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Posts Tagged ‘
help ’
February is Black History Month and to celebrate NASW is inviting its African American members to publish a personal profile on the consumer Web site www.HelpStartsHere.org.
Last year we invited African American social workers to publish a personal profile on our site telling us about their education, their motivation for choosing social work as their career, and describing what they felt were the most pressing challenges facing the African American community. The result was the publication of more than 80 social worker profiles:
http://www.helpstartshere.org/about-social-workers/black-history-month-celebration.
The response to the Black History Month was overwhelming positive. In fact, the Black History Month celebration page was the third most accessed page on the Web site for the entire year.
Anyone wishing to participate this year should submit their responses to the following questions to Theresa Spinner at www.HelpStartsHere.org. Ms. Spinner will upload your profile to the site.
To submit a profile this year, please send NASW Senior Web Communications Associate Theresa Spinner tspinner@naswdc.org your response to the following:
- What is your name, where did you earn your social work degree(s), where do you work, and what is your area of expertise?
- Why did you choose social work as your profession?
- If you were able to make one lasting impact on the world, what would it be and what would be your strategy for achieving it?
Also, please include an electronic photo with your submission, if possible.
Submissions should be sent to Ms. Spinner by Friday, January 29, 2010. They will be published on the site on Monday, February 1, 2010. Below is a profile from last year to give you an idea of what is expected.
Black History Month 2009 Celebration!
Introduction
To honor Black History Month we asked African American social workers to tell us why they chose the social work profession and to describe the unique challenges facing our African American community.
Norma G. "Cindy" Jones, PhD, LCSW, BCD
Retired United States Navy Commander
NASW Social Work Pioneer ®
Associate Professor and Director of the PhD Program Norfolk State University School of Social Work Norfolk, Virginia
Dr. Jones
Q. Where did you earn your social work degree(s); where are you currently employed and what is your area of expertise?
 I am an Associate Professor and the Director of the Ph.D Program in social work at Norfolk State University I received my MSW degree from West Virginia University and my PhD from Norfolk State University. My areas of expertise are: Domestic Violence, Military Families, Children Soldiers/Children Warriors and Veterans. I also carry a clinical licensed and specialize in working with family and couples.
In addition, I have served on a number of university and professional advisory and work groups including: Council on Social Work Education Veteran's Task Force; the Historically Black Colleges and Universities Dean's and Directors Interdisciplinary Academic Program; and Group for the Advancement of Doctoral Education in Social Work. I am also active with the NASW Social Work Pioneers. ® Lastly, I am a retired Navy Commander.
Q. Why did you choose social work as your profession?
I feel that social work chose me. I grew up in a family that was active in the community and embraced helping families in the community who were less fortunate. It felt natural to work with families and assist them during hardship.
Q. What do you feel are the greatest challenges in the African American community and how can social workers help?
Today's greatest challenge is poverty. Another is the lack of jobs and community resources. As a result many families find it difficult to survive within the system: and social workers are challenged in those cases where family members, in an effort to improve their quality of life, turn to criminal activities. Another challenge is the shortage of professional social workers.
Tags: black history month 2010, contribute, help
Posted in
About Social Workers, Black History Month Celebration |
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"There is not a day that goes by that PTSD does not play some part in that day".
Trudi, Spouse of Vietnam Combat Veteran
The Journal of the American Medical Association in March, 2006, reported that 35 percent of Iraq war veterans sought treatment for mental health issues within a year of coming home. The Department of Defense now estimates that between 15 percent and 29 percent of veterans from the war in Iraq and Afghanistan will suffer from Post Traumatic Stress Disorder (PTSD). The caseload for mental health counselors in the Veterans Administration is six times higher than anticipated. By 2008 more than 400,000 troops could need mental health treatment if this trend continues. Who will help the spouses and families of these combat veterans?
Stepping up to help are eleven women with vast experience dealing with combat veterans returning home from war. They are married to vets who have significant PTSD disabilities from previous wars, and the Iraq war, and they have jointly written this article as a way of offering support, encouragement and hope to the spouses and families of Iraq vets. They offer the following thoughts while recognizing that each war is unique and some of these suggestions may not be appropriate for the Iraq war experience. (We use he/him to refer to the vet for convenience only.)
War is a bad thing and terrible things happen. That doesn't make your vet bad. Listen if he talks about the war. Don't judge, and don't try to stop or smooth over his emotions. When he tells you trauma stories, you might tell him he did the best he could under the circumstances, and wars are horrible. If the stories overwhelm you, it's ok to say you need to take a break and you are working on listening. If he doesn't talk about the war after a few months at home, you may want to suggest he see a counselor if he is showing symptoms of PTSD. If he does talk about the war, it's not a good idea to ask for details because this may bring on a flashback. It's not helpful to tell him you understand what he went through because you don't and can't. It's probably not helpful to tell him he is a war hero as there may be things he did in the war that disturb him. Rather you can say he is your hero by making it home. If he cries, let him cry with you or alone, and don't try to interrupt or stop this. It's probably a sign of healing. Make sure you have someone safe to debrief with as well.
