My Teen is Extremely Anxious, What do I do?

My Teen is Extremely Anxious, What do I do?

Over the years children and teenagers have been exposed to stressful life events especially the last two years. The teens today have grown up with daily school shootings and mass shooting drills. Imagine being a second grader having to rehearse a man with a gun is on campus and you don’t know if you are going to live or die. Teenagers today have also grown up with terrorist alerts and having to be searched anytime they went to a concert or places such as Disneyland. Finally they have had to cope with COVID. Over 1,000,000 Americans have died from this virus (CDC). Many children and teenagers have lost grandparents, siblings and parents to this virus. We thought we had turned a corner regarding the Coronavirus and we find out we are back at the beginning. There are still people being diagnosed daily with the Coronavirus and a number of these people have been vaccinated. However, most are not fully vaccinated. Additionally, this time the virus is effecting teenagers and children. Since schools have resumed on site classes at least 1,000 children have died due to the Coronavirus virus (CDC).

This is a lot for a child or teenager to have to adjust to. Remember, their brains are not fully developed yet. Therefore they cannot understand things like adults do. Furthermore, they have very active imaginations which are fueled by misinformation on social media or from people such as Tucker Carlson on Fox. Having to cope with all of this together has resulted in a significant increase in depression, suicide, drug overdose and anxiety disorders. At my office we get at least 20 requests daily for teenagers seeking psychotherapy due to anxiety disorders.

The fact that we thought we were on the right track with the Coronavirus and now we have another spike which is similar to the numbers a year ago is confusing and irritating to teenagers. Just as somethings were opening up and returning somewhat to normal, we had another spike and needed to adjust our lives again. As a result, many things had to be closed down again, there were definite rules regarding wearing masks and teens were not able to freely socialize with their friends. Again we are not able to give children and teenagers any definite answers regarding when life will return to something normal. Now we have changed the rules again and masks are not required but recommended for events inside.

With everything teenagers have had to cope with growing up, terrorist attacks, war, the economy collapsing, mass shooting and now the Coronavirus, we failed to make plans for their mental health care. Yes hospitals were running out of beds and physicians have become exhausted, but we are also running out of psychotherapists. Also psychotherapists are exhausted because they are dealing with adults and teenagers daily who dealing with depression, suicide and anxiety. However, psychotherapist do need some breaks so they can keep going. Finally, more and more insurance companies are declining claims or raising copayments so high that families cannot afford their copayments.

This lack of mental health care is unacceptable in the United States. Parents call the Human Resource Department at your work. They negotiate your benefits with the insurance companies. Therefore, they can renegotiate your coverage so you receive the benefits your family needs. Also call your Senators and demand that insurance companies need to provide mental health care.

As a result, many parents have asked me how to determine if their child is coping with anxiety and what to do if they are coping with anxiety. I can understand why parents are concerned especially because many children tend to try to hide their anxiety because they don’t want to worry their parents. Additionally, parents are trying to find psychotherapist who can treat children and teenagers are parents are trying to figure out how they can afford therapy with the cost of living increasing and insurance companies restricting coverage.

Therefore, the APA (American Psychological Association) developed guidelines that parents can use to determine if their child is dealing with anxiety and what to do if they are dealing with anxiety. You can also use the guidelines for depression too. I have provided an outline to the APA guidelines below:

The American Psychological Association (APA) offers the following tips to recognize if children may be experiencing stress or anxiety:

• Withdrawal from things the child usually enjoys

• Trouble falling or staying asleep

• Unexpected abdominal pain or headaches

• Extreme mood swings

• Development of a nervous habit, such as nail-biting

Parents can actively help kids and adolescents manage stress by:

Being available

• Start the conversation to let kids know you care about what’s happening in their lives.

• Notice times when kids are most likely to talk – for example, in the car or before bed.

Listening actively

• Stop what you’re doing and listen carefully when a child begins to open up about their feelings or thoughts.

• Let kids complete their point before you respond.

• Listen to their point of view even if it’s difficult to hear.

Responding thoughtfully

• Resist arguing about who is right. Instead say “I know you disagree with me, but this is what I think.”

• Express your opinion without minimizing theirs – acknowledge that it’s healthy to disagree sometimes.

• Focus on kids’ feelings rather than your own during conversation.

• Soften strong reactions, as kids will tune you out if you appear angry, defensive or judgmental.

• Word swap.

o   Say ‘and’ instead of ‘but’

o   Say ‘could’ instead of ‘should’

o   Say ‘aren’t going to’ instead of ‘can’t’

o   Say ‘sometimes’ instead of ‘never’ or ‘always’

Consider

• Model the behavior you want children to follow in how they manage anger, solve problems and work through difficult feelings. Kids learn by watching their parents.

• Don’t feel you have to step in each time kids make what you may consider a bad decision, unless the consequences may be dangerous. Kids learn from making their own choices.

• Pay attention to how children play, the words they use or the activities they engage in. Young children may express their feelings of stress during play time when they feel free to be themselves.

• It is important to explain difficult topics in sentences and even individual words kids will understand. For little kids it might mean saying simple things like, “We love you and we are here to keep you safe.” For adolescents, it’s important to be honest and up front about difficult topics and then give them a little space to process the information and ask questions when they’re ready.

Call your child’s or adolescent’s health care provider or a psychotherapist who specializes in treating children and teenagers, if stress begins to interfere with his or her daily activities for several days in a row.

