Published originally by Johns Hopkins University, Lifelines: Stories from the Human Safety Net, 2014
A team of bilingual, bicultural social workers try to help at-risk girls
Five years ago, a 12-year-old Latina girl committed suicide in her family’s garage in the town of Westbury, NY, a diverse suburb on Long Island that has pockets of poverty and has seen an influx of immigration from Central and South American countries in the last few decades.
The town – adjacent to Old Westbury, which was cited by Forbes Magazine as the 10th most expensive zip code in the United States–is rife with overcrowded, rundown multi-family housing, and a large percentage of the population is struggling to make ends meet. Day laborers wait on corners in hopes of picking up some jobs. Many of the immigrants speak little or no English. Some are undocumented, making them hesitant to reach out for legal, medical or mental health services. Even if they are willing, they can’t apply for a driver’s license and therefore are unable to travel to appointments.
It’s an unsafe and stressful environment for anyone, but especially perilous for teenage girls.
While it’s unclear exactly what led to this particular girl’s suicide, her desperate action wasn’t an isolated event, according to Regina Barros-Rivera, Associate Executive Director at North Shore Child & Family Guidance Center, a not-for-profit children’s mental health agency whose social workers, psychiatrists, psychologists and counselors provide extensive services to residents of Nassau County, Long Island.
“We were experiencing a huge influx to our agency of Latina teens with clinical depression and suicidal thoughts,” says Barros-Rivera. “Many were failing school, exhibiting self-harming behaviors such as cutting and talking about ending their lives.”
According to the Centers for Disease Control and Prevention, (CDC), one out of every seven Latina teens attempts suicide.
Some of the girls have neurological or mental health issues, such as impulsivity connected to ADHD, Barros-Rivera notes, while others have been abused. “The girls come with different stories,” she says. “Some are suicidal because their parents are fighting all the time, and they just can’t take it anymore. Some have been sexually abused. But they all were depressed and felt that suicide was their only way out. It was a very alarming trend.”
Barros-Rivera gathered a team of bilingual and bicultural social workers and mental health counselors from North Shore Child & Family Guidance Center to review research on the topic of depression and suicide in the Latina teen population. They discovered that the trend was a nationwide problem.
Family Values
The CDC study, along with other research, indicates that the major factor contributing to the high risk of depression and suicide among first-generation Latinas is the intense pressure they’re under to adhere to the traditional values of their parents’ homeland and not become too “Americanized.”
The activities that are such an accepted part of a typical teen’s life–going to the movies, to the mall, to sleepovers–are forbidden for many Latina girls. And, if they are allowed to venture out, they’re often required to have a chaperone in the form of a parent or older brother. These unrealistic limitations make the girls feel angry, hopeless and marginalized.
In many ways, it’s not surprising that these immigrant parents are overprotective of their daughters, according to Barros-Rivera. “The families have come from very distressed lands, where they have been victims of war, violence and poverty,” she says. “Many of them have been traumatized, and they’ve come here to find safety for their children. They often hover over their daughters and watch their every move. But that leaves the girls feeling they have no way out, which creates a very dangerous situation.”
Edenny Cruz and Vilma Barber of the Guidance Center Latina Girls Project.
A Creative Solution
North Shore Child & Family Guidance Center’s high-risk team knew that something had to be done. The result: The Latina Girls Project, a multifaceted program for Hispanic girls (ages 12-16) that employs individual, family and group therapy, along with monthly outings and other activities, all designed to tackle issues such as depression, suicidal ideation, hopelessness and low self-esteem.
One of the program’s clients is Maria (not her real name), a 16-year-old with large, soulful brown eyes who was born in the United States to parents from El Salvador. According to Edenny Cruz, an LMSW who, along with Barros-Rivera, counseled Maria, the teen was severely depressed and suicidal when she began treatment. Her biggest complaint was that she hated school, and she was distraught and angry that her parents pushed her to attend.
“School wasn’t a healthy or safe place to be for me,” says Maria. “I was being bullied all the time. The other kids called me names and laughed at me ever since elementary school, and I felt like I wasn’t getting any support from the teachers.”
Maria tried to explain to her mother and father the reasons school was difficult for her, but “they didn’t understand,” she says. “They told me to ignore the bullies.” Maria’s parents thought she was being dramatic and defiant, not realizing that her behavior was a sign of depression.
The prevalence of not going to school because of safety concerns was highest among Hispanic females, at 12.6%. In comparison, white females report 7.4% and black females report 8%.
The troubled teen began to skip school, which created many heated arguments in her household. Part of the reason Maria’s parents had come to the United States was to give their children a good education–something they didn’t have in El Salvador, where they spent their days working on farms instead of studying in classrooms.
“My dad hates the fact that he can’t read or write,” says Maria. “He wants me to be more successful, so school is very important to him.”
The constant pressure and fighting at home took its toll, and Maria began to feel that suicide was her only option. “I didn’t know how to deal with everything and get rid of how I was feeling,” she says. “I felt like I was just a big bother to everyone.”
Self-Harming Behaviors
In an attempt to alleviate the pain, Maria began cutting herself–a common response to stress in teen girls.
“Some of them self harm because they feel numb,” says Barros-Rivera. “It helps them experience their pain, which paradoxically provides them with some relief. It’s also something that they are in control of, which gives them a sense of autonomy.”
According to a 2011 study, self-harm among teen girls of every nationality is common, with nearly one in 12 teens deliberately hurting themselves, most often by cutting or burning their own flesh. Self-harming is one of the strongest predictors of who will go on to commit suicide. Some of the findings:
Self-harm is common, reported by about 8 percent of 14- to 19-year-olds.
At every stage, more girls reported self-harm than boys.
Those who cut, burned or otherwise deliberately hurt themselves were more likely to be seriously depressed or anxious, and to report smoking, drinking or abusing drugs.
Similarly, a small subgroup of students who began hurting themselves as young adults were more likely to report having been depressed or anxious as teenagers. The proportion of young men and women reporting self-harm substantially declined as they aged.
For Maria, who had carefully hidden her scars, the self-injurious behavior turned out to be the impetus for her parents to get her into treatment. “I didn’t want them to know that I was cutting myself, but one day I feel asleep on the couch at home and my shirt hiked up. When my mom saw the marks on my stomach, she cried and asked what I was doing.”
Realizing the gravity of the situation, Maria’s parents took her to a psychiatrist, who put the teen on medication. According to Maria, it didn’t alleviate her depression. “I just wanted to die,” she says. “I felt like I couldn’t make my parents happy no matter what I did.”
Maria’s parents reached out to North Shore Child & Family Guidance Center and learned about the Latina Girls Project. Maria began working with Edenny Cruz, whose mother and father were born and raised in Puerto Rico. “My parents were very strict,” says Cruz, “so when Maria and the other girls talk about the conflicts with their parents, I can tell them I know just what they’re talking about.”
Fostering a Common Bond
As with many clients, Maria was resistant to counseling at first, says Cruz. “Her attitude was, if you can’t get me out of school, what good are you?” she says. “She was very angry.”
Depression in teens can look very different from depression in adults. For some depressed teens, symptoms of irritability, aggression and rage are more prominent. A depressed teenager may be hostile, grumpy, or easily lose his or her temper.
“Depression is anger turned inward,” says Barros-Rivera. “Even though the girls are angry at themselves, they might express it by behaving defiantly or becoming physically aggressive–and their mothers are the most frequent targets of their outbursts.” In other girls, depression can lead to eating or sleeping disorders, she adds. “There’s no one profile that fits all the girls.”
Cruz’s strategy to help Maria develop trust during her therapy sessions was to focus on the teen’s other interests, which included singing and cooking vegetarian food.
“Talking about their whole lives–not just their problems–is an important way to get the girls to open up,” says Cruz. “With girls who are oppositional to treatment, I tell them we can talk about whatever they like and not the things that they are sad about. Eventually, they bring up those issues on their own.”
For Maria, an important breakthrough came when the team was able to work with her district to get her into a new school that had smaller classes and psychological support systems for at-risk students. The strategy worked, and Maria’s mood improved tremendously after the placement. “The kids there are just nicer, and they understand because they all had issues with school,” she says. “We all just kind of got each other.”
Maria was grateful that the Latina Girls Project counselors had listened to her frustrations and taken action to find a school that fit her needs. “Once I liked school,” she says, “my mind wasn’t so filled with hating everything.”
Drawing from teen in Latina Girls Project
The Gender Gap
While problems such as bullying, poverty, unemployment among family members, lack of access to healthcare, and racial discrimination contribute to the teens’ depression, the cultural and gender-based expectations forced upon these girls are what create the most conflicts, according to Vilma Barber, an LCSW and member of the Latina Girls Project team.
“These girls face so many stresses that the typical American teenager doesn’t have to deal with,” says Barber. “They are expected to clean the house, cook and take care of their siblings–especially their brothers, whom they refer to as ‘the golden boys,’ ” she says. “Traditionally, boys in their culture aren’t expected to do chores, so it all falls on the girls, who are put in the role of surrogate parents.”
That was the predicament for Ana, another teen who came to the Latina Girls Project suffering from severe depression and suicidal thoughts.
Ana (a pseudonym) was born in the United States to parents from Mexico. Her father worked as a sous chef and her mother as a housekeeper; both parents were often away from home. That left the burden on her–but not her brothers.
“My brothers were treated special,” says Ana, a petite, athletic girl with thick, wavy jet-black hair. “They treated me and my sister like servants.”
“It’s very tough on the girls to be put in the position of doing everything while their brothers are given free reign,” says Barros-Rivera. “It makes them feel frustrated and insignificant.”
Ana also began her life with one huge strike against her: She was a girl–not what her father had hoped for, a fact he made crystal clear. “My dad wanted a boy,” says Ana, fighting back tears. “He told me that ever since I was little.”
According to team member Susannah Sanchez-Agosto, MA-MHC, males are valued more highly in many Hispanic families.
“The Latino culture prioritizes having a strong family unit,” she says. But that unit is highly patriarchal, with females relegated to restrictive roles. “Often you can see a mother’s care-giving for her child and submission to the father’s authority as the machista,” says Sanchez-Agosto.
The Impact of Marital Strife
In addition to bearing household responsibilities, Ana carried a lot of guilt for her parents’ failing marriage. “They fought all the time, and it was very hard,” she says. “I felt like I had to be the toughest one in the house. When my siblings and my mom were crying, I’d be the one saying, ‘Don’t cry.’ I was being the mom.”
Ana’s mother acknowledges that her daughter was under enormous pressure. “The children love their father, and our marital conflicts had a negative impact on them,” she says. But she still had a difficult time understanding why her daughter was always so irritable and sad. She compared her daughter’s life with her own impoverished childhood and felt that Ana had it easy.
“I came to the U.S. because of poverty,” says Ana’s mother, the second oldest of 12 siblings. “Many times, we would all go to sleep without having dinner.”
Those kinds of statements only made Ana feel more angry, guilt-filled and worthless. “My mom would talk about how she had to work in the fields when she was growing up and didn’t have much food to eat,” says Ana. “She’d say that my life was not nearly as hard as hers had been.”
Maria had a similar experience with her father, who blamed Maria for her problems.
“My dad would say to me, ‘I’ve given you everything, I work so hard. Why are you like this?’” she says.
When Hospitalization is Needed
All of the tensions at home led Ana to fall into a deep depression; despite being an avid reader and European history buff, she began skipping school and talking about ending her life. Her mother was so concerned that when the school called one day to say Ana had walked out, she feared that her daughter had killed herself.
“There’s a bridge by my school, and my mom thought I had jumped,” says Ana.
The school social worker recognized that Ana was in danger and recommended that she be hospitalized in an inpatient psychiatric program. Despite the difficulty of dealing with that news, Ana’s mother was grateful that the school had taken action to provide her daughter with protective care. “They made me see the seriousness of the problem,” she says.
Although Ana didn’t believe the hospital experience was helpful (“it made me feel caged in,” she says), Barros-Rivera believes that, in some cases, hospitalization is necessary.
“When it’s not clear whether the girl might act out her suicidal thoughts, the hospital is the safest place for her to be,” she says.
“They can also work to determine if she is suffering from a chemical imbalance that might be helped by medication.”
Short-term inpatient psychiatric stays increased for youth of all ethnicities but declined for older adults between 1996 and 2007, according to an August 2011 study in the Archives of General Psychiatry. Hospitalization rates increased most for children ages 5-12, going from 155 per 100,000 children in 1996 to 283 per 100,000 children in 2007. Among teens, the rate rose by about 35 percent.
But hospitalizations are typically short-term, and follow-up treatment is essential, Barros-Rivera adds. “Through the Latina Girls Project, we can help teach them how to deal with their feelings so they won’t need to go the hospital again.
Finding a Safe Place
After her release from the hospital, Ana entered the Latina Girls Project and was assigned to Vilma Barber. At first, however, both Ana and her parents were hesitant to participate in the program. “I didn’t want to come,” Ana says. “My mom cried when we came, and my dad said ‘that’s for crazy people’.”
It’s not surprising that these immigrant families are reluctant to get help, says Barros-Rivera. “Most of them had no mental health care in their countries, so it’s new to them,” she explains. “There’s a cultural taboo against seeking treatment.” Plus, for families who are undocumented, the prospect of being exposed can be frightening.
But for those who do reach out to North Shore Child & Family Guidance Center and learn about the Latina Girls Project, it quickly becomes clear that they are in a safe place. “They see that we are here to help them,” says Barros-Rivera. “And they’re so happy that we speak Spanish.”
As with most girls, it took some time for Ana to develop trust in Barber. “In the beginning, I told her that I wasn’t going to tell her anything,” says Ana.
