News & Events

5 easy steps to start doing now

The new year is a great time to ramp up marketing efforts to grow your private practice. You and your clients know that you’re a wonderfully skilled and compassionate counselor, but how do you tell that to the world? To grow, you must consistently market yourself as an accessible professional without sounding disingenuous. Here are five ways to start marketing your practice and setting yourself up for success in 2020 and beyond:

  1. Create a website. It doesn’t have to be complicated! Initially, templates with free hosting are the way to go. You can find beginner-friendly templates here and here. Once your website is on its feet, consider upgrading to a premium plan (about $15-$20 monthly). This will give you storage space, a domain (your personalized website name), and easy-to-read analytics, to better measure your business. Build your website based on your style but design the layout with prospective clients in mind. Have a clear, uncluttered navigation bar so browsers can see who you are, where you are, how to (easily) connect with you and resources they will want to read. Choose your words carefully and tailor them to your prospective clients—don’t make it about Do include a professional bio that is welcoming, accessible and that will resonate with prospective clients. Also, upload an updated, professional headshot. Make it easy on yourself and use the bio and professional picture from your Health Affiliates Maine profile.
  2. Write a blog. Consistently writing blogs, publishing them to your website and then sharing them on your social channels (Facebook, LinkedIn, etc.) will help clients find you and will help Google promote your website. Generally, a person only searches for a counselor once they’ve realized that’s what they need. By writing blogs on topics that you are passionate about (addiction, anger management, anxiety) you are helping a future client access a trusted resource that will offer them solutions: your private practice, your counseling services. Even better, create a video blog (vlog). Videos will let browsers see you, hear you and gauge how you would interact together in a therapy session.
  3. List yourself on professional profiles. Again, people will only search for a counselor once they’ve realized that’s what they need, but if you are listed on sites such as Psychology Today and goodtherapy.org, with a clear, organized, approachable profile, clients will be drawn to your authenticity and expertise. Like your website, make the profile about how you can help them to solve their problems. When you attain new clients, ask how they heard of you. Take note of the profile that gets the most visits and keep that one up to date and active. (These sites have annual fees.)
  4. Create an email list and send a newsletter. You can get an email list started from an invitation form on your website. Keep any information you send out relevant and concise and send often enough to keep yourself fresh in their minds without seeming spammy. Send newsletters about any new blogs you’ve added to your website or any approaching public speaking events. And…
  5. Host public speaking events! Reach out to community centers and businesses in your area to host a forum on a topic that you are enthusiastic about. Whether it’s ways to relieve stress, walk and talk therapy techniques, implementing meditation into daily life, use your passion about the topic to create a connection with like-minded individuals who might need your counseling services.

Along with these five ways to market yourself and grow your private practice, you can also post flyers and business cards on community bulletin boards; share posts of businesses you like on Facebook (this creates goodwill and opens a door to future collaboration); and network with other professionals you admire. You can even become an Employee Assistance Provider (EAP) for nearby companies and businesses. Be creative, be genuine, and be excited to talk about your practice and what you can offer your future clients.

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Studies have shown that adults with severe mental illness have a shorter lifespan than adults without a diagnosis by an average of 25 years. Additionally, 68% of adults with a mental health diagnosis have at least one chronic disease that limits their daily functioning.

Behavioral Health Home (BHH) programs are evidence-based care-coordination programs designed to reduce the impact of preventable diseases in people with mental health diagnoses by ensuring the coordination of medical and mental health treatment.

This coordination is done by BHH team members, including a wellness coordinator, peer/parent support person, nurse, consulting psychiatrist and primary care provider. The common goal is to address the gaps between physical health and mental health care plans.

BHH participation, when delivered with core principals, improves the outcomes of the individuals served—reducing emergency care visits and hospitalizations and increasing overall quality of life.

How can BHH help my client?

  • BHH creates treatment plans that address client life experiences, chronic stressors, poverty and isolation to reduce the risk of premature death.
  • A BHH team shows clients how to self-manage physical and mental health symptoms through education, coaching, forming support systems and connecting to community resources.
  • Emergency room use, appointment attendance and medication refills are monitored, and clients who have had two or more refills of antipsychotic medications have their blood sugars monitored.
  • Educational and peer support for adults in the program, and support to parents with children in the program, gives clients and their families the opportunity to learn from each other and to foster a sense of belonging and community engagement.