You can find additional helpful information about kids and stress by visiting the Centers for Disease Control and Prevention’s Helping Children Cope webpage at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/for-parents.html.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and teenagers. For more information about Dr. Rubino’s work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple or on Audible.

The Toll COVID-19 is Taking on Teenagers’ Mental Health

The Toll COVID-19 is Taking on Teenagers’ Mental Health

The pandemic has reached a frightening point and a point where many teenagers feel the Coronavirus will never end. Over 475,000 Americans have died from the coronavirus and daily there are approximately 3,000 Americans dying from the Coronavirus. In addition we are discovering new stains of the Coronavirus and we race to get everyone vaccinated. We are starting to see a drop in the number of people being hospitalized, but all of this may be temporary according to the CDC. The CDC is warning if we do not wear masks on a regular basis and continue to social distance, the numbers will start to increase again.

Today’s teenagers have access to all this information via their smartphones. News updates pop up on their phones and once again their see that nothing in their lives is stable yet. It will be a while before we return to anything looking like normal life.

As a result, teenagers are losing hope and wondering what type of life they will be living. Teenagers have had their lives turned upside down and they are feeling overwhelmed and very stressed about how their lives have changed. Many college students and high school students are continuing to have to attend school remotely. Additionally, events such as sports, the prom and graduation ceremonies have already been cancelled for this school year. The high school experience they have heard about and have been waiting for no longer exists. Many teenagers are feeling depressed and angry about how their lives have changed. Furthermore, they have no control over the situation and have no idea what to expect from life.

Prior to the pandemic depression and anxiety rates were increasing for teenagers (CDC). Additionally, the suicide rate for teenagers had gone from the third leading cause of death to the second leading cause of death for teenagers. Since the Pandemic has started teenagers have had to shelter in place for months, attend school remotely and have not been able to hang out with their friends. This has caused depression and anxiety to reach epidemic levels for teenagers (CDC). The number of teenagers cutting (self-mutilating behavior) have increased significantly because they feel out of control and are having significant difficulties processing all the feelings they are experiencing. Also suicide rates and drug overdoses have increased in teenagers. Again because they feel helpless and are having significant difficulties processing their emotions. Suicide and drug overdoses have increased so much that there are now numbers in communities that teenagers can text for help if they are feeling suicidal or severely depressed.

Furthermore, besides their school experience changing significantly and not being able to hang out with friends, many are living in families who are worrying about paying the rent or having enough money for food. Unemployment is at a record high so many teenagers are living in a family where both parents have lost their jobs. This is a huge amount of stress for a child or teen to experience and have to cope with daily.

Additionally, many of these teenagers are coming from families who never had to worry about money before. Having to stand in a line for food daily is something they thought only occurred in third world countries, they never thought it occurred in the United States or could ever happen to their family.

As a result, many teenagers are struggling with severe mental health issues due to the Coronavirus. As a result, the Mayo Clinic has been studying the impact that the virus and quarantine have on us and our mental health. Here is what they found and their recommendations:

Stress is a normal psychological and physical reaction to the demands of life. Everyone reacts differently to difficult situations, and it’s normal to feel stress and worry during a crisis. But multiple challenges daily, such as the effects of the COVID-19 pandemic, can push you beyond your ability to cope.

Many people may have mental health concerns, such as symptoms of anxiety and depression during this time. And feelings may change over time.

Despite your best efforts, you may find yourself feeling helpless, sad, angry, irritable, hopeless, anxious or afraid. You may have trouble concentrating on typical tasks, changes in appetite, body aches and pains, or difficulty sleeping or you may struggle to face routine chores.

When these signs and symptoms last for several days in a row, make you miserable and cause problems in your daily life so that you find it hard to carry out normal responsibilities, it’s time to ask for help.

Get help when you need it

Hoping mental health problems such as anxiety or depression will go away on their own can lead to worsening symptoms. If you have concerns or if you experience worsening of mental health symptoms, ask for help when you need it, and be upfront about how you’re doing. To get help you may want to:

• Call or use social media to contact a close friend or loved one — even though it may be hard to talk about your feelings.

• Contact a minister, spiritual leader or someone in your faith community.

• Contact your employee assistance program, if your employer has one, and get counseling or ask for a referral to a mental health professional.

• Call your primary care provider or mental health professional to ask about appointment options to talk about your anxiety or depression and get advice and guidance. Some may provide the option of phone, video or online appointments.

• Contact organizations such as the National Alliance on Mental Illness (NAMI) or the Substance Abuse and Mental Health Services Administration (SAMHSA) for help and guidance.

If you’re feeling suicidal or thinking of hurting yourself, seek help. Contact your primary care provider or a mental health professional. Or call a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use its webchat at suicidepreventionlifeline.org/chat.

Continue your self-care strategies

You can expect your current strong feelings to fade when the pandemic is over, but stress won’t disappear from your life when the health crisis of COVID-19 ends. Continue these self-care practices to take care of your mental health and increase your ability to cope with life’s ongoing challenges.

