[Music] good evening and welcome to this special mental health edition of doctors on call i'm dina claba a psychotherapist and founder of insight counseling of duluth and virginia and i will be your host for our program tonight on children's mental health and the pandemic this is our third of four special mental health episodes during this season of doctors on call our program is here to answer your questions about mental health issues that may affect you your family or friends please call or email your questions and we will do our best to address them the telephone numbers and email address can be found at the bottom of your screen our expert guests this evening are dr dan dialler a licensed psychologist with duluth psychological clinic and anne meehan is a licensed professional clinical counselor with map behavioral health center in duluth our phone and email questions are being received this evening by members of the wdse staff who will bring them to me here in the studio now let's begin with a discussion of children's mental health and the pandemic good evening good evening good evening dan and anne thank you for being here i like to start at the beginning with you having an opportunity to introduce yourselves a little bit more talk about your practice and areas of specialty and kind of what you're passionate about so anne would you like to start yeah so i'm ann meehan i'm a therapist over at map behavioral health center in duluth and i work with kids and children ages 4 and up that is really my specialty and i work with lots of different kids with i like to say big emotions so kids that get anxious or kids that are a little bit angry i do a lot of different types of therapy like plate therapy and also therapy that specifically focuses on trauma thank you thank you and dan sure dan d allard i work at the duluth psychological clinic mostly with adults and then i work at northwood children's services in the diagnostic center with children and families i wouldn't say i have a specialty but by by choice but i have a specialty lately in helping families and children adjust to these unusual circumstances we've been in in the last two years so a lot of trauma and sort of chronic stressor focus recently which is apt for tonight's topic right trauma and chronic stress and and something that right we've been experiencing prior to the pandemic it's just once the pandemic hit it it's just exacerbated everything um and i love big emotions and this is a big topic and all of our topics in this series have been incredibly meaningful and important and big and this one i mean so big that even recently the surgeon general released a report an advisory in an attempt to um for us to take action uh it's for children i mean it's unprecedented at times in terms of pressures and stressors and and not only for children but the parents guardians teachers clinicians supporting them i wanted to read just one short excerpt from from the report um if i may everyone has a role to play in combating this mental health pandemic without individual engagement no amount of energy or resources can overcome the biggest barrier to mental health care which is the stigma associated with seeking help for too long mental and emotional health has been considered at best the absence of disease and at worst a shame to be hidden and ignored so thank you dan and ann for having this conversation and talking about it and thank you to pbs north and wdsc for for creating a space for us to have this conversation for sure super important so to comment on one aspect of what you just read i think the pandemic is a bit of an umbrella that has allowed us to say we i'm struggling with mental health of some sort my child is struggling to adjust to this i'm struggling to know how to parent under these conditions folks who may not have come forward and said so or sought out help or talked to their neighbor or their own parent about what do i do here the pandemic is a stressor for all of us that we all acknowledge and so it's i think given more people a chance to step forward and say hey let's let's go finally engage with a therapist or a counselor or what have you beautiful yeah making meaning out of out of tragedy for sure it is definitely happening so well we'll jump in right away to our questions so and we'll start with you when my child is having big feelings anxiety anger sadness and or behaviors such as aggression withdrawal crying episodes trauma what can i do to help i think that that's an excellent question and i see parents really struggling to figure that out with all of these like you said unprecedented times and all of these really big things that are happening in the world that being a kid is hard and being a kid in a pandemic is is so difficult and parents i see parents really wanting to help support their children and not exactly knowing what to do and so i think one of the first things that parents can do is really the first thing that they can do and and one of the most effective things that they can do is tune into themselves and really understand and identify where their feelings are and if they can have a calming presence that is going to be one of the best things for their children to calm them through those big feelings and big emotions and really give space and validate that all feelings are okay it's okay that kids are feeling sad or stressed or scared there's a lot of big things happening in the world and so validating that and naming it can be really powerful thank you dan anything you want to add because i know you had mentioned kind of the parents and modeling for sure behavior like ann's absolutely right the cliche that we say as much with our behavior or more than with our words is absolutely true so when we're modeling stress frustration anger to be aware of it and put into words why it was hard for me to again this month be working from home so that your child hears you putting words to what's stressful for you that's a good model for them there's license to acknowledge their own difficult feelings right if i'm feeling stressed then junior has as much of an opportunity to say that as well