parents – Page 3 – Licensed Mental Health Counselor

Monitoring Your Teen: Your Perspective VS Their Reality

31 May 201331 May 2013by Torey C. Richards, LMHCLeave a Comment

I recently watched an episode of Dr. Phil where a mother thought her 15 year old daughter was a popular teen and earning good grades. This mom thought she had the perfect teen, until one day her daughter disappeared and was found days later by the police.

Only then did her mother find out that this teen had not only recently witnessed a murder, but that the life she actually lived was is stark contrast to the life her parents believed she was living.

In reality, their daughter was not this popular teenager with good grades, but she was a drug using, bullied teen who was meeting and sleeping with older men she would meet online on a regular basis. Some were more than twice her age and married. One even committed suicide and she was the one who found his body.

This reality, was nothing that her mother could ever imagine her daughter going through.

This got me to thinking about a lot of the teens I work with and how their reality often totally differs from the their parents perspectives.

Many teens I work with have parents who believe that they are doing good in school and are really active in after school activities like band and drama, while often these kids are failing school, skipping classes and using after school activities as covers to do other things such as having sex and using drugs.

As a matter of fact, I was so alarmed at the amount of teenage girls who told me that they were having sex after school (while they were supposed to be in drama or band) in an unsupervised location on campus, that I went to multiple school administrators and school resource officers to crack down on the number of teens on campus unsupervised after school.

Here you have parents thinking their child is staying after school to rehearse for a play, yet they are having sex in a storage closet, or leaving campus altogether to have sex or use drugs, but returning to campus later to be picked up by their parents who have the slightest idea of what is really going on in their teens lives.

I’ve sat down with numerous parents who were stunned to find out that their kid was failing multiple classes, missing dozens of unexcused days from school or wasn’t actually in the school play she had been supposedly staying after school for everyday for the past two months.

Teens will be teens, and most of these parents I spoke with took it for granted that they had “good kids” so they rarely checked on them or monitored their activities. They just assumed that they were always doing the right things.

On the Dr. Phil show, he drew the contrast between this young girls realty and her parents’ perspective:

Her Parents’ Perspective Daughters’ Reality

Spent time playing computer games Spent time meeting men online

Spent the night at friends’ houses and didn’t leave Snuck out of friends’ houses to meet men

Popular at school Bullied at school

Relationship was wonderful Parents were distant

I don’t mean for this to scare any parents, but I want you to understand the importance of monitoring your child, even when they are teens… especially when they are teens. It’s important that you trust your teens, but it also important that you verify what ithey tell you is going on.

Monitoring Your Teen

Monitoring your teen means asking questions. It means knowing where they are, who they are with, what they are doing and what time they will be back home. It also means having them check in regularly. Your teen may not like this, but over time they will grow accustomed to it if it is consistent and they know what to expect.

This is especially important when your teen starts getting involved with more activities outside of the home including school activities. Many parents think that as long as their child is at school they are safe and being monitored, but that often is not the case. After school activities can create time and opportunity for teens to get themselves into trouble.

If your teen stays after school for an activity, drop in every now and then to make sure they are where they said they will be.

You don’t have to make it obvious. Maybe bring them a snack or genuinely be interested in whatever the activity they are involved in. The same goes for school. If you can’t drop in every now and then to make sure they are at school, most schools have websites just for parents where you can monitor your child’s attendance, grades and assignments.

Monitoring your teen is about communication and respect on both ends. Here are a few tips:

Let your teen know that you will be monitoring them so that they won’t be surprised. Like I said, they may not like it but they will grow used to it if they know what to expect and it is consistent.
If you sense trouble, make those surprise visits to the school, the park, the football field, or call their friends’ parents to make sure your teen is where they said they would be. Let your teen know this is something you may do sporadically.
Get involved in the activities your teen is doing at school. If your teen is in band, try to become a band parent, or a drama parent, or just show up to support your teen and the school. The more likely the chance that you will be around, the less likely your teen will do things you disapprove of.
Have a rule: “No parents, no party”. The amount of unsupervised parties the teens I work with go to that are filled with sex, drugs and alcohol is astonishing. Make sure that if your teen is going to a party there will be adequate adult supervision.
Get to know the other adults in your teens’ life such at teachers, mentors, coaches, employers, etc. This is important for a number of reasons, but this can also be a network where you can compare notes. If you think your teen is doing great in school, a teacher could tell you that they are missing class a lot or getting bullied for example.
Monitor how your teen is spending their money. You wouldn’t believe how many parents I work with who would give their kids money and have no idea what they are doing with it.
Monitor your teens online and electronic devices such as phones and ipads. Teens get in all sorts of trouble online and they generally don’t want you in their online lives, but when their safety is your priority then compromises have to be made.
Monitor their physical and mental health and look for signs of changes so that you can address them early or seek professional help if needed.

There is much more that could be added to this list, but this is a good start. Most parents will add their own tailored made to their child.

How much monitoring is enough depends on your teen. If they show you that they can be trusted, are accountable and reliable, then you may back off some and only monitor them every now and then, but if they have shown you that they can’t be trusted, you may have to monitor them more.

Look for changes in your teen such as new friends, different behaviors or activities. These are signs that you may want to monitor your teen a little more; also when things are changing such as moving to a new neighborhood, school or when things at home are changing such as divorce or a death in the family.

We all did things as teenagers that make us uncomfortable to think about today, but we are glad that we came out relatively un-scathed. Monitoring your teen so that your perspective matches closely with their reality will hopefully help your teen avoid some of those unnecessary situations, some of which can be life altering and deadly.

