Facts Schools Do Not Tell Parents about IEPs

School is getting ready to resume and so are meetings deciding if a child qualifies for an IEP (Individualized Educational Plan) or a 504 plan. I have posted this article before, but it appears I need to post it again. Once again, I have been hearing from parents all over the country who are afraid about lies they are hearing from their child’s school. Many of these parents are panicked and overwhelmed. They know their child needs help at school, but they do not want to ruin their child’s future. Additionally, many parents do not know what their child is legally entitled to and the school districts take advantage of this fact.

The issue that parents are feeling confused about is should their child have an IEP or a 504 plan. An IEP is for children who are having difficulty learning subjects in the classroom. They do not have an IEP because they are not intelligent. They have an IEP because they have a different learning style. I have seen numerous parents and received numerous emails from parents stating their child’s school has told them an IEP would mark their child for life as unintelligent and possibly bankrupt the school district. None of these remarks are true.

An IEP will not stop your child from getting into a college or getting a job as an adult either. Not having a decent education can stop your child from getting into college or getting a job. Therefore, if your child needs an IEP and not a 504 Plan in order to benefit from their education, not having an IEP could stop your child from getting into college or a job because they failed to receive a proper education.

Also think about when you applied for college or a job, did they ever ask for your middle school or elementary school records? The answer is no. Therefore, there is no way for a college or job to know if your child ever had an IEP unless your child volunteers the information when they apply for college or a job. Once again, colleges and jobs never ask an applicant if they ever had an IEP. Actually, an IEP can help students receive additional time taking the SAT and ACT and assist them in college if they need it. So actually, it can help a child applying to college.

As for the idea that an IEP will bankrupt the school district, this is absurd. The school districts have plenty of money to provide children who need an IEP with an IEP. A 504 plan costs the district nothing and if the district fails to comply with the 504 plan, you really have no legal recourse. However, an IEP is a legal agreement and the laws governing IEPs are the same in every state in the United States. Also if a school doesn’t comply with an IEP, you have a number of options including legal options.

Also parents please do not pay to have your child psychologically tested or undergo any educational testing by a private mental health clinician. Legally, the school district does not have to accept these tests results. The school has the right to do all testing first. If you disagree with the school’s tests results, you can contest the results and request that your child be re-evaluated by an independent clinician. If you request an independent evaluation, you can select who does the testing and the school district must pay for the independent evaluation not you.

The only testing schools currently are not doing are assessments for Attention Deficit Hyperactivity Disorder (ADHD). Too many children were being diagnosed with ADHD and now these assessments need to be done by a mental health clinician in private practice. These evaluations you do have to pay for.

Another issue I am receiving a large number of emails about is that the school is not doing anything. Parents are saying they are hearing from the school that their child is distracted in the classroom and not doing well on tests or homework. However, the school is not doing anything. If you feel your child needs to be assessed, you need to submit a written letter requesting the evaluations to the principal. Requesting it verbally does nothing. Legally you must submit a written letter to the school principal in order to start the IEP process.

Another suggestion, parents before you panic or feel guilty about not signing that you agree with the assessments by the school because the school is pressuring you to accept their recommendations, stop and think. Look at the proposed plan and decide do you think this is really what your child needs or is the school bullying you into signing their proposed plan. If you have doubts, don’t sign the agreement and seek a second opinion. You are the one in charge not the school. The school district cannot do anything until you sign the agreement. I have seen many parents made to feel guilty if they do not sign the school’s plan. You are not a bad parent if you do not sign right away, you are a cautious parent. If you do not agree with the proposed IEP plan, you can sign that you disagree and do not accept the proposed plan. There is a space on the form for you to do so. If you reject the plan, you will not ruin your child’s education. If you reject the plan, it simply means the school district needs to do more work to develop an acceptable plan. However, I have seen many school districts doing what is best for them financially not what is best for your child and making parents feel guilty. There is no need to feel guilty if you do not accept, the first option presented. Think about it when you are selling or buying a house, you do not automatically accept the first offer and you do not feel guilty.

For more information about IEPs and 504 plans visit the website www.lucascenter.org.

Dr. Michael Rubino is a psychotherapist and has worked with children and families for over 20 years. He also worked as an Intern at AB3632 for 2 years. AB3632 is a California program that provides counseling services for children in Special Education. They also participate in IEPs on a regular basis. Dr. Rubino has been an IEP Advocate for over 20 years. For more information about Dr. Michael Rubino’s work or private practice visit his website www.rcs-ca.com or www.RubinoCounseling.com or www.Lucascenter.org.

Autism and Placements

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July 2018

How Did We Get Here?

A Perspective on Residential Therapeutic Treatment

Parents’ dreams for their children seldom include placing them away from the family home before college or adulthood. Yet that is the complicated choice many parents face when their teenagers’ behavioral and mental health reaches a crisis point, whether due to an existing disability, or when a young person develops new struggles that put them at risk. The increasing number of young people with mental health challenges has been well documented. Nearly 1 in 5 young people aged 13-18 years experience a severe mental disorder at some point during their life. See the full infographic from National Alliance Mental Illness (NAMI) here.

