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Archive for the ‘
Healthy Lifestyles ’ Category
Introduction
Janet Liechty received her PhD in Family Studies from the University of Maryland in College Park, an MSW from the University of Maryland School of Social Work in Baltimore, and a B.A. in Social Work from Goshen College. She has worked for over 14 years as a licensed Social Worker in hospitals, clinics, and health promotion programs with families and adolescents, adults with developmental disabilities, and persons with physical disabilities and chronic illness. She also maintained a private practice and consulting business for 10 years prior to joining the faculty at University of Illinois at Urbana-Champaign in 2007. She holds a joint appointment with the School of Social Work and College of Medicine.
Articles by Dr. Liechty on this site are:
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What does it mean to be a healthy eater? Every parent wants to raise children who have
healthy relationships to food and their bodies. Eating with family and friends can be a time of pleasure, conversation, enjoyment, and nourishment. But all too often, food and mealtimes have become arenas for power struggles, shame, guilt, and a sense of inadequacy.
Parents play a powerful role in shaping children’s food preferences, eating habits, dietary attitudes, nutritional knowledge, cooking skills, and food shopping skills. Parents are children’s first teachers and role models concerning food and eating. Children learn more from what they see and experience than from what they are told. Thus, caregivers’ own habits around eating greatly influence their children’s lifetime relationship with food.
Parental feeding styles influence children’s eating. Nutritionist and social worker Ellyn Satter has developed a helpful tool for parents to use to determine appropriate roles and responsibilities for feeding that have been adopted by the Centers for Disease Control and many hospital and clinic programs. Satter’s Division of Responsibility proposes that the adult caregivers are responsible for determining what, when, and where to feed children, and the child is responsible for determining how much and whether or not to eat. This simple but profound approach to family feeding encourages the child to develop and trust his or her own body’s ability to self-regulate calorie intake within safe and nutritionally sound parameters set by the parents.
Nutritionists Evelyn Tribole and Elyse Resch teach about the concept of Intuitive Eating, a process of slowing down, paying attention, and honoring the body’s signals of hunger, fullness, and thirst. This fosters greater reconnection to the body’s natural ability to regulate eating. Social workers Jane Hirschmann and Lela Zaphiropoulos, use a similar approach to help people overcome compulsive eating with a simple but wise formula: eat when you’re hungry, eat exactly what your body craves, and stop when you are full. Their years of experience have convinced them that we can all return to our body’s natural ability to eat well, without guilt or shame, and with enjoyment. Young children are natural intuitive eaters. However, this ability can be threatened by power struggles, food used as reward or punishment, counterproductive role modeling, environments saturated with unhealthy food choices, rushed eating, and food advertising targeted at children.
With so many fad diets and weight loss gimmicks out there, it can be difficult to know what “normal” eating is, and some think they need to be “perfect” at eating healthfully. However, normal eating is actually a flexible process in which you eat when you feel hungry, eat what satisfies, and know that caloric intake can vary day to day but balance out over time. There are no hard and fast rules when it comes to normal eating. Some people may find that eating three meals a day suits them while others prefer 4-6 smaller meals. What is normal will vary according to one’s lifestyle, schedule, moods, and activity levels. Moderation is key. It is important to pay attention to what you eat and focus mostly on healthy foods, but not get too caught up in a strict diet that keeps you from enjoying food, family, and meal traditions. Normal eating is about flexibility, pleasure, and listening to your body’s signals.
Unfortunately, many families use food as a reward (e.g., a cookie for good behavior) or punishment (e.g., no dessert for misbehavior). This misuse of food can disrupt children’s natural intuitive eating ability. As author Alfie Kohn (Punished by Rewards) has shown us, these practices also tend to elevate the desirability of food that is used as a reward, and decrease the desirability of food that must be eaten to receive a reward. Food used as a source of punishment or reward sets up power struggles around eating that further interrupt the child’s natural self-regulation around eating. Do you remember ever being required to “clean your plate” before leaving the table? Such rules can lead to confusion among children between their desire to please their caregivers (or just get up and play!) and their felt sense of fullness or hunger. The “clean plate club” approach may inadvertently require children to keep eating even if they are full, lead to guilt about wasting food, or simply lead some kids to associate eating with frustration, guilt, or anger.
