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Hello and welcome to the questions and answers edition of Thriving Kids, a podcast from the Child Mind Institute, a nonprofit dedicated to transforming the lives of children with mental health and learning disorders. I'm Dr. Dave Anderson, clinical psychologist and your host. Last week, we had a very special conversation with Dr. Alfie about youth, mental health, community care, and what it really means to help young people thrive. Dr. Alfie shared insights from the ACOMA Project's research on young people's mental health, how this is affecting youth today, and especially how this is affecting young people from marginalized communities. The conversation sparked a lot of questions from our community about how parents can talk with kids about mental health, how to reduce stigma at home, how to support young people who turn to social media for connection, and how families can model what it looks like to take mental health seriously. Let's get into it. So our first question on this Thriving Kids podcast Q and A episode is, as a parent, how do I talk to my child about their mental health without making it feel like something is wrong with them? This is a question we get a lot from kids who present for the first time in therapy because it's a phenomenon we call the identified patient. It's that, you know, nobody wants to be that person within their family where for some reason, and, you know, this happens a lot with kids where they'll say, look, my parents fight all the time. My sister is kind of mean to me, but yet I'm the one who has to come in and talk about my problems. And so we want to be sensitive to that. And a lot of times what I'll say to parents is that if we're gonna talk to kids about mental health, why don't we put in the context of all kinds of different strengths and growth areas that we have as people? So I'll say to any kid, like, look, I have some things that come to me easily. I have some things that I'm working on, and then I have some things that I really struggle with. And so it might be that I. And I can highlight this even in my own mental health. I might say, like, look, as a kid, I always felt like I loved sports, and that that came easy to me. Like, if there was any new sport to be learned, I could learn that sport, start kind of playing it. If it was Wiffle ball or tennis or Gaga or dodgeball or something, I could kind of pick up the rules and start playing a sport. Whereas when it came to, like, things that were more musical or especially art, like drawing and stuff, that was always something that came really, it was really hard for me, and, like, I needed to practice a lot to be able to do it, even at the level of, like, what my art teacher might think as I was doing my first, you know, push pot that I would make out of clay, or trying to do a drawing of a still life. And then there are other things I struggle with, just with my feelings or with how I felt stress. And I might talk to a kid about how I felt really anxious as a kid, especially in new situations or with people I didn't know well, you know, any number of things that I might talk about related to my feelings. And I might say to a kid, so what are some things that, like, come easily? You. What are things that you struggle with? And if a kid doesn't volunteer information about what they're struggling with, then what I might give them is a sort of developmentally appropriate packaging of some of the things that we think about in youth mental health that help us to figure out if they might be struggling with a mental health or learning disorder. So I might say to a kid, you know, do you ever get particularly nervous about any particular thing or for school or for meeting new people? And I might ask about a few different categories of anxiety. Or I might ask, do you ever get really sad or feel like, you know, you can't stop getting really frustrated or mad at certain things? And that can be a hallmark of childhood depression, or with depression, I might add, like how a kid's sleep is or how much they're enjoying their activities or how they feel about themselves. If a kid might be having difficulty with adhd, I might ask if they have difficulty focusing in class or if they have trouble following directions, or if people always seem to be telling them to slow down or stop moving or something like that. If it's a kid who struggles with learning, I might say, do you ever have real difficulty with, like, one kind of assignment, like math or writing or reading, you know, over anything else that you might do in school? If I worry that a kid has suffered from a traumatic event or might still be suffering the effects from it, I might ask if anything really scary or disturbing or any number of things where I could ask about those things. I could ask about natural disasters. I could ask about a time when someone might have made them feel like they were gonna hurt their body. All kinds of different questions where we're not necessarily naming the particular mental health, but we're the mental health disorder. But we're saying, look, a lot of times kids struggle with this, and we're really normalizing it the entire time. We're saying that there is, you know, some percentage of kids who struggle with each of these things. You know, for example, with ADHD, you might say, like, 1 in 10 kids we expect might be struggling to focus in class or, you know, regulate moving their body or not blurt things out or follow directions. And we just kind of ask a kid if symptoms are consistent with their experience. And once we hear that maybe a kid might be struggling with mental health, what we want to do is we want to say that these things are. We're not necessarily saying it in this language to young kids, but we're trying to convey these principles, that these things are real, they're common, and they're treatable, that we can work on this together. And just like you'd practice basketball and your jump shot might get better the more that you practice basketball, the more that we practice these skills for our emotional. Our mental health, the more our mental health gets better, or we might feel less stressed. And that's what we can kind of frame for kids as the hope in