Archives

All posts for the month October, 2015

The Spring Carnival is in full flight….the fillies, the fashion and the flutters. Hmmmm…..”flutters”. “Flutters” is one of those words that makes something that could be very serious seem like it’s a tiny, wee thing that is harmless, perhaps even beautiful. For some, a flutter is poison.

Problem gambling, in essence, is when someone has difficulties limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others, or the community.

We know of the stories of parents leaving their children in unattended motor vehicles for long stretches of time while they gamble as casinos or poker machine venues. We know that a problem gambler can get to the point where they spend all of the household’s income… and then some. The effect of this on young children is obviously problematic leading to financial problems and relationship issues in families. According to Australian statistics, problem gamblers are more than six times more likely to divorce than non-problem gamblers. Clearly, family separation has a clear impact on children.

What about children who become problem gamblers? Before you scoff and picture a child standing up on a box to reach a one-armed-bandit, consider how easy it is to gamble these days without even leaving home…in fact, without even leaving your bedroom. These days, it is easier than ever to gamble. People can gamble day and night on their smart phones, tablets or home computers. Television advertisements remind us that we can bet while we watch the season’s final of our favourite sporting codes. People can bet on the outcomes of nearly anything and can gamble in online bingo-type games 24 hours a day, seven days a week. For those who have an urge, there are plenty of ways to follow through at a moment’s notice.

When adults with problem gambling are asked, many will report that they started their problem gambling during their teen years. Young people (age 18-24) spend more money on poker machines that any other age group (and you thought it was those grey-haired nanna’s, didn’t you?).

Statistics tell us that problem gambling in children is linked to a range of factors:

  • Children with parents who have gambling problems are 10 times more likely to become problem gamblers
  • Children who are rated as having emotional distress by their teachers during the kindergarten years were more likely to be gambling by the time they reached year 6 in school. The link between anxiety, depression and emotional distress particularity becomes an issue for early gambling when it involved high levels of impulsivity.
  • We also know that when gambling is portrayed as both glamorous and as a means of achieving financial freedom leaves a strong impressions certain adolescents may crave. If they strongly desire financial good fortune or yearn to be seen as attractive to others, gambling is portrayed as a means to these ends. However, like their adult counterparts, many teens gamble as a means to escape – to avoid a feeling or set of circumstances in their lives that is not working of them or does not feel good

Not all children who play cards as youngsters will go on to become problem gamblers. Most children will grow up to gamble occasionally for fun and be able to walk away before they risk too much money, too much time, or too many social and relationship issues.

So, as perhaps you consider heading on out that door for a champagne cocktail and a “flutter” in the office sweep, you can be reassured that most children will be okay when it comes to gambling, but what signs might indicate that your child may be one that does have issues with gambling?

Things may need a closer look if:

  • your teen has more money than they usually would
  • they are asking for more money than they usually would for food, bus trips of other incidentals…or worse, expensive belongings are missing
  • their day to day language starts to us more betting terminology – some uselful examples can be found here. http://www.bettingterminology.com.au/get-your-betting-terminology-right-329.html
  • they are spending time on internet gambling sites or watching more television broadcasts that may have a link to gambling
  • there’s a change in their mood or usually pattern of socialising (always something to check in with for a range of youth issues)
  • they are skipping school or having relationship issues

I’m not sure that it’s completely possible to guarantee, 100{ba4639bc087185d97391fd5d15a50de89571c56f25425ee41c30a195518528de}, that your child won’t become a problem gambler, but if you want to take some steps towards preventing problem gambling in your kids, the research would suggest you talk with your kids about gambling.

To send healthy messages to young people about gambling and ensure that they can keep it fun and healthy:

  • Ensure that you take any steps to deal with gambling if it’s a problem for you or for someone that you love
  • Teach children about gambling and the signs that gambling may be a problem for someone. When those advertisements pop up on television or computer screens, have a bit of a chat about what your child thinks they are and what they think they mean and what they are trying to get people to do
  • Help children with their decision making and problems solving and ensure they can weigh up the pros and cons of things before they take action. If your child is impulsive, it’s especially important that you promote problem solving and encourage them to stop and think before that act
  • Let them know the true odds of winning and help break down some myths and fallacies about gambling
  • Share fun teaching them card games and how to follow a team without needing to introduce money into the picture.

