Busier Brains: Helping Kids and Teens with Emotional Health Challenges Feel Better by “Doing Enough”

A psychologist named Peter Lewinsohn back in the 70’s wrote an article which suggested that (at least part) of the reason people feel depressed is because a) they don’t have as many potentially rewarding activities in their lives compared to others, and b) that they don’t find the activities as naturally rewarding as other people.

Although today psychologists are more likely to believe there are a range of (more complicated) causes for depression rather than just this one factor - there is some research to support the idea that ’underactivity‘ might be important in at least contributing to low mood - in both adults and for kids/teens.

For example, studies have found that children and adolescents who do less extra-curricular activities like sport, music and other activities - are more likely to have mental health difficulties than other children/teens. There are also studies which show that kids and teens with more social activities, who do more physical exercise, who do more homework and who attend school more often - are usually happier than those who do less of these activities.

Now of course, this is correlational research – in other words these studies usually do not show ‘what causes what’. It might be that kids/teens who are happier and have better mental health in the first place do more sport, extra-curricular, social or homework activities than those who don’t – or it might be some other third factor underneath causes both more activities AND better mental health.

However we do have some – limited - research suggesting that doing more activities might actually lead to better mental health. For instance, there is an interesting psychological treatment called ‘Behavioural Activation’ – in which psychologists help children/teens with low mood to figure out their values and goals, plan and set activities to do which fit with these values, problem solve barriers which come up and help reward themselves when they do these activities. Studies have found that this kind of treatment has regularly been found to be extremely helpful for many young people with low mood.

Studies have also found that when you do any kind of therapy which increases young people’s autonomy (feeling of having choice and control), sense of feeling connected to others and feeling of being involved in things which are meaningful to them – then these things are more likely to lead to better mental health.

All of this research suggests to me, that if we can help children and young people with mental health or life challenges, ’do more important (to them) stuff‘ we have a good chance at improving their mental health.

Ideas for helping children/teens with mental health challenges have busier brains and lives:

Before I start listing some ideas to help increase activity levels in young people, I should acknowledge that this is not an easy task. Often we are going to be fighting against a young person’s very strong instincts to avoid/withdraw (and sometimes this is aided by escaping into technology). So it is important to understand not all of the ideas below will be appropriate for all young people – and even if they are, they may take a significant amount of energy and resources.

Please be kind to yourself as parents/caregivers when thinking about using them. Take it slow, and never hesitate to consult a mental health professional to support your family.

Explaining the importance of activities for children/teens:

Here are the three concepts we can explain to young people:

  1. Often the less we do, the worse we feel.

  2. Often the more we do, the better we feel – especially in the long run.

We can explain that in some ways, parts of the brain can be seen a bit like ’muscles‘ and that just like other muscles, ’moving/using brain systems‘ can help keep them healthy. It can also be helpful as parents to disclose some of our own personal experiences and history to share how this has been true for us.

  1. Explain that there are certain types of activities which are more likely to help us feel better

It can be helpful to help our kids/teens notice how they feel after doing certain activities. For example, we might ask them to think about the general categories of activities they do during the week, and how they think they usually feel during and after those activities – not just immediately after, but also the next day.

Help young people to come up with other meaningful activity ideas which improve their mood

It is hard for young people to come up with meaningful activity ideas for them to engage in. Having categories of activities can sometimes help. I use four categories: ’being with people activities‘ (conversations with others, time spent with friends online or offline, time with family or extended family – or anything in the company of other people), ’ticking stuff off /goal activities‘ (projects related to school, hobbies, investigations, practicing sporting or musical skills – or other skills, making something, rehearsing, collating information, working towards career goals etc), ’fun activities‘ (anything a child/young person finds fun - games, reading, online gaming, watching videos), ’helping activities‘ (volunteering, caring for a pet, caring for family members, checking in or being kind to friends, being an activist, gardening, caring for the environment).

With younger children I call these four categories - healthy mind activities.

In order to identify the activities in each of these categories which are more likely to improve you child/teen’s mood, we need to try to help them identify the values and tasks which matter most to them – and then fit activities to these values.

This is not easy – but we can ask questions like the following:

  • Imagine you are (pick an age – often it might just be a year or two older than they currently are). What would you be doing, thinking about and spending time on if you had the “best life” you can imagine at that age?

  • What kinds of ’being with people‘ activities might you be doing?

  • What kinds of ’helping‘ activities might you be doing?

  • What kinds of ’fun‘ activities might you be doing?

  • What kinds of ‘working towards a goal’ activities might you be doing?

We can be on the lookout for extra-curricular, social, achievement orientated and helping activities - at school, in local areas, on social media groups, council websites, church organisations, not for profit groups etc – and then ask children/young people to give us a score out of 10 for how much they think they might enjoy them.

