Child Therapy Chicago

Parenting Advice: Spoiled Child. Is It Possible to Spoil a Child?

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 07 May 2013 16:00:00 +0000

Is it possible to spoil a child? The simple answer is "no." Some parents worry - or are told by others - that if they respond too quickly or too often to a crying, fussing child, the child will become spoiled. This is not the case.

Infants and babies fuss and cry because they have needs. Before they have words, babies express themselves through their body language and behaviors. Their emotional state comes out in physical ways. This is part of babies' development. Good parenting involves recognizing and responding to babies' needs consistently and routinely with warmth, patience, and calm. The more a baby is responded to in a time of need or distress by a loving caregiver, the more the baby learns to regulate his/her own emotions. The soothing actions and interventions of parents or caregivers help babies calm and feel better, which promotes attachment, self regulation, and self-esteem. With enough positive responsiveness, babies eventually begin to internalize the comforting behaviors of their parents and learn to sooth themselves.

Even toddlers and older children still express their internal states in physical ways, such as tantrums, crying, kicking, hitting, biting, fussing, etc. They still need parental help and support to regulate their emotions in these times. When parents provide a sense of calm, comfort, warmth, and understanding, children feel secure and safe and are able to work on emotional self-regulation. These interactions do not spoil a child; spoiling a child is giving into a child's demands for one's own relief. When parents give into material requests (e.g., candy, toys, etc.), and do so often, in order to cease a child's behavior, this has the potential to send an unintended message that acting out behaviors beget rewards; it does nothing to promote self-regulation. So, what does a parent do?

Parenting Tips: How to Respond to a Fussy or Upset Child

Remember that a child's behavior has meaning and that a fussy or upset child is trying to say something, so try to figure out what is motivating the current behavior (e.g., recent change in schedule, sickness, new school, new parental stressor, etc.)

Respond promptly with a sense of concern, empathy, calm, love, and support

Provide physical comfort

Help the child put feelings to words by verbalizing what you see, hear, think, and feel the child is experiencing; this even works with babies and young, non-verbal children

Try really hard to not be angry; it is ok to feel frustrated and overwhelmed with a child's behaviors but anger at the child for his/her feelings does not promote emotional regulation, instead, it can harbor feelings of insecurity and inadequacy, even for the youngest of infants

Avoid giving into demands for material things; though this might offer a temporary fix, it does not help the child develop

Keeping these things in mind can help parents promote their child's development and not worry about "spoiling."

Sleep Schedule and Feeding Schedule: What Is Better - A Schedule or a Routine?

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 23 Apr 2013 16:00:00 +0000

Parents of infants and toddlers often talk about "schedules." Children have schedules for sleep, feeding, bathing, activities, etc. But what is meant by "schedule?" Do parents actually follow a schedule or is the child's and parent's pattern of behavior more of a routine? And which is better - a schedule or a routine?

Though these words seem similar, there is a difference between a child being on a schedule and child having a routine. A schedule implies certain activities will occur at specific times (e.g., feeding an infant at particular hours - say 1pm and 3pm - or a toddler napping at 2pm, regardless of hunger or sleep cues) while a routine is more of a predictable sequence of events (wake up, eat, play, nap, etc.). Children thrive when they feel a sense of familiarity, comfort, safety, warmth, and support. Routines contribute to these feelings by providing consistency, predictability, and reliability. A child who has a routine feels comfortable, secure, and understood and knows what to expect; they have a sense of a sequence of events in their day and their needs are met as they arise. Schedules can sometimes feel too regimented and produce feelings of anxiety because meeting the child's needs becomes based on time versus a pattern of needs emerging then being met. In this case, a sense of disconnection can develop.

Typically, by watching a child's behaviors and anticipating needs, a good routine can be established very early on and for many aspects of life - sleeping, feeding, grooming, play, etc. Parents can help develop routines by following certain patterns of activities. For example, after a child wakes in the morning, perhaps the pattern becomes: 1) wake up, 2) feed, 3) play, 4) activity/event/outing, 5) relax, and 6) sleep and continues throughout the day. The pattern, or routine, is established and there is a sequence to the events but the exact time frames may vary. Routines are not perfect because there is always the potential for something to get in the way (e.g., unexpected errand, weather, guests, a sick child, etc.) but the general pattern can stay fairly consistent.

Consistency, predictability, reliability, experiencing a feeling of connection and being understood are very important for a child's development and for parent-child bonding. Children who experience a natural routine and attachment tend to be better able to regulate their emotions and, thus, eat, sleep, play, and engage better. Routines makes sense for the child and it helps organize the parents and family as well.

Social Media and Teenagers

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 09 Apr 2013 16:00:00 +0000

How Social Media Affects Teenagers

A major topic of discussion among parents is the effect of technology and social media on the development of children and adolescents. The issue is certainly relevant, considering that 95% of children between the ages of 12-17 are now online and 80% of them are using social media websites (Pew Research Center Internet and American Life Project, 2011). Undoubtedly, there is value to the connections created via social networks, including access to resources and the ability to build a sense of community when one faces physical, geographical, or even social limitations. Nevertheless, it is important for parents to offer guidelines and invite conversations around social media usage to facilitate their teenagers’ optimal growth.

Consider the following areas when assessing social media in the lives of your adolescent:

Privacy: Who has access to the teenager’s social media site(s)? Sometimes teens share passwords with friends, boyfriends or girlfriends, etc. Sharing access may mean something to the teenager, such as a strengthened bond in a relationship. Finding out what privacy means is critical and may tell parents something about the teenager’s view of themselves and their sense of individuality and boundaries.

Content: What sort of messages or images is the teenager putting out? Is there a theme? There is usually an underlying purpose to a message. It may speak to a teenager's wish to belong or bring attention to him or herself. It may also expose a hidden talent, skill, or interest (e.g., writing fantasy or fiction on literary sites, fascination with political topics demonstrated by following certain groups or media feeds, etc.).

Duration: How much time is spent engulfed online? When a teenager is constantly engaged in social media, they are limiting in person contact and missing social learning cues, such as the ability to accurately read facial expressions and emotions. They may also be avoiding human interactions and using social media as a form of escape.

Since social media is so omnipresent in the lives of adolescents, there is benefit to recognizing its meaning and setting proper limits so that no damage is done to their social and relational development. Knowing the answers to the aforementioned questions also helps build a relationship between a parent and adolescent, as it demonstrates investment and interest in their lives. Creating boundaries around the use of social media also models the need for regulation around use and helps teenagers to develop their own capacity to do so. The value to logging off is essential not only to reinforcing in person connections with others but also to the teenager expanding their sense of self outside of the virtual world.

Posted by Asya Brodsky, LSW, CADC

Parenting Tips: The Decision to Parent in the City

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 26 Mar 2013 16:00:00 +0000

If you are a parent raising a child in the city, a soon-to-be parent or even considering having children, you have probably gotten a lot of advice from family and friends about parenting in the city. Some may suggest that you get a different, likely larger, place to live, move to a new location, potentially outside of the city, purchase a new vehicle, etc. Their advice is valid, as some have been through the process and they have made a thoughtful decision that fits their needs and lifestyle. Their choices might not be in line with yours, though.

Like all major decisions in life, having children and deciding where to raise them is extremely important and requires a lot of thoughtful contemplation. For some families, what is important is to have a lot of living space with modern features and amenities, a yard, easy parking, a certain sense of community, a good neighborhood school, etc. Driving to work, nearby shops, restaurants, and other services is not a concern. Interior space, a yard, a place to grow and spread out takes priority. These families want the most for their money and feel that moving outside of the city is the best way to get it.

Space is often a feature that is not easily come by in the city, unless it is at a premium price. For other families, the convenience of city living - easy access to work, shops, restaurants, museums, resources, and a wealth of activities - takes priority over space. Perhaps the value of being close to work, not having to worry about driving, being within walking distance of all the resources you need, and having so many choices in terms of food, shopping, cultural events, activities, etc. outweighs the need for space. Some expenses may even be less (e.g., no need for a car or using less gas when public transportation or walking are options; sometimes utilities or other services - cable/internet - are included in rent or mortgage payments in the city and, given the smaller size of living spaces, basic utilities can be inexpensive). The price for location and city perks outweighs the need for space and some of the other amenities that go along with suburban living. Families can make it work; if they want to live in the city and do not mind the small spaces but worry about, say, good schools, they find a way to save money for schooling options, do research to locate the best neighborhood schools in their preferred living area, etc.

Both living options are valid; both have their good points and less than ideal features; both can feel safe, comfortable, and accommodating. It just depends on the families' priorities.

There is no rule about what one must do as a parent or where a family must live. Some families have stronger opinions about it than others and some feel pressured to follow a status quo but there are no hard and fast rules. For families to thrive, they need to be where they are comfortable and have a lifestyle that fits their personalities and needs. Otherwise, there is the potential for resentment and frustration, which can have a harmful effect on one's sense of self, relationships, and the family as a whole.

Think about what is important for you and your family. Respect and appreciate the advice of others but make the decision that works for you.

New Moms: Motherhood and Identity Changes

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 12 Mar 2013 16:00:00 +0000

Many people spend a lot of time, energy and resources on family planning and conceiving, and just as many are surprised by a new addition to the family. Regardless of how one arrives at a family, there are a lot of concrete resources like books, manuals, classes and trainings available that can help a parent-to-be feel "prepared" for the new baby's arrival. From breastfeeding to diapering to CPR to introducing a sibling, one can educate oneself about what to expect when they are expecting. However, fewer resources are available to help a new or soon-to-be parent prepare for or cope with unexpected emotional and psychological challenges a new baby may raise.

When a woman gets pregnant and has a baby, what often happens is that many unconscious emotional issues surface unexpectedly. This is supposed to happen. She now has to manage a whole new aspect of her identity - impending motherhood - and what the concept “mother” means, then has to blend that identity with her concept of herself that has developed all of her life. Pregnant women often come into well-meaning advice from family, friends, or perfect strangers about how she will lose her identity, that her whole life will change, and that she should "just wait" and "take advantage" of her last few months/days/moments of freedom and life as she knows it. Disguised as a tongue-in-cheek warning of impending doom, what these women offer is a glimpse into identity alteration as a new mother. Based on research in the psychological and social work domains, a new mother’s identity is shown shift in a very real and unexpected way. This does not mean, though, that becoming a mother erases one’s known, established, familiar identity and plunges her into a foreign world that is uncomfortable or undesirable. It just adds another level of identity that, with some thoughtfulness and emotional processing, can be merged into a cohesive whole.