Not all teenagers and young adults with these challenges will need residential placement. If they haven’t responded to outpatient treatment, medication therapy or are at risk of harming themselves or others, placement outside the home may be warranted. Children with an existing disability, like Autism Spectrum Disorder, with an increase in self-injurious or other risky behavior that is not being effectively addressed in their school placement, may also need a more restrictive setting.

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Complaints About ABA Providers

Our office has received an increasing number of phone calls recently from families with children with autism that have complaints about the quality of their ABA providers. While we care about our families and the quality of the health care that they receive, we typically get involved when there are disputes with your health plan about what is medically necessary, or when your health plan is not following consumer protections under the law.

First, try to address your concerns directly with the ABA provider by discussing in person or by phone. If this doesn’t work, outline your complaint in writing. You should include specific examples of your complaint and any dates or times associated with the issue. For example, if a therapist consistently arrives late of fails to show up, document those incidences and include them in your letter. While some providers have their own toll-free complaint or customer service line, it is always a good to document your concerns in writing and then follow up with a phone call.

If you are unable to resolve the conflict with an ABA provider, it may be appropriate to contact the Behavior Analyst Certification Board (BACB). The BACB has a long list of appropriate behaviors that certified behavior analysts must abide by. According to their Ethics code, Behavior Analysts responsibility to clients include: operating in the best interest of their clients, providing effective treatment, and avoiding interruption of service, among other things. For more details, see Professional and Ethical Compliance Code for Behavior Analysts.

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CASES WE HAVE WON

MHAIP Recovered over 10k for Ambulance Services for Client with Eating Disorder

MHAIP was able to recover over $10,000 from Blue Shield of CA for a San Mateo teen girl with eating disorders who was transferred from an eating disorders program to a cardiac unit, after developing urgent cardiac problems.

MHAIP Recovered over 93k for 11 Week Stabilization and Assessment

A 23 year old Alameda County, CA man with autism and severe depression requested stabilization and assessment with a residential facility in Utah through his HealthNet/MHN HMO.

Residential Therapeutic Care Won Through Ongoing Utilization

MHAIP conducts pre-authorizations and ongoing utilization reviews when clients contact us prior to starting residential treatment

We recently won the 161 days of residential coverage (and ongoing) for a 12 year old girl from Colorado with bipolar disorder and severe anxiety from United Health Care.

From Sanford Health Plan, we obtained 98 days of RTC coverage for a 15 year old girl with depression and anxiety from South Dakota.

Autism Treatment Won by MHAIP through DMHC

MHAIP won additional hours of 1:1 ABA therapy and reimbursement for out-of-pocket payments for past ABA therapy hours for a family in San Mateo County, CA who have a six-year old boy severely affected with autism.

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Boot Camps Do Not Work

In my experience as a psychotherapist, I have had many parents decide that their teenager needs to go to Boot Camps. Parents proceed with their plan, but it doesn’t work. Typically teenagers return angry and with more oppositional behavior. This also increases the time in therapy to undue the Boot Camp damage.

Many of these camps are located in Utah. They are located there because they are not closely monitored by the State. Therefore, they can basically do what they want and need no evidence that their methods work. Also most of these camps are not covered by insurance and parents must pay privately. These camps are not cheap either. It is less expensive to go on a vacation to Europe.

As I said, many parents feel Boot Camps are the answer. I have never seen one work. They tend to make things worse. Read about the alternatives that work better. Alternative to Boot Camp For Kids | Empowering Parents https://www.empoweringparents.com/article/is-boot-camp-the-only-option-for-your-child-read-this-first/

Is Your Child Depressed about School Starting?

Summer is ending and school will be starting soon. This means that children who were being bullied at school or having difficulties with homework will be returning to the same environment and they may be experiencing stress or depression. Also you have students who are starting middle school and high school. They may be afraid of not fitting in or already feel the do not fit in and feeling depressed. Finally, you have the students who are leaving home to start college. They are leaving their family and friends going into a completely new environment. This can be over whelming and intimidating. Many parents have been asking me about changes they have noticed in their child or teen and wondering if their child is experiencing depression or anxiety. Since I am asked the question often, I was reading an article by Dr. Jerome Yelder, Sr., which outlines many symptoms of depression. He explained them so they are easy to understand and covered all symptoms parents need to be aware of regarding depression. This is important because typically children and teenagers do not act like adults do when they feel depressed. I have outlined his list below for you to review and decide if you feel your teenager needs to see a mental health clinician for depression.

Sleep Problems

Depression can affect your body as well as your mind. Trouble falling or staying asleep is common in people who are depressed. But some may find that they get too much shut-eye.

Chest Pain

It can be a sign of heart, lung, or stomach problems, so see your doctor to rule out those causes. Sometimes, though, it’s a symptom of depression.

Depression can also raise your risk of heart disease. Plus, people who’ve had heart attacks are more likely to be depressed.

Fatigue and Exhaustion

If you feel so tired that you don’t have energy for everyday tasks — even when you sleep or rest a lot — it may be a sign that you’re depressed. Depression and fatigue together tend to make both conditions seem worse.