One Teens Attempted Suicide

25 May 201325 May 2013by Torey C. Richards, LMHC6 Comments

Today I got one of those out of the blue phone calls that I dread. I was out of the office preparing files for an upcoming audit when I got an email from one of the teachers at the school I work at asking me to call her as soon as possible.

There’s always a lot going on at the school, but I assumed she wanted to ask me for advice with dealing with one of her students or to refer a student to me for counseling. I called her and she informed me that one of my students was in the hospital in critical condition after attempting suicide the night before.

I almost cried. I know that’s not the professional way I was supposed to feel, but I am human and have passion for my clients. Sometimes too much, but that feeling felt appropriate. I have never (fingers crossed) had a client actually commit suicide, but I know it’s always a possiblity. I’ve done crisis counseling at enough schools after a teen has committed suicide to know that it happens all too often. As a matter of fact, 3 weeks ago a student at a high school not too far from the one I work at killed herself.

It’s not that this is the first client of mine to attempt suicide, but this is probably the first client of mine to make a serious suicide attempt. I don’t want to underplay any suicide attempt, but I have had many clients who have made superficial lacerations to their wrists or took three ibuprofens in a “suicide attempt”. Most never needed to go to a medical hospital for medical attention.

Sure, I had to have them sent to the psychiatric hospital because they were having suicidal thoughts and any attempt has to be taken seriously, but it never shocked me because I knew that while they were hurting emotionally and psychologically, they didn’t want to die. They wanted help, they wanted people to see and know that they were hurting, but they didn’t really want to die. The fear in that though is that they could accidentally kill themselves.

This situation was different for a number of reasons.

1) I was very close to this client. I had been working with this particular client for almost two years helping him get through depression, grief and anxiety. I actually tried to become more of his mentor than his counselor because that’s what I felt like he needed most as a young man approaching adult hood.
2) A few months ago this particular client came to me and told me that they were seriously thinking about ending their life. I had him admitted to the psychiatric hospital where he was prescribed medication for anxiety and depression. I was surprised and scared that he didn’t come to me this time before he tried to take his life.
3) He had a lot to look forward to. He was graduating after almost not qualifying to graduate. I had just giving him a graduation card saying that I was excited for him about his future.
4) And lastly, I had just saw this client the day before and he was his normal, apathetic self. I saw no warning signs that less than 24 hours later he would take 3 months worth of medication all at once.
5) While all suicidal talk, gestures and attempts have to be taken seriously, from personal experience, the teens that actually kill themselves do so with little real warning. Some may tell all their friends that they love them, or apologize for past wrongs, but from the crisis counseling I’ve done at different schools after a student has committed suicide, there is rarely any apparent warning signs yet in hindsight, grieving students, faculty and parents usually see subtle signs that they missed.

His mother found him in his room, unresponsive and called 911. He was rushed to the hospital where a host of procedures were done to save his life. When I went to the hospital to see him he was still unresponsive, a result of all the medication he had taken, but the doctor was pretty sure he would make a full recovery… physically.

The fear is, when he finally comes to, is he going to be happy that he’s still alive, or disappointed that he failed to end his life?

That’s why I want to be there for him. I stayed with him in the hospital today for as long as I could, but the hospital staff that was in charge of sitting with him around the clock because he is on suicide watch, told me that it would be at least another day or two before they expected him to start coming around.

I don’t feel like I failed as a counselor. That’s one of the first questions I asked myself. I think that the reason it bothers me so much is because he is my client and I feel a sense of responsibility for him, although I know I can’t be responsible for the decisions he makes.

Looking at him laying in the hospital today was depressing. At times he looked dead except for the frequent rapid eye movement visible through his closed lids. I just hope that when he comes to that he realizes that he is alive for a purpose and rejoices in attempting to discover what that purpose is. I’ll definitely be here to help him anyway I can.

Popular Psychology

Counseling Minors and Confidentiality

14 May 2013by Torey C. Richards, LMHC2 Comments

Confidentiality is a crucial part of counseling. Clients have to believe that they can tell me practically anything and it won’t be repeated to anyone, including their parents.

All of my clients know that everything they tell me stays between us except:

If they tell me they plan on killing themselves or someone else
If they tell me that are being abused
If I am court ordered to release information, and because I work in a school
If they have drugs or weapons on campus.

Also, because I work primarily with juveniles, I leave a little wiggle room by saying I will also report anything “life threatening” which may not include marijuana or alcohol use, but may include intravenous drug use or meeting adults online.

Even with these rules of confidentiality, teens will still inevitably tell me things that need to be reported to their parents, the school, law enforcement or child protective services.

More often than not, the child already knows this before they tell me so they aren’t usually upset when I have to make that phone call.

The problem generally comes from parents, who may not understand confidentiality. They think that their child is in counseling and as the counselor, I should tell them any and everything their child is doing and can get testy when I have to explain to them that confidentiality doesn’t work that way and that it’s actually illegal for me to tell them any information that doesn’t fall under the exceptions above, without their child’s permission.

I understand these rules and have worked within the confines of them for many years, even when I am hearing information that I wish I could tell parents. Information I actually knew would help the situation, if the parents knew.

For instance, last year a young lady was devastated when she went to a friend’s party and got raped by him and four guys she didn’t know. She was in tears when she confided in me and after calming her down, I practically begged for her to give me the name of the guys, some who went to the same school as her, or to report it to law enforcement.I gently repeated this request each session as we processed the trauma.

