Leading Teens to Counseling

By Dr. Jan Hittelman

Q: How do I get my unwilling teenager to talk to someone, such as a therapist?
Sign me, Concerned Mom

A: The pivotal challenge in creating getting your teen to meet with a counselor is getting them to willingly attend the initial session. Who wouldn’t be uncomfortable with the prospect of sharing personal information with a complete stranger? Particularly when you know you’re “not crazy,” don’t particularly like the idea and are other-referred (aka, dragged in by your parent). Luckily, there are steps that you can take that will greatly increase your chances of success:

Do your homework. A common mistake is to pick a random therapist, have it not work out, and have your teen more resistant than ever to see “another shrink.” Make sure that the therapist you go to is licensed and experienced. You can check a psychotherapist’s license status online at: www.doradls.state.co.us/alison.php. Next, try to make sure that he/she has experience working successfully with adolescents. You can accomplish this by getting recommendations from friends, coworkers or community professionals (your pediatrician, school personnel-guidance counselors, school interventionists, etc.). In addition, don’t be reluctant to first interview the therapist over the phone or in person. Ask about their experience working with adolescents and how they would approach treating someone with symptoms like your child is exhibiting. Does this seem like someone your teen could relate to?

Empower  your teen. It is important to give your teen a voice in the decision making whenever possible. After explaining why you feel that talking to someone is important, consider sharing the decision making with him or her. For example, say: “While you need to go to this initial appointment, we can talk together afterward to decide together if continuing would be a good idea.” Any effort to respect his voice in the decision-making process will increase his investment and eventual benefit.

Provide him with an out. One reason that teens (and others) resist the idea of counseling is that there is a concern that it may go on forever. During the initial meeting, I suggest to parents that they make an agreement with their teen to attend four to six additional sessions. If he doesn’t feel that it’s worth his time and (his parents’) money, he can rethink it at that point. That doesn’t necessarily mean stop altogether, but reevaluate it.

Reinforce his efforts. Along the way, make sure to let your teen know that you’re proud of his efforts. This would ideally start with that initial session and continue throughout treatment.

Parents Need to Grow Up Too

 By Dr. Jan Hittelman

Is anyone really ready to be a parent? There’s a shared experience among most new parents; a sense of disbelief that the hospital staff will simply let you walk out with a newborn child. It’s like giving a set of car keys to someone who hasn’t learned how to drive. Yet our parenting has a profound impact not only on our children’s development but also on our own. The challenges of parenthood provide us with an opportunity to grow as individuals. Like our children, we also have developmental tasks. From the first moment, we have no option but to be role models. How and what we model is totally up to us. The same is true of the relationships we develop with our children. If our primary focus is disciplining undesirable behavior, then our long-term relationship with our children will be negatively impacted. It takes conscious effort to focus more on the positive within our children and within ourselves. This brings us back to the developmental task of parenting. Our own level of emotional development impacts the relationship we develop with our children. The more emotional, social, and behavioral issues that we are struggling with, the less capable we will be to develop a healthy relationship with our child (or others). Thus parenting provides us with the opportunity to mature and address issues that we may have previously avoided. But the choice is ours. If we choose not to deal with our own anger problems, for example, we will likely have a higher level of conflict with our already challenging adolescent. If we regularly drink alcohol, our ability to positively impact our child’s view on substance abuse may be compromised. Sometimes our toughest challenge as parents is not our children’s behavior, but our own.

As parents it’s natural to focus on and correct children’s behavior. We rarely consider, however, how our own day-to-day behavior impacts that of our children. Children are extremely sensitive to their parents’ subtle moods, actions, and words. They internalize these characteristics as they develop their own identity and approach to the world. Of course our children bring their own emotional, behavioral, and social issues, in addition to what they learn from us and others. But even if they have significant issues from birth that are uniquely their own, our behavior will still have a significant impact.

Consider channeling your desire to be a good parent into taking better care of yourself by identifying and addressing your own issues and challenges. The better adjusted and happier you are, the healthier your parent-child relationship will be.

