Archive of ‘Teens’ category

Why Aren’t They Ready Yet?? The Stages of Change.

Have you ever been frustrated when you know somebody needs to change something in their life, but they just can’t seem to understand it the way you do? It could be anything from working on physical health, to drug addiction, to a quasi-bad habit that needs to be broken. The other person just doesn’t see how bad things are and that they need to change! What this COULD mean is that you and the other person are at different stages of change.

What are the Stages of Change?

The Stages of Change as discussed in this blog come from Motivational Interviewing, which is a type of therapy that can either be practiced independently or in conjunction with other therapeutic modalities. Here are the stages:

1. Precontemplation Stage

In this stage, someone would not even realize that there is something worth changing. They wouldn’t think they have a problem, and they wouldn’t be contemplating any change. They could be in denial, they could be back at square one after trying a change and giving up, they could be told by folks that they need to change/have a problem but they say “I’m the exception” or “That’ll never be me” statements. 

An example: Jonah smokes a pack of cigarettes a day, and his friends tell him they are worried about his long term health. Jonah responds to his friends “I’m not worried about it. It’s just a pack and I could stop any time I want to! Other people get cancer, but it doesn’t run in my family and it won’t happen to me!”

2. Contemplation Stage

This stage is when someone knows they want to make a change, and they begin weighing their options. Here, therapists and friends will often hear this person express ambivalence about making the change, fear talk, and “I would, but…” statements. 

An example: Mel has been having stomach problems with her anxiety for a few months and knows that a trip to the doctor would likely help her figure out ways to feel better. She is afraid that they may have to run invasive tests or change her diet, which give her even more anxiety and make her stomach issues worse. She has talked to her partner about her stomach issues and has said many times, “I should make that doctor’s appointment soon, but I’m just too busy with school to take a day off!”

3. Preparation Stage

Here, folks will start to get ready to make a change, or they may make small steps toward the change. This could be the point at which we hear someone say “I’m about to start doing ___” as they get ready to make their change. They may start sampling their new lifestyle, or dipping their toe in to test the waters, but haven’t taken any formal action toward the change. 

An example: Jess has become aware of the fact that social media consumption exacerbates her depression and anxiety. She decided that deleting her social media apps off of her phone will be a big step to helping her mental health. She recently posted to her friends that she will be deleting her apps and will be much harder to reach soon. She gave them her other contact information so they can still text and facetime, without the obligation to see everything that has been giving her FOMO and anxiety. The apps are still on her phone for the time being, and she is mentally preparing for the day next week that she will delete them. 

4. Action Stage

A person in this stage is actively trying to make their change happen. This is often where the bulk of therapy work occurs, as our clients have taken steps to call our office and schedule a session, sit with a therapist and discuss their concerns. It is possible to get to the Action stage multiple times (like, with a pesky New Years’ Resolution) only to revert to an earlier stage a few times over. 

An example: Evan started going to the gym Monday through Thursday after work, made an accountability buddy at the gym, and is loving it! He used to go to the gym about once or twice a year, and recently became fed up with his sedentary lifestyle. He is really trying to find ways to keep his gym habit sustainable this time. 

5. Maintenance Stage

This is the stage that we would aim to be in for the longest amount of time. Maintenance is the goal of making a change; we want to maintain our change over time. A person in this stage has become proficient at their action stage and is looking to maintain the change. 

An example: Ori calls himself a “recovering anger-holic.” He grew up with enormous difficulty with expressing his emotions, and often would have angry outbursts. When he became engaged to Amber in his thirties, she asked him to go to therapy for his anger. In this way, Amber helped Ori move from stage 1 through stage 4. He worked with his therapist to express his feelings in healthier ways, manage his anger, and grow his support network. Ori and Amber participated in couples therapy a few times over the years (especially when Ori’s anger looked like it was relapsing), but now that they are in their fifties, they hardly need outside help. He can still be triggered into what used to be fits of anger, but now are fits of coping and emotional expression. Amber knows all of his most reliable coping skills and they use code-words when he really needs to go cool off and take a walk. 

6. Relapse Stage

A relapse is when an individual returns to a previous stage for any amount of time. It is common, when making a change, to be tempted to return to the pre-change lifestyle. It is important during a relapse temptation to seek support and try not to relapse. A relapse could be small or large, and it doesn’t mean you or your treatment failed. After a relapse, an individual could return straight to maintenance, or it may require a return to an earlier stage. It is possible to return to precontemplation after a relapse, as someone could say “oh that wasn’t as bad as I remembered” and be enveloped once again with their pre-change lifestyle.  