Aching Muscles and Joints

When you live with ongoing pain it can raise your risk of depression.

Depression may also lead to pain because the two conditions share chemical messengers in the brain. People who are depressed are three times as likely to get regular pain.

Digestive Problems

Our brains and digestive systems are strongly connected, which is why many of us get stomachaches or nausea when we’re stressed or worried. Depression can get you in your gut too — causing nausea, indigestion, diarrhea, or constipation.

Headaches

One study shows that people with major depression are three times more likely to have migraines, and people with migraines are five times more likely to get depressed.

Changes in Appetite or Weight

Some people feel less hungry when they get depressed. Others can’t stop eating. The result can be weight gain or loss, along with lack of energy. Depression has been linked to eating disorders like bulimia, anorexia, or binge eating.

Back Pain

When it hurts you there on a regular basis, it may contribute to depression. And people who are depressed may be four times more likely to get intense, disabling neck or back pain.

Agitated and Restless

Sleep problems or other depression symptoms can make you feel this way. Men are more likely than women to be irritable when they’re depressed.

Sexual Problems

Hopefully your teenager is not sexually active. While they may not have the sexual problems adults do, when they are depressed, they may show a lack of interest in dating or relationships and tend to isolate. They also may feel they are sexually unattractive.

If you’re depressed, you might lose your interest in sex. Some prescription drugs that treat depression can also take away your drive and affect performance. Talk to your doctor about your medicine options.

Exercise

Research suggests that if you do it regularly, it releases chemicals in your brain that make you feel good, improve your mood, and reduce your sensitivity to pain. Although physical activity alone won’t cure depression, it can help ease it over the long term. If you’re depressed, it can sometimes be hard to get the energy to exercise. But try to remember that it can ease fatigue and help you sleep better.

If you feel you child or teenager are experiencing the above symptoms and may be depressed, have them evaluated by a mental health clinician who specializes in treating children and teenagers. Remember, children and teenagers often display different symptoms when they are depressed so it is often misdiagnosed. Also do not be embarrassed or ashamed. The pressure children and teenagers are facing at school can be very overwhelming and can easily cause a depressive episode. The most important thing is if your child or teenager is experiencing depression, get then the treatment they need.

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

Children and Teenagers Need Sleep for School

The end of summer is coming fast, which means school will be starting soon. Many children and especially teenagers have become use to staying up late and sleeping in because it is summer. However, this pattern will need to change when school starts. Sleep is very important for children and teenagers. In fact, research shows that sleep has a big impact on our mental health and physical health. Research has shown that sleep deprivation can cause a person to have a psychotic break or if the depreciation is really severe it can even result in a person’s death. I recently received some very good information regarding sleep and mental health. It was provided by Jenny Thompson who is associated with www.bettermattressreviews.com. I think it is valuable information for everyone so I have provided it below.

Mental health and sleep are closely related. Sleep problems frequently accompany mental illness, and can even be the first warning sign of a disorder. In turn, lack of sleep worsens mental health symptoms, creating a vicious cycle.

Mental illness is common, with almost 20 percent of Americans suffering from at least one mental health disorder. While only 10 to 18 percent of the general population experience sleep issues, as many as 50 to 80 percent of people with mental illness have trouble sleeping.

Mental health disorders are the largest cause of insomnia. 40 percent of insomniacs and over 46.5 percent of hypersomnias have a comorbid mental health disorder. On the other hand, only 16.4 percent of people have a mental health disorder without any kind of sleep issues.

Sleep problems are closely correlated with ADHD, anxiety disorders, bipolar disorder, depression, and schizophrenia. Below we’ll review how sleep affects several mental health disorders, and provide tips for getting better sleep.

Schizophrenia and sleep

Schizophrenia affects 1 percent of people, or 3 million Americans. Onset often occurs in late adolescence or the early 20s. Individuals with schizophrenia suffer from psychoses such as delusions and hallucinations, and experience difficulty focusing their thoughts and expressing themselves.

Up to 80 percent of people with schizophrenia have sleep problems, including:

Irregular sleeping hours. They may fall asleep anytime during the day or night rather than during the typical overnight sleep period of most people. They may have consistently delayed melatonin release that shifts their sleep pattern later than normal, slowly shift their circadian rhythm later and later each day, or follow no consistent sleep-wake patterns at all.

Irregular sleep quantity. They may get too much (hypersomnia) or too little (insomnia) sleep, as a result of medication side effects, fear or anxiety due to hallucinations (which may cause them to sleep more to escape, or conversely to be afraid of nightmares), or the irregular sleep hours cited above.

Sleep apnea. Individuals with sleep apnea literally stop breathing during the night, due to blocked airways or a miscommunication between the brain and the breathing muscles.

Less refreshing sleep overall. Due to the issues described above, people with schizophrenia experience less refreshing sleep overall because they have trouble getting sufficient amounts of REM sleep.

For many people with schizophrenia, an onset of sleep problems can be a warning sign that psychosis is starting or returning.

