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Centers for Disease Control and Prevention

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Children sometimes argue, are aggressive, or act angry or defiant around adults. A behavior disorder may be diagnosed when these disruptive behaviors are uncommon for the child's age at the time, persist over time, or are severe. Because disruptive behavior disorders involve acting out and showing unwanted behavior towards others they are sometimes called externalizing disorders.

Oppositional Defiant Disorder

When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before 8 years of age, but no later than by about 12 years of age. Children with ODD are more likely to act oppositional or defiant around people they know well, such as family members, a regular care provider, or a teacher. Children with ODD show these behaviors more often than other children their age.

Examples of ODD behaviors include

Often being angry or losing one's temper

Often arguing with adults or refusing to comply with adults' rules or requests

Often resentful or spiteful

Deliberately annoying others or becoming annoyed with others

Often blaming other people for one's own mistakes or misbehavior

Learn more about ODD
Conduct Disorder

Conduct Disorder (CD) is diagnosed when children show an ongoing pattern of aggression toward others, and serious violations of rules and social norms at home, in school, and with peers. These rule violations may involve breaking the law and result in arrest. Children with CD are more likely to get injured and may have difficulties getting along with peers.

Examples of CD behaviors include

Breaking serious rules, such as running away, staying out at night when told not to, or skipping school

Being aggressive in a way that causes harm, such as bullying, fighting, or being cruel to animals

Lying, stealing, or damaging other people's property on purpose

Learn more about CD
Treatment for disruptive behavior disorders

Starting treatment early is important. Treatment is most effective if it fits the needs of the specific child and family. The first step to treatment is to talk with a healthcare provider. A comprehensive evaluation by a mental health professional may be needed to get the right diagnosis. Some of the signs of behavior problems, such as not following rules in school, could be related to learning problems which may need additional intervention. For younger children, the treatment with the strongest evidence is behavior therapy training for parents, where a therapist helps the parent learn effective ways to strengthen the parent-child relationship and respond to the child's behavior. For school-age children and teens, an often-used effective treatment is a combination of training and therapy that includes the child, the family, and the school.

Get help finding treatment

Here are tools to find a healthcare provider familiar with treatment options:

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with behavior or conduct problems. In addition to behavioral therapy and medication, practicing certain healthy lifestyle behaviors may reduce challenging and disruptive behaviors your child might experience. Here are some healthy behaviors that may help:

Engaging in regular physical activity, including aerobic and vigorous exercise

Eating a healthful diet centered on fruits, vegetables, whole grains, legumes (for example, beans, peas, and lentils), lean protein sources, and nuts and seeds

Getting the recommended amount of sleep each night based on age

Strengthening relationships with family members

Prevention of disruptive behavior disorders

It is not known exactly why some children develop disruptive behavior disorders. Many factors may play a role, including biological and social factors. It is known that children are at greater risk when they are exposed to other types of violence and criminal behavior, when they experience maltreatment or harsh or inconsistent parenting, or when their parents have mental health conditions like substance use disorders, depression, or attention-deficit/hyperactivity disorder (ADHD). The quality of early childhood care also can impact whether a child develops behavior problems.

Although these factors appear to increase the risk for disruptive behavior disorders, there are ways to decrease the chance that children experience them. Learn about public health approaches to prevent these risks:

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Behavior or Conduct Problems in Children | CDC

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Children sometimes argue, are aggressive, or act angry or defiant around adults. A behavior disorder may be diagnosed when these disruptive behaviors are uncommon for the child's age at the time, persist over time, or are severe. Learn about behavior or conduct problems in children.

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Behavior Disorders: Definitions, Characteristics & Related Information - Council for Children with B.pdf

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School Counselors Serving Students with DBD

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What Are Mood Disorders?

