child’s ability to do things that are age-appropriate, or your family’s ability to be comfortable and nurturing, it’s important to get help. Here are some things mental health practitioners recommend you consider in deciding whether a child needs professional help. 1. What are the behaviors that are worrying you? To evaluate your situation clearly, it’s important to observe and record specifically the things you are concerned about. Try to avoid generalizations like “He’s acting up all the time!” or “She’s uncooperative.” Think about specific behaviors, like “His teacher complains that he can’t wait for his turn to speak,” or “He gets upset when asked to stop one activity and start another,” or “She cries and is inconsolable when her mother leaves the room.” 2. How often does it happen? If your child seems sad or despondent, is that occurring once a week, or most of the time? If he is having tantrums, when do they occur? How long do they last? Since many problematic behaviors—fears, impulsiveness, irritability, defiance, angst—are behaviors that all children occasionally exhibit, duration and intensity are often key to identifying a disorder. 3. Are these behaviors outside the typical range for his age? Since children and teenagers exhibit a wide range of behaviors, it can be challenging to separate normal acting up, or normal anxiety, from a serious problem. It’s often useful to share your observations with a professional who sees a lot of children—a teacher, school psychologist, or pediatrician, for instance—to get a perspective on whether your child’s behaviors fall outside of the typical range for his age group. Is he more fearful, more disobedient, more prone to tantrums, than many other children? (See our Parents Guide to Developmental Milestones for children five and under.) 4. How long has it been going on? Problematic behavior that’s been happening for a few days or even a few weeks is often a response to a stressful event, and something that will disappear over time. Part of diagnosing a child is eliminating things that are short-term responses, and probably don’t require intervention. 5. How much are they interfering with his life? Perhaps the biggest determinant of whether your child needs help is whether his symptoms and behaviors are getting in the way of his doing age-appropriate things. Is it disrupting the family and causing conflict at home? Is it causing him difficulty at school, or difficulty getting along with friends? If a child is unable to do things he wants to do, or take pleasure in many things his peers enjoy, or get along with teachers, family members and friends, he may need help. Where to Go for Diagnosis Help If you’ve determined that your child’s behaviors, thoughts, or emotions might call for attention, your next move is to consult a professional. But where should you go? A potentially bewildering range of mental health providers are out there, and not all of them are the best people to go to for an evidence-based assessment and sound diagnosis. Where to start depends on the makeup of your child’s current healthcare team and the services available in your area. Not all of the specialists below will deliver a diagnosis, but many of them (pediatrician, school psychologist) can be valuable in the process of getting an accurate diagnosis that will help your child. (See our Guide to Mental Health Specialists for information about the types of specialists who treat children, their training and the kind of services they provide.) Where do I start? For most parents, consulting your family doctor is the first step. While medical doctors are not required to have substantial training in mental health, many do diagnose and treat psychiatric disorders, and others may be able to refer you to a specialist who can. The advantage to going to the pediatrician is that she already knows your child and your family, and she sees so many children, she can be adept at recognizing when behavior is beyond the typical range. She can also do medical testing to rule out possible non-psychiatric causes of troubling symptoms. The disadvantage is that your pediatrician may have limited experience in diagnosing psychiatric and developmental disorders and most don’t have time to do the kind of careful assessment that is important for an accurate diagnosis, given that many common problem behaviors in children—i.e. inattention, tantrums, disruptive behavior—can be caused by several different psychiatric or developmental disorders. Best practices in diagnosing children include using rating scales to get an objective take on symptoms, and collecting information from multiple sources, including the child, the parents, caregivers, teachers, and other adults. (Effective diagnosis of very young children requires extra measures, discussed here.) You should be upfront with your doctor and ask if she is comfortable and knowledgeable concerning mental illness. Ask for a referral or seek out another clinician if you are not comfortable with what your doctor offers.
