The Top 4 Student Mental Health Issues– Must-Have Tips

 

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The Top 4 Student Mental Health Issues

Must-Have Tips on What to Do– and What Not Do

 

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The Top 4 Student Mental Health Issues

Must-Have Tips on What to Do– and What Not Do


speaker student mental healthIt’s really amazing how more and more students seem to have serious mental health issues compared to as little as 15 or 20 years ago. With no disrespect intended, I am often surprised when I speak at school, juvenile justice, foster parent, counseling, social work and mental health conferences at how many common juvenile mental health diagnoses are either misunderstood or unfamiliar to the participants.

Hello from Youth Change Professional Development Workshops director, Ruth Herman Wells. That’s me in the image on the right, speaking at a large education conference in Florida in early 2017.  Often, when I try to explain a commonly misunderstood diagnosis, I almost get booed out of the building. Okay, that was an exaggeration but once at a Texas conference of several thousand, it did take a while until I got the group to settle down and listen. Then the room got really quiet as they realized that many of them had misunderstood some key diagnostic labels. I’m no diagnostic expert but I do know my basics really well and when you get done reading this, you will hopefully have a better grasp of some of the basics too if you don’t already.

WHY DIAGNOSTIC CATEGORIES ARE IMPORTANT

student with SEDIf you lack the ability to understand, refine and label what you are seeing, you are going to be far less effective. That’s why Eskimos apparently have many names for different types of snow. Understanding the snow differences might be important for travel, sport, fishing, hunting, and so on. Similarly, if you just see acting-out students, and sad kids, and angry kids but can’t refine beyond those rather global discriminations, that makes it much harder for you to intervene correctly, intervene using the correct strategies, communicate to others, explain to parents, or help locate the right mental health counselor, family therapist, psychologist, social worker or doctor, for example. But, the bottom line is that you simply won’t be as effective helping your emotionally disturbed and troubled students. There is a laundry list of woes that result when you don’t know your basic diagnostic categories for juveniles. One big risk: You can do great harm. The other big risk: You are much more likely to miss key opportunities to prevent or best manage serious or worsening issues like self-harm, self-endangering, acting out and law violations from occurring.

THE INFORMATION HERE IS JUST APPETIZERS

I can’t cram a semester’s worth of Juvenile Mental Health Diagnostic Categories 101 into this short article so I am going to give you just the starting point. Your homework is to go deeper than the headlines I am going to be able to give here. I will be giving you a quick description of the problems typically associated each diagnosis, and a quick description of the key issues you must be aware of. It will be your job to get the full picture yourself from a reputable source and not attempt to get by on the condensed information in this introductory article. We have hundreds of easy-to-read articles on tailoring your strategies to fit students’ mental health issues. Find them in our How-To Articles Archive.  If you haven’t already familiarized yourself with the Diagnostic Statistical Manual (DSM), that is the bible of mental health diagnosing, I urge you to take time to do that for at least the 4 diagnostic categories I am about to give you. They are, in my opinion, the top diagnoses for juveniles in our contemporary time. As a mental health professional, I know how important it is that absolutely every teacher, school counselor, juvenile court worker, foster parent, social worker and principal be familiar with these mental health designations.

THE TOP 4 JUVENILE MENTAL HEALTH DIAGNOSIS

Here are some of the most common, most unfamiliar and misunderstood juvenile mental health issues that appear to be on the rise, occurring in larger numbers than perhaps ever before. As a non-mental health professional, you can’t diagnose, but you can carry the concern in your mind and make adjustments accordingly. You already do that with other common juvenile mental health diagnoses like ADD, ADHD and depression. However, while those diagnoses are pretty widely understood, and useful, targeted strategies are well documented, the common disorders below are not as well known and are quite frequently misunderstood.

emotional problems1. Conduct Disorder

This is your most misbehaved student. The student is usually male and you can see some or all of the following behaviors, however this list is not complete: manipulation, lying, stealing, damage to people, damage to property,  no relationship capacity, no genuine remorse, no compassion, abusing animals, delinquency, rule violations, defiance, negative leadership, chameleon-like, persuasive, bullies. The hallmark of this disorder is that the child is believed to have no conscience. Without those critical brakes on the youngster’s behavior, this student can appear completely out of control. And he is.

