Mental Health Awareness

May is Mental Health Awareness month.  Please view the video below to learn more about psychotherapy. In psychotherapy, psychologists apply scientifically validated procedures to help people develop healthier, more effective habits. 

Get the facts, Therapy works! 








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ADHD: Signs,Symptoms, and Research

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder associated with difficulties such as inattention, disorganization, and/or hyperactivity-impulsivity. Symptoms of ADHD typically begins in childhood and causes problems across multiple settings areas (e.g., home, public,and school). I recently wrote a blog on Psychology Today discussing medication and treatment. Below is a video providing education about ADHD from the National Institute of Mental Health. 

Potty Training: What should you know? [video]

Many parents struggle with potty training. Difficulties may arise due to behavior issues or the child not being developmentally ready to start the process. I previously provided some basic tips in a post on my Psychology Today blog.

In this post, Dr. Anglim (Omaha Children’s Hospital & Medical Center) discusses mastering potty training. She will review everything from readiness to dealing with night time potty training.

Featured presenter:
Katie Anglim, M.D., FAAP

Children's Hosptial & Medical Center
Omaha, Nebraska

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To Spank or Not to Spank: What the Research Supports

Last month, I had the opportunity to attend the American Psychological Association (APA) convention in Honolulu. As usual, I am re-energized after attending the sessions and learning about new perspectives on science and psychological practice. While attending a talk on spanking and children, it made me think back to all the conversations that I’ve had with parents in my practice around the use of corporal punishment (which includes domestic, school, and judicial). During the talk, Dr. Shawna Lee (assistant professor at University of Michigan) and her colleagues presented data on the frequency of parents that use spanking as a parenting strategy and highlighted the effects of spanking on childhood outcomes (e.g., aggression and compliance). Surprisingly, a high percentage of parents use spanking despite if not being an effective long-term strategy to change behavior.

As a child psychologist, I often discuss the impacts of spanking with parents. First, spanking tends to increase aggressive behavior in children. Secondly, the research shows that spanking is less effective to increase compliance than positive reinforcement. The pros and cons of spanking have been discussed for decades yet many still see it as a viable parenting strategy. Many times when I bring this up with parents they respond, "I was spanked as a child and I turned out fine". But what does the research support? 

During the APA symposium, Dr. Lee, stated that “spanking has the iatrogenic effect of increasing the very child behaviors it is often trying to reduce”.  In a recent study published in Development Psychology (Lee, S. J., Altschul, I., & Gershoff, E. T., 2013), the authors found that maternal spanking  at age 1 was associated with higher levels of child aggression at age 3; and continues to be associated with aggression by age 5. Furthermore, the study found that maternal warmth does not serve as a protective factor against child behavior problems. 

Being someone who is interested in early intervention to prevent more severe behavior difficulties I felt armed with new research findings that I could use in my own life and clinical practice. Overall, the research does not support the use of spanking as an effective parenting strategy and shows that it has significant negative outcomes for children. Currently 31 countries (not including the United States) have recognized the detrimental effects of spanking and have banned the use of corporal punishment in the home. Yet, the U.S. does not have a national policy against spanking. Furthermore, only a small percentage of states ban the use of corporal punishment in school. What are your thoughts on spanking and corporal punishment?

Copyright 2013 Erlanger A. Turner, Ph.D. 

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Note: A version of this was submitted to the Richmond Times Dispatch. 

Tips for Effective Co-Parenting

Many parents raise children together while living apart. This may be the result of co-parenting after a divorce or because the parents never married. When you have a child with someone, even after the relationship ends, your parenting relationship remains. You both remain parents and are responsibile for your child/children. This person is now your child’s other parent – someone your child loves, looks up to, and will likely take after in some ways – not your spouse or partner. Although you are no longer a couple, you are now a co-parent. To make the process easier, avoid calling the other parent your “ex” and refer to them as “the father or mother of your children”.

Below are some additional suggestions to have an effective co-parenting relationship:

·         Don’t project your feelings onto the child or assume the child has the same feelings as you towards the other parent.

o   Accept your own feelings and try to understand your child’s feelings.

o   Remember it is okay to ask the child why they feel a certain way.