How does it benefit me as a healthcare provider to recommend BHH to my client?

  • Unlike other case management programs, BHH is an easier program to access. It does not require specific criteria relating to mental health diagnoses and you don’t need to write a section 17 letter.
  • The BHH team will ensure that the tools used during a client’s session encourage positive treatment outcomes, and that they continue to use the tools in their home and community.
  • Clients that struggle with chronic illness also struggle to attend appointments. As clients begin to feel better, they find it easier to attend sessions and take advantage of other resources available in the program.

Why HAM is the right BHH provider to partner with.

  • We don’t have a waitlist. We will assign your client within 24 hours and have a team member see them within 4-7 days.
  • We are not case management as usual. We worked with Maine Quality Counts to help design an effective program that adheres to the highest standards of BHH. We are fully committed to model fidelity.
  • We welcome client feedback and offer the ability to participate on an advisory board.
  • Our partnerships are important. We will be proactive in our collaboration with you and you can reach us at any time.
  • We collaborate with other case management programs. If we aren’t the right fit for your client, we will transfer them appropriately. (If your client would benefit from Section 13 or 17, they may still want to continue with BHH to work on self-management skills.)
  • We regularly consult with psychiatrists and primary care providers to ensure that we are educated and that we understand the impact of client treatment plans and interactions.

Do clients need to have a chronic illness to benefit from BHH?

No. If you have clients with mental health diagnoses and they are having challenges at school, work, home or community related environments, BHH can offer them help. The BHH program allows us to work on prevention activities that help with the overall well-being of your client such as nutrition, stress relief, physical activity and tobacco cessation.

Does my client need to have MaineCare?

Yes. A client must have full eligibility in MaineCare to qualify for BHH.

How do I refer a client?

We offer BHH services in Androscoggin County, and are accepting referrals for adults in Oxford and Southern Franklin County and surrounding communities.

Referrals can be made by calling us at (207) 333-3278 or (877) 888-4304. Click here for our online referral form. 

References:
Reisinger-Walker, E & Druss, B. (2011, February). Mental health disorders and medical co-morbidity. The Synthesis Project. Retrieved from: http://www.integration.samsha.gov/workforce

The Center for Integrated Health Solutions, SAMSHA-HRSA. (2012, May). Behavioral health homes for people with mental health and substance abuse conditions: The core clinical features. Retrieved at: http://www.integration.samsha.gov/workforce

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Soon “Empty Nest” Has Dad Sad

Our youngest child is a senior in high school and I am looking at a future empty nest with a heavy heart. My wife is the opposite and talking about our retirement years and being kid-free.

This article originally appeared in Macaroni Kid on December 12th, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: Our youngest child is a senior in high school and I am looking at a future empty nest with a heavy heart. My wife is the opposite and talking about our retirement years and being kid-free. I know she will miss the kids too but seems almost gleeful about it being just us. I love my wife and look forward to those years but am also pretty sad about losing our kids. How do I address it best with her to maybe tone down the glee and recognize I may have some tough feelings around our empty nest?

Answer: I think like you. Having my children around, as little ones or adults, is one of the joys of my life. I have found that doesn’t change even though they no longer live under my roof. This time of having children transition to adulthood affects everyone differently. For some, the “Empty Nest Syndrome” is characterized by sadness and even depression, while others may view it as “Empty Nest Symphony” as one feels the lightening of responsibility and a newfound freedom. Most people experience both ways of feeling to some degree.  It is one of those life transitions that take time.

This would be a great time to have a conversation with your wife. Try to really understand what this means to her. After years of insisting that homework get done, teeth get brushed, or they get up and off to school, she may be looking forward to not being responsible for everyone. Enjoying being with you, and having time to herself, may have been put on the back burner.

I also urge you to talk with her about your feelings about having the kids gone, and that it is harder for you. If it is difficult for you to ask her to “tone down the glee,” it may point to a larger issue of needing to find each other again. All parents should work hard to not make their kids be the only focus in their relationship with each other. This is hard to do. It takes an effort to continue to have your personal interests, and those interests you share as a couple, once you have children. Setting aside time for each other without kids, through the years, will help when the empty nest comes around.

