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Reframing young troubles
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Reframing young troubles

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Sometimes young people need help learning how to deal with their emotions. Depression, anxiety, aggression or hyperactivity have caused trouble or worry for many children and their caregivers.

According to Dr. Cynthia Miller, sometimes adolescents and children that have been labeled as “naughty” just need guidance in how to understand their own behaviors, to approach problems and emotions with a different frame of mind.

Miller is a psychologist who leads the Beatrice branch of Nebraska Mental Health Centers, which also has offices in Lincoln and Fremont. The center sees patients of any age for a wide variety of treatment, but Miller said she particularly enjoys helping young children overcome their issues, which accounts for about half of the Beatrice center’s patients.

One of the activities Miller has done with many of her young patients is to color a large poster that all the children contribute to over time. The poster is covered in small animals, leaves and other minute details in a myriad of colors, both realistic and fantastic. But she said the point isn’t just to have “happy fun time.”

“It can feel really uncomfortable for kids to talk about some of their emotional concerns,” Miller said. “What I’ve found is that if I get something like this out, and it’s OK for both of us to be looking down at the paper and coloring … it makes it so much easier for them to open up and talk about things that are really important.”

Miller said activities that kids are socialized to do naturally, like puzzles and drawing, provide a calming familiarity while they discuss uncomfortable topics like behavioral and emotional issues, and can sometimes be an outlet for experiences a child might not be able to talk about.

The activities also serve as a means of encountering problem behaviors in a controlled environment and learning coping strategies for the emotions a child is feeling — frustration or anger when they’re losing a game, or in the case of the poster a strong anxiety when others interfere with something the child wants to control.

“Part of the function of this poster was you had to be OK with knowing that other people were going to color on it and you couldn’t control what other kids were doing. And that element of control is very important with anxiety,” Miller explained.

Jill Zlomke McPherson, executive director of Nebraska Mental Health Centers, said there are some differences when working with adolescents instead of young children. She said the first step of working with teens is to find a way to connect with them, no matter what that is – music, dogs, jewelry, TV – whatever.

“With teenagers, 100 percent it’s about that relationship. … If you try to push before you have that relationship built, then you just have to start over,” she said.

She said teens also have a different perspective about the rules of the world. While the task with young children is often to help them understand why certain rules exist, the focus with teens usually involves reversing patterns of thought that assume rules simply don’t matter.

The typical case, according to Zlomke McPherson, is a teen that says ‘I don’t have to follow the rules and I’m doing just fine.’ Her reply: “Yet you find yourself on probation, sitting in the counselor’s office, expelled from school, grounded all the time, not hanging out with your friends – let’s talk about how that’s working for you. … How about we spend some time talking about your goals, your dreams – because this isn’t working.”

Miller, who also sees teens in her offices in Beatrice and Lincoln, said a worrying trend is seeing more young people who are abusing drugs and alcohol. When it comes to helping them, she said it’s crucial to understand their behavior, without assuming taking the drugs away solves the problem.

“You have to look at what is the function of that drug use? What is that teenager trying to address that’s not been addressed previously?” Miller explained. “A lot of times with marijuana use, you can have a very socially anxious teenager, and they find that the marijuana use calms them down. Instead of just addressing the marijuana use, why don’t we actually correct the problem and come up with a more adaptive way to regulate their anxiety?”

It can often be members of school staff that take steps to address behavioral problems with students. When those students need additional help, several area schools turn to Blue Valley Behavioral Health, another mental health and substance abuse clinic with offices in Beatrice and throughout Southeast Nebraska.

BVBH Executive Director Jon Day said school-age children make up 30-40 percent of the 5,000 patients the clinic sees every year.

Day said emotional, behavioral and substance abuse problems are sometimes related to an individual, and sometimes a result of ongoing family issues. He said the clinic involves families in its work as much as possible because that leads to quicker and more lasting change.

Day said parents having trouble with their kids isn’t anything to be ashamed of, and in fact isn’t even uncommon.

“One thing we know to be fact is that no matter what type of family exists, you’re always going to have some type of difficulty with your kids,” Day said. “Sometimes as parents … we feel like it’s a reflection of us if our kids aren’t doing well.” But every child is unique, he said, and in the end everyone has to make their own choices.

Amber Ferguson is the BVBH counselor that coordinates directly with schools to treat emotional and behavioral issues in students. She has various strategies for working with children of different ages, including allowing children with anxiety to set aside 15 minutes every day to worry as much as they want and talk about worries with their family, and then to “put their worries in a box” for the rest of the day.

Things get more serious, though, when a child has experienced painful abuse or trauma. That requires a very careful, step-by-step program to begin the process of helping a child slowly come to grips with what they’ve been through and, hopefully, to eventually move past what they’ve suffered. Ferguson said the program has been a success for many of those she has helped, even a few with a serious history of abuse.


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