·         Avoid sharing your personal feelings or loss related to the divorce.

o   With the end of the marriage comes the end of that sharing.

o   Separate your feelings from decisions and interactions about your child.

·         “Fake it, til you make it”

o   Establish boundaries to help keep your feelings under control.

o   It is important to have some emotional distancing or disengagement

o   Imagine the other parent is your business partner. You have to be polite, have business like conversations, and work together to raise your child.

Preparing for the “Business Meeting”

In order to improve communication with the other parent, it is encouraged that you emotionally detach (and put your feelings aside) when interacting with each other. Respect the common ground you share that you both love your children and want the nest for them. The following suggestions or offered to help the “business of raising your children”.

• Have regular meetings to share important information
• Be polite, respectful, and business-like
• Keep the conversation focused on the children
• Avoid having the child as the “go-between” and carry messages
• Be prepared and structure conversations
•  Relay information about: emergencies, appointments, school, your child’s successes, or information about social activities. 

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Copyright 2013 Erlanger A. Turner, Ph.D.



Reference:

The Quick Guide to Co-Parenting After Divorce: Three steps to your children’s healthy adjustment by Lisa Gabardi, Ph.D. 

Sibling Rivalry: Tips to overcome sibling conflicts [Video]

If you’re a parent of more than one child, you probably have dealt with some conflict between your children. Most brothers and sisters experience some degree of jealousy or competition, and this can trigger arguments or fights. Dr. St. Germain (Omaha Children’s Hospital & Medical Center) discusses sibling rivalry and how parents can help manage difficulties.

 

Featured presenter:
Melissa L. St. Germain, M.D., FAAP
Pediatrician

Children's Hosptial & Medical Center
Omaha, Nebraska

Stress in America: Where do you fit?

Recently the American Psychological Association (APA) released the findings of their annual nationwide Stress in America survey. The Stress in America survey has been released since 2007 as part of the APA’s  Mind/Body Health campaign.  The Stress in America survey measures attitudes and perceptions of stress among the general public and identifies leading sources of stress, common behaviors used to manage stress and the impact of stress on our lives. 

According to the survey, almost three-quarters (72 percent) of respondents say that their stress level has increased or stayed the same over the past five years and 80 percent say their stress level has increased or stayed the same in the past year. Only 20 percent said their stress level has decreased in the past year. 

Some of the most common sources of stress included money (69 percent), work (65 percent), the economy (61 percent), family responsibilities (57 percent), relationships (56 percent), family health problems (52 percent) and personal health concerns (51 percent). Given the level of stress experienced by American’s we need to continue to work towards strengthening our understanding of the connection between mental and physical health.

How does stress affect your overall health?

The National Institute of Mental Health (NIMH) identifies three different types of stress, all of which carry physical and mental health risks:

• Routine stress related to the pressures of work, family and other daily responsibilities.
• Stress brought about by a sudden negative change, such as losing a job, divorce, or illness.
• Traumatic stress, experienced in an event like a major accident, war, assault, or a natural disaster where one may be seriously hurt or in danger of being killed.

The body responds to each type of stress in similar ways. Different people may feel it in different ways. For example, some people experience mainly digestive symptoms, while others may have headaches, sleeplessness, depressed mood, anger and irritability. People under chronic stress are prone to more frequent and severe viral infections, such as the flu or common cold, and vaccines, such as the flu shot, are less effective for them. 

Ways to cope with stress

Previously, I published a blog on ways to cope with stress. Although not an exhaustive list it provided some simple strategies to cope with stress. The NIMH also provides the following tips:

• Seek help from a qualified mental health care provider if you are overwhelmed, feel you cannot cope, have suicidal thoughts, or are using drugs or alcohol to cope.
• Get proper health care for existing or new health problems.
• Stay in touch with people who can provide emotional and other support. Ask for help from friends, family, and community or religious organizations to reduce stress due to work burdens or family issues, such as caring for a loved one.
• Recognize signs of your body's response to stress, such as difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy.
• Set priorities-decide what must get done and what can wait, and learn to say no to new tasks if they are putting you into overload.
• Note what you have accomplished at the end of the day, not what you have been unable to do.
• Avoid dwelling on problems. If you can't do this on your own, seek help from a qualified mental health professional who can guide you.
• Exercise regularly-just 30 minutes per day of gentle walking can help boost mood and reduce stress.
• Schedule regular times for healthy and relaxing activities.
• Explore stress coping programs, which may incorporate meditation, yoga, tai chi, or other gentle exercises.

