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Building a comprehensive counseling program

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ASCA Ethical Standards for School Counselors

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ASCA Ethical Standards for School Counselors

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Blog with resources and chronicles

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I have been a professional school counselor for 18 years and I enjoy sharing information and resources with colleagues. Currently, I am working with students in the virtual world and discovering how to assist them in the online classroom. In addition to school counseling, I have a doctorate in Teacher Leadership and my focus is training students and adults in conflict resolution education and peer helping skills.

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I have been a professional school counselor for 18 years and I enjoy sharing information and resources with colleagues. Currently, I am working with students in the virtual world and discovering how to assist them in the online classroom.

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Technology Protocols for School Counselors

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Technology Protocols for School Counselors

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Helpful tips to keep in mind as a school counselor

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Six School Counselor Technology Protocols Infographic

Six School Counselor Technology Protocols Infographic

Technology has become a critical tool in school counselor communication, performance and accountability. The Six School Counselor Technology Protocols Infographic provides six protocols that may help maximize your technology effectiveness.

1. Emails and Telephone Calls

Even if you can't fully respond to a call or email, it's a good practice to get back to a person in a short time frame. Your school community notices how long it takes for you to get back to them. (Columbia University, 2015)

2. Social Media

Be sure to review your school or district's "Acceptable Use of Technology" policy. You may then decide to create your own professional account to communicate with your students, families and faculty. You don't want them seeing what you do on the weekends! (Bidwell, 2014)

3. Texting Do not abbreviate words like LOL (laugh out loud) or TTYL (talk to you later).

It is best that you type out all the words. You want to communicate professionally and not with your BFF. (Giang, 2013)

4. Meetings

Counselors are listeners and dividing your attention between a screen and a person sends the wrong message. Unless using a device is integral to the meeting, it's better to turn it off or put it on silent mode.If you must, return a call or text outside.

5. Websites

Does your website have tons of links and a difficult to understand navigation system? Is the information that you post regularly reviewed for relevancy and timeliness? Your users should trust your website for the latest information that is easily accessible.

6. Powerpoints

Too many bullets, moving transitions and slides have contributed to what is called "Death by Powerpoint." Reading from your slides is also not a good idea. A popular guideline for powerpoints: 10 slides, 20 minutes, 30 font. (Kawasaki, 2005)

Via: magic.piktochart.com

Embed This Education Infographic on your Site or Blog! Copy and Paste the following code!

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Six School Counselor Technology Protocols Infographic - e-Learning Infographics

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Technology has become a critical tool in school counselor communication, performance and accountability. The Six School Counselor Technology Protocols Infographic provides six protocols that may help maximize your technology effectiveness. 1. Emails and Telephone Calls Even if you can't fully respond to a call or email, it's a good practice to get back to a person in a short time frame.

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The Science of Mental Illness Infographic

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The Science of Mental Illness Infographic

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Helpful for students and parents to inform about the specific science involved in mental illnesses

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Addressing Mental Health in School Crisis Prevention & Response

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Addressing Mental Health in School Crisis Prevention & Response

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When and How to Refer for Mental Health

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

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

Listen for ongoing or severe traumatic stress symptoms.

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

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

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

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

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

Steps for making a referral

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

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

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

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

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

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

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

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

Keep the door open.

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

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

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

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

Effective mental health treatment for traumatic stress

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

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

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

Do you have experience working with children after trauma?

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

What is your success rate?

How do you work with parents?

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

Online resources - help in finding a mental health professional

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

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

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

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

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

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

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

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When and How to Refer for Mental Health Care

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

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Comprehensive Guide for Various Disorders

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Comprehensive Guide for Various Disorders

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For parents and educators

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Your trusted nonprofit guide to mental health & wellness

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Center for Parent Information & Resources

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Center for Parent Information & Resources

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Home page

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Meetings to write, review, or revise a child's IEP typically bring together a team of people who meet in person at least once a year. Now, because of coronavirus, school closures, and social distancing, IEP teams are meeting , either in conference calls or via the Internet. This collection of tip sheets on planning for and participating in virtual meetings was developed collaboratively by six OSEP-funded technical assistance centers, and includes an infographic about virtual IEP meetings (available in English and Spanish); a sample agenda (also available in English and Spanish); technology tips for all participants; suggestions for hosting a virtual meeting; and tips for those participating in a virtual meeting. Read more about (and download) the tip sheets here.

