Mental health providers and other professionals often talk about a child or adult's "dysregulation" and "self-regulation," but these terms are often left undefined. A 2017 summary and the 2015 report from the U.S. Department of Health and Human Services help define self-regulation and show the complex social, biological, and environmental factors involved in development of self-regulation.

The summary defines self-regulation as "the act of managing one’s thoughts and feelings to engage in goal-directed actions such as organizing behavior, controlling impulses, and solving problems constructively."

Components of self-regulation
Self-regulation is a term that refers to a number of essential capabilities for successful human functioning.

Being able to self-regulate helps us succeed in many aspects of life, including creating satisfying relationships, tolerating difficulty, prospering in school and work, managing finances, and maintaining physical and mental health. Self-regulation is a critical life skill.

Self-regulation depends not only on the individual child or adult's biology and actions, but also on the contributions of parents, teachers, other mentors, as well as conditions in the neighborhood to global environments. As a community, we all play a role in each child's development of self-regulation. Likewise, we all can play a role in helping each other repair missed developmental steps.

When we see poor self-regulation in ourselves or another individual, it helps to remember that as children we do not have much control over whether we learn self-regulation.

Although learning self-regulation is probably easier as a child, humans have the ability to achieve self-regulation at any age, whether through healthy relationships, psychotherapy, or neurofeedback. A large part of my therapeutic work is helping individuals of all ages learn how to self-regulate.

The 2017 summary, Seven Key Principles of Self-Regulation and Self Regulation in Context, is a clear explanation of the development of self-regulation.

The full 2015 report, Self-Regulation and Toxic Stress: Foundations for Understanding Self-Regulation from an Applied Developmental Perspective, is also available.

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If you're wondering how to motivate your child or teen to do their school work, you're not alone. Many parents struggle with this.

An article on motivation noted how difficult it is to motivate kids to do their school work.

That article describes several approaches for encouraging others to change their behavior:

  • economic incentives - rewards that appeal to self-interest,
  • moral or social incentives - pressure to follow social norms for the common good, and
  • intrinsic incentives - being motivated by one's own inner desires.

Behavioral methods often begin with economic or moral incentives, but ideally culminate with the student learning to work for internal or intrinsic incentives.

Break Large Projects Into Smaller Chunks

When motivating kids, typically a large project must be broken into smaller, attainable steps. Each substep should be short-term, relatively small, and thoroughly doable. Teachers and behavioral therapists often help students create charts that show each of the small tasks that make up a larger process.

Imagine, For example, that your middle school student has not been doing or turning in their homework. You want to encourage your child to get better grades, right?

Your first impulse may be to tell your child that you'll give them $20 for each "A" they get at the end of the semester. Unfortunately, that will set your child up for failure. The desired end result (earning "A"s) is not likely to feel short-term, small, or doable, especially if they do poorly on one or more tests or assignments.

Instead, you may want to use a behavioral approach. Break each task into small enough chunks that each step will be easy for your student to complete. Create with your student a chart showing a row for each day. Each row would have blocks for a daily set of tasks which, depending on the project your child is working on, might include tasks, such as:

  • took my homework and books to school,
  • turned in all of my homework,
  • wrote down the assignments given today,
  • brought the needed books and assignments home,
  • completed assignments for math,
  • completed assignments for English,
  • completed assignments for social studies,
  • packed my homework and books for school,
  • ... and so on.

Each day, or even at several points during the day, you and your child would review the chart and fill in stars for the completed tasks.

If the child isn’t completing one or more tasks in the list, those steps would be broken into still smaller tasks. The goal is to make success nearly inevitable.

Provide Timely Rewards

Also important is that rewards be given close to the completion of a task. Daily rewards are much more likely to be effective than rewards given at the end of the week, month, or semester. This isn't as difficult as it might seem. For some students, getting stars on the chart for each task may be sufficient reward. Some students might be motivated if each star allow them ten minutes of screen time (viewing television, engaging with friends on social media apps, or playing video games). Or, if your student would be motivated by a large final reward, the daily reward could involve you, the parent, entering points in a logbook which tracks how many points your student has earned toward a bicycle or computer.

Most kids will need a daily reminder that they are moving toward the larger goal. Daily successes and rewards help instill in your child the belief that steady effort will help them achieve their goal. Daily rewards also ensure that your child realizes that they will not be able to complete their overall goal in a whirlwind of activity at the end of the semester.

In addition, breaking tasks down into small parts helps your child cope with any failures that occur along the way to the larger goal. Without small steps and daily feedback, your student could easily lose hope of being able to earn the larger reward. If your child passes through a rough patch during the semester, the daily feedback and smaller rewards allow your student to see that they are still capable of getting back on track and thus should continue working toward the larger goal.

When behavioral plans work well, they help children and teens learn that they can succeed when they approach long-term goals in a step-by-step manner. Parents can help their children by providing frequent rewards and by walking their children through the process enough times that it becomes second nature for their children.

If you'd like to have help in creating this kind of success for your child or teen, call or email me for an appointment!

