It’s been a tough 4 years since Covid, and experts say our kids are still showing signs of the challenging time. If your child was having mental health struggles before lockdown, chances are those issues have worsened. If they weren’t, it’s likely they are now. But there are steps parents can take to help – you just have to know what to do, how to do it and when. We asked mental health specialists to join us for a special roundtable for parents, about kids.

Participants:

Meg Clark Soriano, MA Director Center for Counseling and Education

Madeleine DiLeonardo, M.Ed. Executive Director Mind, Body and Soul Therapy & Counseling

Amandalynn Salzman, MS Assistant Vice President Oaks Integrated Care

Colleen Fitzpatrick, MSW Instrumental Change

Kids’ Mental Health Today…

Mental health for kids today is exponentially worse than it was 5 to 10 years ago. It’s really the combination of the pandemic, community and school violence, racial trauma, climate change. All of these things combined together have been like a perfect storm in terms of escalating needs in kids’ mental health.
Amandalynn Salzman

We’ve seen significant increases in the rates of children we’re treating with mental health disorders in recent years. The good news is we’re finding parents want to support their children and seek resources to help, which is extremely positive.
Madeleine DiLeonardo

Lasting effects of Covid…

The effects of Covid on children’s mental health has been catastrophic – at every age. Think about it: 3-year-olds were seeing people but not their face, they only saw a mask. And teenagers were saying, “Wait, I could die from this?” Can you imagine the anxiety that caused? If you were 2 years old when Covid hit, that’s two years of developmental milestones that you missed. We were all living day by day, minute by minute, in a very fear-based world.
Colleen Fitzpatrick

We are 100% still seeing problems from Covid – that’s something we’re going to be seeing for decades to come. Kids’ lives were turned upside down. They lost their social connections. They lost routines and the ability to be part of a community. That’s all important. Even as you see kids aging into adulthood, that transitional age from 18 to 21, there’s a real loss of social skills and the ability to tolerate distress.
Amandalynn Salzman

Recognizing Anxiety in your child…

Anxiety is ongoing, and it comes across in many ways, not just physically, but also emotionally. Your child’s stomach may always be hurting, they may be withdrawn, they may refuse to talk, they may be dreading going to a birthday party. Another lesser known sign is fidgeting. Anxiety can be pulling on your hair, it can be twisting your hair, it can be pulling out your eyebrows, resistance to something new. Anxiety can be seen in many different ways.
Colleen Fitzpatrick

Parents may think their child won’t cooperate, won’t listen, they’re getting in trouble at school, perhaps. Sometimes these kids are anxious, and we don’t realize it until we investigate and figure out what’s going on underneath the behavior. It’s important to get to the root of what the child needs.
Meg Clark Soriano

We want kids to experience a range of emotions. We want them to have anxiety, we want them to have sadness. Those are important for being able to deal with stressors in the world. However, when you start seeing long-term, significant changes in your child’s behavior, that’s when you should start thinking about your child’s mental health and ask them what’s going on.
Amandalynn Salzman

Anxiety can manifest itself a lot of different ways in children, but it’s always amazing to me when the anxiety is addressed, how much that can positively impact children’s lives. They may start sleeping better, maybe the stomachaches reduce or go away entirely. It’s up to parents to pick up on behaviors and support their children.
Madeleine DiLeonardo

Anorexia…

Anorexia is scary, because it has such a high mortality rate. But if you get a child into treatment early, there’s a much higher success rate. Sometimes kids will try to hide it with baggy clothes. They may start refusing to eat items such as dessert. Or maybe they used to take a bag of chips every day for school and now they are coming home with the bag still in their backpack.
Meg Clark Soriano

Look for any type of changing patterns in regard to eating or statements girls or boys may make about themselves and their body. What do their friends value in terms of body image or what they look like? The good news is there are a lot of resources in South Jersey to help.
Madeleine DiLeonardo

A lot of times, it’s done in secret so you have to be a detective. Look for changes in behavior or a severe restriction of calories. Another big clue is if you see diet apps on their phone or apps that count calories. And watch what you say. I’ve had many young girls and boys say to me, “Everybody told me this is the best I’ve ever looked.” And they weighed 90 pounds.
Colleen Fitzpatrick

