Tag Archives: Emotional and behavioral disorders

How is youth mental health treatment different from adults?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Crying child

Youth mental health.
Photo courtesy of Pixabay.com

What are the differences between youth and adult mental health treatment?

There are differences in the way a counselor might work with a child and how they might work with an adult. How to “treat” a mental health problem is a complicated subject. It needs several books to fully describe this, but let me focus here on just a few things that may influence how a professional might try to help with an emotional problem in a child.

The way a counselor works with clients is sometimes referred to as our “theoretical orientation.” How I see your issue determines how I might try to help you. I can’t speak for therapists of other theoretical orientations but I would describe my approach as largely Cognitive Behavioral Therapy, that with a dash of learning theory and occasionally a pinch of narrative therapy.

This stuff is largely “skills-based.” I figure that the client is trying the best they can but that there are things they may not know and if they knew them they could do better. I could try to tell them, sometimes that works but mostly they need some help it trying on new behaviors and seeing what works for them and what does not.

Lots of people have “stories” they tell themselves about them. By story I do not mean that this is either true or false, it just is the way that person explains themselves and their life.

That story might sound like “I am such a loser.” Or “I can’t do anything right.” Kids get one thing wrong and they may start saying that they are a failure. See how having a single story that describes you rather than the thing you were not able to do could color your life experiences?

So adults have more experiences in life and may have more ways of thinking of new stories for their life than a younger person. What I am saying is that I would try as much as possible to tailor my approach to the individual, not some specific category or label.

In career counseling, the approach would be very different in working with a person who had worked at lots of jobs and was just downsized than it might be with a client who was very young and had never had a job.

What are some considerations in creating a treatment for a specific client?

Age is only a small part of the picture.

I would want to know in addition to the client’s age something’s about their abilities and their life experiences. Age, I.Q, and developmental stages are all in the mix. So might things like learning disabilities, intellectual disabilities, and other developmental issues.

The approach for someone who has a form of Autism Spectrum Disorder might be different from a younger person who had a less severe challenge. The key, for me, is really getting to know the person and match my efforts to them rather than memorize a particular formula for a given age, I.Q. or disorder.  Here are some things a therapist might do as the child moves through the lifespan and becomes a young adult, a mature adult, and evenly an older adult.

1. Activities build relationships.

With adults, it is often possible to sit down and have a talk with them. The younger the child, the more the anxiety or the more “inside themselves” they are the more we need to work on forming a relationship.

One way to create that relationship is to do things with the client. (Yes even with a five-year-old I think of this person as a “client.”) How would I have wanted to be approached when I was that age? If I can’t remember ever being that age, I take a guess at what that might have been.

So the counselor might play a game, not to waste time but to get the client to feel comfortable. Even with very adult clients, I find they will say more about their lives when we are doing something than when they are sitting in a chair and I am cross-examining them.

2. Pictures versus words in therapy.

Very young people and some adults are better at seeing than describing, they just do not have the words to tell me their story. I ask them to draw me a picture. A rainbow tells me one thing and a tornado-like creature in black and red tells a very different story.

3. Skills training is important.

You need to practice skills if you want them to be there when you need them. Adults practice golf swings. Younger people may need to practice introducing themselves, making friends, and sharing appropriately. A whole lot of people tell me right up front they have an “anger management problem” they do not seem to understand that managing anger is a skill like most other things in life and you can learn that skill.

The younger or more impaired the person the more they need help in learning appropriate skills.

4. Involvement of your support system makes a difference.

With children or youths, I like to know the involvement of the support system. The more people on your side the better your chances. Some people have a parent or caregiver that can help the client through things. Other young clients have no one on their side.

Sometimes I am working on helping the caregiver to learn to help the youth and other times I am helping the client learn how to cope with their less-than-perfect caregiver.

There are a whole lot of specialized treatments for all sorts of mental, emotional, and behavioral problems that a child may experience. This post has not even begun to look at all those possibilities but I hope it has given you some small idea of the ways in which a professional counselor might be able to help a child or their caregiver through a child’s emotional problems.

If you work with children consider taking the Youth Mental Health First Aid training when it is offered in your area.

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

When does recovery start?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Ball recovery

Recovery and Resiliency.
Photo courtesy of Pixabay.com

When will your recovery start?

If we believe in recovery – and I do – we need to ask, when does recovery start? How does someone know that they have begun the process of recovery?

Recognizing what is wrong.

The starting point for recovery is to admit that there is something wrong.

As long as someone continues to pretend that there is nothing wrong nothing changes. I know the old conventional wisdom was to just suck things up and keep going to work doing your tasks, keep trying to control your drinking, and so on.

