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This grounding strategy can be used with students with anxiety disorders.

Reference
The Pragmatic Parent. (2020, June 9). Helping kids manage their worries with these 5 grounding exercises. The Pragmatic Parent. https://www.thepragmaticparent.com/grounding-techniques-for-anxiety-kids/

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This visual provides some important differences between IEPs and 504 plans. This is important when working with students who have mental health disorders and may qualify for either an IEP or 504 plan.

Reference
A Day in Our Shoes. (2020, February 17). 504 plan vs. IEP. A Day in Our Shoes. https://adayinourshoes.com/difference-504-iep/

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McLean Hospital Guide to Helping Students with OCD 

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McLean Hospital Guide to Helping Students with OCD 

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The McLean Hospital provides resources and information on children and teens that have Obsessive Compulsive Disorder. It provides some school specific strategies to help these students.

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While working on a project together, you see a friend packing up their work supplies in a very neat fashion. You can't help but point out that they've organized all their pens to be lined up in order of color and all facing the same direction in their box. "Oh," they reply. "That's just my OCD."

While often thought of as a condition related to neatness and particularness, OCD is often so much more.

Children can be particularly affected by OCD. The onset of symptoms can begin at any time, sometimes as early as three years old.

Parents and teachers need to understand the risk factors to make sure that children and teenagers who are at risk of developing OCD receive appropriate attention.

When treated properly, OCD can be controlled. If it goes unaddressed, it could lead to serious quality-of-life issues, not only for the child but also for family members.

Keep Reading To Learn

The truth about OCD

How to recognize symptoms of OCD in children and adolescents

How to successfully manage and treat OCD in young people

What Is OCD?

Obsessive compulsive disorder is highlighted by a pattern of unwanted and intrusive thoughts, fears, images, or sensations that lead to feelings of distress (including anxiety, disgust, "not just right" sensations) and repetitive behaviors aimed at canceling out that distress.

Usually, these unwanted thoughts are called obsessions. Unwanted, repetitive behaviors or mental acts are called compulsions.

Throughout life, most people will experience unwanted thoughts every so often. If the person doesn't have OCD, these unwanted thoughts won't cause much distress because they won't be interpreted as meaningful. The hallmark of OCD is that obsessions and compulsions lead to a clinically adverse impact on the life of a child.

For example, unwanted thoughts might be so bad that children have trouble sleeping at night. The repetitive behaviors may be so impactful and obstructive that the child has trouble leaving the house to go to school, play sports, or participate in their daily routine.

OCD can be devastating for a child or teen, but there's hope for those who receive proper psychiatric care

The good news is that there has been plenty of research into OCD, and there are treatment options available. Similar to other mental health disorders, the sooner this condition is diagnosed, the faster it can be treated.

For children to get the care they need, it is important to take an in-depth look at the obsessions and compulsions that fuel OCD.

Obsessions: What Are They?

Obsessions, as they relate to OCD, are fears that children, teenagers, and other individuals cannot stop thinking about. People living with OCD are usually aware that something is "off," and they often understand that the thoughts they are having are not normal.

These thoughts can make them anxious, and despite their best efforts, they cannot seem to stop thinking about them.

Some of the most common examples of obsessions include:

Fearfulness that they are going to die or get sick, no matter what they do

Concern that a loved one is going to end up getting sick, hurt, or killed

Worry that they have broken a rule and deserve to be punished severely for it

Fear of touching items because they are potentially dirty

Obsession with making sure that every object is placed in a certain, even, orderly manner

Worry that unless something is done in a specific order, it is going to lead to a bad outcome

The truth is that everyone has unwanted thoughts from time to time. The difference between occasional unwanted thoughts and OCD is that, in OCD, children cannot stop thinking about these thoughts and may be paralyzed by them. Often, these obsessions are so bad that kids cannot think about anything else.

Compulsions: What Are They?

For a child to have OCD, they need to have both obsessions and compulsions.

Compulsions are behaviors or mental acts that are typically repetitive and rigid in nature. These compulsions often take the form of rituals and are designed to counteract stress or prevent fearful outcomes. Kids with OCD have to do these behaviors over and over again in a certain order. If they do not, the obsessions take over, and they are worried that there will be a negative outcome. These behaviors might involve safety, cleanliness, orderliness, or symmetry. They have to be done "just right" or children are compelled to start over.

In a sense, these behaviors are rituals that provide children with a source of power. They feel like if they do these repetitive behaviors in a certain way, they can control what happens next.

Some of the most common examples of compulsions include:

Having to wash or clean things in a certain way every time

Thinking phrases over and over again until it "feels right"

Having to erase and rewrite, redo, or re-read things in a certain manner multiple times

Repeating a certain word or phrase much more often than is necessary until it is said an exact number of times or in exactly the right way

Checking every door in the house multiple times to make sure that is locked or passing in and out of doors several times in a row

Inspecting every light in the house to make sure it is turned off before leaving

Checking each homework assignment a certain number of times to make sure it was done properly

Chewing each bite on each side of the mouth the same number of times

Having to place everything in a specific, even, symmetrical order

Counting all items and objects to certain good numbers to avoid unlucky numbers

It's important to note that compulsions often arise out of adaptive behaviors. For example, it is good for children to double-check their homework to make sure it is done properly. On the other hand, if children end up checking their homework a dozen times to the detriment of other activities, this starts to have a clinically adverse impact on not only their life but the lives of family members as well.

The same can be said of checking to make sure that lights are turned off and doors are locked. It is good to make sure that the house is safe before leaving. However, if this prevents the family from leaving the house, this becomes a major issue.

Reclaiming Her Freedom

Read about one young patient's journey to overcome OCD.
MANAGING HER OCD
How Do You Recognize OCD in Children?

It's important for individuals, such as parents, teachers, and athletic coaches, to be able to recognize the potential signs of OCD in children. The sooner you can intervene at the start of a mental health challenge, the better their chance for a successful outcome.

There are lots of normal developmental rituals that are not attributable to OCD, like bedtime rituals. However, if a ritual is starting to affect how a child functions, that can help identify if it's more than a routine and may point to a sign of OCD.

OCD often develops slowly over time. With a gradual onset of symptoms, coupled with a parent's natural tendency to protect and soothe, it might be hard for adults to pick up on a child's symptoms of OCD when they start appearing.

It might be easier to recognize the impact that OCD has on the quality of life in children and those around them.