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Therapeutic farms use work in a natural environment to improve mental health.

Did you know that the State of Maryland was actually an innovator in this approach over a century ago?

In the 1970s I spent a summer working with older men at the Springfield State Hospital in Sykesville, MD. Long before Springfield was a mental institution, it was an estate and working farm, originally developed as the dowry for the daughter of a wealthy Baltimorean, William Patterson. His daughter was intended to marry Napoleon Bonaparte's brother, Jerome Bonaparte, although the marriage was later blocked by Napoleon.

In 1896, the State of Maryland transformed Springfield into a mental institution. Springfield was intended as an advance, using a more humane medical model for care instead of the prior practice of housing the "insane" in almshouses and poor farms, which were funded by state and local governments. The residents of these institutions were required to perform "hard labor," to the degree they were physically able. At least in its early days, Springfield State Hospital continued the practice of having residents work on the farm because work was viewed as important to mental health (section 8, page 9 of this document). It is unclear whether all residents were required to work or how hard they worked.

Over time, the original vision faded. Public apathy about the needs of the mentally ill led to insufficient funding, overcrowding, and abuse.

By the 1970s, I do not believe the farm employed any of the residents or produced food for the residents. Some younger, higher functioning residents continued to enjoy activities on the grounds of the hospital, while the more severely mentally or physically ill residents were locked in large, crowded dormitories and common rooms. The beautiful rolling fields, however, did appear to be actively maintained for grass or grain production, perhaps by area farmers who rented the fields.

Today Springfield has a much smaller population and the great majority have been referred from the criminal justice system.

Meanwhile, visionaries in the US and in Europe are again reforming mental health treatment by returning to the model pioneered in Maryland in the late 1800s. Read more about Resolving Serious Mental Illness with Therapeutic Farms.

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Work and intensive contact with nature can help people recover from psychotic disorders, sometimes completely.

Maryland was an innovator in this approach over a century ago. The state abandoned this model, perhaps due to the public's fluctuating concern for the mentally ill and unwillingness to fund treatment programs. Eventually Maryland's mental institutions were better known for abuse and overcrowding.

Therapeutic farms are making a comeback. In the US, the Hopewell Community is having positive outcomes with its therapeutic farm community by using work and contact with nature as a means to improving social skills, emotional self-regulation, and consistent medication use. Unfortunately, insurance does not usually pay for this kind of treatment.

There are similar approaches being used successfully in other countries, as Daniel Mackler has shown in several documentaries. His films are fascinating because they demonstrate that there are alternatives to the current inadequate standards of care in the United States.

Healing Homes shows how the Family Care Foundation in Sweden helps people recover from psychosis without medication.

Open Dialogue describes the Western Lapland Open Dialogue Project, which treats first-break psychosis. Mackler reports that 85% of clients achieve full recovery and most no longer require antipsychotic medication by the time they exit the program.

Approaches like these could save lives and reduce costs by helping clients return to productive lives.

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Attention-deficit/hyperactivity disorder (ADHD) and attention deficit disorder (ADD) are common issues for both children and adults. Symptoms may include:

  • narrow focus on the present moment
  • lack of attention to details
  • lack of body awareness and control
  • prone to distraction
  • failure to consider the consequences of behavior
  • difficulty with organization
  • difficulty with sustained projects and following through with chores
  • impulsivity
  • frequent fidgeting or squirming
  • very active, difficulty sitting still
  • talking excessively
  • blurting out answers, not waiting their turn

Individuals with ADHD/ADD often perform poorly in school and in the workplace, even though they may be highly intelligent and creative. These attention issues are often inherited, with the condition appearing in multiple generations of the family.

The most common treatment for ADHD/ADD is medication, but when the medications are stopped, the condition returns. Neurofeedback can be a highly effective alternative because it allows the areas of the brain that control arousal and focus to learn how to self-regulate. Neurofeedback can improve school, sport, and work performance, as well as social skills and self esteem. Unlike medication, the effects of neurofeedback training are often lasting, although occasional "touch-ups" are sometimes necessary in order to maintain the progress.

In this video, a boy who had ADHD describes his experiences before and after training with neurofeedback.

Contact me, if you're wondering whether you or your child might benefit from neurofeedback brain training.

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An article in Time Magazine by Susanna Schrobsdorff, Anxiety, Depression, and the American Adolescent, explores the causes of the recent significant increase in teen mental health issues.
http://time.com/magazine/us/4547305/november-7th-2016-vol-188-no-19-u-s/

TIME article on increased rates of teen depression and anxiety

Schrobsdorff identifies a number of potential causes for the increased rates of depression, anxiety, and other mental health problems: economic and geopolitical insecurity, terrorism, school shootings, a severe recession, academic stress, micromanaging parents and, especially, the rise of social media. She writes that social media presents teens with "a cauldron of stimulus they can’t get away from."

If you or your adolescent are struggling with heavy problems, such as depression, anxiety, self-harm, an eating disorder, or substance use, skilled psychotherapy can help. When we resolve the underlying problems that make life seem so difficult, satisfaction and joy can return.

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