dr-nate-psych

When Success Feels Exhausting

Tue, 17 Feb 2026 19:46:47 GMT

Understanding High-Functioning Anxiety in Adulthood

Dr. Nate Balfanz, founder of Dr. Nate Psych

The majority of adult referrals I receive for psychotherapy are not from individuals in active crisis, but rather from high-functioning professionals, parents, and individuals who appear to be managing their responsibilities quite effectively. From the outside, their lives seem stable and successful. Internally, however, they are often experiencing chronic tension, persistent overthinking, difficulty relaxing, disrupted sleep, and a quiet but relentless sense of pressure.

Unlike childhood behavioral concerns that are can be more easily observed, adult anxiety is often masked by productivity. Because work performance remains intact and responsibilities are fulfilled, many adults question whether their distress “counts.” Yet sustained internal distress, even in the absence of outward dysfunction, can significantly impact long-term emotional and physical health.

What the Research Tells Us

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR; American Psychiatric Association, 2022) defines Generalized Anxiety Disorder (GAD) as excessive anxiety and worry occurring more days than not for at least six months, accompanied by symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance. While some individuals clearly meet diagnostic criteria, many high-functioning adults experience subclinical but chronic anxiety patterns that still impair their quality of life.

Research suggests that chronic worry is often reinforced by the belief that worrying is serving a protective function (Borkovec & Ruscio, 2001). Individuals may assume that anticipating every possible outcome prevents failure or harm. While this style of thinking can drive achievement and preparedness, it also keeps the nervous system in a prolonged state of activation.

Neuroscientific research on stress indicates that chronic activation of the sympathetic nervous system contributes to increased cortisol levels, muscle tension, disrupted sleep cycles, and emotional irritability (McEwen, 2007). Over time, even “manageable” anxiety can lead to burnout, relational strain, and reduced overall life satisfaction.

High-functioning anxiety is not an official diagnosis, but it reflects a clinically meaningful presentation in which competence coexists with persistent internal distress.

Common Presentations in Adults

Adults experiencing high-functioning anxiety may report:

• Constant mental rehearsal of worst-case scenarios
• Difficulty disengaging from work or responsibilities
• Perfectionistic standards and fear of disappointing others
• Trouble sleeping due to racing thoughts
• Physical symptoms such as headaches, gastrointestinal discomfort, or muscle tightness
• Irritability or emotional exhaustion masked as “just stress”

Because productivity remains intact, these symptoms are often normalized or minimized.

Tips for Better Identifying and Managing Anxiety in Adulthood

Differentiate stress from distress.
Mild to moderate stress can enhance focus and motivation. However, when activation persists beyond the task at hand, interferes with rest, or creates ongoing physical tension, it may have crossed into distress. Awareness is the first step toward intervention.
Examine the beliefs that sustain worry.
Ask yourself what you believe would happen if you did not anticipate every possible outcome. Many adults discover an underlying assumption such as, “If I relax, something will fall apart.” Identifying and challenging these beliefs is a core component of many different therapeutic treatment modalities.
Build structured recovery time into your routine.
Just as physical training requires rest for muscle repair, psychological performance requires recovery for nervous system regulation. Intentional transitions—ending the workday at a set time, engaging in technology-free periods, practicing diaphragmatic breathing—help retrain the body to shift out of threat mode.
Seek professional consultation when symptoms persist.
Even if responsibilities are being met, chronic anxiety that impacts sleep, relationships, or overall well-being warrants attention. Evidence-based treatments such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based interventions have strong empirical support for adult anxiety disorders.

A Healthier Definition of Strength

In adulthood, strength is often equated with endurance and constant output. Yet psychological resilience is better defined by flexibility—the capacity to engage when necessary and to disengage when possible. Sustainable success does not require perpetual vigilance.

If you recognize yourself in these patterns, know that anxiety does not need to reach a crisis point before it deserves care. Therapy for adults is not about dismantling what works; it is about reducing what exhausts you so that achievement and well-being can coexist.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

Borkovec, T. D., & Ruscio, A. M. (2001). Psychotherapy for generalized anxiety disorder. Journal of Clinical Psychiatry.

McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation. Physiological Reviews.

Helping Children Develop a Healthy Relationship with Failure

Fri, 14 Nov 2025 17:14:20 GMT

Why Failure Matters

Dr. Nate Balfanz, founder of Dr. Nate Psych

In our achievement-driven culture, children are often taught to fear failure. Parents, teachers, and even peers may unintentionally send the message that mistakes equate to signs of weakness. Yet, it’s precisely through failing and recovering that children build resilience, self-understanding, and confidence. The goal is not to eliminate mistakes—it’s to help children engage with them meaningfully and learn how to move forward.

When caregivers create space for reflection instead of rescue, they empower children to see mistakes as data, not defeat.

What the Research Says

In his research on emotional regulation and development, clinical psychologist Dr. Ross Thompson of University of California-Davis (1991) found that, “Emotional self-management is required for the attentional and problem-solving strategies necessary for effective cognitive functioning.” This finding underscores why teaching emotional regulation is as important as any academic instruction we provide for our young people.

More recent research confirms this connection. A 2023 study published in Developmental Psychology found that children who can identify and reflect on their emotions demonstrate stronger adaptability in school and social settings (Davis et al., 2023). In other words, how a child feels about failure profoundly influences how they respond to it.

How Parents and Caregivers Can Support a Healthy Attitude Toward Failure

Normalize and narrate mistakes.
When your child faces a setback—whether it’s a test score, a team loss, or a conflict—help them see it as part of learning: “I’ve made mistakes too, and they helped me grow.”
Encourage problem-solving instead of rescuing.
Guide your child to identify options by asking, “What could you try next?” rather than immediately fixing the issue for them.
Model "safe failure."
Let your child witness your own attempts, setbacks, and recoveries. Seeing a parent manage failure calmly normalizes imperfection.
Pause before problem-solving.
When frustration runs high, help your child slow down—name the emotion, take a breath, and reflect before acting.
Praise persistence, not perfection.
Reinforce effort, adaptability, and curiosity over flawless results: "I'm proud of how you kept at it, even when it was hard."

Why This Matters

At Dr. Nate Psych, we believe resilience is built through connection, reflection, and courage. By teaching children to engage with failure rather than avoid it, we help them develop the emotional flexibility to handle life’s inevitable challenges with strength and self-confidence.

References

Thompson, R. A. (1991). Emotional regulation and emotional development. Educational Psychologist Review, 3(1), 69-82. Retrieved from sedlpubs.faculty.ucdavis.edu
Davis, E. L., et al. (2023). Early antecedents of emotion differentiation and regulation. Developmental Psychology. Elsevier. https://www.sciencedirect.com/science/article/pii/S016363832200100X

How to Be a Good Friend: Emotional Skills for Kids

Fri, 11 Apr 2025 13:13:29 GMT

How we can teach our children about empathy, kindness, and how to manage conflicts with friends

Dr. Nate Balfanz, founder of Dr. Nate Psych

Friendship is one of the most important parts of a child’s emotional development. Through their friendships, children learn valuable emotional skills like empathy, kindness, and how to navigate conflicts. Teaching kids these skills helps them build strong, positive relationships with their peers. In this article, we’ll explore why these emotional skills are vital and provide practical tips on how to teach children to be good friends.

