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NIMH Resources

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Use these resources to raise awareness about anxiety disorders.

Occasional stress and anxiety is a normal part of life. But anxiety disorders involve more than temporary worry or fear. An anxiety disorder is a medical condition that interfere with daily activities such as job performance, schoolwork, and relationships. For more information on anxiety disorders, visit our health topic page or view our brochures.

Help raise awareness about anxiety disorders by sharing information and materials based on the latest research.

Share these Graphics and Social Media Messages

Download and share these informational graphics to help raise awareness about stress and anxiety. You can share the text and image directly to your Facebook News Feed or Story by clicking on the button to the right of the graphic. NIMH encourages you to use the hashtag #ShareNIMH in your social media posts to connect with people and organizations with similar goals. For more ideas on how to use these education and awareness resources, visit our help page.

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Use Videos to Educate Others

Click "Copy link" to copy the video URL and post these videos on social media, or embed them on your website.

Learn More about Anxiety Disorders

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Shareable Resources on Anxiety Disorders

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Use these resources to raise awareness about anxiety disorders. Occasional stress and anxiety is a normal part of life. But anxiety disorders involve more than temporary worry or fear. An anxiety disorder is a medical condition that interfere with daily activities such as job performance, schoolwork, and relationships.

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AACAP Resource Center

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Anxiety Disorders Resource Center
Last updated February 2020

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

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

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

2. What are the signs and symptoms of anxiety?

3. What causes anxiety disorders?

4. How are anxiety disorders treated?

The American Academy of Child and Adolescent Psychiatry (AACAP) and the American Psychiatric Association (APA) developed Anxiety Disorders: Parents' Medication Guide. This guide is designed to help individuals make informed decisions about treating anxiety disorders in children and adolescents.

Included in this guide is new research on effective treatments for child and adolescent anxiety. The goal of the guide is to help parents make informed decisions about getting the best care for a child or adolescent with anxiety.

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

Dr. John Walkup discusses how to help teenagers with anxiety in a 2-minute video from the Child Mind Institute

Additional Video Clips:

What Are Appropriate Worries? - Youth Anxiety Center

Protecting Your Child - Youth Anxiety Center

When Anxious Children Become Anxious Adolescents

Part-1 John Walkup, MD
Anxiety in typically and developmentally disabled children and adolescents" by John Walkup, Vice Chair, Department of Psychiatry and Director. Weill Cornell Medical College, New York Presbyterian.

Part-2 John Walkup
nxiety in typically and developmentally disabled children and adolescents" by John Walkup, Vice Chair, Department of Psychiatry and Director. Weill Cornell Medical College, New York Presbyterian.

Part 3 John Walkup, MD
Anxiety in typically and developmentally disabled children and adolescents" by John Walkup, Vice Chair, Department of Psychiatry and Director. Weill Cornell Medical College, New York Presbyterian.

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

Additional Clinical Resources

Parent-based treatment as efficacious as cognitive behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions.
Journal of the American Academy of Child & Adolescent Psychiatry:
March 2019 - Volume 58, Issue 3, pp 307-388

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

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

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

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

A recent important study comparing medication and CBT in treating anxiety:
Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety
New England Journal of Medicine, Volume 359:2753-2766 December 25, 2008 Number 26
The use of imaging Technology and Physiological Measurements to Investigate Changes in Biological Stress Systems and Brain Development in Maltreated Children with PTSD
IACAPAP Textbook of Child and Adolescent Mental Health
IACAPAP

Your Adolescent - Anxiety and Avoidant Disorders
AACAP

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

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

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

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

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

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

Worry Time ( Apple) | ( Android)

Breathe ( Apple)

Triangle of Life ( Apple) | ( Android)

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Anxiety Disorders Resource Center Last updated February 2020 All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other caregivers with whom they are close.

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Psychotic Disorders - Bipolar Disorder Resource

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Psychotic Disorders - Bipolar Disorder Resource

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Bipolar Disorder in Children and Teens

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Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows more often than other children? Do these mood changes affect how your child acts at school or at home?

Some children and teens with these symptoms may have bipolar disorder, a brain disorder that causes unusual shifts in mood, energy, activity levels, and day-to-day functioning. With treatment, children and teens with bipolar disorder can get better over time.

What is bipolar disorder?

Bipolar disorder is a mental disorder that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. Sometimes children with bipolar disorder feel very happy or "up" and are much more energetic and active than usual. This is called a manic episode. Sometimes children with bipolar disorder feel very sad or "down" and are much less active than usual. This is called a depressive episode.

