Violence in your Community: Difficult Conversations with Your Kids

The last few weeks have seen a number of tragedies unfold that has brought many issues to the fore for me; as a second generation Asian American, a person who works and resides in Boulder, a child psychologist, and a parent, these events have touched upon issues unique to each of these roles. Although I’ve spent more than decade getting in-depth training on how to talk to youth about all sorts of awkward and difficult topics, conversations about well being and threat to safety are hard, no matter how many years of practice you’ve gained.

Drawn from my work experience and training, here are a few pointers about how to talk to your kids about violence in your community:

  1. Invite your children to have a conversation. For younger kids, this can be as simple as, “Hey, something sad happened this week in our town. Can we talk about it?” For teens, I guarantee you, they already know what happened, and some of them, already overwhelmed by COVID and isolation, may not want to get into it. In that case, set a date in the future (e.g., a week away) to follow up or leave an open invitation for them to talk to you about it when/if they are ready. If they do not want to talk about it, do not press or push them to discuss immediately.

  2. Provide general and a parsimonious amount of details, and allow them to inquire as needed. For kids who are younger or did not know what transpired, start with less information, but a general enough description of what happened, and then let them ask questions.

  3. Describe details at a developmentally appropriate level. For younger children, provide age-appropriate information, but leave out details that are too specific or mature for them to understand. I also encourage parents not to use vague terms like “bad people” or “bad guys,” as that is a blanket nebulous term that can be scary for younger kids. In this case, with elementary school aged kids, it’s ok to share that there are some things we don’t know, and be appropriate with what we do know, such as “The person who did this may have been having some tough times with their thoughts or feelings.” As always, if you don’t know, it’s better to say that than to fill in information.

  4. Discuss at an appropriate time. A lot of kids will need time to process what happened, so conversations right before bed might not be best, as it will lead them to ruminate. I recommend a weekend morning when you will be accessible to your child for the rest of the day so that they can ask you questions as needed.

  5. Validate emotions, and share yours. Younger kids may not be able to name their emotions over this, so it’s ok to help them identify it and share yours if it matches their’s. Obviously, you want to do this an age appropriate way - sharing that you are sad and upset too is ok, but spare any details about the intensity, depth or degree of these feelings, and definitely get support if you or your child are finding yourselves overwhelmed, consistently preoccupied, and low in mood over these events.

  6. State the facts. I am a firm believer in telling our children the truth in age-appropriate ways, as our long term goal as parents is to prepare them for independence and the real world. For younger children, we can acknowledge that these scary events happen, and at the same time, that there is safety in our neighborhood, home, etc. Don’t make promises that you can’t keep, such as being able to keep them safe forever, and don’t provide reassurances that are not realistic.

  7. Encouraging coping and healing behaviors. Some kids want to do something upon hearing about these events, and I encourage parents to support these efforts. Whether this is donating, fundraising, visiting the memorials, writing cards, etc. It is important that kids have a sense of self-efficacy in being able to cope and respond in some way. If your child is unable to come up with any, provide options (e.g., writing letters, donating some money from their piggy bank, etc.) and let them choose.

  8. Take breaks. These types of conversations can happen over the long term, and don’t need to be completed in one go. Let your kids know that it’s ok to raise these issues anytime if needed or schedule a time to continue the conversation if it’s too much. On the other hand, if you are finding that your child seems to be having difficulty talking about anything other than these events, trouble sleeping, and seems stuck on details, questions, what ifs, please get some professional support.

  9. Deal with one issue at a time. Events like these often involve complicated issues, and you may find that when your kids ask questions, some of these questions could lead you in a total other direction or need to be addressed by a whole other conversation. Should these questions arise, it’s ok if you need to curtail the discussion, and you can do this by gentling commenting on your child’s concern (e.g., “X seems to be something that’s bothering you”), or ask them gently what they are thinking or worried about in asking that question (e.g., “I see you are wondering if Y. Can you tell me a little more about what you are thinking?”). If it’s too much to discuss in one go, validate their desire to understand and make plans to talk about it later: “I hear you are really concerned about this issue. I think it’s important for us to talk about but I’d like to do that <whenever>. Is that ok with you? I want you to know that it’s super important to me that you are thinking about this and I want to revisit it.” You may even want to write down some of the questions in a notebook so that your child knows that it’s on your mind and something that will get addressed.