Make an effort to learn who his favorite comrades were during the war. Keeping in contact with these comrades can sometimes be helpful with reentry, and staying in touch with them may last forever, and help with coming to grips with the reality of the war they fought.
Know what to look for. Educate yourself about PTSD as much as you can. Here are a few of the symptoms:
- emotional/social isolation
- numbing
- sexual dysfunction
- sleep disturbance
- intrusive thoughts and memories (flashbacks)
- heightened anxiety and startle reaction
- inability to concentrate
- depression
- nightmares
- survivor guilt
- spacing out
- night sweats
- sudden anger (or repressed anger)
- inability to feel anything but anger
Symptoms may not surface for years. Tracy said "I remember when he talked Vietnamese in his sleep, and had terrible nightmares. Sometimes he still does". Betsy said "he didn't start having flashbacks until many years later when the Iraq war began". If he has flashbacks, ask him what you can do that helps or if he does better handling them alone.
Be willing to accept help even if he doesn't. You can call 1-800-562-2308 in Washington State or go to www.nmfa.org/ to find resources. Or use your health insurance to see a professional of your own choosing. Some employers offer short term confidential counseling as an employee benefit. If your vet is willing, encourage him/her to get a good evaluation from someone experienced in PTSD treatment. Remember though that experts don't agree on what really helps. Trust that what you observe is valid.
Encourage him to set limits on what kinds of questions people ask him. Thoughtless questions can cause soldiers to relive trauma. It's ok to say "that's not an appropriate question".
Criticism of the war should not be taken personally, and vets should be supported in leaving situations where military personnel are criticized for serving in the war. Most people support the troops even if they don't support the war.
You may need to remind your vet that he is not the center of the universe, and he no longer needs to worry about his own survival. He is now part of a family where concern for other family members and their feelings and needs is important.
Get in a support group. It's a relief to be with other people who understand. "It has saved my marriage and maybe my life…". Trudi. Our support group is funded by the Department of Veterans Affairs. In Washington State a unique program is offered where veterans and their significant others can receive counseling at no charge. In Wenatchee the contracted provider of these services is Wayne Ball, LICSW, who started support groups. 509-667-8828.
Children are affected by a parent's PTSD. Symptoms can be passed from one generation to the next which is called intergenerational transmission of trauma. The ages of your children affects how this occurs. For instance small children may experience the numbness of PTSD as disinterest or not caring, while older children may act out. Sometimes children will take on some of the symptoms of PTSD. You can get information on how to help your children from the PTSD Information Line at 802-296-6300 or go to www.ncptsd.org. Your children need to know in an age appropriate and calming way that these symptoms are not their fault.
You cannot fix the PTSD symptoms. Those are his symptoms that he has to learn to manage or not. Make your own goals and keep them in your focus. These goals might be improving your own health with good nutrition, exercise, and rest, or spending time with friends, or doing special things for yourself.
- Always be truthful with your vet. This builds trust. Tell him calmly when his behavior is not normal. If you don't know if it's normal, ask others, and observe others. Don't walk on eggshells.
- He probably will not ever be totally the same. He is in many ways a different person now. Grieve for what is lost and move on. This is your life now even though it‘s not fair.
- Stay on top of medications. Try to notice the changes with new medications or when he stops taking meds and report this calmly to your vet. Suggest he call his medication prescriber if the side effects are problematic. Running out of meds can trigger depression and other problems.
- Anticipate drug and alcohol problems. Learn about resources for you, your kids and for your vet. Find out what to do. Discourage him from isolating and drinking or doing drugs.
- If he isolates himself, point this out and encourage involvement with family, sources of help. Don't go with isolation for long periods of time. Short periods of withdrawal to help control anger make sense, but withdrawing from life into a "bunker" is not helpful.
- When you have conflict which is normal and to be expected, focus on the issue at hand and resist bringing up issues from the past. Stay focused on the issue, not the person and seek solutions, not who is to blame. If possible, set a time limit for hot topics of a few minutes, and take a time out with an agreement to discuss this issue later. Be sure to again discuss later.
- If you feel concerned about violence in your home, bring others into the situation: your minister, a trusted friend, a counseling professional and talk about your concerns calmly when things are not escalated. Don't keep this concern secret. If necessary to protect yourself and your children, call the police.
- Sometimes war experiences cause a spiritual crisis, a loss of faith. If your vet's not finding help with this you might encourage him to keep looking. There are spiritual advisors who understand combat and PTSD.
- Physical exercise helps everyone release anxiety and tension. Stay active and encourage your vet to do the same. Regular meals, good nutrition, plenty of rest and time for play help everyone cope with stress.
- Take care of yourself in many different ways. You matter just as much as your vet Handling traumatic stress in a loved one is very stressful for most partners. Learn and use stress reduction techniques.
Enjoy the good times. When bad times come, hang on! Good times will come again.
This is an article in progress. We are learning that many of the Iraq vets have traumatic brain injury as well as PTSD which brings new challenges, and often requires a spouse to remember things for their vet. We are learning that it is hard to tell how much someone can recover from a traumatic brain injury. We believe that drawing together in a community of support and encouragement is still the best way to face these unknowns, and we are grateful for the good company of one another.
