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It is common for children that exhibit signs of a mental illness to display characteristics with their behaviors and actions (N, 2010).

It is common for children to have a label placed upon them from their peers or adult stake holders that do not understand the specifics behind the academic, emotional and social development of children.  There is a negative stigma that existed for for particular students because of parents, teachers, and other adult members in the child's life not understand how to support them academically or socially because of a lack of effort or understanding of the characteristics of the disorders some children with mental illnesses possess.

References

N. (2010). Emotional Disturbance. Retrieved from https://blackboard.angelo.edu/bbcswebdav/pid-2705183-dt-content-rid-25774750_2/courses/13662.202110/emotional%20disturbance%20fact%20sheet%282%29.pdf

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Normal & Abnormal Anxiety
The difference between normal anxiety and abnormal anxiety is the intensity and frequency of the anxiety occurrences depending on the person and type of anxiety they are suffering from.  Secondly, whether the intensity of the anxiety matches the circumstance and if the length of the anxiety is appropriate to whatever has caused the anxiety to occur.  Finally, whether the body is able to respond to a particular situation where danger has been alerted.

Panic Disorder
Panic disorder causes the heart rate to increase to where the individual may feel like they are having heart problems for what feels like a long time when in reality majority of panic attacks last for minutes with a discrete beginning and end to the episode.  The person may also feel like they are not in control of their surroundings and may begin to tremble nervously.  The anticipation of the occurrence of the next panic attack that has not happened yet causing a “fear of fear” response.

How Anxiety & Anxiety Disorders Affect Lives
Avoidance of activities such as driving, walking or being in large crowds of people could be avoided due to not wanting a panic attack to occur or fear of having a panic attack while participating in these activities.  Secondly, being bound to a safe spot and not traveling or commuting to locations or areas that cause anxiety.  The affects of others around the person suffering can be positive and negative depending on the perception of safety the user experiences and whether or not a person will support the user or “make a big deal” of the panic attack.

Diet Affecting Anxiety
Food items such as caffeine can simulate the physiological response in the body causing the person to have anxiety type symptoms by releasing epinephrine and serotonin hormones.

Panic Disorder & Generalized Anxiety Disorder
Panic disorders are discrete episodes and generalized anxiety disorder is chronic perfuse excessive worrying.  An example of generalized anxiety disorder is worrying about finances, family and other issues that are not related to having a panic attack.  Patients that suffer from panic disorders worry about their anxiety and having another panic attack; usually not about anything else pertaining to other areas of life.

Contributing Factors to Anxiety
Falling asleep, suffering from aches and pains in the body, excessive drinking, and increased dependency on tranquilizers and sleeping pills.  Increased heart rate, palpitations, shortness of breath and the anticipation that something bad is going to happen soon are other contributing factors to the disorders discussed.

Some of the factors that contribute to the risk of having these disorders are previous childhood manifestations of doing something wrong and other things that happened in the childhood experience.  These could play a role in a person suffering from an anxiety disorder but it has not yet been proven.

Types of Treatment
There are three types of treatments for anxiety disorders.  Medication, psychodynamic based psychotherapy using insight to uncover unconscious conflicts, and cognitive behavior psychotherapy that focus on relearning techniques.  Medications include benzodiazepines.

References

Tyler, J. M., Panichelli-Mindel, S. M., Sperrazza, C., & Levitt, M. F. (2019). A Pilot Study Exploring the Relationship between Perfectionism and Anxiety in an Urban Middle School. Journal of Psychoeducational Assessment, 37(8), 989–1001.

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Types of Eating Disorders

Anorexia Nervosa (AN)
The person who has this type of eating disorder usually starves him or herself, resulting in weight-loss that is extreme in nature.

Symptoms May Include:
Because of the small amount of food that is eaten, the body weight is very low.  The person experiencing this eating disorder may be excessive about paying attention to his or her weight.  Fears any gains in weight to the point of obsession and will constantly work to lose any perceived extra weight.  Cannot comprehend why anyone might be concerned or even alarmed at his or her appearance.

Bulimia Nervosa (BN)
The person who has this type of eating disorder usually binge eats and then works to overcome the effects of eating excessively.

Symptoms May Include:
Times of over-eating in excessive amounts then vomiting or taking laxatives to remove the contents from their stomach.  Loss of ability to control their emotions such as fear, panic, and other emotions during the time of binging.