The result of this effort to deny the problems resulted in a whole lot of unhappy people who kept up pretenses but never felt happy, never was able to do all they should do, until that final breakdown occurred.

The nervous breakdown, the DUI, or the arrest was not the problem. The problem was that there has been an underlying emotional or substance use problem that has gone untreated because people believe that denying you have a disease keeps you from having it.

This happens a lot in the medical field. Lots of people avoid tests for cancer or HIV because they do not want to have the disease. As if not knowing would prevent you from getting it. The result of failing to acknowledge an illness is not avoiding that disease.

Not admitting your problem allows it to get worse.

You need to recognize that something is wrong before you reach a point of not being able to avoid it. Untreated problems may even reach the point of being fatal.

Yes, depression untreated can be fatal. So can alcoholism, and addiction.

Many recovered people report that they began their journey to recovery the day they admitted they had a problem.

If you have been chronically depressed or anxious, you know you have had to make a lot of excuses to get out of things that you were unable to do and still not have to tell people about your emotional problem. You know that relapse is a risk.

Making excuses gets in the way of real recovery.

The alcoholic who tries to stop drinking will often, in the beginning, make excuses for why they are not drinking. They have a headache, they need to get up early tomorrow or they just are not in the mood to drink tonight. Others around them will continue to offer to buy them a drink; they want them to join in the “fun.” Many times those friends are alcoholics also so they do not want someone else admitting a drinking problem as that might imply they have one too.

The depressed person misses a lot of activates because they have no energy to participate. The need to make excuses also. But eventually, those excuses wear thin. People begin to think you are avoiding them rather than understanding that there are days when your emotional condition makes it impossible for you to engage in activities that you used to do.

You can suffer for years trying to pretend you do not have a problem. What you may find is that once you recognize what the problem is, the treatment can be remarkably simple, simple but not easy.

You may be trying to avoid other issues.

Many times these things we call emotional illness are really the symptoms of something else we have been unable to cope with. If you hate your job or have relationship problems and drink to cope, you may think the problem is the alcohol. If you keep drinking to avoid other emotional problems, eventually that alcohol will become a problem also.

Sooner or later you need to face not only the depression or the addiction but also the bad relationships you have with your job or your close family and friends. Avoiding these problems of living causes emotional illnesses.

Once you admit to yourself and others the nature of your problem and become ready to take a good look at how you got this way, you may find that recovery is a whole lot easier than continuing to have the disease.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Do emotional problems, depression and anxiety, time travel?

Posted on by
13

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Do your problems follow you around?
Photo courtesy of Pixabay.com

Is time on your side?

When you go for counseling exactly what time period should you be concentrating on?

Some people want to spend a lot of time working through the past. If you have been the victim of abuse or neglected you may find it difficult to move forward until you make peace with the past. Depression or anxiety may have their roots in the past, but at what point does continuing to relive the past interfere with the present and the future?

Staying in the present.

For people in recovery, however, you define that, the emphasis is more likely to be on the present, how to cope with that present, how to live life on life’s terms.

In changing your life, for me, the emphasis should be on the future. How can you get where you want to go without looking at where you will be when you get there? You know about your symptoms, your depression, or maybe you have anger issues or anxiety, what is important is how you move beyond those emotional problems.

Couples who come in for relationship counseling, we used to call that marriage counseling, often want to rehash the past, who did what to whom and why. Often this need to establish whose fault it was or who is right and who is wrong, gets in the way of establishing how that couple will develop the skills they need to create a happy relationship in the future.

Does it really matter why the homeless person is homeless? Say you figure out why you are depressed, has that changed anything. You are still depressed and now you have to pay for therapy to tell you what you already knew.

It might be more important to learn the skills they need to find and hold a job and then to get and maintain a place to live. In looking at why people have a particular emotional problem, I find it is only productive to look to the past when we are looking for ways to prevent this from happening again.

The same is true of break-up counseling. You separate, get a divorce, and now what? Do you stay stuck in the blame them or even blame yourself mode or can you see how there might be something you need to learn or something you need to do differently if the future is going to be different from the past?

Some counselors and this includes relationship counselors, want to work their way through the past. Sometimes you need to do this if there are things that you have not finished with, feelings you are not ready to let go. But isn’t looking forward to the future a whole lot more important than staying stuck in your problems?

The longer I have been involved with the counseling process the more I find myself focused on the future and how to create that happy life that I want for myself and for the client.

