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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Health and Your Child: Tips to Become an Active Family

Keeping a regular exercise routine or engaging in physical activities has many benefits for your mental health and physical health. I previously wrote a blog post on Improving Your Health Status. Given this time of year many strive to change their lifestyle and get healthier. For parents, changing your routine or adding exercise may be more challenging. One way to decrease the challenge is to make time for the entire family to be active.

Here are some ideas to help your family be active together.

Make Time

• Identify free times. Keep track of your daily activities for one week. Pick two 30-minute time slots you could use for family activity time.
• Add physical activity to your daily routine. For example, walk or ride your bike to work or a friend's house, walk the dog with your children, exercise while you watch TV, or park farther away from your destination.
• Try to walk, jog, or swim during your lunch hour, or take fitness breaks instead of coffee breaks. Try doing something active after dinner with your family, or on weekends.
• Check out activities requiring little time. Try walking, jogging, or stair climbing.

Bring Others Into It

• Ask friends and family to support your efforts.
• Invite them to be active with you.
• Set up a party or other social event with activities that get people moving, like dancing or having a jump rope contest.
• Exercise with friends.
• Play with your kids or ask them to join you for an exercise video or fitness game.
• Develop new friendships with physically active people. Join a group, such as the YMCA or a hiking club.

Energize Yourself

• Plan to be active at times in the day or week when you feel you have a lot of energy.
• Convince yourself that if you give it a chance, physical activity will increase your energy level—then try it.

Stay Motivated

• Plan ahead. Make physical activity a regular part of your family's schedule. Write it on a family activity calendar.
• Join an exercise group or class. Sign your children up for community sports teams or lessons.
• Pick activities requiring no new skills, such as walking or climbing stairs.
• Exercise with friends who are at the same skill level as you are. Create opportunities for your children to be active with friends.

Build New Skills

• Find a friend who can teach you new skills.
• Take a class to develop new skills and enroll your children in classes too, such as swimming, dancing, or tennis.

Use Available Resources

• Select activities that don't need costly sports gear, such as walking, jogging, jumping rope, or doing push-ups.
• Identify cheap, local resources in your area, such as programs through your community center, park or recreation group, or worksite.

Make the Most of All Conditions

• Develop a set of activities for you and your family that are always available regardless of weather, such as indoor cycling, indoor swimming, stair climbing, rope skipping, mall walking, dancing, and active games that you can play indoors.

Copyright 2014 Erlanger A. Turner, Ph.D. 

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Source:

http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/get-active/activity-plan.htm 

Understanding Adolescent Self-Harm Behavior

Self-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration. Self-harm behaviors may also be linked to a variety of mental disorders, such as depression, eating disorders and borderline personality disorder. 

The following video presents on adolescent self-harm behaviors.

Featured presenters:

Reo W. Newring, Ph.D.

Licensed Clinical Psychologist

Paige Lembeck, M.A.

Graduate Student

Children's Hosptial & Medical Center

Omaha, Nebraska

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. 

Follow me on Twitter @DrEarlTurner and on Facebook www.facebook.com/DrEarlTurner

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

Tips on Coping with Tragedy: In the wake of the Boston Marathon Explosion

On yesterday, we experienced another tragedy in Boston when an explosion occurred near the finish line at the Boston Marathon. According to the New York Times, almost 23,000 runners participated in the race and approximately three-quarters of the runners had crossed the finish line prior to the bomb exploding. President Obama made a statement following the explosion and stated “I'm supremely confident that Bostonians will pull together, take care of each other, and move forward as one proud city. And as they do, the American people will be with them every single step of the way.”

In the wake of another tragedy, below are some resources to help children and their families cope and process the event.

Evidence-Based Early Psychological Intervention for Victims/Survivors of Mass Violence  

Helping Children and Adolescents Cope with Violence and Disasters: What Rescue Workers Can Do

What Parents Can Do To Help Children

            Spanish version: Que Pueden Hacer los Padres

Tips of talking with children: A guide for teachers and parents

A Guide for Managing Stress in Crisis Response

  

Copyright 2013 Erlanger A. Turner, Ph.D.