this work. And again, none of that has to come with a diagnostic label. A lot of times we're looking for those diagnostic labels as we get older, when kids want a little bit more of an explanation for their symptoms. Especially for young kids, we can just kind of talk about what's happening for them behaviorally, and it's the adults who can use that label to help understand what it is we're dealing with and what it is we're supporting the kid around. Our second question, what should parents do when their child is stressed by politics, current events, or things they're seeing in the news? We're getting this question a lot, especially because we're taping this podcast episode at a time when there are major conflicts going on across the world. In the Middle east, the war with Iran, in Ukraine, as it's been going on for a number of years, and in a number of other places where kids might hear about certain things. We're in the midst of news stories about Hantavirus or about Ebola. We hear about all kinds of moments of violence that occur on a daily basis across the country. There's lots of reasons why kids could be stressed by hearing about the news. And we actually have a couple different resources on our website about this. We can say this is kind of resources about how to talk to kids about traumatic events. We have trauma resources, especially when kids have been exposed to stressful events, that are available in more than 10 languages on our website. Childmind. And we can also link to that in the show notes. But in general, if we're talking about the talking points for these sorts of events, the first is we want to think about how to help kids to engage in somewhat of a diet in terms of the exposure they get for the news. For younger kids, they might be hearing like sort of fractured things through friends, they might not have as much exposure to the news. But especially for teenagers or older kids who might be independently kind of looking at news sites or looking at social media, it's really important to think from an early age critically about where you get to that point of diminishing returns. You want to be an informed citizen, but at some point being informed about things might actually just cause your anxiety and rumination to increase. And so how can we be kind of mindful about the time that we're spending? The next thing is that especially as we're talking to kids about these events, if we're talking about things that are scary or that might involve harm coming to other people, the first point that we would make to any parents or caregivers is to emphasize what you're doing to keep that child safe. So why that child might be safe from what they're hearing on the news, what you're doing, what communities are doing, what government officials are doing, what law enforcement might be doing. Any number of ways that we can reinforce safety for kids is always helpful, at least up front. Next, we're trying to make sure that a kid has a good understanding of what this actually is or, you know, what situation they're dealing with then next, and whether it's politics or a stressful event, what we want to do is open up the conversation and I'll give the stressful event piece first and then the politics piece after. We've kind of focused on, you know, safety and understanding the event itself, opening up to discussion. If it's a scary, upsetting event, we want to say to a kid, look, you know, I'm here. If you want to talk to me about any of your feelings or reactions or worries about this event, you can share them with me. Now, if you want to wait a little while and share them with me later, I just want you to know I'm here. That's extremely important for politics, especially in an increasingly polarized political landscape in this country. What's really important is to not increase that polarization by acting as if, you know, compromise or seeing others viewpoints or something is impossible, or by villainizing another side and saying that are just, you know, evil or bad people who don't believe things that we believe. It's more that what we want to get back to is, especially in having conversations with kids about politics, is that research shows that kids do want to discuss these things with their parents and in school. They want to be able to open conversations and they understand what's going on in our political landscape. And more often than not, what we see is that kids want to understand what each side is thinking and they want to form their own opinions. So even though we might have really intense views about politics or what's going on, what we can do is try to present kids with what's going on within the political spectrum, understand how certain decisions are being made or how certain policies are being enacted, and then perhaps we can ask kids what they think. Perhaps we can go and do more research together and understand it a little bit more. But we want kids to be critical consumers of the news. So the only way we get that to happen is if we seem to be open to critical conversations about what information they know, what information we know, how we understand each side's perspective, and then how we also get credible information about whatever's going on, from politics to world events. Lastly, what I'll just say about anything that could be upsetting or stressful for kids is just a point that I said earlier, but I want to make sure to emphasize again. Let them know the conversation can happen at any time. Whatever they're thinking about, whatever they're having questions about, let's keep that open line, and they can talk to you about what's stressful and you can try to answer what questions you can. And if you can't answer their questions, it's always fine to just say, I don't know, or let's do a little bit of research on that together. Our third question on this thriving kids podcast, Q AND A How do I balance concerns about social media with the reality that some kids find real support and belonging online? So this is a really wonderful question, especially in light of the fact that the former Surgeon General released an advisory about social media, and the Department of Health and Human Services in the current administration also just released an advisory on