There are several things to watch for that may be signs of OCD.

The following aren't always signs of OCD. They are examples of behaviors that may signal that a child is in distress and may need help from a trained professional.

Homework

Children with OCD might take an excessive amount of time to complete their homework. This might include children having to read the same line over and over again, having to write each number perfectly for a math problem, or checking homework repeatedly to the point that it takes a very long time to finish.

Leaving the House

Children with OCD might slow the family down when leaving the house. For example, if a child is taking forever to get ready, then they might be checking every door, window, and light to make sure they are in the "right" positions or condition before leaving. They might throw a temper tantrum about leaving before this routine is finished. This behavior often makes the family chronically late for activities.

Handwashing

Handwashing is one of the most well-known compulsions when it comes to OCD. Handwashing may arise out of obsessions related to germs, feelings of disgust, or other forms of contamination such as "bad emotions" or fears of developing chronic stress, anxiety, or worry. If OCD is tied to handwashing, then it might be helpful to look at the hands for signs of raw, bleeding skin. If children are washing their hands dozens of times per day, the soap is going to make the skin raw, leading to scars, peeling skin, and bleeding.

Drugs or Alcohol

Sometimes when children are struggling to manage a condition, they may turn to substances as a coping mechanism. If a teen is facing mental health challenges, they may feel socially isolated, misunderstood, or overwhelmed. This occasionally leads to substance misuse.

Sleep Habits

OCD often disrupts bedtime or sleep. Children with OCD may have to go through a very specific routine before they get in bed and fall asleep. They may also have a hard time falling asleep if they have intrusive thoughts or worries that are more intense at night. If this routine is disrupted for any reason, they have to start the entire routine over. It is not unusual for OCD to lengthen the bedtime routine by 30 minutes, an hour, or even longer. This deprives children of much-needed sleep, which impacts school performance, emotional development, and relationships with their peers and family members. If sleep is disrupted consistently it can also negatively impact the effectiveness of OCD therapies, including CBT.

Keep in Mind

These behaviors do not include every way that OCD manifests in kids. It also does not mean that if a child experiences difficulty with these, then they have OCD.

These are several examples where a child may have uncomfortable thoughts, feelings, or sensations that are followed by behaviors or avoidance to feel relief from their discomfort or fear.

If this discomfort-relief cycle causes family distress or dysfunction, parents should consider speaking with a trained professional about the possibility of OCD.

Watch Now
Dr. Elizabeth McIngvale shines a light on obsessive compulsive disorder
What Causes OCD in a Child?

Similar to other mental health disorders, there is never a single reason why a child develops OCD.

The following list of risk factors is far from complete but does provide a small glimpse into what could lead to the development of OCD. It is critical to keep in mind that anyone is capable of developing any mental health disorder, including OCD.

Family History, Genetics, and Environment

OCD is heritable. This simply means that if there's someone in your family who has it, there's a higher likelihood that a child might have it. The familial pattern of OCD suggests a genetic component, though there are no specific genes that have been identified to be related to OCD at this point.

When discussing nature vs. nurture, it is important to note the environment plays a role as well. Obsessions and compulsions can be learned over time. If children watch family members and others go through OCD, they may latch onto these behavioral patterns as well. As a result, environmental exposures can play a role in the development of OCD.

Stressful Events

Stressful events can be a risk factor for kids with OCD who may have underlying vulnerabilities. Children who experience trauma may develop PTSD, which can be mistaken for OCD.

While unwanted and intrusive thoughts often occur with trauma and post-traumatic stress disorder (PTSD) and can look similar to OCD, trauma focuses on intrusive thoughts based on the past traumatic event, and OCD typically focuses on future uncertainties and attempts to lessen them.

OCD Can Be Treated and Maintained-Yes, There Is Hope!

It is important to note that there is no cure for OCD. At the same time, there are plenty of ways to manage this condition effectively.

Though people diagnosed with OCD will always have to deal with some symptoms, there are very effective ways to control obsessions and compulsions. Treatment can lead to improvements in quality of life, even if there are minimal symptoms that have to be managed regularly. Over time and with effective treatment, OCD may not have any impact on someone's quality of life.

When it comes to the treatment of a child with OCD, it is important to approach this comprehensively. When all facets of OCD are addressed appropriately, children have the best chance of making a meaningful recovery.

Several components play a role in the treatment of every child with OCD. Like each child's uniqueness, every diagnosis of OCD will respond in its own way to different treatments, and as a result, may require tailoring treatments to the individual to see what works best.

Therapy

Cognitive behavior therapy, usually shortened to CBT, is an effective treatment method for people with OCD. This therapy, and others similar to it, help patients connect behaviors and thoughts.

One of the most important components of CBT is called exposure and response prevention therapy. The goal of this type of therapy is to expose children to a feared object or obsession gradually.

With proper treatment, young people who struggle with OCD can live fulfilling and healthy lives

For example, a child who is afraid of germs might be exposed to dirt. Then, the child, with the guidance of a mental health professional, learns to resist the urge to complete compulsive rituals.

As OCD affects everyone in the family, parents and siblings need to learn how to best support children. Family-based approaches to therapy have been proven to be very successful. Also, there are even parent-led approaches to therapy for kids who are reluctant to go to treatment. The parent learns how to teach their child coping skills.

Even though this type of therapy takes time, it has been shown to vastly improve the quality of life in children with OCD.

Medications

Certain psychiatric medications can help children control the obsessions and compulsions that go along with OCD. If behavioral treatment is difficult to access or appears to be mildly effective, then a serotonin reuptake inhibitor (SRI), a specific class of antidepressant, may be helpful to add to the child's care plan.

Some of the most common antidepressants that might be used in children that have been diagnosed with OCD include:

Anafranil (clomipramine) is used in children ten years of age or older

Fluvoxamine is used in children eight years of age or older

Prozac (fluoxetine) is used in children seven years of age or older

Zoloft (Sertraline) is used in children six years of age or older

If considering medication, parents should speak with doctors in depth about all possibilities to understand the risks and benefits of each medication.

All psychiatric medications have potential side effects. Parents should understand possible side effects, the chances of these side effects developing, know how to spot them, and when to contact their provider about potentially stopping medication.

Many children who are placed on medication for OCD may be able to come off medication once they have learned exposure and response prevention skills and use them regularly.

