Category: therapy

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    • Soft, active, or affectionate–traits that help a withdrawn or anxious child;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.”

Therapy types explained: DBT, CBT, CPS, and others

Therapy types explained: DBT, CBT, CPS, and others

The fantastic news about the brain is that it can heal itself by talking with someone! Ample evidence backs this up.

The therapist or psychologist who works with your child or teen will use a type of therapy or “modality” based on their symptoms or diagnosis, because some work better for mood disorders, some work better for defiant children, some work better for borderlines, and so forth. (In thought disorders like autism and schizophrenia, talk therapy has limits. Those on the autism spectrum need specialized interactions due to their processing issues. Those on the schizophreniform spectrum need medication to think logically before starting

Therapy models. Each type of therapy follows a model, and five are covered in this article. Your child’s therapist must be trained and practiced in any model they use. Why? It’s a matter of quality control. A therapist who has fidelity to a model (adheres to protocol) will help the most people most of the time, because that model has data to prove that the majority will benefit–the ones in the center section of the Bell Curve. (Therapists include psychiatrists, psychologists, and psychotherapists with MSW (Masters in Social Work), LCSW (Licensed Clinical Social Worker) and other licensure.)

Therapy models

CBT – cognitive behavioral therapy
CBT works when the child can examine their own feelings and make sense of them—the “cognitive” part. They learn to understand what affects them and why. The therapist will guide your child to create a list of options for themselves for when they face the next stressful situation that pops up in their lives. CBT helps a person think their way out of the confusion and have plans in place for appropriate actions. It works for mood disorders and anxiety, and some thought disorders if person has ‘insight’ (able to notice when they are behaving or thinking irrationally). CBT is one of the most widely used therapeutic models because it works for people who are relatively stable but enduring a difficult life situation (divorce, medical illness, job loss, and other big stressors).

DBT – dialectical behavioral therapy
DBT is unusual in that it can help anyone for any reason! The term “dialectical” describes how a patient learns to hold two opposing truths in their mind and respond effectively to the discomfort and emotions this causes. DBT is the one therapy model that can work for people with borderline personality disorder, who are considered the hardest to treat. It also helps those with mood dysregulation, those who’ve thought about or attempted suicide, or those with uncontrollable and negative responses to the world, such as oppositional defiant disorder. DBT relies less on personal self-examination and analysis, and instead concentrates on self calming, tolerating stress without overreacting, accurately perceiving the nature of a conflict, and communicating with others appropriately. Anyone can benefit from DBT. Notice how commonly people hear bad news and immediately expect the worst, then act to address the worst possible outcome? Does your child do this, only to extremes?

EMDR – eye movement desensitization and reprocessing
The goal of EMDR therapy is to help a person process extremely distressing memories of trauma and mitigate their torturous subconscious influence so children and adults can adapt and cope when memories are triggered in the future. EMDR is used for people with PTSD (physical, sexual, or emotional abuse) and other traumas such as from war, accidents, and major disasters. The therapy process uses rhythmic stimuli as a distraction during the precise moments when the person relives the traumatic memory—eye movement back and forth (by following a swinging object or a therapist’s hand), clapping, or listening to tones switching from ear to ear through headphones. The person does not have to talk about the horrible memory, so EMDR is less stressful—so important for a trauma survivor! EMDR works but there are no acceptable explanations. It is based on a belief that the memory and associated stimuli of the event must be processed to remove it from “an isolated memory network” where it creates havoc.

Parents as therapists

There are two proven models of therapy that are taught to parents to practice with their children in the home. Like the other models, they don’t work for every child, but they work for most children with a certain range of behaviors, rages, resistance, and physical violence, which can be caused by ODD, ADHD, and depression/bipolar disorders.

CPS – collaborative problem solving
CPS can be learned by anyone to manage an intensely frustrated child who goes into uncontrollable fits or tantrums, and the parent can do nothing to calm them down. The fits may last hours, and must run out of steam on their own. Afterwards, the child is often remorseful. Why? Their brain is “chronically inflexible” and has difficulty with the unexpected, switching from one situation to another or one plan to another. Using CPS, a parent doesn’t enforce rules per se, but negotiates with child so that they together come up with a win-win solution. This is very counterintuitive! The parent does not give away their authority, but offers the child an acceptable choice. For example, if a child can’t get a red jacket because there aren’t any in their size, and they must have red (!), the parent asks the child if they want to order one and wait 2 weeks, or if they will accept another color. This seems fair to the child because they have a say, and much easier on the parent because the child accepts the outcome they’ve chosen.

PMT – parent management training
PMT refers to a proven intensive educational program for parents to teach them skills for managing extremely difficult children, especially those with ODD. PMT helps parents assert consistency and predictability at home and in school, and promote positive social behavior in their child. The parents are also trained to change their own behavior towards their child, and taught how to analyze different home/school situations, “then apply moment-to-moment positive reinforcement or punishment” (called interventions) based on what is happening. The punishments are humane, such as taking time outs. It is hard on the parents, but works for children with serious behavior problems in addition to ODD: Conduct disorder, ADHD, and autism spectrum disorders.