Bipolar disorder, which used to be called manic-depressive illness or manic depression, is not the same as the normal ups and downs every child goes through. The mood changes in bipolar disorder are more extreme, often unprovoked, and accompanied by changes in sleep, energy level, and the ability to think clearly. Bipolar symptoms can make it hard for young people to perform well in school or to get along with friends and family members. Some children and teens with bipolar disorder may try to hurt themselves or attempt suicide.

Most people are diagnosed with bipolar disorder in adolescence or adulthood, but the symptoms can appear earlier in childhood. Bipolar disorder is often episodic, but it usually lasts a lifetime.

Signs and symptoms of bipolar disorder may overlap with symptoms of other disorders that are common in young people, such as attention-deficit/hyperactivity disorder (ADHD), conduct problems, major depression, and anxiety disorders. Diagnosing bipolar disorder can be complicated and requires a careful and thorough evaluation by a trained, experienced mental health professional.

With treatment, children and teens with bipolar disorder can manage their symptoms and lead successful lives.

What causes bipolar disorder?

The exact causes of bipolar disorder are unknown, but several factors may contribute to the illness.

For example, researchers are beginning to uncover genetic mechanisms that are linked to bipolar disorder and other mental disorders. Research shows that people's chance of having bipolar disorder is higher if they have a close family member with the illness, which may be because they have the same genetic variations. However, just because one family member has bipolar disorder, it does not mean that other members of the family will have it. Many genes are involved in the disorder, and no single gene causes it.

Research also suggests that adversity, trauma, and stressful life events may increase the chances of developing bipolar disorder in people with a genetic risk of having the illness.

Some research studies have found differences in brain structure and function between people who have bipolar disorder and those who do not. Researchers are studying the disorder to learn more about its causes and effective treatments.

What are the symptoms of bipolar disorder?

Mood episodes in bipolar disorder include intense emotions along with significant changes in sleep habits, activity levels, thoughts, or behaviors. A person with bipolar disorder may have manic episodes, depressive episodes, or "mixed" episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that often last for several days or weeks. During an episode, the symptoms last every day for most of the day.

These mood and activity changes are very different from the child's usual behavior and from the behavior of healthy children and teens.

Children and teens having a manic episode may:

Show intense happiness or silliness for long periods of time.

Have a very short temper or seem extremely irritable.

Talk fast about a lot of different things.

Have trouble sleeping but not feel tired.

Have trouble staying focused, and experience racing thoughts.

Seem overly interested or involved in pleasurable but risky activities.

Do risky or reckless things that show poor judgment.

Children and teens having a depressive episode may:

Feel frequent and unprovoked sadness.

Show increased irritability, anger, or hostility.

Complain a lot about pain, such as stomachaches and headaches.

Have a noticeable increase in amount of sleep.

Have difficulty concentrating.

Feel hopeless and worthless.

Have difficulty communicating or maintaining relationships.

Eat too much or too little.

Have little energy and no interest in activities they usually enjoy.

Think about death, or have thoughts of suicide.

Can children and teens with bipolar disorder have other problems?

Young people with bipolar disorder can have several problems at the same time. These include:

Misuse of alcohol and drugs. Young people with bipolar disorder are at risk of misusing alcohol or drugs.

Attention-deficit/hyperactivity disorder (ADHD). Children and teens who have both bipolar disorder and ADHD may have trouble staying focused.

Anxiety disorders. Children and teens with bipolar disorder also may have an anxiety disorder.

Sometimes extreme behaviors go along with mood episodes. During manic episodes, young people with bipolar disorder may take extreme risks that they wouldn't usually take or that could cause them harm or injury. During depressive episodes, some young people with bipolar disorder may think about running away from home or have thoughts of suicide.

If your child shows signs of suicidal thinking, take these signs seriously and call your child's health care provider.
If you think your child is in crisis and needs immediate help, call 911. You also can call the National Suicide Prevention Lifeline (Lifeline) at 1‑800‑273‑TALK (8255), or text the Crisis Text Line (text HELLO to 741741). The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. These services are confidential, free, and available 24/7.

How is bipolar disorder diagnosed?

A health care provider will ask questions about your child's mood, sleeping patterns, energy levels, and behavior. There are no blood tests or brain scans that can diagnose bipolar disorder. However, the health care provider may use tests to see if something other than bipolar disorder is causing your child's symptoms. Sometimes health care providers need to know about medical conditions in the family, such as depression or substance use.