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Bibliography
Tags: family, help, husband, listen, military, Post Traumatic Stress Disorder, social worker, spouses, veterans
Posted in
Issues And Answers |
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Ads Coincide with One-Year Anniversary of Hurricane Katrina
The Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services and the Ad Council today launched a series of new national public service print and billboard ads to encourage individuals who may be experiencing psychological distress from last year’s hurricanes to seek mental health services. The Public Service Announcements (PSAs), the latest ads created for the Hurricane Mental Health Awareness Campaign, are being distributed to media outlets nationwide this week to coincide with the one-year anniversary of Hurricane Katrina.
The Hurricane Mental Health Awareness Campaign launched last fall is designed to help adults, children and first responders who have been affected by the hurricanes and who may be in need of mental health services. The public service ads reach out to adult hurricane survivors and first responders and to parents and caregivers who can assess their children’s emotional well-being. These public service ads are part of a larger effort by SAMHSA and the Federal Emergency Management Agency to speed mental health recovery to persons affected by the hurricanes, to date, totaling nearly $110 million in mental health service grants.
Helping Survivors
“Most survivors of Katrina, Rita and Wilma are demonstrating remarkable resiliency and are rebuilding their lives,” said Assistant Surgeon General Eric Broderick, DDS, MPH, Acting Deputy Administrator of SAMHSA. “The new public service ads offer a doorway to help for survivors who are still struggling with the emotional toll of last year’s hurricanes.”
Research on the mental health consequences of disasters tells us that the psychological effects of last year’s hurricanes can be extensive and long-lasting. Individuals displaced by the storms lost their homes, schools, communities, places of worship, daily routines, social support, personal possessions and much more. In some cases, these losses were amplified by the loss of loved ones and the experience of destruction, pain and violence.
Catastrophic Events
Soon after a catastrophic event, some survivors may experience symptoms of post-traumatic stress disorder (PTSD), including depression, grief and anger, or they may experience other behavioral or physical health problems. For other disaster survivors, some of these problems may not surface for years. As many as half of last year’s hurricane survivors have experienced symptoms of depression, and one in 10 have had symptoms of PTSD.
One year later, survivors continue to mourn their losses; some remain separated by the miles between them and families and friends. The one-year anniversary may trigger the reappearance of the same emotions survivors experienced immediately following the hurricanes.
The new print and outdoor advertising features close-up photographs of hurricane survivors’ faces, and say, “a year later, the hurricane isn’t over in the minds of many survivors.” The photos were taken by Clayton James Cubbitt, a native of New Orleans and the Gulf Coast.
The campaign also includes television and radio spots, available in English and Spanish, which are being redistributed at this one-year anniversary.
Public Service Announcements (PSAs)
All of the PSAs encourage audiences to take time to check in on how they and their families are doing and to call a confidential, toll-free number (1-800-789-2647) to speak with a trained professional who can help with information and referral to local services.
“Mental health experts and recent studies have revealed that hurricane victims continue to suffer from the devastating losses they experienced last year,” said Peggy Conlon, President and CEO of The Advertising Council. “As we approach the first anniversary of the hurricanes, it is important to remind survivors that help is available. The new print and outdoor ads, created pro bono by Grey Worldwide, powerfully and beautifully convey this critical message.”
The PSAs are being distributed to media outlets nationwide via the FastChannel Network and will air in advertising time and space that will be donated by the media.
To view the ads, please visit www.samhsa.gov or www.adcouncil.org and click on the link on the homepages.
The Substance Abuse and Mental Health Services Administration, a public health agency within the U.S. Department of Health and Human Services, is the lead Federal agency for improving the quality and availability of substance abuse prevention, addiction treatment and mental health services in the United States. For more information about SAMHSA and its hurricane mental health response, go to www.samhsa.gov
The Ad Council is a private, non-profit organization with a rich history of marshalling volunteer talent from the advertising and media industries to deliver critical messages to the American public To learn more about the Ad Council and its campaigns, visit www.adcouncil.org.
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Tags: Ad Council, help, hurricane Katrina, mental health, Public Service Announcements, SAMHSA, social work, survivors
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Addictions, Current Trends |
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Introduction
The adolescent years can be very challenging for some teenagers and their families. While adolescence can be an emotionally intense, stormy phase for virtually all teenagers, sometimes a teen's struggles require special intervention. Many teens struggle with issues related to mental health, family relationships, friends, school performance, substance abuse, sexuality, and other high-risk behaviors.
Struggling teens usually show signs of distress. Common warning signs include:
- Low self-esteem
- School failure and truancy
- Defiance towards authority (such as parents, teachers, police)
- Running away from home
- Choosing the "wrong" friends
- Impulsive behavior (such as speeding, taking other unsafe risks)
- Getting in trouble with the law
- Depression
- Abusing alcohol or drugs
- Social isolation
- Eating disorders (overeating, not eating, self-induced vomiting)
- Self injury (such as cutting)
There is help for these youngsters and their families through many avenues.
There are many ways to locate and access programs and services for struggling teens. Initially parents can seek help by contacting school personnel (guidance counselors, social workers, administrators), family service agencies, community mental health centers, other community-based social service programs designed specifically for at-risk youngsters and their families, public child welfare agencies, family and juvenile courts, and specialty courts (such as truancy and drug courts).