Psychoanalytic theorist, Daniel Stern, introduced the concept of the “motherhood constellation” in his book The Motherhood Constellation: a unified view of parent-infant psychotherapy (1995). His theory is that when a woman first becomes a mother, she begins to reevaluate her identity and, insodoing, she reevaluates her concept of motherhood. From the woman’s perspective, this can be initially upsetting and often disorienting, as the “warnings” from others can produce doubt and can be confusing. From this psychological perspective, the mother is working to blend her realms of experience - past, present and future. Stern noted three spheres where this evaluation takes place:

Mother-to-mother: When a woman becomes a mother herself, she begins to think about what her own mother was like as a mother and begins to have an internal conversation that helps her see her mother not as a woman or wife, first and foremost, but as a mother, herself as a child, and their relationship. She has the opportunity to revisit all aspects of her early care receiving relationships, the good and the bad, reflect on them and, perhaps, put some of the less satisfying pieces to rest and integrate the more positive experiences into her budding identity as a mother.

Herself-as-mother: In addition to thinking of her own mother and her own childhood in a new way, from a parenting perspective, as a woman becomes a mother, she also now looks at herself in a new way. Thinking about her identity as she knows it, a new or soon-to-be mother begins to incorporate into that thoughts about her baby’s growth and development and the family unit as a whole. Generally, there is less focus on her individual career and hobbies and marriage is no longer necessarily viewed as belonging to a couple only. She thinks about the family and about her husband, less as a partner and lover and more as a father.

Mother-to-baby: As she begins to think about herself in her new role and about the new elements of her identity, a woman is thinking of herself as the mother to a new baby. Practically speaking, she has to take care of the baby’s needs all the while learning about the baby, which can bring up personal insecurities, past memories of early relationships, and doubt. Can she keep the baby alive, healthy and thriving? Will her baby like her? How will she know what to do and what is best for the baby in terms of stimulation, feeding, play, etc. Can she actually do this?

This discussion is important, for many women find themselves feeling abnormal, crazy, or scared that they will lose themselves when they are shaken by the changes to their sense of self-esteem, in their understanding of who they are, and in their abilities as a person and as a parent. Many women feel alone in the way they experience this adjustment to their identity but, the truth is, this change happen to virtually all women and is completely normal. True, parenthood arouses unexpected feelings and memories and triggers different emotional reactions. Self awareness, though, can go a long way to mitigate the challenges of this new-found emotional state and identity configuration. Not every parent is the same or has to follow the path, trends or expectations of others. Parenting can become part of a person’s identity in a way that fits who they are, not as an identity of its own that is vastly different than how the parent experiences herself already. By gaining awareness and comfort in the fact that this is a natural process, it can serve to normalize the experience and make it seem not so scary, unique, or foreign. By talking about this phenomenon - having an internal dialog, sharing her thoughts with her partner a trusted friend or even a mental health professional - a woman can build confidence in herself as a person and parent as her roles and identities begin to integrate into a whole that feels right for her.

Note: Fathers-to-be go through a similar identity re-formation process. Part of this experience includes thinking about themselves in relation to their own fathers and themselves as more than just a partner but as a caretaker and provider. More on this topic in coming posts.

Posted by Andrea Hohf, LSW

Parenting Tips: Finding Balance

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 26 Feb 2013 17:00:00 +0000

One of the best things parents can do for their children is to make time for themselves. So many well-intentioned parents focus all of their time and energy on their children. It is extremely important to be attentive to children and meet not only their need for physical care and safety but attend to their social and emotional needs as well; about that there is no doubt. What can happen, though, is sometimes parents forget about tending to their own needs. They truly believe that the best thing they can do is focus on doing everything for everyone else all the time. While this sounds like a very good, unselfish deed, it can, in fact, be detrimental to the parents, children, and their relationships.

In order for parents to be fully emotionally and physically available to their children, they need to take care of themselves. When parents are overwhelmed by the needs of others, feelings of frustration, anger, guilt, resentment, disappointment in oneself, inadequacy, etc. can build and fester. These feelings affect not only parents' sense of themselves but may then play out, even in subtle, non-intentional ways, in their interactions with their children and their relationships with their spouses and partners. Parents who are not able to take time for themselves may find themselves short tempered, easily distracted, distancing, or cut off from others. These feelings can have a negative impact on parenting and on relationships, which is the exact opposite of what parents, who are all-giving, are trying to do.

To be a good parent, it is important to create a space to focus on one's own emotional and physical health and well being. Having time to oneself helps parents rejuvenate,which strengthens their identity, builds self worth, and gives them the energy and desire to be closer to their children and families. Further, it models, for children, the importance of being aware of one's needs and self care.

Taking time for oneself does not have to be anything elaborate. It can be simple and occasional, like:

Reading a chapter of a book while the children are at school or are napping one day (and saving some chores or tasks that could be done in this time for a little later)
Calling a friend just to check in, even while you are dusting, since you have not been in touch for awhile
Working out, watching a movie, or taking a bath after the children are alseep
Squeezing in time for a manicure/pedicure, massage, yoga class, sporting event, theater show, or lunch with friends or family
Grabbing a cup of coffee or tea in the middle of errands just to treat yourself
Sitting in total silence simply because you can
Going on a date with your spouse or partner

The opportunities are endless and can range from small treats to big getaways. The "what" does not matter as much as the act of "doing" something for oneself. Taking care of oneself gives parents what they need to be better caretakers to their children and be the good parents they strive to be.

Teenage Substance Abuse

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 12 Feb 2013 17:00:00 +0000

Adolescents who abuse substances begin their relationship with drugs without the intention of becoming addicted. Drugs are used for a variety of reasons; many believe adolescents use substances in order to feel accepted and help diminish social anxiety or feel a sense of excitement and power. Usually, when teenagers turn to drugs and alcohol, they do so to help manage their emotions – either trying to numb or block out certain feelings of insecurity, inadequacy, anger, fear, resentment, lack of self worth, etc., negative past experiences or sensations – and/or to feel in control. Substance misuse is indicative of impairment in an adolescents’ sense of who they are. Drugs serve the temporary function of soothing unwanted emotions and providing a false sense that the adolescents are in control of their feelings.

The issue of youth substance abuse may be masked not only because drug experimentation is common among young people but also because adolescents are able to more easily recover from physical effects. Parents and significant others may only recognize a young person’s struggle with chemical dependency when more obvious symptoms, such as changes in physical appearance, struggles with academics, loss of interest in previous activities, and irresponsible behavior no longer remain hidden. Once discovered, adolescents may withdraw or get instinctively angry because there is a threat to their external source of comfort and security and they lack an internal locus of control. If teens are force to give up substances, they become vulnerable to their emotions and the past experiences that contributed to the use of drugs or alcohol in the first place.

Difficulties in adolescents with substance abuse have specifically been found in the following areas:

Self-esteem: Addicted teens struggle with feeling good about themselves and the use of substances helps mask their deflated self image. They feel inadequate, insecure, and vulnerable and use substances to compensate for this sense of emptiness.

Regulating feelings: Chemically dependent adolescents have difficulty tolerating feelings, emotions, or stressful situations. Using drugs or alcohol helps teenagers not have to feel anything and it blocks distressing emotions. It also has the potential to mask painful memories or experiences that the youth has never processed (e.g., traumatic event – including parental divorce/separation – loss, feeling neglected or disconnected from family, feeling unworthy or unwanted, etc.). Conversely, some forms of substance use (e.g., stimulants) can also spark feelings when one experiences an emotional void.

Maintenance of relationships with others: Adolescents may struggle to feel accepted by non-users who do not provide the same sense of relief, comfort, or stability as a substance. Using drug or alcohol allows for withdrawing from others and prevents relationships from forming. Depending on their past relational experiences with family and caregivers as well as friends and peers, relationships may be viewed as difficult or unsupportive, so to engage in them becomes painful and not worth it. Substances can help keep those relationships at bay.

Caring for oneself: When relationships with a substance become superior to all else, such preoccupation help reinforce adolescent insecurities. The need for substances to control emotions and past experiences supersedes any other responsibilities, such as physical care (e.g., hygiene, eating well, etc.), personal tasks (e.g., homework, chores, etc.), maintaining relationships with family or friends, and protecting oneself by making healthy life choices.

With these thing in mind, it is evident that recovery from substance abuse must involve strengthening one’s sense of self in order to develop the capacity for healthy emotional regulation. This process for an adolescent will take time. A young person will need to work through many defensive feelings to address what a drug means, what it means to use/not use and who they are when not on substances. Family members, who may be pushing for the addicted person to recover, must keep this in mind and avoid accelerating the process. To be the most effective caregivers, parents must also understand the basics of substance abuse and the unique characteristics of adolescent dependency. There must be recognition that a chemical has served some role for the adolescent and within the family context. Individual psychotherapy can help provide a space for adolescents to safely explore their past, examine the underlying reasons for their substance use, and work through past experiences and feelings so they no longer overwhelm the adolescent emotionally. Support from others in similar situations, whether through Al-Anon or family support groups, may also be necessary. Finally, family therapy can be considered, not only to help support the struggling adolescent but also to help the family start to reorganize, recover, and work to enhance positive, healthy connections and relationships.

Posted by Asya Brodsky, LSW

Sources:

Meeks, J.E. & Bernet, W. (2001). Chemical Dependency in Adolescents. In Meeks, J.E. & Bernet, W., (5^th Ed.), The Fragile Alliance: An orientation to Psychotherapy of the Adolescent (pp. 412-431). Malabar, FL: Krieger Publishing Company.

Khantzian, E.J. (1995). Self-Regulation Vulnerabilities In Substance Abusers: Treatment Implications. The Psychology and Treatment of Addictive Behavior, p. 17-41.

