Goal setting

Goal Setting

By Patience Domowski

If you don’t know what you’re aiming for, how will you know if you hit it? I remember my dad saying this to a class he was teaching on how to teach. He was discussed making lesson plans for a classroom. I think this also applies to life goals. How will we know if we’ve achieved something or gotten where we want to go, if we don’t make a plan or know what we want?

Often in my work with children and young adults who are unmotivated to do their homework, school assignments, prepare for the future, get a job, etc I help them identify goals and things they want in their future. By just focusing on the things that bother them about their current situation in life, it will further depress them and make them continue to not make progress. However if you focus on something you really want that may be in the near or distant future, you will be more motivated to take the steps to get there.

If you, or your child, or anyone you know, is feeling stuck and not doing the things they know they need to do, try these strategies for making goals and accomplishing them. After they make a goal worksheet and plan, connect their future goals to things they need to do now in order to motivate them. If someone wants a certain career, they need to start with trying hard in school as a child. If someone wants to buy something that costs alot of money, they need to start finding ways to make more money now- job, or selling items, cutting costs, etc. There is always something to start with now, even if the overall goal is a long time off.

Steps to achieving goals:

1) Identify a Goal! 

a) It can be a big or long term goal like ‘Own my own company’, or something smaller like ‘Pass Math class this quarter’.

b) It should be a goal that is something you really want- not just what you parents want or you think you should want. You won’t achieve a goal you don’t care about. You might not be super passionate about it at first, or feel the goal is too far in the future to care enough about, but trying to identify anything to start with will help you get more motivated to try in the little things now that will get you closer to your goal.

c) The goal should be concrete. Abstract goals like ‘Be famous’ or ‘Be successful’ are okay to start with but then you need to add concrete plans underneath that with more specifics such as if the goal is ‘Be a famous singer’ then add a more specific statement so you know you have achieved this goal such as  ‘Have my song played on the radio’.

d)The goal should be achievable. While you might not know now if you can pass Algebra, or become a football player, try to think realistically if this is possible. Do you want be a doctor but failed every biology class and can’t stand the sight of blood? That might be not a legitimate goal. Or saying you want to be a professional sports player but your coach doesn't think you’re really quite at that level of talent. So try to think of something more likely or even something similar like ‘Work in the Sports industry’, or ‘Have a career helping people’.

e) Write it down. (Or draw it, cut out pictures and make a vision board, other creative options).

2) Write an approximate date to achieve the goal.

a) You may not know when this will happen, but set an approximate time frame to accomplish the goal, such as ‘End of the school year’, ‘in Five years’, ‘after I graduate college’.  Giving a time frame will help you stick to the goal better than a ‘sometime in the far away future’ that may feel too abstract to even start working on yet.

b) If you aren’t sure about what date to place, can ask someone else for ideas of when they think you might achieve the goal.

3) Identify the steps to achieve your overall goal.

a) Write the steps down in an order of what needs to happen first, second, third, or just things that have to happen to get to the goal, if order doesn't matter. (To start, just jot down all your ideas and then go back and put them into a more sensible order.)

b) Steps should be specific, if possible. Example: ‘Do my homework’ to get to goal of passing this school year, or ‘pick three colleges/jobs to apply to’ if you are working towards planning a future college/career plans. Be as specific as possible, but can use more general ideas if needed. For example “Get into college” is general, but naming a specific college is better, but if you don’t know which college yet, general is fine. “Get a job”, is general, but more specific would be to name some job options you want to explore like ‘Get a job in an office setting’ or ‘Apply to plumbing jobs’.

c) If you don’t know what steps you need to get to your goal ask for help. Look online, ask your parents/teachers/friends, seek consulting from an expert if needed. (see step 4 below).

d) The in-between steps are the most important ways to make it to the overall goal. Make as many steps as needed. Sometimes there are only 1-3 steps to a goal, and may just take a few days or weeks, sometimes there may be 20 steps and may take years, but try to identify as many as you can think of, leave some space in case you need to add more in later.

e) To motivate yourself for a far off goal try to apply things in your current life to how it can help in the future. For example, if the overall goal is ‘Be my own boss at a company’, but you’re still in elementary/middle school then beginning steps may be ‘Study hard and get good grades in school’, and ‘Learn leadership skills and take leadership roles in clubs/activities’ now, or ‘Ask entrepreneurs I know about their experiences’, ‘Keep my things organized’, ‘Do volunteer work’, and other things that may relate.

f) Write target dates/approximate time frames next to each step, if applicable. The target date can be a time frame like ‘Next week’ or ‘Senior Year’, it doesn't have to be an exact day. Examples: ‘Ask my teacher about___on ___(Monday/date)’, or ‘Take the SAT’ by ___(December of Junior year)’.  Some steps may be ongoing, so write ‘daily’ or ‘as needed’, or when another step is completed, as your “date” like ‘Read my motivation posters Daily’, ‘Ask parents for help As Needed’, or ‘Shop for a car, once I have x amount saved’.

4) Identify people who can help you if needed.

a) Parents/Family, Friends, Teachers, counselors, networking people, consultants, etc. - write down specifically who, not just ‘teachers’ in general, if you can.

b) Write down who can help with which step, or who can help overall.

c) If you don’t know who can help, list anyone who has been helpful in the past that you can rely on,also  ask on social media for your contacts to suggest people such as ‘Hey friends I need someone who can give me advice on buying a car’, or ‘does anyone know who I can ask for help with getting a job?’

d) List their contact info, if needed, on your goal worksheet

5) Write down some positive motivational words, phrases, thoughts, etc that will help you get towards your goal.

a) If you’re artsy, draw some pictures, or put some stickers on your worksheet.

b) Make a poster or something motivating to hang on your wall in your room. Teens looking forward to college may want to hang a poster/banner of their future college logo on their bedroom wall. Adults who want to achieve a professional career position may post a picture or words that remind them of this goal on a bulletin board/vision board, or a photo that reminds them of what motivates them, such as a family member, or friend,

After you’ve written your goal plan, get started with Step 1 on your list towards your goal! Remember if you get stuck and are not sure what to do next- ask for help. Others can give you lots of advice. If you struggle with getting motivated even to start, ask someone you know will help you to encourage you and help you along so that you can get started. Remember you will NEVER reach your goal if you don’t make a plan and then start to follow your plan. Goals don’t just ‘happen’, you have to make them happen!

Goal Worksheet - Free Download to use. 