What questions should I ask about diagnosis? When looking for a mental health specialist to provide a diagnostic evaluation for your child, you’ll want to be prepared with questions that will help you decide if a particular clinician is a good match for your needs:
What if there are no mental health specialists in the area? It is a frustrating fact for far too many families in this country that adequate mental health services are not readily, or even realistically available. This is one reason that so much of the burden of caring for children with psychiatric and learning disorders has fallen to primary care doctors, even if their training isn’t always adequate for a child’s needs, especially in complex cases. Luckily, many state health services have begun to address this problem through telepsychiatry—giving local family doctors access to consultation with trained psychiatrists via telephone or internet. If you are having trouble finding someone competent to evaluate and perhaps diagnose your child, ask your pediatrician or any mental health provider you are in contact with if they can research getting a consultation from a remote service. If that is not available, it may be well worth the time and effort to go to an appropriate center some distance away to get an excellent evaluation and treatment plan that can be taken back for implementation by clinicians closer to home. What Should I Look for in Diagnosis? There are no blood tests or the like for psychiatric and learning disorders, so the diagnosis depends on a detailed picture of a child’s moods, behaviors, test results, etc. So a clinician depends on the information she gets from the child, parents, teachers, and other adults who have knowledge of him. A good clinician will ask you detailed questions about your child’s behavior, diagnosis symptoms, as well as her developmental history and your family’s history. She will also use tools designed to help get an objective take on those behaviors and symptoms. Some of these tools take the form of structured interviews, in which a clinician asks a set of specific questions about a child’s behavior. The clinician’s questions are based on the criteria for each psychiatric disorder in the Diagnostic and Statistical Manual, adapted for children. The answers are then used to determine if the child meets the criteria for a particular disorder. For instance, a clinician might use something referred to as ADIS (Anxiety Disorders Interview Schedule), or the K-SADS (Kiddie Schedule for Affective Disorders and Schizophrenia) to determine whether a child should be diagnosed with one or more psychiatric disorders. Some of the tools used to aid in diagnosis help are rating scales, in which the child is rated numerically on a list of symptoms. For instance, BASC (Behavior Assessment System for Children) is a set of questions that are customized for parents, teachers, and the patient, to utilize multiple perspectives to help understand the behaviors and emotions of children and adolescents. While this scale is not used as a diagnostic tool, it can alert clinicians to areas that are elevated (anxiety, conduct problems, depression) which may indicate that further exploration of a specific area is necessary. For children who may have ADHD, tools commonly used include the SNAP rating scale for teachers and parents, which scores kids on how often each of a list of a 18 symptoms occur. On the other hand, the CPT (Continuous Performance Test), which rates a child’s ability to complete a boring and repetitive task over a period of time, is the gold standard for differentiating kids whose inattention is a symptom of ADHD rather than some other cause, such as anxiety. A-DOS (the Autism Diagnostic Observation Schedule) is a set of tasks that involve interaction between the tester and the child which are designed to diagnose autism. These are just some examples of the kinds of tools qualified diagnosticians use to identify disorders. Most important: Do not accept treatment from a clinician who does not offer a diagnosis for your child. Just as a headache can be caused by many different things, worrisome behavior or moods can be symptoms of a range of psychiatric and developmental disorders. It’s a mistake to try medications to see if they work on the symptoms without a diagnosis that’s clearly explained to you, and based on substantial evidence. What are some questions I should ask? When looking for a mental health specialist to provide an evaluation for your child, you’ll want to be prepared with questions that will help you decide if a particular clinician is a good match for your needs:
Who Can Assist With Treatment? Once you have a diagnosis for your child, it’s time to think about treatment options. In some cases the clinician who did the diagnosis will be a good choice for treatment; in other cases you will need to find a different kind of practitioner. Either way, your primary care practitioner or the diagnosing clinician can be a good place to start the search. A licensed clinical social worker at your child’s school or a mental health facility may play a key role in coordinating care for your child and linking you with other professionals on the treatment team. Through ongoing monitoring, the LCSW helps you evaluate your child’s progress, access necessary services, and address issues as they develop. Before you decide who to work with, get informed. You’ll want to find out what the first-line treatment recommendations are for your child’s disorder, and make sure that the clinician you choose has both training and experience in that treatment. For instance, for many anxiety and mood disorders, there are very specific kinds of behavioral therapies tailored to specific disorders. (For a list of such evidence-based therapies and what they are used for, see our Guide to Behavioral Treatments.) The techniques are not interchangeable: The right clinician for you will be one who has experience in the particular therapy your child needs. If your child would benefit from medication, it’s crucial that you ask if your primary care doctor or psychiatrist who prescribes it actually has experience with that type of medication. Success with psychotropic medications depends on the right dosage, which can take considerable effort to establish, as well as expert monitoring as a child changes and grows. This process takes time and patience; if your doctor is too busy to work with you until the medication is successful, and to monitor your child to see that it stays successful, you should look for another practitioner. Please know