Preparing for College, If you have an IEP in High School or Elementary School

Preparing for College, If you have an IEP in High School or Elementary School

Working with children and adolescents I have had many parents ask about 504 plans and Individual Educational Plans (IEP). Parents tend to focus on the assistance their child may need in elementary or high school due to a learning disability or mental health issues. Over 20 years as a psychotherapist, what I have observed is that children who need assistance in elementary and high school typically need assistance in college. Since we are coming to the end of the school year and as seniors in high school prepare for graduation and decide on plans for college, IEPs need to be addressed with colleges that students will be attending.

From my experience, most families assume there is no assistance in college. However, typically if a child has an IEP, they are also entitled to assistance in college. Most colleges in their Counseling departments have programs designed to help disabled students. A student with a physical or learning disability or mental health issue such as ADHD or depression would qualify for assistance by the Disabled Students Program at a college. I have recently been receiving many questions from Parents about what happens to their child’s IEP when the go to college and questions from parents who have college freshmen asking about their child’s IEP. Therefore, I thought it would be beneficial to provide information about how IEPs are handled by colleges. In addition to an IEP, any student with a learning disability or mental health issue is entitled to accommodations because they are covered by the Americans with Disabilities Act of 1991.

Additionally, if you live in California and you have a physical or learning disability or a mental health issue and if you had or did not have an IEP while in school, you may qualify to be a client of the California Department of Rehabilitation. This Department is responsible for assisting people in California, with a disability, find a job and get the education they may need to find a job. The Department may assist their clients by providing tuition assistance for community or state colleges and provide financial assistance to buy text books and school supplies. What they are able to do depends on the State budget.

This is another reason for parents to insist when their child does need an IEP that the school district places the child on an IEP. The lies schools tell parents that an IEP will prevent their child from getting into a college, the military or getting a job is not true. Another reason to insist on the IEP, if your child qualifies for an IEP, as a result of having an IEP, your child can be granted accommodations on the SAT or ACT. These are tests seniors typically need to take when they are applying to four year universities. The common accommodation most students require is additional time to complete the tests. I have had many teens with ADHD come to me seeking accommodations on the SAT or ACT. A common requirement that the testing boards require is that a student needs to have had an IEP if they are seeking accommodations on these tests.

Therefore, many students who have disabilities or mental health issues can receive assistance in college. While many people may be surprised, it is true. However, for many college students finding the assistance can be confusing and overwhelming. For a Freshman in college dealing with heath or mental health issues the confusion and embarrassment people deal with because of society stereotypes can cause students to give up. However, I was contacted by bettercollege.com with a resource guide they developed for college students with mental health issues. While their guide was created for students with mental health issues, it can also be used as a guide for students with physical or learning disabilities.

Since I feel this is a valuable guide to Freshman students and their families, I am including a link to this resource guide below:

Guide to College Planning for Psychiatrically Impaired Students – https://www.bestcolleges.com/resources/college-planning-with-psychiatric-disabilities/

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with children, teenagers and college students. For more information about Dr. Rubino’s work and private practice visit one of his web sites http://www.RubinoCounseling.com or http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3.

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Facts about Teenage Mental Health Care in the United States

Facts about Teenage Mental Health Care in the United States

The week is dedicated to children’s mental health care. As a psychotherapist who specializes in treating teenagers, I have seen how teenagers and their parents do not receive the access to the mental health care they deserve. Hopefully this article will explain what teenagers and their parents currently deal with and the changes that we need.

We often hear parents complain that their teenager is driving them crazy or a teenager complaining how unfair their parents are to live with on a daily basis. However, there are another set of complaints that get ignored on a routine basis. The complaints that get ignored are parents begging for mental health care for their teen or a teen crying out for help by cutting themselves or running away.

Many of us assume that if a parent wants mental health care help for their teen or if a teen needs help, all either one of them has to do is ask for help. Unfortunately, this is not how our world works.

It is very common for parents to ask everyone they can think of for help for their teenager and the only answer they get is, “I am sorry we cannot help you or your child.”

It is also not uncommon for teens to ask for help by admitting to someone that they are feeling suicidal and the teen is told stop being so dramatic or “sorry there is nothing we can do for you, but try calling this number.”

Some of you may assume that I must be exaggerating, but I am not. I have had many parents beg me to see their child because no one has any appointments or they don’t deal with teen issues. When I interview the parents, they have been every where asking for help, but no one has offered any help or referred them to someone else because they don’t deal with their child’s issues.

