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Tools for Your Toolbelt: Coping Strategies By Tara Motzenbecker, MS, NCSP

4/27/2021

Everyone has stress, worries, fears, and sadness. As I tell my clients, it’s normal and good to have all of these feelings. These feelings only become a problem when they start impacting one’s ability to function or to enjoy life. For the times when the feelings start interfering with life, it’s incredibly important to have a toolbelt full of tools, otherwise known as coping strategies.

Here are some easy tools to try out for your belt:

Deep breathing: You can make it fun by imagining smelling your favorite cookies fresh out of the oven (breathe the smell in through your nose) and imagine blowing on those cookies to cool them off (breathe out through your mouth until all the air is exhaled).
Talk to yourself like you would talk a friend: If a friend just got a bad grade, would you tell them that they are dumb and will probably fail the entire class? No, but we often tell ourselves these things. Imagine what you would say to a friend in that situation and try saying it to yourself.
Have a good cry. My clients all know not to call it a “breakdown”. Humans cry. It’s what we do. A good cry can be a great release. There is nothing broken about it and sometimes it is incredibly freeing to let it all out.
Tear paper. Smash cardboard boxes. Stomp on air pillows.
Drink a glass of water. This actually tricks the brain into thinking things are okay.
EXERCISE. EXERCISE. EXERCISE. Even a brisk walk for 20 minutes gets the happy hormones flowing. Do 100 jumping jacks. Anything that gets your body moving and your heart rate up.
Be creative: Draw, write, create art.
Engage in gratitude: When you’re feeling low, find three things to be thankful for, in that very moment. The items can be as big as the sunshine or as small as being grateful that you have a box of the soft tissues in the house.
Counting: This engages both sides of your brain and calms it. Make it semi-challenging, but not stressful. Count to 99 by 3’s. Count how many items of each color of the rainbow you can find around you. Count how many steps it is to walk the perimeter of your house.
EXERCISE. EXERCISE. EXERCISE. Yes, do it again.

Challenge yourself to pick one or two to try for at least one week. Whenever those strong feelings arise in the week, try your pick and see if it’s a good one to keep in your belt.

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How to Correct your Child without Criticism By Rachel Funnell, LMFT

4/21/2021

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As you know, being a parent is not easy and it’s especially difficult when we don’t see the effects of what we do right away. One thing we know for sure is that our words are powerful and have a lasting effect on our children. This is why it’s important to learn how to correct your child without criticizing them. But, most parents know this and still struggle with implementing it. So why does this happen? Well, one reason is because sometimes it’s hard to differentiate between disciplining our children and criticizing them. This is especially true if our children make the same mistakes over and over again. Due to our own frustration, we tend to let our emotions take over and then criticize. Below are some ways to help correct your child without criticizing them. As with learning anything new, it takes practice so be patient with yourself as you're implementing these new strategies.

Seek to understand

Try to find the reasons behind your child’s behaviors. Listen to what they say and validate their feelings. Keeping in mind that validating doesn’t mean that you have to agree with them. It just means that you believe that they truly feel the way they do. Once a child feels validated and heard, they are more likely to listen and not become defensive.

Don’t take their behaviors personally.

Your child is learning about the world around them and learning how to behave in the world. All kids make mistakes and all kids make the same mistakes more than once. If children don’t make mistakes, then they can’t learn how to prevent it from happening again. If we want our children to learn from us, then we need to give feedback in a way that will make them want to listen, not shut down.

Focus on what you want them to do

Instead of saying “Don’t run in the house” you want to say “Please walk in the house”. By stating what you want them to do rather than what you don’t want them to do, children will learn to comply with your expectations sooner because you told them exactly what you want them to do.

Have realistic expectations

Remember that young children have tantrums. They are still learning how to regulate their emotions and this takes several years. It’s normal for kids to not want to share or to spill things or to not pick up after themselves. If you go into these situations knowing that they are normal then you’ll get less frustrated with them and be more compassionate and patient.

Separate mistakes from your child

While you need to tell your child what they did wrong, you don’t want to identify who they are with their mistakes. Make sure when you are talking to them that you are correcting the behavior not your child. Avoid saying “Why do you always do this?” or “What’s wrong with you?”

Catch your child being good

One of the best ways to get your child to do more of what you want them to do, is to praise them specifically and enthusiastically whenever they do it. Children love praise and they especially want to receive praise from their parents. Every time they share, say “Great job sharing with your sibling/friend”. Every time they stay calm when you tell them no, say “Thank you for staying calm when I said ‘no’.”

Remember, you are only human and will make mistakes too. So have some compassion with yourself and don’t criticize yourself when you forget these strategies. Just own your mistake, apologize to your child and try again.

References:
https://www.creativechild.com/articles/view/how-to-discipline-your-child-without-criticism
https://www.heysigmund.com/kids-and-criticism-heres-what-happens-and-what-to-do-instead/

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Getting through the Hard Moment: Grounding Techniques By Kirsten Ellingsen, Ph.D.

