Counselling Children & Teens

Counselling Children & Teens 2017-01-20T15:19:46+00:00

I help children and teens using the same skills from cognitive behavioural therapy (CBT) which I use with adults using age-appropriate methods. Young clients have fun while learning and practicing strategies to address their issues.

A Double-Barreled Approach to Coping

I use a double-barrelled approach to helping children and teens—problem-focused and self-focused coping. In problem-focused coping, I help young clients take action to solve problems which are adding to their distress such as those they face at home and at school. In self-focused coping, I help children and teens learn skills to manage their emotions.  Self-focused coping skills include scheduling pleasure and mastery activities, switching attention away from negative thoughts, using physical relaxation activities to calm the body, and practicing cognitive skills to identify and change negative thoughts.

Parental Involvement

When I work with children and teens, their parents play an active role in in many ways. It begins with their giving parental consent to treatment as required by the College of Alberta Psychologists. Once I begin working with a child or teen, their parents can facilitate progress by providing helpful information about their child, assisting them in practicing psychological skills between counselling sessions, and taking action to help them address problems at home, at school and in other life situations.

Common Issues I Help Children and Teens Address

Some of the common issues I help children and teens address and manage include depression, generalized anxiety, social anxiety, obsessive compulsive disorder, panic disorder, health anxiety, separation anxiety, post-traumatic stress disorder, phobias, low self-esteem, anger management, stress management, autism, substance use, and eating disorders.

A Skill-Based, Child-Focused Approach

My approach to helping children and teens is skill-based. I tell my young clients that if they can use skills to perform well at school, in sports or in other activities, they have what it takes to use skills to make them feel better by addressing their issues. Before introducing these skills to my child and teen clients, I get to know them and their issues while allowing them to become comfortable opening up to me. To begin each counselling session, I ask my young clients which topics they want to discuss. While we discuss each topic for that session, I look for opportunities to help them apply their existing set of psychological skills and add new skills to their repertoires.

  • Counselling Services by Dr. Pat

To vent or not to vent: That is the question

In this article, I discuss whether venting about difficult people and situations is helpful in and out of your psychologist’s office.


Estimated reading time: 2 minutes.

In my work as a Calgary psychologist and a Cochrane psychologist, I often encounter clients who choose to spend some or all of the time in a counselling session ‘venting’. This typically involves complaining about difficult people and/or situations affecting them.

Given that people pay to see psychologists and that psychologists are ethically obligated to attempt to ensure that clients are benefiting from their services, it is reasonable to consider whether venting is a productive use of time in therapy. A related concern is whether it is beneficial to the client to vent to people other than their psychologist outside of therapy sessions. I will explore these questions in the following paragraphs.

Benefits of venting

It can feel good to have someone listen empathically as you express your frustration and anger about a difficult person or situation. Feeling that someone gets how you are feeling can make it easier to deal with the person or situation.

Getting your frustrations out of your system can also make it easier to take productive steps to deal with the person or situation so that you are less frustrated going forward. In that regard, a supportive listener you can vent to will often give you good advice regarding how to deal with the person or situation effectively.

Downsides to venting

Venting can often lead to rumination in which the person repeatedly expresses the same frustrations regarding the person or the situation without taking steps to cope with matters. Rumination can leave the person stuck in a cycle of expressing anger and frustration which only serves to make them feel worse.

It also taxes the patience of the supportive listener you are venting to as they see that you are only adding to your distress by venting about the same frustrations. This kind of venting can preoccupy the person to the point that they also get away from doing activities which are good for their mood.

Counselling Services by Dr. Pat

 

Putting limits on venting: Get the benefits without the downsides

Putting limits on how often you vent and how much you vent each time is a good way to ensure you get the benefits without the downsides. A good indicator of whether venting is reasonable is whether you have expressed your frustrations about the person or situation to a particular individual already. If you have not done so, then venting may be reasonable and potentially beneficial for the reasons cited above. If you have already done so, then you are likely entering ruminating territory and should consider limiting your venting to that person.

Please note that limiting venting to a supportive listener does not mean that you should not bring up the frustrating person or situation to the individual going forward. Rather, these circumstances suggest that relatively more of your discussion should focus on how to cope with the frustrating person or situation rather than on how frustrated you are.  This focus on coping strategies will help to lessen your frustrations about the person or the situation so that you will have less need to vent about them.