What makes a good therapist? Because multiple models are out there, a really skilled therapist will figure out which model your child needs once they get to know them, and they will apply parts of different models depending on your child’s individual challenges. That same skilled therapist will also be a cheerleader for your child, helping them feel good about themselves (and you), helping them discover their talents, and helping them to stay committed to their need for self-care. This is the very definition of a good therapist! Therapy is hard to take for anyone, but your child will trust a good therapist if they feel they have their best interests. Chemistry is important. If your child doesn’t like the therapist or make progress, it’s worth spending the time to find someone else who’s a better match. If the therapist has professional ethics; they will recognize they are not a fit and recommend someone else.

I know of a 10-year old child whose therapist dragged out appointments for a year with zero progress or results. From the start, the child didn’t like her and simply refused to talk with her. And this child, now 11, refuses any therapy because “it’s boring and a waste of time.” What an unfortunate consequence!

How you know you have a good therapist. A good therapist will be able to discover something valuable that brings light on your child’s situation after the very first session. They should ask you for background information about your child, and listen to you when you talk about recent problematic situations. They cannot talk to you about your child’s therapy, but they can encourage you to partner with them, and should recognize your need (your family’s need) for your child to function as normally as possible. You can ask to have therapy together with your child if its appropriate. If the therapist can’t connect meaningfully with your child after a few weeks, ask them about this. If you have any doubts about the therapist, share them, and expect to have a thoughtful, respectful explanation.

Which therapy is best for your child?

Seek a therapy provider with knowledge of all of them, and with experience treating children and teens. Ask about a specialty when you make the initial contact, and ask about a model you think fits your child’s behaviors (based on their descriptions). You can get a one-time assessment from a therapist for an opinion on which model to use. The best way to find a good therapist is through personal referrals: your child’s doctor or psychiatrist, support groups, school counselors, and other parents.

Naturopathic and holistic mental health treatment

Naturopathic and holistic mental health treatment

This guest article is by a naturopathic physician in Portland, Oregon USA, who specializes in mental health treatment for children and adults.  Following is a summary and link of a podcast about the use of holistic/alternative medicine for the treatment of ADHD.

 

Addressing Mental Health Issues From a Holistic Perspective
Krista Tricarico, ND.  www.openmindmedicine.com

Holistic treatment

The health of the mind and body are intricately linked. Just as our thoughts strongly influence our physical health, our individual physiology affects our mental and emotional well-being. The foods we eat, our digestive health, the toxins in our environments, our hormones, lifestyles, experiences, beliefs and attitudes all play important roles in our physiology and biochemical make-up. As a philosophy, holistic mental health recognizes this beautiful web of interdependency.

Holistic approaches for adults and children can be used in conjunction with psychiatric medication, but unlike pharmaceuticals, holistic mental health treatments usually have the “side effect” of improved physical health and a richer emotional experience. Rather than suppressing or covering up symptoms with a drug, the goal of treatment is to address underlying causes and work towards integration and balance.

As a naturopathic physician, my goal is to support the wisdom of the body and mind and facilitate an individual’s inherent ability to heal. Naturopathic Doctors (ND’s) are licensed primary care physicians who have attended a four-year, postgraduate-level naturopathic medical school and are clinically trained in the art and science of natural therapies. In addition to conventional diagnosis, laboratory testing and pharmaceutical medications, the scope of naturopathic medicine includes nutrition, counseling, homeopathy, botanical medicine, physical therapies, and mind-body approaches. Naturopathic training does encompass the same basic bio-medical sciences as conventional medical training, but the approach to health and disease differs considerably. It is the philosophy of naturopathy that clearly differentiates this medicine and directs how we approach each patient.

Treatments

This will look different for each person and will be guided by conversation and individual interests as well as physical exam and laboratory analysis when appropriate. I have found the following therapies to be key factors in mental health recovery.

Counseling

Some patients see me primarily for counseling, and people with this focus are welcomed. Others are either interested in a blend of counseling and naturopathic approaches or seek care strictly for holistic medical support. A young person’s treatment needs and interests also change over time, so I meet a patient where they are at this moment. My counseling approach has a strong emphasis on self-awareness and mindfulness. Self-observation coupled with an attitude of curiosity, openness and acceptance allows for conscious insight and more freedom in the responses to the stresses and challenges a young person faces daily. Mindfulness-based therapies are a particularly effective approach for depression, anxiety and addiction issues, and can lead to increased clarity and a sense of contentment.

Nutritional Therapies

The foods we eat have a direct impact on the chemistry of our bodies and brains and, therefore, on our mood, thoughts and behavior. Our brains require the correct balance of amino acids, fats, vitamins, minerals and glucose in order to function properly, and individual needs can vary drastically. I work with all patients, children and adults, to uncover their unique nutritional needs through history-taking, diet analysis and lab testing, and then help individuals address underlying biochemical imbalances through shifts in their diet and nutritional supplements. Food allergies or sensitivities can play a significant role in mental health, as well, and the removal of these foods from the diet can have a profound impact on one’s healing. Orthomolecular psychiatry is a field of medicine that has applied these nutrition-based therapies in the treatment of conditions such as schizophrenia, bipolar disorder, anxiety and depression and has helped shape my naturopathic practice.