A 2012 study of mice found that abnormalities in the SNAP-25 gene are linked to schizophrenia as well as disrupted sleep-wake cycle, suggesting that resolving sleep issues may less or resolve schizophrenia symptoms.

Anxiety disorders and sleep

Generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social phobias, and PTSD are all associated with having anxious thoughts while trying to fall asleep at night and related insomnia.

Source: The National Academies Press

Panic episodes may waken an individual with panic disorder from sleep, thus disrupting their overall sleep quality. Likewise, individuals with PTSD are prone to vivid re-experiencing traumatic nightmares which heighten their bedtime anxiety and also cause interrupted sleep.

Individuals with mood and anxiety disorders may be prescribed various medications such as antidepressants and mood stabilizers which can further interfere with sleep.

Insomnia not only accompanies anxiety; it can cause it. When individuals experience chronic sleep deprivation, it disrupts their serotonin and gamma-Aminobutyric acid neurotransmitter levels, which can result in anxiety. One study found that having insomnia increased one’s risk to have yet another mood or anxiety disorder one year later.

Depression and sleep

Insomnia is one of the biggest risk factors for depression. Lack of sleep worsens mood, and the effect is even worse for individuals with a mood disorder. Depressed people with sleep issues have a higher risk of suicide than depressed individuals without sleep problems.

Treatment is also complicated. While antidepressants boost mood and alertness to help treat depression, that same alertness makes the insomnia persist – and not addressing the insomnia can make individuals less responsive to treatment. But certain prescription drugs for insomnia, like Rozerem, may worsen depression. The key is to find a treatment plan that helps both issues, but not at the expense of either.

Depression and sleep issues are bidirectional. That means the problems of one can worsen the other. The good news is, that also means the improvement of one often fixes the other. For example, 35 million Americans suffer from mild depression (dysthymia). For many, their comorbid insomnia goes away once they begin taking antidepressants.

Bipolar disorder and sleep

Bipolar disorder affects 3 percent of Americans, or 6 million adults. In addition to severe changes in mood, behavior, and energy levels, individuals with bipolar disorder may also experience the following sleep problems:

Insomnia, or difficulty falling or staying asleep

Hypersomnia, or oversleeping, especially during depressive episodes

General sleeplessness, where individuals feel fine even when they’ve had significantly less sleep, although this abnormal sleeping pattern eventually catches up with them

Delayed sleep phase syndrome, where the individual has a delayed circadian rhythm, causing them to naturally start to fall asleep or wake up later than others and experience excessive daytime sleepiness as a result

Irregular sleep-wake patterns from manic episodes and related hyperactivity at night

REM sleep issues like vivid nightmares

Sleep apnea affects one-third of individuals with bipolar disorder, resulting in less restful sleep overall and excessive daytime sleepiness

For individuals with bipolar disorders, different sleep issues may arise depending on when they are in a manic or depressive state.

In fact, for 75 percent of individuals with bipolar disorder, sleep problems are one of the biggest warning signs that they are about to experience a manic episode. For example, sleep loss from chronic sleep deprivation or even a night of jet lag can induce a manic episode. Manic periods are so arousing that individuals can go for days without sleep, or sleep drastically less amounts than usual and not feel tired. However, that lack of sleep makes its mark in other ways, as they’ll still experience the other symptoms of sleep deprivation felt by everyone, including increased irritability, trouble focusing, reduce judgment, depressed mood.

As they enter depressive episodes, bipolar people may experience insomnia or hypersomnia, both extremes which cause further imbalances in mood and increased anxiety.

In between manic and depressive episodes, individuals with bipolar disorder experience poorer quality sleep, occasional insomnia, and interrupted sleep.

Sleep tips for individuals with mental health disorders

There are various psychotherapies that treat mental illness, sleep therapies for sleep problems, and other behavioral changes that can help individuals with mental health disorders sleep better at night.

1. Practice good sleep hygiene.

It all starts with good sleep habits. Good sleep hygiene includes keeping the bedroom cool, dark, and quiet, and limiting stimulating activity before bed, such as watching television, using the computer, or engaging in heavy exercise. Heavy meals, as well as alcohol, drugs, and caffeine, should be avoided in the early evening and late night hours.

2. Be careful with napping.

For individuals with excessive daytime sleepiness, power naps of 20 minutes can help give a sense of refreshment. However, naps longer than 20 minutes should be avoided as they can contribute to insomnia later that night.

3. Try sleep therapy.

There are various psychotherapy options that assist individuals with mental health disorders. There are also many specific therapies designed to treat comorbid sleep problems.

Cognitive behavioral therapy (CBT) has proven very effective for treating insomnia. CBT first helps the patient recognize their harmful or disruptive thought patterns and habits. Then, they learn to replace them with positive thoughts and better ways to cope so they can calm anxieties surrounding sleep as well as the rest of their lives. One study in particular found that six 20-minute sessions of CBT resulted in a nearly 50 percent decrease in insomnia, 20 percent decrease in depression and anxiety, and 25 percent decrease in paranoid thoughts, and 30 percent decrease in hallucinations.

