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Common Reasons Children Avoid School by Dr. Kim Champion

Published on Tuesday, February 02, 2010
All children may resist going to school at one time or another, but for some children and their parents, school becomes a stressful daily battle that leads to frustration and conflict. Parents question what could be causing such distress and refusal in their child and what they can do to help their child. The following is a list of common reasons that a child may be refusing or resisting school. Understanding underlying causes can help parents to work with their child to rebuild a comfort level with attending school.

Fatigue –

Children, like adults in our fast-­‐paced, high-­‐entertainment society, often do not get enough sleep at night. Medical professionals recommend that children ages 7– 12 years sleep 10 -­‐ 11 hours per night. When children are tired, they have a harder time coping with stress, managing emotions, and problem-­‐solving. Children with mental health disorders are affected

by lack of sleep even more, since it regularly requires extra energy for them to manage symptoms. For example, a hyperactive, impulsive child may be able to manage these symptoms most days in school, but if he is particularly tired one day, the same symptoms may become far less manageable.

Hyperactivity/Impulsivity/Distractibility –

Even though children with Attention Deficit Hyperactivity Disorder frequently desire to behave appropriately and please others, their impulsivity and fidgetiness can become disruptive to the classroom and annoying to classmates. As a result, they often expend a great deal of energy working to minimize their symptoms during the school day. Over time, children with ADHD can become discouraged and overwhelmed with trying to manage symptoms and

cope with the regular stresses of their school day which may lead to school avoidance.

Anxiety or Depression –

Children experience anxiety and depression for a variety of reasons. Sometimes a child fears for her parent’s safety and may resist separation. Other times, a child may fear being rejected by others, bullied, or embarrassed in public. Sometimes, a child feels he will disappoint others

if he makes mistakes or gets low grades which may cause anxiety and school avoidance. When children are depressed they may avoid being around other people; they may give up hobbies or sports; they often feel unmotivated; and they frequently do not have a desire to

work on anything, including schoolwork, which can make attending school distressing.

Discussing concerns with your child may help you to understand his or her feelings and struggles and will likely lead to ideas for providing help such as earlier bedtime or strategies for concentration. However, if your child’s symptoms are severe, if you have seen a change in your child’s personality, or if symptoms are not improving, enlisting the help of a mental health professional is suggested.

 

Five Great Reasons to Pay Out-of-Pocket for Therapy by Melissa Winters. M.A.

Published on Tuesday, January 05, 2010

Five Great Reasons to Pay Out-of-Pocket for Therapy

Melissa Winters, M.A.

 

As we’ve heard on the news, many people don’t have health insurance coverage. For those who do not, and even for those who are fortunate enough to have it, Pike Creek Psychological Center offers an alternative to using health insurance to seek therapy. You can choose to pay out-of-pocket for therapy, which we call “fee-for-service.”

 

Some of you may be thinking…

 

“But I have insurance… why wouldn’t I use it?”

 

Great question! There are many reasons a person who has insurance may choose this option, and they all relate to having more freedom, flexibility, and choice.

 

What are the benefits of choosing to pay out-of-pocket for therapy?

 

1)      Freedom from hassles of the insurance company. When you make the important decision to see a therapist, you may spend hours getting a referral from your doctor; calling the insurance company to find a provider; getting authorization numbers and letters; figuring out and paying copays; calling the insurance company to check on problems … and the list goes on. Choosing not to use your insurance gives you the freedom to find the therapist you would like to see and begin work, without these added complications.

 

2)      More choice in the provider you wish to see. As people call around looking for a therapist who takes their insurance, many find the perfect provider (or are referred to a specific therapist by someone they trust), only to find out that the therapist does not take their insurance. Some great therapists may not be on your insurance panel; others do not participate with any insurance panels. Choosing to pay out-of-pocket gives you more freedom to see the provider you think is the best fit.