May you do your venting in moderation,

-Dr. Pat

  • One man throwing a life preserver to a drowning man

Viewing addictions as habits: An improvement over viewing them as diseases

In this article, I discuss how viewing addictions as habits can lead to better progress in treatment than viewing addictions as diseases.

Estimated reading time: 4 minutes.

In my last article, I discussed a commonly held view of addictions as diseases. I indicated that while this view has some advantages such as removing shame and consequently making it more likely a person will come for treatment, it also has substantial disadvantages. These include interfering with the person taking the necessary steps to address their addiction if they come to therapy, instilling a passive ‘fix me’ mindset which is counterproductive to making progress, as well as establishing negative expectations for progress.
At the end of my last article, I said that I would propose an alternative way to view addictions which is more conducive to making progress than the view of addictions as diseases. I will discuss this alternative view in the following sections.

An alternative view: Addictions as habits

Addictions can also be viewed as habits. A habit can be defined as a pattern of behaviour people engage in which becomes part of their routine. Habits often begin with a person trying out the behaviour and discovering that it has benefits. This leads a person to engage in the behaviour regularly. As long as the benefits of the behaviour outweigh the costs, there is no reason to break the habit and it is likely to continue.

Unfortunately with some habits, including addictions, over time the person discovers that the costs of the behaviour are outweighing the benefits. By that time, however, the behaviour has become part of the routine and the person is so used to the benefits that they become reluctant to give up the behaviour despite the costs. This is particularly the case when the benefits are immediate and therefore uppermost in one’s mind and the costs are less immediate and therefore not as noticeable. In this scenario, the person often chooses to continue the behaviour and keep the habit going despite the costs ultimately outweighing the benefits.

Advantages of viewing addictions as habits

Viewing addictions as habits has several advantages over viewing addictions as diseases. These include:

(1) The client adopts a more active approach in therapy. Viewing addictions as habits results in clients becoming more actively involved in therapy. This active approach stems from having confidence that they have what it takes to address their issue by breaking a habit—something they have likely done with other problematic behaviours.

Contrast this with the passive approach which comes with viewing addictions as diseases. It is difficult to become actively involved in taking steps to address a problematic behaviour if you believe the behaviour is a symptom of a disease which you will be stuck with for the rest of your life.

(2) The client is more likely to have positive expectations for being able to address their issue. These positive expectations stem from the belief that if you have broken bad habits before, you can break this one involving substance use by using the same strategies. Positive expectations set in motion a positive self-fulfilling prophecy which can keep you on track when challenges arise regarding your substance use. For example, in a stressful situation in which you have urges to use, your positive expectations provide you with confidence that you can get through the challenge and ‘ride out’ the urge without using. In contrast, viewing your substance use as a disease leads to negative expectations which lead to negative self-fulfilling prophecies. This makes it hard to stay on track in the face of challenges. For example, this view may lead you to think “I can’t handle this urge because I have a disease so I might as well give into it and use.”

One man throwing a life preserver to a drowning man

(3) You have a greater sense of control over your substance use. When you view your addiction as a habit, you are more likely to view your behaviour as a conscious choice over which you have control and for which you need to take responsibility. That is, you chose to engage in the habit and you can choose to end it in the same way you have chosen to break other habits.

Contrast this with the view of addictions as diseases in which you view your substance use as a behaviour beyond your control. That is, you did not choose to contract this disease and you cannot choose to make it go away. Although the latter view may result in your not feeling responsible for your addiction, this ultimately detracts from your making different choices to reduce your substance use.

(4) Progress is not an all or nothing prospect. Viewing addictions as diseases typically entails measuring progress by how long it has been since you last used. This can put enormous pressure on the person to ‘stay sober’ and believe that they are back at square one any time they ‘slip’ by using—however briefly and even if they have stayed on track the vast majority of time. The pressure to be perfect stemming from this view can be stressful, demoralizing and lead to relapses in which you abandon the use of the skills you had been using successfully and revert to heavy substance use.

Viewing addictions as habits allows for a less absolutistic view of progress in which you give yourself credit for learning and implementing skills to stay on track even in the midst of slips. This makes it much easier to rebound from slips and get back on track, thereby preventing relapses.

I help my clients address their substance use issues as habits in addiction counselling in my practice as a Calgary psychologist and a Cochrane psychologist.

