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The power of inclusive language for promoting racial equity

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APA’s Inclusive Language Guide offers research-informed recommendations for understanding the relationship between race and power.

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Mental Health Support for Diverse Communities 

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Mental Health Support for Diverse Communities 

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Our culture, beliefs, sexual identity, values, race and language all affect how we perceive and experience mental health conditions. In fact, cultural differences can influence what treatments, coping mechanisms and supports work for us. It is therefore essential for culture and identity to be a part of the conversation as we discuss both mental health and mental [...]

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This website is full of resources to promote diversity and inclusion, including classroom activities and lesson plans, as well as professional development activities and readings. The well organized site includes a section on classroom resources which are aligned with common core standards as well as Teaching Tolerance's Social Justice Standards.

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Being bilingual has lots of great benefits for children and adults. Bilingual and dual-language programs are one way to help children become bilingual or to maintain their languages. Learn more from the resources below.

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Being bilingual has lots of great benefits for children and adults. Bilingual and dual-language programs are one way to help children become bilingual or to maintain their languages. Learn more from the resources below.

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National Service for Learning Disabilities 

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National Service for Learning Disabilities 

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National Center for Learning Disabilities

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See what NCLD has been advocating for and get the most recent news on learning and attention issues.

Tell Congress: Pass the RISE Act

We need your help! Ask your member of Congress to support students with learning and attention issues.

Support NCLD

Thanks to support from generous partners like you, we are able to create programs and resources to support the 1 in 5 individuals with learning and attention issues nationwide.

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NCLD - National Center for Learning Disabilities

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See what NCLD has been advocating for and get the most recent news on learning and attention issues. We need your help! Ask your member of Congress to support students with learning and attention issues. Thanks to support from generous partners like you, we are able to create programs and resources to support the 1 in 5 individuals with learning and attention issues nationwide.

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Free Educational Resources

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Explore and contribute your voice to the priorities that Gen Z and Gen Alpha want to see policymakers do something about, including a just society for all, equitable education and healthcare, and a healthy planet.

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A variety of resources to bridge the gap and creating a safe and inclusive community.

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Big Brothers Big Sisters of America - Youth Mentoring

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Dale Hawkins Long is a survivor of the September 1963 bombing of the Sixteenth Street Baptist Church in Birmingham, AL, where four of his friends were tragically killed and twenty-seven people injured. He and his late brother, Kenneth escaped unscathed. In September 2023 Dale spent a week visiting in Birmingham where he participated in several events commemorating the 60th anniversary of the bombing.

Dale's experience in Birmingham led him to dedicate his life to volunteering. The recipient of numerous awards for volunteer service, for five decades he has been a mentor with Big Brothers and Big Sisters. Dale was honored to be named the 1989 National Big Brother of the Year. In 2007 he was the recipient of the Clifford B. Norman, National Local Board Member of the Year. Last summer he received the inaugural Alpha Phi Alpha Fraternity, Big Brother of the Year at its 97th General Convention in Dallas.

Dale is a speaker on the national platform who has shared his role in American History as a primary source of Jim Crow, 60's era, Birmingham with organizations including the National Urban League, Congressional Black Caucus, the United Methodist Church's General Conference, the University of Michigan, Rutgers University, Texas Wesleyan University, Dallas College, Collin County Community College, the University of Dallas, Texas Southern University, Southern Methodist University, the University of Wyoming, The Dallas Holocaust and Human Rights Museum, The National MENTOR Summitt, ONCOR Electric Delivery, The American Heart Association, the Dallas Black Dance Theater and the Cities of Dallas, Ft. Worth and Plano. In 1990 he shared the podium at the White House with President George H. W. Bush as the President announced one of his Youth Engaged in Service initiatives. In 2004 during the 40th anniversary commemoration of the 1964 Civil Rights Act, President George W. Bush included in his White House addresses one of Dale's childhood memories of growing up in Birmingham. For volunteer work, Dale has garnered media attention from Forbes, Essence, Time and Ebony Magazines, the Dallas Morning News, PBS, CNN, C-Span, the Alpha Phi Alpha Fraternity Sphinx Magazine, the NBC Nightly News and is listed in the 2011 Grio 100.

Dale was born in Tuskegee, Alabama and reared in Birmingham where he graduated from high school in 1970. He accepted a music scholarship, becoming a member of the famous "Ocean of Soul" Marching Band of Texas Southern University, Houston, TX, where he earned the Bachelor of Science Degree in 1974.

He is a member of the Garland Branch NAACP, the Leadership Dallas Alumni Association, Kappa Kappa Psi National Honorary Band Fraternity, a Life member of Alpha Phi Alpha Fraternity, a Life member of the Texas Southern University National Alumni Association - Dallas Chapter, Dallas Holocaust and Human Rights Museum Suvivors Speakers Bureau, a Research Advocate with UT Southwest Medical Center, Dallas and a member of Kidsinbirmingham1963.org.

A resident of Garland, Texas he is the former Community Outreach Coordinator/Public Information Officer for the City of Dallas Public Works Department where he retired in April 2018. Previously he worked for a contractor on the NASA Space Shuttle Program, Houston, Texas Instruments in Dallas, The City of Garland, Texas and a contractor with the Dallas Area Rapid Transit Light Rail Design and Construction Project.

Dale and his wife Ellen Scott Long are proud parents of adult daughters Kendra Dale and Amber Nicole and are members of Hamilton Park United Methodist Church in Dallas. In his spare time Dale enjoys reading, music and photography. A retired marathoner, Dale now does "power walking" and practices yoga.

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Home - Big Brothers Big Sisters of America - Youth Mentoring

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Mentoring can change a child's life. Sign up with BBBS today to start making a difference. Help a child reach their full potential. Learn how mentoring programs make a difference.

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Support for Runaway and Homeless Youth

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This report is focused on the experiences

and needs of LGBTQI+ children and

adolescents up to age 17 years (referred to

collectively as “youth”).

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Stop Bullying: Resources for Prevention and How to Stand up to It 

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Stop Bullying: Resources for Prevention and How to Stand up to It 

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Stop Bullying on the Spot

When adults respond quickly and consistently to bullying behavior they send the message that it is not acceptable. Research shows this can stop bullying behavior over time.

Parents, school staff, and other adults in the community can help kids prevent bullying by talking about it, building a safe school environment, and creating a community-wide bullying prevention strategy.

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StopBullying.gov provides information from various government agencies on bullying, cyberbullying, prevention and response.

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Nation Institute of Food and Agriculture

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A Podcast that Supports Kids Who Learn and Think Differently.

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A Podcast that Supports Kids Who Learn and Think Differently.

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Who's listening?

In It listeners include parents, teachers, and others who want to learn more about supporting kids who learn and think differently. Most In It listeners are based in the United States. Gender (based on Spotify data from 10/12/23)

Age (based on Spotify data from 10/12/23)

In It listeners include parents, caregivers, teachers, physicians, and those who want to learn more about supporting kids who learn and think differently. The majority of In It listeners are based in the United States.

Episode promotion: What's possible

Each new episode of In It is available across all major podcast platforms. This includes Audible, Apple Podcasts, Spotify, and YouTube. They're also posted on the In It show page at Understood.org. The Understood.org site gets more than 20 million visitors a year.

Social media marketing

New episodes of In It are shared across all of Understood's social channels. Worldwide, Understood has 785,000 followers, with 500,000 of those followers coming from the United States.

Email marketing

In It is promoted through our email marketing. This include a network of more than 500,000 email subscribers.

How it works

In It's producer works with each confirmed guest to schedule a one-hour recording session. All recordings can be done remotely. And we ship an audio kit to any guest who doesn't already have a USB mic and headphones to use during the recording. Most of our In It recordings are audio-only. But sometimes, we may invite guests to record video as well. The video element is always optional. All guests are required to sign a release form.

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Understood.org is the leading nonprofit empowering the 70 million people with learning and thinking differences in the United States.

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Through research-based programs, advocacy, and partnerships, they equip educators, families, and communities with tools to create safer, more supportive environments.

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Priorities | Evidence-Based Programs | Committee for Children

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We work with educators, parents, and policy makers to deliver evidence-based programs, advocate for public policies, and provide leadership in our field.

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Supporting Young Children Through Uncertain Times: Resources for Stress and Trauma

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Lessons and Impacts of a Remote Early Childhood

Education Program in Hard-to-Access Settings in

Lebanon

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Home - Child Welfare Information Gateway

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Understanding Adverse Childhood Experiences (ACEs) 

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Understanding Adverse Childhood Experiences (ACEs) 

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Welcoming Families of Different Cultures 

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Welcoming Families of Different Cultures 

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An adapted excerpt from Parents & Teachers Working Together
One of the enduring truths about teaching is that to teach children well, we have to know them: what they're passionate about, what worries them, where they are in their development.

We also have to understand something of their family culture-that world outside the school that has such a huge effect on how well children do in school.

As many teachers know, the U.S. school-age population is becoming increasingly diverse. According to the U.S. Census Bureau, in 2000, 3.4 million U.S. children ages five through seventeen (about one in fifteen) spoke little or no English. And by 2020, nearly half of all U.S. children will be of color; about one in four will be Hispanic. This increasing diversity means that more than ever, we need to be attentive to how students' family cultures can be very different from the dominant culture of the school.

No doubt this can be hard work. It takes time and effort to learn about unfamiliar cultures. It takes stretching our powers of empathy and creativity to adjust teaching practices to fully include families of different cultures.

But this hard work can also be exhilarating. As teachers, we come into the profession because we find joy in seeing children learn. When we build bridges to families of non-mainstream cultures, we're making sure that their children, not just the children of mainstream cultures, can do well in school. We're also opening up exciting new worlds of learning for all children. Just think of how much children can grow socially and academically when our teaching reflects the traditions and contributions of all the cultures in our schools. In the words of parent Bekki Lee, "To have a teacher affirm and embrace all cultures, especially those that our society most under-represents or misrepresents, is incredibly powerful. Teachers shape how our children see the world and each other, and it's never too early to begin."

Many resources-books, websites, community groups, and families and children themselves-can suggest practical ways to welcome families from diverse cultures (see end of this article). Rather than adding more such ideas, this article offers instead one overarching goal and one fundamental belief to keep in mind while taking those practical steps to reach out.

The goal: helping children learn

The goal in working with parents-all parents, no matter what their culture-is to enable them to support their children's learning. It sounds simple, but in the process of finding innovative ways to include all the cultures of our students, it's sometimes easy to lose sight of this goal.

Educator Sonia Nieto observes that many schools believe they're offering multicultural education when they're actually implementing "little more than ethnic additives and cultural celebrations." She writes, "Curiously missing from discussions in most schools that claim to 'do' multicultural education are statements having to do with student learning." Nieto recalls telling a friend about a multicultural education initiative in a nearby school system. The friend's reservations about the project were evident when she asked, "But are the kids learning?" During a similar discussion, another friend asked impatiently, "But can they do math?" (Sonia Nieto, The Light in Their Eyes, page xvi).

"Are the children learning?" needs to be the question that we continually keep in the forefront as we work with all parents. Activities such as celebrating holidays from various cultures and decorating a bulletin board to reflect diverse cultures are worthwhile. But we need to ask whether such efforts, by themselves, help children learn math, reading, science, cooperation, responsibility, empathy-all the things they're supposed to learn in school.

In addition to keeping the classroom focus on learning, we can have practices that enable the children's parents to help them learn. That means making the small but critical everyday efforts to reach out in ways that help parents understand and be part of their child's classroom. For example, we could look for people at school or in the community to translate letters and other school-to-home communications. Whenever possible, we could invite interpreters to join meetings with families. These efforts can help parents feel heard, welcomed, and comfortable asking questions and voicing opinions about their children's education.

A fundamental belief: differences, not deficits

How we view families from cultures different from our own deeply affects how we work with them. All families have had different sets of experiences. We can best help students learn if we believe their family experiences are neither better nor worse than our own, but simply different.

Literacy professor Victoria Purcell-Gates writes about this "difference" versus "deficit" view of family backgrounds. As teachers know, children come to school with widely varying experiences in reading, writing, and other literacy activities at home. Even English speakers come speaking different dialects. But, Purcell-Gates point out, if the family is poor, undereducated, or speaks a "nonstandard" dialect, we're more likely to interpret a child's uniqueness as an inherent deficit or flaw rather than a mere difference in experience.