that, in many cases, treating psychiatric disorders may begin with behavioral or environmental interventions, before medications. However, only a skilled clinician can properly explain the order in which treatments should be started and continued. Above all, you want to work with professionals who communicate effectively with you, explain clearly what they are offering, listen to your concerns, answer your questions, and pay close attention to your child’s particular needs and behaviors. Here are some specific examples of the kinds of professionals who may help in treatment for your child: Learning disorders like dyslexia: If you’ve had a neuropsychological evaluation of your child, and his learning challenges have been identified, you will want to find professionals who can help him build on his strengths and compensate for his weaknesses. He may qualify for an IEP (Individualized Education Plan), which spells out the support the school district is obligated to provide. In addition to whatever help is provided by school-based professionals, you may want to enlist a learning specialist (or educational therapist), who works with a child to build skills and devise strategies for learning in whatever way works best for him. If he needs help with reading or math-related skills, there are specialists who work on those areas. If he is weak in executive functions, the specialist works with him to structure his time and keep track of the schoolwork he needs to do. Sometimes a tutor is useful for a student weak in a particular subject area, and a homework helper can help an unfocused or disorganized student stay on top of his work. If he qualifies for an IEP, it will outline the support the school district is obligated to give him. Though navigating the world of IEP negotiations can be difficult, the Individuals with Disabilities Education Act (IDEA) is firm on the provision of accommodations to children who qualify. If these cannot be provided at your child’s school, it is within your rights to find them elsewhere. Mood disorders like anxiety or depression: For children with anxiety disorders, such as social anxiety disorder or separation anxiety, the first-line treatment is usually behavior therapy. A psychologist works with both the child and the parents using a treatment protocol that is evidence-tested for his specific disorder. OCD and disorders related to it may be managed in a similar fashion. If a child is anxious or depressed enough to need medication, usually in addition to the behavior therapy, a psychiatrist or pediatrician prescribes medication and works with the child’s psychologist to monitor his progress. It’s important to make sure that whoever is doing the prescribing has experience with the medication and children similar to yours, and enough time to work with you to manage it successfully. Since behavior therapy uses very specific techniques that are not necessarily intuitive, it’s important that your psychologist be trained and experienced in the particular therapy that’s appropriate for your child. More often than not, evidence-based behavior or cognitive behavior therapies are manualized and time-limited—that is, procedures are spelled out very specifically—so a therapist should be able to explain clearly what will be expected of both you and your child, and the duration of treatment. Developmental disorders like autism: For children diagnosed with autism spectrum disorder, treatment usually begins as early as possible with applied behavior therapy, to help kids build social and communication skills that they’re not developing naturally. Psychologists with training in behavior therapy (including ABA ) will usually work with children and teach parents how to continue the therapy in between sessions. Children with autism or developmental delays often work with occupational therapists or physical therapists to build motor skills that are lacking. Children with developmental disorders, including autism, often have sensory processing challenges, which cause them to be unusually sensitive to sounds, lights, and other stimuli, or be under-stimulated by their senses. Sensory problems can be severe, when kids are so overwhelmed or disoriented that they can’t function, try to flee, or have alarming meltdowns. They may benefit from behavioral therapy and some children also work with an occupational therapist on these issues. ADHD and behavior disorders: If your child has been diagnosed with moderate to severe ADHD, the first-line treatment is usually stimulant medication. A psychiatrist or pediatrician can prescribe and monitor the medication. It’s crucial that your doctor has expertise and experience with these medications; getting the right dosage and medication schedule, adjusting the dosage and reevaluating the medication as the child grows and changes are critical to its success. Stimulant medication is fast acting, but there are many kinds, each with different durations and delivery systems, and it may take time to find the medication plan that’s most effective for your child. It’s not unusual for children to change dosage and medications over time, so a close alliance with your clinician is crucial for success. For children with ADHD, behavior therapy generally does not affect the inattention, impulsivity, and hyperactivity symptoms, but it can be very helpful in teaching parents and children how to manage them more successfully. Behavioral treatments with a trained psychologist like Parent-Child Interaction Therapy (PCIT), Parent Management Training (PMT) and Positive Parenting Program (Triple P) help families of kids with ADHD. Parents learn to exercise authority and set limits in a calm, positive way; kids learn to rein in their own behavior more effectively. For children with disruptive behavior disorders, these behavior therapies, with an appropriately trained psychologist, can be very helpful. Sometimes behavior therapy is combined with medication, prescribed by a psychiatrist or pediatrician. Pre-Treatment Questions to Ask Your Doctor Before your child begins treatment of any kind you should ask:
Questions for someone prescribing medication:
Questions for someone recommending behavioral therapy:
How Do I Know if I’m Getting Good Treatment? Treatments that can be effective for psychiatric and learning disorders vary widely, and no two children’s needs are exactly alike. But there are some general standards and questions to ask your doctor to determine whether the care your child is getting follows best practices, whether the treatment involves behavioral therapy, medication, or both.
