Helping Your Family Adjust to A Divorce

Helping Your Family Adjust to A Divorce

Divorce can be a devastating event for an entire family. Yes there is the financial cost of a divorce, but there is also the impact that a divorce has on a family especially the children. Many children that I have worked with feel like their entire world has been turned up side down. Also for children they don’t feel the divorce has ended after it is finalized in court.

For many children the divorce is just beginning. They now have to adjust to their parents living in separate houses, visitation schedules, often parents continue to fight even though the divorce is final and many children feel they need to choose a side. They feel a pull by their parents and extended family to take a stand as who was right and wrong in the divorce.

Another thing is children have to learn how to cope with is seeing their parents with someone else. Often parents start dating soon after a divorce and a child or teenager have to adjust to seeing Dad or Mom dating someone else. They are not use to thinking about their parents having intimate relationships. This concept is very often something very difficult for teenagers to adjust to.

As a result of all of these changes, many teenagers may act out. They may start getting into trouble at school or their grades may significantly drop. They may start arguing with their parents and they may refuse to cooperate with the visitation schedule. Some of the teenagers I have worked with also start to drink, smoke marijuana or use other drugs so they don’t have to think about the divorce. Also some teens may start to be sexually active and make it obvious to their parents so Mom and Dad have to deal with the same strange thoughts and feelings they have to deal with when their parents date.

Yes divorce is not easy and no matter how you approach it, a divorce is upsetting to everyone. However, how Mom and Dad handle the divorce process and the adjustment period after a divorce can make a major impact on how their children and teenagers are affected.

To begin with, during the divorce and after the divorce, parents should not discuss any facts pertaining to the divorce settlement with their children. Also neither parent should be saying negative things about the other parent to the children. You may be divorcing each other, but that is still your child’s Mom or Dad. Furthermore, both parents need to speak to their family and make sure grandparents understand not to put down the other parent or tell the kids details about the divorce.

If you need to talk to your children about the divorce, do so in an age appropriate manner and only tell them what they need to know. For example, if the house needs to be sold obviously the children need to be told. If children are asking questions about things that are inappropriate such as about the finances, let the children know that is an issue just between Mom and Dad. Also reassure them that no matter what happens that Mom and Dad will make sure they are taken care of and you understand the divorce is scary but Mom will still be their Mom and Dad will still be their Dad. Let them know both of you will take care of them and they don’t need to worry.

Obviously after the divorce is an adjustment period and learning period for everyone. This period can be easier if you work together as a team and co-parent. Trying to have similar rules at both houses help. Also backing up each other helps. So if a child is talking disrespectfully about Mom or Dad, the other parent lets their child know that will not be tolerate that they are still their Mom or Dad and they need to respect them.

If they are having issues at school such as poor grades or cutting school again if you work together as a co-parent team, you can help the teen accept the divorce and help resolve the school issue.

If you suspect your teen is drinking, smoking or using other drugs, again the most effective is if you function together as a co-parent team. By doing so you reinforce that you have not stopped being their parents, you have just stopped being married to each other. Also by acting together as a team you have a better chance of your teenager cooperating with treatment. If they can see that the two of you still disagree and argue about most issues, they will use this to their advantage. They will try to play the two of you against each other. And they will play the two of you against each other anytime they want something. The end result is the two of you spend more time arguing than you need to, probably more money on attorney bills and your children do not get the structure from the two of you that they need.

Now, as for the issue of you dating. You are both adults, no longer married so you have a right to see someone if you want. If you have children, just use common sense when you decide to date. The children will be spending time with Mom or Dad during their visitation time. Therefore, when you don’t have the kids that is the perfect time to go out with someone. I would suggest not mentioning to your children or introducing your children to anyone you are seeing until you are sure this is a serious relationship. If you introduce your children to someone you have only been seeing for two weeks and then you end the relationship two weeks later it feels strange and awkward to your children. Remember, most children don’t think or don’t want to think about the fact that their parents have sex.

This brings up the issue of having someone spending the night or spending the night at someone else’s house. As I stated above, the children will be spending time with the other parent during visitation. Therefore, when you do not have the children it is fine to have an overnight guest. Besides the fact children don’t want to know anything about their parents having sex, if you have a teenager, you could be creating a problem. If you are having guests spend the night, what do you do when your 16 year old son announces that his girlfriend is spending the night? You say no, but he argues you do it. Yes you are an adult and its different, but there is no need to take that risk. Also as that parent it is your responsibility to be the role model.

Basically, while a divorce is difficult on everyone and there is an adjustment period after, if you and your ex-spouse treat each other with respect and work together as a parenting team, you can minimize the stress and anxiety on your children. Remember, the children had no involvement in you deciding to divorce or what happened during the divorce or the decisions that were made. Therefore, as their parents it is your responsibility to help your children adjust to the divorce.

Dr. Michael Rubino has over 20 years experience working with teenagers and working with high conflict divorces. For more information about Dr. Rubino’s work or private practice visit his website http://www.RubinoCounseling.com or on Twitter @RubinoTherapy.

Healthy Communication Patterns for Family

Healthy Communication Patterns for Family

As a psychotherapist who treats teenagers, I often hear from parents how they feel they are always arguing with their teenagers. We must remember that a teenager’s brain is not fully developed. The prefrontal cortex is still developing in teenagers. This part of the brain is responsible for reasoning and other executive functions. Therefore, while teenagers look mature enough to have a reasonable conversation, their brains may not be mature enough therefore they are more likely to argue. However, an argument is not always bad. There are ways to have a healthy argument and ways to have destructive, hurtful arguments. Most of us never learned how the have a healthy, reasonable disagreement with another person.

Another common issue regarding communication is fighting or disagreements. Many people feel that a disagreement or fight is always a bad thing for a relationship. However, this is not true. If you handle a disagreement or argument fairly, it can be a very healthy thing for a relationship. It can help you overcome past miscommunications or help you to resolve a problem.

As I stated above, parents who are dealing with teenagers need to remember that for teenagers their Frontal Lobes in their brains are still developing. Therefore, they cannot always reason like adults and often have difficulties having fair disagreements. I have included a list by TherapyAid.com which explains fair fighting rules.

Yes this might sound odd, but you can have a disagreement that is fair. You do not always need to use insults or not listen to each other. By using these rules, you and your teenager may be able to resolve an issue or at least come to an understanding without saying things that will hurt one another.