Each OCD journey is different and should be treated as such by providers and parents alike. For some young people and their families, once-weekly outpatient visits aren't enough. If that's the case, it may be helpful to consider getting a consultation from a psychiatrist for medication. Additional options include a higher level of care, like intensive outpatient or residential treatment or a parent-only approach to help through familial support.

What Should I Do If My Child Might Have OCD?

Parents, caretakers, and family members need to remain vigilant and understand that there is nothing wrong with asking for help for their child. Also, kids and teens need to know that it's perfectly okay-and normal-to reach out for help if they are feeling troubled.

It is important to note that children with OCD are not damaged, broken, or harmed beyond repair. When children with OCD are approached with sympathy and understanding, it is easier for them to open up about their problems.

If you think you know someone who may be struggling with OCD, the first step is to not panic. While the disorder may feel crippling, there are many ways to get help that is tailored to what's needed for each child. Seeking help-and treatment-can provide a child and their family with the tools to feel empowered and in control of their mental health.

A potential diagnosis of OCD should be discussed with the child's care team to determine the next steps. Call your primary care physician or a local mental health facility, like McLean, to find the care you need.

How Does Someone Get Formally Diagnosed With OCD?

Several steps must take place to properly diagnose a child. Usually, this diagnosis is going to be made by a trained professional, such as a psychiatrist or psychologist, along with assistance from other doctors or health care providers, such as a pediatrician.

What to Expect

An evaluation to determine a diagnosis may include both self-and parent-reporting questionnaires and personal interviewing. These interviews include specific questions to identify the presence of obsessions and rituals.

A trained professional sits down and speaks with a child about feelings, thoughts, symptoms, and behavioral patterns. The goal is to identify any specific obsessions or compulsions.

Then, a psychological evaluation takes place in an attempt to identify the reason why these obsessions and compulsions are present. There has to be an anxiety or fear of a negative or "not right" experience that might happen if things are not done in a certain way.

Finally, it is important to determine whether or not these behaviors harm the child's quality of life. During this evaluation, the evaluator often speaks with the family members and friends as well.

To make the official diagnosis, the psychiatrist uses criteria that are published in the Diagnostic and Statistical Manual of Mental Health Disorders, usually shortened to DSM-5. This is published by the American Psychiatric Association and guides mental health professionals.

In diagnosing OCD, it is important to rule out alternative causes of this behavior. Therefore, a physical exam might take place to check for symptoms and problems that could be related to complications of OCD or a possible alternative diagnosis.

If this process is completed and the child meets the criteria for OCD, the treatment and recovery process can begin.

Help Your Child Feel More Like a Kid

Whatever mental health difficulties your child may be dealing with, McLean is here to help. Contact us today at 877.626.8140 to learn more about treatment options for children, teens, and young adults.
YOUTH MENTAL HEALTH
What You've Heard About OCD Likely Isn't True

Amongst mental health disorders, obsessive compulsive disorder is one of the most common. Despite this, there are prominent misconceptions about how OCD presents in individuals that can make it challenging for many to understand the condition.

Each case of OCD is as unique as the person diagnosed with it, and there are many misconceptions about the disorder. Along with many people loosely using the terminology "being OCD" to describe perfectionism, several myths have emerged about OCD.

Myth: People With OCD Want Everything to Be Perfect

People diagnosed with OCD may exhibit perfectionism-related behaviors or have perfectionism-related obsessions. However, they typically stem from attempts to reduce anxiety or distress associated with uncertainty or a specific feared outcome-not because they want everything to be perfect.

Myth: People With OCD Are Just Germaphobes

While it is true that some obsessions and compulsions are related to germs and handwashing, OCD comes in many shapes and forms and often does not manifest only with an aversion to germs.

Myth: People With OCD Should "Just Relax," and It'll Go Away

OCD is a serious mental health disorder. It is a medical condition that deserves the same level of care and compassion as cancer, diabetes, or heart disease. Those of us with OCD would love to relax. However, that may not be achievable through being told to calm down.

If your child is struggling, McLean offers world-class mental health care for children and teens with OCD and related disorders. Let us help you find the treatment option that's right for your child. Contact us today.

Want More Info?

Looking for even more information about OCD in children? You may find these resources helpful.

Interesting Articles and Videos and More

Learn more about youth mental health and what you can do if your child is displaying signs of OCD.

Helpful Links

These organizations may also have useful information:

International OCD Foundation
The mission of the International OCD Foundation is to help people affected by obsessive compulsive disorder and related disorders to live full and productive lives. The IOCDF aims to increase access to effective treatment through research and training, foster a hopeful and supportive community for those affected by OCD and the professionals who treat them, and fight stigma surrounding mental health issues.

OCD Massachusetts
As a non-profit affiliate of the IOCDF, OCD Massachusetts aims to provide public and professional education about OCD to raise awareness and improve the quality of treatment provided in Massachusetts. They also work to improve access to resources for those with OCD and their families and advocate and lobby for the OCD community in Massachusetts.

Not Alone Notes
Not Alone Notes is a nonprofit organization that mails free, handwritten letters to people with OCD and related disorders. Their goal is to remind others they aren't alone, encourage hope, and dispense resources.

Peace of Mind
Now part of the International OCD Foundation, provides educational resources and access to self-help tools, offers scholarship opportunities, supports professional training programs, and spreads awareness about OCD and related disorders.

Books About OCD

Obsessive Compulsive Disorder: Elements, History, Treatments, and Research
by Leslie J. Shapiro
(ABC-CLIO, 2020)

Stuff That's Loud: A Teen's Guide to Unspiraling When OCD Gets Noisy
by Ben Sedley and Lisa W. Coyne
(New Harbinger, 2020)

Acceptance and Commitment Therapy: The Clinician's Guide for Supporting Parents
by Koa Whittingham and Lisa W. Coyne
(Elsevier, 2019)

Understanding OCD: Skills to Control the Conscience and Outsmart Obsessive Compulsive Disorder
by Leslie J. Shapiro
(Praeger, 2015)

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Everything You Need To Know About OCD in Kids and Teens

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While working on a project together, you see a friend packing up their work supplies in a very neat fashion. You can't help but point out that they've organized all their pens to be lined up in order of color and all facing the same direction in their box.

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A Teacher's Guide to OCD in the Classroom

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A Teacher's Guide to OCD in the Classroom

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This resource provided by the Child Mind Institute could be used by school counselors when working with teachers who have students with OCD in their classroom.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares.

Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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This resource is specifically catered to teens going through depression or bipolar disorder. An abundance of resources are provided including the stories of those going through mood disorders, podcasts, information, and more.

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What if I'm Having Suicidal Thoughts?

Suicidal thoughts can be scary and overwhelming which is why it's important to let others know how you're feeling. If you are having thoughts of death or suicide, call 1-800-273-8255, use Lifeline Chat, or text DBSA to 741-741. If you are not currently experiencing a crisis but have in the past, learn how to set up a safety plan.
Safety Planning

Find Inspiration

Being diagnosed with depression or bipolar as a teen can feel like a life sentence. Without success stories, it's easy to think you will always feel this way and that you won't be able to have the life you had hoped for.

View Stories Listen to Podcasts

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For Teens - Depression and Bipolar Support Alliance

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Suicidal thoughts can be scary and overwhelming which is why it's important to let others know how you're feeling. If you are having thoughts of death or suicide, call 1-800-273-8255, use Lifeline Chat, or text DBSA to 741-741. If you are not currently experiencing a crisis but have in the past, learn how to set up a safety plan.

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The American Academy of Child and Adolescent Psychiatry regularly updates and adds to this collection of adolescent depression resources.

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The American Academy of Child and Adolescent Psychiatry constantly updates this page with resources on childhood anxiety..

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Anxiety Disorders Resource Center
Last updated July 2016
All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other caregivers with whom they are close. Young children may have short-lived fears, (such as fear of the dark, storms, animals, or strangers). Anxious children are often overly tense or uptight. Some may seek a lot of reassurance, and their worries may interfere with activities. Parents should not discount a child's fears. Because anxious children may also be quiet, compliant and eager to please, their difficulties may be missed. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications.

For additional information see:
AACAP Book Your Adolescent Anxiety and Avoidant Disorders
Glossary of Symptoms and Mental Illnesses Choose a topic:

1. How much anxiety is "normal" for a child?

2. What are the signs and symptoms of anxiety?

3. What causes anxiety disorders?

4. How are anxiety disorders treated?

AACAP's Facts for Families provide concise up-to-date information on issues that affect children, teenagers, and their families.

AACAP Practice Parameters
Considered resources for experts, mental health professional and physicians, AACAP's practice parameters were developed to guide clinical decision making. They show the best treatments and the range of treatment options available to families living with childhood and adolescent mental illness.Considered resources for experts, mental health professional and physicians, AACAP's Practice Parameters were developed to guide clinical decision making. They show the best treatments and the range of treatment options available to families living with childhood and adolescent mental illness.

Additional Clinical Resources

Cognitive-Behavioral Psychotherapy for Anxiety and Depressive Disorders in Children and Adolescents: An Evidence-Based Medicine Review
Journal of the American Academy of Child & Adolescent Psychiatry:
June 2015 - Volume 54 - Issue 6 - pp 454-463

Assessment and Management of Treatment-Refractory Obsessive-Compulsive Disorder in Children
Journal of the American Academy of Child & Adolescent Psychiatry:
April 2015 - Volume 54 - Issue 4 - pp 251-262

A Randomized, Placebo-Controlled Study of Duloxetine for the Treatment of Children and Adolescents With Generalized Anxiety Disorder
Journal of the American Academy of Child & Adolescent Psychiatry:
April 2015 - Volume 54 - Issue 4 - pp 283-293

Anxiety Disorders in Children and Adolescents: A Review of the Past 10 Years
Journal of Amer Academy of Child & Adolescent Psychiatry: Special Articles: PD onlh.

A review of Cognitive-Behavioral Therapy in anxiety and depression:
Cognitive-Behavioral Psychotherapy for Anxiety and Depressive Disorders in Children and Adolescents: An Evidence-Based Medicine Review
Journal of the American Academy of Child & Adolescent Psychiatry:
August 2004 - Volume 43 - Issue 8 - pp 930-959

A recent important study comparing medication and CBT in treating anxiety:
Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety
New England Journal of Medicine, Volume 359:2753-2766 December 25, 2008 Number 26

Obsessive-Compulsive Disorder in Children
John Piacentini, R. Lindsey Bergman
Psychiatric Clinics of North America - 1 September 2000 (Vol. 23, Issue 3, Pages 519-533)

March JS (1995), Cognitive-behavioral psychotherapy for children and adolescents with OCD: a review and recommendations for treatment. Journal of the American Academy of Child and Adolescent Psychiatry 34:7-18
The use of imaging Technology and Physiological Measurements to Investigate Changes in Biological Stress Systems and Brain Development in Maltreated Children with PTSD
2015 Annual Meeting Sessions
Click here to search the Annual Meeting Sessions.

IACAPAP Textbook of Child and Adolescent Mental Health
IACAPAP

Your Adolescent - Anxiety and Avoidant Disorders
AACAP

What You Must Think of Me: A First Hand Account of One Teenager's Experience with Social Anxiety Disorder
Emily Ford

For more bibliotherapy resources, visit Living with Mental Illness: Books, Stories and Memoirs.

Not all children who have experienced anxiety will need treatment. However, treatment can help minimize anxiety. To obtain help, parents should try to find a mental health professional who has advanced training and experience with evaluating and treating children, adolescents, and families. It is important to find a comfortable match between your child, your family, and the mental health professional.

A child and adolescent psychiatrist is a physician who specializes in the diagnosis and treatment of disorders of thinking, feeling and behavior that affect children, adolescents, and their families. Child and adolescent psychiatrists have completed four years of medical school, at least three years of residency training in medicine, neurology, or general psychiatry with adults, and two years of additional training in psychiatric work with children, adolescents, and their families.

Click here to find a child and adolescent psychiatrist in your area.

Facts for Families:
Providing up-to-date information on issues that affect children, teenagers, and their families. These fact sheets are relevant to anxiety disorders.
Related Support Group Web Sites

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Anxiety Disorders Resource Center Last updated July 2016 All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other caregivers with whom they are close.

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New York Times- Helping Children With Anxiety

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New York Times- Helping Children With Anxiety

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This New York Times article focusses on strategies that can be used to help children with anxiety disorders. This article would be helpful for school counselors, teachers, and parents.

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When worrying gets in the way of a child's functioning, parents need to get help rather than arranging the child's life to avoid the occasions of anxiety.