In addition to the facts above, people who have had the virus have been reporting feeling anxious and depressed. They have also reported the virus has impaired their ability to make decisions. This is being referred to as “the long haul syndrome.”The bottom line is the virus is creating mental health issues for those dealing with the quarantine, first responders, medical personnel and people with the virus. We are focusing on getting the virus under control which we must do. However, as we struggle to get control of the virus, we also need to address the mental health issues created by this pandemic. At this point, we have no idea how many will need mental health care and for how long. Therefore, as we focus on finding a cure, we may want to start to prepare for the mental health issues which are occurring and will after the quarantine.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating trauma victims and teenagers. For more information about his work or his private practice visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

There is No Reason to be Ashamed of Mental Health

There is No Reason to be Ashamed of Mental Health

Mental health is a topic we tend to avoid in our society. We avoid it so much that the month of May is dedicated to Mental Health Awareness. Many people are afraid that if other people know they are feeling down or anxious that people will think they are crazy. Many people think of someone living in the streets when you mention mental health. This is not reality. This negative stigma makes it difficult for adults to seek help for mental health issues. This negative stigma also makes it very difficult for children to ask for help when they feel depressed or anxious. They are afraid their friends won’t understand and won’t want to be friends with them. They are also afraid their parents will think they are crazy and be disappointed with them. These ideas are incorrect, but if mental health is overwhelming for an adult, imagine how it can be for a child.

It is very important that children and teenagers do ask for help when they are experiencing mental health issues. The CDC estimates 1in 5 children need psychotherapy for a mental health issue. Furthermore, the CDC has stated that Suicide is an epidemic for children between the ages of 10 and 18 years old and is the second leading cause of death for kids 10 to 18 years old. Cutting, self-harming behaviors, are also now at an epidemic rate in children. Most teenagers I work with, as a psychotherapist, have had suicidal thoughts and have cut before starting therapy with me. They also tell me about many of their friends who are feeling suicidal and cutting. According to the CDC, the Suicide rate and the number of teenagers engaging in self-harming behaviors has been increasing every year for the past twenty years.

While the need for teenagers needing psychotherapy is increasing, the reluctance to attend psychotherapy is increasing. Most teenagers I see for psychotherapy are afraid that their friends would stop being their friends if they knew they were going to therapy. They are afraid it makes them crazy and nothing will help because they are weak. They blame themselves for the feelings they are having. They are shocked when I explain that they are not weak and it is not their fault.

We need to change this stigma associated with mental health. Mental health should be treated the same way a physical health because they are the same. Clinical depression is caused by a chemical imbalance in the brain. If some one is diabetic, do we call them crazy or weak because their pancreas is not producing the correct level of insulin? No we do not. Therefore, when we have numerous research studies which show a link between physical health and mental health, why do we continue to view mental health so negatively? By doing so we are causing a number of teenage deaths. Suicide use to be the third leading cause of death for teenagers, however now according to the CDC it is the second most common cause, as I stated above. Many teens also die every year from eating disorders. Eating disorders occur in both girls and boys despite the belief girls only have eating disorders. Bullying is a severe problem and many teenagers are opting to commit suicide rather than discuss the pain and torture they are experiencing due to being bullied. This does not make sense that teenagers should be dying because the teen or their family are embarrassed to seek treatment.

I was researching this subject and found a video by the Anna Freud Institute. It is called, “We all have mental health.” It is a short video directed at teenagers and middle school students. It discusses the issue in a very relaxed manner and provides teenagers with options for how they can talk about their own feelings. I encourage parents, teachers and anyone who deals with children to watch this video. You may want to watch it with your teen and begin a discussion about feelings. The link to the video is https://youtu.be/DxIDKZHW3-E.

We need to start to change the negative stigma associated with mental health. Besides causing the deaths of teenagers, this stigma effects an entire family. A death impacts everyone in a family. Not being able to talk openly about a death because it was related to a mental health issue, creates more problems for the survivors. Nothing will change until we start to approach mental health differently. I also encourage you to look at the foundation started by Prince William and Henry, Heads Together. It provides a number of ways we can start to change the negative stigma associated with mental health and save lives.

Furthermore, at this time in our world, when we are in the middle of a pandemic which besides killing thousands of people daily, it is creating mental health issues for those in quarantine, those with the virus and our first responders. These issues will not disappear quickly just like the virus will not disappear quickly. As a result, we will have even more people needing mental health care. How will they receive it if they feel ashamed for needing treatment or if we continue to treat mental health as a disease? Mental health and physical health go hand in hand, when will we treat them equally?

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with teenagers and children. For more information about his work or private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.

High School Graduation A Beginning and Ending

High School Graduation A Beginning and Ending

This year most high schools will be having graduation ceremonies. Due to the success of the Coronavirus vaccines, the CDC has acknowledged that it would be safe to hold graduation ceremonies again. Last year many high schools had traditional ceremonies and this year most high schools will be having graduation ceremonies. This is different from the few years when graduation ceremonies were canceled due to the Coronavirus. While schools are having graduation ceremonies, they will most likely be different for the graduates. It will be different because for most of the graduates their high school experiences have been different from the “traditional” high school experience. Many of these students had to attend high school part-time remotely and had typical high school events such as sports and the prom cancelled due to the Coronavirus.

As I stated above for many high school graduates, this year graduation ceremonies will be somewhat differently emotionally. However, High School graduation still marks a big accomplishment for teenagers. They have finished their basic education and they are ready to move on to their life plans as a young adult. For many students this means going to a four year college and earning a Bachelors degree. In addition, many graduates will be celebrating scholarships they received and awards they received for their academic or other accomplishments in high school. They also have friends and family there to join them in celebrating their accomplishments. Of course this is a happy day and it deserves to be celebrated.