Sometimes taught as part of CBT, meditation and deep breathing exercises can soothe anxious thoughts and help relax the body for sleep. You can find audio files of guided meditation and relaxation exercises on the MIT Medical website.

Sleep restriction therapy involves setting a strict bedtime and waketime, and only staying in bed for that allotted amount of time, regardless of how much sleep the individual actually enjoys. Eventually the body gets used to the new sleep-wake cycle and begins to sleep and wake at the proposed appropriate time. A small 2013 study found that sleep restriction therapy improved sleep and reduced symptoms of insomnia for patients with bipolar disorder.

Chronotherapy works similarly by gradually adjusting the bedtime and waketime. It’s a newer therapy and the research is still bearing out.

Bright light therapy helps reset a person’s circadian cycle and make them feel more awake in the morning. Exercising outside in the morning in areas of bright sunlight can provide a similar effect.

4. Explore natural remedies.

Melatonin supplements help kickstart melatonin production in the brain. These can be helpful for insomnia or anyone who has difficulty falling asleep due to a period of mania or delayed sleep-phase syndrome. Valerian root can also help induce sleep. Both melatonin supplements and valerian root are widely available at pharmacies.

5. Keep a sleep diary.

If you’re concerned you may have a comorbid sleep disorder, a sleep diary can help you track your sleep habits. Note when you fell asleep and when you woke up, the total amount of time you were asleep, and anything abnormal that happened during your sleep, such as nightmares or snoring. If you find you’re not getting enough sleep, you can meet with a sleep specialist for a diagnosis and share your diary with them.

You may also want to consult a mental health professional for an evaluation and/or your primary care physician.

Dr. Rubino has 20 years experience as a psychotherapist treating children and teenagers. Many have sleep problems. For more information regarding Dr. Rubino’s work or private practice visit his website http://www.rcs-ca.com.

Teenagers and Their Bedrooms

An issue that comes up daily with teenagers in psychotherapy is their bedroom. Many parents tell me that their teenager’s bedroom is like a junk yard. Parents are embarrassed by the bedroom and feel the teenager is being disrespectful. Many parents ask me should they demand that their teenager clean their bedroom. Also many parents ask about is it appropriate if they search their teenager’s bedroom. Let’s deal with this one issue at a time.

Parents it is very important to remember to pick and choose your battles. There are a lot of issues you will need to discuss with your teenager. Therefore, it is important to ask, is it worth an argument? Teenagers are at a point in their life where they do need their privacy. They are also at a point where they are trying to find their own identity. Their bedroom is a place they use for part of this process. Also you want your teenager to learn responsibility. Their room is something they can be responsible for.

My recommendation is not to make an issue of their bedroom. You have more important issues such as school, how late your teen wants to stay out, where they want to go and the common issues of alcohol, drugs and sexual activity. Therefore, their bedroom really is a minor issue. In my opinion it is not worth the fight. Arguing about their bedroom, which they view as their private space, can lead to bigger problems with some of the other issues I listed above. Also remember these are only some of the issues you will need to set guidelines and expectations about your teenager’s behavior. This is why I strongly recommend leaving the bedroom alone.

Many parents ask me, “then I should just let them live in a junk yard?” The answer is yes. However, there are some guidelines I do set with teenagers. I tell them that Mom and Dad are not going to clean their room as long as they comply with the following guidelines:

1. The bedroom door must be able to be closed so no one else has to look at the mess.

2. People can walk by the room without smelling anything such as rotting food.

3. There are no ants or bugs going into or coming out of the room.

4. They do not keep dishes in their room so Mom has dishes when she needs them.

5. They are responsible for getting their clothes out of the room and cleaned. They are also responsible for putting away their laundry.

If they do not follow these guidelines, then they are giving Mom and Dad permission to go in and clean the room as they see fit. I ask the teenager and parents to both agree to these guidelines. I also recommend writing down the guidelines. Therefore, two months from now if someone remembers the agreement differently, you have a document you can refer back to which states what everyone agreed to.

Therefore, I recommend to parents if their teenager can agree to these guidelines, let them live in a junkyard. If they forget to get their clothes to the washer then they will be the one wearing dirty clothes. This is helping them to learn responsibility. It also gives them a sense of independence which they need.

I remind teenagers, if you do not want Mom and Dad cleaning their room then they need to abide by the guidelines. I also remind them it is their responsibility to get their clothes to the washer. If they don’t then they will be wearing dirty clothes to school. I also remind them that they cannot stay home from school because they do not have any clean clothes. I am basically telling the teenager that their parents and I feel they are responsible enough to take care of their room. This again helps the teen feel more mature and understand that they have to start assuming more responsibility for theirselves.