Credit... Getty Images

By

Anxiety disorders, the most common mental health problems in children and adolescents, often go untreated while children suffer, even though there are effective treatments available, according to a new report on anxiety in children and adolescents from the Child Mind Institute in New York. Anxiety may be missed because it doesn't necessarily declare itself with attention-getting disruptive behaviors; in fact, symptoms may keep some children quiet and inhibited, though in other children, alternatively, anxiety may be misunderstood as oppositional behavior.

Adults may also assume that anxiety in a child is just a phase to be outgrown. A certain amount of anxiety is a normal aspect of development for young children - consider separation anxiety, for example - and it can even be protective, since children need to learn to keep themselves safe and anticipate certain kinds of dangers. But when worrying or avoiding possible threats gets in the way of a child's functioning or a child's enjoyment, it should be a signal to parents that help is needed, not just watching and waiting, not arranging the child's life to avoid the occasions of anxiety.

Kathleen Merikangas, the senior investigator and chief of the Genetic Epidemiology Research Branch at the National Institute of Mental Health, said, "To me, anxiety is one of the most underrecognized or under-treated conditions of childhood and adolescence." These children can get missed, she said, because they may seem to be functioning well; many don't have the kinds of developmental problems or attention issues that draw attention in school, though they may be suffering.

Consider the child whose anxiety about speaking in public gets in the way of participating in class. The child may be silent out of a fear of being laughed at or otherwise rejected, Dr. Merikangas said, but to the teacher, it may look like the child is just not interested. Environmental modifications can really help these children thrive in school, she said; for example, working in small groups with children they know.

The new report, released in September, summarizes the evidence that early temperament in children predicts their later behavior patterns around anxiety; toddlers who show what are called "behaviorally inhibited" behaviors, which parents are likely to perceive as extreme shyness, or anxiety around new people, are more likely to develop social anxiety later on. That doesn't mean that shyness is pathological (as with all varieties of temperament, there's a wide range of function), but it does suggest how important it is to help a child with this temperament who develops difficulties.

The tendency toward anxiety - and toward some specific forms of anxiety, like phobias - may persist throughout childhood and adolescence and into adulthood. And anxiety is closely tied to depression, Dr. Merikangas said. Although there have been reports that anxiety rates among American teenagers have soared, she cited evidence that the international rates of the underlying disorders had stayed consistent from 1998 to 2013; there is no global "epidemic" of clinical anxiety disorders, she said.

But with rates of suicide and suicidal ideation on the rise, it's particularly important to provide information to schools and to parents about recognizing anxiety and getting children help.

Dr. Harold Koplewicz, the president of the Child Mind Institute, said that when anxiety disorders in children are left untreated, anxiety can inhibit their lives, making standard daily activities difficult, from attending school to sleeping in their own beds, and lead to many extra visits to the school nurse or the pediatrician.

But beyond that, he said, "people underestimate that this is a gateway disorder." If children don't get help with these disorders, they may be at risk to develop other mental health problems; the child with severe separation anxiety may develop panic disorder, he said; the child with untreated general anxiety may be at greater risk for depression.

Dr. Merikangas was a co-investigator on a national study of mental disorders in adolescents, which has shown both that anxiety disorders were the most common mental health problems in adolescents in the United States, and also the problems that showed up earliest in those children's lives - the mean age of onset for anxiety disorders was 6. But many adolescents had never received treatment. That makes it essential to get the word out, Dr. Merikangas said, that anxiety is "one of the most treatable symptoms and syndromes, we can really change their lives with minimal intervention."

"All these disorders are remarkably treatable," Dr. Koplewicz said. There are highly effective behavioral and psychosocial therapies, including cognitive behavioral therapies, to help children cope with the demands of daily life. For children who don't respond to psychosocial therapies, he said, medications can be added.

But perhaps because anxiety is a normal response, parents often believe that even severe and disabling anxiety symptoms are just a phase, and on average, there is a two-year lag between the time children develop anxiety and the time they get help. "It's bad for these children's brains," he said. "Having your brain's thermostat miss-set is not good for your brain."

"Anxiety can manifest itself along a continuum," said Rachel Busman, the senior director of the anxiety disorders center at the Child Mind Institute. The report shows that there is some overlap with physical illnesses, such as chronic headaches or stomach aches, often coordinated with school. "That could be a kid's way of saying, 'I'm anxious,'" she said.

And when a child who is having a lot of difficulty with separation gets into the classroom, Dr. Busman said, that child may start throwing things, or running and hiding, and that "bad behavior" may represent the fight or flight response of anxiety. "We've also seen kids who have intense social anxiety and their way of managing it is to be class clown," she said.

Treating children with anxiety always means working with their parents. Jerry Bubrick, senior clinical psychologist at the anxiety disorders center of the Child Mind Institute, said that when children are little, it's normal for parents to operate in "fix-it mode," blocking the staircase so a toddler doesn't tumble down, averting problems before they happen.

As children get older, parents normally pull back, helping children find solutions of their own. "But anxious parents of anxious children remain in fix-it mode," he said, helping their children avoid the situations that make them anxious. Therapy involves exposing children to those situations and helping them develop strategies to manage them; with treatment, Dr. Bubrick said, parents can "let the child experience the anxiety and learn to tolerate and overcome it on their own."

"If you see things you're not sure about, talk to the preschool, talk to the pediatrician, be open to the idea that maybe there is anxiety," even in a young child, Dr. Busman said. Separation anxiety can be a problem even in children who are able to go to school, she said. Parents should pay attention if a child can't be left with a babysitter, a child can't sleep alone at home."These are the kids, they go into the bathroom, and they're like, are you still there?" she said. "We do see really young anxious children."

"If your child is suffering distress and dysfunction, reach out to your pediatrician," Dr. Koplewicz said. When you get to a mental health professional, "make sure you ask the right questions," he said, including asking whether that person has specific experience with treating anxiety and how long the treatment is expected to take.

"You want a professional who understands what they're doing and can explain to you what they're doing."

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How to Help a Child With an Anxiety Disorder

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When worrying gets in the way of a child's functioning, parents need to get help rather than arranging the child's life to avoid the occasions of anxiety. By Anxiety disorders, the most common mental health problems in children and adolescents, often go untreated while children suffer, even though there are effective treatments available, according to a new report on anxiety in children and adolescents from the Child Mind Institute in New York.

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This article by VISTAS focusses on how school counselors (and other individuals in the school settings) can address anxiety in students.

