6 Tips to help your children cope with trauma

The media is full of stories that can cause your child to become anxious, stressed or fearful.  Shootings, school violence, and natural disasters are all events that may trigger trauma.

AUR-0545Events such as this can cause post-traumatic stress reactions, which can range from mild to severe. Reaction to trauma can overwhelm a child’s ability to cope.

Munther Barakat, PsyD is a psychologist in the Child & Adolescent Day treatment program at Aurora Psychiatric Hospital. Here are his suggestions for minimizing the impact of post-traumatic stress reactions.

    • Early intervention in childhood psychic trauma is important. Families that offer support, understanding, and a sense of safety as close to the time of the traumatic event as possible can effectively limit the effects of trauma on a child.
    • Try to keep normal routines. Kids gain security from the predictability of routine.
    • It is important to limit the amount of time spent watching the news because constant exposure may actually heighten their anxiety and fears.
    • Talk about the events with your child to the level your child is developmentally able to handle. It is unlikely they have not heard about the event from peers, social media or news and television. Not talking about it can make the event even more threatening. PBS Parents offers help on how to talk with children about news events.
    • Assure children that they are safe and so are their schools.

Munther Barakat is a doctor of psychology at Aurora Psychiatric Hospital in Wauwatosa.

  • Watch for signs of stress, fear or anxiety. It may also a good idea to consult a child and adolescent psychiatrist or other mental health professional for evaluation and treatment if behaviors are severe.

If your child, or a child you know has experienced trauma, contact us at 1-877-666-7223 or visit the Aurora Psychiatric Hospital website.

For more information on trauma, visit these resources:

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How are your children affected by traumatic events in the media?

Events reported in the media can very traumatic for all of us. And the impact of trauma on children can be particularly devastating to their development. Left untreated, all but the mildest of childhood trauma can have an impact on the child.

Trauma is defined as an “event outside normal human experience”. These events are generally emotionally painful and distressing, and overwhelm a person’s ability to cope, The person’s response involves intense fear, helplessness, or horror.

American Academy of Child and Adolescent Psychiatry identifies 2 types of trauma: One-episode Trauma, and Repeated Trauma. One-episode trauma is the result of a specific “event”.

Repeated trauma can include situations of chronic traumatic stress such as repeated neglect, abuse and maltreatment, including physical violence, sexual abuse, repeated verbal abuse and poor early childhood care.

Substance Abuse and Mental Health Services Administration reports
• More than 60% of youth age 17 and younger have been exposed to crime, violence and abuse either directly or indirectly.
• Young children exposed to 5 or more significant adversities in the first 3 years of childhood face a 76 percent likelihood of having one or more delays in their cognitive, language, or emotional development.
• As the number of traumatic events experienced during childhood increases, the risk for the following health problems in adulthood increases: depression; alcoholism; drug abuse; suicide attempts; heart and liver diseases; pregnancy problems; high stress; uncontrollable anger; and family, financial, and job problems.

According to the Attachment & Trauma Network Inc, parenting a traumatized child is very challenging and requires a more focused, trained approach than parenting emotionally healthy children. Traumatized children frequently show signs of emotional delay, often acting much younger than their chronological age. Behaviors can range from being withdrawn and non-responsive to aggressive and violent. Responses to typical parenting techniques, such as time out or removal of privileges are often surprising, and parents’ frustration to the child’s opposition can inadvertently cause the behaviors to escalate.

In a 2006 report on Trauma Informed Care, the National Association for State Mental Health Program Directors indicates long term effects of trauma on a child vary, depending upon many factors:
• Characteristics of the child- age, past trauma experiences
• Characteristics of the trauma-type of trauma, severity, chronicity
• Post-trauma factors: early intervention, social support & symptom resolution

Early intervention in childhood psychic trauma is important. Families that offer support, understanding, and a sense of safety as close to the time of the traumatic event as possible can effectively limit the effects of trauma on a child. Munther Barakat, PsyD, a licensed clinical psychologist who works with children, provides tips for parents on dealing with trauma.  It is also a good idea to consult a child and adolescent psychiatrist or other mental health professional for evaluation and treatment.

If your child, or a child you know has experienced trauma, contact Aurora Psychiatric Hospital at 877-666-7223 or visit our web site at Aurora Psychiatric Hospital.

For more information on trauma visit these resources:

What happens when grown children return home to live?

Kenneth Christian, MS, LCSW is an adult psychotherapist at the Aurora Behavioral Health Center.

Unlike any time we have seen in recent history, grown children are returning home to live with their parents.

A new study by the U.S. Census Bureau shows that males living at home increased to 19% from 14%, and the number of young women returning to the nest rose to 10% from 8% in the last six years. Unemployment at 9%, a weak labor market, fear about the economy, or just a desire to save money are all contributing to this trend.