Social workers can help parents and struggling teens identify and explore difficult and challenging family issues. Individual, family, and group counseling provided by clinical social workers may help parents and teens improve their communication skills and relationships, resolve conflicts, and address important mental health issues.
Professionals called "educational advocates" and "educational consultants" may be able to help parents and teens obtain needed services. Educational advocates, who are often attorneys, help people obtain specialized educational services. Educational advocates charge parents a fee and work with local, state, and federal education officials to ensure that students receive the services and "special accommodations" to which they are entitled by law. Advocates may file claims in court to force school districts to provide or pay for special-needs services and programs outside the school district.
Educational consultants help parents locate programs and services designed to meet their child's needs. Educational consultants charge parents a fee, assess each teen's unique strengths and needs, and help the family find the most appropriate schools or programs for their teen. Many educational consultants monitor students' progress in the new program or school and, when necessary, advocate for the teen with that program or school when challenging issues arise.
Programs and services for struggling teens can be very expensive. Some families are able to pay for these programs and services "out of pocket." Some families have health insurance that pays for all or part of the program, or the public school system may pay the cost.
Many families cannot afford needed programs and services, do not have adequate insurance, and are unable to obtain funding from their public school department. In some instances families that cannot afford needed services agree to give legal custody of their teen to the local public child welfare agency, which then funds the services or programs (in several states the public child welfare agency will fund services without requiring that parents hand over legal custody). In still other circumstances, desperate parents may turn to the juvenile or family court and formally request that the teen be declared "wayward," thus enabling the court to require the child to accept intervention. In these cases the state typically pays for needed services and programs. Some parents may be reluctant to use this route to services because the court, not they, determine where the child goes for help.
There is a wide range of services and programs run by private and public agencies for struggling teens and their families. Some programs may be available locally; however, some programs may be in other communities or states, which means that the teen must live away from home in order to receive needed services.
A broad range of professionals and agencies offer crisis intervention and follow-up counseling services to teens and families. These services may be available through family service agencies, community mental health centers, hospital outpatient clinics, public child welfare departments, and psychotherapists in private practice (such as clinical social workers, clinical and counseling psychologists, mental health counselors, pastoral counselors, psychiatric nurses, and psychiatrists).
Many communities offer comprehensive counseling and family-intervention programs specifically for teens and families in crisis. These programs – known by names such as "comprehensive emergency services" or "comprehensive intensive services" – provide home-based assessment, emergency counseling, information, and referrals for longer term help.
A variety of alternative schools, therapeutic schools, and treatment programs serve teens who struggle with significant behavioral, emotional, mental health, and substance abuse issues. Some programs, such as alternative high schools, focus primarily on education while being sensitive to students' mental health and behavioral challenges. Other programs, such as residential treatment programs, therapeutic boarding schools, and wilderness therapy programs, focus primarily on mental health, emotional and behavioral issues, while including an educational component. "Emotional growth" boarding schools address mental health, emotional, behavioral, and educational issues simultaneously. Other boarding schools focus on specific learning disabilities while also paying attention to the whole student. In short, different programs give different degrees of emphasis to personal and academic issues.
Parents of struggling teens – particularly teens who are oppositional and defiant – may be tempted to place their child in a school or program that promises to impose needed discipline and structure. Often these schools and programs – such as some military boarding schools and those that advertise their mission as "character education" – do not provide the mental health services many struggling teens need. These schools and programs can cause more harm than good for struggling teens who have personal and mental health issues that contribute to their challenges.
Prominent program options include:
- Alternative high schools provide education, including special education services to teens who have floundered academically or socially in traditional high schools. These schools may be freestanding or sponsored by a community mental health center, family service agency, school district, or a "collaborative" composed of several social service and educational programs.
- Youth diversion programs typically attempt to help struggling teens who have had contact with the police avoid more formal involvement in the juvenile justice system (juvenile courts and correctional facilities). Typical youth diversion programs offer first offenders individual and family counseling, links to other needed services (such as psychiatric medication), and education.
- Independent living programs are designed to help adolescents develop the skills they need to live independently. These programs primarily serve teens who do not have stable families and are in the state's custody. Some independent living programs also serve teens whose families are able to pay for these services privately. Typical services include practice in daily living skills, money management, career and educational planning, mental health services, housing assistance, recreational, and social activities and case management.
- Wilderness therapy programs offer highly structured intensive short-term (three to six weeks) therapy in remote locations that remove adolescents from the distractions available in their home communities (such as television, music, computers, cars, drugs and alcohol, movies, delinquent peer groups). The challenges of living full-time outdoors and developing wilderness survival skills help teens develop self-confidence and pro-social behaviors. Often, families are advised to send their struggling teen first to a wilderness therapy program and then to a therapeutic or emotional growth boarding school, rather than return the teen to their home community environment.
- Boarding schools for teens with significant learning disabilities offer structured academic programs that focus on education and learning while addressing relevant emotional and behavioral issues.
- Emotional growth boarding schools offer structured academic programs and focus on emotional development and personal growth but do not provide the intensive treatment services offered by therapeutic boarding schools.