Mood disorders are a category of illnesses that describe a serious change in mood. Illness under mood disorders include: major depressive disorder, bipolar disorder (mania - euphoric, hyperactive, over inflated ego, unrealistic optimism), persistent depressive disorder (long lasting low grade depression), cyclothymia (a mild form of bipolar disorder), and SAD (seasonal affective disorder).

The following links provide additional information about these categories
Major Depression Bipolar Disorder
How Common Are Mood Disorders?

About 20% of the U.S. population reports at least one depressive symptom in a given month, and 12% report two or more in a year. A survey conducted in 1992 found rates of major depression reaching 5% in the previous 30 days, 17% for a lifetime. Bipolar disorder is less common, occurring at a rate of 1% in the general population, but some believe the diagnosis is often overlooked because manic elation is too rarely reported as an illness.

The Relationship Between Psychiatric Disorders and Mood Disorders

Depression is a common feature of mental illness, whatever its nature and origin. A person with a history of any serious psychiatric disorder has almost as high a chance of developing major depression as someone who has had major depression itself in the past.

Alcohol, Substance Abuse and Depression

Alcoholism and other forms of drug dependence are also related to depression. Dual diagnosis - substance abuse and another psychiatric disorder, usually a mood disorder - is an increasingly serious psychiatric concern. Whether drug abuse causes depression, depression leads to drug abuse, or both have a common cause, a vicious spiral ensues when addicts use the drugs to relieve symptoms the drugs have caused. Cocaine and other stimulants act on neurotransmitters in the brain's pleasure center, causing elation that is followed by depression as the effect subsides. Sometimes what appears to be major depression clears up after abstinence from alcohol or drugs. People with serious mood disorders also have twice the average rate of nicotine addiction, and many become depressed when they try to stop smoking.

Personality and Mood Disorders

People are more easily demoralized by depression and slower to recover if they are withdrawn and unreasonably self-critical or irritable, impulsive, and hypersensitive to loss. Most people with major depression also show some signs of anxiety, and 15-30% have panic attacks. As a biological mechanism for coping with danger, anxiety creates a need for help or protection that may give way to despair if it is disappointed. Chronically anxious people may also medicate themselves with alcohol or drugs that can cause depression.

Depression and Physical Illness

Depression is associated with physical illness as well. Some 25% of hospitalized medical patients have noticeable depressive symptoms and about 5% are suffering from major depression. Chronic medical conditions associated with depression include heart disease, cancer, vitamin deficiencies, diabetes, hepatitis, and malaria. Depression also is a common effect of neurological disorders, including Parkinson's and Alzheimer's diseases, multiple sclerosis, strokes, and brain tumors. Even moderate depressive symptoms are associated with a higher than average rate of arteriosclerosis, heart attacks, and high blood pressure. Depression can mimic medical illness and any illness feels worse to someone suffering from depression.

Other Resources

National Mental Health Consumer Self-Help Clearinghouse
Phone Number: (215) 751-1810
Toll Free Number: (800) 553-4539
Fax Number: (215) 636-6312
Email address: info@mhselfhelp.org
Website URL: http://www.mhselfhelp.org/

Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, DC 20201
Website URL: http://www.mentalhealth.gov/

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What Are Mood Disorders? Mood disorders are a category of illnesses that describe a serious change in mood. Illness under mood disorders include: major depressive disorder, bipolar disorder (mania - euphoric, hyperactive, over inflated ego, unrealistic optimism), persistent depressive disorder (long lasting low grade depression), cyclothymia (a mild form of bipolar disorder), and SAD (seasonal affective disorder).

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Anxiety and depression occur in both genders, but by the teenage years, girls are much more at risk than boys. Before puberty, the prevalence of mood disorders is about the same in boys and girls-3 to 5 percent. But by mid-adolescence girls are more than twice as likely to be diagnosed with a mood disorder as boys, with the prevalence at adult levels, 14 to 20 percent.

Why such a big disparity in mood disorders? We know from looking at brain scans that there are differences in the way girls and boys process emotional stimuli. Girls mature, in terms of their emotional recognition, faster than boys-and that sensitivity could make them more vulnerable to depression and anxiety.

