Articles & Trainings

This article originally appeared in Macaroni Kid on Sep 21, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My son’s friend has ADHD. He often comes to our house to play and sometimes spends the night. He seems not to have much of a filter and says some inappropriate things for his age. He is also impulsive. I get concerned about him using good judgment. I don’t want to discourage the friendship but am not sure how to best talk to my son about what’s appropriate and what’s not when his friend is over. I’ve talked to the parents and they are aware of the issues and have spoken to their son but they have left the parenting up to me when he is at our home. What’s the best way to deal with this when it’s not my kid?

Answer:

 This is a bit difficult to answer without knowing the age of the children. I will give you some general interventions which I hope will apply in your situation. I think you have taken an important first step in talking with the parents. In this way you have already communicated your concerns and they have an expectation that you will address what might come up. 

Having family ground rules for behavior is good for children. This also means that when kids come to play they are under your rules. When behavior starts to cause problems, review the rules of the house, and the consequences for not following. You can say, “We really like it when you come to play, but we have rules in our house about jumping on the sofa. I need you both to find another activity.” Rules can be “no ‘potty’ talk” “no roughhousing inside” “no backtalk to adults,” and the like. When rules are broken it is important to speak up and to have a number of consequences to fit the situation, like having to play separately for a short period, to having to go home. Sometimes finding out that you mean what you say can make better behavior the next time. Kids thrive with rules and boundaries; ultimately they make them feel safe. 

Children with ADHD get lots of negative messages around their behavior which can cause problems with self-esteem. Along with enforcing rules, try to also make a point to reinforce positive behavior. Look for those times to reward positive play by adding extra time to an activity or by giving positive praise. As to your concern about this child’s impulsiveness and judgment; again this can mean very different things at different ages. Adult supervision may be really appropriate for the young ones, with repeated focus on acceptable behavior. Older children need to know to come and talk about behaviors or topics which make them feel uncomfortable. 

The most important thing is to be clear about what the expectations are in your home and to follow through when discipline or positive reinforcement as needed. Lastly, sometimes it is appropriate to discourage friendships that you do not feel are right for your child.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Aug 24, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My 13-year-old daughter recently told me that she is gender fluid. I’ve heard the term before but am not that familiar. I want to be supportive but don’t know where to start to learn more. The web has a lot of conflicting information. Please assist.

Answer: Gender fluid describes a person who identifies with both genders, and moves between expressing themselves as male and female. They can have characteristics and traits of both sexes. Many are comfortable not being either/or, but both. For young people with developing bodies, perspectives, and personalities, it can be confusing. Our culture is also confused, and messages about gender can be hurtful sometimes.

It is great that your first impulse is to be supportive and learn more. That is really good parenting! While your daughter explores her gender identity, provide time of open conversation without judgment and “shoulds.” Let her know you want to understand. Each child is individual and all kinds of uncertainties and insecurities are common. Some children try on different identities while they are finding their way, ultimately settling into one as they develop. 

Counseling is an important option for her to learn more about herself and form healthy self-esteem in the process. Look for a counselor who specializes in these issues. Counseling can also be helpful for you, as you try to understand. Sometimes the picture in our head of how life will go, for us and for our children, doesn’t match the current reality. Sharing this journey with a counselor can give you the information you need going forward.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Jul 19, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My husband and I do not agree politically. It has never been too much of an issue before but after the November election, it has become one. We actually have had yelling fights in front of the kids. Afterward, we came to an agreement as a family that we would just not discuss politics. However, I am rethinking this as I’m not sure it’s healthy to demonstrate to our kids that if we cannot agree, we just won’t discuss. What are some other options we might consider trying?

Answer: This is a challenging time for lots of people. As a country, we are polarized in our political views. You are already thinking appropriately to want to be able to discuss in front of, and with, the children things about which you and your husband disagree. It is also a good sign that you have already come together as a family to try to solve this issue. Arguing and expressing anger is normal and healthy; children need to see it and learn about it in a safe environment. Your children will encounter many people who get angry and disagree with them throughout their lives. It is the parent’s job to teach them that disagreements can happen and people can still love and work together. 

