Why Do Kids Like Creepy Things?

We might not realize this when we are young, but a lot of kids’ shows and films have some dark and creepy themes. I remember being obsessed with the animated Anastasia movie, which contains an intense musical number about killing the main character and a pretty horrifying attempted murder scene.

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I’ve heard adults commenting on how this generation of kids seems to be really drawn to scary stories, but I’ll remind you that the original Jurassic Park was marketed almost exclusively to children, and Goosebumps was one of the biggest series for elementary and middle schoolers in the 1990s.

Children have been drawn to creepy things for quite some time, so if your child likes scary stories, that’s not automatically cause for concern. Partially, it’s the same reason adults like horror movies: we get an adrenaline rush. Excitement and fear feel very similar in our bodies, and who doesn’t like to feel excited?

While kids don’t necessarily need to be protected from any creepy idea, parents simply need to make sure that the media their children consume are developmentally appropriate. An eight-year-old might enjoy a scary movie made for kids (like Coraline), they maybe don’t need to watch the Saw movies.

Another theme I’ve noticed in my practice is that some kids with trauma history or who struggle with problem behaviors find themselves identifying with creepy characters like Pennywise the clown or Slenderman. These children have some negative ideas about themselves that are commonly seen in fictional “bad guys,” or they will relate to feeling disliked or unloved.

Many parents or guardians have the impulse to tell the child they aren’t actually like that character, or that they shouldn’t relate to the character. I think it can be more helpful in this case to lean in to what the child is telling you: they are communicating how they feel on the inside, and rather than telling them they are wrong, you can practice re-framing or finding positive qualities about the character they are relating to. In this way, you validate the child’s feelings, demonstrate that you are listening to them, and showing them that they are lovable. (These children also benefit from ongoing therapy to build self-esteem and work through underlying issues contributing to difficult behaviors, of course!)

It’s not automatically cause for concern if your child likes creepy things. Acknowledging this can be an opportunity to get to know them better and re-frame negative ideas they have about themselves.

Psychological Evaluation 101: What Is A Referral Source?

I spoke last week about referral questions, or what you are hoping to learn from a psychological evaluation. This week, I want to talk about referral sources, or who recommends that you get a psychological evaluation.

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Working with kids, most of my referrals come from pediatricians, and a lot of adults get referred by their doctors as well, which makes sense. Even if the concern is mental instead of physical health, we tend to reach out to our physicians with concerns, and a good doctor knows when to refer someone for extra support and resources. Even if you know you want to get a psychological evaluation, you might need to go to your primary doctor first because some insurances require a doctor’s referral before they will approve testing. (I may or may not talk about insurance and psychological evaluations later in this series – it’s important information, but if I spend too much time thinking about health insurance I see red!)

Some kids get referred by their teachers. There is a huge range of “typical development,” especially with very young kids, so parents might not realize that a behavior goes outside of that range. The structure of the school setting can also bring out behaviors that might not be as evident at home. (By the way, if your child’s teacher recommends psych testing, check with the school to see if they will accept a report from an outside evaluator. Many school districts require that their psychologist do the testing in order to qualify for an IEP or 504 plan. In addition, if the school performs the testing, they pay for it.)

The other place I get a lot of my referrals from is other therapists. As a psychologist, I can work as a therapist and an evaluator, but many therapists do not have the additional training to perform evaluations. If you have a therapist, they might tune in to some symptoms that might indicate further testing and recommend an evaluation.

If you’re going through a legal process (possibly because you are being tried for a crime, or if you are in a custody dispute), your lawyer might suggest an evaluation, or a judge might order you to submit to an evaluation. In this case, they might have a recommendation about who completes the assessment. If they don’t recommend a specific psychologist, or if that person isn’t available to do the evaluation, you want to make sure you reach out to professionals who are familiar with the court system and who are trained in this specific type of assessment. I’ve mentioned before that I don’t specialize in these kinds of assessments, so this is not a common referral source for me.

Of course, you can always refer yourself for an evaluation. If you’re struggling with your mental health, you can reach out to a psychologist and let them know your concerns, and they can determine whether additional testing will help you.

Healthy Screen Habits

This article was published in a local newspaper in February. Since then, screen time has become even more of a concern as parents struggle to find appropriate activities for kids who are home all day, and many kids are attending online school, which increases their screen time by a huge amount! I thought it was a good time to re-share this piece as parents consider what screen time looks like in their households.