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Center for Parent Information and Resources | Your Central Hub for Parent Centers Serving Families of Children With Disabilities

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Meetings to write, review, or revise a child's IEP typically bring together a team of people who meet in person at least once a year. Now, because of coronavirus, school closures, and social distancing, IEP teams are meeting , either in conference calls or via the Internet.

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National Center dedicated to improving education outcomes for all children

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"We initially chose IRIS because of the past experiences and their credible research-based, high-quality modules that align with specific areas of growth and need to support a state-directed corrective action plan in our region."

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"We initially chose IRIS because of the past experiences and their credible research-based, high-quality modules that align with specific areas of growth and need to support a state-directed corrective action plan in our region."

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Strategies for Teaching and Learning

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Strategies for Learning and Teaching | Special Education Support Service

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Copyright © Special Education Support Service is a service of Teacher Education Section of the Department of Education and Skills

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Cecilia McGough's story and resources about schizophrenia via her blog

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My name is Cecilia McGough, and I have a severe case of schizoaffective disorder depressive type (schizophrenia + depression).

Today, I have returned from my second hospitalization this year. This is a condition that I have been struggling with all of my life but has worsen exponentially since junior year of high school. In result, I have become reclusive. I have lost "friends," opportunities, my confidence, but most of all time. Not five minutes go by without me being aware of my affliction. I cared too much of what other people might think as if having schizoaffective disorder was in anyway my fault. I am not making my illness public for any sort of attention or sympathy. Hiding my illness has become more difficult as of late, and I am tired of lying and going in extreme measures for people to not find out. I am not going to let my illness define me or run my life anymore. It is time for me to be me again. I am proud of who I am, for not giving up, and of what I have accomplished with this life crippling illness. This writing, however, is about me taking ownership of my life back.

"The schizophrenic mind is not so much split as shattered. I like to say schizophrenia is like a waking nightmare."-Elyn Saks

I have been dealing with symptoms of schizophrenia for as long as I remember. Until I was about eleven, all I saw was this shadowy figure at night, "Mr. Blob Man." At eleven, I started having panic attacks and severe depression, and I was thirteen when I started hearing whispers that were not there. During this time, I had stressors such as my parents separating, changing schools, and even living in a homeless/domestic abuse shelter for the beginning of my freshman year of high school.

The voices started out as just whispers, and I could not really tell what they were saying. It was like static and noise you get when your radio is getting reception from two different radio stations. I somehow thought this was normal, and I continued on with my life.

By junior year of high school, the before whispers in my head became this dominant middle aged girl who would yell hurtful things to me like, "just die already," "you cannot do that," "you are stupid-stupid " and more harsh of things. Again, I did not think much of this. I suspected that I was depressed, and I saw a doctor for depression, vocal cord dysfunction, and acid reflux. I did not say anything about the voices. I thought that everyone had this; I was not any different.

Nonetheless, I did not let this hinder me. I applied myself to academics, and I excelled in astrophysics: the pulsar discovery and the International Space Olympics. School was going wonderful. In the wake of an abusive home situation and medical problems, academics was the one thing in my life that I could control, so I applied my whole self to it. I do regret, however, that I shut myself away from my family especially my sisters in their times of need. I think that it was a way of me trying to protect myself from not being hurt. I would often hide myself away when I heard fighting so that I would not be triggered to have an episode. I would sometimes hide away under a cramped little space under a table in our storage room, or I would blast P!NK as loud as I could to drowned out the voices. I even eventually during senior year of high school cut my hair short and bleached it like P!NK's. I still have trouble communicating with my family because they trigger the symptoms. This is something that I hope would go away with time.

"Change the voices in your head. Make them like you instead."-P!NK

Junior year was when I started seeing things that were not there. I loved camping with Venture Crew 247. Venture Crew is a high adventure, coed branch of the Boy Scouts of America for youth members ranging from thirteen to twenty-one. I was president at the time, but it came to where I got too scared to really want to camp or go out in the woods especially at night. It started out just shadowy figures from the corner of my eye, then I started seeing It. Yes, I literally started seeing "It" ; a clown like figure that closely resembled the clown from Steven King's It. He would not talk much, just giggle and taunt. At the beginning, I only saw him at night when it was dark. His white death like skin would glow in the darkness. He became more active as time went on.