What the Research Tells Us

Research highlights the importance of emotional skills in forming successful friendships. Studies show that children with high emotional intelligence—like the ability to manage emotions and empathize with others—tend to have better social relationships. A 2024 article in the Journal of Experimental Child Psychology by McDonald and colleagues notes how empathy and a greater awareness of others’ feeling states is crucial for healthy friendships. Children who can understand and respond to their friends' feelings are more likely to have positive peer interactions.

Learning to manage conflicts is also essential. All friendships face disagreements, but children who learn how to resolve conflicts calmly and constructively are more likely to maintain lasting relationships. This helps reduce the chances of social stress and isolation. For children struggling with emotional regulation, individual therapy or personal counseling can provide tools for managing feelings and developing strong social connections.

Tips for Teaching Kids to Be Good Friends

Model empathy and kindness
Helping children identify and label their emotions is one of the first steps toward emotional understanding. Use simple, age-appropriate language to explain different feelings like happy, sad, angry, excited, or scared. You might say, “It sounds like you’re feeling frustrated because you couldn’t finish your puzzle,” or “I can see that you’re really happy today because you’re smiling.” Over time, your child will be able to identify and express their emotions more clearly.

Children often learn by example, so it’s essential to model empathy and kindness in your own behavior. Show your child how to listen attentively and offer support when others share their feelings. For instance, when a friend or family member is upset, demonstrate how to express compassion by saying things like, “I understand how you feel” or “It’s important to be there for our friends when they need us.” By modeling these behaviors, your child will be more likely to adopt them in their own friendships.
Teach conflict resolution skills.
Disagreements are a natural part of any friendship, but teaching kids how to navigate them respectfully is essential. Encourage your child to express their feelings calmly and listen to their friend's perspective. Using phrases like “I feel upset when...” can help kids communicate without blaming others. Teaching them to apologize and make amends when needed can also strengthen their friendships.

A therapist can teach children strategies for resolving disagreements in healthy ways, which is especially helpful if your child struggles with conflict management or social anxiety.
Encourage self-reflection and emotional awareness.
Help your child reflect on their actions and understand how their behavior affects others. After a conflict, ask questions like, “How do you think your friend felt?” or “What could you do differently next time?” Encouraging self-awareness helps children recognize their role in a situation and learn how to adjust their behavior in the future.

Conclusion

Being a good friend requires more than just playing together—it involves empathy, kindness, and the ability to navigate conflicts in a respectful way. Teaching kids these emotional skills will help them build strong, positive friendships that last. By modeling empathy, teaching conflict resolution, and encouraging self-reflection, you can help your child become a better friend. For additional support, individual therapy for children and teens , particularly therapy which focuses on emotional identification and regulation, can be a great resource for kids who need help managing their emotions and social interactions.

What is a Feeling? Understanding Emotions for Kids

Thu, 27 Feb 2025 22:01:43 GMT

Breaking down different emotions and how to express them in healthy ways.

Dr. Nate Balfanz, founder of Dr. Nate Psych

Understanding emotions is a crucial skill that children need to develop in order to more effectively navigate the world around them. Emotions like happiness, sadness, anger, and fear are natural parts of life, but often kids need support in learning how to identify or express them. Teaching children to understand their feelings and express them in prosocial ways not only helps them build emotional intelligence but also promotes optimal mental health and fulfilling interpersonal relationships. In this article, we’ll explore what feelings are, why they matter, and how children can express them in effective ways.

What the Research Tells Us

Research into emotional development suggests that emotional intelligence plays a critical role in a child's overall well-being. According to the American Psychological Association (APA), emotional regulation—the ability to manage and respond to emotions appropriately—is linked to better social skills, mental health, and academic success. Therapists help patients learn emotional regulation skills through both individual and family-focused treatment modalities, which can be particularly helpful for children experiencing depression and anxiety-related disorders.

When children understand that feelings are natural and part of being human, they’re better able to regulate them. For example, children who can identify feelings of frustration and express them without causing harm to others or themselves are more likely to build more fulfilling relationships with both peers and adults. Individual counseling services often focus on helping children learn these skills through guided discussions and behavioral interventions.

Additionally, research shows that children who can express their emotions in proactive ways experience less emotional distress and have better coping mechanisms during stressful situations. Therapy for stress management also encourages these skills by teaching kids how to process and articulate their emotions.

Tips for Helping Kids Understand and Express Their Feelings

Teach emotional vocabulary.
Helping children identify and label their emotions is one of the first steps toward emotional understanding. Use simple, age-appropriate language to explain different feelings like happy, sad, angry, excited, or scared. You might say, “It sounds like you’re feeling frustrated because you couldn’t finish your puzzle,” or “I can see that you’re really happy today because you’re smiling.” Over time, your child will be able to identify and express their emotions more clearly.

If your child struggles to express their emotions, A licensed therapist can offer both individual counseling and parent coaching support to help build these skills in the home setting.
Use tools for emotional expression.
Sometimes words alone aren’t enough for kids to express how they feel, especially if they’re feeling overwhelmed. Art, play, and journaling can be effective tools for helping children communicate their emotions. Encourage your child to draw how they’re feeling or act out their emotions with toys. For older children, keeping an emotion-focused journal where they write down how they’re feeling each day can help them better understand and articulate their feelings.
Model healthy emotional responses.
Children learn by observing adults, so it’s important to model healthy emotional regulation of your own. If you’re feeling stressed or upset, show your child how to manage those emotions in a constructive way. For example, if you’re frustrated, you might say, “I’m feeling upset right now, so I’m going to take a deep breath to help me calm down.” This demonstrates to your child that it’s not only okay to feel a range of emotions, but that there are safe and effective ways to cope with them.

Conclusion

Understanding and expressing emotions is a skill that takes time to develop but is crucial for children’s mental and emotional well-being. By teaching children the vocabulary of emotions, offering creative outlets for emotional expression, and modeling healthy emotional responses, parents can help their kids build emotional intelligence. Whether through individual counseling services, family-focused therapy, parent coaching support or simple, day-to-day conversations, providing a supportive environment where children can talk about and manage their feelings will set them up for long-term emotional success.

For families who may be struggling with emotional expression or conflict, seeking the help of a child and family therapist can provide additional tools for understanding and managing emotions as a unit.

How to Manage Family Conflict: Tips for Parents

Thu, 27 Feb 2025 21:52:48 GMT

Strategies for de-escalating tensions and promoting healthy conflict resolutions within the family.

Dr. Nate Balfanz, founder of Dr. Nate Psych

Family conflict is inevitable. Disagreements, differing values, and varying communication styles can sometimes lead to tension between family members. However, the way parents handle these conflicts can significantly impact the emotional health and well-being of the entire family. When managed correctly, family conflict can become an opportunity for growth, better understanding, and stronger connections. In this article, we’ll discuss strategies parents can use to de-escalate tensions and promote healthier conflict resolution within the family.

What the Research Tells Us

Research consistently emphasizes that how families manage conflict directly affects the overall mental health of the entire family unit. A 2020 study published in the Journal of Family Psychology shows that families who engage in constructive conflict resolution practices are more likely to have healthier relationships and a stronger sense of emotional security. On the other hand, unresolved conflicts and negative communication patterns can lead to stress, anxiety, and strained relationships.

