Does anyone hear me?

Photo Credit: richard_polhill via Compfight ccIs anyone even listening?

Some young people don’t like to go see a doctor or a therapist because they haven’t felt listened to in the past. As a parent, you might have felt this way before with medical professionals. It can even feel more this way as a young person who does not have the experience you do.

Because of this, the young person might feel frustrated and have some of these thoughts:

How is this even going to work if no one is listening to me?

They really don’t care what I think, just what they think.

There’s no way for them to understand anyways.

The problem with these thoughts is that if the young person is working with a professional therapist or doctor, they should not be true. In medicine, doctors are evaluated based on professionalism – which is their code of conduct or the way they are taught and socialized to behave. Professionalism includes having respect for patients and being responsive to their needs. So if someone is really not listening to your child, it is unprofessional. That means they have a right to and should say something!

Some examples of things you could say to your child to encourage them to address the situation in a neutral way are:

Do you feel like you are not being listened to? Maybe we should tell Dr. So and So.

I know you would like to get better; please let me know what is holding you back from talking to the doctor/therapist.

Let’s brainstorm about how to tell Dr. So and So some of the concerns you have.

Has this happened to your child before? How have you and your child addressed it?

Nah, therapy is not for me

Photo Credit: JustLikeWasabi via Compfight cc
Photo Credit: JustLikeWasabi via Compfight cc

Studies show when people have a bad experience with therapy it can make them have a bad attitude about therapy in general. Sometimes I tell my patients that therapy could help them, and they tell me, “Nah, it’s not for me.” If they had a bad experience before, that response totally makes sense.

What are some reasons you feel your child or others you know have had negative experiences with therapy?

Here are a few examples your child may relate to:

The first time they went, it wasn’t their decision.

Going to therapy can help with a lot of different problems your child may have—but if they were made to go or it felt like it was a punishment versus a decision they made to become more healthy, they might have a negative attitude about it. My mom used to make me pick weeds in our driveway, and I kind of have a bad attitude about gardening! Even though a lot of people enjoy it.

The therapist and you did not seem to connect.

We know a big reason therapy works is the therapeutic alliance, which we wrote about in a prior post. If your child felt like they didn’t connect with their first therapist – or especially if they didn’t feel like the therapist cared about them, that might have been a tough experience for them. Telling someone your deepest thoughts makes your child vulnerable and if it didn’t work the first time, maybe they don’t want to take that risk again.

You (the parent) were too involved.

Your child may have felt like they couldn’t be honest if you were always around. Or maybe they felt more nervous and weren’t able to listen because they were worried something they might say would get them into trouble. Parents can still be involved without being overly involved.

Your child felt betrayed.

If your child received therapy when they were younger and the therapist was worried about abuse, that is something that the therapist has to report to the state for their safety. But when you are a kid in the mix of it, sometimes you feel like your trust was betrayed. That can be hard to deal with.

The thing is – one bad experience does not mean the next one will be. And your child’s experience as a young person or child may be different when they are older. There are things you and your child can do to help make sure that their next therapy experience is a good one. We know therapy works and can get your child to better mental health.

If your child had a bad experience before, but wants to try therapy again, here are some things they can try:

  • Make a list of the pros and cons about going to therapy – go over the list with someone they trust like you, another supportive adult or their primary care doctor and together, make a decision if this is a next best step for them
  • At the first session, tell the therapist what their expectations and hopes are from therapy
  • If they feel like they don’t connect with their therapist, ask for a referral to see someone else—therapists are used to this as everyone is different and sometimes certain personalities don’t click
  • If you would like to be involved, talk to the therapist about the best way to communicate with them without making your child feel like they cannot be honest with their therapist. If you feel more work is needed between you and your child, ask your child’s therapist if they recommend family therapy in addition to individual therapy
  • at the first session, your child should talk to their therapist about the limits of confidentiality – what do they always keep private and what if anything, are they not allowed to keep private

Do you have any other examples of negative experiences you or your child have had with therapy? Or tips you have about how to make the next experience positive?

