The Between Years

By Jan Hittelman

Most parents see adolescence as their greatest challenge. Until then, we assume we can comfortably rely on the parenting strategies that have worked in the past with our younger children. This faulty logic often leaves us unprepared for the challenges of the teenage years and results in our parenting approach being more reactive than strategic. In fact, we need to dramatically shift our approach and begin to do so several years before our children become teenagers. The critical window of opportunity is during the preadolescent or “Tween” years when our children are between the ages of 9 and 12.

There are several reasons why this is a critical developmental period and a time of opportunity for parents to positively impact their children in ways that will then make it easier to continue to stay connected when they become teens. The first reason comes from what we know about adolescent brain development. During adolescence there is a dramatic level of neurological development that begins just before puberty (age 11 in girls, 12 in boys). Much of this development occurs in the Prefrontal Cortex, which is responsible for functions like impulse control, judgment, and decision-making. There is a lot that we can do to potentially help our children maximize this developmental opportunity. We also know that a significant number of children begin engaging in a variety of risky behaviors prior to the age of 13. The local Youth Risk Behavior Survey has shown this consistently regarding smoking cigarettes, sexual intercourse, and drug/alcohol use. For example in 2007, over 22% of local high school students indicated that they began to drink alcohol before the age of 13. Knowing how to communicate effectively with our children early on about these issues can make a big difference. Another disturbing statistic is the significant rise in suicidal behavior in children 10-14 years of age. Just within the last month, we have had national news reports of two middle school boys who took their own lives. As parents we need to be more aware of the emotional challenges of our preadolescents and what to do about it. Finally perhaps the most compelling reason to make this parental shift during preadolescence, is that middle school children are much more receptive to adult discussion and feedback than their high school counterparts. As parents we need to take advantage of this critical window of opportunity.

The Between Years: Effective Communication

A key component to effective parenting during the pre-adolescent or Tween years (ages 9-12) is the way we communicate with our child.
The core issue at the heart of most parent-child conflict during the preteen and teen years is that children want to be treated like they’re two years older and parents want to treat them like they’re two years younger. As parents it can be difficult to see that our Tween is actually beginning their journey into adulthood and we tend to use the parenting strategies that have served us well in the past. Developmentally, preadolescents are beginning to go through a profound metamorphosis and we in turn need to metamorphosize our approach as parents.
R-E-S-P-E-C-T: It is important to treat our children with the same level of respect that we want them to show others. Instead of simply telling them what to do as we have in the past, it is now time to first ask for their input and include it whenever possible. By doing so, your child will take more ownership of these decisions and assume more responsibility for their behavior.

Ongoing conversations about safety and wellness issues: If we haven’t started already, now is the time to begin discussing risk behaviors (e.g. cigarette smoking, alcohol/drug use, sexual behavior, bicycle helmets, etc.). Research consistently shows that parents who regularly have these discussions have children that engage less frequently in high risk behaviors. These discussions should not be lectures, but more a sharing of views and information. Attempt to have your child do most of the talking. Start by asking their opinion and what they see among their peer group. Ask neutral follow-up questions. The time to impart your advice is at the end of the conversation. If you find your child is not ready to discuss a specific subject, bring it up again at a later time. These conversations need to be ongoing and continue throughout their adolescence.

The shift from control to advice: A great place to practice this is with their schoolwork. For example, instead of telling your child when to start their homework try having a two-way discussion about homework and time management in order to help your child develop a schedule that makes sense for him/her. Consider giving their suggestions a try, with the understanding that if it doesn’t seem to be working out you can always revisit it together. Being a trusted advisor is a role that you will want to have with your child throughout their lives, especially during their teen years. Now is the time to start building that foundation through mutual trust and respect.