I did not have much support. I finally got the courage to tell my boyfriend at the time what was going on. He laughed at me. He had never seen the movie It. He looked it up and laughed that I would see such a thing that he found more funny than scary. I also told my mom. My dad is a flight attendant, so when he was not home, she let me sleep in her bed at night with her. I was instructed though not to tell anyone about the hallucinations. This was an instruction that I brought with me all the way until second semester of college.

I understand why my parents thought it best not to tell anybody about my condition. They thought that people would think that I was "crazy," "dangerous," and that "I wouldn't get a job" if I told anyone which is a bunch of hogwash. I learned later that in the profession that I am seeking (being a professor) that it would be discrimination if my schizoaffective disorder was the reason that I was not employed. This fear and misunderstanding resulted in years of not being treated. Regardless, living a life with schizophrenia is not worth it and unhealthy. Seek help.

It was senior year of high school that things started to really go down hill. This was probably because of the stress of college applications and disappointment of SAT and ACT scores. This is where I noticed that my thoughts were becoming more and more difficult to organize. I would try to speak, and "kaboom" my thoughts would go everywhere. I would have a difficult time defining them. I also started seeing this other figure as well. It was deathly white with a cloak made out of crow feathers. It had long fingernails that curled, and it was completely bald with a pointy nose. At the time, I was very religious and convinced that it was a devil or something and that I was possessed or being punished. Now, I am very ashamed of my past archaic beliefs and my lack of knowledge of mental illness. I did not see that figure for very long, and it never talked. It was the first to ever interact with me though. One day, this crow cloaked figure was gone-maybe for forever. The girl (audio hallucinations) and the clown (visual and audio hallucinations) continued.

I graduated high school, and then I entered Penn State Schreyer Honors College. I was ready to go. I was still not treated for schizoaffective disorder. I struggled through the first semester. Second semester, I got into a bad place. It became impossible to work. Whenever the girl would talk to me, sharp pains in my chest and thighs would start. I started seeing the clown all the time now, and he would interact with me and the surroundings. It did not matter if it was night or day or if I was stressed or happy. When I walked in crowds, I would see seas of imaginary people and objects flying about, and the world sometimes seemed to be spinning. It became unbearable.

"All sorts of very accomplished artists over the years who have turned out to be schizophrenic, and schizophrenia is not what made their creativity possible. Schizophrenia is what destroyed their careers." - Dr. Robert Sapolsky

I closed myself off from everyone. I stopped talking to my family. I would go days not eating and just hiding in my bed not going to classes. I was too scared to go to class. I ended up dropping the semester for medical leave.

During the summer after freshman year and the beginning of fall semester of sophomore year, the hallucinations became worse. The girl's voice became louder than the voices of real people talking to me.

Fall semester of sophomore year became a nightmare. I did not understand how someone so highly functional could just fall to pieces like this. I encourage all those who have a mental illness to seek treatment. There is help out there. Quit the suffering.

Because of my hospitalization and out patient care, I had to take another semester off of school as a medical leave. I am so thankful for all the support from Penn State University and the Schreyer Honors College during this time for not giving up on me.

It was a roller coaster ride throughout the process of trying different medications. Some made my blood pressure drop scary low and had liquid coming out of my ears. Others made me throw up every day. Others made me restless and always want to move around. Others made me very, very sad all the time. Others made me gain weight.

During this time, the color of the hair of the clown would change from red to green to yellow dependent on what medication that I was on. I even saw a giant hairy spider for a time while in the hospital, then I saw this yellow smooth spider that had a child's giggle when it scampered. The scariest for me though was when I saw the girl for the first time. She was blueish white with long dark uncombed hair. She was wearing a hospital gown. She looked like a drowning victim. Unlike the clown who bounced around in front of me while I walked, she walked beside me but a little behind me as well. What scared me the most was that I would sometimes give her sidewalk space when we were walking around. She held two things: a teddy bear from my past, Brown Bear with Two Shiny Buttons, and a long sharp knife. I finally realized what those sharp pains in my chest and thighs were from; they were from the girl stabbing me. She still stabs me, sometimes in the face. Both the clown and the girl are very against me taking medication. They say that it would not work and that they would never go away. To try to convince me, the clown even took off his makeup and looked like a sad old man. They were both such sad beings. In a way, was I looking at myself?