- Therapeutic boarding schools focus intensively on students' mental health, substance abuse, and behavioral needs while also providing an academic educational program.
- Residential treatment centers offer highly structured treatment addressing substance abuse, family, and other mental health issues. In contrast with therapeutic boarding schools, residential treatment centers are more like a psychiatric hospital than a school, although they may have an academic/educational component in their program.
Many communities run substance abuse courts (sometimes known as drug courts) and truancy courts. These specialty courts use a supportive and nurturing approach rather than a punitive one to help struggling teens. Using case management, counseling, tutoring, mentoring, and parent education, the courts' goal is to prevent future problems and more formal involvement with the juvenile justice system.
Social workers can provide struggling teens and their families with:
- Assessment of the teenager's and family's needs and strengths
- Information about and referral to needed programs and services
- Information about financial and legal issues and resources
- Names of reputable educational advocates and educational consultants
- Crisis intervention counseling services
- On-going psychotherapy for the teen, the parents, and the family as a whole
- Case management (helping staff from multiple agencies coordinate and communicate on behalf of the teen, and advocating for the family with these providers)
- Information about important "warning signs" of teens who are on a downward spiral and the steps needed to get help
- The National Association of Social Workers provides a listing of social workers in your area who can help you with these issues. Please click here to find a social worker.
Information about services and programs for struggling teens and families is available from social workers, schools, public child welfare agencies, juvenile and family courts, family service agencies, community mental health centers, educational advocates, educational consultants, and lawyers. Useful Web sites include:
Frederic G. Reamer, PhD, is the author of The Pocket Guide to Essential Human Services which contains diverse resources compiled into a user-friendly guidebook appropriate for use by professionals, volunteers, and consumers.
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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Tags: adolescence, help, intervention, programs, resources, teens, warning signs
Posted in
How Social Workers Help, Youth Development |
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| A Grieving Young Person Might Ask |
"When is Daddy coming back?"
"Can I go to heaven to see Grandma?"
"Why did Mommy have to go?"
"Are you going to die, too?"
"How did he die? Was it something I did?" |
A strong response to the death of a loved one is a universal phenomenon that exists for people of all ages. Children and adolescents, however, may experience grief differently from adults. Knowledge of how children of different ages have experienced a loss is essential to helping children and adolescents who are grieving.
The loss of an important caregiver or adult can impact the infant's sense of security and well-being in the world. Children of this age are sensitive to changes in routine and stress in their environment. The child may display excessive crying, writhing, rocking, biting and other anxiety related behaviors.
Children at this age may have feelings of sadness, anxiety, insecurity, irritability and anger. They believe that death is a temporary state that can be reversed. They may equate death with sleeping or being away on a trip, or believe their thoughts or behaviors caused the death of their loved one. Some children may act as if nothing happened, while others may exhibit regressive behaviors, such as bedwetting or excessive clinging.
At this age, children are able to consider the biology of death and grasp its finality. They may develop fears associated with their own death or the death of a surviving parent. Feelings of insecurity may be expressed in a reluctance to separate from caregivers. Some children may be hyperactive, aggressive and disruptive, while others are withdrawn, sad and. Children may have nightmares, difficulty sleeping through the night, or display regressive behaviors.
Children this age understand that death is final and that it happens to everyone. Fears and worries associated with the loss may be heightened by the physical occurring within their own bodies. Ironically, they may have a strong need to control their feelings while at the same time they have great difficulty doing so. Because friends are so important to this age group, preteens may feel socially isolated, lonely, confused, scared, guilty and self-conscious.
Teens may have a need to feel "strong", in control of their emotions and "indistinguishable" from their friends. They may hide (or numb?) their emotions of grief by engaging in risk-taking behaviors, such as reckless driving, alcohol and drug use, sexual promiscuity and defiance of authority. They may be reluctant (or unable?) to Express their feelings with others…The death can cause strong feelings of sadness, loneliness, confusion, fear, guilt and anxiety for the grieving adolescent. They may become more easily distracted, experience sleeping and eating disturbances, perform better or worse in school, and display strong emotional mood changes. Like adults, adolescents may have difficulty coping the loss for months or years following the death.
Children of all ages may develop fears associated with a death. These fears can lead to other problems if neglected. Common childhood fears that result from the death of a loved one include: Fear for their own death or the death of a caregiver
- "When will I die?"
- "Is mommy going to die, too?"
Fears about being alone at night or in an empty house, the house being robbed, being in a car accident, or having nightmares
- "The monster/stranger might come."
- "I'm scared to go upstairs."
- "I need you to stay with me."
Concerns about the intensity of their grief related emotions and those of their caregivers
- "If I cry, I won't stop."
- "I can't stand to see my mother crying."
Fears that their friends and family members will treat them differently or that they will be isolated due to the death
- "No one will talk to me at school."
- "They act like I'm weird."
Safety related fears that revolve around who will attend to their needs
- "Who will take care of me?
Depression is a common outcome of extended grief among children and adolescents. Caregivers should be alert for any changes in the child's physical well-being and behavior. Typical signs of childhood depression include the general appearance of discontent, low frustration tolerance, needs for comfort but is unsatisfied when comfort is given, acting out behavior, bedwetting, decline in school performance, moodiness.