Dieing for a Drink

By Dr.  Jan Hittelman

Despite a reduction in crime overall in 2009, locally there has been a surge in alcohol-related arrests, as reported by the Camera (“Major Crime Down, But Drinking Up”, March 5, 2010). This includes offenses by adults as well as minors. University of Colorado Police, for example, report “ a 24 percent increase over 2008 and 45 percent more than 2006”. It is quite common for high school students to report that while their parents don’t want them to drink and drive, they know that “everybody” drinks alcohol at parties and it’s really no big deal. Many people don’t realize that the high from alcohol is due to its toxic nature. It’s the subjective experience of alcohol poisoning. Most adolescents don’t realize that you can die from drinking too much alcohol, falsely assuming that at worst you’ll throw up (which does not prevent alcohol poisoning) or just sleep it off. Unfortunately, many people die from alcohol as a function of their respiratory system shutting down or choking on their own vomit. There are also few intoxicants that are as addictive as alcohol or as dangerous to our overall physical health, with the exception of the other “legal” drug: tobacco. The fact that alcohol is legal is often a reason that adolescents, and perhaps adults, underestimate its deadly potential.
While it is illegal to sell alcohol to minors, it is easily accessible by having an adult purchase it for them or even more conveniently by taking it from their parents’ liquor cabinet.

What’s a parent to do? Consider these suggestions:

• A good place to start is to look at our own behavior and what we are modeling to our children
• Help your children understand that even though alcohol is legal, it’s more dangerous and addictive than many “street drugs”
• Educate your children regarding the devastating effects that alcohol can have on the developing adolescent brain
• Make sure they know that if they do experiment with alcohol and need help, they can call you and you will come get them
• Have ongoing discussions with your child about alcohol and other drugs

As parents we must educate our children, starting in elementary school about the dangers of drinking, how it affects us physiologically and the wisdom of abstinence. Alcohol abuse is serious business. Does your child know that?

Mentoring: The Power of One

 By Dr. Jan Hittelman

In the counseling field there are numerous schools of thought regarding the most effective therapy techniques. While the specific strategies utilized are of great importance, the success of any therapeutic approach is primarily a function of the underlying relationship between client and therapist. More specifically, the client knowing that the therapist genuinely cares.

I recently had the opportunity to sit down with the dedicated and talented staff of September High School. I asked them about their core beliefs regarding their work. They all agreed that the most important ingredient to success was the quality of the relationship with their students.

All human beings have an instinctual need for warmth, nurturance and support from at least one other human being. This begins on a tactile level at birth. Infants (and young children) who are persistently denied caretaker attention invariably develop emotional difficulties and abnormal behavior patterns. These children often display a lack of social responsiveness. They often apathetically stare into space, lacking social interest, curiosity and spontaneity. In severe cases, these children also fail to thrive in terms of weight gain and motor development.

As a parent it’s easy to get consumed by the myriad tasks and issues that come with the responsibilities of raising a child and lose sight of the importance of the underlying relationship. It often involves the simplest things, like conveying a sense of love and caring, as well as simply having fun together.

It is not widely known, but one of the most effective interventions for young children and adolescents is something that you don’t need any graduate training to provide. It should be no surprise, with what we know about the importance of relationship, that this powerful experience is the gift of mentoring. Studies reveal that youth who are provided with an effective mentor often demonstrate significantly improved academic, social and emotional functioning and are at a reduced risk for substance abuse, criminal and violent behavior. Mentoring is a unique way for one person volunteering a limited amount of time to have a powerful impact on the life of a child. Research has shown that it is specifically the quality of the relationship between mentor and child that dictates its success and why mentor training is such an important component of any mentoring program.

There are many agencies in our community that match at-risk youth with mentors. Several of these mentoring programs have formed a collaboration called MentorsMatter. This service helps to match potential mentors with programs based upon their interests and time availability. Typically time commitments vary from a few hours a week, to a few hours a month. Too often we feel helpless in the face of challenges in our society. Mentoring is an opportunity for individuals to make a real impact.

From Paris to Boulder

 By Jan Hittelman

A recent “major news story” was Paris Hilton’s early release from and subsequent return to jail. Ongoing video of the front of her home during her brief release ran for hours on all of the major national news outlets. I wonder how parents of servicemen and women serving in Iraq feel when the news they’re looking for is preempted by the latest Paris update or car chase. Even Paris commented that the news should be focusing on more important matters like the war in Iraq.