I offered to go with her to make the report, but she was adamant about not telling me any identifying information. She told me that she was scared that they would come after her if she told. No amount of me trying to convince her worked and at the end of it all, I had to allow her to make that decision she will have to live with for the rest of her life.

As much as I wanted to report that crime to law enforcement and her parents, I couldn’t. I had no identifying information, she wasn’t abused by a caregiver or someone in authority and she wasn’t a danger to herself or others so my hands were tied. All I could do was try to help her get through the emotional and psychology pain she was feeling. She went through a period of deep depression and eventually transferred schools.

I have had teens who have had abortions and miscarriages without their parents ever knowing they were pregnant. Kids who have battled substance and alcohol abuse right under their parents noses.

I always strongly encourage my teenage clients to involve their parents in their treatment though family counseling, but most teenagers are hesitant to let their parents know the things they do when they are not looking, or think that their parents will just be angry, judgmental or not listen if they do open up.

I usually only do a couple of family sessions a month and those usually happen after emergencies such as suicidal thoughts, severe panic attacks that require medical attention or another extreme circumstance that causes the parents to be concerned.

That’s usually when, with the child’s permission, I feel like I can finally truly help them without restraints. Trying to help a child solve a problem that need parental involvement, when they don’t want the parent to be involved is truly handicapping.

However, this is usually also the time when parents get upset that I knew about the abortion, or the drug use, or the date rape that they didn’t know about, months sometimes even years before.

I let them know about the confidentiality regulations set by the Health Insurance Portability and Accountability Act (HIPPA) that prevented me from giving them that information, even when it was valuable information about their own child.

Most parents calm down once they realize that without the confidentiality between their child and myself, it would have been unlikely that their child would have told any trusted adult and received at the minimal, mental and emotional support as well as guidance and encouragement.

Some minors want help or at least to talk about issues in their lives that are concerning them, but will only do so if they know that their parents will not be notified. Not all parents are supportive and some parents could use the information to further cause damage to their child, knowingly or not.

Take for instance a girl I know who is scared of her father who has a past history of physical abuse against her. He’s told her that if he ever finds out she is having sex he will kick her out on the streets. Yet, she is having sex and thinks she may be pregnant. Should I risk her losing her housing in order to tell her father that she may be pregnant?

I believe breaching confidentiality, while it will give parents more information about their child, it is less likely to truly make a difference if that child just learns to hide their problem or not admit or talk about their problem anymore, resulting in them getting less help.

I definitely understand when parents are frustrated with confidentiality when it comes to their children, which is why I always encourage open communication and family therapy, but most kids I deal with would never want their parents to know their issues and unless it’s something that puts them or someone in immediate danger, my hands are usually tied pretty tight.

Popular Psychology

Have Your Teens Been Looking For Molly?

29 Apr 201329 Apr 2013by Torey C. Richards, LMHC2 Comments

When I am doing presentations on drugs to high school teenagers, one of the many questions I get asked is “What is a Molly?” Many teens have heard of the drug Molly, some have even tried it while many more are simply curious about the drug they are hearing so much about through the music that they are listening to.

If you have never heard of the drug Molly, chances are that the teen in your life has. Molly is an innocent sounding name for a form of ecstasy that usually comes in colorful pills, powder or crystals. Some people mix it in their drinks to mask the taste and because it often gives drinks a different color or flavor.

Many teens think that it is harmless, mostly because so many of their favorite entertainers celebrate using it regularly, but it is not harmless. Part of the lure of the drug Molly is that there are few negative side effects, few verified long term effects (although depression may be one of them), and not a high risk of dependence. The real danger of using a drug like Molly, is not knowing what is really in it or how much.

When Molly is mixed with alcohol, as it often is, the risk for negative side effects increase from dehydration and exhaustion, to more severe side effects including hyperthermia, seizures, electrolyte abnormalities, cardiac episodes and even comas.

The name Molly is a play on the word molecule and it’s supposed to be a pure form of MDMA (3,4-methylenedioxy-N-methylamphetamine), but often isn’t. Some labs that have been busted by law enforcement had the ingredients for chemicals such as bath salts mixed in.

MDMA can come from as far away as Canada, Asia and the Netherlands and can be created in labs with unknown health and safety dangers.

The scary part about Molly is that it is the latest club drug that rappers and other musicians are singing about as if it’s cool and fun to use.

Because popular rappers like Trinidad James, Future and Soulja Boy are practically promoting the drug, teens who may have not ever heard of or been interested in using drugs are becoming more and more curious about what a Molly is and what exactly does it do.

Here are some lines from some popular rap songs that mention Molly:

“pop a Molly I’m sweatin.”-Trinidad James
“”MDMA got you feeling like a champion/the city never sleeps better slip you an ambien.”- Jay Z.
“Something about Mary, she gone off that Molly/Now the whole party is melted like Dali”- Kanye West
“Talkin four door Bugatti/ I’m the life of the party/Let’s get these hoes on the Molly”- Rick Ross
“Take the blunt, dip it in the lean, then light it/Pop a Molly, drink some orange juice, get higher”- Juicy J.
“Pop a molly smoke a blunt/That mean I’m a high roller”- Lil Wayne
“Every Molly got my body feelin’ like I’m outer body/I’ll be high and above the rim, Amare Stoudemire”- Gun Play

A lot of these rappers and songs you may have never heard of, but many of your kids have or at least have heard other songs mentioning taking Molly as if it were as harmless as taking a sip of water. Even Madonna yelled out to a crowd during Miami’s Ultra Music Festival, “How many people in this crowd have seen Molly?”.