Other disorders have symptoms like those of bipolar disorder, including ADHD, disruptive mood regulation disorder, oppositional defiant disorder, conduct disorder, and anxiety disorders. It also can be challenging to distinguish bipolar disorder from depression that occurs without mania, which is referred to as "major depression." A health care provider who specializes in working with children and teens can make a careful and complete evaluation of your child's symptoms to provide the right diagnosis.

How is bipolar disorder treated?

Children and teens can work with their health care provider to develop a treatment plan that will help them manage their symptoms and improve their quality of life. It is important to follow the treatment plan, even when your child is not currently experiencing a mood episode. Steady, dependable treatment works better than treatment that starts and stops.

Treatment options include:

Medication. Several types of medication can help treat symptoms of bipolar disorder. Children respond to medications in different ways, so the right type of medication depends on the child. This means children may need to try different types of medication to see which one works best for them. Some children may need more than one type of medication because their symptoms are complex. Children should take the fewest number of medications and the smallest doses possible to help their symptoms. A good way to remember this is "start low, go slow." Medications can cause side effects. Always tell your child's health care provider about any problems with side effects. Do not stop giving your child medication without speaking to a health care provider. Stopping medication suddenly can be dangerous and can make bipolar symptoms worse.

Psychosocial Therapy. Different kinds of psychosocial therapy can help children and their families manage the symptoms of bipolar disorder. Therapies that are based on scientific research-including cognitive behavioral approaches and family-focused therapy-can provide support, education, and guidance to youth and their families. These therapies teach skills that can help people manage bipolar disorder, including skills for maintaining routines, enhancing emotion regulation, and improving social interactions.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can get better over time. Treatment is more effective when health care providers, parents, and young people work together.

Sometimes a child's symptoms may change, or disappear and then come back. When this happens, your child's health care provider may recommend changes to the treatment plan. Treatment can take time, but sticking with the treatment plan can help young people manage their symptoms and reduce the likelihood of future episodes.

Your child's health care provider may recommend keeping a daily life chart or mood chart to track your child's moods, behaviors, and sleep patterns. This may make it easier to track the illness and see whether treatment is working.

How can I help my child or teen?

Help begins with the right diagnosis and treatment. Talk to your family health care provider about any symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

Be patient.

Encourage your child to talk, and listen to your child carefully.

Pay attention to your child's moods, and be alert to any major changes.

Understand triggers, and learn strategies for managing intense emotions and irritability.

Help your child have fun.

Remember that treatment takes time: sticking with the treatment plan can help your child get better and stay better.

Help your child understand that treatment can make life better.

How does bipolar disorder affect caregivers and families?

Caring for a child or teenager with bipolar disorder can be stressful for parents and families. Coping with a child's mood episodes and other problems-such as short tempers and risky behaviors-can challenge any caregiver.

It is important that caregivers take care of themselves, too. Find someone you can talk to or consult your health care provider about support groups. Finding support and strategies for managing stress can help you and your child.

Where do I go for help?

If you're not sure where to get help, your doctor, pediatrician, or other family health care provider is a good place to start. A health care provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating bipolar disorder and can evaluate your child's symptoms.

You can learn more about getting help and finding a health care provider on the National Institute of Mental Health website. Hospital health care providers can help in an emergency. The Substance Abuse and Mental Health Services Administration (SAMHSA) has an online tool to help you find mental health services in your area.

I know someone who is in crisis. What do I do?

If you know someone who might be thinking about hurting themselves or someone else, get help quickly.

Do not leave the person alone.

Call 911 or go to the nearest hospital emergency room.

Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the toll-free TTY number at 1-800-799-4TTY (4889). You also can text the Crisis Text Line (text HELLO to 741741) or go to the National Suicide Prevention Lifeline website.

What should I know about clinical trials?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit the NIMH Clinical Trials webpage.

Reprints

This publication is in the public domain and may be reproduced or copied without permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, please contact the NIMH Information Resource Center at 1-866‑615‑6464, email nimhinfo@nih.gov, or refer to our reprint guidelines.

For More Information

MedlinePlus (National Library of Medicine) ( En español)

ClinicalTrials.gov ( En español)

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 20-MH-8081
Revised 2020

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Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows more often than other children?

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Psychotic Disorders - Depression Resource

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Psychotic Disorders - Depression Resource

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AACAP Depression Resources

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About

Many children have times when they are sad or down. Occasional sadness is a normal part of growing up. However, if children are sad, irritable, or no longer enjoy things, and this occurs day after day, it may be a sign that they are suffering from major depressive disorder, commonly known as depression.

