Category: parenting

Finding humor in your crazy child

Finding humor in your crazy child

Note of caution: it’s never appropriate to make fun of a child.  The purpose of this article is to help a parent’s stress by finding humor in their situation, private humor–never to be shared with the child or anyone else who will share it with the child.

“I don’t suffer from insanity, I enjoy every minute of it.”

Things can only go downhill so far until you lose it.  Troubles build, going from bad to horrible, and then your child says something so bizarre or silly, and even though it may be politically incorrect, and even though it may seem sick or hurtful or embarrassing, there is absolutely nothing left to do but laugh.

“That boy gave me so much trouble, then one day he said to me, “Mom, why is it always about you?” !
–Mother of an 18-year-old son with mild schizophrenia

Stop pretending your family is normal.

For parents like you, humor is necessary, even “gallows humor.”  Laughter is a legitimate strategy for relieving stress, and brain scans prove it.  An emergency room nurse once told me that ER staff joke about patients to cope with the intensity of their job, but only among co-workers.  They diagnose some victims as “too stupid to live,” or refer to motorcyclists as “organ donors.”  The police joke amongst themselves about knuckleheads.  A juvenile justice therapist told me her team tells youth sex-offender jokes!

“… as high as 94 percent of people deem lightheartedness as a necessary factor in dealing with difficulties associated with stressful life events.”
–David Rosen, Professor of Psychiatry and Behavioral Science, Texas A & M University, May 2005

Even if you child-proofed your house, they would still get in.

You have permission to laugh at all the crazy, zany, exasperating, nonsensical, and nutball things your child does or says, just never in their presence… or in anyone’s presence who doesn’t understand. It doesn’t mean you don’t love or care your child, but it helps your own mental health. In the support groups I run, a parent will occasionally share a funny story about their troubled child and the room roars with laughter.

The 15-year-old girl had professed suicidal thoughts for so long that no one could remember a time when tragedy wasn’t looming. They had locked up every potentially dangerous item, but the terrified parents were never certain they could keep her safe from herself.  Removing the knives and rope was obvious.  But household chemicals?  Daily life became a quest to guess what else she could possibly use to kill herself, then hide it.  But her mother realized one day that her daughter would probably not ingest household chemicals.  They tasted too bad, and mom knew she would not go through the discomfort.

You can’t scare me, I have teenagers!

At health class in high school, the students saw a film about trauma in children.  Upon returning home from school, a 14-year-old son exploded with fury, berated his mother, then charged off to his room and slammed the door, once, twice, three times.  The mother was accustomed to this behavior and went to his room and attempted to calm him down.  He screamed, “I finally found out why I’m having so many problems!  I learned in health class that I am a ‘feral child’ because you abandoned me when I was a baby!

The 20-year-old schizophrenic son angrily obsessed that his mother spoke with his school counselor when he was 11.  He railed that this invasion of privacy was wrong, immoral, hurtful, illegal, unethical, and stupid, and every other sin he could think of.  Mom learned to let him vent, but one day she became exasperated and said, “That was nine years ago! I apologized a hundred times. What more do you want?” The son stopped for a moment, confused, and said, “I don’t believe you. Did you erase my memory again?

The 16-year-old daughter had bipolar disorder. She also had grandiose plans to become a famous person and lead an “epic” life.  She was immensely proud of having an ‘exciting’ disorder that gave her permission to be crazy.  Once she made an unsuccessful attempt to lose weight, explaining, “I tried anorexia but didn’t have the discipline.”


The main purpose of holding children’s parties is to remind yourself that there are children more awful than your own… or maybe not.

The mother of a violent 10-year-old daughter said “I just bought a gallon of spackle on sale, which is great.  Spackle is my friend!”  Another mother with a violent 16-year-old son agreed.  She said she’d become skilled at repairing and texturing dry wall after all the damage he’d done.  Both moms brainstormed starting a company to repair homes battered by troubled children. “It would help the parents, and we could offer support too… and not judge!”

Several parents with troubled children were sharing their frustration from hearing ‘normal’ families talk proudly about their wonderful children, and the fun things they did together.  Each parent had had similar experiences, which made them feel a mix of emotions–embarrassed, ashamed, left out.  One mom finally blurted, “Those stupid happy families, I hate them!”

Do you have a funny story or quote to share about your child?  Please add it in the comments section–you’ll lift another parent’s day.

–Margaret

Your troubled child from birth to 18, what to expect and do

Your troubled child from birth to 18, what to expect and do

Parents face daily challenges with a troubled child or teen, and easily overlook the future.  I know I did.  What’s going to happen as they grow and change?  What does one plan for?  It helped me to hear from parents who had already traveled this path.  Based on their experiences, these are some things you can expect–and do–before your child  reaches the pivotal age of 18.

Your child may not be ready for adulthood by age 18, but be OK with this.  Collective experience indicates your son or daughter  will continue to need your support and health care management into their mid-20’s.