Lots of us have our stories, problem saturated or even problems soaked tales of how our life got this bad. We know why we are depressed, anxious, or even addicted. What we find it difficult to talk about is what we want for the future.

In counseling, I like to use the “miracle question.” I ask the client if this problem you have were suddenly gone tomorrow, what would your life be like? If you had your dream job, what would you be doing? Many of them can’t imagine a life without their problem. Some are not willing to give that problem up just yet.

Some will downright refuse to press that happy button.

Some couples therapists find that the ability to imagine a good relationship predicts the success of relationship counseling. If you are in counseling to find out whose fault it is and then to punish them for your unhappiness, you are wasting your time.

Whatever you do, strive to leave those emotional problems from the past in the past and spend the present making plans and preparations for a happy, contented future.

Your depression, anxiety and other emotional problems can only time travel if you refuse to let go of them as you take this journey we call life.

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Growing up mentally ill effects every part of your life

Posted on by
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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Confused brain

Mental illness.
Photo courtesy of Pixabay.com

The high cost of growing up with a mental illness.

Lots of attention has been focused on how the severely mentally ill may be different from others. Very little attention seems to be paid to how the experience of having a mental or emotional problem in early life changes who that person becomes.

The prevailing myth is that childhood is a happy time; life problems and the resulting emotional distress come later, the cost of growing up. We would like to hold onto this Peter Pan fiction despite the fact that more than a few of us have our own memories of childhood emotional or mental difficulties.

Who we become as an adult is shaped by our experiences and what we learn about the nature of the world we live in. The life events of the mentally or emotionally challenged child are significantly different from those others undergo. These early emotional experiences create the adult they will become.

The challenge of growing up with a mental illness changes every aspect of your experience. Those life experiences contribute more to who the mentally ill child becomes that the particular emotional illness they have.

For the child with an emotional problem, all relationships are fundamentally altered. The cranky from birth child is hard to care for. Interactions with the caregiver depending on the extent of the child’s mental illness and the age at which the symptoms first develop. The problem child gets labeled and learns the role of Black sheep, the creator of the family’s dysfunction.

Peer relationships are likely to be distorted. The depressed or emotional child is more likely to be bullied and rejected by peers. They grow up alone, unaccepted, and victimized.

Their symptoms call down the wrath of teachers and adult authority figures. They are more likely to be judged by their symptoms than for themselves.

As difficult as the teen years are for the “typical” teen they are extra difficult for a teen who is struggling with mental illness. They may find it difficult to establish supportive friendships and have fewer resources to draw on to navigate the developmental tasks of growing up.

When and if they develop an intimate partner relationship that connection will be heavily influenced by the person’s mental illness. They are more likely to enter relationships with other mentally ill partners or to become the victims of partners who take advantage of their weaknesses. Being involved in relationships with other mentally ill people adds a double strain to the process of establishing healthy relationships.

They also have more difficulty staying in school and finishing their education. As a result, career options are more limited and the emotionally challenged youth is more likely to be unemployed or underemployed.

The mentality ill leave home and school to become a permanent member of an unnoticed minority. Regardless of their race or ethnicity, the emotionally challenged child grows up to be a victim of discrimination.

The mentally ill child is often scapegoated and blamed for the family’s problems. Some of them have grown up as the caregivers of mentally ill parents.

They come to question who they are when they are depressed, when they are manic or when they experience other symptoms.  The question becomes which part of their experience and their behavior is them and which is the result of their illness.

They often experience adults who view their symptoms as a matter of choice rather than illness and who tell them to just snap out of it and act normal. They wonder why others can cope with life and they find it such a challenge.

Growing up mentally ill can result in feelings of self-doubt and negative beliefs about the self. They come to think that they can’t do anything right. Not liking themselves is common.

Even when they enter the system they are likely to be viewed as incompetent rather than uneducated. They are likely to be assigned case managers who see their job as permanently managing these people who form a drain on society’s resources.

The professional that believes in recovery and a full and happy life for the mentally ill has long been the exception rather than the standard.

The cumulative impact of these experiences can easily lead to an adult mentally ill person who has come to accept that they are somehow defective and unwanted. They become marginalized unable to work, dependent on scanty government and family handouts and convinced by years of learned helplessness that they would not be able to succeed if given the chance.

We as a society create these angry depressed and isolated adult mentally ill by our unwillingness to recognize and help these youths who are struggling to overcome an emotional issue.

What is critically needed is more emphasis on early detection and treatment of mental and emotional challenges. We also need social service systems that believe in recovery rather than permanently marginalizing the mentally or emotionally ill.

David Miller, LMFT, LPCC

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel