Pine Rest Mission Statement
Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity and compassion.

The Family and the ADHD Child

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that becomes apparent in some children in the preschool and early school years. It is hard for these children to control their behavior and/or pay attention. It is estimated that between 3 and 5 percent of children have ADHD, or approximately 2 million children in the United States. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.

A child with ADHD faces a difficult but not insurmountable task ahead. In order to achieve his or her full potential, he or she should receive help, guidance, and understanding from parents, guidance counselors, and the public education system.

Medication can help the ADHD child in everyday life. He or she may be better able to control some of the behavior problems that have led to trouble with parents and siblings. But it takes time to undo the frustration, blame, and anger that may have gone on for so long. Both parents and children may need special help to develop techniques for managing the patterns of behavior. In such cases, mental health professionals can counsel the child and the family, helping them to develop new skills, attitudes, and ways of relating to each other. In individual counseling, the therapist helps children with ADHD learn to feel better about themselves. The therapist can also help them to identify and build on their strengths, cope with daily problems, and control their attention and aggression. Sometimes only the child with ADHD needs counseling support. But in many cases, because the problem affects the family as a whole, the entire family may need help. The therapist assists the family in finding better ways to handle the disruptive behaviors and promote change. If the child is young, most of the therapist's work is with the parents, teaching them techniques for coping with and improving their child's behavior.

Several intervention approaches are available. Knowing something about the various types of interventions makes it easier for families to choose a therapist that is right for their needs.

Psychotherapy works to help people with ADHD to like and accept themselves despite their disorder. It does not address the symptoms or underlying causes of the disorder. In psychotherapy, patients talk with the therapist about upsetting thoughts and feelings, explore self-defeating patterns of behavior, and learn alternative ways to handle their emotions. As they talk, the therapist tries to help them understand how they can change or better cope with their disorder.

Behavioral therapy (BT) helps people develop more effective ways to work on immediate issues. Rather than helping the child understand his or her feelings and actions, it helps directly in changing their thinking and coping and thus may lead to changes in behavior. The support might be practical assistance, like help in organizing tasks or schoolwork or dealing with emotionally charged events. Or the support might be in self-monitoring one's own behavior and giving self-praise or rewards for acting in a desired way such as controlling anger or thinking before acting.

Social skills training can also help children learn new behaviors. In social skills training, the therapist discusses and models appropriate behaviors important in developing and maintaining social relationships, like waiting for a turn, sharing toys, asking for help, or responding to teasing, then gives children a chance to practice. For example, a child might learn to "read" other people's facial expression and tone of voice in order to respond appropriately. Social skills training helps the child to develop better ways to play and work with other children.

Support groups help parents connect with other people who have similar problems and concerns with their ADHD children. Members of support groups often meet on a regular basis (such as monthly) to hear lectures from experts on ADHD, share frustrations and successes, and obtain referrals to qualified specialists and information about what works. There is strength in numbers, and sharing experiences with others who have similar problems helps people know that they aren't alone. National organizations are listed at the end of this document.

Parenting skills training, offered by therapists or in special classes, gives parents tools and techniques for managing their child's behavior. One such technique is the use of token or point systems for immediately rewarding good behavior or work. Another is the use of "time-out" or isolation to a chair or bedroom when the child becomes too unruly or out of control. During time-outs, the child is removed from the agitating situation and sits alone quietly for a short time to calm down. Parents may also be taught to give the child "quality time" each day, in which they share a pleasurable or relaxing activity. During this time together, the parent looks for opportunities to notice and point out what the child does well, and praise his or her strengths and abilities.

This system of rewards and penalties can be an effective way to modify a child's behavior. The parents (or teacher) identify a few desirable behaviors that they want to encourage in the child—such as asking for a toy instead of grabbing it, or completing a simple task. The child is told exactly what is expected in order to earn the reward. The child receives the reward when he performs the desired behavior and a mild penalty when he doesn't. A reward can be small, perhaps a token that can be exchanged for special privileges, but it should be something the child wants and is eager to earn. The penalty might be removal of a token or a brief time-out. Make an effort to find your child being good. The goal, over time, is to help children learn to control their own behavior and to choose the more desired behavior. The technique works well with all children, although children with ADHD may need more frequent rewards.
In addition, parents may learn to structure situations in ways that will allow their child to succeed. This may include allowing only one or two playmates at a time, so that their child doesn't get over-stimulated. Or if their child has trouble completing tasks, they may learn to help the child divide a large task into small steps, and then praise the child as each step is completed. Regardless of the specific technique parents may use to modify their child's behavior, some general principles appear to be useful for most children with ADHD. These include providing more frequent and immediate feedback (including rewards and punishment), setting up more structure in advance of potential problem situations, and providing greater supervision and encouragement to children with ADHD in relatively unrewarding or tedious situations.