It's plausible that that these gender differences around the time of puberty can be traced to evolutionary advantages: Girls may be wired to tune in earlier to emotional stimuli because it was advantageous for nurturing babies; for young men, given their roles as hunters and tribe protectors, emotional responsiveness might have been an important attribute not to have.

The argument that the differences in emotional sensitivity are hard-wired is underscored by the fact that even as women's lives have clearly changed-with many more women living professional, competitive, Type-A lives-the rate of depression hasn't dropped. Even the participation of far more girls in sports and other intense physical activities hasn't reduced the rate of depression, though physical activity is important to emotional wellbeing, and one effective way to help jumpstart recovery in someone who's depressed.

Symptoms of depression in teenagers

In adolescent depression, the thing people tend to notice first is withdrawal, or when the teenager stops doing things she usually likes to do. There might be other changes in her mood, including sadness or irritability. Or in her behavior, including, appetite, energy level, sleep patterns and academic performance. If several of these symptoms are present, be vigilant about the possibility of depression.

This is especially important because by the time family members and other people around a teenager note her lack of interest in most things, or what we call anhedonia, she's usually been depressed for some time. Depression is an internalizing disorder, i.e. one that disturbs a patient's emotional life, rather than an externalizing one, which manifests in the form of disruptive or problematic behavior. As such, it takes a while not only for others to recognize it, but often for the patient herself to realize that her thinking, and emotional responses, are disturbed.

Note that there are actually two kinds of depression. In major depressive disorder-the most familiar form of depression-the cluster of symptoms that define depression occur in what may be severe episodes that tend to last from seven to nine months. But there is also another form of depression called dysthymic disorder, in which the symptoms are milder, but they last longer, measured in years. So while the experience of dysthymia may be less debilitating for the child at any given moment, the risk is that there is more accrued damage, more time in which the child is kept out of the healthy development process.

Symptoms of anxiety

Anxiety is a normal adaptive system that lets the body know when it's in danger. But anxiety becomes a problem when it's out of proportion to the situation, and interferes with a person's ability to function. An overly anxious teen might withdraw from activities because she's too scared or anxious, and her anxiety doesn't go away with reassurance.

A teenager who has been anxious since childhood may have a lifestyle built around her anxieties: the activities and environments she chooses and those she rules out, the friends she is comfortable with, the expectations and limitations she has trained her family, friends, and teachers to accept. That's why it's more challenging to treat anxiety the longer a child has lived with it, and developed unhealthy coping mechanisms to manage it.

Why early intervention is critical

When a child is depressed or anxious, her suffering isn't the only reason it's important to get help.

In addition to the disorders themselves, there are add-on effects that may cause lifelong issues. With depression comes low energy and poor concentration, two factors that are likely to have a significant impact on social and academic functioning. Anxiety, and the withdrawal that may accompany it, is likewise a detriment to social and academic progress.

It's easy to see the effects of poor academic functioning: falling behind in school undermines a child's confidence and self-image, and can impact her future if it's prolonged. But social learning is just as critical as academic learning in childhood and adolescence. This is a time when a girl would normally be learning such things as how to be a daughter, a sister, a friend; with either depression or anxiety, she may miss or fall behind on these critical kinds of learning. These deficits not only put her behind her peers, but in themselves they can compound her depression or anxiety.

Other disorders

It's important to understand that anxiety and depression often occur in the same teenager, and may need to be treated as two separate disorders. Anxiety is more likely to occur without depression than depression without anxiety. It may be that depression leads to anxiety-the negative state of mind of a depressed teenager lends itself to uncertainty. If you're not feeling good about yourself, or confident, or secure, or safe, anxiety may find fertile ground. It may also be because the regions of the brain affected by anxiety and depression are close together, and mutually affected.