What if My Child Has Multiple Disorders? One reality that can make treating a child with mental illness particularly challenging is that the symptoms she is experiencing may come from multiple disorders. A child who has autism can also have ADHD; a teenager who has social anxiety can also be depressed. When a child has what clinicians call “coexisting” disorders, treating one will not make the other go away. For instance, if a teenager who has ADHD or depression uses alcohol to self-medicate, and develops a substance abuse disorder, treating the original disorder will not cure the substance abuse. When children have more than one disorder, it’s important to work with a clinician, or a team of clinicians, who can understand how the childhood disorders interact, and come up with a treatment plan that responds to each of them. It’s especially important that any clinician who is prescribing medication be aware of all the coexisting disorders, all the medications that are being prescribed, and how they interact. What About Problems With Diagnosis or Treatment? Like all other areas of medicine, some psychiatric and learning disorders are harder to diagnose, and harder to treat, than others. Since there are no blood tests to determine if a child has ADHD or OCD, clinicians depend on measures of behavior. And many behaviors can point to a number of different underlying disorders. If a child is having trouble concentrating in school, for instance, he could have ADHD, but he could also be very anxious. Add to this the fact that some children have multiple disorders—autism and ADHD for instance, or anxiety and depression. All of this contributes to the fact that sometimes the first diagnosis you get is not accurate, and the first treatment is not always effective. How do you know when it’s time to look for a second opinion, and/or pursue different treatment options? When should I get a second opinion from another clinician? 1. If you have poor communication with your clinician, leaving you feeling that you don’t understand the diagnosis or the treatment, or that he or she doesn’t listen to your concerns or answer your questions, you need to find an alternative. It’s important for your child that you and the professionals you engage are all part of a unified treatment team. 2. If your child—especially your teenager—doesn’t have a comfortable relationship with his clinician, and good communication, it can seriously undermine his treatment. If he’s not willing or able to report his feelings and experiences, the clinician can’t effectively tailor the response. 3. If the clinician doesn’t seem to have enough expertise and experience with the diagnosis and especially the specific treatment he or she has proposed, you may need to make a change. Behavioral therapies like exposure and response prevention (for OCD) or habit reversal (for Tourette’s) or dialectical behavioral therapy (for self-injury) are very precise, evidence-based treatment, and vague approximations don’t work. Similarly, medications are best prescribed by a clinician who has substantial experience with effective dosing, managing side effects, and adjusting over the long term. 4. If the clinician proposes medication for your child without giving you a clear diagnosis, you should look elsewhere. Trying medications to see if they work, without a comprehensive evaluation, can lead to inappropriate and ineffective treatment. Response to medication is NOT a diagnostic tool, so someone is wrong if he says, “Let’s see if this works as it will confirm the diagnosis.” 5. If your child is struggling and your clinician is adding one medication after another, it’s easy to lose track of what’s effective and what’s not. When kids are given medications to alleviate side effects of other medications, it may be time to get a second opinion. 6. If your child isn’t responding to treatment, it may mean that the diagnosis was wrong, and you need to seek a new, broader evaluation. It could also mean that there are several disorders involved, and they need to be identified and treated separately. When should I consider switching to different medication, or adding medication? 1. If the medication your child is on is not alleviating his symptoms, the first step is to make sure that you’ve given it enough time to work—some kick in more quickly than others. You also want to make sure that your clinician has tried adjusting the dosage. Sometimes it takes time to get the dosage up to a clinically effective level. If you’ve done those things and you’re not seeing results that work for your child, it may be time to investigate other alternatives. 2. If the medication your child is taking has side effects that are debilitating, the first thing to do is to make sure the dosage is appropriate. If that doesn’t solve the problem, you should look into other options. 3. Adding medications is something clinicians should do with great care. It’s not unusual for children to take two or more medications, because it’s common for children to have several disorders: for instance, kids with ADHD may have anxiety or depression. You want an experienced clinician with clear expertise if you are combining medications, and it’s generally not a good idea to add medications to counter side effects of the first one. What if my child resists the treatment, or the therapist? 1. You may need to try several therapists before you find one with the right personality to bond with your child or teenager—someone with an active and engaging style that will give your child confidence in treatment. 2. Sometimes when kids are dismissive or negative about the value of therapy it is a result of a mood disorder: the pervasive pessimism and lack of enthusiasm he’s feeling may extend to the possibility of working to get better. In that case the first step in treatment is getting him to identify his pessimism and recognize that it is part of his disorder, and that he can feel better. 