Reference
Ybañez-Llorente, K. (2014). Addressing anxiety in school settings: information for counselors. https://www.counseling.org/docs/default-source/vistas/article_62.pdf?sfvrsn=20677d2c_10

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It is important to understand the ethical standards of being a school counselor when working with students who have mental health disorders.

Reference
American School Counselor Association (2016). ASCA ethical standards for school counselors. Alexandria, VA: Author.

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Mayo Clinic- Oppositional Defiant Disorder

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Mayo Clinic- Oppositional Defiant Disorder

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This resource provided by the Mayo Clinic provides insight on individuals with ODD and other conduct disorders.

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Overview

Even the best-behaved children can be difficult and challenging at times. But oppositional defiant disorder (ODD) includes a frequent and ongoing pattern of anger, irritability, arguing and defiance toward parents and other authority figures. ODD also includes being spiteful and seeking revenge, a behavior called vindictiveness.

These emotional and behavioral issues cause serious problems with family life, social activities, school and work. But as a parent, you don't have to try to manage a child with ODD alone. Your health care provider, a mental health professional and a child development expert can help.

Treatment of ODD involves learning skills to help build positive family interactions and to manage problem behaviors. Other therapy, and possibly medicines, may be needed to treat related mental health conditions.

Symptoms

Sometimes it's difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It's common for children to show oppositional behavior at certain stages of development.

Symptoms of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. Oppositional and defiant behaviors are frequent and ongoing. They cause severe problems with relationships, social activities, school and work, for both the child and the family.

Emotional and behavioral symptoms of ODD generally last at least six months. They include angry and irritable mood, argumentative and defiant behavior, and hurtful and revengeful behavior.
Angry and irritable mood

Often and easily loses temper.

Is frequently touchy and easily annoyed by others.

Is often angry and resentful.

Argumentative and defiant behavior

Often argues with adults or people in authority.

Often actively defies or refuses to follow adults' requests or rules.

Often annoys or upsets people on purpose.

Often blames others for their own mistakes or misbehavior.

Hurtful and revengeful behavior

Says mean and hateful things when upset.

Tries to hurt the feelings of others and seeks revenge, also called being vindictive.

Has shown vindictive behavior at least twice in the past six months.

Severity
ODD can be mild, moderate or severe:

Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.

Moderate. Some symptoms occur in at least two settings.

Severe. Some symptoms occur in three or more settings.

For some children, symptoms may first be seen only at home. But with time, problem behavior also may happen in other settings, such as school, social activities and with friends.

When to see a doctor

Your child isn't likely to see their own behavior as a problem. Instead, your child will probably complain about unreasonable demands or blame others for problems.

If you think your child may have ODD or other problem behavior, or you're concerned about your ability to parent a challenging child, seek help from a child psychologist or a child psychiatrist with expertise in behavior problems. Ask your child's pediatrician or other health care provider for a referral to a mental health provider.

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Causes

There's no known clear cause of oppositional defiant disorder. Causes may include a combination of genetic and environmental factors:

Genetics. A child's natural personality or character - also called temperament - may contribute to developing ODD. Differences in the way nerves and the brain function also may play a role.

Environment. Problems with parenting that may involve a lack of supervision, inconsistent or harsh discipline, or abuse or neglect may contribute to developing ODD.

Risk factors

Oppositional defiant disorder is a complex problem. Possible risk factors for ODD include:

Temperament - a child who has a temperament that includes difficulty managing emotions, such as reacting with strong emotions to situations or having trouble tolerating frustration.

Parenting issues - a child who experiences abuse or neglect, harsh or inconsistent discipline, or a lack of proper supervision.

Other family issues - a child who lives with parent or family relationships that are unstable or has a parent with a mental health condition or substance use disorder.

Environment - problem behaviors that are reinforced through attention from peers and inconsistent discipline from other authority figures, such as teachers.

Complications

Children and teenagers with oppositional defiant disorder may have trouble at home with parents and siblings, in school with teachers, and at work with supervisors and other authority figures. Children and teens with ODD may struggle to make and keep friends and relationships.

ODD also may lead to other problems, such as:

Poor school and work performance.

Antisocial behavior.

Legal problems.

Impulse control problems.

Substance use disorder.

Suicide.

Many children and teens with ODD also have other mental health conditions, such as:

Attention-deficit/hyperactivity disorder (ADHD).

Conduct disorder.

Depression.

Anxiety disorders.

Learning and communication disorders.

Treating these other mental health conditions may help reduce ODD symptoms. It may be difficult to treat ODD if these other conditions are not evaluated and treated appropriately.

Prevention

There's no sure way to prevent oppositional defiant disorder. But positive parenting and early treatment can help improve behavior and prevent the situation from getting worse. The earlier that ODD can be managed, the better.

Treatment can help restore your child's self-esteem and rebuild a positive relationship between you and your child. Your child's relationships with other important adults in their life - such as teachers and care providers - also will benefit from early treatment.

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Oppositional defiant disorder (ODD) - Symptoms and causes

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This childhood mental health condition includes frequent and persistent anger, irritability, arguing, defiance or vindictiveness toward authority.

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OHEL- Oppositional Defiant Disorder (ODD) in Children and Adolescents

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OHEL- Oppositional Defiant Disorder (ODD) in Children and Adolescents

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This resource, provided by OHEL, outlines important information to know when working with students that have Oppositional Defiant Disorder.

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This article outlines the differences between IEPs and 504 plans. This is imperative for school counselors to understand when working with students that have mental health disorders.

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Basic Description

A blueprint or plan for a child's special education experience at school.

A blueprint or plan for how the school will provide support and remove barriers for a student with a disability.

What It Does

Provides individualized special education and related services to meet a child's unique needs.

Provides services and changes to the learning environment to enable students to learn alongside their peers.

As with an IEP, a 504 plan is provided at no cost to families.

These services are provided at no cost to families.

What Law Applies

The Individuals with Disabilities Education Act (IDEA)

Section 504 of the Rehabilitation Act of 1973

This is a federal civil rights law to stop discrimination against people with disabilities.

This is a federal special education law for children with disabilities.

Who's Eligible

To get an IEP, there are two requirements:

To get a 504 plan, there are two requirements:

1. A child has any disability. Section 504 covers a wide range of different struggles in school.

2. The disability must interfere with the child's ability to learn in a general education classroom.

Section 504 has a broader definition of a disability than IDEA. (It says a disability must substantially limit one or more basic life activities. This can include learning, reading, communicating, and thinking.) That's why a child who doesn't qualify for an IEP might still be able to get a 504 plan.