Parents what I suggest is that you sit down with these rules with your teenager and discuss that you would like to start to using these rules in your family. Take the time and go over each rule so you both understand the rules. Also make a copy for yourself to keep, your teen to keep and a copy to put on the refrigerator to remind everyone. Remember, these rules will be a change for both of you so don’t be surprised if it takes you some time to get use to these rules and use them on a regular basis. Change usually never occurs over night.

While these rules are beneficial for parents and teenagers, these rules are also useful for couples. Very few people in our society were brought up learning how to clearly communicate. Just look at how many arguments occur due to miscommunication if you need proof. For couples I would recommend the same steps as parents and teens. First sit down and go over the rules so you both have the same understanding of the rules and keep a copy for yourselves. The next time you have a disagreement practice using these rules. Keep practicing until you become comfortable using these rules.

Fair Fighting Rules

1. Before you begin, ask yourself why you feel upset.

Are you truly angry because your partner left the mustard on the counter? Or are you upset because you feel like you’re doing an uneven share of the housework, and this is just one more piece of evidence? Take time to think about your own feelings before starting an argument.

2. Discuss one issue at a time.

“You shouldn’t be spending so much money without talking to me” can quickly turn into “You don’t care about our family”. Now you need to resolve two problems instead of one. Plus, when an argument starts to get off topic, it can easily become about everything a person has ever done wrong. We’ve all done a lot wrong, so this can be especially cumbersome.

3. No degrading language.

Discuss the issue, not the person. No put-downs, swearing, or name-calling. Degrading language is an attempt to express negative feelings while making sure your partner feels just as bad. This will just lead to more character attacks while the original issue is forgotten.

4. Express your feelings with words and take responsibility for them.

“I feel angry.” “I feel hurt when you ignore my phone calls.” “I feel scared when you yell.” These are good ways to express how you feel. Starting with “I” is a good technique to help you take responsibility for your feelings (no, you can’t say whatever you want as long as it starts with “I”).

5. Take turns talking.

This can be tough, but be careful not to interrupt. If this rule is difficult to follow, try setting a timer allowing 1 minute for each person to speak without interruption. Don’t spend your partner’s minute thinking about what you want to say. Listen!

6. No stonewalling.

Sometimes, the easiest way to respond to an argument is to retreat into your shell and refuse to speak. This refusal to communicate is called stonewalling. You might feel better temporarily, but the original issue will remain unresolved and your partner will feel more upset. If you absolutely cannot go on, tell your partner you need to take a time-out. Agree to resume the discussion later.

7. No yelling.

Sometimes arguments are “won” by being the loudest, but the problem only gets worse.

8. Take a time-out if things get too heated.

In a perfect world we would all follow these rules 100% of the time, but it just doesn’t work like that. If an argument starts to become personal or heated, take a time-out. Agree on a time to come back and discuss the problem after everyone has cooled down.

9. Attempt to come to a compromise or an understanding.

There isn’t always a perfect answer to an argument. Life is just too messy for that. Do your best to come to a compromise (this will mean some give and take from both sides). If you can’t come to a compromise, merely understanding can help soothe negative feelings.

Again, this might seem simple to some people, but communication problems are one of the biggest problems I encounter as a psychotherapist. We simply don’t educate children about clear communication, which creates problems when these children become adults and try to talk with each other. So don’t be embarrassed or assume you do not need help in this area. Simply read the rules and try them in your life and see what happens.

Dr. Michael Rubino is a psychotherapist with over 20 years experience and he specializes in treating teenagers, children and families. For more information regarding his work or private practice visit his website at www.rubinocounseling.com or his Facebook page at www.facebook.com/Drrubino3 or follow him on Twitter @RubinoFamily.

Coco Loco A New Teenage Drug

Coco Loco A New Teenage Drug

Coco Loco is the new way teenagers have found to get a high. This product just entered the United States. It is not being marketed as a drug so the FDA has no authority over it. Teens assume it is safe because it is chocolate and natural.

Since this substance is so new, I have included a link that you can look at so you are more familiar with this substance. https://youtu.be/MV6QIsqA_f4

While chocolate is one ingredient it also includes ingredients common in energy drinks so the person feels a burst of energy. What is the problem? Since this is not regulated, there is no way to determine the amount of caffeine or other substances used to increase your heart rate are in it. Therefore, if a teen has been drinking a number of energy drinks and then snorts Coco Loco, they won’t know if they have had too much until it is too late.

Increasing your heart rate can be dangerous. Most people who do cardio exercises take their heart rate to make sure their heart rate is in a safe zone and not too fast. When a person’s heart rate is too fast, they can have a heart attack or a stroke just to mention some of the physical dangers. Also if a person ingest too much caffeine they can cause themselves to have a psychotic episode.

The problem with Coco Loco is since it is marketed as “natural” it does not have to comply with the labeling or health codes that substances considered as medical have to follow. If you go to a store such as GNC that tends to sell products to help lose weight or improve your energy level, you will find many of the items do not list ingredients or health warnings. By law they do not have to.

So the problem is that many teenagers may assume this product is totally safe when it is not. The problem is that they may discover this when their hear is beating 200 beats a minute and their health is at risk or they have had too much caffeine and find themselves waking up in the psychiatric ward of a hospital because they had a psychotic episode.

So parents, take a few minutes and discuss Coco Loco with your teenagers. In fact, discuss it with any of your children who are going to school. There is no age restriction on who can buy it and children may not hesitate to try it because it is chocolate. Explain the difference and the risks so they can make a good choice.

Dr. Michael Rubino has over 20 years working as a psychotherapist treating children and teenagers. For more information regarding Dr. Rubino’s work or private practice visit his website at www.RubinoCounseling.com.

Children Are Not Messangers

Children Are Not Messangers

As a child psychotherapist, I hear from many parents about their concerns for their child when there is a divorce. A divorce is a stressful event on the entire family including the children. However, there are ways parents can reduce the stress, but they do not. The most common mistake I see is using the child as a messenger.

Many divorces are hostile and neither parent wants to speak to the other one. However, when you have children, you must speak to each other. You need to co-parent which means communicating with the other parent. You do not have to talk about your lives or even be friends. However, you must communicate with the other parent about issues involving your children. You need to provide each other with information about school, your child’s health, if they have an activity coming up, etc. Basically, anything that involves your child.