3. With anxiety and disruptive behavior disorders that can be appropriately treated with behavioral therapy, it is sometimes necessary to combine a course of medication to decrease your child’s symptoms enough to enable him to participate effectively in the therapy that can make a big difference in his life. 4. It may also be useful to explore something called “motivational interviewing,” a treatment that’s usually applied to substance abuse. Motivational interviewing is based on meeting a patient where he is in terms of his own self-assessment, and working to help him understand how changing problem behaviors might benefit him. What About Alternative Treatment Options? Parents are rightfully cautious about getting treatment for children with mental health problems, especially if that treatment involves a psychotropic medication. Alternative treatments such as specialized diets (for example, avoiding sugar or food dye) and natural remedies or supplements can seem like a good solution if you are seeking treatment that feels safe, natural, and DIY. However, parents exploring these options should be careful because there is very little data showing that most alternative treatments are actually helpful. Anecdotal evidence isn’t the same as scientific testing, and some alternative treatments, like chelation, are even potentially dangerous. Time spent exploring non-evidence-based care may seem like a good investment, but it comes with an “opportunity cost” to your child. That is, the longer kids miss out on treatment that really affects symptoms the more time they’ll spend impaired, and in many cases missing out on crucial learning and development that goes on during childhood and adolescence. Their disorder may also grow worse without intervention. For many disorders, the longer a child experiences the symptoms, the more challenging it is to treat. For some, particularly autism, some interventions should be undertaken early. Before trying an alternative treatment, discuss it with your child’s doctor. As with any treatment, ask a lot of questions. Learn how it works, what evidence supports it, when you should start seeing progress, and if there are any dangers associated. If you aren’t satisfied with the results of any treatment, make an appointment to discuss other options with your doctor or with another professional who can give a second opinion. Supplementing Treatment While not a treatment by itself, promoting good self-esteem and a healthy lifestyle is important for all kids with psychiatric disorders. Exercise makes us feel good, and it can make a big difference for kids who are feeling badly about themselves or have lots of energy. Things that promote self-awareness and relaxed reflection, like mindfulness meditation and yoga, are also generally beneficial. What Should I Do if My Child Has Learning Issues? If you notice that your child is struggling in school, or doesn’t seem to be picking up basic reading, writing, and math skills the way other kids do, he may have a learning disability. A learning disability is a kind of cognitive disorder that affects basic processes in how we learn, including how we receive, process, recall, and communicate information. The most common one is dyslexia (reading problems), but learning disabilities can also affect how we write, spell, do math, listen, think, and speak. It’s possible for kids to have more than one. If you suspect your child may have learning difficulties, make a list of everything you have observed about how he learns—his strengths and his weaknesses. Compare notes with his teacher, school psychologist, and anyone else who might be helpful. You may want to ask for what’s called a “pre-referral intervention”—a meeting where teachers and the school psychologist meet with you to discuss different educational supports that might enable your child to learn more effectively. A targeted remediation may be all your child needs. But if the pre-referral intervention doesn’t give you the results you want, a formal diagnostic evaluation is the next step. How do I get an evaluation for learning issues? Formal evaluations examine how your child processes information. There are different kinds of evaluations, including educational evaluations (which assess reading, writing, math, and spelling ability) and neuropsychological evaluations (which develop a wide profile of a child’s skills and abilities in reasoning, learning, memory, visual and auditory processing, listening comprehension, verbal expression, executive functioning skills, and academic abilities). Evaluations also establish a baseline for measuring your child’s progress, and they are a necessary step to qualifying for accommodations or special education services. Schools are legally required to provide an evaluation according to the Individuals with Disabilities Education Act (IDEA). The school might be the first to suggest an evaluation, or you can begin the process yourself by requesting an evaluation in writing. Understood.org has a sample letter you can use. After receiving your written notice, the school will set up a time to discuss an evaluation with you. You should bring your child’s school records, notes from teachers, and your own written observations to the meeting, and come prepared to discuss them. The school staff is required to share with you the kind of evaluation they feel is appropriate, and you have the right to object to the kind of assessment offered, or request a different one. You will ultimately need to sign a consent form before the school is allowed to perform a formal evaluation. After the evaluation the school is required to give you a copy of the results. If you prefer, you can also get a private evaluation from outside the school, although you will need to pay for it yourself. You can then choose whether or not to share the results with the school. How Do I Get School Services for My Child? Schools will use evaluation results to determine if your child is eligible for accommodations in school or special education services. Students may qualify for a wide range of supports organized under either a Section 504 accommodations plan or an Individual Education Program (IEP). Most states have a Parent Training and Information Center that can help you with any questions you may have about the laws in your state. Section 504 A Section 504 plan provides kids who have learning disabilities with “reasonable accommodations” that allow them to participate in the general curriculum at school. Section 504 is part of the Rehabilitation Act of 1973, a civil rights law that prevents discrimination against