The Between Years: Discipline Strategies

Preadolescence (ages 9-12) is an ideal time to rethink our approach to discipline. It is important to do so in anticipation of the teenage years when there is often a significant increase in defiant behaviors. Parents who have relied predominantly on punishment are well advised to reconsider their approach. Consider that the definition of “discipline” is not to punish but to teach appropriate behavior. As our children turn the corner into adolescence, they will need to learn a lot about behaving safely, intelligently and successfully. Effective discipline for the tween years will help them to do so. Here are some specific strategies to consider:

Use Your Child as Copilot. Now is the time to start giving your child more ownership of his or her behavior by including them in the discipline decisions. Initiate discussions regarding major behavioral expectations (e.g. school work, chores, respectful communication, screen time, substance use, etc.) and look to your child to take the lead on the consequences of appropriate and inappropriate behaviors. Whenever possible, put it down on paper and have everyone sign at the bottom of the agreement. Always allow for revisiting and revising these agreements as needed.

Have Productive Discussions Before Negative Consequences. The key word in the definition of discipline is “teach”. After your child has misbehaved and after everyone has had a chance to calm down a bit, create an opportunity to first discuss what happened, what mistakes were made, and what your child needs to do differently next time. Look to your child to do as much of the talking as possible, offering advice only afte they have had the opportunity to process the situation. If your child has genuinely learned from their mistakes consider a less harsh punishment.

When considering consequences, use your child as a copilot and include their input.

Remember That Learning Requires Trial and Error. Whether it was learning to write your name, interact socially, or drive a car, you first had to practice and make mistakes. No matter how well we parent, our children will make mistakes as well. The best way we can help them minimize their mistakes is by making sure that we’re not shut out and that we have an opportunity to mentor them based on our experience.

Utilizing these strategies now will increase the likelihood that your child will learn how to behave appropriately and benefit from your advice on their journey to adolescence and beyond.

The Between Years: Keeping Them Safe

While the teenage years are often seen as a time of experimentation and turbulence, the degree to which preadolescents (ages 9-12) are at-risk is often underestimated. These risks include: early drug and alcohol experimentation, stress/anxiety issues, depression, and suicide. There are several simple steps that parents can take to reduce these risks. Here are some suggestions:

Encourage participation in after school activities. Research shows that children are at greatest risk between 3pm and 6pm Monday through Friday. While it is common to involve elementary-age youth in after school activities, this often shifts in middle school. Many tweens are left unsupervised, often hanging out with their friends and bored with “nothing to do”. This is a potentially dangerous scenario that can lead to a wide range of risky behaviors. In addition, it is very difficult to engage high school students in after school activities unless they are continuing an interest from their earlier years. Thus it is important to encourage middle school children to participate in some form of healthy, fun, and supervised after school activity.

Provide healthy ways to deal with stress. Adults often underestimate how stressed youth are. In response to numerous local focus groups regarding substance abuse, depression, and other risk concerns, middle and high school youth consistently identify stress as a common precipitating factor. It is important that your child knows how to effectively manage stress. The first step is providing frequent opportunities for your child to talk about the things that are stressful in their lives and to simply be an attentive listener. Additional stress management techniques include: reducing over-scheduling, learning relaxation techniques, exercise, reducing negative or perfectionistic thinking, and simply prioritizing having more fun.

Be attentive to your child’s emotional life. We all understand the importance of periodic physical exams to ensure that our children are in good health and not in need of any medical follow-up. Unfortunately we don’t monitor our child’s mental health with the same vigilance. If you have concerns about your child’s emotional well-being, consider getting an assessment by a licensed mental health professional with expertise in treating children and adolescents. This is often a one-time visit and can give you the peace of mind of knowing your child is doing well or provide you with a course of action to address any concerns that arise.

As outlined in this series, by strengthening our discipline strategy, communication techniques, and focus on safety, we can maximize our children’s successful transition from childhood to adolescence.

 

 

Starting with a Good Assessment

By Jan Hittelman

Last month’s column on teen depression highlighted the importance of a good assessment. Several readers questioned exactly what an assessment is, let alone a good one.

