One of the most frustrating things about the mental health landscape as it currently stands is that insurance companies will only reimburse for the standard 50-minute therapy session. Many families drag their sons to therapy for them to sit there for an hour shrugging their shoulders while they play Monopoly with their therapists. The truth is that many boys are just not accustomed to sitting in a room across from an adult in a 1:1 setting and talking about emotions. Unfortunately, many boys drop out of therapy and families end up “going it on their own.”
Now let me be clear, for many boys (such as those suffering from anxiety or depressive disorder) individual therapy has been proven to be effective and helpful. However, many families seek mental health assistance for problems such a disruptive behavior in school, problems with following rules at home, risky behavior, or problems with friends – problems that may not be best addressed via individual therapy. Indeed, It can be unrealistic to assume that what takes place in one session a week will be generalized to the problems going on in the “real world.” What often has a greater impact is the psychologist acting as a consultant to the boy and family and coming up with a targeted plan to address the behavior that involves frequent follow-up by phone and e-mail as well as substantive advocacy with the school. While the HMO’s may not agree, it has been my experience that many boys and young men can be helped by thinking outside the box of the 50-minute session. Please check back in to the blog as I plan to write more about what these services can look like and how we can make them both effective and affordable for families.
I am heading out to beautiful Ludlow Vermont on Friday to give a talk on trauma and learning. The talk has me thinking about the needs of this population as we approach the start of school. One thing to remember boys will often to be reluctant to talk about their experiences so you need to pay attention to their behavior. Here are a few tips for teachers and student support staff for working with boys who have experienced chronic trauma:
- Boys who experience trauma are more likely to have a short fuse, to be reactive and will benefit from support around how to recognize the triggers that activate them and the physiological cues that signal they are about to have a meltdown
- When a boy is in a meltdown, help him leave the situation and decompress before you process the situation; processing will not occur in the middle of a meltdown
- Try to minimize transitions and maintain consistent schedules and routines
- Boys who experiences trauma are often hypervigilant so a seemingly innocuous gesture or statement may be taken as a threat
- Collaborate, collaborate, collaborate as much as possible with service agencies, families and community supports. Treatment is only effective when all of the supports in a young person’s life are working together and on the same page.
That’s all for now, have a great last week of summer! JB
Its that time of year: the temperatures are still high but change is in the air. Days are getting shorter and the leaves will soon change and that means back to school for kids and teens across the country. While back to school time can be exciting it can also be stressful. If your son is prone to school anxiety it is worthwhile to take some time to talk to him about about his thoughts and feelings about the school year. Since boys often aren’t exactly thrilled to talk about their feelings it is helpful to have this talk while performing an enjoyable activity (e.g., shooting hoops, throwing a ball, drawing, playing a video game, etc.). Possible sources of anxiety to ask about include:
- conflict with friends or peers form last year that may have abated over the summer
- fear of new teachers or increases in workload
- dating concerns
- fear of new classroom, social groups, or school setting
- concern about performance in athletics
It is important to remind your son that he take the transition to school one step at a time and that the fear of the unknown is usually worse than whatever he will face at school. Also, provide support and comfort that you will be there for him no matter what comes up this year and together you can manage it. Finally, make the last week of summer fun! Go fishing, go for a walk or run, take one last trip to the beach, have an ice cream cone, watch a baseball game, or just hang out together but take advantage of this time before schedules get hectic in September.
Welcome and thanks for reading. I will be blogging about issues relevant to the mental health of boys and teens. I am a psychologist from Cambridge, MA who specializes in treating hard-to-reach boys and teens. Boys who act out can be a true challenge for parents, teachers and other professionals. Unfortunately, many boys are resistant to seeking help for behavioral or mental health problems because they worry it will mean they are weird or different. My goal is to help make mental health treatment more relevant and helpful for boys and teens as well as to help parents and teachers respond to boys and teens in trouble.
I talk about the different types of cyberbullying, warning signs of cyberbullying, as well as ways that parents can respond to cyberbullying.