One of the side effects of taking MDMA is sweating profusely (“pop a Molly I’m sweating”), because people may not realize how hot they get and start sweating. Using Molly just like regular ecstasy can make you feel happy, sexy and less inhibited which could lead to unintended sexual encounters, but some experts report that just one hit of Molly can damage your brain forever.

Rapper Joe Budden told Fox News in New York that after a summer of using Molly, he started hallucinating and not sleeping for days. He reports it took people around him that cared about him to save his life.

Teens are young and impressionable. It’s easy for the music and entertainers they listen to to influence not only how they talk, and dress, but also what they do.

When their favorite entertainers are making casual drug use seem fun, exciting and happening, then it’s only natural that they become curious about and even become tempted to experiment with the things they reference.

Entertainers are always quick to remind us that they are not role models. They think this frees them for being responsible for their actions and words. Well they are Role models, good or bad, but it is our responsibility as responsible adults to be the good role models and to help our kids stay away from bad influences by educating them on drugs and other references made in the movies and music they watch and listen to while answering any questions they have.

Keeping Teens Safe During Prom Night

25 Apr 201325 Apr 2013by Torey C. Richards, LMHC1 Comment

It’s Prom season again and teenagers across the country are getting ready for the big night, spending lots of money on dresses, hair, make up and alcohol.

Yes, alcohol.

The other day I happened to glimpse at one of my 17 year old client’s cell phone screen and saw that she was in the middle of texting someone about Prom. The last message read, “Are you sure your cousin is going to be able to get us the alcohol?”

I wasn’t shocked, but disappointed. After all, this client is one of my “good” kids who generally doesn’t give me any trouble at all, but I was disappointed that she was planning on drinking on Prom night, just as thousands of other students will be doing.

Teens and alcohol simply don’t mix, they never have, and Prom and alcohol definitely don’t mix.

Teens want to party and celebrate, to be “grown” for a night which includes partying and celebrating the way they see or think grown people do, with alcohol which is why Prom and Graduation season are so deadly for teens when it comes to alcohol related accidents and deaths.

For example, in 2005 the National Highway Traffic Safety Administration (NHTSA) reported 676 high school students were killed in alcohol related traffic accidents. One third of all alcohol related traffic accidents involving students happen between the months of April, May and June.

Drinking alcohol can cause adults to make poor decisions, imagine the poor decisions involved with underage drinking.

Young drivers are less likely to wear their seat belts when they have been drinking. In 2005, 64% of young drivers involved in fatal crashes who had been drinking were not wearing a seat belt (NHTSA).

Teens who have been drinking or aren’t thinking about possible consequences, are also more likely to get into a car with someone who has been drinking, which of course puts their lives at risk even if they avoided alcohol themselves.

According to a 2005 report by the CDC Youth Risk Behavior Surveillance, in the last 30 days, nearly 30 percent of high school students reported getting in a car driven by someone they knew had been drinking alcohol.

Other than drinking and driving, there are the other issues that come along with being intoxicated, such as leaving oneself vulnerable to sexual assaults, theft, violence and a host of other reckless, stupid behaviors and decisions.

One statistic I saw estimated that 90 percent of all crimes on college campuses including rape and murder involved alcohol.

Ask your teen how much would it suck on Prom night to end up:

on their knees somewhere throwing up or passed out
embarrassing themselves, their friends or their date
on a Youtube video doing something they wish they could take back
not remembering much of this supposedly unforgettable night
suspended from school or worse, arrested

Some people will say that teens will be teens, they will party and drink, but so what? Well if the statistics about alcohol related traffic accidents above doesn’t cause you to pause, think about these numbers from about.com:

3 million children ages 14 through 17 are regular drinkers who already have a confirmed alcohol problem
Ninth graders who drink are almost twice as likely to attempt suicide as those who don’t
40 percent of children who begin drinking before the age of 15 will become alcoholics at some point in their lives

We can’t ignore the problem of teenage drinking. I am almost positive that the client I spoke about above, parents have not talked to her at all about drinking on Prom night, because she is an excellent student who never has behavioral problems. They would be shocked to know about her intentions, which is why I let her know I saw her text and spoke at length with her about underage drinking.

Parents, talk to your teens about staying safe and away from alcohol and drugs during Prom. Not only should you talk to your teen, you should also speak with their dates and even friends to try to make sure everyone is on the same page. You can even have your teen, their date and friends sign a sobriety or Prom promise, that says something as simple as:

I,__(name)_________ hereby commit to having a safe Prom by not using alcohol, tobacco, or any other drugs. I will also encourage those with me to remain alcohol and drug free and I will not get into a vehicle driven by someone who is not sober.

Have your teen sign and date it. Sounds simple, but this little method has proven to be powerful on high school campuses across the country each Prom and graduation season.

Lastly, parents:

Let your teen know that they can call you or someone else you both trust and agree upon, to come and get them anytime from anywhere
Know your teen’s plans for before, during and after Prom
Know who they are with
Come to a fair and agreed upon curfew
Let them know your expectations for an alcohol and drug free night
Check in with them during and after the Prom, or have to check in. A simple text, “I’m okay” may suffice

Prom is an exciting, memorable time that unfortunately ends in tragedy for far too many young people. Let’s try to keep them safe while allowing them to prove that they are ready for the responsibilities that come along with being young adults.