While this is the stereotype we think about regarding graduation, it’s not the reality for every student. Some students have worked very hard and maintained very good grades, but they did not get accepted into a college they can afford and they did not receive any awards or scholarships. Instead of going to a four year university, they will need to attend the local two year junior college and try to transfer into a four year university. Other students who have learning disabilities are just barely graduating and had to wait to the last minute to see if the past all of their classes. Some did not pass and they have to go to summer school so they may be allowed to participate in the ceremony but they are not finished yet. These students do not get to live the stereotype and often feel embarrassed and ashamed when they compare themselves to the other students in their graduating class.

I had also mentioned celebrating with family and friends. For some students this can be very difficult. If their parents had a hostile divorce, the divorce may be being dragged into the graduation. Instead of a celebration, the parents may be making the graduation a civil war. The graduate may be forced to take sides in regards to who they can invite to the ceremony. Do they invite mom’s side or dad’s side? This can change a happy event into a very stressful event the graduate does not want to be involved in. For some graduates a mother or father has passed away and graduation day is another reminder that this very special person is no longer physically present. Therefore, graduation may be a stressful or sad day.

Another aspect that is overlooked is graduation is an ending. It marks the end of a teenager’s high school experience. Many teens have been very involved with their school and have developed close relationships with teachers and school staff and they have developed very close friendships with their classmates. Graduation marks an end to their high school life. They need to say goodbye to these people and move on to a school they do not know and may not know anyone else who is attending their college. I remember one high school secretary’s comment when she looked at the senior class, “I have never seen so many kids look so happy and sad at the same time”.

In addition to saying goodbye to their high school family, graduates need to say goodbye to their families. If they are going away to school, they will no longer living with their parents or siblings. While they may complain about their families, they will miss them too. Mom and Dad will miss their graduated too. So while traditional we tend to only focus on the positive, which is not uncommon for our society, we also need to acknowledge that graduation marks an ending too. An ending to their high school family, friends they have created and to their high school activities along with a change in the graduates life. They no longer are a high school kid. They are a college student and a young adult and need to start their lives all over. This will have happy moments and sad one too. It’s important to acknowledge both.

While high school students will be starting their lives over, I have included a small segment of a speech by Martin Luther King, Jr. It empathizes that you need to define yourself, don’t let others try to decide who are going to be in life https://www.facebook.com/goalcast/videos/1294330473977473?s=1391497228&v=e&sfns=mo.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and adolescents. He has appeared on television and radio shows and is considered an expert in adolescent psychology. For more information regarding his work or private practice visit his website at www.RubinoCounseling.com, www.rcs-ca.com or his Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Eating Disorders Increased During the Pandemic

Eating Disorders Increased During the Pandemic

Eating disorders have increased for girls & boys during the pandemic. Eating disorders include avoiding eating and also teenagers who gained a lot of weight because they are compulsively The article explains why & how parents can talk to their kids if they think there is an eating disorder ‘I couldn’t stop.’ The pandemic is triggering eating disorders in our children
https://www.cnn.com/2022/02/04/health/eating-disorders-children-covid-wellness/index.html

IEPs Exist During the Pandemic, but 504 plans May Not

IEPs Exist During the Pandemic, but 504 plans May Not

We are in the middle of the school year and also in the middle of another spike in Coronavirus cases. However, this spike is impacting children too not just adults this time. Also many schools and colleges are returning to remote learning while we experience this severe spike in Coronavirus cases. Even though we don’t have an answer regarding how many school districts plan on operating yet, I have been getting questions about IEPs (Individualized Educational Plan). Parents are having difficulties arranging meetings and getting specific answers what will be included in their child’s IEP or is the school going to offer them a 504 plan instead. The IEP process is difficult under normal conditions. When we are in the middle of a pandemic it can become very overwhelming and confusing. Additionally, 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. Hopefully this will explain the differences between an IEP and 504 plan and help parents understand what their child is legally entitled to regardless of what the teacher is trying to make you believe.

The main point parents need to understand is even though we are in the middle of a pandemic, IEPs still exists and the IEP laws are still in effect. Therefore, if your child’s school is claiming they cannot assess a child for an IEP or meet the conditions due to the pandemic, this is not true. School districts still are required to assess and meet the goals and legal timelines even during the pandemic.

While school districts need to still service IEPs, the same requirement does not apply to 504 plans. If your child is on remote learning, the school district does not have to follow through with the 504 plan because there are no laws requiring the district to follow through with the 504 plans. I saw a mother on the news complaining that the school district was not following with her daughter’s 504 plan. She expects the district to follow through with the 504 plan like an IEP. However, this is not the reality of the situation. School districts have to follow through with an IEP because of the IEP laws. The same laws do not apply to 504 plans. Even during a pandemic there are no laws protecting a 504 plan. This is why you want an IEP for your child not a 504 plan. Below is additional information regarding the difference between an IEP plan and a 504 plan.

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..

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 25 years experience working with children and teens. He also has over 25 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 website that deals specifically with IEPs, lucascenter.org or his Facebook page at www.Facebook.com/drrubino3.

Why Teenagers are Isolating and Ignoring Their Parents

Why Teenagers are Isolating and Ignoring Their Parents

“What are we doing to our kids?” is a quote from Cameron Crowe, who wrote the movie Fast Times at Ridgemont High a movie from 1982. I ask this question on a daily basis. Cameron Crowe while discussing the movie with CNN for their special report on movies made his statement about teenagers. He explained he went undercover in a high school as a high school senior to write the movie. He stated he was shocked at how sexually active these kids were in high school. He stated between the focus on sex and working, the kids were being denied their adolescence. They were going from kids to adults very quickly. Sadly what Cameron Crowne noticed in 1982 has continued and has only become worse. It is so bad that I typically have difficulties scheduling appointments with teenagers because of tutoring sessions, meeting with college consultants and their homework. Many teenagers are so overbooked that they seldom have a free minute to relax.

