Avoiding Corporal Punishment

frustrated girlLast week I reviewed research that indicated that corporal punishment is ill advised. This week I’d like to review some ways to avoid it.

Creating distance

There are two kinds of distance that could be created in situations where you might want to give your kid a crack. First, you might consider removing your child from the situation that is causing him or her to behave disruptively (e.g., a toy store, a conflict with a sibling). Creating this space can promote your child calming down so that you become less tempted to hit him or her. Second, if you feel like you’re loosing control, and might manifest undisciplined discipline, see if it’s possible to create some distance between yourself and your kid. Perhaps another adult can take over or you could move to the next room or a few feet away. When you have this distance try belly breathing, relaxing your muscles and clearing your mind (e.g., focus your attention on a narrow stimulus such as your breath).

Use Time Out

Time out is usually preferable to hitting. Time out is punitive, creates a place for your kid to calm down and it isn’t affiliated with the same negative side effects as hitting. Time out is best done in an uncomfortable chair like a dining room chair. Your child should sit in this chair for a minimum sentence of one minute for each year s/he has lived outside of the fretful studentwomb; it should be away from anything s/he can kick or grab, be within your eye line and away from any entertainment. You would keep cycling through periods of minimum sentences until your child is sitting quietly and either agrees to comply with your directive and/or expresses remorse for offenses committed. (There are other details pertaining to time out that can come up. For a fuller review of these issues please see this blog post and Chapter Five of my parenting book.)

Preventative Measures

There are many ways you can reduce the odds that you’ll have to deal with disruptive behavior in your child. I will review three of my favorites here:

1. Spend one hour a week each week doing special time. Readers of this blog know that this is my favorite preventative strategy for a host of issues that come up in child rearing. For a free download on how to do special time click here; click here for a resource for doing special time with teens.

2. Ensure that your child has weekly opportunities to manifest his or her strengths. When a kid doesn’t feel like s/he is doing well s/he is more likely to act out. Click here for a blog entry that elaborates on this theme.

positivity negative sign3. Set up a reward program to change any patterned negative behavior that you’d like to change in your child. That is, instead of using “this bad thing will happen to you when you do that bad thing” make it “this good thing will happen when you do this good thing.” A kid might earn her TV time by cleaning up her toys or he might earn access to his cell phone by completing his homework. Try to flip the negative behavior into it’s positive inverse, and then set up a reward for it. Please note that a reward can be a pleasure that your child is currently getting access to for free. Set these up in advance, make both the expectation and the reward specific and remain an empathic bystander as your child makes choices (e.g., I know how much you enjoy TV so I hope you’ll give yourself that gift by cleaning up your toys) instead of a hawkish warden (DO YOUR HOMEWORK!). Of course, I appreciate that there are times when we all need to insist that something gets done, and now.

In closing let me be Dr. obvious and note that a brief blog entry can’t address all of the questions that are probably percolating through your mind right now. (For example, shouldn’t kids learn to internalize their rewards? How long should I keep a reward program in place? Should I set up a reward program for his or her sibling also? What can I do to get my ex on the same page?) But, hopefully you can find answers to many of your questions by either continuing to search on this blog site or by reading the aforementioned parenting book. And, remember, problem solving- erasing mazeyou probably have a very good child psychologist not far from you whose available to help; for a referral click here. Good luck my fellow parent-lunatic!


New Research on Corporal Punishment

crying toddlerA large study on corporal punishment, that was published nine months ago, just crossed my desk. I thought I’d let readers of this blog know about it. There are twenty authors listed on this paper, the lead one of whom is Dr. Jennifer E. Lansford from Duke University. The entire paper can be found here.

The study investigated 1,196 children, and their mothers, from nine countries, across three points in time spanning three years (sorry dads, they didn’t look at fathers). The researchers were interested in considering how varying degrees of maternal warmth and corporal punishment might affect symptoms of anxiety and aggression in kids. Here are some key points from their review of the existing scientific literature:

• A large study in 24 developing countries found that 29% of parents believe that corporal punishment is necessary in order to parent well.

