Understanding Self-Injury in Distressed Teens

Self-injury among teens is common – and the rate is increasing. This behavior is more common in adolescence than previously thought. Although it is important to assess the associated risk of suicide, self-injury is generally used to cope with distressing emotions, especially anger and depression.

Many therapists have encountered teens that have harmed themselves, but denied suicidal intent. Recent studies have found that one-third to one-half of teens in the U.S. have engaged in some type of self-harm. Self-harming behavior is a considerable problem for therapists, not only because of the obvious danger of the client harming himself/herself, but also because of the difficulties in ascertaining whether the teen was trying to commit suicide.

Self-injury intended to inflict pain on oneself most commonly includes the following:
  • Banging walls
  • Breaking bones
  • Burning
  • Cutting
  • Hitting
  • Ingesting toxic substances
  • Interfering with healing of wounds
  • Pinching
  • Punching objects to induce pain

Self-injury typically begins in mid-adolescence. Adolescents who injure themselves are often impulsive, engaging in self-injury with less than an hour of planning. They commonly report feeling minimal or no pain. Once started, self-harm seems to acquire addictive characteristics and can be quite difficult for the teenager to discontinue. While some studies indicate that self-injury is more frequent in females than males, other studies indicate that there are no consistent gender differences.

Self-injury frequently occurs in teens that, at other times, have contemplated or attempted suicide. Thus, there is a significant risk of suicide and suicide attempts among young people that engage in self-injury. One recent study found that 70 percent of adolescents engaging in self-injury had made at least one suicide attempt – and 55 percent had multiple attempts. However, the non-suicidal and suicidal cases serve distinctly different purposes. Some clients report that they hurt themselves in order to stop suicidal ideation, or to stop themselves from actually attempting suicide. Consequently, self-injury without suicidal intent may be a morbid form of self-help.

Until recently, self-injury was seen as primarily associated with the following three specific psychiatric diagnostic categories: developmental disabilities, eating disorders, and borderline personality disorder (BPD). Self-injury occurs in roughly 15 percent of kids with developmental disabilities, especially profound and severe mental retardation. Among adult females, self-injury accompanies up to 35 percent of those diagnosed with anorexia nervosa, bulimia nervosa, and other eating disorders; girls with anorexia nervosa also tend to engage in self-injury more than those without the eating disorder. Repetitive self-injury is so common among people with BPD that BPD is the only clinical diagnosis in the DSM for which self-harm, whether suicidal or non-suicidal, is a symptom. However, no studies have examined the prevalence of self-injury among boys or girls exhibiting borderline personality symptoms.

Recent research calls into question the assumption that teen self-injury is primarily limited to young people with developmental disabilities, eating disorders, or borderline personality disorder. Psychiatric conditions that are specifically associated with self-injury in teens include internalizing disorders (e.g., depression, posttraumatic stress disorder, generalized anxiety), externalizing disorders (e.g., conduct disorder, oppositional defiant disorder), and substance abuse disorders. There is a strong link between self-injury and maltreatment in early childhood, especially sexual abuse.

About 50% of young people who engage in self-injury may not meet criteria for depression, anxiety, eating disorder, substance use disorder, or other major psychiatric disorders. In fact, self-injury appears to be a common psychiatric symptom found in a variety of disorders, as well as being found in teens without a specific psychiatric diagnosis. It seems more useful to understand self-injury in functional terms rather than as a distinct diagnosis, because a separate diagnostic category is not well supported by current research findings.

Some teens who engage in self-injury have elevated rates of emotional reactivity, intensity, and hyper-arousal. Interpersonal processes associated with self-injury include increased use of avoidant behavior and decreased emotional expressivity. Adolescents who self-injure are more likely to report being bullied by peers and experience discomfort regarding their sexual identity. A recent study also found an association with Goth subculture and self-harming behavior among adolescents. Knowledge of self-injury in peers is a risk factor for self-injury due to an apparent “copy cat” effect, and there has been an increase in publicity about this behavior. A variety of internet websites and chat rooms provide information – and even encourage self-harming behavior.

==> My Out-of-Control Teen: Help for Parents

The major purpose of self-injury appears to be affect regulation and management of distressing thoughts. For example, in one study of high school kids, 55 percent of those who engaged in self-injury indicated their reason for self-injury was, “I wanted to get my mind off my problems,” while 45 percent asserted, “It helped me to release tension or stress and relax.” When a child feels overwhelmed by negative feelings, self-injury can be an effective, although harmful, strategy to stop or reduce these negative thoughts and emotions.

Adolescents that engage in self-injury demonstrate higher levels of physiological arousal during a stressful task compared with teens without self-injury. This finding is consistent with primate research. For example, monkeys engaging in self-harm (usually self-biting) have a blunted cortisol response to mild stress when compared with controls. After experiencing a stress-induced escalation in heart rate, these monkeys appear to use self-injury as a coping strategy to decrease arousal. In turn, the self-injury is associated with a rapid decrease in heart rate.

Self-injury may also regulate emotions by increasing the affective experience. The teen may have the subjective experience of being emotionally “numb” or “empty” or feeling disconnected with others. Self-injury may help the young person to gain a sense of control, to feel excitement, or to stop dissociative experiences. Self-injury may also give the teen the experience of being “real.”

Self-injury may serve interpersonal functions for the teen. It may elicit positive reinforcement in the form of attention from others (although many who injure themselves do so in private and do not tell others). Self-injury may also help the teen to avoid difficult situations. The threat of self-injury may cause parents to decrease interpersonal pressure or to stop attempting to get the child to complete his or her homework, chores, or other tasks.

Treatment—

Self-harm in the teenage years has only recently been recognized as a commonly occurring phenomenon. Consequently, there are few randomized, controlled trials for the specific treatment of self-injury. In grown-ups, the therapeutic intervention with the most research demonstrating efficacy in reducing self-harming behavior is dialectical behavioral therapy (DBT). DBT uses a combination of individual and group therapy to teach skills in emotional regulation, interpersonal effectiveness, distress tolerance, core mindfulness, and self-management. The intensive treatment requires the therapist to be on call for these clients at all times. DBT has been adapted for teens with features of borderline personality disorder, with the additional expectation that the group therapist is on call at all times for the mom and dad of the client. The clinical and financial demands of DBT have led to applications of less intensive treatments to reduce self-injury, but these treatments are still under study.

Treatment is based on a thorough psychiatric evaluation, with a focus on safety issues, suicidal risk, and clarification of comorbid psychiatric conditions. Treating self-injury involves determining the needs that the behavior fulfills and helping the teen devise other, healthier ways to meet those needs (e.g., if self-injury helps a teen to calm down, the therapist will help to find techniques that may provide the same result).

Involving parents in the support and treatment of teens who engage in self-injury is also very important. Poor communication with parents has been associated with suicide in some teens. Improving the parents’ understanding of self-injury can be useful in decreasing conflicts. It can be helpful for the parents to learn de-escalation strategies and expand listening and communication skills. Mothers and fathers can also help with safety plans and practicing problem solving skills.

Medication for self-injury should primarily focus on any underlying psychiatric disorders. Currently, there are no specific medications approved for the treatment of self-injury. Since depression and anxiety often accompany self-injury, identifying and treating these disorders should be a top priority. Concerns about an increase in suicidal thoughts with teens using antidepressant medication should be reviewed with the client and his/her parent(s). While the protective effects of antidepressants appear to outweigh the risk of increased suicidal thoughts, medications should be monitored regularly.


 

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Safe Driving for Your Adolescent

Learning to drive is a major rite of passage for adolescents – and their moms and dads. It's a time of exciting possibilities and achievements. It's also a time of high risk. Driving is fatal for almost 50,000 Americans every year.

Young people between the ages of 16 and 25 have the highest rate of auto-related deaths, even though individuals in this age group may be bright, skilled, and have great reflexes. A collision is the most likely tragedy to kill or cripple an adolescent.