Gender Identity: Transgender Parenting and Child Development

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 29 Jan 2013 17:00:00 +0000

The parent and child relationship is likely the most powerful relationship each person has ever experienced. From day one, there are challenges, struggles and rewards like in no other relationship. The relationship provides the foundation for one’s ability to communicate - to listen and to be heard. It creates one’s ability to love and be loved and to experience conflict or disagreement but then to heal and reconcile. The parent/child relationship provides life’s sustenance, which results in one’s confidence that their environment will provide for basic needs (food, shelter, creative and intellectual stimulation). Ideally, the relationship develops one’s capacity for confidence in both his or her own identity as well as trust in the stability (the extension of identity - availability, presence, existence) of an available parent. Every parent/child pairing also has its conflicts and challenges. It is the continuity of love and care from parent to child that provides the rich foundational qualities listed above, and this protective and fundamental relationship always needs to be supported.

There are many things that can put stress on a parent/child relationship, though none quite as unique as when one or the other experiences turmoil with his or her gender identity.
From the child’s perspective, a parent’s struggle with gender plays a part in how the child understands gender identity as a social role, as an external quality or characteristic. All young children - those with parents who fit into the societal definition of a particular gender (i.e. “cisgender”), and those who are gender nonconforming (i.e. “transgender”), are tasked with learning what it means to be one or the other gender. The child uses many sources of information to figure this out, not the least of which is the parent as a role model. The parent serves as the child’s living example of what it means to be a man or woman (and, by extension, what it means to be a mother, father, sister, brother, or to be a male/female writer, athlete, fashion model, business executive, etc.). So, naturally when the parent’s gender is redefined, it challenges the child’s conception of male and female social roles. For example, a father of a three year old uses the “Male” bathrooms/locker rooms, etc. As this father redefines as a woman, she will begin to use “Female” bathrooms and the like. Something that for some may seem trivial, such as to what door a parent enters to use the restroom, is huge for a child, whose whole life is engrossed in learning about what doors they are allowed to go in and the appropriate place, style, time for doing such things. We do not typically think of potty training as a lesson in gender norms, but in reality it is so - girls sit/boys stand; girls go to the girls room; boys to the boys room; girls have vagina’s, boys have penises, etc. This necessary task inherently stratifies the genders, and three, four and five year olds are naturally learning and digesting rules, “norms” and the concept of “right” and “wrong.” So, when a parent changes the rules, it challenges the child’s sense of the world and how things and people work. The important thing to note is that this is not inherently a bad thing. It is the reality for many, many families and deserves respect, understanding and appropriate support.

A parent’s gender redefinition, or the struggle one must endure before making the decision to redefine, also plays a part in how the child understands gender identity as a personal characteristic. Not to be confused with a parent influencing how a child identifies his or her own gender, what is meant here is how one owns their own gender identity is influenced by how one, or both, parents own, and express, their gender identities. In just thinking of the parent as a role model, personal security or insecurity transmits from parent to child. If a parent is uncomfortable in his or her own body, the child will sense that something’s “off.” Depending on where the child is in terms of development, the parent’s redefinition can have a variety of effects, from none, to mild confusion, to total upheaval and lack of understanding, to outright rejection. Very young children may have fewer expressed difficulties with a parent’s transition and will have more years than not with the parent living as his or her redefined self. This can serve to normalize the experience more quickly. Preschool and school-aged children, because of where they are developmentally (i.e., filled with curiosity and focused on rules) may have a louder voice that might challenge the parent’s decision as going against the rules, as with the bathroom example above. To offer another example, one transgender parent interviewed described a scene where a dozen preschool children rushed her to ask questions or to make comments about her gender nonconformity. This parent experienced her child’s classmates saying “Daddies aren’t girls,” and her daughter replied, “MY daddy IS a girl.” The children in this example are repeating rules that they have learned through their social experience. Who wears what, what it means to be a dad - these things are taught both directly through teaching (parenting, schools, religious doctrine) and indirectly through a lived, social experience.

The older the child, the more complex the issue can be - adolescents have solidified their understanding of gender and are in the process of using their upbringing to forge a life for themselves with an identity separate from that of his or her parents. A parent redefining at this age holds the potential to really shake up the adolescent. Older children and adolescents may have strong feelings against the transition. They may feel embarrassed, angry or lied to. They may go through periods where they experience more or less understanding or acceptance, as they process their parent’s redefinition as a very personal event happening to them, uprooting their world. Some may have nothing but empathy or understanding for their parent as he or she redefines his or her life and identity. None of this is bad or inappropriate and all indicates the processing abilities and challenges of this developmental stage. The reaction a child has is as unique as the child him/herself. In all of these cases, both child and parent need support in coping with the event and reaction.

It is crucial that people know that having a transgender parent will not make a child transgender. It will challenge the child’s conceptions of his or her own sense of what being male and/or female means and how she/he fits into those conceptions, both old and new. There can be opportunity for children to expand the social conception of “gender” and broaden the horizons of future generations and to invite a more thoughtful, all-inclusive conversation about gender and gender identity. Children need support in understanding and coping with their parent’s decision to transition from one expressed gender to one more in line with their inner experience. But, like in many other realms of conflict, where there is a challenge there is also room for deep growth and understanding.

In all likelihood, from the transgender parent’s perspective, this could very well be the one area of their life that they feel most secure in and most happy about. They have probably experienced years of inner turmoil - as a child themselves with gender identity struggles, dealing with being a mismatch to social gender norms, enduring relationships that did not fit with their gender identity or, possibly, sexual identity. Coming to terms with their decision to change their external identity to match their internal identity and taking action to do so takes strength, bravery and a willingness to deal with things that may have been suppressed for a long time, particularly if one has children. It is hard enough for a parent as an individual to contemplate re-identification but being a parent can make it even more challenging because their children are now involved and making this change not only affects the parent-child relationship but it has the possibility to disrupt the family relationship as a whole. Divorce and separation, new alienation and estrangement, prejudice and struggles their children may face naturally affect the re-identified parent. However, their gender re-identification might not be a source of pain and conflict, but, rather, may serve as a source of comfort for them in this new batch of trying times.

Despite finding security in one’s decision to make the transition, partners, friends or family members might not find the same solace. Transgender people often have many losses to mourn. One major loss may be the loss of their partner and co-parent. Many couples who experience the gender redefinition of one partner do not survive and, often, the divorce or separation, which is nearly always difficult, can be downright brutal. While not to be confused with abnormal, transgender issues are not typical, therefore rendering both the formation and dissolution of relationships more complex. Divorce and separation always affects children, but when parents themselves are unable to contain hurtful actions or words about the other parent or the other parent’s decisions, and when the divorce and hurt feelings become more about the pain and less about the relationship, children can become confused about who and what to trust. Children and parents at this juncture benefit greatly from supportive relationships, such as those of trusted friends or with a therapist or support group.

Children are resilient, but they do better the more support they have. Good, thorough and age-appropriate communication is always beneficial. Communicating with children can be a scary thought - what do you say? How do you say it? One idea is to create a storybook in which a narrative is created together and read again and again.This activity can spark deep conversations and can serve to help with processing the experience for both parent and child together and can expand as the child develops deeper and more complex understandings of the world and more and deeper questions about re-identification and gender identity. http://www.mystorybooth.com/?dtrk=861

As was mentioned, support is very important - especially for the developing child and the possibly fragile parent/child relationship. Support can be sought from family and friends who are understanding, by locating and attending support groups, or by considering therapy for oneself and for the child, so each has a place to process feelings related to all the changes. Children, in particular, can find great relief in having a space where they do not have to follow the conventional rules of behavior and self expression. Child psychotherapy - psychodynamic play or talk therapy - can be extremely useful, allowing the child to express and process, feelings, and can be an effective venue for learning new coping and communication skills and well as strengthening relationships.

In sum, here are a few areas where support is needed and, in addition to Child Therapy Chicago, a few additional resources for parents:

For the Child:

Age appropriate support for the child coping with change
Support for coping with other people’s perception of the parent’s transition
Support for other issues, such as, perhaps, being alienated by the non trans parent’s reaction to the transitioning parent
Ongoing support around the dynamics of the relationship changes with the redefining parent

Support for Parent:

Support with decision to transition
Rebuild confidence in one's ability to parent
Support identity rebuilding
Support with social perception
Support with possible rejection of spouse or child

Resources --

Chicago Women’s Health Center - Trans Greater Awareness Project
http://chicagowomenshealthcenter.org/services-page/tgap-trans-greater-access-project

Further Readings --

http://www.transparentcy.org/
http://www.firelily.com/gender/gianna/children.html
http://www.ourfamily.org/
http://transequality.org/

Post by Andrea Hohf, AM, LSW

*I would like to thank the transgender women who contributed their time and information to the making of this blog post. Your input is invaluable.

Helping Children: How to Talk to Children About Traumatic Events

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 15 Jan 2013 17:00:00 +0000

In the wake of the Sandy Hook, Connecticut school shooting, parents have been wondering how to talk about difficult or traumatic events with their children. Many questions arise as to what and how much to say to young children when something potentially frightening or anxiety provoking occurs and how to handle their responses. Conversations can range from discussions of traumatic natural disasters or the recent school shooting in Sandy Hook to talks about divorce, parental health problems, or even age appropriate questions about loss and death.

Here are some things to keep in mind when helping children understand and work through provocative and scary situations:

Stay engaged with your children --
Always make special time every day to check in with your children and focus your attention on them. The more connected and engaged parents are with their children, the more attuned they are to their children's emotions and the more connected and safe children feel. Staying engaged makes it easier to notice when children are affected by something, or not, and helps children feel comfortable talking about what bothers them.

Point out any unusual behaviors and/or changes in mood --
When an event or situation is upsetting to children, parents may see regressive behaviors, such as the need for the children to to stay close to the parents, toileting accidents, aggression, and/or emotional ups and downs/difficulty containing emotions (e.g., more outbursts or tantrums and longer times to console the children). Parents can talk to their children about what behaviors or moods they have noticed and ask them about what has been on their mind. Noting these unusual behaviors lets the children know that the parents are in touch with their experiences and it opens the door for communication.

Acknowledge your children's feelings --
Sometimes children feel upset but are not able to verbalize it. Giving words to feelings that seem unspoken, empathizing with what the children might be feeling, and sharing one's own feelings allows children to feel understood. This helps strengthen the parent-child bond and promotes feelings of safety and well-being for children.