Positive Self Talk

Positive Self-Talk

By Patience Domowski, LCSW

Did you know that talking positively to yourself can change how you feel and behave? It’s amazing how much our minds and thoughts can affect our feelings and behaviors. This is the basis theory for Cognitive Behavioral Therapy, known commonly as ‘CBT’. CBT teaches that changing your thoughts (often through a strategy or coping skill called ‘Self Talk’) changes your feelings, which then changes your behavior.

For example: You see someone you know at the store or a restaurant and they don’t talk to you at all. If you think “That girl didn't talk to me because she doesn't like me”, you might feel sad, annoyed, jealous, etc. Your behavior may be to snub her, not talk to her, or be rude. However if you change your thoughts to “That girl didn't talk to me today; maybe she’s having a rough day, or she didn't see me. Or she was busy/some other reason,” then your feelings change to more neutral/content feeling, not caring about it, or even feeling bad for the girl. Then maybe your behavior might be to go talk to her yourself or just let it go. The situation didn't change- the girl still didn't talk to you, however by changing thoughts from negative (‘she doesn't like me’) to positive (‘maybe she is having a bad day or didn't see me’, or some reason not related to feeling badly about me) then your feelings become more positive and your behavior improves as well.

‘Positive self-talk’ is also used to help you feel better about yourself when you have negative thoughts about yourself. So if your thoughts are ‘I’m a terrible person’, ‘No one likes me’, ‘I’m so stupid’, which makes you feel sad, disappointed, like a failure and leads to behaviors of withdrawal, avoidance, etc you can work on changing those thoughts to ‘Well, I did the best I could’, ‘Not everyone likes me, but my friends do’, ‘I’m still learning and everyone makes mistakes’, then your feelings become more positive such as feeling hopeful, happier, etc and your behavior likely would be to try harder, not continue to think harshly on yourself, maybe be more active or social.

Just going into a situation thinking positively about the possible outcomes will help you notice more positive aspects of situations and likely you will have a better experience than going in with a negative viewpoint. For example maybe you’re dreading a family party because you don’t know a lot of extended relatives that are attending, or there are often family arguments. You head into the party dreading these awkward moments that may arise. Instead you can change the thought to ‘I’m going to enjoy myself, regardless of others’, and instead maybe focus on the food, plan to talk to the one or two people you like/get along with, or anything else that may not be too bad about the event. Then after the party you may realize that it wasn’t so bad because you were focused on the good parts, and even if you didn't know some people, or someone started a fight, at least you were focused on the people you did know, and you stayed out of the drama.

Although thoughts won’t affect what happens- you can’t magically think away something bad happening, but if you focus on the positives/good things, you will feel better than if you are focusing on or looking for the bad things.

The situation may remain the same, but the outlook is different. For example let’s say you and your friend have a day off school or work due to the weather. One person is happy because they don’t have to go to school/work, and can hang out at home doing something they’d rather do for fun. The other person is upset because they either don’t get paid for not working, or they have to make up a school day later, and they are thinking they will be bored while home and really wanted to see their friends that day. The situation is still the same- school/work is closed due to weather, however the positive person will enjoy their day, despite the consequences of lost wages or having to make up the day later, while the negative person will be miserable thinking of what they would’ve rather had happen that day.

Common positive self-talk phrases include self-esteem affirmations such as ‘I’m a good person’, ‘Others like me’, ‘I am smart’, ‘I am loveable’, as well as motivating statements such as:  ‘I can do it’, ‘I can think positively about this’, ‘It will get better’, ‘I just have to try’, etc.

If positive statements do not automatically come to your mind spend a few minutes trying to think of something positive about a situation or thought that you have, and if you get stuck, think what would you tell your friend if they were struggling with the same thought. It might be hard to think positively for yourself, but it may be easier to think of something helpful to tell a friend. If you are still stuck, ask a friend or family member for some help coming up with some positive thoughts and phrases. Write them down so you don’t forget them. If you usually think negatively, it will be very hard to remember the positives, and even harder to believe them! So have them written down so you can go to them and use them when needed.

As you work on thinking more positively, just like physical exercise, it will become easier over time. At first it will be super hard, but then your brain will help you think of them faster. The more you try it the easier it eventually becomes. The more you focus on the positives, the better you will feel. So when you catch yourself thinking negatively about something, try to change that thought right away or focus on another positive aspect of the situation, in order to think and behave better.

People with anxiety and depression mostly need to work on postive self-talk, but all of us have times of feeling down or negative and can use this coping strategy so start stretching the positive 'muscles' of your brain now so you can be ready for when you are having a negative day. 

An old quote from Henry Ford (inventor of the Ford automobile) says “If you think you can, or you think you can’t: you’re right!”

Books flyer

Books for Sale, downloadable flyer to share

Link to Amazon. 

Feelings by Age

Feelings by Age

What your child should be able to understand and express, by age

By Patience Domowski, LCSW

Age 0-1: Baby can express sadness by crying, anger by screaming, and happiness by smiling and laughing. Some babies can express surprise too with a facial expression, often following by happy smile or crying depending on how they feel about the surprise. Babies usually respond to their parents and other caregivers emotions and reactions such as being more fussy if they sense mom is upset, or laughing when big sister makes a funny face at them. [Known emotions: Happy, Sad, Angry, sometimes Surprise]

Age 2-4: These little ones are just learning how to talk to express their feelings. Parents can teach them to name their feelings such as saying “I’m Happy!” or “I’m Mad!” when they are acting like they feel that way with their behaviors or facial expressions. Often these kids have very strong opinions and feelings and may show big emotions like anger and disappointment in the form of tantrums and meltdowns and excitement or anger in screaming. Parents can try to have their child say how they feel. Parents can also model this by naming their own feelings so the child learns which emotion goes with which term. For example “Daddy is sad right now because you aren’t listening and putting on your shoes.” “Mommy is so happy to see you after a long day at preschool!”

Some strategies for calming child is to teach them to take deep breaths, give themselves a hug or ask for a hug, and taking a break (such as child going to a private area to calm down, or parents and older siblings leaving them alone in one area until they are calm). Teaching these skills when the child is not upset is helpful so they are ready to use the skill when needed. Parents can also model these strategies themselves by doing and naming them. For example “Mommy is angry right now because you made a big mess when I asked you not to. I’m going to take a break and calm down. I’ll be right back.” or “Daddy is really disappointed you didn't make a good choice and hit your brother. I’m going to take a deep breath.”

