As the leaves start to fall, so too can our mood. Despite the increase in demands from work and school, we don’t have to let Autumn Anxiety take hold. Let’s work together in small and creative ways to hang on to the resilience and mental wellness we cultivated, so that our inner summer shines through the fall and into winter.
1. Stay Present Focused
The busy bustle of fall threatens to push us into anxiety. But each day this season brings us a bit of change and we can use this to stay present focused. When we notice a change, we can stay in the present and not get swept up by anxiety or expectations about the future and all there is to do. Take a moment to do a mindfulness sensory exercise. Take 30 seconds to fully concentrate on one sensory experience of fall. Will it be the crisp air, changing colors of leaves, the taste of cider donuts? Fully exist and experience this moment; notice your heart rate drop and your mind clear.
2. Support and Shift Executive Functioning
Moving into fall often means significant change and transitions. School starts, workloads often increase, schedules change, routines are structured differently; it’s a lot all at once. When we have to hold more in our minds and coordinate more, stress, anxiety and low mood can creep in. But what if we invest time in creating better support for ourselves? Executive Functioning strategies can be a game changer in reducing stress. Also, what if we shift some of this burden to others, enabling them to function more independently?
What tasks are burdening you that others could be doing? Imagine NOT doing those things 30 days from now. If you find you are carrying a heavy mental load of others’ executive functioning (i.e. organizing, planning, gathering supplies/materials, strategizing, scheduling), it’s time to shift. We serve ourselves best by putting systems into place that increase others’ engagement and independence. While the initial planning and setting up of expectations or supports does take some time, and we have to be ok with mistakes and mess ups, the pay-off is beautiful and long-term. Setting up sustainable structures like visual schedules, laminated/reusable check lists, and nightly preparation routines can shift the executive functioning load. If you’re struggling to know where to start, MBH therapists can help identify how to shift these burdens and alleviate stress for the long haul.
3. New Fall Movement
Of all the health-related behaviors that affect our metal wellness positively, movement is at the top of the list. While we might be tempted to shift into sweater-ready, pumpkin spiced shut-ins, getting out and moving our bodies in the fall will stretch the resilience you built in the summer over into fall and winter. To keep yourself motivated and interested, what activities can you think of that you can only do in the fall? Are there certain outdoor markets that are fun to walk around? Hikes that are particularly beautiful in the fall?
As always, if you feel your mood shifting and Autumn Anxiety building, shoot us a text or give us a call. We can help you learn and practice mindfulness, shift the executive functioning load, and find creative ways to move through the season.
Dr. Jessica, Anastasia and Rachel did an amazing job teaching our campers empowerment and social skills. Our campers were engaged, exited and energetic! It was so fun to see our staff work with your kids to integrate their creativity and kindness with Cognitive Behavioral Therapy and Mindfulness skill building.
If you missed out, or your camper needs any reminders, our skill building infographics are below:
We only get a couple months of warm weather and summer fun here in Michigan. Let’s make the best of these long summer days! Summer activities, routines, and events pose opportunities to build mental wellness – but we do have to be strategic. Here are 5 ways you can purposefully build and support mental wellness in your or your loved one’s lives this summer.
1. Power up Social Skills
Social skills are a major building block of resilience and success for kids and adults. Almost everyone can use some social skill building and summer is the perfect time to work on these strategies. Perhaps you or your child need help learning how to engage in successful introductions to new friends, asking others for help, setting appropriate boundaries, dealing with conflict, or either directing play/activities or going with the flow a bit more? Whatever might help increase confidence and success in social interactions, summertime is a great time to hone these skills.
Here’s how to do it – Make a small list of social skills to practice for the summer. Before a social interaction, identify one specific skill. Talk about the skill and role play the skill; ask when and how the skill might be used. After the social interaction, be sure to talk or journal about how it went. What went well? What could use improvement? What will you do differently next time?
Summer camps focused on building social skills are a great way to build these skills quickly and get professionally guided practice with other kids. If your child is entering grades 2nd through 5th grade, you can sign them up for the Boys Super Social Summer Camp. Girls entering 5th through 8th grade can sign up for the Girl Strong Empowerment camp, which focuses on empowering social skill development for middle schoolers.