If a youth's grief reactions put them at risk of hurting themselves or others, caregivers should promptly seek the support of a mental health professional. For example, if a child or adolescent makes self-destructive behaviors or expresses feelings of hopelessness, it may indicate that there are more serious problems that should be promptly addressed by either a physician or a professional counselor.
While these signs are important indicators of how the child is faring with their grief, caregivers should be aware that most children do not sustain intense emotions for long periods of time (Landreth et al., 2005). A child may be crying about his/her deceased parent one minute and abruptly switch to joyful playing and laughing the next minute. It is OK for children to have "time off" from their grief experience, though this does not mean that the child has resolved all of his/her feelings about the death. Caregivers should also know that children often re-experience grief at different developmental stages.
Grief has different meanings depending on the family's background, spiritual orientation and culture. Rituals surrounding the death are often family specific as well as culturally grounded. In some families, for example, it is believed that children should be protected from the negative experiences associated with death and grief and therefore, children are excluded from rituals and discussions concerning the deceased. In other families, children are encouraged to be involved in all aspects of the death and memorialization of the deceased. Balancing these two extremes are the families that involve children in age appropriate ways. These families expose their children to some aspects of the grieving process while protecting them from other aspects that may overwhelm the child's coping abilities.
Parents and children may need to mourn a family loss individually as well as together as a family. Parents often feel uncomfortable expressing their grief in front of their children, fearing that too much emotion will scare them. Grieving parents should try to strike a balance between modeling the healthy expression of emotions while maintaining a sense of security in the home. Children and adolescents tend to weather the pain of grief more easily when family members:
- Communicate their emotions and their needs concerning the death
- Understand and respect the individuality of each member's grieving experience
- Recognize and cope with their own grief while assisting their children
- Reassure their children that despite the sadness of losing a family member, they will continue to be cared for and they will remain a family unit.
In addition, research has found that adolescents may benefit from:
- Good health habits such as good diet, nutrition, rest and exercise to combat emotional stress related to grief.
- A return to their normal routine including activities outside of school.
- Participating in activities of interest, such as sports teams and student clubs
- Obtaining professional counseling if necessary (Rask, Kaunonen, Paunonen-Illmonen, 2002).
Collaboration among family, school and professional services is essential to identify grieving adolescents who might not otherwise ask for help. Caregivers should notify school personnel when a death occurs. Teachers and school counselors can be watching for changes in the adolescent's mood and behavior. Significant changes in the adolescent may suggest that additional help is needed.
Social workers knowledgeable about grief and children can help caregivers:
- Learn how to explain death to children
- Provide information on how children understand and express grief
- Learn to tolerate and moderate emotions and behaviors exhibited by children
- Communicate to children that they are not at fault or responsible for the death
- Provide assistance for coping with a grieving child or multiple grieving children when the caregiver is also grieving.
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Related Articles:
Tags: Adolescents, age range, caregivers, children, Danielle Parrish, Elizabeth C. Pomeroy, fears, grief, help, loss, Renee Garcia, social workers
Posted in
Grief And Loss, Tip Sheets |
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Introduction
When life is suddenly interrupted by a tragic or traumatic event, it can seem that the world has come to a screeching halt. Murders, assaults, and tragic accidents that occur without warning are particularly disturbing and difficult to manage emotionally. How individuals recover from such situations often depends on the prior psychological functioning of the individual, the exact nature of the trauma, and the individual's ability to regain some sense of safety and control over his or her world. There are, however, striking similarities in the ways in which we humans attempt to regain our composure and resume our lives after such an event.
While grief or sympathy is an expected reaction, another feeling is also tapped following a tragedy: a frightening sense of helplessness. Disasters, accidents, and traumatic events can invoke significant feelings of vulnerability and a loss of control in all of us. While each day brings countless threats and potential dangers to every human being, we have evolved to psychologically "insulate" ourselves from these fears and to proceed through our lives as if we, and everyone around us, have been somehow guaranteed another day. We dismiss the chance of death or loss, and we find comfort in predictability. We create a bubble around ourselves, enabling us to happily overlook our own mortality and the potential for life to suddenly and irreversibly change course. When that bubble is suddenly burst, it can leave us feeling helpless and vulnerable. Life suddenly becomes scary and unpredictable, and those feelings can be paralyzing.
To regain some feeling of control and to again make sense of life after a seemingly senseless occurrence, we may begin to search for both meaning and often blame. We may replay the specifics of the tragedy and the events leading up to it over and over to try and restore a sense of predictability. We may search all of the available information to find something, anything, that could have been done to prevent it: "If only I had taken another road…If only the airports had screened more carefully…If only the levees had been built better…"
If we decide that someone could have intervened and prevented the tragedy, or that some sequence of events could have been recognized as a prelude to the disaster, then we may feel that it is within our capability to prevent such a disturbance to our predictable world from ever happening again. If we begin to believe that it actually wasn't inevitable or unforeseeable, then no matter whom or what is to blame, we believe we can insure that the same mistakes are never repeated. The awful randomness of tragedy is thereby erased, and our impenetrable bubble is once again restored. Life returns to its normal, predictable patterns, and the demons return to the shadows.