Some people think that only adults become depressed. However, approximately 2% of children and at least 4% of adolescents suffer from depression at any given time. By the end of high school, approximately one young person in five will have had at least one episode of depression.

Children and adolescents who are under stress, who experience loss, or who have attentional, learning, conduct, or anxiety disorders are at a higher risk for depression. Depression also tends to run in families. The good news is that depression is a treatable illness.

Frequently Asked Questions

What causes depression in children and adolescents?

Depression has no single cause. Both genetics and the environment play a role. Depression in children and adolescents can be triggered by a medical illness, a stressful situation, family conflict, or a significant loss or disappointment. Young people with behavior problems or anxiety are more likely to get depressed. Sometimes, it can be hard to identify a specific triggering event.

What are the signs and symptoms of depression?

Common symptoms of depression in children and adolescents include:

Feeling or appearing depressed, sad, tearful, or irritable

Not enjoying things as much as they used to

Spending less time with friends or in after school activities

Changes in appetite and/or weight

Sleeping more or less than usual

Feeling tired or having less energy

Feeling like everything is their fault or they are not good at anything

Having more trouble concentrating

Caring less about school or not doing as well in school

Having thoughts of suicide or wanting to die

Children may also have more physical complaints, such as frequent headaches or stomach aches. Depressed adolescents may use alcohol or other drugs as a way of trying to feel better.

How can you tell if a child or adolescent is depressed? Can you screen for depression?

It can be hard to know for sure if a child or adolescent is depressed. Not every child or adolescent displays all of the symptoms of depression listed above. Talking to your children - and making sure that they can always talk to you - increases the chance of learning if and when your child is depressed. Share your concerns with your child and let them know you care about how they feel.

Many pediatricians screen for depression at annual well-child exams. They may use one of the tools listed in the "Clinical Resources" section of this Resource Center. If you have concerns about depression, talk to your child's doctor, who can do an initial evaluation, and if necessary, make a referral for treatment.

Will depression improve without treatment?

Depression may improve, over time, but if left untreated, it can be very serious with potential lasting consequences. When depressed, children and adolescents may lose friends and fall behind at school. Depressed children and adolescents are more likely to try drugs or get into trouble. Untreated depression can also lead to thoughts about suicide. It is also important to note that once someone has an episode of depression, they are more likely to get depressed in the future.

What should treatment consist of?

The good news is that there are several effective treatments for depression. Treatment may include psychotherapy (or "talk therapy"), meetings with your family, and, with your permission, discussions with your child's school. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are forms of psychotherapy shown to be effective in treating depression. Treatment may also include the use of antidepressant medication. Before starting treatment, a doctor will discuss its risks and benefits, as well as how treatment will be monitored.

How does psychotherapy work?

Several types of therapy can be used to help depressed children. Below are some examples of how they work.

Individual Therapy - Several types of therapy have been proven to be effective in depressed youth. The individual therapies with the most evidence are Cognitive Behavior Therapy (CBT) and Interpersonal Therapy (IPT). CBT helps improve a child's mood, by changing unhealthy patterns of thinking. CBT therapists teach children that thoughts cause feelings and moods which can affect behavior. During CBT, a child learns to "see" harmful thought patterns. The therapist then helps the child replace this thinking with thoughts that result in better feelings and behaviors. IPT helps improve mood by improving interpersonal relationships. IPT therapists help depressed children identify "interpersonal events," and how these events affect their relationships, their moods and their lives. Through exercises such as talking and role play, problem relationships are more fully understood and addressed.

Family Therapy focuses on helping the family function in more positive and constructive ways by looking at patterns of communication and providing support and education. Sometimes family therapy uses CBT and IPT principles described above. Family therapy sessions can include the child or adolescent along with parents, siblings, and grandparents.

Group Therapy is a form of psychotherapy where there are multiple patients led by one or more therapists. It uses the power of education and how people interact in a group to improve our understanding of and recovery from depression.

Does medication help? Is it safe?

When prescribed and monitored carefully, medication can be a safe and appropriate intervention for children and adolescents with depression. However, medication is most effective when used as a component of a comprehensive treatment plan, individualized to the needs of the child and family.

Are children and adolescents with depression at risk for suicide?

Suicide is a serious and growing problem among children and adolescents. Each year, thousands of young people die by suicide. Suicide is the second leading cause of death for 10-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds.

The majority of children and adolescents who attempt suicide have a significant mental health disorder, usually depression.