Now for the next issue, searching your teenager’s room. I do not think it is something parents should do on a regular basis just because their child is a teenager. As parents you have a responsibility to make sure you are raising a responsible young adult and if they need help, you have an obligation to provide them with the help they need. Therefore, if you have valid reasons to believe your teenager is using drugs or alcohol on a regular basis, then yes search the room. A valid reason would be noticing the smell of marijuana on their clothes or coming from their room. Finding marijuana or alcohol bottles in their backpack or car that they use. Other signs could be changes in their behavior and grades that are associated with drug use. However, before searching the room, I would recommend when your child enters middle school that you discuss with your child about the conditions which would make you search their room. If you feel it is necessary, tell your teen that you will be searching their room. Obviously, you do not tell them a week a head of time so they can hide things. I suggest you calmly inform them when they are home that you will be starting to search their room in a few minutes. It is important you explain the reasons why you are searching their room.

Parents may be concerned about an argument. This may start an argument, but this argument is worth it. Remind your teen about the agreement the two of you had made about searching their room. If you feel your teenager is not mature enough to abide by the agreement and is likely to start a physical fight, then you do not tell them and search it when they are out of the house. Remember you are only searching the room if you feel your teen is having a serious problem and need professional help. As a parent, it is your responsibility to get them help when they need it. You will want to remember this fact because your teenager may be very angry with you. However, it is better to have an angry teenager than a dead teenager. Many of the drugs teens are using today can kill someone very quickly and teenagers are not usually aware of all the risks.

Therefore, in general respect the privacy of your teenager’s bedroom, however, if you notice signs that indicate your teen is having difficulties then search the room.

Dr. Michael Rubino has over 20 years experience as a psychotherapist who teats teenagers and children. For more information regarding Dr. Rubino’s work or private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino 3.

Girlfriends and Boyfriends Are Not Necessary to Live

“You Complete Me”

Many people are familiar with this line from the movie, Jerry McGuire, starring Tom Cruise. A deaf couple signs this message to each other in an elevator and Tom Cruise’s character assumes they must really be in love. However, this may not be the reality. In reality it may be an unhealthy relationship.

As a psychotherapist with 20 years experience treating couples and teenagers, I have observed a common mistake that many people make regarding relationships. Many people tell me they feel an emptiness inside themselves and describe it as a “big empty hole.” They assume that a relationship will fill this emptiness. In other words, they are relying on their partner to eliminate that empty feeling they are experiencing.

This is a mistake. The only person that can fill that emptiness you feel is you. When I work with couples or an individual who is experiencing this emptiness, they usually are upset with their partner. They are upset because their partner is not filling the emptiness. Also the other partner is frustrated because they are tired of having to constantly reassure their partner. They report they are tired of always having to worry about meeting their partner needs and that their needs are constantly being pushed aside.

This type of pattern is very common in relationships where there is domestic violence or a substance abuse problem. Also jealousy is a major issue in these relationships. The person who is experiencing the emptiness is very sensitive to feeling rejected or abandoned. This is usually a result from childhood issues that have never been addressed. However, as an adult, if they sense these feelings in their relationship they tend to over react to them. The person may drink excessively to reduce their fears and men often result to verbal or physical abuse. Anything that will keep their partner in the relationship and continue to fill the empty space.

This tends to occur because as we grow up there is a great deal of pressure for people to be in relationships. You see this in children in first grade or kindergarten when adults jokingly ask children if they have a boyfriend or girlfriend. If a child doesn’t they often feel there is something wrong with them.

I see this issue a lot with teenagers. I have teenagers who feel they are defective because they never had a girlfriend or boyfriend. This defective feeling increases significantly, if the teenager never has been on a date. They believe if they are going to be a “normal” teenager, they must at least be dating. Boys tend to believe they must be sexually active too. I have had teenagers tell me they felt suicidal or were using drugs because they did not have a girlfriend or boyfriend. They are willing to risk their lives using drugs or believe they are better off dead, if they don’t have a girlfriend or boyfriend. They are so tied up trying to live the stereotype, they can’t believe that many teenagers do not have a girlfriend or boyfriend and do not date in High School.

This pattern continues into adulthood. Many women feel defective if they are 30 years old and not married. Men feel as if they are not men if they do not have a girlfriend. Both men and women often settle for anyone as long as they can say they are in a relationship.

As children, we never learn how to love and care for ourselves. Ask someone if they would go out to dinner by themselves and most people look terrified by the idea. They have no idea what they would do and they are afraid about what other people with think. This is a sad state that we cannot love ourselves. If we always need someone to reinforce we are lovable, we turn our power over to strangers. If someone says something nice about us we feel good, if they say something hurtful, we feel unworthy as a person. But, why should someone else determine our value? We should be the one who judges if we are lovable or not. A relationship should add to our life like a bottle of wine adds to a meal. A relationship should not define us as a person.

As a result of this problem, many couples end up divorcing because a partner is tired of having to reassure their spouse daily. I have seen these divorces become very nasty and costly. So both parties are hurt even more and so are the children. They only people benefiting are the attorneys.

We also have this same issue with teenagers. However, when they break up it tends to be more dramatic. A teenager may start to use drugs, developing an eating disorder, start cutting, become depressed and may attempt suicide. The behaviors are not uncommon after teenagers break up.