Give children information at an age appropriate level --
Avoid over-explaining or providing too much detail. Children will ask the questions they have; offering an honest, simple, straightforward answer is enough (e.g, if a child is expressing a developmentally appropriate curiosity about death, it is fine to say that the person was old or sick or in an accident and is not going to be able to come back - or use whatever words or metaphors that make sense for the family or culture. Be mindful, though, of not increasing the child's anxiety, such as by telling a young child with sleeping fears that the person went to sleep forever. Choose your words carefully.) This way, the child gets an answer without being overwhelmed by the details, which may elicit further anxiety and, thus, more questions. If you do not know the answer, it is ok to say that too. Simply say so and acknowledge it as a good question. Most often, children are not looking for the details but are using their questions as a way to share their feelings and reach out for understanding.

Provide reassurance and comfort --
Understand that when children feel stressed, scared, confused, sad, etc., they may need more closeness, comfort, attention, and reassurance. This is normal. Be patient and allow children to be needy again. Comfort and understanding, along with acknowledging feelings and open communication, help restore a sense of safety and security.

Maintain consistency and structure --
When children are faced with confusing things, they can feel overwhelmed and out of control. To minimize these feelings, it is very useful to maintain a sense of consistency and structure. Putting in these exterior physical boundaries (e.g, routines, schedules, etc.) for children helps them feel safe inside.

Children are pretty resilient. With ongoing support, commitment, engagement, predictability, and reliability from their parents, children can process and work through their curiosities and upset of potentially disturbing events around them.

Good Parenting: Make It Your New Year's Resolution

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 01 Jan 2013 17:00:00 +0000

Happy New Year!

We at Child Therapy Chicago wanted to wish everyone a Happy New Year and encourage one simple but important new year's resolution -- to always keep trying to be a good enough parent. Much has been written about this concept and we address it frequently. Good enough parenting is not about being perfect, never getting upset, and responding or reacting to children the right way all the time; it is about building a relationship of trust, warmth, security, and positive regard by being as reliable, predictable, consistent, supportive, and encouraging as often as possible. When things do not go as planned, which can happen a lot, good enough parenting is about the repair and recovery from those moments. Children learn about relationships and develop their sense of self from their interactions with their parents and caregivers. When things go well in the relationship, great. When there are less than ideal moments, that is ok too. Parents and children can talk about and process those difficult times, which helps children learn how to deal with feeling of upset and disappointment and how to work through them and move forward with their sense of self still intact.

So, for 2013, resolve to keep working on being a good enough parent. The rewards for parents and children are priceless.

The Role of the Adult in Child’s Play

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 18 Dec 2012 17:00:00 +0000

In a previous post (The Importance of Play), we briefly explained how the role of play in a child’s world is of great importance to his or her psychological and physical development. To reiterate, play, for children, is work. Children use play to act out scenarios or events that are consuming their mental energy and they play about them over and over until they have processed enough to move on. Even the most typically developing children are consumed by the massive amounts of information and relational experiences that they must navigate every day and play helps them work it out.

For babies, play might mean cooing with a caregiver or back and forth babbles, chewing on books or handling different textured items. As preschoolers, a lot of play revolves around pretend play, playing out scenes as “mommy” or “daddy” and the quintessential superhero versus villain scenes that are so common. They make up their own rules to their own games and change them as they see fit. Children play a lot with physical competencies - block building, running races, playing on the playground. Regardless of age, there is deeper meaning to their play than even they consciously understand.

In the examples given above, through play, babies are learning about their sensory world - smells as well as physical and visual sensations - relationships, and learning to trust that their caregiver is available and will provide for their needs. Repeated positive and encouraging play interactions help children develop a healthy sense of self and a confidence that supports their interactions in the world. Preschool games provide an outlet for sorting out social and cultural roles. Preschool children at play are figuring out what it mean to be a boy or girl, the struggle with morality and good vs. evil, their own sense of power and self-esteem, and they are learning that the world runs via rules and rewards/consequences. The fun time on the playground is where they build their sense of exploration and develop gross motor skills and strength and learn about physics (gravity comes to mind as a child falls from the monkey bars to the ground). The blocks they use help build fine motor skills, hand-eye coordination as well as the internal feelings of accomplishment (building something successfully; a reward for struggling to work those small muscles in those little hands), and a sense of power (they can also destroy their creation). These examples do not even scratch the surface of the value of different types of and venues for play. While not exhaustive, these examples do show how, for children, play is work.

Play is rich with metaphor, and the adult can have a particularly powerful role in a child’s play. Lev Vygotsky was a pioneer in the process of scaffolding that is used by many preschool teachers, child therapists (occupational, developmental, mental health), and also, perhaps unknowingly, by many parents. Scaffolding is the process of taking the child from where he or she is, for example if he or she is fixated on something, and guiding him or her to resolution or to a greater understanding via play.

A mother and daughter playing dolls might find themselves in a scenario where two siblings are not getting along (a parallel to the family's real life situation). The behaviors within the play (e.g., one sibling bossing around the other or one sibling separating the other out from the rest of the family) may expose the daughter's feelings of resentment toward a new baby sister, of her jealousy of not having the same level of attention from her mother since the birth of the new baby, or of her sadness that she now has to share her mother. The mother may be placed in the role of the new baby and, thus, have the chance to share how the baby feels about being part of the family and having a big sister (i.e., the mother becomes the voice of the baby so the older sibling can come to understand the baby’s experience). Or, the mother may find herself in the role of the older sibling and she can express - through the doll - what she suspects her daughter may be feeling - fear, anger, sadness, uncertainty, or excitement - about having a new sibling. In both instances, the mother is able to help provide words for feelings that are being enacted in the play. The child begins to feel understood and has an opportunity to experience empathy for the new sibling. The child may then be able to see the sibling in a different way - that the baby is hers, too, as part of the family, and that while she has experienced a loss, she can also accept the sibling as a gain. Play is an amazingly open format for children to process feelings and to accept new ways of thinking about things.

In our work as play therapists, children are provided a space where play is safe and sacred, and where trained experts, who understand child psychology, can interpret the meaning behind the play and promote emotional and cognitive growth within the play itself. Our work in play therapy and when counseling children is about:

looking for opportunities within the child’s play to help the child express his or her feelings about different experiences and relationships,
helping the child learn new skills (Vygotsky called this the Zone of Proximal Development or ZPD), and
supporting the child to work through these feelings in order to grow emotionally and cognitively through play

While we cherish this role, there is much you can do as a caring adult in the life of the child to help him or her become secure, confident individuals.

Posted by Andrea Hohf, AM, LSW

Further Reading:

Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Chapter 6 Interaction between learning and development (79-91). Cambridge, MA: Harvard University Press.

Anorexia: More Than a Body Image Distortion for Young Adolescents

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 04 Dec 2012 17:00:00 +0000

Teens with eating disorders, such as anorexia, often have a distorted image of their body and they have difficulty maintaining an average body weight. Young people who are struggling with anorexia typically believe they have multiple physical abnormalities, which they try to change through various means, whether it is starvation, vomiting, or extreme exercise. The continued aspiration to “fix” something about their physical body, however, most often serves as a mask for underlying feelings of insecurity and worthlessness, which they are fiercely striving to hide.

A primary factor to understanding anorexia in adolescents is the recognition that the body is serving as the vehicle through which these young people are attempting to express something about their inner world. In other words, when dealing with eating disorders in teens, it is important to focus on exploring issues of self-esteem, value, and self worth. Many adolescents presenting with symptoms of anorexia feel out of control or unable to manage their emotions. That feeling of insecurity is then expressed by an intense need to take charge of something they think they can control – their physical body. What is important for parents and other caregivers to remember is that adolescents with eating disorders can feel stuck and they need patience, support, and a caring environment in which to develop a healthy sense of self, where they feel confident, unique, and comfortable on the inside and, thus outside.

The following behaviors have been found in young people with eating disorders and may serve as cues that an adolescent has not yet developed a strong, positive sense of self.

Extreme levels of involvement or over-involvement in activities or other achievements: This is especially important if young people express that their achievements are performed/completed for others and not for themselves.

Frequent comparison to or excessive competition with other students, peers, and friends: Young people may express feeling like they are not as “good” as other, feel left out despite trying to be part of a peer group, or describe their relationships with others as superficial and not genuine.

Difficulty separating oneself from parent or caregiver: This may be manifested in constant demands for attention and reassurance and experiencing great anxiety or hyper-alertness when separated from family. Some young people also have few boundaries and share too much intimate information with family when they should be starting to individuate.

Compliant and overtly conforming behavior: This may be expressed by always doing what is expected (e.g., doing things that friends and family want and not expressing an opinion, etc.), not out of desire or a sense of responsibility but in hopes of earning attention, praise, or connection.

Creatingboundaries and modeling the importance of setting limits in a warm, sensitive environment is one way of helping develop a positive sense of self in these young adolescents. While this may seem difficult because of the potential for a negative response, limit setting serves an important function. It allows young people to trust their caregiver to create a safe space that supports the expression of emotions. Helping adolescents express their inner feelings and take responsibility for themselves and their actions increases one’s sense of self esteem and can reduce the temptation to feel in control of oneself by managing one's physical body. Of course, this should be done without taking over the young person's life but by balancing support and involvement. Finally, helping young people to recognize their inner uniqueness builds positive self regard and makes external influences less powerful. These strategies all serve to help struggling adolescents let go of the need to externally control themselves (e.g., via weight and looks) and start to control their inner feelings. That, in turn, will allow them to create a much richer meaning to their life “fed” by much more than lack of food.

Posted by: Asya Brodsky, MSW, LSW

Sources:

Barth, D. (2003). Separate but not alone: Separation-individuation issues in college students with eating disorders. Clinical Social Work Journal, 31(2), 139-153.

Pharis, M. & Penn, M. (1984). A Model for outpatient Treatment of young adolescents with anorexia nervosa. Child and Adolescent Social Work Journal, 1(1), 34-48.