Binge Eating Disorder (BED)
The person who has this type of eating disorder may binge eat without taking any measures to stop the effects of weight gain that such actions may bring about.

Symptoms May Include:
When the binge episodes are out of control, the person with this disorder may eat even when he or she is not hungry, eat until he or she is severely discomforted,  and hide the fact that he or she is eating excessively because of shame, guilt,  and embarrassment.
Avoidant-Restrictive Food Intake Disorder (ARFID)
The person who has this type of eating disorder may display little to no interest in food, be fearful to gaining too much weight, and may be a finicky eater.

Symptoms include:
Little to no food intake and constant complaining of aches and pains in the body for apparent reason. Little to no appetite with a diminishing list of food preferences over time.

Other Specified Feeding or Eating Disorder (OSFED)
The person or persons who may have these eating disorders may experience emotional distress or fear about his or her body image, but the typical systems for the other disorders are usually not seen. Some of the eating disorders often associated with this type of eating disorder are:

Atypical Anorexia Nervosa: Criteria for AN met but weight is not low.    Purging Disorder: Purging without binge eating.
Subthreshold Bulimia Nervosa: Criteria for BN met but with less frequent behaviors.
Night Eating Syndrome: Excessive nighttime eatingSubthreshold Binge Eating Disorder: Criteria for BED met but occurs at a lower frequency (National Eating Disorders Association, 2018).

District Policy/Campus Policy Serving Students With Eating Disorders

School counselors must be aware of the populations most at risk for eating disorders so they can direct appropriate prevention programs to these targeted groups (Stice & Shaw, 2004).

Early intervention in the progression of an eating disorder may result in more successful treatment outcomes (Currin & Schmidt, 2005).

A district shall develop practices and procedures that promote and establish reporting mechanisms to designate a representative.

Include a procedure that provides notice of recommendation about the student to the parent or guardian within a reasonable amount of time if the school counselor suspects:

Unexplained changes in eating habits

Noticeable weight gain or loss

Destructive behavior towards self or others.

Parent/Guardian Contact
Parents and extended family members play a crucial role in early prevention for young people’s education and training from school programs regarding eating disorders (NEDA, 2018).

It is important the school counselor provide messages to families that:

1. Assist to identify signs and symptoms of a possible eating disorder.

2. Give guidance to their children on healthy eating habits.

3. Promote a positive self body image.

4. Explain the facts about eating disorders and where they can go for treatment and support

5. Enhance their recognition of risk.

Do No Harm: Educators must take care in promoting information about eating disorders in order to facilitate care and not accidental harm.  All communication about eating disorders should contribute to one or more of these goals: Recognition, Resilience and Help seeking (NEDA, 2018).

Professional Referrals

A list of professional referrals should be created and utilized when needed.

The list should reflect medical professionals familiar with eating disorders.

Resources should accommodate families who do and do not have health insurance.

School resources and support should be presented to the parents and the student (NEDA, 2018, p.25).

Refer to district guidelines on professional referrals if unsure of the process. (NEDA, 2018, p.17).

Healthy Lifestyle & Eating Examples
How to model healthy eating and lifestyle behaviors for parents and teachers?

1. Be the person a student can trust

2. Keep healthy food in the house

3. Eat meals and snacks together as a family

4. Use healthy cooking methods and ingredients

5. Don’t use food as a reward

6. Avoid food restrictions

7. Don’t forget about physical activity!

Additional Resources
Body Positivity

Bexar County Department of Behavioral Health

Eating Disorder Hotline

Crisis Line & Help Line

Eating Recovery Center

References

Buser, J. (2012).  https://counseling.org/docs/default-source/vistas/the-school-counselor-s-role-in-addressing-eating-disorder.pdf?sfvrsn=flab

2b7e_12.