Try not to think of having your kids move out as a hard stop. Your relationships with them should continue. Enjoying your children as adults can be a new kind of fun. Your children will also need you for many reasons in their young adult lives. Try to view each stage of their lives as new beginnings, not endings. If your adult children plan to live close to you, make some family time together each week. Before long more children may come along to enrich your life. 

Right now, take on the new project of making the most of the marriage that produced those children you have enjoyed so much.  There is a richness there that needs to be rediscovered. The goal is to grow together in the empty nest. Through the child raising years, people grow and change. Many couples seek counseling to help them rekindle those connections which brought them together pre-kids, and to learn to enjoy each other again. Don’t hesitate to seek support in the process, and if you continue to struggle with this transition, seek help for yourself.

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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Beyond Baby Blues: Sister is Worried About Sister

My sister had a baby two months ago and I am concerned she may have postpartum depression.

This article originally appeared in Macaroni Kid on November 27th, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: My sister had a baby two months ago and I am concerned she may have postpartum depression. She is very overwhelmed, angry and sad. She is very loving toward my niece and I don’t worry about her harming the baby but she seems beyond the “baby blues.” I’ve brought it up to her a couple of times and am met with defensiveness. I can’t help but worry and want to be there for her; just not sure how to best do that. Thanks.

Answer: It is great that your sister has a sister who is so caring, and is looking out for her. You are right to be concerned, because this is a change in her normal behavior, at a time when you would expect she would be joyful. New motherhood is full of emotions and being overwhelmed is a normal feeling. Becoming a parent for the first time is a life changing experience which makes going forward feel very intimidating. This can be so overwhelming. Hormonally, the body is readjusting to not being pregnant. Many new moms worry their bodies will never be the same. Most new parents don’t feel equipped for this great responsibility of child-raising, no matter how prepared they may have thought they were. There may also be other circumstances in her life or relationship, which may be contributing to feeling angry and sad. Recognizing this might help you understand.

Here are some of the symptoms of postpartum depression (these symptoms can be present in new dads, too):

–Depressed mood or mood swings
–Crying spells
–Social Withdrawal
–Feeling Overwhelmed
–Altered eating and sleeping
–Sadness
–Loss of interest in sex
–Overwhelming exhaustion

Postpartum Depression that becomes a medical emergency:

–Unable to sleep
–Confused
–Hallucinations/delusions
–Obsessive and fearful about the baby
–Paranoid thinking
–Refusing to eat
–Thought of harming self or baby

Resource:https://www.webmd.com/depression/postpartum-depression/default.htm

We cannot force people to get help unless they have the potential to harm themselves or someone else. As best as you can; continue to be there for her. Support her as she gains more skill in providing for her child’s needs. Reach out to those in her circle who might also be able to support her with love and patience. Don’t allow her to push you and others away, even when she is irritable and angry, which means not taking offense or walking out. When possible, take the baby and give her time to take care of herself, by napping, bathing, or going for a run. Helping to connect her to other new moms could prove very helpful in just realizing she is not the only one struggling. Lastly, as with most problems, don’t try to fix it, JUST LISTEN, and if she doesn’t want to talk, then just be there. This is real sister time, I wish you the best in your efforts to help.  

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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Sad red-haired girl

The Emotional Ripple Effect of Someone’s Suicide

I have a tough subject to talk with you about: the extreme and extensive impact of a loved one’s suicide.

This article originally appeared in Macaroni Kid on November 20th, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

I have a tough subject to talk with you about: the extreme and extensive impact of a loved one’s suicide.

Suicide is always shockingly sad anytime we hear of it, whether we know the person or not.  When it happens to someone we care about, like our spouse, parent, a brother or sister, a child or teenager, a neighbor, cousin, uncle, aunt, coworker or friend, it knocks the wind out of us, like a punch in the gut.  It is hard enough to lose someone in the normal course of living, but to lose them to suicide is immeasurably hard to grasp.  It is an unexpected ending and our lives are suddenly changed.    