Effective conflict resolution is linked to improved emotional regulation and reduced stress for all family members. Family therapy is often recommended for families who experience frequent or intense conflicts, as it provides a structured environment for understanding each member’s perspective. According to the American Psychological Association (APA), families who participate in family counseling tend to improve their communication skills and reduce conflict over time.

Tips for Parents to Manage Family Conflict

Regulate your own emotions first.
One of the most effective ways to de-escalate family conflict is for parents to remain calm during tense moments. When emotions run high, it’s easy to get caught up in the moment and respond reactively. However, staying grounded and managing your emotions is essential for setting a positive example for your children. If you feel overwhelmed, it’s okay to take a break and come back to the conversation when you’re feeling more regulated.
Promote open communication.
Communication is key to resolving family conflicts, but it’s important that each family member feels heard. Encourage your family to express their feelings and concerns in a respectful, non-confrontational way. Use “I” statements like “I feel upset when…” to avoid blaming others and to focus on your own experience. Active listening is also crucial—ensure everyone has a chance to speak and genuinely listen to each other’s viewpoints.

If your family struggles with communication, working with a licensed family therapist can help. Family therapy can teach families how to communicate more effectively, ensuring everyone feels heard and understood. Whether through virtual family therapy or in-person sessions, professional support can provide guidance on healthy communication habits.
Establish family ground rules for conflict.
Set up clear guidelines for how your family will handle conflict when it arises. These rules should include things like no shouting, no name-calling, and a commitment to listening without interrupting. Establishing these boundaries ahead of time can prevent conflicts from escalating and help family members manage their emotions in a structured way. You might also introduce a "time-out" rule, where individuals can take a short break if they feel overwhelmed, and then return to the discussion calmly.

For families experiencing frequent or intense conflicts, treatment modalities such as family systems therapy can help develop these ground rules and foster a supportive environment for conflict resolution. This type of therapy encourages families to view conflict as a shared problem, rather than assigning blame to one person.

Conclusion

Managing family conflict is not always easy, but it’s a vital skill that can strengthen relationships and improve the overall emotional well-being of the entire family unit. By staying calm, promoting open communication, and establishing clear conflict resolution guidelines, parents can foster a positive and supportive family environment. If family conflict is causing significant distress or leading to unhealthy patterns, seeking professional support through individual therapy , parent coaching interventions, and family-focused treatment can help families build healthier ways of dealing with stress and tension.

Barks for the Brain: Why Having a Pet is Healthy

Fri, 17 May 2024 01:57:24 GMT

Neuroscientific research findings suggest that owning and caring for a pet can have a significant positive impact on the biochemical makeup of our brains.

Dr. Nate Balfanz, founder of Dr. Nate Psych

It doesn’t take a doctor to point out the number of benefits that come with owning a pet. As a proud parent of two four-legged, furry children, I have experienced firsthand the positive impact that my dogs have had on making my family’s home a warm and welcoming place to come back to at the end of the day. Pets have the ability to provide us with companionship on lonely days, they help to get us off the couch and out on the running trail, not to mention they can offer us invaluable lessons about how to nurture and care for ourselves and one another. In addition to these benefits, fascinating new research in the domain of cognitive neuroscience suggests that owning a pet can have a profound effect on the actual biochemical makeup of our brains.

What the Research Tells Us

Dr. Rebecca Johnson and her team of researchers at the University of Missouri-Columbia Center for the Study of Animal Wellness have conducted multiple studies that suggest how physical interactions with our pets - petting, hugging, kissing, cuddling – help to promote the release of chemicals in our brain that can, in turn, elevate our mood and ward off feelings of anxiety or depression. Dr. Johnson states,

“Our preliminary results indicate that levels of serotonin, a hormone in humans that fights depression, rises dramatically after interactions with live animals, specifically dogs. This hormone is critical to the psychological wellbeing of an individual.”

She goes on to identify how another naturally produced “feel good” hormone in the human brain, oxytocin, also experiences a spike in production as a result of our interactions with pets.

“This is very beneficial for us, as oxytocin helps us to feel happy and trusting of others,”

notes Dr. Johnson. Thus, while the researchers go on to acknowledge that there is no substitute for positive, nurturing, human-to-human relationships, owning a pet might be the next best thing for both your physical and mental health.

Things to Consider Before Making the Decision to Own a Pet

Is it the right time for me?

A positive pet-owner relationship can best be promoted in the context of a stable and settled home environment. If you are amid any major life transitions — e.g. moving across the country, starting a new job, expecting a baby — then perhaps it would be in the best interest of both you and your future pet to delay the process until the timing is better suited for owning a pet.

Is it the right cost for me?

Whether you’re pursuing an adoption or purchasing from a breeder, owning a pet can get expensive. Between food, shelter, regular and unanticipated trips to the veterinarian, toys, treats and grooming expenses, the costs of owning a pet will add up quickly over time. Take the time to research the average annual costs of owning a pet of your choosing, and see how well it fits into your current budget.

Does it fit with my lifestyle?

Determining if a pet will fit your lifestyle requires careful consideration of several factors. Does your work and travel schedule allow for you to own and care for your pet? Is your home and/or your neighborhood pet-friendly? Does your life’s general structure and routine have room to incorporate caring for a pet? As we have highlighted, while there are innumerable benefits to owning a pet, the costs that come with it are a reality that one will have to consider before deciding to welcome a pet into the home.

How Do We Support Our Adolescents in Their Search for Identity and Acceptance?

Fri, 17 May 2024 01:52:13 GMT

Who am I?

Dr. Nate Balfanz, founder of Dr. Nate Psych

Many of us know all too well the obstacles that the life stage of adolescence can bring. From struggling to understand who we are and where we fit in, to striving for acceptance from adults and same-aged peers, the success with which we were able to navigate this critical period has likely had a lasting impact on who we are today. This search for identity and acceptance in adolescence can manifest itself on multiple levels, not only in how we think and feel about ourselves and others but also in how we develop physically, cognitively, and emotionally. I believe that the vast majority of mental health-related conditions are in part a by-product of our adolescent struggle to know ourselves, to feel comfortable and accepting of ourselves, and to experience those same feelings of comfort and acceptance from the world around us. For current and expecting parents of children in the adolescent age range, it will be critical to have an understanding of how to support your child in their identity search.

What the Research Says

Erik Erikson, a world-renowned practitioner and early pioneer in the research on lifespan development, published a theory of psychosocial growth in the 1960s. In his report, he illustrated the mental struggles we encounter at different, well-defined stages throughout our lives.

Erickson identified the primary struggle of the adolescent life stage as 'identity versus role confusion.'

This struggle includes a negotiation between our internal psychological world (physiological urges and sensations, inner thoughts and feelings, awareness of self, and the relationship between mind and body) and our external social world (influences of family members and peers, our perceived expectations from others and the balance of social hierarchies).

The vast majority of adolescents struggle with the idea of understanding and accepting who they are and what they believe in, frequently displaying an image of themselves to the outside world that is inconsistent with how they think or feel about themselves on the inside.