Why Are Teens Inhaling Condoms and Cinnamon?

22 Apr 201313 May 2013by Torey C. Richards, LMHC15 Comments

Teens are great with coming up with pointless and sometimes dangerous fads that prove to us adults that their brains still aren’t fully developed.

Thanks to the internet, those fads spread like wild fire, putting more and more teens in danger.

Remember The Cinnamon Challenge? If you have no idea what I am talking about, it’s a “game” where you are supposed to put a spoon full of ground cinnamon in your mouth and attempt to swallow it without anything else to help wash it down.

The challenge is pretty much impossible.

There are plenty of YouTube videos demonstrating the challenge with the results usually ending with someone gagging, vomiting, coughing and/or choking.

Why this may sound stupid to us with fully developed brains, thousands of teens have taken this challenge with some ending up in the hospital.

According to the American Association of Poison Control Centers, there were 222 cases of abuse or misuse of cinnamon last year with the numbers steadily increasing.

Trying the cinnamon challenge can be damaging to the lungs with at least one teen being hospitalized with a collapsed lung when she attempted the challenge.

A newer, potentially even more dangerous fad is the The Condom Challenge.

In The Condom Challenge teens open up a condom, snort it through their nostrils, and then attempt to pull it out of their mouths.

You can see the health hazards in this.

Condoms can easily get lodged in the windpipe, causing a person to have trouble breathing or not be able to get any oxygen at all. I haven’t heard of any deaths yet, but as this fad spreads, it’s most likely only a matter of time.

Teens do a lot of stupid things when they get bored and are around or influenced by other teens, including doing drugs, drinking alcohol, and now apparently trying to swallow ground cinnamon and inhaling condoms.

Teens who have better things to do, like go to parks, participate in recreational activities, school sports and/or clubs are less likely to find themselves bored enough or interested enough to try the new fads.

Teens think that they are invincible and nothing will go wrong, but they do go wrong, often very quickly and un-expectantly.

It’s important that teens realize that they are their own person and they don’t have to follow other people in their real lives or in their online lives to be popular or cool.

As parents, caregivers and adults, we have to be aware of the fads our teens are facing and the hazards that go along with them. What may sound stupid, idiotic and dangerous to us most likely sounds harmless, challenging and fun to them.

Teens will be teens and they will be reckless and risk takers. It’s all a part of their developmental stage. Still, our jobs are to educate them and keep them safe the best we can so they can live long enough to become adults and reflect back on how stupid they were when they were teens, just as most of us do.

Parents: Have The “Sex Talk” With Your Teens Or I Will

12 Apr 201312 Apr 2013by Torey C. Richards, LMHC5 Comments

I don’t really like talking to other peoples kids about sex although as a counselor in a high school it’s something that inevitably happens.

I wrote earlier about talking to preteens about sex, but I’m finding that many teens have never had the “sex talk” with their parents beyond their parents threatening to kick them out or disown them if they ever got pregnant (although I’ve never known a parent to actually follow through with either threat).

However, because many teens don’t feel like they can talk to their parents about sex, they are getting their information from some very unreliable sources which usually leaves them unprepared mentally and emotionally for the complexities of sexual activity and vulnerable to sexually transmitted diseases, pregnancy and even abuse.

Last Monday I was counseling a young teenage girl who had just turned 15. She admitted to me nearly a year ago that she not only was having sex, but had been with several partners, most of them not even her boyfriends but guys she was friends with or guys she just liked.

Well now she has a new boyfriend who is a virgin, and although they have been together for a several weeks (which is forever for teenagers), they are thinking about having sex.

Let’s call her Trisha and her boyfriend Zac.

Because Zac is a virgin and apparently has a better relationship with his parents, he told them about him and Trisha’s plans to have sex. Zac’s mom was a little upset, but realistic and instead of scorning her son, she talked to him about sex and protection, a very good call. What she did next however, I’m not so sure how I feel about, but I understand it.

After talking with her son about sex, she then talked to Trisha about sex, assuming that she too was a virgin. She even went as far as to say she would get Trisha birth control, which made Trisha very uncomfortable.

Parents, do you really want someone else talking to your teen about sex and birth control, especially a parent that you do not know?

Well if you don’t talk to your teen about sex, someone else will and they may not have the best information and probably won’t have the same opinions, views or values as you do.

I was concerned because I felt like this was something Trisha should be talking about with her parents, not Zac’s, yet Trisha feels like she can’t talk to her parents about sex because they hold both her and her older sisters to such high standards and even threatened to kick them out if they ever found out they were having sex. By the way, according to Trisha, they are all already having sex.

Because of this fear of not only disappointing her parents, but also of getting kicked out, Trisha doesn’t feel safe talking to her parents about sex at all and has just been getting her information about sex from her friends and sisters, who are all also high school teenagers.

I encouraged Trisha to sit down and talk to her parents, at least her mom about sex.

She wants to get on birth control, but doesn’t think she can talk to her parents about that and definitely doesn’t want to get birth control from Zac’s mom. I even offered to have a family session with her and her mom and/or dad to help facilitate “the talk”, but she’s too scared to even discuss sex with her parents and let them know that she is thinking about sex, let alone already having it.

I know from past experience, because of this fear of talking to her parents about sex, she leaves herself vulnerable.

She’s more likely not to use any protection consistently or properly and to hide everything from her parents, including if she ever feels violated, if she ever thinks she may have a sexually transmitted disease, if she ever gets raped or if she even gets pregnant.