Child Nutrition

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 20 Nov 2012 17:00:00 +0000

Beginning in utero, one of a mother’s primary concerns is typically what to feed her child. A pregnant woman’s body gives the nourishment of her growing fetus top priority, even at the expense of her own general health, physical/nutritional needs, or quality of life. Once the baby is born, whether breast or bottle feeding, that baby is getting all of his or her sustenance from its caretaker. Food is also a source of nurturance and serves as a means of bonding between parent and child. Even into adulthood, food can be source of comfort. A tremendous amount of pressure is placed on parents to provide just the right kind and amount of nutrition (and, thus, emotional nurturance) to children. While most people want to provide the very healthiest foods for their offspring, there are a lot of ways that make doing so complicated.

Emotionality

Feeding an infant is one of the first and most significant means of bonding. There is a strong emotional connection between parent and child that exists in the course of providing nutrition; the parent is giving the child what he or she needs to thrive, which is very powerful. Over the course of one’s life and through their relationships, food can take on many meanings. For some people, certain foods conjure up feelings of warmth, comfort, happiness, and love and, overall, they have good relationship with it. For others, food may be something with which they struggle and may carry negative connotations.

Thus, food, and one’s nutritional selections, play a role in the development of one’s sense of self value and worth.

Culture

Feeding one’s family is a lot more complex than what food goes on the table or in sack lunches. Arguably, the number one ingredient that goes into any recipe is “culture.” Where does one come from, what do one’s ancestors bring with them to their dinner tables? What are the rules? For example, does your family follow certain dietary laws, like keeping kosher? Does your culture disallow the consumption of certain foods like pork or alcohol? Are the foods of your home culturally available to you in your current residence? Does your family cook a certain way, like “southern” style with a lot of butter and/or lard? Are your parents vegetarian or vegan? Does your child have special dietary restrictions or food allergies? Have you learned to see food as a reward or to use food to cope with stress, anxiety or loss?

Never underestimate the power and pervasiveness of the influence of culture in all facets of life, including what to eat, when, where, with whom and why.

Information/Education

One of the most important pieces of the “What do I feed my children?” puzzle is the information regarding what constitutes “good nutrition.” Even if some cultural practices are not always thought by nutritionists to be the healthiest, knowing what “healthy” means is a critical piece to changing the long held habits that get passed down from generation to generation. How does one learn about proper nutrition? The United States’ government has guidelines (http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf) and simple tools to help people figure out how to fill their plates (http://www.choosemyplate.gov). The First Lady, Michelle Obama’s Let’s Move! (www.letsmove.gov) campaign, challenges parents, schools and children in concert with local, state and national government to combat childhood obesity and inactivity by taking steps to become more educated, more active and to become involved in their own food (for example, by planting a box or window garden or creating healthy recipes).

There is no way around the fact that if people do not know what to eat, they are at risk for making less than optimal health choices.

Socioeconomics

Even if one gets all the information about the best way to nourish one’s bodies, sometimes good nutrition is not practical, affordable or available. People can tout the benefits of fresh produce, the importance of getting the 5-a-Day diet (http://www.fns.usda.gov/tn/Healthy/5_Day/5_day_facts.pdf), of the superiority of organics over conventionally grown ingredients all day long, but for many families it boils down to what is available and going to feed the most people the most amount of times on the least amount of money spent. In many communities, where the socioeconomic status is lower, access to those things considered “healthy,” such as fresh fruits and vegetables, may be limited. Families may not be readily able to get to stores, beyond neighborhood convenience stores, that offer healthier items.

It is one thing to provide information to schools and suggestions for how to become more active and grow community gardens, but it is another to expect residents in communities where there is poverty and, perhaps, violence to be in the position to realistically or easily adopt promoted good-health habits or have hope for access to such resources. Survival may be the families’ focus.

It is important to remember that most parents - regardless of class or ethnicity - want the best for their children. There is not always a choice about what to feed a family.

Environment

Peer pressure is blamed for a lot of things, and sometimes rightly so. But, who would have thought that peers could influence food choices? In thinking about food and a child’s environment, the subject inevitably points to school or other school-like settings, such as daycare or summer camp. Unless a parent is packing lunches every day, what children have available to them are the options that the school district or other venue provides. While the US National School Lunch Program has recently gone through an overhaul (http://www.fns.usda.gov/cnd/lunch/AboutLunch/NSLPFactSheet.pdf), offering more fruit, vegetable and whole grain options and gradually reducing the sodium content of foods offered, children still have to make the choice to select and consume those new, healthier options. It is worth considering the difficulty a child might face selecting a whole wheat and turkey sandwich with apple slices when her friend is eating pizza slices and french fries. Healthy options need support where children experience much of their learning and social, cognitive and emotional development - with their peers.

Summary

Of course, the reality is, like any good recipe, feeding one’s children is a mix. Parents balance all of their influences and resources and do the best they can with what they have and with what is available. In order to make the best choices for optimal health, parents need information to understand what “healthy” means, have culturally appropriate access to foods and activities that encourage good health, and need social supports that teach and promote healthy habits. Even if a parent has all of these things in place, access, affordability, and motivation to change are other important considerations.

Food is not only about sustenance but nurturance. Being as conscientious as possible (and as resources permit) regarding food choices and helping children develop good habits, helps support children’s healthy emotional growth and development as well as their physical well-being.

Posted by Andrea Hohf, LSW

Parenting Help: Self-Care and Stress Management

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 06 Nov 2012 17:30:00 +0000

Much like it sounds, self-care is the act of taking care of oneself. This term applies to many categories, and the concept is frequently applied to taking care of one’s physical health. For example, when someone has a cold, taking a day off from work, getting rest, and eating chicken soup might feel like just what is needed. When a person breaks an arm, going to the hospital for an x-ray and a cast is a no-brainer. For a headache, most people reach for the ibuprofen. No problem. However, when it comes to mental or emotional health, the answer does not seem to be so easy. Reaching for the Prozac is rarely as easy as grabbing the Tylenol, and the recipe for chicken soup for the soul is not in the cookbook next to the chocolate chip cookie recipe. Caring for mental and emotional needs is a personal, often difficult and undervalued pursuit, yet it is very important, especially for parents. Aside from personal barriers, there are often external barriers that prevent parents from attending to these needs. Some come from a person’s culture, from society at large, and others may come from opinions of the person’s peer group or partner, and still yet, a lack of awareness, information or resources. However, when a person feels overwhelmed, frazzled, or stressed out - it is a sure indicator that it is time for self-care.

Naturally, since each person is an individual, what “self-care” means is different for everyone. What makes someone feel cared for? Beyond “warm fuzzies,” when people feel cared for, they feel revitalized, assured, more at ease and recharged. They feel relief and ready to return to life’s routine a less-distracted, more “present” person. Some people find relief in an exercise routine like running or cycling, some find relief in meditation, yoga or other mindfulness exercises. Others feel like they are cared for when things are in order around their house or office or when they have a concrete project on which they can work - like an art project or major closet overhaul. The sense of personal accomplishment provides a respite from the stress that builds and overwhelms.

The body’s stress response is a natural and very useful instinct present in all animals. It helps people know when they are in danger (think dark alley, stranger suddenly turns to follow you - you get a stress response and the instinct to get out of there as soon as possible), which may save their life. However, when a parent feels the need to run away during a diaper change or when driving children to school, getting them dressed, thinking of how to pay the bills, or where one’s next paycheck will come from, that builds up and becomes a chronic issue that is not useful for self-preservation. Chronic stress carries negative physiological consequences, meaning that stress causes real effects on the body and its ability to function.

What exactly is stress? Stress is the body’s chemical response to an actual or perceived threat that the body is uncertain how to deal with, which happens when the demands of the situation exceed the immediate available resources a person has to deal with it. So, in other words, a stressor is something that overwhelms, whether or not other people would react in the same way. All living bodies have chemical reactions in their brains when stress is present called a “stress response.” The stress response is a very important part of survival. Ever hear of the “fight or flight” mechanism? It is the body’s way of deciding whether or not a stressor is survivable or not. Quite literally, if a lion lunges from the bush to attack a herd of zebras, the zebras run and run fast. Their brains know that they cannot win a fight against the lion so they instinctively kick it into high gear and flee. It is because of the chemical known as “cortisol” that this response takes over. Cortisol helps to regulate many things, including hunger, mood and emotions, and increases during a stress response. When all of this cortisol shoots through the brain and into the body, some things move faster - for example, respiration (breathing), energy availability (an “adrenaline rush”), heart rate - while other things shut down, such as the sensation of pain, digestion, the ability sleep, tissue repair, reproduction, immune system. Only the systems that the body needs to survive the immediate threat are turned on and turned up, using all of the energy ordinarily saved for the systems that have been shut off.

Chronic stress is when the body never regulates fully and is constantly in a state of stress response. People with stressful jobs, parents who do not have resources or who do not get a break, those who have experienced trauma, who live in poverty, are underemployed or financially stressed, who have ongoing medical issues, have relationship difficulties, or substance abuse addictions, among an endless list of others, are all at risk of experiencing chronic stress. The constant pumping of cortisol into the system keeps the body on high alert, which means that it also keeps resources from other “non-essential” systems of the body like sleep, emotional regulation and reproduction. The effects of chronic stress are all around - uncontrollable diabetes, weight fluctuations, high blood pressure, anger management issues, lack of patience, irrational thinking, panic attacks, and poor decision-making skills, to name a few. All of these can easily translate into troubled parenting. If parents are chronically stressed, their ability to maintain patience and a level head with an energetic, demanding, and not very verbal toddler is not at its fullest potential. Parents may have a quicker temper or find themselves resorting to more aggressive discipline techniques than they would otherwise. Or, they might use the television to entertain their children, when otherwise they might have enjoyed reading a book about his or her favorite subject, solely because they just cannot cope with the constant questioning of a curious four year old at that moment.