You may be surprised to know that even within the mental health field there are a range of definitions regarding a psychological assessment. It is even more surprising that many mental health professionals are not extensively trained in conducting an increase the likelihood of a good fit, BPS offers an online therapist directory. The purpose of the assessment is to clarify the nature of the treatment issues to be addressed.

What is a psychological assessment? First of all it is different than a formal “psychological evaluation”, where standardized psychometric tests are administered (i.e. intelligence, academic, personality, and perceptual tests). Depending on the results of the assessment, a more in-depth psychological evaluation may be recommended. A psychological assessment typically includes several components:

• A detailed history (often from the parent if the client is a minor) that usually includes information on birth, educational, social, familial, and emotional experiences of the referred client.
• A one-on-one interview between the therapist and the client where additional detailed information is collected. This is sometimes referred to as a “Clinical Interview.”
• An opportunity to build a relationship with and empower the client, allowing him or her to be a partner in developing the treatment plan.
• An additional discussion with family members, which may include the client.
• Providing specific diagnoses and recommendations to the client (and/or parent) as a result of the information obtained.

Why is a psychological assessment so important? The assessment is a critical component in helping to develop a thoughtful treatment plan for the client that addresses their underlying social/emotional/behavioral issues. This is of particular importance when the client is a child or adolescent, because, unlike an adult, it may be unclear what the underlying issues really are. An example of why an assessment is critical is teen depression, as it is often misdiagnosed because it can look like anger or irritability. Another common misstep for a client that is a child or adolescent, which can be avoided through an assessment, is providing individual therapy when in fact family therapy may be what is needed. As you can imagine, there are many other examples of issues that are missed without a thorough increase the likelihood of a good fit, BPS offers an online therapist directory. The goal of the assessment is to better understand the initial concerns before investing a lot of time and money in treating the symptoms rather than the underlying problem(s). While there may be an additional cost in obtaining the increase the likelihood of a good fit, BPS offers an online therapist directory, it is well worth the investment and may reduce the overall costs by addressing the correct underlying issue.

What are the Right Questions to Ask? When considering psychological counseling, there are several questions that should be asked: Are you licensed? Do you have extensive experience working with someone this age and who presents these kinds of concerns? And perhaps of equal importance; what is your assessment process and what does it include? Doing a good job as a consumer will increase the odds that therapists will successfully do theirs.

Can Teens Be Trusted?

By Jan Hittelman

As concerns rise regarding teen substance abuse, Internet activity, text messaging, etc., many parents out of fear are “clamping down” and policing their own children. Many “experts” are recommending parents periodically search rooms, monitor cell phone use, text messaging, computer use, and Internet sites visited. This may be warranted if your teen has repeatedly violated your trust, has a known substance abuse problem, and/or has a psychiatric disorder that requires a high level of monitoring. But what if that’s not the case, but you’re still concerned?

The real challenge for parents of teens is trying to balance developing a trusting relationship with looking out for your child’s well being.
Most teens are not abusing substances, engaging in dangerous Internet, text messaging, cell phone, or computer activity. Most of our children deserve to be trusted. If we have difficulty calming our fears, there are far more effective and respectful ways to help ensure that our children avoid a wide range of risk behaviors:

• Engage in frequent, mutually respectful, discussions regarding these behaviors. Try and listen more than lecture. Encourage your child to share his/her point of view. There is a wealth of evidence that when parents effectively communicate their concerns regarding risk behaviors, children engage in them far less often. Based on local (YRBS) data, high school students are 18 times more likely to think it’s wrong for someone their age to drink if they believe their parents think it’s wrong.
• Encourage your child to participate in the discipline plan regarding risk behaviors and consequences. This will increase the likelihood that they will take responsibility for their behavior and truly learn from their mistakes.
• Give fair warning. When/if you are considering monitoring your child’s behavior, let them know the reasons that you are doing so and be honest with them about what you are going to do. Losing the element of surprise is far outweighed by losing their respect.
• If your trust is violated, provide your child with opportunities, guidance and encouragement to regain your trust.

Trying to find the right balance between trust and oversight will help ensure that we develop healthy, respectful, and lasting relationships with our children.