If you need to get help for yourself or for someone who is worrying you with their gambling, there are some fabulous resources for people with problem gambling as well as their families available at Gambling Help Online http://www.gamblinghelponline.org.au/

Kids Help Line has some great resources for young people who have worries or low mood as well as having some information in relation to money issues http://www.kidshelpline.com.au/teens/get-info/hot-topics/money-matters.php

If you are a teacher or a mental health professional, there are a range of useful resources available using skills training, Cognitive Behaviour Therapy and Relapse Prevention Models.

The “best bet” is to spend time with your young people and help them with day to day decisions, taking considered time before acting, getting help early if there are any signs they are not coping with their lot in life, and making sure they can have fun without their needing to be some gain or win.

It seems just so wrong to even be thinking about children perpetrating acts of terrorism or extreme violence. There’s a part of my head that just doesn’t want to go there. I find myself trying to duck and weave to avoid the scandalous, over-inflated, anxiety-provoking media articles designed to keep us glued to screen and print. At times like these when my head and my heart want to be going in separate directions, I know the place I can find solace is in solid research and facts.

When I take the “oh-this-is-too-awful-to-think-about” factor out of it, the sorts of questions my head is left asking go something like:

  • How does this happen?
  • Surely, these kids are not doing it alone, are they?
  • Where are their parents?
  • Why aren’t they spending their time doing what other kids enjoy doing?
  • Could I ever begin to imagine some young person that I know doing something so violent and extreme?
  • How can we keep a level head about this and get children the help that they need before they hurt others?

Studies into Isreali teens growing up in terrorist zones shows they are much more prone to risk taking associated with Post Traumatic Stress concerns, especially for boys.   We also, sadly, understand the role that child soldiers play in other war-torn places on Earth. However, in peaceful places where people are not fighting for their lives on a daily basis, what’s the link between children and violence? Youth violence in more “peaceful” zones is normally attributed by researchers to factors such as substance use, early exposure to family violence and abuse, impulsivity, early aggression or poor regulation and certain anti-social attitudes towards police, schools or authority figures. Violence in the name of terrorism or for an extremist cause is much less likely amongst violent young offenders in Australia. So, where do we begin to focus if we want to prevent acts of terrorism by young people in Australia?

The Centre on Religion & Geopolitics has analyzed a cross-section of 114 propaganda sources ranging from April 2013 to summer 2015 from three Salafi-jihadi groups: ISIS, Jabhat al-Nusra, and al-Qaeda in the Arabian Peninsula.  I think this should be mandatory reading for everyone who cares about other people and who has a concern for the welfare of lonely young people all around the world.

By taking the time to look at the ideals that the researchers uncovered in the three pro-violence jihadi groups, we can see some of the links that may be attractive to children and young people. We can also see how they differ from mainstream Muslim groups or ideals of other faiths.

Indeed, despite ISIS, Jabhar al-Nusra and al-Qaeda all promoting themselves as different and unique, analysis has revealed that they have more principles in common than principles that differentiate them. In particular, their core values overlap significantly and differentiate them from mainstream faiths. There are three areas of values that analysts found were at the core of the pro-violence jihadi groups: 1. Creedal Values: 2. Honour and Solidarity; and 3.“End of Days”.

When you know or have spent time with sad, disenfranchised youth, you can start to see the appeal of each of these core values.

Creedal values – Many faiths have a creed, but not many have objectives that are largely about an “enemy” and about “ending humiliation”. Whilst most violence perpetrated by young people in our country is considered anti-social and comes from a certain combination of risk factors involving impulsivity, family violence, and substance use. The links to risk-taking behaviour in young people differ when they are growing up in a zone of recurrent terrorism. The child attracted to the values of violent jihadi groups is likely looking for help, structure and a guide to live by that will help them manage the feelings they have perhaps generated from being victims of racism, taunts or bullying.

You almost get the feeling that some, very hurt, young people are looking for a “family” that can give them a recipe or roadmap to help them travel through the social-emotional war zone that is, for some, adolescence.

Having rules spelled out in a creed provides some rules to live by. For many, this provides black and white thinking and easy ways of making decisions. Things either fit or they don’t. People are with you or against you. A creed provides structure. It provides a sense that you will always have a right answer, even in really complex, emotional or ethical situations.