  10. Self-care. Parents process their own feelings while trying to also contain and process their children’s. Be sure to take breaks from media and news, and self-care when possible. Make sure you find your own ways of coping and grieving, and it’s ok to let your kids know that you are working through these as well.




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Managing your kid's technology use during COVID-19

A lot of parents having been asking me lately how to manage technology use during quarantine. After all, many kids are not attending school in person and consequently cell phones and computers have become their primary means of connecting with peers. Even more concerning to parents is that, for some kids, “connecting” means playing games with their friends (right now, Among Us is super popular), as kids can chat with each other and collaborate on teams during these games, instead of face to face chatting.

This means though, that parents have kids who are often online for at least 6 or more hours every day during the week. They are online for school, and then several hours more during evenings and weekends for social interaction. Parents who try to restrict cell phone usage report that their kids are resentful and angry, as they feel isolated from their peers. How should one best balance the need to reduce tech usage with their child’s need for social interaction?

While the exact rules of tech usage limits varies from family to family, here are my general thoughts:

  1. First, talk to kids about tech usage and safety. Engage child in conversation about what behaviors they think might not be safe, as well as why they think using too much tech can backfire. I often find that kids admit that too much screen time leaves them feeling irritable or tired when invited, but argue against this when told why less tech is necessary. In general, any time you invite your child to generate reasons or points in a conversation, it tends to go better.

  2. Clearly outline what is allowed and not allowed in terms of tech usage. Some parents are not ok with Snapchat, while others don’t allow games like Among Us. I encourage parents to set their rules around their comfort, but to have clear discussions with their kids about what apps are allowed, and what are not. I invite parents to create their own account and add their children in order to test out what the apps are like, and to have a better idea of each app’s purpose.

  3. Relax limits during social distancing/remote learning, particularly if the child is completing school work/household chores and is still engaging in other interests/activities. While COVID-19 has many parents understandably worried about learning and academics, in my practice, I’ve been more focused on children’s social emotional wellbeing. Kids are not used to being isolated from one another, nor are they meant to be learning through screens. I worry about what the lack of social engagement does, so I have been advocating for kids to have more tech liberties than usual, particularly for families who are observing very strict social distancing measures. That being said, I think that this relaxation of limits needs to be balanced against parents still maintaining basic expectations; if child is meeting parents’ expectations for the day (i.e., this varies from family to family but may include turning in all assignments, getting exercise, completing chores, etc.), I would be in favor of more screen time. Just as long as the additional screen time is not having negative ramifications on their activities of daily living, I think children can benefit from more peer contact. A big red flag for me is when children forgo all other interests in pursuit of tech usage, or start lying for more screen time.

  4. If possible, encourage other forms of (safe) social engagement. Some families have been open to podding, or having outdoor masked playdates. Others have set up online “reading” dates for their kids.

  5. Invite kids to generate solutions on how their tech usage can be better managed and balanced. Parents often hate this suggestion because they feel that their children will come up with unbalanced solutions. In some cases, yes. But sometimes they’ll offer up something totally reasonable, or if not, at least you are making them feel more engaged in the resolution process, as opposed to handing down a rule. I find this to be particularly salient as kids get older; they want to feel that they have some say. An immediate “No” is one sure way to frustrate and complicate communication with your teen.

  6. Finally, establish that tech usage is a privilege, not a right. I often seen kids assume that a cell phone being purchased by their parents is theirs, and this often results in a lot of difficulty limit setting with the kids. I encourage parents to try to find ways to establish early on that cell phones are a form of freedom and responsibility, and that necessitates wise and careful usage.

  7. Have a family tech-free time everyday. Some parents declare this to be bedtime hours, or declare no tech in bedrooms after a certain hour. Some parents have a moratorium on tech during the dinner hours. I think that an imposed break can be helpful not only for kids but their parents as well! Research has shown that getting a text message activates the same neural networks as winning at the slot machines - it’s so easy to get addicted and highly reinforced to check our phones. If we want our kids to take a break from tech, shouldn’t parents/adults be the ones to model what this looks like?




