Author: <span>Beth Church</span>

Men’s Health: Strength & Courage in Pursuit of Mental Wellness

Written by: Dr. Darren Jones, PhD, LP
Edited by: Dr. Julie Braciszewski, PhD, LP

Currently, men are experiencing mental health distress at alarmingly high rates. This distress may look different than stereotypical anxiety or depression, but causes just as much disruption in life. Research tells us that men tend to focus distress outward, engaging in externalizing behaviors such as initiating more relationship conflict, throwing themselves into work, using alcohol or other substances, and/or increasing time spent on ‘escape’ type activities such as video games.  Despite how disruptive these behaviors might be to their lives, men are far less likely than others to seek help. One of the main reasons is due to the stigma associated with seeking mental health services. Though there has been notable progress in reducing the stigma of seeking mental health services in recent years, there is still much work to be done.

Where Does Stigma Come From?

On average boys receive less social emotional coaching as compared to girls. Throughout childhood, adolescence, and into manhood, men receive messages that often inhibit and even punish genuine emotional expression and help seeking. This creates significant barriers to acknowledging distress and seeking effective help. In fact, we know men are currently suffering from high rates of anxiety and depression. In a 2021 survey, 82% of U.S. men ages 25-45 reported moderate to severe feelings of stress, 73% reported symptoms of anxiety, and over 61% reported symptoms of depression. Given that the last several years have increased most individual’s stress, and mental health distress is at an all time high, we must battle the stereotypes that keep men from getting effective care.

A research article published earlier this year in the American Journal of Men’s Health addresses this important topic. The authors reviewed published research from the past decade on the stigma surrounding men’s mental health. They reported that a consistent finding was that men frequently internalize a stereotyped male identity that assumes that being a man means being strong, self-reliant, and healthy. Internalizing means that men often self-identify with and judge themselves against these ‘standards’. These same stereotypes view men with mental health issues as being weak, inadequate, and unmanly. These stereotypes contribute to stigma that creates a barrier for men to access and engage in mental health treatment.

The good news is that all men can play a valuable role in reducing this stigma. The authors describe three promising strategies to pursue.

Peer Support Breaks Stereotypes

First, the role of peer support is vital. Men who experience mental health issues can serve as important sources of support for other men who need services. Setting up formal peer support networks are one way that organizations and communities can encourage and facilitate these connections. However, on a more personal level, informing your friends, dad, uncles, neighbors and coworkers that you are experiencing mental health distress and are seeking out mental health support can also facilitate peer support. Sharing your experiences draws these peer support networks together and more men in your life are likely to seek the support they deserve.

Mental Health Literacy Among Men

Second, mental health literacy can be improved by creating opportunities for men to have interactions with mental health professionals that include positive messaging. Consider inviting a mental health professional to deliver a presentation to your company, church, or social group. If you have engaged in mental health support, share your knowledge of the process and services.

Help Seeking is Strong and Courageous

Third, when men seek help for mental health issues we should frame that behavior as strength- based and courageous. Let your sons, brothers, friends, and co-workers know that you support them and view their seeking help as a positive and laudatory action.

Men may be socialized to inhibit emotional expression and may be taught fewer or less varied coping skills while growing up. But this doesn’t have to get in the way of obtaining the services and support they need to experience happiness, security, and growth. With rates of mental health distress so high currently, all men have an important opportunity to reduce stigma and play a positive role in helping more people access the care that they need.

 

How Do We Know ADHD is a REAL Disorder?

 

 

Anastasia Skobkareva, MA.
Dr. Julie Braciszewski, PhD.

Some people may think that ADHD is just a set of habits or a quirky personality type, but the truth is far more in-depth and interesting ADHD is a neurodevelopmental disorder that first appears in childhood and continues to affect individuals throughout adulthood. The label neurodevelopmental means that ADHD stems from differences in brain development. These differences in brain development result in difficulties with emotional and behavioral control as well as the brain processes responsible for planning, organizing, and executing tasks. Of course, most people have difficulties with inattention, overactivity, or impulsiveness at times. What distinguishes individuals with ADHD from those without the disorder, is the far greater frequency and severity with which these behavioral and emotional patterns occur, and the far greater impairment these difficulties cause in many areas of life, such as school, home, work, and relationships. ADHD is primarily a disorder of the cognitive abilities needed for self-regulation. These cognitive, or mental abilities are called executive functions and are the fundamental brain processes responsible for organizing goal driven behavior and inhibiting impulses. Individuals with ADHD struggle to remember what needs to be done, make a plan, conceptualize and manage time, remember and follow constraints and rules, identify ways to overcome obstacles, and experience extreme variability in their responses to situations. They also struggle to switch between tasks or situations, inhibit off task or ineffective behavior, and modulate emotional responding. Getting an accurate diagnosis of ADHD can be tricky because several other disorders have overlapping behavioral and emotional symptoms. Because of this, it’s important to understand how we know ADHD is a real disorder, and how we go about making an accurate diagnosis.

How do we know that ADHD is a REAL disorder?