However, I see many parents choose to use the child as the message carrier. They tell the child do not forget to tell your father to look at your homework or tell your mother to look at the note regarding your school conference. Many of these children are 10 years old so they forget or get the message wrong and then there is a big fight. The child blames themselves because if they did not forget, there would be no fight.

This is a great deal of responsibility to put on any child at any age. When parents use their child as a messenger, at times children feel they have to take sides or protect a parent. They know mom and dad do not get along and they will do anything to decrease the fighting. So if they have a message that might upset dad, they will worry about it and try to solve the issue so they do not have to give dad the message. The children I see in this situation are very anxious and resentful. They are mad that mom and dad got a divorce and now they feel they have to keep the peace between their parents.

When children are older such as 12 or 13 years old, they may start to act out. They may start using marijuana or alcohol as a way to escape. They also may start to make parenting decisions on their own. They feel if I have to carry the information back and forth, I might as well decide for myself. This can really hurt the relationship that a child has with one parent or both.

What is the solution? Parents, you need to communicate with each other directly and not use your child. The two of you divorced not your child. No one asked them and they should not have to take responsibility for any divorce issues. Also you really cannot get mad at the child for make parenting decisions, if you are putting them in the middle. You can go to co-parenting classes or co-parenting therapy to help the two of you with communication issues. You can also use email. Many Court systems have an email service you can subscribe to so you know messages are delivered. In Contra Costa County they call it the family wizard.

The main point is you can stop being married but you cannot stop being parents. It is important to remember this fact and set up a co-parenting plan during the divorce process not after. Trust me your children will thank you for it.

Dr. Michael Rubino specializes in treating children and teenagers and in high conflict divorces. He has over 20 years experience. For more information about Dr. Rubino’s work or private practice visit his website at www.RubinoCounseling.com.

Ideas to Help Make Visitation Easier On Children

Ideas to Help Make Visitation Easier On Children

After a divorce there are still issues to address. One of the major issues is child custody and visitation, especially exchanges for visitations. The issues usually are addressed in the divorce settlement and the Court Mediation report. However, even though the Mediation Agreement attempts to address these issues, there are usually still issues.

I have parents who are divorced come in very often arguing about issues that occur during visitation exchanges. A majority of times these issues are addressed by the Mediation Agreement. However, many parents are still fighting with each other after their divorce is final. Typically I see this when one or both parents are not ready to let go of each other yet. Arguing over the visitation exchanges is a way to still keep them in contact with each other. However, parents do not pay attention to the price the children are paying. By focusing on visitation exchanges this puts the children in the middle of the divorce.

By focusing on visitation and putting the children in the middle of the divorce, I see children who become depressed and anxious. Often these children start acting out at school and home and their grades start to decline. Also many of these children often start drinking or using marijuana so they can numb themselves out and ignore their parents’ arguments. Most of these children ask me, why can’t they just stop fighting? They are already divorced, what else do they want?

Goldberg Jones is a very good divorce attorney who writes articles regarding issues related to divorce and how these issues impact the children and the family. He wrote a very good article regarding visitation exchange issues. I found the suggestions very good and helpful. I would recommend that divorced parents read these ideas and try them. Therefore, I have included them in this article for you to review and try. You have nothing to lose by trying and you could help reduce the stress your children experience with visitation. You may also reduce your stress and frustration and allow yourself to let go of the marriage and move on with your life.

How often visitation issues occur often depends on the custody agreement, parenting plan, and the visitation schedule. Visitation may be a couple of times a week, once a month, or only around major holidays, but it’s likely going to be a repeating event. Also how well the parents work together as co-parents and allow the divorce issues to be past issues plays a major role in determining if visitation goes easily or is a source of ongoing arguments.

In the best of times, even if both parents can be civil, custody exchanges will probably still be a little awkward. In less amicable scenarios, prepare for outward hostility that resembles the opening scene in Saving Private Ryan. Pack a helmet and prepare to duck.

In more combative circumstances, it helps to have a strategy in place to keep things civil. That’s easier on everyone, especially the kids. There are ways to cut down the amount of face time and limit the friction. It may never be easy or ideal, but it helps with stress level and peace of mind, for both the parents and the children—no kid wants to watch mom and dad fight.

1. CUSTODY EXCHANGES AT THE BABYSITTER’S

In contentious situations, the more you see your ex, the more potential there is for friction and conflict. Sometimes it’s simply best not to see each other if you can avoid it. There are practical ways to circumvent this. One common approach is to make custody exchanges at a babysitter’s house or at daycare.

One parent drops the kids off and the other parent picks them up. If you schedule it right, the two of you may almost never come face-to-face. Because there are other people involved, you may encounter scheduling hurdles. Clear communication about who is picking up the kids and when is key. But once you iron out the kinks, this strategy helps limit contact and potential fights.

2. CUSTODY EXCHANGES AT SCHOOL

Similar to using daycare to facilitate custody exchanges, you can use your child’s education to the same end. Again, one parent drops the kids off at school in the morning while the other picks them up after. This has the desired effect of not having to see your ex more than is absolutely necessary. It can be useful in situations where parents are prone to fighting.

Like with the child care, you’ll need to arrange this with school administrators. Schools like to know they’re handing kids over to right people. But if there is clear communication between all the involved parties, it’s possible to make these arrangements work.

3. CUSTODY EXCHANGES IN PUBLIC

Many people want to avoid causing a scene in public. If you and your ex can’t handle custody exchanges without fighting, consider meeting in a public place. Choose a neutral spot where neither parent is likely to start a ruckus. If such a place exists. In some situations, nowhere is off limits, but being exposed often encourages both parties to be on their best behavior.

Where depends a great deal on the people involved. Pick a centrally located park. The mall, a restaurant, or a coffee shop where you know the regulars are all options. Extreme cases may call for supervised visitation centers or even a police station. Then again, if you just kind of rub each other the wrong way from time to time, a supermarket parking lot may work fine.

4. INVITE A THIRD PARTY WITNESS

While people are reluctant to fight in public, they’re also often hesitant to start trouble in front of friends or acquaintances. One strategy that can smooth over problematic custody exchanges is bringing along a third party. A mutual friend or even authority figure can help keep the peace, especially if it’s someone who knows both parents.

If there are individuals both of you maintain a relationship with, that might be the ideal fit. This approach often serves to calm down heated emotions. And if things do escalate, having a witness never hurts.