Medical Marijuana & Youth

 By Dr. Jan Hittelman

There is tremendous debate underway concerning the impact of medical marijuana laws on the perceptions and behaviors of youth. One concern is that by youth seeing that marijuana use is more socially acceptable with the passing of state medical marijuana laws, it will increase their use and lower their perceptions of danger and risk. Surprisingly, there are a number of studies that indicate that youth marijuana use has actually gone down in states that have legalized medical use. Not surprisingly, these often appear on web sites that support medical marijuana use and frequently the legalization of the drug. According to the Journal of the American Academy of Pediatrics: “Several recent studies concerning American adolescents, the Dutch experience with decriminalization (from 1984 to 1992), and the relationship between cheaper marijuana and use by adolescents suggest that decriminalization increases marijuana use by adolescents.” We have begun to see this trend locally, with surveys of high school students indicating a reduced perception of harm regarding marijuana usage.

At the same time considerable anecdotal evidence suggests that marijuana may be effective in treating a number of medical conditions. These include: reducing chemotherapy-induced nausea, wasting and anorexia associated with AIDS, intraocular pressure in glaucoma, and muscle spasticity arising from such conditions as multiple sclerosis. At the same time there is little objective scientific evidence that demonstrates the benefit of medical marijuana on these health concerns, let alone that other available drugs don’t work better than marijuana. This is in part due to the federal government restricting availability of marijuana needed to actually conduct the research.

The Two Most Dangerous Drugs Are Legal

By Dr. Jan Hittelman

It is always disturbing how many adolescents think alcohol and tobacco are safer because they are legal. Nothing could be further from the truth. As a parent it can be very challenging to protect our children from the temptation to experiment with alcohol and tobacco. Many would argue that alcohol and tobacco companies put tremendous effort into marketing to adolescents. We also know that early experimentation with alcohol and tobacco correlates with higher incidences of other risk behaviors including: use of illegal drugs, more likely to get into fights, carry weapons, attempt suicide, suffer from mental health problems such as depression, and engage in high-risk sexual behaviors. Not to mention the documented health risks associated with alcohol and tobacco use. We also know that when teens begin experimenting with alcohol and tobacco at a young age, they are significantly more likely to develop a lifelong addiction.

Parents often underestimate their power in influencing the choices that their children make. Numerous studies indicate that when parents have ongoing conversations with their children about alcohol, tobacco, and other substances, their children are 50% less likely to engage in these behaviors. We also need to be thoughtful about our modeling these behaviors to our children.

The time to begin the discussion is now!

Keeping Adolescents Safe

By Dr. Jan Hittelman

As concerns rise regarding teen substance abuse and other risk behaviors, many parents out of fear are “clamping down” and policing their own children. Many “experts” are recommending parents periodically search rooms, monitor cell phone use, text messaging, computer use, and Internet sites visited. The real challenge for parents of teens is trying to balance developing a trusting relationship with looking out for your child’s well being. If we have difficulty calming our fears, there are far more effective and respectful ways to help ensure that our children avoid a wide range of risk behaviors.

• Engage in frequent, mutually respectful, discussions regarding these behaviors. Try and listen more than lecture. Encourage your child to share his/her point of view. There is a wealth of evidence that when parents effectively communicate their concerns regarding risk behaviors, children engage in them far less often.
• Encourage your child to participate in the discipline plan regarding risk behaviors and consequences. This will increase the likelihood that they will take responsibility for their behavior and truly learn from their mistakes.
• Give fair warning. When/if you are considering monitoring your child’s behavior, let them know the reasons that you are doing so and be honest with them about what you are going to do. Losing the element of surprise is far outweighed by losing their respect.
• If your trust is violated, provide your child with opportunities, guidance and encouragement to regain your trust. We learn through our mistakes. Take advantage of these teaching moments and encourage your child to learn from their mistakes.

Trying to find the right balance between trust and oversight will help ensure that we develop healthy, respectful, and lasting relationships with our children.