For more information about orthomolecular medicine, visit www.orthomolecular.org.
For more information about food allergy testing, visit www.usbiotek.com.

Homeopathy

Homeopathy is a gentle yet powerful system of healing based on the principle of “like cures like.” People have observed since ancient times that a substance that causes an illness or symptom can, in very small doses, cure the same problem by stimulating the body’s intrinsic healing ability. Through an in-depth interview, I strive to understand a child’s unique physical, mental and emotional experiences and, after careful study, select the appropriate remedy. Homeopathy offers a safe and elegant treatment that is a natural complement to counseling and can be used alongside conventional medications and other naturopathic treatments. As a truly holistic and individualized form of medicine, it is particularly well-suited to psychological and psychiatric concerns. Although identifying the effective remedy can sometimes require patience and perseverance, the results of successful homeopathic treatment are profound and long-lasting.

Restoring Digestive Health

Many mental and emotional concerns have their origins in the gut. It is important to identify and treat conditions such as hypochlorhydria (low stomach acid), candida overgrowth, gut dysbiosis (a bacterial imbalance in our digestive tracts), parasites, inflammation, leaky gut (increased permeability of the intestinal wall), and food allergies as they have direct effects on brain function. Imbalances in the gut play a significant role in many neuropsychological conditions. Conversely, our emotions strongly influence our appetite and digestion. The nervous system and the digestive system are intricately linked by a constant exchange of chemical and electrical messages including nutrients and neurotransmitters. Anything that affects one realm is likely to affect the other, and I have found that addressing gastrointestinal health is often foundational in one’s mental health recovery.

Blood Sugar Balancing

The sugar in our blood is called glucose, and this is the primary fuel for our bodies. Being one of the most sensitive and demanding organs, our brains require a constant supply of this glucose to perform its never-ending functions. A healthy body is able to regulate the blood sugar to provide a consistent energy source for the brain; unfortunately, this function is commonly impaired. Hypoglycemia is a condition in which the body can’t sustain constant glucose levels and can be a causative factor in attention and behavior issues, anxiety, panic attacks, rapid-cycling bipolar disorder, insomnia and addiction. Elevated blood sugar over time not only leads to diabetes, heart disease and obesity but also mood and behavior disturbances, decreased mental functioning and dementia. Many psychiatric medications put people at additional risk for blood sugar problems only exacerbating this problem. Balancing your blood sugar is an important component of disease prevention and general health and will also support your mood, energy, metabolism and mental functioning.

Amino Acid Therapy

Supplementation with amino acids can help optimize neurotransmitter levels. Amino acids are the building blocks of proteins that our bodies transform into neurotransmitters such as serotonin, melatonin, GABA, dopamine, epinephrine and norepinephrine. These are the messenger molecules that allow our nerve cells to communicate and have a direct impact on our mood, learning, attention, pain and pleasure perception, sleep, energy, and thought processes. Most psychiatric drugs manipulate our body’s ability to process these neurotransmitters in an attempt to alter the levels of these important chemicals. Instead of, or in conjunction with, antidepressants or anti-anxiety medications, we can give the body the amino acids it needs to make more neurotransmitters and avoid the negative side effects of the drugs. Neurotransmitter testing is available and can help guide the treatments. Targeted amino acid therapy is a powerful tool for addressing a wide variety of mental health concerns and provides a safe and effective alternative to these medications.

For more information on amino acid therapy, visit www.neuroassist.com.

Balancing Hormones

Our hormones are produced and controlled by our endocrine glands and include chemical messengers such as thyroid hormone, cortisol from the adrenals, insulin from the pancreas, and estrogen, progesterone and testosterone from the reproductive organs. As parents of adolescents who are entering puberty know, hormonal change has a profound effect on behavior. Imbalances or disturbances in any of these interconnected systems can alter the way our brain functions. For example, thyroid dysfunction is an often-overlooked, underlying cause of depression, anxiety, poor memory and fatigue, and PMS is a well-recognized cause of mood swings, depression, anxiety and sleep disturbances. Helping the body regain its delicate hormonal balance can have far-reaching effects for the mind.

Detoxification / Heavy Metal Chelation

We are exposed to an extraordinary amount of toxins through our food supply, the air we breath, and even our tap water. Toxic exposures affect the health of our brains. When the body encounters more toxins than it can effectively process, it stores these chemicals in fat cells, and our brains are largely made up of fat. Some people are good detoxifiers. Others with autism, ADHD, Alzheimer’s, Parkinson’s, depression, chronic fatigue, schizophrenia and bipolar disorder are often not. Supporting detoxification and the safe elimination of toxins can be a key component to mental health recovery. I assist patients with appropriate detoxification strategies whether that is a gentle cleanse, a more intensive detox protocol or heavy metal chelation.

Mind / Body Treatments

Mind/body treatments engage the power of your mind in your own process of healing. I use therapies such as breath work, meditation, memory reintegration, relaxation strategies, and Emotional Freedom Technique (www.emofree.com) to help patients move towards a state of awareness and peace. Reflecting on and connecting with one’s own spirituality can also be an effective stress-management tool. Learning to consciously calm the mind and relax the body has a powerful effect on our neurotransmitters, hormones and immune system, and ultimately our health and sense of well-being.

