A Nation of Children Traumatized for Life

A Nation of Children Traumatized for Life

I recently wrote an article about mass shootings and the impact they are having on children. In light of this week’s events it appears another article is needed. This week there were two mass shootings. One in Colorado and one in North Carolina. Additionally, the one in Colorado appears to be a hate crime too. The shooting occurred in the city’s only LGBTQ+ bar and hate crimes against transgender individuals have seen a significant increase this year. This increases the fear and trauma in the LGBTQ+ community in that city and all across the country too. As of today there have been 612 mass shooting in the United States just this year. There are only 356 days in a year so we are have more than one mass shooting a day in our Country (CDC). Additionally, there are 112 shootings every day in the United States (CDC). These include domestic violence incidents, crimes, suicides and accidents. We are experiencing a tremendous amount of gun violence in our Country. It is no surprise that there is an epidemic of anxiety, depression and cutting in children and teenagers in our Country (CDC). It also no surprise that many people such as teachers, store clerks and first responders are dealing with PTSD in significant numbers (CDC).

However, stop and think for a moment. Every time there is a mass shooting the people who were killed and injured, they and their families are traumatized, but so is every person who was at that school or store that day and so are the first responders who must treat the wounded, deal with the families and the paramedics and police officers who must see the bodies torn apart and the blood all over the crime scene.

However, the trauma doesn’t stop at the site of the shooting. Everyone living in the town is traumatized because the illusion that they are safe has been destroyed. Additionally, anyone any where in our Country who has experienced gun violence relives the trauma all over again. This experience of reliving the trauma doesn’t stop in six months or a year. Most people will carry this trauma with them for life. Some people find it so overwhelming that they eventually commit suicide to stop the trauma. Many people refer to it as survivor guilt. We are seeing parents and teenagers who have experienced past mass shootings committing suicide recently. Many first responders also are at risk for suicide because they blame themselves for not being able to save the victims.

Also, if you take a step back and look at what these children have seen over their lives it makes sense. Most of these teenagers were very young on 9/11, or were not even born yet, when the United States was attacked. However, since 9/11 they have seen two wars and heard on the nightly news about numerous terrorist alerts or attacks around the world and here in the United States. They also have heard how the TSA at times are putting tighter security on travelers and places such as Disneyland are increasing security due to concerns about terrorism.

In addition to terrorism, this is the first generation growing up with mass shootings. According to ABC News from 2000 to 2015 there have been 140 mass shootings and since January 1, 2016, there have been more mass shootings than the previous 15 years. This is a great deal of stress and trauma for a child to endure daily. For the group we are discussing, suicide was the third leading cause of death for children between 10 and 18 years old. It is now the second leading cause of death for teens and using a gun is one of the most popular methods of suicide. Also because of school shootings, students have seen increased security on their school campuses. Many campuses have metal detectors that students have to pass through as the enter the campus and there are police officers assigned to school sites due to the fear of violence.

Now, in addition to these facts stated above, think about what these children see on the news nightly and the video games they play daily. Anytime there is a shootings incident in the United States, or any where in the world, there is pretty much 24 hour news coverage of the event for days. Also when there are bombing or shootings in Europe there is 24 hour news coverage for days too. And now we have moved on to covering funerals. When the officers were killed in Dallas the memorial was televised nationally. If we look at the video games these kids are playing most have to do with killing and death. Since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about their safety due to the former President Trump. They have heard what the former President has said and they are afraid other countries may attack us. Also Hispanic children who are legal citizens are still afraid that they will be deported. This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives. These teenagers are being traumatized. They may not be experiencing the trauma personally but they are experiencing vicarious trauma. With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously. We have never had a generation of children grow up with the amount of trauma that these children are growing up with in the world. Even children growing up during World War II didn’t experience this amount of trauma. We didn’t have instant access to news nor did we have the graphic videos being shown by the news media.

The question now becomes, what do we do? Well we can not change the world unfortunately. However, we can demand that the Senate act. Telephone Senator’s McConnell office at 202-224-2541and demand that he stop refusing to not to pass laws which would protect children. Parents can monitor how much exposure children are receiving to mass shootings when they occur. We can monitor the video games they are playing and limit access to games that focus on violence and killing. Again, we must demand that the Congress and the Senate pass gun control laws that make sense. No one needs an assault weapon or silencer to hunt a deer. All the weapons in this last shooting were purchased legally, no background check or waiting period. In Canada before someone buys a gun their family is interviewed and there is an in-depth investigation of the person. If other countries can do this without terminating someone’s right to own a gun, so can our Country. The government must act.

Another thing parents can do is listen to what our children are saying and talk to them about their concerns. When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.