Two serious problems that are directly associated with teenage depression and anxiety are suicidal thinking (or behavior), and substance abuse. Suicide is the third leading cause of death among adolescents and young adults aged 15 to 24, and we know that most kids who commit suicide have been suffering from a psychiatric illness. Especially at risk are teenagers who hide their depression and anxiety from parents and friends. That's why it's important to be alert to signs of these disorders-withdrawal, changes in school performance, eating habits, sleeping patterns, things she enjoys doing-even when teenagers aren't forthcoming about how they feel. Similarly, the majority of teenagers who develop substance abuse problems also have a psychiatric disorder, including, most commonly, anxiety or depression, which is another important reason to get treatment in a timely way.

Two other problems associated with teenage girls-that is, occurring with greater frequency in girls than boys-are eating disorders and self injury, or cutting. While both of these can overlap with depression, the common assumption that they're caused by depression is not borne out by research. Girls who have eating disorders often show no signs of depression; indeed, they are often very high-functioning, competitive girls who have a distorted body image, but not the symptoms of depression. Similarly, self-injurious behavior is a kind of dysfunctional coping mechanism kids get into to alleviate emotional pain, or numbness they've developed as a result of that pain. It can occur with, and be complicated by, a mood disorder, but isn't thought to be a result of the latter. Antidepressants, the medication of choice for mood disorders, don't usually alleviate eating disorders or cutting, which receive different kinds of treatment.

Treatments for anxiety and depression

Fortunately, early involvement of health care professionals can shorten the period of illness and increase the likelihood of her not missing important life lessons.

The most common treatment a mental health professional is apt to use is some form of cognitive behavioral therapy, and depending on how young the child is, it may involve teaching the parents as well. Cognitive behavioral therapy is based on the idea that a person suffering from a mood disorder is trapped in a negative pattern of thought. Depressed kids tend to evaluate themselves negatively, interpret the actions of others in a negative way, and assume the darkest possible outcome of events. Similarly, a child suffering from anxiety is overwhelmed by fears of negative outcomes long before events occur. In CBT, we teach sufferers to challenge those negative thoughts, to recognize the pattern and train themselves to think outside it. And in many cases we see real improvement in teenagers with depression and anxiety.

If the anxiety or depression is moderate to severe, treatment may involve medications such as antidepressants. For both anxiety and depression, a combination of psychotherapy and medication usually works better than either alone.
Learn more about treatment for anxiety and depression.

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Anxiety and depression occur in both genders, but by the teenage years, girls are much more at risk than boys. Before puberty, the prevalence of mood disorders is about the same in boys and girls-3 to 5 percent.

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National Institute of Mental Health (NIMH)

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Learn about depression, including types, signs and symptoms, risk factors, treatments and therapies, and things you can do to help during treatment.

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NIMH - Bipolar Disorder in Children and Teens.pdf

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Debunking the myths of OCD - Natascha M. Santos

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Overview

Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.

There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, and various phobia-related disorders.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time.

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Panic disorder - panic attacks, causes, symptoms, diagnosis, treatment & pathology

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National Institute of Mental Health (NIMH)

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Learn about obsessive-compulsive disorder, including signs and symptoms, risk factors, treatments and therapies, and links to other resources to learn more.

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The Center for Health Care Services - Bexar County

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Psychosis is a general term to describe a set of symptoms of mental illnesses that result in strange or bizarre thinking, perceptions (sight, sound), behaviors, and emotions. Psychosis is a brain-based condition that is made better or worse by environmental factors - like drug use and stress.

How Common is Psychosis?

One frequently cited statistic is that 1% of the population is diagnosed with Schizophrenia in their lifetime, but actually 3.5% of the population experiences psychosis. Hearing voices and seeing things that aren't there are more common than we think. While these experiences can be scary and confusing, it is possible to recover and getting better, especially when we tackle issues early.[ 1]

What are the Different Kinds of Psychotic Disorders?