But the teen soon realized that Barber understood her situation from personal experience, having come from a strict family in Colombia. “She knew what it was like to be in a house where the girls have to do everything and the boys are treated like princes,” says Ana. “She listened when I told her that I couldn’t do anything that my friends could do, like dating. My father didn’t even want me to look at boys.”
Latina girls client at tiki recording studio
The Desire to Fit In
According to Barber, all of the girls’ parents are suspicious of the freedoms given to the average U.S. teen; they resist acculturation, while the girls embrace it.
“The girls go to school where teens dress in a way that their immigrant parents disapprove of,” says Barber. “They want their girls to wear dresses, not jeans. It makes the girls feel like they don’t fit in.”
Dating is taboo, with parents fearing their daughters will lose their virtue, a value highly prized in their culture. “At school, the girls hear about accepting your body and your sexuality,” says Barber. “They learn about issues like homosexuality and birth control, which are things their parents don’t discuss. The only choice in their minds is abstinence.”
Candice Crawford, an LMHC who is part of the Latina Girls Project team, says that the girls aren’t only forbidden to date, they’re not even supposed to text boys. Girls who do become sexually active are a source of shame.
“I had one mother who threatened to kick her daughter out of the house and send her back to El Salvador when she found out she was having sex,” says Crawford. “She called her a slut and said she had to pay the price.”
Language and Economic Barriers
While most of the parents speak little or no English, it is the primary language spoken by the girls. When their daughters speak English at home, says Barber, “the parents often feel a sense of betrayal at the loss of their culture, which is how they perceive it.”
For the teens, their parents’ inability to communicate among the general population can be a source of embarrassment. They want their mothers and fathers to be more like their peers’ parents, many of whom come from wealthier neighborhoods.
“The Latino families are living in these pockets of poverty within middle and upper-class suburbs,” says Barber. “Our girls go to schools where kids are going skiing and doing all sorts of things they can only dream about. It’s very isolating for them.”
All of these conflicts can add up to very unhappy family relationships, says Barber, in which the parents feel abandoned by their Americanized teens while “the girls feel engulfed, trapped and overprotected.”
A Great, Big World
Recognizing the need for the girls to venture beyond their homes and neighborhoods and experience the world around them, the Latina Girls Project team brings the teens on monthly outings to a variety of cultural, natural and recreational sites. These excursions help the girls become more independent, and they also give them respite from the strict oversight and household responsibilities so common in their families.
Although Maria initially didn’t want to participate, Cruz persuaded her by leveraging the teen’s love of music and booking a group trip to see the musical Wicked–an opportunity that Maria couldn’t resist. Soon, the outings were among the teen’s favorite activities.
The outings also helped Ana overcome her resistance to participating in peer group therapy. “I felt very shy,” she says. But when she learned about the monthly trips, her attitude shifted. “They really made me want to be part of the group.”
The Mother-Daughter Relationship
In addition to the outings and the individual counseling sessions, family therapy is a key component in fostering communication and easing conflicts. While involvement by both parents is ideal, it’s the mother-daughter relationship that is most important, according to Barros-Rivera.
“The father is a part of the process, of course, and many do come to the sessions,” she says. “But for these girls, I believe that to activate long-term change, you have to tackle the mother-daughter relationship.”
A 2008 study backs up her contention. The study states, “Conflict with the mother was especially detrimental for Latina girls; highly conflictive mother-daughter relationships were associated with increased internalizing and externalizing symptomatology, and father support added little in predicting symptomatology.”
During family sessions, the therapists help the mothers learn how to let their daughters develop a sense of independence and autonomy. “We’ve found that once we work with the mothers and help them understand how to let their girls separate from them in healthy, age-appropriate ways, the whole family heals,” says Barros-Rivera, herself the daughter of strict immigrant parents from Chile. “We help them see each other’s perspectives and foster healthier communication.”
When fathers do participate in the family sessions, it often serves to help them to see their own behaviors in a new light.
“Traditionally, the parenting roles are very distinctly defined, whereby the father is the primary breadwinner and the mother the primary caregiver,” explains Sanchez-Agosto. “With family therapy, the father gains a stronger sense of his co-parenting role, becoming more involved as an emotional support.”
The goal, she adds, is to involve as many of the family members as possible. “The inclusion of the extended family is a source of strength, wisdom and influence in the nuclear Latino family.”
Regina barros-rivera and vilma barber of the Guidance Center running a group for the Latina Girls Project
The Benefits of Group Support
Peer group therapy is also an important component of the program, with parents meeting in one group and the teens meeting in another.
“In these groups, both the parents and teens are embraced and supported by those who understand their feelings,” says Barros-Rivera. “It’s such an important tool toward healing for the whole family.”
In the girls’ support group, the team helps the teens identify and practice better ways of handling their stress. The group also serves as an avenue for the girls to mature and develop mentoring skills, according to Barros-Rivera. “The ones who have begun to get better are great at engaging the new girls,” she says. “They’ve been in the same spot, and it makes them feel good about themselves when they can help others. It builds their self-esteem.”
At the parent support group, parents (mostly mothers) learn how their overprotective behavior impedes their daughters’ growth. “The mothers work hard in the group, where they’re allowed to express their fear,” says Barros-Rivera. “We discuss things like communicating with your daughter, allowing them to have friends over, and adolescent sexuality.”
In fact, says Barros-Rivera, the group suggested that Planned Parenthood be invited to speak at one of their meetings. “That was an amazing accomplishment for the program goals,” says Barros-Rivera.
Major Shifts in Family Dynamics
According to Maria, her parents’ participation in the support groups marked a major turning point; they became more understanding of her depression and let go of their self-blame, which enabled them to focus on their daughter’s needs. “They realized that I just wanted them to be there for me and listen,” says Maria. “They learned that it doesn’t help to question why I feel the way I do but to accept it and support me.”
The program has also helped many of the mothers become firmer with their sons and more understanding of their daughters’ desire to identify as American teenagers. Says Ana’s mother, “I communicate better with my daughter, and she has a chance to socialize with children who have similar problems.”
Barros-Rivera is thrilled to witness such transformations in the family dynamic. “It’s so important for the girls to get permission from their parents to move on and take advantage of the opportunities this country has to offer,” she says, adding “I love these girls.”
Moving Forward
According to Barber, once Ana saw that her mother understood her need for freedom and respite from the parental role she had taken on, the teen learned to embrace her role in the family, seeing herself less as a “parentified child” and more as a “broker,” says the counselor.
“She feels proud that she can help her siblings while their mom is at work,” says Barber. “And she no longer feels resentful about helping her mother with English translations. It makes her feel important.”
As her confidence grew, Ana – a baseball and softball fan – took a self-defense class, and she’s developed a passion for the practice. She also decided to join a school group that focuses on values such as diligence, leadership, physical fitness and responsibility.
“Ana has definitely embraced those values,” says Barber. “Having come from a family where her father told her girls aren’t strong, this is a huge shift for her.”
Although Ana’s parents are no longer together, her relationship with her father has improved significantly. He bought her a piano, and she’s been learning to play one of her favorite songs: “Don’t Stop Believing” by Journey.
Empowered and self-confident, both Ana and Maria have put their difficulties behind them and are making plans for the future. Ana hopes to leverage her athleticism and desire to help others by becoming a law enforcement official. While the teen acknowledges that her favorite television shows influenced that ambition, she says her main motivation is to help others, like her parents, who don’t have papers and are prey for unscrupulous people.
“There are so many scams out there, and it makes me so mad,” says Ana. “I want to do something to make a difference for people who can’t speak up for themselves.”
Maria is also highly motivated to reach her goals, which include going to a performing arts college and becoming a professional singer. “The program helped me to not be afraid to talk or sing in front of people,” she says. “I first sang in front of my family, and they clapped, so I felt confident enough to sing in front of my school.” She also sang at a celebration for the funders of the Latina Girls Project, bringing many of the audience to tears with her beautiful, heartfelt performance of a song called “Warrior” by her favorite singer, Demi Lovato, who was diagnosed with bipolar disorder in 2011 and has become an advocate for those with mental illnesses.
Most recently, Maria had the opportunity to record the song at a professional studio, which she calls one of the best experiences of her life. “She was so full of joy the entire time,” says Barros-Rivera, who was there for the session. “Her beautiful smile lit up the room.”
The Land of Hope and Dreams
Although their treatment has concluded, Ana and Maria, as with all graduates, are still invited on the monthly outings, which help expose them to possible career paths.
“They leave here knowing that there are options for them in this country,” says Barros-Rivera. “After we work with them in the program, they see hope; they see that there are other ways to deal with life’s challenges. They’ve developed self-reliance and self-esteem, and they no longer feel suicidal.”Barber and the entire Latina Girls Project team are incredibly proud of the progress Ana and Maria have made. “They’re very smart girls,” says Barber. “They’ve learned that it’s not a betrayal to their parents for them to want more out of life than being a caretaker for their families.”
Kathy Rivera takes on leadership role at Long Island’s leading children’s mental health organization
Roslyn Heights, NY, June 22, 2021 — North Shore Child & Family Guidance Center (the Guidance Center) is pleased to announce that today, June 22, 2021, Kathy Rivera will be the organization’s new Executive Director/CEO. Ms. Rivera is taking over the leadership role upon the retirement of Andrew Malekoff, who served the agency for 45 years.
Ms. Rivera spent the last 14 years at the Jewish Child Care Association (JCCA), where she was the Senior Vice President of Care Management Services. Her experience at this multi-service child welfare agency, which provides comprehensive social services to children and families, makes her a perfect fit for the leading role at the Guidance Center, Long Island’s leading children’s mental health organization.
“We believe Kathy will provide the strong leadership, experience and vision the Guidance Center needs to move into the future,” said Paul Vitale, Guidance Center Board President. “She has a proven track record in governance and fiscal management, and she has built and developed an expert, interdisciplinary leadership team that successfully operates a wide range of mental health, physical health, education and social well-being programs that serve more than 1,000 youth and families across Metro New York.”
“North Shore Child & Family Guidance Center’s mission not only aligns with my core values but supports my commitment to strengthening individuals and families to achieve self-determined optimum well-being,” said Ms. Rivera. “It is an honor and privilege to become part of a dynamic team and outstanding organization dedicated to ensuring equity and access with the highest quality services. I am thrilled to begin this new journey with the Guidance Center and look forward to supporting communities and families on their personal paths toward hope and healing.”
Regina Barros-Rivera will serve as COO. “The Board of Directors believes that with Kathy’s leadership and Regina’s long-standing commitment and value to the organization, the Guidance Center will continue to uphold its unwavering dedication to the Nassau community,” said Mr. Vitale.
Kathy Rivera earned her Bachelor of Arts degree from Hunter College of the City University of New York and her Master of Social Work from the Hunter College School of Social Work. She is a Licensed Clinical Social Worker and holds multiple certifications and trainings including being a Sanctuary Model (Trauma Informed) Trainer. She is a first-generation American-born child of immigrant parents from Thailand. When not working, Ms. Rivera enjoys spending leisure time with her husband, two sons and dog Luna.
About Us:
As the preeminent not-for-profit children’s mental health agency on Long Island, North Shore Child & Family Guidance Center is dedicated to restoring and strengthening the emotional well-being of children (from birth – age 24) and their families. Our highly trained staff of psychiatrists, psychologists, social workers, vocational rehabilitation counselors and other mental health professionals lead the way in diagnosis, treatment, prevention, training, parent education, research and advocacy. The Guidance Center helps children and families address issues such as depression and anxiety; developmental delays; bullying; teen pregnancy; sexual abuse; teen drug and alcohol abuse; and family crises stemming from illness, death, trauma and divorce. For more than 65 years, the Guidance Center has been a place of hope and healing, providing innovative and compassionate treatment to all who enter our doors, regardless of their ability to pay. For more information about the Guidance Center, visit www.northshorechildguidance.org or call (516) 626-1971.
COVID fears and restrictions may be affecting teen mental health. Click here to visit Scripps.org to learn more.
Teens face untold pressures even during the most ordinary times. COVID-19 has added new pressures and they have taken an emotional toll.
Studies show COVID fears and social restrictions have had a negative impact on the mental health of teens, those between the ages of 13 and 19.
According to a recent national poll, nearly 50 percent of parents say their child or teen had shown signs of a new or worsening mental health condition during the pandemic. The poll by researchers at the University of Michigan surveyed 977 parents of teens, and found:
1 in 3 girls and 1 in 5 teen boys have experienced new or worsening anxiety.
More parents of teen girls than parents of teen boys, saw an increase in anxiety and worry or depression and sadness.
3 in 4 parents said COVID restrictions had affected their teen’s connections to friends.
COVID and mental health
COVID has affected everyone in one way or another. Four in 10 adults reported struggling with mental health or substance use in a pandemic-related survey by the Centers for Disease Control and Prevention (CDC). Young people, ages 18 to 24, reported the highest rate of having suicidal thoughts, according to the CDC.
Mental illness among young people was already on the rise when the pandemic hit. COVID and the COVID-related changes, such as social distancing and virtual learning, added new stressors and for some exacerbated existing mental health conditions.
“Teenagers can be moody and temperamental at times. Keep in mind, they’re going through physical changes and asking questions about who they are and what they want to do with their lives as they become more independent,” says Gurinder Dabhia, MD, a pediatrician at Scripps Clinic Rancho Bernardo. “But while occasional bad moods and acting out can be normal adolescent conduct, these types of behaviors also can indicate underlying depression or anxiety.”
Because normal behaviors vary as children and teens develop, it can be challenging to know if your teen is going through a temporary phase or is experiencing depression or anxiety. However, there are warning signs for both conditions that can help parents.
COVID and teen mental health
For the past year, COVID restrictions have limited the type of social interactions and peer group activities that are so important in the lives of teenagers and for their development, such as sport activities, school performances, proms and graduations.