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Surviving COVID-19 School Shut Downs

Now that the coronavirus is here and it’s impacting daily life (many of us living in areas where school has been shut down for at least several weeks, with possibly more on the horizon depending on how the situation unfolds), I thought it would be helpful to post some links/tips about how to make it through:

  • Neuropsychology and Education Services for Children and Adolescents (NESCA) posted this helpful article. It’s filled with a lot of common sense ideas of steps to implement to help everyone.

  • One of NESCA’s suggestions, for example, is setting up a schedule. It helps kids to know what to expect, and parents to have some sense of routine and organization. Jessica McHale Photography provides an excellent example of one here. The blocks in this schedule are longer and hence more appropriate for older-aged children (late elementary school at least and up— can you imagine an hour long walk with a toddler??). For younger kids, I recommend breaking the blocks into smaller chunks.

  • Pinterest. Pinterest is a gold mine for arts and crafts activities, games, and creative play.

  • Be gentle to yourself and those around you. Positive self-talk can be really helpful during stressful situations. This is an exceptional situation that is taxing for everyone. Your kids may be overwhelmed and acting out, and it’s ok if you feel overwhelmed too.

  • Make allowances. I’ve been hearing about GoNoodle (available on Youtube and through their own app) for a while now. Some of the kids I work with mention that they use them during the school day to take indoor “body breaks.” While I prefer for littles to get out and about, it’s simply not possible in Boulder right now (it was snowing last night and it’s still pretty cold right now) so the next best thing? - GoNoodle’s Milkshake Video. It’s not everyday that you find me dancing to a hot dog but it actually ended up being fun!

  • Online museum tours. If not for the kids, for your sanity as a parent!

  • Online Metropolitan Opera Performances. Same as the one above. Cheers to you if you have a kid who loves Puccini. If not, you need some Puccini.

  • Online educational resources. Educational publisher Scholastic is offering all of their online resources for free as are many other sources, as detailed here. For parents who are concerned about tech usage, know that many schools intentionally have kids using tablets as early as kinergarten in order to familiarize them with how to use devices. I’m a big fan of Khan Academy and Sago Mini games (in small doses) for fine motor control.

  • Virtual field trips

  • Downloadable coloring books

  • Mo Willem’s online daily doodle!




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How to Talk to Kids who are Worried about the Coronavirus

Over the last week, I’ve seen an increase in kids (and adults!!) who are worrying about coronavirus. The concerns about the coronavirus aren’t so different from other (what I call) “existential” worries - gun violence, global warming, politics. Kids know just enough of what’s going on to know that there is a real danger without the actual ability to mitigate that danger fully. So, I have parents asking me, “What do I tell X about corona? He’s afraid to go out.”

I was just about to post an article on my thoughts, when I discovered an excellent article from Seattle Children’s Hospital (incidentally also where I completed my residency and fellowship) about what to do. This article focuses on the coronavirus specifically, but I think the approach of gathering facts, answering questions (without reassuring or making impossible promises), and assuming normal daily life is pretty much spot on:

Link to article here




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What's "Phubbing" and Do You Do It?

I came across a new term today: “Phubbing.”

Phubbing is the act of snubbing your child in favor of your phone. Cell phones are meant to be reinforcing and addictive; studies have shown that those seemingly innocent notifications that we get on our cell phones wreak physiological havoc on our brains in exactly the same way that slot machines do (Olson and colleagues, 2018). Because notifications happen so randomly, users get a burst of joy when they do receive one, which in turn encourages more usage and checking in search of that same feeling of happiness. It’s no wonder that cell phone addiction is a real thing, and over-usage has been correlated with mood difficulties (Elhai and colleagues, 2017). One study even found that college students find phones more reinforcing than food (O’Donnell and Epstein, 2019). That’s kind of mind boggling to think about- a basic human need central to human survival has now been trumped by a piece of plastic that wasn’t widespread until about 15 years ago.

