How to Cope with Holiday Stress

How to Cope with Holiday Stress

Halloween signals the beginning of the Holiday season. Many people will be worrying about how they will survive the Holidays with certain relatives and since prices have increased this year many people are worrying about how they will be able to afford the Holiday Season. Additionally, there is the Coronavirus pandemic. Many people have been vaccinated, but others for some reason have decided not to get vaccinated. Therefore, some families are faced with decisions about do they celebrate with relatives who have not been vaccinated. This can be very difficult and a very stressful situation. In addition, the Holidays can be stressful because they may bring up family issues that have not been resolved yet or you have some family members trying so hard to make the day prefect that it becomes a stressful day not a happy one. Also parents are concerned how their children will act around the entire family? Finally this year prices on everything have increased significantly and many families are struggling with being able to afford the rent, in addition to Thanksgiving and the Holiday Season.

Thanksgiving is next and then there is Christmas and Chanukah depending on your family’s tradition. Since Thanksgiving is next, you can evaluate how Thanksgiving went for everyone and decide if you want to make changes for the remaining holidays.

After you have assessed how you would like Thanksgiving and the Holidays to go, the next step is to sit down with your children and ask for their opinions. Also ask about what their expectations are for the Holidays . It is especially important to discuss this point with teenagers because they have been isolated from friends due to the pandemic. Are they expecting to spend Christmas Eve and Day with the family or are they expecting to spend time with friends and girlfriends or boyfriends. It is important to settle this issue before the Holidays. By discussing expectations and trying to accommodate everyone’s wishes, you can avoid arguments. However, many times you cannot accommodate everyone’s wishes and as the parents you may need to make the judgement call. If this occurs explain to your teenager you know they may be mad, but you hope they can understand and you would appreciate their cooperation. May be you make arrangements for them to spend time with their friends the day before or after certain Holidays.

The next discussion is gifts. Explain to your children the point of the Holidays is to appreciate and to be grateful for the people in your life and what you do have in your life. Therefore, if your grandparents give you something you do not like, be grateful that they thought about you and say thank you. Try not to make faces or act disappointed and hurt your grandparents feelings. Again remind them the Holidays are a time to be grateful for what you have in your life.

Reminding your children about being grateful leads us into the next tip for decreasing Holiday Stress. Lori Lite who writes about stress uses the acronym G-R-A-T-E-F-U-L as her Holiday stress guide. It helps her and others get through the day in a peaceful manner. Each letter reminds you of something to do or a way to view the day so you do not get upset.

So here is how to use Gratitude as your Holiday Stress Reliever.

G- Gratitude is the opposite of stress. It is difficult to feel stressed out when we are feeling gratitude.

R- Relax your expectations and let the day unfold. You might be surprised by the outcome.

A- Acceptance is the opposite of judgment. If we accept our family member for who they are and what they are capable of we can relax and enjoy ourselves.

T- Teens can be a part of the Holidays. Ask them what they would like to contribute to the evening or day. Let them what they feel they can contribute.

E- Empower children and let them help with age appropriate assignments. Putting the nuts out or making the centerpiece. Let them do it their way…not your way.

F– Focus on family for this day. Put all work and worries on the shelf

U– Unplug the electronics for dinner so that everyone can be fully present.

L- Love is often overlooked when we are busy. Be present with love… Speak with love… Show your love and gratitude for your family during this Holiday time.

This might seem very simple and obvious, but at times the best solutions are rather simple. Also you may want to practice using this in your daily life. It may seem simple, but it may be harder to do than you think because you are accustomed to doing things and viewing life in a certain way. This idea may challenge you to reassess how you approach life in general.

Many of us are not use to looking at our lives in terms of what we have to be grateful for. Also many of us have a hard time relaxing and not worrying about work or other things we need to do. I have found that just being in the moment is difficult for most people. Most of us believe we always have to be doing something. This creates stress and disappointment. Finally, since we feel we must always be doing something, disconnecting from cellphones and other electronics can be very difficult for the children and for adults too. However, think about it? How can you have fun and enjoy the day with your family, if your mind is not fully present? You can’t. Furthermore, this can create tension for others because they feel ignored and for you because you feel they don’t respect how important what you are doing at the moment is to you. As a result, you have stress which can turn into an argument and everyone is upset. A day of happiness becomes a day of anger and disappointment.