Finally, if you start to notice a change of attitude in your child that you are concerned about have a talk with your child or have them assessed by a psychotherapist. I have included a link to an article by the American Association of Child and Adolescent Psychiatry which describes what parents can do http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Talking-To-Children-About-Terrorism-And-War-087.aspx. There is nothing to be ashamed of if a child needs therapy. We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents. For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma. Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 25 years experience treating children and teenagers and is an expert treating victims of trauma and also performs Critical Incident Debriefing. For more information about his work or private practice visit his website at www.RubinoCounseling.com or on Twitter @RubinoTherapy or his Facebook page www.Facebook.com/drrubino3.

Coping with the Epidemic of Anxiety Disorders in Children and Teenagers

Coping with the Epidemic of Anxiety Disorders in Children and Teenagers

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, and counting, Americans have died from this virus (CDC). Many children and teenagers have lost grandparents, siblings and parents to this virus. Therefore, we also have many children and teenagers who are dealing with grief due to the loss of a loved one. We thought we had turned a corner regarding the Coronavirus, but we found out we have not turned a corner and we are still having spikes in the number of cases. There are still people being diagnosed daily with the Coronavirus and people dying daily from Covid. Many of these people have been vaccinated, however, most people being diagnosed and dying have not been 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 we continue to have spikes is confusing and irritating to teenagers. Just as we think we are returning to our normal lives, we see that we need to still take precautions and maybe we will never return to our pre-Covid lives. 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 they are expected to adjust.

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 is occurring when children and teenagers desperately need psychotherapy. Prior to the pandemic, anxiety disorders in children and teenagers were at epidemic rates (CDC). Since the pandemic there has been a 25% increase in children and teenagers being diagnosed with anxiety disorders. At this point anxiety disorders are the most common psychiatric diagnosis for children and teenagers (CDC). Yes depression, suicide, grief and trauma diagnoses have increased since the pandemic, but we have seen the largest increase in anxiety disorders (CDC). As a result, many children and teenagers have severe anxiety regarding school and many are stating they cannot go to school due to anxiety disorders.

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 a psychotherapist who specializes in treating children and teenagers, if stress begins to interfere with your child’s daily activities for several days in a row. It is very important that you contact a mental health clinician so you get an accurate diagnosis and an appropriate treatment plan for your child.

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.

Looking at the Lessons We Forgot 21 years After 9/11

Looking at the Lessons We Forgot 21 years After 9/11

Today is the 21st anniversary of the 9/11 attacks on New York City and the Pentagon. Our Country said it is a day we will never forget, however people in the early 20s were too young to remember and teenagers were not even born. They most likely have heard numerous stories about that day, but they did not experience the fear we all felt and the uncertainty we all were struggling with that day. 9/11 was the first time in history that the mainland of the United States had ever been attacked. It happened often in Europe but never here in the United States. On that day the safety we all were use to was destroyed. There will be a number of television documentaries this weekend about 9/11. Parents you may want to watch one of these documentaries with your children and discuss with them how they feel and answer any questions it may bring up.

There was something else that changed that day too. We witnessed how our first responders all pulled together in order to help victims and secure the Country. They did not come together for a day, they came together for months and exposed themselves to deadly dust and the possibility that building may further crash in on them killing them. They thought nothing about themselves. They were only thinking about helping survivors and families who lost loved ones. It was also amazing to see how first responders from all over the Country came to New York City and Washington D.C. to help. They also planned on being there for as long as needed which was several months. Regardless of the length of time our first responders were working 24 hours a day, seven days a week and no one complained.

We also witnessed citizens volunteer to help the first responders. We even witnessed a plane of citizens sacrifice their lives in order to protect a plane that was planning on hitting the White House. We all came together regardless of race, sexual preference, socioeconomic status and worked together. We were all Americans and we were going to work together to prove to the terrorist and the world that no one could stop the United States of America. Besides the citizens who volunteered at the sites that were attacked, people from all over the Country donated money, clothes and supplies for homes. Many people had lost their homes, survivors had medical bills and the first responders needed food, clothes and places to sleep. The main point is we all came together as Americans so we could help protect and save Americans impacted by this attack.

We owe a great debt to our first responders and we still do. Our first responders are responding the same way to the ongoing pandemic and the floods and wild fires all over the United States. They are working 24/7 to help victims of the pandemic and to help families who have lost loved ones. Many physicians and nurses have not had a day off since the pandemic started. The first responders continue helping victims of the pandemic while having to also help victims of hurricanes, floods and fires all over the Country. They do not think about themselves, they only think about the jobs and the people they need to save.

While our first responders continue to selflessly respond to the needs of our country, the citizens of our Country do not. Instead we are fighting with each other about who is right. The part that is really disgraceful is we are fighting with first responders and essential workers. When they have asked people to follow guidelines which have been established many of them have been beaten and some even have been shot and killed. We have a pandemic that has killed over 650,000 Americans. The tragedy on 9/11 killed over 3000 Americans. What would have happened after the planes hit the Twin Towers in New York City on 9/11 if we argued with first responders and if we shot at the first responders? I am afraid to think what would have happened.