• “…77% of American men and 65% of American women” agreed with a statement that sometimes kids need “a good hard spanking.”

• In 1989 the United Nation’s Convention on the Rights of the Child determined that corporal punishment is “a human rights violation.”

• The only good outcome consistently found for corporal punishment is immediate compliance with parental commands. “All other negative outcomes during childhood and adulthood (low child moral internalization, child aggression, child delinquent and antisocial behavior, adult aggression and adult criminal and antisocial behavior)…(are) associated with corporal punishment.”

• The negative effects of corporal punishment seem to be smaller in countries physical abusewhere the authority of parents is stressed and corporal punishment is more common.

These are some key quotes regarding what they found in their study:

• “Consistent with much previous research on the negative effects of corporal punishment on children…out first hypothesis that corporal punishment would predict more subsequent child adjustment problems was generally supported…even after taking into account prior child adjustment.”

• “Our hypothesis that maternal warmth would predict a decrease in child anxiety and aggression over time was also generally supported…”

• The overall pattern was that children’s anxiety decreased over time most rapidly for children whose mothers were high in warmth and low in corporal punishment…”

• “Children whose mothers were high in both warmth and corporal punishment had increasing rather than decreasing anxiety over time.”

I would suggest two take home messages:

1. Avoid corstop2poral punishment as there are too many negative side effects associated with it. Moreover, there are many more effective strategies available that do not have such negative side effects. (e.g., see Chapter Five of my parenting book or search this blog site).

2. Trying to be warm as a way of mitigating the effects of consistent corporal punishment can actually have the effect of increasing a child’s anxiety; this most likely happens because achild is confused over and stressed by the mixed messages.

In next week’s blog entry I’ll review some immediate things a parent can do when tempted to give a kid a smack.

Teaching Electronic Etiquette to Kids and Teens

baby at computerOur kids’ use of technology is evolving at a dizzying pace. We all feel varying degrees of uncertainty about what it all means and how to effectively manage it. In this blog post I will list 10 teaching points to share with your kids and teens regarding texting and internet communications.

I’d like to share two important caveats before I get to the teaching points. First, we all do well to begin such conversations with our kid or teen by first asking for his or her perspective, providing empathy and agreement when that’s appropriate. Moreover, we also do well to use question and discussion methods before going into lecture mode. Second, the suggestions below are founded on the assumption that your monitoring protocol for your kid’s or teen’s use of technology is age-appropriate and on board; you can find monitoring guidelines throughout this blog site and my parenting book. Those caveats aside, here are the 10 suggestions:

1. Don’t post or type anything you wouldn’t want read on the school intercom. (This can be a tough sell for a kid who believes that a given friend is 100% trustworthy and will remain so forever.) This guideline goes double for posting on social networking sites. It can be especially useful to point out to teens that social networking posts are OFTEN perused by college admissions personnel, prospective coaches and prospective employers. Providing examples of people laptop big brotherbeing burned can help.

2. Try to avoid texting or posting when angry or hurt. We all experience transient brain dysfunction when feeling painful emotions (you probably won’t have to go too far back in time to provide examples of your own lapses). It’s best to introduce a pause when possible.

3. Avoid hiding behind anonymity to trash another person, no matter how much it may be deserved. You merely need to visit the comments section of online newspaper articles to find examples of this to illustrate to your progeny. Even young kids can often appreciate how this comes across.

4. Avoid responding in kind to insults or other kinds of hurtful communications. You can ask your kid things like: “what are some good ways to put out a fire?” “What are some ways to make a fire grow?” You can also ask your child or teen imagines how others might view such responses.

upset at laptop5. Teach your kids that certain kinds of communications are best done orally and/or in person. You’ve probably noticed that many kids eschew phone calls and prefer to text just about all communications with their peers. You can stress that your kid maintains more control over oral communications than written ones. Again, examples of people being burned can help make this point.

6. Teach your kids that sensitive communications can be easily misunderstood when written. Kids may not be aware of all the additional information that is shared through oral or in-person communications.

