Recently I was talking with a Mum, Taylor* who was despairing about the rudeness of her 15 year old daughter, Jess.  Jess was seeing us for support in managing her anxiety disorder and perfectionism, and I was talking with Taylor about how she was going with supporting her.  Taylor raised the problem of Jess’ rude behaviour at home.  She said Jess was polite and friendly to her teachers and friends, but this ended as soon as she walked in the door at home.  According to Taylor, Jess would often rudely make demands, grunt when she was asked questions or sometimes just ignore her.  Taylor knew Jess was dealing with difficult emotions – but she felt unappreciated, resentful – and worried about how this would affect her and her daughter in the future.

If you work with teens (or pre-teen), you may be nodding along – it’s not uncommon for teens to be surly, rude and disrespectful.    And this is especially true for teens or preteens who are dealing with difficult life situation, emotional or mental health challenges.  Let’s look at the main causes of rude behaviour in these teens.

If you ask parents what they most want for their child, many will say something like this:  “I just want my child to be happy”.  Whilst most of them know, at a logical level, that they can’t make this happen, seeing their children frequently or deeply sad, is very confronting.

This is true for us as professionals too.  While we may be quite used to supporting and working with children who are anxious, frequently frustrated and disappointed, and know the steps to take in helping children manage these other emotions, there is something additionally challenging about working with a child who appears frequently or deeply sad.   

It is also challenging to work with parents of these children.  Often parents who have children who experience frequent or strong sadness themselves feel helpless, frustrated, worried – and like a failure at some very deep level.   Sometimes they express their pain in being particularly demanding towards us.  This then leads to even more pressure for us as professionals to “do something”!

However, the truth is - it is not uncommon for children to experience times of sadness.   Although only about 2-3% of prepubertal children will experience the type and extent of sadness psychologists will diagnose as a formal depressive disorder, many more children experience slightly less severe – but still persistent and frequent – sadness at some point during their childhood.

As a professional working with children and teens, I see tired and sleepy children and teens in schools and in the therapy room almost every single day.   Research suggest that between 25 and 75% of young people are sleep deprived.  This is a wide variation - it seems to depend on how you ask the question and who you ask - but even if we take the middle figure, the suggestion that half of the next generation don't get enough sleep is concerning.  I haven’t seen longitudinal research on this but it seems to me that sleep deprivation in children and teens has become more prevalent over the past 20 years.

Given the significant effects of sleep deprivation on educational and psychological outcomes, I think it is important we continue to work on helping children and teens get more sleep at home.  Of course partly this needs to happen via parent education.  But I also think there is a role for us as professionals to be educating children and teenagers directly about this issue.

But other than "you need to get more sleep" - what exactly should we be telling them?  What do young people themselves need to know?

Below are what I believe to be the 12 most important sleep concepts young people should know and ways of phrasing them so that young people understand.

How many times have you heard a student say “I can’t do it!” or “It’s too hard?” or “I’m not smart enough?” 

Unfortunately, there are some students who really struggle with anxiety about their ability to complete learning, homework or other study tasks.  We can call this low academic confidence.

Although many students experience a lack of academic confidence at times, statistically it is more likely to be girls who experience it most frequently – and particular girls who are surrounded by “academically high achieving” peers.

Unfortunately when students don’t believe they are capable of learning something or completing a task – then they are less likely to do so, regardless of their actual level of ability.  And a chronic lack of confidence and anxiety about learning is associated with higher levels of stress.

I often talk with families who are really struggling with this issue at homework times.   For students who feel highly anxious about their ability to understand ideas and complete tasks, homework can be a nightmare.  Parents/caregivers have to reassure, cajole, support and mop up tears – and often get really stressed themselves.  Some research on homework has indicated that homework time is the most stressful time of the day for families – with one study showing that mothers daily mood ratings are worse on the days when they spend more time around teens/children who are doing homework.

As professionals working with kids we know that children learn a great deal from “playing” with each other.   They learn to interact socially, learn about their environment and how the world works.  It is important for children to have unstructured time to play together without adults directing the action.

Unfortunately we also know that there are some children who often struggle with this unstructured play.  Arguments and fights develop quickly and get out of hand.  Some children find it really difficult to resolve problems among themselves.

In my experience, these children really benefit from us supporting them with these skills.  Here are some of the ways I work with children in this area.

1. Ask children questions about their game playing

Given the importance of game playing skills, when I'm working with kids I routinely ask about their recess/lunch/after school play with their siblings and friends.  For example here are some questions which might be useful to ask children (either in a classroom situation, written “playtime quiz” or when working with children one on one: 

Who are you playing with at the moment? 
What games are you playing? 
When was the last time you/your friend got mad during those games? 
What happened?
What are you good at when playing with friends?
When do you need an adult’s help when playing with friends/siblings?

Once we are aware of how kids are going with their game playing, we can then look at the kind of skill development needed. 

2. Helping children generate useful “rules” or guidelines to play

Before working on an area with a child, I attempt to see if I can get their permission.  For example, I might say:

"Could we do some brainstorming together to make playing games more fun?"

I then ask children to think about specific games they play rather than “playing” in general.   If parents are working with me – I’ll ask parents to help identify games they know the child/their siblings play together.

For example: 

These days part of my role involves supporting a team of people to work it with young people.  This means I get to read delightful publications such as the Harvard Business Review - something I never imagined myself doing many years ago!  However it seems I can't take off my "clinical psychologist hat" - while I'm reading these articles thoughts often come to mind about how the concepts apply to working with young people directly.