and and then self-regulation is important as well i think of one of the goals of parenting in any situation is promoting increased self-regulation as our children develop right and if we're modeling dysregulation because we're frustrated we're excessively anxious etc and we're not putting that into words that's actually what we're teaching regardless of what we're saying and even though the pandemic is unprecedented in our lifetime general principles still apply good parenting is about modeling it's about communication it's about unconditional positive regard it's about maintaining expectations so i understand you're tired of another semester of school on zoom and i expect you to do your best so you know both both pairs seem awfully important that's great and speaking of working from home one of our first questions just came in zoom meetings are even affecting me as an adult how do you help children who are zoom fatigued when it's hard to even help yourself and we start with you and i know you've done some amazing creative engaging work in telehealth with children yeah i hope you'll touch on that i think that that is a spot on question because as adults and i do a lot of virtual therapy we feel it it's it's a lot to be on the screen for many hours a day and one of the the biggest things that parents can do is get really creative and add some movement in for kids and so making sure how are they learning over zoom how are they learning virtually what is the situation or the setup that would be helpful to add some movement into that into their day or into the class so it might be sitting on a yoga ball it might be getting up every chunk of time and doing something fun creative and playful like maybe a dance break or something where they can move their body where they're not sitting for the entire day so that's one of the things that we can do to help with with the zoom meetings and the zoom fatigue excellent anything i'll echo the need for movement breaks i think they're even more important than in the traditional classroom probably uh learning on a screen or via a screen requires a different kind of concentration and self-regulation than you have when you're in a classroom so a child who's gotten really good at doing in the classroom won't automatically do it well in a in a an online environment so so again just speaking the truth out loud this is harder isn't it you have to learn different strategies don't you let's talk about what you can do movement breaks make a ton of sense um talking with your student's teacher and saying we may turn our screen off at times so that my child's self-consciousness gets a break um so um so that he can go and pay attention to what's going on in the other room because his sibling is over there doing it too and he wants to check in and see how he's doing so communicating with teachers allowing the conversation to get to what's hard about this or uniquely hard about it movement breaks and then when school is over lots of opportunity to be in your large muscles right and doing something that doesn't put make a lot of cognitive demand because it's a different cognitive demand again to learn in a virtual environment thank you dr thompson from beaver bay asks what is the result of masking on adolescents what's the effect on their mental health interesting dan um i don't know the research on i have anecdotal sense of it do you know any research on this the research that i know is about social cues more than about the mental health effects what the research says about social cues because i was very interested with masks of how children especially young children are going to pick up and interpret social cues and what what that result for kids was going to be and the research actually is pretty encouraging in that kids pick up social cues just as much as they would if somebody was wearing sunglasses so not obviously as much as we'd like them to we're missing half of the face but social cues kids can still pick up quite a bit of social cues so i think one of the fears in the pandemic was how much are they going to lose the learning and the interpretation and the social connections and cues and we know that there is some lost but not a significant as significant as a mount as i was worried about but i don't have any knowledge of the research on the emotional and mental health beyond the anecdotes that i also am getting into my office the research you cite is very encouraging i have to agree i'll add just anecdotally that children who tended to struggle with reading social cues to begin with struggled more in the pandemic and the kids who were good at it tended to adjust better one thing the panic demonic did in so many ways is sort of widen the gaps between kids of various abilities whether it's academic or social and emotional intelligence or what have you so thank you yeah and how do i help my child when so much in their lives are unpredictable and unknown covet isolation school decision making tree and so on i think that that is definitely one of the unprecedented things within this pandemic is that we don't know when the end point is going to come we don't know what that looks like there's nothing certain that we can really really ground ourselves in and so with all of that uncertainty comes a lot of distress for children children thrive under structure children thrive when they know exactly what to expect and exactly what's expected of them and what's going to happen next and in all of this chaos that's happening whether we're virtual in person for school events that are canceled that we thought we might be able to go to it's a lot for a child and so one of the things that i think parents can do that can be the most helpful and supportive to their children is to validate validate i think we've been talking about that validate how distressing and tough this is and there's a lot of grief i think that happens within the pandemic in cancelled events but as much as you can as a parent orient to structure what's happening today what's happening tomorrow what do we know for sure is going to be going on in our lives and really as parents talk