If you do go this route, it’s important to give some thought to who you bring along. If you have a new spouse or significant other, consider the ramifications of their presence. Is that going to touch on a sore spot and ignite lingering resentment? In some situations, it might be best to ride solo instead of risking a potential fight.

5. COMMUNICATE VIA ALTERNATE MEANS

Visitation, overnights, and custody exchanges often become logistical tangles. With football games, school plays, robot camp, and the many other activities children participate in, scheduling gets complicated. Pulling it off requires regular communication. If there are problems in this area, conflict often arises. When it involved kids, some level of contact must exist. Fortunately, there are alternative means of communication.

You may have mutual friends or family members willing to serve as go-betweens. Though it tends to get expensive fast, enlisting a lawyer or mediator is another potential strategy.

Thanks to modern technology, you have more outlets than ever before. If you can’t talk on the phone or in-person, email, texting, instant messaging, and other online options exist. Websites like Our Family Wizard provide shared scheduling services and online tools for co-parenting. There are even numerous smartphone apps for tracking parenting schedules and children’s activities. 6.

6. PREPARE FOR CUSTODY EXCHANGES AHEAD OF TIME

Preparation in advance of custody exchanges is key. The more prepared you are, the faster and smoother they’ll go. Before your ex picks up the kids, take the time to gather everything they need for this particular stay. Whether it’s a quick overnight or a two-week vacation, make sure to gather the essentials.

Did you pack all of the regular medications they take? Do they have all the school books they need to get their homework done? That report on the solar system isn’t going to write itself. If your daughter has a baseball game, pack the mitt and cleats. If your son can’t sleep without his special stuffed zebra, it needs to make the trip. Knowing you have everything set reduces the amount of time you have to interact with someone you’d rather not see.

Think about what the kids can’t live without and send it with them. Otherwise, you risk a middle-of-the-night call or visit from your ex. If the goal is to limit the amount of contact, that defeats the purpose, doesn’t it?

After a divorce, it may be quite some time before you want to see your ex again, if ever. But when you have kids, that’s not really an option. Custody exchanges can be tough, but it’s something you have to deal with.

For the sake of the kids, for their well-being—as well as your own—it’s important to try to make these encounters as smooth and painless as possible. Have a plan, be efficient, and keep your seething emotions in check for a few minutes. Hopefully, that’s all you’ll need. Taking steps to limit conflict in a custody exchange is healthier for everyone involved.

If you have questions about child custody or parenting plans, feel free to contact Goldberg Jones at his San Diego office.

I think these are all very valid points and important issues to consider and feeling that often occur during and after a divorce. I often recommend the same approach and encourage parents to consider the same issues in regards to their children and themselves. Divorce is a very painful experience even when it is handled well and with respect for each other. However, the truth is most children I see for divorce issues are because their parents are still hurting so they children sense it and take on the family pain trying to solve it. So please try these ideas.

Dr. Michael Rubino has over 20 years experience treating children and teenagers. He is an expert in treating children who are involved in a high conflict divorce. For more information regarding Dr. Michael Rubino or his practice visit his website at www.rcs-ca.com or www.rubinocounseling.com or Facebook page at www.facebook.com/drrubino3.

Should I Have My Child Evaluated for ADHD?

Should I Have My Child Evaluated for ADHD?

Schools have been in session typically since September, and many parents have been receiving reports from their child’s teacher that will cause them to ask, “Does my child have ADHD?” I hear this very often and do many assessments on children to determine if a child has ADHD. Yes ADHD is a really disorder, but too many teachers and schools rush to the conclusion that a child has ADHD and needs medication.

According to statistics by the American Psychological Association, five percent of children in the United States have ADHD. It is also more common in males and it does tend to run in families. However, not every child who has ADHD requires medication. Many children can be treated with psychotherapy and behavior modification. Therefore, if your child is diagnosed with ADHD do not rush to medicate your child. There are different subtypes of ADHD and different severities of the diagnosis.

If you feel your child may have ADHD or their school suggests the idea, make sure you have your child appropriately assessed by a professional who specializes in ADHD. In the past schools would often diagnosis children with ADHD. Schools are no longer supposed to make this diagnosis. If they feel a child might have ADHD, they are supposed to have your child evaluated. Many parents take their child to their pediatrician, however, many pediatricians are not trained in diagnosing ADHD. I would suggest having your child evaluated by a mental health clinician trained in working with children and in assessing for ADHD.

As I stated above, if you are going to have your child evaluated for ADHD, make sure you take your child to a mental health clinician who specializes in children and in doing assessments. The assessment for ADHD is not very difficult and an appropriate evaluation by an appropriate mental health clinician should cost around $250 depending on where you live. I have seen some parents who have spent thousands of dollars getting CT scans, MRIs and PET scans. You do not need an expensive scan of your child’s brian to diagnosis ADHD.

The DSM V, the diagnostic manual that mental health clinicians use, list the criteria needed for the diagnosis. I am including a link to the Center for Disease Control which list the criteria for the diagnosis and other information about ADHD, http://www.cdc.gov/ncbddd/adhd/diagnosis.html. Typically the diagnosis can be made by a clinician interviewing the parents, having a play session or two with the child and observing the child at school or consulting with the teachers. However, remember if you are going to have your child evaluated for ADHD, you want a mental health clinician who specializes in treating children and assessing children for ADHD. Your child’s pedestrian should be able to refer you to someone or if you call your insurance they will probably have referrals.

Before you rush to have your child assessed, remember some basic facts. Most children between the ages of two to five are very active. They also have very short attention spans. Sometimes you need to give a child some time to mature especially if you have a boy. Remember boys mature slower than girls and tend to be more active than girls. It is important to keep these facts in mind when you are wondering if your child has ADHD.

Now if you child is more hyperactive than other kids his age or his attention span is shorter than most kids his age, there might be an issue. Also if there is a strong family history of ADHD in the family such as his father had ADHD as a child and paternal and maternal uncles all had ADHD as children, there might be an issue. Also if your child was born premature or there were complications during the pregnancy or child birth, there might be an issue. Premature babies or babies with a difficult pregnancy or birth are more likely to have ADHD and learning disabilities.

