The Difference between Discipline and Punishment

The Difference between Discipline and Punishment

As a psychotherapist who works with children and adolescents, I often hear how their parents are too strict and unfair. Many children and adolescents feel their parents punishments are not appropriate and their parents are out of touch with today’s world. I also hear parents tell me no matter what rules or punishments they impose that their children refuse to follow the rules. Yes this is a common argument but let’s look at the situation closer.

From my experience, one of the major issues in this situation is the difference between discipline and punishment. Many people may feel there is no difference between the two concepts. However, there is a major difference between the two terms.

Discipline is used to teach a child or teenager about rules and life. Punishments are used to tell a child or teenager they did something wrong such as breaking a house rule. However, punishments often have no association to the broken rule and often make a child feel like they are bad and they often don’t know which rule they broke. Punishments do not teach they only make a child feel bad or angry. For example, if it was the child’s turn to take out the garbage and they forgot and went to a friend’s house instead. Discipline would be having them take out the garbage and clean the dinner table for a week. A punishment would be that they were grounded and had to stay in the house for two weeks. What connection does the grounding have to forgetting to take out the garbage?

Research has shown that discipline is a more effective way to teach children\teenagers about rules and appropriate behavior. The discipline needs to have some association with the rule that was broken. A punishment which tends to make a child think they are bad and has no association to the rule they broke typically teaches a child nothing. What it typically does is make a child feel like they are a bad person and they often don’t understand why they are being punished.

I had a fourth grader ask to come to therapy because they were tired of getting in trouble at home. They felt like they were a bad person and he had no idea why he was doing bad things at home on a regular basis. Therefore, the punishments taught him nothing except it did lower his self-esteem. Research also has shown that children and teenagers who feel they are bad people are more likely not to graduate high school and to get involved with drugs and alcohol. They feel they are bad so they feel they should be doing things associated with “bad kids.”

As I stated discipline has been shown to be more effective with children and teenagers. However, before a parent imposes discipline there are important steps for the parent to take:

1. First, the parent needs to let the child\teenager know that they love them and that the child\teen is not bad, but they made a mistake.

2. The parent needs to explain what mistake the child made and why it is a mistake.

3. Explain that they are imposing the discipline to help the child learn from their mistake and hopefully they won’t make the same mistake again.

4. Let the child know when the discipline starts and ends. Also do not make it too long or severe. It should be in proportion to the mistake. It should also needs to be age appropriate.

5. Finally, ask the child if they understand and if they have any questions.

One thing that makes disciplining a child or teenager easier is having a behavior contract. It is important if parents sit down with the child or teenager and develop a behavior contract and consequences if the child violates the contract. Therefore, if your child makes a mistake, the consequence is already known because it is in the contract. Therefore, it is less likely that the child will feel like a bad person or confused about the consequences because everyone in the family agreed to them.

I recommend contracts on a regular basis. The contracts help reinforce the discipline that choices have consequences. Therefore, the parent is teaching a child to think before they act. Thereby, significantly decreasing the odds that they will make a bad choice. It can also help a child deal with peer pressure because you have already discussed what you feel is appropriate. They also help to reduce arguments at home. If everyone agrees to the contract and a teenager violates the contract they cannot blame Mom and Dad for the consequences. Mom and Dad are only enforcing the agreed upon contract. The teenager needs to take responsibility for their choice.

Dr. Michael Rubino is a psychotherapist with 20 years experience treating children and teenagers. For more information about Dr. Michael Rubino’s work visit his website at www.RubinoCounseling.com or his Facebook page, www.Facebook.com\drrubino3.

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Is Your Child A 2E Child?

Is Your Child A 2E Child?

Many parents are very happy to hear that their child has been classified as “gifted.” They assume that their child will do very well in school and have a very bright future because they are “gifted.” While “gifted” children may excel in certain academic areas, often they have difficulties in other social situations or academic areas. These children are called twice exceptional children. Research by John Hopkins estimates that one out of five children are twice exceptional or 2E which is a more common term. Therefore, John Hopkins estimates that there are approximately 700,000 2E children in the United States.

Wikipedia defines 2E children in the following way:

A 2e child usually refers to a child who, alongside being considered gifted in comparison to same age-peers, is formally diagnosed with one or more disabilities. Although 2e can refer to any general disability, it is often used to refer to students with learning disabilities, although research is not limited to these areas, and a more holistic view of 2e can help move the field forward. The disabilities are varied: dyslexia, visual or auditory processing disorder, obsessive-compulsive disorder, sensory processing disorder, autism, Asperger syndrome, Tourette Syndrome, or any other disability interfering with the student’s ability to learn effectively in a traditional environment. The child might have a diagnosis of attention deficit hyperactivity disorder, or diagnoses of anxiety or depression.[6] Often children with 2e have multiple co-morbid disabilities than present as a paradox to many parents and educators.