When we do this, Purcell-Gates says, we risk lowering our expectations for the child and writing the child off as less teachable or even unteachable. By contrast, when we truly believe that all children can learn and that they vary only in their experiences, we're more likely to maintain high expectations of all children and nonjudgmentally build on the experiences they have had to help them learn at their best. (Lisa Delpit and Joanne Kilgour Dowdy, eds., 2002, The Skin That We Speak, New York: The New Press, pp. 121-139).

The "difference" versus "deficit" view also comes into play in areas beyond language and literacy. Early in her career, Bonnie Baer-Simahk, a teacher of K-6 English language learners in Massachusetts, was surprised to learn that many Southeast Asian students didn't like to take their completed schoolwork home because their parents would throw it away. "I was so upset, thinking that the message the parents gave their children was that their schoolwork was not valued," she recalls. "Later I saw that I was quite wrong." The same parents who never displayed schoolwork welcomed Bonnie into their home to talk about their children's progress in school, came in to help out whenever invited, and urged Bonnie to tell them if their children weren't doing good work in school. Clearly, these parents valued their children's school efforts. Why, then, didn't they display their children's schoolwork?

"I suspect it was a combination of things," says Bonnie. Maybe the parents didn't understand the significance of the papers or the teacher's comments on them. Maybe they expected their children to work hard and thought that positive efforts didn't require any special acknowledgment. Whatever the reason, the point is that the parents' behavior reflects a difference in experience and norms, not a lack of concern for their children.

A further point is that once we recognize differences, we need to respect them. Children from diverse cultures and their families can succeed in American schools without surrendering the customs of their home cultures. For example, Bonnie didn't try to change the Southeast Asian families' customs around taking home and displaying school- work. She simply accepted that these families had other ways of showing pride in educational effort.

Whatever we're trying to understand about students from other cultures, we can teach best when we hold fast to the "difference, not deficit" mentality. In doing so, we're more likely to see intelligence, talent, and caring, even if these are expressed in ways that we're not used to. We can then build on these assets to teach the children what they need to learn in school.

For more about working with families, see our book, Parents & Teachers Working Together.

Resources for Learning about Different Cultures

The children and their parents: Ask parents for help in learning about their culture. Most parents are happy to help if they feel respected.

Colleagues: Teachers of English language learners, other teachers, home liaisons, instructional assistants, and office or other staff may have ideas or skills to offer.

Your school: If possible, talk as a whole staff about cultural and language issues in working with families. Staff teams could learn about a particular issue and share the information with the rest of the school community.

Other schools: See what's worked for other schools serving the same family populations as you do.

Community organizations: Libraries, cultural and social service organizations, churches, other religious organizations, civic groups, and local universities may offer books, pamphlets, and other kinds of help.

The Internet: Here you'll find a wealth of information and practical strategies for working with families from diverse cultures. You'll also find misinformation, so rely on credible sources. A few sites to check out:

Educator's Reference Desk

National Clearinghouse for English Language Acquisition & Language Instruction Educational Programs

Teaching Tolerance

Tags: Family Connections, Working with Families

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Welcoming Families of Different Cultures | Responsive Classroom

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An adapted excerpt from Parents & Teachers Working Together One of the enduring truths about teaching is that to teach children well, we have to know them: what they're passionate about, what worries them, where they are in their development.

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By creating ways for families to feel welcome and included, educators can strengthen the relationship between home and school.

Jing Jing Tsong / The iSpot

1. Make Communication Accessible for all Families

Carve out time for face-to-face connection, and use two-way communication tools that provide seamless translation (e.g., the app Talking Points) to ensure that all families have equitable access to communicating with the school.

Remind families that they have a right to interpretation support.

Share timely information through multiple communication mediums, and make it easier for families to respond with their inquiries. Instead of relying primarily on email, also draw upon video messages, texting, and prerecorded audio messages, and highlight important information at in-person events.

For families that may not reference the school's website, use QR codes with vital information that families can easily access on their phone, and post them on the school newsletter or magnets that they can place on their refrigerator. Consider having a directory that makes it easy for families to know how to contact you and other school staff.

Schedule school events and activities at times that make it easy for families to attend, and offer virtual access when possible to create greater flexibility.

We educators often say we "communicate regularly" with families. But are we communicating on their terms or ours? In our language or theirs? Is communication a one-way street, or are we fostering ongoing two-way communication? To be culturally responsive in building bridges to families, we have learned that some ways of communicating are better than others.

2. Make Consistent Efforts to Learn About Families' Cultures, Identities, Beliefs, and Rich Histories

Avoid scheduling special events such as field trips or tests on important cultural or religious holidays. For instance, students and families should not feel torn to decide between a cherished event with families such as Yom Kippur or Ramadan and performing in their school play, concert, or athletic event.

Engage in professional learning around family partnership best practices and cultural responsiveness, including questioning your own assumptions when it comes to families' identities and practices. This could be a training in how to conduct relationship-centered home visits, two-way communication apps, or an exploration of implicit bias and how it impacts our work with students and families.

Spend time in students' communities to meet families where they are and learn about their lives (i.e., home visits, neighborhood walks, attending students' extracurricular activities).

Learn basic greetings in a variety of languages.

Forge connections and draw upon local cultural organizations that are relevant to families, and collaborate with other school personnel and community partners to support families around key needs.

We educators are often eager for families to learn about the education system. We offer them "orientations," "handbooks," and "newsletters." But do we work equally hard to learn about them? Here are a few key ways that we can show through both our words and actions that we truly value diversity and respect our students' lives beyond the walls of the classroom.

Invite families into the classroom more often to celebrate students' learning, whether that is reading aloud poetry, presenting projects, or incorporating families as guest experts.

Establish ongoing, team-based structures, such as the Families and Educators Together model, so that underrepresented families in particular build stronger relationships with school staff, regularly have seats at the decision-making table, and consistently feel seen and heard.

Solicit meaningful input and feedback from families several times each school year. After asking for families' feedback, educators demonstrate prompt and meaningful follow-through, which includes updating them on the impact of their input.

We like to imagine our schools as open and welcoming to the community, particularly to the families of our students. But after decades of doing this bridge-building work to connect educators with families, it is still too commonplace that school events for families are scheduled around what is most convenient for educators and often designed without family members at the table.

4. Help All Students and Families see Themselves Reflected in the School Community

Ensure that students and families' cultures, identities, experiences, and languages are represented in the school. This can look like greetings in a variety of languages being featured at the front of the school building, posters in the school library that reflect a diverse array of cultural heroes, and ensuring that the curriculum incorporates the cultures of all students that you serve. As Albert Marshall, an Indigenous elder in Canada, puts it, "We need teachers who can weave back and forth between the knowledges" of various cultures so that students have mirrors that reflect their cultural backgrounds and windows into other cultural experiences.

Schools can also host culturally relevant events and activities (i.e., cultural fairs, heritage days, and international nights) and design these events in ways that strengthen relationships with families as well as between them to foster higher levels of collective agency.

5. Help Families Support Their Children's Learning at Home

Explicitly convey that you value families for all that they do at home to support their children's learning rather than evaluating their engagement by how visible they are at school. Bryan Goodwin writes, "The extent to which parents regularly communicate high academic aspirations for their children had a greater effect size than any other parental behavior." Make a concerted and ongoing effort to help families, particularly immigrant families, develop an understanding of how the school operates.

When there is trust and collaboration between educators and all families, children feel it. They feel accepted and valued. They feel known. Then, school and home are like parentheses, with children nested inside a community that feels connected rather than fragmented. In that kind of quality learning environment, it is safer and more enjoyable to learn.

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5 Culturally Responsive Family Engagement Strategies

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By creating ways for families to feel welcome and included, educators can strengthen the relationship between home and school.

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ParentPowered - Evidence-Based Family Engagement

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Culturally Responsive Family Engagement - ParentPowered®

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Culturally responsive family engagement can greatly boost student learning outcomes. Discover ParentPowered’ pathway to family partnership.

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Challenges and Rewards of a Culturally Informed Approach to Mental Health 

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Challenges and Rewards of a Culturally Informed Approach to Mental Health 

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Challenges and Rewards of a culturally-informed approach to mental health | Jessica Dere | TEDxUTSC

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Multicultural Counseling - Center for Mindful Therapy

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Multicultural counseling aims to create a therapeutic environment inclusive, respectful, and supportive of diverse cultural backgrounds.

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Sula Hood, Brittany Campbell, Katie Baker

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Culturally Informed Community Engagement: Implications for Inclusive Science and Health Equity - NCBI Bookshelf

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Public health efforts seeking to reduce disparities and promote equity must be inclusive to reach their full potential. Interventions, programs, and initiatives designed to promote health equity among Communities of Color must be culturally informed. Communities and the cultural values and practices…

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Integrating Culturally Responsive Teaching and Trauma-Informed Practices

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Integrating Culturally Responsive Teaching and Trauma-Informed Practices

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Integrating Culturally Responsive Teaching and Trauma-Informed Practices

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Using these techniques together helps teachers support all students and foster a sense of belonging.

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Learn How to Navigate Mental Health Conversations with Cultural Sensitivity for Inclusive Support

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Learn How to Navigate Mental Health Conversations with Cultural Sensitivity for Inclusive Support

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How to Approach Mental Health Conversations with Cultural Sensitivity - Decolonize Minds

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Learn how to navigate mental health conversations with cultural sensitivity for inclusive support.

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Mindfulness-Based Interventions for Mental Health in Children and Adolescents (A Systematic Review) | PCORI

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Mindfulness-Based Interventions for Mental Health in Children and Adolescents (A Systematic Review)

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Draft Report for Public Comment Now Open Through May 30

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Mental Health Exercises & Interventions 

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Mental Health Exercises & Interventions 

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Mental health is undoubtedly an important topic; however, many people find it uncomfortable to talk about it.

Mental health includes your emotional health, your psychological health, and your social well-being.

The state of your mental health determines how you handle stress, how you relate to others, and how you make choices in life.

Mental health is critically important at every stage of life from childhood to adolescence to adulthood. Mental health problems can affect one's thinking, moods, and behaviors.

There is a myriad of factors that can contribute to mental health issues such as:

Biological factors like brain chemistry or genes.

Experiences in life, such as abuse or trauma.

Family history of mental health issues or problems.

Mental health activities and interventions are designed to help someone cope.

There are many interventions and activities that can make this process a little more approachable from Cognitive Behavioral Therapy (CBT) to Mindfulness.

What is Mental Health Activities?

Mental health activities are things you can do to improve your mental health. Engaging in wellness activities can have a positive effect on your health and wellness, as well as your sense of inner peace.

Mental health activities might include mindfulness or meditation, Cognitive Behavioral Therapy worksheets, Psychotherapy worksheets, and even mood trackers.

5 Examples of Mental Health Techniques and Skills

Cognitive Therapy or Cognitive Behavioral Therapy (CBT) works by helping you identify and change the elements of your belief system and the cognitive distortions that can lead to those automatic negative thoughts or ANTS.

ANTS are those automatic negative thoughts or subconscious thoughts that occur in response to stimuli. These thoughts are often irrational and self-defeating.

A few CBT techniques include:

1. Identifying Cognitive Distortions

2. Cognitive Restructuring and Reframing

3. Keeping a Thought Record

4. The Worry Tree

5. Chunking and Problem-Solving

1. Identifying Cognitive Distortions

Cognitive distortions are irrational thoughts that can influence your emotions.

They are biased ways of thinking about yourself and the world around you. While everyone experiences cognitive distortions to a small degree, some people take it to the extreme.

These irrational thoughts and beliefs (basically distortions) can lead to problematic emotional states and behavior. This might include anxiety, low self-esteem, depression, and even conflicts in relationships.

Taking steps to become more aware of cognitive distortions can help you shift your thinking to more rational and objective thoughts whenever possible. Thinking more rationally tends to lead to more positive emotional and behavioral experiences.

According to Dr. David Burns, MD (Burns, 1989) in the book " The Feeling Good Handbook," there are at least ten different cognitive distortions that one should be aware of.