Among younger children, suicide attempts are often impulsive. They may be associated with feelings of sadness, confusion, and anger. Among teenagers, suicide attempts may be associated with feelings of stress, self-doubt, pressure to succeed, financial uncertainty, disappointment, and loss. For some teens, suicide may appear to be a solution to their problems.

Parents, teachers, and friends should always err on the side of caution and safety. Any child or adolescent with suicidal thoughts or plans should be evaluated immediately by a trained and qualified mental health professional.

AACAP Disclaimer Statement

The contents of AACAP's site, such as text, graphics, images, and all other content are for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. AACAP has made every attempt to ensure the accuracy and reliability of the information provided on this website. However, the information is provided "as is" without warranty of any kind.

AACAP does not accept any responsibility or liability for the accuracy, content, completeness, legality, or reliability of the information contained on this website. AACAP does not endorse or recommend any commercial products or services. In addition, private parties may not use them for advertising or product endorsement purposes. © 2019 by the American Academy of Child and Adolescent Psychiatry

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content_area About Many children have times when they are sad or down. Occasional sadness is a normal part of growing up. However, if children are sad, irritable, or no longer enjoy things, and this occurs day after day, it may be a sign that they are suffering from major depressive disorder, commonly known as depression.

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APA Resource

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Learn more about schizophrenia, including symptoms, risk factors, treatment options, and answers to your questions.

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The Healthy Teen Project

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Eating Disorder Organizations, Informational Websites, and Recommended Books on Eating Disorders

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Anorexia Nervosa and Related Eating Disorders

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Anorexia Nervosa and Related Eating Disorders

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ANRED Resources

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ANRED - Anxorexia & Eating Disorders Information and Resources

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ANRED provided comprehensive information about anorexia nervosa, bulimia, binge eating disorder, and other less well-known eating disorders. We retain the site's original intent, which is to be an objective resource for those seeking information about eating disorders.

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Body Whys - Breaking the cycle of Binge Eating

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Eating Disorder Treatment, Houston

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Our treatment facilities for adults and children are renowned for being beautiful, peaceful settings ideal for healing and recovery. Patients are admitted into the appropriate level of care and then "step-down" to lower levels of treatment as their journey towards recovery progresses.

Residential - For our patients who need 24-hour support, but no longer require complete medical support and stabilization.

Partial Hospitalization - This level of care offers some of the intensity and structure of Residential eating disorders treatment while providing additional opportunities to practice recovery outside of the controlled treatment environment during evenings at home or in peer-supported apartment communities.

Intensive Outpatient and Outpatient - Here, our patients spend their days with us, returning to their homes at night. This allows them to practice the skills necessary to remain healthy and protect their recovery after leaving treatment.

Aftercare - Going back home after treatment can feel scary; however, we'll continue to be with you even after you've left us. We'll ensure there is a seamless transition from your ERC care team to your home-based treatment team and our Alumni Team will continue to check in with you during the days, weeks and months after treatment with us.

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Eating Disorder Treatment | Anorexia, Bulimia, Overeating, Binge

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Our treatment facilities for adults and children are renowned for being beautiful, peaceful settings ideal for healing and recovery. Patients are admitted into the appropriate level of care and then "step-down" to lower levels of treatment as their journey towards recovery progresses.

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CHADD Resources

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CHADD - Improving the lives of people affected by ADHD

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Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) is the nation’s leading nonprofit organization serving people affected by ADHD.

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Moodnetwork.org resource lists

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effective treatments for bipolar disorder

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MoodNetwork, a project of Massachusetts General Hospital, is a nationwide effort to find the best treatments for depression and bipolar disorder. For the first time, patients, families, doctors, and researchers are working together as equal partners to change the direction of mood disorder research.

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Child Mind Institute Resources

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When parents start googling behavior issues, one phrase tends to jump out: oppositional defiant disorder. It's easy to see why. "The words 'oppositional' and 'defiant' show up in parents' vocabulary fairly frequently," says Dr. David Anderson, director of the ADHD and Behavior Disorders Center at the Child Mind Institute. "It's one of the more aptly named diagnoses that exists."

Whether your child has oppositional defiant disorder (or ODD) or not, learning about the disorder can be helpful. That's because the behavior management strategies used in treatment are evidence-based techniques that all parents will benefit from knowing.

What is oppositional defiant disorder?

It is normal for children to be oppositional and defiant at least some of the time. In fact, it's a sign of healthy development. So when does a child have oppositional defiant disorder? The diagnosis should not be given, for example, to a toddler who has just discovered that her new favorite word is "no."