When someone is the one left behind by a suicide they experience so many emotions, unusual circumstances, awkward conversations, and they have so many questions, most of which have no good answers.  If this were to happen to you, here are some things you may experience:

You may have to endure a police investigation. A police investigation can be unsettling, especially when you’re grieving.  The police have to investigate and they are looking for information, but because of the shock and confusion, giving answers may be difficult.  

You may feel confused, forgetful, or exhausted. A typical reaction to traumatic events is to feel confused or forgetful. You may forget to do your usual routines, like eating or brushing your teeth.  You may feel like you can’t think straight.  You may experience extreme exhaustion (as is typical with emotional pain), yet sleep can be elusive.

You may feel abandoned, left alone by someone you thought cared.  You may wonder, “Didn’t they care about me?” and “Why wasn’t my loving them, enough? Why didn’t they come to me?” Children may wonder what they did wrong.

You may be in denial and not believe that this actually happened, and that it was actually a suicide. 

You may feel numb and feel nothing.  You may even think you have gotten over the event.  Then, suddenly, you are living it with intense emotion.

You may have regrets about not having known they were in serious trouble.  Some people present as fine on the outside and are torn-up with despair on the inside.  Sometimes they work really hard to hide these feelings from loved ones.  I have known many people who say “I wear a mask.”

You may feel guilt or responsibility.  “If only I had…” and “If I would have/could have done something, they would still be here.” 

You may be angry.  You may be very angry–at the person (“How could she do this?” “How could he throw away his beautiful life?”) or at those who you feel should have helped (“Why didn’t the doctor/the school/the counselor do something?”) It is no one’s fault, and certainly not yours.

Your faith may be rocked. “How could God let this happen?”

You may feel shame about it and not want it to be public knowledge.  There is stigma which makes us not want to share when we or a loved one struggles with mental illness.  Our society has equated emotional suffering with weakness.

You may feel relief, which often leads to feeling more shame because you do feel relief.  When someone is depressed to the point of suicide it affects everyone around them.  Their depression can make us feel hopeless and anxious.

You may feel depressed, and alone in your grief.

Emerging after someone’s suicide takes time.  It is best to allow yourself time to grieve, to feel what you feel, and to talk about your questions with a counselor, pastor, or a caring friend.  Don’t do it alone.  If you feel depressed, or in spiritual despair, seek help.  If you feel suicidal, seek help. 

This person you have loved was part of your world.  Talk about your loved one by remembering the good times, as well as the bad times.  This can help with healing.  Say their name.  It keeps them alive in your heart.  Eventually you will come to your own acceptance and peace.  Be gentle with yourself.

 

Suicide Hotline:  1-800-273-8255             Maine Crisis Hotline   1-888-568-1112

 

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 weekend Andrea Krebs, Executive Director and Kate Marble, Case Management Program Director from Health Affiliates Maine proudly accepted the NAMI Maine Outstanding Partner Agency award on HAMs behalf.

HAM is dedicated to working toward the mission of reducing stigma, spreading awareness and creating access to supports for people in Maine effected by mental health struggles. We are happy to support NAMI and honored to work toward these shared goals for the people we serve.

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Teen’s Mood Has Mom Confused

How do you tell the difference between teenage moodiness and depression?

This article originally appeared in Macaroni Kid on October 28th, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: How do you tell the difference between teenage moodiness and depression? My son has been very tired, withdrawn, and sulky since school started. I ask him about school and he says everything is fine. He has friends and is in sports. His grades are fine. When I ask if he is feeling down, he says no and that he’s just tired. It seems like more than being tired or teenage moodiness though. How do I tell the difference?

Answer: You are doing a good job, mom, at paying attention! That is the key to finding an answer to your first question. There seems to be a lot going on here. Some of what is happening may be quite normal and age appropriate, while some may indicate some intervention is needed.  

Many parents are alarmed when their sweet-natured, family-oriented young teen turns, seemingly overnight, into a dark, moody stranger who wants nothing to do with the family. This is also the time when many things parents say are met with rolling eyes and disbelief. The good news; they usually grow out of this. This can be is part of a teen’s developmental task, which is moving toward becoming an adult and separating from parents. The teen years, with the help of hormones, can be full of testing, pulling away, moodiness and pushing boundaries, as they struggle to be different from their parents. It can be a baffling time for parents and really baffling for the teens. The emotions and uncertainty may cause them to experiment with risky behaviors, and affect their feelings about themselves, their world view, and sense of belonging. Sometimes they are overwhelmed by it all and can become moody and depressed, often isolating themselves from family activities and friends. 