any person with a disability at an institution that receives federal funding, including schools and colleges. To qualify under Section 504 your child must demonstrate that she has a disability that substantially limits her in one or more “major life activity.” This might include speaking, listening, concentrating, reading, or writing. Children who do not qualify for services under the Individuals with Disabilities Education Act (IDEA) may qualify under Section 504. Depending on your child’s needs, her Section 504 plan could entitle her to a wide range of accommodations, such as special seating, a quiet place for testing, extra breaks, the use of a computer, different text books, different testing formats, and much more. All appropriate accommodations will be established at the 504 Planning Meeting, which you should attend, as well as any subsequent periodic reviews. Learn more about 504 plans from the National Center for Learning Disabilities. What is an IEP: Individual Education Program Students can get an Individual Education Program (IEP) if they qualify under the Individuals with Disabilities Education Act, a federal law that promises a “free and appropriate education” to children classified with various specific legal disabilities. Categories of disability under IDEA include:
All children who qualify can receive assistance through their local public school district, including those who attend private or parochial schools. To set up an IEP you will attend a
meeting with representatives from the school district
(teacher, special education teacher, school psychologist,
appropriate specialists, etc) to plan
an education program that suits your child’s unique
needs. This will involve
setting specific measurable goals for what you would like
your child to accomplish (e.g. reading X number of words a
minute) and whatever special education services or
accommodations she needs to accomplish those goals. An IEP
might include specially trained educators, special teaching
methods, accommodations like extra testing time, and
whatever else is considered appropriate. You are free to
bring an advocate, private learning specialist, or special
education attorney with you to the meeting or consult with
them before signing off on the IEP. The plan must be
reviewed at least once a year, although you can request to
do it more frequently. Learn more
about IEPs at Understood.org. People
Who Talk to Themselves Aren’t Crazy, They’re
Actually Geniuses You’re a genius. I mean, this should be a no-brainer, right? After all, some of the smartest people in history talk to themselves: poets, writers, philosophers, every one! Even Einstein used to “repeat his sentences to himself softly.” But now, we have proof. Proof, I say! A study printed in The Quarterly Journal of Experimental Psychology claims that talking to yourself makes your brain work more efficiently. Authors Daniel Swingley and Gary Lupyan hypothesized that talking to yourself could actually be beneficial. Their first trial, in which they gave subjects an object to buy at the grocery store, seemed to prove their point. The people who were allowed to say the name of the item aloud were much more likely to find it than the ones bound to silence. It turns out that talking out loud might not always be helpful, though. “Speaking to yourself isn’t always helping – if you don’t really know what an object looks like, saying its name can have no effect, or actually slow you down. If, on the other hand, you know that bananas are yellow and have a particular shape, by saying banana you’re activating these visual properties in the brain to help you find them.” Basically, if you know what an object looks like – the banana, for instance – then saying the word will help you find what you’re looking for. But, if you’ve never seen a rutabaga, saying it out loud isn’t going to be of any assistance at all. Not that you’d ever actually want to find a rutabaga, but in case you do, here’s a picture. It can be helpful for the indecisive scatterbrains among us. Talking through things aloud can help organize your thoughts, as well as validate difficult decisions, according to psychologist Linda Sapadin “It helps you clarify your thoughts, tend to what’s important, and firm up any decisions you’re contemplating.” I mean, basically, it’s best to talk the big decisions out…even if it’s just with yourself. Talking to yourself about your goals also helps you attain them. It turns out saying your goals aloud is even better for achieving them than making a written list, which can seem daunting. As Sapadin says, “Saying your goals out loud focuses your attention, reinforces the message, controls your runaway emotions, and screens out distractions.” It’s exactly what we
“crazies” who talk to ourselves have always known
– we’re smart, and we give great advice. Why not
listen to it, out loud and wherever you want! Therapy
Prevents Repeat Suicide Attempts Using detailed Danish government health records, researchers studied 5,678 people who had attempted suicide and then received a program of short-term psychotherapy based on needs, including crisis intervention, cognitive therapy, behavioral therapy, and psychodynamic and psychoanalytic treatment. They compared them with 17,034 people who had attempted suicide but received standard care, including admission to a hospital, referral for treatment or discharge with no referral. They were able to match the groups in more than 30 genetic, health, behavioral and socioeconomic characteristics. The study is online in Lancet Psychiatry. Treatment focused on suicide prevention and comprised eight to 10 weeks of individual sessions. Over a 20-year follow-up, 16.5 percent of the treated group attempted suicide again, compared with 19.1 percent of the untreated group. In the treated group, 1.6 percent died by suicide, compared with 2.2 percent of the untreated. “Suicide is a rare event,” said the lead author, Annette Erlangsen, an associate professor at the Johns Hopkins Bloomberg School of Public Health, “and you need a huge sample to study it. We had that, and we were able to find a significant effect.” The authors estimate that therapy
prevented 145 suicide attempts and 30 deaths by suicide in
the group studied. A
helpful list of mental health resources to remind you