Parents if you compare what is happening in our Country currently with how people responded on 9/11, it is very disappointing. It seems like we have forgotten. We are not acting together as one Country, we are fighting with each other and we are emphasizing our differences. Parents try thinking back 21 years ago and explain to your children what it was like when we all acted together as one and we were all proud of our Country and that we were all working together. Maybe if we can explain this to our children and teenagers maybe they can start to work together and once again be proud about all of us being Americans.

Dr. Michael Rubino is a psychotherapist who has over 25 years experience treating children and teenagers and trauma victims including first responders. For more information about his work visit his website at www.RubinoCounseling.com or his Facebook page www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

Facts about Attending High School in 2022

Facts about Attending High School in 2022

All over the Country teenagers will be starting their first year in high school or returning to high school. Typically I would recommend that parents think back to their first day of high school and how they felt and what they were expecting high school to be like and how they were expecting there other kids to act. I did this to help parents relate to some of the feelings their teenager maybe having as a way for parents to help their teenagers starting high school. This may help parents with some of the issues facing their teenagers, but teenagers starting high school or resuming high school in 2022 do so with mass school shootings occurring on a regular basis and we are still dealing with a deadly pandemic. Therefore, high school students are facing additional issues besides the typical first day of school issues. They are facing life and death issues, we never had to face in high school. Additionally, they see that the government is doing very little to protect from gun violence. Therefore, today’s teenagers are facing overwhelming issues we never had to face when we went to high school. This can make it difficult for parents to be able to completely understand the feelings teenagers and having starting high school.

High school students, in fact all students, are starting school when there is a significant increase in the Coronavirus due another new variant. As a result, many people including teenagers are contracting the virus (CDC). The number of people contracting the virus is similar to the numbers we were seeing a year ago (CDC).

Therefore, high school students are starting high school not knowing if they will or will not contact the virus. Yes there are vaccinations they can get and they can wear masks, all of which decreases their chances of getting the virus, but some governors, school boards and parents are refusing these options. People are objecting because they say the precautions are not necessary and do not work. However, teens are hearing that the virus is spreading rapidly in most counties in the country. In fact, some counties such as Los Angeles County and considering returning to indoor mask mandates (LA County Public Health). Having to keep up with homework and after school activities, such as sports, is a lot for most teenagers without having to worry about the pandemic. Teenagers are worried about it because I hear them tell me about their concerns and some students would prefer to go back to remote learning due to the threat posed by the virus.

In addition to worrying about contracting the virus, students return to school having to deal with mass shootings. According to the Gun Violence Archives, there has been more than one mass shooting a day so far this year. The Gun Violence Archives also report there has been a 50% increase in mass shootings since 2020. Unfortunately, the recent shooting at the school in Texas showed we have not improved how we handle these shootings. The police waited outside for 77 minutes while children and teachers bled to death. Since most teenagers have smartphones, they have access to all of this information. They know the number of shootings are increasing, police are not handling the situations and the government refuses to pass laws that can have a real impact on gun violence. They also see the news that the mass shootings are a problem for the United States and they seldom occur in other countries. Given this environment, it is no surprise that we are seeing a significant increase in depression and anxiety disorders in teenagers (CDC). Teenagers today are not crazy and do not live in a fantasy world. They have access to the news very easily and they are very aware about what is occurring in our Country. Based on what the see and the lack of help by the government feeling anxious and depressed is a normal response.

One other issue, besides worrying about contracting the virus and mass shootings, students have missed an entire year of high school. Therefore, students who are sophomores never had a freshman year and have no idea what to expect. Teenagers who were enjoying their high school experience have missed out on an entire year. Therefore, students starting high school and returning to high school in 2022 are doing so facing many issues that students usually never face. For example, the main issue is adjusting from remote learning to being back in the class. Their school days are longer, they have more homework and they are around more people. This is not a simple adjustment. As a result of all the issues we have seen a significant increase in depression and anxiety in high school students (CDC).

Parents hopefully you can remember everything teenagers and you are facing as your teenagers start high school. You may need to contact your teenager’s school and ask for assistance from the school. You may need to seek out a psychotherapist who specializes in treating teenagers and have your teenager participate in psychotherapy. There is no shame in doing this because teenagers are facing tremendous mental health issues and many need help. Since the pandemic and school resuming, there has been a significant increase in the number of teenagers needing psychotherapy (CDC). In fact we are running out of psychotherapist who are able to treat these teenagers. No one planned on how to adequately handle the number of teenagers needing psychotherapy due to the pandemic.

Parents all you can do is to be patient and listen to your teenagers and seek the help you feel is appropriate. Also do not forget yourselves. Parents are under a great deal of stress too and you may need psychotherapy too. If you try to work together and are patient with each other, you should be able to handle the stress teenagers are facing due to the pandemic.

In addition to the pandemic, students starting high school still deal with common anxieties most teenagers have faced over the years. One common stressor for many teenagers are the stories they have heard about how seniors picking on and teasing the freshman students. Another common fear for freshman is that they are going to get lost on the campus and not be able to find their classrooms. Your teenagers are at a point in their life where they want to make a good impression on the other students. At their age image is very important. Therefore the idea of being teased by the seniors or getting lost on the campus can be very stressful and also create a great deal of anxiety for a student starting high school.