Many people ask, how do you know ADHD is a real disorder? How do you know these difficulties aren’t just ‘bad’ behavior, ‘bad’ habits, or a ‘difficult’ personality? To answer this, we turn to the last several decades of brain research on ADHD. Research clearly and repeatedly indicates that the ADHD brain is developing differently from the non-ADHD brain. When we look at groups of hundreds or even thousands of ADHD brains compared to non-ADHD brains, the differences in brain development between the groups are very clear. This profile of brain development differences is distinct and does not mirror any other disorder or injury. It is incredibly important to dispel any ideas that ADHD is due to an individual simply not trying hard enough or poor behavioral management. Instead, individuals with ADHD, and parents raising kids with ADHD, are often the hardest working people in the room! So why can’t we diagnose ADHD with brain imaging like a CAT scan or MRI? The truth is, ADHD affects several areas and functions of the brain and is a disorder with a wide range of symptoms and presentations. Although we can tell the difference between groups of brains very clearly, when just looking at one individual’s brain imaging results, the information just isn’t enough to ‘see’ ADHD clearly. This is actually the case for many medical disorders and diagnoses that originate or involve the brain. Many disorders can not be detected by brain imaging alone and require further testing, often by a psychologist or medical professional. To diagnose ADHD we use a battery of tests that assess these specific areas of brain functioning, and also rule out all other disorders that have common symptoms with ADHD, such as anxiety disorders and learning disorders. This type of assessment, a neuropsychological assessment, is an accurate way to diagnose ADHD in both children and adults.

What Causes ADHD?

Research suggests that ADHD is a result of one or more issues that affect brain development. In the majority of cases, ADHD brain differences are due to genetics; inherited from parents. In recent years, specific genes and gene mutations have even been identified as likely causing or contributing significantly to ADHD. However, in a minority of cases, brain development delays are due to subtle brain injuries or exposure to substances or toxins that occurs during gestation, birth, or early childhood. We also know that getting the correct treatment helps brain areas affected by ADHD to develop further.

How are ADHD brains developing differently?

We know ADHD is a real disorder and that ADHD brains are developing differently, but in what ways? The brains of individuals with ADHD have structural and functional differences, as well as differences in brain chemistry when compared to typically developing brains.

Brain Activity

Studies using an electroencephalograph (EEG), which measures brain activity, indicate that the electrical activity in brains of children with ADHD is lower than that of typically developing children. Specifically, children with ADHD have an increased amount of slow-wave brain activity which is often associated with immaturity of the brain, drowsiness, and lack of concentration. Children with ADHD have also been found to have less blood flow to the frontal area and in the caudate nucleus, which is important in inhibiting behavior and sustaining attention. Now, you might be wondering how is it that children with ADHD, who appear more active and energetic than children without ADHD, could have brains that are less active? The areas of the brain that are less active in those with ADHD are those areas that are responsible for inhibiting behaviors, delaying responding to situations, and permitting us to think about our potential actions and consequences before we respond. The less active these centers are, the less self-control and self-regulation an individual will be able to demonstrate. Thus, these areas of underactivity result in more difficulty regulating emotional and behavioral responding.

Brain Chemistry

Neurotransmitters are the chemical messengers in the brain that help transmit information from one nerve cell to another. Individuals with ADHD appear to have less of these messengers, or cells in the brain are less sensitive to them. Specifically, evidence seems to point to a problem in how much dopamine (and possibly norepinephrine) is produced and released in the brains of those with ADHD. Therefor, stimulant and non-stimulant medications, used to treat ADHD, work to make more of these chemical messengers available. This helps with communication between brain centers and structures and produces significant improvements in behavioral and emotional regulation of those with ADHD.

Treatment of ADHD: There’s Hope!

Individuals with ADHD posses a great many strengths such as creativity, ability to hyper-focus on tasks and areas of great interest, and less traditional problem-solving approaches. Evidence-based treatment for ADHD often includes medication prescribed by a medical practitioner, as well as Cognitive Behavioral Therapy (CBT) and parent support. Those uncomfortable with medication often engage in CBT alone and experience a great deal of improvement. While CBT helps the individual develop coping strategies and effective patterns of thinking and behaving, treatment also focuses on building personal strengths and positive identity. Although ADHD is a lifelong neurodevelopmental disorder, and symptoms generally persist into adulthood, we do know that children who are treated with medication and therapy (specifically cognitive behavioral therapy with parent support) have the best outcomes in adulthood. Medications and evidence-based therapy appear to improve brain volume and connectivity over time, implying that engaging in treatment may actually help the brain maturation process. The interaction of increased learning opportunities due to proper treatment also has a positive impact on brain growth and connectivity. As an individual with ADHD obtains treatment, they are actually changing their brain! Treatment for pediatric ADHD should also include a parent component. Parenting support focuses on developing parenting practices and strategies, as well as household structure that support the functioning and growth of a child with  ADHD. Kids with ADHD often do not respond to typical parenting strategies and need more ADHD specific support. And finally, treatment for ADHD also involves receiving support and accommodation in the school and/or work environment. Those with ADHD can flourish when they are working simultaneously to use effective coping and capitalize on their strengths.

 

Navigating the Winding Road: The IEP Process

 

Many kids and teens need Individualized Education Plans (IEP) to support their development and education. The IEP process can be an overwhelming and confusing path to navigate as a parent. We want to help make you feel prepared and informed about the process.  The following steps are what will typically occur through the IEP process. 

Alyssa Hedke, MA, TLLP
Written by: Alyssa Hedke, MA, TLLP
Dr. Julie Braciszewski, PhD, LP
Edited by: Dr. Julie Braciszewski, PhD. L

Step 1: Referral

If you, as a parent, are concerned your child may be having learning struggles, social, emotional or behavioral difficulties that are interfering with learning, developmental delay, or any disability that is impacting their education needs you can begin the IEP process. The process begins with a formal request to receive comprehensive evaluation for special education eligibility. This evaluation assesses if your child qualifies for special education services. Each child with an IEP must be shown to qualify for services under one of several categories. This request can be verbal or written; although we recommend a written request for documentation purposes. The Michigan Alliance for Families has sample request letters available for parents to feel prepared without the hassle. We’ve included the link below for your convenience. It’s important to keep a dated copy of this request yourself for records. Someone within the school system who has concerns about your child’s learning or development can also make a request for an evaluation. You will be notified if this happens. Sometimes schools will gather data and/or put informal interventions into place before a child is formally referred for an IEP evaluation. 