The family mealtime offers a great opportunity for families to develop and practice healthy eating habits. Research shows that children who eat more meals with their families consume more fruits, vegetables, and milk, while eating less fried foods and soft drinks. In turn, children who eat fewer family meals are more likely to experience overweight or obesity. The family mealtime also provides an opportunity for parents to model healthy behavior, including menu planning, food preparation, and portion size. Mealtimes should be a positive and pleasurable experience that promote positive associations with healthy eating, cooking, and socializing. Conversations that provoke anxiety, such as highly personal conflicts or disciplinary measures, are best saved for another time. Distractions such as telephone, TV, and radio are best avoided as well. Research suggests that families should aim for at least four regular family mealtimes per week.
Although it may be challenging, making the family mealtime a priority is not impossible. Creativity, flexibility and planning ahead are needed to help overcome scheduling challenges. For instance, families might try changing the time of day or meal that they eat together, incorporating a picnic into an outing or sporting event, or setting aside at least one day of the week when everyone agrees to regularly eat together. If you must eat fast food, skip the drive- through and take a few minutes to park the car and sit down inside. If your child must eat early or separately from the family to get to a sports practice or event, try sitting down with him/her at the table while he/she eats and chatting. If your family struggles to include even one shared meal per week, start with small changes. Setting aside 10 minutes to eat together counts! Even a shared snack in the afternoon or evening where family members sit down around a table together can be a good place to start.
Here are some useful guidelines for parents and caregivers to promote healthy eating in their children.
- Remember the division of responsibility. Parents decide what, when, and where to feed their children; and children decide how much and whether or not to eat.
- Trust the child’s capability to self-regulate and mange his or her own eating, and support him or her in the choice of how much and whether or not to eat.
- Remember there are no “good” and “bad” foods. Any food can be enjoyed in moderation and balanced with other nutrients.
- Offer a range of fresh or non-processed food choices to children including fruit and vegetable options and whole grains for snacks and at every meal.
- Cultivate nutritional knowledge in your children by talking about what nutrients are found in various foods.
- Teach and guide children to listen to their bodies, and pay attention to stages of hunger and thirst.
- Help your children identify and express difficult feelings in ways other than turning to food to deal with emotional discomfort.
- Foster positive and pleasant attitudes towards eating, and avoid using rigid or coercive rules.
- Slow down! Eat slowly and mindfully, and savor your food. Sit down while eating, and take a few relaxing breaths between bites.
- Try to get some physical activity or exercise in every day. It helps balance mood and appetite, reduce stress, and improve circulation.
- Stay informed about school lunch policies and food options for children, and support changes that provide healthful options.
- Advocate for local policies to improve access to non-processed, healthy foods for all families, including those with limited transportation and income.
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Hispanic high school students may be at greater risk for drug use and suicide attempts than their black or white classmates, according to a new survey by the Centers for Disease Control and Prevention.
The study, reported by the Associated Press, is the latest in a series of surveys of American high school students conducted each two years.
Among its results: Black and white high school students report less sexual activity in the past, but there was no drop among Hispanics. Also, Hispanic students were more likely than their classmates to attempt suicide; use cocaine, heroin or ecstasy; ride with a driver who had been drinking; drink on school property; sell or be offered drugs; or skip school because of fear for their safety.
Those results do not necessarily reflect the reality for students in Tahlequah and Cherokee County, say local authorities who work with young people.
“Tahlequah Public Schools participates in these national surveys, but the last one taken did not indicate that our Hispanic students were more at risk for risky behaviors than our Native American or white students,” said Val Dobbins, who coordinates the safe school/healthy school programs at Tahlequah Middle School.
She said the district will participate in the 2009 survey, and this data will provide updated information.