This disorder is believed to occur with roughly 11-14% of the mainstream population. When the child becomes an adult, the disorder’s name is normally shifted to be the adult version of this juvenile diagnosis, switching to a designation such as Anti-Social Disorder. Some passable, but not ideal examples from popular culture: J.R. Ewing from the TV show, Dallas; McCauley Culkin in The Good Son movie; Sid, the boy dismembering toys in the Toy Story movie.

Here is the most important thing to know: Routine, everyday, common intervention strategies –like making amends, for example– fail to rein in this very unmanageable student. That is why in my inservice workshops, teachers and others often underscore that “nothing works” to manage this student. If you believe you are working with a child with this disorder, you must switch to a different style of intervention and avoid or extremely limit relationship-based approaches as not only do these methods fail badly, they usually make the situation worse. In addition, the use of counter-indicated intervention strategies often lead the student to believe that the adult doesn’t have a clue so they can just do whatever they want. This assessment is certain to create and/or worsen safety and behavior management issues.

Learn more about this common juvenile mental health diagnosis.

 

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2. Oppositional Defiant Disorder

Non-mental health professionals often confuse Conduct Disorder with Oppositional Defiant Disorder, abbreviated as ODD. To the lay person, ODD can seem to be very similar to Conduct Disorder.  This youngster does engage in problem acting-out behavior but the frequency, severity and duration of the misconduct is usually less than that seen from a student with Conduct Disorder. The overarching, key difference, however, is that the student with ODD does have a conscience but that conscience doesn’t appear to be having much positive impact. The key with this youngster is to “pull up” that conscience and get it to do its job better. That goal varies dramatically from the goal for working with students with Conduct Disorder. However, both students need to learn step-by-step to use more socially acceptable behavior, temper any rebelliousness and impulsiveness, and avoid leading or following other students into misconduct. Both types of students need firm rules and over-the-top consequences.

It is important to be aware that mental health counselors, social workers and other clinicians are hesitant to apply the diagnosis of Conduct Disorder as it has such grave implications for the child’s future. So often the diagnostician waits until the students’ behavior is so extreme that they feel comfortable and confident that they must apply that diagnosis. In the meantime, they may still be required to offer a diagnosis. Since there is no category of “I’m worried this kid may have Conduct Disorder,” diagnosticians often “park” the child in a catch-all category. The most popular catch-all category: ODD. So, quite often students initially labeled with ODD are really kids with Conduct Disorder who just haven’t acted out enough to “earn” the diagnosis. Sadly, this tendency to “park” youngsters confuses teachers and others who believe the “temporary” diagnosis. So what do you do under these circumstances? Use the methods for Conduct Disorders but don’t completely cut off relationship-based methods. However, use just a little bit of relationship-based methods and watch what happens. If the outcome is often grim, consider reducing the use of that class of intervention strategy dramatically as using relationship-based behavior management strategies with students who are actually Conduct Disordered, tends to fail spectacularly.

3. Thought Disorder

Although this is not a terribly common disorder, it is frequently misunderstood. Affecting about 1% of mainstream students, this disorder means that the student sees things no one else can see, hears voices no one else can hear, or has upsetting thoughts that are profoundly disturbing. An extreme, but good example is John Hinckley, who attempted to kill Ronald Reagan to impress Jodie Foster. Children and teens with thought disorder have trouble discerning what is real and what is only in their brain. The most important intervention is to have a mental health professional assess the child and possibly prescribe medicine that can control the disorder. This child has a conscience but her brain is not working right. This mental health problem is primarily a physiological issue although clearly the child’s behavior and functioning is gravely affected.

4. Bipolar Disorder

Bipolar Disorder used to be called Manic-Depression. That term was really a big help to aid non-mental health staff to remember what this disorder is all about. This disorder has two parts. The child swings rapidly at random intervals from being very depressed to being very excited and overwrought. This child also has a conscience, but they get so “up” when they swing quickly from being depressed to over-excited, that they can impulsively engage in all manner of problem behaviors. As with the child with thought disorder, medicine is the key. This is also a physiologically-based disorder even though it affects every aspect of the students’ life.