Also if the child resists using a strategy to calm down, parents can offer an incentive such as use of a toy or a treat for calming quickly. Often it’s best to ignore screaming and tantrum behaviors until the child calms (if they are too upset to reason with) and then praise them when they are calm and divert to something else. At the preschool age some children are more verbal and understanding than others so it will vary based on your child’s language ability to be able to talk out the feelings and handle them appropriately. [Known emotions: Happy, Sad, Anger, Surprise, Excited, Love, Scared, sometimes Disappointed, Frustrated]

Age 5-7: These early school agers should know the names of most common emotions by now and be able to do some calming strategies. Parents should continue to encourage them to name their feelings and model handling their feelings too. These children may also be recognizing how their actions affect others’ feelings too. Some kids are very sensitive to recognizing others feelings while others are more oblivious. Helping them be aware of how their behaviors and feelings impact others is important. For example if they are mad and hit their sister, it can make their sister feel sad. Or if they are jealous and take their friends toy, the friend may be angry. Expanding their understanding of emotions can grow beyond the basic feelings to more specifics like Happy vs Proud specifically, or Angry broken down into disappointment, frustration, or fear. There are many games and flashcards/posters to use to teach the various emotions. Having children learn what each feeling is called, what it looks like on someone’s face and body, as well as what can cause that feeling is really important for them to grow in emotional intelligence. [Known feelings: Happy, Sad, Scared, Mad, Nervous, Surprised, Excited, Proud, Loved, Disappointed, Frustrated. Maybe: Jealous, Anxious]

Ages 8-10: These kids should be pretty familiar with most emotions. They may continue to express their feelings in acting out ways, but should know some strategies for coping and calming down. If they still struggle they may need to see a specialist to help. They should be more aware of other people’s feelings and be able to offer comfort to others if needed. They should be able to name an experience that would cause a feeling. For example “If my brother messes up my lego creation, I would be mad” or “If my friend got a new toy and I didn't, I would be jealous”. [Known feelings: Happy, Sad, Mad, Scared, Surprised, Anxious, Excited, Proud, Disappointed, Frustrated, Jealous, Loved, Uneasy, Annoyed, Nervous]

Ages 11-13: Preteens are hitting that hormonal puberty stage where their feelings may be all over the place. They may be getting upset and angry for no clear reason and acting out more than usual. Helping them realize its their hormones that are out of whack, not that the world is against them may be helpful in helping them calm their reactions. They may need more space and understanding as they navigate this difficult time. Parents should be understanding but also not allow them to be disrespectful either. Often preteens need time and space to calm down and think through their feelings and when they are in a better mood often talking about it can help. [Known emotions: at this age they should know most if not all the emotions, but may struggle to differentiate specific breakdowns of feelings such as anxious versus scared].

Ages 14-18: Teens should be able to name and know all the emotions and may admit to struggling with certain ones specifically- like anxiety or anger. They should know some coping strategies to calm down and be able to manage their extreme feelings. If they are extremely up and down with mood it can be a sign of a problem and they may need expert help (ask your doctor or therapist). While it’s normal to feel all the emotions at some point the teen should likely not be all over the place severely such as excitement to furious in a few minutes, for example. As they mature they should be better handling their emotions and learning how to regulate their responses. [Known emotions: All of them. They may have slang terms for some feelings].

Overall it's important to teach children of any age the names of feelings as well as how to recognize them (by facial expression and body language) in themselves and in others. It’s also important for children to learn what causes what feelings. After they learn those basic skills then they can learn calming and coping strategies to feel better such as taking a deep breath when angry or anxious (it tells your brain and body to relax), taking a break (such as walk away, go to room to calm down ,etc). After the child is calm then they can work on a strategy to solve the problem! Even positive emotions like excitement can cause problem behaviors if the child gets too silly, or screams, gets super energetic, etc and may need to calm down. Learning when and where to act appropriately is helpful too. Such as its okay to be silly when playing, or loud when outside, but not during library time at school, for example. There are many books, games, flashcards, posters, etc available for teaching these skills. Look online for ideas. Also realize that if your child has any developmental delays or autism than often these skills will be very delayed and may not come naturally- they may have to be specifically and deliberately taught. For example most children can recognize when their parents are angry, or their friend is upset, but a child with a delay or autism may be completely clueless.

If your child is struggling beyond reasonable expectation seek out help from their pediatrician, school guidance counselor, or a child behavioral therapist.

Some online printable resources: 
Free Download of Various Feelings Activities

More Fun Feelings Crafts and Activities

These are for learning ESL but can be used by native English speakers too!

There are plenty more! Just do a search on Google or Pinterest for free printable emotions activities. 

I have some books on these topics as well. "Violet" discusses Anxiety, "Brianna" discusses Depression (deep long lasting sadness), "Julian" learns about Anger, and "Lily" learns about making friends/social skills (which is related to recognizing others' feelings). They are all for sale on Amazon. 

No Social Media? What to do when you feel left out.

No Social Media? When you Feel Left Out

By, Patience Domowski, LCSW

When all your friends are talking about ‘Insta’ and Tweeting and ‘Snapping’ and you’re not… you’re likely feeling left out. So what do you do if all your friends are on Social Media and you’re not?

Maybe you’re not on social media because you’re parents won’t let you, you’ve lost the privilege because you got in trouble for making a poor choice online, or you’re just too young but your older siblings and friends are on there (legal age is 13+). Maybe you just don’t really want to get sucked into Instagram or your parents won’t let you have a smartphone, or they let you do some social media but not others.

Regardless of why you can’t be on it, what do you do about it?

1)Realize it's okay to not be doing something just because ‘everyone else’ is. It’s certainly hard, and you may feel left out, but realize there’s a reason you aren’t on it, and it’s okay.

2) Find other ways to connect with your friends- texting, talking in person, emails, etc

3)Remember not everything on social media is real. For example often people only present their ‘best selves’ and will only show pictures of them looking their best, or pictures that look like they’re having fun, when that might not be the reality of their life.

4)Try to cultivate other aspects of your social life that is offline such as joining clubs, activities, gatherings, and other events. Try to take up hobbies and find other interests. Kids are often happier interacting in person and having hobbies and interests than just perusing their friend’s profiles online.

Being on social media can cause some depression too. Seeing all the ‘perfect’ lives of your friends, realizing you’re not invited to parties that everyone else enjoyed, or even being a target of cyber bullying, can all cause feelings of sadness and loneliness. Remember that it's not about how many online friends or followers you have, or how many ‘likes’ on your photos you get, but it's about the real-life connections and friendships you make that will last and be more meaningful and real for you now and in the future.