While a return to normal is on the horizon with the arrival of COVID vaccines, the struggles of the past year will likely continue to affect families for some time.
Dr. Dabhia recommends parents to continue checking in with their teen and watch and listen for signs of depression or anxiety.
Symptoms of teen depression
Signs that may indicate depression include:
Sudden bursts of anger coupled with irritability
Negative thinking
Extreme sensitivity to criticism
Sulking
Feeling misunderstood
A drop in school grades, attendance or not doing homework
High-risk behaviors, such as using alcohol and drugs
A change in sleeping patterns or trouble sleeping
A change in eating habits, such as eating more or less than usual
Difficulty concentrating
Unexplained aches and pains, such as headaches
Withdrawal from family and friends, including texting and video chatting
Symptoms of teen anxiety
Everyone experiences feelings of anxiety at times, and it is a normal reaction to stress. When anxiety seems to be continually out of proportion to the situation and affects your teen’s daily life and happiness, then it may signal an anxiety disorder. Symptoms include:
Excessive worry most days of the week
Trouble sleeping at night or sleepiness during the day
Restlessness or fatigue during waking hours
Trouble concentrating
Irritability
“Depression and anxiety often occur together, although they should be diagnosed separately and treated as two separate issues,” says Dr. Dabhia.
When to see your pediatrician
If your teen exhibits signs of either depression or anxiety that persist for more than two weeks, make an appointment with your teen’s doctor or pediatrician.
The doctor will ask the appropriate screening questions, usually with the parents present, and will also have a confidential discussion with your child. If necessary, your doctor can refer you to a specialist.
“Be ready to discuss specific information about your adolescent’s symptoms, including how long they’ve been present, how much they’re affecting your teen’s daily life and any patterns you’ve noticed,” Dr. Dabhia says.
In addition, bring up any family history of close relatives who have been diagnosed with a mood disorder or mental illness, as well as events in your own immediate family.
Sometimes depression or anxiety may be triggered by changes within the family unit, such as a divorce, remarriage, a new sibling or move. During the pandemic, it could be a loss of a family member or friend to COVID or another illness or the loss of a job.
Suicide prevention
Pediatricians can screen for depression and ask about other concerns like anxiety or trouble coping with stress. They can also screen for suicide risk.
Any suicide talk should be taken seriously. Seek help immediately by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or texting the Crisis Text Line by texting ‘TALK’ to 741741.
“It’s important that parents stay positive and that they keep the lines of communication open with their teen,” says Dr. Dabhia. “Most people think these conditions are difficult to treat, but there are a variety of options that can help, including talk therapy. Early treatment can shorten the period of illness and help your teen cope.”
How parents can help
The University of Michigan poll noted what parents were doing to help improve their teens’ mental health during the pandemic. Many relaxed social media rules. One in four said they sought help from a mental health professional for their teen. Most said it had a positive effect. Many also reported using mental health apps.
“Make sure to talk to your teen frequently and offer your support,” adds Dr. Dabhia. “Make it clear you are willing to offer whatever support they need.”
Be persistent, she says. “Don’t give up if your adolescent refuses to talk at first. Talking about depression can be tough, but helpful.”
Also, don’t lecture. “Accept what your teen tells you without judging or criticizing,” Dr. Dabhia says. “It’s important to validate their feeling,” she says. “Don’t think you can just talk your adolescent out of his or her anxiety or depression. Learn to take the stresses and worries of your teen seriously and never dismiss talk of suicide.”
If your child or teen is expressing suicidal thoughts or feelings, we can help through our Douglas S. Feldman Suicide Prevention Project. To learn more, click here.
The pandemic has been the psychological workout of their lives. The next few months can be a time of recovery.
In the more than two decades I’ve spent as a psychologist working with adolescents, I have never seen teenagers so worn down at the end of an academic year as they are right now. Whether classes have been online, in-person or hybrid, young people are dragging themselves to the finish line of a frustrating, depressing and, for some, unbearably isolating year of school.
But now, with the number of new infections headed down and vaccinations widely available to ages 12 and up, most teenagers in the United States can anticipate a truly post-Covid summer. What should they look to make of it? For me, the answer is not “recover lost ground,” or even “put the past year behind them.” With the stress and constant adaptation of the pandemic now largely in the past, young people can enjoy the payoff of converting that experience into increased maturity and psychological strength.
To that end, it’s important to remember that building psychological muscle is a lot like building physical muscle. Any kid who has spent time in a gym knows that you gain strength when a period of exertion is followed by an interval of sufficient recovery.
For most teenagers, the pandemic has been the psychological workout of their lives. To put that workout to use, they need time for recovery so that they can enjoy increased emotional resilienceby fall. For adults on board with that plan, here are a few guidelines to help.
Give teenagers room to process what they’ve been through.
For adolescents, as for many of us, the pandemic has been characterized by deep feelings of loss. They’ve missed sports seasons, holidays with grandparents, milestone birthday parties and other plans that are beyond rescheduling. Some have stepped back from friendships that won’t be rekindled. Many have had to experience the deaths of people dear to them.
As adults, our loving instinct might be to steer our teenagers away from dwelling on the anguish of the pandemic and toward taking advantage of the now brightening future and expanding opportunities. But we should remember that grieving, though a painful process, ultimately helps us move forward when allowed to run its course.
Teenagers may do some of their most productive grieving in the company of their friends. Colin Mooney, 15, of Highland Heights, Ohio, recently got together with several peers whom he hadn’t seen in person since their eighth grade year was derailed by lockdown in March, 2020. Sitting in a circle in one friend’s backyard, they talked about what they lost, including “our field day, our graduation and a special Mass where each eighth grader passes a candle to a seventh grader to make them eighth graders.” Talking through what they’d all missed offered much needed closure. “Sharing as a group,” he said, “really helped ease our minds and remember that everyone was going through the same thing.”
Other adolescents may mourn in a more private fashion. Arielle Green, 15, of Brooklyn, N.Y., writes poems to make sense of her feelings. Her recent poetry has centered on “how the pandemic sucks, and how things are still going on in the world that are really horrible.” She said that her poems offer a way “to let it all out.”
However your teenager goes about it, expect grief to be part of the summer. Give adolescents time and space to come to terms with the impact of Covid-19 on their lives so that they can, over time, savor what remains and embrace what lies ahead.
Be open to negotiating the “must dos.”
As with any summer, there will be some non-negotiables when it comes to how young people spend their days. Teenagers may need to get jobs, take over chores or brush up academically. Required activities can certainly be part of a recovery-focused summer, but when possible, let teens have some say in the details.
Ava Vestergaard, a 17-year-old senior at Sunset High School in Portland, Ore., needs to earn money for college, but she’s really hoping for the kind of job that will help her fill her emotional tank after a draining academic year. “When there’s a job I like, I enjoy the work and getting to know my co-workers.” For her, a job that’s gratifying might be worth much more in the long run than one that pays a few dollars per hour more but offers little of what she finds restoring.
And, of course, ambitious, self-improving pursuits can also fit the bill, so long as they’re more wanted than mandated. Ezekiel Salama, 17, of Shelbyville, Ky., can’t wait to attend the Governor’s School for Entrepreneurs, a selective summer program for teenagers in Kentucky. He’s expecting his constructive summer plans to leave him fresher than ever for the coming school year.
That said, everyone has different emotional settings. What energizes one person might leave another spent. Should an adolescent be fortunate enough to have some choices about how she spends her summer, adults may be able to help by tuning in to how much, and what, she wants to do. If you can tell that your teenager is genuinely eager to learn a new language, start a business or write a novel, stay out of her way. But if you get the sense that she’s crafting a punishing improvement regimen in an anxious attempt to compensate for a stripped-down school year, you might invite her to reconsider this approach so as not to risk returning to school feeling more depleted than she left it.
In a similar vein, parents may have their own concerns that their teenager has fallen behind academically this year. But if the school hasn’t called for an intervention, it may be best to let it go.
Don’t let guilt ruin restoration.
Given how much the pandemic upended expectations for what adolescents were supposed to be achieving, teenagers themselves might feel uneasy about the idea of making recovery a priority this summer. “Covid was a lot of doing nothing,” said Kari Robinson, age 14, of Evanston, Ill. “I think I might feel a little guilty if I use my summer freedom to relax.” Help your young people see past this way of thinking. The point of recovery is not to relax, but to grow. And if downtime is soaked in guilt, that growth is going to suffer.
Don’t underestimate the value of whatever they turn to — even if it’s “just hanging out” — as they go through the quiet work of rebuilding themselves.
There aren’t many upsides to having a virus wreak havoc with one’s adolescence, but on that very short list might be coming to appreciate the growth-giving practice of following stressful periods with deliberate recovery. This may be especially true at this moment in time, and it’s also how we want young people to be thinking about stress, recovery and growth long after the pandemic is over.
Illustration by Yifan Wu
Lisa Damour is a psychologist and the author of the New York Times best sellers “Untangled” and “Under Pressure.” Dr. Damour also co-hosts the podcast “Ask Lisa: The Psychology of Parenting.”
By Emily Esfahani Smith, Originally published in the New York Times, May 4,2021
When schools shut down last spring, Carson Roubison, a charter school student in Phoenix, was initially relieved. There were some difficulties in those early days at home — when classes went online, Carson and his parents, both public-school teachers, had to share the sole family computer. But Carson’s stress levels fell as school became less demanding during the transition to distance learning.
“I wasn’t aware of the giant impact the pandemic would have,” he said, “so I was excited, to be honest, to have some time off school.”
But things changed in the fall. The academic load went back to prepandemic levels, even though learning was still remote. Carson, a senior, struggled to stay motivated. His mental health suffered. He hoped to attend community college the following fall, but grew increasingly “terrified” that the education he’d received in high school over the past year would leave him unprepared.
“I’m afraid I’m going to get to community college,” he said, “and be held to the same standards as past students, and fail. That’s the biggest source of my anxiety.”
Carson’s story is not unique. The pandemic has taken a toll on the mental health of millions. But adolescents have been hit especially hard. According to a national poll conducted in January by the University of Michigan’s C.S. Mott Children’s Hospital, 46 percent of parents say their teenagers’ mental health has worsened during the pandemic. More alarmingly, a report by the Centers for Disease Control and Preventionfound that the proportion of 12- to 17-year-olds visiting emergency rooms for mental health reasons rose 31 percent for most of 2020 compared with 2019. And this is all on top of an already existing mental health crisis among young people.
While many experts believe that the reason adolescents are struggling today is that they’re away from friends and school, a closer look at the research reveals a more complicated picture. According to psychologists who study adolescent resilience, one of the biggest threats to the well-being of today’s teenagers is not social isolation but something else — the pressure to achieve, which has intensified over the past year.
Psychologists define resilience as the ability to adapt well to stress. For decades, they have studied why some kids are more resilient in adversity than others. Suniya Luthar, emerita professor of psychology at Columbia’s Teachers College and a leading resilience researcher, believes the pandemic is a “natural experiment” that can help answer that question: When you expose adolescents to an event that changes their lives significantly, how do they cope?
Dr. Luthar began her career studying resilience among urban youth living in poverty in Connecticut in the 1990s. At the urging of one of her students at Yale, where she was teaching, she also started studying teenagers living in middle- and upper-middle-class suburbs like Westport, Conn., where many of the parents are high-achieving professionals who emphasize the value of status and achievement to their children.
Comparing these students with the poor, urban adolescents, she was shocked to discover that the suburban children were doing worse on drug and alcohol abuse. They also had higher rates of anxiety and depression as compared with national norms. Researchers knew that social conditions were important determinants of resilience, but they hadn’t known that living in success-oriented cultures was a risk factor.
In the years since, Dr. Luthar and her colleagues at Authentic Connections, a research group that works to foster resilience in school communities, have studied tens of thousands of teenagers attending “high-achieving schools,” which she defines as public and private institutions where students on average score in the top third on standardized tests. The students in these samples come from a variety of racial, regional and socioeconomic backgrounds. In one group of students Dr. Luthar studied, for example, one-third were members of ethnic and racial minorities and one-quarter came from homes where at least one parent did not attend college.
But regardless of these differences, many of them were struggling in the same way. In a paper published in 2020 in the academic journal American Psychologist, Dr. Luthar and her colleagues — the psychological researchers Nina Kumar and Nicole Zillmer — reviewed three decades’ worth of research findings showing that adolescents at high-achieving schools suffer from symptoms of clinical depression and anxiety at rates three to seven times higher than national norms for children their age.
What’s driving their misery, the research shows, is the pressure to excel in multiple academic and extracurricular pursuits. The National Academies of Sciences, Engineering, and Medicine and the Robert Wood Johnson Foundationsuggest children living in an achievement-oriented culture are at risk for adjustment problems, like those facing more predictable forms of adversity, such as poverty and trauma.
The pandemic offered a rare reprieve for students — at first. Since 2019, Dr. Luthar and her colleagues have surveyed thousands of adolescents each year at public and private schools across the nation. Replicating findings of earlier research, these students reported suffering from anxiety and depression at higher rates than national norms before the pandemic. But when schools closed last spring, something unexpected happened — the well-being of these students actually improved.As classes and exams were canceled, grading moved to pass/fail and extracurricular activity ceased, they reported lower levels of stress, anxiety and depression compared with 2019.
But these improvements were short-lived. Dr. Luthar and her colleagues found that beginning in the fall of 2020, as schoolwork ramped back up, the mental health of adolescents returned to prepandemic levels or worse. According to research that will be published in Social Policy Report, a quarterly publication of the Society for Research in Child Development, the strongest predictor of depression among these students was perceived parental criticism and unreachable standards.
“Even though I’m trying my best, it never really goes the way I wished,” a student Dr. Luthar studied wrote, “and my mother adds stress because she is always saying that I NEED to have a 90 or higher averages in all my classes.”
