Macaroni Kid

This article originally appeared in Macaroni Kid on October 1, 2021, by Mary Gagnon, LMFT, and Clinical Development and Training Specialist for Health Affiliates Maine. 

Question: I have three children ages 4, 3, and 6 months. How do I get my 4- and 3-year-olds to listen without raising my voice and losing my temper? My 4-year-old is sensitive and doesn’t respond well to anger.

Answer: Ah, those early years are certainly a challenge! So much growth, so little attention span and capacity for self-regulation.

You’re off to a great start. Self-awareness is one of the most important tools in your parenting toolbox. An awareness of your child’s unique personality traits and tolerances is another. And, of course, most people don’t respond well to anger, nor do you want to spend your time with your children feeling angry. So, what else can you do?

Let’s start with you. Are you taking care of yourself? Having three children under five is a great deal of work, and it absorbs a lot of your time and energy. Make sure that you’re meeting some basic self-care needs: nutrition, exercise, sleep (a tough one with young children, I know), time with family and friends, engagement in meaningful activities (paid or unpaid, hobbies, spiritual fulfillment, etc.), whatever you think you need to feel whole and healthy. You may need to ask for help in getting your needs met. You may feel selfish or like you don’t want to “burden” anyone else, but time for yourself helps you to be a better parent, friend, partner, and so on. It’s a win for everyone.

Envisioning and setting intentions for the day can be very helpful. Knowing what you want out of the day and how you want to be as a parent that day helps your mind walk that path. So, for example, you can say to yourself at the beginning of the day, “Today I want to show my children that they are loved. I’m going to make cookies with them.” If things go awry, remind yourself that plans don’t always work out as you hope, and grant yourself and your children grace and the benefit of the doubt, and that even if the cookies don’t get made, there are many ways to show your children that they are loved.

Now, about your children. They’re in exciting times in their development. The world is a big place, an interesting place, an unknown and sometimes even scary place. They’re newbies in this world, newbies even to their own bodies and minds, and they don’t know how to read the map. It’s our job as parents to help them navigate this brave new world, to help them feel secure enough to explore. If we’re doing our job, then they’ll do just that…and sometimes they’ll go too far and we must pull them in. They won’t always like it (just as we don’t like it when our desires are thwarted), and we’ll have to endure the inevitable challenges to our limit-setting—tantrums. Young children have less experience in the world, less understanding and control of their emotions and bodies, and though we may not appreciate their outbursts, they’re perfectly normal.

Young children, too, aren’t known for their high attention spans. Developmentally, their brains are absorbing many, many things, and they don’t know what to pay attention to. It’s a parent’s job to help them learn what to pay attention to and how to act, physically and emotionally, in the world.

So, how do you do that? Here are a few concrete tips:

  • Speak to them at their level. This is both physical and mental. Get down onto your knees when you talk to them, so that you are eye-to-eye with them. Use words that they understand. Use short sentences that don’t have multiple commands in them (“You need to get dressed, pick up your toys, and eat your breakfast” is a lot for a young brain to process).
  • Use a firm but loving voice. Your voice should be calm and loving, but also confident and firm. You’re their teacher, and you’re teaching them how to act.
  • Touch (or not). Some children find touch comforting and grounding, others find it overstimulating. Look for clues that tell you how your child feels about touch.
  • Warn them of consequences. Tell them what behavior you don’t like and warn them that if the behavior continues, what consequence will occur as a result. Consequences should relate to the behavior when possible (“If you keep pulling the dog’s fur, you won’t be allowed to pat the dog anymore. Use gentle hands, please. Let’s do it together.”).
  • Calmly follow through with consequences. Again, you’re teaching them. Their education should be calm and matter-of-fact.
  • Talk about it later. None of us can talk about an issue when we’re still overly emotional about it. When everyone has calmed down and is more focused, that’s the time to review what happened. Keep it simple (“You pulled the dog’s fur again, and that hurts the dog, so you couldn’t pat the dog anymore. Next time, please use gentle hands with the dog so you don’t hurt him.”)
  • Repetition is your friend. Kids (and adults, too) don’t typically learn something the very first time. They need lots of practice and repetition. This might be a bit tiring for parents, but it’s vitally important to understand that they’re not trying to upset you; they just need more time to learn what you’re trying to teach them.