All or Nothing Thinking: This occurs when someone sees things in terms of black-and-white categories. For this type of thinker, anything short of perfection is a failure.

Overgeneralization: This occurs when you view a single event as a never-ending pattern of defeat. Those who overgeneralize might also make broad interpretations from a single event like feeling awkward in a job interview leading you to falsely believe that you are always awkward.

Mental Filter: A mental filter is when you pick out a single negative detail and dwell on it to the point of exclusivity. As a result, your vision of reality becomes darkened, like a drop of ink discoloring an entire beaker of water.

Disqualifying the Positive: This occurs when you reject positive experiences and insist they "don't count" for some reason or other. Thinking this way helps you maintain a negative belief that is contradicted by your everyday experiences.

Jumping to Conclusions: When you jump to conclusions, you don't think things through, and you react impulsively. This might manifest as mind-reading, or concluding someone is reacting negatively toward you without checking it out or fortune-telling or predicting something will turn out bad.

Magnification: This is also known as catastrophizing or minimization. This occurs when you exaggerate or minimize the importance of events. For example, someone might mistakenly believe that their achievements are not important, or their mistakes are incredibly damaging.

Emotional Reasoning: This occurs when you assume that your negative emotions reflect the way things are. For example, you might say to yourself that you feel like a lousy friend; therefore, you must be a bad friend.

Should Statements: These occur when you believe that things should be a certain way like you should always be friendly.

Labeling and Mislabeling: This is an extreme form of an overgeneralization, and it happens when you attach a negative label to yourself, such as thinking you are a loser.

Personalization: This occurs when you believe you are responsible for events outside of your control. You might also see yourself as the cause of some adverse external event, which you were not primarily responsible for.

The Putting Thoughts on Trial Worksheet is a Cognitive Behavioral Therapy activity focused on the logical examination of irrational thoughts. In this exercise, the client acts as his own advocate as he puts himself in different positions.

Just like in a real courtroom, the client is forced to recognize that he or she can only work with hard cold facts.

This exercise is extremely valuable because it helps someone see things from many different perspectives.

As a therapist, you can help by challenging evidence that you believe breaks the rules. You can also offer up evidence that your client may have missed.

2. Cognitive Restructuring and Reframing

Cognitive restructuring and reframing is a psychological technique that allows you to actively reprogram your brain. In short, if you change your beliefs, you create real, physical changes in your brain.

According to a study done with those who drive cabs in London, (Maguire, Woollett & Spiers, 2006) humans have a remarkable capacity to acquire and use knowledge of a large complex city to navigate within it.

The cab drivers brain scans were compared with the scans of normal brains with average people. The study found the section of the brain used for mapping and memorizing routes was more developed in those who drive cabs, and also physically bigger.

The Socratic Question worksheet is a great tool to help you reframe your thoughts, which are often a running dialogue. Our thoughts determine how we feel and how we act, so taking the time to challenge them can be very helpful.

Negative thinking strengthens the negative part of our mind, whereas positive thinking strengthens the positive.

The brain is basically like a muscle with many different parts. The parts you use more often grow bigger and stronger.

3. Thought Record

Keeping a Thought Record is another excellent tool to help change thoughts. Thought records are used to teach clients about the interactions between thoughts, feelings, and behaviors, and is used for clients to record their own experiences. In terms of cognitive restructuring, keeping a thought record is a great place to begin challenging irrational thoughts.

The Thought Record worksheet offers plenty of space for your clients to record their thoughts, feelings, and behaviors.

4. The Worry Tree

The Worry Tree is designed to help you think differently when it comes to things that worry you. As you dive deeper and deeper into what is going on, as it pertains to your worry, you start to get a new perspective.

The Worry Tree is a simple tool developed by Butler & Hope (1995) to help focus the attention and help people make better decisions. It can also stop someone from turning a worry into a catastrophe.

The further you break the worry down, the more clearly you can see other outcomes and change your focus of attention.

This Worry Tree was accessed via getselfhelo.co.uk/worrytree.htm

5. Chunking and Problem-Solving

Chunking is breaking large amounts of information down into smaller pieces, and it is a great problem-solving technique. It refers to the process of grouping separate pieces of information together, but it can also be used to solve problems. It is also a great way to stand back and look at the bigger picture.

By chunking down, you can ask yourself how you did something or why you think something happened.

Chunking also allows you to analyze what happened when and if it will happen again so that you can then begin to see the underlying cause.

You can also chunk up and ask yourself what something means or what you were trying to achieve.

Chunking up refers to moving to a more general or abstract piece of information.

Chunking down means moving to more specific or detailed information.

Taking the time to work through a Problem Solving worksheet can be very helpful when it comes to breaking problems down.

What are Mental Health Interventions?

Sometimes a mental health issue will escalate and require an intervention. A mental health intervention can help someone through tragedy, trauma, or through any underlying untreated psychiatric disorder.

Ideally, a therapist or intervention specialist of some kind is involved in helping convince someone to get mental health or medical treatment.

A mental health intervention team may consist of many different experts, including a therapist, social worker, psychiatrist, or psychologist.

The overall goal is to help intervene before a situation gets into a crisis mode.

The Types of Mental Health Interventions (Incl. List)

According to the Foundations Recovery Network, a foundation that specializes in the dual diagnosis of substance addiction and mental health disorders, the top four types of interventions include:

1. Simple intervention

2. Classical intervention

3. Family system intervention

4. Crisis intervention

A simple intervention involves a single family member, but it can also include a professional of some sort.

This occurs without the staging of a massive gathering of people, which can be a lot less intimidating. The person doing the intervention would confront the patient and ask them to stop using drugs or ask them to get into some type of treatment program or mental health counseling. This type of one-on-one intervention can be very effective when done thoughtfully and correctly.

The classical intervention typically begins with some kind of planning session without the patient. This type of intervention may also include counseling and education for family member and participants.

Often deemed the Johnson Model intervention, in this type of intervention, family members can discuss their part before the official intervention begins.

A counselor or interventionist is present to help prepare and set the stage as to what is to come.

The family system intervention is based upon the family system theory and treatment, where multiple people in a family might struggle with an issue such as addiction or co-dependence.

In this type of intervention, all family members are encouraged to participate and continue beyond the initial intervention.

A crisis intervention might be necessary if the patient is becoming a danger to himself or others.

The immediate objective of this type of impromptu intervention is to stabilize the situation and ensure everyone is safe.

4 Examples of Evidence-Based Mental Health Interventions

Evidence-Based interventions are programs and practices that have peer-reviewed, documented, empirical evidence of effectiveness.

1. Mindfulness-based cognitive therapy

Mindfulness-based cognitive therapy is a treatment designed to help those who suffer from ongoing episodes of depression or for those who suffer from chronic unhappiness.

A study was done by Kuyken, Warren, Taylor, et al. looked at the efficacy of mindfulness-based cognitive therapy in the prevention of depressive relapse.

The relapse of depression is a significant public health problem, according to the study. Mindfulness-based cognitive therapy was used in randomized trials with 1,258 patients.

Mindfulness-based cognitive therapy appeared to be efficacious in terms of treatment for relapse prevention for depression, especially for those with more pronounced symptoms.

MBCT was developed by John Teasdale, Mark Williams, and Zindel Segal and is based upon the same premise as Mindfulness-Based Stress Reduction.

Though this form of treatment was initially developed to address recurrent depression, it may also be beneficial for those seeking treatment for a wide range of mental health concerns.

2. Solution-focused brief therapy

Solution-focused brief therapy (SFBT) is another good evidence-based therapy. It is a short resource-oriented and goal-focused approach to therapy that helps individuals change by constructing solutions.

It aims to enhance optimism and positive expectancy along with the experience of positive emotions to improve outcomes.

A study done by Franklin, Zhang, Froerer & Johnson (2016) showed that SFBT techniques have a great deal of support when it comes to demonstrating positive results.

3. Schema-focused therapy

Schema-focused therapy is designed to help people identify the thought and behavioral patterns underlying and perpetuating mental health conditions.

Schemas are like a framework of thoughts, per se. Schemas help us organize and interpret complex information.

These constructs are often the product of how our basic childhood needs were dealt with.

Schema-focused therapy has also been useful in treating borderline personality disorder, which involves feelings of instability, extreme emotional reactions, and chronic fear of abandonment.

This type of therapy might include cognitive-behavioral techniques, Gestalt work, or even visual imagery. (Kahl, Winter, & Schweiger, 2012).

4. Interpersonal psychotherapy

Interpersonal psychotherapy (IPT) is a brief and very structured type of approach. It helps one deal with interpersonal issues that could cause them problems in terms of their mental health.

IPT is based on the idea that interpersonal problems are often interconnected with mental health issues. The goal of this therapy is to help someone better understand how these problems, operating in their current life situation, lead him or her to become distressed.

Interpersonal problems may include interpersonal disputes, role transitions, grief, and interpersonal deficits. IPT helps to explore one's perceptions and expectations of relationships, aiming to improve communication and interpersonal skills. (Jakobsen, Hansen, Simonsen, Simonsen & Gluud, 2012).

A Look at Using Interventions with Depression

Evidence-based interventions can also be helpful for depressed patients with cancer. Depression is significantly higher in patients with cancer when compared to the general population. (Holland, 2002)

At least 25% of oncology patients experience some form of depression.

The most evidence has been seen in the use of cognitive-behavioral therapy. This type of brief, goal-oriented therapy helps people learn the principles of behavior change, which they can direct toward a specific clinical outcome. (Osborn, Democada, & Feuerstein, 2006).

This type of therapy is designed to help teach people strength-based skills to solve problems. As they learn to solve problems, they begin reframing their thoughts and thinking differently.

3 Mental Health Group Activities and Exercises

There are many wonderful group activities and exercises that can help boost mental health. A few of these are:

1. Group Beginnings

2. Cracking the Nuts and Eliminating the ANTS

3. Teaching Acceptance Strategies through Visualization

The Group Beginnings worksheet is a valuable tool for organizing a group session. According to Judith Belmont, a psychotherapist, and an author, effective beginnings and endings are one of the major determinants of the effectiveness of a group.

The Group Beginnings worksheet has a checklist of items to review at the start and end of each group session.

Some of these items include:

1. Sharing successes and challenges.

2. Providing feedback from prior sessions.

3. Informal mood check.

4. Homework review.

5. Setting agendas.

6. Establishing goals.

7. Taking a mindful minute.

Cracking the Nuts and Eliminating the ANTS worksheet is a tool developed by psychologists Elisha Goldstein, Aaron Beck, and David Burns. It uses acronyms to help people uncover and eliminate unhealthy patterns of thought.

The activity involves clients listing and discussing ANTS and NUTS as part of the therapy. ANTS refer to automatic negative thoughts that result in anxiety or depression, and NUTS refers to negative unconscious thoughts.

Teaching Acceptance Strategies through Visualization worksheet offers tips and activities for visualization.

These include:

1. Quicksand visualization.

2. Beach ball visualization.

3. Mountain visualization.

4. Train visualization.

5. Helicopter and Airplane visualization.

6. Balloon visualization.

7. Computer visualization.

8. Teflon mind visualization.

These exercises serve as metaphors helping the client visualize different motivating strategies for change.

2 Therapeutic Mental Health Activities and Interventions for Adults

The Identify Your Internal Core Beliefs worksheet helps someone identify how they see the world by focusing on their core beliefs.

This also helps someone see the internal filters they have in place that may be distorting their viewpoint. The worksheet has a list of negative core beliefs like ' I am unlikeable' or ' I am a bad person' and a list of positive core beliefs such as ' I am loveable' or ' I am a good person.' These beliefs are checked off and scored to help someone better understand how they see the world.

The Problematic Thinking Habit worksheet is another excellent way to identify problematic thinking and means to create healthy thinking. Clients can choose from a list of problematic thinking habits and then focus on ways to think more positively.

6 Mental Health Promotion Activities for the Workplace

Many helpful activities can be done in the workplace. Some of these include:

1. 8 Hours of Sleep Challenge where employees wear a sleep tracker and compete for prizes or incentives.

2. 30 days of Gratitude Jar where employees write down one thing they feel grateful for every day for 30 days.