4/15/2021

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Grounding involves using mental or physical strategies to focus attention to the present moment. It can help a person get through a difficult or seemingly overwhelming moment. Grounding techniques can be used when a child or teen is experiencing distressing or strong negative thoughts, emotions, panic or anxiety.

Grounding is different than other relaxation strategies. It is an active strategy to temporarily detach from emotional discomfort and connect thoughts and body to the “here and now”. Grounding can be done anywhere and anytime. It is particularly helpful when negative thoughts feel uncontrollable.

Grounding Techniques

Ground with 5 Senses / 5-4-3-2-1 Senses Grounding:
Name 5 things you can see right now.
Name 4 Things you can feel. Feel them.
Name 3 things you can hear.
Name 2 things you can smell.
Name 1 thing you can taste (have mint or gum near). * Younger children might want to think about one thing they like to see, feel, hear, taste or smell.

Play a “categories” game. Choose a category and spend a few minutes thinking of as many items as you can for the category. Animals, comedy movies, songs with the word “LOVE” in the title, countries, cars, fruits and vegetables. Also, take turns doing this alphabetically. For example, name animals alphabetically (alligator, bear, cat…) or take turns naming fruit alphabetically with your child or teen (e.g., apple, blue berry, cantaloupe, dates).

Mental Exercises. Think about something else deliberately to take mind off distressing or uncomfortable thoughts and feelings. For example, describe steps to perform an activity you know well. Count backwards from 20. Count backwards from100 by 7. Think of an object and “draw” it in your mind or in the air with your finger.

Find items of the same color. Look for and name everything blue in the room. How many different shades of blue are there? (use any preferred color)

Come up with a coping statement that you (or your child) can repeat such as, “I can handle this”, “this feeling will pass”, “I am safe right now”.

Physical grounding: Place both feet firmly on the ground, push and feel the ground below you. Stretch. Touch different objects around you. Notice how each object feels, texture, pattern.
Run cool water over your hands. Splash cold water on your face.

Stress Press: Flatten your palms and press them together, raising your arms so that your forearms are straight and parallel to the floor. Push them together and hold 5 seconds. Release arms down. Repeat.

Body Awareness Exercise: Focus on bodily sensations. Take 5 deep breaths, breathe in through nose and out through your mouth. 1) Place both feet on the floor and wiggle your toes. Pay attention to how your toes feel. 2) Stomp your feet on the ground several times. Notice the feeling of the floor beneath you. 3) Make a fist, clench your hands tightly then release several times. Notice how your hands feel 4) Rub your palms together quickly several times and feel the warm sensation when you stop 6) Stretch with your hands over your head high and slightly back behind ears your ears. Hold for 5 seconds. Bring your arms back down and relax arms. Take 5 more deep breaths.

Practice these grounding techniques with your child or teen when calm to be able to access them during times of stress.

Grounding does not solve the problem causing negative emotions, but it can help you regain control and prevent you from feeling worse. Understanding and learning coping strategies and solving the underlying problems that are contributing to distress, anxiety or strong negative emotions is important for long term well-being. Please reach out if you would like to discuss how we can help provide this support for you, your child or teen.

References and Additional Resources:
https://www.therapistaid.com/worksheets/grounding-techniques.pdf
https://www.anxietycanada.com/articles/using-your-senses/
https://positivepsychology.com/grounding-techniques/

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What is an Individual Educational Plan (IEP) VS. a 504 Accommodation Plan? By Lauren Zakaib, Psy.S.

4/8/2021

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An IEP and 504 Accommodation Plan are both written and personalized documents for students with disabilities. However, they vary regarding the eligibility requirements and services they provide to children.

An IEP is a written document that indicates a child is disabled and requires Exceptional Student Educational (ESE) services. Typically, once a child is evaluated and found eligible to receive educational services (outlined by state laws), an IEP is formed. Every student found eligible for ESE has an IEP. A child entitled to an IEP must have a disability which adversely affects their educational performance and/or ability to benefit from general education.

Below are the following common areas students may receive an IEP for:

Specific Learning Disability
Other Health Impairment
- This includes, but is not limited to: asthma, attention deficit disorder or attention deficit hyperactivity disorder, Tourette syndrome, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and acquired brain injury.
Speech Impairment
Language Impairment
Emotional/Behavioral Disability
Intellectual Disability
Developmental Delay
Autism Spectrum Disorder
Occupational Therapy
Orthopedically Impaired
Physical Therapy
Deaf/Hard of Hearing
Visually Impaired
Traumatic Brain Injury

An IEP is a tailored document that is individualized to address the students needs. An IEP may include: educational goals, along with clearly outlined services the school will provide and accommodations within the school setting. And IEP provides individualized supplemental educational services and supports, in addition to what is provided to students in the general education curriculum. The basis for most IEP laws is found in The Individual with Disabilities Education Act. The Individuals with Disabilities Education Act (IDEA) is a part of American legislation that safeguards students with a disability and ensures they are provided with a Free Appropriate Public Education (FAPE) that is personalized to their individual needs. Students with an IEP require a re-evaluation (either formal or informal) every three years by the IEP team to determine if services are still needed to support the student. A parent can request an IEP meeting at any time to address any concerns. An IEP is updated on a yearly basis.