“We have found that at an elementary level, our Hispanic families are among some of the most responsible and caring of their children attending our schools, meaning their children make great students,” she said.
Between 1990 and 2000, the U.S. Census Bureau ranked Cherokee County among the highest ratings in the nation in the growth of its Hispanic population, with an increase of more than 200 percent. Between 40 and 49 percent of those Hispanics were under age 18.
And the number has continued to grow since 2000, the Census Bureau estimates.
Experts interviewed by the AP about the study could come up with no explanation for why the Hispanic behavior trends differed. They speculated the school environment faced by many of the Hispanics may differ considerably from those of other students, and Hispanics and blacks more commonly attend highly segregated schools.
Students who do experience problems may find it harder to obtain the counseling they need than their white counterparts.
There is an increasing gap in counseling services for Hispanic youth, said Lynne McAllister, licensed clinical social worker and coordinator of guidance clinic services at the Cherokee County Health Department. For an effective impact on counseling in a family situation, the counselor must be bilingual.
“There is too much of a chance for miscommunication when you don’t have a bilingual therapist. Words and phrases vary in the translation; cultural differences, parenting roles may vary; and even a seasoned therapist cannot bridge the gap in families unless they are bilingual,” McAllister said. “With the influx of Hispanics in our community, there continues to be gaps in counseling services for them.”
The health department has no bilingual counselors, but has two translators who have helped with counseling, as well as in the health clinic. However, translation is more effective when dealing with specific physical symptoms and advice on such issues as family planning than it is in a counseling setting.
Dobbins said the Hispanics in the national study may be different than the ones here, who most often come from families that have immigrated to this country relatively recently.
These families tend to be strong and encourage their children to do well.
However, one statistic that is applicable to Cherokee County, whatever the ethnic group, is suicide. The leading causes of death for teens are vehicle accidents, homicide and suicide.
In Cherokee County, suicide among people ages 15 to 24 is ranked second in the state, according to Vital Statistics, Health Care Information Division, Oklahoma State Department of Health.
“Part of the challenge as parents is to recognize the signs and symptoms of depression and seek counseling/support for your teen whenever possible,” McAllister said. “Teens are struggling to be independent, fit in at school, home and with friends. Oftentimes, it is critical to continue to provide guidance, support and boundaries for an adolescent who clearly wants to ‘be their own person.’”
With all the challenges facing young people today, it is more important than ever for parents to have good communication with their children, she said.
She said parents can look for these warning signs that their teens are struggling with depression:
• Changes in eating or sleeping habits.
• Frequent absences from school or poor school performance.
• Lack of interest in activities, friends, or hobbies.
• Difficulty concentrating in school.
• Running away from home.
• Lack of interest in personal appearance.
• Physical symptoms.
• Talking about death or suicide.
• Suicide attempts.
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The majority of the Latin women feel especially proud of the culinary riches they have inherited from their parents, especially during times when they gather around a table of full-flavored, high-carb spicy dishes.
Accepting your Latina body, is a subject widely discussed in a recently published book of Bárbara Trujillo-Gómez titled Barbara por Atrás: A Latin Woman’s Guide to Fitness. It talks about the prominent hips of the Latin women, the impact it has in the feminine aesthetic and in the acceptance of the Latin men.
It is the delicious Latin food that often contributes to those “curves” that Latina women exhibit with pride – or in some cases as Barbara explains, they try to hide.
As Latina women live in the United States, it is natural that they will begin to assimilate to the mainstream American culture values and begin to move away from their Latin aesthetic values.
Conflicts may begin to develop between what is considered to be the ideal body and body shape, physical characteristics that reflect genetics and eating habits learned in the family.
It is expected that issues about body image make Latinas prone to inappropriate behaviors, severe disturbances in eating behaviors that are found in eating disorders as Anorexia and Bulimia.
The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) characterizes Anorexia as a refusal to maintain a minimally normal body weight. Bulimia is characterized by repeated episodes of binge eating followed by inappropriate compensatory behaviors that include self-induced vomiting, fasting, excessive exercise, misuse of laxatives, diuretics (“water pills) or other medication.