The physical signs of mental health

Many people are surprised to learn that the diagnoses of depression and anxiety include physical symptoms as well as mental symptoms.

Depression includes psychomotor retardation – which means that your body moves at a slower pace than normal. You might talk slower and not be quick to react.

Anxiety includes feeling restless, easily fatigued, muscle tension, and unsatisfying sleep.

Photo Credit: Souls of San Francisco via Compfight cc
Photo Credit: Souls of San Francisco via Compfight cc

Have you ever noticed if you feel wound up about something, and then try to take some deep breaths to calm down, only then do you realize that you have been holding your shoulders tight all day. Over and over, our mental health symptoms can be expressed in our bodies – on the outside and even on the inside through stress hormones, our immune system, and our gastrointestinal system.

We’ve posted a few times now about self-care. But why is it so important to our mental health? One reason is self-care can help us take care of our bodies and mind. Its helpful to think about our minds in the context of our bodies. When we feel strong emotions, what happens to our physical bodies? You might feel your chest get tighter, your breathing quicken, or your stomach churning. In the same way, when we take care of our bodies by relaxation methods, deep breathing, or eating healthy, we can also help our minds be healthy.

Have you found this applies in your life? What ways have you noticed that your mind and body are connected?

A shoulder

If your child really needed help, who would they go to? They might think first of a friend their own age, and while this friend may be good at listening and empathizing with them, they might not know what kind of advice to give. This is because as a young person, they have not had as much experience as an adult. We recommend to young people that when they have more serious concerns, they go to a supportive adult. Some young people don’t feel comfortable going to their parent with their concerns, because they feel guilty or that their parent will be disappointed. Going to another supportive adult can help a lot.  A supportive adult can be your parent, relative, teacher, priest, therapist, nurse, doctor.  But how does your child know if this adult is someone they can depend on?

Photo Credit: LauraGilchrist4 via Compfight cc
Photo Credit: LauraGilchrist4 via Compfight cc

They should ask themselves:

  • Does this person care about me? do they want me to succeed?
  • Are they someone who I consider a role model? someone I wouldn’t mind being like when I get older?
  • Have they been kind to me in the past?
  • Do they listen to what I have to say?
  • Do they respect me and my decisions?

Surround your child with other adults who you feel are good role models. Even if they are not comfortable coming to you, they may be able to trust another close adult. Also, if you have concerns bring your child to their PCP or to an adolescent medicine specialist. These healthcare provides should spend time alone talking to your child. This might allow for a  more comfortable environment where they can share their concerns.

How has a supportive adult helped your child in the past? Are there any questions you would add to our list?

How to talk to your child about tough topics

Do you remember when you were young and had tough topics you wanted to talk to your parent or caregiver about?  Sometimes it is important to reflect on those times and realize your child is going through them too. Today, we posted an article on our SOVA site (for adolescents) about talking to their parents using the listed tips below. We think they are also good tips for parents!

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Continue reading How to talk to your child about tough topics

How Do I Know Whether Therapy Is Going Well For My Child?

Your child and you can feel pretty vulnerable when you talk to a therapist. Think about it – you are telling them your deepest thoughts and you are not sure what they are thinking!  You might not know what a therapist is supposed to do or act like if you’ve never seen one before. So how do you know if things are going well in therapy?

Here are some suggestions we have:

Ask your child:

  • Do they think therapy will help them?
  • What do they expect out of their therapist?

Ask yourself:

  • Are I willing to participate in therapy together or alone for myself if needed?
  • What do I expect out of my child for therapy?
  • What do I expect out of the therapist?

Discuss your answers to the above questions with your child’s therapist and your child so you can have a clear idea if what you think will happen is what will happen.

As you get to know your child’s therapist, ask yourself these questions:

  • Does my child feel accepted?
  • Is the therapist caring?
  • Does the therapist explain things clearly?
  • If the therapist and my child disagree, can they have a productive conversation about it?
  • Does the therapist recognize if there is a problem and addresses it instead of avoiding it?