If he or she reaches young adulthood with the capacity to maintain well-being on their own, you’ve done a good job.

From birth to age ~5

YouConsider yourself lucky if he or she has an identifiable behavior problem early!  You have ample time to understand your parenting needs and prepare, and use the many “special needs” services for young children.  Start a file and keep absolutely every medical and school record and contacts for people and services.  You are about to become a case manager.

Your family

  • Talk with siblings frankly.  Explain that sister or brother has a different brain and will be treated differently.  Inform them you will be distracted by their sibling’s need for appointments and other issues, and that it may feel unfair.  Ask for their patience.  Reassure them you love them very much.
  • Talk with your partner or spouse about revising expectations for your child, and accepting that your life may be harder than you planned .  Discuss how you will work together and share responsibilities, and work through disagreements about parenting the child in the future.

Everyone – Keep friends, activities, and plans the same.  Keep hobbies and interests alive.  Be as inclusive as possible of your special needs child but don’t sacrifice your family’s needs.  It’s a tricky balance.

Ages ~6-11  – young children

If your child’s behavior problems started at this age, read the above.  It still applies, except you may find fewer services, and sadly, more blame.  Seek professional help now.  Early intervention is the key to future mental health.

What to teach your family:

    • Our lives will be different from other families, but this is normal for families like ours.
    • We will support your sister or brother, but we will take care of ourselves and each other, we will have each other’s back.

What you should do:

  1. Make safety a high priority in your home, emotional safety as well as physical safety.
  2. Focus on schedules and planned time for activities every day.  Maintain this structure consistently, including weekends and holidays.
  3. Teach your child skills for managing behavior–they may not be able to stop it completely.
  4. Modify your home to reduce stress: Less noise or over-stimulation.  Better diet. A separate time-out  space.  Lock up valuables or dangerous items.  Consider a therapy pet.  Create a  tradition of whole-family activities:  Wii, playing cards, board games, exercise games, art or crafts, movie night…
  5. Take frequent “mental health breaks.”  Be generous with yourself without guilt.  Let other family members have breaks too.

 Managing resistance: tips and advice

Practical ways to calm yourself, your child, your family

From ~12-18 – ‘tweens and teens

If your child started having problems at this age, most information above still applies, but this may be the most difficult period!

Two things happen in the teen years:

  1. They enter a normal phase of development where they seek their own identity, and want freedom and a social life separate from the family.  But they take more risks, and expose themselves to more risks.
  2. Some mental disorders start at this phase, or get much worse and become quite serious:  major depression, bipolar disorder, schizophrenia and schizoaffective disorder, anorexia, borderline personality disorder… Risks include school failure, criminal activity, substance abuse, suicide, and assault.

Priorities

Safety – You may need to take unusually strong measures to ensure physical and emotional safety. Many need to lock up all knives, or allow siblings to lock themselves in their own room for protection, or search their teen’s room, or take away the cell phone and internet access.

Your well-being and that of other family members – Assertively seek outside support for your family, such as a support network of friends and family, or a religious community or support group, or mental health treatment for yourself, or all of the above.

Education – This is critical, even if it’s only for one or two classes per day.  If your teen cannot complete high school in time with their peers, it’s not a disaster. They may not graduate now, but they can finish their education eventually.  It’s never too late.

Positive peers and adult mentors – Keep your son or daughter from risky youth or adults.  Encourage activities with anyone they like and trust whom you approve of.

Ongoing mental health treatment –  your child may not believe (or accept) they have a mental health problem but they can at least comply with treatment.

By age 18

mature at 25

At a minimum, this is what your child needs–fundamental criteria for a functional adult life:

  • A steady job and income, or a meaningful activity (volunteering, school)
  • Healthy, stable relationships
  • Maintenance of health and hygiene
  • Decent housing, maintenance of housing and belongings
  • Maintenance of financial stability
Faith can help, and harm, a family’s mental health

Faith can help, and harm, a family’s mental health

When faith helps

Most of the time, people can heal and find peace and self-acceptance through faith. All the world’s great faiths, those that have lasted centuries, are kept alive for this reason. All have common themes of healing and service to others. When things go poorly, meditation and prayer, with others or in private, lead to connection and wholeness. Faith reveals that things are better, and will be better, than they seem.

When families are in crisis because of their troubled child, parents tell me they depend on faith, even parents who don’t profess a faith practice. They say it’s their only source of strength. Most families with a child who is sick, disabled, or mentally ill will go through dark times, when a parent’s world is simply too overwhelming. Most often, no answers are forthcoming, nor any rescue. The only choice is to hand over their burden to a “higher power,” God, the Buddha, Allah, the Great Spirit… This act of “handing over” is a foundation of healing in Alcoholics Anonymous, Narcotics Anonymous, and dialectical behavioral therapy (DBT).