This confusion around what they believe to be true about themselves triggers adolescents to behave in a way that they think will be pleasing or socially acceptable to others. This behavior can result in depressive symptoms, intense feelings of anxiety, social isolation, and discord in interpersonal relationships. It can also manifest as struggles in academic or occupational pursuits, habitual drug and alcohol use, or even thoughts and feelings of self-harm or suicide.

In optimal situations though, adolescents will successfully navigate this stage and emerge into adulthood with a clearly understood and accepted sense of self-meaning, they have an understanding of who they are and what they believe in and it's consistent with the personhood and the belief system that they present to the outside world. This understanding then grants them the confidence to form healthy interpersonal relationships, the ability to maintain safe boundaries, and the courage to act with conviction and try new things.

Tips for Supporting Your Developing Adolescent

Scale back the advice-giving.
Unless your adolescent has explicitly asked you for it, try to resist the urge to lead with giving advice. More often than not, children simply want to have their feelings heard and validated without being told a solution to their problems.
Allow your child to make mistakes.
Other than those that might result in injury to themselves or others, mistakes can teach adolescents just as much about themselves, if not more, than successes can. Most importantly, allowing for mistakes will teach children that it's not necessary to be perfect all the time.
Avoid the temptation to say, "I told you so."
This tip goes hand-in-hand with the first two. The only thing worse than too much advice-giving or too much rescuing is telling our children "I told you so," after things did not work out the way they had hoped. No valuable lesson or guidance will come as a result of reminding your adolescent that they were wrong and you were right.

How Do We Remain Responsive to the Mental Health Needs of our Children?

Mon, 08 Apr 2024 06:17:19 GMT

Consistency is the key.

Dr. Nate Balfanz, founder of Dr. Nate Psych

After serving the mental health community for nearly 20 years, I've witnessed an ongoing trend in the mental and emotional wellness of many of the children I see in my role as a therapist. Typically, these children are referred to therapy by a parent or school provider in the early months of the academic year, when learning and behavioral problems begin to surface. After meeting for their initial consultations, some parents will elect to discontinue the treatment for a variety of reasons. This is most often because one of the many school holidays is on the horizon and the timing of the treatment does not feel ideal. The holiday passes, at which point the parents question whether resuming treatment will be necessary or not. By the time they have made their decision, perhaps another school holiday is upon us, and again it no longer feels like an opportune time to resume.

Meanwhile, the child's symptoms have intensified to the point where ongoing treatment is no longer an option, but rather a medical necessity. By now it's spring, and with all the holidays behind them, the parents finally resume their child's treatment. After trying therapy again for a couple of sessions, the summer holiday arrives, the family goes on break for two months, and the cycle starts all over again the following year.

Does This Situation Sound Familiar to You?

In this article, I’d like to provide a guide for parents and other caregiving adults on how to earlier identify the warning signs and symptoms of mental health-related concerns in their children. I will also cover how to discuss these concerns with your child and highlight how ongoing, consistent adherence to mental health treatment can make all the difference in a child's ability to effectively manage their symptoms.

Assessing Mental Health Concerns in Your Child

Listed below are four separate, but related domains of mental health signs and symptoms in children. While all children will experience symptoms in each of these categories from time to time, if you begin to observe an elevation of symptoms across multiple domains, then it's likely the right time to schedule a visit with a mental health professional.

1. Physical

Headache
Stomachache/nausea
Restlessness
Over/under-reactivity
Feeling 'on edge'

2. Cognitive

Difficulties concentrating
Confusion
Indecisiveness
Forgetfulness
Reduced academic performance

3. Emotional

Fluctuations in mood
Low frustration tolerance
Crying and sadness
Anger and irritability
Flat affect (lack of reaction to emotional stimuli)

4. Behavioral and Interpersonal

Frequent disagreements with adults/peers
Changes in daily routine
Changes in eating and sleeping habits
Increased school absences
Withdrawing and isolating from others

Tips for Responding Proactively to a Child's Mental Health Needs

Give the therapy process time.
Similar to going to the gym to work out your body, going to the therapist to work out your mind takes consistency and time. While each case will differ, I often encourage my patients and their families to allow for 8-10 consistent, weekly sessions before they see positive changes in mood and daily functioning take shape.
Help your child to differentiate between stress and distress.
Each of us operates along a continuum of stress; in fact, it’s those mild to moderate doses of life stress that help get us out of bed and motivate us to accomplish tasks throughout the day. With that said, the amount of stress we endure has its point of diminishing returns, where once healthy, motivating stress can progress to the point of overwhelming and debilitating distress. Have a conversation with your children about what stress means, how it can be healthy, how to recognize their stress limits, and when it's time to reach out for support.
If you see something, say something.
Children often refrain from disclosing their mental health concerns for fear their parents won't understand or they will be disappointed in them. As a result, the responsibility will fall on you as the concerned adult to raise these sensitive topics with your child, particularly if you've noticed them exhibiting some of the signs and symptoms listed above.

How to Help Children Manage Ruptures to Friendships

Mon, 08 Apr 2024 06:10:31 GMT

Making things right.

Dr. Nate Balfanz, founder of Dr. Nate Psych

As a child and family-focused clinician serving the South Orange County, CA community, the spring season is by far my busiest time of the year for a variety of reasons. For starters, the majority of national holidays and school breaks have passed, and parents who were considering therapy for their children at some point throughout the school year now feel ready to begin the process. In addition, school teachers and administrators can identify more clearly which students with academic and/or behavioral challenges they can manage within the school setting, versus those that would benefit from the additional support of an outside treatment provider. Recently, many of the referrals I have received involve children who are experiencing prolonged challenges with initiating and maintaining positive relationships with others, while also struggling to resolve the disruptions that tend to occur in those relationships. As one can imagine, this often leads to a detrimental impact on a child’s sense of self-worth and regard for school as a safe and welcoming environment.

So, what can we do as parents and supportive adults to help our children manage the inevitable challenges that come with making and maintaining a consistent and reliable group of friends?

What the Research Says

Time and again, research has indicated how a child’s ability to tolerate frustrations and navigate disruptions that can occur in peer relationships originates within the home environment.

In a 2013 longitudinal study on the evolution of children’s social competency from infancy to adolescence, developmental neuroscience expert Dr. Ruth Feldman and her colleagues derived this finding. One of the strongest predictors of a child’s ability to demonstrate social capabilities, to exercise conflict resolution strategies and to minimize aggressive, acting out behavior in social exchanges was the frequency and quality of interpersonal relationships with caring and attentive adults in the infancy and toddler years. In other words, there is a direct correlation between the success with which your child is able to manage conflicts and ruptures in their relationships beyond the home, and the quality of your relationship as a parent to your child from infancy and throughout the childhood years.

Tips for Parents in Helping Their Children Manage Their Social Relationships

Validate the feeling while modifying the approach.
I always make it a point to remind parents and children alike that our feelings are never wrong; it’s what we choose to do with them that makes all the difference. Teach your child that it’s okay to feel angry, sad, or upset after a disagreement with a friend, and then brainstorm with them the language they could use to communicate those feelings in a manner that does not further escalate the situation. For example, “When we argued, it made me feel sad because our friendship is important to me.”
Model healthy conflict resolution for your child.
I will often encourage parents to conduct themselves, whether at home or in the workplace, as if their child is watching their every move. As research suggests, there is no model more important than a parent to demonstrate how to effectively manage disputes and repair ruptures to interpersonal relationships.
Help facilitate a discussion to restore the relationship.
An effective strategy that I see frequently utilized in schools is requesting a counselor to host a ‘restorative chat’ to help resolve a dispute that has occurred amongst friends in the school setting. With the assistance of a supportive adult to help facilitate the discussion, children are encouraged to take ownership of their actions, validate one another’s feelings, and work cooperatively to arrive at a peaceful resolution to the problem at hand.