While these maneuvers to restore a sense of mastery over our world are natural and usually benign coping strategies, they can also be the catalyst for a disaster of another kind. If, in our attempt to make sense out of the senseless, we misplace blame on either ourselves or on another, then we create culpability or responsibility where there is none. This results in essentially restoring our own sanity by sacrificing our humanity.
While we cannot be expected to completely avoid these tragic tendencies, we can be expected to constantly question our own motives and reactions. Anger, grief, sadness, confusion are all valid and understandable emotions in response to life's sudden attempt to exert its own will. But they are emotions that we, as individuals, must process and resolve for ourselves. It is important to recognize that a sense of helplessness may be complicating recovery. We must be able to look to life-affirming activities to help restore a sense of peace and balance.
If we are able to keep in mind that our own responses to tragedy and loss are often based in fear and a false sense of omnipotence, then we may be able to resist the desire to throw our neighbor into the volcano to deter the next eruption. Then, once we begin to accept that in many ways our lives are unpredictable and our days fleeting, we can begin to live more fully and cherish each moment that we are given.
In the aftermath of a tragedy, social workers are often "first responders" who provide services both on-site and in the subsequent days and months. Whether the situation involves only a handful of individuals such as in a shooting or an entire region such as with Hurricane Katrina, social workers are involved in the task of getting people's lives back to normal as quickly as possible.
- Social workers help connect victims and their families with critical services and provide mental health interventions for emergency personnel.
- Social workers provide ongoing psychological services for those directly impacted by a tragedy and help individuals move through their grief and fear related to the trauma.
- Social workers normalize feelings which create a greater sense of control.
- In situations where children are displaced, state social workers often assist them in finding temporary or long-term placement.
- When the tragedy involves the loss of a home or income, social workers help locate things like food, clothing, and shelter for the affected individuals. Social workers also help with job placement and the application for state or federal funds for which the individual might qualify.
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Tags: blaming, death, event, grief, help, Lesa Warren, loss, meaning, social workers, tragedy, tragic
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Introduction
According to the National Association for Children of Alcoholics (NACoA), there are approximately 11 million children of alcoholics / substance abusers in the United States who are less than 18-years-old. Being raised in a family where abuse of alcohol or other substances (illegal drugs or prescription medications) occurs can lead to a host of challenges for children. Children raised in homes with addictions often silently suffer and struggle with schoolwork, peers, self-esteem, and other problems
Any child who has a parent / guardian / primary caretaker who abuses alcohol or other substances would be considered a child of alcoholics or a child of substances abusers.
Alcohol or substance use among parents / guardians impacts overall family functioning and significantly impacts the ability of parents or guardians to provide appropriate safety and structure for children.
Children are at great risk for emotional, sexual, and physical abuse by parents or guardians who use alcohol or other substances. Many adult children of substance users report years of silent trauma while growing up in an addicted home. Children become vulnerable to assuming the role of the family scapegoat and are frequently blamed for the substance user’s behaviors.
Additionally, interactions with family members become unpredictable, which can lead to children feeling frightened or stressed. Children may feel as if they are "walking on eggshells" and are unaware that alcohol or other drugs influence their parents' moods.
Children often blame themselves for their parents' use of alcohol or drugs. This may result in children attempting to change their own behavior in order to satisfy parents who are difficult to please.
Children of alcoholics / children of substance abusers are at risk to develop several emotional disorders, including:
- Depression
- Anxiety / Panic Attacks
- Post-traumatic Stress Disorder
- Sleep Disturbances
- Social Development Issues
- Substance Abuse Disorders
- Eating Disorders
Many personal characteristics frequently develop in children who are raised in a family where an adult abuses alcohol or other substances. Children frequently become fixated on order, become "perfectionistic," feel different from their peers, become extra-responsible (or act as the "parents"), have difficulty with age-appropriate activities, take themselves too seriously, may be loyal despite proof that the loyalty is not deserved, or develop passive-aggressive ways of dealing with conflict. Conversely, children of alcoholics / children of substance abusers may become rebellious, demonstrate problem behavior, or have difficulty controlling emotions or behavior. In addition, children of alcoholics / children of substance abusers may start alcohol or drug use to cope with stressors, potentially being at risk for leading to a substance use problem.
There are a variety of effective services available for children growing up in families with addiction.
- School Counseling Centers: Public and private schools often employ social workers or guidance counselors who are available to discuss concerns around family addiction and the impact it has on children. This type of program is often designed as a preventive support that attempts to assist students prior to academic issues developing. Individual and group services may be offered.
- Individual Psychotherapy: Therapists trained with addressing family addiction issues are helpful to provide children with support and treatment. For younger children, play therapy (a type of talk therapy that involves the use of games and toys to express feelings) is useful for addressing issues that may be related to parental alcohol or substance use. For adolescents, there is a range of talk therapies available that will build on strength and resilience as well as focus on any symptoms that may have arisen, including depression, self-harming behavior, eating disorders, or anxiety.
- Self-Help: For older children and adolescents, Alateen may be a helpful resource and peer support group. This is a group of other children and teens who are dealing with some sort of family / peer substance use. It is based on a theory that is similar to Alcoholics Anonymous.
