What You Need to Know About Taking a Child to Therapy

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Disclosure: CHOC Children’s is a Tiny Oranges Partner

This post will hopefully explain any questions you might have about taking a child to see a therapist thanks to the expert advice of Dr. Carlos Konishi Ph.D., a pediatric psychologist at CHOC Children’s. We will cover how to find a therapist for your child, what to prepare for your first session, some questions you might want to ask and most importantly, how to know you have found a good one.

Kids’ mental health.  We need to talk about it.

But there are still stigmas and misinformation around mental health because we don’t understand mental illness like we do physical illness.

If your child was complaining about a persistent physical pain, what would you do?

Make an appointment with your doctor.

You probably wouldn’t even think twice about it, right?

What if you noticed persistent and noticeable changes in your child’s emotional or mental state or behaviors, what would you do?

The answer is not as clear as a physical ailment, is it?

But it should be.

Make an appointment with your therapist.

If you have never seen a therapist before, the idea of taking your child to one might seem daunting. But it doesn’t have to be. The first step is often the hardest but the end results will be well worth it.

Here are some of the questions I had for Dr. Konishi. If you have any to ask him, please comment below!

My child needs therapy, where do I start? How do I even find a therapist? 

“The best place to start is often with your pediatrician who can give you a referral or provide you with list of providers contracted through your insurance. When researching therapists for your child, it is extremely important to find someone who specializes in working with children, because it takes a specific skill set. It is also helpful to see if the provider has experience working with the issue you are seeking treatment for,” Dr. Konishi explained.

I made an appointment, do I need to prepare anything for our first meeting?

“Just like an initial doctor’s appointment, there will be a good amount of paperwork to complete prior to the first session. It is helpful to ask if you can get the paperwork ahead of time to allow you to arrive with everything filled out,” he suggested.

You can also bring in any information that will help the therapist learn more about your child.

“Documents like IEP’s, grades, special testing results, teacher or coach feedback, any information that will help the therapist get a more complete picture of your child is extremely helpful.”

He also recommended writing down any questions you have for the therapist before going in so you can leave with all your questions answered.

To that point, what questions are good to ask the therapist?

Along with the questions you come up with, Dr. Konishi said there are some good ones to address in the first session:

How often will we meet?

Will the sessions include both myself and my child? Or will you also want to meet with us alone?

What are the specific goals of therapy?

How are we going to be able to identify progress in a way we can objectively track?

What’s the best way to communicate with you if I have questions or concerns in-between sessions?

Which led me to my next question..

How do I explain therapy to my child?

Dr. Konishi said you can simply describe therapy as going to see a person whose job it is to help them feel better.

“Some parents have helped prepare their child for a first therapy visit by comparing a psychologist to a school counselor. Most students know who a school counselor is and usually have a positive impression of them,” he explained. ” They also understand that they are there to help, even if they have not gone and seen one themselves. Using this example can help remove the fear of the unknown.” 

For those who like books as conversation starters, he suggested a book called “Feeling Better” about therapy on Amazon (affiliate link) you can get and read together with your child.

If your child is older, like tween or teenager, “It might be a good idea to ask them what they would like to get out of therapy and what their goals are? This gives them ownership and power over the process,” he said.

What should I expect in the first session with my child?

“The first session is typically spent building rapport with the child and family while gathering information about the child’s strengths, interests and life situations.”

The therapist will also likely cover any relevant history like asking about any family history of mental illness, traumas, developmental or social delays, etc.

It might seem very personal but all of this information will help the therapist devise a plan for therapy and treatment that will be most effective for your child.

“It is important to know that everything said in a therapy session, barring any information about the child being a danger to him or herself, to others, or being the victim of acts that put the child in danger, are kept strictly confidential by HIPPA law,” Dr. Konishi stressed.

How long will it take for therapy to work?

“It is really important for parents to exercise patience when assessing the effectiveness of therapy.  The first 2 – 3 sessions are generally spent building rapport with the child and making them feel comfortable,” he expressed.

Before making any knee-jerk reactions or conclusions about therapy not working, he said to give it at least 5 sessions and sometimes it might even take up to 10 before you might start to notice any improvements.

“Change is hard for anyone, and changes do not happen overnight, so it is important to trust the process and give it some time before evaluating.”   

What if I don’t think therapy is working for my child?

The most important component of therapy is having open communication with your therapist about the things that are working but also any concerns you might have.