Holiday Tidings, Traditions, and Togetherness

Sun, 17 Dec 2023 23:11:38 GMT

How can the rituals and traditions of the holiday season contribute to shaping our identity and sense of self?

Dr. Nate Balfanz, founder of Dr. Nate Psych

One of the most enjoyable aspects of being a mental health practitioner in a diverse, Southern California community is having the opportunity to learn about a patient’s cultural practices, belief systems, and traditions that may be similar or different from my own. These therapeutic exchanges not only enhance my understanding of the unique qualities of each individual but also provide patients with an opportunity to rediscover and reconnect with aspects of their identity that may have been overlooked. The holiday season, in particular, serves as an ideal time to reflect on the personal, family, and culture-specific rituals and traditions that contribute to shaping our understanding of identity and sense of self over the years. It is during these moments of cultural exchange that the richness of our diverse backgrounds becomes more pronounced, fostering a deeper connection between practitioner and patient.

What the Research Tells Us

Research has reflected time and again that there are numerous benefits to regularly practicing time-honored rituals, traditions, and routines for both the individual and collective psyche of a family unit. Specific to children and adolescents, research informs us that kids who have a good understanding of their family values and heritage, and regularly engage in culturally specific rituals are likely to grow up to become more resilient, higher-functioning adults. A 2000 study by Syracuse University researchers Samia Markson and Barbara Fiese demonstrated how children who were reared in families that placed a great deal of importance on cultural practices and honoring of traditions not only reported lower levels of anxiety but these meaningful family rituals also were shown to be a protective component of the child’s overall physical health and general wellbeing.

The researchers noted that a child who has a good grasp of the routines and rituals specific to their family is likely better equipped to take on life’s inevitable challenges and unexpected events.

Tips for Maintaining Rituals and Traditions This Holiday Season

Connect with your local government or chamber of commerce to discover holiday activities tailored to your personal, cultural, and/or religious background
Given the diverse landscape of Southern California, there’s a good chance you will discover other individuals and families who share in your cultural rituals and routines.
Share your time-honored, family traditions and values with the next generation to foster a sense of inclusion and connectedness.
This could also include empowering your child or the youth in your family by involving them in the creation of new holiday rituals that align with your family's values and belief systems.
Reflect on special memories from holidays past
Reminiscing about positive experiences from one’s past can help improve one’s psychological and emotional well-being (numerous treatment modalities incorporate the act of “reminiscing” as a key component of effective therapeutic practice). Take time out this holiday season to gather around the kitchen table with your family and friends, and encourage each other to share your most cherished memories from holidays past.

Addressing the Sensitive Topic of Suicide With Our Children

Wed, 15 Nov 2023 23:03:47 GMT

How can we as parents identify and support our young people struggling with thoughts of suicide?

Dr. Nate Balfanz, founder of Dr. Nate Psych

One of the first questions that I ask all of my new patients starting therapy (regardless of the reasons they came to see me) is, “Have you ever had thoughts, either currently or in the past, of suicide or wanting to harm yourself?” And in my nearly 20 years of practice in the field, I’m struck by the number of young patients who answer “yes” to this question, with responses ranging from casual passing thoughts of self-harm to active suicidal ideation coupled with recent attempts. As with most mental health conditions, early detection and intervention are key, thus our current focus will be on how we as parents can identify and support our young people struggling with thoughts of suicide.

What the Research Says

According to a 2016 research study published by representatives from the World Health Organization, suicide accounts for approximately 6% of deaths among our child and young adult population, ranking as the second-leading cause of death for 15-29 year-olds worldwide. For every completed suicide, the number of additional individuals experiencing active suicidal ideation and attempting suicide occurs at an alarming rate of 20 times that.

Given the status of suicide as a global epidemic happening across different cultures, classes, and countries of origin, it further stresses the importance for us practitioners working in diverse communities to screen every one of our patients at the outset of treatment for any evidence of either current or past suicidal ideation and/or attempts. For families with children who are experiencing thoughts of suicide, I always advocate for having an honest, open, and ongoing discussion regarding the matter until both the child and parents feel as though the dangerousness of the situation has abated.

Despite the increased incidence of suicide and suicide attempts worldwide, such thoughts or behaviors are never to be considered a typical reaction to childhood stress—thus the importance of these discussions with your children should not be minimized or overlooked.

Tips for Talking to Your Child about Suicide

Do not avoid the discussion
Oftentimes parents will shy away from a discussion about suicide, for fear that talking about it may increase the likelihood that their child will act upon it. In actuality, research and clinical practice have shown that providing children with a safe and supportive outlet to discuss their feelings is a primary method of suicide prevention.
Be direct with the language you use
We want to avoid using veiled language or euphemisms in discussing suicidal thoughts or worries with our children, as it further contributes to the ambiguity about whether or not this is a safe topic to discuss. An example of being direct with our children about our concerns might sound something like, “I heard that you were feeling so upset lately that you wanted to hurt yourself. This has me worried, and I’d like for us to talk about it.”
Refrain from the blaming and shaming
The number one reason children give me as to why they avoid discussing thoughts of suicide with their parents is the fear that mom and/or dad would be mad at them. In these sensitive discussions with your child, stay focused on their feelings and avoid using language that might contribute to the shame that they are likely already experiencing about having such thoughts in the first place.

Identifying Strategies to Help Children Set Realistic and Achievable Goals

Tue, 17 Oct 2023 22:11:54 GMT

How can we utilize a pragmatic method in helping our children set challenging but achievable goals for themselves, both in and outside of the classroom?

Dr. Nate Balfanz, founder of Dr. Nate Psych

With the winter holiday season drawing near, I try to make it a point to encourage my families to use the upcoming break exactly as it is intended – to relax, enjoy the company of family and friends, and ultimately recharge our batteries before diving headfirst into the new year.

Before you know it though, the break will come to an end, and life will inevitably require us to shift our focus to preparing our children (and ourselves!) for the second half of the academic calendar year. For those kids who had a difficult start academically or otherwise, I will suggest to both the child and the parents to consider the holiday break as a "hard reset," with hopes of inspiring a renewed sense of encouragement and vigor for the remainder of the school year. In our role as parents, we can use this as an opportunity to help our children create goals that will reinforce a "can do it" attitude and a belief in their abilities. Let’s take a moment here to explore a pragmatic method of helping our children set challenging but achievable goals for themselves, both in and outside of the classroom.

What the Research Says

In the mid-1960s, American industrial/organizational psychologist Dr. Edwin Locke conducted research examining the relationship between motivation and human behavior, to develop a concept he would identify as 'Goal Setting Theory.' The theory demonstrated wide-range applicability across multiple settings, and would later provide the basis for a useful mnemonic created by business performance consultant George T. Doran, known as the S.M.A.R.T. method of goal setting.