As parents, you can talk to your teenagers about your first days days at high school and reassure them that the stories they hear about Freshmen being targets for the seniors are greatly exaggerated. Also you can try to go with them over to the school before it starts and walk around the campus so they can get use to where everything is at their new school. Another thing you can do is remind them that everyone makes mistakes so if they do get lost the first day it is not a big deal. Remind them there will be a lot of other kids starting their first day of school too and there will be other kids getting lost. This is also another opportunity to continue to establish an open relationship with your teenager. The more you talk with each other, you increase the likelihood that they will feel comfortable coming and talking to you about issues they will have while in high school.

Another issue facing some students is starting all over. In middle school may be everyone knew them and they were in the “popular group.” Now no one knows them and they need to start all over. This may be frightening to them, but remind them there will be many times in life when they will need to start as the new person. Also remind them, if they were able to do it in middle school, they can do it in high school too. Be sure to encourage them to have faith in themselves because it won’t happen over night. Now for many students middle school was a nightmare. They may be looking forward to starting over. Again remind them if they have the desire to try they can do it. All the Freshmen are starting all over just like them, but also to be patient because it may not happen as quickly as they like.

Also before school actually starts is a very good time to establish what your expectations are regarding grades and after school activities and hanging out with friends. At this time is a good time to establish what your expectations are homework, after school jobs and weekend curfews. If you establish an understanding between yourself and your teenager before these situations arise you can save yourself a lot of time arguing with your teenager. However as you establish these guidelines you want to have a conversation with your teenager about these issues. Remember your teenager is starting to enter the adult world, if you simply just tell them these are the rules, they will feel that you are being unfair and they will try to find a way around your rules. If you have a discussion with them about the rules they will feel that their opinions were respected, they are more likely to feel that the rules are fair and are more likely to follow the rules. It is also a good idea to write a contract with all the things you agreed to. If you write the agreements down and there is a misunderstanding you simply need to refer back to the contract. Also this is another opportunity for you to establish a relationship with your teenager where they feel comfortable enough to come to you and discuss any problems they may be having. You are also role modeling to them how to have an adult discussion and how to negotiate fairly and respectfully with other their people.

Of course you also want to take this opportunity to discuss with your teenager the fact that they are going to be faced with making decisions about alcohol, drugs and sex. This is a good time to provide them with the education they will need in order to cope with these situations. It is even more important today because technology has changed a number of rules. For example, if a girl texts a nude photo to a boy, he is guilty of having child pornography. Yes it was mutually agreed to but they are still under 18 years old so it is a crime. Texting is another area where they can get into trouble. If someone takes a text as a threat they can get into trouble for bullying or assault. As I said, technology has changed the rules and many of us have not been able to keep it. Therefore, remind them that information they may receive from their friends may not always be accurate. Furthermore, encourage them that at any time if they have any questions or concerns regarding these matters or any other matters you are always there to listen and to talk with them.

One thing to remember is acronym HALT. I teach this often with anger management, but it helps with communication too.

H – hunger

A – anger

L – lonely

T – tired

If either one of you are having these feelings, it is generally not a good time to have a discussion. Also if either one of you is feeling like this and you may not be listening to each other. Therefore, if either one of you are having these feelings or don’t feel like talking, then it’s better to postpone the conversation until you are both ready to talk.

Lastly, remind them that they are starting a brand-new phase in their life and it is normal to feel anxious and stress. Also remind them that these feelings are normal in the beginning but they usually quickly disappear after they have started school.

Besides having to face the pandemic, high school students today also have to face the issue of school shootings, as I mentioned above. Sadly, this is another stressful subject you may want to discuss with your teenager. Develop a plan with your teenager about what they would do if there was a shooting at their school. Also discuss with them what to do if they hear rumors or have concerns about how another student is acting. Finally, discuss how you can help if they are feeling worried or not safe at school. It is sad, but this is the world we live in today. Talking to you teen can help decrease anxiety and help you to maintain open communication with your teenager.

A few things you can do on the first day of classes to help with any anxiety are you can get up in the morning with them and have breakfast with them before they go to school. You can also put a note of encouragement in their backpack that they will find when they are at school and this can help reassure them and remind them how much support they have at home. Finally, you can arrange to be at home when when they get home from their first day of high school so you can talk about it with them. Also plan to have a family dinner to discuss everyone’s first day of school and offer encouragement where needed. These are just a few ideas to help with the transition process.