For instance, I've just been reading about what organisational psychologists call: "Post implementation reviews" which from my (albeit limited) understanding thus far seem to be the process of reviewing a project with a team after it is completed.  From the length of the article I'm assuming there must be more to them than this (?) but apparently doing a PIR (yes - there is an acronym :)) after the completion of a project significantly improves the performance of the team in their next project, even if the projects are unrelated.

This has made me think about the "PIR's" we do as professionals with children and teens about their school year.  As it draws to a close, I regularly spend time with the young people I work with asking them to reflect on what the year was like for them and what they'd like to do next year.  I believe these conversations often help them - socially, emotionally and academically - in the following year.

If you are working with children/teens in a classroom setting, or in a counselling room, it might be worth putting some time aside to help them self-reflect on their year.

Here's how to do your own PIR (see, now it's part of your vocab too) with child/teens you work with. 

This week I've felt disappointed and worried about various situations.  One of my kids was sick and I was worried about him.  I had a disagreement with my partner and felt frustrated. I felt overwhelmed by my task list at work.

In other words, I'm a (fairly :)) normal human being who had a pretty normal week.  As humans, we all experience difficult times - and negative emotions - most of us at least weekly, if not every day.

One of the strategies most adults instinctively use to cope with these negative emotions is to generate calm, reassuring and positive sentences to say to ourselves to give us another perspective on our situation.   

An article published by the Australian Psychological Society in 2009 estimated that 50,000 children in Australia each year experience separation and divorce each year.  This means as professionals who work with children, we are likely to have many children in our classrooms and therapy rooms who are experiencing this life change at any one time.  

Obviously there is a great deal of variety in how these children manage.  Some of them find the experience pretty hard going for a while. They might feel sad, worried about the future, irritated, guilty or frustrated.  Sometimes these feelings creep out as tricky behaviour, becoming "clingy", crying, "acting out", getting more frustrated than normal, anxious behaviour or struggles at school.

One of our jobs as professionals is to help young people express their negative emotions clearly and respectfully - to us, and to others.

This isn't easy.  Many children and teens find it hard to tell us how they feel when they are upset, angry, worried or embarrassed.  

This is not surprising.

It is not easy for us as adults to describe negative emotions, what might have caused them and what we would like to happen differently.   It's even harder for young people, with less developed brains - and sometimes bigger and more powerful feelings which interfere with communication skills anyway.

Something to work on.......

While it is normal for young people to struggle to say how they feel AND it's okay for them to choose not to tell us everything they feel upset about - it's also important for them to gradually improve their ability to express negative emotion.

“AAARRRRKKGGGH”

This was (roughly speaking - I may have got the spelling wrong) the word *Josh yelled when a leaf blower was used outside our office in a session last month.  At the same time, he put his hands over his ears and ran to the corner. 

Josh hates loud noises and gets really distressed whenever they occur around him.  It’s especially hard for him when they are sudden.

And Josh of course is not unusual  – there are many children who are extremely sensitive to loud noise.  Many children I see clinically will report some sensitivity to noise.  Sometimes noise sensitivity is associated with a broader sensory disorder (for example, Autism Spectrum Disorder), but sometimes these are just noise sensitive kids without any further disorders in the background. 

Last night, I settled in with my large hot chocolate on the couch to watch the movie on eating disorders - “To The Bone”. 

For those of you who haven’t seen the shorts – this is a movie about a young woman with anorexia who gets treatment for an eating disorder.  She has a short stay in a group home facility, meets others with eating disorders, has some family therapy, a short romantic relationship with another person with an eating disorder and ponders whether she really does want to get “better” and overcome her eating disorder.

Along with many of you - I've worked with many kids/teens with symptoms of disordered eating and struggles with body image for many years - so I was keen to see whether this was going to be a useful movie I could recommend to families.

Unfortunately, I don’t think it is. 

But as usual when it comes to these kinds of issues, I have mixed feelings.  Here are my thoughts.

Here are the four aspects of this movie I like.

1. The movie will raise awareness of the existence and nature of eating disorders.  This is probably a good thing.  Although as professionals working with young people we are often (or constantly - depending on your role) - exposed to eating and weight related problems - society in general doesn't get a lot of exposure to this problem.  Movies like this therefore may be helpful in that people with an eating disorder may watch and feel comforted to be reminded they are not alone.  Those in the general community may learn about these disorders and feel compassion for those who suffer. 

Various research reports suggests that 10-20% of teens have sent or received a sexually explicit photo in the last 12 months (some studies estimate as low as 4%, some as high as 50% - depending on how you ask the question).  If we assume around 15%, this means the average sized secondary school will contain 150 -200 students who have recently sent or received a naked or semi naked picture of themselves.

Given the prevalence of this issue, we can’t bury our head in the sand.  Teenagers everywhere are doing this - including the teens we work with.

In our clinics, the most COMMON area of challenge for the children /teens we see is managing anxiety.  This is a reflection of a wider trend - anxiety is the most common psychological symptom experienced by kids and teens in Australia.

Often in my writing, I drill down to the specifics of the work we can do as professionals, teachers and counsellors in helping young people cope with anxiety.  Today, I'd like to take a step back and think about the five broad goals we are trying to achieve when we work with children and young people who are anxious..