If you notice you are getting angry or your teenager is getting angry use the acronym HALT:

H – hunger, do not try to discuss a difficult situation if you or your teen are hungry.

A – anger, if it is obvious someone is angry give them time to calm down before discussing an issue. Pushing a discussion when someone is angry will only result in making a bad situation worse.

Lonely – lonely, if someone is feeling down or alone again pushing them to talk can make it worse. Let them know when they are ready you are there to listen.

Tired – tired, trying to have a conversation with a tired teenager can turn into an argument fast. Wait until they are ready to talk. There is no need to make a bad situation worse.

Therefore, in order to avoid the possibility of an unpleasant Holiday for everyone try to

use the words GRATEFUL and HALT as guidelines for the day. What do you have to lose?

Dr. Michael Rubino specializes in working with children, teenagers and their families. He has over 25 years experience. For more information about his work or private practice visit his website at www.RubinoCounseling.com or visit his Facebook page at www.facebook.com/drrubino3 or his podcast on Spotify or Apple.

Teaching Teenagers How to Cope with the Daily Hate They See

Teaching Teenagers How to Cope with the Daily Hate They See

Unfortunately we are living in a divided nation and people are getting hurt or killed due to their beliefs and/or the color of their skin. For example, the Federal Government has documented increased hate crimes against Asian Americans and Antisemitic crimes. In addition, there is a significant increase in hate crimes against transexual adults and teenagers. Asian Americans are getting attacked and killed just walking down the streets because they are Asian. Many people are blaming Asian Americans for the Coronavirus. We also continue to have African Americans being shot by police officers. All of these incidents are creating a divided nation. We are seeing a significant increase in hate crimes and laws that unfairly impact women, transsexuals and other minorities.

We are now living in a country where many people are afraid to go outside because they might be attacked. Additionally, in public people are being rude to each other and no one feels safe. This feeling is severally impacting children and teenagers.

Prior to all of this hate, children and teenagers were reporting increased depression and anxiety. Since the beginning of 2021, more children and teenagers are reporting depression and anxiety. The number of teenagers dying from drug overdoses and suicide continues to rise (CDC). Some teenagers are now taking things into their own hands and are carrying guns and knifes so they can protect themselves or others. Remember the teenager who went from Iowa to Minnesota with a gun and killed two people during the riots. He felt he had a right to stop the chaos. He felt he did nothing wrong shooting people because again he felt he was entitled to help stop the riots. Teenagers should not have to stop the chaos occurring in the United States. This is placing too much pressure on them resulting in teenagers feeling depressed and anxious and seeing no future for themselves.

The United States is supposed to be the “great melting pot.” The Statue of Liberty says, “Give me your tired, your poor, Your huddled masses yearning to breathe free, The wretched refuse of your teeming shore.” We are all supposed to be equal and live together in a Country where we can be ourselves and have a chance at making a decent life for our families. However, we are losing that dream quickly especially if we allow those who are spreading hate and lies to continue to spread hate and lies.

The Harlem Globetrotters developed an anti-bullying program for school children in order to stop bullying. The United States belongs to everyone who is a citizen, not just a select few. Yes there are people who are not citizens, but according to the saying on the Statue of Liberty and our history of accepting immigrants, we still need to treat them with respect and dignity because they are fellow human beings. Therefore, we are all in this together and we all have to fix the problems together. Or, would we prefer that the children continue to live in an environment which is creating depression and anxiety for them and causing thousands of children to commit suicide every year. We are talking about children as young as 8 years old who are committing suicide and the number of children committing suicide is increasing every year (CDC).

The anti-bullying program developed by the Harlem Globetrotters is no longer just for school recesses, it is something we all need to start applying anywhere we see someone being treated unfairly. The Harlem Globetrotters program is not that hard. All you have to do is remember is A, B, C. A is for action, B is for bravery and C is for compassion. To make it easier let’s use an example, if you see an Asian American being attacked on the street, (B) be brave and don’t ignore it, (A) act by calling the police with your cellphone and screaming for help, (C) stay around and show the person some compassion asking if they need anything or reporting what you witnessed to the police. We can do this, we have done it before. This is exactly what happened in the George Floyd case and by everyone working together a bad police officer is now off the streets. If we had not acted together, that officer would still be on the streets chocking people.