One final issue to remember, since there has been a significant increase in anxiety and depression in high school students, many students are having difficulties in class and completing their homework. If they are having difficulties, they may be entitled to a 504 plan or an Individual Educational Plan (IEP). Most school districts will offer you a 504 plan because it is easy for the school and costs the school no money. However, if your teen is having significant problems with school demand in writing that they be evaluated for an IEP. There is nothing to be ashamed about and an IEP will not prevent your child from going to college or getting a job. If you need further information regarding IEPs refer to my articles regarding IEPs or contact my office regarding an IEP consultation.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers. He has over 25 years experience working with teenagers. To learn more about his private practice in Pleasant or the work he has done over 25 years visit his web site at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

Teenagers Continue to Experience Vicariously Trauma Daily

Teenagers Continue to Experience Vicariously Trauma Daily

Many people tend to assume only people who were directly exposed to a trauma will experience issues related to the trauma and may develop Post Traumatic Stress Disorder (PTSD). However, this is not the truth. Many people may not have lived through the trauma, but they may know someone who did or they were exposed to very explicit images of the trauma or have been hearing about the trauma a lot on the news. It may also trigger memories of a trauma they experienced in their lives or in their family. This can cause what is referred to as vicarious trauma. Vicarious trauma is when someone is traumatized by an event but they did not experience the event themselves. Simply knowing about or hearing about the event is traumatizing to them. This is happening to many children and families in the United States. However, when are we going to pay attention to the way children in the United States are being traumatized over and over?

If this sounds confusing, let’s look at what children and teenagers have been dealing with and living through the last few years. This last year teenagers and children have been living with the trauma of the Coronavirus. Their schools were closed without warning and so were the sports and other after school activities stopped suddenly. In addition they were not able to hang out with friends and had to go to school remotely.

In addition to these changes, many children and teenagers had family members they could no longer see, such as grandparents and many had family members who died due to the Coronavirus. However, they were not able to attend funeral services and say goodbye. Over 525,000 Americans died to the Coronavirus. All of those people had family members and friends who are grieving for them still. A fact we tend to overlook. However, children and teenagers are dealing with it daily especially if they lost a parent, grandparents or a sibling.

While children and teenagers are still dealing with how poorly the Pandemic was handled by the government, now many are being told we are reopening states including schools. Therefore, they no longer have to deal with remote school now they will be back in their classrooms. This brings up anxiety about how school will be because they still need to be cautious so they don’t contract the Coronavirus. Many children and teenagers have told me they are very worried about being exposed to the Coronavirus or their parents being exposed to the Coronavirus.

In addition to the Coronavirus, children and teenagers now have to worry again about mass shootings. We just started opening the Country and already there have been two mass shootings. This brings up the anxiety and vicarious trauma children have been exposed to regarding school shootings for years. They have been increasing every year since 2010 (CDC) and in 2019 by November there had been 336 mass shootings averaging out to a mass shooting every 1.2 days (Gun Violence Archive). These are overwhelming statistics for adults and we are expecting children and teenagers to cope with them. The students know there have been no changes to the gun laws. Therefore, they are having to return to school and worry about mass school shootings.

Look at what they are returning to when they return to school. Today in most United States schools, the classroom doors are kept lock while class is in session and no one can enter a school campus without checking in with the main office and they must wear an identification badge while on campus. In fact, all school employees must wear official school identification badges while at work. Many elementary students noticed these changes and have asked why the door must be locked? Students are told it is for their safety. The school is preventing any people who do not belong at the school from getting near the students. No one mentions someone with a gun, but children have heard about and remember all the mass shootings and they know why the door needs to be locked. I have many elementary students mention this to me during their therapy sessions.

Now when we were in school we had fire alarm drills in case there ever was a fire in the school. No one thought much about them. Some students felt the fire alarm was too loud but no one really worried about a fire happening at school. We never worried about it because we never heard about any school fires and people dying.

Today students face more than fire alarm drills. Schools routinely have active shooter drills. During these drills students are taught to shelter in place and to remain very quiet so the shooter will not enter their room. Therefore, besides having heard about and remembering mass school shootings, school students know they are returning to a place where they could be killed. They know they are practicing what to do in case there is a shooter at their school trying to kill them. Therefore, they worry about could a shooting happen at their school and could they die. As a result of these fears, the CDC has documented that anxiety disorders and depression had significantly increasing in children since school shootings increased and they have documented a further increase in anxiety and depression due to the Coronavirus.

To add to the trauma students now face, if there is an incident, such as a bank robbery, involving someone with a gun near a school, the police put the school on lock down. The students must shelter in place and they don’t know if the person with the gun will come to their school or not. This creates a significant amount of anxiety for children and many are traumatized by the incident. Here is another incident causing trauma for children and teenagers. How many do we expect them to cope with at their ages? When will we provide mental health care for the children, teenagers, their parents, the school staff and the first responders? All of these people are being exposed to trauma regarding the Coronavirus and mass shootings on a regular basis. This creates traumatic reactions and exacerbates old traumatic reactions.