Currin, L., & Schmidt, U. (2005). A critical analysis of the utility of an early intervention approach in the eating disorders. Journal

of  Mental Health, 14(6), 611-624. doi: 10.1080/09638230500347939

Miller, C. (2017).  Parents and teachers: Are you a healthy role model?  https://www.lesun-news.com/story/life/diet-fitness/

2017/03/02/parents-and-teachers-you-healthy-role-model/98663446/

National Eating Disorders Association (NEDA). (2018). Educator toolkit.

https://www.nationaleatingdisorders.org/sites/default/files/Toolkits/EducatorToolkit.pdf

Stice, E., & Shaw (2004). Eating disorder prevention programs: A meta-analytic review. Psychological Bulletin, 130(2), 206-227. doi:

10.1037/0033-2909.130.2.206

Taylor, Z. (2011). Modeling Healthy Eating for Children. Retrieved 2011, from

https://www.psychologytoday.com/us/blog/million-meals/201111/modeling-healthy-eating-children

Texas Counseling Association. (2018). The Texas model for comprehensive school counseling programs (5th ed.). Austin, TX:  Texas

Counseling Association.https://tea.texas.gov/sites/default/files/Pub_2018_Texas-Model_5th-Edition.pdf.

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What Are Mood Disorders?
Mood disorders are conditions that involve a change in mood, thoughts, energy and behavior (DBSA, 2016).

Bipolar Disorder
Bipolar disorder is a mental disorder that causes unusual changes in mood, energy, activity levels and the inability to carry out day to day tasks (NIMH, 2020).

Depression
The exact cause of depression is unknown.  We do know that genetics and a stressful environment play roles in the onset and cause of depression (DBSR, 2019).

Schizophrenia
Schizophrenia is another type of mental illness that affects the way a person thinks, feel and behaves overall (NIMH, 2020).  Symptoms of schizophrenia usually fall into three categories: Psychotic, negative or cognitive (NIMH, 2020).

Local Resources

SAMHSA's National Helpline

SAMHSA’s National Helpline is a free confidential resource that offers 24/7, 365-day-a-year treatment referrals and information service for individuals suffering with alcoholism, tobacco or drug use, suicidal thoughts, bipolar, depression and other mental disorders.

www.samhsa.gov
1-800-662-4357

NAMI Greater Houston
NAMI Greater Houston helps individuals and families affected by mental illness build better lives by offering free mental health education classes and support groups.
namigreaterhouston.org
(713) 970-4419

Depression and Bipolar Support Alliance
The Depression and Bipolar Support Alliance is a resource that provides education, peer support, and testimonies from individuals who suffer with bipolar and depression.
Dbsalliance.org
1-800-826-3632

Schizophrenia Support Group Online
A Houston online support group for individuals living with Schizophrenia facilitated by both male and female therapists that gives the client a feminine and masculine approach.
Session Cost: $30
(832) 509-5179

National Alliance for Mental Health & Substance Abuse Recovery
NAMHSAR offers weekly support groups and meetings for those with Schizophrenia and related disorders.  The group is offered to all members of the public.  The meetings are free to attend but NAMHSAR encourages donations of five or ten dollars.
namhsar.org
(281)-397-3916

References

Depression and Bipolar Support, A. (2016). Helping A Friend Or Family Member With Depression Or Bipolar Disorder. Retrieved 2020, from https://www.dbsalliance.org/brochures/helping-a-friend-or-family-member-with-depression-or-bipolar-disorder/

Depression & Bipolar Support, R. (2019). Understanding Depression and Bipolar Disorders. Retrieved 2019, from https://www.remindsupport.org/media/files/files/24c33246/Dep_BipolarDisorder_HRremind.pdf

National Institute of Mental Health, N. (2020). Shareable Resources on Bipolar Disorder. Retrieved 2020, from https://www.nimh.nih.gov/health/education-awareness/shareable-resources-on-bipolar-disorder.shtml

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Brief Description of ADHD

Childhood ADHD (Attention Deficit Hyperactivity Disorder) is one of the most commonly diagnosed childhood disorders that is characterized by a persistent and developmentally inappropriate levels of inattention and hyperactivity that impairs their day to day function and activities (Nfonoyim, Griffis, & Guevara, 2020).  Examples include higher rates of mental illnesses, interpersonal academic difficulties (Nfonoyim et al., 2020).