Other research supports these findings. In a nationally representative study conducted by NBC News and Challenge Success, a nonprofit affiliated with Stanford’s education school, researchers studied over 10,000 high school students in the fall of 2020. Comparing the experience of these students with about 65,000 adolescents surveyed between 2018 and February 2020, these researchers, too, found that many students reported feeling more stressed about school during the fall of 2020 than before the pandemic. A chief cause of their stress: the pressure to achieve.
Nearly half of all students reported that the pressure to do well in school had increased since 2019, and over half said their school-related stress over all had risen. Grades, workload, time management, lack of sleep and college fears were the most commonly cited sources of stress. These findings held across socioeconomically diverse schools. At underresourced schools, students were more likely to report being stressed about family finances, according to Denise Pope, a founder of Challenge Success, but the top stressors were still grades, assessments and college.
“My school is giving too much work,” a 10th grader in this study wrote, “even though times are tough for everyone. At first, this was just a break from school, but now all I feel is stress, anxiety and pain.”
Parents appear to play a big role in this phenomenon. Fifty-seven percent of students said that their parents’ expectations for their performance stayed the same during the pandemic, while 34 percent said their expectations increased. The stereotype of the adolescent aloof from parental influence doesn’t seem to apply to these students, who report feeling more stressed about family pressure than peer pressure.
When Dr. Pope asks parents to define success, they inevitably say that they want their children to be happy and healthy, have loving relationships and give back to society. But when she asks children how they define success, many describe a narrow path: getting good grades, going to college and securing a high-paying job.
Dr. Pope believes the gap is due in part to how parents praise their kids. Many parents reward their children when they perform well, which sends a signal to the kids that the approval and love of their parents depends on how much they’re achieving. So inevitably, if they believe they are falling short of their parents’ expectations, their sense of worth and well-being suffers.
Larger cultural forces are also pushing students to define success narrowly. As inequality rises and two major recessions in the past decade have left millions out of work, many students may feel compelled to climb the ladder to ensure their economic security as adults. College admissions at top-tiered schools has become more selective over the same period of time, leaving students competing harder for fewer spots — only to receive an education that will likely leave them or their parents in debt for many years to come.
If we want more-resilient kids coming out of the pandemic, then we need to heed a lesson of this past year — that the pressure to achieve is crushing the spirits of many young people and should be dialed back. Parents can play a vital role here. They can help ease their children’s anxiety by reminding them that where they attend college will not make or break them — and that getting Bs does not equal failure.
They can encourage them to prioritize their health and well-being by getting enough sleep and making time for play and leisure. And above all, they can teach their children that loss is an inevitable part of life by speaking to them about the grief of the past year. This doesn’t mean parents should necessarily lower their standards. But they might emphasize different benchmarks for achievement, like those they themselves claim to most value for their children — happiness, health and love.
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.
Ms. Esfahani Smith is a doctoral student in clinical psychology and the author of “The Power of Meaning.” At the beginning of the pandemic, she wrote about how a key to surviving the mental-health trials of isolation is to look for meaning rather than happiness.
If your child or teen is expressing suicidal thoughts or feelings, we can help through our Douglas S. Feldman Suicide Prevention Project. To learn more, click here.
Illustration by Kensuke Koike; Photograph via Getty/Digital Light Source
Temper tantrums, “talking back” and other forms of acting out are a normal part of a child’s development. When a youngster is feeling, tired, stressed, upset or out of sorts for any reason, these behaviors aren’t uncommon. Ask any parent!
But when a child’s words and actions cause serious problems at home, school or with peers, they may be diagnosed with a condition known as Oppositional Defiant Disorder, or ODD, a condition that takes a huge toll on family relationships.
“It’s not unusual for children to express their frustrations by losing their tempers or testing your limits by disobeying rules,” says Dr. Sue Cohen, Director of Early Childhood and Psychological Services at North Shore Child & Family Guidance Center. “But when it becomes a pattern of being uncooperative and hostile toward you, their siblings and peers, and other authority figures in such a way that it impacts their daily functioning, it may require professional intervention.”
A diagnosis of ODD is made when behaviors are extreme and go on for at least six months.
Active defiance and refusal to comply with adult requests and rules
Deliberate attempts to annoy or upset people
Blaming others for his or her mistakes or misbehavior
Often being touchy or easily annoyed by others
Frequent anger and resentment
Mean and hateful talking when upset
Spiteful attitude and revenge seeking
Signs of ODD typical arise during preschool year, though it can develop later (though usually before early adolescence). Experts aren’t sure what causes ODD, but say that biological, psychological and social issues may play a role. While extreme forms of parenting—too lax or too harsh— may contribute to ODD, that isn’t always the case.
“Parents may feel guilty when their child has ODD, but there are so many unknowns,” says Cohen. “Often one child in the same family has ODD, while other siblings may not. What’s important is getting help, especially since other issues such as attention-deficit hyperactivity disorder (ADHD), learning disabilities, bipolar disorder, depression and anxiety disorders may be present.”
Treatment for ODD can include a variety of therapeutic methods, such as teaching the child anger management and communication techniques, impulse control and problem-solving skills. Including the family in the treatment plan is important, as parents need to develop skills to manage their child’s behavior.
Also, medications may be appropriate, which can be determined in a review with a psychiatrist or other psychiatric professional.
To learn if your child may have ODD, or to get help with other issues that are negatively impacting the life of your child, teen or family, contact the Guidance Center at (516) 626-1971.
Always build on the positives, give the child praise and positive reinforcement when s/he shows flexibility or cooperation.
Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if s/he decides to take a time-out to prevent overreacting.
Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don’t add time for arguing. Say “your time will start when you go to your room.”
Set reasonable, age-appropriate limits with consequences that can be enforced consistently.
Maintain interests other than your child with ODD, so that managing your child doesn’t take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.
Manage your own stress with healthy life choices such as exercise and relaxation. Use respite care and other breaks as needed.
The past year has brought with it more stress than many of us have ever experienced. Given the fear, anxiety, isolation and overall disruption of our normal lives caused by the pandemic, it would be surprising not to feel more stressed out than usual.
Uncertainties have been the rule rather than the exception. Should I let my kids go to summer camp? Can we take a family vacation? Is my job secure? Can I get a vaccination appointment? The questions are never-ending.
So, the big question is, how do you manage to handle all that stress so that it doesn’t create further emotional or physical problems?
First and foremost, parents need to let go of the idea that self-care is selfish. “Most of us have heard that, in the event of a drop in pressure on an airplane, parents should put on their own oxygen mask before their child’s,” says Dr. Sue Cohen, Director of Early Childhood and Psychological Services at North Shore Child & Family Guidance Center. “If you aren’t able to breathe, you’ll be no good for your kids, and that’s true in all areas of your family life.”
It’s not that you’re putting your child’s needs below your own; rather, you realize that you will be a better parent by being as healthy in mind, body and spirit as possible. “As human beings, we cannot avoid all stress, but there are strategies we can take to help ourselves manage when things seem overwhelming,” says Cohen.
Some suggestions:
Exercise is a benefit to both your mind and body. Don’t have an hour for the gym? Even 15 or 20 minutes of walking, yoga, gardening or another activity that you enjoy will make a difference. If it’s hard to fit into your schedule, choose an activity that’s good for the whole family—but don’t feel guilty if you want to set aside some time just for you!
You’ve heard it before: Try meditation. It’s a proven method of reducing stress, and anyone can do it, anywhere. There are many free apps out there to guide you, whether you are new to meditation or a seasoned practitioner. One good bet: Insight Timer.
Even if you decide meditation isn’t for you, we all know how to breathe. Taking low, slow breaths is a guaranteed way to slow down your anxiety response. Click here for more info.
Ask for backup when you need it. If you’re having trouble making time for yourself, set up a regular swap with a friend or neighbor for playdates.
Limit your exposure to bad news. While there are many things you can’t control, you can turn off the TV when your blood pressure is rising.
Bottom line: A tired, stressed-out parent isn’t helpful to anyone. Taking time to recharge your batteries won’t only benefit you, but it will benefit your children.
In this monthly column, therapists from North Shore Child & Family Guidance Center answer your questions on issues related to parenting, mental health and children’s well-being. To submit a question, email NSCFGCexperts@gmail.com.
Question: I had my beautiful baby girl two months ago, but being a mother is nothing like what I expected. I am so depressed most of the time that I have trouble getting up in the morning, let alone taking care of my baby. I’m also paralyzed by fear that something bad will happen to her. How can I be so sad when this is supposed to be one of the best times in my life? I feel like the worst mother in the world.
— Distressed Mom
Dear Distressed Mom: It’s very possible that what you are experiencing is a condition known as postpartum (maternal) depression. First off, please know that this is not about whether or not you are a loving and dedicated mother. It’s a disease like any other, and there are steps you can take to get better.
While many women experience some mild mood changes during or after the birth of a child, 15 percent to 20 percent experience more significant symptoms of postpartum depression and other perinatal mood and anxiety disorders.
The symptoms can include feelings of anger, sadness, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, thoughts of hopelessness and sometimes even thoughts of harming the baby or herself. These symptoms can also begin during pregnancy, not just after they have the baby.
The good news is that help is available. One resource is North Shore Child and Family Guidance Center’s Diane Goldberg Maternal Depression Program. Services include:
Screening and assessment
Individual, couple and family therapy
Crisis intervention consultation
Psychiatric evaluations and medication management, where needed
While motherhood is wonderful in many ways, it’s OK to admit it can be really hard, especially in the beginning. Don’t hesitate to reach out for help!
Question:My son is in fourth grade and is insisting all his friends already have a cell phone. We think it’s too soon. What should we do?
— Old-fashioned Parents
Dear Old -Fashioned Parents: There is no “right time” to give your child his own cell phone—but acquiescing to the “but everyone has one” plea is definitely not a smart move. Is he apart from you often beyond school hours and active with extracurricular activities? That might make it a useful means of communicating with you. Is he typically responsible with his possessions? Is he good when it comes to respecting limits you put on screen time?
If you feel like it might be useful for him to have a cell phone but you think he is too young for access to texting or the Internet, look into plans that only allow phone calls. Other plans will allow for just calls and text, but that’s all.
Stay tuned for next month’s column, when we’ll talk about how to regulate your child’s use of phones and other tech devices.
During the pandemic, North Shore Child & Family Guidance Center is seeing clients remotely via telehealth platforms or, when deemed necessary, in person. To make an appointment, call (516) 626-1971 or email intake@northshorechildguidance.org.
The guilty verdict in the Derek Chauvin murder trial was, in no small part, the result of a video taken by a teenaged girl who witnessed the murder of George Floyd on May 25, 2020.
Fifty years earlier, on May 4, 1970, another teenaged girl found herself on the other side of a camera, her arms extended and mouth agape in horrified anguish, kneeling beside the body of Jeffrey Miller, one of four Kent State students shot and killed protesting against the U.S. invasion of Cambodia and the presence of the Ohio National Guard on campus.
In an April 19, 2021 story in the Washington Post, reporter Patricia McCormick wrote about her meeting with a wary Mary Ann Vecchio, the then 14-year-old at the center of the Kent State photo.
McCormick recalled, as “Mary Ann watched the video of George Floyd’s dying moments, she felt herself plummet through time and space — to a day almost exactly 50 years earlier. On that afternoon in 1970, the world was just as riveted by an image that showed the life draining out of a young man on the ground, this one a black-and-white still photo” taken by Kent State student John Filo.
The impact of certain images cannot be underestimated. In her story, McCormick referenced a few more, including the protester standing alone in front of a line of tanks in Tiananmen Square in China and the unforgettable photo of Kim Phuc, the naked Vietnamese girl fleeing napalm that has just set her home afire.
Perhaps a lesser-known photo was the subject of the book Sons of Mississippi.
The photo, which originally appeared in a 1962 issue of Life magazine, portrays a gathering of seven Mississippi sheriffs at the University of Mississippi just prior to the admission of its first black student James Meredith.
One of the sheriffs is wielding an axe handle as if were a baseball bat, to the obvious delight of the others. They are anticipating the upheaval to come as James Meredith is about to integrate the University of Mississippi.
In his discussion of the photo of the sheriffs, the author Paul Hendrickson cited poet Mark Strand who, referring to a certain artist’s (Edward Hopper) work, said “The shadow of dark hangs over them, making whatever narratives we construct around them seem sentimental and beside the point.” Which, to me, is another way of saying, sometimes no words are necessary.
When she was called to the witness stand in the Derek Chauvin murder trial, Darnella Frazier was asked by the prosecutor, “What did you see?” She responded, “A man terrified and scared, begging for his life.”
Yet, Darnella’s video requires no accompanying narrative – it speaks for itself. According to McCormick, when Mary Ann Vecchio watched the video of George Floyd’s death last May, “she was so shaken . . . she jumped off her couch and yelled at the crowd in the video. “Mary Ann,” McCormick said to her, “It seems to me that you’re still that girl in the photo, you’re still that girl saying, ‘Doesn’t anyone see what’s happening here?’”
Mary Ann, who confesses to feeling stuck in that moment half-a-century ago, says that she feels like she needs to do something good. To which McCormick tries to reassure her, “In that moment when you knelt over Jeffrey Miller’s body you expressed the grief and horror that so many people were feeling. You helped end the Vietnam War.”
Fifty years later, when she felt helpless to do anything else to deal with the terror of a traumatic event playing out at close range before her eyes and in the shadow of darkness, Darnella Frazier had the presence of mind to take out her cell phone in broad daylight and start filming. In so doing she brought light to a troubled nation and she brought justice for George Floyd.