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Over the past few decades, screens have become an increasingly pervasive part of our lives. Changes in technology have happened so quickly that it is difficult for parents to keep up regarding what is best for their children, especially with emerging research that suggests that young children’s brain development can be affected by screens.

Until recently, many mental health professionals recommended little or no screen time at all. With the way the world is today, this is impossible. Schools use tablets for education purposes, relatives who live out of town want to video chat, and there are times when the “virtual babysitter” makes running errands infinitely easier. Not to mention, eliminating screen time all together can cause children to become fixated and have difficulty self-regulating and moderating when the option becomes available. As kids grow into adults, they need to be able to use screens in order to function. (I could not have written and distributed this article without my computer, after all!)

So how do parents regulate screen time appropriately? As with many things, there is not a one-size-fits-all answer. Each family has to decide what is best in each unique situation, and there are different factors to consider.

Some parents focus on making screen time educational. They give their kids access to “games” that teach them different skills, like visual-spatial tasks or math. Others reserve screen time for weekends or special occasions. Some see that screen time is their child’s “currency” and let the child earn tablet time like an allowance. Only you can decide what is best for your child.

One thing to keep in mind when deciding when and how much screen time to allow your child is that any screen activity is stimulating. Tablets, televisions, and smart phones emit blue light that makes the brain thing that it is time to be awake, so allowing screen time too close to bed time could make it difficult for your child to fall asleep.

Research has suggested that children can become “screen dependent,” or even “screen addicted.” Signs that your child is dependent on screen time include being fixated on getting screen time, sneaking screen time at inappropriate times, or having difficulty or tantrums when screen time ends. If screen time is a reward for your child, make sure it is not their only reinforcement. Encourage them to take breaks, spend time on preferred activities other than screen time, and get plenty of exercise. Have periodic technology vacations to “detox” from screens.

Even though technology can bring people together from great distances and gives us access to unlimited information, it is not without its difficulties. Parents can help their kids have a healthy relationship with screens!

Online Dollhouse

I’ve been trying to create a virtual dollhouse for months and could not figure out the best way to make it intuitive, simple, and aesthetically pleasing. Fortunately, I’m one of thousands in my field, and someone else had a strength I was lacking.

Dr. Karen Fried did an amazing job creating an interactive virtual dollhouse, and then she made it FREE to use on her website! We should all drop her a note telling her she’s awesome or check out her books on Amazon because between this resource and the virtual sand tray (also FREE), she is saving our professional lives in 2020/2021!

It’s so beautiful!

Like the virtual sand tray, you pull up the site and screen share, then give your client remote control so they can play with the dollhouse in whatever way they prefer. I’d argue this is even better than playing with a dollhouse in person because, again, kids can put in duplicates of the same thing and make pieces bigger or smaller if they want. (Imagine having kids show you who in the family has “big” and “small” presence!)

If the child is using a Chrome book and can’t take remote control of the screen, you can always send them the link and let them screen share with you so you can observe them. The downside, of course, is this limits options for interactive play. But overall, this just might be my new favorite resource, especially with kids whose favorite in-person activity was the dollhouse. Finally, I can deliver a similar activity online!

Today’s The Day! Telehealth And Kids Certification with PESI

Good morning, followers! If you haven’t seen my dozens of posts, tweets, and Facebook mentions about it, today and tomorrow I am teaching a certification on telehealth with kids thanks to the support of the awesome people at PESI. I’m told there have been quite a few sign ups, but it is being recorded, so you can purchase it to view at your convenience if you prefer.

My co-presenter is ready

This seminar counts as 12.5 hours of continuing education (which comes out to either 12 or 12.5 CEUs depending on your state, or 760 minutes of continuing education if you are in a country that counts continuing education that way), with two hours of ethics. At the end, you take a test, which qualifies you as a Certified Clinical Telemental Health Provider (CTMH). Pretty awesome, right?

I’ve been working on this presentation for months, and I am so excited that it is finally time to share my knowledge. When I transitioned to working from home in March, it was a scramble to figure out best practice for converting my in-person practice to Zoom. I know many other therapists had similar issues, and I’m so happy that I have the opportunity to share what I learned.

Armani believes in me and also plans to interrupt my presentation at least six times.

If you viewed the seminar after it was recorded, or I didn’t get to your question, questions about the presentation can be submitted here. Please be aware that it might take me up to a week to respond to your question. If you haven’t gotten a reply and it has been over a week, please re-submit your question, as it is possible my inbox ate your first submission.

