Category: ADHD

For Fathers Who Raise Troubled Kids

For Fathers Who Raise Troubled Kids

Fathers are critical to a troubled child’s wellbeing.  Yet in my experience, they aren’t as present in support groups or meetings set-up for a child’s care.  It’s not that they don’t care; they need a different kind of support.

Every year, I attend conferences around the nation that focus on the families, children, and policies associated with children’s mental health.  The majority in attendance are women.  I was a social worker in children’s mental health for 5 years, and a parent advocate for insurance parity in my state.  In every meeting I attended were lots of mothers and female social workers, and one father.  Parents who attend my family support group are also mostly woman:  bio mothers, adoptive mothers, girlfriends, stepmothers, grandmothers, aunts, and sisters involved in caring for a troubled child.  I always encourage moms to bring in the dad, stepdad, eldest son, brother, boyfriend… any male who’s important in the child’s life, and some are able to convince them to attend at least once, and it always seems to help.  I’ll call them all “dads” here,

We need the men.  I know they are out there.  I know they are engaged in raising a troubled child and perhaps alone with their concerns.

At a national “Building on Family Strengths” conference in Portland, Oregon, was a presentation on the subject of dads helping dads.  It was the first time I attended a seminar where mostly men attended.  I asked the panel, founders of Washington Dads, www.wadads.org, “why hasn’t there been a gathering like this before?”  Apparently, panel members tried to find help and it wasn’t there, so they started a support organization for themselves.  They believe it’s the only one like it in the nation.

“We’ve been down on our knees in pain for our kids…”

The messages – One panel member said men feel they are supposed to fix the problem, but since they can’t  they feel like failures.  Another said that “dads are often not the main caregivers, and perhaps they lack experience,” and after trying what they think will work, are at a loss when it doesn’t.  Another, “we want a quick fix, but a clear concrete fix will do… we want to know how to problem solve.”  That’s a big one, men fix things, they want to get together and hash out solutions.  “Men talk solutions right away instead of talking through emotions.”  They said men like rules or instructions such as Collaborative Problem Solving techniques, the use of technology, and concrete, measurable plans such as IEPs. (Here is another story about a father who wants to fix his daughters illness.)

In general, moms tend to feel guilty, but dads tend to be resentful or feel like failures:

  • Their family’s problems are right out there in public
  • Mom is too lenient and easily gives in to the child.
  • The child gets all the attention; other family members are neglected.
  • Quality relationships with all family members are lost.

According to the dads’ panel in the seminar, sad’s emotions are there but expressed very differently.  “Some men need to vent aggressively… blow a gasket, but only other men are OK with this.”  Some want to reveal things to each other they wouldn’t share with their wife or partner; “men need to bond without women present” and with personal face-to-face contact.  Men tend to have custody issues too, and often face challenges to their rights to visit their children or maintain relationships with them.

Gentlemen, trust me, moms want you to have support that works for you.

Can you help me out?  I’d like to find other articles about issues fathers face:

  • custody of the children
  • disagreements with mom
  • their influence on treatment, or placement, or educational issues
  • their need for social support with other men

 

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Research on the very positive influences of fathers

Devoted dad key to reducing risky teen behavior – Moms help, but an involved father has twice the influence, new study finds  [EXCERPT],  By Linda Carroll, June 5, 2009

Teenagers whose fathers are more involved in their lives are less likely to engage in risky sexual activities such as unprotected intercourse, according to a new study.  The more attentive the dad — and the more he knows about his teenage child’s friends — the bigger the impact on the teen’s sexual behavior, the researchers found.  While an involved mother can also help stave off a teen’s activity, dads have twice the influence.

“Maybe there’s something different about the way fathers and adolescents interact,” said the study’s lead author Rebekah Levine Coley, an associate professor at Boston College. “It could be because it’s less expected for fathers to be so involved, so it packs more punch when they are.”