Many people may find this hard to believe, however, as a psychotherapist who specializes in treating children and teenagers, I have seen many “gifted” children who do have the disabilities listed above. A common issue I have encountered is that “gifted” children often have difficulties making friends and dealing with social situations. If they had not been classified as “gifted”, parents would see that they do meet the criteria for Asperger’s Syndrome. Another common issue I have seen in psychotherapy with “gifted” children is that they have difficulties organizing their ideas and maintaining sustained attention. These children meet the criteria for ADHD.

One of the primary difficulties for these children is since they have been classified as “gifted,” many schools do not want to offer support services for a “gifted” child who has ADHD or a processing problem. Because they are not receiving the academic support they need, many of these children suffer with depression, anxiety and low self-esteem. I have seen this many times with “gifted” children that I see for psychotherapy. It also creates a great deal of stress for the parents. They can see their child is having difficulties and the child is complaining about difficulties, but the school tells the parents the child is doing fine because they are “gifted.”

The research from John Hopkins University shows us that the two are not mutually exclusive. A child can be “gifted” in one area and have a learning disability in another area of life. Therefore, a “gifted” child may need a 504 plan or an individualized educational plan (IEP). Therefore, if you are the parent of a 2E child and you notice that your child is having difficulties at school, do not be afraid or nervous to advocate for your child. To make this easier, I have included a link which discusses misconceptions about 2E children, 7 Myths About Twice-Exceptional (2E) Students http://u.org/2hp0dNU. I am also providing a link to a newsletter for an organization which helps parents with 2E children and advocates for them, https://www.google.com/url?sa=t&source=web&cd=3&ved=0ahUKEwiv8PmrxYDYAhUH6oMKHbmyD10QFggiMAI&url=http%3A%2F%2Fwww.2enewsletter.com%2Farticle_2e_what_are_they.html&usg=AOvVaw35GmKdn_P9FJzqMBPkMMrD.

If this sounds like your child do not panic. Arrange to have your child evaluated by a mental health clinician who is familiar with 2E children. They can help you develop a treatment plan and let you know if your child needs accommodations at school.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. In fact, he specializes in treating children and teenagers. If you want to know more about Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or his Facebook page http://www.Facebook.com\drrubino3.

The Traumatic World U.S. Children Live In

The Traumatic World U.S. Children Live In

In light of the terrible attack on the high school in Santa Fe, Texas and the shooting at the high school in Parkside, Florida, a couple months ago, it is important to remind parents and help them deal with the trauma their children are having to face. Also let’s not forget the shooting seven months ago in Las Vegas where a man shot at families, teens and adults enjoying a concert killing and injuring hundreds of people.

As a result of these shootings, I have been seeing more and more teenagers who are complaining of anxiety and depression. Many of these teenagers are also afraid to go to school too. I have also been seeing more teenagers being placed on home/hospital for school due to anxiety. This means a teacher comes to the house once a week instead of the teenager going to school. This is an alarming trend.

I have also been hearing more teenagers talking about needing to carry a knife with them for their own safety. They tell me you never know when someone might try to attack you. These are not juvenile delinquents or gang members, these are average teenagers. They come from healthy families and are doing well in school and not involved in drugs. This need they feel to protect themselves is an alarming trend.

However, if you take a step back and look at what these children have seen over their lives it makes sense. Most of these teenagers were very young or not even born yet on 9/11 when the United States was attacked. Since 9/11 they have also seen two wars and heard on the nightly news about terrorist alerts or attacks around the world and in the United States.

In addition to terrorism, this is the first generation growing up with mass shootings. According to ABC News from 2000 to 2015 there have been 140 mass shootings and since January 1, 2016, there have been more mass shootings than the previous 15 years combined. According to the statistics on mass shootings every day 36 people are killed in the United States by a gun. This does not include suicides. For the group we are discussing, suicide is the third leading cause of death for children between 10 and 18 years old and using a gun is one of the most popular methods of suicide.