After you’ve gotten to know your child’s therapist, ask yourself:

  • Does the therapist have a good relationship with my child?
  • Does the therapist and my child get along?
  • Does the therapist and my child agree on the goals of what I am going to get from treatment?
  • Does the therapist get along with me?
  • Does the therapist agree with me on the goals of my child’s treatment?
Photo Credit: fraser wilson via Compfight cc
Photo Credit: fraser wilson via Compfight cc

These questions have been shown in research to influence how well therapy can work for kids and adolescents which is why we think it is important to think about them.

If the answers are no to any of these questions, talk to the therapist on how you might address them. If it doesn’t feel comfortable to talk to the therapist, then talk to whoever referred your child to them – like your child’s primary care provider about whether they can help talk to the therapist and investigate whether they are a good fit for them.

Did you try out using any of these questions? Is there something new you learned? Are there other questions you suggest for talking to your child’s therapist?

What Is Depression?

depressedboy

If a doctor or medical professional tells you that your child may be depressed, what does that really mean? The trouble with depression is it’s not a rash—it’s hard to “see”—although in research, brain studies can show how the brain can look different in someone who is depressed. So then how does a doctor know that’s what’s wrong?

It comes down to symptoms—these are complaints your child may have or you may notice—that tend to go together in someone who is depressed. Sometimes your child might not tell you they feel this way so it can be tough for you to see the symptoms. On the other hand, they might say they feel fine because they don’t want you to worry, but you definitely notice something is not right. Symptoms include:

  • Feeling down most of the day. Maybe your child notices they are just feeling sad, empty, or down in the dumps. They might not even notice—but you might see they are tearful or irritable much of the time.
  • Not interested in things they used to like. Things they used to think were fun aren’t fun anymore. They don’t really do them and even if they don’t notice or say they don’t care, you notice the difference.
  • Changes in appetite or weight. They’re hungry all the time, or they don’t feel like anything tastes good anymore.
  • Problems with sleep. They are tired and sleepy all day even when they get enough rest, or the opposite—they can’t fall asleep no matter how hard they try.
  • Tiredness or not having energy. 
  • They feel like everything is their fault. They feel like they’re no good at anything.
  • They have a tough time concentrating or making decisions.
  • They may have thoughts of suicide.

MOST important is that because of these symptoms, they are having trouble living the life they want to live. 

It might mean they are not achieving their goals, getting to school every day, getting to work, doing the fun activities they used to do, or being the kind of friend they want to be.

A health professional can help you and your child figure out if your child should get treatment for depression or if something else could be causing the symptoms. For example, having a low blood count can cause sleepiness, fatigue, and a tough time concentrating. Sometimes it can take many visits for you, your child, and your health professional to figure out the best way to help.

The most important thing is if you notice these symptoms in your child, something is wrong, and although its easier to say to yourself, “Maybe they will just go away,” often they won’t. The good news is the sooner you do something about them, the better. The brain of the adolescent and young adult is amazing—it is kind of like clay—mold-able into many different things! Talking to a trusted health professional will be your next best step.

Self-Care Outside of Therapy

Actual Conversation:

Person 1: I go to therapy every week, why do I need to do anything else about this?

Person 2: If you do your self-care work, therapy is going to go a lot smoother.

Person 1: Therapy IS my self-care!

Person 2: It’s part of your self-care.

519431487_30b3b4d881_oPerhaps you’ve been on both sides of this conversation, maybe you’ve had it with yourself. It’s important to remember that therapy and medication are parts of the self-care and self-love process.

That can be really hard to cope with when it takes a lot to just get to therapy and open up there. It’s important to be mindful that adolescents may not want to discuss their therapy or self-care activities with you. But it is important to keep the door of communication open.

One way to do that is to create a habit of just checking in with your adolescent daily. Or just going on a walk together where no one has to say anything, but the door is open to it. Another way is to demonstrate that you do self-care for yourself, and name the activity “self-care time.” Doing so makes it easier for them to say “Other people also do things to take care of themselves outside of treatment, maybe I can too.”

What are some ways that you encourage your adolescent to engage in self-care outside of therapy or medication? What are ways that you take care of yourself?