Remember that everyone has a bad day, children and parents alike. If you do end up raising your voice and losing your temper, take time to apologize to your child and speak calmly about what happened. They may not understand everything you’re saying, but they’ll remember how it felt to have their parent speak to them kindly and acknowledge their mistakes. It’s a wonderful lesson for when they make their own mistakes, giving them both the blueprint for how to handle those situations and a safe space with you to admit them and try again.

Raising children is a marathon, not a sprint, and you’re bound to get a charley horse or two along the way. What’s most important is that your children know how much you love them. Best of luck to you!

Mary Gagnon is a Licensed Marriage and Family Therapist and Clinical Development and Training Specialist at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on September 3, 2021, by Cindy Mailhot, LCSW, CCS, Assistant Director of the Outpatient Therapy Program, Health Affiliates Maine. 

Question:  My 13-year-old is struggling with mental health and starting to act out in concerning ways. How can I help and be supportive while also parenting and setting healthy boundaries with screens, dating, and outbursts toward younger siblings?

Answer:  First, I want to commend you on considering the two sides to every parent’s dilemma…how to be their biggest supporter and their disciplinarian at the same time. That is not an easy job! At thirteen years old you are on the starting line of those all-important teen years, so considering this now will help you set the tone for your relationship in the coming years. I think the answer lies in achieving a balance between these things. There are situations when you will be able to take on a stronger role as a supporter while offering gentle guidance and other times where you will need to fall heavier on the disciplinarian side. 

Being prepared can help alleviate stress for everyone in many situations. It is important to establish the rules and consequences for breaking those rules ahead of time (I.e. outbursts toward others). It helps both parents and children when navigating those emotionally charged moments. To ensure consistency, be sure to include anyone that might be significant in co-parenting (parents, stepparents, grandparents, etc.). Rules and consequences allow parents to remain levelheaded in these situations. Without them, heightened emotions can lead us to giving consequences (i.e., “you are grounded for a month”) and giving in later when the emotions are lower.   

Screen time is generally recommended to be no more than two hours per day.  That being said, you will want to determine what is right for your child and family. Once you establish that, set some clear rules around that. Does it need to be done after homework is complete? Do their grades factor in? What about chores? Do you want to change your Wi-Fi password daily and provide it after they meet your established boundaries? These are all things to consider before the issue arises.

Dating is another topic that you will want to consider before the need arises. When can they meet a date somewhere? What age will you have the date pick them up? Do you meet dates ahead of time?  What is the curfew and the consequence if broken? This is a great topic to have some discussion around so that your child understands your concerns. This is a great topic for safe dating discussions as well—internet safety, safety planning if a date if going poorly, red flags in choosing dating partners, etc. Allowing opportunities for your child to discuss this topic before and during their dating experiences will be important to you feeling comfortable with their plans and them feeling comfortable talking to you if challenges or questions arise.

The supportive parent may also incorporate several strategies to be sure that the relationship does not become defined as a series of arguments and punishments:

  • Incorporate time together to just have fun and talk.  Maybe take turns planning those “dates” or plan them together.  It is important to engage in activities that your child likes to do too (even if you do not).
  • Listen to your children about all topics. These are great times to teach them your family values but also how to think for themselves and make informed decisions. Listening also sends the message that they can talk to you—and even disagree with you—and it is okay. These are great skills for them to learn and will preserve your relationship for those harder times.
  • While very challenging, try to keep emotion level when disciplining. It is all too easy to fall into shaming and blaming when we are responding out of our own fear or anger. Those parenting behaviors may put a rift in your relationship, making the discipline times more challenging. Be firm about the discipline, acknowledge your emotions, and allow them to express theirs.   
  • Just like in adult relationships, talking when both parties are angry is probably not a great idea.  Come back to discipline and discussion later when you both have a chance to calm down.

In summary, know the rules and consequences for your family and be consistent with them but always leave communication lines open. 

If you notice anything concerning (you know your child best), reach out to a mental health specialist for assistance. Behavior changes could include a change in social activities, isolation, sadness, anger, acting out, or essentially any behavior that is outside the norm for your child.

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This article originally appeared in Macaroni Kid on August 15, 2021, by Marylena Chaisson, LCPC, Case Management Supervisor, Health Affiliates Maine. 