Its okay to remind your friends ‘Hey, I'm not on facebook, so if you throw a birthday party, make sure to personally invite me!’ If you feel like you’re not being invited or included in activities, maybe set up an event or party yourself. Invite everyone with text or email, or be super old school and send print invitations in the mail. Then the people who come are people you can be friends with. You can still take pictures and enjoy the event, even if its not online.

As you get older your parents may allow you a presence online, or as you learn to make more mature decisions they may loosen the rules. Or even not, when you’re an adult you can decide these things for yourself. But make sure you’re not getting sucked into doing anything just because ‘everyone else is doing it’ and that you’re still grounded in ‘Real Life’ friendships and social connections, not just online ones.

Cold Weather Brings More than Winter Woes, by guest writer Caleb Anderson

Cold Weather Brings More Than Winter Woes - by Caleb Anderson - http://recoveryhope.org/

It’s not uncommon to get a little down in the dumps when winter weather arrives. Most of us get over it pretty quickly and actually start to look forward to crisp temperatures, hot cocoa and snow days. But for the millions of Americans who suffer with Seasonal Affective Disorder (SAD), cold weather means crippling depression that doesn’t go away until spring.

If you or someone you love shows signs of depression that occur only in the winter months, SAD may be the culprit. Here are a few tips on how to manage seasonal sadness:

• Go outside. One of the most effective ways to put SAD on hiatus is to simply go outside when the sun is shining. The Mayo Clinic lists reduced exposure to sunlight as a potential trigger for SAD and reports that more nighttime hours can disrupt your circadian rhythm and reduce your body’s level of serotonin.

• Look to the light. If getting outside is not an option, there are ways to see the light from behind closed shutters. Your doctor may recommend a light therapy box. These are available without a prescription. However, these bright light therapy devices, which range in price from $25 to several hundred dollars, are not regulated by the FDA and may increase your risk for overexposure to UV rays.

• Talk about it. Similar to traditional depression, those who suffer with Seasonal Affective Disorder may benefit from speaking with a cognitive behavioral therapist. Therapy, when used alongside other treatment methods, may reduce your risk of experiencing a recurrent bout of SAD in subsequent years.

• Get creative. Using art to get in touch with your feelings may help you overcome depression, seasonal or otherwise. The American Art Therapy Association was founded in 1969 and advocates the use of artistic endeavors to help patients come to term with everything from posttraumatic stress disorder to OCD. Even if you cannot afford this integrated therapy, the simple act of drawing, painting, writing or playing music may help you relax long enough to see the world outside of your depression.

• Take your vitamins. Vitamin D deficiency has been linked to Seasonal Affective Disorder, along with cancer, asthma and numerous other health conditions. Consider investing in a high-quality vitamin D supplement, which may reduce or alleviate some symptoms of SAD.

• Stay in motion. Taking care of your physical health does more than just make your body strong. Exercise triggers chemicals in your brain that can help counter depression. When you stay in motion, your body feels better. This can make it easier for you to cope with stress and other issues that can exacerbate negative feelings.

• Do something you love. Perhaps the most important thing you can do while fighting depression is to simply do something you enjoy. Give yourself a quick mental health boost by participating in activities that make you happy. This could be reading, which can give you a timeout in the midst of a hectic day; taking a walk in the park, which will help you clear your mind; or volunteering, which will help you put your life into perspective. Behavioral Wellness & Recovery also suggest spending time with animals and considering a service dog to help you cope with anxiety.

Even though SAD is a temporary, it can have long-lasting effects on your self-esteem as well as your relationships. It’s a debilitating mental health condition that you must actively work to overcome, and you can overcome it. So get outside, enjoy the light and make your physical and mental health a priority today and every day. Soon, the sun will return, and you will feel better and be better prepared for next year’s winter woes.

Gift Ideas for Mental Health

10 Holiday Gift Ideas for Merrier Mental Health

by Jennifer Scott, Spiritfinder

If you have a friend or loved one who needs a little extra mental health boost this holiday season, we have the perfect gift ideas for you. Whether they live with depression, anxiety, bipolar disorder, or just the regular holiday blues, we’ve carefully selected a list of gifts that won’t just be something new to wear, a household appliance or tool, but a gift that can truly change their life.

Here are our top 10 picks for gifts that make for merrier mental health.

●        Shiatsu Pillow Massager with Heat for Back, Neck, Shoulders Muscle tension is an ugly side effect of many anxiety disorders, and can lead to agonizing muscle pains in the neck and shoulder area. This powerful deep-kneading massager works to relax tight muscles similar to a visit to a local masseur. Programmed with a 20-minute auto shut-off, this heated massager costs $39.95, and is designed to fit perfectly behind the neck or in other body contours of the lower back, calf and thigh areas.

●        A Massage Gift Certificate Who doesn’t like a trip to the masseur for a luxurious hour of pampering? A new study shows that beyond the pleasure, massage actually helps to treat anxiety and other mental health disorders like depression by reducing cortisol levels, which decreases anxiety symptoms.

●        Relaxation CD In just about any store that sells CDs, you can pick up a relaxation playlist. These CDs can be used in the car during rush hour or at home before bedtime to lower the heart rate and reduce stress.

●        Online Guitar Lessons According to Neuropsychologist Daniel Levitin, PhD, there’s “strong evidence” that music can affect our heart rate and our mood, and even improve our immune systems. The gift of music provides a healthy outlet and the opportunity for positive changes for your special someone. Online guitar lessons provide a more cost-effective way to take private lessons, and you get to do it from the comfort of your own home for around $20/month.

●        13 Things Mentally Strong People Don't Do: Take Back Your Power, Embrace Change, Face Your Fears, and Train Your Brain for Happiness and Success Psychotherapist Amy Morin shares her poignant story of becoming a widow at age 26, and how she developed the mental strength to move on. Through “powerful lessons,” Morin encourages readers to overcome life’s challenges by developing healthy habits, exercise and hard work.

●        BioSense Pillow from Brookstone Some mental health disorders, like anxiety and depression, can be caused by sleep deprivation, so a good night’s sleep is important. The BioSense Pillow uses memory foam that helps relieve pressure, and includes three natural ingredients to help soothe and neutralize odors: green tea, seed oil, and charcoal.

●        Soundspa Machines These sound-making devices, often kept bedside, provide a variety of natural sounds, such as rain, thunder, ocean, babbling brook and white noise, to soothe.