Dr. Krista, www.openmindmedicine.com


Foods that support brain and mental health

  • Avocado
  • Walnuts, almonds, other nuts and seeds
  • Salmon, tuna, sardines, mackerel, herring, trout
  • Ground flaxseed
  • Brightly colored fruits and vegetables – eat the rainbow
  • 70% cacao and higher dark chocolate
  • Green tea (stone ground from whole tea leaves)
  • Berries:  acai, blueberry, cranberry, blackberry

 

Herbs and other alternatives that support brain and mental health

  • Fish, cod liver or krill oil (if you could only have one thing, this would be it)
  • L-theanine or kava kava for calming and reducing anxiety
  • Turmeric, curry and other antioxidants
  • B-complex vitamins
  • Magnesium
  • Light therapy, for improved mood and energy

 

Substances that are bad for brain health

  • Alcohol
  • Artificial food coloring
  • Artificial sweeteners
  • Sugars: cane sugar, soft drinks, corn syrup
  • Hydrogenated/partially hydrogenated fats and trans fats (fried foods). Saturated fats are fine, it’s the hydrogenated and trans fats that are bad.  I actually highly recommend organic coconut oil
  • Nicotine, THC, all other controlled substances

 


Integrative Management of ADHD – What the Evidence Suggests
By Richard Balon, MD | January 6, 2011

The use of complementary and alternative medicine treatments by children and adults with ADHD is the rule rather than the exception…more than half of parents who have children with ADHD treat their child’s symptoms with vitamins, dietary changes, and expressive therapies—but only a small minority tell their doctor. And roughly 8 out of 10 patients who use these treatments regard them as their primary therapy.

Practical ways to calm yourself, your child, your family

Practical ways to calm yourself, your child, your family

You need peace and calm in your household, and you can provide the touch that supports all other approaches:  Therapy; disciplined meditation and yoga, anti-anxiety medications (don’t be afraid to use them), but they’re not the best long-term solution.  There are proven techniques for calming yourself, your stormy child, and all other family members.

1. Calming yourself in the tension-filled moment

Become consciously aware of your tension and ask:  What are my options for coping with my tension right now?  Brainstorm options ahead of time and create a list because you won’t be able to process in the moment.  For example:  take a very deep breath, then silently count to 10 backwards.  Another idea:  eliminate distractions.  Turn off the cell phone, send others out of the room, pull the car over, turn off the music…  You must strategically choose your response to a common situation.

Ways to calm your child in the moment

Note:  the techniques are different for each child depending on their disorder and its characteristics.  Experiment to find out what works with your child’s typical patterns at home, in school, with others, and in other situations that are stressful for them.

In a steady voice, give them directions or requests to calm down.  You will need to repeat yourself periodically as they struggle with their inner storm.  If you ask them to move to another space or use their own calming, skills, use your body language to initiate the act.  If you ask them to take a deep breath, do it yourself.  If it helps them to punch a pillow, punch it yourself and hand it over.

2. Be your own cheerleader.

Silently think, “I can handle this;” “I’m the one in control;” “I am the calm upon the face of troubled waters…”  Have fun with it.

3. Give your child a calm place to go.

There’s nothing like a kid cave, or a blanket fort, a special garden spot, or other time-out space, even the car.  My personal favorite is a tree house.

4. Give them extra time to “change channels”

An anxious child or teen is stuck in a fear loop, and has great difficulty moving from one environment to another–something called “transitioning.”  Some typical transition problems occur when: coming home from school; getting out of the car after a long ride; going to bed after a stimulating activity; and waking up in the morning.  Plan extra time for transitions.  If they are too wound up but not hurting anything, wait them out.

5. Redirect their focus to physical action.

Draw attention to something to distract them in the moment (this is a useful kind of channel-changing).  A young child could be directed to a physical activity (draw, grapple with clay, throw a Nerf ball against the wall), a teen can be allowed to play their favorite music (if you hate it, have them use headphones, or you use earplugs, seriously.); shoot baskets; or take the dog for a walk.

6. Other supports

Animals heal, but strategically pick the best animals.  See “Animals that make the best therapy pets.”  Think of a calm smiling dog, a calm affectionate cat, or a little mellow animal like a hamster or turtle, and you’ve got pet therapists.  Energetic or barking dogs or scratchy kitties probably won’t work.

A big squeeze.  People and many kinds of animals are comforted with enveloping physical pressure, like a full hug.  I’ve completely wrapped anxious children and teens in a blanket or coat, and they quickly calmed down.  Teach your child the self hug… and hug yourself often, too!

You may be able to stop things before they start.  Once a situation has passed, ask yourself what happened just prior to your child’s episode.  Was there a trigger?  Did they just transition from one kind of place to another?  Do you have options for removing the trigger?  Triggering events can be so small or elusive that you miss it.  The child’s sibling could have sniffed or rolled their eyes without you noticing.  An object your child or teen reached for (like a remote control) could have just been unintentionally grabbed by someone else.  If you can identify the little frustrations that send them to the stratosphere and address them immediately, it will reduce the length of distress.