For example, one Thanksgiving I had a mother have my answering service page me and she was begging me for help because her teen was suicidal. I was referred her to the mother by the County hospital because the County hospital said they had no room for her son. When speaking to the mother it was obvious the teenager needed to be hospitalized. When I asked her why her son was not in the hospital, she again told me the County hospital gave her my telephone number because they had no more beds for suicidal teenagers. No one in the system cared what she was dealing with and how concerned she was about her son.

Again, some people might believe this is an isolated case. Sadly this is not an isolated case. I specialize in treating suicidal and bipolar teens. There have been a number of times I have sent a suicidal teen by ambulance from my office to the County hospital only to have the teen released in less than an hour because the hospital had no beds. I had one person on the Psychiatric Crises Unit tell me on the telephone unless the person had a shotgun in their mouth not to send them to the Hospital because they had no beds for suicidal teens.

Now, some of you may assume the situation would be different if the teen had private insurance because I have been referring to the County Hospital. If you are thinking having private insurance would make a difference, you are wrong. I have had many private insurance companies deny my request to authorize additional therapy sessions for a suicidal teenager. When I remind the insurance that the teen is suicidal and needs therapy to prevent them from acting on their feeling, they often say to refer them to a community counseling center. When I remind them that most non-profit counseling centers have closed due to the economy they simply say sorry they have exhausted their benefits and they will no longer cover their treatment.

This puts the therapist in a difficult position. Do you just discharge the teen or do you continue to treat the teen for a low fee or for free? When 1 out of 5 teens have a psychological condition that needs treatment, what do you do when treatment is denied or there are no treatment options? Also, when you examine the results further you find that teens who need therapy but fail to receive it are more likely to get involved with drugs, crime, are more likely to drop out of school, more likely to get pregnant or father a child and that child is more likely to become a foster child. These teens are also more likely to end up on probation, homeless and on welfare.

As a society we do not place much emphasis on mental health care. Mental health care programs are always some of the first programs cut when the budget is cutback. In fact if you look at the recent cut backs due to the Congress not balancing the budget, mental health programs were some of the first programs to be cut.

I find it very interesting that Contra Costa County had enough money to build a new Juvenile Hall, which is three times the size of the old Juvenile Hall, but there was not enough money to fund a large number of mental health services which had to be cut.

We often look at teens who are acting out and blame their parents. We ask why don’t they get their child the help they need? What stops them from helping their teenager? Why is the teen always getting involved with drugs or not going to school? The answer could be because the teen needs mental health care and the parents have been and continue to try to get their teen help but their is no help. The teen may be acting out because they are tired of asking for help and being in pain so they start looking for the easiest way out of pain.

If we want our teenagers to grow up to become productive members of society then we need to provide them with the mental health care they need. If we want parents to be responsible parents then we need to provide parents options for how to get their teens help when they ask for it.

What can we do? We can write our Congressmen and Senators and demand that they fund community mental health centers. We need more mental health clinics. We don’t need an useless wall on the Southern border.

We can also demand that private insurance companies be required to offer teenagers and their families adequate mental health benefits based on what professional therapists are recommending. The professional treating the child knows what the child needs not some clerical worker with a Bachelors degree who is answering phone calls at the insurance company.

In short, if we want our teenagers to survive their teen years we all need to act together and demand that our children receive the treatment they need and deserve. Private insurance companies make huge profits and drive the cost of health care up based on how they do business. If we don’t start to speak up for our kids, they will never receive the care they need. Look at your next pay stub and look at how much you pay for health insurance and compare that to the benefits you receive.

Dr. Michael Rubino has over 20 years experience treating children and teenagers. If you would like more information about his work or private practice visit his website at http://www.RubinoCounseling.com.

Why Teenager’s Need Sleep

Why Teenager’s Need Sleep

This week is dedicated to children’s mental health. A new study was just published again showing how important sleep is for children and teenagers. Here is the link to the study ChildrensMentalHealthWeek.org.uk/Research. Sleep is very important for children and teenagers. In fact, as you see research shows that sleep has a big impact on our mental health and physical health. Research continues to show that sleep deprivation can cause a person to suffer a psychotic break or if the depreciation is really severe it can even result in a person’s death. I received some very good information regarding sleep and mental health. It was provided by Jenny Thompson who is associated with http://www.bettermattressreviews.com. Given it is children’s mental health week, 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 over 20 years experience as a psychotherapist treating children and teenagers. Many children and teenagers have undiagnosed sleep problems. For more information regarding Dr. Rubino’s work or private practice visit his websites http://www.rcs-ca.com or http://www.RubinoCounseling.com or visit his Facebook page http://www.Facebook.com/drrubino3.