Few things help a family more than a supportive community of believers.  There will be one person who listens to a frightened parent on the phone, and another person who takes a traumatized sibling on an outing, and another person who provides hugs and cookies. If a mentally ill child continues to decline, a good faith-based support network will stay on. The child may not thrive, but the family does, and has the strength and forbearance to handle the years’ long task of supporting their mentally ill loved one.

Science shows that faith results in better lifetime outcomes for a child

This writer typically trusts science, but in the depths of my family’s despair, only faith and the prayers of others kept me from falling apart.

There are scientists among the faithful who have asked the question: does faith really help the mentally ill? In another blog post, Spirituality and mental health, some research are summaries of research going back 36 years.  (Follow this link for the research citations.)  The answer?  Yes, faith makes a real and measurable difference in improving mental health.

More recent scientific research shows clear evidence from brain scans that meditation and prayer change brain electrical activity, from anxious or agitated to serene and grounded.  The person actually feels and behaves better.  This article has more information on this, Yoga – Safe and effective for depression and anxiety.

Like prayer, “talk therapy” or psychotherapy also shows improvement on brain scans. Imagine, just talking with someone improves the physical brain. According to the article appended below, “When God Is Part of Therapy,” many prefer therapists who respect and encourage their faith. It just makes sense.

When faith harms

This section is a personal appeal to faith communities who have unconscionably failed families and their children with mental disorders.

Faith communities depend on people, and people have biases and foibles.  Many of ‘the faithful’ hold negative beliefs about others, right or wrong.  Children who suffer, and their families, are identified as possessed, of evil character, disbelievers, victims of abuse, or cruelest:  those who are paying for their sins. Families are repeatedly told these very things today.

“Sometimes, people hide from the Bible. That is, they use the Christian holy book as an authority and excuse for biases that have nothing to do with God.”
–Leonard Pitts Jr., Miami Herald

Stigmatization from a faith community is a cruel betrayal.

A child’s inappropriate behavior is not a choice, it is a verifiable medical illness, one with a higher mortality rate than cancer:  Mental illness more deadly than cancer for teens, young adults.  Families with sick children need support; our sense of loss is devastating.

Testimonials

Mother with five children, one with bipolar disorder:

“We were members of our church since we were first married, all our daughters grew up here, but when my youngest spiraled down, I was told the sins of the father are visited on the sons. Or we weren’t praying enough. I knew they thought (Dad) had done something bad to her. We left and went church shopping until we found a pastor who understood and supported us.”

Mother of two children, one with acute pervasive development disorder:

“I wish we had a “special needs” church. We’re so afraid our kid is going to say something and we’re not going to be accepted. We haven’t gone to church for years because of this. They just turned their backs on us, it happened to another family with a deaf child. They avoid parents in pain. Deep down in my heart I believe in the Lord, but there are days when I wonder “where is God?” People call out to pray for a job, or a kid’s grades, but we wouldn’t dare ask for us, no one would get it, we’d be told we were bad parents or didn’t punish him enough.”

Mother of two children, one with schizoaffective disorder:

“When I went up to the front to light a candle and ask for a prayer for my daughter, I expected people would come up afterward and give a hug or something, just like with other families with cancer and such. But it didn’t happen. No one even looked at me. I left alone and decided never to go back.”

Some good news

FaithNet

The National Alliance on Mental Illness (NAMI) has recognized the need for the mentally ill to be part of faith communities, and the negative experiences most face when they attempt to participate in a religious community. NAMI started FaithNet to encourage and equip NAMI members to engage with and share their story and NAMI resources with local faith groups, and appeal for their acceptance.

Key Ministry

Key Ministry: Welcoming Youth and Their Families at Church
Stephen Grcevich, M.D., president, Key Ministry and child & adolescent psychiatry in private practice, Chagrin Falls, Ohio

“Key Ministry believes it is not okay for youth living with mental illness and their families to face barriers to participation in worship services, educational programming and service opportunities available through local churches.”

Churches in American culture lack understanding of the causes and the needs of families impacted by mental illness, which poses a significant barrier to full inclusion.

“A study published recently by investigators at Baylor University examined the relationship between mental illness and family stressors, strengths and faith practices among nearly 5,900 adults in 24 churches representing four Protestant denominations. The presence of mental illness in a family member has a significant negative impact on both church attendance and the frequency of engagement in spiritual practices.” When asked what help the church could offer these families, they ranked “support for mental illness” 2nd out of 47 possibilities. Among unaffected families, support for mental illness ranked 42nd.

________________________________________

When God Is Part of Therapy
Tara Parker Pope, March 2011, New York Times

Faith-based therapy is growing in popularity, reports Psychology Today, as more patients look for counselors who can discuss their problems and goals from a religious frame of reference.