into that and help kids understand what life looks like in the short term and then figure out how to be creative in adding things that are fun exciting engaging and bringing families together that are under your control that can't be cancelled or taken away by any sort of shift that might happen with the pandemic excellent well and speaking of i'm just going to kind of jump into the next question and dan i would love your feedback as well but with movement breaks for instance like we just talked about one of our viewers asked how do we encourage children to be excited about this especially even teens who are often on phones computers screens and so on when you mention creative being creative yes what i think that in order for kids to be excited about it you as the parent have to be excited about it if you are coming into this and you're not quite sure if it's going to work or you're bringing energy that you're not quite clear of like you know how this is going to all work out you're going to bring that to the child and they're they're going to pick that up kids read our social cues and our energy so quickly and i would say get creative but also get their buy-in ask them say what do you think would be helpful for you to get some movement here what would be helpful for you what would be exciting for you what would be fun for you to to get some of that movement and to get just i like to call it discharge all the energy that you have from from sitting all day you can do a lot of creative things i always go to pinterest which is a treasure trove of ideas which is legit but there are you can like write things on popsicle sticks and pick one out you can have a little jar that it's a surprise and there's an element of kind of the unknown that that gets kids really really excited and so really ask your kid but there's a lot of ways to brainstorm and bringing your own good positive energy to it yeah makes me think about all that co-regulating and your enthusiasm and you're mirroring that like it's a theme that we've been talking about you know far down anything um to add again i'd second what ann had to say and i'd amplify it by saying new circumstances are opportunities to learn new things about ourselves and develop new skills and there are often opportunities to talk about values so how in an online learning environment let's say how can you discover something new about yourself you can be patient being you know without without your classmates near you but you have to listen to them talk through something for example it might be easier when you kind of look around the classroom but when you're in your sterile room at home and your classmates talking a long time how can you discover a new way to self-regulate and be patient how can you be supportive of your friend who seems to be struggling from a distance what new skills can you develop around this and how can you discover new ways to express your values so we think of pandemic conditions as restricting but they can also support a sort of blossoming of what you understand yourself as capable to do and again that comes from parents if parents have an attitude right of this stinks i can't wait till it's over it's all loss then that's generally going to be where our kids start from excellent thank you ann next question wonderful questions from the viewers thank you and if you are just tuning in we're having a beautiful discussion on children's mental health and the pandemic do you think there will be lasting effects on children's mental health for years to come following this pandemic i i would say with certainty absolutely and and that's a really hard truth to hold but to be asking children to completely change the way that they operate within the world is is really really difficult and if we think about the kids who were at their elementary years they're just starting to learn to read they're just starting to learn to to write and we're thinking about maybe the key kindergarten through second graders they're trying to learn all these foundational skills on zoom or virtual or missing time periods and then we have the middle schoolers going into high school where there's a lot of in-person social dynamics that are really important for social skills development that they're also having a really different experience of that and then the grief and loss i think about a lot of the seniors that i'm seeing who maybe graduated and didn't get to experience a prom or didn't get to do the activities that they were looking so forward to in high school like playing on sports teams or going to dances or things like that and so there's just so much developmentally that the pandemic has placed on children that i do believe it will be years before we see the full effects and also we'll be holding this for for years to come i also think in that kids are resilient so i don't want to miss that if we hold that the pandemic does impact kids it will impact kids it will impact their mental health they are also resilient and i don't want us to lose sight of that either wonderful dan how about the media the news so on and so forth how much or little would you recommend that children and parents are exposed to so that's so individualistic i think it really requires a parent to know what's in their child's best interest probably the middle of the bell curve is not a lot you know like your starting point ought to be not a lot of exposure to media around this but whatever the level of exposure particular you know if you have a child who's especially interested and is very verbal about what he or she sees on media then maybe more but always talking through what what did you hear today would you see today what sense do you make of it how does it square with what you thought was going on out in the world how does that affect you what emotions does it bring up it's hard to go wrong with questions so probably not a lot of exposure to media but read your child dial it back or dial it up as your child expresses an interest or or shows difficulty handling what they're learning in the media and then always conversation always conversation about it checking in