 

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professional development classWe've gotten a makeover. Not me. Actually, it's our website that has gotten a pretty dramatic makeover, the first in a very long time.

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Below you can see a picture of our new, improved, better-than-ever professional development resource website. Take a look at our "Before" and "After" glamor shots. Don't worry. Our site is now very beautiful, but still packed with serious answers for all your most serious student behavioral, emotional and motivational problems.
 

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    teachermissYou have students who struggle. We have solutions for students who struggle…so your job doesn’t have to be so difficult. We have cutting-edge strategies to manage group and classroom management problems like behavior disorders, trauma, disrespect, bullying, emotional issues, withdrawal, substance abuse, tardiness, cyberbullying, delinquency, work refusal, defiance, depression, Asperger’s, ADHD and more.

     

    Schedule the Breakthrough Strategies to Teach and Counsel Troubled Workshop to come to your site. This is the one professional development inservice that produces results, results, results. Call 1.800.545.5736 now. This surprisingly affordable inservice also makes a terrific fund raiser. College credit and 10 professional development clock hours are available. Your staff will finally have the more effective, real-world tools they need to work with today’s challenging, difficult youth.

     

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    © Copyright 2019, All Rights Reserved | Permission granted to forward magazine to others.


Children’s Pain Relievers: Your Actions Can Ease or Worsen Children’s Trauma and Tragedy

 

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Essential Children's Pain Relievers: Your Actions Can Ease or Worsen Trauma and Tragedy

 
 

 

early education keynote speakerPresenting our Breakthrough Strategies to Teach and Counsel Troubled Youth Workshop at schools in Katrina-ravaged New Orleans and Waveland, Mississippi in the past few weeks was a real eye-opener. While most of our readers will hopefully never have to cope with the level of trauma that the Gulf Coast area still faces, you still will encounter your share of youngsters coping with death, divorce, loss, abuse, and other tragedy. It is critical that you know as much as you can about working with these students as even little mistakes can be quite damaging to youngsters who are struggling.

I'm Ruth Herman Wells, M.S. I write books and give workshops on how to help children and teens to cope with crisis and trauma. I want to share with you some of my best ideas that can help children and adolescents to weather serious emotional turmoil.

We were totally shocked to see that schools throughout the Katrina region are still in pieces. We want to be of service to those of you who are teaching and counseling in tiny trailers or buildings that are still falling down. Whether you work with many traumatized children like professionals on the Gulf Coast, or you encounter them in much smaller numbers, you need to know all you can about helping these fragile youngsters. Here are some of the most important questions posed in our recent Gulf Coast workshops:
 

Helping Children and Teens in Times of Trauma

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Q: Can traumatized students become ADD?

A: No, trauma can't cause ADD, but trauma can cause symptoms that are similar to some of the symptoms of ADD. So, traumatized students can be distracted, unable to maintain focus, have trouble completing tasks, lose their train of thought, and have little enthusiasm for school. Think back to the last crisis you faced– a car accident, for example. You showed the same symptoms until the crisis ebbed. The symptoms are all normal reactions that can persist.

What To Do: During your crisis, no one could have "forced" you to function better. The same guideline is true for youngsters in crisis. Like you, they are doing the best they can. Since being in pain is no fun, most of us stop feeling bad as quickly as we can. Your students' symptoms should lessen as the crisis lessens, but for on-going crises, expect the symptoms to persist.

For Gulf Coast students still living in trailers, or for youngsters caught in an on-going battle between divorcing parents, the crisis continues– and so do the symptoms. Your expectations should rise and fall with the child's level of functioning. When a child is particularly dissipated, reduce your expectations. On days, the child is more functional, increase expectations. Your goal for distressed children: Work as hard as you can on days that you're able. Is it fair to ask more than that of any distressed human being?

Q: I thought that people are supposed to start "getting over it" one year after major trauma like a death, hurricane or divorce. Is that true?