●        Heartmath Biofeedback Devices Biofeedback is a mind-body technique that works to help patients influence their autonomic nervous systems. More than 11,000 Heartmath users reported the following mental health benefits: a 50% drop in fatigue, a 46% drop in anxiety, a 60% drop in depression, a 24% improvement in ability to focus, and a 30% improvement in sleep. Heartmath comes in three models, ranging from $129 for the iPad and iPhone app to $299 for a computer-based, multi-user system.

●        Yoga DVD Yoga has many mental health benefits, but most notably, it changes your body’s nervous system from a fight-or-flight anxiety response to a rest-and-digest calm response. Yoga’s deep breathing, combined with its stretching movements, takes your body into a more relaxed state. Yoga DVDs cost around $15.

●        Weighted Blanket These provide comfort and security for people with PTSD, depression, anxiety and related disorders.

A gift that benefits one’s mental health can have a lasting impact. So as you prepare to share the holiday with your loved ones, show them how much you support their mental health condition with a gift that improves their quality of life. Share it with the gift of your time, and it will be extra special.

Aggression in Children and How to Handle it

Aggression- how to decrease behaviors

By Patience Domowski, LCSW

Aggression in children is really difficult. From yelling to hitting, its very disruptive and sometimes even dangerous. Especially as the child gets older it becomes more of a safety concern. A 3 yr old hitting a parent is not that big of a problem, but a 13 yr old could really hurt someone.

To solve this problem we need to figure out why it is happening. Here are some possible causes:

-Child cannot manage their emotions (needs coping strategies), gets easily angry, anxious, frustrated, etc

-Child cannot effectively communicate (hasn't developed full speech due to age or speech delay, or autism)

-Child has a mental health diagnosis (autism, bipolar, ODD, …)

-Child has observed and copied aggression from older siblings, parents, violent TV

-Child is very impulsive (can’t stop and control themselves)

-Child has discovered that this gets them what they want from others  (example: if they hit then people leave them alone, if they yell then dad gives in, etc)

-Child gets attention from their behavior (even though it is negative, some children still want this attention).

-Other reasons…

For some children there may be a combination of reasons. Sometimes the reason is easy to discover but other times it may be more complicated. Collecting data (writing down the behaviors and what happened before and after) and doing an FBA (Functional Behavior Analysis) can be helpful. Ask your child’s teacher or behavioral therapist about how to do one if it is difficult to figure out the ‘why’ for the behaviors.

To correct the behavior we want to teach the child a combination of better coping strategies and a more effective way to get what they want.

For example: if they get angry easily when their sibling takes their toy we want to teach them to calm down, and also the skill of asking for the toy nicely, or asking a parent for help. If the child wants attention then teaching the child a more appropriate way such as saying “Mom, play with me!” instead of hitting would be helpful. Also the parent should ignore the inappropriate behavior until the child does the expected response.

If the child is copying others aggressive behavior- whether in person or on TV shows/games/ etc it is important to limit this exposure. If the parents are showing aggression such as yelling and hitting children, then it's likely the child will copy this as well. If the parents can try to be more patient and handle their frustrations in a more appropriate coping way, this can greatly help the child. Parents may want to seek therapy on their own, or try anger management groups, or even medication to help, if they are really struggling with depression for example. If older siblings are exhibiting aggression it is helpful to try to get them some more help and teaching the younger child to not copy those behaviors. If the child is watching violent TV shows, movies, video games, eliminate or at least reduce the frequency the child is exposed to that. If the child resists, explain that if they reduce their aggression they can slowly return to those games/shows etc. Pay attention to the ratings on games and shows however and the child’s age.

For cursing- if it’s in conjunction with anger and aggression, use same strategies already listed to teaching better coping behaviors, but besides that mostly ignore it, or teach a silly replacement word “peanut butter jelly sticks!” The more attention you give the curse word, the more powerful they become. You can tell them not to say that word and maybe even why, and if necessary punish for it, but if you make a huge deal about it (such as yelling and lecturing) it will likely make it worse. Also make sure parents and older siblings are refraining from using those words completely. Even if parents tell child not to say a word, if they are saying it themselves, the child will still learn it and repeat it. With any behavior, parents need to model good behavior and not to do anything they would not want their child to do (for the most part). Sometimes an old fashioned ‘swear jar’ is helpful. The person that says the bad word is ‘fined’ and has to pay real money into the jar.When the jar is full some families will use it for a fun activity, sometimes the money would go to the non-swearing person, or maybe the family would donate it to a charity.

Make sure the child’s aggressive behavior is not getting them what they want. If they are hitting their sibling to get them to leave them alone, and its effective, that is going to maintain the behavior. Try to teach the sibling to respond better and quicker and teach the aggressive child to request space in a better way. If the aggressive behavior is getting them the attention or item they want from parents, parents need to try hard to not give in. Even though it makes the screaming stop now, it will just make the behavior worse the next time if you give in.

If the child has not developed appropriate speech, due to age or delays, it maybe be helpful to teach a simple hand gesture/sign language to use to communicate. Maybe a clap means ‘Can I have it?’ or a hand tap means ‘I need help’. Ask your child’s speech therapist for some ideas to figure out what will work best for your child’s speech needs.

For kids who don’t have good coping strategies have them write up a list (or draw) several things they can do when they are angry and then hang the list in a well-trafficked area in the home (living room or kitchen is usually good). The list should be visible because when someone is angry they are not going to go searching for a paper in a drawer to figure out what to do. The strategies can include deep breathing, walking away/ignoring, asking parents for help, doing something fun to distract yourself, and remembering to ask nicely for things. There are many coping strategy lists that can be found online. The key is to find which ones work best for your child and to have your child identify these as well. The more the child is involved in identifying the strategies the more likely the child will use them.  Also have the child act out the appropriate coping strategy when they are in a good mood, as a role play, or after they made a poor choice to reenact making a better choice.

Try giving a reward to the child for using a strategy. For example if the child takes a deep breath instead of hitting mom, or stops screaming by deciding to go chill out in their room, give them a piece of candy, access to a special toy, or extra ipad time for making a good choice. Praise your child for calming down, whether it took 10 seconds or 1 hour, immediately praise them when they are calm so they associate positive attention with calming down.

Try behavioral charts. Children are often not motivated to make a better choice internally - it’s easier for them, or not big deal for them to yell and hit versus breathe and ask nicely. But if you sweeten the deal by offering candy, toys, extra time, other privileges then they are more likely to make the better choice. Some kids will need the reinforcement reward immediately and some can wait until the end of the day or week. Think about your child’s needs and personality to figure out the immediacy of rewards. If you aren't sure how to do this seek out a behavioral therapist who is experienced in this and can help you. Once your child learns the strategies to handle their feelings more appropriately they are likely to reduce aggression and you can fade out the behavior chart, or use the rewards to target another behavior.