Distractions are a problem for everyone, including adolescents. Using cell phones for talking, texting, email, or other Internet use is a proven cause of accidents – and must be strictly avoided. Vehicles have many important safety features (e.g., seat belts, shoulder straps, headrests, air bags, padded dashes, safety glass, collapsible steering columns, anti-lock brakes, etc.), but even with safety equipment, reckless driving is still a real danger to adolescents.

All new drivers should take a driver's education course. These courses have been proven to reduce accidents, but they are not enough. Adolescents often believe that serious accidents will not happen to them; however, these young people can take steps to change the odds in their favor.

Adolescent-related driving deaths frequently occur in the following situations:
  • With recreational driving. For the first 3 to 6 months after getting a license, new drivers should try to get experience driving to school and work, not for fun.
  • When not buckled-up. Use safety gear.
  • When drowsy. Anyone who is sleepy should stop driving until fully alert. Sleepiness may cause even more accidents than alcohol.
  • When driving with friends. Adolescents are safer driving by themselves or with family. They should drive as much as possible with an experienced driver who can help develop good driving habits. As tempting as it may be, new drivers should wait until they have a consistent, safe driving record before taking friends as passengers. Friends, to the new driver, are a big distraction and liability – and this liability often extends to the parent.
  • When distracted. Using cell phones for any reason, eating, drinking, or putting on makeup while driving is dangerous for all drivers.
  • After the use of marijuana or any other illegal drug or any prescription drug that is sedating. Drugs can be just as dangerous as alcohol.
  • After drinking alcohol. Drinking slows reflexes and impairs judgment. These effects happen to anyone who drinks. So, NEVER drink and drive. ALWAYS find someone to drive who has not been drinking -- even if this means making an uncomfortable phone call.
  • After dark. Automatic reflexes and driving skills are just developing during the first months of driving. Darkness is an extra variable to cope with.

Moms and dads should discuss "driving rules" with their adolescents and help their new drivers stick to them. An excellent method to stimulate discussions and set expectations is to draft a "driving contract." This contract should list the rules and consequences of breaking the “driving rules.” Be sure to state in the contract that the mother or father has the final say. Consider all of the issues above when drafting the contract.

Moms and dads should encourage their adolescents to call “without consequence” rather than get in a car with a driver who has been drinking. If parents discover that their son or daughter has been driving and drinking, they should ask the State to suspend that adolescent’s license until age 18. In many states, the mother or father must sign for an adolescent under 18 to get a driver's license. At any time before the 18th birthday, the parent can refuse responsibility, and the State will take the license.

These suggestions are not intended to be a punishment for your teenager, but to prevent accidents, life-long disability and death. Your child is worth far more than the inconvenience and hassle and a driving contract. Your teenage can set an example for his or her peers on how to drive responsibly. And he or she might even save a life!


 

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Sex Education and Your Adolescent

Sex education basics may be covered in health class, but adolescents might not hear or understand everything they need to know to make tough choices about sex. That's where parents come in. Awkward as it may be, sex education is your responsibility. By reinforcing and supplementing what your adolescent learns in school, you can set the stage for a lifetime of healthy sexuality.

CLICK HERE for more...


 

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Raising Defiant Teens: The Parent's Grief Cycle

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Adolescent Athletes & Performance-Enhancing Drugs/Supplements

If you're the mother or father of an adolescent athlete, your life is probably as busy as your son's or daughter’s. It's important, however, to make time to talk to your adolescent about the dangers of performance-enhancing drugs and supplements. By setting rules and consequences and explaining the possible health effects of drug use, you can help your adolescent steer clear of performance-enhancing drugs and supplements.

For adolescents, the most common performance-enhancing drugs and supplements include the following:
  • Steroid precursors, such as androstenedione ("andro") and dehydroepiandrosterone (DHEA), are substances that the body converts into anabolic steroids. They're used to increase muscle mass. Most steroid precursors are illegal without a prescription. DHEA, however, is still available in over-the-counter preparations. Side effects of steroid precursors are similar to those for steroids.
  • Creatine is a naturally occurring compound in the body that's also sold as an over-the-counter supplement. It's primarily used to enhance recovery after a workout and increase muscle mass and strength. Creatine is popular with athletes who participate in football, gymnastics, hockey and wrestling. Side effects include weight gain, nausea, muscle cramps and kidney damage. 
  • Anabolic steroids are synthetic versions of the hormone testosterone, used to build muscle and increase strength. They're popular with football players and weightlifters. Use of anabolic steroids can cause heart and liver damage, can halt bone growth, and can result in a permanently short stature.

Some adolescents experiment with performance-enhancing drugs as a way to cope with insecurities, difficulties fitting in with a peer group, or a desire for independence. Others may be influenced by societal pressure to win at all costs.

Common risk factors for adolescent use of performance-enhancing drugs and supplements include:
  • Pressure from moms and dads or peers regarding weight or muscles
  • Being male (males are more likely to use performance-enhancing drugs and supplements than are females)
  • Negative body image or a tendency to compare one's appearance with others
  • Desire to gain muscle mass or strength

You can take various steps to prevent your adolescent from using performance-enhancing drugs and supplements or supplements. For example:
  1. Monitor your adolescent's purchases. Check the ingredients of any over-the-counter products your adolescent uses. Watch for performance-enhancing drug paraphernalia, (e.g., vials, re-sealable plastic bags, hypodermic needles, etc.).
  2. Get involved. Attend games and practices. Encourage your adolescent's coaches, school and sports organizations to discourage the use of performance-enhancing drugs and supplements. Reassure your adolescent of your love and support, regardless of his or her competitive performance.
  3. Discuss ethics and proper training. Remind your adolescent that using a performance-enhancing drug is similar to cheating and, more importantly, could lead to serious health problems. Explain that a healthy diet and rigorous training are the true keys to athletic performance.
  4. Be clear about your expectations. Tell your adolescent that you expect him or her to avoid performance-enhancing drugs and supplements. Set rules and explain the consequences of breaking them (e.g., if your adolescent uses performance-enhancing drugs and supplements, he or she has to quit the team).

Warning signs of performance-enhancing drug use:
  • Needle marks in the buttocks or thighs
  • Increased acne and facial bloating
  • Enlarged breasts in males or smaller breasts in females
  • Changes in body build (e.g., muscle growth, rapid weight gain, development of the upper body)
  • Behavioral, emotional or psychological changes (e.g., increased aggressiveness)

If you suspect that your adolescent is using performance-enhancing drugs or supplements, talk to him or her. Encourage your adolescent to be honest with you. If your adolescent admits to using performance-enhancing drugs or supplements, encourage him or her to stop immediately and offer a reminder of the health risks. Make an appointment for your adolescent to see his or her doctor for a medical evaluation and counseling. Consider informing your adolescent's coach, so he or she is aware of the problem. In addition, be sure to tell your adolescent that you're disappointed and enforce the consequences that you've established (e.g., quitting the team). Most importantly, emphasize the healthy alternatives to achieving his or her goals.


 

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Preventing Alcohol Abuse in Your Teenager

Adolescents are particularly vulnerable to alcohol use. The physical changes of puberty might make your adolescent feel self-conscious and more likely to take risks to fit in or please others. Also, your adolescent might have trouble understanding that his actions can have adverse consequences. Common risk factors for underage drinking include:
  • History of behavior problems or mental health conditions
  • Family problems (e.g., marital conflict, parental alcohol abuse, etc.)
  • Increased stress at home or school
  • Transitions (e.g., the move from middle school to high school, getting a driver's license, etc.)

Whatever causes an adolescent to drink, the consequences may be the same. For example, underage drinking can lead to:
  • Stunted development: Research shows that alcohol use may permanently distort an adolescent's emotional and intellectual development.
  • Sexual activity: Adolescents that drink tend to become sexually active earlier and have sex more often than do adolescents who don't drink. Adolescents that drink are also more likely to have unprotected sex than are adolescents who don't drink.
  • School problems: Adolescents that drink tend to have more academic and conduct problems than do adolescents who don't drink. Also, drinking can lead to temporary or permanent suspension from sports and other extracurricular activities.
  • Being a victim of violent crime: Alcohol-related crimes can include rape, assault and robbery.
  • Alcohol-related fatalities: Alcohol-related accidents are a leading cause of adolescent deaths. Drowning, suicides and murders also have been linked with alcohol use.
  • Alcoholism: Individuals who begin drinking as adolescents are more likely to develop alcohol dependence than are those who wait until they're grown-ups to drink.