Now, in addition to these facts stated above, think about what these children see on the news and the video games they play. Anytime there is a shootings incident in the United States there is pretty much 24 hour news coverage of the event for days. Also when there are bombing or shootings in Europe there is 24 hour news coverage for days. And now we have moved on to covering funerals. When the officers were killed in Dallas the memorial was televised nationally. If we look at the video games these kids are playing most have to do with killing and death. And since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about our President’s attitudes and what he tweets. They have heard what Trump has said and they are afraid other countries might attack us or Trump may start a war. Also Hispanic children who are legal citizens are afraid that they will be deported. This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives. These teenagers are being traumatized. They may not be experiencing the trauma personally but they are experiencing vicarious trauma. With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously. We have never had a generation of children grow up with the amount of trauma that these children are growing up. Even children growing up during World War II didn’t experience this amount of trauma. We didn’t have instant access to news nor did we have the graphic videos being shown by the news media.

The question now becomes, what do we do? Well we can not change the world unfortunately. However, we can monitor how much exposure our children are receiving to mass shootings when they occur. We can monitor the video games they are playing and limit access to games that focus on violence and killing. We can demand that the Congress pass gun control laws that make sense. No one needs an assault weapon to hunt a deer. We can also listen to what our children are saying and talk to them about their concerns. When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.

Finally, if you start to notice a change of attitude in your child that you are concerned about have them assessed by a psychotherapist. There is nothing to be ashamed of if a child needs therapy. We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents. For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma. Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 20 years experience treating children and teenagers and dealing with victims of trauma. For more information about his work or private practice visit his website at www.RubinoCounseling.com or on Twitter @RubinoTherapye

Parents A Call to Action

Parents A Call to Action

This is a different article than I typically write. First I want to say my thoughts and prayers are with all the victims, their families and friends, the students and teachers and first responders of the school shooting this week in Santa Fe, Texas. Next, I want to ask the United States Government, when will they finally take action and protect our children? This shooting is not long after the shooting in Florida. The students there and across the country protested across the United States demanding laws impacting mental health care and requesting sane gun control laws. They were tired of the NRA dictating to the United States Congress about what gun laws would be passed and which were unacceptable.

The NRA always points to the second amendment which grants people the right to protect themselves with guns. However, the NRA ignores the fact that the U.S. Declaration of Independence guarantees everyone the unalienable rights to life, liberty and happiness. I do not see how students having to go to school everyday and worrying if they will be killed fulfills this promise of life, liberty and happiness.

Another important point is the United States is the only country in the world which is dealing with this problem of school shootings. The ABC news show 20/20 did a story about school shootings last year. In their report they reported that more students had been killed in school shootings in 2017 than the previous 17 years added all together. CNN had reported on January 24, 2018 that there had been a school shooting every day of 2018. These are very alarming statistics.

As a psychotherapist, who treats children and teenagers, I have seen a significant increase in anxiety in children and teens over the last several years. Most of these children and teens are reporting that they are afraid to go to school. They are afraid that they will be shot and killed at school. Many teenagers I work with have started caring knifes with them. They tell me they need the knifes for their protection. They tell me they have no way of knowing who has a gun or knife and if they will be shot at school. These children and adolescents fear for their lives because they see our government doing nothing to protect them. Instead, they hear daily about school shootings and they have drills at their schools about what to do if a shooter is on their campus.

When are children fear for their lives and are demonstrating for sane gun control, when will the government act? As the Congress debates this issue, students are still being killed on a regular basis. In February of this year, there was the school shooting in Parkland, Florida. It has only been about two months and we have this shooting in Santa Fe, Texas. There have been other school shootings during this time too. When do we say, enough?

Parents, the U.S. Congress is not paying attention to the students protesting and requesting gun laws to be changed so they can go to school and feel safe. They ignore the students because most of them are not old enough to vote. Many of the members of the U.S. Congress are mainly concerned with being re-elected and maintaining their high paying job where they do not have to do a great deal of work. Parents it is time for you to act! The 2018 elections are occurring this year and many seats in the House of Representatives and Senate are up for re-election. Since the U.S. Congress will do nothing to protect the school children then you must. Every parent needs to go to the polls this year. You need to vote for people who will stand up to the NRA and vote for people who will enact laws which will protect the children of our country. You also need to cast votes that will remove those members of the Congress who refuse to enact laws that will protect our children. Many of the high school students impacted by shootings may not be old enough to vote in the 2018 election, but parents you can. You can send a very important message to the teenagers of our country. You can tell them that you hear their cries asking for laws that will make them feel safer and you agree with their demonstrations and you are responding to their requests to be safe. You can say the Congress may ignore them but we will not ignore them. You are too important to ignore and we will keep you safe.