Bottom line, if someone suggests that your child has ADHD don’t rush to the pedestrian seeking medication. Compare your child’s behavior to other children and consider the risk factors. If your child doesn’t have many risk factors for ADHD maybe wait six months and reassess the situation. The most important thing to remember is if you decide to have your child assessed for ADHD, make sure you go to a mental health clinician who specializes in children and ADHD. You want a mental health clinician who specializes in treating children with ADHD and assessing children for ADHD. Also remember you do not need any expensive scans like a CT scan. There are other treatment options besides medication, so do not rush to medicate your child either. Consider all the treatment options.

Dr. Michael Rubino specializes in treating children and assessing children. He has over 20 years experience treating and assessing children and teenagers. For more information about Dr. Michael Rubino’s work visit his website at www.rcs-ca.com or his Facebook page http://www.Facebook.com/Drrubino3

Condom Snorting

Condom Snorting

“Condom Snorting” is a new dangerous trend in teenagers. They first snort the condom up their nose and then try to pull it out of their mouth. This can cause choking, allergic reactions to the latex and other health problems.

This trend is similar to the trend where teenagers are swallowing Tide Pods. While both trends may seem odd to adults, parents need to remember that the prefrontal cortex of a teenager’s brain is not fully developed. This part of the brain is responsible for reasoning and risk assessment. Since it is not fully developed yet in teenagers, they are prone to taking risks.

I have included a link to a story done by ABC 7 News in San Francisco which details this new teenage trend. http://abc7.com/3296850/ via @abc7.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers. For more information about Dr. Rubino and his private practice visit his website http://www.RubinoCounseling.com.

Teenagers and Cellphones

Teenagers and Cellphones

In today’s society many people including teenagers view cell phones as a necessity of life. However, cellphones are a privilege not a necessity. We need to remember that fact.

In a couple of weeks many students will be starting Middle School and moving on to High School. Many of those students, who do not have cellphones, will be asking for Smartphones. For those students who have Smartphones many will be asking for better Smartphones. Many teens feel they are entitled smartphones and cannot live without one.

Many people have forgotten that cellphones are privileges especially teens and children in Middle School. This is a common argument I encounter between children and parents. The other argument that is common between parent and children is how much and where the cell phone is being used. Teens basically accuse parents of child abuse if they say no to a phone or if the parent set limits. You are not being abusive, you are being a responsible parent. Remember being a parent is not a popularity contest. You need to do what you feel is best for your child.

Parents if you stop and think about it, why does an 11 year old child need an IPhone 7? They do not need to track mileage or expense accounts nor do they remember their own appointments. There is really no reason they need a Smartphone.

Smartphones are an area where technology has moved faster than our ethics. If you think about it, IPhones and Smartphones were not around in the year 2000. Now everyone including a majority of teens have an IPhone or Smartphone. In my opinion an adolescent does not need a cellphone until they enter Middle School and at that point all they need is a basic cellphone. They need a basic phone so they can check-in with you if their plans change or if they feel they are in need of help.

As I stated above, there is no reason that a teenager really needs a Smartphone. They are not taking care of a family nor are they running a business. Therefore, a basic cellphone should be adequate for what they need it for. I understand that given the way our society has changed some parents may find that it is helpful to their family if a child in middle school has a cellphone. This is a decision that every parent needs to make based on their family’s situation.

The parent needs to make this decision, not let the child guilt them into buying them a cell phone. If you are divorced and have children, this may be extremely difficult, but the decision about if your child gets a cellphone or not, should be a joint decision by both parents and a decision you both agree on. One parent should not buy a cellphone without consulting the other parent and they should not use it as a weapon in the divorce.

If you decide that your middle school child is mature enough for a cellphone, you should discuss the rules and guidelines about using the phone prior to getting a phone. Some things to discuss are who they give their cell number to, not texting during class and not taking it into the bedroom at night so they can text most of the night. Many kids will text with their friends until 2 or 3 am and then be too tired for school the next day.

Also there should be a discussion about sharing photos. You never know what someone will do with a photo if they get mad with you. Also there needs to be a discussion about the law. It is not uncommon for teens to send their boyfriend/girlfriend nude photos of themselves. What they don’t understand is they are under the age of 18 years old. Therefore, if they have a nude picture of their 15 year old girlfriend, they can be charged with possession of child pornography. Many may say this won’t happen to me, but I have had a number of teens in psychotherapy because they were charged with having child pornography. Also you need to remember, once those pictures are out on the internet, they are out there forever. There also needs to be a discussion about on-line perpetrators too. There are many pedophiles on line trying to lure unsuspecting teens into their plans. Your children need to understand this is a real risk and what to watch for.

Finally, it should be made clear that the phone does not belong to the child — the phone belongs to you the parent. Yes you are giving them the phone to use, but it still belongs to you. If you ask for it back, then the child hands it over no questions asked. Also if you feel they are using their phone in an inappropriate manner, all you need to do is call your cellphone carrier and request that their phone line be suspended. It cost you nothing and it is an easy way to control the phone. When you feel that your child has earned the right to have the cellphone back all you do is call your carrier to reinstate that phone line.

It is very important that you and your teen have an agreement about conditions regarding their cellphone use. All of these conditions and agreements should be written down in an agreement that you sign and the child signs. You each get a copy of the agreement and one copy is posted on the refrigerator. If there are any disputes about a rule, you simply go back to the agreement and you follow what is written. A written agreement is very important because I have seen parents have conversations, make agreements and then 6 months later there is a disagreement and everyone’s memory is slightly different so you have a big fight.

Also given how many adults have gotten into trouble with their Smartphones, if you are going to allow your child to use any kind of cellphone you must discuss the pros and cons so the child does not get into major trouble with the phone.

Below I have included a sample contract that you can use with your child and modify as you need.

Cellphone Contract

I, child’s name, will not bring my cellphone to the family dinner table.

I will not go over our plan’s monthly minutes or text message limits. If I do, I understand that I may be responsible for paying any additional charges or that I may lose my cellphone privileges.

I understand that I am responsible for knowing where my phone is, and for keeping it in good condition.

I understand that my cellphone may be taken away if I talk back to my parents, I fail to do my chores, or I fail to keep my grades up.

I will obey rules of etiquette regarding cellphones in public places. I will make sure my phone is turned off when I am in church, in restaurants, or quiet settings.

I will obey any rules my school has regarding cellphones, such as turning them off during class, or keeping them on vibrate while riding the school bus.