Solidarity offers a community of people who think the same way as you. It gives you the chance to belong with others who share a common purpose or common responsibilities. It gives you an escape from loneliness and a feeling of sameness and camaraderie.

Honour – a source of respect, a system of merit a way of judging yourself and others. It gives you a chance to be one of the great ones. No longer one of those lonely, “out group” young men that has been hurt by “in group”, “cool kid” bullies who have all of the latest gadgets that their parents’ money can buy.

End of days – There’s nothing like a deadline to get you motivated and get you taking action sooner rather than sitting back and thinking about it all without actually taking any action. Turning ideas into willing action -the idea that there will be a day coming where all those who have filled the creed will be celebrated and reap benefits and those who do not will suffer.

So, in all, these groups offer lonely and disappointed children and youth a chance to belong. If you join, you will belong to a group that has solid and clear values. It will be an honourable choice and you don’t need to be good at making friends. You will get your payback and your enemies will get the hard times that they deserve.

And so…to my questions… Thinking about it like this makes it clearer to me how it could all happen – how a young, disenfranchised, lonely youth might find all he is seeking in a pro-terrorism group. Certainly, they are not doing it alone. While their individual acts of violence might be solo, they are backed by ideas and support that is perhaps stronger than they have felt “backed and supported” in awhile…perhaps ever. You can imagine these lonely young boys living under the same roof as their parents. Perhaps they rarely leave the house except to gather with some like-minded others. After all, they can access all of the support and ideals and enthusiasm online on their laptops or smart phones. They may even belong to a religious community, but if it isn’t offering them enough, isn’t youth-focused enough and doesn’t give them the immediate answers they need when they feel hurt or left out, then they will, like other young people, look elsewhere to get their needs met.

So, in a way, they are spending time doing what other kids are doing. They are looking for a place to fit and to belong and they find it in the structure and idealism of the groups that encourage them to hurry up and do something that will secure their place as heroes in the eyes of others – if not now, on some approaching future day of reckoning. Sadly, now I know I could imagine some of the young people I have met getting caught up in situations that lead them to committing acts of terrorism in the name of a certain group. Perhaps, these children differ a little from those I have worked with in Youth Justice systems over the years because they are not necessarily affected by substances, school refusing, impulsive, domestic violence and the other factors normally associated with youth violence in Australia.

How can we keep a level head about this and get children the help that they need before they hurt others? I think that, until we have an evidence base to work on (young people are always good at getting involved in issues well ahead of the research and researchers are often caught on the hop and needing time to build reliable data) the answer lies in inclusion. We need to do our utmost to include young people of all races, religions, gender identities, music genres in all that we offer. We should celebrate our diversity and help young people who, by the very nature of their developing brains, are simultaneously seeking to belong and build their own identities to get to know, explore, compare, listen to and weigh up the pros and cons of all the choices there are for them in our amazing country.

The answer does certainly not lie in attacking people of other races or religions or going on witch hunts for their children.

While it goes without saying that we should do our utmost to keep all children safe from harm, we need to be careful that in so doing we don’t shut them away from meeting, learning about and being with others.

Again, I encourage you to read…http://tonyblairfaithfoundation.org/religion-geopolitics/reports-analysis/report/inside-jihadi-mind.

I know that you may not want to “go there”, but it’s well worth the trip!

Depression in young people is something we hear more about these days, but sadly, it is still something that goes undetected and can seriously affect a young person…even to the point of suicide. There are many programs out there that attempt to make things better for young people and mental health. The great news is that young people are more aware of mental health issues than in years gone by. In fact, I would go so far as to say that young people are very interested in their mental health and in learning more. The other great news is that young people are better at help seeking then they once were. The not-so-good news is we still do not have an iron clad way of preventing depression in young people and the terrible news is that there are still many depressed young people who go undetected. However (more great news…) we can prevent depression from worsening if we work with high risk groups and with those who have the early signs of depression.