3. Peaceful Planting Project where employees bring a plant into the office.

4. Bring Your Pet to Work Day to create a family-friendly atmosphere.

5. Chair Massages given throughout the day.

6. Meditation Month for stress relief and dedicating a few minutes a day toward the practice.

These activities and more can be found at the Austin Benefits Group website.

3 Activities for Teens and Students (Incl. Mental Health Awareness Exercises)

Checklist for Assertive Behavior worksheet is a tool for teens to identify assertive behavior. The worksheet can help someone clarify a goal, decide on significant points they want to say, and help them anticipate positive and negative responses.

Learning About Communication worksheet is a useful resource for helping teens and students identify whether their behavior is non-assertive, aggressive, or assertive.

Tips for Emotional Resilience worksheet is a great resource to help teens and students develop a sense of resilience. The worksheet offers tips for using events as learning experiences, helping one focus on what they can control, how to develop compassion, and how to develop good self-care habits.

3 Mental Health Activities and Ideas for kids

The Helping Children Identify Feelings worksheet helps children be more self-aware of their emotions instead of acting them out. Children are asked to identify a feeling or feelings by thinking of a situation that upsets them.

They are then asked to circle their feelings and write what they are upset about and how they can ask for change. Through this activity, children can select certain emotions like anger, sadness, or confusion and identify strategies for coping.

Making a Calming Box worksheet is another metaphorical tool that can help a child cope. Children can bring in their own box and use actual objects such as a stress ball or a glitter-calming jar to self-soothe.

I-Messages for Kids worksheet is a useful tool for naming an emotion, describing a behavior, and requesting a change. An I-message is a respectful and truthful way to ask for change tactfully.

Mental Health Worksheets (incl. PDF)

The teenmentalhealth.org website offers an evidence-based guide for students. The Mental Health and High School Curriculum Guide offered as a pdf provides a wide variety of tools to help teens and students, including modules on:

1. The stigma of mental illness.

2. Understanding mental health and mental illness.

3. Information on specific mental illnesses.

4. The importance of family communication.

5. Seeking help and finding support.

6. The importance of positive mental health.

The guide also includes several quizzes and activities.

A Take-Home Message

The stigma that used to be associated with mental health has dramatically diminished over the years.

Mental health is critically important to living a good life. From cognitive-behavioral therapy to interpersonal psychotherapy to evidence-based interventions, there is an endless supply of resources that can help someone.

While these exercises and interventions are fantastic, you might want to take some time to read more on the subject. Peruse our selection of mental health books to pick reading material that will suit you.

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26 Mental Health Exercises & Interventions Based on Science

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Mental health is undoubtedly an important topic; however, many people find it uncomfortable to talk about it. Mental health includes your emotional health, your psychological health, and your social well-being. The state of your mental health determines how you handle stress, how you relate to others, and how you make choices in life.

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Resilience and mental health in children and adolescents: an update of the recent literature and future directions

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In order to promote optimal development of children and adolescents at risk for psychiatric disorders, a better understanding of the concept resilience is crucial. Here, we provide an overview of recent work on clinical and epidemiological…

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Treating Children's Mental Health with Therapy 

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Treating Children's Mental Health with Therapy 

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Treating Children’s Mental Health with Therapy

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Treating children’s mental health problems can help reduce problems at home and in school.

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A trauma-informed approach benefits both counselors and clients, yet more work needs to be done to ensure these principles are adopted across health care systems.

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The Effectiveness of Psychoeducational Interventions in Adolescents’ Anxiety

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The Effectiveness of Psychoeducational Interventions in Adolescents’ Anxiety

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The Effectiveness of Psychoeducational Interventions in Adolescents’ Anxiety: A Systematic Review Protocol

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The COVID-19 pandemic had a strong impact on increasing anxiety in adolescents. This systematic review aims to identify the most effective psychoeducational interventions for reducing anxiety in adolescents following the guidelines of the Joanna…

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Sexuality Education for Children and Adolescents 

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Sexuality Education for Children and Adolescents 

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The purpose of this clinical report is to provide pediatricians updated research on evidence-based sexual and reproductive health education.

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Sexuality Education for Children and Adolescents

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This Clinical Report was reaffirmed January 2022.. The purpose of this clinical report is to provide pediatricians updated research on evidence-based sexual and reproductive health education conducted since the original clinical report on the subject was published by the American Academy of Pediatrics in 2001. Sexuality education is defined as teaching about human sexuality, including intimate relationships, human sexual anatomy, sexual reproduction, sexually transmitted infections, sexual activity, sexual orientation, gender identity, abstinence, contraception, and reproductive rights and responsibilities. Developmentally appropriate and evidence-based education about human sexuality and sexual reproduction over time provided by pediatricians, schools, other professionals, and parents is important to help children and adolescents make informed, positive, and safe choices about healthy relationships, responsible sexual activity, and their reproductive health. Sexuality education has been shown to help to prevent and reduce the risks of adolescent pregnancy, HIV, and sexually transmitted infections for children and adolescents with and without chronic health conditions and disabilities in the United States.

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Child Welfare Information

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Implementing School Mental Health Support

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Implementing School Mental Health Support

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Everyone experiences occasional stress; it is a normal part of life.

Long-term stress can lead to worsening health problems.

Managing stress daily can prevent you from developing long-term stress.

Find resources if you are struggling to cope with stress for extra support.

How it impacts everyday life

Everyone experiences stress, which is your body's physical and emotional response to new or challenging situations. This can occur when you face problems such as those related to work, school, health, and relationships. Feeling stress can be a normal coping response and can forge a healthy sense of our ability to solve problems. However, when the stress is long term, known as chronic stress, it can lead to worsening health problems.

Stress can cause the following:

Feelings of fear, anger, sadness, worry, numbness, or frustration

Changes in appetite, energy, desires, and interests

Trouble concentrating and making decisions

Nightmares or problems sleeping

Physical reactions, such as headaches, body pains, stomach problems, or skin rashes

Worsening of chronic health problems and mental health conditions

Increased use of alcohol, drugs, and other substances

Healthy ways to cope with stress

Learning to cope in a healthy way can help reduce your stress. Taking small steps in your daily life to manage stress can have a big impact. Everyone manages stress differently. You can find and manage what triggers your stress and the right combination of healthy techniques that work for you.
Take care of your mind.

Take breaks from news and social media. It's good to be informed, but constant information about negative events can be upsetting.

Make time to unwind.

Take deep breaths, stretch, or meditate.

Keep a journal.

Spend time outdoors either being active or relaxing.

Try to do some other relaxing activities you enjoy.

Practice gratitude daily. Remind yourself of specific things you are grateful for and write them down.

Connect with others.

Talk with people you trust about your concerns and how you are feeling.

Connect with your community-based or faith-based organizations.

Take care of your body.

Get enough sleep. Go to bed and wake up at the same time each day to help you sleep better. Adults need 7 or more hours per night.

Move more. Staying physically healthy can improve your emotional well-being. Every little bit of physical activity helps.

Start small and build up to 2 ½ hours a week.

Break it into smaller amounts such as 20 to 30 minutes a day.

Eat healthy. Have fruits and vegetables, lean protein, whole grains, and low-fat or no-fat dairy. Limit foods with unhealthy fats, salt, and added sugars. See Healthy Eating Tips.

Limit alcohol intake. Choose not to drink, or drink in moderation on days you drink alcohol. Moderation means:

Avoid smoking, vaping, and the use of other tobacco products. People can and do quit smoking for good.

Continue with regular health appointments, tests, screenings, and vaccinations.

Resources and support

Resources

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Chronic stress can impact everyday life and lead to worsening health problems.

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SCHOOL MENTAL HEALTH TOOLKIT

School mental health interventions

This toolkit is a resource for occupational therapy practitioners working with children and youth in school and community settings to obtain specific knowledge about mental health (MH) promotion, prevention, and intervention and to guide service provision. Each topic in the toolkit provides an overview of the topic, implications for occupational therapy, and strategies for MH promotion, prevention, and intervention in a variety of settings.

Anxiety disorders

Symptoms of anxiety can interfere with a child’s ability to engage in school activities, chosen occupations, and social opportunities.

Childhood trauma

Children may experience trauma from abuse (physical, sexual, emotional), neglect (physical, medical, emotional, educational), natural disasters, illness, and violence (school, community, domestic). Children who have experienced complex trauma need environments and opportunities to regain a sense of personal safety, competence, and pleasurable connection to others.

Foster care

Early adversity, trauma, and disruption to living situations experienced by children and youth negatively impact their overall health and well-being.

School OT crisis response & prevention

Crisis response and prevention is an important component of the scope of practice of school occupational therapy practitioners.

Discover more school mental health topics

Bullying Prevention

Bullying is considered one of the most common forms of violence in schools and as such, most schools have adopted programs to reduce bullying and create emotionally and physically safe places contexts for learning.

Cafeteria: Creating a positive mealtime experience

Occupational therapy practitioners and cafeteria staff can work together to create a positive cafeteria environment.

Childhood Obesity

Childhood obesity is defined as is a condition in which excessive body fat negatively affects a child’s overall health or well-being across all environments, including home, school, and the community

Explore more school mental health topics

Grief & loss

With knowledge and skills in the therapeutic use of self and facilitating therapeutic groups, occupational therapy practitioners can help support children in their grieving process through the use of meaningful occupations

Inclusion of children with disabilities

Occupational therapy practitioners promote integrated services in all contexts and environments where children are learning, playing, and growing.

Read more school mental health topics

Promoting strengths

In strength-based approaches, the practitioner focuses on identifying and building upon the student’s abilities versus focusing on their limitations or disabilities.

Recess promotion

Recess is an important part of each school day and an opportune time for OTs to implement innovative programs to address a variety of issues related to school performance.

Social & emotional learning (SEL)

Occupational therapy practitioners serve an important role in promoting SEL at the universal, targeted, or intensive levels of intervention. Occupational therapy practitioners have specialized knowledge of the interaction of student contextual, psychosocial, and performance factors.

Intervention

Children & Youth

Mental, Behavioral and Neurodevelopmental Topics

Mental & Behavioral Health Settings

Schools, Early Intervention, and Community Education Settings

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Resource for OT practitioners working with children and youth in school and community settings promoting mental health prevention and intervention.

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Guidelines on Mental Health Promotive and Preventive interventions

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Guidelines on Mental Health Promotive and Preventive interventions

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Guidelines on mental health promotive and preventive interventions for adolescents: helping adolescents thrive

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The Guidelines on promotive and preventive mental health interventions for adolescents - Helping Adolescents thrive (HAT), provide evidence-informed recommendations on psychosocial interventions to promote mental health, prevent mental disorders, and reduce self-harm and other risk behaviours among adolescents.

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Community Interventions to Promote Mental Health and Social Equity

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We review recent community interventions to promote mental health and social equity. We define community interventions as those that involve multi-sector partnerships, emphasize community members as integral to the intervention, and/or deliver…

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What Mental Health Is and Why It's Important.

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What Mental Health Is and Why It's Important.

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What Mental Health Is and Why It’s Important to Take Care of It? - Kids Academy

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Mental Health and Mental Disorders — Evidence-Based Resources - Healthy People 2030 | odphp.health.gov

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Healthy People 2030 includes objectives focused on the prevention, screening, assessment, and treatment of mental disorders and behavioral conditions. Learn more about mental health and mental disorders.

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Adolescence is the transitional bridge between childhood and adulthood; it encompasses developmental milestones that are unique to this age group. Healthy cognitive, physical, sexual, and psychosocial development is both a right and a responsibility that must be guaranteed for all adolescents to successfully enter adulthood. There is consensus among national and international organizations that the unique needs of adolescents must be addressed and promoted to ensure the health of all adolescents. This policy statement outlines the special health challenges that adolescents face on their journey and transition to adulthood and provides recommendations for those who care for adolescents, their families, and the communities in which they live.