Calming your home for the long term

Calm your emotional self first and think Zen.  If you can take 5 minutes during a day, even a stressful day, sit quietly and breathe, and consciously work at eliminating all thoughts, ALL THOUGHTS, you would calm down.  Not thinking anything is the hard part of meditation, yet it is the skill that makes it work, and there’s proof.

Maintain bodily calm with the big three: exercise, sleep, and healthy diet.  I know you’ve heard this a million times already, but there’s good reason and proof.  If you can’t simultaneously maintain all three habits in your family, take one at time and you will still see benefits.

Calm the sensations that exist in your home environment.  Reduce noise, disorder, family emotional upheavals, and the intrusive stimulation of an always-on TV and other screen time, etc.  Create a place for quiet time in your home where anyone can go that’s contemplative, where people agree to behave as if they’re in a library, or a place of worship, or a safe zone.  Or create a time period for settling in, such as right after school, or right before dinner.

Did you know that psychiatric hospital units are designed to keep patients calm?  I’ve toured a number of psychiatric hospitals, and the best ones I saw had these elements.

  • Soothing visual environment:  they had windows and lots of light, plants, beautiful aquariums with gorgeous fish and lots of bubbles, and a TV screen with a film or a burning log.  All great for relaxation and brain-calming.
  • Soothing sound environment:  besides the bubbling aquarium, there was low-energy music of various styles.
  • Soothing physical environment:  soft furniture, a large table where people could gather in the comfort and buzz of a group, and nooks where people could remove themselves from the group buzz to avoid over-stimulation or listen to music on headphones.

Add these to your home too, or create a special calming room: Calming room ideas to prevent tantrums for kids with autism or other disorders.

Two things to avoid

1.  Do not communicate strong emotions in your voice.  What you say absolutely does not matter as much as how you say it!  Negative tone of voice is the only thing an upset child or teen will hear.  Yes I know, this is hard to control when you are excited or under stress! (Later on, after the incident, apologize for how you said something, but don’t apologize for an appropriate direction or request you made.)  Practice vocal neutrality.  Take a deep breath and an extra 2 seconds to squash the urge.  Which is better: “Will you please let the cat out?” versus “Will you PULLEEEEZ let the cat OUT!!!

2.  Don’t pressure the child to calm down when they’re not ready—it takes time for anyone to unwind.  Wait patiently while a child or teen works through ugly emotions and finishes spewing their ugly stuff.  Let them have their catharsis.  We all need to release our stuff, and we all need others to patiently listen and endure.

In my support group, I’ve observed that very stressed parents need at least one solid hour to vent and cry before they’re calm enough to benefit from other parents’ supportive words and sympathy.  They start out with ugly or devastating emotions–things they might not say to anyone outside the safety of the group–and eventually calm down and come to peace with their situation.  That’s when they are able to listen to the support and advice from other members.

–Margaret

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ABSTRACT – Mindfulness practice leads to increases in regional brain gray matter density
Britta K. Hölzelab, James Carmodyc, Mark Vangela, Christina Congletona, Sita M. Yerramsettia, Tim Gardab, Sara W. Lazara
Psychiatry Research: Neuroimaging,Volume 191, Issue 1, Pages 36-43 (30 January 2011)

Summary in plain English:  Meditation causes structural changes in the brain associated with memory, empathy, and stress, according to new research. Researchers examined MRI scans of participants over a period of 8 weeks. Daily meditation sessions of 30 minutes produced measurable changes in subjects with no previous meditation history. The anxiety and stress region of the brain, the amygdala, produced less gray matter. In a non-meditating control group, these positive changes did not take place.

“Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular, but to date little is known about neural mechanisms associated with these interventions. Mindfulness-Based Stress Reduction (MBSR), one of the most widely used mindfulness training programs, has been reported to produce positive effects on psychological well-being and to ameliorate symptoms of a number of disorders. Here, we report a controlled longitudinal study to investigate pre–post changes in brain gray matter concentration attributable to participation in an MBSR program. Anatomical magnetic resonance (MR) images from 16 healthy, meditation-naïve participants were obtained before and after they underwent the 8-week program. Changes in gray matter concentration were investigated using voxel-based morphometry, and compared with a waiting list control group of 17 individuals. Analyses in a priori regions of interest confirmed increases in gray matter concentration within the left hippocampus. Whole brain analyses identified increases in the posterior cingulate cortex, the temporo-parietal junction, and the cerebellum in the MBSR group compared with the controls. The results suggest that participation in MBSR is associated with changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.

Youth with mental disorders demand rights!

Youth with mental disorders demand rights!

Troubled young people have rights, and a national organization is there to support them. Youth M.O.V.E. (Motivating Others through Voices of Experience) offers peer support, social and educational support, and advocacy for youth with brain disorders.  The Oregon Chapterin  partnership with Portland State University, wrote  a Youth Bill or Rights for teens to young adults between ~16 to mid 20’s.  As you can see in the Rights document below, they believe youth should be allowed to guide their mental health treatment, and receive respectful, humane care.

“YOUTH BILL of RIGHTS  –  We believe that all youth should have the following rights in their mental health care:

1) Youth have the right to be leaders of their psychiatric treatment plans.