In a nutshell, what self-care boils down to stress-relief. No person wants to live in a constant state of agitation. Nobody chooses to be impatient with their child(ren). Yet, so often the very thing that might offer a respite from the feeling of being overwhelmed and over-extended - self-care - makes people, parents in particular, feel guilty or selfish. As if taking care of oneself were not, by extension, taking care of one’s other responsibilities or that by doing something for oneself is bad because it is time away from doing for others who are dependent. Being cared for, and in this case caring for oneself, allows the stress levels to reduce so all systems can balance out and function optimally and, thus, allows for people to be happier and more “present” in their tasks. Parents especially need to practice self-care because they have the lives of their little ones to manage as well, and they cannot afford to be anything but able to do so. Not to mention that a stressed parent makes for a stressed child. If parents practice self-care, children will learn that caring for themselves is an okay and valuable thing to do. So it is the furthest thing from selfish to practice self-care.

So, take some time to think about what it is that makes you feel cared for. A hobby - painting, building model cars, collecting stamps, scrapbooking, cooking? Athletics - running, yoga, martial arts, group classes? Socializing - social clubs that meet around topics that interest you, book groups, role play games, girls-night-out? Time alone - meditation, a hot bath, listening to music, reading a book? Academic pursuits - going back to school for a degree or a certificate, taking a pottery, photography, or dance class. Whatever it is, make time for you in order to make life for you and your others better.

Posted by Andrea Hohf, LSW

Good Parenting

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 23 Oct 2012 16:00:00 +0000

Parents bring their life histories with them into their parenting philosophies and practices, and it usually happens without awareness. This means that, while parents might bring the very best intentions and the very best traits of their own parents, their values, and their ideals, sometimes previous life experiences can get in the way of building healthy relationships or effective parenting.

For many new parents, their past experiences in relationships provide a template for how they presume relationships are supposed to work, ideally. From these ideals, parents impose meaning on newborn’s behavior. This imposed meaning, for most, is essential to the bonding process with their baby. Yet, for others, life and/or relationship histories interfere with bonding efforts and serve to make relating and reading baby’s cues very difficult. For example, for Erin*, whose mother died during her childhood and she never really had the chance to mourn, she may be extra sensitive to her new daughter excessively crying and worry that the baby is afraid that Erin herself might disappear. So, in an effort to keep the baby close and reduce the fear of abandonment she thinks the baby has, Erin may choose to co-sleep, even if the baby is not exhibiting any particular need for it. By doing this, Erin feels that she is attending to a very important need of her baby and feel validated as a “good parent,” even though the meaning of Erin’s baby’s cry is imposed by Erin herself and not necessarily coming from her baby, whose cries may be of discomfort, hunger, cold, etc..

If it were looked at from another angle, Erin may feel that she has no model for how to be an effective mother and fears abandoning her baby as she felt abandoned by her mother. She may take the baby’s cries of hunger or excessive fussiness, which she seems to be unable to stop, to be cries of dissatisfaction with her mothering skills. She might emotionally withdraw from her baby in order to cope with the overwhelming demands of being a new mother, the seeming rejection of her mothering efforts, and the emotions dredged up from her own childhood. If not attended to, this interpretation may lead to a lack of healthy attachment and to frustration on both Erin’s part and on the part of the baby ,who is struggling to learn self-regulation and effective communication with a mother who has not had the opportunity to grieve her past loss.

So, what makes a good parent? There are ways in which one can try and attend to difficult histories or traits that one would rather not pass down to the next generation, ways to work on this include:

Identify/admit shortcomings, fears, anxieties
Allow yourself an opportunity to be sad or angry about things that were not so great in your past
Allow yourself the opportunity to grieve the absence of missing relationships and let go of those that were less than optimal
Forgive yourself for your mistakes
Seek help (counseling, talk to a friend or confidant, meditation)
Try to do better
If you tried and failed, then try again tomorrow
Always remember that one event or one characteristic does not define who you are as a whole, being human is complicated - and that’s ok!

It is also very important to remember that, no matter how difficult childhood might have been for someone or how many “ghosts” from the past that lurk in the dark, there are usually some positive experiences that can be accessed as well. Ask yourself if you had an example of someone - a role model, a mentor, a close friend, teacher, coach, therapist - who made you feel good about yourself. The experience itself does not have to be profound to have left a lasting and useful impression on you. Channel the positive experience and use it to guide you to a place where you are happy. Think of why that person made you feel good and how you can use those characteristics in your own personal life and with your own child(ren). Just as we all have ghosts that can interfere, we also have positive experiences which can serve to help us through difficult times - memories of people or times to look back on and think, “What would Mrs. Green have done? What would my grandmother tell me to do if she was still alive today?”

As long as personal histories are buried, they remain hidden and can pop out - for better or for worse - at any given moment. As cliche as it sounds, every day IS a new day. Children are resilient and, best of all, very forgiving. They long to have positive experiences and relationships with their parents and caregivers. When parents get caught off guard, it is harder to realize and correct behaviors that, if conscious of them, one would choose to avoid. It is easy to get caught in a cycle of self-blame and negativity, all the while your child waits at the ready to forgive and get on with it. While addressing personal challenges and accessing strengths - always remaining as aware as possible of one’s own history - successful relationships and nurturing parenting is possible and the next generation can be given better. Nobody is perfect, but with awareness progress is possible. These are the qualities of a good parent.

Posted by Andrea Hohf, LSW

*Based on a real example, although the name has been changed to protect anonymity

Resources:

Fraiberg S, Adelson E, Shapiro V. (1975). Ghosts in the nursery. A psychoanalytic approach to the problems of impaired infant-mother relationships. Journal of the American Academy of Child Psychiatry, Summer; 14(3), 387-421.

Lieberman, A.F, et al. (2005). Angels in the nursery: The intergenerational transmission of benevolent parental influences. Infant Mental Health Journal, 26(6), 504–520.

Understanding Parents' Own Histories and the Influence on the Parent Child Relationship

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 09 Oct 2012 16:00:00 +0000

By the time parents reach adulthood, they have experienced a lifetime’s worth of relationships, both good and bad.These relationships exist with caregivers, siblings, peers, friends, and so on. A normal effect of having relationships is that they leave indelible impressions upon the psyche, which create templates, often unconscious, about how particular kinds of relationships are supposed to work. In a sense, people become “programmed” as to what to expect from others (parents, friends, partners, etc.) and how they feel about themselves based on previous experiences with people already in these roles, and the impressions start during even the earliest days of infancy.

With new parents, these impressions happens all the time. The parents teach more by doing and relating than they ever could by saying. Parents who are supportive and encouraging, listen and reflect produce thoughtful, intuitive, self confident children who have patience, develop (in time) skills of good communication, and have healthy relationships.

Parents relate to their children based on their own early experiences and what has become an innate part of their personality. Child development specialists and authors T. Berry Brazelton and Bertrand Cramer, in their 1990 article The Earliest Relationship, suggest that parents have images and fantasies about themselves and their families, their ideals, goals and values, and they have anxieties, worries, and fears, many of which originated in their own childhoods. Children tend to trigger some of these fantasies and fears in ways parents cannot even imagine. When someone says things like, “She has the same expression that my grandmother used to have” or “Just look at his eyes; he’s going to be a wild one, that one,” meaning is being attributed to certain characteristics based on that person’s experiences. Someone else may see the same expression or the same look in the eyes and interpret it very differently. In other instances, parents sometimes say, “I can’t get her to settle down, she hates me” or “He is such a charmer, he needs a lot of attention.” These parents are experiencing something from the child’s behavior that is stirring for them. Assigning intention or meaning to child behavior tends to come from within parents and various others, and most often is a result of personal histories and is not associated directly with the child or child’s behavior. The behavior triggers a personal response. So, when people have babies, their own histories are what they use to define, defend and build their new roles as parents.Their own life experience becomes their primary resource for how and what to do.

Every adult brings memories (both conscious and unconscious) from infancy and childhood into their interactions with the world around them. This is a normal and healthy part of becoming an adult. What is key is how parents reflect upon their lives, as this helps them make optimal decisions as they go along. Not only do parents pass along genetics, moral standards, family values, cultural histories, and physical mannerisms, they also pass along their own childhood experiences.

So, what does all this mean? It just means that it is very valuable for parents to reflect on their past experiences and relationships - positive and negative - and think about how those things played a part in their development. Being aware of these things will help parents better understand themselves and their emotional reactions, which ultimately enhances their interactions and relationships with their children.

Stay tuned. The next post will discuss what parents can do when there are memories or experiences from that past they would rather not bring into their current relationships with their children.

Posted by Andrea Hohf, LSW

Effects of Divorce on Children

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 25 Sep 2012 16:00:00 +0000

When parents divorce, they worry about the emotional effects on the children and they wonder how to best handle the situation. They have hurt feelings, and although they want to keep the children out of the middle, this is not always easy.

There are several ways parents can help children get through the emotional difficulty and confusion of divorce and make sure they are not caught in the crossfire:

Maintain open, honest, age appropriate communication (talk about the divorce and answer the child's questions in an age appropriate way without giving un-necessary detail)
Allow for the child to ask questions and offer repeated opportunities for discussion
Allow for feelings and do not judge or make light of them (“I see you’re upset” vs. “Don’t be upset”; “I know this is hard for you” vs. “You’ll get over it”), reflect on and model feelings; help the child describe feelings using colors/shapes or how things feel in the body
Allow for many opportunities for the child to express him/herself
Point out and describe the behaviors and emotions you see in the child (child may not always respond but is listening and knows you understand how he/she feels)
Provide reassurance to the child that he/she is loved and will always be taken care of
Reassure the child that he/she still has a family
Look through baby photos with child – talk about how much the child was wanted and enjoyed
Read stories about marital discord or divorce
Tell stories about other kids going through the same things; normalize feelings
Keep creative art supplies handy and encourage drawing, building, painting, crafting, etc.; especially beneficial for non-verbal children
Know that the child may need extra comfort, patience, and attention
Be the grown up; parents need to stay in charge (do not let guilty feelings get in the way of maintaining boundaries and parenting standards)
Give the child a say in how certain things are handled with the divorce (e.g., visitation) – ask for input, where appropriate - but take responsibility for the final decisions
Provide structure, consistency, and predictability at both homes; routines help children feel safe
Use a color coded calendar, created with the child, to help reduce confusion and anxiety about where the child will be when
Support the other parent and make it easy for the other parent to have a good relationship with the child, provided it is safe
Make it easy for the other parent to know what is happening with the child
Both parents should participate in the child’s life (school work, activities, etc.)
Try to acknowledge the good in the other parent; do not talk down
Never threaten the child with abandonment
Do not require child to take sides
Make sure child knows he/she does not have to choose
Give the child permission to love the other parent
Allow the child to take things back and forth between homes
Let important others know about the situation (family, friends, teachers)– affords support to the child and sets a good example
Know and respond to danger signals (e.g., child behavior problems, emotional withdrawal and other changes in mood or relationships)
Keep kids out of the middle when communicating with the other parent; no messages sent through the child

Go directly to the other parent for information and answers
Do not bad mouth the other parent in the child’s presence
Do not participate in the child’s angry feelings about the other parent
Encourage the child to speak about his/her difficulties with the other parent to that parent
Do not ask the child about the other parent’s life or circumstances Do not ask the child to keep secrets

Divorce is hard for parents and children but it does not have to be destructive. The better the parents handle their own emotions and deal with the relationship with the other parent in a constructive way, the better the children can weather the storm.