ODD is typically diagnosed around early elementary school ages and stops being diagnosed around adolescence. Kids who have ODD have a well-established pattern of behavior problems. Symptoms include:

Being unusually angry and irritable

Frequently losing their temper

Being easily annoyed

Arguing with authority figures

Refusing to follow rules

Deliberately annoying people

Blaming others for mistakes

Being vindictive

All children can have these symptoms from time to time. What distinguishes ODD from normal oppositional behavior is how severe it is, and how long it has been going on for. A child with ODD will have had extreme behavior issues for at least six months.

Another hallmark of ODD is the toll it takes on family relationships. Regular daily frustrations - ignored commands, arguments, explosive outbursts - build up over time, and these negative interactions damage the parent-child bond and reinforce hostile patterns of behavior.

Parenting under fire

"Kids who have behavioral issues push parents towards the extremes," says Dr. Anderson. "They push parents to become permissive and they push parents to become hyper-coercive in the hope that a larger amount of control will get the kid to listen."

Neither of these extremes make for ideal parenting. It is never a parent's intention to reinforce bad behavior, and we often don't realize when we're doing it. Here are two common scenarios:

1. You tell your child to stop playing a game and get ready for bed. He ignores your first two requests. By the third time you ask, you're so mad that you yell.

2. You tell your child to stop playing a game and get ready for bed. He throws a tantrum because he wants to keep playing. You don't want him to be so worked up before bedtime, so you back down and say he can play for another ten minutes - but then he has to go to bed.

In the first scenario, your child learns that yelling is an acceptable way to get a message across. More subtly, he might also be learning that he can continue ignoring those first few requests - when you escalate the situation is when he knows you're serious.

In the second scenario, your child has learned that throwing a tantrum might give him something that he wants, so he'll be more likely to do it again in the future.

Both of these scenarios can set families up for future conflicts, and the more they are repeated the more they become familiar patterns of behavior that are harder to break out of. Your child doesn't have to have ODD for these scenarios to happen, but repeated negative interactions like these make diagnosing a behavior disorder much more likely.

And just like parents aren't necessarily to blame, neither are the kids, says Dr. Anderson. "Through no conscious effort of the child, he learns through hundreds of trials that this is a way to continue getting what he wants."

This also explains why kids who have ODD might act out more at home. Dr. Anderson notes, "Kids who have ODD are likely to be more oppositional with people they know well, partly because the pathways are so well worn. Whereas in a place like school, where a kid has less control in general over their environment, the types of behaviors that are common to ODD may not pay off as much."

ADHD and other risk factors

There is a very high overlap in kids who have ADHD who are also diagnosed with ODD. Depending on the study, the overlap could be 30 to 50 percent of kids with ADHD also have ODD.

Dr. Anderson explains the connection like this: "Kids with ADHD are biologically loaded to be distractible, to be impulsive, to have difficulty staying in one place for a little while. So kids with ADHD start off doing things that parents perceive as off limits. And then when those kids get negative feedback they start to become even more negatively oriented towards adults." These repeated patterns of negative interactions can lead to developing ODD.

But another pathway into developing ODD has more to do with a child's temperament and might be apparent early on. Children who had a lot of difficulty soothing themselves as toddlers and continue to struggle with an age-appropriate ability to control their emotions in the face of disappointment or frustration can sometimes develop ODD. The adults in their environment might be more inclined to accommodate their demands in order to keep the family functioning as harmoniously as possible.

Kids who have experienced a lot of life stress and trauma are also more likely to develop ODD.

Why treatment is important

It's important to get treatment to improve the parent-child relationship, which is crucial to the health and happiness of the entire household. It is also important for your child's future. Some children will grow out of oppositional defiant disorder, but others will continue to have behavior issues, which could lead to peer rejection and difficulty forming healthy relationships, not to mention continued family discord.

They'll also be less likely to achieve their potential. If something doesn't go their way, they might think it's anyone's fault but theirs. Dr. Anderson says they might also "retreat to the places where they know they can get what they want. That might mean that they try even less, push even more on the people who are closest to them, who they actually care about the most, causing even more frayed relationships."

A small percentage of kids with ODD go on to develop something called conduct disorder, which is a more severe behavior disorder that includes criminal acts like stealing, setting fires and hurting people. Getting treatment sooner rather than later improves a child's trajectory.

What treatment for ODD looks like

Parents play a key role in treatment for oppositional defiant disorder. This might be surprising, since children are the ones given the diagnosis, but in ODD the parent-child relationship needs to be repaired, which means both parties need to make changes to get back on track.