We know that young people at risk for depression may have a family history, some past traumatic experiences, a personality type or come from some marginalised or minority group because of their race, gender identity or even risk of homelessness. We also need to keep an eye out for the early signs of depression in young people. Warning signs to watch are:

  • Bodily signs – tiredness, change in appetite, change in sleep patterns or a change in energy levels
  • Emotional signs – feeling worthless, sad, low self worth, anger, guilt, fear and worry, change in personality, flatness to mood
  • Behavioural signs – agitation, aggression, withdrawal, isolation, avoidance of preferred activities, self harm, poor self care/cleanliness/hygiene, poor school attendance, reduction in school grades
  • Thinking signs – preoccupation with death, difficulty staying focused, reduction in memory, indecisiveness

I know that many of these things sound like day to day symptoms of being “just a young person” and that is why it can be hard to detect, but be aware of change and be especially mindful if things remain concerning for longer than they might normally be. Also keep a close eye on young people if there are stressors in their friendship groups, if relationships end, if they have issues with drugs or alcohol, if they have a disability or chronic medical illness or if there has been a death in the family or in their social circles.

Once we’ve noticed the signs…what to do then?

Well, this is where all sorts of people in all sorts of professions selling all sorts of snake oil might come into play. If we want them to get a depressed young person to a happier place, we want to get them there by the most direct route and with the least mucking about. This is an important, sometimes even a life and death, issue – too important for any mucking about.

If you knew the fastest route from here to, say, Hawaii was a plane and you wanted to get there as quickly as possible, why would you walk?

The research clearly tells us that the best way to get a depressed young person to a happier place is by using a qualified psychologist or other mental health professional. In Australia, AHPRA register health professional and you can check any registered professionals qualifications or even make complaints at the AHPRA website. If we are looking for the best person to assist a young person on their journey to mental wellness, we also need to make sure that the services are youth-friendly and culturally responsive and that the young person is supported to develop an ongoing relationship with the psychologist or other mental heath clinician.

Okay – so we have the type of professional we need. What techniques should we be looking for? Aerobatic manoeuvres are likely unnecessary on a trip across the Pacific.

If we want to get a young person well in the fastest, most straight forward way, the research tells us that Cognitive Behaviour Therapy (CBT) or Interpersonal Therapy (IPT) work best with young depressed people.

CBT encompasses a variety of sub-types, but at its essence focuses on thinking and behavioural habits that precipitate and perpetuate depression and looks at a variety of techniques to change thought patterns and behaviours. With young people, it is especially important that the psychological work that is done is done with respect to the context of what is happening for the young person and that there is appropriate involvement and collaboration with family, support people and even school.

Sometimes if the young person has a moderate or severe level of depression, some medications may be warranted. Medication for young people with depression can be controversial because young people are much more at risk of suicide when they are agitated and the early side effects of many antidepressant medications are agitation. Current guidelines suggest that medical practitioners should consider an SSRI, but that they need to monitor the young person closely after prescribing pharmacological treatment and that best outcomes occur when the medication occurs in conjunction with CBT or IPT. Also, when things start to get better, best practice guidelines tell us that we should continue to provide treatment and monitoring for a further six months.

Also, while we are flying to our destination, it’s important that we have a safety plan.

Flight attendants repeatedly tell us about the need to know what to do in the “unlikely event of an emergency”. A young person’s psychologist or mental health clinician and medical practitioner should also discuss an emergency plan with the young person and the young person’s support team.

Knowing what we know about young people and the path to recovery from depression, we should not stop looking for other routes that could be even more effective, more comfortable, less expensive, or less effort. More research into mental health is always warranted because we still have a way to go to make the journey smoother – especially for those with really complex issues.  Meanwhile, I would encourage everyone who has an interest in the mental health of young people to read the Clinical Practice Guidelines published by Beyond Blue who have done an amazing job of reviewing the available evidence to help clinicians with good practice points.

If the destination is mental health, then, at this point in time, the best way to get a young, depressed person there is CBT or IPT with a qualified psychologist or registered mental health practitioner who can build rapport with young people and appropriately involve their families or others to ensure the safest, most effective journey with the happiest of landings.

When you think about health, what do you think about? How fit you are? Whether you have a disease or not? Being injury free?

Most people think about health as being something they either have or do not have, when, generally speaking, we are probably all on a spectrum of health. Some people who have chronic illnesses can be considered healthy if their conditions are managed well. However, like many things, when we start to think about health or sickness as something we either have or don’t have, we can open up a dyad of absolutes in our thinking that can generate anxiety. If I’m not healthy, I must be sick!