technology in youth that has a lot of parents asking questions similar to this, where what we know from the research is that we can, you know, for any number of reasons, especially with teenagers, we can be concerned about certain risks with social media that have been mapped. So in that sense, it's research looking at body image and how the effects of certain ways that bodies and filters and Beauty standards are presented on social media might affect kids beliefs about the subject. We can be worried about ways that privacy or contact in social media might be established, especially with strangers. And kids might be contacted by people we don't want to get in touch with them for any number of reasons. We can be worried about cyberbullying. We can be worried about effects that social media might have in the sense that an infinite scroll for a kid who's depressed might act as an accelerant for that depression. Because we know that the treatment for a kid who is depressed is to get out of bed and actually engage in real life activities, behavioral activation, and that social media or screens might function to keep a kid in their bed or in their room alone and not necessarily engaging in the world in a way that would be helpful for their depression. So again, there are a lot of concerns about social media that we want parents to be realistic about. At the same time, what research shows, and the former Surgeon General Murthy's report really did highlight this research in the advisory on social media that especially for historically marginalized or oppressed youth, there are lifelines that exist online that can give a sense of belonging and a network of support that can be life saving in terms of helping kids to deal with the kinds of struggles they're experiencing, to be able to have a safe space to develop their identity and to find connections and support and to make sure they feel a sense of belonging that is massively preventative against suicidality and depression and self harm. So this is where we want parents just kind of carefully think about how they can engage in these worlds with their kids. You know, setting boundaries, making sure that we limit screen access, say in bedrooms, that we make sure screens aren't infringing on sleep, that we make sure kids are critical consumers of the messages they're getting from social media, while at the same time thinking about are there aspects of my kids identity where it might actually be enriching or enhancing of their well being for them to find communities of belonging online? And the more that we can allow them space to do that, the better. Our fourth question on this thriving kids podcast. Q and A. What should parents understand about the mental health needs of marginalized kids, including kids of color, LGBTQ kids and disabled kids? So when we talk about the mental health needs of these populations, you know, I think that Dr. Alfie really spoke incredibly eloquently about helping to support these populations through her work on the ACOMA project, through the work that she's currently doing, through the kind of Funds that she distributes to organizations attempting to connect with kids who might be marginalized. I think, at the end of the day, what we're looking at is the fact that all mental health and learning disorders occur at some base rate within the population. But what we know from the research is that particularly for kids with marginalized identities, with historically oppressed or marginalized identities, mental health and learning disorder frequency can actually be higher. And that can happen for a number of reasons. It can happen because of a lack of resources, a lack of support. It can happen because of racism and things that are forms of prejudice that exist within these communities that also have an outsized effect on the mental health and emotional health of kids who are part of these marginalized identities. So there are a lot of factors that we want to be aware of that at a systems level, we can work to decrease those stressors for kids, to put more resources and supports in communities, and to try to decrease the impact of marginalization, of bullying, of ostracization, of racism, of sexism, of homophobia that exist in communities that might affect kids whose identities fit within these populations. I think another thing that we just kind of want to think about as we wrestle with the politics that I think we place upon these populations is this notion that people are just trying to live their lives. People are just trying to get support for the things that they struggle with. People are just trying to live their real, authentic identities. And at the end of the day, what I think we advocate for is, is to meet people where they're at, to validate what their experience might have been. To be able to say, like, I hear you, and I believe those things you experienced were real. To be able to say, I hear how you are seeing your own identity, and I want to validate who you are and the authenticity of that person, and to know that being able to show up for people like that has an immediate effect on their mental health and emotional wellness. When we look at the level of belonging that kids with marginalized identities feel, being accepted by the primary people in their community, being told that they matter, being told that their identities matter and that you see them for who they are, those things can have an immensely positive effect on mental and emotional health. And I'll also say, if you're looking to understand more about the mental health needs of any population, you know, especially for marginalized communities, obviously Dr. Alfie's work is one resource. I'll also say, particularly for LGBTQ youth, one can look to hrc. One can look to the Trevor Project. These are Friends and partners of the Child Mind Institute. And, you know, especially if you're looking for any information on kind of how to support kids who might be coming from different kind of walks of life, just doing some research for advocacy organizations in this space can help you to really understand what kinds of support is most needed for these populations. So our fifth question on this thriving kids podcast, Q AND A. How can parents reduce stigma