The good women and men who started the Guidance Center had the foresight, intellect and diligence that led to the creation of a force that would provide quality mental health care for hundreds of thousands of children, teens and family members for nearly seven decades.
I owe the founders a debt of gratitude for offering me such an enriching spot to hang my hat for almost all my adult life. Confucius was right when he said, “Choose a job you love, and you will never have to work a day in your life.”
Although the 45 years have come and gone swiftly, I’ve developed a capacity akin to time-lapse photography that has enabled me to observe change through a series of evolving images.
The waiting room of Guidance Center headquarters in Roslyn Heights provides a snapshot of who seeks help. And who seeks help at any given time is in part a function of how mental illness and mental health are viewed by the public.
As I contemplate my 45 years, I discover that the waiting room has become a much more richly heterogeneous place with respect to race, ethnicity, religion and language. Increasingly, families who were once averse to seeking outside help for emotional issues occupy that space like never before.
What led to the change? A combination of factors including sustained public education efforts aimed at reducing stigma and ambitious advocacy initiatives directed at reducing disparities and increasing access to care. Both education and advocacy combined to ensure that diseases of the brain be treated on par with diseases of the body.
Along with the demographic changes in who seeks help, there came the need for diversifying the workforce and providing consistent professional education to enhance the cultural literacy of frontline mental health practitioners. This is especially germane today when the social and political winds inside our nation reveal more profound divisions than in all my time at the Guidance Center.
Intersecting with my reel of waiting room images is a reel of traumatic events that I never would have predicted when I started in 1977, all of which impacted the children who sat in our waiting rooms. Just a few examples: the Challenger explosion (1986), LIRR massacre (1993), Columbine High School shooting (1999), 9/11 attacks (2001), Madoff financial disaster (2008), superstorm Sandy (2012), Sandy Hook Elementary School shooting (2012), Parkland High School shooting (2018) and today’s COVID-19 pandemic.
Throughout the reel is also a steady succession of racial injustices, deaths of unarmed people of color at the hands of law enforcement officers. The final frame I see is the January 6 domestic terrorist insurrection in Washington.
In today’s waiting room sit people of all colors and backgrounds with personal stories of trauma and grief, and far too many young ones who feel as though they cannot live one day longer. They live in a world in which their mental health struggles are compounded by a toxic surround that we as adults either fuel, ignore or deny but cannot escape.
These children have profound troubles and live in a profoundly troubled world. Yet there is hope in places like ours, where people of all backgrounds and skin colors share the dream that their children might live a peaceful and prosperous life in a better world.
My message to anyone who wishes to follow in my footsteps is to never lose sight of the situational surround. Context counts. We can all do better to understand our children from the inside-out and the outside-in. And, if you’re fortunate enough to find your authentic voice, don’t let anyone take it away from you. Healing involves quality care and a strong voice underpinned by a social consciousness, social conscience and an enduring quest for social justice.
In this monthly column, therapists from North Shore Child & Family Guidance Center answer your questions on issues related to parenting, mental health and children’s well-being. To submit a question, email NSCFGCexperts@gmail.com.
Question:We think our son might be engaging in unsafe driving behavior. The other night, he came home from being out with a friend and we could smell beer on his breath. Worse, he’d been the driver. What can we do?
—Nassau Parents
Dear Nassau Parents: You have reason to be concerned. The statistics are frightening: More teens die from motor vehicle crashes than any other cause of death, and teen drivers are 17 times more likely to be involved in a fatal car crash when they have alcohol in their system as opposed to when they are sober.
The same holds true for marijuana and other drugs. A report from Liberty Mutual and SADD (Students Against Destructive Decisions) found that one in five teens admit driving under the influence of marijuana, and one in four say they would take a ride from a driver impaired by alcohol or prescription drugs.
While many adults make foolish decisions about driving when they’ve been drinking, teenagers are even more susceptible to feeling like they’re safe to drive even when intoxicated. Their brains are still developing, and they tend to behave more impulsively, especially when they are under the influence of drugs or alcohol. Plus, when they do consume alcohol, teens are more likely to binge drink than adults.
While the good news is that drinking and driving among U.S. teens has gone down by more than half since 1991, they still drive after drinking an average of 2.4 million times a month.
As a parent, you play a crucial role in your teen’s choices, even though sometimes it might not feel that way. Some ways you can encourage safe driving include:
Make a driving contract with your teen that agrees upon zero tolerance for drinking alcohol or using drugs when driving.
Tell them that getting in a car with anyone who has been drinking or using substances is never OK.
Promise you will pick them up if they end up in that circumstance.
Insist upon a “no texting while driving” rule—or their phones will be taken away.
Require seat belt wearing for both the front and back seats, even for a short trip.
Consider limiting nighttime driving, especially if your teen is a new driver.
Be a good role model: Follow all the rules of the road and never drink and drive.
Question:I hear about all the things people are accomplishing with their pandemic “down time,” but I feel more stressed than ever, since I’m working at home and have two kids who are in remote schooling part of the time. Am I being too hard on myself?
—Tired All the Time
Dear Tired: In a word, yes! Despite the fact that Shakespeare purportedly wrote King Lear during a pandemic, he surely didn’t have kids pulling on his cloak and asking for help with homework.
The stresses brought on by the COVID-19 crisis have been overwhelming. Please give yourself a break! You don’t need to master crocheting or learn a new language right now. And don’t forget to take care of yourself while you’re focusing on everyone else’s needs. Whatever it is that soothes you—yoga, a warm bath, some time on Netflix—put it in your schedule. And ask for help, whether from your spouse, friend or another person who cares about you. You won’t be a good parent if you are burned out.
During the pandemic, North Shore Child & Family Guidance Center is seeing clients remotely via telehealth platforms or, when deemed necessary, in person. To make an appointment, call us at (516) 626-1971 or email intake@northshorechildguidance.org.
Last month, our country reached a devastating milestone: More than a half million Americans have died from COVID-19.
Losing a loved one can be devastating under any circumstances, but it’s especially difficult now, when we’ve also lost many of the traditions that bring us together in our grief, such as wakes, Shivas and funeral services. Moreover, many were unable to say good-bye because of restrictions at hospitals and nursing homes.
In the pandemic era, more children and teens are grieving perhaps than at any other era in our history. Even if they haven’t personally lost someone, odds are that they have a friend who has, and it comes at a time when they’ve lost so much—school routines, graduations and a host of other activities.
While our instincts are to protect our children from pain and sadness, death is a universal experience in all our lives. As a parent or caretaker, it’s your job to help guide them through the often-complicated process of bereavement, but how?
One of the most important things you can do is simple but powerful: Listen and validate your child’s feelings, which may run the gamut from denial and confusion to anger and sadness. All those emotions are a normal part of grieving, and they need to know it’s OK to have them and talk with you about them.
It’s also important for them to know that you are sad, too. When you express feelings of sadness, it will make your child feel more comfortable expressing their own grief.
Younger children may not fully grasp the concept of death and the fact that their loved one is not coming back. That’s one reason to use accurate terms when discussing the loss. Avoid saying grandpa “passed away.” Such vague terminology creates confusion.
It’s also helpful to bring up fond memories of your loved one. Focusing on the person’s life, not only their death, is a part of the healing process.
Also, grief often comes out behaviorally with young children, expressed in tantrums, clinginess or other forms of acting out, so it’s important for you to recognize that this might be their way of coping.
It’s also possible your child may feel some guilt and fear surrounding the death. Reassure them that they are not to blame, and that you and they are safe.
How do you know it’s time to seek professional treatment? If your child or teen isolates and seems withdrawn for an extended period of time, that may indicate that therapy would be helpful. Other signs might be sleep problems, changes in appetite or an academic decline.
Additionally, many children are reluctant to speak about their loss because they are afraid it will make their parents sad, and therapy can help provide a safe space for them to talk about and process their grief.
Of course, if your child expresses recurring thoughts of wanting to join the deceased or any other indication of suicidal feelings, it’s imperative to take that seriously and contact North Shore Child & Family Guidance Center or another mental health provider.
If your child is experiencing grief from a loss, or facing any other mental health challenge, please call North Shore Child & Family Guidance Center at 516-626-1971 or email intake@northshorechildguidance.org.
Elissa Smilowitz is the Director of Triage, Emergency and Suicide Prevention Services at North Shore Child & Family Guidance Center. She also heads up the Guidance Center’s Douglas S. Feldman Suicide Prevention Project.
The thought of suicide is terrifying, but we have to make talking about it a part of everyday life.
Dr. Morris is a developmental psychologist whose research has focused on early childhood education. Recently, she has turned her attention to preventing suicide.
I always felt so blessed watching my boy-girl twins; even as teenagers they would walk arm in arm down the street, chatting and laughing together.
But that blessed feeling evaporated in June of 2019, when I lost my daughter, Frankie, to suicide, three weeks before her high school graduation. Ever since that day, I have thought of little else except how I could help the next struggling teenager, the next Frankie.
Several days after her passing, we opened our home up to our community, including Frankie’s very large group of teenage friends. It was a muggy June day, and the air conditioning was no match for the hundreds of people who came through our New York City apartment.
There was a momentary pause in the steady stream of people offering hugs and condolences when a parent of one of Frankie’s friends put her hand on my shoulder and said gently: “What strength Frankie had. It must have taken enormous energy for her to do what she did each day.”
That was Frankie. She had the strength to engage in school and in theater, despite her anxiety and depression. She had an ability to connect — emotionally, profoundly — with others, even when she was struggling herself. Her friends spoke to us of being caught off guard by her hugs or endearing comments. A teacher once described her as “empathy personified, with quite the fabulous earring collection.”
I like to think that some of her strength came from the home we tried to give her. Whether that strength came from her home or somewhere else, or both, Frankie just had a way of drawing out warmth wherever she went.
But like many who struggle with suicidal thinking, she kept her own pain camouflaged for a long time, perhaps for too long.
Suicidal thinking, whether it is the result of mental illness, stress, trauma or loss, is actually far more common and difficult to see than many of us realize. A June 2020 Centers for Disease Control survey found that one in four 18- to 24-year-olds reported that they had seriously thought about taking their lives in the past 30 days; prepandemic estimates found that just under one in five high schoolers had seriously considered suicide, and just under one in 10 had made at least one suicide attempt during the previous year.
That’s a whole lot of kids. And some, like Frankie, are able to muster the energy to make their struggle almost invisible. Despite 50 years of research, predicting death by suicide is still nearly impossible. And with suicidal thinking common, suicide remains the second leading cause of death among 15- to 24-year-olds, after accidents.
Like others who have lost a child to suicide, I have spent countless hours going over relentless “what ifs.” And because I am a developmental psychologist who specializes in prevention programs, my “what ifs” also include the ways the world might look different so that another family won’t experience our fate.
One day while driving on a familiar stretch of highway with “what ifs” swirling in my head, I saw a sign flash “Click it or Ticket.” It struck me: Maybe what we need are seatbelts for suicide.
“Click it or Ticket” was born in part out of a concern in the 1980s about teenagers dying in car accidents. Just as with suicides today, adults couldn’t predict who would get into a car accident, and one of the best solutions we had — seatbelts — was used routinely, in some estimates, by only 15 percent of the population. Indeed, as children, my siblings and I used to make a game of rolling around in the back of our car, seatbelts ignored.
Three decades later, our world is unlike anything I could have imagined as a child. Putting on a seatbelt is the first lesson of driver’s education; cars get inspected annually for working seatbelts; car companies embed those annoying beeping sounds to remind you to buckle your seatbelt; and for added measure, highway signs flash that “Click it or Ticket” message as part of a National Highway Traffic Safety Administration campaign. The result? Most of us (estimates range as high as 91 percent) now wear a seatbelt.
What would it look like if we had an approach to suicide akin to universal seatbelt safety, starting early in adolescence?
Just as my parents couldn’t predict in the 1980s what seatbelt safety would look like now, I am not sure what suicide prevention should look like in the future. But I imagine a world in which every health worker, school professional, employer and religious leader can recognize the signs of suicidal thinking and know how to ask about it, respond to it and offer resources to someone who is struggling. Just as today we all know to dial 9-1-1 in an emergency (a system that came into being in the late 1960s), we would all know the national suicide prevention hotline (1-800-273-TALK, which will also be reachable at 9-8-8 in 2022) and text line (text HOME to 741741). We would “suicide-proof” our homes by locking up handguns, lethal medications and other things teenagers can use to harm themselves. And families would ask their children often about suicidal thinking.
When I told Frankie’s orthodontist about her suicide, his response surprised me: “We really don’t come across that in our practice.” Even though orthodontists don’t ask about it, they see children during their early teenage years, when suicidal thinking often begins to emerge. Can you imagine a world in which signs for the prevention hotline and text line are posted for kids to see as they get their braces adjusted? Or one with pamphlets in waiting rooms that instructed parents about suicide’s warning signs?
What if the annual teenage pediatric checkup involved a discussion of one-at-a-time pill packaging and boxes to lock up lethal medications, the way there is a discussion of baby-proofing homes when children start to crawl? What if pediatricians handed each adolescent a card with the prevention hotline on it (or better yet, if companies preprogrammed that number into cellphones) and the pediatrician talked through what happens when a teenager calls? What if doctors coached parents on how to ask their teenager, “Are you thinking about suicide?”
What if we required and funded every school to put in place one of the existing programs that train teachers and other school professionals to be a resource for struggling students? A number of states mandate training in suicide prevention, some as part of the Jason Flatt Act. States like New York and California (along with 13 others) encourage, but do not mandate, such programming. A few, like Rhode Island (which incidentally has the lowest teenage suicide rate in the nation), have no mandate but have still managed to pair training of teachers with resources for students, who are often the first to notice the signs of suicidal thinking in their friends.