To increase your odds of having a meaningful discussion about alcohol abuse, choose a time when you and your adolescent are relaxed. Don't worry about covering everything at once. If you talk often, you might have a greater impact on your adolescent than if you have only a single discussion.  When you talk about underage drinking, you might include the following:

1. Ask your adolescent's views. Find out what your adolescent knows and thinks about alcohol.

2. Be prepared to discuss your own drinking. Your adolescent might ask if you drank alcohol when you were underage. If you chose not to drink, explain why. If you chose to drink, you might share an example of a negative consequence of your drinking. If you drink today, be prepared to talk about why social drinking is OK for you and not for your adolescent.

3. Debunk myths. Adolescents often think that drinking makes them popular or happy. Explain that alcohol can make you feel "high" but it's a depressant that also can cause sadness and anger.

4. Develop a strong relationship with your adolescent. Your support will help your adolescent build the self-esteem she needs to stand up to peer pressure and live up to your expectations.

5. Discuss reasons not to drink alcohol. Avoid scare tactics. Instead, explain the risks and appeal to your adolescent's self-respect. If you have a family history of alcoholism or drinking problems, be honest with your adolescent. Strongly discourage your adolescent from trying alcohol — even as an grown-up — since there's a considerable chance that your adolescent could develop an alcohol problem, too.

6. Encourage healthy friendships. If your adolescent's friends drink alcohol, he is more likely to drink, too. Get to know your adolescent's friends and their moms and dads.

7. Establish rules and consequences. Rules might include no underage drinking, leaving parties where alcohol is served, and not riding in a car with a driver who's been drinking. Agree on the consequences of breaking the rules ahead of time, and enforce them consistently.

8. Watch for signs of alcohol drinking and issue immediate consequences. If you suspect that your adolescent has been drinking (e.g., you've noticed mood changes or behavior problems, your adolescent has red or glazed eyes or unusual health complaints), then talk to her. Enforce the consequences you've established so that your adolescent understands that using alcohol will always result in a loss of privileges.

9. Know your adolescent's activities. Pay attention to your adolescent's plans and whereabouts. Encourage participation in supervised after-school and weekend activities.

10. Plan ways to handle peer pressure. Brainstorm with your adolescent about how to respond to offers of alcohol. It might be as simple as saying, "No thanks" or "Do you have any Mountain Dew?"

11. Set an example. If you drink, do so only in moderation and explain to your adolescent why it's OK for grown-ups to drink responsibly. Describe the rules you follow (e.g., not drinking and driving). Don't serve alcohol to anyone who's underage.

12. Share facts. Explain that alcohol is a powerful drug that slows the body and mind, and that anyone can develop an alcohol problem — even an adolescent without risk factors for alcohol abuse.

If you think your adolescent might have a drinking problem, contact the doctor or a counselor who specializes in alcohol problems. Adolescents that have alcohol problems aren't likely to realize it or seek help on their own.


 

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Eating Disorders: Tips to Help Your Teenage Daughter

Eating disorders can take a devastating toll on teenagers — especially females. To help your teenage daughter, learn the possible causes of eating disorders and know how to talk to her about healthy eating habits.

The exact cause of eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge-eating disorder) is unknown. However, various factors might put adolescent girls at risk of developing eating disorders. For example:
  • Favorite activities. Participation in activities that value leanness (e.g., wrestling, running, ballet) can increase the risk of teenage eating disorders.
  • Low self-esteem. Teenagers that have low self-esteem might use their eating habits or weight loss to achieve a sense of stability or control.
  • Personal factors. Genetics or biological factors might make some teenage girls more likely to develop eating disorders. Personality traits such as perfectionism, anxiety or rigidity might also play a role.
  • Societal pressure. Modern Western culture tends to place a premium on being physically attractive and having a slim body. Even with a normal body weight, teenagers can easily develop the perception that they're fat. This can trigger an obsession with losing weight, dieting and being thin — especially for females.

At first, teenage eating disorders can cause signs and symptoms such as:
  • Constipation
  • Difficulty concentrating
  • Dizziness 
  • Fatigue 
  • Menstrual irregularities
  • Irritability
  • Trouble sleeping
  • Weakness

Eventually, teenage eating disorders can cause more-serious or even life-threatening health problems, including:
  • Anemia
  • Bone loss
  • Delayed growth and development
  • Depression
  • Digestive problems
  • Heart problems
  • Muscle wasting
  • Seizures 
  • Suicidal thoughts or behavior 
  • Thinning hair 
  • Tooth decay

To help prevent teenage eating disorders, talk to your daughter about eating habits and body image. It might not be easy, but it's important. To get started, try these parenting tips:

1. Use food for nourishment — not as a reward or consequence. Resist the temptation to offer food as a bribe. Similarly, don't take away food as a punishment.

2. Share the dangers of dieting and emotional eating. Explain that dieting can compromise your daughter’s nutrition, growth and health, as well as lead to the development of binge-eating over time. Remind her that eating or controlling her diet isn't a healthy way to cope with emotions. Instead, encourage her to talk to loved ones, friends or a counselor about problems she might be facing.

3. Schedule a medical checkup for your teenager. The doctor can assess your teen's risk of an eating disorder, as well as order urine tests, blood tests or other tests to detect complications. Your daughter's doctor can reinforce the messages you're giving her at home, as well as help identify early signs of an eating disorder. For example, the doctor can look for unusual changes in your daughter’s body mass index or weight percentiles during routine medical appointments. The doctor can talk to her about her eating habits, exercise routine, and body image. If necessary, the doctor can refer your child to a mental health provider.

4. Remember the importance of setting a good example yourself. If you're constantly dieting, using food to cope with your emotions or talking about losing weight, you might have a hard time encouraging your teenage daughter to eat a healthy diet or feel satisfied with her appearance. Instead, make conscious choices about your lifestyle and take pride in your body.

5. Promote a healthy body image. Talk to your child about her self-image and offer reassurance that healthy body shapes vary. Don't allow hurtful nicknames or jokes based on a person's physical characteristics. Avoid making comments about another person based on weight or body shape.

6. If your teenager is diagnosed with an eating disorder, treatment will likely involve a type of family therapy that helps you work with daughter to improve her eating habits, reach a healthy weight, and manage other symptoms. Sometimes medication is prescribed to treat accompanying mental health conditions (e.g., depression, anxiety, obsessive-compulsive disorder, etc.). In severe cases, hospitalization might be needed.

7. If you suspect that your teenage daughter has an eating disorder (e.g., you've noticed baggy clothes to hide weight loss, or perhaps excessive exercise, or reluctance to eat meals with the family), then start the conversation about body image. Encourage your adolescent to open up about her problems and concerns.

8. Foster self-esteem. Respect your daughter’s accomplishments, and support her goals. Listen when she speaks. Look for positive qualities (e.g., curiosity, generosity, sense of humor, etc.). Remind your adolescent that your love and acceptance is unconditional — not based on her weight or appearance.

9. Encourage reasonable eating habits. Talk to your teenage daughter about how diet can affect her health, appearance and energy level. Encourage her to eat when she is hungry. Make a habit of eating together as a family.

10. Discuss media messages. Television programs, movies, websites and other media might send your teenager the message that only a certain body type is acceptable. Encourage your child to talk about and question what she has seen or heard — especially from websites or other sources that promote anorexia as a lifestyle choice, rather than an eating disorder.


 

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Help for Tired Teenagers: Tips for Parents

Adolescents are notorious for staying up late and being hard to awaken in the morning. If your teenage son or daughter is no exception, it's not necessarily because he or she is pushing the limits or fighting the rules. This behavior pattern actually has a physical cause and can be modified to improve your adolescent's sleep schedule.