I am proud to say, that I ignored them and that I was strong. After my second hospital stay, I am currently on a medicine that is finally working. I do not see the girl or the clown everyday anymore. These days of clarity and peace have given me hope. I am still on a very low dose of this medicine, and we are walking it up to a larger dose. Even if I may never get rid of my hallucinations completely, I am confident that I can lead a highly functional and happy life due to medical help, therapy, and the support from the people around me. I encourage people like me to seek out people that you can trust. Do not suffer with this alone. Also, get medical help. There are so many resources out there and people willing to help.

Do not live your life in fear. Get Help.

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My name is Cecilia McGough, and I have a severe case of schizoaffective disorder depressive type (schizophrenia + depression). Today, I have returned from my second hospitalization this year. This is a condition that I have been struggling with all of my life but has worsen exponentially since junior year of high school.

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FAQ's for Teachers and Educators about Dissociation/Multiple Personality Disorder

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FAQ's for Teachers and Educators about Dissociation/Multiple Personality Disorder

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Questions Frequently Asked by Teachers Prepared by ISSTD's Child and Adolescent Taskforce Note: These questions and answers are designed to assist teachers in understanding and helping children who have experienced trauma and may be experiencing dissociation. The recommendations below are not a substitute for professional consultation and treatment with a psychologist, psychiatrist, therapist and/or doctor specializing in the area of trauma and dissociation.

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Children with a specific phobia have an excessive and uncontrollable fear of an object or situation that triggers so much anxiety it disrupts normal activities. This guide takes a look at how to recognize specific phobias, how they are diagnosed and how they are treated.

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Children with a specific phobia have an excessive and uncontrollable fear of an object or situation that triggers so much anxiety it disrupts normal activities. This guide takes a look at how to recognize specific phobias, how they are diagnosed and how they are treated.

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Students Who Self-Injure: School Counselor Ethical and Legal Considerations

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Students Who Self-Injure: School Counselor Ethical and Legal Considerations

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Why the show is both a learning experience for parents and an inaccurate representation of how schools and school counselors prepare for and deal with suicide

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"13 Reasons Why" opening dialogue about suicide

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Bipolar Disorder & Depression Infographic

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Bipolar Disorder & Depression Infographic

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Handout created for Dysfunctional Behavior course with information for parents and students on bipolar disorder, depression, 504 plans and IDEA

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The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder

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Required Reading for Parents, Educators and Providers, This exceptional book is an in-depth, yet easy-to-read, "bible" on early-onset (childhood) bipolar disorder. It covers every aspect of this devastating and misunderstood illness-from genetics, symptoms, diagnosis, and treatment/medications to impact on the family, educational implications, and insurance. This book ought to be "required" reading for everyone involved in the life of a bipolar child, including parents, relatives, teachers, therapists, and doctors. It is a medical reference book, parent handbook, educational planning book, treatment roadmap, and book of hope-all rolled into one!

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Bipolar Children & Early-Onset Bipolar Disorder | Bipolar Child

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Required Reading for Parents, Educators and Providers, This exceptional book is an in-depth, yet easy-to-read, "bible" on early-onset (childhood) bipolar disorder. It covers every aspect of this devastating and misunderstood illness-from genetics, symptoms, diagnosis, and treatment/medications to impact on the family, educational implications, and insurance.

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Addressing Anxiety in Schools: Information for Counselors

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Addressing Anxiety in Schools: Information for Counselors

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From Dr. Tamar Chansky Creator of Worrywisekids.org

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The chance for recovery increases the earlier an eating disorder is detected. Therefore, it is important to be aware of some of the warning signs of an eating disorder.