But doesn’t asking about suicide put the idea in a kid’s head? Nope. Scientists at Columbia University have shown that it does not make them more suicidal, findings that were confirmed in a recent meta-analysis across studies of adolescents and adults. While it’s true that safe messaging about suicide matters, asking about suicide among adolescents does not increase their risk.
I recognize that despite progress identifying effective programs to combat suicidal thinking, their success rate and simplicity does not compare with what we see with seatbelts. But that doesn’t mean we shouldn’t do more.
Part of doing more also includes making the world more just and caring. To give one example, state-level same-sex-marriage policies that were in place before the Supreme Court legalizedsame-sex marriage nationally have been linked to reductions in suicide attempts among adolescents, especially among sexual minorities. Just as safer highways and car models make seatbelts more effective, asking about and responding to suicidal thinking is only one part of a solution that also includes attention to societal injustices.
I understand, of course, that asking about suicidal thinking is scary. But if it is scary for you to ask about it, it is even scarier for the teenager who is thinking about it.
I will never forget sitting with Frankie in the waiting room in the pediatric psychiatric wing on the night I brought her to the inpatient unit, three months before she took her life. We had been there for hours, seeing one group of doctors and then another. A nice nurse had given us some apple juice and granola bars. Sipping from those child-size juice boxes and munching on one of the granola bars, Frankie turned to me and said, softly, almost in a whisper, “You know, I am so glad you finally know.” I could hear the relief in her voice. I just nodded, understandingly, but it broke my heart that she held on to such a painful secret for so long.
How do we build a more supportive world for our children? I find myself inspired by Frankie’s teenage friends, who cared deeply for her and now support one another after her passing.
During high school, Frankie found warmth and healing in the theater program office, tucked behind a door in a bustling New York City public school. On good days, she would sit on the worn couch in that office, snuggle in a pile of teenagers and discuss plays, schoolwork and their lives. On hard days, she would hide in an untraveled corner of that same office and allow the anxiety and depression to run its course. And in that corner space, she would text a friend to help her get to class or, after she had opened up about her struggles, encourage others to open up as well.
The fall after Frankie left us, some students decided to remake that hidden corner, dotting the walls with colored Post-it notes. Scrawled on a pink Post-it were the words “you matter”; a yellow one read “it gets better”; an orange one shared a cellphone number to call for help. Tiny Post-it squares had transformed the corner into a space to comfort, heal and support the next struggling teenager.
I don’t know if a seatbelt approach would have saved Frankie. And I understand that all the details of such an approach aren’t fully worked out here. But I don’t want us to lose any more children because we weren’t brave enough to take on something that scares us, something we don’t fully understand, something that is much more prevalent than many of us realize.
If 17- and 18-year-olds who’ve lost a friend have the strength to imagine a world dotted with healing, then the least we can do as adults is design and build the structure to support them.
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.
Pamela Morris (@pamela_a_morris) is a professor of applied psychology at NYU’s Steinhardt School of Culture, Education and Human Development.
If your child or teen is expressing suicidal thoughts or feelings, we can help through our Douglas S. Feldman Suicide Prevention Project. To learn more, click here.
As we reach the end of National Social Work month, which runs through March, we want to take the opportunity to thank our wonderful staff at North Shore Child & Family Guidance Center, which consists of social workers, mental health counselors, psychologists, psychiatrists and other mental health professionals, all of whom devote themselves to the children and families they serve.
Following are thoughts from some of our dedicated staff members on why they chose to work in the mental health field, making a difference every day of the year!
Although my undergraduate school major was economics and I thought I was headed for a career in big business, I chose to pursue a career in social work after working as a volunteer, first as a Big Brother with a couple of school-age kids while at Rutgers University in the early 1970s. About a year after I graduated, I joined Volunteers in Service to America (VISTA) and worked with teenaged boys and girls in a low-income Mexican-American community in Grand Island, Nebraska. After spending three years in Nebraska, I knew I had to go back to school if I wished to pursue this kind of work as a career. After some research, I thought the social work field suited me best because of its values. Social work didn’t only see troubled kids as broken objects to be fixed, but as whole persons with assets and strengths. It recognized one’s environment as a critical influencing factor in their life—for good and bad. And, finally, social work believed in self- determination, human dignity and social justice. It was a good fit. – Andrew Malekoff, LCSW
“Blessed are the flexible for they shall not get bent out of shape.”
We are living in a time of unprecedented chaos and transitions; our children and families are in search of an accepting, calming environment to strengthen their skills and successfully overcome challenges. As therapists we can provide a much-needed safety net and take a transformative place in role modeling effective communication, adaptive self-care and mental health wellness in children and families. It is a privilege and a passion to continue my journey as a Mental Health Counselor. – Hillary McGrath, LMHC
The past year has highlighted the importance of mental health services and support for our society. As social workers, we’ve known this for a long time, and I think it’s a reason that many of us have chosen to do this work. It’s not easy work, and it’s often undervalued, but the reward that comes from making a difference in the life a child or their family is what keeps me going. – Vanessa McMullan, LCSW
“Social work didn’t only see troubled kids as broken objects to be fixed, but as whole persons with assets and strengths.”
I chose social work after realizing that no matter where I worked or in what role, I always wanted every person I spoke with to feel like no matter what issue they had at the time, someone was in it with them. There’s no stop sign on your corner? That is concerning, let’s call public works together! Not enough crunch topping on your ice cream cone? Maddening! Let’s see what we can do. (Yes, I was fired from TCBY). I got my Master’s in social work as my third degree. I have worked as a journalist, supervised a long-distance learning department and managed a local radio station. I worked in various settings, from a run-down office in Southern Brooklyn to a posh corner suite on Wall Street. It was never quite right, and whatever I did never seemed enough. Working with children and families is special; so much of our understanding of the world and ourselves comes from the experiences from our family system. Small changes at home can really generate positive impact in other areas of our lives, especially for little ones. – Laura Mauceri, LCSW
After I started my Master’s degree, I knew right away that I would do clinical work. If only I can help people tolerate their distress and contribute to their better mental state by being empathic, listening to what they go through, teaching them coping skills and sharing my positive energy. They say, “Better late than never.” I am very thankful to my new profession which allows me to contribute to others and wake up every day knowing that I can make a difference. – Masha Leder, LMSW
“Having chosen the career pathway to work with children and families has proven to be both invaluable and rewarding during these unprecedented times.”
A career in social work provided me the choice of working in a multitude of settings. Counseling is a rewarding practice, as this service can improve outcomes for children, families and their communities. I have always valued the importance of a stable family unit. Having chosen the career pathway to work with children and families has proven to be both invaluable and rewarding during these unprecedented times. All children deserve the opportunity to thrive throughout their lifetime, and I am proud to foster their success. – Julia Bassin, LMSW
I wanted to be a social worker and to work with adolescents and families because I had hoped to become a trusted person that youth could connect with and let inside their world. Having children and teens open up and share their inner feelings and experiences during the most challenging times in their lives is an honor and a privilege. – Brooke Hambrecht, LMSW
“Small changes at home can really generate positive impact in other areas of our lives, especially for little ones.”
In retrospect, there was nothing I wanted to do more than to become an agent of change, and I found that in social work. One could say that social work found me! As I went through my years within the social work field and up to the day I decided to complete my Master’s in social work, I found that my passion lied specifically in working with children and families. That is where I felt that I would have the most impact to make change possible. Families live, grow and heal together, so why not be present for these struggles, changes and achievements to support families in seeing the end of their own rainbow? – Edenny Cruz, LCSW
I have no children of my own, and it is heartache, but I feel good about them and me when I reach out to these little ones and see them grow. I am in the fight to save as many lives as I can during this season. – Ruthellen Trimmer, Psychiatric Mental Health Nurse Practitioner
“I am very thankful to my new profession which allows me to contribute to others and wake up every day knowing that I can make a difference.”
I entered the world of social service post undergrad due to my own personal experience with individual therapy and watching my own family navigate various systems of care for my older sister who is diagnosed with Cerebral Palsy, and my father who was diagnosed with a terminal illness early on in his life. I spent five years working with adults with a variety of psychiatric diagnosis in various settings prior to return to school to obtain my Master’s in social work. The turning point to obtain this degree for me very much had to do with wanting additional knowledge and training to have more accessibility to other settings of care. My supervisor during my first clinical placement said something to me that made me pivot to working with children. She said, “Whenever I have felt complacent or that I was overly knowledgeable in an area, I have challenged myself and changed the populations or setting I was working in.” Perhaps she sensed my complacency in the adult mental health world at the time. This is what led me to request that my second clinical internship be with young children and families. That was a defining moment for me, and I have been working with children and families since. I didn’t know it then, but I most certainly know now, that this is in fact my calling: to help children and families heal with an array of challenges and dynamics that this life presents. I take pride in wearing this title and continuing to improve my practice. –Gillian Pipia, LCSW
I went into psychiatric nursing with children because I always liked working with children and their families. I like getting to know people in a more intimate and involved way. The relationships are ongoing and meaningful for the time that you are with them. It is rewarding and gratifying to see them move on and make progress. I am happy to be a part of that. – D.S., Psychiatric Nurse
Note: The Guidance Center received permission from Andrew Malekoff to post this commentary which he authored independently.
“We have seen this terrible nightmare before.”
So said Chinese-American activist Helen Zia during a forum on anti-Asian racism hosted by the Washington Post on March 8th. What she was referring to is the disturbing uptick in verbal and physical assault against Asian-Americans of all ages ever since the onset of the COVID-19 pandemic.
Zia and historian Erika Lee, reviewed some of the historical markers in this recurrent nightmare, beginning with the establishment of Japanese internment camps from 1942 to 1945, in reaction to Japan’s 1941 bombing of Pearl Harbor and America’s entry into WWII. The interning of Japanese-Americans has long been considered one of the most dreadful violations of American civil rights in the 20th century.
Some 70 years earlier on October 24, 1871, in what some have labelled the largest mass lynching in American history, up to 20 innocent Chinese immigrants were beaten, murdered and hanged by an enraged mob after a police officer and rancher had been killed, supposedly as the result of a conflict between two rival Chinese gangs.
Ten assailants were prosecuted and eight were convicted of manslaughter. The convictions were later overturned on appeal due to technicalities.
Eleven years following the Chinese Massacre of 1871, the Chinese Exclusion Act of 1882 became law. It was aimed at curtailing the influx of Chinese immigrant laborers into the United States.
This marks the only time in American history that a specific law was passed that prohibited all members of a particular ethnic or national group from settling in the United States.
One hundred years later, in 1982, Vincent Chin, a Chinese-American draftsman was beaten to death in Detroit by two white men – a Chrysler plant supervisor and a laid-off autoworker.
Asian-Americans of all backgrounds became prime targets, as automakers from Japan who were producing more fuel-efficient cars were blamed for layoffs at “The Big Three” – Ford, General Motors, and Chrysler. Chin’s murderers got off on probation.
Looking back, “people knew from personal experience that we were lumped together,” said Helen Zia. “But in terms of identifying as pan-Asian, the key thing was that a man was killed because they thought he looked like a different ethnicity.”
In her latest book Caste: The Origins of Our Discontents Pulitzer-prize winning author Isabel Wilkerson cites anthropologists Audrey and Brian Smedley who explain, “We think we ‘see’ race when we encounter certain physical difference among people such as skin color, eye shape and hair texture.
What we actually ‘see’ are the learned social meanings, the stereotypes that have been linked to those physical features by the ideology of race and the historical legacy it has left us.” Indeed, most of the attacks against people of Asian descent in American are not against Chinese but anyone who looks East Asian.
Fast forward to 2021. The public health crisis we have been facing for a full year now has put a bullseye squarely on all people of Asian descent living in the U.S. According to reports by the Anti-Defamation League, “Go back to China” has become a familiar taunt against anyone who looks to be Asian and thought to be a source of contagion and disease.
Historically, immigrant communities have been singled out in times of public health crises. Their passage to the U.S. has been given pejorative labels such as plague and invasion, objectifying them as if they are riddled with infection or akin to swarms of insects carrying disease.
Here we are in the opening decades of the 21st century and the nightmare is back with a vengeance. In recent months it was brought to my attention that a 5-year-old Asian-American child was on the receiving end of a coronavirus-driven tirade while playing in a park in Nassau County. The verbal assault left him shaken and stunned that someone would yell such things at him.
On February 10th, USA Today reported that “in one week in February, a 91-year-old man in Oakland Chinatown was brutally assaulted, a Thai man was attacked and killed in San Francisco and a Vietnamese woman was assaulted and robbed of $1,000 in San Jose.”
Law enforcement can and should help, but nothing less than empathy will ultimately make the difference – “radical empathy” as Isabel Wilkerson advised, “the kindred connection from a place of deep knowing that opens your spirit to the pain of another as they perceive it.”
We all – all of us, bear the moral responsibility to stand up, as opposed to sitting by silently when we witness this terrible nightmare come to life.
Since the beginning of her career at North Shore Child & Family Guidance Center 15 years ago, Vanessa McMullan’s work has focused on bringing healing to the youngest of our clients.
“It’s a misconception that little kids only have little problems,” says McMullan, LCSW, Supervisor at our Marks Family Right from the Start 0-3+ Center. “Some children have difficulty regulating their emotions and behavior, and some have had to deal with very difficult circumstances” such as divorce or loss of a loved one.
Additionally, the pandemic has impacted youngsters in profound ways. “They may not fully understand what’s going on, but their lives have changed dramatically,” she says. “They’ve lost their pre-school routines, visits with grandparents and more. The anxiety level is very high for both kids and their parents.”
In her work with children, McMullan—mom to Riley, 4, and Addison, 2— incorporates a variety of tools, including games, music, books and the Guidance Center’s organic garden. “Youngsters can’t necessarily sit still and just talk to process problems,” she says. “Using creative methods to engage them is really the hallmark of what we do at Right from the Start. It’s woven into all our work.”