This can create tension among parents and children alike who are accustomed to living independently. Ken Christian, LCSW, therapist for Aurora Behavioral Health Services offers his advice:

From a parent’s perspective, there are a number of things to keep in mind to help with the transition.

  • Flexibility:  Give them space, they will have different ideas about curfews, habits, etc.  Give them options, within reason.  You no longer should be expected to pick up after them (if that was ever the case).
  • Patience:  Issues will come up.  Stop and think before jumping in with knee-jerk reaction.  They are used to having more independence and won’t want to give that up. . . setting the state quickly for conflict.
  • Understanding:  Their priorities have changed.  Don’t assume it will be the same as when they were in high school.
  • Limits:  Basics, common courtesy, kids may have acquired some values (while gone) different from what you taught them, however when under your roof your values still prevail.  If they don’t have a curfew that doesn’t mean they can stumble in noisily at 3:00 a.m.
  • Your choices:  There has been much discussion over whether or not to charge a grown child rent.  This depends on circumstances, both theirs and yours.  If the purpose of living at home is saving money for a legitimate purpose, such as buying a house or saving for school, rent might be ignored.  But if there is no specific goal or plan and the grown child is working, then rent lets them know they are adults and expected to pay their own way.  By the way, paying rent does not give them the right to overlook your values or your rules.
  • Opportunity:  For you to continue to set examples which were on some levels overlooked when the kids were younger.
  • Give options and examples:  as opposed to using language like “You need to.”  Give them the benefit of your years of experience without dictating to them.  What seemed natural in grade school will no longer work; only irritate and stir up friction.
  • Speak positively about goals/potential goals.  If they’ve moved back in as an adult there’s a good chance their plans aren’t working out as they may have planned.  This creates tension and uncertainty in their life and the last they thing they need is any kind of ?message that they may in some way have failed or are not measuring up.  It’s called giving unconditional love, not to be confused with “You are an adult so I don’t have any right to tell you what to do.”

Be firm in a caring way—try to refrain from giving ultimatums!

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

How do you manage through times of emotional distress, depression and anxiety?

Major crises, such as the loss of a job, health or relationship, can put anyone into this situation.

Dr. Gregory Schramka is a behavioral health supervisor at Aurora Psychiatric Hospital.

I just learned of a dear friend, who lost her job due to the economic downturn. She responded as many people do – she became sad, she suffered from low self-esteem, she lost motivation to keep searching for a new job. I wondered what I could do to help her.

Greg Schramka, PsyD, Director of Behavioral Health Therapy at Aurora Psychiatric Hospital, describes this as avoidance behavior – staying in bed, withdrawing from friends, exercise or normal routines – that can tend to lead to, maintain or worsen depression.

“People often resort to avoidance to escape stressful events and depressive feelings. Individuals need to identify personally meaningful activities and be encouraged to schedule them into their week and carry them out regardless of their mood.”

So I will encourage my friend to take action (one of the concepts behind a research-supported therapy used by Dr. Schramka called Behavioral Activation), and to break patterns of avoidance. I understand that is may be far from easy for her.  And if she needs more help, professional therapy is available.

For more information about treatment for individuals experiencing emotional distress, feelings of hopelessness, or depression, visit the web site for Aurora Psychiatric Hospital.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

Tips for parents with strong-willed children

Do you know of a strong-willed child?  Is it impossible to get your child to go to bed?  Does your child struggle with taking directions from you?  If you’ve answered yes to these two questions you may be dealing with a strong-willed child.

Parents of strong-willed children are often left feeling frustrated.  They spend countless hours feeling guilty for vacillating between feelings of dislike for their children and questioning what went wrong to create such a child.

Children who are classified as strong- willed tend to be overly independent, stubborn, screams, has increased temper tantrums, demands attention,  is sassy, and can be aggressive.  As they become older, parents may report behaviors such as defiance, disrespectful and even verbally and/or physically abusive.  However, these same children when channeled appropriately can become kind, nurturing, are fast learners, and display leadership qualities.

The question is how do we promote more compliance and create a calmer environment from children that are stubborn or strong- willed?

Aurora Behavioral Health Services offers a few quick practices to help a parent get on the right track:

  • Try to structure the child’s play as much as possible to avoid moments of unobserved frustration.  It is important to observe the child trying to make sense of their world, in order to assist them with the correct way to respond to challenges.
  • Physically interact and play with your child.  It is easy to become distracted in our busy day to day lives where we allow our children to entertain themselves with the ills of technology and media.
  • Ignore inappropriate behaviors.  Children will often engage in behaviors that are annoying, disrespectful and bad-mannered.  If the behaviors do not pose a physical threat to yourself or your child, ignore them.
  • The most important thing we can do to diminish stubborn behaviors is to “catch them being good” and reward those behaviors.  Rewards are often viewed by parents as paying a child to do something that they should naturally be doing.  However, social rewards are the most effective rewards.  Social rewards involve praising a child for good manners, acknowledging sharing with a smile, and a pat on the back for working hard.  These are the rewards that children yearn for and that parents most often take for granted.