Cameron Crowe was commenting on high school students in 1982. However, what he noticed occurring in high school in 1982, however it is now starting to occur in middle school not high school. In middle school today it is not uncommon for kids to be sexually active. In fact, many middle schools now provide condoms to sixth graders. Many 6th graders do not think oral sex is being sexually active. They tell me they are jus “messing around, like kissing.” In addition to sex, kids in middle school are using drugs. They are not just using marijuana. Many middle school students are using concerta, ecstasy, vaping and designer drugs.

In addition to being sexually active and using drugs many middle school students are worrying about how much money they will make at their jobs. Kids are looking at different careers and thinking about how much they will get in paid and what they will be able to afford. They wonder about, how big of a house or what type of car will they be able to afford as adults? Mr. Crowe’s observation was correct in 1982. However in 2021, kids are losing their childhood too early and they are losing their childhood earlier and earlier. In 1982 it was high school in 2019 it is occurring in middle school. When will it start occurring in fifth grade?

In addition to these factors, teens in middle school and high school continue to live through the pandemic. Most kids had a year of remote learning which was a disaster. Therefore, teenagers were forced to spend over a year at home by themselves and their main interaction with friends was by texting or gaming. As a result, many teenagers feel like they have lost a year of their lives that they will never get back and a year of exploring life with their friends. Many teenagers are reporting depression , suicidal feelings and anxiety due to the Coronavirus. Who can blame them because they have lost a year of their childhood that they cannot get back.

Even though many teenagers are back in school, their school experience is not the same as it was prior to the pandemic. Their ability to socialize is still limited greatly and schools have changed many after school activities and have canceled events such as indoor dances. So teenagers are back in the classroom, but they still feel lonely and many see no end to the pandemic or school shootings in site.

Since I specialize in treating children and teenagers, I have had more children and teenagers reporting depression, anxiety and a sense of loneliness over this past year. In fact, in my office the number of middle and high school students seeking therapy has increased by a factor of 10. Besides parents calling, schools and insurance companies call daily regarding adolescents who need therapy. Many of these teens are feeling disconnected and out of touch with their friends and other teenagers their age. In 2000, I was noticing this in a few teenagers now in 2022 a majority or teens and middle school students report feeling lonely and isolated and anxious. I am also beginning to hear this from fifth grade boys too. Besides loneliness increasing in middle school and high school, the number of kids feeling depressed is increasing significantly. It makes sense. Teenagers have lost a year of “normal” teenage life and no one knows what to expect next, another school shooting or a return to remote learning due to this new variant. Many colleges returned to remote learning, so are middle schools and high schools next? This provokes anxiety and depression when you don’t know what to expect from the future. Especially when predictions are changing daily, teenagers are left having to wait and they see no end in site.

You may ask with their focus on friends and sex, how are they feeling lonely or isolated? With this focus on friends, sex, drugs and the future comes a great deal of competition. Everyone wants to look like they know exactly what they are doing. Therefore, they may be talking and texting each other, but they focus more on shallow issues. No one really opens up about their true fears and worries. As a result, they feel lonely and isolated. They also have missed a year of “normal, typical” experiences which help them mature. Teenagers know they are not going to get these years back which is depressing. Therefore, they are using computers, drugs and sex as a way to numb out the anger, disappointment and anxiety about what they are missing and not to worry about what their futures will be like.

A very good example of this are teenage boys. Most teenage boys are trying to live up to the outdated stereotype about what it takes to be a man. According to the stereotypes men don’t cry, don’t focus on emotions because they are weak and must be sexually active to be a man. There is a documentary, The Mask You Live In, which focuses on boys conforming to this outdated stereotype. Overwhelming the boys in the documentary reported feeling lonely and isolated. They shared they had no one who they could talk to when they felt overwhelmed or confused by life. They always had to have the right answer and they did not always what was the right answer. As a result, they made mistakes and they felt lonely not being able to ask for help. They felt like they had to hide their true feelings which makes them feel lonely.

Having over two years with little to no personal contact with their friends only increases this feeling of isolation and loneliness. Since teenagers try not to act like they need help, they are experiencing more feelings of anxiety and depression. The CDC has documented a significant increase in the number of teenagers coping with depression and anxiety since the beginning of the pandemic. Also as I stated above we have experienced a tidal wave of teenagers seeking psychotherapy. Furthermore, the longer the pandemic continues and the longer our society remains in chaos, the numbers continue to increase not decrease.

Texting and online gaming have increased as a way for teenagers to feel a connection with their friends. Many parents worry about their teenagers texting or gaming, but if it provides a sense of connection with their friends and the world, I have recommended to parents to adjust their rules regarding these behaviors during the pandemic. Teenagers need a way to feel connected to others. Without this sense of connection during the pandemic, we see an increase in the number of teenagers committing suicide or overdosing on drugs.

Another aspect to teenage boys and girls feeling lonely, isolated, depressed and anxious is that they tend to close themselves off emotionally. As a result, they do not know if anyone cares about them. They never know if someone loves them. This can create major issues for teens. In the Disney movie Frozen, they point out how people will act out in pain and make mistakes when they don’t feel loved or cared for by people. The movie also points out how opening yourself up so you can feel love will help people change and make better choices. The lead character, Elsa, when she felt lonely and afraid could not control her power and it only caused destruction. When she finally opened herself up and saw she could be loved she discovered the good her powers could do. When she was afraid she isolated and when she felt loved she opened up and interacted with others. I see this happen daily with teens. When they feel no one cares, they isolate themselves and say hurtful things to keep themselves isolated. When they discover people care, they allow themselves to open up and start to share their true feelings and interact with others. They are very happy and surprised when they make this discovery.

