The Teenage Vaping Epidemic

The Teenage Vaping Epidemic

Many people thought that teenage tobacco use was decreasing. In fact, over the past few years teenage tobacco use had been decreasing. However, a recent report by the CDC indicates that teenage tobacco use has increased. Between 2017 and 2018, 1.3 million teenagers starting using tobacco. In high school students the increase is 77% and for middle school students the increase is 48.5% (CDC). This increase eliminates any decrease that in the use of tobacco since 1999.

The report contributes the increase in smoking to e-cigarettes, vaporizing and the use of JUUL. These products especially juul uses flavored tobacco such as bubblegum. Teenagers start using the flavored tobacco thinking it is safe and become hooked on nicotine. It is then an easy jump from juul or vaporizing to smoking cigarettes. In the period between 2017-2018 the use of Juul went up 600%. Tobacco companies are targeting teenagers with the flavored tobacco products. As a result, teenagers are trying it because they think it is safe. However, they are smoking more when using a juul, vaporizing or using an e-cigarette. Since they are using flavored tobacco products they think they are safe. However, they are gradually becoming addicted to nicotine and addicted to cigarettes.

The Juul is so addictive that many retailers who sell tobacco products are refusing to sell juul products anymore. One store owner said he would not continue to carry juuls because it was an easy way for tobacco companies to get teenagers addicted to nicotine.

If you are a parent, you need to discuss this situation with your teenagers and children in middle school. I hear many teenagers and middle school students tell me that vaporizing and juuls are safe to use. They tell me how different they are from cigarettes. However, when I challenge them to stop vaporizing or using a juul, they find out that it is very difficult. They then admit that maybe vaporizing or a juul is not as safe as they thought. However, they are now addicted to nicotine.

Therefore, if you have a calm conversation with your teenager and if you go to CNN on line, you can find the report. If you discuss it with them calmly maybe you can prevent your teenager from becoming addicted to nicotine. Also vaporizing and juuls create a significant number of problems at school too.

Dr. Michael Rubino is a psychotherapist who specializes in treating adolescents and children. He has over 20 years experience working with teenagers and children. For more information about Dr. Rubino’s work or private practice please visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.

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Gifted Children May Have Learning Disabilities too

Gifted Children May Have Learning Disabilities too

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

Wikipedia defines 2E children in the following way:

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

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

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

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

If this sounds like your child do not panic. Arrange to have your child evaluated by a mental health clinician who is familiar with 2E children. They can help you develop a treatment plan and let you know if your child needs accommodations at school. If your child needs accommodations at school do not pay for any psychological testing for your child. According to California law, the school district has the right to test the child first. They do not have to accept outside testing, if the district has not tested the child. If you disagree with the school district’s testing, say so and request a second evaluation. This evaluation is completed by a professional not associated with the school district and the school district pays for the testing not you.

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

What to Do if You Think Your Teen is Cutting?

What to Do if You Think Your Teen is Cutting?

Self-harming or Cutting is at an epidemic rate in the teenage population. Teens who engage is this behavior feel a great deal a shame about the behavior and themselves. Therefore, if you think your teenager is cutting it is very important how you talk to them about it.

If you increase their feeling of shame, it is very likely they will close down emotionally and refuse to discuss it. I work with many teenagers who cut and feel people have judged them negatively for cutting. In therapy, I have a very difficult time working with them. It is difficult because they assume I am judging them negatively too. It takes a lot of work to gain their trust.

This is a very scary topic for parents and our society does not handle mental health issues in a positive way. Therefore, talking about this issue without shaming the teenager can be very difficult.

Dr. Pooky Knightsnan has developed a video regarding how to approach this issue and addresses what not to say. If you believe your teen is cutting, please watch this video, What not to do if a child is self harming https://youtu.be/gfRwez8ergg via @YouTube

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. Cutting is an area he specializes in treating. For more information about his work or practice visit his website http://www.RubinoCounseling.com or http://www.Facebook.com/drrubino3.

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

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

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

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

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

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

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

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

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

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

Facts about Teenage Mental Health Care in the United States

Facts about Teenage Mental Health Care in the United States

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A Safe Super Bowl Party

A Safe Super Bowl Party

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

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

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

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

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

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

It would also be helpful to remember the acronym HALT:

H – hungry

A – angry

L – lonely

T – tired, too much alcohol

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

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

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

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

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

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