“Knowing this information gives the therapist insight and opportunity to tweak their approach,” he explained. 

But Dr. Konishi, isn’t it insulting to tell my therapist if I don’t think they are being effective for my child? The therapist is the expert after all, right?

“Yes, therapists are experts in how to work with certain problems and behaviors, but you are the expert when it comes to your child,” he clarified.

No one else on this planet knows your child like you do, so it is absolutely appropriate to share feedback with your therapist.

How do I know if I have found a good therapist?

Your therapist should make you and your child feel comfortable and be able to lay out specific goals for therapy so you can work together to meet these goals and help your child feel better.

“A good therapist should view therapy as a collaboration between the child, the child’s parents and the child’s medical team with the goal of treating the whole child, mind AND body. Collaboration takes communication, so it is important to communicate with both your therapist and your doctor what is going on with your child to give them better insight in treating your child most effectively,” he stressed.   

Lastly, a good therapist will also be open to hearing your honest feedback and work together with you on the best way to treat your child. 

Any final notes?

Dr. Konishi answered, “Don’t expect perfect progress. Therapy doesn’t work that way.”

It’s not like taking an antibiotic for an infection, where you take it for 10 days and you are done. Therapy is a series of progress and setbacks. You might see some steps moving forward, but then a life stressor or situation might arise, and you might see a few steps back.

“What’s important is you continue to communicate these life circumstances so your therapist can integrate proper coping tools to help get the child back moving in the right direction.”

If you would like to learn more about CHOC Children’s Mental Health services and programs please visit www.choc.org/mental-health.

6 Conversation Starters About Mental Health

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CHOC Children’s Mental Health Inpatient Center

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CHOC Children’s is a partner of Tiny Oranges, but this is not a sponsored post.

As a proud CHOC Children’s partner, I was invited to tour their brand new Mental Health Inpatient Center before it opens its doors to patients this month. The desperately-needed facility will provide 18 beds to treat children ages 3 – 17 in a mental health crisis and allow them to receive care close to home.

An estimated one in five children has a diagnosable mental illness during childhood. That would be 150,000 children in Orange County alone. But until now, children under 12 that were a danger to themselves, others, or gravely disabled didn’t have any inpatient bed options in O.C.  The children would have to wait in Emergency Rooms until they stabilized enough to be moved to an inpatient bed outside of the county. That, to me is tragic!

This new facility will fill a big hole in the system and undoubtedly will make a big difference in the lives of local children and their families in the middle of mental health emergencies.


CHOC Children’s Inpatient Health Center, which will be a major component of the comprehensive system of mental health care CHOC is creating, was built to provide the highest level of patient safety in a relaxing environment that promotes healing.

All of the 18 patient rooms are private, and there is an option for parents to stay overnight with their children, both of which are unique for the state of California.

Every single detail has been considered with patient safety in mind. For example, the windows are made of shatterproof glass and every fixture is designed to not be a “tie-off” opportunity. You can see an example with one of the doorknobs in the photo collage below.

I can only imagine the peace of mind it would give parents knowing their child was in a safe place to get help during a crisis.

The average length of stay is typically 5 – 7 days and will include mental health screenings and access to care through CHOC’s mental health resources. In most centers, programming is not available on the weekends, but CHOC’s center will provide the full scope of programming seven days a week.

In addition to their medical care, patients will also have access to complementary therapies such as art and music therapy, mindfulness, exercise, nutrition, and two sensory rooms, high and low, for patients requiring sensory therapy.

When a child is discharged, care planning for the future has already been underway, including connections to outpatient therapy, schools, medical care, support groups, parent assistance. The goal is to provide support after a child leaves to reduce the risk of re-admittance.

Early Intervention is Key!

Mental health is just as important as physical health.

In childhood, many troublesome behaviors might be dismissed with the thoughts, “It’s just a phase.” or “He/She will grow out of it.”

However, as parents, we know our children best. We also have the gift of parental gut instinct. If you sense something might be wrong with your child, don’t wait to get seen by a professional.

There are a wide array of mental health services available to help children who are struggling to give them the tools they need to heal.

For more information visit: www.choc.org/mental-health

 

 

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How to Talk to Your Kids About Tragic Events

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Sponsored

In the wake of last week’s horrific mass shooting in Las Vegas, this article on how to talk to your kids about a tragic event in the news is brought to you by CHOC Children’s

When tragic events happen in the news it is sometimes hard to know how to handle conversations about it with our children. How much information should we give? How do we answer specific questions? How does this vary with a child’s age?