A 504 Accommodation Plan is a document that also indicates a child has a disability and/or has an impairment (e.g., Anxiety, Selective Mutism), but only requires accommodations within the school setting. A 504 Accommodation Plan eliminates barriers that prevent students from participating to their fullest potential in the general education curriculum. The basis for a 504 Accommodation Plan can be found in Section 504 of the Rehabilitation Act of 1973. Section 504 requires that reasonable accommodations be made for children to level the playing field. A common 504 Accommodation Plan for a student with Attention Deficit Hyperactivity Disorder may include, but not limited to: additional time, frequent cues and reminders, movement breaks, preferential seating, chunking of assignments, etc. Unlike an IEP, a 504 Accommodation Plan does not contain specific goals.

Do your best to know your child’s right and advocate on their behalf. If you suspect your child may have a Learning Disability, please contact us for a consultation.

For additional information regarding students with disabilities, refer to the U.S. Department of Education’s Individuals with Disabilities Education Act (IDEA) website: https://sites.ed.gov/idea/
For Sarasota Public Schools information and procedures regarding students with disabilities refer to: https://beessgsw.org/#/Spp/Institution/f6909903-1422-4978-9c86-e5c5efa09241/Document/5fad5d0f-8e97-466e-b4ae-fc9a432c3749/Public

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Pediatric Mental health during the pandemic by tara motzenbecker, ms, ncsp

4/1/2021

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One of the most common inquiries I have been getting is if I have seen an increase in mental health problems in children during the pandemic. I have been answering this question anecdotally, but now FAIR Health has released the data. FAIR Health is an independent nonprofit that collects data for and manages the nation’s largest database of privately billed health insurance claims and is entrusted with Medicare Parts A, B and D claims data for 2013 to the present.

Defining the pediatric population as individuals aged 0-22 years, and focusing on the age groups 13-18 years and 19-22 years, FAIR Health studied the effects of the COVID-19 pandemic on US pediatric mental health. To do so, FAIR Health analyzed data from its database of over 32 billion private healthcare claim records, tracking month-by-month changes from January to November 2020 compared to the same months in 2019. Aspects of pediatric mental health investigated include overall mental health, intentional self-harm, overdoses and substance use disorders, top mental health diagnoses, reasons for emergency room visits and state-by-state variations.

FAIR found that mental health claims for teens (ages 13-18) approximately doubled in March and April 2020 over the same months in the previous year.
Other notable findings include:

Comparing August 2019 to August 2020 in the Northeast, for the age group 13-18, there was a 333.93 percent increase in intentional self-harm claim lines as a percentage of all medical claim lines, a rate higher than that in any other region in any month studied for that age group.
Claim lines for intentional self-harm as a percentage of all medical claim lines in the 13-18 age group increased 90.71 percent in March 2020 compared to March 2019. The increase was even larger when comparing April 2020 to April 2019, nearly doubling (99.83 percent).
For the age group 13-18, claim lines for overdoses increased 94.91 percent as a percentage of all medical claim lines in March 2020 and 119.31 percent in April 2020 over the same months the year before. Claim lines for substance use disorders also increased as a percentage of all medical claim lines in March (64.64 percent) and April (62.69 percent) 2020 as compared to their corresponding months in 2019.
For the age group 6-12, from spring to November 2020, claim lines for obsessive-compulsive disorder and tic disorders increased as a percentage of all medical claim lines from their levels in the corresponding months of 2019.
For the age group 13-18, in April 2020, claim lines for generalized anxiety disorder increased 93.6 percent as a percentage of all medical claim lines over April 2019, while major depressive disorder claim lines increased 83.9 percent and adjustment disorder claim lines 89.7 percent.
In general, the age group 19-22 had mental health trends similar to but less pronounced than the age group 13-18.

This data demonstrates a profound impact on the mental health of children and the increased need for mental health services for children. If your child is struggling, please speak to a mental health professional.

For the full 34 page report from FAIR Health (March 2, 2021), Click here.

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Photos from Marco Verch (CC BY 2.0), verchmarco, wriggly_toes, verchmarco

Tools for Your Toolbelt: Coping Strategies By Tara Motzenbecker, MS, NCSP

How to Correct your Child without Criticism By Rachel Funnell, LMFT

Getting through the Hard Moment: Grounding Techniques By Kirsten Ellingsen, Ph.D.

What is an Individual Educational Plan (IEP) VS. a 504 Accommodation Plan? By Lauren Zakaib, Psy.S.

Pediatric Mental health during the pandemic by tara motzenbecker, ms, ncsp

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