Most of the difficulties with teen behavior are episodic, meaning they may have periods of moodiness but also are able to move on from that. So consider how long the moodiness has been going on. If he is able to pull himself out of it and have some periods of a lighter mood it is less serious than if it is prolonged.

The concerning part of your description of your son is about his tiredness. I recommend he have a health check-up to make sure there is nothing physically going on. Many things can cause fatigue. He may be staying up late studying, being online or playing video games. Is he tired from the sports workouts and staying up late to finish homework? If so, there will need to be some monitoring to ensure he is getting more regular sleep. Signs that there may be a problem are if he is spending an unusual amount of time sleeping or he is taking frequent naps. This could indicate depression or another health issue.

Here are some other important questions to consider. How you answer these questions may help you know what you need to do.  

  • Is he spending time with his friends? Are they old friends or new friends?  
  • Is there a special relationship starting or stopping? 
  • Is he feeling bullied or otherwise intimidated at school?  
  • Is his behavior different outside home?  
  • Is he engaged in activities that you have not previously seen him engage in? 
  • Is he pushing you away with his mood, so you won’t recognize that he may be using substances like alcohol, marijuana and other drugs?  
  • Does the school report that he attends regularly?  
  • Has anyone else noticed any change in his behavior?
  • Is he complaining of physical symptoms like stomachaches and headaches? 

Your teen may not choose to talk to you about any of this. If you suspect there is more behind his tiredness, if his symptoms are prolonged, or if he is losing interest in school, friends, sports, etc., then have him screened for depression. Your PCP is the first place to start. Lastly, many teens benefit from seeing a counselor who can be help them navigate the transition into adulthood. There are many counselors who work with youth, both male and female. It is difficult when a parent knows that something is making their teen struggle. I wish the best for you, and him.  

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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Christine Rogerson

Ethics, Decision Making, and Our Professional Commitment to Social Justice

Training events from late November to early December in Orono, Falmouth & Lewiston.

OronoFri, November 8, 2019 from 8:00am – 4:00pm
Black Bear Inn
4 Godfrey Drive
Orono, ME
Register
FalmouthFri, December 6, 2019 from 8:00 AM – 4:00 PM
The Woodlands Club
39 Woods Road
Falmouth, ME
Register
LewistonFri, December 13, 2019 from 8:00 AM – 4:00 PM
Franco Center
46 Cedar Street
Lewiston, ME
Register

About the Program

The world seems to be spinning faster and faster these days, and the call to social justice greater and greater. As clinicians, what is our responsibility to social justice? What is our role in pursuing social change? How do we wade through the ethical quagmires? This workshop will assist clinicians in defining social change, identifying the roles we play in upholding social justice, and explore the ethical decision making process as it relates to social change.

Exposure to violence and abuse also has implications for the healers including safety concerns and compassion fatigue. We will consider personal and systemic support for professional resiliency.

Objectives for the day:

  1. Define Social Justice and identify the role we as helping professional play
  2. Explore Codes of Ethics and identify steps to ethical decision making
  3. Determine strategies to elicit our professional responsibility to social justice

Agenda for the day

8:30 Opening Introductions & Ice breaker
9:00 What is Social Justice?
10:15 Break
10:30 Ethics
12:00 Lunch
1:00 Ethical Decision Making
2:15 Break
2:30 Ethics & Our Commitment to Social Justice
3:45 So now what?
4:00 Conclusion

About the Presenter

Christine Rogerson, LCSW

A graduate of the University of Maine at Orono with a Bachelor of Arts in psychology, Christine Rogerson earned her Master of Social Work from the University of New England. Currently, she is pursuing a PhD. in social work at Simmons University and is a Field Practicum Coordinator for the University of New England’s Master of Social Work program. Christine’s work in education at the University of New England is robust, having served as an academic advisor, a visiting clinical assistant professor, and an adjunct faculty member. Particularly knowledgeable when it comes to social justice, Christine recently taught a course at Simmons on racism and oppression.