I promise I will alert my parents when I receive suspicious or alarming phone calls or text messages from people I don’t know. I will also alert my parents if I am being harassed by someone via my cellphone.

I will not use my cellphone to bully another person.

I will send no more than _____ texts per day I understand that having a cellphone can be helpful in a emergency, but I know that I must still practice good judgment and make good choices that will keep me out of trouble or out of danger.

I will not send embarrassing photos of my family or friends to others. In addition, I will not use my phone’s camera to take embarrassing photos of others. I understand that having a cell phone is a privilege, and that if I fail to adhere to this contract, my cell phone privilege may be revoked.

Parent Responsibilities I understand that I will make myself available to answer any questions my tween might have about owning a cellphone and using it responsibly.

I will support my child when he or she alerts me to an alarming message or text message that he or she has received. I will alert my child if our cellphone plan changes and impacts the plan’s minutes.

I will give my child _______ warning(s) before I take his or her cellphone away

Signed ______________________________ (Tween) Signed ______________________________ (Parents). Date ______________________________

Dr. Michael Rubino has been working with middle school and high school students for over 20 years. He is considered an expert in this field. Dr. Rubino is one of the founding members of the National Alive & Free Program, a program designed to work with teens. For more information about Dr. Michael Rubino’s work and private practice visit his website at www.rcs-ca.com or www.rubinocounseling.com or follow him on Twitter @RubinoTherapy.

Camouflaging A Way Teenagers Lose Their Identity

Camouflaging A Way Teenagers Lose Their Identity

A new behavior for teenage and tween girls has been identified by an adolescent psychologist. The behavior that has been identified is called “Camouflaging.” This behavior left unidentified can lead to low self-esteem, depression, cutting etc.

Camouflaging is when an adolescent girl changes how she looks, her opinions or things that she does in order to be accepted by the other girls. The real problem occurs when the girl is changing so much about herself or does it for so long that she forgets or losses track of her real self.

While this behavior has just been identified in girls and what the researcher explains appears correct, I believe this behavior applies to boys too.

Many adolescent boys change the way they dress, their beliefs and the way they act to be accepted by their friends. I hear many of these boys telling me in therapy that they feel lost. They tell me they no longer have an idea of who they really are or believe or feel. These boys often turn to alcohol, drugs and cutting. Usually to numb out their lost feeling or to feel something.

As a result, many teens start acting like someone they are not just to be accepted. This fear of not being accepted and forgetting their real self because they has been covering their true self up for so long or denying their true feelings for so long can result in boys and girls having low self-esteem and/or feeling depressed.

This low self-esteem and depression can result in such behaviors as cutting, eating disorders, drug use, becoming sexually active etc. Often boys and girls cut just so they can feel as I stated above. The constant denying of their emotions can cause boys and girls to lose a sense of their true feelings. Therefore, cutting can occur so boys and girls feel. Denying their feeling or who they are can result in boys and girls feeling very confused. Therefore, they look for behaviors that help them remember who they are and help them identify their true feelings. They also seek behaviors that help them deal with denying their feelings or changing their behaviors. This can trigger eating disorders, drug abuse or other self-destructive behavior. This helps numb out the confusion and disappear of denying their feeling and trying to forget their true self. This can cause feelings of depression and anxiety too.

What should parents look for in their teens? If your son or daughter tries to stop wearing his or her glasses or if he or she all of a sudden changes how he or she dresses or acts these are possible warning signs. Another change could be not doing as well in their classes because they are afraid of looking too smart. Basically, if you see signs indicating that your teenager is trying to deny who they are so they will be accepted by others.

While it is normal for teenagers to make changes in their attitudes or how they dress, we are talking about something that goes far beyond normal self-expression. We are referring to changes where a teenager is trying to deny who they are because they feel they are unacceptable.

This is what we are talking about. If teenagers are changing their hair or how they dress as a way to express themselves that is normal teenage behavior. However, if teenagers are doing it just to fit in and they end up losing a sense of their true self this is camouflaging.

As I stated, Camouflaging results in depression or low self-esteem because the teenager is forgetting their true self. If they are doing it as a way of trying to experiment with their self expression, the teenager is happy and confident as stated above. This is the main point to understand. Experimenting with their dress and beliefs etc. is normal for teens and helps teenagers identify themselves, however denying or camouflaging their feelings results in teens losing themselves and many behavior problems. This is the main thing for parents to watch for in their adolescents behavior.

If you go onto Yahoo and look up Camouflaging you will find a segment on Good Morning America about Camouflaging. In fact, here is the link to the GMA segment https://gma.yahoo.com/video/parents-worry-tween-teen-camouflaging-122935763.html?soc_src=copy. Also if parents look at the February issue of Teen Vogue, you will find an article about Camouflaging.

Dr Michael Rubino has over 20 years experience working with teenagers and their families. Dr Rubino is considered an expert psychotherapist in the treatment of teens. For more information about Dr Rubino and his private practice visit his website at http://www.rcs-ca.com

New Drugs Teenagers are Using

New Drugs Teenagers are Using

As a psychotherapist who treats teenagers, I hear about what is going on with teenagers and what they are doing. I have been hearing from many teens about new designer drugs they are taking. Many people assume teenagers are primarily using marijuana. However, teenagers are looking for new drugs and ways to modify how they use marijuana. These new drugs can be very dangerous, even deadly. However, many teenagers are not aware of the dangers.

Spring Break is occurring and summer break is around the corner and for many teenagers this means partying and using drugs. One major issue is many Emergency Room physicians cannot keep up with all the new drugs. Therefore, if a teenager ends up in the Emergency Room due to overdosing or having a bad reaction to one of these new drugs, a teenager may die before an Emergency Room physician determines what the teenager took and how to treat it. The show The Good Doctor recently had an episode which addressed this issue. The teen had used, Molly, not a new drug but because there were so many options, the teenager almost died before they could determine how to treat him.

Recently I read an article by Angela Chen. The article discusses these new dangerous drugs and how deadly these drugs can be. I have included her article below so parents can be aware of the dangers facing their teenagers. Hopefully, parents will also take this opportunity to discuss this issue with their teenagers.

On a July day a little over a year ago, over 30 people collapsed on a street in Brooklyn. They lay on the ground, vomiting down their shirts, twitching and blank-faced. Some, half-naked, made jerking movements with their arms, eyes rolled back. Others groaned and clutched onto fire hydrants to try to stay upright. Witnesses said the scene was like The Walking Dead. Headlines claimed that people had turned into “zombies,” while police said that the 33 affected were lucky to be alive.