When you discuss political things you will need to be able to do it mindfully, recognizing that you are symbolically “walking through a minefield.” Choose words carefully and remember that you are modeling for the children.

Both of you should agree that your points should not belittle or make a mockery of the other’s viewpoint or resort to snide comments on someone’s physical attributes; to do so is not helpful and supports the bullying mentality.

Present your side of the discussion calmly and supported by facts and intelligent, thoughtful opinions. Once you do that, it will be your turn to be quiet and listen. This shows respect, even when disagreeing. Inject humor when possible and decide together when it is time to put the conflict away for a while. For the sake of sanity, make a habit of also looking for the topics or points about which you agree. When marital conflict becomes too pronounced and it is “sucking the air out of the room,” it is time to get some help from a counselor in sorting it out. Good luck.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Jun 21, 2017 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: I was widowed last year and am now the single mum to 2 great kids. I’ve been dating for some time a man with 2 kids of his own. We have gotten our families together several times. The kids get along well but have significantly different personalities. My boyfriend and I have discussed the possibility of moving in with one another, and I am looking for advice on how to broach the subject with my children. I’m not sure they will see this as happy news. Thank you for your consideration.

Answer: I am going to start out by asking you to bear with me because the first part of my answer is not really what your question was about. I will come back to it, but there are things (and people) I want you to consider first. Importantly, you are first. You shared that you just lost a husband in the last year and are new to the single mum experience. Then there are your two children who have lost a dad and are getting used to having only one parent. Then, there is your new boyfriend to think about since this is a new relationship for you, and him. Then, there are his two kids to consider. This is not just one new relationship, it is six. To answer you, I would like to pose my own questions. How have your children expressed their grief over the death of their father? Are either of them having problems at school or any disturbance of mood or behavior since his death? This would be the same question I would ask of someone entering a new relationship following a divorce. Everyone handles these loses differently. You may be ready to move on, but your children may not. Also, after a loss, it may be difficult to trust your own emotions. What feels like love may just feel better than being alone. You have lots to consider. Moving in together is a really big step. My advice would be to consider this carefully. If your children do really like this person, but you decide it isn’t right, then they will experience another loss. Since you are already sensing that they may not see this as happy news, slow the pace down and see how things go as the relationships develop. Now, let’s look at your question on broaching the subject with your children. When you feel you have assessed and responded to the concerns above, start with a series of discussions about blending the families. Introduce it. Give the children time to process it. Talk about it again and hear their concerns. Think about and address their concerns. Then talk about it again. During this time, join the families together repeatedly and watch the dynamics and also how your boyfriend parents his children. How you handle major things in your children’s lives can impact them positively and negatively. This new blended family relationship is an important one. It may be a wonderful one. Moving carefully and lovingly around how these changes affect your children, shows the high value you put on their well being.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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How to Help Someone Who Is Thinking of Suicide

This article originally appeared in Macaroni Kid on May 30, 2017 by Mary Gagnon, LMFT; Health Affiliates Maine

What do you do when someone you love is feeling down? We’ve all been down at some point, and understand when our friends or family feel the same way. Most of us try to take a little extra special care – make them tea, give them a hug, and tell them everything will be okay. 

But what happens when things aren’t okay? What happens when a down mood turns into depression? What happens when your loved one can’t see their way forward, and you are worried they might be thinking of suicide?

Cause for Concern — Most people show some warning signs that they are thinking of suicide. The most concerning sign is when someone communicates in some way that they are thinking about dying or suicide. They may do this verbally or non-verbally (such as by writing about it). Other signs include:

  • Increased substance use
  • Anxiety or depression
  • Feeling purposeless, hopeless, or trapped
  • Anger
  • Recklessness
  • Mood changes
  • Withdrawing from loved ones or activities (such as work, school, or hobbies)

The highest risk groups are males, particularly those ages 45-64 and those over 75. However, younger people (ages 15-24) have a high number of attempts, and suicide is the second leading cause of death for this age group. Although it might be hard to imagine, even younger children can feel like they want to die. Look for mood and behavior changes, including anger or sadness, impulsivity, and play that may have themes of death.

