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Many college institutions and universities offer the opportunity for students to study a semester abroad in a foreign country. This is an invaluable experience for a young person to learn and grow both academically and personally. This topic of discussion has come up in my sessions working alongside college-aged students in eating disorder recovery. The decision to study abroad is a commitment that requires an extended amount of time away from family, friends, and other sources of support. I utilize these evaluative questions to explore with my client their readiness to travel abroad in recovery:

• Are my symptoms managed well? Am I able to regulate using healthy coping skills? Do I have a relapse-prevention plan in place?
• Is my physical and mental health stabilized?
• Have I been making progress in recovery for a continual amount of time?
• Do I feel properly supported?
• Does the thought of travel bring joy and excitement (not fear or anxiety)?

How Do I Know I Am Ready to Study Abroad?
From traveling long hours on a plane, exposure to different foods, adjustments to time zones, experiencing a new culture and way of daily living – the choice to study abroad would be carefully considered and discussed with a treatment team (primary therapist, registered dietician, medical provider, etc). Considering the costs and benefits of the timing of the trip abroad is also important – a person should ideally be at an outpatient level of care, medically and psychologically stable and solidly in recovery. With guidance from a treatment team, realistic expectations and goals can be met if planned out accordingly.

Maintaining Mental and Physical Health Abroad:
Choose with recovery in mind. Traveling abroad for the first time in recovery is not the time to push or challenge too much. I encourage clients to be mindful in choosing a location and/or program type that will be aligned with maintaining recovery (i.e. access to appropriate dietary needs, ability to maintain contact with support network) – reminding them that there will be other opportunities to explore different destinations in trips to come.

Engage in self-care. Ah, the infamous s-word. Taking care of basic health needs is a fundamental way to preserve any type of recovery. Upholding a regular sleep schedule, proper nutrition, limiting alcohol, taking daily medications, journaling before bed or beginning the day with a meditation; whatever works in day-to-day life in America should be translated abroad to incorporate stability into the new and potentially changing environment.

Stay connected. Traveling or studying abroad can feel isolating at times, especially when navigating a different culture. Staying connected to various sources of support is important. This can be met through an online eating disorder support group, emails from a treatment team member or regular scheduled FaceTime or phone calls with a loved one.

 

Cassy Taverna, MSW, LCSW-A currently sees individual clients and facilitates S.O.A.R (Staying Open about Recovery), a support group for college-aged women who are making strides to positively stay on track with eating disorder recovery. Her clinical interests include the treatment of eating disorders, trauma, anxiety/mood disorders and LGBTQIA issues. Cassy loves to travel as she presented her research on Disordered Eating Among Newly Bereaved Spouses at the International Conference on Community Mental Health in Bangalore, India during her graduate studies at the University of North Carolina at Wilmington.



Many people are surprised to hear that I often eat with my clients. They think it is odd to ask a client to bring a snack or a meal to a nutrition appointment or silly that we might complete a meal together one-on-one or in a group setting. The reality is that some of the most valuable information about one’s food intake and eating behaviors is gathered by eating with them. During this snack or meal time the food rules, fear foods, and/or eating disorder behaviors can be addressed in the moment in an encouraging and supportive way. Meal time can be very stressful for a person with a poor relationship with food and/or for those individuals with disordered eating or an eating disorder so providing meal support as part of treatment can be a game-changer.

Meal support is common at the residential, partial hospitalization, and intensive outpatient levels of care but is may not be offered as commonly in an outpatient setting. I’ve found that adding meal support as part of the treatment plan at the outpatient level can be monumental to achieving nutrition-related goals. Some outcomes of meal support may include:

  • Improved ability to complete a meal or snack
  • Acceptance and tolerance of  a variety of foods and beverages
  • Confidence in portioning and eating appropriate amounts of food for one’s needs
  • Practicing normal eating behaviors and while decreasing eating disorder behaviors
  • Challenging and reducing food rules and rituals
  • Practicing distress tolerance while feeling emotionally supported
  • Improved confidence around self-regulated food intake
  • Recognition of  hunger and fullness cues
  • Improved mindfulness at mealtime