1. A child has one or more of the 13 disabilities listed in IDEA. The law lists specific challenges, like learning disabilities, ADHD, autism, and others.

2. The disability must affect the child's educational performance and/or ability to learn and benefit from the general education curriculum. The child must need specialized instruction to make progress in school.

Independent Educational Evaluation

Families can ask the school district to pay for an independent educational evaluation (IEE) by an outside expert. The district doesn't have to agree.

Doesn't allow families to ask for an IEE. As with an IEP evaluation, families can always pay for an outside evaluation themselves.

Families can always pay for an outside evaluation themselves, but the district may not give it much weight.

Who Creates It

There are strict legal requirements about who participates. An IEP is created by an IEP team that must include:

The rules about who's on the 504 team are less specific than they are for an IEP.

A 504 plan is created by a team of people who are familiar with the child and who understand the evaluation data and special services options. This might include:

The child's parent or caregiver

General and special education teachers

The school principal

The child's parent or caregiver

At least one of the child's general education teachers

At least one special education teacher

School psychologist or other specialist who can interpret evaluation results

A district representative with authority over special education services

With a few exceptions, the entire team must be present for IEP meetings.

What's in It

The IEP sets learning goals and describes the services the school will provide. It's a written document.

There is no standard 504 plan. Unlike an IEP, a 504 plan doesn't have to be a written document.

A 504 plan generally includes the following:

Specific accommodations, supports, or services for the child

Names of who will provide each service

Name of the person responsible for ensuring the plan is implemented

Here are some of the most important things the IEP must include:

The child's present levels of academic and functional performance-how the child is currently doing in school

Annual education goals for the child and how the school will track progress

The services the child will get-this may include special education, related, supplementary, and extended school year services

The timing of services-when they start, how often they occur, and how long they last

Any accommodations-changes to the child's learning environment

Any modifications-changes to what the child is expected to learn or know

How the child will participate in standardized tests

How the child will be included in general education classes and school activities

Notice

When the school wants to change a child's services or placement, it has to tell families in writing before the change. This is called prior written notice. Notice is also required for any IEP meetings and evaluations.

The school must notify families about an evaluation or a "significant change" in placement. Notice doesn't have to be in writing, but most schools do so anyway.

Families also have "stay put" rights to keep services in place while there's a disagreement about the IEP.

Consent

A parent or caregiver must consent in writing for the school to evaluate a child. They must also consent in writing before the school can provide the services in an IEP.

A parent or caregiver's consent is required for the school district to evaluate a child.

How Often It's Reviewed and Revised

The IEP team must review the IEP at least once a year.

The rules vary by state. Generally, a 504 plan is reviewed each year and a reevaluation is done every three years or when needed.

The child must be reevaluated every three years to determine whether services are still needed.

How to Resolve Disputes

IDEA gives families several ways to resolve disputes (usually in this order):

Section 504 gives families several options for resolving disagreements with the school:

Mediation

Alternative dispute resolution

Impartial hearing

Complaint to the Office for Civil Rights (OCR)

Lawsuit

Funding/Costs

Students receive these services at no charge.

Students receive these services at no charge.

States do not receive extra funding for students with 504 plans. But the federal government can take funding away from programs (including schools) that don't meet their legal duty to serve kids with disabilities.

IDEA funds can't be used to serve students with 504 plans.

States receive additional funding for students with IEPs.

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IEP vs. 504 Plan: What's the Difference?

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Basic Description A blueprint or plan for a child's special education experience at school. A blueprint or plan for how the school will provide support and remove barriers for a student with a disability. What It Does Provides individualized special education and related services to meet a child's unique needs.

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Counseling services are provided free to any family living in Bexar County who has a child aged 6 through 18. Both family, individual, and group counseling is offered.

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At the request of governments around the world, BCFS Health and Human Services has established programs that care for abused and neglected children, unite new or struggling families, and help those in need.

BCFS Health and Human Services has been a leading foster care and adoption agency for nearly 76 years. Today, BCFS Health and Human Services operates programs for families both stateside and overseas that offer guidance, training and counseling to parents on how to raise healthy children, encourage developmental growth, help families communicate and mitigate conflict, and value academic achievement.

Overseas, BCFS Systems' global division ( Children's Emergency Relief International) works to establish safe and loving foster and adoptive homes for children who are orphans. To ensure families can adequately support another child in their homes, CERI offers microenterprise loans, education and employment opportunities, medical and healthcare services, financial aid, as well as counseling and trainings.

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BCFS Health and Human Services has been a leading foster care and adoption agency for nearly 76 years. Today, BCFS Health and Human Services operates programs for families both stateside and overseas that offer guidance, training and counseling to parents on how to raise healthy children, encourage developmental growth, help families communicate and mitigate conflict, and value academic achievement.

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The Center for Health Care Services provides services for both children and adults in the San Antonio area. They treat all mental health disorders and offer both intensive in patient and out patient therapy options.

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CHCS Home Page | The Center for Health Care Services

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The Center for Health Care Services provides integrated care to improve the lives of children and adults with mental health conditions, substance use challenges and intellectual or developmental disabilities.

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The Jewish Family Services of San Antonio provides affordable counseling services to children dealing with an array of mental health challenges. Both individual counseling and group counseling is offered.

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Jewish Family Service (JFS)has beenproviding affordable mental health counseling, group therapy, case management, and senior services to the greater San Antonio community and beyond since 1973. Our services are available to all, regardless of age, race, faith, sexual orientation, or economic status.

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Laurel Ridge is a treatment center dedicated to helping children with mental health disorders. Services offered consist of inpatient treatment, partial hospitalization, intensive outpatient, and residential treatment. All major insurances are accepted.

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Clarity provides both in patient and outpatient services to children dealing with a wide range of mental health challenges. Clarity accepts all major insurances including Medicaid. The prices will vary based on the services provided.

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Get Help Now Give Now Pay My Bill 210-616-0300 Giving Tree Donation DriveCollect gifts, toys, clothes, and more for kids ... Read moreHome

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Child Mind Institute- Schizophrenia Resources

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Child Mind Institute- Schizophrenia Resources

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The Child Mind Institute offers an array of resources for mental health disorders specifically in children. This resource specifically focusses on schizophrenia in children.