Christine’s clinical work is also extensive. She has spent a decade as a clinician working with families and children through school-based counseling, behavioral health agencies, and in the hospital setting.

Committed to her community and to giving back, her service includes a seat on the Board of Directors of Sweetser as a Corporator, as a representative to the York Diversity Council, and as a LEND Grant inter-professional team member representing social work in a pediatric neurology clinic.

OronoFri, November 8, 2019 from 8:00am – 4:00pm
Black Bear Inn
4 Godfrey Drive
Orono, ME
Register
FalmouthFri, December 6, 2019 from 8:00 AM – 4:00 PM
The Woodlands Club
39 Woods Road
Falmouth, ME
Register
LewistonFri, December 13, 2019 from 8:00 AM – 4:00 PM
Franco Center
46 Cedar Street
Lewiston, ME
Register

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Learn more tips on living well and understanding mental illness. Help to end the stigma, and hear inspiring stories of recovery. Sign up here!
Child playing

Mom Seeks Alternatives to ADHD Meds

My son is 7 years-old and his teacher recently suggested that he may have ADHD. He is very active and sometimes distracted. I'm very hesitant to ask his doctor about it though because I do not feel like we need to put him on medication, at least not at such a young age.

This article originally appeared in Macaroni Kid on September 26th, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question:  My son is 7 years-old and his teacher recently suggested that he may have ADHD. He is very active and sometimes distracted. I’m very hesitant to ask his doctor about it though because I do not feel like we need to put him on medication, at least not at such a young age. I’d like to explore some ways to help him with focus and calm his body over the summer to see if it helps before the start of school. Please share any suggestions you may have.

Answer:  Although this response isn’t fitting with your timeframe, I hope it can still be helpful throughout the year.  Many parents feel like you, and are concerned about their children taking medication at such a young age.  Some question whether medication would change their child’s personality when perhaps they could eventually grow out of their unfocused nature. They worry about side effects.  There are things you can do at home, and some other options to consider. Let’s start by understanding this condition and what contributes to ADHD (Attention Deficit Hyperactivity Disorder). 

What is ADHD?   In order to be diagnosed with ADHD a child must have at least six ADHD symptoms of either: inattention, hyperactivity-impulsivity; one or the other, or both. These symptoms must be present for at least 6 months or longer, be present before the age of twelve and cause significant difficulties or impairment in two or more settings, such as home, school/work or social settings.  Adults can also have symptoms and be diagnosed with ADHD.

Some symptoms of inattention include: 

  • having difficulty maintaining attention, 
  • having difficulties listening or following instructions, 
  • making careless mistakes, 
  • avoiding tasks that require a sustained focus, 
  • being forgetful, 
  • getting distracted easily and 
  • losing things easily. 

The symptoms of hyperactivity-impulsivity include:

  • having difficulty engaging in quiet activities 
  • restlessness (needing to move around, fidgety, etc.) 
  • excessively talking or blurting out answers  
  • interrupting others 
  • having difficulty with waiting their turn

https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889

Is it really ADHD?   Many disorders can mimic ADHD, including just about every anxiety disorder and some physical conditions. A thorough medical work-up and talking with your PCP about exploring other health issues that can affect your child’s ability to concentrate will be essential for your child.  Sometimes children will become temporarily hyperactive or distracted in the setting of a family stressor like death of a loved one, divorce, or traumatic event.

Parenting is key and your style of parenting may need to be modified to help your child.  Chaotic and hectic households (many of us have them) can contribute to how a child’s brain develops. Just as you would make changes for any child who has special needs, changes in your approach, schedule, your home, and your parenting skills may make a significant difference.  The best way to address behaviors in a child (ADHD or otherwise) is to provide an environment that is scheduled and consistent.  Seeking counseling can help you learn parenting skills that help you manage a distracted child, while being a loving parent who is consistent and firm.    

Limiting screen time: I realize that this seems impossible in our current culture.  However, it is so important in developing children.  A child with attention and hyperactivity issues can wear on a parent.  As a result, they may choose to allow screen time to distract them for some relief.  However, this is not a solution; it actually contributes to the problem.  Limit screens to no more than 20 minutes twice a day (at the most) with the parent controlling all access to screens including TV. 