So in addition to overuse being bad for the user, new research has now found that using your cell phone to the exclusion of your children can have long-term detrimental effects. Research already established that cell phone usage can cause kids to act out while they are being ignored, but now we know that children suffer the effects of being technologically “phubbed” for the longer term.

So what is a(n addicted) parent to do?

  1. Have everyone in the family put phones away in a communal basket during family times (meals, movie night, etc.). If kids can follow the rule of no tech, so can parents.

  2. Turn off WiFi during “tech-free” times throughout the day.

  3. Realize that initially, breaking the cycle of checking will be difficult. As with any behavior, it helps to replace your habit to check your phone with another positive and enjoyable behavior. Set measurable goals (a certain number of checks per hour), and slowly reduce the number of hourly checks until you reach your goal. Be sure to reward yourself (or your child) for weaning off your cell phone!

  4. Install an application that locks you out for a certain period of time

  5. Turn off notifications




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The Not-so-Harmless YouTube videos your kids are watching

I was in a session about a year ago when a mother asked me if I had heard of the “latest thing that all the kids these days are watching on YouTube.” I’ve heard of some weird stuff, but what she was telling me about did sound pretty odd - the latest craze she was referring to? Kids watching other kids (or adults) open up toys in boxes and packaging.

For. Hours. On. End.

While such videos seemed pointless to me, I kept an open mind and watched a few. After 10 minutes, I started to understand the obsession. The presenters are incredibly enthusiastic (there is SO MUCH COO’ing), and there’s something really satisfying about watching people open up packages (in a lot of these videos, the package opening happens in a really careful and systematic way). Plus, these videos are a bit like window shopping - you get to see everything all shiny and new and it all looks so tempting and attractive.

Well, a recent study out of my alma mater, CU Boulder, suggests that these videos, unsurprisingly, are not good for your kids. These videos are, after all, a clear reminder of the haves and the haves not:

https://www.colorado.edu/today/2019/12/03/unboxing-videos-fueling-kids-tantrums-breeding-consumerism

I’ve also heard some parents say they have found some toy opening videos that initially seem innocuous but then cut halfway through to really disturbing/frightening content. I have no idea why people would want to do that, but it’s all the more reason to monitor what your kids are watching, however innocent it may seem.




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Another parenting principle: It's not just what you say that matters, but HOW you say it.

When providing parent coaching, I often find that many parents already know what to say when their children are upset or distressed. Many of them provide thoughtful emotion coaching (i.e., helping their child identify the emotion they feel or giving words to what their child is feeling), and many also express appropriate empathy (i.e., "You must be so upset about that - I’m so sorry you’re sad!”). Some praise when they see their children respond to difficult emotions in a positive and effective manner (this makes me especially happy to see!).

While I definitely focus on the content of a message, I also spend a lot of time helping parents evaluate how they talk to their children. When I say how, I mean specifically the tone, feel, and emotional delivery of what they are saying.

It’s important, especially for little ones, that the intensity of or emotion in your voice matches what they are feeling. Can you imagine if you were seriously upset about something and were talking to a friend about it who responded in a totally flat and blase voice “Oh, I’m so sorry. That’s so terrible.” The content would be totally spot on, but the emotional intensity and meaning behind it would leave you feeling totally unsatisfied, if not dismissed. It’s the same for children - when they are upset, it’s important that you match their intensity and tenor, as this helps them feel heard and validated.

It can be difficult doing this when your child is upset about something that feels unreasonable (some parents tell me they feel like their kids’ requests are outright insane). I’m not asking you to agree to their demands, I’m asking you to acknowledge and agree to how upset or distressed they are when they don’t get what they want. Validating their emotions doesn’t mean you have to agree to what they want. This can be hard for parents, as many have asked, “Well, if I say that it’s okay for her to feel upset, doesn’t that mean I need to give into what she wants?”

Not necessarily. As adults, we often encounter disappointments. The important thing isn’t that we can always change circumstances to be in our favor, it’s that we learn to deal with feelings of sadness, disappointment, anger, etc. that arise as a result of these trials and tribulations. By holding the line and validating our children’s emotions, we are starting to teach the early lessons of facing the realities of life while being able to manage difficult emotions.