Fear of gaining weight and their desire to lose weight is driven by a level of dissatisfaction with their bodies. However, in some cases, eating disorders can be rooted in a need to avoid mental pain stemming from childhood trauma, such as sexual abuse or neglect or other self esteem issues.
According to studies conducted by Dr. Suzzette M. Evans, professor of Clinical Neuroscience at Columbia University, food can function in the same way as drugs and alcohol.
Studies also demonstrate that women who suffer these conditions, have less interest in sex than the general population, and less inclined to initiate romantic-affective relations.
When a young woman shows signs of weight loss or weight gain, it is necessary to obtain information from the parents and other outside sources, to determine if an eating disorders exists. It is not unusual for clients to deny that there is a problem and to lack insight or the ability to self mentor.
But the good news is that the eating disorders are often not just a problem with food, many times they are only a symptom of underlying problems. Many Latinas suffer from Bulimia and Anorexia when they try to emulate the American Pop culture and copy Hollywood celebrity images. Young Latinas try to look slim and trim and to resemble their favorite stars. But at what cost?
We need to embrace our Latina heritage, our spoken English with an accent and ours “curves”, like Bárbara Trujillo-Gómez asserts in her book. We must accept who we are and to forge ahead. Love and forgiveness are the fundamental keys to overcoming and acceptance.
We cannot do it alone. We need to reach out to each other.
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Introducción
La mayoría de las mujeres Latinas se sienten orgullosas de la herencia culinaria que han recibido de sus padres, especialmente cuando festejan alrededor de una mesa llena de platos con alimentos con alto contenido en carbohidratos, picante y salsas.
Aceptar el cuerpo de la mujer latina, es un tema ampliamente explicado en el libro, recientemente publicado de Bárbara Trujillo-Gómez titulado Bárbara por Atrás.
El mismo se refiere a los glúteos de las mujeres latinas, lo prominente que suelen ser y el impacto que tienen en la estética femenina y en la aceptación entre los hombres latinos.
La deliciosa comida latina en este caso, suele contribuir a crear las “curvas” que las mujeres latinas exhiben con orgullo, o que en algunos casos como explica Bárbara, tratan de esconder.
Muchas mujeres latinas que viven en Estados Unidos asimilan la cultura anglosajona y comienzan a cambiar sus “valores estéticos’’ latinos, por otros de la raza blanca europea.
A partir de este momento comienzan a aparecer las discrepancias entre lo que se considera el cuerpo ideal, y el cuerpo que se desarrolla de acuerdo a la genética y los hábitos alimenticios, entre otros factores.
Como consecuencia, surge en la mente de las mujeres una imagen del cuerpo que desean tener, pero cuando esa idea se vuelve obsesiva, puede convertirse en la causa de comportamientos enfermizos. De allí surgen los desórdenes alimenticios, tales como Anorexia Nerviosa y Bulimia Nerviosa.
El Manual de Estadísticas y Diagnóstico de Desórdenes Mentales (DSM-V) en su quinta versión, indica que la Anorexia se caracteriza por el rechazo de mantener el peso mínimo normal.
La Bulimia se refiere a repetidos episodios en que la mujer ingiere abundante comida, y luego tiene una serie de comportamientos poco apropiados como una forma de tratar de eliminar el exceso de comida en el cuerpo.
Por eso se auto provoca vómitos, ayuna, abusa de ejercicios físicos y de laxativos, diuréticos y otros medicamentos.
El miedo de ganar peso y de perderlo indica el nivel de descontento con sus cuerpos.
Pero en algunos casos, los desordenes alimenticios también tienen su origen en la necesidad de evitar el dolor de un trauma en la infancia, abuso sexual, abandono y baja auto estima.
Gracias a los Estudios de la doctora Suzzette M. Evans, profesora de Neurociencia Clínica de la Universidad de Columbia, se ha podido comprender que la comida puede funcionar de la misma forma que lo hacen las drogas y el alcohol.