2. Leverage Schedule Changes to Build Executive Functioning Skills
While it feels wonderful to be freed from the typical school year schedule, after a few days or weeks, kids often become bored and/or irritable, and parents can feel overwhelmed. Adults and kids who struggle with executive functioning may find schedule and routine changes especially difficult. Summer is an opportunity to develop and practice new executive functioning strategies. For instance, plotting out the daily and weekly schedule can help everyone in the household orient to changing routines and expectations. For families, this might include mapping out parent work schedules, who is on kid caretaking duty each day, and scheduled activities such as practices, social hangouts, and camps. However, be sure to mindfully schedule free time! Purposefully put it on the calendar so you or your child knows when a block of free time will occur, and we can look forward to and schedule something fun. If your child or teen continues to struggle with their summer schedule, completing daily routines, or getting stuck when faced with transitions, make the schedule visual – color code different types of activities and include pictures. It might seem silly to do for an older kid or teen – but being able to orient oneself to the day with a brief glance really helps regulate emotions and executive functioning.
3. Mindful (not mindless) Screen Time
As daily routines and schedules loosen up, screens often fill in the blanks. However, increased screen time is typically associated with decreased positive mood, increased anxiety, and increased irritability. Summer is a great time to facilitate insights and skills that increase screen time regulation – set a daily screen ‘allowance’, ask yourself or your kid how this allowance will be ‘spent’, and follow up by asking how it went or sitting down together to look at screen time on a tracking app. If you or your child has trouble conceptualizing their screen time allowance, make it visual – draw a circle or bar graph to represent the number of minutes that can be ‘spent’ on each app or game. To increase insight and motivation to self-regulate screen time, reflect on days in which you or your child used screens more; how do your/their bodies and brains feel? On days screens are used less; how do your/their bodies and brains feel? Kids and adults often both need help developing the ability to reflect on how screens actually make their brains and bodies feel and enacting effective regulation skills.
4. Focused Bonding
Sometimes the adventures we can have during summer are the perfect prescription for family or relationship closeness. Research shows that when families feel close and connected, including strong child-parent communication, bonding time with siblings and regular family mealtimes, kids and teens are less likely to experience depression. Relationship closeness built on shared experience also impacts adults’ mood and anxiety positively. However, the summer schedule can be overwhelming. One trick is to build in small, focused bursts of relationship focused time. This might look like an end of day 10-minute check in with purposeful physical contact, watching a short video clip that’s part of a series 3-4 times per week, or sharing meals together regularly. Building relationship routines that include regular, seemingly inconsequential time spent together, as well as larger adventures will help you and/or your child build resilience.
5. Address Mental Health Issues Now
Don’t wait for mental health issues to go away on their own. If emotional or behavioral difficulties last more than 2 weeks, it’s not a ‘phase’, get real support and guidance. Summer is a great time to start therapy, engage in a short-term treatment plan to build resilience, or engage in a camp supporting mental wellness. We encourage people to reach out before a crisis occurs, so that when difficult situations or events occur, you or your child already have coping strategies in place.
After being cooped up inside for the long winter, there is a definite appeal to the idea of spring cleaning. Just as we long to shed the layers of heavy clothing, our belongings can start to weigh on us as well and we may feel the urge to declutter and strip down to basics in our surroundings.
Clutter & Mental Health
In fact, clutter can be a cause or a result of mental health distress. Several studies have shown the negative effects of clutter on our well-being, stress levels at work, and even our parenting (Dao & Ferrari, 2020; Roster et al, 2016; Thornock et al. 2013). When someone struggles with anxiety, depression or ADHD, it can be challenging to keep up with housework due to fatigue, difficulties concentrating, low motivation and other symptoms. Eventually, one’s physical spaces may reflect that inner turmoil and dysfunction.
Starting Small has Big Effect
Small spring-cleaning tasks can have a positive effect on your mental wellness. Cleaning your space can give you a sense of accomplishment as well as provide a calm, relaxing place to work or live. Starting small by tackling just one drawer or one closet can help keep things from feeling too overwhelming and can also motivate you to keep going. Give yourself time limits, like 15-minute blocks of work time, so small tasks don’t develop into full afternoon stress cleaning sessions.
As always, asking for help is encouraged! Get your partner or family members involved. A one-time professional house cleaning or an appointment with a professional organizer might be a thoughtful gift to yourself, a friend or loved one. If you have the financial means to hire a cleaning service, it can be a helpful way to outsource a task you dread and free up time for more meaningful spring-cleaning pursuits.
This can be a freeing time of year with opportunities to address our mental health in really effective and sustainable ways. Working in small, yet achievable ways to clean and organize our environment can have a measurable and lasting impact on our mental health.