Even though it’s predominantly girls who experience anorexia, there’s actually been an increase in boys. I had a family member who, every time we had a meal together, would get up and go to the bathroom for about 20 minutes afterwards. Eventually we found out he was bulimic and needed to get some help. You don’t notice right away, because people go to the bathroom. But if that happens after every meal, that should raise an alarm bell.
Amandalynn Salzman

Coping with divorce…

A lot of parents have great intentions for their children, that they’re going to not “put them in the middle,” but that’s easier said than done when there are a lot of high emotions. Unfortunately, we see that kids do get stuck in the middle and feel like they must act or feel a certain way because of the parental conflict.
Madeleine DiLeonardo

With little ones, you’ll notice separation anxiety, possibly regression in behaviors, like bedwetting. With kids in grade school, they’ll ask tons of questions, like “What happened?” Teenagers wonder whose fault it was, and why can’t my parents just work it out? But it comes down to how mom and dad treat each other. If mom and dad aren’t treating each other with respect, the child is not going to respond very well.
Colleen Fitzpatrick

A divorce is a major life event, so it is completely normal to see a child be sad or worried or unsure about what’s going to happen. Some kids, though, will experience pretty significant grief. So pay attention if they’re crying all the time, if they are more argumentative or they avoid the parents. These are signs that your child is really struggling with the divorce.
Amandalynn Salzman

When parents are in high conflict, they have trouble prioritizing their child, even though they think they’re prioritizing their child. But bad-mouthing the other parent, even if it’s non-verbally, is very damaging to kids. What parents should do is the opposite. If you see a quality in your child that is just like the other parent – even though you didn’t want to stay married to the other parent — you could say, “Hey, you know, you do that thing well, just like your mom.” That’s the best gift you can give a child.
Meg Clark Soriano 

Managing grief…

A parent can model what it looks like to deal with grief in a healthy way. Talk about grief with your child and normalize that losing a loved one is painful. Explain that they might have days where they feel better, and they might have days where unexpectedly it hits you and you can’t figure out why. Being able to dialogue with your kids about that is important.
Amandalynn Salzman

A child who has lost somebody significant can become scared about losing another person. I’ve worked with a lot of kids who lost a parent, and then they worry about losing the other parent. This wasn’t something that ever crossed their minds before, but now it’s a reality. Then the other parent is grieving, so it’s very hard for them to be there for the child. The child knows that, so the child tries to protect the parent. Then you see the child’s feelings go underground.
Meg Clark Soriano 

When a child is experiencing grief, parents should hold space for those feelings. Let them know it’s ok that Mommy needs to cry, and here’s why. Play therapy can be an effective tool for children who may not have all the vocabulary to express how they’re feeling, but still need to work through it.
Madeleine DiLeonardo

When you’re talking with a younger child, be direct with language and say the person has died. Don’t say the person has passed. When we use the word pass, they will think of a car passing by.
Colleen Fitzpatrick

Social media & kids’ mental health…

We are absolutely seeing that social media has a direct impact on the mental health of children and adolescents. It’s irrefutable at this point. Social media can lead to increased feelings of isolation. It impacts feelings of self-worth. Parents should monitor their child’s consumption. Limit their social media usage to certain times of the day, and look into having parental controls on devices.
Madeleine DiLeonardo

There are some good things about social media, and some not so good. We have wonderful apps, such as Calm, for people who have self-injurious behavior. It’s phenomenal and has been shown to help so many people. The other thing is people don’t feel alone. They have that sense of joining a community. The not-so-good things are some of the apps can go to a very dark place and give children ideas that wouldn’t really be in their head. And bullying has become a huge part of social media.
Colleen Fitzpatrick

The thing that stands out to me is that the Surgeon General of the United States issued a warning about social media and the impact it’s having on kids and said we should treat it as a public health crisis. There are a lot of studies about social media and its impact on brain development, distress tolerance and emotional regulation. I know you want to give your children some privacy and autonomy, but it’s important to know what kind of content they’re looking at.
Amandalynn Salzman

Finding a therapist for your child…

There are several ways parents can look for a therapist for their child. Ask your pediatrician if they have referral sources. I’ve seen a lot of families rely on Facebook community groups to get some real-world experiences from other people. You can also call your insurance company directly, and they will send you a list of who is in network. Or there are databases online, like psychologytoday.com, where you can filter the type of therapist you’re looking for, in the area you’re looking in.
Madeleine DiLeonardo