Follow me on twitter @DrEarlTurner

References:

Image from the Boston Globe 

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

Breast Cancer Awareness

October is designated as National Breast Cancer Awareness month. In the United States, over 100,000 new cases of breast cancer are diagnosed each year. Several years ago, I was personally faced with dealing with breast cancer as my mother was diagnosed. I vividly recall it was the summer before I was preparing to move away for graduate school when I got the news. It was very devastating at the time. Yet my thoughts didn’t consider what she was experiencing at that time. First, how was she going to cope with the diagnosis? Second, how was she feeling about opening up and talking about her diagnosis with her first born child right before his departure to begin a journey towards becoming a psychologist? Now that she is healthy and remains in my life I have been treasuring each day with her. I have also been making an active effort to take part in activities that focus on Breast Cancer Awareness. For example, every year I travel home to run in the Susan G. Komen 5K in her honor.

I can only imagine what it is like for a mother to tell her child about her illness. Given the incidence of breast cancer, many women are faced with this issue each year. Here are a few facts you should know about Breast Cancer:

• Typically, breast cancer starts out too small to feel and does not cause signs and symptoms
• It is important to have a regular mammogram. Doctors use a mammogram to look for early signs of breast cancer.
• Having regular mammograms can lower the risk of dying from breast cancer. 
• Men can also get breast cancer, but it is not very common. For every 100 cases of breast cancer, less than 1 is in men.

Dealing with a breast cancer diagnosis:

If you are diagnosed with breast cancer it is important to make sure you receive appropriate care. The links below provide some resources to help throughout the process.

• Tips on talking to your doctor
• Questions to ask your doctor
• Resources for getting a free mammogram
• Fact sheet on coping with breast cancer

Talking to your child about breast cancer:

View the links below for help on how to talk with your child about breast cancer and how to help them cope with your illness.

• Helping children understand cancer
• Talking to kids about “what is cancer”
• What it takes to be a caregiver
• Information on finding a support group

Written by Erlanger A. Turner, Ph.D. October 2012

© Copyright 2012 Erlanger A. Turner 

ADHD in young children: One of the most common difficulties of childhood

Working as a licensed clinical psychologist I am often faced with parents coming to me for help with their young child. These families may seek help with managing a number of concerns such as anger, excessive worrying, or attention problems. Now that summer vacation for children has ended and the school year is here, many parents and teachers will be confronted with over-active children. Some of these concerns may be due to limited opportunities to go outside and play, while others may have difficulties resulting from a more complex issue such as a diagnosable disruptive behavior disorder.

During early childhood children often have difficulty sitting still, paying attention, or controlling their impulses. This is part of the normal developmental process. However, for a small number of these children the problem is more persistent and impacts their daily lives at home and at school. Children with pervasive over-activity levels and inattention may have Attention-Deficit Hyperactivity Disorder also known as ADHD.  ADHD is a neurobiological disorder characterized by developmentally inappropriate impulsivity, inattention, and in some cases, hyperactivity. There are several types of ADHD that can be diagnosed and children may present with different symptoms. About 9.5 percent of children ages 4 to 17 in the United States have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. People with ADHD can be very successful in life. But without appropriate identification and treatment, ADHD can have serious consequences such as difficulties with school work, poor social skills, and conduct problems. Early identification and treatment are extremely important so if you notice concerns please consult with a psychologist.

The best outcomes for children with ADHD are associated with the use behavior therapy and medication management. According to Pediatrics, it is recommended that young children with ADHD receive behavioral interventions first, such as parent training in behavior management techniques. These treatments can be followed-up with medication if behavioral interventions are not successful.  In my practice, I typically recommend that parents attempt to implement behavior treatments. If the difficulties associated with ADHD are moderate or severe I will recommend consultation with a pediatrician or psychiatrist for medication management considerations. There is some evidence showing benefits of medication for treating ADHD in young children, however it is unclear how medication affects the child’s brain.