Sometimes if the child is so out of control and aggressive they have to be restrained. Parents can learn appropriate ways to restrain their children (ask the school, doctor, or a therapist). If the child is in danger to themselves or others it is okay to restrain them until they are calm and in control again. The police and mental health crisis workers can also be helpful in these situations. If aggression is a regular occurrence, behavioral interventions are not effective, and the behaviors are fairly severe, medication may be necessary. Talk to your child’s doctor or seek a child psychiatrist for help.

Helpful Links:

Swear Jar: https://en.wikipedia.org/wiki/Swear_jar

Child Restraining: https://www.k-state.edu/wwparent/courses/rd/toolbox/rdtool-37.html

Causes of Aggression:

https://childmind.org/article/aggression-in-children-causes/

Handling aggressive behavior:

https://www.empoweringparents.com/article/how-to-manage-aggressive-child-behavior/

Taming Aggression and Coping for parents:

http://www.parentingscience.com/aggression-in-children.html

Anger Strategies (Other helpful blog articles)

Medication, Mental Health, and Children

Medication and Children’s Mental and Behavioral Health
by Patience Domowski, LCSW

Should I put my kid on medication?

Many parents wonder this when their child is struggling with mental health issues. Is this just a ‘quick fix’? Is medication going to harm the child worse than their diagnosis already affects them? It’s a difficult decision and many parents worry about side affects, addiction, and long term necessity. Many parents have heard horror stories of kids over medicated. The stories in the media are mostly negative, and most of the information about medication that is commonly known isn’t always accurate too. So how does one make that decision?

While it’s a personal decision to be made by the parent(s), and perhaps the child, (if the child is of age to make that decision, such as a teenager), here are some helpful things to consider when trying to decide what the best course of treatment is. Consider some other options for treatment before going the medicine route, except in certain situations, to be discussed below.

Treatment Options

First, try therapy. If your child is able and at least moderately willing to attend sessions, try a behavioral therapist to help with the child’s emotional or behavioral issues. Often the coping strategies taught in sessions are sufficient, and medication is not even necessary. Children with ADHD can learn some tips and tricks to help focus, kids with anxiety can learn some coping skills to calm themselves when anxious, and parents can learn some ways to better manage their child’s behavioral symptoms and emotional distress. Most child behavioral therapists will teach the parents some ways to handle the child’s behavior including ways to help calm the child when they are angry or anxious, and some behavioral strategies such as reward charts and consequences to utilize at home. There are behavioral therapists that are in offices, some that come to the homes, and some that work in the schools. Find out what is best for your child and what is available in your community, by asking your insurance agency, pediatrician, or school guidance counselor for suggestions.

If the problem occurs at school, get help from the school. If the child’s behavior is affecting their schooling whether it’s acting up in class, panic attacks that send them to guidance frequently, or the child is unable or unwilling to complete homework, ask the school for help. The school can evaluate the child to see if they qualify for an IEP for 504. If the child meets the requirements they can get extra formal and informal supports and services from the school district.

What if therapy doesn’t work?

If therapy and school supports are not sufficient, or the child is unable to even participate in therapy or school programs due to their emotional state or extreme behaviors, then it is time to consider medication. The question as to how long to wait to see if therapy and school supports are helpful enough will vary per child, however a few months is often a good time, and asking the school and therapist about this is a good option.

For example after several months of school interventions the child is still unable to focus, has frequent anger outbursts and can’t seem to control them, or other issues, it may be time to consider another path of treatment. Or after several months of therapy the anxious or depressed child is not seeing results, they are unable to do the skills at home, or the results are very minimal, they may need medication to help them achieve the ability to try the skills learned at home or school.

Do children ever absolutely have to be on medication or aren’t candidates for therapy?

Technically no, you never ‘have’ to put your child on medication, but sometimes it is strongly advised. Not every child qualifies for or would benefit from the same types of therapies. There are different options to consider to see what best fits your child’s needs. Some children need high levels of care such as hospitalization, or residential treatment, while most only need outpatient (office-based) therapy, or home based therapy.

In some cases it may be necessary to start medication immediately, prior to implementing other treatment options. If the child is extremely suicidal, has severe panic attacks on a very frequent basis, cannot focus or sit down long enough to learn in school or participate in therapy, or their behaviors are so extreme they include aggression, inability to reason (think logically), or have dangerous behaviors such as severe aggression or impulsivity, it may be imperative to start medication before, and in conjunction with, other treatment options. Sometimes children are too affected by their symptoms to even learn coping strategies in therapy or to learn and respond to school that they need something to settle them down before they can try other options.

Can my child get off their meds or are they on it for life?

Once the child, or teen, is able to settle down, because of the medication, they are better able to learn coping strategies. Often the medication takes the edge off enough that they can think more clearly, make better decisions, and use the skills and strategies that the therapist and teachers are trying to teach them. Most professional recommend a combination of both medication and therapy to best treatment.

Often kids are able to get off of medication over time, when they show progress using their strategies. Some kids are only struggling temporarily perhaps due to trauma, parent’s divorce, being bullied, or other life event, and after they have processed their feelings from these events are able to move off their medication as well. Sometimes children will be on medication for a long time however. Some children may continue to have their symptoms into adulthood. Talk to your doctor about the length and likelihood of medication for your child, as it varies per person. It may be hard for your doctor to tell you how long the child will need medication as their response to the treatment will vary.

What about side affects?

Side affects and effectiveness of medication is a real concern. Most side affects go away in a few days, and some medication works immediately (most ADHD meds) while others can take up to a month to see effectiveness (most anxiety/depression medication). If the medication is causing severe problematic side affects you should call the doctor immediately and see what they recommend. Don’t just pull your child off of certain meds that need to be tapered off, of there can be worse symptoms. If the medication isn’t working, talk to the doctor and they may increase the dose slowly, or try a different medication. They are many medications for each diagnosis, so they are several treatment options out there, not just the first one your doctor recommended. Some doctors can do genetic testing that will test the effectiveness of medication for your child and even side effects, before the child/teen even starts the medication. This may be a helpful option for some families.

Could my child become addicted to their medication?