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Handbook of Mental Health Interventions 

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Handbook of Mental Health Interventions 

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Promoting Healthy Behavioral and Emotional Development 

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Promoting Healthy Behavioral and Emotional Development 

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Lauren Geary, MPH, American Academy of Pediatrics
Kathy Janies, American Academy of Pediatrics
Jane Bassewitz, MA, American Academy of Pediatrics

The American Academy of Pediatrics (AAP) and Bright Futures are committed to advocating for optimal health and well-being of all infants, children, adolescents, and families. Bright Futures operationalizes this vision by supporting pediatric and other health care professionals in providing care to children and adolescents according to the Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition. ¹ The AAP and Bright Futures understand that emotional well-being and mental health are as important as physical health throughout childhood and adolescence. To that end, content specific to emotional well-being and healthy behavioral development is woven throughout the Bright Futures Guidelines, 4th Edition, and can be found in the Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), within each health supervision visit, as well as in health promotion themes focused on mental health and the social determinants of health. ¹

A 2019 report from the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates around 26 percent of young adults ages 18-25 had a mental illness within the past year. ² In 2018, an estimated 3.5 million adolescents had a major depressive episode within the past year. ² As reported by Kessler et al., almost half of all adults with behavioral health problems indicate their disorders first appeared in early adolescence. ³ Given these statistics, states, communities, and health care professionals need to be equipped to promote emotional well-being, as well as screen for potential concerns, on a regular basis. Bright Futures, and other AAP resources, support the implementation of annual psychosocial/behavioral assessment and adolescent depression screening in the context of healthy behavioral and emotional development of adolescents in states, communities, and clinical settings.

Mental Health Within Bright Futures

An emphasis on emotional well-being is woven throughout the Bright Futures Guidelines, 4th Edition. This information can be found within each of the health supervision visits and health promotion themes (e.g., Promoting Mental Health). Pediatric health care professionals, states, and communities can use this content to ensure that programs and recommendations align with current evidence-informed guidance.

Bright Futures Health Supervision Visits

Annual Bright Futures health supervision visits provide ongoing opportunities for health care professionals to address specific concerns identified by adolescents and families. The visits are also an opportunity to identify strengths and protective factors while minimizing the negative impact of potential environmental and structural risk factors affecting adolescents and their families. Bright Futures identifies five priority topics for each visit; emotional well-being is a priority topic for each annual adolescent visit. Health care professionals are encouraged to talk with adolescents and their families about mood regulation, mental health, healthy sexuality, and other related topics that may arise during a visit.

Screening for Behavioral Health Issues

Connecting with adolescents at their annual health supervision visit is a significant opportunity to promote social, emotional, and behavioral health as well as identify and address any emotional and behavioral health concerns. According to the Periodicity Schedule, psychosocial/behavioral assessment should be conducted annually, beginning at the newborn visit through age 21.4 Per the Periodicity Schedule, this assessment should be family centered and may include an assessment of caregiver depression and social determinants of health.4 In addition, the Periodicity Schedule recommends universal screening for depression beginning at age 12, and continuing annually until age 21. Considering social determinants of health and the family's emotional well-being helps to identify structural risk factors and strengths in the adolescent's own environment that can significantly impact healthy development and emotional well-being.

A list of commonly used behavioral and psychosocial screening tools can be found on the Bright Futures website.

Anticipatory Guidance

Because emotional well-being is a priority for every adolescent visit, the Bright Futures Guidelines provide sample questions and anticipatory guidance ( see examples within the Adolescence Visits content) health care professionals can use when discussing these topics with adolescents and their families. In addition, Bright Futures facilitates appropriate referrals to specialists/specialty services and links to community-based resources.

Bright Futures Health Promotion Themes

Bright Futures contains 12 health promotion themes about important issues related to child and adolescent health. Promoting Mental Health provides a state-of-the-art overview of mental health throughout childhood and adolescence. The theme contains information and guidance specific to the four main stages of development. This detailed information enables health care professionals to tailor their anticipatory guidance, recommendations, and resources based on the age of the child or adolescent. States and communities looking to inform their pediatric mental health programming should refer to this theme.

In the health promotion theme, Promoting Lifelong Health for Families and Communities, the 4 th Edition reviews the emerging sciences of early brain development and epigenetics that can alter the developmental trajectory of adolescents. This important theme discusses the impact of social determinants of health on child and family health and well-being and provides insight to how this deeper understanding of the sciences can be applied in both clinical settings and on the state and community levels.

Adolescent Health Promotion at the AAP

In 2016, the Committee on Adolescence (COA) authored a policy statement entitled " Achieving Quality Health Services for Adolescents." ⁵ The statement focuses on adolescent care within the medical home model, and offers practical recommendations related to confidentiality, developmentally appropriate care, and transition into adult care. In 2018, the COA endorsed the statement entitled " Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management." ⁶ As a companion implementation resource, the GLAD-PC Toolkit can be found at http://www.glad-pc.org. In 2015, the AAP released the " Promoting Optimal Development: Screening for Behavioral and Emotional Problems"³ clinical report. This report offers potential improvements in practice and the health system and research needed to create change. Other key resources can be found on the AAP Adolescent Sexual Health and Mental Health Initiatives webpages.

For more information about Bright Futures, visit BrightFutures.aap.org, email us at brightfutures@aap.org , or call (630) 626-6783.

References

1. Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017

2. Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19‑5068, NSDUH Series H‑54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/

3. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593-602.

4. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine and AAP Bright Futures Periodicity Schedule Workgroup. 2019 Recommendations for Preventive Pediatric Health Care. Pediatrics. 2019;143(3):e20183971

5. American Academy of Pediatrics Committee on Adolescence. Achieving quality health services for adolescents. Pediatrics. 2016;138(2):e20161347

6. Zuckerbrot R. A., Cheung, A., & Jensen, P. S., et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management. Pediatrics. 2018;141(3):e20174081

This program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $5,000,000 with 10 percent financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

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Resources for Promoting Healthy Behavioral and Emotional Development in Adolescents - AMCHP

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Lauren Geary, MPH, American Academy of Pediatrics Kathy Janies, American Academy of Pediatrics Jane Bassewitz, MA, American Academy of Pediatrics The American Academy of Pediatrics (AAP) and Bright Futures are committed [...]

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Anxiety in Children and Adolescents: Screening 

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Anxiety in Children and Adolescents: Screening 

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Source: U.S. Preventive Services Task Force

October 2022 Last Reviewed:

The U.S. Preventive Services Task Force (USPSTF) recommends screening for anxiety in children and adolescents ages 8 to 18 years and who are not showing recognized signs or symptoms of anxiety. Anxiety is a common mental health condition. Anxiety disorders in childhood and adolescents are associated with increased likelihood of a future anxiety disorder or depression. USPSTF found insufficient evidence to assess whether the benefits outweigh the harms in screening for anxiety in children age 7 years and younger.

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mental health and mental disordersadolescents

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Anxiety in Children and Adolescents: Screening

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The U.S. Preventive Services Task Force (USPSTF) recommends screening for anxiety in children and adolescents ages 8 to 18 years and who are not showing recognized signs or symptoms of anxiety. Anxiety is a common mental health condition. Anxiety disorders in childhood and adolescents are associated with increased likelihood of a future anxiety disorder or depression.

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Help to promote healthy mental development and address concerns of your patients with these practice tools and resources.

Readying the Practice

Practice Workflow

Mental Health Tools for Pediatrics (Updated 2/2021). A compilation of tools that are potentially useful at each stage of a clinical process through which mental health content can be integrated into pediatric care. (Note: Inclusion of a tool in this list does not indicate endorsement by the American Academy of Pediatrics).

Brief Interventions and Symptom-Based Care

Effective Referrals

HIPAA Privacy Rule and Provider to Provider Communication. This tool can help address common questions-and provide scenarios-about when it's appropriate to share your patients' or clients' health information with other providers under the Health Insurance Portability and Accountability Act (HIPAA).

Family Handouts

The AAP has developed a number of handouts and resources to support families in managing mental health concerns or supporting healthy mental development. These include family handouts as well as Healthychildren.org articles.

Additional AAP Resources

External Resources:

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mental health resources for pediatricians

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Mental Health Practice Tools and Resources

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View a collection of practice resources for health professionals to address mental health concerns and support healthy mental development.

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Resources and Publications for Families 

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Resources and Publications for Families 

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Improving Mental Health of Children and Adolescents: APA Reports & Related Publications

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APA reports and publications related to improving mental health of children and adolescents

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Community programs and services for families in need.

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United is the Way we create lasting change. United Way brings communities together to find strength and share hope. It’s the way we rally in hard times to meet people’s needs so they can rise back up and build a better future.

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A guideline of health information for families

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Centers for Disease Control and Prevention

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CDC is the nation's leading science-based, data-driven, service organization that protects the public's health. For more than 70 years, we've put science into action to help children stay healthy so they can grow and learn; to help families, businesses, and communities fight disease and stay strong; and to protect the public's health.

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Refers to the capacity for health care professionals to provide trauma-informed assessment and intervention knowledge

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What is Culturally-Sensitive Trauma-Informed Care?
How does this complement culturally competent health care practice?
As in all pediatric care, Culturally-Sensitive Trauma-Informed Care requires attention to be paid to a child's and family's values and beliefs about health and illness. What's unique is that attention must also be paid to cultural variations in the child's and family's experience of and response to trauma.

Research suggests that although there is a universal biological response to trauma, cultural factors can influence the biopsychosocial experience of trauma and subsequent traumatic stress reactions. Ethnocultural factors play an important role in an individual's vulnerability to, and experience and expression of traumatic stress, as well as one's response to trauma treatment.
What are the key components of Culturally-Sensitive Trauma-Informed Care?
A culturally-sensitive, trauma-informed care provider can help traumatized children and families by:
How do I implement Culturally-Sensitive Trauma Informed Care?
Understanding perceptions of traumatic stress and the role of beliefs:
Research suggests that it is NOT the objective severity of the trauma, but how it is experienced by the child or parent that determines traumatic stress responses.

Cultural differences can exist in the perception and interpretation of the trauma event, the meaning given to the traumatic event and beliefs about control over the event.
Viewed through a cultural lens, a child's or family's subjective perceptions of the trauma experience can sometimes be quite different from a provider's.

For example, some cultures interpret illness and other trauma events as punishment, a test or rite of passage, or a special message.

The way a child or family interprets the meaning of the trauma will influence subsequent distress, reactions, and ways of coping.

Cultural differences can also exist in beliefs about if, when, and how to resolve traumatic stress symptoms, and about help-seeking and utilization of supportive resources outside their community

Remembering that some interpretations may differ from your own, it is best to ask children and families about what the trauma means to them, and incorporate those beliefs into assessment and treatment.

Restoring safety and re-establishing trust:
Trauma erodes a child's or family's sense of physical and emotional safety; promoting trust rebuilds it.

When a trauma occurs, children's and families' global beliefs about safety, vulnerability, responsibility, control, and appropriate ways of coping play a significant role regarding how the trauma impacts them.

Initially, many traumatized children and families can feel physically unsafe and emotionally vulnerable; they may have a difficult time trusting others or accepting help as a result.

Viewed through a cultural lens, some groups are less likely to trust health care providers with the details of the trauma, their symptoms, or treatment recommendations.

In these instances, providers should take a step back to assess how their helping role is perceived. Providers should also try to connect the family with resources they trust - including other types of professionals and traditional healers.

Safety and trust is established not only through words, but through actions.

Providers' cultural awareness and sensitivity help to create provider-patient interactions that build trust and promote optimal patient communication and adherence.

Beyond the words providers choose, some cultures are highly sensitive to nonverbal communication - including eye contact, tone of voice, facial expressions, body language and touch.

Culturally appropriate communication practices have been shown to result in higher levels of perceived trust and increased reporting of information.

Attending to distress:
Significant cultural variations exist in a child's or family's expression of distress.

Pain, fear, worry, or hyperarousal are sometimes expressed somatically. Traumatic stress reactions can be extremely subdued, can appear to be over-magnified, or can even mimic psychotic reactions. Often, family and cultural factors combine to define what is considered an appropriate reaction to illness or trauma.

Some families and cultural groups are less comfortable responding to personal questions about emotional distress. They may think that being distressed means that there is something mentally wrong.

What providers can do:

Provide psychoeducation about common, universal reactions to trauma.

Understand emotional reactions by asking about and responding to specific behaviors (sleep and eating patterns, jitters, etc.).