Proven Strategies

The role of intervention to improve daily function in school-aged children diagnosed with ADHD is important.  In Effects of a Cognitive-Functional Intervention Method on Improving Executive Function and Self-Directed Learning in School-aged Children with Attention Deficit Hyperactivity Disorder: A Single-Subject Design Study, young adult participants diagnosed with ADHD with given an experiment to perform that measured executive functioning and self-directed learning performance (Kim, Park, Yoo & Kim, 2020).  The experiments the children were given to perform were the CCTT (Color Trails Test) and Stroop test.  The CCTT measures accuracy on self-directed tasks on puzzles, memory, colors and numbers.  The Stroop test displays a list of colors written in a different color other than the color that is being displayed to the child.  The child must select the correct option given with a minimal time limit imposed for task completion.  The CCTT and the Stroop test take an average of two minutes to complete however multiple attempts should be taken to ensure validity and accuracy of test results.  The participants were given a total of 17 experimental sessions over a seven day period.    Results showed a significant change in executive function following the Stroop and CCTT tests.  The children’s accuracy increased and errors decreased in one of the CCTT puzzles they were given to complete which represents a decrease in impulsive behavior and an increase in cognitive function and memory (Kim et al., 2020).

Implementing Strategies In School And At Home

Intervention principles that will be crucial to follow for the CCTT and Stroop test to be effective in school and at home include setting realistic goals, learning execution strategies in the home environment and integrating them into daily routines, and supporting the child’s use of execution strategies if the child needs to modify their own environment as needed (Kim et al., 2020).  As a future school counselor, I will need to serve as a key intermediary between parents and teachers and can be essential in helping students with ADHD thrive.  Secondly, I will need to be an essential resource for teachers in assisting them with ADHD students and modifying their environment as needed in the classroom setting (Addrc, 2017).

Conclusion: The Support from the School Counseling Program

The school counseling program can support students by setting realistic goals such as helping students identify supportive people who can help them stay on track and tackle roadblocks.  Examples of roadblocks would be an increase in impulsive behavior and a decrease in academics previously discussed.  Secondly, setting up SMART goals for ADHD students.  SMART stands for specific, measureable, achievable, realistic and timely.  School counselors should create and maintain as much structure in the students daily life as possible so that integrative strategies can be utilized in and away from school.  Group counseling activities such as the Stroop and the CCTT test that elicit behaviors and feelings associated with emotion that can affect cognitive and memory function positively will help participants relate with each other.

References

Addrc, A. (2017, October 23). Strategies for ADHD: How Counselors Help Today's Students Succeed. Retrieved November 03, 2020, from https://www.addrc.org/strategies-for-adhd-how-counselors-help-todays-students-succeed/

Kim, M. J., Park, H. Y., Yoo, E.-Y., & Kim, J.-R. (2020). Effects of a Cognitive-Functional Intervention Method on Improving Executive Function and Self-Directed Learning in School-Aged Children with Attention Deficit Hyperactivity Disorder: A Single-Subject Design Study. Occupational Therapy International, 1–9. https://doi-org.easydb.angelo.edu/10.1155/2020/1250801

Nfonoyim, B., Griffis, H., & Guevara, J. (2020). Disparities in Childhood Attention Deficit Hyperactivity Disorder Symptom Severity by Neighborhood Poverty. Academic Pediatrics, 20(7), 917–925. https://doi-org.easydb.angelo.edu/10.1016/j.acap.2020.02.015

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Case Study - Depression & Winnie the Pooh

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Case Study - Depression & Winnie the Pooh

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Winnie the Pooh: A Brief Synopsis

Winnie the Pooh is a story inspired and written by A.A. Milne.  The characters in the story are a bear named Pooh, Tiger a Tiger that jumps on his tail, Eeyore a sad donkey, Kanga a Kangaroo, Rooh Kanga’s son, Piglet a worrsyome pig, Rabbit a nervous Rabbit and Christopher Robin a young boy who watches over the characters.  The plot summarizes as Pooh is attempting to look for honey.  While searching for honey, Pooh and his friends set out on an adventure to find Eeyore’s missing tail and to rescue Christopher Robin from an unknown monster called The Backson because of misinterpreting a note from Christopher Robin.  An owl convinces the animals that Christopher Robin is in danger (Pooh, 2011).  Eeyore is the main character that will be focused on in this assignment.  He is characterized as being gloomy, pessimistic and depressed.  Making connections with Eeyore and the students I will be servicing one day as a professional school counselor will be crucial in how I plan or prepare for students suffering from depression or depressive symptoms.