Often parents worry about long term addiction to medication, or the child is never able to learn to live without it. While that could occur certainly, often children and teens are able to learn other coping strategies and are able to wean off the medication at some point in their lives. Also the medication should be closely monitored by the doctor to make sure no other issues are starting. People with ADHD and bipolar are far more likely to become addicted to illegal drugs than medication, as they often will ‘self medicate’ with drugs and alcohol to control their symptoms. It is much healthier to have them on legal medication that can meet their needs and is controlled by a doctor, than for them to turn to other unsafe methods to meet their needs. If the child is extremely suicidal, aggressive, or impulsive the risks of medication may outweigh the risks of non-medication due to the child’s likelihood of harming themselves or others from their symptoms.

How does medication help?

How does medication help? It fills in the chemicals in the brain that are ‘missing’ or reduced in the brain that are causing the child’s symptoms.  Often behavioral problems and mental health disorders are genetic, in that they are passed down biologically, or occur randomly in the child’s brain. It is not the parent’s fault, or the child’s fault. It just happens. Sometimes however problems can occur from environmental issues such as the child being raised in a stressful or difficult family situation, significant issues at school, a traumatic event, or significant loss. Then these situations ‘cause’ the diagnosis to some degree. Often there is a both a genetic and environmental factor that combine to cause the disorder, and fixing the brain chemicals can be done by treating with medication, and also by changing brain pathways in therapy in learning new ways to re-train or think about things differently and therefore respond, cope, in a better way.

Is there a medication for behavioral issues like ODD?

Oppositional Defiant Disorder is one diagnosis where there is not a specific medication or even category of medication for it specifically. While ADHD has a variety of meds to choose from, including stimulants, and nonstimulants, and there are numerous meds for anxiety and depression, and antipsychotics and other types of medication for certain disorders, there is not really anything specific for ODD. ODD is best treated with behavioral interventions. However if the child is experiencing depression symptoms along with their oppositional behavior, such as chronic sadness, frequent and prolonged anger outbursts, or aggression, there are medications that can address some of these issues. Medication for depression can help with these other symptoms to help the child be able to think more positively, be more flexible in thinking which can then help behavior. There are also medications for aggression and impulsivity that calm the body down to help the child stop and think and slows their impulses. If you aren’t sure if your child can be helped by medication for their behavioral issues, ask their doctor.

Who should I have prescribe the medication?

For children, often their primary care doctors, such as family doctors or pediatricians, will prescribe medications. Sometimes they will only prescribe something initially to start with and then refer you to a psychiatrist, other times they will handle the medication long term. Some pediatricians specialize or have a lot of experience handling emotional issues, or ADHD for example, and have no problem managing the medication, however others are reluctant to do so. Some children respond to the first medication and others need to have it figured out. If its more complex than just trying one medication, often pediatricians recommend to see a psychiatrist. A child psychiatrist specializes in handling medication for children and knows much more about these issues than a general physician would. They are the best option most of the time. Sometimes neurologists will handle medication for children with ADHD, and sometimes other diagnoses too.

What if my child refuses to take their medication?

Often children will refuse to take medication. Sometimes it’s just that they don’t like how it tastes or feels in their mouth, other times its because they are being teased about it from siblings or peers, or they aren’t sure it will help them. Making it easier for them to swallow by putting the medication into food can help, as well as providing them education on how it can help them. Often children report they feel much better on their medication and look forward to taking it. If they are refusing to take it because they don’t think they need it, have them talk directly to their prescribing doctor and/or therapist to discuss these issues. If they are not taking it because of behavioral reasons, a simple reward system for taking their pill daily can often be the best solution.

My child’s other parent refuses to allow them to take medication

This is a common problem, especially in divorced families. Often one parent doesn’t see, or believe, the same behaviors and symptoms that the other parent witnesses. Sometimes parents have personal reasons, have heard horror stories, or have bad experiences with medication themselves that they are not open to this type of treatment. It can be helpful for that parent to participate more in the child’s therapy, school support meetings, and attend the doctor’s appointments so that parent can discuss their concerns with the doctor and others involved in the child’s treatment. It may be helpful for the child to communicate directly to the other parent if they want to take medication (often teens ask for anti-depressants for example), so it’s not just coming from the other parent. In the end however if the child is underage both parents have to agree and sign off on medication. Perhaps asking the other parent to just allow it for a trial period to see if anything improves may be a good resort. Have them take data of the behaviors or feelings before and after the medication to see the results themselves.

Personal Note

Personally, as a behavioral therapist, I often do not recommend medication right away, because most children respond pretty well to behavioral therapy, and having parents involved in therapy and willing to take the therapist’s suggestions and try them at home, is often sufficient. However sometimes there are times, as mentioned above, where medication is necessary. I recommend medication sometimes after trying therapy for a little while without a lot of progress, or in some extreme situations where it is necessary to go ahead with it sooner rather than later. I support parents’ desires to make informed decisions regarding their child’s treatment while also encouraging an open mind to other forms of treatment available. Parents are often surprised to learn that there are many other children already on medication and it makes a huge different in their child’s life. Some parents are so happy to finally see progress from something that is very simple to implement. Often the information parents have on medication is outdated, as things have changed since the ‘ritalin age’ where kids were over-diagnosed with ADHD and over-medicated with Ritalin for example. Now there are more options out there and more information. I encourage parents to research and ask questions and find a doctor that can help.

Other helpful articles and information

 http://www.aacap.org/aacap/families_and_youth/facts_for_families/FFF-Guide/Psychiatric-Medication-For-Children-And-Adolescents-Part-I-How-Medications-Are-Used-021.aspx

http://kidshealth.org/en/kids/ritalin.html?ref=search&WT.ac=msh-p-dtop-en-search-clk
http://www.specialneeds.com/children-and-parents/general-special-needs/behavioral-problems-and-medication-kids

Depression in Young Children

Depression in Children
by, Patience Domowski, LCSW

            Depression is often characterized by symptoms such as severe chronic sadness; frequent crying, difficulty or resistance in doing regular activities like going to school or work, not interested or motivated to interact with others like hanging out with friends or going to social events. Sometimes there are also suicidal thoughts or actions as well. However in young children the symptoms for depression can look a bit different. Often parents are looking for the symptoms listed above in their child to identify them as “depressed” and are surprised or confused when their young child is identified with depression or a mood disorder when they really don’t seem sad.

            Children with depression may have the above listed symptoms, however oftentimes children present with symptoms of anger or rage outbursts, often very cranky or irritable, easily frustrated or upset, and overreaction or extreme aggression outbursts (often over small problems). Aggression can be physical- like hitting, kicking, throwing objects, or verbal- screaming, saying mean things.