Studies show that people prefer counselors who share their religious beliefs and support, rather than challenge, their faith. Religious people often complain that secular therapists see their faith as a problem or a symptom, rather than as a conviction to be respected and incorporated into the therapeutic dialogue, a concern that is especially pronounced among the elderly and twenty-somethings. According to a nationwide survey by the American Association of Pastoral Counselors (AAPC), 83 percent of Americans believe their spiritual faith and religious beliefs are closely tied to their state of mental and emotional health. Three-fourths say it’s important for them to see a professional counselor who integrates their values and beliefs into the counseling process.

The problem for many patients in therapy is that many patients are far more religious than their therapists.

Nearly three-fourths of Americans say their whole approach to life is based on religion. But only 32 percent of psychiatrists, 33 percent of clinical psychologists and 46 percent of clinical social workers feel the same. The majority of traditional counselor training programs have no courses dealing with spiritual matters.

When children are hospitalized with other ailments, the family draws sympathy and support from others.  But because of mental health stigma, most families like ours don’t when our child is hospitalized.  If not blame, we are second-guessed, or as bad, met with silence or a change of subject.

ARE YOU OVERREACTING?

ARE YOU OVERREACTING?

Your child’s incessant problems and scares can literally give you symptoms of PTSD and anxiety disorder that you can’t control.

Like many parents, you might go to extremes to control situations so they won’t get out of hand. You might not intend to go overboard, but so much frustration has built up that any little irritation sets you off like a warrior on a battle for control. Or a battle to make things stop now.

Overreactions are emergency alarms without the emergency.

You can’t see it coming, but then it happens.  In an instant you are on an unstoppable mission to fix, contain, punish, or halt anything that upsets your sense of well-being, imagined or not. Overreactions are sure signs of stress and that you need a break!  Overreactions may also come from the anger of losing the day you planned, or the life you planned and came to expect.

Dad, project strength on the outside, even when you don’t feel it on the inside. Relieve your tension later, away from the family or co-workers, by doing something physical, for example.

If you are overreacting to gain control, you are actually losing control.  Your parenting choices need considered, thoughtful decisions instead of an automatic 911 call. When your blood boils, you’re not aware how your behavior creates a toxic environment around you and the rest of your family… nor how it worsens a troubled kid’s behavior.

  • Do you worry even when things are fine?  Do you find things to worry about that aren’t problems?
  • Are you so stressed and traumatized that you just can’t stand it anymore and want the behavior to stop immediately, yesterday?
  • Is every little minor thing a reason to pull out the heavy artillery?
  • Do you overwhelm difficult situations with your own anxieties or explosions?

It’s common for parents with really difficult kids to get stuck this way, so forgive yourself if you overreact, and stop and look at what this does to your relationships and interactions with your troubled child.

  • Do you stop eating, or start drinking, when your stress is just an overreaction to a situation you’ve already handled?
  • If you’ll do anything to make your child stop a challenging behavior, might you go too far with little things? Will you call the police because they slammed the door?
  • When others hear you constantly complaining, might they consider that the problem is you?
  • Do you mirror your child’s bad behavior to show them what it looks like? Are they interpreting this the way you hope, or are you lowering yourself?
Mom, you know this helps no one. You have every reason to “lose it” but find a safer way to relieve tension. Get away occasionally, or distract your worries with friends or an activity you enjoy.

Overreactions sabotage opportunities for improvement. They terrify everyone , and your family starts to hide things from you, or downplay things, just so you won’t overreact or worry yourself to death. When family members feel a need to keep secrets, the isolation feeds your worry. Members will smooth over problems or distract you with lightness to counterbalance your fearful or explosive state of mind. Now you are less in control and receive less of the support you need for your own well-being.

If you feel paralyzed by worry or lash out as a way of coping, you are disabling yourself stress and/or depression. Before you completely lose control and your self-respect and parental authority, take care of yourself and get help for both your physical and emotional exhaustion. Check in with others and ask them if you are thinking clearly or realistically.

You must be emotionally centered and healthy or you will never be able to help your child become healthy.

Remember, your child and family need you to be 100% together.  Let some things go for the greater peace.  Center yourself so you can notice when your child is doing well and offer praise.  When centered, you are flexible, patient, compassionate, and forgiving.   This draws people towards you, to look after you and care for you.  Go ahead, aim for sainthood.  Just starting down that path would relieve everyone else’s stress over you.

–Margaret

 

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Animals that make good therapy pets

Animals that make good therapy pets

Dogs, cats, and “pocket pets” like ferrets, birds, or lizards are therapeutic for children who struggle with any disability: physical, behavioral and developmental. A calm smiling dog, an affectionate cat, or a small pet they can hold is a great therapist. The right animal offers unconditional love and affection, and the right animal makes your child feel special. If you are considering animal therapy or a pet for your child, strategically pick the right animal. Measurable benefits have been seen with many creatures “ranging from dogs, cats, birds, and fish to goats and snakes.”