 

3)      Freedom from insurance-related restrictions. Many insurance companies don’t cover sessions more than once per week, or double sessions, phone sessions, group therapy, workshops, and other types of treatment that might be especially helpful to you. Paying out-of-pocket means that you can seek these other types of treatment when you and your therapist think it is suitable.

 

4)      Liberty to stay in therapy longer than your benefits allow, and to explore issues that may not be covered by insurance. Many insurance companies allow only a certain number of sessions per year, which may not be enough to address the concerns that brought you to therapy in the first place. Insurance companies reserve the right to manage how often and how long you can use your benefits, and may decide that you cannot use your full number of sessions for certain problems. When paying out-of-pocket for therapy, you and your therapist will work together to figure out how long you can stay in therapy and what issues you want to work on.

 

5)      More flexibility to fit therapy into your own schedule. When you call our office to schedule a new appointment, you will be asked questions about when you are available to come in. We realize that not everyone has the ability to come to therapy during regular business hours. You may find that many therapists who see only fee-for-service clients are available to see you on nights and even weekends, and may have more flexibility to find a time that works best for you.

 

But can I really afford it?

 

Chances are, our office has a fee-for-service therapist who can see you at a rate you can afford. The base rate of each therapist is determined by their highest academic degree and how far along in the licensing process they are. In addition, we offer a sliding scale option, which is a discount based on your income and number of people living in your home.

 

How does it work?

 

Our friendly and knowledgeable office staff specializes in helping you find a great therapist who is a good fit for you, and can see you at a time when you are available, at a rate you can afford. Starting the process is simple. All you need to do is visit the website to request an appointment, or call the office to speak with one of these specialists, and she will guide you through the process.

 

Now that you have five great reasons to consider paying out-of-pocket for therapy, we hope you will consider how it could benefit you and your family. These are just a few, but there are many, many more. Can you think of more reasons why it might be helpful to choose this route?

 

The Lists by Jeff Ernst, MA

Published on Thursday, December 10, 2009

The Lists We Keep

by Jeff Ernst, M.A.

 

Several years ago a popular TV show depicted a man who set out to make amends to all the people he had offended, hurt, cheated, lied to, and stole from.  Basically, this person kept a running list, and dedicated his life to seeking out those individuals, doing right by them, and then crossing their names off the list.

 

Now, I’m not blogging today to say we should be keeping a similar list.  However, his example and perseverance should cause us to stop and examine if we are keeping an un-written list of all those we have offended, or been offended by, possibly triggering guilt feelings, anxiety, and damaged emotions.

 

Making amends is a key part of on-going emotional health, as well as an on-going spiritual journey toward freedom from residual baggage…to keep our slate clean and our relationships with God and others close.

 

As we approach this Christmas season, with our lists for gifts to buy and gifts to receive, my hope is that we not forget a list for making amends…to those we’ve hurt, offended, been resentful and unforgiving toward, or others we’ve refused to love and forgive, because they’ve hurt and wounded us.

 

One of the most powerful resources for emotional healing and freedom from anxiety is the gift of making amends…of forgiveness!  First, when we accept God’s grace and mercy for ourselves, He promises to wipe the slate clean and blot out our transgressions. This frees us from pervasive guilt and remorse.  The scriptures are clear:

 

            “I, even I, am he who blots out your transgressions, for my sake,

And remembers your sins no more.” (Isaiah 43:25, NIV)

 

Once we experience such forgiveness, we can get out the lists we’ve kept stored in our minds and hearts, and pass on the gift of grace to other people.

 

What a great Christmas and New Year’s resolution gift: The gift of making amends…Crossing those names off the list once and forever!  Sounds like a fantastic script and title for a TV show…We could call it “My Name Is ‘Forgiveness’ – Let Me Wipe Your Slate (List) Clean!”

 

The Perils of Internet Pornography by Mitch Ruoff, Psy.D.