Conditions that have psychosis as a main symptom are referred to as psychotic disorders; however, psychosis may also occur as a feature of other disorders like bipolar or major depression. Some of the more common types of psychotic disorders include:

Schizophrenia: is a serious mental health disorder that affects how a person thinks, feels, and acts. People with schizophrenia may have trouble distinguishing what is real and what is imaginary.

Schizophreniform Disorder: consists of the same symptoms of Schizophrenia but occurs for a time period of at least one month but no more than six months. If symptoms last longer than this period, a person is given a diagnosis of Schizophrenia. [ 2]

Schizoaffective Disorder:is characterized by persistent symptoms of psychosis resembling schizophrenia with additional periodic symptoms of mood (or affective) disorders.

: is characterized by irrational or intense belief(s) or suspicion(s) which a person believes to be true. These beliefs may seem outlandish and impossible (bizarre) or fit within the realm of what is possible (non-bizarre). Symptoms must last for 1 month or longer in order for someone to be diagnosed with delusional disorder.

Brief Psychotic Disorder: includes symptoms of psychosis that last at least 1 day but no longer than 1 month. Symptoms are typically sudden and are sometimes responses to a stressful life event. While an individual may experience severe distress during the episode, people quickly return to their daily lives and their symptoms do not return.[ 3]

: is a personality disorder that can easily be confused with schizophrenia due to the nature of people with schizotypal personality disorder to have "magical" or eccentric beliefs, unusual thoughts and paranoia. People with schizotypal personality disorder may experience brief psychotic episodes with delusions or hallucinations, but the episodes are not as frequent, prolonged or intense as in schizophrenia.[4]

Symptoms of Psychotic Disorders

When trying to figure out if something is going on, it's important to keep a few things in mind. A person might experience one symptom, but it's more concerning when someone experiences more than one symptom. A change for one or two days might be a related to sleep or stress, but experiencing symptoms for more than a few days or weeks, is worthy of an evaluation by a mental health professional. If you're concerned about a loved one, pay attention to sudden changes in their thoughts, emotions, and behaviors. Changes that seem really out of character might be early warning signs of psychosis. The following is a list of symptoms of psychosis:

Hearing or seeing something that isn't there

A constant feeling of being watched

Disorganized or bizarre speech or writing

Inappropriate or unusual behavior

Strange body movements or positioning

Feeling indifferent or numb about important situations

Deterioration of academic or work performance

A change in personal hygiene and appearance

A change in personality

Increasing withdrawal from social situations

Irrational, angry or fearful response to loved ones

Inability to sleep or concentrate

Extreme preoccupation or fears that seem bizarre

Please be aware that the screening is to identify individuals who are at ultra high-risk for psychosis, which means that being identified as possibly at-risk is sensitive. Overall, if you're concerned it's a good idea to reach out to someone you trust.

Getting Help

Recovering from psychosis is possible and treatment can make a big difference. If you are a young person and you think you might be showing the early signs of psychosis, visit Partners for Strong Minds and learn more about specialized supports that can help.

If you're an adult struggling with psychosis, visit our Finding Help page, or use our Where to Get Help Interactive Tool to find the best treatment options for you.

To learn more visit:

En Espanol:

From our Partners:

Read stories from people living with psychosis on The Mighty.
Sources
[1] Perälä J, Suvisaari J, Saarni SI, et al. Lifetime Prevalence of Psychotic and Bipolar I Disorders in a General Population. Arch Gen Psychiatry. 2007;64(1):19-28. doi:10.1001/archpsyc.64.1.19.

[2] American Psychiatric Association. (2014). Understanding Mental Disorders: Your Guide to DSM-5. Washington, DC: American Psychiatric Publishing.

[3] IBID

[4] http://www.mayoclinic.org/diseases-conditions/schizotypal-personality-disorder/symptoms-causes/dxc-2...

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Psychosis is a general term to describe a set of symptoms of mental illnesses that result in strange or bizarre thinking, perceptions (sight, sound), behaviors, and emotions. Psychosis is a brain-based condition that is made better or worse by environmental factors - like drug use and stress.