All had smoked an “herbal incense” product called AK-47 24 Karat Gold. Eighteen people were sent to the hospital by ambulance. The situation had all the signs of a drug overdose, and so doctors ordered the usual tests: blood count, urine analysis, heart rate monitoring.

The first patient tested was a 28-year-old man who was slow to respond, but otherwise showed few clear signs of trauma. Heart sounds: normal. Blood count: normal. His lungs were clear and there were no major neurological problems, no excessive sweating or skin lesions. He tested negative for opiates, cocaine, amphetamines. Nothing came up.

The case went to the Department of Homeland Security and the Drug Enforcement Agency. They knew who to call to get a second opinion. They packed blood and urine samples on dry ice and shipped them to a small lab 3,000 miles away in San Francisco, run by toxicologist Roy Gerona. If anyone in the country could figure out what was in 24 Karat Gold, it would be him.

Forty years ago, drugs had easy names: cocaine, meth, heroin. Today, the names can read like an ingredients list for a chemistry class: 5F-AMB, PX-2, MDMB-CHMINACA. Today’s designer drugs are made by synthesizing chemicals and hoping they give you a high that’s strong enough to be worth it, but not strong enough to send you to the hospital.

Designer drugs are volatile. If you tweak just one molecule, you can get an entirely differently substance, one you hadn’t bargained for. They’re also easy to get. There’s no shortage of “research chemicals” vendors on the dark web are willing to sell. And they’re growing more popular. These so-called “novel psychoactive substances” entered the mainstream in 2009. That year, according to the United Nations Office on Drug and Crime, there were about 100 of these substances reported; six years later, there were nearly 500. Because designer drugs don’t show up on traditional drug tests, they’re hard to track and identify. It’s a public health problem that requires a special set of skills to handle.

One of the most prominent categories of designer drugs are those intended to mimic marijuana, called synthetic cannabinoids. Marijuana, or cannabis, is widely considered one of the safest drugs, but synthetic cannabinoids are some of the most dangerous synthetic drugs. The Global Drug Survey (GDS) found that last year, for the fourth year running, the risk of seeking emergency medical treatment was higher after using synthetic weed than for any other drug.

When you smoke a regular joint, a chemical called tetrahydrocannabinol (THC) travels through your blood. It binds with receptors called CB1 and CB2. Because of the structure, there’s “kind of a limit on how stoned you can get,” says Adam Winstock, a London-based psychiatrist who administers the GDS. If you’re smoking a popular cannabinoid like K2 Spice, a chemical travels through your blood, but this time, it’s not THC. It’s something else that also binds with CB1 and CB2 — but unlike with regular weed, we don’t know exactly how these chemicals bind, especially when they’re illicit drugs from the black market. This mystery makes synthetic marijuana likely to lead to “much more extreme responses,” like seizures and psychosis, according to Winstock.

Synthetic cannabinoids originated in a quest to create a better pain medication. A Clemson University chemist named John W. Huffman synthesized hundreds of compounds in an attempt to find a better painkiller, but often created incredibly psychoactive substances with no medicinal properties at all. When he published the results of these compounds — called JWH compounds, after his initials — he made the information available to be copied.

There are more than 300 JWH compounds alone, and around 2004, labs in China began studying old research papers, synthesizing the compounds and distributing them as “herbal incense” products. K2 Spice itself — often partly based off the JWH-018 compound — started in China, became popular in Germany around 2008, and entered the US around 2009.

Labs can also turn to the expired patents — patents that are rich fodder, even if (or perhaps because) there was a good reason said drugs never made it to market. It’s nearly impossible to figure out how to shut down the overseas labs producing these drugs. As soon as you ban one substance, the labs move on to another.

Gerona, a toxicologist with gray hair styled in an undercut, was the one who received the biological samples from the DEA. From a small lab in the Medical Sciences Building at the University of California, San Francisco, Gerona says he and his team are playing a “cat and mouse game” with illicit international drug manufacturers. When an overdose happens, Gerona’s team tries to identify the drug in question — often synthetic substances no one has seen before. But the lab goes one further: Gerona’s lab attempts to identify and classify these substances before the mass overdoses even happen.

Inside, the lab is meticulously neat: rows of spotless tables are covered in bottles with orange rubber caps, all labeled with orange duct tape, and small gray centrifuges. A window overlooking a courtyard has molecular structures scribbled over it in pink and green marker. Near the door sits an enormous freezer, filled with thousands of brightly colored, frost-covered boxes of drug samples kept at -112 degrees Fahrenheit.

Gerona launched his toxicology lab in 2010, in partnership with the San Francisco Poison Control Center. The date wasn’t a coincidence; he says that 2010 was the year that a designer drug called “bath salts” began flooding the market. “Bath salts” is a blanket term for a group of designer drugs made from stimulants; they create a euphoric high like MDMA, sometimes with hallucinations thrown in. The drugs usually come in powdered and capsule form, and can cause freak-outs that were well-documented on YouTube at the time. The most famous of these was a viral story of a 31-year-old Miami resident attacking and then eating a homeless man. (Scientists dispute the drugs’ role.)

For users and the DEA, the spike in bath salts use was a nightmare. For Gerona, the increased interest in designer drugs led to more work and more samples from around the country. Eventually, the lab caught the notice of both Michael Schwartz, a toxicologist at the Centers for Disease Control and Prevention, and DEA pharmacologist Jordan Trecki. A collaboration between Gerona’s lab and the DEA was formed. (Neither the DEA nor the CDC responded to repeated requests for comment.)

The first step in doing an analysis at Gerona’s lab is getting the sample — urine, blood or, rarely, a tiny bit of drug itself — shipped over on dry ice. In traditional drug testing, you check to see if the sample matches any of the known substances: marijuana, heroin, cocaine, and so on. They match, or they don’t. Designer drugs, almost by definition, are made of chemical combinations we haven’t seen before. They almost never match traditional databases, and the chemists often don’t know what they’re looking for. So Gerona’s lab gathers as much information about the substance as possible.