yeah right uh and and kind of along those lines anthony from virginia asks does too much of electronics affect my child's mental health so i know we get a lot at our practice you know a lot of questions about screen time and i think some of the research has shown that it's a little bit less about the time and more about the content and so on but anything that you could share about yeah i think that that is so complex you know like you're saying it's what are they watching how are they watching it and i'm really interested in how they're engaging with it and so is it a time that they're going on autopilot and it's almost like mindless scrolling and that's very different than some of the teens that i have that have online communities of friends and they co-game together and they have these communities and these relationships online where they're getting a lot of social needs met from that so i think that really figuring out how are they consuming media and also how is it affecting them because i think like you said with the media taking in news media it's the same thing with video games and technology there are some kids who are able to know their limits observe when it's getting to be too much they can put it down they can step away and there are other young people where it truly becomes an addiction where they're not able to set it down and they're not able to put it away and what is the impact of that what are they missing and what is the effect in their life and that's usually what i focus on when we're talking about media use and are we in that range that feels regulated and feels like a healthy amount or are we in that space where it feels disregulating like there's a lot of big emotions getting off there's things that the child isn't doing because they're on media wonderful can i amplify that last point i really like your emphasis on individualizing your sense of how much media and under what circumstances fits each child yeah but what's not happening when they're on screens what developmentally appropriate or necessary tasks are they not doing what large motor tasks are they not doing or socializing or going to church or sitting with the rest of the family at meals or getting to sleep on time right i think it's easy to let what's replaced by screen time become invisible to us and um i think the research the research i'm familiar with suggests that we got awful worried about the content of video violent video games and such and we should be attentive to that but the research suggests that the content might be less important than what's being replaced by video games so i think attention to that and attention to the american academy of pediatrics guidelines of two hours of screen time per day for kids none below i want to say age two thank you so uh that's i think that's smart too thank you and i can't believe we're almost out of time this went by so fast and it is such a big topic so i'm at this last question i'm really excited that somebody asked it because i think it's important to share with viewers resources and where to go so the question is what are my options for therapy for my child what would you say to someone looking for i need more i have more questions you know after seeing this program and i i think i want to learn more and need help either myself or my child what would you recommend if you have access to the internet i would google mental health help for children in the twin ports or in duluth and sort of start there there is a burgeoning number of therapists available in the twin ports it's wonderful news there's increasing access there's lots of people who can be helpful to you and your family and and don't be afraid to do to be a consumer to shop around for the person who feels like the right fit for you and your family you don't have to settle for the first person that you that you happen to make a connection with i love that because research shows that the relationship that you have with your therapist is the number one factor for change and so if clients aren't feeling connected with their therapist if kids don't feel like their therapist is somebody they can talk to or somebody who gets them they're not going to put their walls down enough to open up and and like jumping off of that i really think that depending on the age of the kid in the child might need a different type of therapy and so the therapy that i provide for teens is very different than the therapy that i provide for small children so you also want to make sure that it's developmentally appropriate whatever therapist you're looking into how are you going to speak the language of how old that child is so for an example i love play therapy for kids eight nine and under and more talk based therapy for kids that are a little older wonderful just maybe one more question and i'm not even quite sure the context of this one but let's let's give it a shot and this is mike from hibbing thank you should i plan mental health days for my child dan again i think that depends on your read of your child sometimes a child knowing there's a mental health day on the horizon can be really valuable it can help your child gut out a tough day at school on the other hand it might be nice to have those as surprises for a different sort of child and it might also make sense to not plan anything at all and just see if your kid can learn that hey i can do this again i don't need to have no there's a break or the weekend is break enough so i guess my generic advice would be read your child try to understand what he or she needs as best you can and do it only if it seems pretty indicated wonderful thank you thank you anne thank you thank you thank you thank you dan and ann dr dandy allard and ann meehan for their time and expertise tonight and to the wdse staff members for answering the phones and for those of you who called in or email questions please join dr mary owen next week for a program on end of life and advanced care planning when her guests will be dr jeff copeman and dr amy greminger i'm dina claiba for the guests and crew here at wdse thank you for watching good night [Music] [Music] you