All programs have certain goals in common, like helping parents find the middle ground between being too authoritative and too permissive. A behavioral therapist helps parents learn how to train their child's behavior through setting clear expectations, praising kids when they follow through and using effective consequences when they don't. Parents also learn to use these strategies consistently - one reason why behavior management strategies sometimes don't work is because parents try different, conflicting techniques, or don't stick to one program long enough to see gains. Parents and children will also learn problem solving skills they can rely on when they run into issues.

Parent training programs might include sessions with parents and children working together, or just parents alone. Some different programs include:

Parent-Child Interaction Therapy (PCIT)

Parent Management Training (PMT)

Defiant Teens

Positive Parenting Program (Triple P)

The Incredible Years

Clinicians might also recommend social skills training to help improve your child's peer relationships or cognitive behavioral therapy if she is struggling with anxiety or depression.

There is no FDA-approved medication for ODD, but medications are sometimes used as an adjunct to behavioral therapy. Anti-psychotic medications like Abilify (aripiprazole) and Risperdal (risperidone), which have been shown to reduce aggression and irritability, are frequently used in cases where a child is at risk of being removed from the school or home. Stimulant medication may be used if a child has excessive impulsivity, including those who have an ADHD diagnosis. Antidepressants (SSRIs) may be helpful if a child has underlying depression or anxiety.

Regardless of the treatment plan your therapist recommends, parents will need to provide a lot of encouragement. "Make no mistake, kids do not often just suddenly wake up with the insight that they wish their behavior was better and then ask all the adults in their life how they can change," warns Dr. Anderson. "They'll stick with whatever behavior is working for them, even if it's not working that well."

But once the family dynamic begins to change, and kids (and parents) begin to feel more confident in their ability to get along, everyone will be a lot happier.

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When parents start googling behavior issues, one phrase tends to jump out: oppositional defiant disorder. It's easy to see why. "The words 'oppositional' and 'defiant' show up in parents' vocabulary fairly frequently," says Dr. David Anderson, director of the ADHD and Behavior Disorders Center at the Child Mind Institute.

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https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm
International OCD Foundation

The International OCD Foundation is a donor supported non-profit organization that aims to improve outcomes for individuals with OCD and related disorders by providing resources and support for those affected by OCD, promoting awareness about OCD and related disorders, and increasing access to effective treatment.
https://iocdf.org/
TLC Foundation for Body-Focused Repetitive Behaviors

The TLC Foundation for Body-Focused Repetitive Behaviors (formerly known as 'The Trichotillomania Learning Center') provides a variety of helpful tools and resources to those who suffer from skin-picking, trichotillomania (hair pulling), and other related disorders.

Additional resources and information are also available for those who wish to donate or volunteer to raise support and awareness for these disorders.
http://www.bfrb.org/
VeryWellMind.com - OCD Resources

"Are you experiencing obsessions and compulsions to a debilitating degree? Learn the hallmark symptoms of OCD, treatment options, and where to find support."

These articles from VeryWellMind.com are medically reviewed and cover a vast array of topics pertaining to OCD.
https://www.verywellmind.com/ocd-4157242
Obsessive-Compulsive Support Groups

Debtors Anonymous

Debtors Anonymous, a 12-step group, is a fellowship of men and women who share their experience, strength and hope with each other so that they may solve their common problem and help others to recover from compulsive debting.
https://www.debtorsanonymous.org/
OCD-UK

OCD-UK is a dynamic UK charity, which has been founded for people who are affected by obsessive-compulsive disorder. They aim to bring the facts about OCD to the public and to support those who suffer in silence from this often debilitating anxiety disorder.
http://www.ocduk.org/
Psych Central Forums - OCD & Trichotillomania

General discussion and support for folks with obsessive-compulsive disorders, including dermotillomania and trichotillomania.
https://psychcentralforums.com/ocd-and-trichotillomania/

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https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm The International OCD Foundation is a donor supported non-profit organization that aims to improve outcomes for individuals with OCD and related disorders by providing resources and support for those affected by OCD, promoting awareness about OCD and related disorders, and increasing access to effective treatment.

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Referral
Missouri Comprehensive School Counseling Program: Responsive Services Guide

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Guidance - ASCA Back-to-School Resources

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Guidance for School Counselors

As schools begin reentry and/or virtual learning, school counselors will face unprecedented challenges. Although the school's virtual learning plans must be flexible to allow for changes in state and local policies, they should outline what and how school counseling activities will be provided as well as address equity and access issues such as ensuring students have access to computers and internet. As student advocates, school counselors have an important voice to add to these discussions as the school year begins.