There are many ways to begin to alleviate those frustrating behaviors displayed by a child.  It is important for parents to understand that you cannot create a strong -willed child.   Unfortunately the combination of one’s environment and a child’s temperament can influence problematic behaviors from strong- willed children. Specific situations such as divorcing parents, alcoholism within the family, inconsistent responses to behavior problems, and overall family stress can trigger strong-willed behavior in young children.

The most difficult challenge for parents is to recognize that they may need to change how they are responding and interacting with their child.  Problematic behaviors can be exacerbated through inconsistent interactions and attending to inappropriate behaviors.

If you’ve recognized any of these behaviors in a child and want further resources on how to deal with strong-willed children, contact Aurora Behavioral Health Services for outpatient counseling or access to the Child and Adolescent Day Treatment Program.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

Why it’s SO hard to keep your New Year’s resolutions?

Over 40 percent of American adults make one or more resolutions each year. But how long do they actually last?

  • Over one week: 75%
  • Over 2 weeks: 71%
  • Over one month: 64%
  • Over 6 months: 46%

Data shows only 12 percent of people making New Year’s resolutions actually achieve them. The problem is that many of us don’t understand what New Year’s resolutions are about- namely, change, usually significant life change. Anyone who has ever tried to change their thinking, emotions, or behavior knows how difficult it is.

So the question that must be asked is: why do we have such a hard time making significant changes in our lives? Continue reading

Are you having a Blue Christmas?

Like me, many of you grew up listening to the song “Blue Christmas” by Elvis Presley. For me it was a holiday tradition, with great harmonies by the Jordaires and one of my favorite Christmas albums. But I never really gave much thought to those who do experience a Blue Christmas.

For many folks this time of year is not a happy, joyful experience. It is common for those that have lost loved ones, divorced, or those with family deployed in the military. For some people, it is a time of self-evaluation, loneliness, reflection on past failures and anxiety about an uncertain future.

The holidays can also exacerbate depression in someone who already suffers from it. Additionally, fluctuations in weather and sunlight caused by the changing seasons can influence depressive symptoms, such as those   experienced by people with seasonal affective disorder.

According to the National Institute of Mental Health, about 19 million American adults suffer from depressive illnesses every year. Unfortunately, many people with clinical depression don’t seek help, even though depression is a treatable condition.

The holiday blues refers to specific feelings and symptoms that can mimic depression such as:

  • Depressed mood
  • Decreased interest in life activities normally enjoyed such as social gatherings, shopping, cooking, hobbies
  • Feeling overwhelmed
  • Irritability
  • Fatigue, feeling drained physically and emotionally
  • Sleep or appetite disturbances
  • Anxiety, feeling nervous, edgy or “keyed up”
  • Excessive guilt

Here are some ways to alleviate the holiday blues:

  • Stay connected.  The worse thing you can do for the holiday blues is to isolate yourself. Many people who are depressed during the holidays are also lonely. Spend time with supportive and caring people. Reach out and make new friends, or contact someone you haven’t heard from in a while.
  • Write a gratitude letter.  Write a letter of gratitude to your parents, God, or yourself – detailing all the things that ARE great about your life today. Focus on the positive will be beneficial.
  • Do something for someone else. Try volunteering some of your time to help others.
  • Get moving.  Exercise – even mild exercise – helps alleviate the symptoms of depression. Taking a brisk walk in the am before your day or to wind down after your day – is a great way to beat the blues.
  • Avoid drinking and drugs.  While you may experience a temporary numbing effect – your feelings of “the blues” will only become magnified once you come down off of your drug of choice.
  • Pace yourself.  If you are feeling depressed, don’t say “yes” to everything. Take on one thing or nothing if need be. Do what you feel is realistic.
  • Tell someone.  It will be easier to get through the holidays if someone else knows how hard it is for you. People that love you – want to help.  Talking about what is going on with you emotionally (in talk therapy) is one of the best ways to get through a depression of any kind.

If you or someone you know is experiencing a blue Christmas, click here or a free, confidential, on-line depression screening tool. For more information about depression,  contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services

How are your eating habits affected by the holidays?

For many, the holidays represent food-oriented festivities. For individuals with disordered eating, the holidays can be anxiety provoking and overwhelming.   The fact that many of us celebrate the holidays with special meals, treats and parties, can pose a special challenge to our loved ones with eating disorders.

Sandra Blaies, licensed clinical social worker and  Eating Disorder Program supervisor at Aurora Psychiatric Hospital, provides the following suggestions for families dealing with an eating disorder — or for anyone who wants to eat well during the holidays.