Parents may notice that their teenagers are not taking to them or listening to them despite the fact that parents are trying to be supportive. The problem is that your teenagers are feeling so depressed and anxious that they are ignoring their parents. Many teenagers see how society is acting and they see no hope. They assume you are going to try to make them feel better, but you are just as powerless as they are so they ignore you. Be patient with them and continue to be there for them. By taking this approach when your teenager is ready to talk, you will be there and not miss the opportunity.

In 1982 the world was much easier. In today’s world things are moving fast and make it easy for people to isolate by texting or using social media to communicate. In addition, teenagers are living through a pandemic, mass shootings and a political climate that has changed how we communicate and view the world and each other. As a result, teenage boys and girls feel pressure to follow the outdated stereotypes about men and women. There are few people telling teens they don’t need to follow these stereotypes. We also need to set examples about communication. Adults need to not text so much and rely on social media as often as they do. Parents need to take time talking with their children as soon as they are born. Technology can be a great thing but it is making many people feel lonely and isolated. Teens as well as adults. We need to study technology and look at how it is impacting our lives and the lives of our children. One thing for sure, I have seen technology increasing the amount of teens feeling lonely and depressed. We don’t want our kids to lose out on their childhood. Therefore, we need to study the impact technology has on us and teach our children how to use it responsibly. Also we need to teach teenage boys and girls that they don’t need to live up to the outdated stereotypes about men and women. We need to encourage our kids to be themselves and to accept themselves.

Additionally, teenagers today are the only teenagers in recent history who have had to cope with daily mass shootings and a pandemic which has killed over 800,000 Americans. We need to look at all these issues and help our children and teenagers cope with the world they have to live in. Hopefully this will help our children reclaim their childhood and be kids.

Dr. Michael Rubino is a psychotherapist with over 24 years experience treating children and teenagers. For more information about his work or private practice visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Stress Teenagers Face During Finals and the Holidays

Stress Teenagers Face During Finals and the Holidays

The end of the Fall semester is around the corner and it is a time of year that students panic because it’s Finals time. Your teenagers are probably very stressed or getting stressed. There is a lot going on right now. Seniors are trying to complete college applications, seniors and juniors are worried about grades because these grades will impact which colleges they can go to. In addition, there is time off for Christmas so many teenagers are focusing on spending time with their friends. However, due to the outbreak of another Coronavirus variant, they may not be able to see their friends and if they can what they can do is limited because of precautions trying to prevent the spread of the virus. Also they need to allow for time with their families too.

As I stated besides finals, teenagers are having to balance between friends and family during another surge in Coronavirus cases. In addition to spending time with friends there are the parties that probably will not be occurring due to the Coronavirus. Therefore, they are dealing with another winter break which is severely limited due to the virus. over. Besides having to balance time between family and friends, they still have to keep the homework current and study for finals or complete semester projects. They are getting tired of having to focus on school and not be free to see their friends because it seems like this virus is never going away.

In many classes the final may be worth fifty percent of the students grade. The final grade in a class is very important. This grade will be part of their overall GPA which can affect what colleges Juniors can apply to and their ability to get scholarships. Also for seniors these are the grades colleges will be using to determine who they accept or reject. Seniors know they need a decent Fall semester GPA to have a chance of being accepted by a college.

As you can see there is a great deal of pressure on high school students during this time of year. Also since the competition to get into colleges has increased and the competition for scholarships have increased so has the stress on high school students.

Many students will do what ever they need to in order to survive this time of year. This includes using alcohol or weed to help them relax or sleep. They will also take friends ADHD medication, use cocaine, or start taking caffeine pills or start drinking a great deal of coffee or energy drinks so they can stay awake and study. They don’t realize how much caffeine those energized drinks contain. Also the combination of weed to sleep and caffeine to stay awake can cause mood changes, psychosis and even death.

Most teens want to do things on there own so they will tell you everything is fine and they have it covered. They think it is fine because of the substances they are using. Remember a teenagers prefrontal lobes are not fully developed yet. Therefore, they only focus on the here and now and not on the future. They also do not always think about the long term consequences about some of the things they are using.

If your teenager is getting angry very easily or crying easily this is a sign that something is going on. If you notice a change in their eating habits such as going from eating a lot to eating nothing, this is another sign. Also if you notice a change in their sleep pattern such as awake all night and falling asleep at odd times this is also a sign.

What do you do if you notice anything that is making you worry, you should sit down and talk to your teenager. Explain you know there is a lot of stress right now and point out the changes you have noticed and what you are concerned about. Reinforce you are not having this conversation because you are mad and they are not in trouble, you are having this conversation because you love them. If they are using things or doing things because they think it will help them study, let them know you are there to help. Explain some of the dangers associated with what they are doing. Remind them no grade is worth their life.

One thing you may want to do, is say to your teenager you know the end of the semester is a stressful time. Ask them if they need any help studying or help organizing their time. Let them know if there is any way you can help, you are there to help. Remind them, all they need to do is ask you for help and you will help. Many teenagers hate to ask for help, so you may want to comment on how you see them struggling and discuss how you can help, even if they don’t think they need it. Ask them to allow you to help because you can’t help it but you worry about them and by helping them, they would be helping you cope with your stress.