Parents may also learn to use stress management methods, such as meditation, relaxation techniques, and exercise, to increase their own tolerance for frustration so that they can respond more calmly to their child's behavior.

(This article was excerpted from the NIMH article located at http://www.nimh.nih.gov/publicat/adhd.cfm#intro. Additional information and references may be obtained there.)

Social Phobia (Social Anxiety Disorder)

"In any social situation, I felt fear. I would be anxious before I even left the house, and it would escalate as I got closer to a college class, a party, or whatever. I would feel sick in my stomach-it almost felt like I had the flu. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else."

"When I would walk into a room full of people, I'd turn red and it would feel like everybody's eyes were on me. I was embarrassed to stand off in a corner by myself, but I couldn't think of anything to say to anybody. It was humiliating. I felt so clumsy, I couldn't wait to get out."

Social phobia, also called social anxiety disorder, is diagnosed when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.

While many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them. Even if they manage to confront their fears and be around others, they are usually very anxious beforehand, are intensely uncomfortable throughout the encounter, and worry about how they were judged for hours afterward.

Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others) or may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost anyone other than the family.

Physical symptoms that often accompany social phobia include blushing, profuse sweating, trembling, nausea, and difficulty talking. When these symptoms occur, people with social phobia feel as though all eyes are focused on them.

Social phobia affects about 15 million American adults. Women and men are equally likely to develop the disorder, which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved. Social phobia is often accompanied by other anxiety disorders or depression, and substance abuse may develop if people try to self-medicate their anxiety.
Social phobia can be successfully treated with certain kinds of psychotherapy or medications.

How to Get Help
If you think you have an anxiety disorder, the first person you should see is your family doctor. A physician can determine whether the symptoms that alarm you are due to an anxiety disorder, another medical condition, or both.

If an anxiety disorder is diagnosed, the next step is usually seeing a mental health professional. The practitioners who are most helpful with anxiety disorders are those who have training in cognitive-behavioral therapy and/or behavioral therapy, and who are open to using medication if it is needed.
You should feel comfortable talking with the mental health professional you choose. If you do not, you should seek help elsewhere. Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder together.

Remember that once you start on medication, it is important not to stop taking it abruptly. Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur. Make sure you talk to the doctor who prescribed your medication before you stop taking it. If you are having trouble with side effects, it's possible that they can be eliminated by adjusting how much medication you take and when you take it.

Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out. If you do not have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.

Ways to Make Treatment More Effective
Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common. Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a mental health professional.
Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy. There is preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided. Check with your physician or pharmacist before taking any additional medications.

The family is very important in the recovery of a person with an anxiety disorder. Ideally, the family should be supportive but not help perpetuate their loved one's symptoms. Family members should not trivialize the disorder or demand improvement without treatment. If your family is doing either of these things, you may want to show them this booklet so they can become educated allies and help you succeed in therapy.

(This article was excerpted from the NIMH article located at http://www.nimh.nih.gov/publicat/anxiety.cfm#anx5. Additional information and references may be obtained there.)

April 10
Pine Rest Family Institute Marriage and Family Building Series
11:30 a.m. - 1:30 p.m. on Pine Rest' main campus, 300 68th Street, SE, Grand Rapids. "Marriage Preparation: Crash Course for Busy Pastors," featuring Mark Eastburg, PhD. This series of speakers and topics equips pastors, church, and lay leaders wit the tools and resources for strengthening marriages and supporting families in their congregations. Cost: $5 (includes lunch). To register or for more information, call 616/455-5279.
For more information click here.

April 14, 21, 28
Pine Rest Family Institute 'Secrets for Successful Marriage'
Pre-marital workshop taught by experienced marriage professionals for couples who want to grow their relationship in preparation for marriage. Because it is skill-based, it is a valuable addition to traditional pastoral or professional premarital counseling. 9 a.m. to noon. Cost: $95/couple. Call 616/455-5279 for more information.
For more information click here.