Question: My sister is six years older than me. Growing up, she was responsible for a lot of my care and was abusive both verbally and physically. We barely speak now which is fine by me. She has been living in another state but recently told us she is moving back to Maine. My parents live in Maine also. If it were not for them, I would have no relationship with my sister. However, I know that now I will see her at every holiday. I am dreading it. The only time I spoke to my mother about this (as an adult) she brushed me off as being dramatic. I am feeling a lot of anxiety around seeing my sister more (even though I know she can no longer hurt me). I’m struggling with the need to talk with my parents to let them know I may not be able to visit at the same time as my sister. I do not want to be hurt but nor do I want to be hurt. I know seeing my sister regularly will bring up many bad feelings. Am I best to avoid my sister, talk to my parents, or just try and suck it up?

Answer: I first want to express that your feelings about this are valid, and you are doing a fabulous job thinking about these potential changes ahead of time.  It is natural for you to want to protect yourself from a person who hurt you in the past. Your mother brushing off these concerns when you attempted to speak to her in the past about it does not invalidate your experiences or need to protect yourself in the slightest. I most certainly do not endorse the idea of you choosing to “suck it up” because that feels inauthentic and invalidating of the hurt you have experienced.

There is an array of paths you can take in this situation.  This is not an all-or-nothing, nor is it a one-time permanent decision for which path to take.  It is okay to decide that, for your own sense of emotional safety, you are not ready to have in-person contact (or any contact) with your sister.  You can choose to explain or not explain this to your parents in whatever level of detail you feel comfortable.  You do not owe anyone, including your parents or your sister, an explanation of what you are doing to make yourself feel safe and comfortable in the world.  You also reserve the right to change your mind in the future whenever you feel fit. This is a time where it is important to put your own emotional safety and needs ahead of your desire to please your parents or attempts to help them avoid feeling any discomfort.  They might experience uncomfortable feelings about what you say (or don’t say), but managing their feelings is their responsibility, not yours.  You must look out for your own best interest.

Here are some examples of explanations, varying from matter-of-fact statements with no detail, ideas for redirection, or all the way to including a more thorough, detailed explanation:

“I’m going to miss this family event.”  

“I want to start a new tradition of taking you [parents] out to dinner for holidays – just you and me.”

“I am not interested in seeing [sister] so I will not be attending events where she is present.”

“Remember I told you about the times that [sister] hurt me in the past.  I do not feel able to be in the same room as her right now.  That might be upsetting for you to hear and upsetting you is not my intent, but I need to do what I feel comfortable with. I am seeing a counselor with the hope that I might be able to attend events with her in the future, but I can’t right now.”

That last example leads me to my next thought: this is a perfect situation to bring to a counseling relationship if you have any interest in working through some of the stress you are experiencing related to this.  You have competing desires here—you want to participate in family events and see your parents during the holidays and you also want to avoid seeing your sister. These desires are coming into direct conflict, so something is going to have to give.  The only part of this dynamic you have control over is your own responses and decision-making.  There is room here, should you choose, to develop skills for distress tolerance and self-management while being physically present with her.  A counselor, especially one trained in family dynamics like a LMFT (Licensed Marriage & Family Therapist), could be helpful in supporting you to build skills for managing your reaction, memories, and stress related to the past abuse you experienced. With skills and support, you very well could find yourself able to attend family gatherings with her present without experiencing an unbearable level of distress.  This path is only recommended if you feel that she will not engage in further abusive behavior now that you are both adults—I would never encourage you to expose yourself to further abuse.  

Please remember, your path forward here should be focused on what feels emotionally safest to you, and not based on a misplaced sense of owing your parents contact with your sister. You can choose to work towards increasing your ability to be around her in the future—or not—again, that is totally up to you and may evolve over time.  Stay authentic to your truth and honor yourself and you will see the best path forward in this complicated situation.

Marylena Chaisson, LCPC is a clinical social worker and the Case Management Supervisor 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 and click on “Referrals.” 


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This article originally appeared in Macaroni Kid on July 1, 2021, by Lindsay McKeen, LCSW, CCS, Outpatient Therapy Supervisor, Health Affiliates Maine. 

Question: My husband and I divorced last year and while initially our daughter (11) was adjusting well to the big change in her life, she seems to be struggling more and more. We want to find a counselor for her to talk with. I’m wondering if you can suggest what types of questions are good ones to ask when trying to find the right counselor? My ex and I want to be sure it’s a good fit. Thank you so much.

Answer: It can be difficult to take that first step in getting yourself or a loved one into counseling, and even more so when you are navigating a new family dynamic and trying to find that support for your child. It is important that you and your ex-husband are on the same page here. In sharing this awareness of her needs and interest in finding a counselor that is a good fit for her, you are off to a good start.

Before looking at what to ask of the counselor, it is important to be sure the right questions have been asked within the family. While your child may not be hands-on in the search for a counselor, it will end up being her service and provider and so including her voice early on may help enhance her connection and engagement. What is her understanding of counseling? Is she agreeable to seeing a counselor? Are there any questions she would like answered before seeing the counselor? Does she have any questions for you? While parents are the decision makers, children value being heard and having a sense of control where appropriate. Giving her this voice before starting the counseling relationship can set a good tone for creating a trusting environment where she feels she can be open about the struggles she has been having.

Then, when it comes time to ask questions of the potential counselor, it may also be helpful to ensure you and your ex-husband have similar definitions of what a “good fit” would look like. You may have already had this dialogue, or you might try answering the questions below with one another to see if your definitions align. Many counselors also have online profiles and viewing these together could be another way to get a sense for what you both are looking for in a counselor for your daughter. Here are some topics and questions to consider when looking for a counselor:

Experience: While it is possible for counselors to work with people of all ages, many counselors find their niche in working with certain client populations. This niche may be developed around age group, diagnoses or presenting concerns, and/or specialized treatment approaches. Asking about the counselor’s experience may help you feel more comfortable with their ability to support your daughter with her needs.

  • Does the counselor have experience working with children or your child’s particular age group?
  • Does the counselor have experience working with families, especially those navigating divorce?
  • What is the counselor’s therapeutic modality or approach to working with children?

If you have spiritual beliefs or other cultural considerations you would like considered by the counselor:

  • What is the counselor’s understanding of that belief/culture?
  • How does the counselor manage differences in beliefs/culture and/or how does the counselor understand the ways in which the belief/culture may impact a child’s mental health care?

Potential Scenarios: In learning about the counselor’s experience and approach in therapy, you may get a sense for how the clinician will interact with the child and family, or you may want to ask more questions to get a better understanding. You might try thinking ahead to potential scenarios that might arise using the questions below:

  • How will the counselor navigate confidentiality and privacy for the child in relation to parental involvement?
  • How will the counselor handle concerns that they themselves or the parent(s) have identified?
  • How does the counselor foresee handling differences in opinion that may arise between parent(s), child, and/or counselor?

Logistics: Though the counselor’s experience and approach are likely most influential in selecting the right provider, the logistics are important too. Having discussions about the logistics upfront can help clarify expectations of both parties and minimize disruptions to the counseling relationship once it has begun.

  • Does the counselor provide in-person or telehealth-based services?
  • Does the counselor have the availability to offer a standing appointment? Or is their scheduling flexible/varying depending on the week?
  • Does the counselor have any policies in place around attendance or payment?

  • What are the counselor’s practices for communicating information to parents?
  • Are there expectations for parental involvement?
  • What is the best way to communicate with the counselor?

Though this article presents many questions and considerations for finding the right counselor, know that this is not all-inclusive. Having conversations with your ex-husband and child may expand or narrow this list to what feels most relevant to her needs. Most important in this process is open communication, with one another and the counselor, keeping in mind that the common goal is to support your child, and that the search can continue if you find yourselves feeling like the counselor is not a good fit.


Lindsey McKeen, LCSW, CCS is a clinical social worker and Outpatient Therapy Supervisor at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on June 10, 2021, by Marylena Chaisson, LCPC, Case Management Clinical Supervisor, Health Affiliates Maine. 

Question: My son is a senior and will be going out of state for college next year. He has fairly high anxiety and lacks executive functioning skills. I am feeling very anxious about him being far from home. How do we both prepare for this big change?

Answer: Big changes ahead! Let me tell you that you’re already doing great just by thinking about these challenges ahead of time and acknowledging there might be a couple of bumps here and there for both of you, so first off, please give yourself a pat on the back for being a caring and nurturing parent! Changes like this can be stressful for the whole family. Please remember to take care of yourself and attend to your own anxiety and stress over this change by seeking the support of a counselor, even if just for a few short-term, solution-focused sessions. 