May you view your addiction in a manner which is conducive to your addressing it,

-Dr. Pat

  • One man throwing a life preserver to a drowning man

Viewing addictions as diseases: The pros and cons

In this article, I discuss the commonly held view of addictions as diseases along with the pros and cons of this view including its effects on progress in treatment.

Estimated reading time: 3 minutes.

A commonly held view of addictions is that they are diseases. The view holds that if you are unlucky enough to be afflicted with such a disease, it will be with you for your life because it cannot be cured. Furthermore, because your addiction is a disease, you are unable to exert control over it. Acknowledging this lack of control or powerlessness is the basis of 12-step programs which are used to help people with addictions for issues such as alcohol and drug use, gambling and sexual activity by appealing to the help of a ‘higher power’.

In the following sections, I will examine the advantages and disadvantages of viewing addictions as diseases. I will then mention an alternative view of addictions which may be more conducive to clients making progress in therapy to address their addictions.

One man throwing a life preserver to a drowning man

Advantages of viewing addictions as diseases

There are several positive aspects to viewing addictions as diseases. One is that doing so removes a lot of the shame from having an addiction. On a related point, if you have hurt people close to you because of your addiction they are less likely to blame you and display anger toward you. Although they may not be happy with you for your actions, their believing that these actions were the result of a condition over which you have no control makes it less likely they will resent you.

Because there is less shame, blaming and anger when the addict and people in the addict’s life view the addiction as a disease, having this view often makes it easier for the addict to admit that they have a problem. In turn, viewing their addiction as a disease may facilitate their taking steps to address their addiction.

Disadvantages of viewing addictions as diseases

There are several disadvantages of viewing addictions as diseases. Viewing addictions as diseases can interfere with taking the necessary steps to address your addiction in therapy. The reason is that if you believe that your addiction is the result of a disease over which you have no control, this is inconsistent with taking steps in therapy to exert control over your addiction through changes in your thinking and behaviour.

Viewing addictions as diseases can also instill a passive ‘fix me’ mindset which is not conducive to making progress in therapy. This is antithetical to an active approach which is more conducive to progress through the client taking steps to manage their urges to engage in addictive behaviours.

Viewing addictions as diseases can also be counterproductive in therapy because it instills negative expectations for progress. That is, if I believe I have a disease which will never be cured, then it is only a matter of time before I relapse. This belief can result in a negative self-fulfilling prophecy in which the client’s expectation of failure leads them to think and behave in ways which produce failure. For example, believing that your addiction is a disease would make it more likely you will give up and return to the addictive behaviour when you encounter challenges in your life which lead to urges.

Viewing addictions as diseases: Do the pros outweigh the cons?

In summary, viewing addictions as diseases may make it easier for the addicted individual to face their problem, deal with people affected by it and enter treatment. Unfortunately, the person who views their addiction as a disease is less likely to have the mindset which is conducive to making progress in addressing their addiction in therapy. So if your ultimate goal is to address your addiction, the cons of viewing your addiction as a disease outweigh the pros.

This might lead you to wonder whether there is a different view which is more conducive to making progress in addressing your addiction in therapy. There is indeed such an alternative view. That will be the topic of my next article.

May you view your addiction in a manner which is conducive to your addressing it,

-Dr. Pat

Practicing skills: A formula for success inside and outside your psychologist’s office

In this article, I discuss how you can use the same route to success in addressing your psychological issues which you are already following in other endeavours in your life.

Estimated reading time: 3 minutes.

In my work as a Calgary psychologist and a Cochrane psychologist, I offer prospective clients a free 30-minute consultation to allow them to determine whether the approach I use would be a good fit for them. In order to help people with this decision, I frequently remark that if you can be successful by learning and practicing skills in other endeavours in your life, you can be successful at using cognitive behavioural therapy (CBT) to address your issues.

When I find out that a person has succeeded by learning and practicing skills in endeavours such as work, school, sports, and music (to name just a few), I tell them that they have reason to be optimistic about addressing their psychological issues using CBT. That is, their having a track record of success in learning and practicing skills points to their having what it takes to succeed using CBT to address counselling issues. Among these issues are depression, anxiety, stress and anger management, substance use, eating disorders, post-traumatic stress disorder (PTSD), low self-esteem and relationship concerns which arise in couples counselling.

In the following sections, I will discuss how learning and practicing skills in other life endeavours can give a client a leg up in using CBT to address their psychological issues.