Step 2: Parent Notification, MET & REED 

After a formal request has been submitted to the school they have 10  calendar days to respond. The school will either deny the request, stating the reasons why, or agree to conduct the evaluation. A (usually brief) meeting will then be held with parents to review the evaluation process and obtain written consent before the evaluation is conducted. 

Multidisciplinary Evaluation Team (MET) and Review of Existing Evaluation Data (REED)

After the request has been made and accepted, the school assembles a Multidisciplinary Evaluation Team (MET) of professionals to evaluate your child. This team may include general education teachers, special education teachers, psychologists, social workers, therapists, or other specialists. This team engages in the Review of Existing Evaluation Data (REED) to determine what data they have regarding the areas of concern, as well as what additional evaluations must be completed. The team will develop a written report with recommendations for eligibility. 

Evaluations are often requested because parents and/or teachers notice a child is struggling a great deal academically, socially, emotionally/behaviorally or developmentally, but they don’t know exactly why.  It is important to know that the school does not and can not diagnose your child with a learning disability such as Dyslexia or Dysgraphia, language disorder, or neurodevelopmental disorder such as ADHD, Autism Spectrum Disorder, or Developmental Delay. These diagnoses can only be made by qualified professionals outside the school context. A diagnosis can support the case for eligibility in many cases.

Evaluations may be conducted during this time that look at academic functioning, behavioral/emotional functioning, executive functioning, and socio-emotional functioning within the classroom. You can also ask that private professionals, such as your psychologist or counselor are invited to be part of the MET and attend this meeting. The data from the evaluation guides what supports, accommodations and interventions your child may receive. If your child has a disability that has already been identified and documented by a professional (e.g.,. psychologist, medical doctor, speech pathologist, or occupational therapist) this process can be pretty straightforward. 

Diagnoses having to do with learning (e.g., Dyslexia, Dysgraphia, Dyscalculia), socio-emotional or behavioral functioning, neurodevelopment (e.g., ADHD), or developmental delay are generally made by psychologists who work at an outpatient clinic or hospital setting, outside of the school. These diagnoses are typically made after a full psycho-educational or neuropsychological evaluation has been completed. Head over to the psychological assessment/testing page of our website if you would like to learn more about this type of evaluation (https://www.mbh-mi.com/testing/general-information/). You may share the psychologist’s report with the school to help them understand your child’s difficulties and diagnoses. Schools generally use the evaluation data in psychologists’ reports, as well as the recommendations given to help support and structure the IEP.

Step 3: Individualized Educational Planning Team Meeting

A second meeting within 30 school days will be scheduled with the IEP Team to discuss the results of any additional evaluation and your child’s eligibility for special education services. The IEP team includes parents, general education teachers, special education teachers, psychologists, counselors, and a representative from the school. This can be an overwhelming process and meeting for parents, and many parents choose to bring a child advocate to the meeting. This advocate should have a working knowledge of IEP procedures, law, and most importantly, your child. At Monarch Behavioral Health, we frequently attend these meetings with parents. We aim to advocate for evidence-based interventions for children, support parents, forge a partnership with teachers and school staff, and explain psycho-educational or neuro-psychological testing results and diagnoses. 

Once eligibility has been established, the IEP Team will put together an initial IEP. This may or may not already be developed at this meeting. If it is not, parents will receive notification when the IEP is complete and when it will be implemented. Parents will have the opportunity to review the IEP with the IEP Team and get an understanding how the school will be supporting their child’s needs. If you want, after the meeting is over you should be able to take the IEP document to review it at home. Be sure to ask any questions you may have. Once parents sign the IEP and consent, the school will begin implementing the IEP within 15 school days. 

What’s in the IEP?  IEP forms can look different but must include: 

  • Present levels of academic achievement and functional performance. This is information on how your child is doing in school and how their disability may affect progress in the general education curriculum.
  • Specific goals, with specific skills to be taught to reach these goals. These goals must be reasonable and achievable. Goals must also be measurable (this is important!).
  • A clear description of how your child’s progress on their goals will be measured.
  • Special education and related services, including supplementary aids and services they will receive. These are often labeled as accommodations.
  • The amount of time during the school day your child will spend apart from the general education classroom.
  • The amount of time weekly or monthly the child will receive services from specific persons or programs in the school (e.g., reading recovery specialist, speech pathologist, occupational therapist, school psychologist, ect.) 
  • The status of your child’s participation in state and district tests, including their test accommodations. 
  • The projected start date for services and modifications provided for your child including, where, how often, and how long. 

Step 4: Implementation & Progress Monitoring

Progress monitoring is used to assess your child’s academic, behavioral, executive functioning, and socio-emotional functioning on IEP goals and evaluate the effectiveness of interventions and instruction as the year progresses. Progress monitoring tells the teacher what a child has learned and what still needs to be taught.  Monitoring should determine your child’s current level of performance, measure your child’s performance on a regular basis, and compare the expected progress to their actual performance.  We encourage actual data to be collected for monitoring, as opposed to teachers and staff’s general impressions. During this step the IEP team will consider changes to instruction or services when your child’s progress toward goals is not being made, process is slower than expected, or the goals have been met. There is no set timeline for progress monitoring. We often suggest progress monitoring be done monthly for new IEPs, and quarterly for ongoing IEPs.

Step 5: Annual Review

You should meet with the IEP team at least every 12 months for an annual review. Annual reviews often take place in the spring, as the school year is drawing to a close. At this time, the team will examine your child’s progress towards goals and make appropriate updates as they develop. It is recommended parents ask about the specific measurement of these goals. A parent or school team member may request an IEP review prior to the annual 12 month meeting if the need arises.