When finding a pet, monitor your child’s interactions when they are first introduced to the creature. Be honest with yourself, the animal you like may not be the best for your child. Hyperactive and barking dogs, biting cats, fearful hamsters, and noisy birds don’t work and can be outright stressful. Pay attention—people are often unaware how much stress fussy pets generate and how distracting and chaotic they can be.

What is the right animal?

  • The animal’s natural manner fits your child’s emotional needs.
    • Quiet–if child easily experience sensory overload;
    • Soft, active, or affectionate–traits that help a withdrawn or anxious child;
    • Interactive–if your child needs to maintain interest or needs attention: a bird that speaks, or a dog that follows instructions;
  • The animal likes to be with your child for long periods. The animal has a preference for your child.
  • Your child is able to treat the pet humanely. (Animals can be abused consciously or unconsciously by troubled children.)
  • You appreciate the animal too and aren’t concerned about mess, smell, hair, or feathers in your home. You should consider yourself the one responsible for its care. This pet is a therapist first, and not a lesson in responsibility for your child. They can learn responsibility later.
  • The child’s pet should still be welcome and cared for if it doesn’t work out for your child. If it’s not wanted, consider a rescue shelter or humane society that can find another caring owner.

Dogs

Most people are familiar with therapy dogs. Their natural affinity with humans is the reason why dogs are the most popular of pets.  And research shows dogs reduce depression and anxiety.  If you are interested in getting a puppy to train as a therapy dog, you can find instructions on how to train certified therapy dogs, and modify them to fit your home. Certified dogs need significantly more training because they can be used in nursing homes, hospitals, and schools. “How to train a therapy dog”

Birds

The parrots and parrot-like or hooked beak birds have marvelous personalities and will bond with their owner for life. These colorful birds love to perch on a finger or shoulder and spend time with people, other birds, even dogs and cats! The best low-cost option is a parakeet, which is low maintenance, happily chirpy, easily tamed, and easily trained to talk.

“Patients hold and stroke cockatiels so tame that they often fall asleep in a human lap.” Maureen Horton, the founder of “On a Wing and a Prayer” tells of “non-responsive patients in wheelchairs who suddenly begin speaking again while petting a cockatiel as their relatives weep at the transformation.” She described bringing her birds to visit a group of violent teenage delinquents who clamored to touch a cockatoo named Bela. “For a few minutes,” Horton says, “these hardened criminals became children again.”
— “On a Wing and a Prayer,” a pet-assisted therapy program, uses birds to visit patients.” Connie Cronley, Tulsapeople.com

Fish

Fish can’t be held, but few things beat the visual delight and serenity of a beautiful aquarium. Fish do have personalities and form interactive communities in a tank, which are fun to watch, and individuals are fun to name. There is a reason aquariums are common in waiting rooms and clinics, lobbies, and hospitals.  They help people relax and calmly pass the time.

“Pocket pets”

These are usually mammals that like to be cuddled and carried around, often in pockets: ferrets, mice, rats, gerbils, hamsters, guinea pigs, and very small dogs. It is best to select a young animal that is calm and won’t bite, and handle it gently and often so that it becomes accustomed to being held. Challenges with many pocket pets include running away or escaping their enclosures, urine smell, and unwanted breeding. As the main caretaker, you will want to be comfortable with their needs.

Reptiles

Lizards are also excellent pets and demand little attention, and they are readily accepted by children. My bearded dragon, Spike, comes with me to my support groups. Dragons are a very docile species–safe with young children and popular with teens and parents. Other good species are iguanas, and geckos.

“I’d have to say my Leopard Gecko Mindy is very much therapy for me. She really is my therapy lizard, she wants to sit with me when I’m upset and tolerates me, which even my two dogs and cat won’t. She’ll just find a place on me and curl up and be like “I’m here, I won’t leave you.””
–User name “Midori”, Herp Center Network

Horses

Properly trained horses are extraordinarily healing. certified horse therapy programs are considered medically effective treatment and often covered by health insurance. Horses benefit disabled children and teens across the board: those with physical disabilities such as paralysis and loss of limbs, mental/cognitive disabilities such as development disabilities and retardation, and children with mental and behavioral disorders. The horses are selected for their demeanor and trained to reliably respond appropriately to children who may misbehave. Therapists are specially trained also to collaborate with the horse as a team. Horses have a “large” serenity and a lack of concern with the child’s behavior. They are also intelligent and interactive like dogs, provide a warm soft hide to lean on, and they empower their riders. A child on a horse will connect with the animal’s rhythmic bodily movement, which stimulates the physical senses and keeps the child physically and mentally balanced. According to parents and children in these programs, horses change lives.  New research proves horses are genuinely effective:  Study Suggests That Equine Therapy is Effective.

–Margaret

How has your child’s pet improved mental health?
Your comments help others who read this article.