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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.

Transforming Children's Mental Health

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need to thrive.

We're the leading independent nonprofit in children's mental health, operating three Mission Areas that work together for greater impact: Care, Education and Science.

Care at the Child Mind Institute

Our clinicians provide gold-standard, evidence-based treatment to thousands of kids annually through our clinical centers and in-school programs:

Education at the Child Mind Institute

We deliver free resources to millions of families and training to hundreds of educators each year, so more kids get the help they need:

Science at the Child Mind Institute

Our researchers and engineers are uncovering the causes of mental health and learning disorders to develop tomorrow's breakthrough treatments:

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Child Mind Institute | Transforming Children's Lives.

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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. Transforming Children's Mental Health The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need to thrive.

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Hello! Welcome to The Helpful Counselor website! I'm Heather, the author behind The Helpful Counselor blog and counseling products. If you're like most people who visit The Helpful Counselor, you are undoubtedly trying to help a ... Read More

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THE ROLE OF SCHOOLCOUNSELORS IN MEETING STUDENTS' MENTAL HEALTH NEEDS- EXAMINING ISSUES OF PROFESSIONAL IDENTITY..pdf

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Most children and parents will have some distress or upset - so how do I know when a child or family needs additional help?

Ask your patients (and their parents) about reactions and coping.

Listen for ongoing or severe traumatic stress symptoms.

Consider a referral for a more thorough evaluation with a mental health professional if:

Traumatic stress reactions are severe or prolonged (more than a month).

Traumatic stress reactions interfere with recovery or with returning to normal activities.

Consider: Is the child participating in daily activities to the extent possible given their medical condition? Are stress reactions interfering with treatment adherence? Are new fears or worries troubling the child or parent?

Steps for making a referral Effective mental health treatment for traumatic stress Online resources - help in finding a mental health professional Distinguishing between types of mental health professionals
Therapist Resource Guide: There are many ongoing stressors that children and families endure after diagnosis of an illness or an injury. This guide focuses specifically on medical traumatic stress and responses that children and families may have.

Steps for making a referral

Mention concerns you have identified.
Say something like: "I'm concerned that (you are / your child is) having these upsetting thoughts and feelings. It might be useful to talk with a specialist who can help your family more."

Involve child and family in making a plan.
Ask for their ideas about what is needed now
Say something like: "What issues or difficulties are impacting you / your family the most right now? What would help make things better?"

Ask for permission to offer advice. Present advice as range of possibilities; be sure to incorporate patient/family ideas

Say something like: "I have some suggestions that have helped other patients in the past in situations similar to yours. May I share them with you?"

Range of possibilities might include: patient education materials / websites; speaking with social worker, local clergy, school counselor; seeking out support group, referral to therapist / community mental health center.

Ask about their readiness to act on this now or in the future.
Say something like: "Is this (suggested plan) something you would be willing to do when you leave today, or if you need it next week...month?"

Ask about barriers to potential plans / referrals, and strategies to overcome barriers.
Say something like: "What kinds of things would interfere with following-up on this plan we just discussed? How can we work through this so you end up getting the help you need.?"

Involve the child and parent in setting the agenda*:*Adapted from Wissow et al. (2008)

Keep the door open.

If your patient or their parents are not quite ready to act on a suggested referral now, arrange to follow up to see how your patient is doing.

You might say: "I'd like to talk with you again in a few weeks to see how things are going."

Promote continuity of care.
If your care for this patient is ending, ask permission to communicate your concerns about traumatic stress reactions or risk factors to the child's primary care provider, or to other providers who will continue to take care of this patient.