Below are a few suggestions for managing difficulties associated with ADHD:

• Provide positive attention to the child
• Target performance goals and monitoring behavior by tracking progress
• Implement individualized home and school reinforcement programs
• Utilize non-physical punishment procedures such as time-out or response cost systems

It should be noted that some of these recommendations may be implemented at home without a professional. However, if the child’s difficulties are persistent and long-standing you will benefit from contacting a psychologist in your area who can help tailor treatment to you and your child. Additionally, teachers and parents may consult with a school psychologist at their local school who can assist with interventions in the classroom settings and developing appropriate educational accommodations.

Additional suggestions for parents:

Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood By: Edward M. Hallowell and John J. Ratey

Taking Charge of ADHD: The Complete, Authoritative Guide for Parents  By: Russell A. Barkley PhD




© Copyright 2012 Erlanger A. Turner 

References:

http://www.chadd.org/ http://www.apa.org/monitor/2012/03/adhd-guidelines.aspx
http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml
http://www.cdc.gov/ncbddd/adhd/
http://kidshealth.org/teen/school_jobs/school/adhd.html#

Mental Health Services Use in Ethnic Minorities

Given July is designated as Minority Mental Health month; I decided to write a post on disparities in mental health. One of the reasons I pursued a Ph.D. in clinical psychology was because as an undergraduate student I felt that the research on mental health concerns in children was limited, specifically as it related to service utilization for ethnic minorities.

According to the Center for Disease Control (CDC) Office of Minority Health and Health Disparities₁, less than ½ of adults and 1/3 of children receive the needed mental health treatment. This is alarming given that over time these problems may become worse resulting in poor daily functioning and having a negative impact on relationships. Additionally, mental health difficulties can also impact health outcomes such as chronic diseases.

According to the research ethnic minority populations (e.g., African American, Hispanic American, and Asian American) are less likely to seek help from a mental health professional such as a psychologist. My own research_2,3 on child mental health services focuses on examining what are some contributing factors to preventing parents from seeking treatment. The US Surgeons General₄ has reported that for ethnic minority groups some of these barriers include financial considerations, racism, and discrimination. Other_{1, 2} report barriers such as stigma, attitudes, income, mistrust, and lack of health care providers. In my own research, I have found that attitudes toward mental health and mental health stigma are highly important to the lack of service use by ethnic minorities.

Given these disparities in mental health, what can be done to meet the needs of ethnic minorities? Personally, I believe there needs to be increased education about the benefits of psychological treatment. The American Psychological Association, Division 42 (Psychologist in Independent Practice) has developed a video that promotes seeking treatment. See below:

Additional ways to help decrease the stigma around mental health services include:

·         Ensuring that mental health and behavioral health services are covered by insurance

·         Training psychologist to provide culturally sensitive treatments

·         Applying a community based approach to treatment

·         Talk to a doctor about mental health (to increase the referral process)

Note: If you feel the need to seek treatment, you can access the following sites to locate a provider in your area.  

American Psychological Association

APA Division 42, Psychologist in Independent Practice

National Register Health Service Providers in Psychology

© Copyright 2012 Erlanger A. Turner 

Sources:

1. Fact Sheet on Mental Health Disparities (http://www.cdc.gov/omhd/amh/factsheets/mental.htm)

2. Turner, E.A., Heffer, R., & Jensen-Doss, A. (August, 2010). Disparities in Child Mental Health Services: The Role of Ethnicity, Attitudes, and Stigma. Presentation at the American Psychological Association Convention, San Diego, CA.

3.  Turner, E.A., & Liew, J. (2010). Children’s Adjustment and Child Mental Health Service Use: The Role of Parents’ Attitudes and Personal Service Use in an Upper Middle Class Sample. Community Mental Health Journal, 46,3, 231-240.

4. American Psychiatric Association, Minority Mental Health (http://www.psychiatry.org/mental-illness/people/minority-mental-health)

5. National Council of Community Behavioral Health (http://www.thenationalcouncil.org/cs/about_us/mental_health_stats_infographic)

June 1 - 30, 2012 is LGBT Pride month

June is LGBT Pride month. The American Psychological Association has several resources available for professionals and the public. These resources may be located here.