You can also ask your school counselor. And there are trauma websites and websites if you want play therapy, like the Association for Play Therapy (a4pt.org). Sometimes you have to try a few therapists before you find a good fit.
Meg Clark Soriano

One of the things you want to consider is involving your child in terms of their preferences – would they be more comfortable with a woman, or with somebody with experience around sexuality issues, or somebody who’s younger or older, all of those things. You want their input so you can try to find the best provider for them.
Amandalynn Salzman

Ask friends and family and look at reviews online. People tell the truth on Google reviews. 99% of therapy is getting along with and respecting your therapist. Children need to look forward to coming to therapy. They need to have a warm, welcoming place in a safe environment.
Colleen Fitzpatrick

A parent’s role in their child’s therapy…

At the first session, I spend time with the parent and child and talk about goals. I always ask the child, whether they’re 3 or 16, if they’re comfortable for the two of us to meet by ourselves. If it’s a no, then it’s a no. They set that rule. One thing I want to emphasize is your child has to want to be here.
Colleen Fitzpatrick

For teenagers, we try to work with the parents so they understand that this space is for the teens. If the teen thinks we’re reporting everything they say back to the parent, we sometimes see resistance, and the treatment is not as effective. It’s helpful if parents can relinquish some of that control and acknowledge that what is best for their child is for them to have a space to process with somebody who’s not a family member and who’s not a friend. This is a space for them.
Madeleine DiLeonardo

If the child is under 12, the first thing we do is meet with the parents alone to hear their concerns and gather a developmental history. In the second session, I meet with the whole family, and make it more of a family process rather than singling out one child. I would ask, “What would you like to change or make better?” And I would ask the parents and the children to answer that question. That’s how we begin goal setting. In the third session, depending on the child’s comfort level, we will begin play therapy with the therapist and child, if the child will separate from the parent. If not, we stay with the parent and child.
Meg Clark Soriano

Is there still a stigma about therapy…

The new “Inside Out 2” movie is a big plus for us. Lots of the kids are talking about it. We have the little figures in the office and the kids go right to anxiety and say, “You know what? This was my week.”
Meg Clark Soriano

It’s completely more acceptable. It is phenomenal how they’re using stress reduction techniques like yoga in schools with little ones. We’re finally acknowledging that school can be a huge stressor for them. Everyone is much more aware of children’s mental health needs, whether it be in school, with family or friends, at camp, in just every aspect.
Colleen Fitzpatrick

The stigma around kids accessing mental health has definitely changed. A lot of that has to do with parents being more comfortable and taking the steps to get treatment for themselves. It’s just a much more prevalent topic that people are getting more comfortable discussing.
Amandalynn Salzman

We do a lot of work to try to reduce that stigma. If we do a good job with children, they then know therapy is a tool in their toolbox that they can come back to if they’re experiencing a hard time in the future.
Madeleine DiLeonardo

How a parent can help…

At the core of this is your relationship with your child. Spend time with them and talk to them. Be observant. When the time is right, approach them in a very gentle manner. Not like, “Why aren’t you going to the dance?!” Because they’re probably not going to the dance because they’re anxious. You could say, “How can we make this more enjoyable for you?” And, “Do you really not want to go?” I’m a big believer that children should have choices. If they don’t want to go, don’t make them go.
Colleen Fitzpatrick

It’s helpful when a parent reaches out to a therapist and asks for a session to talk about how to speak with their child about their concerns. Sometimes the child doesn’t need therapy, the parents need coaching. We do a lot of parent coaching. The parents are with the children every day. They can be co-therapists.
Meg Soriano Clark

It is important that parents have the skills to communicate with their child. If a parent is seeing very concerning behavior, severe depression or anxiety, the best thing to do is to ask them, “Are you thinking of hurting yourself? Have you thought about killing yourself?” Don’t beat around the bush. Be direct and clear, so you get a direct and clear response.
Amandalynn Salzman

It’s useful for parents to be proactive and incorporate therapy as part of their child’s wellness routine. The other piece is that children don’t need to be in crisis. I use this example: If your house is on fire, we’re going to help you put out the fire. After that, we’re going to teach you the coping skills to be sure your house doesn’t catch fire again. When things are in crisis, it can be more challenging to address those underlying issues and coping skills.
Madeleine DiLeonardo