In addition to uses these strategies, it may also be helpful to seek professional help if you feel that you are extremely overwhelmed by life circumstances. The APA provides a free tool to locate psychologist in your area. You can also contact your local state psychological association for resources to help locate a therapist.

Copyright 2013 Erlanger A. Turner, Ph.D.

Follow me on Twitter @DrEarlTurner and on Facebook at “Get Psych’d with Dr. T”

School violence: Tips on helping your child manage their emotions

Earlier today we witnessed another tragic school situation in Connecticut. According to the New York Times, 26 people (18 were children) were killed in a shooting this morning at an elementary school in Newton, CT. It was reported that the gunman shot his mother (who is a teacher at the school) and then 18 students in the class. In the wake of many recent school incidents of violence, a huge burden is placed on parents to help their child cope with the traumatizing event. 

Below are a few tips from the American Psychological Association (APA) on managing distress in children:

• Take "news breaks". Your children may want to keep informed by gathering information about the event from the internet, television, or newspapers. It is important to limit the amount of time spent watching the news because constant exposure may actually heighten their anxiety and fears. Also, scheduling some breaks for yourself is important; allow yourself time to engage in activities you enjoy.

• Talk with your child. Talking to your children about their worries and concerns is the first step to help them feel safe and begin to cope with the events occurring around them. What you talk about and how you say it does depend on their age, but all children need to be able to know you are there listening to them.
• Start the conversation; let them know you are interested in them and how they are coping with the information they are getting.
• Listen to their thoughts and point of view; don't interrupt--allow them to express their ideas and understanding before you respond.
• Express your own opinions and ideas without putting down theirs; acknowledge that it is okay to disagree.
• Remind them you are there for them to provide safety, comfort and support. Give them a hug.

• Keep home a safe place. Children, regardless of age, often find home to be a safe haven when the world around them becomes overwhelming. During times of crisis, it is important to remember that your children may come home seeking the safe feeling they have being there. Help make it a place where your children find the solitude or comfort they need. Plan a night where everyone participates in a favorite family activity.

• Watch for signs of stress, fear or anxiety. After a traumatic event, it is typical for children (and adults) to experience a wide range of emotions, including fearfulness, shock, anger, grief and anxiety. Your children's behaviors may change because of their response to the event. They may experience trouble sleeping, difficulty with concentrating on school work, or changes in appetite. This is normal for everyone and should begin to disappear in a few months. Encourage your children to put their feelings into words by talking about them or journaling. Some children may find it helpful to express their feelings through art.

• Take care of yourself. Take care of yourself so you can take care of your children. Be a model for your children on how to manage traumatic events. Keep regular schedules for activities such as family meals and exercise to help restore a sense of security and normalcy.

If you find that your child is experiencing significant trauma and emotional difficulties you should consult with the school counselor or seek professional help in your area. It is possible that you may find a resource of providers by searching the website of the psychological association in your state. You can also browse for a psychologist in your area through APA.

Copyright 2012 Erlanger A. Turner, Ph.D.

Follow me on Twitter @DrEarlTurner and on Facebook at “Get Psych’d with Dr. T”

References:

American Psychological Association (2011). Helping your child manage distress in the aftermath of a shooting. Obtained December 14, 2012 from http://www.apa.org/helpcenter/aftermath.aspx

Photo: courtesy of Shannon Hick/The Newton Bee

Temper Tantrums: Tips for Parents

A recent article in the Monitor on Psychology, a publication by the American Psychological Association, discussed temper tantrums in preschool children. According to the article, “daily tantrums only occur in less than 10 percent of preschool children, regardless of gender, socioeconomic status or ethnicity.” This was based on a study conducted at Northwestern University Feinberg School of Medicine.

In my practice over the years, I have encountered many parents who come to my office to cope with their child’s tantrums. Often times, many parents may not seek help for this issue because tantrums are seen as a common behavior among toddlers. However, based on research you can see that only a small number of children exhibit tantrums at a high rate. As a behavioral psychologist, there are a number of ways to manage tantrums. The following tips may be useful.