Similarly, the “CWA Debate” story permeated local and national news. A debate ensued over questionable remarks made during an April panel discussion at Boulder High School regarding drug use and sexual behavior. Regardless of which side of the debate you’re on, can’t we all agree that our time and energy would be better spent helping teens reduce at-risk behaviors? Better yet, begin to focus more on teens’ strengths and the fact that most teens do make healthy choices.

It’s important to remember that the majority of our local high school youth do NOT drink alcohol, smoke marijuana, use other drugs, have sex, and when they do have sex, the majority uses a condom (Boulder County Youth Risk Behavior Survey, 2005).
Based on the facts, we have every reason to believe that most local high school students possess the ability to effectively evaluate information and exercise good judgment. There is little disagreement that certain comments made by some panelists were ill advised. The real travesty is the prejudicial assumption that youth are incapable of critically evaluating others’ opinions. Ironically, zealous critics may have done more harm insulting the intelligence of those students in attendance, than the actual comments in question.

If only it were true that one statement from a panel discussion could profoundly impact youth behavior. For the minority of youth who are engaging in high-risk behaviors, we need to be thinking about ways to provide needed resources, ongoing education and support to empower them to make healthier choices.

In last month’s column, when asked about efforts to provide an emotional safety net for our children, the incoming Boulder Valley School District Superintendent Dr. Chris King said: “I’ve been surprised at the lack of coordination and the dearth of services in our community.” Clearly, while a variety of excellent support services for youth currently exist, there’s still work to be done. If only this story could get more attention.

An often-underestimated resource for teens is the influence of trusted adults. Whether it’s parents, relatives, teachers, neighbors, parents of peers, counselors, older siblings, or clergy, teens listen to adults that they know and respect. Research shows, for example, that when parents have ongoing discussions with their children about substance abuse, they are 50% less likely to use drugs and alcohol. We need to think about the messages that we’re imparting to our children, rather than that of strangers during a one-hour talk.

What’s on the Mind of Middle School Youth?

By Dr. Jan Hittelman

We often assume that the pressures and risk factors that impact youth begin in high school. The truth is that they begin in middle school, when youth are typically 11 to 14 years of age. Boulder County Healthy Youth Alliance partners, a collaboration of local youth-serving agencies and groups, conducted “youth summits” with local high school and, most recently, middle school students in order to better understand the factors influencing decisions about their health. One significant finding of the high school youth summits was that “middle school was repeatedly identified as the place where engaging in risk behaviors began.”

In the recently completed report “Voices and Views Middle School Youth Speak Out”, we are given a unique opportunity to hear from youth on a variety of important topics including: stress, depression, substance use, intimacy, sex, peer pressure, harassment and bullying.
Beginning the very challenging process of adolescence, middle school youth are confronted with a wide range of very difficult issues and are often under-prepared to deal with these issues due to their stage of social, emotional and neurological development.

An overriding finding from the summit is that youth view parental involvement as a critical variable. In terms of stress and depression for example, students indicate that “good relationships with parents are preventative” and “adults should talk about suicide and depression.” At the same time students also indicated that “parents pressure kids to do well in everything – be good in school, be good in sports” and that this can fuel feelings of stress and depression. We also know from research that children whose parents talk to them about risk behaviors are safer. Data from the 2007 BVSD Youth Risk Behavior Survey indicate that if students believe their parents think its wrong they are half as likely to ever drink alcohol, 15 times more likely to think smoking is wrong, and 12 times more likely to think marijuana is harmful.

As parents we must put real effort into creating opportunities to frequently talk with our children about challenges and experiences in their lives and do it in a way that will foster ongoing open communication about a wide range of risk behaviors and topics. This is particularly true during the middle school years when children are often more receptive to parental feedback than they will be during high school. This should be a discussion and not a lecture. A simple rule of thumb is to make every effort for your child to do most of the talking; ask questions, encourage and respect your child’s opinions, let them know that you appreciate them sharing their points of view even if you don’t necessarily agree with them. After they have fully expressed themselves, that’s the time to share your feelings, opinions and concerns.

It is quite common for parents to underestimate their influence on their adolescent children. While it may not be obvious, adolescents want their parents’ praise and approval more than ever.