Which is why I was so grateful to have the opportunity to speak with Dr. Nicole Vincent, PhD, a licensed psychologist at CHOC Children’s to get her advice to share with you today. 

 5 Key Things to Remember When Talking to Your Kids About a Tragic Event in the News

My very first question I had for her was,

“Is it better to bring up the event with your child at home first OR wait and see if they hear something from a friend or at school before discussing it?” 

1. Be Mindful of the Child’s Age

Dr. Vincent expressed how we talk to our kids about tragic events in the news will vary depending on the age of the child.

For preschoolers through about 1st grade, the chance a child would be exposed to information in the news is not as likely as it is for older children. So for young ones, a parent might consider not bringing up the event unless the child specifically asks about something they heard.  

For older elementary schoolers she suggested it might be a good idea to touch base with your child’s teacher or administrators to ask if the event has been brought up in class or if it is being talked about? Depending on the answer, this might cue you in to whether you might want to address it with your child at home. 

As kids become middle and high school age, it is very likely, especially with technology and social media exposure, to hear about tragic events and get information outside of the home. For these ages, Dr. Vincent said it is usually a good idea to take a proactive approach and start the conversation at home so you can discuss the facts and give them the opportunity to ask questions. 

Which led to my next question, how do you approach the topic about a tragic news event with your kids?

2. Consider Starting the Conversation With These Questions

The best way to start the conversation is to ask your child open-ended questions like “Have you talked about events in the news?” If yes,What have you heard about it? Tell me what you know.” 

The answers will help guide the conversation as to how much information to share.

For younger age groups, it is best to keep your responses honest and factual, but brief. Details are not totally necessary and often times these responses will be enough to satisfy their curiosity.

For older age groups, she advised to let your child take the lead with information they heard or questions they might ask. It is important to validate their concerns by letting them know they are asking great questions. It’s okay to not always have the answers, you can tell them as much, and empathize with also wanting to also know.  Being there to listen to your child is the most important. 

But regardless of age, she stressed you know your child the best and to pay attention to behavior and cues that might indicate they heard something or have questions. Even young children can pick up on information or overhear things that might surprise you.

Bottom line, take the above age suggestions as general guidelines. But again, you know your child the best.

For me personally, I was surprised my 8-year-old daughter had many more questions and wanted to talk about Las Vegas much more than my 11-year-old daughter. It also elicited more fear in her than her sister. For kids who seem to be experiencing an increase in fear as a result, I asked for suggestions on how to help.

3. Reinforce the Rarity of the Event

Tragic events often trigger fear and anxiety in people of all ages, and for children tragic events can be especially scary

Dr. Vincent suggested this could be a time to highlight the fact that a shooting like the one that occurred in Las Vegas is a rare event. And when rare tragic events happen there are many people that will work together to try to avoid it from happening in the future.

4. Teach Kids to Look for the Helpers

In times like this, I often see people quoting Mister Rodgers when he said, “When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”

Dr. Vincent mentioned it is very helpful to highlight for your children the people that step up to help in crisis.  Teach them to look at the first responders, volunteers, or strangers helping strangers. These people show us the beauty of humanity in a crisis. 

For some kids, she suggested even possibly talking about what you can do to help as a family. Even a small act like choosing a Go Fund Me account to donate to, writing a letter to a first responder, or looking up supplies to donate can help by showing there are always things people can do to help. 

5. Keep Home Life as Normal as Possible 

One last parting piece of advice was to keep your routine at home as normal as possible.  When a child’s day to day routine is altered for whatever reason, it can cause additional anxiety to build. 

On this note, Dr. Vincent also stressed how important it is to allow yourself the time to process the events. Whether it’s talking to your partner, friends or therapist, it is important to be mindful of your own self-care so you are in the right state of mind to discuss it with your child. 

When To Seek Help

After a tragic event, it is not uncommon to experience a variety of emotions or symptoms like mood changes, difficulty with sleep, or increased headaches or stomachaches. If any of these changes persist in you or your child for more than a couple weeks, and if the symptoms are disrupting daily life, it might be a good idea to pursue help by a mental health professional. 