The Negative Side of Office Clutter: Impact on Work-Related Well-Being and Job Satisfaction Trina N. Dao and Joseph R. Ferrari, North American Journal of Psychology, 2020, Vol. 22, No. 3, 441-454.
The dark side of home: Assessing possession ‘clutter’ on subjective well-being, Catherine A. Roster, Joseph R. Ferrari, M. Peter Jurkat, Journal of Environmental Psychology, Volume 46, 2016, Pages 32-41, ISSN 0272-4944.
The Direct and Indirect Effects of Home Clutter on Parenting: Carly M. Thornock, Larry J. Nelson, Clyde C. Robinson, Craig H. Hart, Family Relations, 2013
Written by Dr. Darren Jones, PhD, LP & Dr. Julie Braciszewski, PhD, LP
After a tragedy or traumatic event occurs it can be difficult to know what to do next and when to seek additional support. Many individuals experience intense distress right after the event while some individuals experience little to no distress in the early days after a trauma, only to find the effects present themselves later on and seem to linger. Given the wide range of responses to traumatic experiences, it’s helpful to know the typical responses immediately following a tragedy or traumatic event, as well as signs that it might be a good idea to seek professional support. Read below to also learn what effective treatment for traumatic stress looks like, what questions to ask your potential therapist, and to gain more resources for you or your loved ones.
What is a ‘normal’ response to a traumatic event?
Immediately following a tragic or traumatic event you may…
Experience troubling memories that repeatedly enter your mind even when you are trying not think about them (intrusive thoughts or rumination)
Feel on edge, and have difficulty sleeping and paying attention
Feel mentally foggy and have trouble thinking clearly or remembering things
Have strong emotions such as sadness, anger, fear, or guilt that flow from one to the next quickly, or happen at the same time at an overwhelming intensity
Have blunted, or less intense emotions than usual
Feel pulled to engage in highly distracting activities and even unhealthy coping strategies
Want to avoid things, places, people and sensory experiences that remind you of the event
Isolate yourself from others more than usual
Have thoughts that amplify perception of potential risk; your thinking patterns might be looking out for danger and risky situations and over interpret potentials risks
Feel highly stressed or irritated about things that typically would not bother you
These are a normal reactions to an abnormal event, and for most people these symptoms go away on their own within a few days or weeks.
However, symptoms of Posttraumatic Stress Disorder (PTSD) may develop in some people who experience a traumatic event
Anyone can develop PTSD at any age and in some cases the symptoms begin many months or even years after the traumatic experience
Who might experience traumatic stress as a result of a tragedy or traumatic event?
Those present at the tragedy or traumatic event
Those who were not immediately present but feared for their safety or the safety of others
Parents who feared their children were in danger
Those with elevated risk due to one or multiple Adverse Childhood Experiences or previous traumatic experience(s)
What are signs or symptoms that indicate more support is needed?
The above reactions and experiences continue after a month or so
Certain places, sensory experiences, people or things that remind you of the tragedy or trauma cause you to experience heightened physical and emotional responses that get in the way of your everyday life
Avoidance of things, people, places or sensations that might remind you of the event
You find yourself reliving the experience through upsetting memories or nightmares about the event
You notice an increase in negative thoughts and feelings
Ongoing sadness, anxiety or anger that persists several months after the event
Feeling on edge and unsafe weeks, months or years after the event
You are having difficulties at work or school
Relationships seem strained or it is harder to feel connected with others
What are the treatments for supporting healing after tragedy or trauma?
There are several effective, evidence-based treatments for adjustment after a tragedy or trauma, as well as the disorder known as PTSD. Although there are many approaches to treating traumatic stress, research indicates that the two most effective psychotherapeutic treatments for these difficulties are Cognitive Behavioral Therapy and Prolonged Exposure. While treatments might feel scary to engage in, your clinician should be able to tailor your treatment to your needs and respect the pace at which you need to go to feel safe.
Treatments for traumatic stress often include:
Working to reduce the power the experience has over your thinking, feeling and behavioral patterns
If needed, working to regain a sense of control and safety in your everyday life
Understanding and address changes in your nervous system due to the event
Addressing how the event(s) have affected how your view of yourself and the world
A respect for and awareness of your individual identity and life experiences as well as cultural and religious beliefs
Medications can also effectively treat some of the symptoms of traumatic stress. Some people find that a combination of both psychotherapy and medication treatment for traumatic stress is most effective. Your psychologist or therapist can work with your physician to help support and guide this process if this feels like a good route for you.
What questions should I ask when seeking treatment after a tragedy or trauma?
Treating trauma is a specialty in behavioral health and not all providers have the appropriate training and experience. Ask your provider about their training and experience.
Ask a potential provider if they specialize in treating adjustment after tragedy and trauma, or PTSD and inquire about what evidence-based treatments they offer.
If they do not have a background or training in treating PTSD it is important to move on to other providers that have that specialization. General ‘talk therapy’, and/or ‘supportive counseling’ are not effective treatments of traumatic stress.
In the immediate aftermath of tragedy there are ways we can support ourselves and our loved ones to reduce distress and build resilience and coping. The complex physical, emotional, and behavioral aftershocks of trauma can hit immediately after an event, or occur over time in what can feel like surprising waves of reactions.
Please see below for resources on coping with tragedy and trauma. And as always, please reach out if you or a loved one needs support.
The holidays are here and for many people that means that they are feeling higher levels of stress than usual. In a survey published by the American Psychological Society, 61% of respondents reported that the holidays were a significantly stressful time for them. One of the most challenging holiday stressors is managing our relationships this time of year. But why can our relationships with friends and family be so challenging during the holiday season and what can we can do to ease this stress?
Why Are Relationships More Strained During the Holidays?
First, it can be difficult to meet the expectations that people in our lives have regarding the holidays. Our family, friends or significant others may want us to attend a certain get together or buy a particular gift. We may end up feeling like we disappointed them if we are unable to anticipate or meet these expectations. We also often set very high expectations ourselves, leading to stress and relationship conflict. Second, the heightened pressure of the holidays can worsen already existing relationship stressors. The patterns and dynamics with people that you struggle to get along with during the rest of the year may be much more pronounced during the holidays. Third, the holidays often remind family members of loved ones who they have lost. This contributes to an emotionally charged environment that can be difficult to navigate while we are busy with a hectic holiday schedule. The good news is that there are some things that we can all do to better manage relationships during the holidays:
Actively Manage Expectations
You have the opportunity to align your expectations with your situation and clearly communicate. Unspoken expectations are often unmet expectations. Be clear about what you want and ask others directly what they want. However, it is also important to remind yourself that holiday stress is often related to unrealistic expectations that nobody can live up to. Do not take on the responsibility of creating an ideal holiday experience for your family, friends and/or partner. Everything is not going to go perfectly, and you must remind yourself that perfectionism steals opportunities for connection and joy.
Encourage Healthy Interactions
A lot of interactions this time of year aren’t really under our control, and this can cause increased stress. However, we can contribute to creating a healthier and less stressful environment for the holidays. You can choose what you focus on, what your emotional reactions are, and how you respond to others. This time of year, it reduces stress to focus your energy on finding even small things that grow gratitude. In stressful relationships, you can search for what you might have in common, instead of differences that drive you apart. We also often have to practice more ‘letting go’ and acceptance at the holidays than is typical. Giving up control and practicing radical acceptance can actually help you cultivate healthier interactions. You can, however, influence others’ behaviors and interactions with how you choose to regulate your emotions and respond. You can also consider asking everyone at a holiday gathering to share something that they are grateful for. Research tells us that expressing gratitude is correlated with improved stress management and reduced conflict.
Take care of yourself
‘Tis the season for holiday treats, drinks, stuffed stockings late nights and latkes. While this can fill us up with joy, this deviation from our typical routines can also take a physical and mental toll. It is important to remember that we cannot be at our best for family and friends if we are not attending to our own psychological and physiological needs. Take time to exercise, meditate, or engage in other stress management techniques. When we are juggling busy holiday schedules it can be easy to overlook the basics, like drinking enough water and getting adequate sleep. Make sure that you attend to your emotional and physical needs so that you can enjoy your holiday time with the people that are important to you.
Make time and space for grief
Whether you’ve lost someone recently or are grieving a lost relationship, making space and time for grief is important during the holidays. This space allows us to recognize and validate the experience and not let it overshadow opportunities for joy and connection. Take time to purposefully commemorate and honor your loss and find moments to connect with others around this loss.
Reach out; the people around us often do not realize that we are struggling. Identify a family member or friend that you can talk to when you are feeling stressed. They may be going through a similar experience, and you can support each other. Research shows that when people are feeling stressed, they often feel isolated, and this makes the situation worse. Reach out and let someone know that you are feeling stressed. And of course, give us a call –we are here for you and want you to have a great holiday season.
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.
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.
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.
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.
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.
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.
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.
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 Familiesis 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.
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.
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.