Sources:

Lanksy, V. (1998). It’s not your fault Ko-ko bear. Book Peddlers: Minnetonka, MN

Ricci, I. (1997). Mom’s house, dad’s house: Making two homes for your child. Fireside Book: New York

Dealing with Divorce: Co-Parenting after Divorce

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 11 Sep 2012 16:00:00 +0000

Divorce is never easy. When parents have relationship problems and separate, not only do the children experience many different emotions but the parents do as well. It is important for parents to be able to manage their emotions so they can learn how to deal with divorce and find ways of successfully co-parenting the children.

There are several things that parents can do to cope with the difficulties of divorce and work together as parents:

Acknowledge and be honest with yourself about the difficulties in the relationship
Reflect on the variety of feelings that emerge; do not try to bury the feelings, dealing with them gives you more control and those feelings are then less likely to emerge unexpectedly
Examine what the problems in the marriage/partnership mean and what they stir in you
Be sure to take care of yourself and allow time to do things that feel relaxing and relieve stress
Ensure that you have private space and time to regenerate
Create and use support systems (family, friends, support groups, therapy, social/community organizations – especially if the child has special needs)
Give yourself a chance to grieve the loss that comes with divorce
Be prepared for various questions from the child about the divorce and respond as honestly and age appropriately as possible without bringing the child into the middle
Do not let the negativity of the other parent get in your way of showing affection and reassurance to the child
Show appreciation for other parent’s efforts; acknowledge that parent’s commitment to and love for the child
Demonstrate an understanding of what the other parent is saying to show respect and that you are listening and trying to work together
Know when not to engage in un-necessary conversation; ignore and “let go” of some thing
Keep the focus and agenda on the child
Know your own and the other parent’s triggers and try to avoid them so conflict does not emerge
Try to be flexible but maintain consistency – avoid surprises, impromptu changes
Be reliable and follow through so the other parent and the child know they can trust you
View the relationship as a business arrangement – partners; keep communication formal and direct, if needed (email, text, phone)
Do not avoid other parent because of personal difficulties; this means avoiding the child
Acknowledge that shared parenting will have its glitches and give it time; do not use it as an excuse to stop trying
Realize that plans will eventually be outgrown and need to be reworked

Keeping these things in mind can ease the stress and emotional pain of divorce and help parents focus on what is most important - the children. The parents may no longer be a couple but they will always be parents together.

Sources:

Lanksy, V. (1998). It’s not your fault Ko-ko bear. Book Peddlers: Minnetonka, MN

Ricci, I. (1997). Mom’s house, dad’s house: Making two homes for your child. Fireside Book: New York

Teenage Relationships with Parents; Adolescence and Puberty

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 28 Aug 2012 16:00:00 +0000

A young person’s transition to adolescence is influenced by individual characteristics as well as contextual factors. These dynamics may affect the relationship between adolescents and their parents. During puberty, conflict often arises, as adolescents are experiencing hormonal and physical changes and are going through a developmental process of ongoing definition and redefinition of themselves. Typically, these conflicts are only mildly intense, though frequent and annoying, and focus on rule/regulation disagreements.

Family conflict is often experienced when:

Less time is spent with parents or caregivers, as peer relationships take precedence

Adolescents become emotionally distant and appear to disconnect from the family; they seem like they are in their own world

Power struggles emerge, as adolescents seek to establish their own identity and experience a new found grandiosity that rebuffs parental guidance

o Power struggles can range from minor disagreements over food, music, and fashion tastes to bigger issues such as romantic relationships, future goals and ideals, roles and responsibilities

As hard as it is to believe, it is important for parents to recognize that their developing adolescents are not intentionally acting “crazy” or seeking fights but are going through a normal and necessary transition process. Their identity and sense of self are solidifying. Though parents are no longer idealized like they once were and needed to be to help the child feel safe and secure, this de-idealization is not a purposeful, direct insult or attack; it is a necessary, natural step in adolescents’ movement toward autonomy.

Conflict during pubertal development does not mean that the parent-child bond is ruptured. It serves as a manifestation of a young person’s psychological separation from the caregiver. Adolescents sense parental reactions and this influences their own responses to developmental changes. The key to successfully navigating this process is to maintain consistency, be patient and warm toward the adolescents, and give them the needed physical and psychological space to come into their own. Being open and honest about feelings provides a model for self insight and emotional regulation. Maintaining boundaries and structure, while giving adolescents more responsibility, helps strengthen trust and develop a sense of self efficacy. Adolescents respond better to their parents when they believe they are heard and understood and feel they have a say in the problem solving process. Adolescents do not need to and should not always get their way, but if their feelings and perspective are acknowledged (they receive empathy), they are more tolerant of disappointment.

Providing this kind of support for young people will reinforce the affective bond between the children and parents and serve to strengthen adolescents’ exploration of the self.

Post by Asya Brodsky, LSW

Normal Sexual Behavior in Children

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 14 Aug 2012 16:00:00 +0000

Child psychosexual development begins at a young age and occurs within the context of a child’s environment. Families have an important influence on the sexual behavior of their children. Parents’ own sexual adjustment, level of comfort with children’s sexual development and feelings related to their own sexual selves re-emerging with a child’s sexual maturation, play a role in the appearance and exhibition of child sexual behavior. Families more open to or tolerant of certain age-appropriate behavior, such as nudity or co-bathing, may be more encouraging of child sexual exploration, while maintaining boundaries, and more likely to recognize the behavior as such. Children may also pick up on social cues, imitate adults in their homes or in popular culture, or learn to conceal certain behaviors they recognize are not socially appropriate. Typically, a child’s interest is a matter of curiosity.

The sexual exploratory behaviors children exhibit occur at a continuum and vary somewhat by age, peaking between three to five years old. Genital play is common during this time and the prevalence of sexual behaviors among elementary aged children is not unusual. Notable behaviors, grouped into broad categories, include the following:

Playing Doctor: A frequently reported sexual game, primarily aimed at the exploration of children’s genitals. This game utilizes pretend play where one of the children is a nurse or doctor and the other plays the patient. Undressing and sexual exploration games are noted among 4-year-old boys and girls.
Exposure (genital exhibitionism): Another common form of sexual exploration among children. Both exhibitionism and voyeurism has been noted among nursery school children as well as boys and girls ages 4-6.
Experiments in Stimulation: Games involving physical contact among children, which result in feelings of sexual excitement. When children are still learning appropriate boundaries, they may casually touch a parent’s genitals or rub against themselves or other people. Rubbing of the thighs has been observed in preschool girls.
Kissing Games: Games where kissing is the primary focus. Kissing, among both family and non-family children, has been observed in both boys and girls in the 2 to 6 year old age ranges.
Fantasy Sexual Play: Game in which children pretend to play different roles, whether real-life, such as a parent, or characters from books or television.

A child is attuned to the family environment and sexual behavior is one reflection. A child should feel protected when exploring their sexual selves. Families can help their children develop by handling sexual matters in a gentle and encouraging way and maintaining boundaries.

Post by Asya Brodsky, LSW

Sources:

Normative Sexual Behavior in Children

http://pediatrics.aappublications.org/content/101/4/e9.abstract

“Normal” Childhood Sexual Play and Games: Differentiating Play from Abuse

http://www.sciencedirect.com/science/article/pii/0145213493900262

Attachment Parenting

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 31 Jul 2012 16:00:00 +0000

"Attachment parenting" is a term coined by pediatrician William Sears. It is a parenting philosophy based on the principles of attachment theory. Parents who are sensitive to their children's needs, empathic, and emotionally available, help children form secure attachments. Secure attachments promote healthy social and emotional growth and well being.

Parents want their children to have positive relationships, feel confident, be able to tolerate disappointment, be responsible and accountable, be kind, and get along in the world. To foster this, it is important for parents to remember these basic things:

1) Unconditional positive regard helps instill a sense of trust and self-confidence in children. Accept the child for who he/she is and support his/her strengths and interests. Regularly remind the child of his/her importance, value and worth by showing interest in what the child is doing.

2) Patience and calm helps children manage their emotions, which, in turn, promotes positive behaviors and relationships. Providing consistency, structure, boundaries, and attention helps children feel safe and loved and allows them to better control their behaviors and build healthy relationships.

3) Sharing feelings provides a model for self-reflection. Parents who can openly reflect on their feelings and help put feelings into words for their children tend to have children who learn to do the same.

4) Attempting to understand the meaning behind children's behavior can help parents better connect with and support their children's growth and development. Children want to be good. Misbehavior is a sign that the child is struggling and likely cannot express what is bothering him/her in words. The behavior is speaking for the child. Understanding the meaning behind the behavior helps the parent connect with the child, helps the child feel validated, further enhances attachment, and improves behavior.

These are just a few good parenting skills that can help parents stay connected to their children and promote positive attachments.

For more on this topic, check out What is Connective Parenting.

The Importance of Empathy

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 17 Jul 2012 16:00:00 +0000

Parental responsiveness to children's emotions is an important part of child development. Parents who are able to offer moments of empathic understanding not only help reduce their children's anxious, sad, or angry feelings, but make them feel understood. This helps children learn to manage emotions and handle future disappointments.

There has been some debate about contemporary parenting and over-indulging children's emotions. However, empathy helps teach children that feelings matter; when they believe their feelings matter, they begin to recognize the value of others' feelings as well. This awareness promotes appropriate behaviors, positive relationships, and self restraint.