Specific to parenting, you may view this publication on isues related to lesbian and gay parenting. The publication is provided for the use of clinicians, researchers, students, lawyers, and parents involved in legal and policy issues related to lesbian and gay parenting. Lesbian and Gay Parenting is the successor to Lesbian and Gay Parenting: A Resource for Psychologists (1995).

It is divided into three parts.

• Part I is a summary of research findings on lesbian mothers, gay fathers, and their children written by Charlotte J. Patterson, PhD.
• Part II is an annotated bibliography of the literature cited in the summary.
• Part III provides some additional resources relevant to lesbian and gay parenting in the forensic context: APA amicus briefs, professional association policies, and contact information for relevant organizations.

Autism and social skills: Parenting Guides to Help Your Child

As a licensed psychologist, I have worked with children with a variety of difficulties such as behavior problems, anxiety, and difficulties with social skills. These difficulties may encompass many psychological disorders such ADHD, Autism, or social anxiety disorder. The focus of this post is on Autism Spectrum Disorders (ASD). ASD is associated with difficulties in social interactions, verbal and nonverbal communication, and repetitive behaviors.

When working with a family, it is common that the family will attend therapy once a week. Therefore, the majority of the work practicing skills must occur at home (outside of the therapy session). Specific to children with an Autism Spectrum Disorder, therapy often requires more intense treatment. Discussions regarding appropriate services should be addressed with your psychologist or behavior therapist.

Below are some suggested readings to help your child with navigating the social world:

·         You are a Social Detective! by Michelle Garcia Winner and Pamela Crooke

·         Whole Body Listening Larry at Home by Kristen Wilson and Elizabeth Sautter

Other suggestions for understanding difficulties associated with autism include:

·         Children with Autism: A Parent's Guide by Michael D. Powers

·         Could It Be Autism?: A Parent's Guide to the First Signs and Next Steps by Nancy D. Wiseman

© Copyright 2012 Erlanger A. Turner 

The ABC’s of Child Behavior – Why children don’t follow directions

If you have a child, you’ve thought to yourself at some point “I don’t understand why he or she acts like that”. As a parent you often give instructions, directions, or commands that you expect to be done by your child.  However, occasionally for some parents they have difficulties getting their child to listen and comply with directions.  So why doesn’t your child follow directions? The answer to your question is as simple as ABC. The ABC's refer to Antecedents, Behaviors, and Consequences.  

Antecedents refer to what happens before the behavior. In the case of your child’s behavior, antecedents are the things that occur in the environment before your child responds. Antecedents may include the location, the individual(s) present, or activities.  

*Tips: Before giving an instruction to your child, make sure that you have their attention. Remove distractions from the room and try to avoid shouting directions or commands from another room. Just think what would happen if your boss called you at your desk or shouted for you to do something. You probably would do it faster if it was told face to face. The same applies to your child. 

Behaviors refer to actions performed following antecedents or preceding a consequence. For example, your child puts his toys away. 

Consequences refer to responses that occur after a behavioral response (e.g., what happens after a behavior). Some consequences include repeating directions, reprimands, giving a reward, or taking away a privilege.

 *Tips: To improve the chances of changing behavior, consequences are really important. If your child does not comply with your directions, use incentives or rewards to improve future behavior. Rewards can be as simple as parental attention or praising your child. Other options may include following through with a loss of a privilege (not just saying they will not be able to play). Imagine that your boss deducted money from your pay if you didn’t reach a performance goal. You will probably work harder to meet goals so that you can get an increase in pay versus loss.

So the next time you think about why your child doesn’t listen, remember the ABC’s of behavior. Behavior change occurs by modifying antecedents and consequences. The key to changing your child’s behavior is that you must be prepared to change your own.

© Copyright 2012 Erlanger A. Turner 

 Note: There are a number of reasons why children misbehave in addition to what is mentioned above. This post is not meant as a substitute to seeking professional help if desired or needed. One helpful resource may also be reading a self-help book on parenting by authors such as Dr. Russell Barkley or Dr. Alan Kazdin.