Youth should be informed of the possible side effects of medications, how long recommended medications take to go into effect, and the possible long-term effects of recommended medication. Service providers should work with youth to explore possible alternatives to using psychiatric medication before medication is given. Communication between youth and all medical providers should be collaborative, clear, and with limited use of medical terminology.

2) Youth have the right to evaluate their mental health services.

Mental health counselors, social workers, psychologists, and other service providers should provide opportunities for youth to evaluate the satisfaction of their services throughout the duration of care in a respectful and non-threatening manner. This includes evaluation of the relationship with the provider, counseling plans, and implemented treatment models.

3) Youth have rights to services that are as non invasive as possible.

When youth are transitioning into new services, mental health programs should strive to make the transition as accommodating as possible for the youth. Youth should be consulted on the ways they would like to end their relationship with the current provider and whether they would like the current provider to share their file with their new provider. Providers should share if there will be any changes in the costs of services and/or insurance coverage.

4) Youth have rights to get treatment from trained, sensitive providers.

Youth should have access to mental health professionals that are familiar with the unique needs and challenges of youth with mental health needs. All mental health professionals should have specialized training that fosters positive youth development and support. Youth mental health service consumers should be included in the creation and implementation of these trainings.”

This document was created and signed in 2009 by 30 mental health service-experienced youth gathered in Portland, OR, from the following states: California, Hawaii, Idaho, Illinois, Kentucky, Maine, Massachusetts, Missouri, Michigan, New York, North Carolina, Oregon, Texas, and Washington.  http://youthmove.us

 This list of rights is similar to the “Mental Health Consumer Rights” developed by adult mental health consumers, which is appended at the end of this article.

What do you think?  I say “bravo,” these are appropriate and necessary–anyone receiving treatment must be comfortable and safe with care providers, and treated with dignity and respect, period  But I’d like to see something similar for parents and caregivers, too, who also participate in treatment and need to feel respected and heard.

What does your teen or young adult child think?  Tell them about an opinion survey where they can comment and read other’s comments, http://mentalhealthyouthbillofrights.blogspot.com .

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Adult Consumer Bill of Rights – for adults in mental health service systems

  1. Information Disclosure:  Consumers have the right to receive accurate, easily understood information and may require assistance in making informed health care decisions about their health plans, professionals, and facilities.
  2. Choice of Providers and Plans:  Consumers have the right to a choice of health care providers that is sufficient to ensure access to appropriate high-quality health care.
  3. Access to Emergency Services:  Consumers have the right to access emergency health care services when and where the need arises.
  4. Participation in Treatment Decisions:  Consumers have the right and responsibility to fully participate in all decisions related to their health care.
  5. Respect and Nondiscrimination:  Consumers have the right to considerate, respectful care from all members of the health care system at all times and under all circumstances. An environment of mutual respect is essential to maintain a quality health care system.
  6. Confidentiality of Health Information:  Consumers have the right to communicate with health care providers in confidence and to have the confidentiality of their individually identifiable health care information protected.
  7. Complaints and Appeals:  All consumers have the right to a fair and efficient process for resolving differences with their health plans, health care providers, and the institutions that serve them, including a rigorous system of internal review and an independent system of external review.
  8. Consumer Responsibilities:  In a health care system that protects consumers’ rights, it is reasonable to expect and encourage consumers to assume reasonable responsibilities.

The federal Substance Abuse and Mental Health Services Administration (SAMHSA) established the Consumer Bill of Rights Workgroup to promote and implement the Presidential Advisory Commission’s Consumer Bill of Rights and Responsibilities in health care. http://mentalhealth.samhsa.gov/consumersurvivor/billofrights.asp

Yoga – Safe and effective for depression and anxiety

Yoga – Safe and effective for depression and anxiety

“Meditating, it makes you calm, and calm. Om.” Andre, 7

Yoga is being taught to and practiced by adults with mental and emotional disorders, including those who are developmentally disabled.  And relatively recently, it is being taught to children and teens with similar challenges.  According to people who suffer brain disorders, a session of yoga has more than physical benefits:

  • Improving mood, and increasing self-esteem and energy
  • Reducing anger and hostility, reducing tension and anxiety, and reducing confusion or bewilderment in developmentally disabled people

Yoga is simple:  a series of gentle poses, postures, stretches, and breathing and physical exercises that can be practiced by most people.  Yoga is safe and anyone can benefit for free.  And from 65% to 73%  report they have been genuinely helped by yoga practice.  Types of yoga used in treatment settings are Iyengar and Hatha yoga (poses and exercise), and Pranayamas (breathing exercises).  The specifics of these types of yoga are best explained in the articloes at the end of this article.

There are a number of research studies showing that yoga qualitatively improves mood as self-reported by adult psychiatric patients (on evidence-based survey instruments, see below).  But yoga has also been shown to help children and teens with serious mental and behavioral disorders.  It is currently being taught in schools for special needs children (ex: Pioneer School in Portland, Oregon) and in psychiatric residential treatment programs for children.

At the end of this post are excerpts from articles on the benefits of yoga for calming, easing anxiety, and reducing depression in children and adults.

For more information on the practice of yoga specifically for troubled and traumatized children and teenagers, there are two organizations that provide yoga classes to help young people feel better, function better, and support their recovery.