One girl I knew hid her pregnancy from her parents all the way up until she went into labor and had a child at 15. Her parents had never had the “sex talk” with her and it was only then did her parents find out that their daughter was no longer a virgin.

I definitely don’t want that to happen to Trisha and so if she is afraid to have the sex talk with her parents, I feel like it is my responsibility to at least give her valid information about sex, protection and to point her in the right direction for other information and questions she may have.

We talked about condoms, the importance of putting them on correctly and using them each and every time from the beginning to the end. We also talked about birth control for her, but I strongly encouraged her to have the conversation with her parents. I also had the school nurse talk to her and gave her several pamphlets for her and her boyfriend about sex.

She had lots of questions and lots of the information she had was so invalid that she was sure to end up pregnant before graduating from high school, such as standing up right after having sex is a foolproof way to avoid getting pregnant because gravity will prevent the sperm from swimming up.

Another thing I did was encourage her to wait. I talked to her about how sex can change relationships, sometimes for the worst and how there are other things they can do besides having sex, such as holding hands, kissing, hugging, talking, going for walks, out on dates, etc.

All the while I also kept encouraging her, trying to give her the strength to have this conversation with at least one of her parents. I don’t think a 15 year old should be engaging in intercourse, but she’s already been doing it since she was 14 so we have to be realistic.

Many parents feel like having the “sex talk” will encourage their teens to have sex, but teens are going to be curious about sex and may engage in sex regardless. It’s just a matter of how informed or ill-informed they will be.

Lot’s of parents feel betrayed and hurt when they find out their teenager is having sex, almost as if they just found out their teen was using drugs.

Remember that consensual sex between teenagers is not a crime and your teen is more likely to get pregnant or worse if they feel like they can’t talk to you because you will get mad or upset. It’s important that parents put their emotions aside and consider their teens’ choices and emotions.

I encourage parents to talk to their teens about sex, about being safe and healthy. They can also allow their teen to talk to their doctor about being sexually active and the physical responsibilities that come along with that, if they don’t feel comfortable or knowledgable enough to do it.

It’s important that your teen feels like they can trust you and that you guys have an open relationship where they can talk to you about everything, just remember that even with that, your teen probably won’t tell you every single thing.

The teen years are about trying to discover their own independence and breaking away from their parents some, so accept that there may still be things your teen won’t tell you, but make sure that they know that you will be there for them if they need you.

While I definitely prefer not to be the one having the sex talk with your teen, I’d much rather do that now than to be talking to them about how to get a pregnancy test, being good parents while trying to stay in school or about visiting a free clinic to get tested for a STD, three conversations I actually have way more often.

Disordered Eating And Body Image Issues In Teenage Girls: Part 1

8 Apr 20138 Apr 2013by Torey C. Richards, LMHC2 Comments

Working in a high school with teenage girls, I come across teenage girls with body image issues regularly.

Take for instance, one of my 15 year old clients who is so convinced that she is fat that when I first met her she was only drinking water mixed with apple cider vinegar for breakfast and lunch.

For dinner she would have a very small meal. She was not overweight, but due to teasing about her “putting on some weight” by both her mom and peers, she see’s herself as fat and ugly.

Because of all this, her self-esteem is shot and it’s taken weekly individual therapy sessions and weekly support group sessions to get her to at least start eating a light breakfast and lunch, although she is still struggling with body image and self-esteem issues.

Society Creates Body Image Issues In Girls

Unlike boys, teenage girls are put under immense pressure to be beautiful, thin and feminine in most Western industrialized countries. However, biological changes and weight gain are natural parts of pubertal development.

Like the client I was talking about above, her weight gain seems to be more of a womanly weight gain. She seems to be filling out and taken on the body of a woman, compared to that of a prepubescent child. This natural weight gain that most girls experience during puberty, goes against our cultural’s view of what being beautiful is, which for women includes extreme thinness.

These are conflicting messages for preteen and teenage girls.

On one hand, they are naturally developing and putting on weight, while on the other hand, they are getting messages from society that says their weight gain is unattractive.

Female identity in one part is defined in relational terms, society says they are supposed to be interpersonal and care about other peoples needs, feelings and interests which makes them more vulnerable than males to other people’s behaviors towards and opinions of them.

Another major part of female identity is beauty. In our culture, physical attractiveness contributes a lot to interpersonal success, which is one of the main reasons females strive to be beautiful, to assure popularity and respect.

Also, physically attractive girls are typically seen as more feminine compared to less attractive girls or girls who challenge our cultures traditional views on femininity through their political views such as feminist, or through their sexual orientation, such as lesbians.

Girls tell our society that they are feminine by being concerned with her looks and trying to achieve our culture’s ideal of beauty.

Because our culture demands that girls care about other people’s opinions and that they are defined by their physical appearance, which society says includes being very thin, there’s no wonder girls are motivated to pursue thinness, at times by any means necessary including starving themselves to death.

Combine these issues with the natural weight gain of puberty and there’s no wonder many teenage girls develop body image issues.

Many teenage girls I’ve worked with who are physically perfect, not even slightly overweight, some were even underweight, suffer from intense body image dissatisfaction.

A girl I’ve been working with since last year was naturally thin, yet wanted to be thinner so bad that she starved herself to the point of needing to be hospitalized. Like many of the girls I work with who have body image issues, her pursuit for thinness and beauty was so consuming that almost every other aspect of her life, including her education, goals and future took a back seat.