Skills for BIG Feelings: An Interview with Casey O’Brien Martin

As you all know, I’m constantly looking for new resources for my therapy practice, especially resources that I can share with other therapists. About two weeks ago, I found a fantastic workbook that can be used with kids individually or in a group setting. Skills for BIG Feelings author Casey O’Brien Martin is not only an author and therapist, but she runs a website with resources for kids and the people who help them.

Thanks to the wonder of the internet, I found out that Casey and I are in a common Facebook group, so I had the opportunity to chat with her about her book and her career.

Can you tell us a bit about your professional background?

I’m a registered expressive arts therapist, which is really my passion.  After I obtained my Master’s degree and became a licensed mental health counselor, I went back to school and became a registered nurse. I am really interested in mind-body medicine and a life-long learner! I have experience working in all kinds of settings including emergency rooms, inpatient psychiatric facilities, group homes, outpatient, community settings, schools etc. 

My current work is as a full time School Adjustment Counselor in an urban school district and teaching part time at Lesley University in the Expressive Therapies division in the Graduate School of Arts and Social Sciences.  I really love the combination of teaching graduate students and also doing direct work with children in the school systems. I feel blessed because I really love my job and feel so passionate about this work.

What was your inspiration behind Skills for BIG Feelings?

I started creating this program for the kids I was working with. This is the program I wish someone had taught me when I was a child! 

The program was derived from a need to shift my approach from a crisis-oriented, responsive school counselor style to a more preventative tier-one approach to mental wellness in schools.  One of the shifts in my thinking happened when I received a call and learned about the trauma a student at my school was experiencing, and it was shocking as this student was never referred to me or identified as needing mental health support. It was at that point that I realized I needed to shift my focus to teaching ALL children these vital life skills – and not just focus all of my energy on the small percentage of kids who were misbehaving by acting out and externalizing their behavior.

When I first created Skills for Big Feelings, I didn’t have any thoughts of publishing it.  I decided to publish it once I started collecting data and seeing feedback from not only the children I was working with, but also from their families.  They were sharing how impactful the program was and it was then that I decided I should publish this so I could reach more children and help them learn these coping skills and relaxation tools.

There are a lot of group manuals out there for kids, but I think yours is the first I’ve seen that uses a coloring book to teach the skills. What made you decide to incorporate art into your group?

There is a reason why there is a whole market of adult coloring books for stress relief!  As a Registered Expressive Arts Therapist, I’ve studied the research on the benefits of various forms of art making, including coloring.  Coloring has been shown to help reduce anxiety, increase perseverance, and elicit feelings of relaxation.  I also think by coloring the skills, and making them their own, the children are also better able to internalize them and later recall and use the skills. The kids also just LOVE coloring the skills and having their own special workbook to take home. The coloring workbook also acts as a transitional object once the sessions are over, not to mention the fact that it is a concrete book of coping tools the students can keep and later refer back to.

What’s the main message you want practitioners using Skills for BIG Feelings to take away?

First, you always have to start with relationships. I built a wonderful, helpful program that has shown to be very successful with many children, but the work needs to be grounded in a positive presence and a healing relationship to be most impactful. The research shows us that one positive relationship with an adult is all a child needs to build resiliency.

The second message I hope clinicians and educators take away from the book is the concept that Dr. Greene of Lives in the Balance writes about which is “kids do well if they can.”  A lot of kids are just lacking the social-emotional skills they need to succeed and many kids need direct instruction on these lagging skills. They need to be taught coping and emotional regulation skills. My hope is that practitioners come away feeling empowered because they will have many coping tools and strategies that they can easily teach to children in a fun, engaging, and developmentally appropriate way.

What’s the number one message you want kids participating in a Skills for BIG Feelings group to take away?

I want the kids participating in Skills for Big Feelings to walk away knowing that that all feelings are okay, and I want them to leave feeling empowered because they’ll have a variety of tools to help them cope with their big feelings. 

What projects are you considering in the future?

At the moment I am working on a lot of companion resources related to Skills for Big Feelings to help educators and mental health professionals expand upon and extend the concepts and learning. I’m also working on some craft projects that go along with the skills.  I also have another book started which is about using expressive arts therapy interventions in a school-based setting.

Psychological Evaluation 101: What Is A Referral Question?

Seeking support for your mental health can be overwhelming and scary. The goal of a psychological evaluation is to answer a question, and finding the right provider to complete the evaluation starts with knowing what that question is.