Dad’s positive effect
Parental knowledge of a teen’s friends and activities was rated on a five point scale.  When it came to the dads, each point higher in parental knowledge translated into a 7 percent lower rate of sexual activity in the teen.  For the moms, one point higher in knowledge translated to only a 3 percent lower rate.  The impact of family time overall was even more striking. One additional family activity per week predicted a 9 percent drop in sexual activity.

Child development experts said the study was carefully done and important. “It’s praiseworthy by any measure,” said Alan E. Kazdin, a professor of psychology and child psychiatry at Yale University.

Why would dads have a more powerful influence?

“Dads vary markedly in their roles as caretakers from not there at all to really helping moms,” Kazdin said. “The greater impact of dads might be that moms are more of a constant and when dads are there their impact is magnified.”  Also, Kazdin said “when dads are involved with families, the stress on the mom is usually reduced because of the diffusion of child-rearing or the support for the mom.”

In other words, dad’s positive effect on mom makes life better for the child, Kazdin explains.

The study underscores the importance of parental engagement overall, said Patrick Tolan, a professor of psychiatry and director of the Institute for Juvenile Research at the University of Illinois in Chicago.  “For one thing, the more time you spend with them, they’re going to get your values and they’re more likely to think things through rather than acting impulsively.”

Coley hopes that the study will encourage both moms and dads to keep trying to connect with their teenage children, even as their kids are pushing them away.  “…it’s normal for teens to want to pull away from the family, [but] that doesn’t mean they don’t want to engage at all,”

Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in The New York Times, Newsday, Health magazine and SmartMoney.

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The Father-Daughter Relationship During the Teen Years – Ways to strengthen the bond  [EXCERPT],  by Linda Nielsen

According to recent research and my own 30 years of experience as a psychologist, most fathers and teenage daughters never get to know one another as well, or spend as much time together, or talk as comfortably to one another, as mothers and daughters.  Why is this bad news?  Because a father has as much or more impact as a mother does on their daughter’s school achievement, future job and income, relationships with men, self-confidence, and mental health.

When I ask young adult daughters why they aren’t as comfortable sharing personal things or getting to know their fathers as they are with their mothers, most make negative comments about men.

  • “Because he’s a man, he doesn’t want to talk about serious or personal things.”
  • “Because men aren’t capable of being as sensitive or as understanding as women.”
  • “Because fathers aren’t interested in getting to know their daughters very well.”

If a daughter grows up with these kinds of negative assumptions about fathers, she will not give her father the same opportunities she gives her mother to develop a comfortable, meaningful relationship. As parents, we strengthen father-daughter relationships by teaching our daughters how to give their fathers the opportunities to be understanding, communicative and personal.

Creating more father-daughter time alone – Regardless of a daughter’s age, the most important thing we can do is to make sure fathers and daughters spend more time alone with one another.  Since most fathers and daughters haven’t spent much time together without other people around, they might feel a little uncomfortable at first.  If so, they can start by taking turns participating in activities that each enjoys.  One idea:  The father could choose 15 or 20 of his favorite photographs from various times of his life — as a little boy, a teenager or a young man — and then use the pictures to tell his daughter stories about his life.  The key to the success of this father-daughter time is that they alone are sharing this experience.

Staying involved during dad’s absence – Teenage daughters and fathers can strengthen their relationship during dad’s absence through e-mails, letters, pictures and a touch of silliness.  Before dad departs, for one example, father and daughter can talk about how much their relationship means to each of them and agree to write or e-mail at least twice a week.

Linda Nielsen is a psychology professor at Wake Forest University in Winston-Salem, N.C. Her most recent book is Embracing your Father: How to Create the Relationship You Always Wanted With Your Dad. For more information on father-daughter relationships visit www.wfu.edu/~nielsen/.