Facilitating collaboration between pediatric health care and mental health providers: The American Academy of Pediatrics Task Force on Mental Health has developed tools to facilitate collaboration between pediatric health care providers and mental health professionals, including a Physician Referral and Feedback Form template

Effective mental health treatment for traumatic stress

There are very good and helpful treatments for children who continue to have traumatic stress symptoms.
What treatment approaches are effective?
Evidence-based treatments include cognitive-behavioral treatment approaches, and in particular Trauma-Focused Cognitive Behavior Therapy (TF-CBT).

Click here for a fact sheet about effective treatments for youth trauma from the National Child Traumatic Stress Network.

A recent article includes informative summaries of effective mental health treatments for child traumatic stress symptoms, and guidance for health care professionals:
Cohen, J, Kelleher, K, Mannarino, A.. Identifying, treating, and referring traumatized children: The role of pediatric providers. Archives of Pediatric and Adolescent Medicine 2008;162(5):447-452 How can I help parents find effective treatment for their child?
When helping parents find a counselor or therapist to help their child with traumatic stress symptoms, you might suggest that they ask prospective therapists questions such as:

Do you have experience working with children after trauma?

What is your approach to working with this type of problem?

What is your success rate?

How do you work with parents?

The National Child Traumatic Stress Network offers useful tips and information about finding a mental health professional to help children and their families after trauma.

Online resources - help in finding a mental health professional

The National Child Traumatic Stress Network (NCTSN) has trauma-trained, child mental health professionals and community-based treatment centers in 35 states in the US. For information about or referral to a NCTSN center near you, please go to the NCTSN Organizational Members site.
American Psychological Association - Psychologist Locator National Association of Social Workers - Find a Licensed Social Worker American Academy of Child and Adolescent Psychiatrists - Psychiatrist Finder Anxiety Disorders Association of America - Find a Therapist Sidran Institute Help Desk - Locate Trauma Resources ISTSS Clinician Directory - Find a Clinician, Counselor or Mental Health Professional
Distinguishing between types of mental health professionals

Psychologists are professionals who have earned a doctoral degree (Ph.D. or Psy.D.) after 4-6 years of graduate-level training in human behavior and development, psychological testing and evaluation, and psychotherapy. Psychologists are licensed by the state in which they practice.

Psychiatrists are physicians (M.D. or D.O.) who have completed medical school, plus additional advanced training in the evaluation and treatment of psychiatric disorders and emotional and behavioral problems. Psychiatrists are licensed by the state in which they practice. As medical doctors, psychiatrists can prescribe and monitor medications.

Clinical Social Workers are professionals who have earned a master's degree (M.S.W.) after 2-3 years of graduate training. Clinical Social Workers are licensed by the state in which they practice (LCSW or similar credential - varies by state).

Marriage and Family Therapists are professionals who have completed a master's degree (M.A. or M.S.) after 2-3 years of graduate training. Some Marriage and Family Therapists have completed a required amount of clinical hours and passed a state-administered examination to become licensed marriage and family therapist (LMFT).

Licensed Professional Counselors (LPC) & Licensed Mental Health Counselors (LMHC) are mental health professionals who have earned a master's degree (M.A. or M.S.) after 2-3 years of graduate training and have obtained a required amount of clinical experience and passed a state-administered licensing examination.

For more information on the training and credentialing of mental health professionals, see Mayo Clinic: Mental health providers.

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When and How to Refer for Mental Health Care

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Pediatric providers can follow specific steps to determine if and how to refer a child and familiy for further mental health services after a medically traumatic event. Providers can also become familiar with current evidence-based treatments and online resources for mental health services for traumatic stress.

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Example of School Counselor Referral Form

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Individuals with Disabilities Education Act

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Individuals with Disabilities Education Act (IDEA)

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The U.S. Department of Education’s Individuals with Disabilities Education Act website brings together department and grantee IDEA information and resources. The IDEA makes available a free appropriate public education to and ensures special education and related services to eligible children with disabilities.