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The referral question is what you hope to have answered following the evaluation. Referral questions can be specific to a diagnosis (“Do I have ADHD?”) or about how your mental health impacts your life (“Do I need a supportive living environment?”). They can also be more general (“I have symptoms of mental illness and I want to know what my diagnosis is”). They can also have to do with your referral source (“My doctor wants more information about my symptoms before prescribing medication”).

It can help to ask yourself: What do I want to know as a result of this evaluation that I don’t know now?

In my own practice, I do evaluations for ADHD, Autism, mood disorders, anxiety, and learning disorders, but I don’t do custody evaluations, neuropsychological assessments, or forensic assessments. Evaluations are so different from each other, and it’s impossible to be fully competent in everything!

You don’t need to go in knowing what measures you want done or the clinical name for the type of assessment you’re looking for, but if you know your referral question, providers can know who is the best fit to tell you what you need to know.

Intrusive Thoughts: Changing The Radio Station

Intrusive thoughts are common for trauma survivors or people with diagnoses such as obsessive-compulsive disorder or anxiety disorders. That’s why it is important for therapists to have a variety of thought stopping exercises. The following is written with children in mind, but this skill can absolutely be used by adults as well.

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Do you ever listen to the radio when you’re in the car with your parents? Or do you use a music streaming service, like Pandora or Spotify, that you can set to play random songs? Sometimes upbeat songs come on that make you want to dance, or soothing songs come on that make you feel very relaxed, and sometimes a song comes on that you absolutely hate.

Your thoughts are like a radio station, and sometimes your brain plays “songs” or thoughts that you don’t want to hear. Sometimes you have thoughts that you didn’t plan to think about and don’t want to think about. When that “bad song” comes on, you have the option to change the station!

Write or draw what the bad thoughts look or feel like. Then, write or draw the thoughts that make you feel happy and calm. When you have the bad thoughts, imagine yourself changing the radio station to the good thoughts!

This can work when you’re having thoughts that upset you, but you can do it at other times too! Like if there is a time when the “song” that’s playing makes you really excited and want to move around, but you’re at school and need to stay in your seat. You can change the station to something that helps you feel calm and relaxed.

Thoughts sometimes come into our brains when we don’t want them to, but we can change what we’re thinking about and play thought-songs that make us feel better!

Psychological Evaluation 101: What Is A Psych Eval?

One of the tricky things about getting help with your mental health is that many people don’t know where to start or what to ask for. We don’t get educated about psychology unless we specifically go to school for it (but thank God I memorized all 50 state capitals and only remember 10 of them!).

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A psychological evaluation refers, essentially, to any group of tests that give providers information about your mental health. There are thousands of different measures in existence, and the measures you take depend on why you are being evaluated.

I want to create a series of posts to help the average, non-psychologist person understand what a psychological evaluation is, what it entails, and what to ask for when seeking services. I can’t tell you how many times someone has called me saying they need a “full psychological evaluation,” and when I ask for more information, they don’t know what to tell me.

It’s understandable! Like I said, unless you went to years of graduate school, you don’t learn this information. But the thing is, there are so many different kinds of psychological evaluations. Do you need to know your diagnosis so your physician can prescribe the right medication? I can help you with that! Did you commit a crime, and your lawyer wants to know if you’re competent to stand trail? I don’t have training in forensic evaluations and need to refer you somewhere else.

You deserve to understand your health care, and knowing this information can help you advocate for the right services. Through this series, I will break down different kinds of evaluations and what you can expect when you’re referred.

Do you have a specific question about psychological evaluations? Let me know, and I will try to include it.

Frequently Asked Questions about Telemental Health and Kids

Parents have a lot of questions when bringing their children for therapy services, and this has never been more true than with the rise of telehealth. It can already be anxiety-provoking to reach out, and combined with navigating technology and “doing therapy” in a different way than what you might be used to is scary.

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Some co-workers and I put together a list of frequently asked questions that parents have about telemental health for their kids, and I thought I would share it. Most of the information here is general, so other therapists can feel free to use this when developing their own FAQ for parents. I do have many parents ask about my qualifications, so this document is specific to my practice, but you can use this as a starting point in your work.

You can download Frequently Asked Questions about Telemental Health and Kids here:

Although I currently have a full caseload (I’m writing this as of December 9, 2020), those in South Dakota who are in need of therapy services during this time can reach out to Sioux Falls Psychological Services for an appointment.