Listen to and incorporate the child's or family own terms for what they are experiencing into discussions and treatment planning.

Working within and through the family structure:
Some families and cultural groups have distinct customs about who makes decisions and how they are communicated.

These customs may lead to limitations on the child's or other family members' involvement in discussions and decisions.

Incorporating extended family and kinship networks, as well as other types of healing professionals and practices that the child and family view as helpful, may positively impact assessment and treatment.

Considerations in providing Culturally-Sensitive Trauma-Informed Care
What considerations should I keep in mind in providing Culturally-Sensitive Trauma-Informed Care? View RELATIONSHIPS through a Culturally-Sensitive Trauma-Informed lens

Understand your role as a provider within this family's world.

Gain a better understanding of the roles and dynamics within this family.

Consider and facilitate the inclusion of others (extended family, clergy, healers) when treating patients.

View ASSESSMENT through a Culturally-Sensitive Trauma-Informed lens

The manifestation and expression of psychological states differ depending on personal, familial, and cultural beliefs and practices.

Listen to and use the family's own terms during assessment and treatment planning

Trust in / comfort with the provider has been shown to be associated with increases in patient disclosure in some cultural groups.

View TREATMENT through a Culturally-Sensitive Trauma-Informed lens

Healing comes in many different forms; your ideas, beliefs, and values may differ from the family's.

Be sure you have integrated the family's understanding of diagnosis, prognosis, and healing into your treatment planning.

Consider each family's resources and barriers to help-seeking and utilization of supportive services within the community.

Implementing Culturally-Sensitive Trauma- Informed Care with patients
How do I implement Culturally-Sensitive Trauma-Informed Care in my own patient interactions? Culturally-sensitive care begins with the provider

CPTS designed the D-E-F protocol as a practical tool to guide health care providers in implementing trauma-informed pediatric care.

The cultural considerations component of the D-E-F protocol helps providers implement trauma informed care in a culturally-sensitive manner that considers a child and family's unique cultural beliefs, values, and practices.

Additional Resources:
The National Child Traumatic Stress Network (NCTSN) website features various resources related to culture and trauma.

The National Center for PTSD (NCPTSD) website features a course module entitled PTSD: General Cross-Cultural Considerations.

Betancourt, J. R., Green, A. R., & Carrillo, J. E. (2002). Cultural competence in health care: Emerging frameworks and practical approaches: Field Report. Retrieved from www.commonwealthfund.org.

Davidhizar, R. (1999). Assessing culturally diverse pediatric clients. Pediatric Nursing, 25(4), 371-376.

Marsella, A. J., Friedman, M. J., Gerrity, E. T., & Scurfield, R. M. (1996). Ethnocultural aspects of posttraumatic stress disorder: Issues, research, and clinical applications. Washington, D.C.: American Psychological Association.

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Culturally-Sensitive Trauma-Informed Care | Patient Centered Care and Trauma Informed Care for Pediatric Patients - HEALTHCARE TOOLBOX

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How does this complement culturally competent health care practice? As in all pediatric care, Culturally-Sensitive Trauma-Informed Care requires attention to be paid to a child's and family's values and beliefs about health and illness. What's unique is that attention must also be paid to cultural variations in the child's and family's experience of and response to trauma.

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Offers resources and support for legal professionals

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Promoting the Well-being of Individuals with Previous Trauma. 

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Promoting the Well-being of Individuals with Previous Trauma. 

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Provides an analysis of trauma-informed care and helping those with mental health and substance use.

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Child Welfare Policies, Programs, and Practices 

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Child Welfare Policies, Programs, and Practices 

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Home - Child Welfare Information Gateway

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Programs to Prevent Child Abuse and Support Families.

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Programs to Prevent Child Abuse and Support Families.

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Prevent Child Abuse America is the nation's oldest and largest organization committed to preventing child abuse and neglect before it happens. We promote programs and resources informed by science that enable kids, families, and entire communities to thrive-today, tomorrow, and for generations to come. ​

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Support for Early Childhood Development and Well-being. 

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Support for Early Childhood Development and Well-being. 

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Ages zero to three are the most important for lifelong mental health and well-being.

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Includes screening tools, educational materials, and advocacy.

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Mental Health America is the nation's leading national nonprofit dedicated to the promotion of mental health, well-being, and condition prevention.

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Support & Resources for Families of Children with Special Needs

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Support & Resources for Families of Children with Special Needs

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We help parents navigate the special education system.

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Exceptional Children's Assistance Center (ECAC)

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We help parents navigate the special education system, know their rights, and use their voice. We provide information, support, training and resources to assist families caring for children with special needs from birth to age 26. We also support young adults with disabilities in becoming self-advocates and leaders and the educators and professionals who serve them.

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Improving Educational Success of Individuals with Disabilities. 

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Improving Educational Success of Individuals with Disabilities. 

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Council for Exceptional Children | The premier association for special education professionals

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The Council for Exceptional Children (CEC)'s Partner Solutions Directory is an online resource for special education products, services, and programming support! Search for a topic and quickly receive a list of partners who provide products, services, or programming supporting your work and career.
View More Partner Solutions

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Council for Exceptional Children | The premier association for special education professionals

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The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving the educational success of children and youth with disabilities and/or gifts and talents.

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Resources and Support for Parents of Children with Learning and Thinking Differences. 

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Resources and Support for Parents of Children with Learning and Thinking Differences. 

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How can we help?

I want help with behaviors , learning , and everyday skills

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Understood - For Learning and Thinking Differences

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Understood.org is the resource that helps the 70 million people with learning and thinking differences anticipate the challenges, barriers, or opportunities in life and confidently reach their potential.

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Special Education Law, Education Law, and Advocacy for Children with Disabilities.

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Special Education Law, Education Law, and Advocacy for Children with Disabilities.

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Peter W.D. Wright, Esq. and Pamela Darr Wright, MA, MSW

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Wrightslaw provides free access to articles, cases, resources and training about special education law and advocacy.

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Support & Resources for Students with Learning and Attention issues. 

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Support & Resources for Students with Learning and Attention issues. 

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See what NCLD has been advocating for and get the most recent news on learning and attention issues.

Tell Congress: Pass the RISE Act

We need your help! Ask your member of Congress to support students with learning and attention issues.

Support NCLD

Thanks to support from generous partners like you, we are able to create programs and resources to support the 1 in 5 individuals with learning and attention issues nationwide.

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NCLD - National Center for Learning Disabilities

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See what NCLD has been advocating for and get the most recent news on learning and attention issues. We need your help! Ask your member of Congress to support students with learning and attention issues. Thanks to support from generous partners like you, we are able to create programs and resources to support the 1 in 5 individuals with learning and attention issues nationwide.

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Information on Local Food Banks & Food Assistance Programs 

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Information on Local Food Banks & Food Assistance Programs 

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Making healthy food easy to access and supporting laws that make food available for everyone.

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U.S. Hunger Relief Organization | Feeding America

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Feeding America is a nonprofit network of 200 food banks leading the fight against hunger in the United States. Learn how you can help end hunger in America.

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Bilingual Resources for Educators and Families 

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Bilingual Resources for Educators and Families 

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A bilingual site for educators and families of English language learners

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Learnign For Justice, Resources to promote Diversity, Equity, and Inclusion. 

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Learnign For Justice, Resources to promote Diversity, Equity, and Inclusion. 

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Learning for Justice is a community education program of the Southern Poverty Law Center (SPLC) that centers civic and political action education for everyone.

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A Collection of Children's Books with Diverse Charactors.

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A Collection of Children's Books with Diverse Charactors.

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Diverse BookFinder | Identify & Explore Multicultural Picture Books

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Are you looking for multicultural children’s books? We’ve got you covered! You can search our circulating collection of picture books (2002-present), explore our quick lists, then borrow our books from your own library through interlibrary loan. We believe that too many children are left out of main…

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Strategies for Culturally Responsive Teaching. 

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Strategies for Culturally Responsive Teaching. 

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Culturally Responsive Teaching & the Brain

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Home - Culturally Responsive Teaching & the Brain

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Archive Collection of Stories and Film, Exploring Cultural Diversity 

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Archive Collection of Stories and Film, Exploring Cultural Diversity 

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Inspire students to expand on their worldviews and diversity

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Stories and lessons for growing minds

We are a free multimedia platform for educators and students. Through our immersive storytelling and curricula, we aim to plant seeds of empathy, interconnectedness, and a sacred relationship with our planet. Use our award-winning films, photo essays, and essays to learn about social, cultural, and environmental issues from individuals and communities worldwide. For grades 3-12, our stories and lessons encourage students to broaden their perspectives and worldviews while fostering universal human values and respect for the living world. We aim to bring universal values into the lives of educators and students.

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These five shorts films follows five Native American communities who are restoring their traditional land management practices.

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This feature shares the stories of four Indigenous communities in California who are working to revitalize their languages and cultures in order to pass them on to the next generation.

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"This film has historic relevancy. I can see myself using it to encourage students to think about the value of the space program and how it speaks to the American Spirit and how we are often looking forward in our progress. This film begs to be used as an exploration of what it means to be a global citizen, how students can learn from people not like themselves, and what actions students can take in their everyday lives to make the world a better place."

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Stories Exploring Climate Change

Celebrating Student Artwork: New Student Gallery

Encourage thoughtful and meaningful conversations in the classroom with our student gallery. Use the gallery as a tool to foster curiosity, observation skills, and perspective-taking.

The gallery encourages students to learn from each other's perspectives. How are students witnessing and engaging with the world in new ways since the start of Covid-19? Search by theme, previous Global Oneness Project contests, or from locations around the world. The gallery is accompanied by an image analysis activity, including a Visible Thinking Routine from Project Zero, Harvard Graduate School of Education.

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An after-school program filled with activities for children.

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"What age should I let my child have social media?" Unfortunately, there's no one-size-fits-all answer to support parents in deciding the appropriate age for social media. But looking to recent data, expert guidance and your child's development, parents can make informed decisions on when and how kids use social media.

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Boys & Girls Clubs of America - Providing millions of kids and teens a safe place to develop essential skills, make lasting connections and have fun.

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Help make great futures a reality for America's youth with Boys & Girls Clubs of America

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National Association for Bilingual Education 

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National Association for Bilingual Education 

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A non-profit organization that advocates for equity in education.

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Since 1975, the National Association for Bilingual Education (NABE) has been a non-profit membership organization that works to advocate for educational equity and excellence for bilingual/multilingual students in a global society.

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Assitance with Diaper Needs for Low-income Families.

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Assitance with Diaper Needs for Low-income Families.

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Meeting the basic needs of all families in America.

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Evidence-based information from the American Academy of Pediatrics to help guide parents on health information and specific needs.

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HealthyChildren.org - From the American Academy of Pediatrics

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SUbstance Abuse and Mental Health Support for Parents and Caregivers 

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SUbstance Abuse and Mental Health Support for Parents and Caregivers 

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SAMHSA - The Substance Abuse Mental Health Services Administration

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SAMHSA - Substance Abuse and Mental Health Services Administration

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SAMHSA.gov, Substance Abuse and Mental Health Services Administration

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Nemours KidsHealth - the Web's most visited site about children's health

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KidsHealth is the #1 most-trusted source for physician-reviewed information and advice on children's health and parenting issues. For parents, kids, teens, and educators, in English and in Spanish.

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The National Child Traumatic Stress Network

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Enhancing cultural competence and encouraging cultural humility are essential to increasing access and improving the standard of care for traumatized children, families, and communities across the

The following resources on Culture and Trauma were developed by the NCTSN.

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Trauma intersects in many different ways with culture, history, race, gender, location, and language. Trauma-informed systems acknowledge the compounding impact of structural inequity and are responsive to the unique needs of diverse communities.

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Family Guide to Mental Health "Impact on Families"

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Family Guide to Mental Health "Impact on Families"

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Family Guide to Mental Health "Impact on Families"

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Centers for Disease Control and Prevention

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Learn About Children's Mental Health | CDC

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Mental health in childhood means reaching developmental and emotional milestones, and learning healthy social skills and how to cope when there are problems.