In its original form, Doran proposed that goals which were:

Specific, Measurable, Assignable, Realistic, and Time-related

helped to provide the goal setter with a clearer roadmap for how to achieve their objectives. The acronym itself has gone through multiple iterations since its original design, which is often dictated by the setting and population to which they are applied. Research and real-world applications have demonstrated how the S.M.A.R.T. method can also be useful in guiding our children through their various academic and extracurricular pursuits by providing them with a realistic and objective measure of achievement to collaboratively work towards.

Using the S.M.A.R.T. Method with Our Children

While goals will vary with age and circumstance, listed below are basic examples of how to turn a 'good' goal into a 'better' goal by applying the S.M.A.R.T. method of goal setting.

Specific: Be clear and concise about what is trying to be achieved
Good: Get good grades
Better: Get all A's and B's this quarter

Measurable: Ensure that the goal can be easily tracked and monitored
Good: Participate in more extracurricular activities
Better: Join one new club and participate in one new sport this semester

Achievable: Consider if achieving the goal is realistic
Good: Learn to speak a new language
Better: Meet with my Spanish tutor three times a week for the next three months

Relevant: Make the goal meaningful and contextually significant
Good: Decide what I want to do for my career
Better: Pick a college major that is consistent with my academic strengths and interests

Time-based: Assign a specific time frame by which to achieve the goal
Good: Submit all of my college applications
Better: Submit each of my college applications one week before their due date

Talking With Our Teens

Tue, 17 Oct 2023 21:52:52 GMT

How do we maintain strong connections with our children during the challenging transition period of adolescence?

Dr. Nate Balfanz, founder of Dr. Nate Psych

In a previously written article, I highlighted how understanding developmental changes in the adolescent brain could help to provide a framework for responding to corresponding observable changes in an adolescent’s personality and behavior. Specifically, I noted how the rapid growth and restructuring that occurs in the brain during the teenage years helps to prime adolescents for a time in their lives geared towards developing peer relationships, taking risks and trying new things, and exploring their own talents, passions, and belief systems as they face the inevitable launch into adulthood.

While the article was well received, a number of parents emailed me with follow-up questions requesting more explicit feedback about how to apply what was learned about the adolescent brain to helping build more effective communication channels with their adolescent sons and daughters. Thus, I have since taken the liberty of developing a “teen talk checklist” which highlights strategies gleaned from research and clinical application over my time as a clinical psychologist specializing in the treatment of children and families. While the items on the list are in no particular order, the more strategies parents are able to utilize in their daily interactions with their teens , the more effective they will be at connecting with their children on a meaningful, intimate level.

The Teen Talk Checklist

Take on the teen's perspective
In attempting to connect with your teen, you’ll need to consciously move from the position of an outside observer of the child’s experience to that of an active and involved participant. This can be accomplished by asking yourself the question, “What would I need right now if I were in my child’s shoes?” while also using statements that convey genuine curiosity and interest into your child’s experience (ex. “What was that like for you?”).
Validate and contain the teen's feeling states
In addition to aligning with your child’s perspective, you’ll want to provide affirmation and validation for your child’s feeling states (an important step that parents frequently overlook). This can be done by providing process commentary about what you see happening for your child on an emotional level through phrases such as, “I can see how this made you feel…” or “That must have made you feel really…” It’s only after you have validated your child’s feeling states that you can then switch gears to providing more explicit direction and support for what to do in a situation.
Use self-disclosure and humility to your advantage
It will be helpful to consider the importance of well-timed self-disclosures in your role as a supporting adult in your child’s life. A thoughtful self-disclosure is useful such that it humanizes you as a parent and helps the teen to feel less alone in his/her struggles. Real healing can only take place when your child experiences you less as an adult simply talking down to them as a child, but more so as a kind, compassionate, and consistent human being in whom they can relate and confide.
Trust that everything being said has meaning
This helps to demonstrate that you are engaged and that you place value in what the child considers important enough to talk about, even if at first it may be seemingly insignificant. If you can have the patience to look closely for the details in the minutiae of what your children are saying, you’ll be demonstrating to them that you know how to listen and you’ll be there to hear them out when they choose to go deeper.
Remain aware of your own feeling states
I encourage all parents in the families that I work with to make sure they are performing regular “self check-ins” to recognize which of their own needs are not being met, as it will likely have an impact on their capacity to effectively attune to the needs of their children. Monitoring and exercising self-care is critical for parents not only because they are entitled to it, but also because their children deserve a positive model for what healthy mental and emotional functioning will look like.

What is the Role of Empathy in Raising Happy and Successful Children?

Tue, 17 Oct 2023 21:40:07 GMT

To put it simply: when we are emotionally kind to our children, they will be emotionally kind to others.

Dr. Nate Balfanz, founder of Dr. Nate Psych

While many of us are familiar with the concept of empathy, perhaps we have a less firm understanding of what it means to apply it to the practice of raising our children. In psychological literature, empathy is defined as the ability to 'feel' the experience of someone else, or to have the capacity to relate to and understand one another as the result of a shared experience. In my work as a child- and family-focused practitioner, there is a common strategy I use to promote the practice of empathy in my parent-focused sessions. I regularly encourage parents to think back to a time when they were their child's age and experienced struggles or challenges similar to what they might be managing. Despite the differences that will exist as a result of contextual factors or generational gaps, parents are typically able to access a moment from their upbringing that aligns with their child's experience. When parents are capable of relating their own experience to that of their child's, we often find that it leads to more informed and supportive parenting intervention approaches.

What the research says

Childhood development experts and researchers indicate that when we respond to our children in an empathic manner, through the use of emotionally supportive language and attunement, we can in turn teach them to become more thoughtful, caring, and considerate individuals from an early age. There is a 2013 study by Dr. Celia Brownell and her colleagues at the University of Pittsburgh (US), aimed at measuring the capacity for sharing and helping behavior in toddlers.

They found when parents facilitated dialogue with their children that encouraged reflection on both their own emotional experiences and the emotional experiences of others, the children were more likely to demonstrate altruistic helping and sharing behaviors towards their same-aged peers.

The authors go on to note that despite not yet having a firm grasp of the moral implications of their altruistic behavior, toddlers can develop these abilities purely as the result of having parents who both demonstrate and encourage empathic behavior and reflection in their children. To put it simply: when we are emotionally kind to our children, they will be emotionally kind to others.

Tips for building empathetic connections with our children

Frequently utilize your emotional vocabulary
Emotions begin as sensory experiences in the body, and children who have a firm grasp on the words that we use to describe these experiences are better able to self-regulate and manage their feelings. As a parent, you can help with this by frequently acknowledging and voicing both the emotions that you feel as well as the emotions that you observe in your child.
Don't shy away from serious topics
Empathy occurs on both micro and macro levels. This means that we observe it not only in how we treat one another but also in how our greater society operates. Having age-appropriate conversations with our children regarding what's happening in the world will enhance their abilities to experience compassion and foster caring relationships.
Encourage cooperative play and problem-solving from a young age
Empathy—both our ability to experience it and express it—is built primarily in the context of interpersonal relationships. As early as the toddler years, provide your child with multiple opportunities to be involved in cooperative play activities with same-aged children. When disruptions inevitably occur in the play, modeling and encouraging our children to talk through their disagreements with one another will help develop their emotional awareness.