A Safe Super Bowl Party

A Safe Super Bowl Party

This weekend people will be watching the Super Bowl. Some people may be upset because the referee failed to correctly call the Saints vs. the Rams game. Possibly costing the Saints a place in the Super Bowl. As I stated in my previous article for many people it is a day to party and have fun, but it is also the day when the most domestic violence occurs in the United States. This statistic is for adults and teenagers. So, how do you have a safe, fun Super Bowl Sunday? You need to develop a plan that reduces stress and too much drinking.

First, remember that it is just a day and just a football game. Therefore, if everything is not perfect such as you don’t have all the food you wanted or things are not arranged how you wanted, do not stress over it. You can still enjoy the game without a lot food or alcohol. Also if everything is not arranged perfectly, you can still enjoy the game. In other words, do not stress and argue over minor details.

If you are going to have small children around, set up a separate room with food and activities for them. Many children under 10 years old will lose interest in the game and if there is nothing else for them to do, they will want attention and distract people from the game. Therefore, set up another room where they can watch other television shows and have games to play. This way they are not bored and they can enjoy themselves.

People drinking too much is a common problem during Super Bowl parties. Therefore, when your friends arrive, tell them you care about them and their safety. Therefore, you want everyone to put their car keys in the basket as they enter. This way if someone accidentally has too much to drink, you can give them a ride home. This way if someone has too much to drink, you don’t have to argue about them driving if they are not safe to drive. This can help avoid an argument and a possible physical fight.

Also watch how much alcohol you are serving. If you are serving alcohol, serve food too. The food helps to absorb the alcohol and decreases the likelihood that someone will drink too much. Also towards the end of the game stop serving alcohol and switch to sodas. If someone has had too much to drink, this gives them a chance for their body to process the alcohol they consumed so they can lower their blood alcohol level.

Another good idea is to set rules for your party. Announce to your guests that you want everyone to have a good time and no arguing or fighting. Therefore, cheering for their team or favorite player is fine, but you do not want any name calling nor is there to be any insulting other people at the party. Also good nature teasing is fine but no swearing and if someone asks you to stop the joking, respect their request. Bottom line, state that regardless of who wins or loses, you expect everyone to act like adults and to treat each other respectfully so it is a fun day for everyone.

It would also be helpful to remember the acronym HALT:

H – hungry

A – angry

L – lonely

T – tired, too much alcohol

If you notice someone expressing these emotions or drinking too much, this is a situation which could result in an argument or violence. Therefore, if you notice a potential violent situation, try talking to the person to see what is bothering them. If you notice a couple arguing try having one person step outside with you for a time out so they can calm down. You may want to let them know that they seem slightly upset and you are just checking-in to see if there is a problem and if you can help. Instead of ignoring the situation try to offer some help so people can calm down. This can help a great deal.

At the end of your party, if someone is not sober enough to drive, offer to drive them home. Remember all the car keys are in a basket so you do not have to argue to get the car keys. Remind them that you are only offering to drive because you care about them. You do not want to see them arrested for driving under the influence, you do not want to see them get into a car accident and you definitely do not want to see them kill someone else or themselves in a car accident.

If you notice a couple who appear to be arguing, offer to allow one person to stay for a while and you will drive them home later. Giving them a chance to calm down could help avoid a domestic violent incident. If after a little while the person at your house or the person who went home tells you they do not feel safe around the other person right now – listen to them! Offer to let the person stay at your house for the night. You do not want to assign blame to anyone. Simply state that they seem to be having a stressful day and instead of them both staying in the same house that night and arguing all night and arguing in front of the children is not a good idea. It is okay if they need to take a break for the night and talk about it tomorrow. You are providing them and the children with a safe environment and hopefully avoiding a domestic violent incident. Many people are afraid to step in and offer help when they see a potential domestic violent situation. However, if more people offered to help and did not shame the family, the incidence of domestic violence could decrease and more people may be willing to seek help.

If you are a couple who are having incidents with domestic violence, discuss the issue before the day. Hopefully, the two of you are in psychotherapy and can discuss the issue in a therapy session. Discussing a potential problem with a therapist or even a friend prior to the event can be very helpful. If you are not in therapy and afraid to talk to a friend and do not feel safe call the following number for help: The National Domestic Hotline 1-800-799-SAFE (7233). Someone will answer 24 hours a day, 356 days a year. Do not be embarrassed to call. If you need help, please reach out and ask for it before someone gets seriously injured or killed.

Hopefully these suggestions help and you can enjoy the game in a fun peaceful environment.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and he is certified to assess and treat domestic violence. If you want additional information regarding Dr. Rubino’s work or his private practice visit his websites http://www.rcs-ca.com, http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.