Dr. Michael Rubino has over 20 years experience as a psychotherapist treating children and teenagers. For more information about Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or on Twitter @RubinoTherapy.

Helping Teenagers Grieve Another School Shooting

Helping Teenagers Grieve Another School Shooting

Unfortunately, our Country suffered another school shooting in Texas this week. High School who were rehearsing for their graduation had to run for their lives because someone was shooting. Unfortunately some of those students were killed including a teacher. Graduation, which should be a happy day, has become a sad day for these students. When this occurs no one knows what to say or do. Many patients have asked me about what to do in these situations. While doing research regarding grief for patients, I found this information from the grief center. I think it is very good information and very easy to understand. Therefore, I will present the information in three sections.

The 10 Best and 10 Worst Things to Say to Someone in Grief

Sheryl Sandberg’s post on Facebook gave us much insight into how those in grief feel about the responses of others to loss. Many of us have said “The Best” and “The Worst.” We meant no harm, in fact the opposite. We were trying to comfort. A grieving person may say one of the worst ones about themselves and it’s OK. It may make sense for a member of the clergy to say, “He is in a better place” when someone comes to them for guidance. Where as an acquaintance saying it may not feel good.

You would also not want to say to someone, you are in the stages of grief. In our work, On Grief and Grieving, Elisabeth Kubler-Ross and I share that the stages were never meant to tuck messy emotions into neat packages. While some of these things to say have been helpful to some people, the way in which they are often said has the exact opposite effect than what was originally intended.

The Best Things to Say to Someone in Grief

1. I am so sorry for your loss.

2. I wish I had the right words, just know I care.

3. I don’t know how you feel, but I am here to help in anyway I can.

4. You and your loved one will be in my thoughts and prayers.

5. My favorite memory of your loved one is…

6. I am always just a phone call away

7. Give a hug instead of saying something

8. We all need help at times like this, I am here for you

9. I am usually up early or late, if you need anything

10. Saying nothing, just be with the person

The Worst Things to Say to Someone in Grief

1. At least she lived a long life, many people die young

2. He is in a better place

3. She brought this on herself

4. There is a reason for everything

5. Aren’t you over him yet, he has been dead for awhile now

6. You can have another child still

7. She was such a good person God wanted her to be with him

8. I know how you feel

9. She did what she came here to do and it was her time to go

10. Be strong

Best & Worst Traits of people just trying to help

When in the position of wanting to help a friend or loved one in grief, often times our first desire is to try to “fix” the situation, when in all actuality our good intentions can lead to nothing but more grief. Knowing the right thing to say is only half of the responsibility of being a supportive emotional caregiver. We have comprised two lists which examine both the GOOD and the NOT SO GOOD traits of people just trying to help.

The Best Traits

Supportive, but not trying to fix it

About feelings

Non active, not telling anyone what to do

Admitting can’t make it better

Not asking for something or someone to change feelings

Recognize loss

Not time limited

The Worst Traits

They want to fix the loss

They are about our discomfort

They are directive in nature

They rationalize or try to explain loss/li>

They may be judgmental

May minimize the loss

Put a timeline on loss

The above information is meant to be used as a guideline. Everyone goes through the grieving process in their own way. It is very important to understand that point. It is also important to remember while the above is a guideline, the most important thing is your intent. So if you say a worse thing but you said it out of love the person will understand. The guideline will hopefully make you more comfortable to offer support to your grieving loved one or friend. Because someone who is grieving need people to talk to without people feeling awkward. Also everyone is around immediately after the death and through the funeral services. Most people then go back to their normal lives. However, those who were really close to the person are still grieving and trying to figure out how to proceed with life. So don’t forget the person who is grieving can use emotional support for the first year especially. Therefore, do not forget to call, send a card or stop by occasionally. Especially around the holidays and birthdays.

Dr. Michael Rubino has over 20 years experience as a psychotherapist treating adolescents, children and their families. For more information regarding Dr. Rubino visit his website www.rcs-ca.com or on Twitter @RubinoTherapy

Facts About High School Sports and Concussions

Facts About High School Sports and Concussions

Many high school students look forward to participating in high school sports and other physical activities as part of their high school experience. While school may be ending for the year, many athletes will be practicing over the summer for next years games. Football is one example of a sport where the players practice the entire summer in order to be ready for the next school year’s season. Typically most people look at the fun and the positive experience these activities provide for students. However, high school athletes do get hurt, sometimes seriously. High school athletes do suffer broken arms and legs, but they also suffer concussions, traumatic brain injuries and spinal cord injuries. Parents are now learning that “basic” concussions in teenagers are more common than people think and can create more problems that people think. A concussion can cause physical impairment such as not being able to walk or emotional issues such as a teenager suddenly having anger problems or depression. Unfortunately, this year we had example of these issues, when a wrestler from College Park High School suffered a spinal cord injury and was paralyzed.