The science behind animal therapy

Are dogs man’s best therapist?
Psychiatric Times. H. Steven Moffic, MD. February 29, 2012

Note: this is an excellent article by a psychiatrist who moved from disbelief to belief that dogs have a genuine therapeutic value, healing some of the most psychiatrically challenging children. http://www.psychiatrictimes.com/blog/moffic/content/article/10168/2040421

Children’s best friend, dogs help autistic children adapt (summary)
Journal: Psychoneuroendocrinology, 2011, Universite de Montreal

Dogs may not only be man’s best friend, they may also have a special role in the lives of children with special needs. According to a new study, specifically trained service dogs can help reduce the anxiety and enhance the socialization skills of children with Autism Syndrome Disorders (ASDs). The findings may lead to a relatively simple solution to help affected children and their families cope with these challenging disorders.

“Our findings showed that the dogs had a clear impact on the children’s stress hormone levels,” says Sonia Lupien, senior researcher and a professor at the Université de Montréal Department of Psychiatry and Director of the Centre for Studies on Human Stress at Louis-H. Lafontaine Hospital, “I have not seen such a dramatic effect before.”

http://www.npr.org/blogs/health/2012/03/09/146583986/pet-therapy-how-animals-and-humans-heal-each-other?ps=sh_stcathdl

Pet therapy: how animals and humans heal each other. (summary)
by Julie Rovner, March 5, 2012, National Public Radio

“A growing body of scientific research is showing that our pets can make us healthy, or healthier. “That helps explain the increasing use of animals — dogs and cats mostly, but also birds, fish and even horses — in settings ranging from hospitals and nursing homes to schools, jails and mental institutions.”

“In the late 1970s that researchers started to uncover the scientific underpinnings animal therapy. One of the earliest studies, published in 1980, found that heart attack patients who owned pets lived longer than those who didn’t. Another early study found that petting one’s own dog could reduce blood pressure.

“More recently, says Rebecca Johnson, a nurse who heads the Research Center for Human/Animal Interaction at the University of Missouri College of Veterinary Medicine, studies have been focusing on the fact that interacting with animals can increase people’s level of the hormone oxytocin. “That is very beneficial for us,” says Johnson. “Oxytocin helps us feel happy and trusting.” Which, Johnson says, may be one of the ways that humans bond with their animals over time.”

Your rights as the parent of a teen with a mental disorder

Your rights as the parent of a teen with a mental disorder

Parents have more rights than they think.

In a previous blog article on the subject of parents rights, I described how parents can be shocked to learn that their troubled teenager has the right to refuse treatment, Balancing teen rights with parent rights when the teen has a mental disorder.

What if your teen refuses treatment?  They get worse. Over months and years, if your child experiences serious symptoms of the disorder, such as schizophrenia, depression, or bipolar disorder, their brain loses cognitive function just as in Alzheimer’s disease.  Breaks in treatment means loss of brain function, and they become more vulnerable to multiple hospitalizations.  A troubled teenager can refuse treatment  for any reason however–explaining the mental health risks could go nowhere.

If a teenager had any other illness besides a behavioral disorder, refusing or withholding treatment would be considered child abuse and grounds for removing the child from the home.

Laws in many countries err on the side of protecting a person’s civil rights, but a teenager is not ready to take the responsibility that goes with these rights.(An excellent website on pertaining to Special Education Law is Wrightslaw. Click on “Topics from A to Z.”)

What if you’re teen becomes involved in crime?

  • For safety and health reasons, you have the right to search your teen’s room and remove or lock-up risky items like drugs, weapons, razors, pornography, or anything affecting health (rotten food, unclean garments, chemicals). Be careful: this can destroy trust if done inappropriately. Inform your teen only if you find and remove unsafe items but otherwise leave everything else alone!
  • You can set any curfew time you think appropriate, and you do not have to adhere to curfew times used by law enforcement. Suggestion: compare with other parents’ curfews. Your teen will more likely follow rules that his or her peers follow.
  • You can monitor everything in your home, and on your computer and phone. You can limit cell phone services, and get GPS tracking on the phone and in the car. Prevention is more effective if your teen is informed about this, and it prevents others from taking advantage of your child, too.
  • You can report your concerns to anyone: teachers, other parents, and the local police precinct.
  • You can search for your child by calling other parents or businesses, or visiting their friends’ homes, or searching public places where your child might be.
  • You can and should call the police if your child runs away, or if your child is being harbored by someone who wants to ‘protect’ them. It is illegal to harbor runaways and those who do are subject to criminal charges.
  • You can and should notify anyone who encourages your teen to run away or who takes your teen with them without your permission, that this is custodial interference and subject to criminal charges.

What if your child’s mental health provider doesn’t share information you should know as the parent?

