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.
In my last blog post, “Emotions are the Solution, Not the Enemy” I explained the importance of accepting
all emotions, even the most difficult ones, and tuning in to what they might be telling us. In this blog post, I will expand on the mind-body connection and explain how our thoughts impact our emotional experiences and sometimes make us feel worse than we need to. Just like emotions are our constant companions, our thoughts are also always in our mind, telling us stories about ourselves, others, and the world around us. Sometimes, we discover that our thoughts fall into unhelpful patterns that can trick us into believing something that is not necessarily true. These unhelpful thoughts can trigger difficult emotions and interact with emotions to make us feel worse about situations. By learning how to recognize patterns of unhelpful thinking, we can learn how to explore and manage our thoughts. If we can take a step back from our thoughts, we might be able to look at things from a different view and feel better about ourselves, others, and the world around us.
We think in patterns
As human beings, we develop habits and patterns of doing things in our daily lives. Our thoughts tend to
form habitual patterns in the same way! Our brain is built to recognize patterns and themes that help us make connections between new situations and old information/experiences. Recognizing patterns helps us make quicker judgements, predict outcomes, and make informed decisions. For example, this is one way that we determine if a situation seems safe or dangerous, by making connections between the current and past environments/experiences. We learn from our experiences and apply that information to make interpretations and decisions as we approach new situations. Our thought patterns are shaped through our environment, experiences, relationships, and cultural/social beliefs. Thought patterns work as a general framework that impacts and filters the way we tend to think about ourselves, others, and the world. These thought patterns affect the way we interpret situations, which leads into how we feel and what we do about those situations. These patterns can make us habitually interpret situations in a way that causes us to feel badly about ourselves, other people, and the world around us. While some thinking patterns keep us safe, result in healthy relationships, and lead us to make great decisions, others cause us to make incorrect assumptions that negatively impact our feelings, relationships, and decisions. By paying attention to our patterns of thinking, we can learn how to take a step back from our thoughts and try to look at things from a different perspective.
The Mind-Body Connection: Thoughts make our bodies react
In my last blog post, “Emotions are the Solution, Not the Enemy” I explained that our thoughts, emotions, and behaviors are connected, and all interact with each other. Thoughts and interpretations trigger our brain and body to feel related emotions. Imagine that you are giving a speech that seems to be going well, and you see someone in the room laugh. You might think that the person is making fun of you, which would make you feel embarrassed, anxious, sad, or angry. That thought would trigger those emotions in your brain and body, and you might feel your heart start to beat faster, your face flush red, and butterflies in your stomach. That person may have been laughing at something completely unrelated, but the thought you had in that moment triggered your brain and body to feel uncomfortable emotions. By paying attention to our thoughts and feelings, we can notice how they are connected,and we can recognize when our thoughts may be contributing to our difficult emotions.
An automatic thought is the first thought that pops into our mind. They are super fast and, sometimes, super sneaky because they usually follow our thinking patterns and can heighten unhelpful emotions. Automatic thoughts can also be colored by the emotions we are already feeling. Using the example from above, if you were already feeling nervous about giving the speech, then there was a higher chance that you would have thought that the person laughing was making fun of you. If you are already irritated, your automatic thoughts will fall into anger patterns. If you are feeling socially disconnected… your thoughts will fall into patterns of social anxiety and withdraw. These automatic thoughts can feed into difficult emotions like throwing gasoline on a fire. Automatic thoughts often fall into common patterns of distorted, unhelpful thinking “traps” (also called “cognitive distortions”). Unhelpful, distorted thoughts may not be accurate, or they may be exaggerated, as we assume things without considering all of the possibilities. When we experience automatic thoughts, we often only pay attention to information that makes us believe the thought. As a result, we ignore other information that might show us that the thought is not necessarily true. You can see how this spiral of thought trap, heightened emotion, attending to limited information, and further thought trap can result in intense emotions than can spiral out of control. But, the good news is that we can learn to notice our thoughts and change our thinking patterns. No more unconscious emotional spiraling!