An individual with an eating disorder generally won't have all of these signs and symptoms at once, and warning signs and symptoms vary across eating disorders, so this isn't intended as a checklist. Rather, it is intended as a general overview of the types of behaviors that may indicate an eating disorder. If you have any concerns about yourself or a loved one, please seek additional medical help.
Emotional and behavioral signs of an eating disorder

In general, behaviors and attitudes indicate that weight loss, dieting, and control of food are becoming primary concerns

Dramatic weight loss

Dresses in layers to hide weight loss or stay warm

Is preoccupied with weight, food, calories, carbohydrates, fat grams, and dieting

Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

Makes frequent comments about feeling "fat" or overweight despite weight loss

Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy

Denies feeling hungry

Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food

Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics

Appears uncomfortable eating around others

Develops food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn't allow foods to touch)

Skips meals or takes small portions of food at regular meals

Disappears after eating, often to the bathroom

Any new practice with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)

Fear of eating in public or with others

Steals or hoards food in strange places

Drinks excessive amounts of water or non-caloric beverages

Uses excessive amounts of mouthwash, mints, and gum

Hides body with baggy clothes

Maintains excessive, rigid exercise regimen - despite weather, fatigue, illness, or injury - due to the need to "burn off " calories

Shows unusual swelling of the cheeks or jaw area

Has calluses on the back of the hands and knuckles from self- induced vomiting

Teeth are discolored, stained

Creates lifestyle schedules or rituals to make time for binge-and-purge sessions

Withdraws from usual friends and activities

Looks bloated from fluid retention

Frequently diets

Shows extreme concern with body weight and shape

Frequent checking in the mirror for perceived flaws in appearance

Has secret recurring episodes of binge eating (eating in a discrete period of time an amount of food that is much larger than most individuals would eat under similar circumstances); feels lack of control over ability to stop eating

Purges after a binge (e.g. self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, fasting)

Body weight is typically within the normal weight range; may be overweight

Extreme mood swings

Physical signs of eating disorders

Noticeable fluctuations in weight, both up and down

Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

Menstrual irregularities - missing periods or only having a period while on hormonal contraceptives (this is not considered a "true" period)

Difficulties concentrating

Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)

Dizziness, especially upon standing

Fainting/syncope

Feeling cold all the time

Sleep problems

Cuts and calluses across the top of finger joints (a result of inducing vomiting)

Dental problems, such as enamel erosion, cavities, and tooth sensitivity

Dry skin

Dry and brittle nails

Swelling around area of salivary glands

Fine hair on body (lanugo)

Thinning of hair on head, dry and brittle hair

Cavities, or discoloration of teeth, from vomiting

Muscle weakness

Yellow skin (in context of eating large amounts of carrots)

Cold, mottled hands and feet or swelling of feet

Poor wound healing

Impaired immune functioning

References:
Mitchell, J. E., & Crow, S. (2006). Medical complications of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry, 19(4), 438-443.

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The chance for recovery increases the earlier an eating disorder is detected. Therefore, it is important to be aware of some of the warning signs of an eating disorder. An individual with an eating disorder generally won't have all of these signs and symptoms at once, and warning signs and symptoms vary across eating disorders, so this isn't intended as a checklist.

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What is an Eating Disorder: Types, Symptoms, Risks, and Causes

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Eating disorders are serious mental and physical illnesses that involve complex and damaging relationships with food, eating, exercise, and body image.

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Stephanie Pena talks about her diagnosis of OCD and ways she has overcome, embraced, and struggled with the disorder

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Living With #OCD | Samantha Pena | TEDxYouth@TCS

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Child Mind Institute: Teachers Guide to OCD in the Classroom

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Child Mind Institute: Teachers Guide to OCD in the Classroom

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

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

Obsessions Common in Kids With OCD

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

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

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

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

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

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

Behaviors You Might See in Students With OCD

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

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

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

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

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

Behaviors Often Confused With Another Disorder

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

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

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

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

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

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

How to Help Students With OCD

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

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

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

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

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

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

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

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

How to Minimize Behavioral Problems

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

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

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

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

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

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

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

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Credit: Julius-Maximilians-Universität Würzburg, JMU

An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection.

Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body. They are trapped in a vicious circle, as the fear of new contamination returns quickly after washing. Sufferers see no way out. They are even incapable of changing their behaviour when the excessive washing has led to skin irritation or damage.