A: The "One Year Rule" developed because the thinking is that one year after a death, for example, you've made it through all the birthdays, holidays and other painful dates that you will face after your tragedy or loss. That is a major reason why one year is viewed as a marker to gauge the pace of recovery. However, the year starts when the crisis stops. If the crisis persists then the clock really doesn't start ticking toward one year.

What To Do: You probably have no power to hasten the end of the crisis, but that is what the distressed child really needs. Until then, you proceed as described above, expecting students to work as hard as they can on days they are able. In addition, teach students that the One Year Rule is just a guide. Teach them that just as the time needed for a physical wound to heal will vary from person to person, teach them that human beings don't all heal emotionally at one single pace. Conveying this information can alleviate children's guilt over continuing to feel bad after they are "supposed to."

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children in crisisQ: Do I let children in pain use problem behaviors without consequencing them?

A: Each distressed youngster manages their distress differently. Two children can face the exact same trauma, but manage their distress utterly differently. One child may become verbally abusive while another may become almost mute. There is no "right way" for youngsters to manage pain. Even though a child faces difficulty, you can not lower your standards for acting in socially acceptable ways. Courts and police won't accept that excuse so neither can you. You also can not just suspend all customary consequences for misconduct, because the real world won't react that way. Plus, if there are no consequences for misbehavior, then there is no impetus to ever stop misbehaving.

What To Do: You can take extenuating circumstances into account as you mete out consequences. Try to strike the balance between maintaining expectations for conduct, and being sensitive to the difficult circumstances that the child is facing. Remember: "An abnormal reaction to an abnormal situation is normal behavior." That quote is from Viktor Frankl, a concentration camp survivor. For children who struggle with very grave crises, such as the on-going homelessness of Katrina survivors, there is no "correct" way to react.

While socially inappropriate behaviors can't be tolerated, children in crisis do the best they can. There will never be a "normal" way to react to a year of living in a cramped FEMA trailer. There will never be a "normal" way to react to feeling like a human ping pong ball in divorcing parents' brutal battle. While there may not be a "normal" way to react to overwhelming pain, the pain can't become a license to hurt others or grossly misbehave. Teach your students: "It's okay to be mad. It's not okay to be mean."

Q: Do I have many distressed students?

A: Pain is not always obvious, but here are some guesses on how much pain exists: About 15% of children cope with substance abuse in the home; 10% cope with severe emotional disturbance; 15% live with verbal abuse, beatings, or emotional abuse. A staggering 20% or more live with sexual abuse or incest. Some youngsters face pain in more than one of these areas. Kids seldom announce their distress, but it often drives their behavior. The more you can understand their behavior, the more readily you can manage it.

What To Do: Even though today's teacher works with many traumatized and acting-out students, traditional teacher training typically does not include much course work on the topic. Most teachers need to get this training that their college preparation omitted. If you want more in-depth suggestions on traumatized youth, look at the column on the right side of this page for more educational articles on working with traumatized children and teens.

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    teachermissYou have students who struggle. We have solutions for students who struggle…so your job doesn’t have to be so difficult. We have cutting-edge strategies to manage group and classroom management problems like behavior disorders, trauma, disrespect, bullying, emotional issues, withdrawal, substance abuse, tardiness, cyberbullying, delinquency, work refusal, defiance, depression, Asperger’s, ADHD and more.

     

    Schedule the Breakthrough Strategies to Teach and Counsel Troubled Workshop to come to your site. This is the one professional development inservice that produces results, results, results. Call 1.800.545.5736 now. This surprisingly affordable inservice also makes a terrific fund raiser. College credit and 10 professional development clock hours are available. Your staff will finally have the more effective, real-world tools they need to work with today’s challenging, difficult youth.

     

    Contact us now, and begin solving your worst “kid problems” today. Call 1.800.545.5736, or email.

     

    Working with Troubled Students Doesn’t Have to be So Difficult
     


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    Library of Congress ISSN: 1526-9981 | Youth Change, Your Problem-Kid Problem-Solver
    http://www.youthchg.com | 1.503.982.4220 | 275 N. 3rd St; Woodburn, OR 97071
    © Copyright 2019, All Rights Reserved | Permission granted to forward magazine to others.