there’s always hope If you or someone in your life is struggling with mental health issues, know you're not alone, and that help, support, and treatment methods are available. SEE ALSO: Don't know how to open up about your mental health? Lady Gaga's mom has some advice. Here's a list of organizations and hotlines that offer support, provide additional informational, and connect you with other impactful professionals and resources. Emergency Medical Services If time-sensitive or potentially life-threatening emergencies arise, consider calling 911 and seeking professional medical care. The National Suicide Prevention Lifeline The National Suicide Prevention Lifeline is a free, confidential service that connects anyone experiencing suicidal thoughts or emotional distress with local crisis centers across the United States. Can't sleep? Call 1-800-273-8255 or text "SOS" to 741741 for help & support. 24/7/366 You can also find an international list of suicide hotlines here. If you're looking for someone to talk with, you can also text Crisis Text Line at 741741. The mobile service offers 24/7 support from trained crisis counselors in the United States at no cost. Your experiences are yours alone, but you never have to be alone in them. Text SOS to 741741 for crisis support in the US, text SOS to 686868 for support in Canada. LGBTQ support The Trevor Project is a nonprofit organization dedicated to helping LGBTQ youth by providing crisis intervention and suicide prevention methods. Trained counselors at the organization can be reached 24/7 through an online chat, by texting "Trevor" to 1-202-304-1200 Monday through Friday from 3pm–10pm EST, or by calling the TrevorLifeline any time at 866-488-7386. The organization also offers TrevorSpace — a safe online space for members of the youth LGBTQ community to interact with one another, build meaningful relationships, and offer support. Trans support Trans Lifeline is another option for transgender people seeking help in time of emotional crisis. Currently, the hotline is staffed by trans volunteers 18 hours a day, every day of the week. United States residents can call (877) 565-8860, and people in Canada can call (877) 330-6366. National Sexual Assault Hotline Survivors of sexual harassment and assault can reach out to the national the Rape, Abuse & Incest National Network’s confidential hotline to speak with a trained member of local RAINN affiliate organization. By calling 800-656-4673 or using the live chat online, you can discuss your experiences, obtain medical and legal information, and receive additional resources and support. As the largest anti-sexual violence organization in the United States, RAINN also offers a comprehensive list of resources to help assault survivors and their loved ones. Veterans Crisis Line The Veterans Crisis Line provides confidential support for veterans and service members, as well as their families and friends. Trained responders from the U.S. Department of Veterans Affairs are available through online chat, by texting 838255, or by calling the toll-free hotline at 1-800-273-8255. A helpful list of mental health resources to remind you there’s always hope Find local mental health centers and professionals The Substance Abuse and Mental Health Services Administration (SAMHSA) helpline provides insight on mental health and substance misuse issues, offers treatment referrals, and shares prevention and recovery methods You can call at 1-800-662-HELP (4357) or find local treatment centers on SAMHSA's website. Mental Health America also provides information on local support groups as well as an interactive tool that will help determine where you should seek help. Explore online resources For more information, guidance, and support on which steps to take if you or someone you know is experiencing mental or emotional distress, here are some great references:
Be aware of suicide warning signs and how to respond to them Not all people experiencing suicidal thoughts show obvious warning signs, but it's important to know what behavior to look for. Signs, according to the Suicide Prevention Resource Center, include:
If you see a person showing any of those signs, or suspect he or she might be having suicidal thoughts, reach out to a hotline or other resource listed here, or seek assistance from a trusted friend, family member, or professional. Make sure the person is in a safe environment free from alcohol, drugs, firearms, or other means that could be used for self-harm, and offer them your support. Remember: Self-care isn't selfish Though it's easy to forget, your mental health and emotional well-being should always be a priority in your life. Whether you take a mental heath day
from work every now and again or decide to avoid social
media for awhile, it's crucial to set aside time to care for
yourself. Here's a
list of doable self-care suggestions
to consider. A
totally doable, not so intimidating self-care survival guide
to 2018 Afterwards, I drove to a bookstore and spent $82.47. I went home, applied a face mask and collapsed onto my bed, escaping into the pages of one of my new books for hours. I met my friend for dinner, cherished every single bite of a cheeseburger, rushed back to my pillow, and fell asleep watching re-runs of The Mindy Project. This was my own personal form of self-care. SEE ALSO: Meditation app aims to help veterans tackle anxiety, loneliness For so many, self-care has been the unsung savior of 2017. You've probably heard the term thrown around daily, but learning exactly what it means and why it's so essential will help to better practice it in the new year. Am I doing this thing right? Self-care methods — personalized rituals that allow people to take a step back from this messy world to prioritize their well-being and preserve their mental health — differ for each individual and in each scenario, so there's really no right or wrong. For Hillary Clinton self-care could mean anything from frantic closet cleaning, long walks in the woods, and playing with her dogs, to yoga or sitting down to enjoy a glass of wine. For Michael Phelps, who's conquered the pressures of Olympic competition but has struggled with depression and anxiety over the years, it's working out or heading to