Los estudios también demuestran que las mujeres que padecen estas condiciones, tienen menos interés en el sexo que la población en general, y menos tendencia a iniciar relaciones románticas-afectivas.
Cuando una mujer muestra signos de pérdida o ganancia de peso, es necesario obtener información de los padres y de otras personas cercanas, para detectar si existe un problema relacionado con desórdenes alimenticios. La mayoría de los afectados niegan ser víctimas de este tipo de enfermedades.
Pero la buena noticia es que los desórdenes alimenticios se pueden eliminar porque no siempre están asociados con la comida. Muchas veces, son síntomas de problemas más profundos.
Muchas mujeres latinas padecen de ambos desórdenes cuando tratan de emular la cultura americana y copiar las figuras de las celebridades de Hollywood.
Las más jóvenes tratan de lucir delgadas y esbeltas, para parecerse a sus estrellas favoritas. ¿Pero cuál es el costo?.
Debemos aceptar nuestra herencia Latina, nuestro ingles con acento y nuestras “curvas’’, tal y como las describe Bárbara Trujillo-Gómez en su libro, para aceptar quienes somos y seguir adelante.
El amor y el perdón son las llaves fundamentales en el proceso de auto aceptación.
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Introduction:
Joycelyn Curtis, PhD, is a Licensed Clinical Social Worker/ Patient Advocate for a nationwide community–based organization.
Q. Why is it important for women to know their own bodies?
Women are the experts when it comes to their own bodies. They are the only ones that can effectively communicate with their health care peroviders when something is wrong with them physically. Women are the only ones that can share with their physicians the symptoms, concerns and desires, regarding their health. Also, it is important for women to know their own bodies because knowledge is the first line of defense in staying healthy and prevention.
Q. Why is age appropriate screening vital to women’s overall health and wellness?
Age appropriate screenings are tools use in early detection and prevention in the quest to maintain health and wellness. Also, screening assist healthcare providers in making appropriate assessments, recommendations for diagnosis and treatment. Some recommended screenings by health experts in the U.S. Preventive Services Task Force http://www.ahrq.gov/ppip/healthywom.htm) for women are:
- Obesity
- Cancer (breast, cervical, colon)
- Cholesterol Check
- High Blood Pressure
- Diabetes
- Depression
- Osteoporosis
- Sexually Transmitted Diseases
- HIV/AIDS
Q. What should women do when they perceive that something is wrong physically wrong with their bodies?
A. Women should not panic, if they perceive that something is physically wrong with their bodies. They should contact their health care provider for a appropriate assessment. If their condition is an emergency they should take appropriate measures to get their concerns addressed immediately (Call 911).
Women should write down all of their symptoms, how often and how long they have had their symptoms and any concerns in order to share with their health care providers.
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To find a social worker in your area who can help you with these issues, please click here.
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Introduction
Sherry Katz, LCSW has practiced social work for 27 years, and currently practices family therapy in Ridgewood, NJ. She has both a broad range of social work, clinical, and consulting experience in various older adult settings, as well as advanced clinical training in couples and family therapy. If you have questions or an interest in Ms. Katz’s work, contact her directly at sherrykatz@optonline.net or in her office, 201.445.4770.
Q. How do men explain what they want without hurting their partner?
Start by asking yourself why stating what you want from your partner will feel hurtful to her. Anyone reading this section already has a sense of empathy for their partner; the difficulty is learning to rely on your natural empathy tool to state your needs in a considerate way.
Many of the beliefs which men were raised to consider as plain truths, are actually not valid or useful in many relationships; “provide and protect”, “talking about feelings is for girls”, “if you’re hurt, keep it to yourself and move on” for example.
Perhaps the best kept therapist’s secret is that the highest priority of women who feel frustrated with their partners, is their frequent statement that, “he never talks to me”. Because the majority of women are raised to reflect in great detail about their relationships, there is a great potential for enhancing, not hurting your female partner, by allowing her to hear what truly is important to you. Give yourself the chance to find out!