What Can You Do?
Remember, for a person considering suicide, a crisis point has been reached and their pain feels unbearable. However, ambivalence often exists, communicating their distress is common, and they often show you in some way that they are hurting – by expressing their feelings or thoughts or by their behavior. Remember, though, that they might not ask you for help directly. Many people are afraid of what will happen, or they don’t want to upset others. We might even be afraid to ask someone – because we might not know what to do, or we’re afraid of saying the wrong thing, or we’re afraid of the answer. We don’t like to see our loved ones hurting, and it’s frightening to think that a loved one might be thinking of ending their lives. However, if you’re worried enough to wonder if they might be thinking about suicide, it’s time to ask. 

You can intervene, and you don’t need any special training to do it. There are three steps:
1) Show you care – tell your loved one what you’re noticing and why you’re concerned. Allow them to talk.
2) Ask the question – ask your loved one “Are you thinking about suicide?” It is hard to do, but important to know. Sometimes, you might be the only person they tell, or they might be relieved that someone finally cared enough to ask. For younger children, ask them in words they will understand – but do ask.
3) Get help – If the answer is yes, don’t leave them alone. Assure them that you will get some support for them, together. 

Getting Help
Several resources are available to you, including:
911/Police
Statewide Crisis Hotline 1-888-568-1112
Local Crisis Agency
Hospital emergency room staff
Physicians/health care providers
Private mental health clinicians and facilities

Your care and intervention can make a real difference. 

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This article originally appeared in Macaroni Kid on May 11, 2017

Question: My seven year old whines a lot….a lot…a whole lot. He whines so much that I am beginning to get resentful and lose patience easily. I feel as though I am very consistent in not giving into the whining and yet it continues. He is never rewarded for whining and I have gotten to the point where I walk out of the room when he begins to. This is usually met with stomping of feet and slamming of his bedroom door only for him to appear later sulking around. I’m losing patience and starting to wonder if more is going on than his desire for a treat or to watch television. How do I know what is normal whining and how do I deal with it without losing my cool?

Answer: It is difficult in our busy lives to divvy out attention when needed, or wanted, on demand: hence, the invention of whining. Whining is hard to take. It sounds like you have tried coping as best you can. Children are whining to get more attention, or when they are over tired and hungry. Try to assess which it is. If they are hungry ask them to help make the meal while they crunch on carrots. This way the child gets your attention and a healthy snack. Sometimes the attention they get is negative attention (like you losing your cool) but, it is attention none the less. Also, investigate where the whining is working for the child, whether it is at home, school, or daycare. Behaviors exist because they work for the child. This step, when identified, can make it much more successful in extinguishing the behavior. 

The most important thing is to not reinforce the behavior, which it sounds like you have been trying to do. At a time when it is calm with no whining going on, explain that there is a new rule…NO WHINING. Explain that if whining happens, it will be ignored. Only when requests are made without whining will attention be paid to them. This can be turned into a fun family discussion, introducing stickers for specific rewards especially for the young ones, and opportunities for special attention when the stickers show consistent behavior (Ex. “Mom and me”, or “Dad and me” time, to play catch or go for ice cream. In my house, it was a special shopping trip for a new GI Joe!). In fact, initially try to respond to in a positive and happy way when your child’s behaviors are the opposite of whining. Like when he/she asks politely or uses big boy/girl words. 

Here are some tips for eliminating whining for shopping in stores. Talk about the ground rules for purchases (and whining) before the trip. An important lesson to follow, takes time, but is well worth it. If your child tries to manipulate you by whining in a store, take the child by hand and walk out of the store putting purchases back in their places and promptly leave. Make sure that the child knows that it is because of the whining and not following the new rule. You usually will only have to do that only once. However, you must be consistent in not responding to whining. Your child needs to know that you are in charge, that the rules are important and that you will enforce them. I have been in stores and have witnessed a child who is whining about wanting an item, the parent says ‘no’… the child continues whining, cajoling, and pleading… the parent threatens loss of TV, or straight to bed once home…the child continues to whine…now everyone is watching the drama…at wits end, the parent buys the child the item. The whole affair leaves the parent stressed, angry and embarrassed. The whining and bad behavior was reinforced and the 7 year old is in charge. The best scenario would be to take the child out of the store as soon as the whining starts. Establish that whining will not be tolerated and no purchases will be made for the child. 