Step 6: Three Year Re-Evaluation

Every three years, the IEP team will do a formal re-evaluation to document a student’s changing needs and consider progress on goals.  Reevaluation will look similar to the initial evaluation. It begins with a Review of Existing Evaluation Data (REED) available for the child, and may include the child’s classroom work, discipline records, performance on State or district assessments, and information provided by the parents. If needed, the school may conduct an updated evaluation on academic, behavioral, executive functioning, and socio-emotional functioning. Parents often seek an updated psycho-educational or neuropsychological assessment from a professional outside the school at this time to support and add to the REED. Similar to the initial IEP meeting, parents will sit down with the team and come up with a revamped IEP, setting new goals and delineating new services, supports and accommodations.  Again, parents often choose to invite a child advocate to this meeting.

Importance of Documentation

We encourage all data and interventions to be formally documented. When changes in interventions and approaches occur, amendments can be made to the IEP. Although we appreciate all the informal strategies and approaches teachers and school staff take to address a kid’s needs, when these strategies and approaches are not documented, we lose an account of what worked and what didn’t. An important purpose of the IEP is to create a road map. This road map serves the child now, as well as in the future years. We encourage parents to keep all their child’s IEP documents and evaluation data. Keeping these documents organized can help you feel better prepared for meetings and stay up to date on your child’s progress. Reviewing these documents also often gives helpful ideas and support for interventions down the road.

GREAT TIP!

Making an IEP binder is a great way to keep information organized and at the ready when you need it. This tool can help you communicate and collaborate with teachers and  your child’s IEP team. The binder can include communication logs where you keep track of meetings, phone calls, letters, emails, and other important interactions with the school. It is important to keep track of evaluations, evaluation reports, standardized and state testing data, and your consent forms. It’s also a good idea to have copies of the IEP handy since they need to be updated annually. You’ll be able to look at the exact changes made at IEP updates, as well as when services started or ended. Report cards and progress notes can help you monitor your child’s progress toward each annual goal in the IEP. Sample work can be included that shows signs of progress or concerns. Lastly, keep a copy (if included) of your child’s behavior intervention plan or contract to see how your child is progressing in the classroom. 

Even though all school districts will have slightly different procedures in place, always ask when the following steps are not conducted. The steps include; 1) Referral, 2) Parent Notification, MET & REED, Additional Evaluation, 3) Individualized Educational Planning Meeting,  4) IEP Implementation with Progress Monitoring, 5) Annual Review, and 6) Re-evaluation.

We know the IEP process can be daunting to navigate as parents. Don’t hesitate to reach out for support and consultation. At Monarch Behavioral Health we work closely with families, school staff,  and administration to advocate, create, and implement individualized school accommodations that work for your child.

Need more? 

IEP Resource Guide 

If your family needs additional support and guidance through the IEP process and  want to gather more information for empowerment look at the  following websites listed below. 

Michigan Alliance for Families

Michigan Alliance for Families is a statewide resource that connects families of children with disabilities to resources to help improve their children’s education. They assist in facilitating parent involvement as a means of improving educational services and outcomes for students with disabilities. This resource assists you in knowing your rights, how to effectively communicate your child’s needs, and advises on how to help your child develop, learn, and thrive in the school context.  

https://www.michiganallianceforfamilies.org 

 

Student Advocacy Center of Michigan 

The Student Advocacy Center of Michigan is another statewide resource that supports families in knowing their rights by understanding policies, laws, and processes. They provide free templates for building letters needed throughout the IEP process. Bonus! They also provide a Statewide Helpline  for general education and special education students to receive free support and education advocacy advice every step of the way. 

https://www.studentadvocacycenter.org

 

Disability Rights- Michigan 

Disability Rights of Michigan is a federally mandated protect and advocacy system for Michigan. A wonderful resource manual they provide families with is the  “Students with Disabilities: An Advocate’s Guide”.  Each chapter includes a brief summary, a list of “Advocacy Hints,” detailed descriptions of state and federal rights, sample letters, and resources for more information.

https://www.drmich.org/resources/special-education/

                                                           

Emotions are the Solution, Not the Enemy

Written by Mareena Atalla, MA, TLLP
Edited by Julie Braciszewski, PhD, LP 

Emotions are our constant companions, ever present and impacting us. We spend a lot of time trying to manage them, push them down, and fence them off. However, emotions are hard-wired in our brains and bodies. This hard-wired system is designed to keep us safe, motivate us, and connect us with others. If we are open to shifting our perspective and accepting that all emotions are useful and important, not just the pleasant ones, we just might be able to accept them, manage them, and hone our ability to use them as a guidance system. If we experience all of our emotions we gain more of what we want and need in life.

 Shifting Perspectives: Emotions can be difficult, but they are not “bad”

Emotions are often labeled as “positive” or “negative.” Most people learn very early in life that emotions like anxiety, sadness, and anger are “bad”, are signs of weakness and/or are to be avoided. We are told that the ‘good’ emotions are the ones we must strive to feel and show to others. However, the perspective that only ‘positive’ emotions are ‘good’ leads to shame and embarrassment, which then lead us to ignore or suppress more difficult emotions. However, this usually makes the feelings and situations worse. What if I told you all emotions are of equal value? Really think about it; consider that your sadness is just as important and valuable as your happiness. How would this perspective change your experiences? We think that in a perfect world, people would feel positive emotions such as happiness, excitement, joy, love, or curiosity all of the time. However, it is the vast experience of emotion, and the contrast between pleasurable and difficult emotions that paint the landscape of our lives. Emotions motivate and guide us through situations, interactions, and decisions. We must have a full range of emotional experience to engage in life. All emotions are equally valuable because they tell us very important information about ourselves, others, and our experiences. We know that many emotions are difficult and painful to deal with, but it is important to allow ourselves to feel all emotions in order to be able to learn from and cope with them. By accepting all of our feelings as equal in value and importance, we can better learn to express and cope with them.