Another issue which adds to this trauma is gun control. Since the shooting in Florida many students have been actively campaigning for sane gun control. However, nothing has been done to enact sane gun control laws. High school students know nothing is being done and elementary children are hearing nothing is being done about guns. This makes them worry because they know guns are still out there that can be used to kill them. The shooting which occurred in New Zealand cause high school and elementary students to wonder why our Country does nothing about gun control. Our government has done nothing even though students and parents are demanding safe gun laws. While our government debates the issue, more students were killed and may be killed. Just look at the two mass shooting this past week. However, New Zealand in a matter of 3 weeks after a shooting banned all assault weapons. This makes students wonder why we have not done anything when we have a bigger problem with mass shootings. Also it doesn’t make them feel safe at school because they do not feel like a priority. Some people will say children and teenagers are not aware of such issues. However, remember with their Smartphones they have instant access to the news and this generation of teenagers are politically active.

Working with teenagers and children I have seen that anxiety and trauma reactions have

increased significantly for children. Also children are afraid of returning to school because they might be killed. These are responses to the mass shootings. Every time there is a mass shooting children become more anxious and afraid. We had two mass shootings this last week and as I am writing this article another mass shooting is occurring in the Florida Keys. We have just started to open the Country and we already have had 3 mass shootings. This will exacerbate previous traumatic reactions and create new ones. We are expecting children and teenagers to cope with the Coronavirus and mass shootings at the same time. For those children and teenagers not directly effected by the virus or shootings, they still have to cope with the issues which results in vicarious trauma.

Furthermore, if we want to reduce the vicarious trauma children and teenagers experience, we must be honest and not lie to children and teenagers. Remember, they have their smartphones phones and easy access to news and videos clips of the news. The best example is when the US Capital building was attacked by people trying to prevent President Biden from winning the Presidential Election. There have been Republican Congressmen and Senators saying they were safe and down playing the event. However, police were killed and injured and people were chanting “hang Pence”. To me that doesn’t sound safe. Additionally, despite the video showing these protesters breaking windows, spraying police with pepper spay and beating officers with flag poles, the former President Trump went on television saying the protesters were hugging the police, waving hello and walking calmly into the Capital. This type of blatant lie causes teenagers not to trust authority figures because they may be lying and it can cause them to second guess what they saw in the video. This creates a situation where teenagers do not know who to trust and this exacerbates their fear and traumatic reactions because they feel they have no one to trust. Children and teenagers need the truth in age appropriate terms. The truth is easier to handle than their emotions.

Summing up, children and teenagers in the United States have been traumatized and vicariously traumatized by mass shootings and the Coronavirus. As we start to open up the Country, they continue to have to deal with the Coronavirus and mass shootings. Therefore, they continue to be traumatized and vicariously traumatized. Many will need psychotherapy to help them with these issues. The American Association of Children and Adolescent Psychiatry has put out the following guidelines. If you notice any of these signs or symptoms in your child or teenager it explains how to start to talk to your child or teenager and how to find the appropriate psychotherapist for your child. It is important to get a therapist who specializes in anxiety disorders and trauma issues http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Talking-To-Children-About-Terrorism-And-War-087.aspx.

One final aspect about vicarious trauma that has emerged regarding mass shootings and the Coronavirus is suicide. Family members and survivors of mass shootings are feeling survivors guilt and as a result committing suicide. There was a report of 3 people who committed suicide who either survived a mass shooting or their child died in one. This has been occurring for a long time. It has been occurring since Columbine. Family members feel they can no longer cope with the pain. Survivors can’t cope with the guilt of surviving. Family and friends of some one who was killed or injured in a mass school shooting have had their lives changed forever! People, family members and first responders, especially hospital workers dealing with the Coronavirus are also committing suicide. They are dealing with depression, anxiety and trauma reactions on a daily basis. However, we do not have adequate mental health resources to help these people. Also people assume after a few months, most people may be grieving but can handle their situation. This is not true. They are experience anxiety and trauma that for many of them is very confusing. This only increases the anxiety and trauma. The children experiencing the shooter drills are also confused by their anxiety and traumatic reactions. They do not know what to do and this causes isolation and the feelings increase.

We must eliminate the stigma associated with mental health issues. We also need to make sure that anyone who is even remotely exposed to a mass shooting (including first responders and emergency room physicians) or anyone who has had to deal with the Coronavirus have access to mental health care. Not just for a month or two but for as long as they need psychotherapy and they should be able to receive the therapy without worrying about the cost.

We have a generation of children growing up with anxiety and traumatic reactions. If we don’t help them now, they will only get worse as time goes on. May be we need to take a lesson from New Zealand and how they responded to a mass shooting. They banned assault weapons after one shooting. We have been having shootings for 20 years and have done nothing, why? We have a great deal of information about the Coronavirus and we are arguing about wearing masks. Why?

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

Three Years After the Park Side Shootings and What has Changed?

Three Years After the Park Side Shootings and What has Changed?