the golf course. The only constant is that methods of self-care must benefit and focus on you. "A lot of times people will say 'I spend time with my kids,' which is great and meaningful but that’s still taking care of somebody else," said Monnica Williams, Ph.D., a clinical psychologist and associate professor at University of Connecticut's Department of Psychological Sciences. "When you self-care it’s really about you recharging." Self-care isn't selfish Some people abstain from self-care for fear that their behavior would come across as selfish. They simply can't resist the urge to put other people first. According to a 2017 "Women's Wellness Report" from Everyday Health, which studied 3,000 women from ages 25 to 65 in the U.S., 76 percent of women said they were were more likely to put their own personal needs after someone else's. However, more than half of the participants said that taking time for themselves was the greatest factor in achieving wellness. (Disclosure: Mashable and Everyday Health are owned by the same company, Ziff Davis.) "You can’t be the best you in any other "It’s essential for your mental health and your physical health," Williams said, noting that self-care is anything but selfish. "You can’t be the best you in any other contexts if you’re not taking care of yourself." "I heard someone say that it's like putting on your own oxygen mask in an airplane emergency before putting one on a child," added Crystal Park, another professor at the University of Connecticut's Department of Psychological Sciences. "The healthier and more resilient we are, the more effective we can be in our lives." Heading into 2018 with some solid self-care guidelines will help you better manage your stress and survive whatever challenges are in store, so here are a few to keep in mind. Don't be afraid to take a mental health day Your mental health is important, but it's also extremely easy to ignore. When your job gets too overwhelming or events in your personal life prevent or distract you from doing your best work in the office it's time to take a step back. For inspiration, look no further than one of 2017's viral personal tales: the story of Olark CEO Ben Congleton advocating for his employee after learning she'd taken time off for mental health reasons. After Congleton's understanding email sparked discussion about mental health in the workplace, he wrote a post on Medium further emphasizing the need to normalize it. When you are at work, take additional steps to make your environment a place of comfort. Personalize your desk with a plant, a framed photo of something that makes you smile, or set the mood with a tiny lamp. And every so often, book a conference room for lunch with your coworkers to share pizza and a cake you buy for the sole reason of craving cake. Work will still be there when your lunch break ends, but taking time to clear your head is crucial. Give social media and screens a rest Social media usage often starts with the intention of getting caught up on current events and quickly spirals into a black hole of negativity. "So many people are plugged in and instantly alerted to everything that is happening in the news in ways that weren’t possible 10 years ago," said Dr. Carolyn Mazure, director of Women’s Health Research at Yale. While platforms like Facebook, Instagram, and Twitter have been proven to take a toll on self-esteem and mental health, social media isn't all bad. Here are a few ways to make online communities safer spaces for you:
While it's healthy to disconnect from technology every so often, when you do have your phone by your side these tips can help make the experience more enjoyable.
Treat yourself, but treat others, too No matter how small, make a daily attempt to treat yourself to an experience or a purchase that'll brighten your mood. Get a pedicure or massage, take a hot bath, go for a walk around the block, go out with friends, or cancel plans to stay in on a Friday night to recharge and binge-watch mindless television, if that's what you need. And while being good to oneself is key, Park noted "balance is important" in self-care, and making an effort to give back to others often helps people feel better. Consider volunteering, or clean out your closets and drawers to donate unwanted items to charity. Put positivity on display One form of self-care can be as simple as not being so hard on yourself all the time. It sounds simple, but it can be a serious challenge at times. Visual reminders can help. When in doubt, turn to this handy self-care printable, titled "Everything is Awful and I'm Not Okay." The checklist presents 16 questions for you to answer and serves as a helpful reminder to stay hydrated, shower, participate in physical activity, and be kind to yourself. Keep a copy of the printout in your bag for comfort or hang it somewhere you know you'll see it. (Mashable HQ has one on the wall of the women's restroom.) Affirmations are another great way to be kind to yourself and can serve as help. Glancing at inspirational quotes, uplifting doodles, or a few words of positivity can lift your spirits. The Mashable women's restroom also has a few on display. (Very good restroom.) Don't be afraid to ask for help Though the term self-care sounds like an isolated practice, it doesn't have to be. If you're someone who struggles to commit to individual self-care routines, or simply takes enjoyment from the company of others, spending time with and opening up to a friend, loved one, therapist, or even reaching out to the 741741 Crisis Text Line could be extremely beneficial. Just know that you're not alone in your stress and professionals are out there to help. "Certainly, if possible, try to see a stressful situation as an opportunity to grow, and consider the power of reorienting how you confront a stressful situation when it arrives," Mazure said. "Instead of thinking, 'Oh no, not again,' perhaps a good self-care perspective might be, 'I’ve seen stress before. I've got this.'" If you want to talk to someone or are
experiencing suicidal thoughts, text SOS to the Crisis Text
Line at 741741 or call the National Suicide Prevention
Lifeline at 1-800-273-8255. Here is a list
of
international resources.
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