7. Be extremely cautious about sharing or posting pictures of others without first getting their permission. What one person thinks of as an innocent picture can be mortifying to another. This would also be a place to review the problems, legal and otherwise, with sexting and/or sharing nude pictures.

8. Try to avoid writing things about others that you wouldn’t want them to read. Again, examples of this going bad for a person can help.

9. Avoid observing or fueling other people’s social networking train wrecks. cyberbullying2There is something about the presence of an audience that fuels such unfortunate exchanges.

10. Encourage your child or teen to let you know if s/he experiences electronic bullying or becomes aware of another kid experiencing it. Victims of these behaviors can sometimes spiral downwards in tragic ways. If your kid(s) take you up on this, get some expert consultation regarding how to proceed (e.g., a good child psychologist). For a referral click here.

Good luck, my fellow parent!

Mindfulness Techniques for Kids and Teens

dad and daughter in a high mountainThere is a growing body of evidence that mindfulness–which is tuning into the moment in a non-judgmental way–is associated with an array of positive wellness outcomes. In this blog entry I will review some specific mindfulness strategies for we parents to use with our kids and teens.

The older your youth is the easier this will be to teach and the more time you will be able to spend doing the techniques. It also helps if you are engaged in your own mindfulness practice. The length of time invested in each of the following strategies can be adjusted based on factors such as those.

To teach the concept of mindfulness you might try to start with a stimulus that is interesting to your child: a flower, a captured insect, a colorful dress, a colorful rock, and so forth. Make sure everyone’s technology is off (not on silent or vibrate, but off). Ask your child to take two to five minutes with you and study the details of the thing, making sure to not judge and only to observe. As you’re doing this, suggest that you both pretend that your lungs are in your belly, instead of your chest, and breathe more deeply (but comfortably), both in and out. Suggest that if other thoughts come to mind, that your child just bring them back to the object without judging the fact that s/he was distracted for a moment (you can model this by recounting your own distractions later). Afterwards ask your child how this affected him or her, listening for evidence of feeling more calm or peaceful. You might also have your child or teen give a calmness rating, from 1-100, comparing how s/he felt before and after.burnout:balance sign

Here are some other examples of mindfulness techniques:

During agitating waits. When in a long retail line, a traffic jam or other time-slowing and bothersome situations, encourage your child to study the details of something around you: the sweater of the person in line in front of you, the cracks in the side of the road. “Study” doesn’t mean glance and move on. It means keep a focus on that area and notice a level of detail that most would normally not attend to. When finished, be sure to ask what this did for the agitation and the sense of time (usually reduces agitation and speeds up time).

During eating. In our run-and-gun culture we can get into the habit of devouring instead of savoring. Mindful eating, which has been associated with enhanced pleasure and reduced calorie intake, involves engages all of the senses in eating. This would include chewing slowly and savoring the details of each mouthful in a way that typically wouldn’t be noticed.

Tmom and daughter shadowo reduce self-criticism. Ask your child or teen to try balancing an egg for two minutes. When doing so s/he should pay attention to the details of the egg and the surface as well as not judge his or her performance; the latter is especially important in this exercise.

As a hobby. Photography is an example of a hobby that is mindfulness friendly. You can ask your child to join you in taking a few pictures of things that people might not normally notice. Agree to non-judgmentally study the thing for some moments before you take a picture of it.

As a way of joining with nature. Take a hike in nature, agreeing to stop a predesignated number of times to study a particular object.

To learn about each other. You can take turns studying the details of each others face, being careful to remain neutral in any commentary. (When it’s all over you can be positively judgmental if you’d like.)

The final two are examples of more advanced techniques:

To observe negative feelings. There is something about non-judgmentally naming and noticing negative emotion that promotes dealing effectively with them. In our culture we sometimes have a low threshold for experiencing the inevitable valleys of our lives and can rush in with self-medications of a wide array. If you practice a spirituality, you teach your child to turn over named negative feelings to his or her Higher Power. Teaching our kids to be mindful about painful feelings can be difficult to do (including for us as we are challenged God in all thingsto suppress our urge to immediately jump in with strategies and reassurances) but offers an invaluable life lesson.