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Early Father Involvement Moderates Biobehavioral Susceptibility to Mental Health Problems in Middle Childhood

Boyce, W. Thomas; Essex, Marilyn J.; Alkon, Abbey; Goldsmith, H. Hill; Kraemer, Helena C.; Kupfer, David J.;  Journal of the American Academy of Child and Adolescent Psychiatry, v45 n12 p1510-1520 Dec 2006

[my summary in everyday English:  When fathers are engaged in nurturing and parenting a child from infancy, the child develops healthy responses to social situations when they reach the middle childhood years ~age 9.  The father’s engagement actually improves brain function on the emotional level and reduces activity in the stress area of the brain.  If a father is not involved, the child is at a high risk of behavioral problems.  Also, if a mother is depressed in their child’s early years, the child is at an ever higher risk of behavioral problems.]

Spirituality and mental health, some research

Spirituality and mental health, some research

Scientists worldwide have been studying the effect of religion and spirituality on mental health and addiction recovery in children, teens, and adults.  Below are research findings that show religion and spirituality improve adult and adolescent mental health, including recovery from mental crises and substance abuse, when the spiritual approach carries messages of love, kindness, tolerance, and moral responsibility.  But when religion had a punitive or unforgiving message to those with mental or substance abuse disorders, the results were disheartening: a worsening of psychotic symptoms; inability to sustain recovery from substance abuse; and physical abuse.

If you look at the dates of some of these studies, you’ll see that researchers have been measuring of the value of spirituality for mental health and addiction for ~30 years, and results have consistently shown statistically significant positive benefits.

Below are summaries research reports–clinical writing that can be difficult to wade through if you’re not a mental health geek, so key findings and conclusions are highlighted in brown to make it easier to scan.

–Margaret

A second article in this blog documents both positive and negative effects of parents’ experiences in a religious community, Faith can help, & harm, a family’s mental health.


God Imagery and Treatment Outcomes Examined
Currier JM, Foster JD, Abernathy AD, et al. God imagery and affective outcomes in a spiritually integrative inpatient program. [Published online ahead of print May 5, 2017]. Psychiatry Res. doi:10.1016/j.psychres.2017.05.003.

Patients’ ability to derive comfort from their religious faith and/or spirituality emerged as a salient mediating pathway between their God imagery at the start of treatment and positive affect at discharge, a recent study found. Drawing on a combination of qualitative and quantitative information with a religiously heterogeneous sample of 241 adults who completed a spiritually-integrative inpatient program over a 2-year period, researchers tested direct and indirect associations between imagery of how God views oneself, religious comforts and strains, and affective outcomes.

Findings  —  Analyses revealed that patients generally experienced reductions in negative emotion in God imagery over the course of their admissions.


When God Is Part of Therapy
Tara Parker Pope, March 2011, New York Times

Faith-based therapy is growing in popularity, reports Psychology Today, as more patients look for counselors who can discuss their problems and goals from a religious frame of reference.

Studies show that people prefer counselors who share their religious beliefs and support, rather than challenge, their faith. Religious people often complain that secular therapists see their faith as a problem or a symptom, rather than as a conviction to be respected and incorporated into the therapeutic dialogue, a concern that is especially pronounced among the elderly and twenty-somethings. According to a nationwide survey by the American Association of Pastoral Counselors (AAPC), 83 percent of Americans believe their spiritual faith and religious beliefs are closely tied to their state of mental and emotional health. Three-fourths say it’s important for them to see a professional counselor who integrates their values and beliefs into the counseling process.

The problem for many patients in therapy is that many patients are far more religious than their therapists.

Nearly three-fourths of Americans say their whole approach to life is based on religion. But only 32 percent of psychiatrists, 33 percent of clinical psychologists and 46 percent of clinical social workers feel the same. The majority of traditional counselor training programs have no courses dealing with spiritual matters.


“[Spirituality] enables neurotic conflicts typical for adolescence to be more easily overcome.”