An example: Ellee realized she had a gaming addiction when she was 22. After the challenge of quitting video games and seeking help, she maintains an abstinence from video games as a 28 year old. She recently relapsed when a new group of friends had a housewarming party for their friend. She didn’t know that there would be a console with the expectation to play some party games over drinks, and she had gone home afterward and continued a game-watching binge on Twitch. Ellee felt guilty and embarrassed the next day when she realized what she had done. She called her dad (her “biggest supporter”) the next day to tell him what happened, and told her therapist about it in their next session. She made a plan to tell the new group of friends how they can support her and why she has to stay away from video games. They worked together to make a plan to have console nights without her, and include her for other activities instead. It was her third ever relapse, and she commented in therapy that the aftercare seems to “get easier every time” when she relapses. She will easily get back into her maintenance stage, as she does not own any platforms that allow for her previous video game habits, and she has now blocked Twitch on her laptop to prevent another similar relapse. 

Fun Facts

Fun Fact 1: Someone can bounce around to various stages many times before coming to their “final” maintenance stage. Even then, relapses may occur and require a re-do of some earlier stages before returning to maintenance. 

Fun Fact 2: It can be extremely frustrating when you are at a different stage of change from a loved one with a change that needs to be made. These stages can be discussed with your therapist, and you and your loved one can come to a decision about how best to proceed together in sessions. 

If you are ready to talk about making a change in your life, reach out to us at [email protected] or 512-298-3381. 

(The Stages of Change discussed in this blog are taken from Prochaska and DiClemente’s 1983 Stages of Change Model, and the book Motivational Interviewing, Third Edition: Helping People Change by Miller and Rollnick)


Tips For A Successful Transition To Summer

The temperatures are climbing, school dismissal bells are ringing, and sandals are reclaiming their rightful place as a wardrobe go-to. Summer is around the corner! While summer is usually associated with fun in the sun, it’s not always popsicles and rainbows. Summer is also a big time of transition for kids and their families. The change in routine and lack of schedule can be challenging for some people. However, this is also a great season for rest, relaxation, and rejuvenation – especially after a tough school year like this one has been! Here are some of my favorite ways to make the most of your family’s transition to summer. 

Maintain A Routine

One of the toughest challenges I see is the change in routine for kids and their families. Within a matter of weeks kids go from a structured, time oriented lifestyle to a very loose and non-directive day. This shift in expectations and routine can be tough for kids and teens who thrive on structure, routine, and activity-based schedules. 

Consider maintaining a routine for summer that helps provide some parameters for everyone’s day to day experience. A great way to start this conversation is by hosting a family meeting. Bring the family together to discuss appropriate boundaries for wake up & sleep time, chores, and screen time during the summer. Ask each family member for input and find ways to meet everyone’s needs in agreement. Once or twice a month, consider revisiting this conversation in another family meeting to make adjustments as needed. As the months go on, the needs of the kids may change (and potentially yours will too!) This will help ensure a steady transition from spring to summer, and may make the transition from summer into fall easier as well. Find a local Certified Positive Discipline Parent Educator to learn more about the benefits of family meetings and how to incorporate them into your routine. 

Let’s Go Exploring!

One of the highlights of summer is the gift of time! Less time spent in school means more time for extracurricular activities and interests. It can be really hard to weave in hobbies and new activities during the school year. Use this time to get in touch with your inner explorer! 

I encourage families to find ways to try new things over the summer to break up the monotony of long unstructured days. It’s a great time for kids to explore new interests they may have. Ask your children if they have any new sports or hobbies they want to try over the summer and enroll them in a class or interest group. It’s an easy way to meet new friends with common interests and help encourage new neural connections in the brain. Another easy way to introduce new things is planning a Staycation in your own city. Maybe there are some cool new restaurants you’ve been wanting to try, or a local park you haven’t had a chance to visit. Take some time to collect ideas of different places or activities and write them on popsicle sticks. Take one or two sticks out of the jar each Sunday to see where the week will take you!

Keep Up With Your Therapy

The kids are out of school, children are taking breaks from our regular routine of after school activities, and adults are taking time off work for fun vacations and day trips. Without the regular stressors of everyday life, keeping your regular weekly therapy may feel a bit unnecessary, right? Actually, it may be the furthest from the truth! Summer is the best time to jumpstart progress and growth, especially for kids and teens. Less stressors means more opportunity for the brain to stay grounded, attuned, and ready for processing. This is a great time for teens to work on emotion regulation, peer relationships, and overall exploration of their mind, body, and soul. It’s so important to model the prioritization of mental health year round, and maintaining regular sessions over the summer is a perfect time to model this self care for yourself and others. 