Success comes from practicing a set of skills

Most endeavours have a set of skills you need to practice in order to become successful. For example, a golfer must practice driving, hitting long irons from the fairway, chipping from close to the green, hitting out of the rough and from sand traps, and putting.

The same goes for addressing psychological issues. For example, in addressing issues like depression and anxiety there are cognitive skills which involve practicing balanced thinking patterns, behavioural skills involving activities which enhance your mood and help you to manage stress, physical relaxation skills to help you feel better and calmer in your body, attention-switching skills to take the focus off negative thoughts, and problem-solving skills to address stressors at work, school, relationships and other parts of your life.

Whether it’s an endeavour like golf or a psychological issue, devoting time to becoming proficient at various skills is pivotal to success.

Consistent practice produces results

If you want to become successful in your work, at school, in a sport, playing a musical instrument or at other endeavours, consistent practice of skills is the best route to follow. For example, when Tiger Woods dominated the world of golf he would spend several hours on most days practicing the various skills in his sport as well as on cardio fitness and weight training.

Consistent practice also leads to the best results in addressing psychological issues. For example, as a CBT psychologist I encourage my clients to do thought records regularly so that balanced thinking will exert positive effects on their moods on an ongoing basis.

Practice skills according to a plan

In order to make your efforts at practicing skills pay off in success, you need to know which skills to practice and when to practice them as part of a plan. For example, my successes in running marathons, completing triathlons and getting my black belt in karate have been the result of my following training plans provided by my coaches and mentors. They have provided me with guidance and advice in learning and practicing skills related to their respective sports and have helped me to stay consistent at practicing the skills until I achieved my goals.

In a similar manner, I work with my clients to develop treatment plans comprised of a set of skills for them to practice to address their psychological issues. And like a coach or mentor in other endeavours, I give my clients guidance and advice in learning these skills along with helping them to stay consistent at practicing these skills until they have achieved their goals in counselling.

In short, addressing psychological issues is less about coming to grand insights and understandings and more about the less glamorous but effective endeavour of consistently practicing skills to address those issues.

May you practice skills to succeed both inside and outside your psychologist’s office,

-Dr. Pat

Reducing self-injury behaviours: Identify and address the motives

In this article, I discuss ways to reduce non-suicidal self-injury behaviours by identifying and addressing the motives for these behaviours.

Estimated reading time: 2 minutes.

In my practice as a Calgary psychologist and a Cochrane psychologist, among the most challenging issues I encounter is clients engaged in self-injury behaviours such as cutting or burning oneself.  Referred to as non-suicidal self-injury (NSSI), these behaviours are not engaged in for the purpose of taking one’s life. However, they are often precursors to later suicide attempts and are most commonly displayed by adolescents.

To help these clients, my strategy is first to identify the reasons they are engaging in self-injury behaviours. Several people may engage in identical self-injury behaviours for very different reasons. Pinpointing the motivating factors for each individual is the key to helping them reduce and eliminate such behaviours.

In the following sections, I will identify the most common motivators for self-injury behaviours and how I and other therapists help clients to address the behaviours by targeting these motivators.

Self-punishment due to self-loathing

Some people engage in self-injury behaviours because they literally hate themselves and feel they deserve punishment as a result. Helping the person to change this negative view of themselves is key to reducing self-injury behaviours in these cases.

Avoiding the pain of difficult emotions

Emotions like anxiety, depression, frustration, guilt, and anger are difficult for many people to face. Self-injury can numb a person to the experience of these unpleasant emotions. Helping the person develop skills to face these emotions removes a key motivator for self-injury behaviours.

A self-soothing strategy

This self-injury motivator focuses on the notion that for some people, these behaviours serves as stress management tools which help them to soothe and calm themselves. Giving the person alternative means to self-soothe can reduce the tendency to use self-injury for this purpose.

A release of endorphins

For other people, self-injury behaviours create an experience of pleasure through the release of endorphins. Helping the person practice safe ways to simulate these feelings can lessen the use of self-injury behaviours when this motive is present.

Avoiding dealing with difficult life situations

Sometimes we are faced with having to deal with life situations with which we feel unable to cope. One way to avoid having to deal with these situations is by engaging in self-injury behaviours. Giving the person coping skills to increase confidence that they can cope with difficult life situations can lessen their tendency to use self-injury behaviours as a form of avoidance.