It is sometimes difficult to seek help for personal issues and seeking help when one’s parent has an alcohol or substance abuse problem is not exception. However, if you or someone you know is being impacted by family substance abuse, there is help!
Here are some helpful suggestions:
- Talk to a school counselor or teacher.
- Talk with a pediatrician.
- Talk with a mental health professional.
- Talk with an addictions counselor.
- Talk with another family member.
- Attend a self-help meeting.
- Talk to someone else you trust.
- Educate yourself! Read about resources on the Internet.
Resources
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Introduction
Parents of children with special needs (such as health, emotional, or behavioral conditions) often experience a complex array of feelings, including sadness, despair, uncertainty, anger, and loss. Leaving behind all they had previously known, families are faced with a new perception of daily life and asked to adapt to new and challenging responsibilities. In the first several months following diagnosis, the family’s focus centers on the child and his or her schedule for treatment, doctor’s visits, and life style adjustments. While the parents endure this necessary yet challenging phase, their own needs often fall by the wayside.
Mothers and fathers play an important role as parents but they also play an equally important role as spouses to one another. Given the significant stressors that families face, it is not unreasonable to expect their marital satisfaction to be impacted during this time. The ways in which each spouse reacts to and copes with the stress of their child’s illness has a dramatic influence on their relationship. Each partner deals with powerful feelings and responsibilities in their own individual way. Often times, this is the first time that parents see how their partner copes with tremendous disappointment and loss. Some coping styles are complementary while others contrast. One partner may be very expressive about how they are feeling, while the other may need space and time to sort through their feelings. It is important to recognize that all parents cope differently.
Societal expectations influence how parents "should" respond further reinforcing the demands specific to each partner. Many mothers feel like they need to do "everything." Mothers often feel pressure to continue to meet the needs of their husbands, household obligations, and other siblings. Unfortunately, they often leave behind their own needs and places of employment.
Fathers commonly state that there is an increased need to continue to provide for their families while under duress and to fight the stigma against being weak, sad, or tearful. Rather, they should be brave, strong, and in control. In trying to live up to the expectations of others, some fathers let go of their need for expression, connection, and time with their partner and family.
Over time the pressure to fulfill these demands becomes too great. Parents are bombarded with financial, emotional, and physical burdens. They are confronted with social isolation, communication breakdown, sibling resentment, conflict, role reversal, and a loss of intimacy.
When both partners are hurting, it is difficult for them to be supportive of one another. Spouses become convenient targets for each other’s anger and frustration. Stress and the threat of loss can intensify our need for love, affection, and reassurance and change our expectations of how our partners should behave. These changes highlight any potential insecurities or difficulties already existent within the relationship. Secure attachment, or the sense that one can count on their loved one, has been linked to resilience or the ability to deal with stress effectively. This "secure attachment" is a buffer against ongoing stress and the negative effects that stress might have on their relationship.
In the greatest race of their life, couples often forget which team they are on and turn against one another. In the face of such adversity we often ask what options couples are left with. Is it possible for couples to advocate for the needs of their child and at the same time the needs of their marriage as well?
Couples can maintain their relationship by using communication methods that work for them such as the following:
- Spouses need to identify one another’s needs and means of expression.
- Setting aside time each day to touch base with one another will prevent communication breakdowns and the build-up of resentment.
- Couples need to practice active listening. This enables each partner to feel truly heard by the other and to promote a genuine sharing of their experience.
- For couples that find active listening challenging, the creation of a daily sharing notebook is passed back and forth to maintain connection and enhance communication.
- The sharing of emotions such as anger, fear, and hope foster attachment and intimacy.
Couples need to create opportunities or activities including:
- Scheduling a date night every week. Although this seems difficult, many couples find it enhances their relationship. They can make this a reality by finding a friend or a family member that they trust to baby-sit for them.
- Selecting one activity that you always do alone together or a time of day that you always spend together. It is not important what you choose to do, but rather, that you make it a regular priority to do something together as a couple.
When couples spend positive time alone together they can begin to engage in and respond to one another’s needs. These positive interactions promote open communication, the ability to empathize, and hear other’s perspectives in a way that builds trust, intimacy, and security.
It is not uncommon for couples to need some help from professionals during this time. Communication skills and the art of compromise are often looked upon lightly. However, in the midst of a crisis, it can be quite difficult to master these tasks. Parents may choose to pursue short-term couples counseling to enhance communication practices, work through differences, or repair old wounds that have been brought to the surface in light of the recent crisis. The tools obtained in counseling will not only benefit the family in the short-term but will carry them through the longevity of their marriage.
Living successfully with a child with special needs requires good planning, effective coping strategies, and a lot of love. Parents are confronted with a challenge they are not prepared for and are asked to relinquish control of their previous life. They take on a host of new roles including medical experts, advocates, and insurance warriors. In doing so, their own needs often get neglected and their marriages go unnoticed. Despite the needs of their child, parents must find a way to support one another and meet their own needs as well. In doing so, they will not only help themselves but their child as well.
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Tags: child, couple, help, illness, parents, serious, special needs, Stacey L. Bergman
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