Here are some specific thoughts about your son and his transition to college life:

  • I would encourage him (maybe with a little support from you) to reach out to the college’s student counseling staff right away–even this summer. This could be something you can support him with. Counseling staff at college are well-versed in the array of transitional struggles that frequently occur with this population of young adults and can better support new college students if they know ahead of time what challenges might surface. I will be surprised if the college does not have a counseling option for their students. If they don’t, reaching out to the Dean for guidance towards locally available counselors might be the next thing I’d try.
  • Review with your young adult the various strategies that you’ve both been implementing already for him to keep up with his high school classes and helping out around the house–if he’s passed high school and been accepted to college, that tells me he has some capacity for executive functioning as long as there are some supports in place. Is he a list-maker? Does he use a planner? Does he have a calendar on his phone? Do you use a weekly chore chart in the house? Every family and every individual is different, and it’s very common for most of us to use one or more helpful strategies or tools to stay on track. You will want to encourage him to replicate these same tools/strategies in his new college environment as soon as he moves out of the house. 
  • Begin the transition to more independence early.  Sit down with your young adult and discuss what activities he will need to accomplish independently when at college–doing laundry, making it to the cafeteria during mealtime, waking up to an alarm so he can make it to his classes on time, being responsible about bedtime–and think of ways you can start promoting independence on these things this summer. Follow through with natural consequences. If he commits to waking up by himself to an alarm to get to a summer job, and then sleeps through the alarm and ends up getting in trouble at work–that’s a natural consequence that he might need to experience and learn from. It can be very hard as a parent of a transitional-age youth to avoid jumping in and “rescuing” them from poor decision-making or low responsibility, but that is part of your work as a parent right now to assure a smoother transition to independent living.
  • Look at the college schedule for the academic year and plan ahead about staying connected during the week through video chats or phone calls, and make a plan for his trips home so you both know what to expect. For the extended times he plans to remain on campus, make sure you come up with some fun activities to keep yourself occupied–have there been hobbies or activities you’ve been wanting to get back into or try that you haven’t had time for? This can be a great time of personal growth for you, too!

Remember that times like this are a great opportunity for growth for everyone in your family. Sometimes growth doesn’t feel good at first (remember growing pains as a kid?), but a little bit of discomfort isn’t necessarily a bad thing. Open and honest communication and great boundaries are some of the biggest stepping stones towards this transition being as smooth as possible!  I’m excited for you!

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This article originally appeared in Macaroni Kid on May 13, 2021, by Cindy Mailhot, LCPC, LADC, CCS; Health Affiliates Maine. 

Question: My daughter was touched sexually without consent by a classmate last year. She has not had in-person classes with the student this year due to mostly remote classes. She has lately been expressing a lot of anxiousness about seeing him in person when classes resume to normal. How can she best prepare for seeing him again and feeling safe? (The school is aware and spoke to the boy and his parents when this happened. He received a school suspension.)

Answer: I can just imagine how stressful this situation has been for your daughter and for you as a parent. You are doing an amazing job as a parent in supporting your daughter and working with the school to ensure her safety and sense of safety with the world around her.

Not knowing the age of your daughter, here are some suggestions for a variety of ages:

  • Work with the school to determine a schedule and plan that involves minimal interactions with this other student and a plan for when interaction may happen.
  • Sit down with your daughter and review the potential spaces and places she expects to see this other student in school–in the classroom, in the halls, at lunch. Explore the possible interactions she can imagine (good and bad) and brainstorm how she might manage in different situations–walk away, go to the principal or guidance counselor’s office, find her friend group, calmly but firmly say “leave me alone.”
  • Try to understand her “ideal” situation and brainstorm how that might be able to happen.
  • Remind her that the other student might be feeling awkward and uncomfortable, too, and may also be worried about seeing her.
  • Find out what the return to the classroom will look like and perhaps try a trial run rather than going back full-speed immediately.
  • Find out who her supports would be in the school if she’s having a difficult time and work on familiarizing her with these supports (if she isn’t already familiar with them) so she might feel more comfortable seeking help if needed.
  • Explore who the safe people are to talk to if something were to happen that she is uncomfortable with.
  • Stay hopeful. Try something on this list each day. Dwell on thoughts of when the pandemic ends and of all the things you will want to do and explore with your child. Do not hesitate to reach out for help.
  • Find one friend that can be her “buddy” for the first few days or weeks, so she won’t feel alone as she gets a feel for the situation.
  • A transition object from home that she can keep in her pocket that reminds her of your unconditional love and support throughout her day may ease the transition.
  • Provide plenty of opportunities to discuss her worries and concerns with you and anyone else she might feel comfortable with.