To observe urges. You can ask your child to sit up straight in a dining room chair and not respond to, but non-judgmentally notice, any urges (e.g., to slouch down, shift weight, cross legs) for a few minutes. A similar exercise would be to put your child’s phone face down and to note urges to respond to its beck-and-call. Afterwards, you can debrief about the role of urges and that we have more power to create distance and control over them than we might sometimes imagine.

While I’ve given some sample exercises, just about any activity can be done more mindfully: listening to music, commuting to school, showing, brushing teeth, and so forth. Like any wellness habit, it becomes easier to do the more it is practiced.

Four Stress Management Strategies off the Beaten Path

grpx_1889In last week’s blog entry I reviewed highlights from the recently released Stress in America Survey, a national evaluation of American stress conducted annually by the American Psychological Association. In this week’s entry I will review four of my favorite, perhaps less broadly known, stress management strategies.

I suppose just about everyone reading this blog knows that the tripod of effective stress management is healthy sleep, regular physical activity and a balanced diet. I suppose just about everyone also knows that certain techniques commonly used to manage stress are ultimately ineffective or even toxic (e.g., smoking, drinking alcohol). So, I won’t make those points here. What I would like to focus on are four strategies that might not be as well promulgated but which nonetheless have an impressive empirical track record supporting their usage.

#1. Be in the moment. So often our thoughts are in places other than the moment before us; or we might be partially in the moment and partially somewhere else. The science behind “mindfulness” indicates that methods for tuning into the moment facilitate peace and effective stress management. There are so many ways to do this: meditating, studying the details of the environment in which we find ourselves, mindful photography, mindful eating and so forth. This can be done in a few moments (e.g., see www.donothingfor2minutes.com) or can be a sustained practice (e.g., see The Power of Now).

#2. Practice gratitude. I’m not suggesting that someone try to be gratefulholding a heart for things that are not true, but merely to tune into those things that promote grateful feelings and thoughts. Our minds can be like hyperactive squirrels as they ping pong from one stressful thought to another. A gratitude practice can be a way of inserting true and uplifting thoughts, which then help to manage stress. Like mindfulness strategies, gratitude can be practiced in snatches of time (e.g., reflecting on things one is grateful for while showering) or be more elaborate (e.g., writing a gratitude letter). Enter the term “gratitude” in the search bar above for some additional ideas.

#3. Perform acts of kindness. The phenomenon of the “helpers high” has been scientifically established to be true. Sometimes stress causes us to shrink inwards, making the notion of being kind to others seem impractical. However, being intentionally kind can lift one’s mood and promote a sense of meaning. I don’t know that this next statement has been empirically investigated, so take it with a grain of salt. But my experience is that when kindness is done for the purpose of creating a helper’s high it may offer a more limited benefit. It’s almost like one must surrender all expectation of a return on the investment in order to experience such a return. This also can be done simply and quickly or in a more sustained and elaborate fashion. Just enter the term “kindness” in the search bar above for some ideas.

spiritual man, african-american#4. Practice the Serenity Prayer. (Google the prayer if you’re not familiar with it.) One can be an atheist and still receive the psychological benefit of practicing this construct. Many types of personal, family and institutional illnesses flow from trying to control important things that can’t be controlled. This is part of the reason why 12-step recovery programs routinely use this prayer. The power of this prayer warrants all of us posting it where we can be reminded of it regularly. By the way, releasing control doesn’t mean becoming cold or indifferent to pain or unfortunate events. It just means that I don’t make myself sick trying to control that which is outside my control. Click here for an entry I wrote on using this prayer in parenting.



New Research on Stress in America

on edgeThe American Psychological Association (APA) just published the 2014 edition of its annual Stress in America survey (click here for the complete report). APA has been conducting this national survey since 2007. Here are some key findings from this year’s edition:

• Just about 3 out of 4 Americans worry about money at least some of the time.

• Just about one out of four adults report that they worry about money to the extreme, with that same approximate number reporting that they worry about finances on a daily basis.