  • Try making your family’s holiday traditions more about relationships and activities than about food.
  • The key to success is preparation. Knowing the details of holiday events will minimize stress, anxiety and fear associated with parties, meals and holiday gatherings. Planning ahead will go a long way toward successfully navigating these challenging times.
  • Rely on the support of family, friends and treatment professionals. Establish a good support system and have them on speed dial.
  • Talk to other family members in advance about not pushing food or commenting on diets, calories, or weight loss. Even too much emphasis on trying to make healthy choices at holiday meals can add to the stress.
  • Know how to take a break when events become overwhelming.
  • Remember that it is okay to enjoy food.  There is nothing wrong with having a holiday treat!

Holiday meals can also be a time for progress. Knowing that you need to have your usual good breakfast, that you can negotiate serving sizes and other choices, and planning  what to eat (focusing on taking care of the basic food groups: protein, carbs, calcium, fat, veggies) are good steps to recovery.

NEDA (National Eating Disorder Association) also has 12 ideas to help people with eating disorders during the holiday season.

If you or someone you know may be struggling with an eating disorder, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.

Are you stressed out by the holiday season?

Stress is a year-round fact of life. But does your stress level increase during the holidays?

Family conflict, “Martha Stewart syndrome”, taking on too much and overspending are just some of the additional stressors you may experience at this time of year.

Holiday stress statistics reported by the American Psychological Association show that up to 69% of people are stressed by the feeling of having a “lack of time”, 69% are stressed by perceiving a “lack of money”, and 51% feel stressed out over the “pressure to give or get gifts”.

Stress is the perception of pressure, tension, worry, fear, dread or anxiety. The way we respond to stress can exacerbate, or even create physical and emotional problems.

Stress contributes to problems such as allergies, muscle tension, upset stomach or heartburn, sore throats, sinus infections, colds & flu, migraine or tension headaches, sleep disorders, high blood pressure, angina, heart disease and heart attacks. And many individuals develop unhealthy behaviors to cope with stress: overeating, using alcohol or drugs, or irritability.

Begin reducing your stress today.

  • Learn to relax
  • Control, change, or let go of what you cannot change
  • Create time to do what you enjoy during the holidays

Change your reaction to the stressful situation.

  • Find the positive
  • Slow down. Think before you react
  • Learn to recognize when you are upset or worried about things you cannot control or change.
  • Avoid spending energy blaming, holding a grudge, or resentment
  • Use the word “no” – sometimes you need to set limits

Embrace healthy ways to manage stress.

  • Get enough sleep
  • Eat & drink in moderation
  • Stay on budget
  • Plan ahead and don’t overextend yourself. Don’t be afraid to ask for help, and delegate when possible
  • Relax
  • Nurture your relationships
  • Use stress management techniques, like deep breathing exercises, visualization, progressive muscle relaxation, exercise or yoga can help manage stress (click here for a free, downloadable meditation exercise)

For more information about managing holiday stress, visit our Stress Resource Center and take our confidential Stress Assessment.

If you or someone you know is experiencing high levels of stress, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.

Work-life balance: are you tipping over the edge?

Kimberlee Moster, Aurora Behavioral Services therapist

Anthem Blue Cross Blue Shield hosted a Women’s Health Initiative Event held September 8 at the Country Springs Hotel in Waukesha.  This was the fourth year that Aurora Health Care has partnered with Anthem to bring this event to Anthem’s client businesses and prospective clients.

Over 150 community businesswomen attended the event, which included on site health screenings, health information, local health providers and vendors, chair massages, interactive exhibits, healthy cooking demonstrations and “Healthy Chat” presentations.  The keynote speaker was author and nutritionist, David Meinz,  known as “America’s Personal Health Improvement Expert”.

Kimberlee Moster, LPC, a therapist with Aurora Behavioral Health Services, provided one of the Health Chat presentations, discussing Work–Life Balance.  “This is an issue so important for working women.” said Kim. “With all the roles women must fill, it’s hard to find the balance needed to stay healthy and happy. When we overextend ourselves in our work or at home, we are under-extending ourselves in every other aspect of our lives”

Here are some of Kim’s recommendations for finding balance.

  • Prioritize:
    • Prioritize your reasons for working. Focusing on the rewards of work helps to maintain a more positive attitude about your job.
    • Prioritize your responsibilities at home. Anytime someone feels burdened with too many responsibilities it is usually because the priorities have not been discussed.
  • Don’t set unrealistically high expectations for perfection – watch out for “shoulds”
  • Careful of the need to do and have it all – “have to” vs “need to” vs “want to”
  • Practice deep breathing or relaxation exercises
  • Set limits
  • Delegate
  • Have a support system

If you are feeling overwhelmed and stressed, you may find it helpful to work with a therapist. Contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services