I’ve run into the effects of incongruence between message and delivery with kids who tell me that their parents don’t “get” that they are sad, anxious, or upset despite the fact that the parents saying all the right things. Sometimes it’s just a matter of parents tweaking how they speak to their kids - lowering their pitch, softening their tone, slowing their speech, adding a bit of sadness - for kids to really feel heard and understood.

I recently came across a research study by Weinstein and colleagues (2019) in the journal Developmental Psychology, titled Listen to your mother: Motivating tones of voice predict adolescents’ reactions to mothers. As I discussed above, tone matters early in childhood when validating and emotion coaching, but it also continues to matter in adolescence, and in positive interactions. In this study, mothers of teens provided motivational instructions (e.g., “Do well in the play) in a variety of tones - supportive, neutral, and controlling. Unsurprisingly, the teens who had mothers provide the instructions in a supportive voice tended to report having more positive emotions, more closeness with their mothers, and were also more engaged than the teens whose mothers used a controlling voice.

Taken together, this study (and many before it) tells us that it’s not just how parents talk when dealing with difficult situations that matters, but also how they express provide encouragement and support that matters. Parents sometimes ask me how they will know they get it right - I ask them to practice with me in session (role playing helps A LOT!), and to practice with each other and give each other feedback. I’ve had parents come back to tell me that it not only helps how they relate to their kids, but how they relate to each other - that doesn’t surprise me. At the core, all people, children and adults alike, want to feel like our emotions are reasonable, acceptable, and understandable. Having that message delivered in a way that resonates goes a long way to help achieve that.




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Teens and Suicide

During my residency and post-doctoral fellowship, a significant part of my training involved treating suicidal teens and kids. Like many mental illnesses, suicidality does not discriminate -I treated patients from all ethnicities, socioeconomic backgrounds, and genders and some who were elementary school-aged. The scariest part for me was that there was nothing consistent across all of those cases that could have predicted who, when, or why, or how. The article below resonated with me and is a thoughtful discussion of what suicidality looks like in youth today:

Article: I treat teens who attempted suicide. Here’s what they told me.




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Why Child Therapy Often Involves Parent Therapy

Today, I’m writing about a question I get asked very often in my practice. I’ve invited my friend and colleague, Dr. Craig Springer, PhD, to join me in writing this article. Dr. Craig is a brilliant psychologist who worked for years in academia before establishing a flourishing child, adolescent, and adult practice, the Good Life Center for Mental Health (https://goodlifecenternj.com/), in Cranford, New Jersey. We met years ago through a good friend, and now here we are, both in private practice. I was talking to Dr. Craig the other day when I mentioned that parents often ask me why they need to be involved in their children’s therapy. In response, Dr. Craig shared that parents often expect to drop their children off and do not know why they need to be involved in treatment.

While I appreciate that parents want to give their children space and confidentiality, I think it’s important to discuss just why child therapy necessitates parent involvement.

First – Particularly with respect to younger children, it’s incredibly hard for children to change their thoughts and behaviors on their own. There are entire therapies that focus on changing how adults behave and think, and even those can take a while to implement. Young children have limited insight into their thoughts and feelings, and even more than that, their brains are still developing. How many of us have tried to ask children post-tantrum why they were angry, only to receive an incomprehensible answer. While parents find this frustrating to no end, many children truly don’t understand the cause and effect that lead them to be angry.

So, given how hard it is for adults to change unhelpful patterns and thoughts, one can imagine that it’s necessarily even harder for little kids to simply stop their behaviors and change. Teens might have more insight and talk like they know what they are doing, but countless studies have established that the teenage brain is still in a state of development (see Arain and colleagues, 2013, Casey and Caudle, 2013) across many domains – complex reasoning, self-control, and emotional maturity. Given the still maturing brain, it’s developmentally unreasonable for us to expect kids to just learn to change on their own.