A new study out of the University of Alberta has found that by the age of 5, children who spent two hours or more looking at a screen each day were 7.7 times more likely to meet the criteria for a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) when compared to children who spent 30 minutes or less. https://www.ualberta.ca/medicine/news/2019/april/too-much-screen-time-associated-with-behavioural-problems-in-preschoolers

That means take the screens out of the bedroom, the car, and the kitchen.  Parents/caregivers should take charge of dispensing the screens and locking them up when not in use. Do this consistently and get all caregivers on board.  There are benefits for everyone when screens are limited. Here is a helpful link:  https://abcnews.go.com/Health/screen-time-linked-higher-risk-adhd-preschool-aged/story?id=62429157

Time Outside:  Make time for high energy play: outside.  I remember when my mother would have enough of me and my brothers pestering her, and we would get sent outside to play.  I would always fight it, claiming it was “too cold”, “too hot”, “there was nothing to do”, and “no one to play with”.  In the end, she would have to call and call for us to come in for supper.  Physical outside play and exercise is recommended for all children (actually for adults, too) and can be very helpful for the symptoms of ADHD. If you want your children to do something that helps their wellbeing, then take a strong parenting role and make it happen.  You can let them sit outside pouting until they grow tired of doing that.  This will communicate that you are in charge, and crying and complaining doesn’t change that fact.  You can adopt this ‘in charge’ stance in other areas.  When children know that a parent is in control, they feel safe.

Check out this link:  https://www.health.harvard.edu/blog/6-reasons-children-need-to-play-outside-2018052213880

Regular Bedtime with the recommended number of hours of sleep for your child’s age is also critical.  The American Academy of Pediatrics recommend children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health.  Consistent bedtime can help in many ways with children’s behavior and health.  Set a consistent bedtime for your child and stick to it.  This is another time when the parent must be in charge, and not let the child dictate the bedtime.  Whatever time you set, your child will adjust to it, if you are consistent.  

Read more:  https://www.parents.com/health/healthy-happy-kids/young-children-behave-better-when-they-have-a-consistent-bedtime/

ADHD is serious.  One caution is that you not wait too long after you have tried other alternatives. People who grow up with untreated ADHD often have low self-esteem.  They think of themselves as “stupid”. Throughout their lives they get messages from teachers, schoolmates, and family, when they are unable to settle, focus, or complete a task, that they are deficient and defective.  There are lifelong impacts to low self-esteem which can be serious.

 If your child continues to struggle with concentration, hyperactivity or both, his or her learning and overall functioning in the world is at risk, and may be enhanced on medication.  Please consider that medications aren’t evil, they are a tool and similar to a child with nearsightedness who can read if they really concentrate and squint their eyes, we don’t withhold glasses from them because we think they will grow out of it or do better if they just try harder, we give them glasses and are quite proud that they now enjoy reading instead of avoid it.

Here are some alternative ways ADHD symptoms are treated.  

  • Counseling to learn skills to focus their minds and modify behaviors.  This can be essential for parents.  Counseling also helps with self-esteem problems.
  • Acupuncture, Yoga and Tai Chi: Rooted in Eastern medicine, current studies show that this can be helpful.
  • Chiropractic: Call and ask about treating ADHD.
  • Nutritional counseling: There is some evidence that a low carb/sugar, high fat diet is helpful.

I wish you well as you explore what is best 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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Divorced Dad Has Disinterested Kids

 I am a divorced dad and don't see my teenage children as much as I would like due to my work requiring significant travel. We've grown apart a lot in recent months and now even when we do see each other, I feel like I don't even know what to say or ask.

This article originally appeared in Macaroni Kid on August 15th, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question:  I am a divorced dad and don’t see my teenage children as much as I would like due to my work requiring significant travel. We’ve grown apart a lot in recent months and now even when we do see each other, I feel like I don’t even know what to say or ask. My kids seem disinterested in maintaining a relationship with me. They often do not answer my texts or phone calls. I think sometimes they make excuses for not seeing me too. I’m looking for unique ways to help strengthen my relationship with my kids and connect again. Thanks.