Automatic thoughts and unhelpful thinking traps
People tend to believe their thoughts and feel that they are ‘correct’ or ‘true’. We often believe the first thought that pops into our mind, and we fail to consider all of the possible explanations of a situation. We only pay attention to the information that fits into our thought pattern, and we miss other information that may tell us something different. By believing our thoughts are always right and true, it gives our emotions full reign to direct our moods, decisions, and interactions. However, if we acknowledge that our thoughts are just our interpretation of a situation or event, based on our life experience, colored by our current emotional state and thinking patterns, then we are free to second guess and even correct our thinking patterns. These thought patterns often fall into easy-to-identify traps.
Examples of common unhelpful thinking patterns/traps:
Below are descriptions of common thinking traps, as well as a related automatic thought that someone might have in response to the following situation: You see your friend walking toward you on the sidewalk. You wave at them, but they don’t wave back. Thought trap: Personalization: Taking things personally when the situation might not have anything to do with you. This can include things like blaming yourself for something that you had no fault in or assuming that someone is purposely doing something to you. Automatic thought: My friend purposely ignored me when I waved at them. Thought trap: Mind reading: Assuming you know what others are thinking or saying about you. Automatic thought: My friend didn’t wave back at me; they must think I’m annoying or weird. They don’t really like me. Mental filtering: Only paying attention to certain information or details in a situation. Automatic thought: They didn’t even wave at me. (failing to notice that they smiled at you instead). Catastrophizing: Assuming the worst possible scenario. Automatic thought: My friend didn’t wave back at me…they must not want to be my friend anymore. Nobody ever wants to be my friend. If you believed any of the unhelpful automatic thoughts in response to your friend not waving back, how would you feel? You would likely feel sad, embarrassed, angry, or anxious. You might then want to ignore them or yell at them. By noticing automatic thoughts and thought traps, we can recognize when our thoughts are causing us to feel unnecessary difficult emotions and act in ways that can hurt ourselves and others.
*Click on this link to see a longer list of common unhelpful thinking patterns/traps:
Challenge your thoughts: Calm your mind
When we get used to acknowledging our automatic thoughts and identifying thought traps, we can challenge those traps. This enables us to look at all possible sides of a situation, to determine whether certain thoughts are exaggerated or inaccurate, and help us to think in a more balanced way. This is not to say that all of our thoughts are incorrect, but we gain a great deal of power when we can identify ones that are. When we can decide if the thoughts fit into a thinking trap, we can explore and challenge them. We can challenge and reframe unhelpful thoughts guiding our emotions, decisions and relationships to a healthier place. Some general questions you can ask yourself to explore your thoughts and see if there are any steps to take to gain more information: Are there any other ways I can look at this situation or myself? What evidence do I have to support this thought? Am I looking at the situation from all angles? Am I assuming the worst? Am I assuming I know what they are thinking or feeling? What can I do to see if my thought is true? Let’s return to the same example from above. Maybe your friend didn’t see you or maybe they were having a rough day and did not feel like waving at anybody. Maybe they smiled at you instead of waving back, and you didn’t notice them smile so you thought they ignored you. Perhaps if you asked your friend what happened, they would tell you they didn’t see you, they were having a rough day, or they smiled at you instead. After thinking about the different possible explanations or taking action to find out more information about what happened, instead of feeling embarrassed, angry, or sad, you would probably feel much better about the situation. You would see that they didn’t ignore you on purpose and that there was nothing to worry about. Exploring and challenging automatic thoughts can alleviate a lot of anxiety, mood troubles and relationship distress.
Putting it all together
Combining the physical coping strategies from our last blog post, “Emotions are the Solution, Not the Enemy” and the thought-related strategies from this blog post can help you calm your body and mind. It can be difficult to think clearly when your body feels so worked up! When your emotions feel strong, it is often helpful to first use the physical relaxation skills to calm your body, and then explore your thoughts to calm your mind. Don’t be discouraged if you find it difficult to practice any of these strategies. It’s important to be patient and compassionate with yourself and keep practicing! Practicing these skills is like building a muscle; the more you use them, the stronger they will get! If you ever feel like your emotions and/or thoughts are becoming too much to handle on your own, don’t be afraid to seek professional help. It takes a very strong person to admit they are struggling and to ask for help, and we are always here for you!
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.
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.
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:
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:
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.