Incorporating meal support into practice is useful not only for clinicians but also for the client’s community of support, if appropriate. I recommend that a team approach (dietitian, therapist, support persons, client, etc.) is used in planning and preparing for the meal and that meal support goals and the experience is individualized for each client.  For example, person A might set a short term goal to practice eating a meal mindfully with the ultimate goal of identifying hunger and fullness cues while person B may set a short term goal of eating 100% of the meal to help achieve the long term goal of re-nourishing their body. Goals will evolve and change as appropriate throughout the journey. Seek out a registered dietitian that specializes in eating disorder treatment to help identify appropriate meal support goals and to assist in planning meals and giving guidance and tips for before, during and after the meal.

Chrysalis Center offers meal support 3 times a week as part of their Intensive Outpatient Program and once a week for those partaking in outpatient services. Talk to your treatment team if you think this would be beneficial for you!

 

Courtney is a registered dietitian who specializes in sports nutrition and eating disorder treatment. She incorporates HAES and non-diet principles into her practice. In addition to nutrition consultations, Courtney leads IOP and outpatient meal support group and IOP nutrition group.


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In a lamp lit room, a group of six casually dressed people sit in chairs which are arranged in a circle.  All, but one, seem to be engaged in two or three different conversations as a more formally dressed woman enters the room. She sits in one of the vacant seats of the circle as the people in the room gradually turn their eyes toward her. “Good morning,” she says, “you guys are a bubbly group this morning.” She smiles wryly as a tall gray-haired man in the group says, “Well, Amy started it.” He turns his gaze onto a thirty-year-old blonde woman sitting to his left who smiles as she begins to explain, “I picked up my six-month chip last night. It’s the longest I have been sober since I started drinking fifteen years ago.” Members of the group all offer her their congratulations in various ways. John, the quiet one, glances up quickly and says in a flat voice, “Keep up the good work, Amy.” “You don’t seem yourself today, John. What is going on with you,” asks the more formally dressed woman, a therapist facilitating this relapse prevention therapy group. Looking down at the floor, John reveals to the group that he used yesterday.

Like everyone else in this therapy group, John is an addict. Most of the people in the room have at least 90 days clean and are now working on relapse prevention skills. If they are not actively using drugs or alcohol, why are they still in treatment? What are relapse prevention skills? And, what is a “relapse”?

One reason to remain in treatment after discontinuing the use of substances is because the physiological addiction is only part of the challenge. Long after the individual has ceased substance use, the psychological and behavioral elements of addiction remain. Many addicts struggle with how to cope with stress, celebrate, socialize, or even go to sleep without relying on a substance.    These elements of addiction need to be addressed or most addicts slip right back into substance use.

Another aspect to consider is that “withdrawal symptoms” can actually last for up to two years after cessation of use. While the acute symptoms may alleviate within a few weeks, there are “post acute” withdrawal symptoms that follow. During this time, changes that occur in the brain, as the brain is adjusting to no longer having the effects of the substance use, can trigger a person to want to use. It can even cause them to have very vivid dreams of using that are so real, the individual may have trouble telling the difference between the dream and reality.

This is what happened to John mentioned earlier. He awoke one morning having had a “using dream.” It felt real, as if he had used his drug of choice and actually felt high. Realizing this was a dream, he tried to put it out of his mind, but he just kept thinking about it. He didn’t share his struggles with anyone, feeling like a dream was a silly thing with which to trouble his sponsor and other friends. Later that day, he received a call from an old using buddy whose car had broken down and who needed a ride. John picked up his friend, and when he dropped that friend off, the friend repaid him for his help with his drug of choice. John tried to decline, but his friend left the drugs on the seat of the car and waved goodbye. John returned home to an empty apartment and used.

The bottom line is, getting sober is different from staying sober. To recover from substance addiction requires learning a new lifestyle, developing a support system that will help you maintain that lifestyle, and learning how to cope with life on life’s terms… without using. The relapse prevention phase of treatment focuses on achieving these goals. While someone, like John, might slip up and use while in the process of learning such skills, they can remain connected with support and treatment, using the experience as a learning tool, and preventing a complete return to his/her former way of life.