Published on Monday, November 02, 2009

Some startling statistics:

  • Worldwide revenue from online pornography in 2006 was over $97 Billion
  • Average visitors per month to adult websites:  72 Million
  • More than 70% of men ages 18-34 visit a pornographic website in a typical month
  • Excessive online pornography is a factor in more than half of current divorces
  • Visitors to pornographic websites: 72% men, 28 % women
  • Average age of first Internet exposure to pornography:  11
  • 90% of children ages 8-16 have viewed online pornography (most while doing homework)

      Sources: Top Ten Reviews, Fireproof Your Marriage Participants Guide

As startling as these statistics are, there are some who would say that Internet pornography is no worse than its predecessors, print and video media. For several reasons, I disagree. The most obvious reason has to do with increased accessibility. Pornography usage has exploded with online availability. It used to be that someone who wanted to view pornography had to go to the convenience store to buy a magazine or the video rental store to rent a movie. The step of getting into the car to go somewhere is no longer necessary. Instead, you can turn on the television or computer at any hour of the day. The removal of this small step has made it more likely that people will not resist the temptation to use pornography.

The second reason that Internet pornography is worse has to do with anonymity. Lack of anonymity was a major deterrent for many to using pornography. For instance when someone would buy a magazine or rent a movie, they had to face at least one other person who knew exactly what they were doing. Unfortunately, this barrier has now also been removed. The shame or guilt of using pornography is now completely internal. What one does with the television or computer in the privacy of home is completely anonymous. Similarly, the common “stash” of materials has been made obsolete. Now the pornography user can simply delete the history on the screen or turn off the television with little worry about being caught.

The final reason that online pornography is worse is that it has accelerated the normalization of exhibitionism and voyeurism. What I mean by this is that when seemingly everyone is looking at sexual material, it starts to feel like a normal thing to do. Whereas producing pornography used to be confined to those in the x-rated industry, now anyone can post nude pictures of themselves or suggestive videos online. This barrier too has eroded and been washed out to sea. Exhibitionism has become cool instead of disgraceful. Voyeurism has become just another form of entertainment.

So what are we to do? The most obvious answer is to put some of those barriers back in place. Fortunately, there are some things that can be done to reduce the likelihood of pornography use.

Concerning availability, use the parental controls on your remote to ensure that adult channels are blocked. Likewise, get filtering software that blocks adult websites from view. While it may not be perfect, it will make accessing pornography more difficult for anyone using the computer.

Concerning anonymity, keep computers with Internet access in a common space rather than a private room. Limit computer hours if possible so that no one uses it when everyone is asleep or away. Filtering software will also keep a record of sites visited, making for some accountability, and making it less likely that someone will give in to temptation. Check the cable bill periodically to make sure no one has ordered adult movies or shows.

Concerning the normalization issue, seek out a Biblical view of sexuality. Keep in mind that sex is a sacred gift from God. It is to be enjoyed as He intended, not by devaluing others and using them to satisfy our urges. Remember that staying pure will be healthier for you and for your marriage.

Finally, if you have already engaged in compulsive pornography use, get help. This is a real problem that can ruin your marriage and your life. The same Internet that pulled you down can be a useful tool in lifting you up. There are many websites to visit for help with pornography addiction including newlifehabits.com, no-porn.com, sexualrecovery.com, and throughtheflame.org. Therapy may also be a good starting point to recovery. If you want to break free from the power of pornography, don’t hesitate to schedule an appointment today.

Parenting Children with Learning Disabilities and ADHD by Rick Holmes, Ph.D

Published on Thursday, October 01, 2009

In a 2003 study by the CDC, approximately 16% of boys and 8% of girls aged 5--17 years had ever had diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) or learning disabilities (LD), according to parental reports. Boys were three times more likely than girls to have diagnoses of ADHD without LD.  Do I believe that ADHD is overdiagnosed? Absolutely.  However, even with a smaller percentage, these are huge numbers in terms of the children impacted at both home and school.  Boys, in particular, struggle with the traditional academic model of sitting for an extended period of time and trying to absorb mostly verbally presented information.