April 5, 2007
National Alcohol Screening Day
Pine Rest will be hosting this annual community service event at several outpatient clinics. Receive a free, confidential screening to learn if you or a loved one are experiencing problems with alcohol and, if so, how you can get help. The screening process includes a written self-test and the opportunity to meet with a trained health professional. Educational information also provided.
For more information click here.

April 11, 2007
'Together We Can' Comfort The Anxious Child
Pine Rest Christian Mental Health Services’ Traverse City Clinic will host a workshop entitled, “Together We Can Comfort the Anxious Child,” as part of the new “Together We Can” community education series. The presentation will take place on Wednesday, April 11, from 6:00 to 7:00 p.m. at the Pine Rest Traverse City Clinic, 1050 Silver Drive, Traverse City. The event is free and open to the public. Linda Frank, MA, LPC, a licensed professional counselor, is the presenter and moderator.
For more information click here.

April 25, 2007
Brain-Based Treatment Approaches for ADHD Across the Lifespan
Featuring Kathleen G. Nadeau, Ph.D., from 9 a.m. to 12:15 p.m. in the Pinnacle Center, 3330 Highland Drive, Hudsonville, MI. The lecture is free of charge and open to the public. For more information, call (616) 455-6500. 3 CME/CEU credits. 3 NASW CE clock hours.
For more information click here.

May 16, 2007
Family Psychoeducation In Schizophrenia: Why It Is As Important As Medical Treatment
Featuring David Levine, M.D., from 9 a.m. to 12:15 p.m. in the Pinnacle Center, 3330 Highland Drive, Hudsonville, MI. 3 CAC contact hours (related) for MCBAP accreditation. 3 NASW CE clock hours. Call 616/455.6500 for more information.
For more information click here.

Support Groups

April 5, 12, 19, 26
Eating Disorders Educational/Support Group
Pine Rest Christian Mental Health Services’ Northeast Clinic will continue offering a free, confidential eating disorders educational support group. This group is geared for persons with diagnosed eating disorders who are also receiving treatment from a health professional. An assessment or referral is required prior to joining the group. To schedule an assessment or for more information, interested persons should call Pine Rest ’s Northeast Clinic at 616/364-1500.
For more information click here.

April 9
Pine Rest Family Connections Support Group
Monthly group for families who have a member with a diagnosed mental illness. Helps spouses, parents, siblings, and other caregivers more effectively deal with stress created by symptoms and behaviors. 5:30 – 6:30 p.m. at Pine Rest's Southwest Clinic, 4211 Parkway Place, Suite 100, Grandville. Cost: Free. Facilitated by Jim Vander May, LMSW. Call 616/222-3700, ext. 4 for more information.
For more information click here.

Workshops and Classes

April 28
Raising Children Without Raising the Roof: Parenting for the Rest of Us
Pine Rest’s Northwest and Northeast Clinics have teamed up to offer a FREE parenting workshop for all interested parents.
Who: Any parent in the Grand Rapids area
What: A parenting group designed to tackle the real-life challenges of raising children
When: 9 am to 11:30 am
For more information click here.

April 10, 17, 24, May 1
Anger Management Classes for Teens
Led by Ryan LaRue, MSW, LMSW, ACSW, outpatient therapist at Pine Rest Campus Clinic. 4:15 -5:30 p.m. in the Van Andel Center on Pine Rest's main campus, 300 68th Street, SE, Grand Rapids. Open to male and female teens ages 12-17. Cost: $75/person. Call 616/222-4584 for more information or to register.
For more information click here.

April 3, April 10, May 17, 24
Anger Management Classes for Adults
Led by Jim Bottenhorn, MA, LLP, Director of Pine Rest’s Contact Center. 7 p.m. to 8:30 p.m. on Pine Rest's main campus, 300 68th Street, SE, Grand Rapids. Open to adults and older teens. Registration is required. Cost: $65/individual or $95/two family members. Class fee due at first class. Call 616/493-6033 for more information and to register.
For more information click here.

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Disclaimer

Copyright © 2007, Pine Rest Christian Mental Health Services. All rights reserved. The contents of Mental Health News & Information are for informational purposes only. The content is not intended to be a substitute for professional medical or mental health advice, diagnosis, or treatment. It cannot and should not be used as a basis for diagnosis or choice of treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical or mental health condition.