• Many Americans report significant side effects from not having enough money. For instance, about one third indicate that money limitations interfere with living a healthy lifestyle; moreover, 12% report that such limitations caused them from seeking out needed healthcare.

• In 20work-life balance207 household income did not appear to differentiate the stress that people reported. However, this year those living in households making less than 50K reported substantively higher levels of stress. These individuals also report higher levels of not being able to live a healthy lifestyle (i.e., 45%).

• A little over three out of four parents report higher levels of money-based stress; parents also report higher levels of not feeling financially secure. (In my practice I hear a lot about concerns regarding saving enough for college.) Parents also reported higher levels of not doing enough to manage their stress as well as engaging in more unhealthy stress management behaviors (e.g., drinking alcohol).

• Interestingly, many adults report that discussing money-based stress in their family is taboo (18%) or makes them feel uncomfortable (36%).

• Women report higher levels financial-based than men (e.g., 30% of women report worrying about money all or most of the time compared to 21% of men). Women also reported more negative consequences from stress than did men (e.g., a greater sense of loneliness or isolation).

Here are some other key findings from the survey:

old woman upset• Those who report having emotional support report lower levels of stress and better outcomes than those who do not. Moreover, the sense of not having emotional support is higher among those who make less money (27% compared to 17% in higher income households). One out of four parents report feeling this vulnerability as well.

• The degree of emotional support also seems to be affiliated with how sad folks feel and with the perception that their stress has increased over the past year.

• Almost half of Americans report that they are not doing enough to manage their stress (i.e., 42%).

• After financial concerns, the stresses most bothering Americans are work (60%), the economy (49%), family responsibilities (47%) and health concerns (46%).

anxious black man• The top consequences respondents indicated experiencing from stress are feeling irritable or angry (37%), feeling anxious or nervous (35%), having lower motivation (34%), feeling tired (32%), and feeling overwhelmed and/or depressed (both at 32%). Moreover, 41% of those who are married or living with a partner reported that they lost patience or yelled at their partner in the past month secondary to stress.

I bet those of you reading this blog can relate to these findings. Please tune into next week’s blog entry when I’ll describe some of the most time-efficient and effective ways of managing stress.

New Research: Treatments for Teen Suicidal Thinking and Self-Harm Work!

depressed headphones onMeta-analytic studies are called “studies of studies.” They entail grouping together findings from numerous studies on the same topic in order to reach more substantive and sweeping conclusions.

In the February, 2015 edition of the Journal of the American Academy of Child and Adolescent Psychiatry, a meta-analysis is published regarding psychosocial treatments for teenagers struggling with self-harm (e.g., self-mutilation) and suicidal ideation. The authors of this research are Drs. Dennis Ougrin, Troy Tranah, Paul Moran and Joan Rosenbaum Asarnow.

This is an important piece of research as, and quoting the authors, suicide “…is the second or third leading cause of death in adolescents in the West…” For example, the authors’ review indicates that the annual suicide rate among teens is 7.8%. Moreover, and regarding self-harm “…a systematic review of 128 studies reported a pooled lifetime prevalence of 13.2%…”

In considering the extant research the authors retrieved 389 articles. upsetTheir most important conclusions are based on 17 random control treatment trials on 2,176 youth. Their bottom line regarding how teens responded post treatment: “The proportion of the adolescents who self-harmed over the follow-up period was lower in the intervention groups (28%) than in controls (33%).” The treatments “…with largest effect sizes are dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and mentalization-based therapy (MBT).”

I have described CBT in other posts on this blog (e.g., click here) and in Chapter 10 of my parenting book. As I reviewed in more depth elsewhere, CBT involves teaching a collection of cognitive and behavioral skills for managing mood, anxiety and stress based symptoms. It is a time-limited and structured treatment approach.