Schools and districts across the country begin classes this fall with a mix of settings including reopening for in-person classroom learning - in many cases with adapted schedules and significant health and safety practices - and schools reopening with virtual learning only. And for all schools, the situation could change at any time based on current risk of COVID-19 transmission. What's certain is that the fall semester, and likely the spring semester as well, will be anything but predictable.
While many school counseling recommendations and practices for virtual learning and school reentry have been addressed in guidelines documents and other resources, many other questions and uncertainties remain. Below you'll find resources and information to help you as you navigate this new terrain.

School Re-entry: The School Counselor's Role: School counselors have specific training to help students successfully transition to a new school year, even a year as challenging as 2020. By focusing on direct student services, school counselors can help students develop skills that will help them navigate changing expectations and environments. By providing indirect student services including consultation and collaboration with families, teachers and other stakeholders, school counselors can partner with others to make this year the best that it can be, even with its many uncertainties.

School Reentry Guidelines and Considerations: Organizations including ASCA, National Association of School Psychologists, CASEL, AASA (School Superintendents Association) and others have released detailed recommendations regarding school reentry. Among the issues addressed are multidisciplinary teams, addressing social/emotional learning and academic needs, school safety protocols and equity and access considerations.

Program Goals in a Virtual Setting: How schools and school districts track attendance and discipline data may look different this year, particularly in a virtual setting. To aid in the development of program goals during the 2020-2021 school year, refer to this guidance document.

Don't Skip Your Annual Administrative Conference: As you adapt your program for the uncertain 2020-2021 school year, be sure to schedule a meeting with the administrator who supervises the school counseling program to share your program priorities and plans for the year. Helping your administrator understand your school counseling program and agree on program priorities is more important than ever.

FAQs: Virtual School Counseling Ethics: When school counselors were suddenly thrust into online school counseling this spring, myriad ethical questions followed. Even though online school counseling guidance and recommendations have been available for a number of years, new issues have emerged as all school counselors ramped up to support students whose world had shifted.

Anti-Racism Efforts Upon Return to School: All educators have an obligation to end racism and bias, and school counselors have a unique opportunity to be an important part of the solution. Through implementation of a school counseling program, school counselors promote equity and access for all students and make a significant impact on creating a school culture free from racism and bias. While online instruction will create new challenges, consider how the ASCA standards specifically address the school counselor role in anti-racism. (Coming soon: Anti-Racism Efforts in a Virtual World.)

Practicing Self-Care During a Pandemic: School counselors are great at caring for others, but they don't always care for themselves. Clearly, there are no easy answers when it comes to self-care, but you can take a number of steps to improve your daily outlook.

ASCA's Pandemic Resources: Since March, ASCA has created and curated a variety of resources related to navigating COVID-19, including webinars, town halls, guidelines, resources, curated information from related organizations and more. These resources are updated regularly.

New Books for School Counseling: ASCA is releasing three new publications in September 2020, including:

Culturally Sustaining School Counseling: Implementing Diverse, Equitable, Inclusive Programs," by Tim Grothaus, Ph.D.; Kaprea F. Johnson, Ph.D.; and Natalie Edirmanasinghe

"Making MTSS Work," by Emily Goodman-Scott, Ph.D.; Jennifer Betters-Bubon, Ph.D.; Jacob Olsen, Ph.D.; and Peg Donohue, Ph.D.

"Making Supervision Work," by Taqueena S. Quintana, Ed.D., and Sonia Gooden Alexis, Ed.D.

Visit the ASCA bookstore in September to order.
Add Certification to Your Professional Growth this Winter: The new ASCA-Certified School Counselor (ACSC) certification demonstrates school counselor knowledge in designing, implementing and assessing a school counseling program. ACSC applications are accepted twice per year: Jan. 15 (awarded in May) and June 15 (awarded in September). Certification shows your administrators, school board and the community at large that you're committed to delivering a data-informed school counseling program.

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Back-to-School: School Counselors | American School Counselor Association (ASCA)

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Guidance for School Counselors As schools begin reentry and/or virtual learning, school counselors will face unprecedented challenges. Although the school's virtual learning plans must be flexible to allow for changes in state and local policies, they should outline what and how school counseling activities will be provided as well as address equity and access issues such as ensuring students have access to computers and internet.

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Prevention - Framework for Safe and Successful Schools

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The Texas Model