To know if she’s adjusting well, keep the lines of communication open. Check-in with her regularly and ask how she’s feeling, if the plans that were made are working and if anything needs to change. I also recommend that you watch for behavior changes. If you notice anything concerning (you know your daughter best), reach out to a mental health specialist for assistance. Behavior changes could include a change in social activities, isolation, sadness, anger, acting out, or essentially any behavior that is outside the norm for your child.


Cindy Mailhot, LCSW, CCS is a clinical social worker and the Assistant Director of Outpatient Therapy at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on March 25, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I am absolutely fed up with my mother-in-law. She has spent pretty much my entire marriage to her son criticizing me as a wife and mother. My husband used to defend me more but has given up saying his mom won’t change her ways so it’s not worth the fight. Recently she called me a “lazy mom” in front of our ten-year-old. Our daughter cried on the way home and said she doesn’t want to see grandma anymore. My husband brushed it off. I’m furious as my daughter deserves to see him stick up for me (and her) and should not be exposed to that. I want to have a discussion with my husband but see red every time I start to gear up for it. How can I discuss this without making matters worse?

Answer: This is an important question to which so many can relate. You would like to not be criticized by your mother-in-law. You would like to be supported by your husband when there are problems between your mother-in-law and yourself. And you want healthy behavior about relationships and respect, to be modeled for your daughter.

Relationships with in-laws and parents are so significant. When troubled, they can be like a tormenting drip, drip, drip of a faucet or they may be like walking through a field with dangerous mines all around, always waiting for an explosion. The criticism can be at the table for every family gathering. When good, however, they can add richness to your life and the lives of your children. All your family relationships can be impacted by this difficulty with your mother-in-law. It can be helpful to see a counselor, a neutral party, to help you sort it out.

“Seeing red” when you want to talk with your husband is not getting the problem solved. Keep in mind that your goal is to help him understand what you need from him. If you go about this angrily or in an accusatory fashion, he will stop listening. Also, remember that he is in the middle. His mother may have been critical all his life, and he may feel powerless to think she can change. He will need some tools to be able to help and counseling may help the two of you stand together to resolve this.

Learning about setting boundaries is one way of making improvements. I encourage you to get a book or do an internet study on how to set boundaries or ask the counselor to help you with this. Learning to set boundaries helps you know what to do when you are not respected. The result of healthy boundaries is that slowly you will begin to gain respect. One of my favorite sayings about boundaries is “people use the people they can use and respect the people they cannot use.” If your mother-in-law can get you upset, cause you to storm out, and leave you hurting then she is the one who is in control. You can say to your mother-in-law, “I value our relationship and your time with your granddaughter, but I cannot allow you to speak to me in that way especially in front of her. Please speak to me with respect or we will need to leave.” If she continues and you allow it, she remains in control. Instead, quietly gather your things and your daughter and let her know you are leaving. No drama, no tears, just leave.

This learning process also includes evaluating those areas in which you may be contributing to the discord between the two of you. You cannot ask to be spoken to with respect unless you also speak and treat her with respect. Most often in these situations, everyone needs to do better.

Lastly, it may sound odd, but try to ignite feelings of love and kindness towards her. You can do this by looking at her life. Is she lonely, hurt, depressed; does she have needs that are not met, or were never met? People often push away the people they need most by the things they say and the things they do. Creating kind thoughts for her may help you connect with her in a more meaningful way. This takes practice, but modeling this for your daughter can have a big payoff for everyone.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on February 23, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: My son has battled depression and anxiety since late elementary school. He is 16 now. We have tried multiple medications for him, and he sees a therapist regularly. He seems to have gotten worse in the last six months which is no surprise given the difficulties of the past year. I am frustrated because I don’t feel like the meds he is on do enough. It feels like we have tried them all. Any advice would be appreciated.

Answer: Whatever you do, keep trying. I can just imagine how frustrated and hopeless you and he feel—you are doing the right things, and you are not seeing any change. Do not give up.