Eating Disorders

Not all girls with body image issues go on to develop an eating disorder like the young girl I just mentioned above, but many of them will.

Eating disorders are a major concern when it comes to the health of teenage girls with an estimated 1% to 3% likely to meet diagnostic criteria for either anorexia nervosa or bulimia nervosa.

Anorexia nervosa is when someone refuses to maintain a minimal average body weight and has body image disturbances such as feeling fat even when they are very thin, and in females who are menstruating, they may experience amenorrhea if their body weight is low enough.

Bulimia nervosa typically includes periods of binge eating, followed by drastic methods to compensate for the binge eating including excessive exercising, fasting, vomiting, using laxatives, etc., accompanied with body image disturbance such as thinking one is much more overweight or unattractive than they really are.

Besides these two eating disorders, there are some girls who have other patterns of eating that fall under disordered eating, such as laxative abuse, vomiting after eating some meals, extreme calorie restriction, and binge eating.

Eating disorders typically begin in early adolescence with much of it’s symptoms typically evident by the late teen years.

While not all girls with body image issues develop full blown eating disorders, there is little research into why some girls do and others don’t develop an eating disorder.

During part 2 we will look at some of the risk and protective factors for young girls to develop an eating disorder.

Setting Expectations And Rules For Your Teen

5 Apr 20137 Apr 2013by Torey C. Richards, LMHC1 Comment

As I thought about this post, I watched as four young teens, approximately 13 years of age, two boys and two girls, stood on the corner flirting for a second night past 10pm on a school night.

I started thinking that sooner or later, one or both of those young girls is bound to end up pregnant, and then I started thinking, where are there parents and why are they allowing their young teens to be out so late on a school night unsupervised.

Then I started thinking that there are probably no set rules or expectations in these teens households.

They are probably being raised with inconsistent and even contradictory messages. Yet, when one of these young girls ends up pregnant, their parents will be shocked and angry that these young teens “disappointed them”.

Rules and Expectations

Rules and expectations are two different things that together help guide your teen as they navigate through the murky waters of adolescence.

Expectations help you define the standards of behavior you expect from your teen such as being responsible and making responsible decisions.

Rules on the other hand help to bring your expectations to reality such as requiring your teen to finish their chores before going out with friends. Rules and the consequences of those rules help your child with both understanding your expectations and learning self-control.

As always with teens, communication is key. I am always amazed at parents who come to me disappointed in their teens behavior when they never actually sat down with their teen and discussed their expectations in the first place.

The teenager may have had some idea about how their parents felt about certain issues, but without a clear understanding of what the parents expect, they leave a gray area and teenagers typically don’t do well with gray areas. They like to know exactly where you stand.

Sitting down and speaking with your teenager about your expectations also opens up the door to talk about risky behaviors.

Clearly defined expectations about limits for risk-taking behavior helps your teen be prepared for temptations and challenges that will face them when confronted with risky decisions towards things such as alcohol, drugs and sex.

When you lay down clear expectations, you are letting your teenager know that they are responsible for their behavior.

This discussion also allows for you to hear what and how your teen thinks about certain issues and also gives you the opportunity to help them think more realistically.

A lot of teens think “this can’t happen to me” or that they are immune to many of the perils we as adults know are out there. Talking to your teen will give you the opportunity to educate them on the possible consequences of their decisions and behaviors.

No matter how clear you think you have made your expectations, your teen may still feel unclear about them. Rules help to enforce your expectations.

Many parents are unsure about how to set rules and what rules are needed. Here is a good starting point.

Besides rules regarding substance use and other risky behaviors, you also want rules regarding:

curfew
unsupervised time
homework
chores
driving
cell phones
internet use
use of other media such as movies, television and video games

Naturally, most teens are going to try to push back against rules, but teens do want and expect limitations and boundaries.

Be respectful, listen to your teen and explain your reasons for having the rules you do. Some parents feel like they don’t have to explain any rules they set to their children, but children tend to follow rules better when they at least understand, even if they don’t agree with them.

Other tips include:

Focus on setting rules for safety based more on guidance than power, control or punishment.
Don’t be overly intrusive or restrictive, but still be firm.
Give your teen an opportunity to negotiate some of the rules, but remember that you have the final say
Be very specific when it comes to substance use. Such as letting your teen know that they are not allowed to use alcohol, tobacco, prescription medication or any other illicit drug at all.
You should set very fixed rules regarding health and safety, and then negotiate with your teen about other rules.
Be flexible with those other rules (outside of health and safety) and willing to renegotiate as your teen shows maturity and responsibility.

Along with clear rules and expectations, there should also be clear consequences for breaking the rules.

Consequences help teens slow down and think before they make a risky decision and also provides them with the perfect excuse to tell their friends if peer pressure is an issue.

Tips for setting consequences:

Consequences should be something the parent can follow through with consistently in order to be effective. Many parents are very inconsistent with following through with consequences which teens pick up on and it makes it more likely that they will disobey your rules.
Consequences should be logical, and more about teaching than about punishing or retaliation.
Remember that consequences can be positive. Praise your teen when they are doing something right, when they are following the rules and they are more likely to continue.
Award your teen with special privileges or some other type of award for following the rules.

Without rules and expectations, many teens are lost and parents feel as if they have out of control or disrespectful kids when in reality, the child never learned the rules, expectations or the consequences of breaking those rules and expectations.