Most adolescents need about 9 hours of sleep a night to maintain optimal daytime alertness. But few adolescents actually get that much sleep regularly thanks to factors like early-morning classes, extracurricular activities, homework, part-time jobs, social demands, and use of computers and other electronic gadgets. More than 90% of adolescents in a recent study published in the Journal of School Health reported sleeping less than the recommended nine hours a night. In the same study, 10% of adolescents reported sleeping less than six hours a night.

Sleep-deprived teenagers are more likely than their well-rested peers to report the following risky health behaviors:
  • Drank alcohol
  • Drank full-sugar soda at least once per day
  • Had been in at least one physical fight
  • Had feelings of sadness or hopelessness
  • Participated in 60 minutes of physical activity fewer than twice in the preceding week
  • Seriously considered attempting suicide
  • Smoked cigarettes
  • Spent 3 or more hours each day on the computer
  • Used marijuana
  • Was sexually active

Although this might seem like no big deal, sleep deprivation can have serious consequences. Tired adolescents can find it difficult to concentrate and learn, or even stay awake in class. Too little sleep also might contribute to mood swings and behavioral problems. Another major concern is drowsy driving, which can lead to serious — or even deadly — accidents.

Everyone has an internal clock that influences body temperature, sleep cycles, appetite and hormonal changes. The biological and psychological processes that follow the cycle of this 24-hour internal clock are called circadian rhythms. Before adolescence, these circadian rhythms direct most kids to naturally fall asleep around 8 or 9 p.m. But puberty changes an adolescent's internal clock, delaying the time he or she starts feeling sleepy — often until 11 p.m. or later. Staying up late to study or socialize can disrupt an adolescent's internal clock even more. The good news is that your adolescent doesn't have to be at the mercy of his or her internal clock.

==> My Out-of-Control Teen: Help for Parents

Tips to help your adolescent develop better sleep habits:

1. Adjust the lighting. As bedtime approaches, dim the lights. Then turn off the lights during sleep. In the morning, expose your adolescent to bright light. These simple cues can help signal when it's time to sleep and when it's time to wake up.

2. Curb the caffeine. A jolt of caffeine might help your adolescent stay awake during class, but the effects are fleeting — and too much caffeine can interfere with a good night's sleep.

3. Don’t use meds. Sleeping pills and other medications generally aren't recommended. For many adolescents, lifestyle changes can effectively improve sleep.

4. Keep it calm. Encourage your adolescent to wind down at night with a warm shower, a book or other relaxing activities. Discourage stimulating activities — including vigorous exercise, loud music, video games, television, computer use and text messaging — an hour or two before bedtime.

5. Know when to unplug. Take the TV out of your adolescent's room, or keep it off at night. The same goes for your adolescent's cell phone, computer and other electronic gadgets.

6. Nix long naps. If your adolescent is drowsy during the day, a 30-minute nap after school might be refreshing. Be cautious, though. Too much daytime shut-eye might only make it harder to fall asleep at night.

7. Stick to a schedule. Tough as it may be, encourage your adolescent to go to bed and get up at the same time every day — even on weekends. Prioritize extracurricular activities and curb late-night social time as needed. If your adolescent has a job, limit working hours to no more than 16 to 20 hours a week.

In some cases, excessive daytime sleepiness can be a sign of something more than a problem with your adolescent's internal clock. Other problems can include:
  • Depression. Sleeping too much or too little is a common sign of depression.
  • Insomnia or biological clock disturbance. If your adolescent has trouble falling asleep or staying asleep, he or she is likely to struggle with daytime sleepiness.
  • Medication side effects. Many medications — including over-the-counter cold and allergy medications and prescription medications to treat depression and attention-deficit/hyperactivity disorder — can disrupt sleep.
  • Narcolepsy. Sudden daytime sleep, usually for only short periods of time, can be a sign of narcolepsy. Narcoleptic episodes can occur at any time — even in the middle of a conversation. Sudden attacks of muscle weakness in response to emotions such as laughter, anger or surprise are possible, too. 
  • Obstructive sleep apnea. When throat muscles fall slack during sleep, they stop air from moving freely through the nose and windpipe. This can interfere with breathing and disrupt sleep. You might notice loud snoring or intermittent pauses in breathing, often followed by snorting and more snoring. 
  • Restless legs syndrome. This condition causes a "creepy" sensation in the legs and an irresistible urge to move the legs, usually shortly after going to bed. The discomfort and movement can interrupt sleep.

If you're concerned about your adolescent's daytime sleepiness or sleep habits, contact his or her doctor. If your adolescent is depressed or has a sleep disorder, proper treatment can be the key to a good night's sleep.


 

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Teens and Texting Issues

Are you concerned about your teenager and all the texting he or she does? For many adolescents, text messaging has become a primary way to communicate with peers. As one mother stated, "It seems that my son is texting people all day and all night long. It's an addiction if there ever was one." A lack of maturity can get your adolescent into big trouble when texting, though. Help him or her to understand and avoid the risks associated with texting by using the following tips:

Cyber-bullying— Cyber-bullying refers to sending harassing texts, emails or instant messages, as well as posting intimidating or threatening content on websites or blogs.  Of course, cyber-bullying can make young people feel unsafe and might lead to school absences or other issues. It has even be a contributing factor to suicide in some cases. Encourage your adolescent to talk to you or another trusted grown-up if he or she receives harassing text messages. You might also suggest rejecting texts from unknown numbers. On the other hand, make sure your adolescent understands that it isn't acceptable to spread rumors or bully someone through texting. Remind him or her that any text message that is sent can be forwarded to anyone else, so it's important to use good judgment with every text.

Enforcing consequences— If your adolescent isn't willing to follow the rules and you've established, or if you're concerned that texting is interfering with his or her schoolwork or other responsibilities — take action! Remove your adolescent's ability to text or send pictures through his or her phone, or simply take the phone away. Remind your adolescent that having a phone is a privilege, not a right. Preventing potentially serious consequences outweighs any anger he or she is likely to exhibit.

==> My Out-of-Control Teen: Help for Parents

Monitoring messages— Sit down with your adolescent and look through his or her text messages occasionally, or let your adolescent know that you'll periodically check the phone for content. You might also review phone records to see when and how often your adolescent is sending and receiving texts.  As your adolescent gets older and engages with a larger group of people, it becomes even more important to monitor the messages.

Sexting— Sexting refers to sending a text message with sexually explicit content (e.g., naked pictures, pictures of people engaging in sexual acts, etc.). Even if sexting seems to be the norm among your adolescent's peer group, explain the emotional consequences of sexting to him or her. Sexting can be uncomfortable for the sender as well as the receiver. The possible long-term impact of sexting matters, too. A picture or message meant for one friend can be forwarded to an entire contact list at any time — and once it's in circulation, there's no way to control it. A photo or message could resurface years later under other circumstances, possibly causing great embarrassment – and even problems with work or school. Although laws may vary from state to state, make sure your adolescent understands that the possession of sexually explicit images of a minor is considered a crime. The consequences could be serious (e.g., a police record, suspension from school, legal action, etc.). You might say something like, “If you wouldn't be comfortable sharing the photo or message with the entire world, don't send it.”

Texting instead of sleeping— Texting after going to bed interferes with a good night's sleep, especially if the messages are stressful or emotional. This can lead to serious issues (e.g., lost sleep, difficulty falling asleep, poor sleep quality, daytime sleepiness, poor grades, etc.). Work with your son or daughter to establish reasonable hours for texting (e.g., no texting after 10:30 p.m. on school nights). To enforce the rule, you might keep your adolescent's cell phone out of his or her room at night.