How Parents Shape a Child’s Ability to Communicate Their Feelings

Tue, 17 Oct 2023 21:25:09 GMT

What is the critical role that parents and other caregivers play in shaping their child's temperament and emotional competency?

Dr. Nate Balfanz, founder of Dr. Nate Psych

In the early stages of my career as a practicing psychotherapist , a supervisor taught me I could learn more about my patients when I focused less on 'what' they had to say, and more on 'how' they said it. From the pitch and intonation in a person's voice to their body language and facial expressions, the spoken word is perhaps the least reliable indicator when it comes to conveying our honest thoughts and feelings to one another.

More often than not, the interpersonal conflicts and disagreements that I encounter among family members can be attributed to simple misunderstandings and miscommunications of the spoken word

This dilemma becomes of particular importance when we consider the contrasting communication styles — both verbal and nonverbal — that often exist between parents and their still-developing children. For this insight into emotional awareness and communication styles, let's take a closer look at the role that parents play in modeling these abilities in their children, starting from an early age.

What Research Says

One of the most important lessons we can teach our children is how to be more emotionally competent, which means teaching them how to understand both their feelings and the feelings of others. A 2015 study conducted by Samantha Taylor-Colls and her colleagues at the Anna Freud National Centre for Children and Families (UK) contributed to an already-growing body of research that suggests children as young as infants, despite being preverbal, have the capacity to understand and interpret the emotions of others.

In their study, 77 infants were shown over 200 images of different facial expressions (happy, fearful, and neutral) while their brain activity was measured via EEG recordings. In addition, parental responsiveness to their infant's cues was measured via observation and assessment of prolonged dyadic interactions.

The findings indicated that infants showed an amplified level of responsiveness to 'fearful' facial stimuli when compared to 'happy' or 'neutral' facial stimuli. Also, the infants whose mothers were assessed as more sensitive and attuned to their child's cues showed more responsiveness to 'happy' facial cues over 'neutral' ones. This potentially suggests that even in infancy, children are reinforced by warm and positive interactions and will direct their attention and behavior accordingly.

Findings like this give credence to the notion that children are digesting and interpreting emotions from the world around them immediately. This underscores the critical role that parents and other caregivers play in shaping their child's temperament and emotional competency.

Tips for Developing Your Child's Emotional Competency

Start Young
As the research on preverbal infants would suggest, children need not possess their language capacity to grasp how others are feeling. The more frequently we talk to and emotionally engage with our children from an early age, the more capable they are of developing their own emotional competency.
Be aware of the emotional climate in your household
Children (particularly young children) are first and foremost 'feelings-driven' beings. This means they rely primarily on their emotional filter to learn from and interpret their surrounding world. The way that we talk to and treat ourselves, our partners, and other members of the household can all have a profound impact on the psyche and emotional stability of your developing child.
Take ownership of your own feelings and actions
Children are often more likely to do what we do than what we say. When we model for our children how to take accountability for our feelings and the actions that follow, we convey to the children that it's safe for them to do the same.

Saying Our Final Goodbyes

Tue, 17 Oct 2023 21:19:46 GMT

How can we model for our children healthy ways to deal with their feelings of grief after a loved one dies?

Dr. Nate Balfanz, founder of Dr. Nate Psych

It’s safe to say that nearly every one of us has experienced the death of someone we love, whether it be a family member, a friend, a pet, or someone else we hold dear to our hearts. And yet, despite this universally shared experience of death that we all go through, discussions about death and the grieving process remain largely taboo in the vast majority of societies around the world today. Time and again, I have met with children who have suffered the death of someone they love and often felt alone in processing their grief, perhaps because the otherwise supportive adults in their lives did not know what to say, how to say it, or they were too stricken with their own grief about who died that there was not enough in their emotional reservoir to help the children manage theirs. As a result of the inevitably strong feelings that death will conjure up, coupled with a lack of a proper outlet to express those strong feelings, oftentimes children will either withdraw from the world around them, or they will choose to act out in ways that cause significant disruptions both in their own lives and the lives of those around them.

What the Experts Say

"For children, most of their energy is consumed with trying to understand what happened to the person who died. It takes time and a lot of explanation for them to eventually come to that understanding that they need to then go on to process their emotions,"

states Lauren Schneider, LCSW, Clinical Director of Child and Adolescent Programs at Our House Grief Support Center of Los Angeles, CA. It becomes the role of parents, counselors, and other supportive adults in a child’s life to provide a safe and welcoming space for that child to experience the variety of emotions and behavioral reactions that come as a result of grieving the death of someone they love. Experts stress the importance of providing regular opportunities for the child to express their grief-related feelings, serving as healthy role models in processing grief and sharing their own feelings about the loved one who has died, and most importantly recognizing that grief is a lifelong process and not something that a child is to simply “get over.” The more that we as adults can demonstrate to our children how to talk about death and how we feel when someone we love has died, the more likely our children will be able to manage the experience and gradually return to a healthier level of daily functioning.

Talking Tips for Helping Our Children Grieve

(Adapted from OUR HOUSE Grief Support Center, 2016)

Parenting in a Culturally Diverse Context

Tue, 17 Oct 2023 21:12:59 GMT

How can parents from differing cultural backgrounds effectively complement one another’s approach to raising their kids?

Dr. Nate Balfanz, founder of Dr. Nate Psych

Culture consists of a myriad of factors, including but not limited to—traditions and customs, morals, language, faith and spiritual practice, geography, as well as generational influences which will in turn shape a person’s behaviors, belief systems, and ultimately the ways in which they interpret the world. When taking into consideration all of these complex variables, it should be of no surprise that the already challenging task of being a parent can be exacerbated when you have two partners whose own upbringing and cultural heritage may not be reflective of one another. As a mental health professional working in a multicultural community like Orange County, I find myself repeatedly encountering parents from differing cultural backgrounds, in addition to witnessing it in my circle of friends who also happen to be parents. As a husband and father in an intercultural marriage of my own, my wife and I will frequently discuss how growing our own little family is influenced in large part by the vastly different environments in which we were reared. So how do we as parents find a common cultural ground with our partners by which to raise our kids?

What the Experts Say

"With so much emphasis on identification of differences among peoples, it is easy to forget that nearly all parents regardless of culture seek to lead happy, healthy, fulfilled parenthoods and to rear, healthy, fulfilled children,"

notes senior investigator and cross-cultural parenting expert Dr. Marc Bornstein of the National Institute of Child Health and Human Development (U.S.A.). Dr. Bornstein indicates the method by which parents can achieve this is by not only considering their own cultural experiences and upbringing, but more importantly recognizing and understanding the modern cultural climate in which their child is living. As he puts it,

"Both parents and children are required to be flexible in order to appropriately select, edit, and re-fashion cultural information" in order to become what he calls "culturally competent members of their society."

In other words, while the cultural backgrounds and practices of each parent are to be respected and cooperative incorporated in their child-rearing practices, a greater emphasis should be placed on examining how those traditional cultural elements do or do not fit in with their child’s daily living experience.