If adults are willing to take action, we can teach children and teenagers the same A,B,Cs and if they see their parents and grandparents getting involved they will follow your example. Additionally, if they see adults working together for the common good, maybe we may see a reduction in the number of teenagers feeling depressed and anxious. If that occurs we would most likely see a decrease in the number of teenagers cutting and overdosing on drugs. We would also see a reduction in the number of teenagers and children committing suicide because they would feel a sense of hope for their futures.

Finally, if we all work together we would be worthy of what is inscribed in the Statue of Liberty. We also would stop being a joke to the world. We are the United States, the most powerful nation in the world! However, how can we say that if we allow stereotypes and racism to decide how we treat each other?

Dr. Rubino is a psychotherapist with over 25 years experience treating children, teenagers, trauma victims including first responders. If you would like to learn more about his work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Rules for Healthy Family Disagreements

Rules for Healthy Family Disagreements

Many parents, who have teenagers, often encounter power struggles with their teenager. Typically the power struggle occurs because the teenager disagrees with the limits their parents are setting. Many parents get frustrated by the power struggles, but teenagers at times enjoy the power struggle. If they get their parents into an argument most parents forget the main point of the discussion and the teenager wins.

This is the situation which occurs in normal life. However, we are not living during normal times. We are dealing with a pandemic and the possibility that another pandemic maybe beginning. We still are struggling with the Coronavirus and now we have another virus, monkeypox, beginning. By this time many families are tired of dealing with the pandemic and want to return to their lives prior to the Coronavirus. Therefore, we are in a situation with families tired of dealing with a virus and inflation and people can get annoyed easily.

At this point, it is important for parents to remember that a teenager’s brain is not fully developed. The prefrontal cortex is still developing in teenagers. This is the part of the brain responsible for reasoning and other executive functions such as making decisions. Therefore, while teenagers look mature enough to be able to participate in a reasonable conversation, their brains may not be mature enough. To put it another way, you are not debating the house rules regarding curfew or issues related to the Coronavirus with a 16 year old, you are debating the rules with a fifth grader in terms of their physical and emotional development. Therefore, they are more likely to argue and to be disrespectful. However, an argument is not always bad. There are ways to have a healthy arguments and avoid destructive, hurtful arguments. Most of us never learned how the have a healthy, reasonable disagreement. Many people may think this idea is crazy, but it’s not.

Many people feel that a disagreement or fight is always is a bad thing for a relationship. However, this is not true. Especially now, with most people feeling overwhelmed and uncertain about the future there are bound to be things that irritate everyone. Instead of ignoring these issues until everyone is screaming and yelling. It is better to address these issues in a healthy manner and lower everyone’s stress level. Besides lowering the stress level in the house, you are modeling for your teenager how to have a reasonable discussion about differences of opinions without having to say hurtful things to each other.

As I stated above, parents who are dealing with teenagers and children need to remember that their children’s Frontal Lobes are still developing. Therefore, they cannot always reason like adults and often have difficulties having fair disagreements. This is one of the reasons fair fighting was developed. I have included a list by TherapyAid.com which explains fair fighting rules.

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

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

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

Fair Fighting Rules

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

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

2. Discuss one issue at a time.

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

3. No degrading language.

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

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

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

5. Take turns talking.

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

6. No stonewalling.

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

7. No yelling.

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

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

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

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

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

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

Dr. Michael Rubino is a psychotherapist with over 25 years experience and he specializes in treating teenagers, children, trauma victims and their families including first responders. For more information regarding his work or private practice visit his website at www.rubinocounseling.com or his Facebook page at www.facebook.com/Drrubino3 or follow him on Twitter @RubinoFamily.