 

Over the past ten years, I have seen the use of ADHD stimulant medication skyrocket to help children focus better in the classroom. I have also seen more specific accommodations put in place to help children with learning disabilities.  But, I am not sure that the underlying issue is being addressed that most children tend to learn better when presented material is interactive, experiential, and mult-sensory.  I believe there are many extremely gifted teachers who are limited by having to teach to the standardized tests. This prevents them from being creative.  My personal struggle to find a better way to provide services for children with LD and ADHD led me to join the board of a proposed charter school in Delaware, Gateway Lab School, (www. gatewaylabschool.org) modeled on the principles of The Lab School of Washington founded by Sally L. Smith.

 

How can parents better understand the many needs of their LD/ADHD children at home and respond differently?  Children with LD/ADHD and related disorders puzzle parents because of their many abilities and disabilities.  It can be difficult to understand how much of their behavior is the nature of the condition and how much is oppositional.  It is all too easy for parents to “catch” a child’s feeling of inadequacy and then feel bad as a parent.  Parenting approaches that include clear, concise instructions; structure without rigidity; nurturing a child’s gifts and interests; and constant approval of positive behavior help parents feel better and help children feel safe.

 

Parents and teachers of children with learning disabilities can help them by providing clear structuring of time and space. To help children with structuring space, visual aids can be helpful.  For example, shelves can be used instead of drawers so children can see where things belong and how to put them back.  The use of visual cues, such as lists or labels, can augment efforts to help children organize tasks and belongings.  In addition, developing understandable and reinforced routines can help with structuring time.  Breaking routines and other tasks into manageable chunks and communicating what must be done first, next, and last is important.

 

Children with learning disabilities begin to notice that others can easily do tasks that are intensely difficult for them. As a result of this they begin to feel bad about themselves or have low self-esteem or self-worth.  By training themselves to reinforce the positive as much as possible and offering concrete comments on what their child is doing well, parents will cultivate desired behaviors and boost their children’s self-worth.  Visual, concrete proof of progress also helps children notice and feel confident about their progress and accomplishments.  Homemade certificates, gold stars, stickers, charts, and check lists with lots of checks can be used when children work hard on tasks at home. Tasks to be rewarded can include remembering to take out the garbage, to clean their room, to set the table correctly, to make their beds, and to put the dishes in the dishwasher. 

 

Children with learning disabilities, ADHD, and related disorders often feel powerless and inadequate.  They tend to be passive learners and need to be totally involved in activities to make them active learners.  Parents can encourage hands-on activities, such as help with cooking, cleaning, shopping, and running errands.  These learning activities have the additional benefit of resulting in tangible, visible products appreciated by the whole family.

 

If you are frustrated about your child’s behavioral issues at school or increased conflict at home, please make an appointment with one of our therapists to talk about strategies that may be able to help.

 

How to Identify and Manage Stress by Ken Williams

Published on Thursday, September 03, 2009

“I’m just overwhelmed and stressed out,” a young man recently told me.  “I’m not sleeping well and my job is really crazy right now.   I find myself feeling anxious all the time, and I can’t seem to relax.” 

Like this young man, many of us experience the effects of stress in our lives, and if left unchecked, stress can cause a multitude of problems.  Chronic effects of stress literally can make us sick and have contributed to the onset of many diseases such as adult onset type 2 diabetes, high blood pressure, and heart disease.   So if stress is so bad, why does the body experience it anyway? 

As it turns out, stress is the body’s way of helping us get out of danger.  You know, real life-and-death stuff.  We are created in such a way that when we perceive danger, we experience what is known as the fight-or-flight response, also known as the stress response.   This physiological reaction prepares the body to take action and helps us survive what would otherwise be a really bad day.

So what exactly happens in the body when it experiences the stress response? First the body makes chemicals, mostly adrenaline, to send energy to the muscles.  The heart rate increases, and the body shuts down any non-essentials like digestion, growth, and reproductive processes. This is great when you need to run away from danger, but the problem is that most of life doesn’t require this type of stress reaction.