After John shared with the group, they offered him support. Amy said, “John, I know how hard it was to come in here and say that. I know I’d be worried that people would judge me, so thank you for sharing and showing us that it is safe to do so.” Others chimed in and echoed Amy’s commendation. One group member shared, “When I feel like I  want to use, I call someone from our group and call my sponsor. I keep calling numbers until I get someone on the phone.” Another said, “When I am craving, I get out of wherever I am and go somewhere safe. I like to walk on the beach. It clears my mind and calms me down.” Then, the therapist facilitated a discussion around the various elements of John’s story and the skills that any group member could use should any of them face similar things in the future.

  • I am a Psychologist and Clinical Addictions Specialist at the Chrysalis Center. I have successfully treated individuals who struggle with addiction for eight years. I also treat individuals with binge eating, anxiety, depression, and trauma challenges. To schedule an appointment to see me, please call the Chrysalis Center at 910.790.9500. ~Lillian Hood, LPA, LCAS

*John and Amy are fictional characters used to demonstrate the real experience that individuals under these circumstances tend to face.


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Hopefully it’s coming to an end but flu activity this season is the worst we’ve seen in over a decade, The flu vaccine is less than 20% effective against the current strain of flu. So what can we do to protect ourselves in effort to prevent? What can we do to support our bodies and boost our immune system if good ol’ influenza comes knocking at your door?

Proper nutrition can help ward off the flu or during a bout of the flu can help to limit the severity and duration of the illness, which helps to prevent the flu from escalating. One way to boost the immune system is to maintain a vitamin C regimen. 1,000-2,000 mg of vitamin C/day may reduce severity of symptoms and shorten the duration of the illness. Consuming adequate produce is another simple way to boost immunity since they are loaded with Vit C and other antioxidants. A few favorites to add are citrus fruit, cabbage, broccoli, pumpkin, sweet potato, and spinach.

Include in your meal planning a healthy level of good bacteria. Incorporating probiotics is valuable in restoring levels of these healthy bacteria in our body to protect us from infection. A quality probiotic supplement is recommended but remember to always take after antibiotic use. A few fermented foods to include are kefir, yogurt (make sure the label says it contains “live active culture”) and sauerkraut.

We experience fevers because the body’s defense mechanism is heating up in effort to kill the virus. This can cause loses of vital fluids, especially if you experience vomiting and diarrhea, so it’s crucial to rehydrate. Keeping the kidneys hydrated will naturally support the immune and lymphatic system. Our lymphatic system filters out foreign invaders and it’s comprised of mostly water. Since our lymphatic system and immune system work synergistically, it’s imperative to keep drinking those fluids which will keep everything moving smoothly.

Try sipping on this tea to prevent the flu but if already contracted, it will help you recover more quickly.

Mulled Apple Cider
Serves: 4 cups
4 cups apple cider
3-4 cups water
1 tbsp. dried ginger
star anise pods
3 whole cinnamon sticks
2 tsp. cloves
1 tsp. allspice
Put all ingredients into a soup pot and bring to a boil.
Reduce heat to simmer.
Cover and simmer for one hour.

Physical exhaustion is a common symptom of the flu. Light meals such as chicken or veggie soup with homemade bone broth let the body divert it’s energy to the healing process rather than straining to digest a large meal. Let yourself rest and sleep to allow your body to recuperate. Good sleep cycles help the immune system work well.

When you have yellow or green phlegm, reach for garlic. It helps your body suppress infection. Garlic is an antibiotic, antimicrobial, and antibacterial and can work wonders.

When you have clear phlegm, reach for ginger. It is a muscle relaxant and may have the power to reduce coughing and inflammation. Adding 1-2 tsp of raw honey to ginger tea. A cough can be a good thing; your body is trying to get rid of mucus that may be collecting in your lungs. However, a persistent cough may be annoying if it keeps you up at night. Ginger can help with nausea too.