The Flawless Foundation – “Creates and supports programs that enrich the lives of children who courageously face challenges of neurodevelopmental and psychiatric disorders on a daily basis.”  http://www.flawlessfoundation.org/

Street Yoga – Street Yoga teaches yoga, mindfulness and compassionate communication to youth and families struggling with homelessness, poverty, abuse, addiction, trauma,  and neurological and psychiatric issues, so that they can grow stronger, heal from past traumas, and create for themselves a life that is inspired, safe, and joyful.   http://www.streetyoga.org/

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Study: Yoga Enhances Mood

Journal of Alternative and Complementary Medicine, August 20, 2010

Research confirms what many have suspected—that yoga has positive effects on mood over other physical activities. In a recent study of 2 randomized groups of healthy participants, it was found that the group that practiced yoga 3 times a week for an hour increased brain gamma aminobutyric (GABA) levels over the other group that walked 3 times a week for an hour.

Boston University School of Medicine (BUSM) researchers compared participants’ GABA levels on the first and final day of the 12-week study through magnetic resonance spectroscopic (MRS) imaging. With his colleagues, lead author Chris Streeter, MD, an associate professor of psychiatry and neurology at BUSM

Details available at: Streeter CC, Jensen JE, Perlmutter RM, et al. Yoga Asana sessions increase brain GABA levels: a pilot study. J Altern Complement Med. 2007;13:419-426.

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The effects of yoga on mood in psychiatric inpatients

Roberta Lavey, Tom Sherman, Kim T. Mueser, Donna D. Osborne, Melinda Currier, Rosemarie Wolfe

Psychiatric Rehabilitation Journal, Volume 28, Number 4 / Spring 2005

Abstract

The effects of yoga on mood were examined in 113 psychiatric inpatients at New Hampshire Hospital.  Participants completed the Profile of Mood States (POMS) prior to and following participation in a yoga class.  Analyses indicated that participants reported significant improvements on all five of the negative emotion factors on the POMS, including tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia, and confusion-bewilderment.  There was no significant change on the sixth POMS factor: vigor-activity.  Improvements in mood were not related to gender or diagnosis.  The results suggest that yoga was associated with improved mood, and may be a useful way of reducing stress during inpatient psychiatric treatment.

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Practitioners using yoga therapy to mend bodies and spirits (excerpt)

By Michelle Goodman, The Seattle Times, January 11, 2006

As Tisha Satow stretches into the standing yoga pose known as Warrior II, she encourages her student Shaun, clad in sneakers, jeans and a Seahawks T-shirt, to adjust his feet.  Across from Shaun, fellow yogi Susan, who travels with a baby stroller occupied by three teddy bears, grips a metal folding chair for balance.

Welcome to yoga therapy, one of the newer recreational activities available to clients of Seattle Mental Health on Capitol Hill. Shaun and Susan, adults who live in group homes and are diagnosed as both developmentally disabled and mentally ill, are regulars in this class, taught weekly by Satow or one of her co-workers at the Samarya Center, a Seattle nonprofit organization devoted to providing yoga to everyone it can, regardless of health issues or finances.

What is yoga therapy? Simply put, it’s the adaptation of yoga breathing, stretching, even chanting techniques to help people with health issues alleviate pain, gain energy and basically feel a heck of a lot better. Who can benefit from it? Anyone from typical backache sufferers to the terminally ill.

“Science is beginning to catch up to this, is beginning to validate this,” says John Kepner, director of the International Association of Yoga Therapists, which has about 1,400 members worldwide.

For the Seattle Mental Health clients, who often attend less glamorous classes such as anger management and checkbook balancing, yoga seems a breath of fresh air. Shaun, who’s shy yet quick to share a laugh with his classmates, says he likes the stretching best. And Susan, who calls yoga “fun” and likes that it gives her a chance to “see people,” shows off her biceps after class so instructor Satow can feel how strong she’s getting.

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Yoga as a Complementary Treatment of Depression:  Effects of Traits and Moods on Treatment Outcome  (excerpt)

David Shapiro; Ian A. Cook; Dmitry M. Davydov; Cristina Ottaviani; Andrew F. Leuchter; Michelle Abrams

Abstract

Our preliminary research findings support the potential of yoga as a complementary treatment of depressed patients who are taking anti-depressant medications but who are only in partial remission.  In this study, participants were diagnosed with unipolar major depression in partial remission.  They took classes led by senior Iyengar yoga teachers.  Significant reductions were shown for depression, anger, anxiety, neurotic symptoms and low frequency heart rate variability.  Of those in the study, 65% achieved remission levels post-intervention.  Yoga is cost-effective and easy to implement.  It produces many beneficial emotional, psychological and biological effects, as supported by observations in this study.

Iyengar yoga classes typically involve sitting and standing poses, inversions (head stand, shoulder stand), breathing exercises (pranayama) and short periods of relaxation at the end of each class (savasana–corpse pose).  An important feature of participation in Iyengar yoga is sustained attention and concentration.  Iyengar theory and practice specifies asanas (poses, postures, positions), and certain asanas have been found to enhance positive mood in healthy (non-depressed) participants.