Reasons Why Boys Cut and Warning Signs of Cutting

Reasons Why Boys Cut and Warning Signs of Cutting

When I was guest co-hosting the Street Soldier radio show on 106.1 KMEL, the topic was how teenagers are impacted by social media. The topic of depression and cutting came up during the conversation. The adults were shocked to hear about cutting and the teens tended to feel the cutting was more of an issue for the girls. However, as a psychotherapist who works with teenagers, I have observed the increase in teenage cutting over the years. I have also observed that a behavior that once was believed to occur mainly in girls is also occurring in teenage boys too. From what I have seen it appears that just as many boys are cutting as girls. I mentioned when I was co-hosting and it was before the Coronavirus. Since the Coronavirus pandemic and quarantine and the significant increase in mass shootings the number of teenagers cutting has significantly increased (CDC).

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

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

Why do teenagers cut? The reasons I commonly hear is it is easier to deal with the physical pain than the emotional pain they are feeling. Also it is away for them to feel alive. Many teenagers with severe depression often don’t feel connected to their bodies and the cutting helps them feel reconnected to life. Many teens who are severally depressed will tell me that cutting reminds them they are alive. They are so depressed that they feel nothing, but when they cut they feel. Also teenagers cut as a way to punish themselves because they are ashamed about something they did or they feel they have let their parents down. Cutting is a way for teenagers to deal with the guilt and shame they are experiencing. It is also a way that they can feel in control of life when their life feels or the world feels out of control or overwhelming. This is an important point to remember. Our world feels very overwhelming and confusing right now and teenagers are having a very difficult time dealing with all the chaos.

Many teenagers were feeling overwhelmed and afraid for their safety due to all the mass shootings and increase in hate crimes. Since the Coronavirus pandemic many teenagers are feeling even more overwhelmed and powerless. They also see very little hope for things to improve. As a result, many more teenagers have started cutting since the beginning of the pandemic. It is a way teenagers can try to cope with feeling overwhelmed and powerless due to the pandemic. I have had more teenagers reporting incidents of cutting and more friends who are cutting since the beginning of the pandemic and as the pandemic continues.

If we look at how boys are raised, cutting is a good fit for boys. Most boys grow up learning that boys can’t cry and if you express feelings of sadness or disappointment you are weak. Teenage boys are always supposed to look like life is perfect and they can handle anything without help. Cutting allows them to express sadness, fear or embarrassment in private. No one knows they are cutting or how they are feeling. Unfortunately, this leads to a vicious circle where emotions can get out of control and a boy may end up doing something he never indented to do. The number of boys cutting has increased due to the pandemic because they feel overwhelmed and out of control. There is nothing they can do about mass shootings or the Coronavirus and how their lives have changed due to mass shootings and the Coronavirus.

At this point, most people working with teenagers consider cutting an epidemic. In fact, the CDC does consider teenage cutting to be an epidemic. Additionally, the little research we have about this behavior supports this idea, but we are unable to determine how severe the epidemic is in teenagers. In the year 2000, when I asked about cutting some teenagers knew what I was talking about, but others had no idea. Today when I mention cutting to a teenager, they don’t look shocked. Instead they talk about it like we are talking about the weather. They often tell me about friends who are cutting too. Most teens who cut have friends that cut. Most teenage boys who have girlfriends tend to have girlfriends who cut too. It is something they will do together and talk to each other about. It becomes part of their relationship and they support each other regarding the feelings they have about cutting. As I stated above, the number of teenagers cutting has increased significantly since mass shootings and the Coronavirus pandemic because many teenagers are feeling helpless and overwhelmed by life. No other teenagers have had to deal with mass shootings and a pandemic so teenagers feel helpless and hopeless about life. This has been my experience.

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

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

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

Risk Factors

Knowledge that friends or acquaintances are cutting

Difficulty expressing feelings

Extreme emotional reactions to minor occurrences (anger or sorrow)

Stressful family events (divorce, death, conflict)

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

Negative body image

Lack of coping skills

Depression

Warning Signs

Wearing long sleeves during warm weather

Wearing thick wristbands that are never removed

Unexplained marks on body

Secretive or elusive behavior

Spending lengthy periods of time alone

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

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

Dr. Michael Rubino has over 25 years experience treating children, teenagers, trauma victims and first responders. He has treated many teenagers who cut and is considered an expert in this area. For more information regarding Dr. Rubino visit his websites www.rcs-ca.com , www.RubinoCounseling.com , or his Facebook page, www.Facebook.com/Drrubino3 or his podcasts Understanding Today’s Teenagers on Spotify or Apple.

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.