Quoting from the New York University Langone Medical Center: “DBT strategically blends the change techniques from traditional cognitive behavioral therapy with acceptance-based strategies from Zen mindfulness practice.” Mindfulness strategies essentially involve garnering feelings of peacefulness and contentment by tuning into the details of the moment.

sad boyQuoting from PsychCentral.com “Mentalization based therapy (MBT) is a specific type of psychodynamically-oriented psychotherapy…Its focus is helping people to differentiate and separate out their own thoughts and feelings from those around them… In …MBT, the concept of mentalization is emphasized, reinforced and practiced within a safe and supportive psychotherapy setting. Because the approach is psychodynamic, therapy tends to be less directive than cognitive-behavioral approaches.”

As I’ve reviewed elsewhere on this blog (e.g., click here) and in my parenting book, most teens who could benefit from mental health services don’t receive it, including kids who self-mutilate or struggle with suicidal thinking. This new research confirms and elaborates on an established finding in the scientific literature: mental health treatments for teens work!

If you even suspect that your teen is struggling with these issues, please consider taking the (sometimes lifesaving) step of seeking out a mental health evaluation. For a referral, click here. For other content pertaining to suicide, just enter that word in the search bar above.

Making the Most Out of Snow Days

girl, little, outsideUnanticipated days off from school can present some significant challenges for we parents. This entry is meant to provide you with 12 ideas on making the most out of them, each of which is probably better for your kid(s) than vedging in front of the TV or Xbox all day.

• Use the problem solving method to develop plans for the summer. Ask you kid(s) to generate at least 10 ideas for summer activities or plans without evaluating them. After the ideas are generated, ask them to rate each of them from one to ten, with ten being the best idea (ideas can have the same rating). Then, if they are old enough, ask them to start researching things like dates and costs.

• Make a snow person family on the property where you live.

• Use the snow from shoveling driveways or walkways to build snow forts and have snowball battles. (You may have to make rules about the weight of snowballs. I wonder if Bill Belichick or Tom Brady might have some advice to offer ;-) ) You might also augment these battles with water guns!

• Try geocaching. This activity involves using a handheld GPS to find hidden treasures. Just Google the term to learn about this universe around you. Alternatively, you could set up your own treasure hunt inside and outside your home.

Baby pictured by artistic mom• Have your kids produce their own movie. Write a plot (or improv it), have costumes, make up, direction, filming, and so forth.

• Have your own cupcake wars. Invite a neighbor in to judge. Get a trophy for the winner.

• Have a photo contest regarding the outdoor winter wonderland. Find someone to judge the pictures, making sure to keep undisclosed who authored which pictures. Arrange for a nice prize (e.g., I love winning back rubs).

• Create some crafts using family photos; most of us have a ton of these on our phones. Again, many ideas are available online.

diverse happy parents• Do makeovers on each other, incorporating makeup, hair and clothes. (When my girls were younger they loved applying makeup to me.)

• Have a tournament with any games you might have that involve physical activity (e.g., ping pong, Wii games).

• Perform science experiments. Here’s a site with some good ideas.

• Play winter wiffle ball (use socks and a broom stick if you don’t have a wiffle ball and bat). You can play with as few as two, but you could probably easily find other kids to play with a little effort. (IMHO, baseball is God’s sport. Who says it has to be warm out to have a ton of fun with it!)

I bet you’ll find that you can make some pretty special memories doing these activities, so be sure to take some pictures and videos as you go!



Is He Just Being a Boy, or Does He Have ADHD?

adhd signHow can the difference between a boy being a boy and ADHD be determined? Many parents of young active boys, who run into trouble at school, struggle with this question. This blog entry is meant to provide some guidance.

ADHD involves two clusters of symptoms: problems with inattention and problems with hyperactivity; the later of which can usually be traced back to difficulties with impulsivity (i.e., the problem is more with poor brakes than a revved up engine). In order to qualify for an ADHD diagnosis a child should  be more inattentive and/or hyperactive than 93% of his peer group (i.e., a standard deviation and a half above the mean in a normal distribution), and the symptoms are usually required to have been present for six months or longer, have had an onset in childhood (the first symptom usually by age 7) and not be attributable to any other viable cause. For this reason a boy whose activity level does not rise to this level, even when it causes adults distress, would not typically meet diagnostic criteria for ADHD.