Today, February 14, 2021, will mark the three year anniversary of the at the high school in Parkside, Florida. On that day 17 people were killed and 17 people were injured. The lives of these students, teachers and staff and families were changed forever. Additionally, the lives of the first responders, paramedics and police, were also changed forever. A family never fully recovers from the death of a child. Furthermore, these statistics do not account for how many students at the school, teachers and family members are suffering from grief and Post Traumatic Disorder. Remember, this is Valentines Day and students and families were expecting a day of fun not a day of horror that has changed them for life.

Additionally, this year will be the nine year anniversary of the tragic shooting at the Sandy Hook Elementary school where many children and adults where senselessly killed. Again the students and families’ lives were changed forever on that day. Since the Sandy Hook shooting more than 500,000 people in the United States have been killed by senseless gun violence. This means over 500,000 families have been changed forever and we have no idea how many children and adults continue to suffer with PTSD. The research shows people associated with these shootings do suffer from PTSD afterwards and many survivors have committed suicide (CDC).

In reviewing the subject of school shootings, I read an article by Cody Fenwick regarding children and gun violence. His article was very alarming. Since it is the three year anniversary of the Park Side shooting and the nine year anniversary of the Sandy Hook shooting, Fenwick’s article about children and guns is very important. His article also outlines a strong connection to guns and the senseless shootings and to the alarming numbers of teenagers who commit suicide with a gun. The article by, Fenwick, confirmed what I am hearing from teenagers and children in psychotherapy. Additionally, other school shootings, such as the one in Nashville, or the shootings in the Synagogue in Pennsylvania or in the Texas Church, confirm the need for gun control. A point the statistics in Fenwick’s article support.

Many of us feel because we live in Pleasant Hill, Walnut Creek or Lafayette that our children and teenagers do not have to worry about gangs or gun violence. Unfortunately, this is not the truth. According to a new research study in the Journal of Pediatrics, guns continue to be the third-leading cause of death for Americans younger than 18 years old, killing around 1,300 children and teenagers a year in the United States. In addition, almost 6,000 children and teenagers are injured per year by guns. Many teenagers are permanently disabled from these gun injuries too.

The study examined data from the Centers for Disease Control and Prevention and the Consumer Product Safety Commission between 2002 and 2014. The study found that boys, especially older boys such as teenagers and minorities, were much more likely to be the victims of gun violence. The study did not say anything about where the boys lived. The facts are children who are male and teenagers, are at a higher risk for becoming a victim of gun violence. Therefore, teenagers in our area are at risk of becoming a victim of gun violence.

The study does indicate there has been a decrease in accidental deaths such as boys cleaning a gun. However, the rate as a method for suicide has increased. I have mentioned before in other articles that suicide is the third leading cause of death for 10 year old boys. However, since the article was published, the CDC states that suicide is the second leading case of death for children 10 to 18 years old. This study confirms that the preferred method of suicide for boys and teenagers are guns. According to Katherine Fowler, one of the lead researchers at the CDC, “Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children.” Understanding their nature [guns] and impact is a first step toward prevention.”

When we look at these numbers, can anyone argue against taking steps to protect our children? Can you imagine a 10 year old boy using a gun to kill himself? Can you imagine a 10 year old boy feeling that his life is so bad at the age of ten that death seems like a better option than living?

The study indicates that in recent years guns were responsible for a large number of adolescent, males who were murdered. The study documented that deaths in the category of murder for boys under the age of 18 years old decreased to 53 percent. This is a decrease yet the rate is still 53%. The other causes of gun-related deaths include:

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

The study found 82% of those killed due to a gun were boys. This means 82% of gun deaths were boys who were children or teenagers. Putting it another way, this means these boys were not even 18 years old yet at the time of their deaths. The study also found that white and American Indian children have the highest rate of suicide using a gun.

We also like to think that the United States in one of the most advanced nations in the world. However, the statistics show that the United States has the highest rate in the world for children under 14 years old committing suicide. Again, the United States has the highest rate of children under 14 years old using a gun to commit suicide. That number scares me and is appalling to me. However, as an adolescent and child psychotherapist, I do not doubt it. I have heard 6 year old boys seriously discussing suicide.

Furthermore, I hear teenagers routinely talking about needing to carry a knife or gun with them for protection. They tell me you never know when you will be jumped and you need to be able to protect yourself. In fact, a few years ago a teenager was shot on his front door step in Danville over a marijuana deal. When I mention to teens the risks they are taking by caring knives or guns, the boys tell me there is no guarantee they will live until 30 years old. They would rather die protecting themselves than doing nothing. Violence in our society has become so severe that many teenagers do not expect to live to the age of 30. Think about that fact.

As a society, we need to look at these numbers and ask ourselves some questions. What are we going to do in order to improve gun safety? Most importantly, why are children as young as 6 years old thinking about suicide? Also what are we going to do so that children who are suicidal have access to mental health care? This is our problem because it does happen in Pleasant Hill, Walnut Creek and Lafayette.