Texting while driving— Research suggests that “texting while driving” is more than 20 times as dangerous as driving alone. Even more disturbing, texting is an even greater threat for young drivers than for older drivers, because teenagers are less likely to stop texting when faced with a difficult driving situation. Talk to your son or daughter about the consequences of texting while driving (e.g., getting a traffic ticket, serious or deadly accidents, losing driver’s license, etc.). Talking isn't enough, though. Set clear rules and consequences about texting and driving. Explain that texting while driving isn't allowed under any circumstances, and that driving and cell phone privileges will be revoked if your adolescent texts while driving. Remind your son or daughter that texting while driving is illegal in many states. To help your adolescent resist temptation while driving, you can suggest storing the cell phone out of easy reach in the car (e.g., in the glove compartment, tucked away in a purse or bag, etc.). Also, consider apps or other safety features that disable texting while driving.


 

==> My Out-of-Control Teen: Help for Parents
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How To Help Your Teen Stop Smoking

Adolescent smoking is a BIG issue, because adolescents who smoke are likely to turn into grown-ups who smoke. If you find your adolescent smoking, take it seriously. Stopping adolescent smoking in its tracks is the best way to promote a lifetime of good health. Adolescent smoking might begin innocently, but it can become a long-term problem. Help your teenage son or daughter avoid taking that first puff, or to stop smoking if he or she has already started the habit.

Follow these parenting tips to help stop - or prevent - adolescent smoking:

1. Adolescent smoking can be a form of rebellion or a way to fit in with a particular group of peers. Some adolescents begin smoking to control their weight. Others smoke to feel cool or independent. Ask your adolescent how she feels about smoking and if any of your adolescent's friends smoke. Applaud your adolescent's good choices, and talk about the consequences of bad choices.

2. Adolescent smoking is more common among adolescents whose moms and dads smoke. If you don't smoke, keep it up. If you do smoke, quit — now. The earlier you stop smoking, the less likely your adolescent is to become a smoker. Ask a health professional about ways to stop smoking. In the meantime, don't smoke in the house, in the car or in front of your adolescent, and don't leave cigarettes where your adolescent might find them. Explain to your adolescent how unhappy you are with your smoking, how difficult it is to quit and that you'll keep trying until you stop smoking for good.

3. Adolescents can become addicted to nicotine surprisingly quickly — sometimes within just a few weeks of experimenting with smoking. While many adolescents who smoke think they can stop anytime, research shows this isn't usually true. When you talk to your adolescent about stopping smoking, ask if any of his friends have tried to stop smoking. Consider why they were — or weren't — successful. Then ask your adolescent which stop-smoking strategies he thinks might be most helpful.

4. Adolescents tend to assume that bad things happen only to other people. Most adolescents think cancer, heart attacks and strokes occur only in the abstract. Use loved ones, friends, neighbors or celebrities who've been ill as real-life examples.

5. Although nicotine replacement products (e.g., nicotine gums, patches, inhalers or nasal sprays) weren't designed for adolescents, they might be helpful in some cases. Ask your adolescent's doctor which options might be best for your adolescent.

6. Although the consequences of smoking (e.g., cancer, heart attack and stroke) are real, they're probably beyond the realm of your adolescent's concern. Rather than lecturing your adolescent on the long-term dangers of smoking, ask your adolescent what she considers the negative aspects of smoking. Once your adolescent has had her say, offer your own list of negatives.

7. Celebrate your adolescent's success. You might offer a favorite meal for a smoke-free day, a new shirt for a smoke-free week, or a party with nonsmoking buddies for a smoke-free month. Rewards and positive reinforcement can help your adolescent maintain the motivation to stop smoking for good.

8. Contact a tobacco-cessation specialist. A tobacco-cessation specialist can give your adolescent the tools and support she needs to stop smoking. Some hospitals and local organizations offer stop-smoking groups just for adolescents. You might look for adolescent groups online, too. Web-based programs can also provide support for your adolescent whenever she needs it.

9. Encourage your adolescent to write down why he wants to stop smoking. The list can help your adolescent stay motivated when temptation arises.

10. Help your adolescent choose a date to stop smoking. Avoid placing the stop date during a stressful time (e.g., during final exams).

==> My Out-of-Control Teen: Help for Parents

11. If your adolescent feels pressured to smoke, encourage him to get involved in new activities. Making new friends who don't smoke could make it easier to avoid friends who aren't willing to stop smoking.

12. If your adolescent has already started smoking, avoid threats and ultimatums. Instead, find out why your adolescent is smoking, and discuss ways to help your adolescent quit.

13. If your adolescent slips, remain supportive. Congratulate your adolescent on the progress she has made so far, and encourage your adolescent not to give up. Help your adolescent identify what went wrong and what to do differently next time.

14. Instead of getting angry, be curious and supportive. Ask your adolescent what made her start smoking. Perhaps your adolescent is trying to fit in at school, or maybe your adolescent thinks that smoking will help relieve stress. Sometimes adolescent smoking is an attempt to feel cool or more grown-up. Once you understand why your adolescent is smoking, you'll be better equipped to address smoking as a potential problem — as well as help your adolescent eventually stop smoking.

15. Most adolescents believe occasional smoking won't cause them to become addicted and that, if they become regular smokers, they can stop smoking anytime they want. Adolescents, however, can become addicted with intermittent and relatively low levels of smoking. Remind your adolescent that most adult smokers start as adolescents. Once you're hooked, it's tough to quit.

16. Participate in local and school-sponsored smoking prevention campaigns.

17. Peer pressure to smoke might be inevitable, but your adolescent doesn't need to give in. Help your adolescent practice saying, "No thanks, I don't smoke." Peers who smoke can be convincing, but you can give your adolescent the tools he needs to stay away from people who smoke. Rehearse how to handle tough social situations. It might be as simple as walking away from friends who are puffing away.

18. Prompt your adolescent to calculate the weekly, monthly or yearly cost of smoking. You might compare the cost of smoking with electronic devices, clothes or other items your adolescent considers important.

19. Remind your adolescent that if she can hold out long enough — usually just a few minutes — the nicotine craving will pass. Suggest taking a few deep breaths. Offer sugarless gum, cinnamon sticks, toothpicks or straws to help your adolescent keep her mouth busy.

20. Smokeless tobacco, clove cigarettes and candy-flavored cigarettes are sometimes mistaken as less harmful or addictive than are traditional cigarettes. Adolescents also often think that water pipe smoking is safe. Nothing could be further from the truth. Don't let your adolescent be fooled.

21. Smoking isn't glamorous. Remind your adolescent that smoking is dirty and smelly. Smoking gives you bad breath and wrinkles. Smoking makes your clothes and hair smell, and it turns your teeth yellow. Smoking can leave you with a chronic cough and less energy for sports and other enjoyable activities.

22. Support efforts to make public places smoke-free and increase taxes on tobacco products.

23. Talk with your adolescent about how tobacco companies try to influence ideas about smoking (e.g., through advertisements or product placement in the movies that create the perception that smoking is glamorous and more prevalent than it really is).

24. You might feel as if your adolescent doesn't hear a word you say, but say it anyway. Tell your adolescent that smoking isn't allowed. Your disapproval will have more impact than you think. Adolescents whose moms and dads set the firmest smoking restrictions tend to smoke less than do adolescents whose moms and dads don't set smoking limits. The same goes for adolescents who feel close to their parents.

25. Consider appealing to your adolescent's vanity. Smoking:
  • causes wrinkles
  • gives you bad breath
  • leaves you with a hacking cough
  • makes your clothes and hair smell
  • turns your teeth and fingernails yellow
  • zaps your energy for sports and other activities


 

==> My Out-of-Control Teen: Help for Parents
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How to Help Your Teenager Avoid Alcohol and Drugs

"Any thoughts on how to get a 17 year old to stop using drugs? He's headed for prison if he doesn't change his ways soon! He's already on probation through juvenile court."

Adolescents who experiment with alcohol and drugs put their health and safety at risk. Parents can help prevent adolescent alcohol/drug abuse by talking to their sons and daughters about the consequences of using harmful substances and the importance of making healthy choices.