The influence of religious moral beliefs on adolescents’ mental stability.
Pajević I, Hasanović M, Delić A., : Psychiatry Danub. 2007 Sep;19(3):173-83

University Clinical Centre Tuzla, Trnovac b.b, 75 000 Tuzla, Bosnia & Herzegovina. zikjri@bih.net.ba.
This study included 240 mentally and physically healthy male and female adolescents attending a high school, who were divided into groups equalized by gender (male and female), age (younger 15, older 18 years); school achievement (very good, average student); behaviour (excellent, average); family structure (complete family with satisfactory family relations), and level of exposure to psycho-social stress (they were not exposed to specific traumatizing events).  Subjects were assessed with regard to the level of belief in some basic ethical principles that arise from religious moral values.

Conclusions — A higher index of religious moral beliefs in adolescents enables better control of impulses, providing better mental health stability.  It enables neurotic conflicts typical for adolescence to be more easily overcome.  It also causes healthier reactions to external stimuli.  A higher index of religious moral beliefs of young people provides a healthier and more efficient mechanism of anger control and aggression control.  It enables transformation of that psychical energy into neutral energy which supports the growth and development of personality, which is expressed through socially acceptable behaviour.  In this way, it helps growth, development and socialization of the personality, leading to the improvement in mental health.


Religion, Stress, and Mental Health in Adolescence: Findings from Add Health
Nooney, J. G. 2008-10-23 from http://www.allacademic.com/meta/p106431_index.html

A growing body of multidisciplinary research documents the associations between religious involvement and mental health outcomes, yet the causal mechanisms linking them are not well understood.  Ellison and his colleagues (2001) tested the life stress paradigm linking religious involvement to adult well-being and distress.  This study looked at adolescents, a particularly understudied group in religious research. Analysis of data from the National Longitudinal Study of Adolescent Health (Add Health) reveals that religious effects on adolescent mental health are complex.  While religious involvement did not appear to prevent the occurrence of stressors or buffer their impact, some support was found for the hypothesis that religion facilitates coping by enhancing social and psychological resources.


Study Links Religion and Mental Health
David H. Rosmarin and Kenneth Pargament, Bowling Green State University, Ohio, (IsraelNN.com) 2008

A series of research studies – known as the JPSYCH program – reveals that traditional religious beliefs and practices are protective against anxiety and depression among Jews.  The research indicates that frequency of prayer, synagogue attendance, and religious study, and positive beliefs about the Divine are associated with markedly decreased levels of anxiety and with higher levels of happiness.  “In this day and age, there is a lot to worry about,” Rosmarin notes, “and the practice of religion may help people to maintain equanimity and perspective.”


The Once-Forgotten Factor in Psychiatry: Research Findings on Religious Commitment and Mental Health (excerpt)
David B. Larson, M.D., M.S.P.H., Susan S. Larson, M.A.T., and Harold G. Koenig, M.D., M.H.Sc., Psychiatric Times.  Vol. 17 No. 10, October 1, 2000

“The data from many of the studies conducted to date are both sufficiently robust and tantalizing to warrant continued and expanded clinical investigations.”