The second part of my reply is about what you questioned was “normal whining.” That’s always a good question for a parent to ask. Children need different things at different phases of their young lives. Sometimes they are uncertain of themselves and just need reassurance that they are loved. They are trying to grow up, but they are still a child. Spend some time one-on-one for ‘hug and talk time’ (away from other siblings) to explore what else might be going on. If your senses tell you there is something more going on, and special attention is not helping, there are many ways counselors can help children learn skills and cope with emotions. Counselors who work with children have toys, sandboxes, games, drums and other cool kid stuff which helps make it a positive experience. Counselors can also identify when your child appears to be developing just fine!

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Apr 12, 2017

Do you have a question for our experts? Email kaytd@macaronikid.com with “Ask the Experts“ in the subject line. (Please note: If we select your question for inclusion in Macaroni Kid, your name or any identifying characteristics will not be included.)

Question: My 10 year old has developed breasts before any other girl in her class. She is getting teased about it (kids saying she stuffs her bra). She is very self-conscious and has started wearing baggy shirts and sweatshirts. How can I help her feel better about herself and not feel self-conscious?

Answer: While we are delighted to see our children hit the milestones toward adulthood, it is difficult to watch them be challenged, especially by their own bodies. Puberty is awkward. Some girls develop breasts early, some quite late (and they get teased also). The best you can do is to allow her freedom to be comfortable as she changes and to choose the clothes she wants to wear. Soon all the other girls will catch up and she won’t feel all alone. Sharing your own experiences during this time of life might also help to normalize her feelings. Remind her that everyone in her class has something about themselves that makes them uncomfortable. Some may feel too tall, too short, too fat, too thin…sometimes it is something that can’t be seen; she is not alone in her discomfort. The point is that this situation will pass. Your job is to help her grow to love her healthy body (breasts and all); she is going to need it going forward! There is a helpful book for girls called My Body Myself by Lynda Madaras. There is one written for boys as well.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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This article originally appeared in Macaroni Kid on Mar 9, 2017

Do you have a question for our experts? Email kaytd@macaronikid.com with “Ask the Experts“ in the subject line. (Please note: If we select your question for inclusion in Macaroni Kid, your name or any identifying characteristics will not be included.)

Question: My son is angry all the time. He has friends, makes good grades and doesn’t seem to have a worry in the world but he is always angry. He has been raising his voice a lot and recently was sent home from school for pushing another boy. We have tried grounding him, taking away screens and deducting his allowance as consequences. It doesn’t seem to help. How can we help him better cope with his emotions?

Answer: Sometimes being a kid is tough. It is important to remember that anger is one of our primary emotions. Everyone experiences anger. Learning to express it in healthy ways is better for all of us. This is a great opportunity to help your son learn a skill that will serve him all his life. Explore with him the emotions that are underlying his expression of anger. A question you may ask him after he has calmed down is, “I noticed you were really angry today. Is something happening at home or at school that is upsetting you?” Remind him that he can always talk with you about things that trouble him. Perhaps he is experiencing being bullied or ridiculed at school, causing him to lash out. Maybe he feels he is not being listened to, or is being treated unfairly. His perceptions may even be wrong, but his need to talk about them is real. You can help your son learn to express his anger by saying, “I feel angry when you….” This can diffuse a situation. Seeing our kid’s anger is tough for parents. Sometimes we yell back, sometimes we give in, and sometimes we don’t do anything. The most important thing to do is to not let it go. Even if you wait until the dust settles, go back and talk about it. As parents, we have to remember that we model how anger is expressed, or not expressed. Kids learn from how we cope. You must model that it is never okay to physically attack another in anger, and to always to apologize when we hurt another’s feelings with our anger. Counseling could be helpful if the outbursts continue. You son could learn some coping skills and how to speak up for himself.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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Three clinicians from Health Affiliates Maine (HAM) have responded to a request from the American Red Cross of Maine in providing relief efforts within areas of West Virginia. We are deeply grateful for the volunteer efforts of Echo Dixon-LCSW, Karen Hardy-LCPC and Shannon Morris-LCPC who are providing mental health support to individuals who have been impacted by devastating floods.