Alert! Alert! Emotions are a signal

All emotions serve a purpose, and if we understand them as signals, telling us what to be aware of and what to do next, we are much more effective in getting what we want and what we need. What we call emotions are actually a cascade of thoughts, brain reactions, and bodily reactions. First, our brain reacts to a situation, we may or may not have an interpretive thought, and this reaction or thought then result in signals sent to our body. For instance, when we are faced with difficult situations, our brain’s stress-response system sends a signal to our body that something might be wrong, so that we can decide what to do next. If our brain thinks we might be in danger, it sends stress hormones through our body to protect us. These hormones translate directly into bodily reactions. For instance, our heart beats faster to get more blood and oxygen to our body, in case we need to run or fight for our lives. Our breathing also becomes faster as our lungs work to get more oxygen into our body. Our pupils dilate to help us scan our environment better. We label these bodily sensations as emotions, such as nervous or irritated, and we are motivated to act. We might fight, freeze, or run away. When we are feeling sad, our brain signals to our body that we need to rest and recover. This is why we often feel tired and drained when we experience sadness or grief. Paying attention to what we feel in our body can help us understand what our emotions are guiding us to do to meet the demands of a situation. When we are disconnected from our emotions, we are disconnected from solutions.

 The Mind-Body Connection

Emotions are the lens we view the world through; hence the saying, seeing something through ‘rose colored glasses’. The physical aspects of emotions influence our thoughts and behaviors a great deal. This may seem obvious, but often times it’s not so obvious in our daily experiences. When we understand that emotions are interconnected with our bodily sensations, thoughts, motivations and behaviors, we can, in turn, learn how to manage these different experiences of emotions. For instance, when we are angry, we tend to think angry thoughts. Thinking angry thoughts then feeds and fuels our emotion further, and leads us to want to act on our anger. The stronger the emotion, the more intense the motivation, sometimes leading to decisions or actions that don’t work for us, or that we regret. Now here’s were the work comes in! We learn to identify the emotion, increase awareness of bodily sensations, and use this insight to guide us toward what we need. Coping skills can be used to manage the physical feelings and behavior urges that come with intense emotions. We can then effectively explore the thoughts that might be colored by those emotions, and consider what actions best meet our needs or wants. We can’t control how our body reacts or what thoughts initially pop into our heads, but we can control how we look through the lens.

 The Mind-Body Connection

One way of gaining insight and control over emotions is to increase awareness and control of bodily reactions. Although some people are skeptical about breathing and grounding exercises, science shows us that using these strategies can send a signal to the part of the brain that turns down the “stress-response system” (sympathetic nervous system), and turns up the “calm down system” (para-sympathetic nervous system). Active strategies that use your whole body help to regulate stronger bodily responses to emotions, especially frustration and anger. These techniques aim to help you focus on something else, while calming and shifting your bodily responses and sensations.

The 4-7-8 breathing technique: Slowly breathe in through your nose for 4 seconds, hold your breathe for 7 seconds, and breathe out slowly through your mouth for 8 seconds. Repeat this sequence until you feel your body calm down.

Five senses grounding: Acknowledge 5 things you see around you. Acknowledge 4 things you can touch around you. Acknowledge 3 things you hear. Acknowledge 2 things you can smell. Acknowledge 1 thing you can taste.

Move your body! Sometimes, our emotions feel so strong that the calming techniques above are not enough to release that emotional energy. Instead, moving your body around can help release that built up energy. Play one of your favorite fast-paced songs and dance around! Go for a run or bike ride! Kick or throw a ball around! These strategies are meant to help you focus on the activity, while moving your entire body, to release the built up energy that emotions give us.

 Put it all together

When we see emotions as equally valuable, we can harness the power of a full range of emotional experiences. These experiences provide us with incredibly important signs and signals, guiding our expression, behaviors, and choices. This leads us to be more effective in getting more of what we want and need.  However, to ensure we don’t feel overwhelmed by these experiences, we also must attune to our bodily responses and learn to turn the dial up or down.  Stay tuned for more on recognizing and managing thought patterns.

*Click on this link to view a “Feelings Wheel” which can help you identify and express your emotions using different terms that describe different levels of the common emotions humans feel.

https://feelingswheel.com/

 

Responding to Mass Violence: Resources for Parents, Teens, Kids, and Teachers

We extend our deepest sympathies to all who were affected by the violent events at Oxford High School. In the aftermath of a tragic event it can feel difficult and overwhelming to provide the needed support and care.  Below are resources to help guide families, teens, school staff and providers through this time. Please reach out for additional support.

Resources in Response to the Oxford High School Shooting

National Child Traumatic Stress Network has developed resources to help families and communities:

·          For Teens: Coping After Mass Violence

·          Tips for Parents on Media Coverage

·          Parent Guidelines for Helping Youth after the Recent Shooting (Also in Spanish)

·          Tip Sheet for Youth Talking to Journalists about the Shooting

·          Talking to Children about the Shooting

·          Helping Youth After a Community Trauma: Tips for Educators

·          Helping Teens with Traumatic Grief: Tips for Caregivers

·          Helping School-Age Children with Traumatic Grief: Tips for Caregivers

·          Helping Young Children with Traumatic Grief: Tips for Caregivers

·          After the Injury—website for families with injured children

·          Health Care Toolbox—website for pediatric health providers working with injured children

Psychological First Aid

The NCTSN also has resources for responders on Psychological First Aid (PFA). PFA is an early intervention to support children, adolescents, adults, and families impacted by these types of events. PFA Mobile is an app that can be accessed for free on Apple and Android mobile devices. Additional PFA resources include:

·          Psychological First Aid for Schools (PFA-S) – field operations guide

·          Providing PFA-S: For Health-Related Professionals – handout

·          Providing PFA-S: For Principals and Administrators – handout

·          Providing PFA-S: For School Support Staff – handout

·          Providing PFA-S: For Teachers – handout

Disaster Hotline

SAMHSA has a Disaster Distress Helpline – call or text 1-800-985-5990 (for Spanish, press “2”) to be connected to a trained counselor 24/7/365.