I hope I can give you some things to think about that might provide ways to further explore and treat his depression. Some people have what is called “treatment-resistant depression.” It means they are not responding as expected to the usual methods of treatment. That means it is necessary for everyone, both professionals and family, to look at other interventions. These are things which need to be considered:

Is the diagnosis correct? There are different kinds of depression which require different kinds of treatment. Since your son’s depression has gone on for this long, he should be treated by a psychiatrist and not a primary care physician.

Is the dose correct? Many psychiatrists are like artists and chemists, in a sense, adding some of this and tweaking some of that, until they get just the right combination. It can take time to find just the right formula of medications. Every person is unique and responds to medications differently.

Are there other mental health conditions complicating treatment? For example, if your son has Attention Deficit Hyperactivity Disorder (ADHD), he could be having trouble both socially and academically, which may contribute to him feeling bad about himself. Treating the ADHD could help with this.

Are there other medical conditions complicating treatment? Medical conditions such as thyroid disorders, mononucleosis, iron deficiency anemia and other vitamin deficiencies like Vitamin D, B2, B6, or folate (Treatment-Resistant Depression in Adolescents, David Brent, MD) can all contribute to depression. Lab work can help assess for these.

How well is your son sleeping? Adolescents are known to spend late night hours on screens and devices; this can interfere with a normal sleep cycle and greatly impact his mood. Medication is not a substitute for lifestyle deficits. Sleep, exercise, good nutrition, and social interactions make life better.

Is your son taking his medication regularly and as prescribed? Missing doses, for example, greatly reduces a medication’s effectiveness.

Is there depression in the family? Is there a family member’s depression, particularly a parent’s, which is not being treated or fully treated? This has a significant influence on how a child views the world.

Is your son currently experiencing bullying, or does he have a history of trauma or abuse? Medication does not treat these issues; however, they have a profound effect on mood. If he has these issues, is he working on them in therapy? Does he need additional assistance from parents, school officials or other professionals with these situations?

Is your son struggling with his sexuality or gender identity? Sexuality and gender identity are big and confusing to adolescents. Could his sexuality or gender identity lead him to family rejection or bullying by peers?

Is your son using substances like alcohol, marijuana or other drugs? Is there alcohol or drug abuse in the family? Using these substances or being affected by someone else’s use of substances alters normal emotional coping.

Is your son thinking about suicide or self-harm? This is so important. Ask him. Educate him that these choices are sometimes the result of feeling very depressed and hopeless. Help him know that there is hope, that as a family you will keep trying to help him feel better. Do not hesitate to take him to the hospital if he is doing things or saying things that make you think he is suicidal. He may be angry, but it is the safest thing to do. If you need help getting him there, do not hesitate to call 911.

Does he have a good relationship with his therapist? Not every therapist is right for every person. Check-in and make sure that he feels connected with and heard by his therapist.

It is very hard to have a child with prolonged depression. Parents feel hopeless and lost. Sometimes parents of depressed children need to talk to someone about it. Call a counselor to help you. Thank you for asking this question. You are not alone.

This and other helpful information on Treatment-Resistant Depression in Adolescents can be found here.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on January 20, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I am a new mom and COVID has been very difficult. My husband works out of the home and I feel very isolated. We are not seeing my parents right now even though they live close because they are high risk. I so appreciate Macaroni Kid as a resource but am missing in-person events and the ability to mingle with other moms. Can you share ideas for trying to stay connected and beat the heavy feeling of isolation? I am particularly worried with winter here that it will just get worse.

Answer: I can just imagine how badly you are missing in-person events and the ability to mingle with family and other moms. You are missing the fun of showing off your new baby to the world, and especially enjoying seeing your parents with their grandchild. This pandemic has really emphasized for all of us what really matters and the things we took for granted. New parenting should be a well-supported endeavor, and it’s not meant to be done alone.  

There are many things to do to take care of a new baby. I am going to add one more important job to your list and that is to take care of yourself. This is so important when you are feeling isolated. You will have to work to stay connected and fight the feelings of sadness that can often do just the reverse—cause you to withdraw.  

Not knowing your parents’ conditions, I am not sure if this can apply to your circumstance, but as long as you wear a mask and stay six feet apart, there are some activities you can do together. Outdoor activities are best. 