Various factors can contribute to adolescent alcohol/drug abuse, from insecurity to a desire for social acceptance. Adolescents often feel indestructible and might not consider the consequences of their actions, leading them to take dangerous risks like abusing alcohol and legal/illegal drugs.

Common risk factors for adolescent alcohol/drug abuse include:
  • academic failure
  • alcohol and drug availability
  • belief that alcohol/drug abuse is OK 
  • early aggressive or impulsive behavior 
  • family history of substance abuse 
  • feelings of social rejection 
  • history of traumatic events (e.g., experiencing a car accident, being a victim of abuse)
  • lack of nurturing by mom or dad
  • low self-esteem
  • mental or behavioral health condition (e.g., depression, anxiety, ADHD) 
  • poor social coping skills
  • relationships with peers who drink alcohol or use drugs

Negative consequences of adolescent alcohol/drug abuse might include:
  • Sexual activity. Adolescents who abuse alcohol and drugs are more likely to have poor judgment, which can result in unplanned and unsafe sex.
  • Serious health problems. Abuse of prescription or over-the-counter medications can cause respiratory distress and seizures. Chronic use of inhalants can harm the heart, lungs, liver and kidneys. Ecstasy can cause liver damage and heart failure. High doses of or chronic use of methamphetamine can cause psychotic behavior.
  • Impaired driving. Driving under the influence of alcohol and/or drugs impairs a driver's motor skills, reaction time and judgment, thus putting the driver, her passengers, and others on the road at risk.
  • Drug dependence. Adolescents who abuse alcohol and drugs are at increased risk of serious dependency later in life. 
  • Concentration problems. Some drugs (e.g., marijuana) affect an adolescent's memory, motivation, and ability to learn.

It may seem difficult to talk to your adolescent about alcohol/drug abuse. Start by choosing a comfortable time and setting when you're unlikely to be interrupted. If you're nervous about discussing the topic, share your feelings with your adolescent. You might also consider sharing the responsibility with another nurturing adult in your adolescent's life.

==> My Out-of-Control Teen: Help for Parents

Here are some tips for talking with your adolescent about alcohol and drugs:
  • Discuss ways to resist peer pressure. Brainstorm with your adolescent about how to turn down offers to drink alcohol or use drugs.
  • Discuss reasons not to abuse alcohol or drugs. Avoid scare tactics. Emphasize how alcohol/drug use can affect things important to your adolescent (e.g., sports, driving, health, appearance, etc.). Explain that even an adolescent can develop an alcohol or drug problem.
  • Consider media messages. Some television programs, movies, websites or songs glamorize or trivialize alcohol/drug use. Talk about what your adolescent has seen or heard. 
  • Be ready to discuss your own alcohol or drug use. Think ahead about how you'll respond if your adolescent asks about your own alcohol or drug use. If you chose not to use alcohol or drugs, explain why. If you did drink alcohol or use drugs, share what the experience taught you.
  • Ask your adolescent's views. Avoid long, boring lectures. Instead, listen to your adolescent's opinions and questions about alcohol/drug use. Observe your adolescent's nonverbal responses to see how he or she feels about the topic. Encourage your adolescent to talk by making statements instead of asking questions. For example, saying, "I'm interested in your opinion" might work better than "What do you think?"

Don't be afraid that talking about alcohol/drug abuse will plant ideas in your adolescent's head. Conversations about alcohol and drugs won't tempt your adolescent to try these chemicals. Instead, talking about it lets your adolescent know your views and understand what you expect of him or her.

In addition to talking to your adolescent, consider other strategies to prevent adolescent alcohol/drug abuse:
  • Set a good example. Don't abuse substances yourself.
  • Provide support. Offer praise and encouragement when your adolescent succeeds, whether at school or at home. A strong bond between you and your adolescent might help prevent him from abusing alcohol and drugs. 
  • Know your adolescent's peers. If your adolescent's friends abuse alcohol or drugs, she might feel pressure to experiment, too. Get to know your adolescent's friends and their moms and dads.
  • Know your adolescent's activities. Pay attention to your adolescent's whereabouts. Find out what adult-supervised activities he is interested in and encourage him to get involved.
  • Keep an eye on prescription drugs. Take an inventory of all prescription and over-the-counter medications in your home and keep them out of easily accessible places (e.g., the medicine cabinet). If your adolescent needs to take prescription medication during school hours, it should be dispensed by the school nurse.
  • Establish rules and consequences. Make it clear that you won't tolerate alcohol or drug abuse. Rules might include leaving a party where alcohol drinking and drug use occurs and not riding in a car with a driver who's been using any substances. Agree on the consequences of breaking the rules ahead of time — and enforce them consistently.

Be aware of possible red flags, such as:
  • An unusual chemical or medicine smell on your adolescent or in her room
  • Drug paraphernalia in your adolescent's room
  • Hostile or uncooperative attitude
  • Loss of interest in hobbies or family activities
  • Medicine containers, despite a lack of illness
  • Secrecy about actions or possessions
  • Stealing money or an unexplained need for money
  • Sudden or extreme change in friends, eating habits, sleeping patterns, physical appearance, coordination or school performance

If you suspect that your adolescent is abusing alcohol or drugs, talk to him. Avoid accusations. Instead, ask your adolescent what's going on in his life and encourage him to be honest. If your adolescent admits to abusing drugs, let him know that you're disappointed. Enforce the consequences you've established and explain to your adolescent ways that he can help regain your lost trust (e.g., being home by curfew, improving grades, etc.). 


 

==> My Out-of-Control Teen: Help for Parents
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Pregnancy in Adolescence: Important Tips for Parents

Pregnancy in adolescence is often a crisis for a young lady and her family, as well as the child's dad and his family. Common reactions include anger, guilt and denial. Your adolescent might also experience anxiety, fear, shock and depression. Talk to your teenager about what she's feeling and the choices ahead. She needs your love, guidance and support now more than ever.

A pregnant adolescent (along with her mom and dad, the father of the child and his mom and dad) has a variety of options to consider:

• Terminate the pregnancy. Some pregnant adolescents choose to end their pregnancies. If your teenager is considering abortion, discuss the risks and the emotional consequences. Keep in mind that some states require parental notification for a legal abortion.

• Give the child up for adoption. Some pregnant adolescents choose to give their child up for adoption. If your teenager is considering adoption, help her explore the different types of adoption available. Also discuss the emotional impact of giving a child up for adoption.

• Keep the child. Many pregnant adolescents keep their child. Some marry the child's dad and raise the child together. Others rely on family support to raise the child. Finishing school and getting a good job can be difficult for an adolescent parent, however. If your teenager is thinking about keeping the child, make sure she understands the challenges and responsibilities involved. In addition to talking to you, encourage your teenager to talk about the options with her health care provider or a specialist in pregnancy counseling. 
 

Pregnant adolescents and their children are at higher risk of health problems than are pregnant females who are older. The most common complications for pregnant adolescents (especially those younger than age 15 and those who don't receive prenatal care) include a low level of iron in the blood (i.e., anemia) and preterm labor. Some research suggests that pregnant adolescents might be more likely to develop high blood pressure as well. Children born to adolescent moms are more likely to be born prematurely and have a low birth weight. A pregnant adolescent can improve her chances of having a healthy boy or girl by taking good care of herself. 

If your teenager decides to continue the pregnancy, encourage her to do the following:

• Avoid dangerous chemicals. Alcohol, tobacco, marijuana and other illicit drugs are off-limits during pregnancy. Even moderate alcohol use during pregnancy can harm a developing child. Smoking increases the risk of premature birth, problems with the placenta and low birth weight — and drugs your adolescent takes can pass from her to her child, sometimes with devastating effects. Even prescription and over-the-counter medications deserve caution. Remind your teenager to clear any medications or supplements with her health care provider ahead of time.

• Maintain a healthy diet. During pregnancy, your teenager will need more folic acid, calcium, iron, protein and other essential nutrients. A daily prenatal vitamin can help fill any gaps. In addition, your teenager might need extra calcium and phosphorus because her own bones are still growing.