Some of the time, children and young people with mental health challenges may not be overly interested in any activities at all. For young people with challenges, this is not because they are ’lazy‘ or ’addicted to technology‘ or ’just don’t care‘. This might be due to deep seated instincts to withdraw, avoid, or attempt (albeit often not helpful) to manage their own mental health and insecurities.

At this point, parents/caregivers have to make a decision about how much to ’push‘ or insist upon some activities being part of their life (including perhaps using consequences – potentially such we will keep discussing this until you choose an activity, there might be no wifi/phone usage etc unless you are involved in X/Y), and how much to just allow the young person to determine how much and what they will do themselves (we will encourage but allow you to make your own decisions about what you want to be involved in).

There is no easy way to know how to make this decision about how much to ’take charge‘ as a parent. It will depend on a variety of factors such as the following:

Age – it is sometimes easier for parents/caregivers to insist younger children are involved in activities compared to teens. For this reason, I often tell parents of younger children to consider making a family rule about involvement of activities when they are young, knowing how important it will be for mental health when they are older – and that it might become harder as they get older.

Relationship – parents/caregivers who have a closer relationship with young people are sometimes able to ’push‘ a young person more – because their relationship is strong enough to withstand the challenge which comes with insisting a young person be involved in more activity.

Temperament – some young people with mental health challenges also have a very strongly independent temperament, and trying to talk about this and support young people to do this backfires and is not the right approach.

Extent of mental health challenges and potential benefits – some children and young people have serious mental health challenges and are in desperate need of more activities in their life, and therefore their parents/caregivers are prepared to do more work/put consequences in place in order to ensure this occurs. Other children/young people may have lower mental health needs and/or extra activities in their life may not be as beneficial or needed – in which case it might not be worth parents/caregivers insisting these occur.

Parent time/energy resources – supporting children and young people with mental health challenges to have more social, physical, helping and goal orientated activities in their life can be a very time consuming, tiring and never-ending task. Sometimes parents/caregivers can scrape together the energy to be working on this (usually slowly) but sometimes understandably they just don’t have the energy to do any of it.

Ask children/teens to then make a commitment to a schedule for when/how much they will do the identified activities:

Once you have agreed on certain activities that your child/teen is prepared to do (or that you as their parent/caregiver are prepared to assist them to do despite their reluctance), it is then helpful to try to come up with some specific schedules for when/how much/how long it will occur.

This usually means having a written plan, for example we might:

  • Put commitments on phone/device calendars

  • Draw up a schedule on paper or a whiteboard and stick it on the door/fridge

  • Set alarms

  • Identify specific numbers of times the activities will occur over a certain time period and for specific lengths of time (some research suggests identifying a ’range‘ is more likely to be complied with than identifying a specific numerical target)

  • Identify the specific places and times the activities will occur

For young people and children with challenges it is sometimes best to start activity schedules for a short period of time – ie 2 weeks – as a trial, rather than for the long term. This can be explained as an ’experiment‘ to see how it impacts on mood – and then it can be reviewed.

Making it as fun as possible

Ideally we do not want children or young people doing activities just because we have asked them to. After the activities have been completed, we want them to have a sense of achievement or enjoyment, and to notice that it felt good in some way to have done them.

To do this, we might ask them what they enjoyed about the activity, ask them to congratulate themselves for doing it, praise them ourselves or notice some kind of sense of satisfaction in doing the activity.

Problem Solving

It is not too hard for young people/children and families to plan for them to do certain activities regularly – but it is much harder to help young people to actually commit to doing them.

In my experience, it is therefore important to anticipate the problems and then problem solve these in advance.

  • This is all good in theory, but tell me – really – what is going to make this hard to actually do when it comes to the day?

  • What could you do when you really don’t feel like it?

  • How can we help you do this when you can’t be bothered?

  • What might get in the way of you wanting to do X/Y/Z – is there something we could do to make getting started easier?

Follow up

For young people/children managing mental health concerns, there is never a ‘set and forget’ button. Usually this requires ongoing management and discussion – and then review.

All the best in doing this sometimes very hard work with kids and teens. Although it can be an exhausting process (especially if it involves a pushing back against a young person’s instincts) – personally, I believe that it can be one of the very important things we can do for our children/teen’s mental health. Sometimes I even wonder if Australia had a few less ‘mental health services’ and a few more easily accessible, free and convenient options for increasing social, achievement orientated, helping and fun activities for children and young people – perhaps the mental health of our young people would improve.

Kirrilie

If you have a 4 to 11 year old child, and would like them to learn about the importance of engaging in "healthy mind activities", go to calmkidcentral.com. In this program there is a video, poster, and activity sheets to help children understand this idea. There are also other videos, lessons and games for kids, and articles and lessons for parents/caregivers about supporting children with emotional, mental health or life challenges. You can also ask questions of our child psychologists and receive a response within 48 hours.