around therapy, anxiety, depression, or asking for help, especially for boys and young men? And this is a really good question, also looking at the intersection of kind of male gender role and identity and then asking for therapy. Because what is kind of implicit in this question is the notion that it can be socialized for men to think that it's kind of weak to speak about your feelings, to speak about the stress that you're experiencing, to speak about emotions. This is one reason why frequently when you look at kind of developmental trajectories for boys and young men, you see that that stigma that's associated with seeking help and that kind of feeling that it's, like, less manly to be seeking help around these things can lead to much more maladaptive coping mechanisms, which might involve all kinds of risky behaviors or using drugs and alcohol rather than actually talking about them or processing them with supportive people. So what we want to do, you know, if we're talking about what parents can do, and particularly what fathers can model, if, you know, you are a male caregiver in a boy or young man's life, it's modeling against that particular kind of conditioning. So it's saying that, like, yes, men can be strong, men can be, you know, aligning with any number of beliefs that kids might have about what boys or young men are. But also, men can be many things that you can still be good at talking about your feelings, you can still be good at talking about your emotions. You can still be good at talking with others about how certain things make you feel, about having conversations about your impact on other people. And what's important, especially for boys and young men, is to undermine what often happens in peer groups when you go from late elementary school up through high school, where there tends to be not only a rejection of men kind of emoting about what they're feeling or how they're experiencing relationships, but also even a certain aspect of, like, homophobia and labeling that comes along with those experiences, almost as if to do that is to be more feminine or to be more homosexual. And we want to also try to undermine that as much as we can where we help men to think of identities as multifaceted things where you want to kind of like push out the sort of social conditioning that comes around this, that says that it is weak or soft. And instead, to help men understand the overall benefits of this, that we're likely to see more high quality connections with friends and romantic relationships, we're more likely to see more longevity in romantic relationships. We're more likely to see more satisfaction at work and at home when you can actually talk about feelings and work through problems in relationships. And also, as much as we can possibly do it, we want to break down that stigma around therapy that helps men to think, wait a second, instead of just thinking, I have to muscle through this or power through, if I'm having difficulties at work, at school, at home, with my partner, with my friends, I can just go and talk to somebody who's a sounding board. That isn't a sign of weakness. That's actually a sign of a man handling his own problems. Like, so therapy becomes instead a gesture of empowerment and self confidence instead of a gesture of sort of weakness or flowery things that, you know, might go against what some might consider to be the men's gender role. So with that, you know, we hope that that gives you some elements of things that you can perhaps emphasize with those boys or teenagers or young men in your life. Our sixth question for today's Q and A. What are some realistic ways parents can build community around caregiving instead of trying to handle parenting stress alone? So this is a great one where I kind of will ask parents oftentimes when they're in the office, if they can name for me the last time that they sat down with another parent to have, you know, a glass of water, glass of lemonade, a cup of tea, a cup of coffee, a beer, you know, anything with another parent and what that experience felt like. And lots of parents will say, like, oh my God, it's so validating. Like, we both start talking about just kind of how nuts our kids are, the little idiosyncrasies of what they do, and all of a sudden it becomes less like, you know, I'm on a team fighting against this child, and instead that we're kind of like all in this together. And so what I'll end up trying to figure out with parents is I'll kind of say like, you know, let's figure out kind of where your social battery is. And it's the intersection of like, your social battery and, and the level of support you get from community. Some parents will say, like, I'm very Introverted, I don't need a lot of social contact. So we gotta think about, like, you know, really conserving my energy and where I seek support. And other parents will say, like, I wish I could just parent at all times with other parents or kind of embedded in community. And so depending on where someone falls along that continuum, we would say, like, let's talk about the value of parenting and community, how it feels validating the different ways that parents come into contact. Through school, through the kids, extracurricular activities, through play dates, through getting together on your own. How we can make space for those things that feel most supportive to you about communal caregiving or most like, it gives you an opportunity to kind of parent with other people and then also how certain interactions with other parents do decrease or increase parenting stress. And now we can focus on, you know, kind of increasing the interactions that might help you to manage parenting stress a little bit more or feel like you're more in this together. I'll also say this relates to other aspects of other Thriving Kids Podcast episodes about parental self care. But so often what we're trying to also think about with parents is like, there's the community aspect that decreases parental stress, and then there's also the self care aspect that decreased parental stress. And some parents might say, like, look, you know, it helps me to decrease by being with other parents in my community. And sometimes it helps me because I just take a walk by