Month: March 2016

Going back to my second blog, “Emotional Vocabulary..,” I wanted to update my readers on the “talk” I gave to a group of 4-year-old children and their teachers. I think it is important to mention more about the “process” of interacting with them in effective, positive ways, compared to the content (at least in this particular blog entry). When I met all twelve (yes 12!) 4-year olds, I asked them to sit down in a circle. For parents and clinicians alike, this particular age group poses difficulties in the attention and hyperactivity department. Have you ever witnessed how much food a 4-year-old throughout the day consumes? It is a true testament to how much energy they are expelling. Young children are in constant “move mode” and when they are asked to sit and be still, this is akin to asking Mexican jumping beans to stay still and not fall off the counter. It just won’t happen.

So, if I have to work with young children with lots of energy, it was important that I engage them in different activities every five minutes (give or take a minute). They need constant reinforcement, whether that is a small present (e.g., plastic animals, stickers) or verbal praise. Young children are soooooo responsive to this reinforcement when learning new skills. They also love to be the “teacher” when given the opportunity. I had one child stand up and act out all different emotions (joy, sadness, disgust, fear, anger) and had the other children guess which emotions she was expressing (on a more complicated level, this enables the children to really start practicing emotion recognition, a more developmentally advanced skill). The other children were rewarded for raising their hands AND giving the correct answer. One boy ended up with 3 small plastic animals as a reward after answering all the questions correctly AND raising his hand. Other children were asking why they did not have a small toy, and I responded by saying it was because he demonstrated the proper behavior AND answers. In a small microenvironment, they were learning that positive behaviors could have a positive result. On a side note, this is where parents sometimes can go awry and feel that ALL kids need a toy no matter what (usually this is because they feel bad if the children feel bad). In small doses, not rewarding behavior that does not warrant a reward can have long-term benefits in terms of tolerating distress, increasing motivation, and reducing overall levels of anxiety. All the kids in the class were so responsive and at the end, I told them all that if they all practiced diaphragmatic breathing and problem-solving techniques with me, they could each earn a small toy. Each child was individually singled out for their positive engaged behavior and given verbal praise, followed by a toy (however, this was CONTINGENT upon the prior behaviors).

You may ask, how is this all relevant to me, as a parent? It definitely is! When teaching your child a new skill (e.g., making their bed, or placing clothes in the laundry, not being mean to their sibling, etc.), it is important you first teach the skills step by step, then model the behavior for them (use your acting skills, and then have them practice with you without laughing), then have them re-teach you the skill, all the while loading on the positive, genuine verbal reinforcement. I would recommend that if they can demonstrate this behavior for a longer time frame (e.g., 2-3 days or a week), you consider a small tangible reward. Kids need stimulation and to be engaged. You will get more positive behaviors from them with these skills. If you try it this week, give me a shout and let me know how it goes!

For the first time, Generation Y, aka the Millenials, are outnumbering both Generation X and the Baby Boomers. Young adults in this generation are considered those who are currently 17-34 years of age. Approximately 31.5% of these individuals are living with their parents in the United States and of those, 40% have a clinical anxiety or depressive disorder. Many young adults in this group are considered to be “regrouping,” a term coined by David Sachs, where a young adult goes home with the intention of moving forward within a self-initiated short-term timeline (e.g., saving money for a few months or years and applying to graduate school or jobs). However, for some young adults, they become stagnant in a “Floundering” or “Meandering” stage, where they have no self-initiated goals and are not motivated to change their current circumstances.

When I work with these young adults I first determine if there is a clinical anxiety or depressive disorder that has not been diagnosed and therefore treated. However, if a clinical disorder is not applicable after thorough assessment, it is essential that the family structure and the individual’s current skills be evaluated. These are just some of the questions I ask my young adult and their parents: “What are your responsibilities at home? How are your finances handled? Are you expected to do chores at home? What are your short and long-term goals? Do you have any plans to achieve them?” If a young adult is not experiencing any natural real-world consequences for their actions, then their behaviors will likely maintain and/or increase. We have to decrease behavior by not reinforcing it, or rewarding it. This is a tough task, especially for parents who see their role as providers and have difficulty setting limits.

It is important that the contingencies within the family are examined. For example, if a young adult refuses to get a job and make a financial contribution towards the household, are the parents financially compensating them? A frequent comment I hear from parents is “I just don’t understand why they [young adult] aren’t motivated to move on with their life.” This is an interesting comment because their lack of launching can be due to pre-existing contingencies within the family and/or a deficiency in skills. Sometimes, we as parents expect that our child should know something. I made this mistake the other day when I admittedly became frustrated with my 4-year-old child for not making their bed. The 4-year-old was expressing frustration in the form of a behavioral tantrum. I questioned myself and asked, “Wait, have I ever taught them to make their bed?” The answer was “no.” The lack of their behavior initiation was not due to motivation, but rather lack of skills. We want to be careful that we do not assume a lack of launching is because of motivation, because it could be do to a lack of skills. For example, does your young adult want to get a job, but does not know how to interview? Do they not know how to write a resume or CV. Ask them where they feel deficient in their ability to achieve their goals, and if they are able to identify their goals. This process is really one step at a time, but be patient, and be like a sleuth who is there to assist but not to overcompensate.

I will be giving a presentation on this topic at the Anxiety and Depression Association of America’s conference in Philadelphia in late March 2016. Make sure to post a question about this topic.