Herbs to include: Oregano is a powerhouse of flu-fighting properties since it’s antibacterial, anti-fungal, and an antioxidant. Rosemary is highly antiviral and antibacterial. Thyme is a powerful antimicrobial remedy. Echinacea acts as an anti-inflammatory, which can help reduce bronchial symptoms of the flu.

Keep your immune system strong throughout the year!



As we wrap up National Eating Disorder Awareness week, with this year’s theme of “Let’s Get Real”, a major focus of the campaign is on ending stigma. One group of people who struggle with being stigmatized the most are males with eating disorders. It is a common stereotype that only women struggle with eating and body image issues, when in reality 1 in 3 people with an eating disorder is male and 10 million males in the United States alone will be impacted by an eating disorder at some point in their lives. There is also a commonly held misperception that the only males who suffer from eating disorders are homosexuals; actually, the majority of men with eating disorders are heterosexual.

Men and boys of all backgrounds experience eating disorders, and there is a high prevalence rate amongst athletes. Just this week, Seattle Mariner’s catcher Mike Marajma opened up about his battle with an eating disorder (https://www.nationaleatingdisorders.org/blog/seattle-mariners-catcher-mike-marjama-has-message-men-struggling-eating-disorders). Sports that focus on weight restriction as a means for improving performance create increased vulnerability for the development of eating disorders. Gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers are at risk when pressure is put on them to achieve a certain weight.

Men often go undiagnosed or untreated for a variety of reasons. They are less likely to seek treatment and more likely to be overlooked by medical professionals. Eating disorders in general have the highest mortality rate of any mental health condition and studies have shown that males have an even greater risk of dying from an eating disorder than their female peers; again, a lag in proper diagnosis or barriers to seeking treatment can contribute. To highlight this, the last male with anorexia that I encountered clinically had been seeing a therapist for a year for anxiety and had undergone extensive medical testing for reported GI issues. He’d lost over 40 pounds in a short period of time and was at roughly 65% of his ideal body weight when I encountered him in the hospital (he was there for flu and dehydration). No one had recognized that what he was dealing with was in fact an eating disorder. He ended up requiring months of inpatient hospitalization to help him restore weight.

Luckily there are more intensive treatment options for men with eating disorders available as the field recognizes the need to offer gender inclusive treatment. In fact, a review of hospitalizations for men with eating disorders showed a 53% increase over a 10 year period from 1999-2009. If you are a male struggling with an eating disorder, or know a male who is, know that help is available!

A few resources:
www.nationaleatingdisorders.org/learn/general-information/research-on-males
www.namedinc.org
www.mengetedstoo.co.uk
“Man Up To Eating Disorders” by Andrew Walen

 



Eating Disorder Awareness Week

For the National Eating Disorder Association (NEDA)’s Eating Disorder Awareness Week (February 26-March 4), the theme is “Let’s Get Real.” The goal is to highlight the stories we don’t hear as often and to open the conversation to everyone.

For more info from NEDA, please go to https://www.nationaleatingdisorders.org/, and if you are concerned you might have an eating disorder, use their Helpline 1-800-931-2237 or their screening tool https://www.nationaleatingdisorders.org/screening-tool.

According to statistics provided by NEDA, 30 million Americans struggle with a “full blown” eating disorder, and countless more struggle with eating and body image concerns. Because of the stereotypes and stigma attached to mental illness and eating disorders, a lot of people don’t reach out for help.

Last year, the theme was “It’s Time To Talk About It” and Kelly Broadwater, LPA here at Chrysalis Center highlighted the high mortality rate, the lack of funding for research, the negative messages about food and weight we get bombarded with every day, getting help, and having hope. To read more from this blog post, go to http://chrysaliscenter-nc.com/its-time-to-talk-about-it/.

Truths About Eating Disorders

There are a lot of stereotypes about eating disorders. How many of those are even real? Instead of going through all the myths about eating disorders, here are some truths:

  • An eating disorder is not a choice; it is a mental illness with serious physical, cognitive, and psychological implications.
  • It is not possible to “just snap out of it.”
  • There is no one cause for an eating disorder, it is a different root for every person.
  • It is a big deal.
  • Anorexia is not the only eating disorder, even if it is the one we think of most often – bulimia, binge eating disorder, and avoidant/restrictive food intake disorder are also serious, life threatening illnesses that need to be taken seriously.
  • Just because you don’t see it physically, doesn’t mean it’s not there or that you should ignore signs because it doesn’t fit the stereotype.
  • There are a lot of other issues linked to eating disorders, including anxiety, depression, and trauma.
  • People need their support system, including friends, family, and treatment team, to recover.
  • Men can have eating disorders, and the CDC found that about 1/3 of all eating disorder sufferers are male.
  • Children as young as five can develop eating disorders, and many people who struggle with eating disorders as a child or adolescent will continue to struggle with them as an adult unless they receive help.
  • It is not just about food.

For people with these disorders, one of the biggest obstacles is the secrets and shame that go along with those behaviors.

Say Something!

Too often, loved ones will see something wrong and not say anything – if we are going to “Get Real” that needs to change. People are afraid to bring things up, but that is one of the things that keeps the stigmas about mental health and eating disorders alive.

Why not ask, or express concern? What is wrong with talking about it, really? It can be a difficult topic, but if it is approached with concern, caring, and empathy, people will rarely shut down the conversation.

If this seems too stressful or delicate to do on your own, seek help from a professional (a therapist or dietician who specializes in eating disorders) to help you have the conversation.

As an eating disorder specialist, the most important message I want people to hear is that truth and honesty is necessary from everyone affected – the person with the eating disorder and their loved ones.

Don’t walk on eggshells – but don’t smash them either. If you try to get real, make sure you are coming from a genuine place of caring before you try to open the conversation. If it is approached with compassion, the conversation has a much better chance of being productive for the person with the eating disorder and their loved ones.

#NEDAwareness

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The new and “Free” Weight Watchers program directed towards adolescent’s may negatively harm them.

Weight Watchers announced on February 7th, that they will be providing free memberships, six weeks during the summer, for teenagers between the ages of 13 to 17 years old. Weight Watchers aims to increase its’ program reach to 5 million people by the end of 2020 – as they plan to build lifelong customers.

The question here is, what are the impacts of this program on adolescents today?

Although this may initially sound enticing and may be hard to see the harm, let’s look at some points that  show how this could negatively impact teenagers–now and in the future.

Weight Watchers is sending out a message to all teenagers, participants of the program or not, that something is wrong with their body, which is a form of body shaming. Is this the kind of message that we want to give to teenagers today? According to the Mayo Clinic, one of the main reasons teens develop eating disorders is SOCIETAL PRESSURE. We should be showing teens we love them as they are.

The obesity epidemic is no doubt a major concern relating to teens’ health and to their future. Obesity and eating disorders are widespread among teenagers. Everywhere you turn, there is a picture of what a perfect body looks like and the many ways one can try to achieve it.

However, programs such as this needs to be evaluated before being promoted, especially considering the psychological outcome. A 2016 research study by the American Academy of Pediatrics suggests that obesity prevention can lead to eating disorders. Eating disorders are the 3rd most chronic condition following obesity and asthma in adolescents. Adolescence is a critical age where the individual develops self-identity, and messages like these can trigger young people to believe their bodies are not perfect, which can lead to eating disorders.

According to Dr. Eve Freidl at Columbia University, teenagers are supposed to be growing and getting bigger, and their brains just aren’t fully developed yet — the part of the brain that is more involved in the emotional world is developing faster than the part of the brain that is really good at long-term planning and decision making,” she says. “So while Weight Watchers is suggesting that this might be a good time to implement healthy behavioral strategies, I think saying that without data and research, as to the most responsible way to do it, can be dangerous.”

So, if  programs and messages like these are not in the best interest of the child then how do we help them?

What we need to do is to create a more balanced environment for them to be able to adopt a healthier lifestyle – guiding them constructively to make healthier and wiser choices and to increase physical activity is the best approach.  This message starts at home with parents. They have the biggest responsibility of shaping a child’ behavior. What they eat and how they live their lives  is determined by their environment and relationships at home.

We want to create a healthier body image not a distorted body image. This can be accomplished with an integrated approach from family members and health professionals such as a registered dietitian to apply lifestyle modifications.

 Reference:

 http://pediatrics.aappublications.org/content/early/2016/08/18/peds.2016-1649

 

This blog is co-written by dietetic student intern Rub Ali.


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Rachel Hendricks
21/Apr/2018

The Olympics. From the opening ceremonies to the tally of medals, the Olympics is an event we love to watch. The Olympics represents the culmination or continuation of a dream for each athlete attending. A dream that often consumes their lives. And, at times, a dream that causes harm.

As Gracie Gold took a break from ice skating in January, she identified that she needed to pursue treatment for her mental health, broadly, and an eating disorder, more specifically. While we can applaud the courage it took for her to take a break and focus on her wellness, we can also question the environment in which she participated that brought her to that point.

Health, Exercise, and Culture

As a country, we idolize exercise. In fact, attitudes and trends have shifted from women being as focused on “thinspo” to being focused on “fitspo.”  Research also shows that males are being pressured to have “fit” bodies, as well- with an emphasis on bulk and definition. As a result, it is not uncommon for me to see several clients in the same day mentioning they simply want to be “fit” and the role of “healthy” eating and “healthy” exercise to accomplish those goals.

Of course, I am not saying that there is no such thing as healthy eating or healthy exercise. But, as is often the case in our culture, we live in a world of extremes. If one piece of broccoli is good, a whole shake of broccoli (plus all the other so-called super foods) must be better. If running one mile is good, running a marathon must be better. Again, I mean no aspersions towards broccoli or running.

However, there is not an exponential benefit to any one particular food (or food group) or to exercise.

As we watch these athletes who have dedicated their lives to their sport, it is important to recognize what it takes to do so. A balanced and varied diet (purportedly, Michael Phelps eats upwards of 10,000 kcals per day to maintain his stamina). Constant and rigorous physical training (sometimes beyond the point of injury as when Keri Strung completed her second vault after injuring her left leg and had to land on one foot). And, a single-minded focus that when applied elsewhere would be seen as obsessive or compulsive.

Listening to Our Bodies

When we push people to ignore the cues and signals their bodies send them, we set them up for all sorts of problems later on. And, when our criteria of their “wellness” is how well they are performing at their sport, we seriously minimize the reality of the risky world in which these athletes exist.

I can’t tell you how many times I have had someone tell me they cannot recover from their eating disorder because, in their mind, the eating disorder is what makes them excel at their sport. Often, these clients who are living with internal turmoil are getting compliments and positive feedback from others based on their performance.

When our eyes turn towards the Olympics in South Korea, let us do so with greater awareness. And, let us focus on the athlete as a complete, complex, and multi-dimensional person. A person who has worth outside of their sport. A person who deserves to be able to treat their body well. A person who deserves to be celebrated for all that they are.

 

If you are an athlete struggling with eating or exercise behaviors, please don’t hesitate to reach out for additional support. We have a dietitian and several therapists who both specialize in working with athletes as well as being athletes, themselves. Contact our admissions office at (910) 790-9500 for additional information and to get scheduled.

 

Rachel Hendricks, LCSW specializes in working with clients who have had their eating disorder for ten or more years, clients with co-occurring substance use behaviors, as well as working with couples and families. She facilitates two groups: Motivation to Change and Declutter Class, and she is currently accepting referrals for both. She is excited to be making the transition to Wilmington from the Center for Eating Disorders in Baltimore, Maryland. Rachel looks forward to continuing her reputation for providing excellent clinical care in the field of behavioral health.

 



Online games, music, videos, written content, and various social media have reshaped the ways in which our pre-teens and teens interact with the world. In many ways, this is a scary prospect for parents, who did not grow up carrying a powerful computer in their pockets with the capacity to access (or send videos to) the entire world in seconds. While our initial inclination as parents may be to take technology away, we also know that there are many positives that come from technology and like it or not it is an integral part of daily life.

 

Controlling internet use can be more straightforward with younger children where limiting access to technology, blocking non-kid-friendly sites, and setting strict time limits are developmentally appropriate. Unfortunately, much of this changes in the pre-teen and teenage years. Adolescents want and need more independent access to technology than younger children for homework, recreation, and socialization—and severely limiting that can be harmful… but letting it be a free-for-all can be harmful as well. So what does a conscientious parent do?

 

The good news is that there are many ways that we can help our pre-teens and teens learn to be more safe, to avoid perils and to take advantage of positive, age-appropriate opportunities online. Some more good news is that the internet has a lot of great things to offer that will enrich our children’s lives and help them learn key skills for their future. So, how do we make sure that our pre-teens and teens navigate this seemingly limitless online world safely and productively? The answer is us, or more specifically, our relationships with our teens.

 

The number one thing that we can do to make sure our children are safe is to have conversations with them about their online activity on a regular basis. This engagement likely looks different than what you think. It is not the typical parental grilling: What are you doing? Who are you talking to? Show me everything! Followed by a lecture of why this or that is wrong. This approach often shuts down teens and pre-teens. It can have the negative effect of decreasing communication between parents and teens, which is the opposite of what we want.

 

Instead, we need to foster conversations that are genuinely focused on teens’ online interests and goals, while also setting developmentally appropriate limits on device types and usage time as well as having parental monitoring of use. This means actively engaging our children in the aspects of the internet that are nearest and dearest to them and may be completely foreign (or boring or trivial) to us as parents. This parent-teen dialog is a vital way to open doors and build bridges that ultimately keep them safe and help them make better choices online.

 

The purpose of engaging our youth about their online interests is not so parents can start SnapChatting. The purpose is to stay in a parental role while building a relationship that maximally facilitates our teens coming to us for guidance when they have a question or are in trouble. Rather than fearing that they will be punished, we want our kids to know that we are their allies. Developing a foundation built on a positive relationship about online matters will shift our kids’ perceptions from seeing parents as roadblocks to seeing parents as resources.

 

Exactly how is this done? This is a highly personal matter that differs from family to family and should be centered on your core values. To help support families in this conversation, we are offering seminars for parents and pre-teens/teens ages 12-17 at Chrysalis. Parents and pre-teens will have separate seminars to allow youth and parents to find support and guidance in safe spaces.

 

The purpose of the pre-teen/teen seminar is to open up the conversation and provide a supportive environment for youth to talk about the positive and negative aspects of being online—this will not be a lecture. It will be fun for your pre-teens and teens, while also providing valuable information. In the teen seminar, we will be asking questions to teens to better understand their online experience. A summary of this information will be shared with parents as a window into what teens and pre-teens are experiencing when they are online.

 

The parent seminar that follows the teen seminar will be an opportunity for parents to learn specific tools to open and develop the conversation about technology with teens and pre-teens. Parents will also be able to share their own experiences in a private setting as a way to learn what is most helpful and what to avoid. Following these seminars, opportunities will be available for individual family work to address specific needs, challenges or concerns, all with the goal of strengthening families and keeping our teens and pre-teens safe and healthy.

 

I look forward to seeing you there and starting the conversation! If you are interested you can call the Chrysalis main number 910-790-9500 for seminar dates and times and to sign up.

 


Dr. Kate Brody Nooner is a licensed clinical psychologist and associate professor of psychology at UNCW. She also holds an adjunct appointment at Duke University and is the principal investigator of NIH-funded grants aimed at reducing child and adolescent trauma and preventing alcoholism.



On a cloudy, cold and rainy day in November, Tom walks out of his front door at 6:00 AM. He doesn’t have to be at work until 7:30, but as usual, he has a stop to make before work. He pulls into the parking lot of “the clinic” around 6:30 and parks close to the building. There aren’t many people here yet. As he walks in the front door, a middle-aged African American woman greets him, “Hey Tom!” “Good mornin’ Ms. Janey, He responds as he beams at her. They exchange a few quips as she flips through a stack of tickets. She pulls out one and stamps it twice; once with a number indicating his place in line and once with an mark indicating he is required to leave a drug screen today. He looks down at the ticket, and says, “Have a good day, Ms. Janey,” as he takes a seat in the waiting room. The ticket he holds in his hand has his name, the afore mentioned stamps, and a check mark next to something that says, Methadone Dosing. Tom, is a heroin addict and has been for 12 years now. He is being treated for his addiction at a clinic that provides medication-assisted treatment for opiate addiction.

Opiates include drugs like heroin, morphine, and codeine as well as synthetic drugs like oxycodon and hydrocodone. When individuals use large enough amounts of such substances, frequently, over a long enough period of time, their brains become physiologically dependent on (or addicted to) that substance. The chemistry in their brains acclimates to the presence of the substance, and when that substance is no longer present, it takes a while for the brain to reacclimatize to functioning without that substance. The result is withdrawal. Withdrawal from opiates can include a variety of symptoms, including anxiety, insomnia, sweats, vomiting, diarrhea and muscle pain. Many who decide they want to stop using opiates find that they continue to use simply to prevent the severe withdrawal symptoms. Those who share needles to inject the substance also put themselves at risk for contracting infections like hepatitis C.  Finally, in order to afford to continue using, some find themselves engaging in other risky and illegal activities.

One way to break this cycle is “medication-assisted treatment.” This means that an individual is prescribed a medication by a physician in an amount that will stop withdrawal symptoms and will decrease or eliminate cravings to use. This allows a person to discontinue use of the substance, without going through withdrawals, while they are making lifestyle changes, developing a support system, and learning skills for coping. It also promotes discontinuation of illegal and/or risky activities.

The National Institute on Drug Abuse indicates that research has shown participation in a medication-assisted treatment program using methadone is most effective when the individual remains engaged for a minimum of one year. Some individuals remain on medication-assisted treatment for many years because they are unable to maintain abstinence any other way. Others use this treatment for a period of time and then eventually taper off of the medication, i.e. they are prescribed smaller and smaller doses over time until they are no longer in need of the prescription. This slow taper allows a person to discontinue the need for the prescription without triggering an onset of severe withdrawal symptoms.  According to the Substance Abuse and Mental Health Services Administration, “For optimal results, patients should also participate in a comprehensive medication-assisted treatment (MAT) program that includes counseling and social support.”

Tom, mentioned at the outset, looks down at his ticket, “Drug screen,” he mutters to himself. He is a little annoyed thinking about the extra time it is going to take and how that means he won’t be able to get out of the clinic before the heavy traffic kicks in. On the other hand, he is looking forward to it. The person who was in line in front of him comes back down the hall. He gets up and walks down the hall and around the corner to the window where a nurse is waiting. “Morning Judy! He says with a light-hearted grin. “Looks like you’ve got a drug screen today, Tom” “Yes ma’am.” As his grin widens, Judy raises her eye brows. “This will be my first clean drug screen!” She smiles back. “Keep up the good work, Tom,” she says as she watches him drink today’s dose of liquid methadone. As he walks away from the window, he smiles again to himself, “I’m clean.” A reminder pops up on his cell phone, “Therapy appointment at 6:00 PM.” “That’s right,” he says to himself, “and I have my home group NA (narcotics anonymous) meeting after that.

*I am a Psychologist and Clinical Addictions Specialist at the Chrysalis Center. I specialize in working with individuals with addiction challenges as well as those with binge eating, anxiety, trauma, depression and other mental health challenges. Feel free to call to schedule an appointment. –Lillian Hood, LPA, LCAS

References:

Substance Abuse and Mental Health Services Administration

https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone

National Institute on Drug Abu7se

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment


About Us

At Chrysalis, we believe that a supportive, healing environment is essential in order for change and growth to occur. We seek to offer such an environment to clients and help them create that in their lives and relationships. Read More

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