Previous research on the effects of yoga on mood in non-depressed healthy subjects, suggests the potential of yoga for use in the management of clinical major depression.  In a form of yoga (Hatha Yoga) that has a strong exercise dimension much like Iyengar yoga, subjects reported being less anxious, tense, angry, fatigued and confused after classes than just before class.

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How Hatha Yoga saved the life of one manic depressive.  (excerpt)

By: Amy Weintraub ; Psychology Today Magazine, Nov/Dec 2000

When Jenny Smith was 41 years old, her mental illness became so severe that she could barely walk or speak.  After days of feeling wonderful one moment and hallucinating that spiders and bugs were crawling on her skin the next, she landed in the hospital.

Smith is a victim of bipolar disorder, an illness characterized by oscillating feelings of elation and utter depression.  And though she had tried 11 different medications for relief, some in combination, nothing seemed to work.  Upon leaving the hospital, Smith was told that she could expect to be in and out of psychiatric hospitals for the rest of her life.  Soon after her release, Smith decided to learn Hatha yoga, which incorporates specific postures, meditation and Pranayamas, deep abdominal breathing techniques that relax the body.  As she practiced daily, Smith noticed that her panic attacks—were subsiding.  She has since become a certified hatha yoga instructor, and with the help of only Paxil, Smith’s pattern of severe mood swings seems to have ended.

Key to reaping Hatha yoga’s mental benefits is reducing stress and anxiety.  To that end, Jon Cabot-Zinn, Ph.D., of the University of Massachusetts, developed the Stress Reduction and Relaxation Program (SRRP), a system that emphasizes mindfulness, a meditation technique where practitioners observe their own mental process.  In the last 20 years, SRRP has been shown to significantly reduce anxiety and depression, and thus alleviate mental illness.

Research conducted by the National Institute of Mental Health and Neuroscience in India has shown a high success rate—up to 73 percent—for treating depression with sudharshan kriya, a pranayama technique taught in the U.S. as “The Healing Breath Technique.”  It involves breathing naturally through the nose, mouth closed, in three distinct rhythms.

According to Stephen Cope, a psychotherapist and author of Yoga and the Quest for the True Self, “Hatha yoga is an accessible form of learning self-soothing,” he says.”  Yoga students may also benefit from their relationship with the yoga instructor, Cope said, which can provide a “container” or a safe place for investigating, expressing and resolving emotional issues.

My son has the problem, yet the therapist focuses on me, huh?

My son has the problem, yet the therapist focuses on me, huh?

Question:   My son’s therapist keeps telling me what to do, or that I’m not doing the right things at home.  But my son is the one with the problem, why all this focus on me?

Answer:
   You could be the problem or the therapist could be the problem.  You are working hard to manage a difficult situation, and you clearly care about your son because you are bringing him to therapy, but your own stress and exhaustion may look like you’re the one with the behavior problem.  My guess is that the therapist is trying to tell you how to change your parenting or communication style to reduce your son’s stress and better manage his issues.  This is a hard message to take when you know you’re doing everything you can, and you’ve been put through a lot by a difficult child.

Someone who doesn’t know me is telling me I’m not good enough?  What?

How can you tell it’s the therapist with the problem?

  • One problem I’ve seen with therapists is that they often don’t know how to talk to parents about parenting issues without sounding like they are making presumptions and blaming the parent for the child’s problems.  Everyone loves to blame the parents.
  • Some therapists put themselves in the child’s shoes.  That’s why they got into child therapy in the first place, they love children!  Yet pro-child therapists put their emotional biases in the mix to protect your child from you.  This ridiculous attitude is changing, thankfully. The mental health profession has begun to realize how critical the family is for the child’s treatment.
  • The worst situation is when a therapist embarrasses you or blames you in front of your child.  That’s grounds for firing them!  You may indeed need parenting guidance, but you should never have someone undermine your authority.
  • Another problem is when a therapist doesn’t have children, or doesn’t have troubled children.  They feel too confident in their abilities and don’t know what it’s like living with a troubled child 24/7, so they make assumptions and you constantly feel you need to defend yourself.

A good therapist or doctor will show compassion for a stressed parent, listen to their side of the story, and help the parent feel understood and believed.  Then they will take the time to explain exactly what the parent might do differently at home and why.

You should leave every meeting feeling better about yourself and child.

Try giving this therapist a chance first, and ask him or her if you can meet them without your son, and request that they fully explain their advice.  Let them know that this has been hard for you and you’ve felt blamed, and that you need their support.  Then listen carefully.  If you’re still not convinced of their point, ask them if there’s a book or a website or support group for you (it’s easier to accept advice from other parents who’ve learned from their mistakes).  If you feel that you can’t work with this therapist, consider finding someone who takes a better approach to you and your situation.

You and your child have to “click” with a therapist or doctor, or they can’t help you.

Parent to Parent Guidance

Parent to Parent Guidance

Margaret Puckette is a Certified Parent Support Provider, and assists parents on how to effectively raise their troubled child. She believes parents need realistic practical guidance for family life and school, not just information about disorders. Margaret has mentored families for over 20 years. She is an author & speaker, and knows from personal experience there is reason for hope.

You Can Handle This.

You Can Handle This.

You are not alone. It's 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.
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