How do we handle this issue? We need to start to acknowledge as a society that a relationship doesn’t make you a complete person. Only you can make yourself feel complete as a person. Also we need to remove the stigma of seeking mental health care. We need to encourage adults who feel incomplete without a relationship to seek psychotherapy and deal with their issues. Parents, if you notice that your teenager is desperate to be in a relationship, help them get psychotherapy so they can deal with the pain they are feeling.

Again, please remember a relationship should add to your life, it should not make you a person or define you as a person.

Dr. Michael Rubino has 20 years experience working with families and teenagers. If you would like more information about his work or private practice visit his website at http://www.rubinocounseling.com.

What Parents Need to Know about IEP’s vs. 504 plans

Dr Michael Rubino

Many parents do not know what an IEP is or what a 504 Plan is in regards to a child’s education. Also many parents are not aware of their rights or their child’s educational rights. I receive numerous emails from parents anytime I write about IEPs. Therefore, here is an article describing IEPs and 504 plans for parents.

Parents here is important information about Individualized Education Plans (IEP) and 504 agreements. Besides ensuring that your child receives a good education, you do not need to pay for items such as special computer programs that the school district should be paying for not you. If your child has an IEP the school district is responsible for most educational expenses even a private school if necessary. Please read this article so you understand your rights and your child’s rights.

The beginning of the school year is fast approaching. Besides the mad dash to get ready for school and schools are going to start assessing students to determine if they qualify for an Individualized Educational Program (IEP). I am already hearing from parents how school districts are misleading them and pressuring them to sign an agreement for a 504 before the parents clearly understand the difference between an IEP and 504 plan. The definition for both is further down in this article. An IEP and 504 are not the same. An IEP is legally enforceable and has legal guidelines and time frames. An IEP follows a student from school to school or state to state. A 504 is not legally enforceable and doesn’t follow a child nor are there legal guidelines.

An IEP will not stop your child from getting a job or from getting into college. In fact and college because they still would be entitled to assistance and the State of California may pay for their books. Also educational records are confidential therefore, no one would know your child had an IEP in school.

Many schools say your child must be two grades below in order to qualify for an IEP. If you said your child had a math or reading disability this is true. However, if they have ADHD, Bipolar, school anxiety etc. they can qualify under OTHER HEALTH IMPAIRMENTS. All your child needs is a diagnosis such as ADHD which would interfere with their ability to fully benefit from their learning experience in the classroom. The 2 grade below level qualification doesn’t apply to this category.

Also if you have a child in private school and they would benefit from additional assistance, contact your child’s public school district. Even though they attend private school the public school district is legally obligated to provide your child with services.

One more issue, never pay for outside testing before the school district tests your child. They have the right not to accept any outside testing until they test the child. If you disagree with the district’s testing then you can request an objective testing from an outside professional and you can request that the school district pays for the testing and you can select the evaluator.

An IEP or an Individualized Education Plan is a document that outlines the specialized education services that a student will receive due to their disability. It ensures the student will receive the assistance necessary so they will receive an education.

When most parents hear disability, they usually think of a person in a wheelchair or a student wIth a learning disability. There are various condItions that can qualify as a disability. Depression, Bipolar Disorder or even diabetes. The disability is any condition that will interfere in the student receiving the same education as other students. The students who qualify for an IEP need accommodations which meet the criteria of needing specialized education. As I stated above their are numerous conditions which may qualify a student for an IEP.

if a student does qualify for an IEP, they also qualify for Special Education. Many parents hear this and are afraid or embassies. There is nothing to be afraid of or embossed about. If a student qualifies for Special Education, if the student needs speech therapy or special computer programs, the school district is obligated to provide the services to the student at no expense to the student’s family.

There is also an option called a 504 Plan. This was established in the Rehabilitation Act of 1973. The 504 plan ensures that a student with a disability will receive accommodations so they will receive the same education as other students. However, the 504 plan does not qualify a student for Special Education services and It is not overseen as closely as an IEP plan.

Currently, many districts are telling parents that their child does not need or qualify for an IEP and a 504 plan is just a good. This is not true. Many school districts are telling parents that their child does not qualify for an IEP because the IEP is more expensive for the district and most districts are trying to save money.The districts take advantage of the fact that as parents, you do not know all the differences between an IEP and a 504 so they can talk a family into a 504 plan easily.

If you find that your child is having difficulties at school due to a learning disability, health issue or emotional issue, consult an outside professional before you automatically assume that the school is giving you the appropriate recommendation.

I see many parents who have been told that their child is better with a 504 plan and that is not the truth. You can consult an educational consultant or a therapist who works with children. You can contact me at via my website http://www.rcs-ca.com. I help many families at their child’s IEP meeting. The main thing is, do not be afraid to ask if your child should have a 504 or an IEP. Also don’t let the district make you feel guilty because you want time to think and investigate the options. This is your child and you should never sign anything until you are sure it is in your child’s best interest.

I have added a link to a chart that will help you compare the two and understand the differences.

504 Plan vs. IEP – Education Centerwww.ed-center.com/504This pages lists the differences between an IEP and a 504 plan.

I have also added a link to a video which helps to explain the differences between an IEP and 504 plan.