Answer: 

What an important and difficult situation, thank you for asking about this, I am sure others can relate.  The situation sounds like you need an immediate, (take some vacation time) and go camping, fishing or anything that would give you some extended time together to rekindle a connection.  

Let’s start with communication.  Often we talk to our kids by asking yes/no questions, questions that can be answered with one word like: “How was your day?”  “Fine”  “Is Mike coming over?” “Yes.”  “Was your test difficult?”  “No.”  “Did you get your homework done?”  You know the drill.  This is not conversation, and it is especially brutal when it is on the phone.   Instead, ask the questions in such a way that they must provide more information, like:   “Tell me something about your day?” “If Mike comes over what do you think you would like to do?”  When you are engaged in what they are studying or who their friends are, your questions can be more relevant, allowing for more conversation.  Remember that conversation goes both ways.  Without burdening them with your troubles, tell them things about yourself.  How are they like you?  What was important when you were their age, or a story about something that struck you as funny.  Send them pictures from your travels.   Whatever you do, be genuine.  Teens know when you don’t really care.  Learn their favorite video games and have them also teach you to play when you are with them.  Then you can ask about what levels they have achieved, they will know you understand.  Find an app that has a game you can play back and forth, while apart.  I know a dad that always has a chess match going with his teen.  Teens also prefer texts and many don’t answer calls.  Texting a note or picture is like communicating to them that right now, I am thinking about you. 

When you are together, you will have to put in some time to plan.  Set out to make your short time together meaningful.   TV and pizza, as much a kid’s like that, do not really make for relationship building experiences.  Ask yourself; are we making memories?  Try making your own pizzas with lots of fun ingredients, or go on a hike, fishing, or roller skating.  Make some family rituals for when you and your kids are together:  like morning waffle making or bike riding.  There are a lot of ideas online.  If at all possible, take one child along on one of your travels if they are old enough to safely bide their time when you are working.  Consider adding a day to the trip to explore, and make memories.  If your teens have special events, important sport activities or a role in a play, do whatever you can, alter your schedule when possible, to be able to be there.  I have had many people say, “My father never came to one of my games”.  

It is important to have fun, make memories, it is also vitally important to be a dad who participates in the heavy lifting of parenting, when necessary.  That is why you have no time to lose, to improve those connections with your teens.  You will want them to take you seriously and to listen to you when struggles come.  One way to do this, if the situation allows, is to have a positive-parenting connection with their mother.  Parenting with two parents is no walk in the park.  Being a divorced dad, who travels for work, is doubly hard. Don’t let your work be an excuse for not being involved.   You might want to try counseling around parenting issues, which can also be done confidentially online, when you travel.  Be careful not to put your kids in the middle between you and their mother, by asking what she is doing, if she is dating, or saying things to them about her which upsets them.  Kids will naturally want to defend her, which means, you are out. 

The other night I was with family in a pizza shop. When looking around the room, I could see dads alone with kids; thinking perhaps they were divorced and it was ‘their weekend.’  One father and teenage son stood out to me, because the teenager looked over my way rather bored and forlorn.  Dad was deep in his phone as they ate, scrolling away and texting.  This went on for some time.  It occurred to me that I would not want to be sitting there either, with no company.  The message we send our children and teens, when we are constantly consumed with other things, is that they are not important.  They feel invisible to us. This is a set-up for children to develop low self-esteem, a serious and sad condition.  As parents we need to be careful of the magnetic draw of our phones and other media, when the kids are around.  The natural progression of this situation of the teen in the pizza shop is that he may pull away.  Eventually he may find more interesting company than dad.    

I hear in your question that you want better.  I’m sharing this scenario to help you to think of what other factors are in your behavior, (intentional and unintentional) which might be contributing to your children distancing themselves from you.  I wish you success, whatever you do, don’t stop trying.  Kids need us, and want us, with changing intensity throughout our lives.  As you keep trying to engage you are sending the message that you will always be open to relationship with them.

Helpful links:

http://fathers.com/wp39/wp-content/uploads/2015/01/Five-Tips-for-Dads-Who-Travel.pdf

https://www.artofmanliness.com/articles/how-to-be-a-better-dad-when-you-travel-for-business/

healthaffiliatesmaine.com

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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