Another important part of McMullan’s work is her role as Coordinator of our Diane Goldberg Maternal Depression Program, where she has helped numerous mothers experiencing postpartum depression and other perinatal mood and anxiety disorders.
“Maternal mental health and early childhood health are so connected,” she explains. “We help these moms realize that they are not alone, they are not to blame and there is help!”
McMullan is grateful to her coworkers, both current and past. “Everyone on the team is dedicated to the work that we do,” she says. “It makes dealing with these difficult times so much better. We all really do have each other to lean on.”
Washington Post contributing columnist Dr. Leana S. Wen answered reader questions on the coronavirus in a recent interview in the newspaper. Below are excerpts from that column that most directly relate to children and families. To read the full transcript, which covers many more topics, click here.
Q: My spouse and I just received our second vaccine. Can we visit our children and grandchildren even though they are not vaccinated?
Wen: My answer here is yes: if the main reason you were not visiting the rest of your family was out of concern for your health, if you are now fully vaccinated (and it’s been 14 days to allow for optimal immunity), you should be able to visit them. Just remember that you could still, in theory, carry coronavirus and be a danger to them, so try to reduce your risk as much as possible before seeing them (i.e., do not also have other social gatherings), and make sure you are wearing a mask during travel. Longer answer about dos/don’ts after vaccination are in my latest column here .
Q: When will teenagers be allowed to get the vaccine?
Wen: Teens 16 and above are able to receive the Pfizer vaccine when it’s their turn, and those 18 and above are authorized for the Moderna vaccine. Studies are now being done for children 12 and above. Those should have results by the summer.
Q: My 5- & 6-year-old children have been doing remote learning since last March, however their friends have been back in school for a while now. Is it ok for us to have playdates either indoor or outside with them? None of their families feel that it is necessary for the kids to wear masks on playdates, which has made it pretty awkward for us. We pretty much just stick to ourselves, but I am wondering if that is totally necessary? It is getting harder to explain to them why so many of our friends and family members are back to normal life, while we are definitely not.
Wen: I would not have playdates with families who are not taking the same type of precautions as you. If you do have playdates, make sure there are masks on at all times from all involved and that they are outdoors. Remember that most infections are not arising in formal settings (like schools), but in informal social settings. Your family and so many others have given up so much during the pandemic. We are not far from the end–let’s hang on for a little longer!
Q: Should pregnant women be vaccinated? Does the answer change if the otherwise healthy woman developed gestational diabetes during a previous pregnancy?
Wen: The vaccines were not tested in pregnant women, so they aren’t explicitly recommended for them, but there is also no recommendation against it either. There is no known adverse effect in pregnant women, and the vaccine does not contain a live virus, so there’s no physiological reason as to why it can’t be given. Multiple groups of OB/GYNs have said that this decision should be left up to the woman, in consultation with her doctor. Pregnant patients are at higher risk for severe disease from covid-19. Someone who is in at high-risk for exposure (i.e., essential worker) and/or has underlying medical conditions may decide that the risk of contracting covid-19 outweighs any theoretical risk of the vaccine.
Q:We live in MD and have a son who is a young adult with autism. The best place for him to receive the vaccine is at our PCP’s practice because they know him. He will not wear a mask and will be very afraid. So why are these doctors not being allocated vaccines? Ours has the necessary storage for either one.
Wen: Good question. I really think it’s critical for primary care doctors to have access to the vaccine. Many patients prefer to go to their PCPs. PCPs are also trusted messengers, and it would make sense for PCPs to recommend the vaccine and then have the vaccine right there and then for their patients, instead of having to refer them to mass vaccination sites or pharmacies. I think this will change as there is more vaccine supply. Having the Johnson & Johnson vaccine will also help, as it’s one (like AstraZeneca’s) that can be stored for months at normal refrigerator temperatures. Best wishes to you and your son!
Q:Thinking ahead to the late spring/early summer – what is the possibility that large gatherings will be safe if held outside and everyone attending is vaccinated? What about the necessity of masks?
Wen: There’s a good chance that we can get together with others by the summer if everyone there is fully vaccinated. Whether this happens will depend on several factors, including if vaccines are found to offer excellent protection against emerging variants, if vaccine verification can be done reliably for all attendees, and if data continue to show that vaccines will reduce likelihood of being a carrier for coronavirus. Depending on the answers to these questions and the size of the gathering, masks may still be advised, but I’d predict–based on what we know thus far–that outdoor events like weddings and such can probably be held by the summer.
Q:Once I’ve had my second vaccination shot and the appropriate amount of time afterwards has passed, what freedoms do I now have? Can I be around other people who have not had their vaccinations? Do I still need to wear a mask? Basically, how should I behave now?
Wen: The short answer is that we don’t know yet. That’s because the vaccines are so effective at preventing you from getting sick from coronavirus yourself, but we don’t yet know whether it prevents you from being a carrier and transmitting it to others. The CDC recommends that you continue wearing a mask and practicing social distancing for this reason. It has not given guidelines for interacting with others. Here’s what I’d say. I think you should be able to see others who are fully vaccinated, because the chance of you infecting the others involved and vice versa, and getting sick from it, is pretty low. I also think that grandparents who are eager to see grandkids should be able to do, with some precautions.
Q:Why is there not more guidance on ineffective face coverings like bandanas and gaiters? Even employees in drug stores and groceries often use them. Can you please further redefine face covering to masks and described how they need to fit. Clarity does not necessarily lead to public resistance, just as likely to better cooperation.
Wen: The CDC has come out with updated guidance on facial coverings . I like their new guidance on double-masking too, especially in higher-risk areas (i.e., surgical mask on first, then tighter-fitting cloth mask on top).
Q:After having had Covid-19 and if you are exposed to someone else who has it should you quarantine?
Wen: The CDC issued new guidance about this last week: if you’re fully vaccinated and/or have recently recovered from covid-19, you do not need to quarantine after being exposed to someone with covid-19.
North Shore Child & Family Guidance Center is dedicated to providing the highest quality services in order to restore and strengthen the emotional well-being of children and their families.
Joining us in this lifesaving mission are two of our most devoted and active supporters, Andrea and Michael Leeds.
“It’s been a privilege to be part of the Guidance Center,” says Andrea, who has been an invaluable member of our Board of Directors for more than two decades. “The Guidance Center’s programs continue to grow to meet the needs of children dealing with difficult personal issues like depression, anxiety, bullying and so many others. The mission is more important now than ever during the COVID crisis, with illness, death and trauma having a devastating impact on the children and families in our community.”
All in the Family
The Leeds family’s connection to the Guidance Center has a long history. Andrea was introduced to the Guidance Center by her mother-in-law, Lilo Leeds, a Board Member for many years. In recognition of the family’s remarkable intergenerational support, in 2007 we named our Westbury location “The Leeds Place—Serving Young People.”
Michael and Andrea with Lilo and Gerry Leeds at The Leeds Place
As philanthropists, Andrea and Michael have assumed many leadership roles. They have co-chaired seven galas and served as co-honorees for our 65th Anniversary Gala in 2018, which raised a record-breaking $622,000 to support our lifesaving work.
Andrea has proudly served on many Guidance Center committees, including Steering & Development. She and Michael hosted a special evening in their home, where therapist Linda Silversmith led the discussion as grandparents shared stories and gained insight on the importance of their role in the American family.
Andrea and Board Member Jo-Ellen Hazan also co-chaired a memorable dinner where Mary Tyler Moore spoke about her life to a large and appreciative crowd. The event created awareness and raised funds to support the important work of the Guidance Center’s then-new Lucille S. and Martin E. Kantor Bereavement & Trauma Center.
Through these events, the Leeds have introduced our mission to many of their wonderful friends, with several becoming Board members themselves or serving in other vital positions.
“It’s a joy to be able to give back to the community,” says Andrea. “When you are personally involved, you receive so much more than you give.” When their daughters were young, Andrea played an active role in their school, synagogue and many other organizations, while Mike headed up publishing giant CMP Media.
“I love how the Guidance Center has provided an ever-evolving range of innovative services for children and their families—and they do so regardless of the family’s ability to pay,” says Andrea. “The new Douglas S. Feldman Suicide Prevention Project is a prime example of how the Guidance Center recognizes a need and jumps right in to make a difference.”
Adds Michael, “It’s been inspiring to see how the Guidance Center has responded so quickly to the COVID-19 crisis, pivoting from in-person therapy to telehealth so every child and family gets the help they need during this incredibly difficult time.”
Big Hearts and Boundless Energy
Andrea and Michael are very proud of their wonderful family: twin daughters Caryn and Lauren, Tracy, son-in-law Nick and grandson Samuel. While the family is now bicoastal, they spend as much time together as possible.
Andrea and Michael with their daughters, son-in-law and grandson.
“When I walk through the doors of the Guidance Center and look at the parents, I totally relate,” says Andrea. “As the mother of three girls, I understand a child in pain. I understand the relief a family can feel when treatment is helping to sort out complex, emotional situations.”
According to past Board President and current Board Member Nancy Lane, the Leeds’ compassion for others is what sets them apart.
“Both Andrea and Michael have big hearts and boundless energy, and they continue to be passionate advocates for the mental health of children and families in our community,” says Lane. “Having such a dynamic couple as part of our Guidance Center family is a real blessing.”
If your child or teen is expressing suicidal thoughts or feelings, we can help through our Douglas S. Feldman Suicide Prevention Project. To learn more, click here.
To learn more about supporting North Shore Child & Family Guidance Center, contact Director of Development Lauren McGowan at (516) 626-1971, ext. 320.
In this monthly column, therapists from North Shore Child & Family Guidance Center answer your questions on issues related to parenting, mental health and children’s well-being. To submit a question, email NSCFGCexperts@gmail.com.
Question:My sons, who are four and seven, seem to be having more bad dreams than usual. They’ve both woken up during the night saying they were scared that we would die or get sick and they’d be left all alone. Any tips how to handle these nightmares?
—Up at Night
Dear Up at Night: The pandemic is impacting the daily lives of our children in numerous ways, with anxiety related to remote learning difficulties, loss of social activities and fear of illness and death creating a mental health crisis. So, it’s no surprise that COVID worries are also encroaching on their nights.
With our younger clients, we use creative ways such as drawing or playing with toys to help them express and process their fears. Many of them have been drawing scary monsters or big waves that overwhelm them, which reflects the fact that feel they have no control over the virus. Odds are that your boys are having the same thoughts.
There are several things you can do to help your kids at bedtime. First, suggest that they comfort themselves with items that help them feel safe, such as a favorite stuffed animal or a special blanket. You could also try a practice that we use with clients, called “Grounding in the Five Senses,” which involves thinking about five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste. This process helps them let go of their worry of the future and focus on the here and now.
Some other strategies:
Stick to their normal bedtime routine, perhaps reading an extra book that focuses on a happy, comforting topic.
Validate their worry and other feelings so they feel seen and heard.
Model reassurance and safety either verbally (“I’m here, I will protect you”) or physically with a hug.
Encourage them to imagine happy endings for their dreams before bedtime.
Limit their exposure to COVID-related news—but do respond to any of their questions in an age-appropriate way.
Question:As the mom of a daughter who has depression and anxiety, I feel guilty thinking about spending time on my own needs. Is it selfish to want some me-time?
—Exhausted Mom
Dear Exhausted Mom: Have you ever heard that if an airplane loses cabin pressure, parents should put on their oxygen masks first, so they are able to help their children?
It’s way past time that moms (and dads, too) learn that self-care isn’t selfish, especially if you have a child with special needs. If you are depleted and neglect your own mental and/or physical health, you won’t be able to be there for your family.
Prioritize your wellness, even if you have to tell yourself you are doing it for your daughter. The basics: Get enough sleep; fit in some exercise, even in five-minute spurts (it all adds up!); add a short period of meditation to your daily routine; and eat healthy foods. Most important of all: Ask for help! Family and friends rally around you if your child has cancer. Chances are, they’ll want to be there for you when the issue is mental health.
During the pandemic, North Shore Child & Family Guidance Center is seeing clients remotely via telehealth platforms or, when deemed necessary, in person. To make an appointment, call us at (516) 626-1971 or email intake@northshorechildguidance.org.
It’s a phone call we get all too often: A parent tells us their son or daughter is experiencing severe depression, anxiety and thoughts of suicide. And the situation has worsened due to the COVID-19 virus.
“The isolation brought on by the pandemic is hard on everyone, but it’s especially difficult for young people,” says Regina Barros-Rivera, Associate Executive Director of North Shore Child & Family Guidance Center. “All their normal routines have been upended, like going to school, playing sports and celebrating special occasions. Many have lost someone close to them, and they are in a constant state of fear. It’s a crisis that’s getting worse by the day.”
Sadly, suicide among young people isn’t a new problem. According to the Centers for Disease Control and Prevention, suicide is the second-leading cause of death for ages 10-24, with more teens and young adults dying from suicide than from cancer, heart disease, birth defects and other major illnesses combined.
Thanks to a generous gift from Donald and Ellen Feldman, in September the Guidance Center launched a new program, the Douglas S. Feldman Suicide Prevention Project, an expansive initiative that aims to tackle the epidemic of suicide among young people.
“Through the Douglas S. Feldman Suicide Prevention Project, we will bring essential, life-changing services to the children and families in our community,” says Elissa Smilowitz, who is heading up the program. “We will address high-risk cases with a thorough evaluation for suicide risk; multiple weekly sessions of individual, group and family therapy; and a culturally sensitive treatment plan that focuses on safety strategies, healthy coping skills and relapse prevention.”
Evaluation with a psychiatrist regarding the possible use of medication will also be provided, along with in-home treatment and referrals to programs and services that will support parents’ efforts to protect their children.