• Gain weight sensibly. Gaining the right amount of weight can support the child's health — and make it easier for your adolescent to lose the extra pounds after delivery. A weight gain of 25 to 35 pounds is often recommended for females who have a healthy weight before pregnancy. Pregnant adolescents may need to gain more weight. Encourage your teenager to work with her health care provider to determine what's right for her.

• Get tested for infections. Sexually transmitted infections (e.g., gonorrhea, Chlamydia, syphilis) can increase the risk of miscarriage, premature birth, low birth weight, birth defects and other pregnancy complications. If your adolescent has a sexually transmitted infection, treatment is critical.

• Get prenatal care. During pregnancy, regular prenatal visits can help your teenager's health care provider monitor her health and the child's health.

• Exercise. Regular physical activity can help ease or even prevent discomfort, boost your adolescent's energy level and improve her overall health. It also can help her prepare for labor and childbirth by increasing her stamina and muscle strength. Encourage your teenager to get her health care provider's permission before starting or continuing an exercise program, especially if she has an underlying medical condition.

• Take child birth classes. These classes can help prepare your teenager for pregnancy, child birth, breast-feeding and being a parent. If your teenager lacks the finances or transportation needed to obtain prenatal care — or needs help continuing her education — a counselor or social worker might be able to help. 
 

Pregnancy in adolescence often has a negative impact on an adolescent's future. Adolescent moms are less likely to graduate from high school and to attend college, are more likely to live in poverty, and are at risk of domestic violence. Adolescent dads tend to finish fewer years of school than do older dads. They're also less likely to earn a livable wage and hold a steady job. In addition, kids of adolescent mothers and fathers are more likely to have health and cognitive conditions and are more likely to be neglected or abused. Females born to adolescent moms and dads are more likely to experience teen pregnancy themselves.

If your teenager decides to continue the pregnancy, address these challenges head-on. Discuss her goals for the future and how she might go about achieving them as a mother. Look for special programs available to help pregnant adolescents remain in school or complete course work from home. Encourage your teenager to take parenting classes, and help her prepare to financially support and raise a youngster. Whatever choice your teenager makes, be there for her as much as possible. Your love and support will help her deal with pregnancy and the challenges ahead.

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Dealing with Difficult Teen Behavior: 40 Tips for Parents

Helping a teenager become a caring, independent and responsible grown-up is no small task. The teenage years can be a confusing “time of change” for adolescents and moms and dads alike. But while these years can be tough, there's plenty you can do to nurture your adolescent and encourage responsible behavior.

Use the following parenting skills to deal with the challenges of raising an adolescent:

1. As you allow your adolescent some degree of self-expression, remember that you can still maintain high expectations for your adolescent and the kind of person he or she will become.

2. As your adolescent demonstrates more responsibility, grant him or her more freedom. If your adolescent shows poor judgment, impose more restrictions.

3. Avoid disciplining your adolescent when you're angry.

4. Avoid reprimanding your adolescent in front of his or her friends.

5. Avoid setting rules your adolescent can't possibly follow. A chronically messy adolescent may not be able to maintain a spotless bedroom overnight.

6. Avoid ultimatums. Your adolescent may view an ultimatum as condescending and interpret it as a challenge.

7. Avoid using a sarcastic, demeaning or disrespectful tone.

8. Be consistent when you enforce limits. Whatever disciplinary technique you choose, relate the consequences to the broken rule and deliver them immediately.

9. Be prepared to explain your decisions. Your adolescent may be more likely to comply with a rule when he or she understands its purpose.

10. Be specific. Rather than telling your adolescent not to stay out late, set a specific curfew.

11. Before negotiating with your adolescent, consider how far you're willing to bend. Don't negotiate when it comes to restrictions imposed for your adolescent's safety (e.g., substance abuse, sexual activity, reckless driving, etc.).

12. Don't impose penalties you're not prepared to carry out.

13. Don't pressure your adolescent to be like you were or wish you had been at his or her age.

14. Encourage your adolescent to talk to other supportive adults (e.g., uncle, older cousin) for additional guidance.

15. Enforcing consequences can be tough — but your adolescent needs you to be his or her parent, not a pal. Being too lenient may send the message that you don't take your adolescent's behavior seriously, while being too harsh can cause resentment.

16. Focus on what you want your teenager to learn from a particular consequence - not whether or not he or she going to care.

17. Get to know the technology your adolescent is using and the websites he or she visits. If possible, keep the computer in a common area in your home. Remind your adolescent to practice basic safety rules (e.g., talk to a parent or trusted adult if an interaction or message makes you uncomfortable, don't text or chat on the phone while driving, don't share personal information online, don't share passwords, don't send anything in a message you wouldn't say face to face, don't plagiarize, don't get together with someone you meet online, and so on).

18. Give your adolescent some leeway when it comes to clothing and hairstyles. It's natural for adolescents to rebel and express themselves in ways that differ from their moms and dads.

19. Have plenty of time-outs (i.e., time away from your difficult teenager).

20. If your adolescent doesn't seem interested in bonding, keep trying.

==> My Out-of-Control Teen: Help for Parents

21. If your adolescent shows an interest in body art (e.g., tattoos, piercings), make sure he or she understands the health risks (e.g., skin infections, allergic reactions, hepatitis B and C). Also, talk about potential permanence or scarring.

22. Keep in mind that only reprimanding your adolescent and never giving him or her any justified praise can prove demoralizing. For every time you discipline or correct your adolescent, try to compliment him or her twice.

23. Keep your rules short and to the point.

24. Limit consequences to a few hours or days to make them most effective.

25. Listen to your adolescent when he or she talks.

26. Make sure you reprimand your adolescent's behavior, not the adolescent.

27. Make sure your adolescent knows early on that you won't tolerate tobacco, alcohol or other drug use.

28. Not sure if you're setting reasonable limits? Talk to your adolescent, other moms and dads and your adolescent's doctor. Whenever possible, give your adolescent a say in establishing the rules he or she is expected to follow.

29. On days when you're having trouble connecting with your adolescent, consider each doing your own thing in the same space. Being near each other could lead to the start of a conversation.

30. One of the most important parenting skills needed for raising healthy adolescents involves positive attention.

31. Punish only the guilty party, not other family members.

32. Put house-rules in writing. Use this technique to counter a selective memory.

33. Regularly eating meals together may be a good way to stay connected to your adolescent. Better yet, invite your adolescent to prepare the meal with you.

34. Remember, adolescents learn how to behave by watching their moms and dads. Your actions generally speak louder than your words. Set a positive example and your adolescent will likely follow your lead.

35. Respect your adolescent's feelings.

36. Spend time with your adolescent to remind him or her that you care.

37. To encourage your adolescent to behave well, identify what constitutes acceptable and unacceptable behavior at home, at school and elsewhere. As you establish appropriate rules, be sure to explain to your adolescent the behavior you expect as well as the consequences for complying and disobeying.

38. Use “active ignoring.” Tell your adolescent that you'll talk to him or her when the whining, sulking or yelling stops. Ignore your adolescent in the meantime.

39. When a consequence needs to be issued for misbehavior, ask the adolescent to suggest one. Your adolescent may have an easier time accepting a consequence if he or she played a role in deciding it.

40. While it's important to consistently enforce your rules, you can occasionally make exceptions when it comes to matters such as homework habits, TV watching and bedtime. Prioritizing rules will give you and your adolescent a chance to practice negotiating and compromising.


 

==> My Out-of-Control Teen: Help for Parents
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Creating An Effective Behavioral Agreement With Your Teen

Having problems getting through to your defiant adolescent about needed behavior changes? A behavioral agreement may be the way to go. Behavioral agreements are contracts between parent and youngster intended to produce desired outcomes. It may be higher grades, doing more chores, developing a better attitude, or making new friends. Regardless, the process to create a behavioral agreement is the same.

All moms and dads have a wish list for their kids. College preparation may be on the list. Doing more work around the house, or at least keep their bedroom clean makes most lists. Improved attitudes and more respect for moms and dads and other adult authority figures can be big. Pick the changes and plan an agreement that will lead to what you want.