Decoding Dyslexia

October 22, 2021

Julie Braciszewski, PhD, LP  &  Alyssa Hedke, MA, TLLP

 

Dyslexia is tricky to spot! Although stereotypes of Dyslexia may conjure up visions of ‘reading backwards’ or ‘seeing numbers and letters reversed’,  that isn’t the way Dyslexia typically presents.  Read our info sheet below to learn more about early signs of Dyslexia, testing, and treatment.

 

 

Julie Braciszewski, PhD, LP

 

Alyssa Hedke, MA, TLLP

 

 

Gratitude Grows Mental Wellness

November 9, 2021

Julie Braciszewski, Ph.D.

 As we move into this season of gratitude, I think it’s helpful to highlight just how connected the experience, mindset, and expression of gratitude is to mental wellness. Gratitude gives your mental and physical health a boost, improving mood, squashing anxiety, positively affecting relationships, and even leading to positive health outcomes such as improved sleep and lower blood pressure. Gratitude helps connect what we already have, to what we want in the future, and often moves people’s thinking patterns in a more optimistic direction. But we don’t have to stop there, because expressing gratitude to others actually increases positive social and family bonds! People who express gratitude to others often report feeling more connected and more loved. And who among us would not like to feel more connected and more loved? Gratitude is like a sling-shot of positivity. When we give it to others, it swings around and affects our own mental health and well-being in several positive ways.

Make gratitude part of your daily routine

When do you or your family have a still moment? Is it in the car? Bedtime? Mealtime? During these quieter moments, ask yourself, your partner, and/or your kids about one thing they felt grateful for each day. Make it part of a routine check-in at the same time every day and soon your mind will be trained to think of gratitude each and every day.

Make it physical

By making something physical that represents our gratitude, the experience, thoughts, and emotions surrounding gratitude stick with us longer. For example, you can make a large picture of a tree and grow your ‘gratitude leaves’. Each person in the household writes moments of gratitude on leaves and sticks them onto the tree. It’s so fun, gratifying and heart-warming to see your tree bloom over several weeks.

Pay it forward

Of course, one of the best expressions of gratitude is to donate or volunteer your time and energy to benefit others. Although we might feel short on time and energy lately, plenty of research supports the fact that volunteering promotes positive mental health. Stepping outside our own experiences and problems to act and work on behalf of others helps us see the positive impact we can have in this world.

Our expressions of gratitude not only have positive impacts on others, but also provide ourselves with connection and resilience. I hope this season you are both on the receiving and the giving end of lots of gratitude.

Julie Braciszewski, PhD, LP

                 

Calming Back to School Jitters:

 

Alyssa Hedke, MA, LLPC

As the days draw a bit shorter, the end of summer marks the beginning of a new school year. Children prepare by picking out their new backpacks and wait in anticipation for their room assignments, all while soaking up the last of the summer sun.  As parents, we want to send our children out into the new school year feeling prepared, confident, and excited. However, we enter this new school year bringing with us the experiences of managing life during a global pandemic. The changes in routines, family life, and ongoing pandemic continue to affect us all. Your child may be more nervous, anxious, fearful, or unsure compared to years past. Here are 4 ways to help with the new school year jitters.

Talk to your child:

Start by talking with your child!  I know it sounds simple – but it takes purpose and planning to set the time aside and initiate the conversation. Research has shown us that children and youth who discussed the pandemic with their parents were less likely to develop stress, depression, and anxiety symptoms. Many parents try to shelter children from current events, but we know that providing measured and purposeful information helps reduce anxiety. Additionally, children often do not talk about their concerns because of confusion or fear of worrying their loved ones.  Encourage them to verbalize their thoughts and feelings about the new school year and let their questions guide you. It’s important to remember that how we discuss COVID can increase or decrease our children’s’ fears. Don’t avoid giving them information that experts say is crucial to their well-being and staying healthy. You should answer your children truthfully and help them develop their expectations for the school year, routines (e.g., masks or no masks, seating at lunch, what will happen at their school if someone gets sick). However, leave out unnecessary details and unknown factors. It’s also ok to say, ‘I don’t know, but we will work together to figure it out.’ This is a great opportunity for modeling calm in the face of ambiguity, as well as collaborative problem solving. You can be a good listener while providing the love and reassurance your child needs.

During unpredictable times, foster a sense of control:

Before the pandemic, schools were a source of consistency in our children’s lives.  For most families, the 20/21 school year included constant changes which disrupted our daily schedules for months on end.  Keeping your child on a regular schedule provides a sense of control, calm, well-being, and predictability.  We can foster our children’s sense of control this fall by structuring schedules and expectations. First, think about your fall schedule and work with your child to make a daily or weekly calendar. Use blocks of color to represent places of activities to make it as visual as possible.  You may think this would only benefit younger children, but we find it very effective with high schoolers and even college aged ‘kids’.  You may also build concrete expectations to help your children foster a sense of control in their world.  Your children may fear getting sick, quarantining, switching to online learning, or closures.  Using language appropriate for their developmental level, describe their school’s new policies and procedures so they feel prepared for structured changes. Be clear about your household and school’s expectations regarding what your child will be doing to prevent COVID spread and infection.  Remind them about hand washing and other safety precautions – these efforts to mitigate spread might seem so simple, but they work!  Lastly, sit down together and make a list of what is in their control during their day.  When children are able to identify what they are in control of, they feel calmer and more confident!