The Guidance Center will also provide educational forums and a suicide survivors’ support group for those who suffer this tragic loss.
Andrew Malekoff, Executive Director of the Guidance Center, says, “We are grateful to the Feldmans for enabling us to develop a suicide prevention initiative that will enhance our ability to reach young people who may see no way out from the despair they are feeling. It’s a prime example of how our dedicated supporters make a profound difference in the well-being of our community.”
He adds, “Join us in spreading the word to schools, community organizations and friends. Information is power, and this program can save lives.”
Donations to support the Douglas S. Feldman Suicide Prevention Project can be made at www.northshorechildguidance.org/donate or by calling (516) 626-1971, ext. 320.
Pregnancy and childbirth are exciting times in a family’s life, filled with joy and awe. For some mothers, however, the situation is far more complex. While many women experience some mild mood changes during or after the birth of a child, 15 to 20 percent of women have more significant symptoms of postpartum depression and other perinatal mood and anxiety disorders or PMADs.
Fifteen to 20 percent of women have more significant symptoms of postpartum depression and other perinatal mood and anxiety disorders or PMADs.
At North Shore Child & Family Guidance Center, we work with moms and pregnant women whose symptoms may include feelings of sadness, irritability, guilt, lack of interest in the baby and changes in eating and sleeping habits. Some also experience trouble concentrating, thoughts of hopelessness and even thoughts of harming the baby or herself. Research shows that the pandemic has increased the incidents of PMADs, and also heightened symptoms. One study found that the rate of symptoms of depression in new mothers amid the pandemic was nearly three times the rate of new mothers’ symptoms pre-pandemic.
The reality is that, as with so much about the virus, there are still many unknowns as to the impact of COVID-19 during pregnancy and for babies and young children, which creates enormous stress. Being a new mother can be isolating under normal circumstances, but during the quarantine and social distancing protocols, the sense of isolation has been greatly magnified. Expectant and new parents are concerned about a host of issues, from financial and job stability to the health of their babies and themselves.
The pregnancy and birth experience, especially during the height of the pandemic, was anything but normal. Many pregnant women and new moms had to go to their doctor’s appointments by themselves, and if they got bad news, they had no one with them to lean on. Most had no baby showers, no visits from grandparents, no birthday parties—even an absence of partners in the hospital before, during and after the birth. They often had very little support from friends and relatives who typically help the new parents in the days after the baby comes home, for fear of catching or transmitting the virus.
Families who have school-aged children have had to struggle with the decision of whether or not to send them back to the classroom, where they may be exposed to the virus and bring it home to the family. Even though New York has improved in terms of COVID-19 numbers since the height of the pandemic, being cautious is still important, and we have no way of knowing what the next several months will bring. And the fact that all of us will be inside more will likely present significant challenges.
The good news is that North Shore Child & Family Guidance Center has been able to serve these moms and families during the pandemic through remote therapy, either by video or phone. In addition to individual and family therapy, the Guidance Center has continued to offer remote group counseling, so parents don’t feel so alone. Our psychiatrists are also seeing clients remotely, in the cases where medication is needed.
Through our Diane Goldberg Maternal Depression Program, the Guidance Center provides:
• Screening and assessments • Individual, couple and family therapy • Crisis intervention consultation • Psychiatric evaluations and medication management, where needed • Support groups • Back-to-work family support • Help with self-care
As one new mother told us, “You’ve been my lifeline during this time when I needed connection and reassurance and support.” If you or someone you love is experiencing symptoms of postpartum depression or other perinatal mood disorders, call the Guidance Center at 516-626-1971 and tell them you are seeking help for maternal depression. We are here for you.
Vanessa McMullan, LCSW, is supervisor at The Marks Family Right from the Start 0-3+ Center at North Shore Child & Family Guidance Center. She also heads up the organization’s Diane Goldberg Maternal Depression Program. Call 516-626-1971 or visit www.northshorechildguidance.org to learn more.
The pandemic is impacting the daily lives of our children in numerous ways, with anxiety related to remote learning difficulties, loss of social activities and fear of illness and death creating a mental health crisis. But COVID is also having a big effect on their nightly lives.
Gillian Pipia, who works with North Shore Child & Family Guidance Center’s younger clients at our Marks Family Right from the Start 0-3+ Center, has seen a significant increase in children’s intrusive thoughts related to COVID-19, particularly when it comes to their bedtime routines and sleeping patterns.
“Bedtime is usually a period when the usual distractions and tasks of life such as school, homework, dinner and bath time are completed, and children are left in bed, in the dark, alone with their thoughts,” says Pipia, LCSW. “The virus has created a situation of heightened anxiety that has resulted in behaviors such as bedtime avoidance, clinging to parents during their bedtime routine, refusal to get off electronics or more frequent nightmares.”
It’s not uncommon for children to internalize and hold in their fears as a way of coping, she adds, which is why their pandemic worries are likely to manifest in nightmares.
While some older kids can articulate their feelings by discussing them in therapy, younger children need more creative ways to express their feelings; therefore, during therapy sessions, Pipia encourages them to draw, write or play with toys as a way to express and process their fears.
“Many of the children draw scary monsters, and some have had reoccurring dreams where they are drowning, which reflects the fact that the virus is invisible,” she says. “They feel they have no control over it.”
When it comes to reducing nightmares, Pipia encourages her young clients to think of items or people that help them feel safe, such as a hug from a parent, favorite stuffed animal, special blanket or night lights. She also teaches them a practice called “Grounding in the Five Senses,” which involves thinking about five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste.
“It helps them to let go of the worry and focus on something more concrete,” says Pipia. “Parents can teach this to their children and use it anytime they are having trouble sleeping, or for other anxious moments.”
Parents can incorporate many other strategies to help children with COVID-related nightmares:
Stick to their normal, calming bedtime routine, perhaps reading an extra book that focuses on a happy, comforting topic.
Validate their worry and other feelings so they feel seen and heard.
Don’t tell them they have nothing to worry about or are being silly.
Model reassurance and safety either verbally (“I’m here, I will protect you”) or physically with a hug.
Encourage them to imagine happy endings for their dreams before bedtime.
During the daytime, give them the choice about whether to draw, talk or in some other way convey their feelings, which will help them feel some sense of empowerment in the face of uncertainty and fear.
Limit their exposure to COVID-related news—but do respond to any of their questions in an age-appropriate way.
During the pandemic, North Shore Child & Family Guidance Center is seeing clients remotely via telehealth platforms or, when deemed necessary, in person. To make an appointment, call us at (516) 626-1971 or email intake@northshorechildguidance.org. Remember, we never turn anyone away for inability to pay.
Note: The following column will run this week in the Roslyn News and other Anton Media newspapers.
Despite the economic woes brought on by the pandemic, one type of store is popping up in increasing numbers in neighborhoods all across Long Island: smoke shops, which carry everything from cigarettes and e-cigarettes to pipes and bongs.
These stores are taking advantage of the growth in popularity of vaping, which involves inhaling and exhaling an aerosol (or vapor) produced by an e-cigarette, vape pen or other smoking device, some of which resemble flash drives or other everyday objects. You may have heard vaping referred to as JUULing, since the brand JUUL has become so ubiquitous.
Many e-cigs are clearly designed to appeal to young people, with flavors such as strawberry, gummi bear and cotton candy. In 2020, 83% of youth e-cigarette consumers used flavored e-cigarettes. (New York is seeking a ban on the sale of these flavored products, but an appellate court placed a hold on the ban this September.)
Today, there are approximately 3.6 million middle and high schoolers who are regular users of e-cigarettes, and the numbers have been growing. Studies show that from 2017 to 2019, the percentage of teens who said they vaped in the past 12 months doubled: from 7.5% to 16.5% among eighth graders; from 15.8% to 30.7% among 10th graders; and from 18.8% to 35.3% among 12th graders.
Alarming Health Impacts
Although many tweens and teens are sold on the idea that vaping is far less dangerous than smoking regular cigarettes, the research strongly suggests otherwise.
According to the Centers for Disease Control and Prevention, the vast majority of e-cigarettes contain nicotine, which is highly addictive and can harm adolescent and young adult brain development. In addition, a variety of toxic chemical additives are often in the mix, including ultrafine particles that can be inhaled deeply into the lungs; diacetyl, also damaging to the lungs; and heavy metals such as nickel, tin and lead.
So what is a parent to do? First, let your kids know that e-cigarettes are not safe alternatives to cigarettes. The studies increasingly show that they can cause:
Damage to the brain, heart and lungs
Cancerous tumor development
Preterm deliveries and stillbirths in pregnant women
Harmful effects on brain and lung development when use occurs during fetal development or adolescence
When you approach the conversation, instead of lecturing, ask an open-ended question, such as “Have you heard about vaping?” and “Is it popular at school?” Offer honest, science-based information, geared toward your child’s or teen’s age—and start these conversations when your kids are young.
Make your reasons for not wanting your child to vape clear. Many of them have no idea that e-cigarettes have nicotine and are highly addictive, since marketers have told them it’s safe and “cool” to vape. You may want to rehearse a situation where they might be asked to try vaping, letting them practice saying, “No thanks, I don’t smoke” in a direct, clear fashion.
If your tween or teen has already started vaping, don’t punish or shame them. Explore online programs like “Truth Initiative,” which offers a free smoking cessation program called “This is Quitting,” or call the American Lung Association at 800-LUNGUSA for more resources.
Finally, be a positive role model and don’t smoke. Your behavior matters far more than you might imagine.
Dr. Nellie Taylor-Walthrust is the Director of North Shore Child & Family Guidance Center’s Leeds Place, which operates an Adolescent Outpatient Chemical Dependency Treatment Program. If your child or teen is having problems with vaping, drugs or alcohol, call the Guidance Center at (516) 626-1971 for help.
In this new monthly column in Blank Slate Media’s The Island Now newspapers, therapists from North Shore Child & Family Guidance Center answer your questions on issues related to parenting, mental health and children’s well-being. To submit a question, email NSCFGCexperts@gmail.com.
Question:We’ve recently been concerned that our teen daughter seems to be feeling more blue than usual. Her grades have been going down, and she wants to sleep all the time. When we ask her how she’s doing, she gets very emotional. Should we be worried? —Panicked Parents
Dear Panicked Parents: The pandemic has created an enormous amount of stress, anxiety and sadness for all of us, including our kids. We’ve been dealing with this strange, new reality for eight months now, and there’s no clear answer as to when we will turn the corner and be back to our routines.
The fact that your daughter is feeling stressed and sad isn’t surprising; in fact, studies indicate that these feelings are on the rise all over the country. Changes in sleep and eating patterns are common, as are struggles with the unusual school schedule. Kids are also worried that their loved ones may become ill.
It’s crucial that you always keep the lines of communication open. As parents, we tend to jump in to try to “fix” what’s wrong, instead of realizing that sometimes, your child just needs you to listen and be empathetic, acknowledging their feelings and assuring them you are there for them.
Of course, it’s important to look out for signs that your daughter’s issues might be more significant and require therapeutic intervention. Some warning signs: a continued drop in grades or refusal to go to school; withdrawing from friends and family; significant changes in weight, either losing or gaining; the inability to feel joy; increased anger; physical complaints like headaches or stomachaches; use of drugs or alcohol; and expressing thoughts of suicide or preoccupation with death.
North Shore Child & Family Guidance Center is seeing children and teens via remote therapy during this time, or in person when the situation calls for it. Our Douglas S. Feldman Suicide Prevention Project offers a host of services to help children and teens experiencing suicidal thoughts. Don’t hesitate to call us at (516) 626-1971 for an evaluation.
Last week’s news of violence and rioting at the U.S. Capitol building has shaken us all, regardless of political affiliation. The uncertainty, worry and fear many of us are experiencing is also impacting our kids, and many parents are struggling with how they can help them navigate this troubling situation.
“Much of what you say to your children should depend on their age,” says Vanessa McMullan, Supervisor at our Marks Family Right from the Start 0-3+ Center. “For younger children, your focus should be on letting them know they are safe and that you are there to help them.”
Children under age seven shouldn’t be exposed to news media, especially information that may be traumatic. Of course, that doesn’t mean they won’t hear about troubling events—perhaps on a news preview on television, from friends at school or overhearing conversations from the people around them.
“Kids are always listening,” says McMullan. “Even if we think they don’t understand what we’re talking about, they hear it and are trying to make sense of what they’re hearing.”
So what’s a parent to do? “Ask your children what they already know, and provide simple information in a comforting way,” says McMullan. “They pick up on your energy, so it’s important that you remain as calm as possible.”
Also, be sure that you are giving yourself a break from the news and practicing self-care so you don’t get overwhelmed. “It’s understandable that you want to stay informed, but to be the best parent for your kids, you need to take care of yourself, too,” she says.
Older children and teens will likely be exposed to more information and have more nuanced questions and responses to events such as the ones we saw last week, as well as any kind of traumatic occurrence.
Encourage them to share their thoughts with you and to express their emotions, which may range from fear and confusion to sadness and anger. Let them know their feelings are normal and that you are there to listen. Give them information that is fact-based, sharing news and information resources that you trust.
For kids of any age, news events provide you with opportunity to share your values with them. For example, with Martin Luther King Jr. Day coming up next week, perhaps you can speak with your kids about issues such as diversity, discrimination, racism, non-violence, activism, volunteerism and other pertinent topics.
North Shore Child & Family Guidance Center has been there for children and families during crises of many sorts since our founding in 1953, including Hurricane Sandy, the attacks of 9/11 and the more recent COVID-19 pandemic. We are currently providing remote therapy and, when needed, in-person sessions. Reach out to us at (516) 626-1971 for help, and remember, we never turn anyone away for inability to pay.