Second – Without a question, parents have the most significant impact on their children. Parents are often the main attachment figure (because of this, most children are really motivated to please their parents), have had the most time with their children across different settings and environments, and know their children’s’ strengths and weaknesses the best. Therapists often only have 1 hour a week with a child. Although we can teach and practice skills and tools, parents must be the ones to help them generalize those behaviors and can also set up an environment filled with rewards and consequences for reinforcing effective behaviors. If, in my work with parents, I can teach them the skills and tools to set up a positive environment and model more adaptive behaviors, this change will inevitably trickle down to their children (research also supports the importance of parent involvement, beyond just facilitating how kids make it to/from therapy – Haine-Schlagel & Walsh, 2016).

Third – A supervisor of mine once said that I cannot change children’s behavior without changing the family system. What he meant by that is that every person in a family plays a specific role and that an individual’s role cannot change if the family doesn’t change how it operates. The troublemaker child, for example, has no room or impetus to change her devious ways if the family continues to treat her like a truant. If the parents change how they operate, however, the family dynamic will shift, thereby giving each individual space to behave differently and try new ways of interacting. This significant of a shit can only be achieved through working with the parents.

Finally, change requires safety, trust and understanding. Children use their behaviors to express their thoughts and feelings and to have their needs met. Over time, they establish patterns of behavior to navigate their world and protect themselves from vulnerabilities, insecurities, or to cope with challenges. Trying to utilize a different way of interacting requires incredible amounts of courage. Parents, through their understanding, support, and reassurance can provide children with the necessary characteristics for change to take place.




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Where did you learn that??!

While I’m a child and adolescent psychologist, I also spend a lot of time working with parents. This is because it’s hard for young kids to change their thoughts and behaviors on their own. Instead, parents have to be the one to set the environment to help kids do that. During our work together, parents often tell me that they want to change how they parent, but that it also feels overwhelming because there is so much to keep track of! There’s no doubt - it is a lot! Parenting is a full time job and studies show that parents today are busier and taking on more responsibilities than parents of the previous generations. We are more engaged in play and activities and working longer hours, all while we are less likely to live in communities where we have family members to help and support us.

When working with parents, I try to simplify all the steps they are taking into big picture principles. One of the most important ones is the Principle of Modeling. A lot of the smaller changes I try to implement can fall under the category of Modeling, which basically means to show your child how to behave in a way that you’d like them to behave. In other words, model for them the behavior you’d like them to learn and repeat.

This Principle can apply across many domains or problems. For example,

If you have an anxious child, you can show them how you too may have fears, but that instead of avoiding them, you face them and are working on tolerating your anxiety.

When you are angry, you can model taking a break or deep breaths instead of yelling or hitting.

If you tend to eat the same foods, that you try tasting different cuisines or flavors.

If want your child to use the cell phone less, make sure that you put the phone away during family time (e.g., meal times, movie night, etc). Put away your own phone while driving and in the evening hours. This can be an especially helpful way for parents to model ways of reducing cell phone consumption, without explicitly telling them what to do (which can be a huge source of discord between parents and kids). It also avoids the classic “Well, YOU DO IT” argument.

When you are hurt or sad, you practice talking about your feelings, instead of withdrawing or stonewalling.

Now, the catch of the Principle of Modeling is that it can also applies to less desirable behaviors.

Take a study recently published in the Journal of Experimental Child Psychology by Setoh and colleagues (https://www.sciencedirect.com/science/article/abs/pii/S002209651830540X). This study found that parents who were lied to by their parents, even if the intent was innocuous (e.g., if you swallow bubblegum, your belly will explode from the gum and you will turn pink) tended to lie more themselves as adults. Now, this is pretty scary stuff - parents tell little fibs all the time, sometimes because it’s just an easier way to get maximal impact (and cooperation), but also sometimes because it’s hard to tell our kids the truth (think the birds and the bees conversation). The point of this article isn’t to say that avoiding an honest answer here or there will cause ruination in our kids. I think of it more as a gentle nudge to remind parents to think big picture - what behavior am I modeling here, what is my kid learning from me, and what behaviors do I want them to learn?

As for how to answer tricky questions, I will get to that next time. But for now, the idea isn’t for parents to be perfect models. Mistakes will be made, guaranteed. Just sometimes though, if your kid is acting in a way you don’t approve of or like, take a pause and honestly examine- just where did they learn that behavior from? And what could I model differently for them?




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