A cry for help and attention

Some people have difficulty getting the attention of those close to them—sometimes because they have trouble communicating their needs and at other times because those close to them do not pay attention to their needs. In these instances, self-injury behaviours serve a ‘social signaling’ function. Helping these people find constructive ways to get the attention of those close to them is the key to helping these people reduce their self-injury behaviours.

If you or someone close to you engages in self-injury behaviours, there is help available.

-Dr. Pat

Being a fan of a sports team: How to enjoy the psychological benefits while minimizing the psychological costs

In this article, I discuss how you can enjoy the psychological benefits of being a fan of a sports team while taking steps to prevent the psychological downsides.

Estimated reading time: 4 minutes.

Some of my most memorable times have been those in which I have been a fan of sports teams. Team Canada’s narrow win over the Soviet Union in the 1972 hockey Summit Series brought excitement and passion to me and millions of other Canadians who watched the landmark event. In my younger days, I also regularly enjoyed going to the games of my hometown Winnipeg Blue Bombers football team which I attended with my father and siblings.

On the other hand, my support of sports teams has at times had negative effects on my mood. For example, I have recently seen my hometown Winnipeg Jets miss making the NHL playoffs and my adopted hometown Calgary Flames get swept out of the playoffs in the first round. For the last two seasons, the Toronto Blue Jays’ baseball success had me and many Canadians on a high as we followed their exploits. In contrast, so far this season I cannot bear to watch the Blue Jays as they currently sport the worst record in the major leagues.

These examples illustrate that being a fan can have highs and lows. This gave me the impetus to write this article on how to enjoy the psychological benefits of supporting a sports team as well as tips to make the difficult times easier to take.

The psychological benefits of being a fan

Supporting a sports team can be good for your mood by giving you a regular activity to do which you enjoy. Watching a team’s games lets you take your mind off your problems and gives you a chance to relax and recharge your emotional batteries.

The positive effects on your mood can be enhanced if your team performs well. This fits with research supporting ‘social identity theory’. According to this perspective, how we feel about ourselves is based to a degree on our accomplishments—those we achieve ourselves as well as those achieved by the groups to which we belong. In other words, if you belong to a group or organization which is successful or respected you will tend to feel better about yourself. Among the entities which can generate this ‘basking in reflected glory’ phenomenon are our families, our employers and professions, associations/clubs/teams of which we are a member as well as sports teams which we support as fans.

Following the exploits of your favourite team and its opponents can provide a regular boost to your self-esteem by being one of your ‘mastery’ activities. These are activities which you find stimulating and challenging as a result of using your skills, talents and knowledge. As you follow a team which you support, many times you become so immersed in knowledge of the team and the game that you feel that sense of mastery in a particular domain.

Being a fan of a sports team is also an excellent way to build connection and relationships with others. Parties and other settings in which fans watch games together facilitate this bonding. Whenever I am watching my team with my fellow fans, I recall the research demonstrating that one of the most reliable ways to build connection with others is working together toward a common goal. Supporting the same sports team constitutes working toward a common goal to foster closeness among the team’s supporters.

The psychological downsides of supporting a sports team and how to minimize them

One downside of supporting a sports team is that your mood and self-esteem can take a hit when the team you are supporting fails in various way such as losing a game, not making the playoffs, and being eliminated from the playoffs. The negative effects will be particularly prominent if you have invested a lot of time and emotion in support of the team. Fortunately, in most cases the down feelings you experience will be short-lived.

In some instances, failure by the team you are supporting can lead you to experience negative feelings which last longer to the point that your emotional well-being is significantly impacted. This result is most likely if you have all your eggs in the basket of supporting the team. That is the case when there is little else is going on in your life to bring enjoyment and a sense of feeling good about yourself through achievement.

The best way to prevent succumbing to these negative emotional effects is to have balance in your life.  It is fine to spend some time supporting your team but ensure that you also have other activities from which you derive enjoyment and a sense of accomplishment. With this balance in place, the good feelings you experience when your team succeeds will add to your enjoyment of life rather than filling a void. In turn, the failures of your team will be easier for you to experience because you will have other activities in your life you can focus on to cushion the blow.

If you have an issue which needs to be addressed, it may be helpful for you to meet with a psychologist who specializes in cognitive behavioural therapy (CBT). I help my clients address their issues by using CBT skills in my work as a Calgary psychologist and a Cochrane psychologist.

May you enjoy being a fan while having balance in your life,

-Dr. Pat