Posts Tagged ‘ substance abuse ’

Glee Star Death: Tips For Talking To Your Child

Monday, July 15th, 2013

If your child is a fan of Glee, then you have probably heard of the sad death of actor Cory Monteith. Here are a few tips for talking to your child about his death

Remember That These Kinds Of Deaths Are Important To Your Child: For tweens and teens, celebrities are important. Kids follow their lives – especially in this age of social media when they have more access than ever to information. They will undoubtedly have emotions (not just sadness but others including anger) stirred up by the death of someone they never met who nonetheless played a role in their life. Be sure to honor and respect that and not be dismissive. Which leads to the next tip …

Think Back To When You Were Young: We all have experienced deaths of celebrities that touched us. Remember how you felt – and the questions you had – when you experienced the death of a public figure.  Reflecting on your own experiences will provide a good reminder of what your kid may be feeling and thinking right now.

Start A Conversation: Given that your child is thinking about Monteith’s death – and will continue to hear a lot more about it – it’s important to let them know they can talk to you about it. So just start a conversation – any icebreaker will do. The goal here is not to probe or question or deliver information – it’s just an opening so that they know it’s okay to discuss with you. Let them do the talking and concentrate on listening – find out what’s on their mind. You can even be explicit and say it’s okay to talk more about it whenever they want.

Follow Their Lead: Kids are different. Some will want to talk about it frequently and in detail. Others may just mention something in passing now and then. Some might be emotional, some very calm. Be sensitive to their personalities and do what you do naturally – be supportive and responsive whenever they bring it up.

Be Honest But In An Age Appropriate Way: Monteith’s struggles with addiction are well publicized. You should be ready to have a discussion about addiction and substance use with your kids. Monteith had reported abusing substances in his teen years and your child may be aware of this. You can be respectful of the sadness of his death while, at the same time, discussing honestly the dangers of substance use and abuse, especially in the teen years. Do keep it simple and brief and factual – and anticipate follow-up questions that you will answer in the same style.

Support Your Child’s Efforts To Do Something: Some kids may be motivated to do something. Write a letter, post something online, make a collage. It’s healthy for them to act on their emotions and it’s important to support their efforts. Again bear in mind the first tip – even though they didn’t know Monteith they are still experiencing some type of grief and learning that it’s okay to act on that is a good (if sobering) message.

Be Ready For Deeper Questions: For some kids, the death of someone young, talented and successful can be hard to process. They might have questions about how this could happen. It’s a good time to have a sensitive conversation about how Monteith was as human as anyone else – and how bad things can happen to anyone. Depending on age and personality, some kids might want to talk about death in general – so be ready to have an open conversation on that very big topic (again being a listener first and a talker second).

Cory Monteith via D Free/ Shutterstock.com

 

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Why Callous-Unemotional Traits Matter In DSM-5

Wednesday, May 29th, 2013

DSM-5 has raised lots of controversies by making changes to the way some psychiatric disorders are defined. But less controversial is flagging the importance of callous-unemotional traits in childhood as part of the diagnostic approach to Conduct Disorder. 

Conduct Disorder refers to a pattern of behavior that consistently violates the rights of others. As kids reach later childhood and their early teens, the types of behaviors include what we would think about as things that would get kids in trouble: destroying property, breaking and entering, fighting, lying, stealing. While some kids may do some of these things now and then, what’s important clinically is when a lot of these behaviors cluster together and occur with some frequency.

There can be many reasons why kids behave this way. It’s clear that kids exhibiting signs of Conduct Disorder require some type of intervention. It’s a pattern of behavior which can be associated with a lot of bad outcomes – dropping out of school, eventual substance abuse, and even jail.

So why are callous-emotional traits relevant, and flagged in DSM-5? The risk for these outcomes may be especially high if a child is showing callous-unemotional traits – such as a lack of empathy, a lack of remorse, and shallow emotions. When tracked over time, youth with these traits are especially likely to show a stable pattern of antisocial behavior over time – from childhood through adulthood. Their actions may be (or become) especially aggressive and violent.

Treating kids with callous-unemotional traits is complicated. A number of behavioral strategies may be considered, as well as some forms of drug treatment (especially if they have symptoms of other disorders, such as ADHD or depression).

DSM-5 has certainly be criticized. There are many hot-button topics raised in the revision. But the inclusion of callous-unemotional traits is an example of how research findings can lead to diagnostic changes that are simply there to signal which kids may be at especially high risk for a number of bad long-term outcomes and hence require some immediate form of intervention. That’s solid information for a clinician to weigh during the evaluation process.

Doctor with checklist via Shutterstock.com 

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