Identified Behavior & Disorder

Eeyore the Donkey exhibits symptoms that is related to depression or having a depressive episode including being depressed most of the day, a diminished interest in activities, fatigue or loss of energy almost every day, feelings of worthlessness and a diminished ability to think or concentrate (SUNY, 2005).

Impacted School Life for Eeyore

Eeyore’s academic, social and emotional life would be negatively impacted as a result of having depression and experience depressive episodes.  She would be more at risk to school fights, threats of weapon related violence and overall bullying because of safety concerns that would lower academic performance levels in majority of Eeyore’s courses and cause a major safety concern no matter if Eeyore was a male or female (Kim, Sanders, Makubuya, 2020).  Eeyore’s depression would cause his social life to be complex.  In Evaluation of Depression with Respect to Different Social Skill Levels: A Turkish Study, children 12-14 years depression levels were evaluated by using different social skills test and levels using the Children’s Depression Inventory.  Results of the study showed that social skills were significantly impacted on students that had high levels of depression and high negative social behaviors.  Comparatively, students with lower levels of depression had more positive social behaviors with teachers, family members and peers (Deniz, Ozturk, Turan & Ozyesil, 2009).

How Others Are Affected

Eeyore’s friends, family members and peers would be affected by depressive episodes.  Indications exist with family and parents associated with their youngsters high risk of depression.  The family emotional climate can be positively or negatively impacted depending on the diagnosis and treatment of their child having depressive episodes (Sander & McCarty, 2005).  In Youth Depression In The Family Context: Familial Risk Factors and Models of Treatment, successful parent inclusion treatments for youngster’s diagnoses with depression are cognitive-behavioral therapy, interpersonal therapy, and family systems approach.  Interpersonal therapy was found to be successful in the study by Sander & McCarty when there was high involvement and low conflict with the paternal and household father figure.  According to Sanford and his colleagues, “less positive involvement of fathers and higher conflict with fathers distinguished adolescents who had persistent depressive symptoms from those with remitted depressive symptoms at follow-up” (Sanders, 1995).  Youth in the study were also less responsive to discipline from parents if depressive symptoms continued or exacerbated at the one-year check of the study (Sander & McCarty, 2005).   It is crucial to consider the at home family environment if a supportive plan is to be successful implemented by the school counselor.

Conclusion: Developing A Plan

As a future school counselor, I would begin by having Eeyore come to my office once a week preferably during a non-core subject Eeyore is enrolled in.  The American Schools Counseling Association has plenty of depression supportive templates an effective school counselor can utilize while also partnering up with classroom teachers to develop a successful plan for the student.  Figuring out which modalities of support that promote parent and teacher support will be crucial in ensuring the student has a positive educational experience with minimized depression episodes in their learning environment.  If the student does experience an episode, appropriate actions will be in place from the student support team to help minimize the episode such as home and classroom visits, educational presentations on depression, bullying, school fights and other factors that affect the day to day happenings of a students life.  My specific plan would include identify the behavior or disorder, social skills and school safety training, and finally a home visit to collaborate with the students family members to understand any other factors of support they find useful at home to implement in the school setting.

References

DENIZ, M. E., ÖZTÜRK, A., TURAN, D. E., & ÖZYEŞIL, Z. (2009). Evaluation of Depression with Respect to Different Social Skill Levels: A Turkish Study. Social Behavior & Personality: An International Journal, 37(7), 881–888.

Kim, Y. K., Sanders, J. E., Makubuya, T., & Yu, M. (2020). Risk Factors of Academic Performance: Experiences of School Violence, School Safety Concerns, and Depression by Gender. Child & Youth Care Forum, 49(5), 725–742. https://doi-org.easydb.angelo.edu/10.1007/s10566-020-09552-7

Sander, J. B., & McCarty, C. A. (2005). Youth Depression in the Family Context: Familial Risk Factors and Models of Treatment. Clinical Child and Family Psychology Review, 8(3), 203. https://doi-org.easydb.angelo.edu/10.1007/s10567-005-6666-3

SUNY, W. (2005). Abnormal Psychology. Retrieved November 11, 2020, from https://courses.lumenlearning.com/abnormalpsychology/chapter/major-depressive-disorder/

Winnie the Pooh. (2011). Retrieved November 11, 2020, from https://www.imdb.com/title/tt1449283/plotsummary