Helping Struggling Teens

Category: Cognitive Restructuring

  • Identifying Signs of Anger

    “If you are patient in one moment of anger you will avoid 100 days of sorrow.”
    Confuscious

    Many people who have not learned to understand anger within themselves struggle to recognize it as it approaches, only becoming aware once it has exploded and become overwhelming. Learning to identify anger as it begins to escalate is an enormous step in taking control of anger within yourself.

    Definition of Anger:
    1. [n] belligerence aroused by a real or supposed wrong (personified as one of the deadly sins)
    2. [n] a strong emotion; a feeling that is oriented toward some real or supposed grievance

    Physical Cues –
    Anger is a normal reaction to a perceived threat. All animals have certain physiological reactions to threat which allow us to respond physically: for example, to run away from danger, to fight to protect ourselves or our family, or to ‘freeze’ in order to avoid being seen by another creature that poses a danger.

    Examples of physical cues girls have listed in discussion:
    Ringing in ears
    Headache
    Feeling over heated
    Clench jaw
    Get very quiet
    Heart begins to race
    Get knots in stomach
    Experience a back ache
    Make fists
    Get sweaty palms
    Feel legs shaking
    Tap feet

    These signs can be used as ‘cues’ to let you know when your anger is escalating and you need to take control before things get out of hand. Some of these cues may take place sooner than others. If you tune into these physical cues to anger, you can learn to recognize them earlier and respond to your emotions in more planned and effective ways.

    Ask Yourself: What can you do to control your physical cues? What coping mechanisms could you use that could help you stop the escalation of anger? Have you ever controlled your physical cues in the past, if so how? What would it look like when you do control your physical cues?

    Emotional cues –
    When people get angry they frequently notice themselves starting to feel differently.  It is important to notice how you are changing internally when you experience anger so it can be kept in control.

    Examples of emotional cues girls have listed in discussion:
    Sadness
    Crying
    Frustration
    Annoyance
    Stressed
    Queasy
    Content

    These signs can be used to help you identify when you are getting angry. These emotions are not always bad emotions, but when used to fuel anger they can be hurtful. When these emotions are noticed in relationship to anger it is important for you to take control of these emotions so they do not spiral out of control.

    Ask Yourself: Why do you notice emotional cues when you are beginning to experience anger? How is anger tied into your emotions? What can you do to control the emotions you are experiencing due to anger?

  • American Psychological Association’s Best First Line Treatment Options

    In order to aid in the treatment of several mental health disorders, the American Psychological Association has defined the best first lines of treatment. We at The Academy at Sisters understand the importance of a consistent philosophical approach to changing at-risk behaviors and use a cognitive behavioral therapy model which follows evidence-based validated best practices. A case manager guides each student through their own individualized treatment plan.

    Although we believe short-term use of medication to control behavior may be necessary, it is not a healthy long-term solution to behavioral problems. In our programs, we include the services of a clinical psychologist, board certified psychiatrist, doctor of counseling and autism specialist, as well as other specialists as needed.

    ADHD, Attention Deficit / Hyperactivity Disorder:
    Behavioral treatments have the most favorable risk-benefit ratios, suggesting they be the first line interventions. Combining behavior based treatment with medication can yield better short-term outcomes than either intervention alone. Combining both medication and behavioral treatments enables lower doses of medication to be used.

    Conduct Disorder Oppositional Defiant:
    Evidence shows psychosocial cognitive behavior interventions should be first line of treatment and tried before psychotropic.

    Obsessive Compulsive Disorder:
    Cognitive behavior treatment is the first line of intervention. Health Topics Medication should be added only if necessary.

    Anxiety Disorders:
    Strong evidence to support cognitive behavior treatment as a first line treatment and does not pose health risks as medications do.

    Depression:
    First line treatment strategy designed to minimize risks would involve sequential use of psychosocial interventions and close monitoring followed by medication if necessary. (Fluoxetine is the only medication approved by FDA for treating depression in children.)

    Bipolar:
    The limited research suggests psychosocial treatments are beneficial and do not present adverse side effects. Short and long-term medication trials are needed to clarify the risk-benefit ratios for medications used to treat bipolar.

    Anorexia/Bulimia:
    For bulimia, cognitive behavior treatment appears to have the most scientific support and a more favorable risk-benefit ratio. For anorexia there is a general lack of evidence of effectiveness for both psychological and pharmacological.

  • Motivational Interviewing

    Motivational Interviewing: is a directive, client centered counseling style for eliciting behavior change by helping clients explore and resolve ambivalence.

    • Motivation to change is elicited from the client and not imposed from without. You can’t give someone motivation much like you can’t give them self-esteem. This relies upon identifying and utilizing the client’s intrinsic values to stimulate behavior change.

    • It’s the clients task (not the counselors) to articulate and resolve ambivalence. Each course of action has perceived benefits and costs associated with it.
    Example: If I stop smoking I’ll feel better about myself, but I’ll gain weight which will make me unattractive and unhappy. The counselor’s job is to facilitate expression of this seeming impasse to how the ambivalence may be resolved.
    Example: If I drop my demanding behavior I’ll feel weak and vulnerable.

    • Direct persuasion is not an effective method for resolving ambivalence.
    Urgent persuading increase client resistance.

    • The counseling tone is a quiet and eliciting one.
    Direct persuasion, aggressive confrontation and argumentation are the conceptual opposites of MI.

    • The counselor is directive in helping the client examine and resolve ambivalence.
    The operational assumption in MI is that ambivalence or lack of resolve or choice is the principal obstacle to be overcome in triggering change.

    • Readiness to change is not a client trait but a fluctuating product of interaction with the counselor.
    The counselor then must be responsive to signs of motivation. Resistance and denial are feedback on how the counselor is doing and may be a cue to modify the approach.

    • The counselor/client relationship is a partnership or collaboration.