Fight anxieties with activities:

Since the onset of the pandemic, children have increased their screen time and sedentary behaviors. They are sitting more than they ever have before! Engagement in physical activity is particularly important to help reduce anxiety during stressful periods. Research tells us that youth who regularly engage in physical activity report less stress and have an easier time regulating their moods. As kids resume in person school this fall, provide a physical outlet for their difficult feelings. It can take the form of sports teams, walks around the neighborhood, silly obstacle courses in the yard or living room, or simply tossing a ball around. It doesn’t matter how your child chooses to move, as long as they move! 

Stay vigilant and know the signs: 

Most youth will manage the transition well with the support of their family, even if they show some symptoms of anxiety.  Some youth may be at greater risk of developing mental health challenges and will need more support. If you notice your child has exhibited significant changes in behavior or any of the difficulties listed below, please reach out for more support. Research indicates that kids who receive supports earlier tend to recovery faster and have more stable gains in treatment.  Also, if you want general support in providing your child with the skills to succeed and thrive during these extraordinary times, don’t hesitate to reach out.  Emotional intelligence and regulation is one of the greatest predictors of positive child outcomes. It’s always a good idea to support mental wellness throughout a child’s development.

Clues that more support is needed:

Elementary Age Children– irritability, aggressiveness, clinginess, nightmares or other sleep disruption, school avoidance, poor concentration, stomach issues/headaches/body aches and pains, and withdrawal from activities and friends. 

Adolescents– sleep and eating disturbances, agitation or irritability, increase in conflicts, physical complaints, social withdrawal, poor concentration, and rule breaking/oppositional behavior. 

Together we can provide the skills and supports our kids and teens need to feel healthy and confident during these extraordinary times.

Your Relationship & The Pandemic: Map a Course for Change

Courtney Zullo, MA, LLP

If you are struggling in your relationship, you aren’t alone! During the pandemic, while we have simultaneously been changing roles at home and work, and dealing with constant transitions, stress has come at us from all directions. For many, this stress and disruption has brought to light markers of change they wish to make in their relationships. These markers create a map, guiding movement forward toward a happier, healthier, and more resilient relationship. If we are able to construct, read, and follow this map, it can lead us to a place in our relationship of greater connection, stability, and intimacy.

Map Marker 1: Acceptance

For many, managing life during the pandemic has meant a sharp increase in stress, job change or loss, and never ending changes at work, school and home. Any one of these added stressors to our lives would affect our relationship, let alone all of these at once! So, the first marker we must see on our map to relationship change is acceptance. We must accept that some degree of disruption, conflict, and unmet needs in our relationship is reasonable right now.  When we feel that conflict, distance or disruption is not reasonable, given our circumstances, we attribute the difficulties to our relationship (e.g., “Maybe we just aren’t meant for each other”, “We can’t get through this”). Or, we personalize the difficulties (e.g., “S/He/They Don’t love me anymore,” “S/He/They are such a negative person”, “S/He/They need way more than I can give”). Instead, we must say to ourselves and our partner, “It’s ok that we are fighting, feeling distant, irritable, or angry right now. This is reasonable, so much has happened this year.”   But, we don’t want to rest in acceptance as our only marker on our map to relationship growth and change. We must continue to move forward to gain true relationship connection and peace. We must also know we have the insight and power to change in response to these needs.

Map Marker 2: Shifting Roles

One marker on our map to relationship change may point to our need to investigate how roles have shifted during this pandemic.  Most Americans report shifting roles at work, at home, or in the family in the last 18 months. As our roles in life shift, so do our relationship needs and dynamics. It is important to account for these shifts, and ensure our relationship is shifting to support these new roles. In your new role, or additional role you’ve taken on, what else do you need from your partner? What else can you be giving your partner? The ship always rocks when encountering new waves, but you can find the balance with insight and communication.

Map Marker 3: Old Patterns Emerge

Many couples are realizing that their less helpful or less-than-healthy relationship patterns have been amplified during the pandemic. Many markers on our map of relationship change may actually direct us to recognize and develop insight around relationship patterns that were not serving us before the pandemic, but have unfortunately been pressurized and brought to the forefront. As we feel stressed and overwhelmed, as most have during the pandemic, we fall back on old patterns of reacting, thinking, relating and communicating. We do this quite automatically, often not recognizing the havoc it wreaks on our relationships.  However, we have the power to develop insight around these patterns and get what we want and what we need from our relationship in much more healthy, adaptive, and long-lasting ways. To start the journey of insight, go ahead and fill in the blanks; “When _______ happens, I tend to react by _________, which is actually me trying to get _________ need met. But I don’t think it’s working for me.” From here we can rethink our patterns of relating, communicating, engaging in conflict, sharing emotion, receiving and/or expressing affection.

Map Marker 4: Retell Your Love Story

When I’m first working with a couple, I like to sit down and and ask the couple to share their love story. What brought you both together? What makes you still love your partner today? What I have found is that regardless of why couples enter counseling, every couple has a unique love story worth hearing. Some couples are stuck, some couples are lost, and some couples have been so unhappy for so long that happiness seems unreachable. When stuck in the midst of the storm it seems impossible to see the sun. That’s where exploration and open and honest communication comes into play. This is even more important in our current circumstances, in which stress due to the pandemic has overshadowed our daily lives. Indeed, many of daily reminders of love we often provide have been overwritten by the burdens of the last 18 months.  Perhaps a marker on your relationship change map is to revisit your own love story. Remember and openly discuss what made you fall in love and why. Being in a relationship is a choice each and every day. Openly and honestly discuss what can help you feel love toward your partner, even in small ways, each and every day.