2. I want to take care of her; how do I figure out what she wants?
The simple and complex answer is, “ask her”. A direct question is always the clearest way to state what someone wants to know. And for most men, the Prince Charming, adventure/hero, and stories of rescuing beautiful damsels in distress drive relationship logic until examined for personal pertinence. Perhaps she prefers stating her wishes rather than dreaming of magic fulfillment. You may be burdening yourself through imagining your partner’s desires, which she may be very willing to disclose, if asked.
3. “I love my partner and want to have sex with her every night; why isn’t she
interested?”
Sexually pleasing your partner probably does satisfy her, but more so when she feels as though she’s pleased you in ways that she values. Women generally cannot separate their emotions from how open they will be sexually. Her sexual interest will increase when she feels accepted by you emotionally, usually shown through engaged listening and dialogue, partnering in shared activities. Initiating and participating in household or routine matters is a way to give of yourself in ways that will be appreciated, show that you care, which in turn will open doors for mutually enriched sexual activity.
These brief answers are built upon complex ways of self-understanding, gender beliefs and social expectations. To create effective and lasting change requires detailed understanding and practice of new behaviors.
Utilize a therapist for this purpose: your efforts to reflect and redesign systems of thinking and interacting require confidentiality, supportive reflection, and guidance, from a professional who has many times walked alongside the road of a client who is changing their personal mindset and dynamics.
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Introduction
Sherry Katz, LCSW has practiced social work for 27 years, and currently practices family therapy in Ridgewood, NJ. She has both a broad range of social work, clinical, and consulting experience in various older adult settings, as well as advanced clinical training in couples and family therapy. If you have questions or an interest in Ms. Katz’s work, contact her directly at sherrykatz@optonline.net or in her office, 201.445.4770.
Q. ”Is thinking about myself selfish?”
Most women were raised to pay much more attention to others than themselves; “be nice, let so and so go first, don’t take the biggest piece, don’t you want to give aunt Whoever a kiss good-bye, education for girls is not as important as it is for boys, a good wife takes care of her home, sit like a lady.
As girls, most women were never asked their reason for not wanting to “be nice”; maybe the day before, the very person toward whom “niceness” was expected, had hurt the feelings of our theoretical person. And what’s so bad about taking the biggest piece? And maybe aunt Whoever is scary or mean, academic learning is exhilarating, not all people, which include women, like managing or cleaning their homes, and why does anyone care how I sit?
Everyone develops life habits and their own internal logic based on the messages we received during our early days. If the culture contained messages such as, “be a woman”, meaning to stand up for what’s right, follow your dreams, don’t let disappointment get in your way, pick yourself up and carry on”, then most likely, most women, would not have the enormous difficulty most of us do, in deciphering who we truly are and what we truly want from life and others.
How therapists help is to encourage open mindedness in their patients, to examine carefully what and how the principles of their lives are defined based on inner identity or conformity to standards set by others, which for some women’s sensitivity, can lead to depression, anxiety or disease.
Q. “How can I begin to change to a more genuinely self-focused approach to my life?”
Start by stating the facts and being willing to continue dialogue with whoever wants to know more about you. If you feel angry that someone has ignored you for several months, instead of not addressing your hurt feelings, when that person finally does call, tell whomever it is, how you felt. Be willing to keep opening the descriptions of your inner mood. We each have a right to say what’s on our mind and relationships improve the more others know about who we are.
Q. Won’t people start to get angry and drift away from me if I say that I’m angry?’
Some people may have that response, but how happy have you been with a relationship in which it is necessary for you to stifle your true mood and feelings in order for the relationship to survive? Picture how you might feel if the other person with whom you have a relationship, could accept that you have ups and downs, sometimes feel you could use emotional support, want to be alone or together based on your unique individual tastes.
Talk therapy is a way to experiment with new ways of relating; therapists are trained to relate with the patient’s best interest as primary; the patient has safety and freedom to practice new modalities of relating.
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To find a social worker in your area who can help you with issues like these, please click here.
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