As a result of these head injuries, many teenagers develop Post Concussion Syndrome after a concussion. Teenagers can have violent mood swings, difficulties concentrating and with memory. This can cause problems at school and with family and friends. I have seen teenagers who get so depressed by these changes that they become suicidal. Post Concussion Syndrome can last a year and often physicians do not warn parents or teenagers about this syndrome. This makes matters worse because they feel like they are crazy because they don’t understand why they have the symptoms. Also these symptoms can create problems at school that the student may need accommodations for in order for the student to understand the classes.

We have been hearing more and more about concussion in professional sports in recent years. We have also seen professional athletes walk away from their careers because they are not willing to risk the after effects of multiple concussions. A fact that some in professional sports do not want to be publicized. Will Smith stared in a movie regarding a professional football player and how his life significantly changed after several concussions. The National Football League tried to stop this movie from being made and shown, but they lost.

However, we do have examples. Mohammad Ali is the most notable example of how multiple concussions can change a person and leave them disabled. Also a news anchor for ABC News documented how his life changed after receiving a traumatic brain injury while covering the war in Afghanistan.

Concussions, Traumatic Brain Injuries and Spinal Cord Injuries also occur in teenagers. Teen athletes such as football players routinely suffer concussions, traumatic brain injuries or spinal cord injuries. Many of these athletes suffer permanent brain damage such as difficulty remembering things or emotional issues such as mood swings. Also a number of high school athletes do die from concussions every year.

A research study from Boston University released shows that boys who play football before the age of 12 years old are more likely to have memory problems and problems making decisions as adults. This study also shows that boys who play football before age 12 are three times more likely to develop clinical depression as an adult. The study suggests the reason this occurs is because around the age of 12, a child’s brain is undergoing a great deal of development at this age. Robert Stern, one of the authors of the study, explained that “the brain is going through this incredible time of growth between the years of 10 and 12, and if you subject that developing brain to repetitive head impacts, it may cause problems later in life.”

Another MRI study, by the Wakes Forest School of Medicine, showed that boys between the ages of 8 years old to 13 years old who played even just one season of football showed signs of diminished brain function.

High school athletes are not the only teenagers at risk for concussions or other serious injuries. Teens in general are at risk because teens are willing to engage in risky behavior such as jumping off something or racing cars. Many teens feel they are safe. They hear about these issues but think it would never happen to them. However we never know who it will happen to. Therefore, parents you need to educate and monitor your teenager’s behavior. If you have a teen athlete, you may need to make the decision to stop them from playing a sport if they have suffered a couple concussions. This is not easy but you must think of their lives after high school.

Also boys are not the only ones at risk for concussions. Girls are at risk for concussions and other serious injuries. In fact, some studies show that cheerleaders are at a higher risk of getting a concussion than football players. Cheerleaders do not use helmets and have no head protection. Also many people assume a child needs to be knocked out in order to sustain a concussion. This is not true. You can sustain a concussion without losing consciousness. So football players are not the only one at risks. Any high school athlete is at risk – boy or girl. Anything that causes a jarring of the head can cause a concussion. Our brain sits in fluid in our skull. Therefore any jarring force can cause the brain to hit the side of the skull and cause a concussion. This is why all high school athletes are at risk for concussions.

I have included a link to a YouTube video where a physician describes the basic information about what happens to a brain during a concussion and the process of recovery from a concussion. This is a must see for any parent https://youtu.be/zCCD52Pty4A.

In addition to this video I have included a fact sheet from the CDC regarding information about concussions for you to review http://www.cdc.gov/headsup/pdfs/schools/tbi_factsheets_parents-508-a.pdf.

I have also included this link from the CDC which helps parents, coaches and schools https://www.cdc.gov/headsup/.

Parents need to talk to their teenagers’ school and coaches regarding making sure that they use the latest safety equipment for their sport. Parents may even want to research what the latest safety equipment so if your teen’s school is not using the latest safety equipment, you can inform the school. The ultimate goal is we want high school sports to be fun and safe for high school students.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families. For more information on Dr. Rubino’s work or private practice, where he treats Post Concussion Syndrome, please visit his website at www.RubinoCounseling.com or follow him on Twitter @RubinoTherapy.