Tips to Support Culturally Cooperative Parenting

Increase your personal cultural competence.
Spend some time in thoughtful consideration of your own cultural upbringing and how it has impacted who you are today. What elements of your experience were helpful in navigating the oft-turbulent waters of childhood? Which ones were not? Discuss this with your partner, and consider together how it can positively inform your approach to parenting.
Maintain healthy boundaries.
Whether it be grandparents, friends, teachers, or the many other well-intentioned individuals in your family’s life, everyone seems to have their own insights and advice as to how to best raise your children. And while we can graciously thank those supportive others for sharing their feedback, ultimately it is up to the parents to determine which culturally informed methods are most appropriate for raising their kids.
Focus on developing your child's own cultural identity.
A primary struggle for children as they age is in how to develop esteem and a strong self-concept, with culture dictating to a significant degree how that will play out. The aim here is for parents to help their children forge their own unique identities rooted in equal parts of each partner’s cultural heritage, while also considering how this fits in the context of the modern cultural climate.

The Not So Terrible 2's

Tue, 17 Oct 2023 21:06:33 GMT

How can we reframe our understanding of this critical childhood stage to better support our child's socioemotional development?

Dr. Nate Balfanz, founder of Dr. Nate Psych

Prior to living and practicing in Orange County, I spent a few years working as a therapist and classroom aid in an alternative preschool setting for children ages 2-5 in Los Angeles. This was perhaps the richest clinical experience I’ve had to date, as it provided me with a firsthand glimpse into the early workings of how a child’s personality formation could be understood and shaped within the context of relationships with the significant adults in their life. It was in this setting where I learned that the oft-labeled defiant, unruly, or otherwise “bad” behavior of young children could be reconsidered as a child’s emerging attempt to express their personality and to communicate unmet needs. And while these early toddler years can be a frustrating time period for parents trying to manage what may seem like a never-ending barrage of protests and tantrum-like behaviors, child-focused researchers and experts have suggested how we can take solace in the idea that noncompliant behavior in toddler-aged children is both a healthy and positive stage in their developmental process.

What the Research Tells Us

From age two onwards, in typically developing children we are likely to see a significant increase in language development, mobility, and a desire to test the limits that the grown-ups have put in place for them. As psychologist and founder of BabyShrink.com Dr. Heather Wittenberg put it,

"A two-year-old starts to understand limits and starts to learn rules and structure to the world...and limits are all about 'no,' which is why you get so much negativity from two-year-olds.

For the parents of these children, the primary focus should be on learning how to strike a delicate balance between providing those limits and encouraging the child’s emerging ability to think, feel, and explore the surrounding world in a more autonomous way. While we do not want to simply appease children when their noncompliant behavior intensifies, we should also be cognizant that we are not so rigidly adhering to the limits we set so as to avoid stifling the child’s emerging sense of mastery, self-worth, and a “can do” attitude.

Tips For Managing a Toddler's Noncompliant Behavior

Pick your power struggles.
Toddlers are often referred to in the child development literature as “little scientists,” meaning that they are constantly looking to test out how the world works through repeated trial and error. Thus, look for opportunities to encourage and facilitate this learning process while still maintaining limits where you see best fit (i.e. when it becomes a matter of the child’s safety or personal wellbeing).
Help grow your toddler's emotional vocabulary.
As the toddler’s capacity for language develops, we will want to use this as an opportunity to enhance his/her emotional vocabulary and use words rather than actions to communicate distressed feeling states (ex. “I can see that you’re feeling very angry right now!”). Not only are we teaching our children how to use their words, but we are also validating their emotional experience to help convey that we value their feelings regardless of the way they may choose to communicate them.
Shift your understanding of the behavior.
The noncompliant behaviors of a toddler are their earliest attempts at individuation and autonomy, which are necessary and important steps for any human being’s development. Try to reconsider your children’s noncompliance as an indication that they are taking the necessary steps towards becoming an independent adult that is confident in communicating their needs and advocating on their own behalf.

Does My Child Have ADHD?

Tue, 17 Oct 2023 18:56:15 GMT

What to look for and what to ask about a diagnosis that is both commonly used and commonly misunderstood.

Dr. Nate Balfanz, founder of Dr. Nate Psych

The majority of referrals I receive for psychotherapy are from parents, teachers, or school administrators reporting observable changes in a child’s behavior both at home and at school, including noticeable declines in their academic performance. When these changes occur (specifically when there is a downturn in the child’s grades), parents will often pose the question to me,

"Do you think my child has ADHD?

As a mental health professional who specializes in working with children and families, I recognize the inherent challenges that come with discerning between what symptoms are the result of an actual, neurologically-based learning disorder, and what symptoms may be better accounted for by say, a mood and/or anxiety-based mental health condition. As caring and concerned adults who wish to support our children in all their social, emotional, and learning needs, we might consider it helpful to have a basis for understanding what symptoms are consistent with a formal learning disorder diagnosis.

What the Research Tells Us

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR, 2022) describes Attention-Deficit/Hyperactivity Disorder or “ADHD” for short, as a mental health condition marked by longstanding challenges in an individual’s ability to maintain one's attention span or contain one's impulses. ADHD is divided into three separate subcategories: 1) Predominantly Inattentive Type, 2) Predominantly Hyperactive/Impulsive Type, and 3) Combined Type. Some of the hallmark characteristics of ADHD-Predominantly Inattentive Type include challenges with closely attending to school work, difficulties with sustained attention during classroom instruction, frequently losing things, or an inability to stay organized and on task. Meanwhile, characteristics of ADHD-Predominantly Hyperactive/Impulsive Type are observed in a child who frequently squirms or fidgets in their seat, one who frequently runs about and is “on the go,” a child who has difficulties with waiting turns or interrupting others, or a child who may frequently blurt things out or behave in an otherwise impulsive manner. Last but not least, ADHD Combined Type is when symptom criteria for both Inattentive Type and Hyperactive/Impulsive type are met. While the DSM-5 notes that the onset of ADHD can occur in adolescence or adulthood, the vast majority of individuals with ADHD have shown symptoms dating back to as early as the primary and elementary school years.

Tips For Better Identifying and Managing ADHD-Consistent Symptoms

Use caution in assessing your child’s symptoms.
If your child demonstrates only one or two of the symptoms listed above, it is highly unlikely that they would be considered for a formal ADHD diagnosis. Rather, if you notice that your child displays a number of these symptoms, it may be worth arranging for a consultation with a mental health professional.
Seek out a formal assessment by a specialty-trained mental health professional.
Given that ADHD is one of the most frequently misdiagnosed mental health conditions in children, you will want to have a proper assessment conducted by a child and adolescent-focused practitioner who specializes in this treatment domain. While well-informed pediatricians and other general medical practitioners likely have some experience with and exposure to ADHD symptoms in children, it often takes the well-trained eye of a mental health specialist to determine what symptoms and behaviors warrant a formal diagnosis of ADHD.
Advocate on your child’s behalf.
While the over-diagnosis and public misunderstanding of ADHD is evident, a true neurological ADHD condition can be quite debilitating for both the child and the family as a whole. The Orange County community has multiple resources and learning centers that specialize in the treatment and advocacy of children with learning-related challenges. Utilize the resources available to you to ensure that your child receives a proper assessment that can then translate to home and school accommodations that best fit their learning style.