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Article by Neha Navsaria, Ph.D., Assistant Professor of Psychiatry (Child)

Everyone experiences challenges in life, and especially now- with COVID-19, racism, returning to work, balancing family/work obligations, to name a few-the number of challenges can feel overwhelming. What do you do when you are under chronic stress that feels never-ending? What you are experiencing right now could be wearing you down and require a new way of coping that you are simply not used to doing.

This is where learning resilience might be helpful. Resilience is the process of adapting in the face of difficult times and significant sources of stress. It is not, as it can sometimes feel when people use it as a buzzword, a weakness we are lacking and need to build, but a strength we have that we can cope with and learn to better rely on. Current stressors may make you feel like you don't have any control of what is happening in life, and this can lead to feelings of helplessness. Helplessness can lead to anxiety, fear, and even depression. But there are many aspects of your life you can control, modify, and grow - that is resilience. Learning to live with uncertainty, especially now, is a key and needed strength.

How can you start on your path towards resilience? Psychologists have identified four key ingredients ¹ to developing coping skills for resilience: connection, wellness, healthy thinking, and finding meaning.
Connection

Build connections with those who support you. It is easy to isolate yourself during this time but isolation can have negative effects. This does not mean you have to be around people all the time and cannot find time for yourself, this means you want to find time for meaningful connections.

Find a way to connect to a group. There are online groups and forums for individuals who may share the same interests or engage in discussions about specific topics. Here at Washington University we also have Zoom support groups available to help you better connect and build the skills to cope. Please check wustl.edu to find the schedule and sign up.

Connecting with an individual or a group is a reminder that you are not alone in the face of challenges. It also can help you create a new normal when connection and normal looks a lot different right now (see: masks and social distancing!)

Self-care is often easier said than done but making it a priority can really develop your sense of resilience. Stress is not just emotional; it is also physical. You are tired because stress is like running a marathon, not just because work is in itself exhausting.

Think about your nutrition, sleep patterns, hydration, and exercise routines. Then, think about how they need to change in small and realistic steps. Too often people try to change their wellness routines in a dramatic manner and ultimately feel like they haven't accomplished much. Small changes are accomplishable, big changes are easy to avoid even starting.

Find outlets for emotional expression and mindfulness. This could be journaling, art, yoga, dance, or spiritual practices like prayer or meditation. We even have a creative expression zoom group here at Wash U! This can help to slow you down and shift your focus to something positive and calming. Remember there is no one-size-fits-all coping method and you should try out ones that work for you.

Make space for yourself, even if it is only for a short amount of time. This can be challenging but taking a few minutes to keep overwhelming feelings at bay is important. Being able to disconnect is vital to replenishing your emotional energy.

Healthy thinking

Acknowledge and accept your thoughts and emotions during these times. Think about your thinking and mindset when faced with challenges. Are your thoughts positive? Negative? Realistic? Do they feel not grounded in fact? How are these thoughts helping or not helping you cope?

Learn from the past. Look back at situations that you did not handle well and identify the elements that led to that outcome. Think about situations that went well and remind yourself of the thinking patterns and actions that got you there - these are your sources of strength.

Identify areas of hope and people or things that make you grateful. In times of despair, this can be hard to do, but a doing this gives you a positive source to change the focus of your thinking.

Accept that there are certain circumstances that cannot change right now. Focusing on things you cannot change can lead to feelings of helplessness. It is important to acknowledge your feelings of grief and loss and then focus on how you can creatively go forward by trying new ways to do things. Even outside of the recovery community, the serenity prayer mindset can be helpful here, "accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."

Finding Meaning and Purpose

Take a problem and break it down into manageable pieces to find solutions. Again, small pieces.

Start identifying goals that you can work towards. Even in the uncertainty of the current times, it might help to think about simple goals for each week. Then you can think of doing something small that contributes to that goal. This gives you a sense of purpose that you are moving towards something that has meaning for you.

Celebrate your own strengths and growth. Taking the time to do this will remind you that you have these skills to apply in other challenging and stressful situations.

Focusing on these skills can help you to build resilience, but using that word is not in any way to minimize the intensity of current stressors or your response to them. Learning resilience is just something that can be helpful as you navigate these challenging times and allow yourself to grow with uncertainty. And, please remember, that it is not easy and that learning resilience takes time and practice. Give yourself patience and treat yourself like you would a friend. Part of the process is also knowing when to seek help. You don't have to only ask for during a crisis - you can also ask for help when growing your coping skill set. The road to resilience does not have to be alone! Please call our WellBeing Line at 314-286-1700 for in-the-moment support or reach out to the Department of Psychiatry for appointments if you need one. There is no wrong time to get help and asking for it, is a strength.

Sources:

¹American Psychological Association (February 1, 2020). Building your resilience. Retrieved online from https://www.apa.org/topics/resilience?fbclid=IwAR05tZfPpGV_F3B_wQDuSF73XE7sPqNmDHgsHGZLWRMoP_5l_zg6oTgMqMM

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Developing healthy coping skills for resilience

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Article by Neha Navsaria, Ph.D., Assistant Professor of Psychiatry (Child) Everyone experiences challenges in life, and especially now- with COVID-19, racism, returning to work, balancing family/work obligations, to name a few-the number of challenges can feel overwhelming. What do you do when you are under chronic stress that feels never-ending?

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Mental health: What it is and why it matters | CBC Kids News

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Understanding Cultural Sensitives through a Trauma-Informed Lens

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This article explores some preconceived notions and hopefully draws on the need for cultural competence in the workplace. The concepts discussed are transferrable to multiple settings: the courtroom, meeting rooms, interviews and even emails. The need to be culturally sensitive should have a broad application and applies to all professional interactions. Specific examples focus on Indigenous practitioners, but there are transferrable concepts that apply to all groups of people.

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Research is focused on child and teen mental health, exploring why they are struggling and what can be done to help them

Cite this

Abrams, Z. (2023, January 1). Kids' mental health is in crisis. Here's what psychologists are doing to help. Monitor on Psychology, 54(1). https://www.apa.org/monitor/2023/01/trends-improving-youth-mental-health

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The Covid-19 pandemic era ushered in a new set of challenges for youth in the United States, leading to a mental health crisis as declared by the United States surgeon general just over a year ago. But U.S. children and teens have been suffering for far longer.

In the 10 years leading up to the pandemic, feelings of persistent sadness and hopelessness-as well as suicidal thoughts and behaviors-increased by about 40% among young people, according to the Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System.

"We're seeing really high rates of suicide and depression, and this has been going on for a while," said psychologist Kimberly Hoagwood, PhD, a professor of child and adolescent psychiatry at New York University's Grossman School of Medicine. "It certainly got worse during the pandemic."

In addition to the social isolation and academic disruption nearly all children and teens faced, many also lost caregivers to Covid-19, had a parent lose their job, or were victims of physical or emotional abuse at home.

All these difficulties, on top of growing concerns about social media, mass violence, natural disasters, climate change, and political polarization-not to mention the normal ups and downs of childhood and adolescence-can feel insurmountable for those who work with kids.

"The idea of a 'mental health crisis' is really broad. For providers and parents, the term can be anxiety-provoking," said Melissa Brymer, PhD, who directs terrorism and disaster programs at the UCLA-Duke University National Center for Child Traumatic Stress. "Part of our role is to highlight specific areas that are critical in this discussion."

Across the field, psychologists are doing just that. In addition to studying the biological, social, and structural contributors to the current situation, they are developing and disseminating solutions to families, in schools, and at the state level. They're exploring ways to improve clinical training and capacity and working to restructure policies to support the most vulnerable children and teens.

Psychologists were also behind new mental health recommendations from the U.S. Preventive Services Task Force, a group of volunteer health professionals who evaluate evidence on various preventive health services. The task force now recommends regular anxiety screenings for youth ages 8 to 18 and regular depression screenings for adolescents ages 12 to 18.

"I see these trends in children's mental health problems as being critical, but there are solutions," Hoagwood said. "If we refocus our efforts toward those solutions, we could see some of these tides turn."

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Sources of stress

Across the United States, more than 200,000 children lost a parent or primary caregiver to Covid-19 ("Covid-19 Orphanhood," Imperial College London, 2022). In the face of those losses, families had to curtail mourning rituals and goodbye traditions because of social distancing requirements and other public health measures, Brymer said. Many children are still grieving, sometimes while facing added challenges such as moving to a different home or transferring to a new school with unfamiliar peers.

The CDC also reports that during the pandemic, 29% of U.S. high school students had a parent or caregiver who lost their job, 55% were emotionally abused by a parent or caregiver, and 11% were physically abused (Adolescent Behaviors and Experiences Survey-United States, January-June 2021, CDC).

"Schools are crucial for keeping kids safe and connecting them with services, but the pandemic completely disrupted those kinds of supports," Brymer said.

Those extreme disruptions didn't affect all young people equally. Echoing pre-Covid-19 trends, the CDC also found that girls, LGBTQ+ youth, and those who have experienced racism were more likely to have poor mental health during the pandemic, said social psychologist Kathleen Ethier, PhD, director of the CDC's Division of Adolescent and School Health.

Contributing factors likely include stigma, discrimination, and online bullying, Ethier said. Female students also report much higher levels of sexual violence than their male peers, which can further harm mental health.

As much hardship as Covid-19 wrought, it's far from the only factor contributing to the current crisis. Biology also appears to play a role. The age of puberty has been dropping for decades, especially in girls, likely leading to difficulty processing complex feelings and knowing what to do about them ( Eckert-Lind, C., et al., JAMA Pediatrics, Vol. 174, No. 4, 2020). In early puberty, regions of the brain linked to emotions and social behavior are developing more quickly than regions responsible for the cognitive control of behavior, such as the prefrontal cortex, Ethier said.

Those developmental changes drive young people to seek attention and approval from their peers. For some, using social media fulfills that need in a healthy way, providing opportunities for connection and validation to youth who may be isolated from peers, geographically or otherwise.

For others, negative messages-including online bullying and unrealistic standards around physical appearance-appear to have a detrimental effect, but more research is needed to understand who is most at risk.

"There is clearly some aspect of young people's online life that's contributing [to the mental health crisis], we just don't know exactly what that is," said Ethier.

Finally, structural factors that affect millions of U.S. children, including poverty, food insecurity, homelessness, and lack of access to health care and educational opportunities, can lead to stress-response patterns that are known to underlie mental health challenges.

"Even in very young children, prolonged stress can trigger a cycle of emotion-regulation problems, which can in turn lead to anxiety, depression, and behavioral difficulties," Hoagwood said. "These things are well established, but we're not doing enough as a field to address them."

Building capacity in schools

The biggest challenge facing mental health care providers right now, experts say, is a shortage of providers trained to meet the mounting needs of children and adolescents.

"There's a growing recognition that mental health is just as important as physical health in young people's development, but that's happening just as mental health services are under extreme strain," said clinical psychologist Robin Gurwitch, PhD, a professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center.

Schools, for example, are a key way to reach and help children-but a 2022 Pew Research Center survey found that only about half of U.S. public schools offer mental health assessments and even fewer offer treatment services. Psychologists are now ramping up efforts to better equip schools to support student well-being onsite.

Much of that work involves changing policies at the school or district level to provide more support for all students. For example, school connectedness-the degree to which young people feel that adults and peers at school care about them and are invested in their success-is a key contributor to mental health. Youth who felt connected during middle and high school have fewer problems with substance use, mental health, suicidality, and risky sexual behavior as adults ( Steiner, R. J., et al., Pediatrics, Vol. 144, No. 1, 2019).

Through its What Works in Schools program, the CDC funds school districts to make changes that research shows foster school connectedness. Those include improving classroom management, implementing service-learning programs for students in their communities, bringing mentors from the community into schools, and making schools safer and more supportive for LGBTQ+ students.

Psychologists are also building training programs to help teachers and other school staff create supportive classrooms and aid students who are in distress. Classroom Wise (Well-Being Information and Strategies for Educators), developed by the Mental Health Technology Transfer Center Network and the University of Maryland's National Center for School Mental Health (NCSMH), is a free, flexible online course and resource library that draws on psychological research on social-emotional learning, behavioral regulation, mental health literacy, trauma, and more ( Evidence-Based Components of Classroom Wise (PDF, 205KB), NCSMH, 2021).