Cutting Occurs in Boys and Girl Teenagers

Cutting Occurs in Boys and Girl Teenagers

As a psychotherapist who works with teenagers, I have observed the increase in teenage cutting over the years. I have also observed that a behavior that once was believed to occur mainly in girls is also occurring in teenage boys. From what I have seen it appears that just as many boys are cutting as girls.

The first question I often receive when I mention cutting is, what is it? Cutting is any behavior that a person engages in with the goal of self-mutilating. Teenagers cut with razors, knifes, paper clips, staples, using erasers or even scratching themselves. These are just a few ways teenagers have found to self-mutilate themselves. Since this is an activity associated with a great deal of guilt and shame, I am sure there are more ways that we have not learned about yet.

Also because cutting is associated with a great deal of guilt and shame our statistics on how many teenagers cut are not entirely accurate. Most recent studies indicate that approximately a third of all teenagers have tried cutting or actively cutting. If you noticed the research shows a third of all teenagers, which means boys too. I have more and more teenage boys who say they are cutting, have cut or are thinking about it. Cutting occurs in boys too. We need to be aware of this fact. Cutting can lead to accidental suicide attempts if an artery is cut or permanent damage if nerves in the arm or legs are severely cut. These are things that teenagers and parents don’t think about.

Why do teenagers cut? The reasons I commonly hear is it is easier to deal with the physical pain than the emotional pain they are feeling. Teens who are severally depressed state that cutting reminds them they are alive. They are so depressed that they feel nothing, but when they cut they feel. Also teenagers cut as a way to punish themselves because they are ashamed about something they did or they feel they have let their parents down. Cutting is a way to deal with the guilt and shame they are experiencing.

If we look at how boys are raised, cutting is a good fit for boys. Most boys grow up learning that boys can’t cry and if you express feelings of sadness or disappointment you are weak. Teenage boys are always supposed to look like life is perfect and they can handle anything without help. Cutting allows them to express sadness, fear or embarrassment in private. No one knows they are cutting or how they are feeling. Unfortunately, this leads to a vicious circle where emotions can get out of control and a boy may end up doing something he never indented to do.

At this point, most people working with teenagers consider cutting an epidemic. In fact, the CDC does consider teenage cutting to be an epidemic. Additionally, the little research we have about this behavior supports this idea, but we are unable to determine how severe the epidemic is in teenagers. When I mention cutting to a teenager now, they don’t look shocked and discuss it like the weather. They often tell me about friends who are cutting too.

Cutting can be a very dangerous behavior and does need to be treated with psychotherapy. If you feel your teen may be cutting talk to them in an understanding manner. Do not give them any reason to feel guilty or ashamed if they say yes. As I stated above, the teen already feels a great deal of shame and if they feel they will be looked at in a shameful manner or that you will be shocked they will never open up to you. You need to reassure them you love them and you only care about their safety.

I said it needs to be treated with psychotherapy. Find a psychotherapist who specializes in treating teenagers and in treating self-mutilating behavior. This is very important because if the therapist acts negatively or shocked, the teenager will shut down and therapy may not work with any other therapist. I have had teens test me in various ways because of what a previous therapist said about their behavior or what the therapist said to their parents. They need to feel safe and accepted by their therapist if therapy is going to work.

I have included some risk factors and warning signs for you to be aware of in case you think your teen might be cutting:

Risk Factors

Knowledge that friends or acquaintances are cutting

Difficulty expressing feelings

Extreme emotional reactions to minor occurrences (anger or sorrow)

Stressful family events (divorce, death, conflict)

Loss of a friend, boyfriend/girlfriend, or social status

Negative body image

Lack of coping skills

Depression

Warning Signs

Wearing long sleeves during warm weather

Wearing thick wristbands that are never removed

Unexplained marks on body

Secretive or elusive behavior

Spending lengthy periods of time alone

Items that could be used for cutting (knives, scissors, safety pins, razors) are missing.

While this is a scary subject, I have worked with many teens who have overcome this issue. The important thing is as parents you are accepting and non judgmental. Also you need to be aware that this issue does exist. My last point is that boys cut too. Girls are not the only teenagers engaging in this behavior.

Dr. Michael Rubino has over 20 years experience treating children and teenagers. He had treated many teenagers who cut and is considered an expert in this area. For more information regarding Dr. Rubino visit his websites www.rcs-ca.com , www.RubinoCounseling.com , or his Facebook page, http://www.Facebook.com/Drrubino3