Dr. Michael Rubino has over 20 years experience working with children and teens. He also has over 19 years experience working with children in Special Education and was an Intern for the AB3632 program which works with children in Special Ed and IEPs. For more information about Dr. Rubino’s practice visit his website at www.rcs-ca.com or his new website that deals specifically with IEPs, lucascenter.org.

Smartphones are not Necessary for a Teenager’s Survival

In today’s society many people including teenagers view cell phones as a necessity of life. I have seen teenagers argue with their parents how they could not function at school without their cellphones. Most teenagers also say they need Smatphones, a regular cellphone will not work. 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.

Middle School in the 21st Century

The school year will be starting soon and many parents are focused on their children’s transition into High School or Kindergarten. However, there is another important transition for children. Beginning Middle School is a major transition for pre-adolescents. As a psychotherapist who works with adolescents, I am very familiar with what is happening on High School and Middle School campuses and how big the transition is into Middle School these days. However, some parents are not aware of what happens in Middle School today. One example, when I mention to parents who have a child going into middle school or a child in middle school, if they have spoken to their child about drugs and alcohol, I am told no.

I hear parents say every day that they don’t need to worry about drugs or alcohol with their child in middle school because their child is too young for that right now. Well the reality is that Middle School Students are drinking, using drugs and having sex. Many parents are unaware of what is happening in Middle Schools these days. Drugs and alcohol are just the tip of the iceberg. Children that are in the age group of middle school are now involved numerous dangerous activities such as selling drugs.

To begin with, most middle school campuses are better pharmacies than your pharmacy. I have had middle school kids say they can get Vicodin, Concerta, Ecstasy and of course weed and alcohol on their school campus. Some kids use at school and some use after school and on the weekends. More and more middle school kids are deciding to experiment with drugs and alcohol due to the pressure to feel successful as a teenager and so they fit in with friends.

Also many middle school kids are sexually active, but they don’t think they are sexually active. They think because they are not engaging in intercourse and they are engaging in sexual activity. Most 6th graders tell me oral sex doesn’t count as being sexually active. The kids say they are just “messing around” with each other and do not consider this sex. They also have no idea about sexually transmitted diseases or how to protect themselves from contracting STDs or getting pregnant. However, the number of middle school kids engaging in oral sex and intercourse has increased significantly over the last few years. The rate is now high enough that some middle schools, such as the San Francisco School District, are disrupting condoms to middle school kids. Yes, Middle Schools are giving condoms to children in the sixth grade. These kids are only 11 years old.

Another common issue in middle school is bullying. However, we are not just talking about one kid teasing another kid at school anymore. Today there is for a group of kids teasing one kid and it is not just at school. Now kids are using Facebook, Twitter, Instagram, Snapchat and texting by cellphone to tease and harass other kids. As many of you may recall there have been a number of kids who have committed suicide due to the teasing occurring at school. I wrote an article about a middle school girl who committed suicide and in her obituary she left a note to the other students just asking them to be nice to each other.

Another issue with teasing, is that a number of middle school students have been arrested for photos they text and for harassment. Besides teasing, texting a nude photo of a student in middle school means the middle school child violated child pornography laws. Something many parents and students are not aware of is that when a child texts a nude photo of a middle school student, who is under 18 years old, it violates child pornography laws and the child who texts it and received it can both be arrested.

Also many kids in middle school, especially boys, don’t feel safe and are afraid of someone trying to beat them up before or afraid school. They say they have to fight because other kids are recording it and posting it on YouTube. Boys are bragging about their fights on YouTube and comparing how many people have watched their fight with their friend’s fight. Therefore, boys feel they must fight, otherwise if they don’t fight the other kids will think they are a “whimp” so they have to fight. Due to this fear many middle school students carry knives, metal pipes, guns or anything they can think of to protect themselves. This is very sad that kids have to live in fear for their lives and safety at school. Also parents and students don’t realize, if a student is caught with any of these items on campus they can be removed from their entire school district and required to go to continuation school. In addition, the school can have the student arrested. Due to terrorist activities, schools take anyone possessing items that can severely hurt someone very seriously.

These are just a few of the issues that are occurring at all middle schools and they are very serious. Your child is not going to come to you to ask about these issues or tell you about them because they feel embarrassed and they are afraid of getting in to trouble. So parents even though you may feel embarrassed or awkward discussing these issues with your 11 year-old child, please do so. If you notice anything about your child’s behavior that seems different to you and you feel a sense of concern, ask your child about what is happening at school and with friends. Mention they are getting older so are the issues in their lives and mention drinking, sex or being teased and ask if they need to talk about it. You may be saving their lives because they are dealing with things they know nothing about and these things can kill or have life long effects.

Here is a YouTube video that might help:

Life Talk | PSA: This could be your child (Teen drinking, alcohol,partying,peer pressure)

Dr Michael Rubino is an expert dealing with adolescents and adolescent issues. He has over 20 years experience treating adolescents. For more information about Dr. Michael Rubino’s or his Facebook page http://www.Facebook.com/Drrubino3.

Dr Michael Rubinio

Understanding Your Teenager

Month: July 2018