Around two percent of the general population suffer from some kind of obsessive-compulsive disorder (OCD) at least once in their life. The disorder is characterised by persistent intrusive thoughts which the sufferers try to compensate for by repetitive ritualized behaviour.

Like depression, eating disorders and other mental diseases, OCD is treated with antidepressants. However, the drugs are non-specific, that is they are not tailored to the respective disease. Therefore, scientists have been looking for new and better targeted therapies that have fewer side effects.
Missing protein triggers urge to wash
Professor Kai Schuh from the Institute of Physiology at the Julius-Maximilians-Universität (JMU) Würzburg (Germany) and his team explore the underlying causes of obsessive-compulsive disorder in collaboration with the JMU's Departments of Psychiatry and Neurology.

"We were able to show in mouse models that the absence of the protein SPRED2 alone can trigger an excessive grooming behaviour," Schuh says. He believes that this finding is crucial as no clear trigger for this type of disorder has been identified until now. Previous research pointed to multiple factors being responsible for developing OCD.

Occurring in all cells of the body, the protein SPRED2 is found in particularly high concentrations in regions of the brain, namely in the basal ganglia and the amygdala. Normally, the protein inhibits an important signal pathway of the cell, the so-called Ras/ERK-MAP kinase cascade. When it is missing, this signal pathway is more active than usual.
Hyperactive signal cascade in the brain
"It is primarily the brain-specific initiator of the signal pathway, the receptor tyrosine kinase TrkB, that is excessively active and causes the overshooting reaction of the downstream components", biologist Dr. Melanie Ullrich explains.

Administering an inhibitor to attenuate the overactive signal cascade in the animal model improves the obsessive-compulsive symptoms. Moreover, the JMU research team was able to treat the OCD with an antidepressant, similarly to standard therapy in humans. Their detailed results have been published in the journal Molecular Psychiatry.
New targets for therapies pinpointed
"Our study delivers a valuable new model that allows the disease mechanisms to be investigated and new therapy options for obsessive-compulsive disorders to be tested," Professor Schuh says.

The recently discovered link between OCDs and the Ras/ERK-MAP kinase cascade also opens up new targets for therapy. Drugs that inhibit this cascade are already available and some of them are approved for human treatment.

According to Melanie Ullrich, these are cancer drugs, as overactivation of the Ras/ERK-MAP kinase cascade is also a frequent trigger of cancer: "So we are wondering whether such drugs could also be effective in the treatment of obsessive-compulsive disorders and whether they are beneficial in terms of side effects."

More information: M Ullrich et al. OCD-like behavior is caused by dysfunction of thalamo-amygdala circuits and upregulated TrkB/ERK-MAPK signaling as a result of SPRED2 deficiency, Molecular Psychiatry (2017). DOI: 10.1038/mp.2016.232

Provided by Julius-Maximilians-Universität Würzburg

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An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection. Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body.

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result, their presence severely constrains the ability of the school systems to educate students effectively. The prevalence of behavioral problems among children and young adults is substantial. Many surveys indicate that behavioral disorders vary among young adults, ranging from 2 and 6 percent among K-12 students. This percentage translates into 1.3 to 3.8 million cases of behavioral disorders among the school and pre-college population.

Behavior disorders have also been referred to in a variety of different terminologies, including but not limited to:

1. Emotional and Behavior Disorders (EBD)

2. Emotional Conflict (EC)

3. Serious Emotional Disturbance (SED)

Behavioral disorders become apparent when the student displays a repetitive and impact persistent pattern of behavior that results in the significant disruption of other students. Such disturbances may cause significant impairments in academic, social, and or occupational functioning. Among the characteristics of a behavioral disorder among children and adolescents are:

General Strategies

Multidisciplinary educational teams, including parents, must design programs to meet the individual behavioral and academic needs of identified SED students. Most students can benefit from supportive treatments provided in general education programs. For others, at least temporary placements in special education classrooms, schools, or institutional programs may be appropriate.