myself or there's a moment where I watch a show that I like, or I make sure I take some reading time or, you know, there's a walk with just another parent that I really find to be supportive, or I go and visit, you know, the center of my faith just by myself as an enriching experience. Any number of things we can say, like, let's think about all the different ways you handle parenting stress, either within the community or without. Our seventh question, this Thriving Kids Podcast Q and A. How can parents help kids develop self esteem, self efficacy, and self love without sounding like they're just giving empty reassurance? This is a great question, because what is inherent in this question is that you actually can't give a kid self esteem just by telling a kid they're awesome? Self esteem comes from a couple different things. The first is exposure to a wide range of experiences, making it so that kids have an opportunity to be engaged in all kinds of things from school through to hobbies and different things they might like kind of test out at home to different activities as they are available within your community. That they might kind of test out where they can test their abilities and they can also persevere and put effort into the development of all kinds of different skills that can help them to feel like this is kind of who I am or these are the facets of my identity. So what we'll often go through with parents is kind of an inventory if they're trying to build kids self esteem of all the different ways that kids can engage at school, in activities, in cultivating hobbies with peers, in home activities, you know, whatever we might be thinking about where we can expose kids to those things. Also, it helps to expose kids to a wide range of walks of life because this helps them to appreciate certain things about other people and the variety of qualities that other people might present with as well as being able to define themselves, like, being able to answer that question of like, give me three words that kind of describe you. Where I just think, I believe someone asked my son this the other day and one of the words he used was adventurous. And I just remember being like, oh wow, like that's a word that we're using. I thought to myself like, oh yeah. Recently he's really gotten into like building some like crazy constructions in the woods. So maybe he thinks that's adventurous, but that's like also an experience that he's gotten some recent exposure to and now it's become more of a part of his identity. The other thing I'll say about building self esteem that lasts versus building self esteem that is kind of shallow or might evaporate at the slightest bit, is that you're looking to develop self esteem around the idea that experiences in life or for learning and they're an opportunity to put effort in, to develop persistence, to develop grit, to kind of, you know, focus on how you can, you know, make this an iterative learning process with your kid where you're trying all kinds of different solutions for challenging situations. That's how you develop self esteem that lasts. It is not just saying to kids, hey, you should be good at this, you should be good from the get go. And that's what you should then make the anchor of your self esteem. It's more about parents who will sit right beside their kid, not necessarily solve problems for them, but find those kind of moderate levels of challenge where they can support their kid on persisting, support their kid on developing their own kind of conscientiousness in approaching these tasks and help kids to really feel like their self esteem is anchored in certain things they've cultivated, certain things they put effort into and then certain things that kind of define them as a person. Our final question for this Thriving Kids podcast Q AND A if a child is struggling emotionally but therapy isn't immediately available, what can parents do in the meantime to support their child's well being? And I am always glad when people ask this question because that is one of the reasons the public education arm of the Child Mind Institute exists. This is why we have our website, childmind.org on which there are hundreds of articles for parents, caregivers and educators and on which we've also included child facing resources that teach the same skills that we would teach in therapy. And this is what I tell parents is that if you believe your child could use some therapeutic support, but you can't necessarily find a school counselor or someone who might be covered by your insurance or referral from your pediatrician for extra support, or perhaps someone in your community who is somewhat of a counselor or a mentor. What you can also do is take some of these kid Facing resources and go through them with your child and this is what we have. Actually on our website you can see this under headings like Mental Health Fitness or under the Thriving Kids projects where we've created Kid Facing videos for pre K, elementary, middle and high school populations that teach skills like understanding and being able to just talk about your feelings, relaxation skills, mindfulness, managing really distressing or big feelings and also talking back, you know, to your thoughts and really thinking about how you think about situations and how you might be able to change that in order to respond to stress in a more helpful way. All of these resources come with child facing videos tailored to their age group in both English and Spanish that take about five or six minutes to watch and then also include written resources that you can use for application at home. So in essence, we are giving parents the ability to do therapy lite alongside their kid teaching those same skills that we would teach in the beginnings of evidence based therapy for youth. So if those resources be of help for you, I hope that you can find them easily on the website. We will also include them in our show notes if you're looking for links with that. Thank you so much for joining us on this Q and A edition of Thriving Kids. As I said, we'll include links, resources and references in the show notes if you want to keep learning about any of today's topics. Thanks for listening and we'll see you next week.