Get more tips from CHOC experts

For more information about CHOC Children’s and their mental health services visit www.choc.org/services/mental-health

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Rising Rates of Depression Amongst Teen Girls

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This article is sponsored by CHOC Children’s Hospital

The teenage years are a time in life unlike any other marked by new, fluctuating hormones, social pressures, and school stresses. These new situations can understandably cause kids to feel down or depressed at times. But for others the feelings of sadness or hopelessness can persist in a state of depression. In fact, it is estimated that approximately 20% of teenagers experience depression before reaching adulthood.

A recent study published in the journal Pediatrics found depression rates amongst teens stayed fairly stable from the years 2005 – 2011. However from 2012 to 2014 the rates of depression were on the rise for both boys and girls, with a more pronounced increase for teenage girls.

What is causing this increase? Is the advent of social media playing a role at putting more girls at risk for depression?

I am exploring this question, along with other extremely helpful information provided by Dr. Adrianne Alpern Ph.D. a child psychologist at CHOC Children’s Hospital on warning signs of depression in teens, symptoms and how to get help if you suspect your teenager might be depressed.

depression in teens

My daughter will be eleven soon and over the past year I have seen her evolve from a little girl into a blossoming tween where friends are paramount and Music.ly’s have taken the place of pretend play. She’s growing up.

And it terrifies me.

But why is the idea of having a teenager so scary? Growing up is part of life. We all have to go through it. Logically I know this. However, as I see the years of hovering under her at the big ladder at the park and holding her hand across every street slowly come to an end I also see my ability to protect her start to fade.

At the root of the fear is the loss of control.

Up until now it’s been my job as her mom to protect her and keep her out of harms way. When our babies are close to the nest we can watch them and keep them safe. But as she spreads her wings and starts to fly into the world without me I won’t be able to protect her in the same way.

Girls will hurt her feelings, disappointments will sting on a bigger scale, and pressures at school will build. All of which will be things completely out of my control.

My role as her mother is starting to change. 

Instead of trying to protect her from these hurts, my job will be to listen, support and encourage her to dust off her wings and try again.

More damage control versus prevention.

And it is my prayer that  she will be able to work through whatever hard times the teenage years hold for her.

But what happens when your teen has difficulty getting through a hard time? What happens when hurt feelings or disappointments turn into sad moods that last for weeks?

How do you know when a teen mood swing isn’t a swing at all, but could actually be an episode of depression?

depressioninteens

This week I had the opportunity to interview pediatric psychologist Dr. Adrianne Alpern Ph.D. about depression in teens which I am happy to share with you today as I feel it is extremely important information to have as parents.

Normal Teenage Moodiness vs. Depression

My first question was, “How do you know the difference between ‘normal’ teen moodiness and clinical depression?” Dr. Alpern highlighted the fact everyone feels sad or down sometimes and being sad is a normal part of the human experience. But an episode of depression differentiates in important ways and this is a simple way to remember possible warning signs of depression.

Depression is when feeling sad or disinterested in activities you used to enjoy lasts for:

– > Most of the day

– > More days than not

– > For two weeks or more

Say it with me moms…depression is when feeling sad or disinterested in enjoyable activities lasts for most of the day, more days than not, for two weeks or more. I will remember that, won’t you?

Some Other Symptoms of Depression in Your Teenager Could Include:

– > More or less sleep

– > Changes in appetite

– > Fatigue

– > Changes in concentration

– > Thoughts of being a “bad daughter” or “bad friend”

– > Changes in movement….moving either quicker or slower than normal

– > Thoughts of not wanting to be around anymore, wanting to disappear or die

Study Finds Depression Rates Increasing in Teenage Girls

A recent study published in the journal Pediatrics found depression rates amongst teens increased from 2012 – 2014 from 8.7% to 11%, and the rise in rates of depression was more pronounced in teenage girls.

Professionals theorize the use of social media could play a role in the increase in depression. Teenage girls are more likely to engage in social media and use it as a source of their self-esteem looking to others for validation or acceptance. Social media can unfortunately also be another avenue for bullying or social shaming.

Others suggest the economic downturn could have played a role in the way teens viewed the future. Or, maybe our evolving openness in the media with celebrities sharing their mental health struggles might encourage teens to be more apt to report their depression than in years past.

But regardless of the cause, the take away for us as parents though is the same – depression amongst teens is very real, and our girls are especially vulnerable. Teen depression is increasing and we need to be aware of it.

teendepression

What To Do If You Think Your Teen is Depressed

Dr. Alpern stressed parents know their teen the best. If you notice changes in your teen’s mood or behavior, there’s no reason to panic, but it is a sign to pay attention and start some conversations.