Here are a few ways to stay connected with loved ones, other parents, and your community: 

  • Bundle up the baby for brief porch visits. Let folks know you are coming so they can bundle up, too!
  • Try “car talk.” Park next to each other in opposite directions and talk for as long as you can handle the open window temperatures. Enjoy a hot drink while you chat.
  • Text pictures of the little one daily to your parents and in-laws. They will love it since they are probably feeling isolated and alone, too. Everyone will feel more engaged. 
  • Should baby nap long enough, bake something for your parents and make a delivery so they can get a quick peek at the little one.
  • There are many online groups. Try one on Facebook specifically for those who welcomed a baby during COVID called “COVID-19 Baby Parents Group.” These types of groups are just a chat forum to support one another and share ideas and resources.
  • Make sure you are letting your husband know how isolated you feel. He may be doing it already, but if not, ask that your husband check in on you during his work breaks.
  • Make a list of those friends and family for whom you can have regular contact whether by phone, Skype, Facetime, email, or car talk. Ask them for regular virtual or phone visits. Most importantly, let them know how you are feeling. You will find others feel as you do. 
  • Don’t let cold weather keep you from attending outdoor events. Most town recreation centers have developed “safe” family or kid activities to do which can connect and get families out of the house. Some are ongoing weekly events like skating, snowshoeing, or winter walks. One mom told me that she has enjoyed this so much. She bundles up her daughter and puts her in the sled at the event. It is a great place to meet other moms. The fresh, cool air can invigorate both mom and baby, giving you energy.
  • Some local farms are allowing families to visit the animals in the barns. Call ahead and ask. The sights, sounds, and smells of the working farm can make for a wonderful adventure.
  • Reach out to other new moms you may know. Share with them how you are feeling.  
  • Think of someone in your circle of acquaintances who might also be feeling isolated. In helping others, we often help ourselves.
  • Connect to a counselor via teletherapy. Most insurances will pay for this. There are many uncertainties in being a new mom even in times when accessing regular supports is easy. It is common for new parents to experience stress, anxiety, and some experience postpartum depression. The challenges of new parenting are emphasized during a pandemic. Asking for help is the act of a healthy person. 

Stay hopeful! Try something on this list each day. Dwell on thoughts when the pandemic will end and of all things you will want to do and explore with your child. Do not hesitate to reach out for help. We will get through this.


Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on December 17, 2020, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I am a bi-sexual woman married to a woman. My daughter will be starting school next year and we hope to do some preschool programs this year if possible. My daughter has a biological dad she doesn’t see often. I know questions will arise for her during the school years on having two moms. My wife and I have open conversations with our daughter and want to help prepare her for questions and how she can best handle them. Do you have suggestions on where to start?

Answer: It is so good that you are thinking ahead to help your daughter with complicated moments. We can’t be there all the time, but sometimes we can give our children tools to help them navigate. 

Like all the kinds of diversity that she will experience, your family situation of having two moms sets her apart. Diversity is about differences. The place to start is by helping her embrace all the beauty of diversity, the positive benefits diversity brings to our world. Has she tried foods like Chinese, Thai, or Italian? Does she know anyone whose family immigrated to our country? Does she have questions about how Somali women dress? Does she have questions about disabled (I like “otherly-abled”) people? Talking openly about these groups as well as gay and lesbian families will provide comfort, confidence, and information when these subjects come up at school.

Here is an example of just one of the many conversations to broaden her world of acceptance. When you enter a store together with automatic doors, explain that the doors were made that way so someone using a wheelchair can roll in easily and that the slopes at the end of a sidewalk mean everyone can get around easily. This normalizes these differences and shows how everyone is important. 

Having toys and books that celebrate differences, including having two moms, can be helpful and can provide opportunities for larger conversations. I’ve included some examples and urge you to explore the many fine options:

  • Matching Game: I Never Forget a Face by the EEBOO Corporation
  • Crayons: People Color Crayons by Lake Shore Learning
  • Book: Mommy, Mama and Me by Leslea Newman
  • Book: My Two Moms and Me by Michael Joosten
  • Book: Love Makes a Family by Sophia Beer

In your open conversations with her, talk about why she has two moms. Without knowing what questions will arise, increasing her knowledge and understanding of your relationship may give her the words she needs. In language, a child will understand, explain about love (“People are like peanut butter and jelly, meant to be together”). Let her know that sometimes people might not understand because they’ve never seen it before, and sometimes people are unkind about things they don’t understand. Invite her to always bring their questions to you and to talk about how she’s feeling.

Some families have two parents of different races. Some only have one parent, while some are being raised by grandparents. Your daughter is different. Your daughter is special—she has two moms.  



Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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