• Establish a sleep routine. For many children, their moods are dependent on how much or little sleep they have had the previous night. Children who often have poor sleep habits tend to be more irritable and may exhibit more tantrum behavior. To help prevent tantrums make sure your child gets adequate sleep.
• Don’t fall into the attention trap. Children often get additional attention when they exhibit tantrums. To decrease tantrum behaviors avoid giving attention to your child when they have a tantrum. For example, if your child has a tantrum, remove attention by looking away and remaining silent. Do not scold the child or tell them to stop crying.
• Reward appropriate behavior. Occasionally, children exhibit tantrums as a way to communicate their wants and desires. By using rewards, you can shape your child’s appropriate behavior. For example, reward your child for using their words to request objects or for sharing with others if tantrums occur during play.
• Talk to a psychologist. If tantrum behavior occur more days than not, seek professional help from a behavior therapist or psychologist. Child psychologist and/or behavior therapist are specifically trained to analyze behavior and determine what the function of that behavior is. You can seek an evaluation or functional behavior assessment by a professional who can work with you and your family to determine the best approach to improve your child’s functioning.

Copyright 2012 Erlanger A. Turner, Ph.D.

Note: The following information is intended to be general advice for managing behavior. Please consult with a mental health professional in your area if treatment is desired. You can find a brief list of psychologist at http://locator.apa.org/ provided by the American Psychological Association. 

Everyday Discipline for Toddlers

New feature: Video post on Everyday Discipline for Toddlers (approximately 72 minutes)

Featured presenter:

Ashley Harlow, Ph.D.

Licensed Psychologist

Nationally Certified School Psychologist 

Children's Hosptial & Medical Center

Children's Behavioral Health

Omaha, Nebraska

Dr. Harlow's Bio:

http://www.childrensomaha.org/AshleyGibbPhD

National Childhood Obesity Awareness Month

September has been designated as National Childhood Obesity Awareness Month. According to the Center for Disease Control and Prevention (CDC), childhood obesity has more than tripled in the past 30 years. These rates are very alarming considering both the short- and long-term effects on a child’s health status. According to the Institute of Medicine, children and adolescents ages 2 to 18 years with a BMI of > 30 or > 95th percentile for age and gender—whichever is smaller—are considered obese.  Additionally, it has been recommended that children and adolescents with a BMI > 85th percentile but < 95th percentile or a BMI of 30—whichever is smaller—be considered overweight.

What are the consequences of childhood obesity?

According to research, studies have found that compared to healthy children and adolescents, children and adolescents who are obese have significant impairments in health related quality of life (HRQOL) in all domains, including physical and psychosocial functioning (e.g., emotional, social, and school). The CDC notes that some immediate health effects include: higher risk of cardiovascular disease, high cholesterol or high blood pressure, diabetes, bone and joint problems, and sleep apnea. Furthermore, long-term consequences of obesity may include type 2 diabetes, cancer (e.g., colon, breast, or prostate), osteoarthritis, or stroke.

Interventions and treatment of childhood obesity:

As a parent or caregiver, you can play a major role in improving childhood obesity. First Lady Michelle Obama has worked with organizations across the United States with her Let’s Move! initiative to expand access to nutritious foods and promote physical activity among children. To access more information about the Let’s Move! Campaign and how you can deal with the issue of childhood obesity, visit www.letsmove.gov

In my work as a psychologist and researcher, I have collaborated with others to examine the impact of obesity on children. We have found that psychologists can be a great resource to assist with changing healthy lifestyles and decreasing childhood obesity. The use of behavioral modification and behavior therapy can significantly improve health eating and physical activity. Limbers, Turner, and Varni (2008) discuss how behavior modification programs and motivational interviewing can target eating, exercise, and diet behaviors to result in significant improvements in weight status, increasing physical fitness, and psychosocial improvements for children who are obese children. 

General resources to improve healthy eating and increase physical activity:

• Strategies for parents and communities
• Basic prevention tips
• Resources & Facts from the American Psychological Association

Note: Please contact Dr. Erlanger Turner for references.

© Copyright 2012 Erlanger A. Turner