Special education programs usually attempt to provide a structured environment where students experience a high degree of success; rules and routines are predictable; and students are consistently rewarded for appropriate behavior. Behavior management techniques, such as positive reinforcement, token economies, contracting, and time-out, which rely on direct measurement and monitoring of behavioral change, are commonly used in SED programs. The assessment and systematic teaching of social skills through modeling, discussion, and rehearsal are frequently used to help students increase control over their behavior and improve their relations with others. In addition, supportive therapies involving music, art, exercise, and relaxation techniques, as well as affective education, individual, and group counseling are sometimes employed to improve self-understanding, self-esteem, and self-control. The following are strategies that may be effective with students with EBD:

Teacher Presentation

Laboratory

Group Interaction and Discussion

1. Acknowledge the contributions of the student with an emotional disorder.

2. Call for responses and participation commensurate with the student's socialization skills.

3. As the student's comfort level rises and when a safe topic is available, encourage the student to be a group spokesperson.

4. Along with the student, devise a contingency plan in which inappropriate forms of response are replaced by appropriate ones.

5. Gradually increase the challenges in the student's participation in group exercises while providing increased positive reinforcement.

6. Help the student to feel as though he or she has something worthwhile to contribute to the discussion.

7. Some students may experience considerable strain in social adjustment in a group context. It may be necessary to work gradually toward group activities. One can devise a strategy of progressing from spectatorship to one-to-one instruction and eventually to small group discussion.

8. Should monitor carefully to ensure that the nondisabled students do not dominate the discussion or detract in any way from the successful performance of the student with the behavioral disorder.

Reading

1. It is necessary to target specific pro-social behaviors for appropriate instruction and assessment to occur such as:

1. Taking turns, working with partner, following directions.

2. Reading in group or with others.

3. Increasing positive relationships by means of awards when they read appropriately.

4. Demonstrating appropriate reading

2. Instructional strategies involving self-control, self-reinforcement, self-monitoring, self-management, problem solving, cognitive behavior modification, and metacognitive skills should be focused on teaching students reading skills

Research

1. Review and discuss with the student the steps involved in a research activity. Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.

2. Use appropriate laboratory and field strategies.

3. Depending on the site of the research check the previous two sections.

4. Show clear examples of what the students should expect as an outcome of their research.

Field Experiences

1. Use appropriate general strategies.

2. Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.

3. In field activities acknowledge the contributions and assistance of the student with an emotional disorder.

4. Help the student to feel as though he or she has something worthwhile to contribute to the field trip.

5. Use a buddy system.

6. Gradually increase the challenges in the student's participation in field exercises while providing increased positive reinforcement.

7. Group participation in field activities is highly desirable because it enhances social contacts.

8. Make the student with the behavioral disorder become one of the field trip leader of an activity which can often reduce their disorder.

9. Special efforts should be made to get students with behavioral disorders to interact with other students.

10. You should encourage students to practice field skills during their free hours.

11. Every effort should be made to arouse the interest of such students in activities, so they will learn to perform the activities with success and pleasure with appropriate behaviors.

Testing

1. Be sensitive to the student's reactions to the various aspects of assessment.

2. For each student, accumulate in his or her portfolio several examples of work (quizzes, assignments, projects) that demonstrate knowledge of the subject matter or the unit of study.

3. Make special arrangements for the student with an emotional disorder according to what their special needs are and that they do not compromise the integrity of the testing situation.

4. Stay on top of student progress through informal assessment, don't wait until it's too late to discover that there is a problem.

5. Provide private room/smaller group setting/alternative test site (with proctor present); alternatively screens to block out distractions.

Organizations

Council for Exceptional Children-Council for Children with Behavior Disorders (CCBD)
The Council for Children with Behavioral Disorders (CCBD) is dedicated to supporting the professional development and enhancing the expertise of those who work on behalf of children with challenging behavior and their families. It is a division of the Council for Exceptional Children (CEC).

CCBD Foundation
The CCBD Foundation was founded in 1997 by the Council for Children with Behavioral Disorders (CCBD), to support its mission of improving the education of children and youth with emotional or behavioral disorders (EBD).

Resources

Council for Exceptional Children (Behavior Disorders/Emotional Disturbance)
The Council for Exceptional Children (CEC) page on EBD. The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving the educational success of individuals with disabilities and/or gifts and talents.

BehaviorDisorder.org
The site offers information on behavior disorders, conduct disorders, and other behavior problems.

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K–12 classrooms…