If we are lucky, our everyday stressors include things like traffic or standing in line at the grocery store when we are in a hurry.  Unfortunately, our bodies cannot tell the difference between these frustrating moments from the real life-or-death moments, and they reacts in exactly the same way to both.  This is often problematic, because we don’t even realize that we’re stressed out and at risk from long-term effects of stress.  The simple truth is that even thinking anxiously can initiate the stress reaction in the body.   

Therefore, it is necessary for us to pay attention to our bodies and anxious thinking and take steps to relax.  Notice things like muscle tension, headaches, disrupted sleep, anxiety and even panic attacks.  This is the body’s way of letting us know that we are stressed out.    

I encourage people to respond to stress by initiating the body’s “relaxation response.”  Imagine that the body has a large button with the word “RELAX” on it in big letters. Now press it.  Imagine it bringing calm and serenity into your body.  The best way to press this button is to simply breathe and say the word “relax” to one’s self.  Actually, any positive self-soothing statement will do the trick.   

The simple, but invaluable, act of breathing begins to reset the body’s stress response and restores the body’s balance to its natural state of calm.  Studies have shown that people who practice more disciplined breathing and meditation experience greater well-being and report less suffering from chronic stressors.   

Here are some other tips to get a handle on stress:

•  Get the body in motion. Walking and exercising are wonderful ways to help manage stress.

•  Get enough sleep.

•  Spend an afternoon with a friend.

•  Go to church or say a prayer.

•  Use hobbies and interests to promote healthy “play” and recreation.

• Take a vacation or go on a retreat.

•  Remember to laugh. 

If you are interested in learning more about managing stress and about the mind-body connection, please take advantage of the “Living with Pain and Illness Workshop” being held at PCPC on September 24th, at 6:30 p.m.  This workshop is designed for those who are hurting physically and emotionally, as well as those who care for them.   

For more information, sign up on line or call (302) 738-6859.  The cost of the workshop is $20 per person, but register by September 21, and receive a discount. 

Parental Substance Abuse by Pam LaPorte, M.S.S.

Published on Saturday, August 01, 2009
“Train a child in the way he should go, and when he is old he will not turn from it” (Proverbs 22:6 NIV).  This verse came to mind repeatedly as I read two recent studies published by the National Survey on Drug Use and Health. The results of both studies indicate a large number of U.S. children and adolescents are being affected by their parent(s) alcohol and drug abuse. The first study dated April 16, 2009 reported that over 8.3 million children under 18 years old live with at least one parent who abused alcohol or drugs in the past year.  

A parent’s substance abuse often has profound and traumatic effects on children. One major effect was described in the second study I read which was dated June 18, 2009.  This study reported that adolescents living with an alcohol abusing father are at increased risk of substance use and abuse themselves.  Also of note was that teenagers who have fathers that drink even just moderate amounts of alcohol are at greater risk of binge drinking, alcohol and drug abuse. 

Considering the nature of the parent-child relationship, these study results are not surprising.  From the time a child is born, parents become the primary role models in the child’s life.  Most parents can easily recall their children as toddlers imitating their own behavior – whether it be dressing up in mom or dad’s clothes or “making dinner” in their miniature kitchens.  Therefore, it makes sense that just as children imitate their parents in this way, they would be inclined to repeat their parents’ behavior with regard to alcohol and drug use.

While I am not an advocate of abstinence from alcohol, I do believe it is very important for parents to examine their own substance use habits and consider the possible influence that their behavior may have on their children.  As Ephesians 6:4 reads, “Fathers, do not exasperate your children; instead, bring them up in the training and instruction of the Lord.”  

If you feel that you may have a substance use problem or you are concerned about the substance use of a family member or friend, you may contact this office to schedule an appointment.  Symptoms of alcohol and/or drug abuse include withdrawal, increased or decreased tolerance, using in dangerous situations (including driving), trouble with the law and interference with obligations such as work, school and/or home. 

You may also get more information on substance use disorders and the studies referenced from the Substance Abuse and Mental Health Service Administration, http://www.samhsa.gov/.


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