The partnership between HAM and the Red Cross of Maine illustrates our focus, passion and mission to ‘Share a Journey to Wellness’.  

We share our expertise. We share our resources. We share our hearts. 

Andrea Krebs, Executive Director of Health Affiliates Maine confirmed three mental health clinicians have deployed to West Virginia and a few others are waiting their call to deploy as well.  “It is truly amazing how professionals in our field come together in times of crisis, and willingly give of their expertise as volunteers.” says Krebs. 

Jan Frost, Disaster Mental Health Manager with American Red Cross of Maine, reached out to Luanne Rhoades, Outpatient Therapy Program Director with Health Affiliates Maine for volunteers. “The support of Health Affiliates has made a great deal of difference on this operation,” Frost said. “Your efforts got qualified mental health providers to an area of great need. Your ongoing support and valued partnership are much appreciated.”

Preliminary reports indicate upwards of 2,000 homes could have been damaged or destroyed.  Many areas are still not accessible and the number of affected homes is likely to change. Since the flooding began, there have been more than 1,900 overnight stays in emergency shelters. The Red Cross, in coordination partner agencies, has served more than 113,800 meals and snacks, and distributed more than 103,600 relief supplies including cleaning supplies and comfort items. This is a difficult time for many families unexpectedly forced from their homes – and Red Cross disaster mental health workers and their partners are helping people cope.

HOW TO HELP: This is a large relief response and the Red Cross needs the public’s support.  Those who would like to help people affected by disasters like flooding and countless other crises can make a donation to Red Cross Disaster Relief.  People can donate by visiting redcross.org, calling 1-800-RED CROSS or texting the word REDCROSS to 90999 to make a $10 donation.  These donations enable the Red Cross to prepare for, respond to and help people recover from disasters big and small.

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Have you ever had that haunting feeling that you’ve become your mother, or that you sound just like dad?  That’s because you probably studied them as you were growing up.  You studied their mannerisms, their behavior, the way they spoke and what they did.  You may find you even use the same favorite saying, “Don’t do what I do, do what I say.” 

Some of those old sayings are not good rules for parenting.

It is important to remember that your children are studying you all the time, even when you’re relaxed and having fun on holidays like the 4th of July.  Cold drinks and summer fun go together.  Alcohol is often in that mix as family and friends gather for a good time. 

As parents, we can often be challenged as we try to model the behavior we wish to see in our children. As a parent you are role-model-number-one; the big cheese, and what your child longs to be.  This is why it is especially important for you to be mindful of your own behavior.   

If you want to make sure your kids learn to have fun without alcohol, then, show them that you can too!

If you want your kids to learn NOT to drink and drive, by all means DON’T DRINK AND DRIVE!

Not even when you think you are fine and able to drive. 

Some parents wonder if letting their underage kids drink with them is safer.  Step back and think again! Here is the message you are sending:  drinking is okay and breaking the law is okay (legal drinking age in Maine is 21).  You are putting yourself in legal jeopardy by providing alcohol to your child or their friends   NEVER provide alcohol to someone else’s child!  

Here’s 5 tips for modeling healthy behavior:    

  1. Be moderate in your consumption of alcohol.  You might choose to drink, but not choose to be drunk.   
  2. Don’t approve of adults who are drinking too much, by laughing at their behaviors. 
  3. Talk to your kids about healthy social behaviors you want to see in them — regularly and often, including you feelings about underage drinking.
  4. Don’t drink and drive.
  5. Don’t provide alcohol to anyone underage.

This article was brought to you by Health Affiliates Maine.  Call 1-877-888-4304 for help with parenting, substance use and mental health problems, and other issues which effect families.

Author:  Luanne Rhoades LCPC, LADC, CCS – Outpatient Therapy Director

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