How The Internet And Technology Are Affecting Our Teens

4 Apr 20134 Apr 2013by Torey C. Richards, LMHC4 Comments

Today’s children are using the technology and internet more than ever, with approximately 93 percent of them online and at least 73 percent of them using social networking sites, while 75 percent of them own cell phones according to data from Pew Internet American Life Project.

With this increased presence on the internet and use of smartphones and tablets comes concerns by teachers, parents and counselors when it comes to what exactly are our kids doing online and on their smart devices.

The media fuels much anxiety when they report on issues such as “sexting” with young people sending provocative photographs of each other back and forth through their cell phones. Images that can end up in the wrong hands. Even videos of risque and sexual activities are spread through cell phones and often end up going viral and creating new avenues for harrassment, bullying and embarrassment that may seem inescapable.

Something that may seem like a good idea five minutes ago can end up haunting a teen for weeks, months, or even a lifetime.

The large majority of children and teens who use the internet and cellphones do so responsibly. It is a rather small segment of children who abuse the internet and technology.

Online bullying, also known as cyber-bullying is a real concern as it typically targets kids who are already being bullied or harassed in person. They are most likely already facing multiple challenges as is. With online bullying, kids who are bullied already in person, feel like there is no escape from the bullying as they are also targeted online where the bullying can be relentless due to the hidden nature of the internet.

To some adults and parents this may seem silly, but you have to understand to to teens, much of their social life is conducted online so an attack on their online social life is pretty much an attack on their world.

We all know of the horror stories of teens who were bullied to the point of suicide such as Amanda Cummings. Children who are being bullied are more likely to suffer from depression, suicidal thoughts, social problems, substance abuse and are more likely to have poor relationships with their caregivers.

Teen friendships and relationships are more and more online so they depend more on social networking which is one reason cyber-bullying can be so detrimental.

Look at Manti Te’o’s fake girlfriend situation. Here’s a college age young man that reportedly met and fell in love with someone online he never met. I’ve counseled many young teenage girls who were depressed and suicidal after a break up with someone they met online, but never met in person. This just goes to show how entwined the internet, social networking and technology are to the lives of young people and of course, some of us adults as well.

Some research also tries to suggests that the internet is not giving teens more access to sexual content and that they are still finding it the old fashion way through television, movies and music. This may be true when it comes to suggestive and “soft” content such as kissing, hugging and touching or showing a couple having sex under the covers, but the teens I work with look for the more hardcore content found on the internet. They visit free porn sites on their phones and computers often, usually out of curiosity or for amusement, but still it’s through the internet that they access these hardcore porn sites.

It’s frightening to think that many of these same kids viewing porn on the internet, have parents who are in denial about their teens sexual or potential for sexual activity and have not actually had any real conversations with them about relationships or sex and so while watching this porn, they are also getting education, or mis-education that their parents likely would not approve of.

One thing I have noticed, and what made me want to write this post in the first place is that I think in part because of social networking, today’s teens are less private and understand the meaning of privacy less than teens in the past.

So many times when I am talking with a group of teens, outside of the confidentiality of an actual group setting, one of the teens will start talking about something very personal and private such as thinking that they are pregnant, stating that they just had an abortion or miscarriage, or thinking they may have a sexually transmitted disease, you name it, they’ll blurt it out.

At that point I’ll try to stop them and tell them, “I think this is something we need to talk about in private” and sometimes they will still press on and say “No it’s okay, I don’t mind talking in front of them” and I’ll have to continue stating “No, we need to talk about this in private”.

Many of them seem to have lost the sense of privacy and I contribute at least some of that to the amount of private information they share on social networking sites.

The downfall in that is that some of the private information they share to people who don’t value them or their privacy, will be turned around and used against them, sometimes to the point of harassment and bullying.

They may not realize the fact that they just had an abortion should be kept private, until they read about it from someone else on Twitter or a random stranger comes up and asks them. Then they may be shocked and embarrassed, but they were the ones who originally divulged that information to begin with.

You wouldn’t believe the amount of physical and verbal confrontations I’ve seen between high school girls that started this way.

At the same time, research shows that overuse of social media is linked to poor health, poor grades and symptoms of mental health problems such as narcissism.

Part of the reason for this is because young people often wake up to, live the day through and go to sleep with technology. They wake up checking their text messages, their social media sites and continue that throughout the day until they go to sleep at night, which research suggests is making them more prone to mental health problems, poor grades and even being physically sick more often.

Take for example that teens that study for one hour, focusing on their assignment, do better than teens who study, yet check their text messages or social networking sites periodically while they are studying.

I thought about this as I watched my niece who is a high school junior studying the other night. Her text book was in front of her, her cell phone in her hand and periodically it would light up and she would reply to a text and then go back to studying. I think within a thirty minute period she probably did that about seven to ten times.

Researched done by Larry D. Rosen, PhD. that is not yet published shows that “Whether they checked Facebook just one time during a 15 minute observation period even predicted worse grades”.

Besides narcissism, teens who overuse social media sites also show more signs of other mental disorders such as borderline personality disorder, bipolar disorder, and antisocial personality disorder.

The news of course isn’t all bad.

While some research shows that teenagers are less empathetic due to being over sensitized to pain and misery on the internet, other studies show that teens who engage in social networking are more likely to show “virtual empathy” which can translate to them showing more actual empathy in the real world.

The internet of course offers us much in the forms of information, education and entertainment, but parents should set clear guidelines and limits early on with their teens about the internet and technology they use to avoid overuse and abuse.