“Communication between providers and family members needs to be recognized as a clinical best practice.”*

  • You have the right to contact any mental health professional directly, and provide information relevant to your child, your family (e.g. marital conflict), and your family’s needs (e.g. bullied siblings). The professional can legally receive and document this information, but may not be able to discuss it with you.
  • You have the right to communicate freely and openly with a practitioner or teacher about anything you both already know—no confidentiality exists.
  • You have the right to schedule your own appointment with a professional without your teenager, and ask for information about how to get help for yourself and your family, and what kinds of help you may need.
  • You have the right to information about your child’s diagnosis and behavioral expectations, the course of your child’s treatment, and how you should interact with your child at home.
  • You have the right to a second opinion. And you have the right to change treatment or refuse treatment based on that second opinion.
  • You have to right to participate fully in medical decisions about your child. For example, you have the right to ask a doctor to stop or change medication or treatment that is creating behavior problems or side effects, which harm your ability to manage your teen.
  • You have the right to “information about the treatment plan, the safety plan, and progress toward goals of treatment.” *

What if your child’s provider claims they must keep all information confidential to protect patient privacy?

“While confidentiality is a fundamental component of a therapeutic relationship, it is not an absolute.”*

“Medical professionals can talk freely to family and friends, unless the patient objects after being notified of the intended communication. No signed authorization is necessary.”

–Susan McAndrew, Deputy Director of Health Information Privacy, U.S. Department of Health and Human Services

Teachers and mental health professionals have leeway with confidentiality.  Professionals often misunderstand the Health Information Privacy and Accountability Act (HIPAA), which defines what must be kept confidential. Many also misunderstand the Family Educational Rights and Privacy Act (FERPA) and state laws that govern confidentiality, so they tend to err on the side of confidentiality. However, the American Psychiatric Association states:

“Disclosures can sometimes be justified on the grounds that they are necessary to protect the patient. For instance, it is generally acceptable for a psychiatrist to warn a patient’s family or roommate when the patient is very depressed and has voiced suicidal thoughts”* or plans to harm others.

Professionals should provide explicit information about safety concerns: such as the warning signs of suicide; the need to adhere to medication and other treatment; an explanation of how your teen’s disorder can impair judgment; an explanation of reasons the teen must avoid substances like alcohol and drugs (including some over-the-counter drugs); and the need to remove the means for suicide, especially firearms, sharp objects, matches, chemicals, etc.

How doctors and therapists manage confidentiality

Their basic philosophy is to do what is in the best interest of their patient. For example, if the teen is in an abusive family situation or seeking care only on the condition of confidentiality, their privacy will be protected. “The default position is to maintain confidentiality unless the patient gives consent… However, [family members or friends] may need to be contacted to furnish historical information…” If the practitioner determines that the teen is (or is likely to become) harmful to him- or herself or to others, and will not consent, then they are… “justified in breaking confidentiality to the extent needed to address the safety of the patient and others.
–The American Medical Association, 2001, “The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry.”

A good professional will be honest with your teen, and tell them that they will communicate with parents based on what they already know. They will also tell your child that suicide or violence risk will always be communicated to you and/or an emergency medical service. From everyone’s perspective “It is always better to defend an inappropriate disclosure than to defend a failure to disclose with bad outcome (e.g. injury or death).”

Giving a teenager with behavioral problems the rights to make critical medical decisions is too risky!

I hope that families and mental health advocates can someday agree on how to maintain civil rights without letting a person control their future when they are not in their right mind. Until then, work with the system as best you can. I find that teachers and practitioners do their best to help families despite the restrictive civil rights and confidentiality mandates. Good luck.

How am I doing? Please rate this article, thanks.  Margaret

* Reference“The Clinician Should Maintain a Confidential Relationship With the Child or Adolescent While Developing Collaborative Relationships With Parents, Medical Providers, Other Mental Health Professionals, and Appropriate School Personnel,” developed by Jerry Gabay JD and Stewart S. Newman MD. The authors would like to acknowledge the support of the Oregon Council of Child and Adolescent Psychiatry for their support of this effort.

Five-minute wisdom for parenting troubled children and teens

Five-minute wisdom for parenting troubled children and teens

From many years of  counseling parents, I’ve found the following parenting wisdom quickly helps parents understand, clarify priorities, and take the next steps.

You are not alone. All families experience the same fears no matter what the child’s challenges: guilt, anger, frustration, failure, and mental and physical exhaustion.

There is a way. The steps to finding peace in the home are the same for all families.

You can start now. You can improve behavior without having a diagnosis, and the techniques work for the majority of difficult children.

There is reason for HOPE. They have the capacity to do better. With support and treatment, difficult children improve.

Have realistic expectations: They may not be ready for adulthood, and may need extra support into their 20’s… but that’s OK. There’s time to catch up with their peers.

Plan ahead for a crisis, brainstorm options for an effective response and create a checklist. We can’t think clearly in a tension-filled moment.

GOOD Things to do for Your CHILD or TEEN

Pay attention to STRENGTHS not weaknesses. Always find something great about them.