            Sometimes depression comes from a specific event such as someone dying, parents divorce, being bullied at school, or a traumatic event. Other times it comes from “nowhere”- it could be genetic, or just something is off in the person’s brain chemicals. Often depression and mood issues are genetic and run in families. Sometimes symptoms only occur in one setting- such as just at home, or only at school. Sometimes they are worse or more prevalent in one place than another (more at mom’s house than dad’s house, for example in divorced families).

            It’s helpful to be aware of what depression can look like in young children because it differs from the typical symptoms we think of that are more easily seen in adults and teens. By being more aware we can help get children and families help sooner. If you see these symptoms or have concerns about a child, please have them see their pediatrician, school psychologist, or a behavioral therapist/mental health clinician. The clinician or doctor can help figure out what the problem is and how to fix it so the child is feeling better and behaving better at home and school.

There are a few different diagnoses that may be considered. Here are some general ideas of what each disorder means. They must be diagnosed by a licensed therapist or doctor however. This is not an exhaustive list or inclusive of all the symptoms, but just a very brief overview/explanation.

Depressive disorder – depression symptoms, as listed above
Mood disorder - mood issues, doesn’t fit exact definition of another disorder
Disruptive Mood Dysregulation Disorder (DMDD)- depression symptoms such as frequent irritability with oppositional defiant disorder (ODD) symptoms
Childhood emotional disorder- other emotional issues related to children
Adjustment disorder with depression- patient is adjusting to a trauma or life event that is causing the depression symptoms

            Prognosis is usually pretty good for young children who are identified and treated early. Some children will just “grow out” of their symptoms, while other children may need treatment. Sometimes the symptoms occur at different times and go away and then return in a different form. Children with depression/mood disorder don’t necessarily have a diagnosis for a lifetime. Children often may only have depression symptoms for a short period of time, or they may occur cyclically, while some may suffer for a longer period of time, even into adulthood. Usually with treatment children can learn to manage or overcome their symptoms. Parents can also learn how to better support and help their children going through this as well.

            Treatment for children usually involves first identifying the need such as noticing the symptoms, and reaching out to a child specialist to help. Getting your child diagnosed may also be the first step. Pediatricians, psychiatrists, school psychologists, mental health therapists and clinicians can diagnose, treat, or refer to someone who can help. Sometimes there is just an initial discussion with a therapist or doctor about the symptoms and other times there is a more formal assessment (including observations, testing, etc) for diagnosis. Treatment can include cognitive behavioral therapy with a child behavioral therapist, social worker, school counselor, or psychologist. A psychiatrist or pediatrician may recommend medication to help improve mood, which affects behavior. Sometimes if there are behaviors at school that are causing a problem there may be a need for a formal school evaluation and services provided via a 504 or IEP plan. Often a mix of treatment modalities such as medication, therapy, and school supports are the most effective.

Other helpful articles:

http://www.webmd.com/depression/guide/depression-children
http://kidshealth.org/en/parents/understanding-depression.html
http://www.nytimes.com/2010/08/29/magazine/29preschool-t.html
http://www.wingofmadness.com/depression-in-children/
https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Childhood-Depression-What-Parents-Can-Do-To-Help.aspx
http://www.medicinenet.com/depression_in_children/article.htm

 https://www.jenreviews.com/mental-health-diagnosis/

Homework organizer

I made a homework organizer worksheet for all those kids who are having trouble keeping track of their homework, turning in assignments, etc. Having things organized is a huge stress reducer for kids with anxiety and depression, and very helpful for kids with ADHD who are struggling with organization. Now just make sure they bring this paper back and forth to school! 

Download Homework Organizer Worksheet here! 

Depression Coping strategies

Note: Depression in children often looks different than depression in teens and adults. Instead of constant sadness, unable to function, crying, and suicidal thoughts, a child may be angry often, easily upset, grumpy/irritable most of the time, doesn't find things fun, complains often, and sometimes aggressive behaviors as well. For a diagnosis please see your child's pediatrician, or a licensed therapist. 

Some suggestions for depression:

·         Try to do something fun every day even if you don’t feel like it!

·         Incorporate exercise into your routine

·         Go to bed and get up on a regular schedule and try to eat balanced meals

·         Look for evidence that your negative thoughts are true. [For example if your thoughts are “I'm unlovable” then change that thought to “Is it true no one loves me? Oh wait, my mom does” so then you realize your thought isn’t true.]

Emotionality/Handling Meltdowns in children

Emotionality and handling Meltdowns

When your child is very emotional/gets upset easily/meltdowns

Do’s and Don’ts for parents~  by Patience Domowski, LCSW

Do…

·         allow your child to express their feelings (as long as they are safe)

·         provide a safe spot for your child to go to calm down

·         give your child space (if they are really angry don’t keep talking to them, let them calm down first or they will just get more upset)

·         use a “code word”  (silly secret word) for your child to say if they need space and need to be left alone when upset and respect that word by not continuing to engage with them at that time (Alternatively parents can use the word when they need child to give them space too to calm down)

·         come up with a list of coping strategies/chill skills for child to use when child is in a good mood and post it where they can see it

·         try to remind child of coping strategies BEFORE they become extremely angry (include an incentive like extra time with something or a treat if they use a chill skill to calm down)

·         try to help our child recognize the middle part between annoyed and furious so they can work on calming at that time instead of when they are super angry

·         wait until child is calm before problem solving

Remember: FIRST Calm, THEN problem solve!

Don’t…

·         tell your child not to feel angry/anxious/sad/ etc (they can feel what they feel)

·         punish your child for feeling [discipline for “behavior” not “feelings”]

·          keep yelling/pushing your child to do what you asked/discuss the problem/etc when they are getting upset

·         allow child to be disrespectful or aggressive even if they are upset. [If they do so have them apologize afterwards ]

·         threaten things you don’t mean or won’t follow through with such as a punishment

·         give in to child’s wants when they aren’t making a good choice, or after saying no already (even if it means a meltdown is coming)

Goal Worksheet

Goal Worksheet- this is helpful for teens/adults who need to focus on accomplishing goals, especially those with depression

Goal Worksheet~ by Patience Domowski, LCSW

GOAL 1: ________________________________________________________

Why this is important to me:

Approximate time I should meet this goal:__________________________________

·         Step 1/ (What can I do now to work on this?) [Include sub-steps if needed]

·         Step 2

·         Step 3

·         Step 4

What might keep me from reaching my goal?

What can I do to handle those things that keep me from my goal?

What can I say to remind myself to keep working towards my goal?