Hopefully they will listen to you and confide in you. If they continue to deny everything, but it is obvious they are using drugs, then go to any local pharmacy and buy a drug testing kit. Explain you are only doing this for their safety and they are not in trouble. They may be afraid or embarrassed to tell you. They may feel like a failure in your eyes. As their parent they really need your love and support right now not a lecture. Again remember when you were in high school and how difficult it was to tell your parents certain things. Good luck.

Dr. Michael Rubino specializes in working with teens and has over 24 years experience and his work is nationally recognized. To find out more about Dr. Michael Rubino visit his website at www.RubinoCounseling.com or his Facebook page at Facebook.com/Drrubino3

Teenagers are Crying Out for Help

Teenagers are Crying Out for Help

Today’s teenagers are under a great deal pressure. In fact, according to the CDC, 1 out of every teenager has a diagnosable mental health issue. In addition, depression, anxiety, drug overdoses and suicide are currently at epidemic rates for teenagers. In fact, suicide was the third leading cause of death for teenagers and now it is the second leading cause of death (CDC). Furthermore, cutting or self-harming behaviors are also at epidemic rates for teenagers (CDC). Self-harming behaviors include teenagers cutting themselves with knives or scissors in addition to scratching themselves severely and sometimes teenagers may even use erasers to erase their skin and cause sores. These are only a few examples.

Let’s look at the pressure teenagers are facing today. One major stressor is social media. They look at the accounts of other teens who post everything is going great in their lives and they have a lot of friends. This is not the reality, but most teenagers are not aware of this fact and they start to wonder what is wrong with them. Why don’t they have the same wonderful lives full of friends and good grades?

Another stressor for teenagers is the Coronavirus. Over 700,000 Americans have died from Covid and 1200 Americans are still dying daily (CDC). Therefore, many teenagers are grieving the loss of family members and friends and the grief is especially difficult during the Holidays. Additionally, we do not have a firm grip on the Coronavirus and information is changing daily. Therefore, teenagers are still dealing with restrictions at school and are not able to see their friends on a regular basis. Furthermore, they don’t know if their lives are ever going to return to pre-pandemic routines or have their lives and childhood been permanently changed.

Finally, teenagers today are dealing with school shootings which continue on a regular basis. The school shootings impact more teenagers than we think are impacted by them. When there is a school shooting every student at that school, in that community and in our Country is effected. They are traumatized again and again begin to worry, will I be killed today at school. This is why the shooter in Oxford was charged with terrorism. Every student, teacher, parent and first responders were terrified about would they be killed, would someone they know be killed, how are they going to cope with what they find at the school and students, parents are teachers all over the Country worried about could this happen at our school? As a result, many teenagers do not want to go to school because they don’t feel safe and parents worry when their child leaves that day for school, could it be the last time they see their child alive. All of these factors are a lot to expect a 13 year old to cope with on a daily basis, year after year.

Ten years ago as part of my initial evaluation of a teenager I would ask, if they were cutting or had ever cut, once in a while I would get an answer of yes. Today when you ask teenagers about cutting most teenagers answer yes. They say they have used cutting to cope with the stress of life or they have thought about it. In fact, it’s no longer just teenagers. Children as young as 8 or 10 years old often respond yes to this question. This is alarming, but it is evidence of the amount of emotional pressure these kids have to deal with today. They apologize for trying it or thinking about it, but they explain life was so stressful they didn’t know how to cope with the emotions they were feeling. Again these teenagers are facing stress because they are admitting that life has become too stressful. They are afraid that I will be upset with them or that their parents may be upset that they cannot handle everything that is going on in their lives.

When you ask a teenager about cutting behavior, they usually respond it was easier to deal with the physical pain than the emotional turmoil they were dealing with inside. Others will say the cutting takes their mind off of the emotional situation and others even say it makes them feel human. So as you can see there are numerous reasons, but teenagers are also very embarrassed and ashamed about the cutting behavior, as I stated above. If I am treating a teen who is engaging in cutting I must be very sensitive and non-judgmental about the behavior if I’m going to help. In addition, the family needs to be non-judgmental as well. Teenagers do not cut for the attention and as I stated above they are embarrassed about their behavior. If they sense that someone is viewing them in a negative way, they will not talk about it. Additionally, teenagers who are engaged in cutting hide their cuts so no one will know about their behavior.

Therefore, when treating or dealing with a teenager who is cutting you need to be patient and non-judgmental. Remember they are resorting to this behavior because it is the only way they are able to deal with the emotions they are feeling and the situations they are facing. Life today can be very overwhelming and often teenagers are not prepared for what they have to face in life and they are embarrassed to ask for help too. Often they are embarrassed because our society looks down on people dealing with mental health issues. I recently had a 13 year old ask me, “why don’t we place more emphasis on mental health so people can get the help when they need it?” A very good question to ask. Our society has a very strong negative stereotype regarding mental health and therapy. As a result, it is very difficult for teenagers to ask for and receive the mental health care they need.

After being treated for cutting, many teenagers are still embarrassed and feel awkward about their past behavior. Many times teenagers are left with scars on their bodies from cutting. Most families cannot afford plastic surgery and insurance will not cover it, even though it is a mental health need and in my opinion should be covered. The point is many teenagers continue to feel embarrassed and ashamed of the scars years after they have stopped cutting. Below is a blog from a teenager who discusses how they feel about their scars and people’s reactions. It also may help give you some insight to what teenagers are going through these days and how many of them are feeling overwhelmed by life. Instead of ignoring their cries for help we need to figure out how we can help them without making them feel embarrassed or crazy.