In my clinical experience (which is an albeit very limited parameter), there are three common instances when ADHD is misdiagnosed:

1. A very active boy (but not a boy with ADHD) is also defiant. boy in suit with attitudeOppositional Defiant Disorder (ODD), which involves problems with anger control and doing what adults expect, is very distressing. If the evaluation is not sufficiently thorough, it can be easy to misdiagnose ADHD in this scenario.

2. The primary assessment tool, for a boy who is illustrating behavioral problems that are not attributable to ADHD, is the response to a stimulant medication. Even kids who do not have ADHD may have a positive response to medications that are designed to treat ADHD. So, it’s important to avoid using a medication response as the primary assessment tool.

3. A boy has an internalizing disorder (e.g., a mood or an anxiety disorder) but the evaluation misses this (usually because it has not been thorough enough). For example, a child who is very anxious can be quite inattentive.

In order to avoid these kinds of misdiagnoses it is important that the evaluation include some key elements. These are some assessment methods that can be helpful in ruling ADHD in or out:

kid overwhelmed by books1. The use of teacher, parent and self-report (if a child has ≥6th Grade reading level) behavior rating scales. These measures can help determine if a child’s level of activity or ability to concentrate are typical (i.e., among children of the same sex and age group). There are measures designed to rule out ADHD as well as an assortment of potential collateral problems. It is important to survey all three groups of people (i.e., parents, teachers and the child of concern), when they are available and able to participate that is, in order to increase the odds of arriving at an accurate impression.

2. A review of school records. What can be especially helpful is to review behavior grades and ratings in the early elementary school years.

3. Family and individual child interviews (or play sessions for very young children). These interviews can help in determining if there is another viable theory to explain any symptoms of hyperactivity or inattentiveness that are being displayed. These interviews would typically inquire regarding all important domains (e.g., the developmental history, the school history, the medical history). As I mentioned, ADHD is a diagnosis by exclusion; if another problem viably explains the symptoms, the ADHD diagnosis is usually set aside until the other problem(s) can be treated.

4. Diagnostic testing that measures attention and/or other executive stairs up to a brain and skyfunctions. This testing can add considerable cost to the evaluation. So, I often prefer to not do it unless the first three methods leave the ADHD question in doubt. (However, if cost is not a significant consideration, it can be helpful to include this testing anyway.)

Three closing thoughts:

1. A child with ADHD often meets diagnostic criteria for at least one other disorder (e.g., ODD, a learning disability). So, and for example, documenting that a child suffers attentional problems secondary to anxiety does not automatically mean that said child does not also have ADHD.

2. A child whose behavior is causing impairment, at school or home or both, will usually meet criteria for some diagnosable problem, even if it is not ADHD.

parent guilde3. Parents do well to educate themselves as to the nature of ADHD (or any other diagnosis that is suggested). Being an informed consumer of mental health services is very important. Please see Chapter 10 of my parenting book, or other articles on this blog site, for guidance.

Becoming the Person You Wish to Be

man on a cliffMany of are in the midst of breaking out new resolutions for change. This entry is designed to increase your odds of success. I’ll review four planning steps and a dozen strategies for promoting effective change.

The first step in the planning phase is to visualize what you like about yourself today. I’m skeptical that your self-improvement project can survive and thrive if you do not know and enjoy your strengths, not only at the start, but consistently throughout. I like a prayer that British psychologist Robert Holden recommends in one of his books: “Oh God, help me to believe the truth about myself, no matter how beautiful it is.  Amen.” If you’re in doubt about your strengths, enter the term “strengths” in the search bar above and take some of the assessments you’ll read about.

The second step is to picture yourself as the most fulfilled version of you. What is different about that person? What changes, that are under your control today, would help to get you there?

Third, list the obstacles you’ll experience in taking this voyage. This is a step worthy of your most honest and thorough consideration. What function does the unhealthy behavior serve? What obstacles arise within you when you seek out the healthy, life-giving behavior?

Fourth, what steps can you take to reduce the obstacles and lessen your imagination2reliance on will power?