If you are a little person, your brain will tend to see things more in absolute terms. If you are told often enough that germs will make you sick, or “don’t’ touch that you’ll get germs”, then the idea of germs linking to illness and probably death can easily become something that dominates the thinking of an anxiety prone child.

How old were you before you understood exactly what a germ was?

In order to avoid explaining complicated medical situations to children, many adults just tell them that a germ made them sick. Anyone who knows even the slightest thing about germs and the immune system know that many people can be exposed to the same virus or bacteria and some will become ill and others will not. The more you understand about health and the human body, the more you know that it is complex relationship. Health involves a complicated interplay of a person’s biology, their environment, their psychology (or the way they are thinking about it) as well as the society they live in and the society’s expectations about health and wellness. To put poor health, or death, down to germs can be dangerously oversimplifying things for some little people who are vulnerable to health anxiety.

Sadly, some children can become so preoccupied with germs or getting sick that they begin to shape their lives in ways that make it very hard for them to enjoy day to day life, even though all of their vital signs are healthy!

When too much importance is placed on germs or health, the intense focus can actually make a young person mentally unhealthy and very unhappy.

Having a fear of germs or illness can become excessive and can lead to behaviour that is unhelpful – focusing too intently on body signs, checking poo and wee, washing hands excessively, not eating food that is close to its “use by” date, avoiding sick people, not being able to use public toilets, avoiding school camp or even school for fear of getting a germ that might make them sick….and die. Some children with a fear of germs or a health anxiety can need lots of reassurance from friends or family. They can ask too many questions about a person’s health, they cannot visit a sick friend or relative for fear of getting sick themselves or they may even be unable to watch medical shows on television. Factors on the outside of them can combine with factors in their thoughts. Sometimes, because they are so hyper aware of any possible symptom in their body, a rumbling tummy combined with news of a heath scare can combine to produce debilitating anxiety.

Some parents with health anxieties can exacerbate the problem for their children. At the earliest sign of any tiredness or fatigue, they are on the computer asking Dr Internet about child Leukemia. Yes, on some occasions tiredness is a sign of a disease state in a child, but there is a sensible response to exploring symptoms and there are over-anxious or even avoidant responses that can exacerbate a child’s anxiety.

Researchers are finding that people who are anxious about their health often do have certain vulnerabilities linked to their childhood. Sometimes, things have happened in their early life and their early attachments may be insecure, leaving them feeling vulnerable and prone to attack even before their brains have developed the ability to talk or think about it in words. It could be that a child has experienced poor health in their early years or that someone in the family has experienced very poor health. Sometimes, children can be left thinking that they have to be sick in order to be cared for and have their needs met. Sometimes, they have such a lousy time of it that they become hyper-vigilant to any sign that they might get ill again. There is also some new evidence that suggests that people who are anxious and monitor their health too closely, may also need more skills in being able to get along with people so that they do not feel so distant from others and do not need to worry about being sick in order to have warm interactions.

Clearly, the health anxieties in children and adults are complex, and if a child is being affected by a fear of germs or being sick in a way that limits their involvement and enjoyment in life, it is worth having a professional consider all of the factors that could be contributing and then working through the factors to find some relief for the affected child.

So, let’s stop giving germs a bad reputation!

Instead, let’s work on helping children to have balanced thoughts and beliefs about health.  To this end…

  • Teach children about their bodies in age-appropriate ways. Human bodies are truly amazing things – let’s celebrate what they can do rather than go looking for signs of illness.
  • Encourage a healthy relationship with “germs”. Do some research with your child about germs and the roles they play in our health and in making the World tick.
  • Don’t avoid talking about death or illness, but modify the conversation to match your child’s understanding and to gradually extend and expand on what they know. If they have questions, find ways that you can answer them together or go, together, and ask someone who may know more about it than you do.
  • Rather than making too many rigid rules about cleanliness, try to go with general guidelines. I think a general guideline might be that you wash your hands before you help with the cooking or before you eat your dinner, but if you do miss one or two occasions there’s no need to panic.
  • Watch for avoidance and checking.  Keep  children involved in life, even if they are genuinely not well for a time, keep the relationships and learning going if they need to miss school or dance class/basketball/swimming.
  • If your child has a an excessive fear of germs or getting sick that is starting to get in the way of them having a happy and involved life, then take them to your GP to consider a referral to a qualified psychologist or mental health practitioner.

No more bad press for germs!