"We're using evidence-based practices from child and adolescent mental health but making these strategies readily available for teachers to apply in the classroom," said clinical psychologist Nancy Lever, PhD, codirector of NCSMH, who helped develop Classroom Wise.

The course incorporates the voices of students and educators and teaches actionable strategies such as how to create rules and routines that make classrooms feel safe and how to model emotional self-regulation. The strategies can be used by anyone who interacts with students, from teachers and administrators to school nurses, coaches, and bus drivers.

"What we need is to build capacity through all of the systems that are part of children's lives-in families, in schools, in the education of everybody who interacts with children," said psychologist Ann Masten, PhD, a professor of child development at the University of Minnesota.

Other training efforts focus on the students themselves. Given that preteens and teenagers tend to seek support from their peers before turning to adults, the National Child Traumatic Stress Network (NCTSN) created conversation cards to equip kids with basic skills for talking about suicide. The advice, available in English and Spanish, includes how to ask about suicidal thoughts, how to listen without judgment, and when to seek guidance from an adult ( Talking About Suicide With Friends and Peers, NCTSN, 2021).

While training people across the school population to spot and address mental health concerns can help reduce the strain on mental health professionals, there will always be a subset of students who need more specialized support.

Telehealth, nearly ubiquitous these days, is one of the best ways to do that. In South Carolina, psychologist Regan Stewart, PhD, and her colleagues colaunched the Telehealth Outreach Program at the Medical University of South Carolina in 2015. Today, nearly every school in the state has telehealth equipment (Wi-Fi and tablets or laptops that kids can use at school or take home) and access to providers (psychology and social work graduate students and clinicians trained in trauma-focused cognitive behavioral therapy). Students who need services, which are free thanks to grant funding or covered by Medicaid, meet one-on-one with their clinician during the school day or after hours (American Psychologist, Vol. 75, No. 8, 2020).

"We learned a lot about the use of technology during the pandemic," Ethier said. "At this point, it's very much a matter of having sufficient resources so more school districts can access those sources of care."

Expanding the workforce

Limited resources are leaving families low on options, with some young people making multiple trips to the emergency room for mental health-related concerns or spending more than six months on a waiting list for mental health support. That points to a need for more trained emergency responders and psychiatric beds, psychologists say, but also for better upstream screening and prevention to reduce the need for intensive care.

"Just as we need more capacity for psychiatric emergencies in kids, we also need an infusion of knowledge and ordinary strategies to support mental health on the positive side," Masten said.

In New York, Hoagwood helped launch the state-funded Evidence Based Treatment Dissemination Center in 2006, which offers free training on evidence-based practices for trauma, behavioral and attention problems, anxiety, depression, and more to all mental health professionals who work with children in state-licensed programs, which include foster care, juvenile justice, and school settings, among others. The center provides training on a core set of tools known as PracticeWise ( Chorpita, B. F., & Daleiden E. L., Journal of Consulting and Clinical Psychology, Vol. 77, No. 3, 2009). It also offers tailored training based on requests from community agency leaders and clinicians who provide services to children and their families.

Hoagwood, in collaboration with a consortium of family advocates, state officials, and researchers, also helped build and test a state-approved training model and credentialing program for family and youth peer advocates. The peer advocate programs help expand the mental health workforce while giving families access to peers who have similar lived experience ( Psychiatric Services, Vol. 71, No. 5, 2020).

Youth peer advocates are young adults who have personal experience with systems such as foster care, juvenile justice, or state psychiatric care. They work within care teams to provide basic education and emotional support to other youth, such as giving advice on what questions to ask a new mental health practitioner and explaining the differences between psychologists, psychiatrists, and social workers. Youth peer advocates in New York can now receive college credit for their training in peer specialist work.

"Making community health work into a viable career can also increase diversity among mental health workers and help us address structural racism," Hoagwood said.

Pediatricians are another group that can provide a first line of defense, drawing on their relationships with parents to destigmatize mental health care.

"Pediatricians are in many ways uniquely positioned to help address the mental health crisis in youth," said Janine A. Rethy, MD, MPH, division chief of community pediatrics at MedStar Georgetown University Hospital and an associate professor of pediatrics at Georgetown University School of Medicine. "We have the privilege of building long-term relationships with children and their families over many years," with at least 12 well-child checkups in just the first three years of a child's life, followed by annual visits.

During these visits, they can watch for warning signs of social and behavioral problems and screen for maternal depression and other issues in parents, which is now recommended by the American Academy of Pediatrics (PDF, 660KB). Several new resources provide guidance for integrating mental health care into pediatric practices, including the Behavioral Health Integration Compendium (PDF, 4.1MB) and the Healthy Steps program. But most pediatricians need more education on mental health issues in order to effectively respond, Rethy said-yet another area where psychologists may be able to help. Psychologists can provide direct consultations and training to pediatricians through the Pediatric Mental Health Care Access program.

"The more we can weave mental health knowledge, capacity, and checkpoints into places where parents feel comfortable-like the doctor's office and at school-the better," Masten said. "All professionals who work with young people really need the knowledge that's being generated by psychologists."

11 emerging trends for 2023

Further reading

Science shows how to protect kids' mental health, but it's being ignored
Prinstein, M., & Ethier, K. A., Scientific American, 2022

How pediatricians can help mitigate the mental health crisis
Rethy, J. A., & Chawla, E. M., Contemporary Pediatrics, 2022

Review: Structural racism, children's mental health service systems, and recommendations for policy and practice change
Alvarez, K., et al., Journal of the American Academy of Child and Adolescent Psychiatry, 2022

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Kids' mental health is in crisis. Here's what psychologists are doing to help

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Research is focused on child and teen mental health, exploring why they are struggling and what can be done to help them

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Helping a Loved One Cope with Mental Illness

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Learn about what you can do to help a loved one cope with a mental illness

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7-Minute Emotion Regulating Activity To Help Kids Calm Down! [with mindful breathing techniques]

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Mental Health Support for South Carolina Students | Carolina Family Engagement Center

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Resources for Children Struggling with Anxiety 

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Resources for Children Struggling with Anxiety 

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The Arc of South Carolina The Arc of South Carolina is an organization that promotes and protects the human rights of people with intellectual and developmental disabilities and actively supports their full inclusion and participation in the community throughout their lifetimes.

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Selective Mutism the Brave Muscle Method 

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How to help parents understand anxiety: SELECTIVE MUTISM and SOCIAL ANXIETY

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What Differentiates Healthy Anxiety from Symptoms of an Anxiety Disorder

There are 4 main types of anxiety disorders:

Separation Anxiety Disorder;

Social Anxiety Disorder;

Selective Mutism;

Generalized Anxiety Disorder;

Additional types of anxiety include panic disorder, agoraphobia, specific phobia substance/medication induced anxiety.

The 4 main types of anxiety disorders begin in elementary school (6-12 years of age) or even before, however, they are not always identified or treated until adolescence. Sadly, many students never get assessed or treated.

The triggers for these anxiety disorders are normal developmental activities that most children routinely master or even enjoy. The school environment by its nature exposes students to developmentally appropriate challenges and thus schools are environments where students will commonly demonstrate symptoms of an anxiety disorder.

Triggers for Separation Anxiety Disorder are developmentally appropriate separations from parents or caregivers, and include:

Going to school;

Going to other kids' houses for play dates;

Doing sleep overs or going away to camp;

Falling asleep alone at night;

Being in a different room in the house from the caregiver.

When faced with developmentally appropriated separations they may express physical symptoms, "melt downs," or tantrums.

Triggers for Social Anxiety Disorder are developmentally appropriate social and interactional challenges. It may be expressed in the following ways:

Being extremely self-conscious, worry about 'goofing up,' being laughed at or humiliated in social situations; observers sometimes consider them to be shy;

Will not raise their hand to ask questions;

When called on, will not make eye contact (when culturally appropriate to do so) and will speak softly or use single word answers;

Will not join a group of children to play;

Does not like to attend parties or social events;

Will not volunteer to read aloud or go to the board when others are watching.

Speaking in developmentally appropriate situations (Selective Mutism) is described as

An early onset and more severe form of social anxiety;

Normal speaking ability in the home environment but will not speak at school or other situations outside the home.

Triggers for Generalized Anxiety Disorder are developmentally appropriate levels of uncertainty and performance challenges. These children and adolescents struggle with not knowing everything that might happen at school, at home or in the world; and are excessively driven to perfection. These children and adolescents worry excessively about the past, current events, and the future.

For example:

6 year olds worrying about going to college.

8 year olds worrying about whether the teacher will be sick or at school today, if there might be a test that they don't know about or whether they forgot to do something for school.

Asks a lot of "what if..." questions and doesn't respond to appropriate reassurance.

Often lives with dread that something will go wrong even in routine activities.

Often perfectionistic (maybe even a teacher favorite), but rigid and can't tolerate change or ambiguity at school.

Studies hard - sometimes too much.

Can "freeze up" or experience their mind "going blank" and do poorly when under pressure.

Complains of muscle tension.

May know the answer but isn't "sure," may over think and then make a wrong choice.

Get diagnosed with inattention but their inattention is due to preoccupation with worry about performance and uncertainty, but not ADHD.

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Supporting Students with Anxiety in School

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Discover valuable AAP resources for supporting students with anxiety in school. Explore effective interventions, coping strategies, and educator resources to create an anxiety-aware and stress-free learning environment. Access AAP guidelines for promoting mental well-being and preventing anxiety in students. Enhance your school’s approach to mental health with expert recommendations from the American Academy of Pediatrics.

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Always Online: Weighing the Effects of Social Media on Teens' Mental Health

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>> More information on depression can be found here.

"What is anxiety?"

Anxiety is the feeling you get when you're worried or scared about something. Small amounts of worry and fear can help keep us safe. But sometimes anxiety can make us feel like things are worse than they are and stop us from doing things we enjoy or living life fully.

Anxious children tend to need constant reassurance from their parents and caregivers. They may also be quiet and eager to please. This means their condition can be easy to miss.

Signs and symptoms of anxiety in children include:

Shortness of breath, headaches or feeling faint

A racing heart and sometimes high blood pressure

Feeling fidgety, trembling or feeling weak in the legs

Feeling sick in your stomach - cramps, diarrhoea or frequent visits to the bathroom

Having trouble sleeping or a reduced appetite

Dry mouth, excessive sweating or feeling hot.

Emotional and mental

Struggling to focus on things

Feeling panicky, nervous or on edge

Feeling overwhelmed or a sense of dread

Feeling out of control in a situation

Feeling tired and grumpy.

Be alert to the signs of anxiety so you can seek help and care for your child early if needed. Remember, feelings of anxiety among children are preventable and can be managed.

"How can I help my child cope with anxiety?"

Explore the feeling together: Ask your child to tell you what is happening when they feel anxious. (How do they feel? How long does the feeling last? What might be the reason for feeling anxious?) Remind them that the feeling will pass.

Help them shift their focus to the present moment: You can ask questions like, "What would you like to have for dinner?" or ask them about some of the things they can see and smell around them.

Help them get enough sleep:

Experts recommend

Limit their screentime at night to help them sleep better: Consider making their bedroom a device-free zone.

Help them do belly breathing: When we're anxious we can forget to breathe deeply. Belly (abdominal) breathing is very calming and helps us to draw oxygen deep into our lungs. Here's an easy 3-step process you can teach your child to do:

Place your hand on your stomach

Take 5 deep breaths - spend 5 seconds breathing in and 5 seconds breathing out, breathing in through your nose and out through your mouth

Explain that when your child inhales, they are blowing up their tummy softly like a balloon, and when they exhale the air is going slowly out of the balloon again.

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Supporting children with depression, stress and anxiety

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Tips to help parents recognise children struggling with mental health and how they can help

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Anxiety and depression in kids: Healthy Head to Toe

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The National Child Traumatic Stress Network

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Enhancing cultural competence and encouraging cultural humility are essential to increasing access and improving the standard of care for traumatized children, families, and communities across the

The following resources on Culture and Trauma were developed by the NCTSN.

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Trauma intersects in many different ways with culture, history, race, gender, location, and language. Trauma-informed systems acknowledge the compounding impact of structural inequity and are responsive to the unique needs of diverse communities.