In addition, summer is a great time to schedule appointments with other practitioners to help coincide with ongoing therapeutic treatment. Summer is the perfect time to explore new treatment modalities or complete in depth psychological assessments. The extra time off from school allows for time for kids to adjust to new medications, build relationships with collaborative practitioners, and develop a plan for success for the upcoming school year. Ask your therapist if they have any recommendations for collaborative care in your ongoing treatment plan. Your therapist should have a list of referrals available for local psychologists, psychiatrists, and dietitians who are ready and able to help work together to create the best treatment plan for you or your child. 

In the spirit of full disclosure, summer is my favorite season. With these tips (and a good amount of Air Conditioning!) it can become yours, too! Incorporating these areas of growth into your life will help ease the transition from season to season, and prepare you for an amazing and bright few months ahead. Consider reaching out to your favorite therapist for support in making summer 2021 the best one yet! 

Written By: Sara Balkanli, LPC-Associate Supervised by Lora Ferguson, LPC-S


Child & Adolescent Nutrition 101

Early childhood and adolescent nutrition is a lost educational opportunity in many sectors. There are a few ways to approach the introduction of foods to a child at an early age for them to develop a healthy relationship with food from birth. Here are a few of my tips I give to parents and adolescents to help them shape a healthy relationship with foods and their bodies.

Remember to include a variety of foods on the plate.

Whether color, textures, flavors, or nutritional components (carbohydrates, proteins, fats, additional micronutrient rich foods like fruits/vegetables).

Remember to not ‘force’ your child to eat just because it’s a designated ‘meal’ time.

Provide them with a variety of foods on a plate and trust and nurture the idea that when your child is hungry they will get to the food that has been prepared and plated for them.

Allow your child to have at least 10 exposures to a food before deciding that they don’t ‘like’ it.

Research from the American Journal of clinical nutrition shows increased acceptability of foods after 8-10 of repetitive exposure. Just because your child doesn’t like a food the first time they try it, doesn’t mean they actually don’t like it, it may be that they have never experienced that flavor, texture, smell, etc, and will develop tolerance to it over time.

Mirror a healthy relationship with food yourself (inclusion of all foods).

Children heavily rely on learning cues from adults and older siblings, so your relationship with foods and the terminology you use around foods (good v bad foods) molds your child’s view of food too.

Secondary to childhood, adolescence is a time in which a child’s relationship to food and their bodies’ can be highly sensitive. And the education surrounding adolescent nutrition is heavily laced with dieting messages, which promote the development of disorder eating, eating disorders, low self-esteem, low self-worth, etc. Society relies heavily on media (social, TV, ads, magazines, etc.) to give our kids the information that they need in regards to caring for themselves well and making sure they know why food is important. Hard facts are that they get incredibly misinformative information that is entrenched  in what we know as DIET CULTURE. 

DIET CULTURE is known to be a system of beliefs that worship ideals surrounding thinness, equating it to moralistic virtues of more acceptability, love, and overall worth, regardless of true health status/vitals. 

Diet Culture gives very sneaky messages surrounding food holding moralistic weight/value. In the most general sense, food serves the purpose to nourish and nurture growth and development in adolescence. Engagement in dieting behaviors, can increase risk for malnutrition, delayed development/growth, and bone fractures/breakage. 

Here’s some ‘go-to’ basic nutritional information surrounding the value of all foods: 

Carbohydrates (no matter the source-whether ‘refined/white’ or whole grains): are broken down by the body and converted to glucose (blood sugar) to help cells have the energy needed to send signals to different parts of the body for functioning; Provide the brain exclusively with the energy it needs to think and process information clearly and effectively; Provides energy for organ/organ systems to run at optimal capacity.

Proteins (no matter if it’s higher or lower in fat content): Provides energy for muscle, cell, and tissue repair, growth, and regeneration (creation). 

Fats (no matter the source-whether saturated (animal sources) or unsaturated (plant sources): Provide energy for body temperature regulation; energy needed for absorption of vitamins & minerals; energy needed for protection of vital organs; energy needed to facilitate hormone balance (develops in adolescence-estrogen, progesterone, testosterone).  

For additional resources and materials surrounding Childhood & Adolescent Nutrition from an Intuitive Eating and Health at Every Size (HAES) lens, check out:

Books:

Intuitive Eating Workbook for Teens: A Non-Diet, Body Positive Approach to Building a Healthy Relationship with Food

By: Evelyn Tribole & Elyse Resch

Born to Eat 

By: Leslie Schilling & Wendy Jo Peterson

Celebrate Your Body (and its changes, too!): The Ultimate Puberty Book for Girls

By: Sonya Renee Taylor

Videos:

Poodle Science

Research on Food Exposures:

https://academic.oup.com/ajcn/issue/109/Supplement_1

Written By: Tess M Patterson MS RD LD


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