A teenager’s blog about cutting. My self-harm scars are “hideous.” I’m covered in them. Head to toe. No amount of time, no amount of fading will make them unnoticeable. That doesn’t mean I hate them. It doesn’t mean I’m embarrassed by them. I am aware that they make other people uncomfortable and there are times, when out of respect for others, I will cover them. There are other times when I won’t cover them. Whether I choose to cover them or not, I don’t feel that I should have to explain my choice. If I choose to cover them, it doesn’t mean I’m ashamed or feel forced to cover them. If I choose not to cover them, it doesn’t mean I want attention.

I regularly see people comment on social media saying, “If you make a public post people have the right to say whatever they want.” Apparently this entitles people to be nasty and judgmental. It excuses them from filtering what they say and think. It exempts them from extending basic decency and courtesy to others.

I’ve heard the same said about people who walk around with self-harm scars exposed. No. Just because you can see my scars doesn’t give you a free pass to say what you want. You don’t get to say, “You’re too pretty for that.” You don’t get to say, “You’re too smart for that.” It doesn’t matter whether you know me or not. They are my scars from my battles. Even if you know me, I can guarantee you won’t know all about my battles. You won’t know my darkest moments or thoughts. If you’re a stranger? What could you possibly think you know about my life? You don’t get a say on what my scars look like. You don’t get a say on whether or not I’m too pretty, too smart or too strong for that. You don’t get a say on whether or not I cover them.

Yes, you can see them. Yes, they are “hideous.” Look away. Walk away. Think about it by all means. Talk to someone else about it. If you’re game, educate yourself on it. Take responsibility for what you are doing. Take responsibility for what you are saying. Yes, you can see my scars but that doesn’t make me responsible for your reaction.

This is how one teenager tries to explain cutting to adults and how it makes them feel years after they have stopped cutting. Really read and think about what this teenager is saying. Should any teenager have to feel this way because they are feeling overwhelmed by life? Overwhelmed by circumstances which are not their fault and they cannot control? Is it fair they should suffer this way, when they are asking for help, but insurance companies deny to help them? What responsibility do we have to help these teenagers who are begging for help?

Dr. Michael Rubino is a psychotherapist with over 24 years experience treating children and teenagers. In addition, he specializes in treating victims of trauma and first responders. For more information about his work or private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Santa, Please Bring My Daddy A Job for Christmas

Santa, Please Bring My Daddy A Job for Christmas

The Holiday Season is here again, however, this year it will not be our typical Holiday Season because we are still dealing with the effects of the Coronavirus. Over 700,000 Americans have died due to the Coronavirus and another 1,200 are dying daily due to the virus (CDC). So we have numerous people who are grieving for spouses, grandparents, siblings, parents, friends and children. Furthermore, many parents are unemployed. Millions of families cannot afford to pay the rent or buy food. Food Banks are reporting a significant increase in the number of people seeking food. Parents are getting in line at 5 am when the Food Bank opens at 9am. There are doing this because they are desperate for food so they can feed their children. Many of these people had well paying jobs prior to the pandemic and they never dreamed that they would be going to food banks or churches looking for food.

A teacher asked her first grade class to write letters for Christmas. She asked each student to write one thing they want and something they need. One of the children wrote this heartbreaking letter asking for food and shoes. However, she was not the only one. Many children were asking for food, clothes and a place to live.

This video details the need that many families are facing and how many children are focusing on food and clothes for Christmas not toys. https://youtu.be/j_05ZuhqCZM

This video is the tip of the iceberg. Currently in the United States one out of five children are going to bed without food and are homeless (CDC). This is the United States, how are we allowing this to occur? While families are having to beg for food and a place to live, the former President Trump continues to lie about how he did not lose the election and spreading lies about the pandemic which only serves to make these children’s lives worse. Many have asked him to stop the lying and misinformation, but he ignores the pleas.

Many people assume that hunger is not a problem in the United States. However the current statistics of one in five children living below the poverty level and not having enough to eat and many living on the streets tells us that we have a severe problem in the United States. It’s not because they have drug addicted parents either. Many of their parents work 2 or 3 jobs, if they can find a job. As a result of the pandemic, we have unemployment rates that were to the Great Depression. I have children who tell me they are happy to be going back to school because public schools now provide free breakfast and lunch. Therefore, by going to school they get to eat and not have to starve.

I do see children in this situation for psychotherapy. These children are often depressed and see no hope for the future. They feel that they will be homeless for their entire life. In therapy I am trying to help them to not give up. The suicide rate has increased due to the Coronavirus pandemic and if a child sees no hope for their future they do think about suicide. Many children I see I need to see pro bono or for a very low fee because their families don’t have insurance or their parents cannot afford the copayments the insurance companies require.

The other sad fact is that the United States government continues not to act. Additionally, the few programs that are helping these families will expire soon. However, the Senate refuses to pass a package President Biden proposed to help these families and to give them their dignity back. Many of these programs are their only source of food and shelter for children. The children are the future of our country. Why would the United States, considered the richest country in the world, cut programs that will increase the number of children living in poverty? Should a child in the United States, need to be asking Santa Claus for food and a blanket? Where are our priorities?

Dr. Michael Rubino has 24 years experience as a psychotherapist working with children and teenagers. For more information about his work with children visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple or Audible.