When talking to your teen, she emphasized how the most important thing we can do as parents is to listen. Sometimes it is easy to downplay teen struggles because many parents think “life is easy” for a teen. What on earth could be so stressful? They have no mortgage, food is on the table, they have a roof over their head, etc.

However, teenagers have legitimate stressors in life, many of which they are encountering for the first time, so it’s important to empathize and validate their feelings versus discounting them.

starttheconversation

If the sad or down moods persist and start to interfere with your child’s relationships with friends or family, school work, or ability to complete daily activities (such as chores), it might be time to seek the help of trained mental health professionals.

Your child’s pediatrician could be the first place you turn to for direction on where to go to help. Many insurance plans also have lists of mental health providers.

Help is available and effective treatments exist for depression. 

How to Explain What Therapy is to Your Teen

Dr. Alpern expressed how there are so many misconceptions about therapy and we both agreed that “myths and facts about therapy” deserves its own entire blog post for this very reason! Many people think therapy is a place where you just talk about problems and vent but that is what friends and family are for. Therapy is so much more.

To break it down simply for your teen, therapy is a place to get help with the thoughts or behaviors that are causing you to be “stuck” and therapists are trained to notice these thoughts or behaviors and are able to brainstorm with you to help get you “unstuck”.

But What If My Teen Doesn’t Want to go to Therapy?

Dr. Alpern brought up the point that a lot of teens are resistant to the idea of going to therapy. However, if as a parent, you can get them in the door, the therapist can take it from there.

She suggested telling your teen how much you love them and how as their parent you want them to give it a try to see if it helps. Urge them to try it for 3 – 4 times and assure them they do not have to talk about anything they don’t want to. Tell them they can decide what they want to talk about. Giving them this sense of control can be comforting when going into an unknown situation.

There are Effective Treatments for Depression!

Dr. Alpern told me effective treatments exist for depression, and there is ALWAYS hope. With the help of a licensed trained counselor or psychologist in addition to adjunct consultation from a psychiatrist when necessary, depression can be treated.

If you are looking into help for your child, the website www.effectivechildtherapy.org can be a great place to start.  She suggests this site to many parents as a mental health resource. Click on “The Public” and you can find lists of symptoms and treatment options.

Teens Are Not Ticking Time Bombs

When I was expressing my fears about having a teenage daughter someday she told me many parents approach their teen like a ticking time bomb with gloves on, trying to diffuse whatever might come their way. I had a good laugh at this visual. So true!

She assured me that MOST teenagers do JUST FINE in the teen years. She assured me that many teens are using social media appropriately without significant harmful effects. After all, 87% of girls and 94% of boys in the study in Pediatrics did not report significant symptoms of depression within the past year. She assured me that many teens will  be able to navigate life without any major issues.

Exhale.

However, help is out there and you do not, I repeat, do NOT have to face these challenges and your child does not have to face challenges alone. Getting help for depression, anxiety or other mental health concerns is nothing to be ashamed of, it is just as important as their physical health. If your child has a broken leg, you would rush them into the doctor for treatment. If your child seems “stuck” in weeks of sadness or withdrawal from activities they used to enjoy, it’s time to take them into the doctor for treatment.

Same, same.

For more information on the CHOC Children’s pediatric mental health initiative visit:

www.choc.org/giving/mental-health/lets-talk-about-it

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Glass Slipper Guild Gala 2014

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Glass Slipper Guild Gala 2014

The Glass Slipper Guild Gala 2014 will be held the evening of Saturday, May 17th at the beautiful Big Canyon Country Club in Newport Beach.

This year’s theme is Speakeasy Soiree and will be an outdoor formal occasion featuring  amazing Silent/Live Auctions, stirring speakers and a fun speakeasy post-party.

CHOC Children’s is the only private, not-for-private hospital in Orange County devoted to the health and well being of children, regardless of their families ability to pay.

The Glass Slipper Guild is one of 13 guilds that support CHOC Children’s.

The goal of the Glass Slipper Guild is to acquaint the community with the mission and needs of CHOC Children’s and to support the hospital through service and fundraising.

To purchase tickets to this year’s gala and help support fundraising for CHOC’s post-anesthesia unit, click here. They are hoping this will be their largest fundraising year yet!

If you would like to see a video of last year’s Gala and the fun in store at the event, click here.

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