An article was recently published in Psychology Today about this very topic. It is an excellent summary of the empathy debate and speaks to the value of empathic parenting. Check it out for yourself and see where you stand.

Empathy Is Not Indulgence

Parenting Teenagers

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 03 Jul 2012 16:00:00 +0000

A big topic of discussion among parents of adolescents is how to talk to teenagers. Raising teenagers can feel like a daunting task, at times. Parents often experience periods of frustration, exhaustion, and bewilderment as well as a sense of helplessness, hopelessness, confusion, and failure.

Communicating with your teenager does not have feel so exacerbating if you can keep these few basic things in mind:

Adolescence is a normal period of development. In may ways, teens are like toddlers - they are in search of new things and beginning to discover themselves. So much is happening developmentally, socially, and physically that it can be emotionally overwhelming and reactions and behaviors do not always make sense.

Take an interest in what your teen is doing. Even if your teen seems to be in his/her own world or is terse when responding to questions, it is important to try and stay connected by expressing genuine interest in what he/she is doing, likes, and dislikes without bombarding him/her with questions. Though they may not admit it, teens feel important and their sense of self further solidifies when the people that are important to them acknowledge and support their interests.

Allow your teen some space. Teens need opportunities to discover themselves. Whether it is through music, sports, fashion, or art, they need some room to try on different characteristics without fear of judgment or ridicule.

Model mutual respect. If your teen sees you handling difficult interactions in a calm, respectful manner, including disagreements with him/her, he/she feels respected and has a model for future interactions.

Maintain consistency and boundaries. Teens are still children and need rules, boundaries, and consistency. It is these things that help children feel safe, protected, and valued. You may no longer be able to sit your child on your lap to calm him/her but there can be realistic consequences for negative behaviors and reflective conversation about the reasons for the behavior. Though they may fight it, teens truly want and need this kind of ongoing support.

Keep the lines of communication open. Make sure your teen knows you are always willing to talk and will be there for him/her whenever needed. Though he/she may not directly take you up on the offer, knowing it is there is what is most important.

Know that your teen still loves you and this too shall pass. It is in no one's best interest to alienate others. Teens are smart; they are not purposefully trying to create drama. Remind yourself that there is meaning behind the madness and trust that your relationship with your teen will carry him/her and you through this developmental period.

These are just a few things to think about when it comes to talking with teens. Yes, sometimes they are easier said then done, but maintaining a healthy relationship with your teen is vital to his/her identity formation and growth into young adulthood.

Potty Training Tips

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 19 Jun 2012 16:00:00 +0000

Summer is here! For many parents of toddlers, that means school is out, schedules change, and activities are being planned. Parents of toddlers often wonder, "Is this a good time to start toilet training?"

Though there is no exact age to start potty training, typically, many toddlers develop the physical, mental, and emotional skills to tack the task by 18-24 months. For others, those skills may emerge closer to age 3 or 4.

What is most important is that the child and parents are ready and the process is experienced as a joint, pleasurable venture; not something that feels forced, required, shameful, overwhelming, completely frustrating or exhausting. Without a patient, calm, supportive, consistent, nurturing environment, there is the risk that a child may feel inadequate or badly about him/herself, believe he/she is disappointing parents, or experience anger. Resentment and frustration may then breed in both the child and the parents. For toddlers, potty training represents a psychological need to give up some part of him/herself. though liberating, it can be frightening too.

Once the emotional foundation is set and everyone is engaged and committed to start potty training, there are some basic things you can do it make it a good, successful experience. Our friends at Victoria Chart Company have come up with 10 Steps to Successfully Potty Train using My Big Star Reward Chart. Here is what they suggest:

Potty training can prove to be a messy business and the thought of starting it a daunting one!

We would therefore like to help and guide you through this process. Below are 10 steps to successfully potty train using My Big Star Chart as a rewarding tool for kids.

1 Make sure your child is ready
Signs of readiness consist of your child staying dry for at least a couple of hours, they show an interest in bathroom activities, they take themselves to a quiet place or tell you when they are doing something. Summer is the ideal time to potty train - less clothes are worn and time spent outside make the little accidents easier to deal with.

2 Plan for it
Potty training is a process that will require a lot effort, not only from yourself but from friends, family members and carers involved with your child. Decide upon a date from which you will all start - it is from this date you say good bye to diapers during the day.

3 Set up your chart
Hang your My Big Star Chart in a clear, visible place. This will be a central focus for you and your child to work from. Place the potty training sticker in the top position of the chart. Let your child know that this will be their special sticker for using their potty and they can earn lots of rewards. You may like to add some other activities to the chart too.

4 Teamwork
Consistency and routine from all involved will help your child reach their goal. You may like to forewarn visitors of your efforts so they can be positive and encourage as you do. Forwarding these notes to those people who look after your child in your absence will help them to achieve the same goal. Children will love showing friends and family their chart.

5 Actively involve your child with their potty
You may like to take your child on a shopping trip to choose their potty - which colour would they like? Is there a character one they particularly like? Tell them it will be their own special potty, they may even like to choose a name for it. Decorating the potty with stickers will help them take ownership of it. You may like to demonstrate their special toy using the potty.

6 Prepare your child
Encourage your child to sit on their potty before they properly start using it, practice putting on pants and washing their hands to complete the task. It is at this point you should start praising and rewarding your child with a smiley face reward sticker, remember to tell them how well they are doing.

7 Don’t rush your child when they use the potty
Let them look at a book, or listen to short story for a few quiet moments when sitting on the potty. Blowing bubbles is another great way to encourage them to sit still. Tell them it is a good try and well done for sitting nicely even if they don’t achieve anything, again reward them with a smiley face sticker for their efforts.

8 Be patient, positive and consistent
Be patient, potty training does not happen over night. Positive interaction will help your child achieve their new skill, and feel good about their progress. Accidents will happen but continue to keep up the routine, when you choose not to use diapers - stick with it! Going back and forth between diapers and pants gives your child a confused message. If you experience naughtiness or defiance - stay calm, ignore it, do not reward.

9 On the go
Long journeys will take slightly more preparation than usual. You will need to make more regular stops so make sure you leave enough traveling time. Pack all familiar supplies including books and toys when using the potty on route. You may like to take some reward stickers for the journey - children love wearing these.

10 Achieving success
In a short space of time you will start to see great results. Use the enclosed gold star reward stickers to reward when your child does exceptionally well such as asking to use the potty, using the potty of their own accord, remembering to wash their hands, choosing to use the grown-up toilet. We wish you every success!

My Big Star Chart is available to purchase online at www.VictoriaChartCompany.com for $18.99.
Use coupon code ‘DRDDUVAL’ and get 15% OFF of our whole range of products.

Overview of Greenspan's DIR/Floortime Model

noreply@blogger.com (Denise Duval, PhD, LCSW) — Tue, 05 Jun 2012 16:00:00 +0000

There are many treatment methods available to support learning, appropriate behaviors, social and emotional growth, and relationships with children on the autistic spectrum. Many of these techniques are behaviorally based, which can provide some structure and containment for children. However, to fully develop a child's long-term capacity to interact in the world, relate to others, problem solve, tolerate frustrations, and enjoy engaging, relationally based approaches to treatment are the way to go.

In the 1980s, Stanley Greenspan developed a model for working with children with deficits in relating and communicating. This model became known as the "Developmental Individual Difference Relationship Model" or DIR. "Floortime" is a specific therapeutic technique within this model. All children learn via relationships; relationships are necessary in order for learning to occur. Floortime is built on this premise and informed by research, theory, and practice from a variety of disciplines, including infant mental health, psychoanalysis, developmental psychology, neurobiology, etc.

Floortime therapy is commonly associated with children with autistic spectrum disorders but it is also useful for connecting with and expanding the learning and emotional growth of children with social and behavioral problems, in general.

Below is an overview of the basic goals, steps, and strategies of floortime training.

Goals of Floortime

To help the child --

Become more alert
Take more initiative
Become more flexible
Tolerate frustration
Sequence longer actions - plan and execute them
Mediate process of finding solutions
Communicate verbally and with gestures
Take pleasure in learning

Step in Floortime

Observe the child's actions
Open circles of communication by building on whatever the child's current interest is in the moment (e.g., playing with a toy, flapping, turning switches on and off)
Follow the child's lead (e.g., copy the child's behavior)
Extend and expand the child's play by encouraging the child to build on the play narrative (e.g., do something that builds on the child's behavior, ask questions)
Close circles of communication - circles are closed when the child builds upon a comment or makes a gesture of his/her own that expands the play and lead to the beginning of another circle

Intervention Strategies

Follow child's lead and join him/her - it does not matter what they do as long as they initiate the move
Be persistent
Treat what the child does as intentional and purposeful - give new meanings to the actions
Help child do what he/she wants to do
Position self in front of the child; the parent should be the "toy" (what the child is focused on)
Invest in whatever the child initiates or imitates
Join perseverative play
Do not treat avoidance or "no"as rejection
Be patient and wait for the child to initiate then expand on that idea
Be dramatic in voice tone and gestures to demonstrate understanding and model affect
Expand, expand, expand - keep going, play dumb - but not too dumb, do wrong moves, do as told, interfere, etc.
Do not interrupt or change the subject as long as it is interactive
Insist on a response
Do not turn the session into a structured teaching experience

All human learning begins within the context of a relationship. Floortime is designed to use these relationships to help children with autistic like behaviors develop the skills to regulate emotions, tolerate upset, connect and interact with others, communicate, reason, think logically, and solve problems. Using the relationship to start where the child is and join him/her in the action then expand on themes is key to helping a child with autistic like behaviors grow and develop to his/her full potential.

Adapted from article entitled, "The Greenspan Floortime Model." www.cms-kids.com

DIR/Floortime resources:
The Greenspan Floortime Approach
Interdisciplinary Counsel on Developmental and Learning Disorders/Floortime.org
Floortime videos:
Dr. Stanley Greenspan Founder of Floortime Speaks
The Greenspan Foortime Approach
Floortime services in Chicagoland:
Beth Osten and Associates
Cawn-Krantz and Associates