Points to consider before drafting a behavioral agreement:

1. You are unlikely to turn an extremely poor student into the class academic leader with one quick agreement. Pick your battles and put them in writing. Avoid making the agreement sound like an ultimatum if possible. This is a contract reached by something resembling mutual consent. If both of you do not agree on it, it will not work very well.

2. Reducing unwanted behavior should have a reward attached. Likewise, when positive behavior is observed, it needs to be rewarded, too. The trick here is to find out how much change is enough to receive a reward. If you make it too little change, you will see very little progress. If you make it too much change, your adolescent may lose the incentive to try. This can be a little trial and error until you find what works best for your youngster. Your adolescent will probably tell you if it is too hard. It is not likely to be said if it is too easy. Find a system of rewards that excite your adolescent enough to keep her working for it. The reward may be something that you have on your list of dislikes which is really not terrible in the big scheme of things (e.g., a body piercing).

3. Failing to come home on time needs to be part of an agreement if it is a problem. Playing too many video games for too long and too often may need to be considered. For most adolescents, you need to include sexual activity as something to be eliminated. You will have your own list of behaviors to eliminate.

4. Lack of quality communication is what leads to most situations between adolescents and their moms and dads. Use the development of this agreement to establish some lines of communication. Make sure that the changes are not to just make you happy, but are intended to cause long-term benefits for the adolescent.

5. Be flexible when opening the negotiations. Listen to your adolescent as much as you talk. Make sure that it is not just you lecturing your adolescent. Be willing to delay some of your wants to get your adolescent on board with the agreement. Once it is working and your youngster sees the upside, making a new and more extensive agreement will be much easier. Keep this one simple. A mutual agreement that will work is your goal.

==> My Out-of-Control Teen: Help for Parents

Creating the behavioral agreement:

1. First, arrange a time to meet with all the grown-ups who are responsible for enforcing rules and disciplining your adolescent (e.g., biological parent who lives outside the home, stepparent).

2. Discuss the problems that you are having with your adolescent. Allow everyone involved to offer input as different issues may arise with different caregivers. Behaviors that may be addressed include:
  • treatment of parents
  • school performance
  • dating
  • curfew
  • car use
  • cell phone use
  • alcohol and drug abuse

3.  Note ideas on paper as you brainstorm together. Finalize a list of pertinent matters and number the matters in order of importance (e.g., potentially dangerous issues like drug and alcohol use require more urgent attention than the amount of time your adolescent spends on her cell phone).

4. Narrow the list down to no more than 5 behaviors that you want the adolescent to focus on improving. Include these behaviors in the initial agreement and add others at a later date as he progresses.

5. Write a sentence for each behavior that states how your adolescent is expected to behave in a given situation. Format the sentence in first person perspective from your adolescent’s point of view. Utilize positive words and phrases.

6. Decide on a positive consequence that will result when your adolescent fulfills the expectation (e.g., a special privilege). You may also choose to simply list the natural consequences of good behavior (e.g., trust, respect, more freedom).

7. Determine what the consequence will be if your adolescent fails to behave in the desired manner. Consider consequences that are effective with your youngster and appropriate to the behavior, as well as your ability to enforce the chosen discipline.

8. List both the positive and negative consequences underneath each expectation. Establish the period of time for which the agreement will be valid and note the date at the bottom.

9. Create a chart with each expectation listed on the side and the days of the week across the top. Track your adolescent’s behavior throughout the length of the agreement by filling in the chart accordingly.

10. Meet with all the parties who are involved in the agreement. Review the terms of the agreement and clarify any questions that are presented. Allow your adolescent an opportunity to offer constructive feedback.

11. Include revisions as required to the agreement. Have everyone sign and date the final draft. Make a copy of it for each party.

12. Use the behavior chart to monitor your adolescent’s behavior on a daily basis. Enforce the terms of the agreement consistently to achieve positive results.

13. Revise the behavioral contract accordingly upon its expiration date. New expectations can be added as your adolescent displays a consistent ability to make positive choices in situations addressed within the original agreement.


 

==> My Out-of-Control Teen: Help for Parents
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Parent's Reverse Psychology: The Power of Choice

As moms and dads, we want to know that we’re in control. But our children tend to beg, plead, and whine about the options we make for them. So, give your children options (without really letting them choose). This is a great way to let children have an option without giving up all the parental control.

But you don’t have to make it an option between something they want and something you want for them, like candy or an orange. Choose the orange for them, but they get to choose how they’re going to eat it… in slices or with cottage cheese.

Empowering your children with options gives them more independence. It teaches them the relationship between their decisions and outcomes. And with more practice, their decision making skills will grow into a valuable lifelong lesson. Giving children options encourages cooperation, which is what we are trying to get in the first place. Giving children options helps prevent power struggles.

The ability to choose is a natural human need. Quench their thirst for control and watch the power struggles fade. The ability to create options is what gives your kids a sense of purpose. They are no longer helpless babies. They are functioning human beings that are fully capable of creating their own options.

Offering your kids options is an excellent strategy to have in your parenting "tool kit." If you make an effort to be genuine with the options you offer, you will communicate respect for your kids at the same time, which will result in greater collaboration and overall peace. 

Here are some strategies to apply when providing options for your kids:

1. Don’t forget to add the words ‘you choose’: “Would you like to play a video game, or color while I cook? You choose.” This will make it next to impossible for the power hungry child to pass up.

2. Give specific options that you are comfortable with. If you don’t feel like cooking lasagna for dinner, don’t offer the option.

3. If kids don’t like the option they made, acknowledge their disappointment and remind them that they can choose another option next time.

4. If your child tends to change his/her mind, confirm the option and your expectation that he/she sticks with it. For example say, "Okay, you chose corn flakes, right? Once I pour the milk on it, I expect you to eat it."

5. If you say, "Do you want juice or milk" and your youngster responds, "I want both," you can reply, "Which one first?"

==> My Out-of-Control Teen: Help for Parents

6. If your youngster is reluctant to suggest some options, you can say, "You can decide or I’ll decide for you, but you might not like what I decide."

7. Limit options to two or three. Giving your child the option between 5 different shirts is going to do more harm than good.

8. Make sure the options are age appropriate. Four-year-olds are great at picking out their own pajamas, but don’t expect them to choose the color of your new car.

9. Make the options respectful to both you and your youngster. If you say, "Either quit throwing the ball in the house or I’ll take it away," you are making a threat and not offering a respectful, fair option. An effective, mutually respectful option would be, "You can either play with the ball outside or with another toy inside. You choose." Here, you can address safety concerns and respect the youngster’s need or desire to play.

10. Offer options that you can live with. For example, you might ask, "Do you want peas or carrots for dinner?" This narrows down the options and gives your youngster some say in the matter.

11. Offer options as often as possible. Much of your youngster's day includes following directions. As moms and dads, we tell our children when to be ready, where to go, and how to behave. At school, their entire day is scheduled around following "orders." So as often as is appropriate, give your youngster options. This might be something as simple as "Do you want to wear the long sleeve shirt or the short sleeve one?"

12. State your bottom line (the minimum standards that must occur or what is non-negotiable). Then you or your husband or wife can offer options within those limits. Your limits will usually relate to safety, health, rules, rights and things like that. Those are issues that the both of you can and need to control.

13. Don’t be overly rigid about forcing kids to pick one of your options. Any option that meets your bottom line is okay, because your goal is to reach a win/win solution.

14. Talk about options in advance. This gives your youngster a chance to think about the options and make an informed decision. For example, you might be planning a special family outing for your kids. If it really makes no difference to you which place you go (e.g., park, beach, museum, etc.), then give them the option to choose. This increases their sense of inclusion in the process and will likely help them participate more enthusiastically when the day comes.

15. Give your youngster time to make a positive decision. Learning how to make the right decision takes time, and sometimes your children just need a little space to come to the decision "on their own."


 

==> My Out-of-Control Teen: Help for Parents
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