Treatment of Drug Abuse

  • The lack of religious/spiritual commitment stands out as a risk factor for drug abuse, according to past reviews of published studies.  Benson (1992) reviewed nearly 40 studies documenting that people with stronger religious commitment are less likely to become involved in substance abuse.
  • Gorsuch and Butler (1976) found that lack of religious commitment was a predictor of drug abuse.  The researchers wrote:  “Whenever religion is used in analysis, it predicts those who have not used an illicit drug regardless of whether the religious variable is defined in terms of membership, active participation, religious upbringing or the meaningfulness of religion as viewed by the person himself.”
  • Lorch and Hughes (1985), as cited by the National Institute for Healthcare Research (1999), surveyed almost 14,000 youths and found that the analysis of six measures of religious commitment and eight measures of substance abuse revealed religious commitment was linked with less drug abuse.  The measure of “importance of religion” was the best predictor in indicating lack of substance abuse.  The authors stated, “This implies that the controls operating here are deeply internalized values and norms rather than fear or peer pressure.”
  • Developing and drawing upon spiritual resources can also make a difference in improving drug treatment.  For instance, 45% of participants in a religious treatment program for opium addiction were still drug-free one year later, compared to only 5% of participants in a nonreligious public health service hospital treatment program-a nine-fold difference(Desmond and Maddux, 1981).
  • Confirming other studies showing reduced depression and substance abuse, a study of 1,900 female twins found significantly lower rates of major depression, smoking and alcohol abuse among those who were more religious (Kendler et al., 1997).  Since these twins had similar genetic makeup, the potential effects of nurture versus nature stood out more clearly.

“lack of religious commitment was a predictor of drug abuse”

Treatment of Alcohol Abuse

  • Religious/spiritual commitment predicts fewer problems with alcohol (Hardesty and Kirby, 1995).  People lacking a strong religious commitment are more at risk to abuse alcohol (Gartner et al., 1991).  Religious involvement tends to be low among people diagnosed for substance abuse treatment (Brizer, 1993).
  • A study of the religious lives of alcoholics found that 89% of alcoholics had lost interest in religion during their teen-age years, whereas 48% among the community control group had increased interest in religion, and 32% had remained unchanged (Larson and Wilson, 1980).
  • A relationship between religious or spiritual commitment and the non-use or moderate use of alcohol has been documented.  Amoateng and Bahr (1986) reported that, whether or not a religious tradition specifically proscribes alcohol use, those who are active in a religious group consumed substantially less alcohol than those who are not active.
  • Religion or spirituality is also often a strong force in [addiction] recovery.  Alcoholics Anonymous (AA) invokes a Higher Power to help alcoholics recover from addiction.  Those who participate in AA are more likely to remain abstinent after inpatient or outpatient treatmen t(Montgomery et al., 1995).

“…adolescents [who were] frequent church-goers with high spiritual support had the lowest scores on the Beck Depression Inventory.”

Suicide Prevention – Surging suicide rates plague the United States, especially among adolescents.  One in seven deaths among those 15 to 19 years of age results from suicide.

  • One study of 525 adolescents found that religious commitment significantly reduced risk of suicide (Stein et al., 1992).
  • A study of adolescents found that frequent church-goers with high spiritual support had the lowest scores on the Beck Depression Inventory (Wright et al., 1993).  High school students of either gender who attended church infrequently and had low spiritual support had the highest rates of depression, often at clinically significant levels.
  • How significantly might religious commitment prevent suicide?  One early large-scale study found that people who did not attend church were four times more likely to kill themselves than were frequent church-goers (Comstock and Partridge, 1972).  Stack (1983) found rates of church attendance predicted suicide rates more effectively than any other evaluated factor, including unemployment.  He proposed several ways in which religion might help prevent suicide, including enhancing self-esteem through a belief that one is loved by God and improving moral accountability, which reduces the appeal of potentially self-destructive behavior.
  • Many psychiatric inpatients indicate that spiritual/religious beliefs and practices help them to cope. Lindgren and Coursey (1995) reported 83% of psychiatric patients felt that spiritual belief had a positive impact on their illness through the comfort it provided and the feelings of being cared for and not being alone it engendered.

Potential Harmful Effects

Psychiatry still needs more research and clearer hypotheses in differentiating between the supportive use of religion/spirituality in finding hope, meaning, and a sense of being valued and loved versus harmful beliefs that may manipulate or condemn.”