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IEP vs. 504 Plan: What's the Difference? | Special Education Law.pdf

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Many people confuse panic disorder and phobias, believing that these two conditions are the same. It is undeniable that panic disorder and phobias share similar symptoms, including intense fear, feelings of anxiety, and panic attacks. Both conditions can involve difficult symptoms that can tremendously impact one's relationships, career, and other responsibilities and goals.

Additionally, according to information found in the Diagnostic and Statistical Manual of Mental Disorders ( DSM 5), both conditions are classified as "anxiety disorders." However, panic disorder and phobias are considered separate conditions, each with a distinct set of diagnostic criteria.

A phobia is defined as a relentless fear of a certain object or situation. The fear associated with a phobia goes beyond just feelings of dislike or discomfort. A person with a phobia is severely afraid of the object or situation, far beyond any threat of danger it presents. For example, many people have an aversion to spiders, but a person who has a fear of spiders ( arachnophobia), will go to great lengths to steer clear of spiders and may even behave seemingly unreasonable if encountered by one.

Phobia sufferers may recognize that their fear is excessive and irrational, but often feel unable to control their apprehension. Avoidance behaviors are common, as the phobic is determined to stay away from her specific fear. If forced to face the feared object or situation, the person will experience marked distress and anxiety. Common symptoms of phobias include accelerated heart rate, shaking, feelings of terror, and a tremendous need to get away from the object or situation.

As outlined in the DSM, phobias fall into one of three main categories: specific phobias, social phobias (social anxiety disorder), and agoraphobia. Specific phobias involve a fear of a particular object or situation. Common specific phobias include a fear of particular situations (e.g., heights, flying, elevators), medical circumstances (e.g., blood, needles, dentists), nature/environmental influences (e.g., water, tornadoes, or earthquakes), or animals (e.g. snakes, dogs, bees).

Social phobias entail an excessive fear of being embarrassed or negatively evaluated in a social situation. A person with a social phobia will avoid doing activities in public, such as speaking, in which he would at risk of being judged by others. Agoraphobia may similarly involve a fear of being embarrassed, however, the person is afraid of having a panic attack in a place or situation in which it would be embarrassing and/or difficult to flee from. The symptoms of agoraphobia typically lead to further limitations in one's life such as avoiding driving, crowds, or large open spaces.

Panic attacks and panic-like symptoms, such as trembling, shortness of breath, and excessive sweating, are typical symptoms of both panic disorder and phobias. However, these symptoms are triggered differently for each condition. People who have a phobia will experience panic and anxiety when thinking about or being exposed to their fear.

Panic disorder sufferers, on the other hand, are not generally triggered by a specific fear. People with panic disorder experience panic attacks suddenly and unexpectedly. People with panic disorder often must cope with a fear of when their next panic attack will strike. It is also possible to have a co-occurring diagnosis of both a specific phobia and panic disorder.

Both panic disorder and phobias are complex conditions that can only be diagnosed by a qualified mental health provider. If you suspect that you are suffering from either or both of these conditions, make an appointment to discuss your symptoms with your doctor. She will be able to assist you in receiving an accurate diagnosis, treatment, and referrals when necessary.

The treatment options available for phobias are similar to those for panic disorder. Most people diagnosed with a phobia will choose a combination of psychotherapy, medication, and self-help techniques to help in managing their symptoms.

Psychotherapy can assist in a variety of ways including developing coping strategies, although medications are more likely to be a component of lowering the intensity of fear and anxiety, and self-help techniques can be beneficial in managing everyday stress, medication options may help lower the intensity of fear and anxiety, and self-help techniques can be beneficial in managing everyday stress.

View Article Sources

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.)." Washington, DC: Author.

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Phobias and Panic Disorders: Similar Symptoms, Distinct Conditions

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Many people confuse panic disorder and phobias, believing that these two conditions are the same. It is undeniable that panic disorder and phobias share similar symptoms, including intense fear, feelings of anxiety, and panic attacks. Both conditions can involve difficult symptoms that can tremendously impact one's relationships, career, and other responsibilities and goals.