Map Marker 5: Additional Support & Guidance

And finally, there might be a marker on your map of relationship change that leads you right into my office. The pressures and changes of this past year may feel overwhelming to address on your own, and that’s alright.  Seeking couples therapy shows dedication to your relationship. It is a non-judgmental space so you can work to make your marriage or relationship exactly what you want and need it to be; a stronger foundation from which you may build amazing things in your life. After all, the map markers mentioned above are really just a starting place for your journey. With help and support, you can set a course on your map of relationship change that will help you and your partner get exactly where you want to be in life.

Courtney Zullo, MA, LLP

 

Managing Back to Work Anxiety

Dr. Julie Braciszewski PhD, LP

Michiganders are headed back to in-person work this week, and while some are feeling a renewed sense of freedom, others are facing significant anxiety. ‘Back to Work Anxiety’, as some are calling it, is part of the larger experience of ‘Re-Entry Anxiety’. We have been expressly avoiding many situations, interactions, and contexts for over a year to keep ourselves, and others, safe.  However, when we avoid a feared situation, our perception of danger increases, as does our bodily response to this fear. So now, as we venture out into the world, it is reasonable to feel a little wary, or even downright intense anxiety. The closeness of others, enclosed spaces, people touching things… it might all be a bit overwhelming. It’s imperative to highlight what we can do to manage back to work anxiety and make this transition a bit easier.

Evaluate What Has & Has Not Been Working For You

Over the past year we have adjusted to working at home by developing new routines and patterns of life.  Inevitably, some of these changes have brought additional stress. We can make a list of what new routines, situations, or responsibilities are causing more stress, reducing work engagement or satisfaction, and target these for change.  For instance, most people feel like ‘Zoom Zombies’ after a couple of hours of video conferencing. As you go back  to in-person work, specify a time threshold for video conference meetings and work toward shifting to more in-person meetings. However, for some the ability to take a break from work and do household tasks or errands has been a very positive shift while working from home. Additionally, people with families are reporting engaging in more meals together. Perhaps these are things you want to hold on to? Just as importantly as working to address added stressors, make a list of what is bringing more connection, relaxation, balance, and satisfaction and fight to keep those routines in place.

Communicate

This might seem like a no-brainer, but many struggle to really communicate what they need and what they want.  When we are stressed, our ability to communicate often declines further.  This makes the transition back to in-person work a potential black hole for communication.  About 60% of people report already feeling burned out, and are thus less likely to communicate their needs.  Once you’ve sat down and clarified what is working and what is not, translate this into actionable steps. Formulate assertive statements around what you want, why you want it, and how it will actually benefit your team, the business, or your work quality. Communication during this transition will pay off long-term for you and your employer.

Boundaries, Boundaries, Boundaries

For many, as work moved into their homes, it became difficult to separate work life, home life, and all our other responsibilities/roles in life. Our separate roles no longer fit neatly into their contexts and have compounded stress as we try to meet these intersecting demands. For instance, many people are simultaneously working, facilitating their children’s schooling at home or in a hybrid model, and providing support or care for other family or community members. It’s all a bit much, isn’t it?!? As we shift back to in-person work it’s important to think about boundaries between work and home, and reassess how to be sure you get time to relax, connect, and recharge. When will you NOT be available for work. If you return to in person work, practice putting down your phone, ipad, laptop, ect., and unplugging from work once you are home. If you are returning to a hybrid work model, you might have to work even harder to set your boundaries. Reclaim your home as your sanctuary, reclaim your family and friendship connections without the constant distraction and pull from work, and reclaim your balance.

Get Clear Answers

Returning to work in person is going to result in a lot of ambiguity at first. This will take a lot of planning on employers’ parts and at first, it might be hard to get answers to your questions. However, now is the time to speak up and ask important questions around expectations, policies, flexibility, and work roles. Do you have a firm sense of what the policies are around office safety and sanitizing? Do you have questions around flexibility of work schedules? It’s important you give your employer the opportunity to grapple with these questions at the outset, so that you, in turn, have the opportunity to get what you want and what you need.

Support Your Mental Wellness

The pandemic has caused a mental health crisis of the likes we have never before seen. Usually 15 – 20% of people are experiencing mental health challenges at any given time. But right now, about 40-60% of people are struggling with their mental health, before even contending with back to work anxiety! The importance of this increase in mental health difficulties cannot be overstated. The majority of individuals returning to in-person work are already feeling anxious, depressed, stressed, and burned out. We can not really switch into a ‘full steam ahead’ attitude at work. Instead, we must make room for how mental health is impacting our well-being. Identify what you need to prioritize your mental well-being during this transition. Many are asking to start back in stages, so that they can adjust their household needs, such as childcare, and get used to their new schedule. Should you ask to take walks on your break or lunch? Do you need to shift your work day to address sleep disruption? Can you seek out additional communities out of your office? Groups like recreational sports teams, moms groups, religious meetings, crafting group, sober living group, super-niche-car-guy group, provide connection and positive sense of identity. We can be purposeful in creating our own mental wellness. If you need support, don’t hesitate to reach out to us.

It’s OK To Not Be OK

Be aware that you will have a stress response to this transition. Because mental health IS medical health, you will feel back to work anxiety in your body as well. This may present in the form of headaches, gastro-intestinal distress, body aches, sleep changes and fatigue. Be attentive to this reaction. If your stress reaction, anxiety or mood difficulties are worsening, or have not gone away in a couple of weeks, give yourself the gift of professional support. You deserve it!