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Schizophrenia is a disorder characterized by distorted perceptions of reality, including hallucinations, delusions and "disorganized" thinking and speech. Our guide explains the signs and symptoms of schizophrenia and how it's diagnosed and treated, usually in young adults.

Schizophrenia: What Is It?

Schizophrenia is a chronic psychiatric disorder characterized by distorted thinking, hallucinations, and/or delusions-called "positive" symptoms-and "negative" symptoms including social isolation and flat affect. Children with schizophrenia often experience paranoid delusions-seeing hostile intent where there isn't any-and their resulting behavior is misinterpreted as conduct disorder. They may believe other people can control their thoughts or read their minds, or believe that there are special messages for them in things like television shows or coincidences. While childhood schizophrenia is very uncommon, preliminary symptoms of the disorder can manifest in younger kids.

Schizophrenia: What to Look For

Children with schizophrenia may exhibit unusual thoughts and behavior. If your child has schizophrenia, he might express ideas that don't make sense, appear internally distracted, or perceive hostility in others where none is apparent. While it is common for young children to have imaginary friends, the voices that kids with schizophrenia hear are experienced as external, not internal, as if they're hearing someone else talking, or telling them what to do. Other signs include a child's belief that strangers know about him or are talking about him, or that the television is relaying special messages to him. For a child with schizophrenia, everyday tasks such as eating, bathing, attending school, and communicating coherently may become difficult, and he might withdraw from social interaction or appear to have little emotional range.

Schizophrenia: Risk Factors

Children who have a family history of schizophrenia are at higher risk for the disorder, though most kids who have a parent with schizophrenia never develop it. Pregnancy and birth complications are also linked to schizophrenia, though, again, the vast majority of children with these risk factors don't develop the disorder.

Schizophrenia: Diagnosis

The characteristic symptoms of schizophrenia include delusions, or beliefs held contrary to all evidence; hallucinations, or distortions in the perception of reality; disorganized or incoherent speech; and extremely disorganized or catatonic behavior (i.e. physical immobility or excessive mobility). Children with schizophrenia may display a lack of emotional responsiveness (called blunted or flattened affect), a lack of motivation (called avolition) and a lack of voluntary speech (called alogia). Other symptoms may include strange eating rituals, irritability, or inappropriate emotions. A child will be diagnosed with schizophrenia only if his symptoms interfere with age-appropriate activities, and have been in evidence for at least 6 months.

Schizophrenia is very difficult to diagnose because other psychiatric disorders (bipolar disorder, OCD, depression, even substance abuse) can generate similar symptoms if they manifest in psychosis. It is possible children with schizophrenia will be falsely diagnosed with conduct disorder because paranoia makes them respond in hostile or oppositional ways.

Schizophrenia: Treatment

The recommended treatment for schizophrenia, called Coordinated Specialty Care, involves a combination of services coordinated by a group of professionals working with the patient and the family. This treatment, within the first two to three years after a patient's initial psychotic episode, has been shown to decrease relapses of psychosis by more than 50 percent and prevent much of the disability associated with a psychotic illness.

Elements of the treatment include:

Low doses of antipsychotic medication

Cognitive behavioral therapy for psychosis (CBTp)

Family education and support

Educational and vocational rehabilitation

Unlike the old standard treatment for schizophrenia, which involved higher doses of medication and no follow-up after hospitalization, the goal of early treatment is not only to reduce psychotic symptoms, but also to help young people learn to manage them and to construct a support network to prevent relapse.

Related:

Schizophrenia: Risk For Other Disorders

Some children diagnosed with schizophrenia in fact have other disorders that manifest in psychosis, including obsessive-compulsive disorder and depression. And some develop other disorders as well, including OCD, panic disorder and post-traumatic stress disorder. Substance abuse is also a big problem for adolescents and young adults with schizophrenia, as it may drastically worsen their symptoms.

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Schizophrenia is a disorder characterized by distorted perceptions of reality, including hallucinations, delusions and "disorganized" thinking and speech. Our guide explains the signs and symptoms of schizophrenia and how it's diagnosed and treated, usually in young adults. Schizophrenia is a chronic psychiatric disorder characterized by distorted thinking, hallucinations, and/or delusions-called "positive" symptoms-and "negative" symptoms including social isolation and flat affect.

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The Schizophrenia Oral History Project is a collection of personal reflections of individuals with schizophrenia. It it designed to educated others on schizophrenia and to remove the negative stigma that comes with the disorder.

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The Esperanza Eating Disorders Center is a recovery center in San Antonio for individuals with eating disorders. The center also offers resources, events, and professional development on the topic of eating disorders.

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Esperanza Eating Disorders Center San Antonio Texas

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At Esperanza Eating Disorders Center, our goal is to provide a supportive, empowering environment for eating disorder recovery. Our team of experienced, multidisciplinary clinicians utilize evidence-based treatment approaches to provide individuals with a wide range of skills and healthy coping behaviors to guide them to a life of fulfilling recovery. As a locally owned facility, Esperanza is able to provide individualized care plans that are both effective and flexible.

Our cornerstone philosophy is Recovery by Doing. Patients do not just hear about what to do, they get hands-on experience doing recovery. Integrative therapies as well as grocery shopping, cooking and plating their own meals and activities like restaurant outings are all part of our hands-on approach to healing.

We look forward to doing recovery with families and professionals in the South Texas community.

Contact us at (210) 253-9763 to take the first step.

With Shared Hope,

Susan C. Mengden, PhD
Certified Eating Disorder Specialistiaedp Approved Supervisor
Clinical Director & CEO

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At Esperanza Eating Disorders Center, our goal is to provide a supportive, empowering environment for eating disorder recovery. Our team of experienced, multidisciplinary clinicians utilize evidence-based treatment approaches to provide individuals with a wide range of skills and healthy coping behaviors to guide them to a life of fulfilling recovery.

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The Eating Recovery Center is a national company with a location in the heart of San Antonio. They not only provide services for those working through eating disorders, but they offer both online and in-person events for those wanting to learn more about eating disorders and the treatment options.

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ERC Pathlight offers events and educational opportunities to our alumni, families, caregivers, professionals and community members. Find events near you.

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The School Counselor's Role in Addressing Eating Disorders

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The School Counselor's Role in Addressing Eating Disorders

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The American Counseling Association addresses the role that a school counselor should ethically play when addressing eating disorders.

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The School Counselor's Role in Addressing Eating Disorder