A tiny vial of the biological sample — usually plasma, the colorless part of blood — goes into a bulky, printer-like machine. That machine is called a liquid chromatography mass spectrometer, and very crudely put, it separates out all the different parts of the plasma by mass. (Think of it like an extremely sensitive centrifuge.) That process makes it easier to identify chemicals, and the mass spectrometer then spits out the different measurements in a computer chart with peaks and valleys called a chromatogram.

Then, says Axel Adams, a graduate student in Gerona’s lab, you turn to the so-called “prophetic library.”

“ RESEARCHES LOOK FOR POSTS ABOUT DRUGS ON SUBREDDITS LIKE R/RESEARCHCHEMICALS

Gerona’s “prophetic library,” about three years in the making, is a detailed catalog of already synthesized variants that his team believes is going to be the next big street drug. The library was made possible with the help of Samuel Banister, a synthetic chemist at Stanford University. Banister synthesizes variants of popular street drugs and takes down their chemical information to create “reference standards.” Synthesizing can take anywhere from a few days to a couple of weeks; the lab now has almost 150 variants on file. It’s a side job for Banister, but at one point, he says, “I was pumping out five to 10 a week.” The final products look like white crystalline solids and are kept in drawers in the lab, ready for when a case like AK-47 24 Karat Gold comes along.

In addition, lab members spend hours each week on drug forums, researching trends. It’s more of an art than a science. Researches look for posts about drugs on subreddits like r/researchchemicals. They reference surveys like the Global Drug Survey and survey “trip reports” from experiential documentation sites like Erowid and PsychonautWiki.

They look for terms like synthetic pot, K2, Spice, and sometimes, scientific terms like “cannabinoids,” or a specific popular class of cannabinoids, like “FUBINACA” or “JWH compounds.” Often, the posts themselves will include the name of the chemical. Gerona has ordered drugs off the dark web. In one case, the invoice billed him for “cosmetics,” and the package included lipstick, fake eyelashes, and tabs labeled “powder.” The “powder,” unsurprisingly, turned out to be drugs. But most of the time, the drugs in the powder were not the drug that was ordered.

“ THE INVOICE BILLED HIM FOR “COSMETICS,” AND THE PACKAGE INCLUDED LIPSTICK, FAKE EYELASHES, AND TABS LABELED “POWDER”

If there is a match because the compound is already in the library, finding the right variant is “only going to take 15 minutes,” says Gerona. “Otherwise, it could take a week, or it could not be solved.”

Adams checked the results of a blood sample tied to AK-47 24 Karat Gold against the prophetic library. The computer pulled up a chart that indicated a line — jagged, up and down — that shows the mass of the components of AK-47 24 Karat Gold, versus the same information for AMB-FUBINACA.

Drugs don’t pass through the body untouched. Once they’re ingested, the body processes the compounds. So by the time they’re in the blood or urine, it’s not exactly the same compound as the drug that was ingested. It’s hard enough to find a reference standard for the original compound; it’s even more difficult to find a reference standard for the possible variants. In the case of AMB-FUBINACA, the chemical in the biological sample from Brooklyn wasn’t the parent compound. It was a derivative. Luckily, Banister had already synthesized that variant, too.

The peaks and valleys of the two lines of AK-47 24 Karat Gold and AMB-FUBINACA matched up precisely. It took the team only seven days to identify the substance in the Brooklyn case — and most of that time was spent waiting for the sample to get there.

Gerona’s lab has worked on cases across the country, from New York City to Sacramento to Colorado. The number of cases varies. Sometimes, they’ll get 15 to 25 samples a month. One Mississippi case involving synthetic cannabinoids resulted in over 400 samples. The average turnaround on results is about six months, says Adams. That’s not good enough for Gerona.

And it’s not likely that the problem will go away. Marijuana legalization advocates claim that people will stop with the synthetic stuff once the real thing is okay. But that’s not true in the experience of Andrew Monte, a clinical toxicologist at the University of Colorado School of Medicine who collaborates with Gerona’s lab. Recreational marijuana is legal in Colorado, but he sees patients who are on these synthetic compounds anyway. Monte’s team has surveyed people who come into the ER and even set up at music festivals to ask attendees questions. Synthetic drug users are “taking it for a different reason, to get a different high,” Monte says. “They’re really looking for something different than what pot gives, the same way you might choose cocaine over pot or meth over pot.”

“ ONE MISSISSIPPI CASE INVOLVING SYNTHETIC CANNABINOIDS RESULTED IN OVER 400 SAMPLES

To help address this problem, in 2016 Gerona started a new research consortium called P SCAN, or the Psychoactive Surveillance Consortium and Analysis Network. (Yes, the double entendre is intended.) They’re working with about 10 poison control centers in places like Kansas and Colorado. They’ve had more than 100 cases referred to them and are writing up case reports and manuscripts. (The 24 Karat Gold case was published by the New England Journal of Medicine.)

P SCAN will continue to do the surveillance work Gerona has been doing for years, but also create a database of clinical data connected to the specific synthetic drugs they track and discover. Think of it like a medical version of Erowid. This way, the next time there’s an outbreak like the one in Brooklyn, investigators and researchers can look at specific physical indicators (heart rate, respiratory information, neurological information, and more) and say, “Ah, this matches the symptoms of AMB-FUBINACA” — all without shipping samples across the country.

But even with P SCAN and the prophetic library, the task is huge. “The identity of a lab needs to constantly expand and rework in order for it to stay relevant,” says Gerona.

Gerona is a biochemist by training. Before launching his lab, he didn’t know anything about Spice, or AK-47 Gold, or the dark net. But now, Gerona says, “I have no other choice but to really learn about it, so that I am relevant and retain my relevance in the field.” He’s hoping to work with people in technology to automate this “market research” to glean new insights and make the prediction process even faster. “It would be so great if we could predict the drugs coming in with more accuracy, instead of after people are hurt,” he says.

Weeding out designer drugs is a Sisyphean task, Gerona admits. It may be impossible to shut down the overseas labs, but he wants to have even better methods for predicting what’s going to get big and then, instantly identifying the substances. He compares the endless drug variations to nature: the cold virus is still around because it changes all the time. HIV has never been cured because it continues mutating. “In a sense, they’re reinventing themselves all the time, so reinvention is key to persistence. As long as you’re reinventing yourself, you can persist.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers. He treats teenagers with drug issues and has seen many end up in the Emergency Room because teenagers think they are the experts. For more information about Dr. Rubino’s work or his private practice visit his website www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3.