  • Alcoholics often report negative experiences with religion and hold concepts of God that are punitive, rather than loving and forgiving (Gorsuch, 1993).
  • Bowman (1989).  In assessing multiple personality disorder, children in rigid religious families, whose harsh parenting practices border on abuse, harbor negative images of God.  Josephson (1993). Individual psychopathology is linked with families whose enmeshment, rigidity and emotional harshness were supported by enlisting spiritual precepts.
  • Sheehan and Kroll (1990).  Of 52 seriously mentally ill hospitalized patients diagnosed with major depression, schizophrenia, manic episode, personality disorder and anxiety disorder, almost one-fourth of [psychiatric patients] believed their sinful thoughts or acts may have contributed to the development of their illness.  Without the psychiatrist inquiring about potential religious concerns, these beliefs would remain unaddressed, potentially hindering treatment until discovered and resolved.  Collaboration with hospital chaplains or clergy may help in some of these instances of spiritual problems or distress.

Conclusion

Religious/spiritual commitment may enhance recovery from depression, serious mental or physical illness, and substance abuse; help curtail suicide; and reduce health risks.  More longitudinal research with better multidimensional measures will help further clarify the roles of these factors and how they are beneficial or harmful.

–Margaret

Your troubled child’s recovery and how you help them achieve it

Your troubled child’s recovery and how you help them achieve it

What recovery looks like – A person with a mental or emotional disorder who is in “recovery” can look and act like anyone else.  They have:

  • stable relationships
  • a steady job or in school
  • a place to live
  • a proper diet
  • cleanliness
  • regular mental health check-ins.
Their mind is unstable. It’s like they stand on a beach ball that can topple them at any moment.

Recovery is maintained when your child can pay attention to themselves and notice if their symptoms are starting up, and then take action to stop the symptoms.  You teach them what to look for, and how to do a personal check-in.  It’s just as if they are monitoring any other problem in order to stay healthy such as: blood sugar, body temperature weight gain or loss, digestive system function (gut microbes).  In mental disorders, their signs and symptoms are not steady.  Anything can lead them from “OK” to “out of control” in an instant, and problems can last minutes to weeks to months.

What your child will need to sustain recovery as an adult:

INSIGHT  +  STABILITY  +  RESILIENCE

INSIGHT– self awareness

Insight allows a child to recognize they have a problem, and choose to act to avoid the problem.  If insight is not possible, they need a toolbox of options that help them to respond appropriately, instead of reacting to chaotic messages in their brain. Knowing and admitting they have a problem, or knowing techniques for avoiding problems, are very powerful skills they need as adults.

STABILITY – fewer falls or softer falls

Your child is like a boat that’s easier to tip over than most other boats; any little wave will capsize them, and everyday life is full of waves, big and small.  Your job is to notice when the troubled child is starting to capsize and show them how to right the boat, or if that doesn’t work, how to use the lifesaver.  Eventually, your child will learn how to sense when trouble is coming on, avoid the thing that causes problems, and ask others for help.

  • Sense it.
  • Avoid it.
  • Ask for Help.
Life throws punches. Vulnerable brains need to be more wary and resilient than the average person.

RESILIENCE – bounce back when they fall

Troubled children have a much harder time bouncing back from problems.  They have extreme responses to simple disappointments like breaking a toy, or poor grades, or something as serious as the parents’ divorce.  Some even fall apart in joyous times because the emotional energy is too much!  You must be acutely aware of this–they will not get back on track by themselves.  Don’t worry that helping them will spoil them or “enable” them.  Eventually they will learn from you how you do it.

“…We are all born with an innate capacity for resilience, by which we are able to develop social competence, problem-solving skills, a critical consciousness, autonomy, and a sense of purpose.”

     “Several research studies followed individuals over the course of a lifespan and consistently documented that between half and two-thirds of children growing up in families with mentally ill, alcoholic, abusive, or criminally involved parents, or in poverty-stricken or war-torn communities, do overcome the odds and turn a life trajectory of risk into one that manifests “resilience,” the term used to describe a set of qualities that foster a process of successful adaptation and transformation despite risk and adversity…”   http://www.athealth.com

–Margaret

 

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