A problem that many of us run into is called “present bias.” The person who we are when we make a resolution–present me–is steely eyed and filled with gritty resolve. However, present me may also be inclined to be harsh (“okay, you really need to stop being so weak!”), excessively ambitious (“I’m going to never yell again!”) or inclined to invest in ways that aren’t always helpful (e.g., purchasing expensive equipment that proves to be impractical). The problem is that present me is not the same person who will be doing the heavy lifting; that person is future me. If present me doesn’t adequately understand future me’s strengths and vulnerabilities, then present me is destined for disappointment. A skilled therapist can also be of great assistance in a deliberation like this. For a referral, click here.

Each of us are like snowflakes, completely unique. Thus, a strategy that helps another person make substantive changes could be a useless idea for you. Use your world’s leading expert knowledge of yourself to develop a plan that is supportive of future you. Use your strengths. Establish support for your vulnerabilities. Some of the following twelve tips may help:

health graffic, cool1. Set small regular goals and build from there. Avoid goals like “I’m going to lose 30 pounds.” Instead, try “today I’m going to eat a balanced diet and walk for 20 minutes.” Six months of tortoise behavior will leave you feeling much better than brief bursts of hare behavior. (By the way, if loosing weight is one of your interests, I’d recommend the movie Fed Up. It’s provocative and enlightening.)

2. Try to attach a behavior you want to add to things you routinely do. This link is to a very good YouTube video by psychologist BJ Fogg on this topic.

3. Keep a daily log of those behaviors that are most important to your goal(s). Many self-destructive behaviors occur when we disassociate from ourselves (i.e., only partially notice what we’re doing). Writing your behaviors down combats disassociation and increases the odds that you will remain self-aware and in the moment.

happy older man and woman4. Join with others. Two things characterize those who are successful in setting aside self-limiting patterns: they work on themselves and they surround themselves with people who are striving towards the same goal(s). Relying on others could involve partnering with friends, starting counseling, or attending support group meetings.

5. Ask your partners for help. Many people are willing to help your future self reach your present self’s goals. All you need do is swallow your pride (which can be very freeing), share your vulnerabilities and ask for ideas and/or assistance. For example, I know one pair of friends who committed to playing a rotating aerobic game before work each day (e.g., basketball, racquetball, etc.). They rotated the role of cheerleader for those days when one or both of them was tempted to cancel.

6. Establish rewards for yourself. For instance, so many days of completing a desired behavior change earns you a treat. Also, give yourself hefty mental pats on the back for success along the way. Reflecting on three things your grateful for over the course of the past 25 hours, while you’re taking your daily shower, can be one way of doing this.

7. Take lapses as opportunities to learn more about your vulnerabilities and how present you can do a better job of supporting future you. Avoid being cranky, cruel and harsh with yourself as this risks putting your goals further out of reach. WebI’ll sometimes ask clients, who are parents, to react to themselves as they would react to their child if their child showed a similar lapse (sometimes this involves projecting forward in time and imagining their child at their age, having fallen prey to the same vulnerability).

8. Use music if that motivates you. Start your playlist with the mood your at and then change it gradually towards the mood you want to morph to.

9. Focus your mind on the positive behavior or outcome you want rather than grinding against temptation. Imagining the beach vacation you’ll take with saved money is usually preferred over trying to directly focus on not making an impulse buy.

10. Have present you write encouraging and positive messages for future you. There are numerous wellness apps available to help with this.

11. Make a plan to remove as much temptation as possible from the eye line of future you. As I mentioned above, excessive reliance on willpower is generally to be avoided.

12. If you are a spiritual person, lean on that part of your life as much as you can. A wonderful book that regards using your Higher Power to overcome difficult challenges, is Breathing Under Water by Richard Rohr.

Good luck! And, remember:

√ Being in the fight for self-improvement matters at least as much as the outcome.

√ We all fall and fail sometimes.

√ Falling and failing affords you the opportunity to demonstrate character when Printyou dust yourself off and get back after it.

√ You deserve to treat yourself with kindness, compassion and love at all points throughout your journey.




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