Guide them to their gifts. Give them ample opportunity to do what they are already good at.

GOOD Things to do for YOU

o Be your own cheerleader. Silently think, “I can handle this;” “I’m the one in control.

o Regularly talk through your feelings with others who understand and won’t judge.

o Get a life, maintain personal interests, and set thoughts of the child aside without guilt.

o Commit to doing the best you can, and accept that this enough – plan to let go someday.

You’ve done a good job when they are able to take responsibility for their own care. This is a monumental personal achievement!

KEYS to CALM

In a neutral patient voice, give directions or requests . You will need to repeat yourself, calmly, several times. Your voice should not communicate strong emotions. Tone of voice, not words or volume, is what creates a bad response.

Don’t rush calm. Give the child plenty of time to unwind and settle. Calm is more important than quick.

Ensure there’s a calm place to go – a time-out space, even for you.

Get an appropriate therapy animal – a calm and durable creature unlikely to be harmed.

Reduce chaos in your home: noise, disorder, family emotional upheavals, the intrusive stimulation of an always-on TV, etc.

Ideas for MANAGING resistance

You want your child to be resistant to the negative things they’ll face in life. It represents willpower, and is a strength to cultivate.

o Be quiet and LISTEN. If you respond, address how they feel, not what they say.

o Use reverse psychology-ask them to do something you don’t want them to do, so they can defy you and do the opposite.

o Choose your battles. Let them think they’ve won on occasion.

o For an ODD child, give multiple instructions at once, including things they do and don’t want to do. It becomes too much work to sort out what to defy.

o Actively ignore – Stay in the vicinity but don’t respond, look away, act like you can’t hear. They eventually give up. Works best for ages 2 – 12.

o Mix it up – Be unpredictable. Give a reward sometimes but not all the time. Try new ways to use incentives or set boundaries and structure.

DON’T make these Nine COMMON Parenting MISTAKES

1. Treat your home like a democracy, let your child have an equal say in decisions.

2. Find fault with them and tell them about it repeatedly. If they do something positive, it’s not good enough.

3. Pretend your child has no reason for their behavior. Ignore his or her needs or challenges. Are they being bullied? Are they having a hard time sleeping? Is your home too chaotic?

4. Make rules and only enforce them once in a while, or have consequence come later.

5. Don’t treat your child appropriately for his or her age. Make long explanations to a 3-year-old about your reasoning. Assume a teen wants to be just like you.

6. Expect common sense from children who are too young (5), or from young adults with a long track record of not showing common sense.

7. Keep trying the same things that still don’t work. Repeat yourself, scream, show how frustrated you are with them.

8. Jump to conclusions that demonize the child. “You are manipulative and deceitful,” “You don’t listen to me on purpose,” “I’m tired of your selfishness…”

9. Make your child responsible for your feelings. If you lose your cool, insist they apologize.

Problem SYMPTOMS, not problem children

– Does not show common sense and is not influenced by reason and logic;

– Has no instincts for self-preservation, and poor personal boundaries;

– Has no well-adjusted friends; has friends who are risky or troublesome;

– Doesn’t respond to rewards and consequences;

– Has limited character strengths: honesty, tolerance, respect for others, self-control;

– Does not make plans they can realistically achieve, hangs on to fantasies;

– Acts younger than their peers. Will not be ready for adulthood by 18;

– Lives in the here and now; doesn’t think about the past or future;

– Does not notice their effect on others.

Your PRIORITIES in Order

1. You and your primary relationship(s)

2. Basic needs and responsibilities: housing, clothing, food, income, health

3. Your challenged child or teen.

How parents spend their time when a child has a mental illness. Make the slices equal in size–too much for one, too little for others.
Time spent on all the important things better supports the child and the family they depend on.

 

 

 

 

Parent to Parent Guidance

Parent to Parent Guidance

Margaret Puckette is a Certified Parent Support Provider, and helps parents with tailored advice for raising their troubled child, teen, or young adult. She is a parent who understands that parents and families need realistic practical guidance for maintaining their lives without stress. Margaret has coached and mentored families for over 20 years. She is an author & speaker, and believes parent & family support is essential. Mentally healthy parents with the right skills raise mentally healthy children.

You Can Handle This.

You Can Handle This.

You are not alone. Your situation is no one's fault. Behavior disorders are disabilities!
Troubled children need a very different parenting approach than 'normal' kids.

Care for yourself first, then set new goals:
1. Physical and emotional safety for all
2. Acceptance of the way things are
3. Family balance, meet the needs of all
4. One step at a time, one day at a time

Practical Guide for Parents

Practical Guide for Parents

A guide with practical steps for reducing stress at home and successfully raising a troubled child. You use the same proven techniques as mental health and other professionals. It starts by taking care of your wellbeing first, then taking an entirely different approach to parenting.
Amazon $14.99, Kindle $5.99