The students at the high school in Park Side and the parents from Sunny Hook have marched and petitioned for sane gun control laws. Senators and former President Trump both promised to improve laws so children would be safe going to school. They are becoming angry and discouraged and how can you blame them? It is now 3 years after Park Side and 9 years after Sandy Hook, but there have been no changes. These students and families have been marching, holding rallies and speaking to Congressmen and Senators who have promised changes. However, nothing has happened so far. How long do these students and families need to wait for sane gun laws. Also, why should children and families believe us when we say we will keep them safe?

Dr. Rubino has 20 years experience as a psychotherapist working with children and teenagers. For more information about his work or private practice visit his website at www.RubinoCounseling.com or his Facebook page www.facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Helping Children Traumatized by Mass Shootings

Helping Children Traumatized by Mass Shootings

I recently wrote an article about mass shootings and the impact they are having on children. In light of this week’s events it appears another article is needed. There was another mass shooting and at least 12 people lost their lives. This shooting also created more fear regarding mass shootings. The shooter used a silencer on his gun so you could not hear the shot. This is part of the training we give to students. We tell them to run away from the sound of the gun, but if there is no sound how do the run. First responders are now re-evaluating how they will handle mass shootings, if they cannot hear the gun. Children are already anxious about going to school and being killed. This new fact will only add to their fear.

I anticipate that I will be hearing more teenagers talking about needing to carry a knife with them for their own safety. They tell me you never know when someone might try to attack you. These are not juvenile delinquents or gang members, these are average teenagers. They come from healthy families and are doing well in school and not involved in drugs. This need they feel to protect themselves is an alarming trend, but given the number of mass shootings in makes sense.

However, if you take a step back and look at what these children have seen over their lives it makes sense. Most of these teenagers were very young on 9/11, or were not even born yet, when the United States was attacked. Since 9/11 they have also seen two wars and heard on the nightly news about numerous terrorist alerts or attacks around the world and here in the United States. They also hear how the TSA at times are putting tighter security on travelers and places such as Disneyland are increasing security due to concerns about terrorism.

In addition to terrorism, this is the first generation growing up with mass shootings. According to ABC News from 2000 to 2015 there have been 140 mass shootings and since January 1, 2016, there have been more mass shootings than the previous 15 years. With the recent shooting it is estimated that there have been over 150 mass shootings since the year 2000 (CNN). According to the statistics on mass shootings every day 36 people are killed in the United States by a gun. Also it is estimated that every 11.8 days there is a mass shooting in the United States (CDC). This does not include suicides. For the group we are discussing, suicide was the third leading cause of death for children between 10 and 18 years old. It is now the third leading cause of death for teens and using a gun is one of the most popular methods of suicide. Also because of school shootings, students have seen increased security on their school campuses. Many campuses have metal detectors that students have to pass through as the enter the campus and there are police officers assigned to school sites due to the fear of violence.

Now, in addition to these facts stated above, think about what these children see on the news nightly and the video games they play daily. Anytime there is a shootings incident in the United States, or any where in the world, there is pretty much 24 hour news coverage of the event for days. Also when there are bombing or shootings in Europe there is 24 hour news coverage for days too. And now we have moved on to covering funerals. When the officers were killed in Dallas the memorial was televised nationally. If we look at the video games these kids are playing most have to do with killing and death. Since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about their safety due to the President. They have heard what the President has said and they are afraid other countries may attack us or that the President may start a war. Also Hispanic children who are legal citizens are still afraid that they will be deported. This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives. These teenagers are being traumatized. They may not be experiencing the trauma personally but they are experiencing vicarious trauma. With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously. We have never had a generation of children grow up with the amount of trauma that these children are growing up with in the world. Even children growing up during World War II didn’t experience this amount of trauma. We didn’t have instant access to news nor did we have the graphic videos being shown by the news media.

The question now becomes, what do we do? Well we can not change the world unfortunately. However, we can demand that the Senate act. Telephone Senator’s McConnell office at 202-224-2541and demand that he stop refusing to put the bills passed by the Congress on the Senate floor for a vote. Parents can monitor how much exposure children are receiving to mass shootings when they occur. We can monitor the video games they are playing and limit access to games that focus on violence and killing. Again, we must demand that the Congress and the Senate pass gun control laws that make sense. No one needs an assault weapon or silencer to hunt a deer. All the weapons in this last shooting were purchased legally. The government must act.

Another thing parents can do is listen to what our children are saying and talk to them about their concerns. When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.

Finally, if you start to notice a change of attitude in your child that you are concerned about have a talk with your child or have them assessed by a psychotherapist. I have included a link to an article by the American Association of Child and Adolescent Psychiatry which describes what parents can do http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Talking-To-Children-About-Terrorism-And-War-087.aspx. There is nothing to be ashamed of if a child needs therapy. We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents. For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma. Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 20 years experience treating children and teenagers and is an expert treating victims of trauma and also performs Critical Incident Debriefing. For more information about his work or private practice visit his website at http://www.RubinoCounseling.com or on Twitter @RubinoTherapy or his Facebook page http://www.Facebook.com/drrubino3.