Nurture Shock

I just came across this summary I wrote of a book I read several years ago, called "Nurture Shock." The authors took some of the most common child-rearing beliefs and practices and evaluated them using research, and came to some counter-intuitive conclusions. I thought the book was so interesting, and when I read back at what I wrote, it was just as surprising as when I first read it. I love reading things like this because I love the art of research and child psychology (I work at a child psychology practice). Anyway, if you are interested, I summarized the nine main points in the book (one for each chapter). Because Blogger stinks, they all have a 1 in from of them.

1. “Esteem-building praise” often backfires. Constantly telling kids they’re smart can actually undermine their confidence and lead to under-performing. Kids who are praised for their smarts or innate abilities view their failures as a result of being “not-smart” and thus avoid difficult tasks. When kids are praised for their effort, they view failure as a result of not focusing hard enough and try harder next time. “When they get to college, heavily praised students commonly dropped out of classes rather than risk a mediocre grade and they have a hard time picking a major ; they’re afraid to commit to something because they’re afraid of not succeeding.” One really cool study discussed compared Chinese vs. American mothers’ responses when told (falsely) that their child under-performed on a task. American mothers avoided making negative comments and stayed positive, mentioning the test briefly and then focusing on something else. Chinese children were more likely to hear “You didn’t concentrate” or “Let’s look it over.” The Chinese childrens’ scores jumped 33% on the next task, 2x that of the American children. The Chinese mothers smiled and hugged their kids as much as the American mothers did.

1. Lack of sleep in kids and teens is more likely related to rising obesity rates and learning difficulties in kids and teens than is TV, lack of activity, or internet/video gaming. 90% of parents think their kids get enough sleep when 5% of teens actually do. The authors label it “the lost hour.” The fragility of children’s developing brain is way more sensitive to sleep deprivation than an adult’s, and a lack of 1 hour of sleep a night for a week can result in the equivalent of losing 2 years of intelligence in performing (a sixth grader performing like a fourth grader in school). It is highly related to many of the traits that plague teens: depression, moodiness, impulsiveness, and disengagement. Part of this is that schools start too early. Ten hours of sleep is ideal for children and teens, with a minimum of 8 hours for teens.

1. Racism isn’t necessarily “taught.” We actually promote racism by not talking about it. Kids naturally categorize and develop racial constructs at an early age. They are developmentally prone to in-group favoritism. When parents fail to talk about race because they don’t want to say the wrong thing, or they want their children to “see everyone as equal”, it backfires because it is not possible to create a color-blind environment in kids’ minds… they end up developing their own “my group is better” attitude. Really fascinating is the research that shows how the strategy of exposing your children to diverse environments doesn’t result in more integrated friendships or attitudes. The more diverse the school, the more kids tend to self-segregate and their likelihood of cross cultural friendships actually go down. What impacts kids views on race is whether their parents talk about it at an early age. Children’s minds are forming their first racial conclusions early, so talking about it when their attitudes are most amenable to change has the most impact. First graders were found to be impacted by cross-racial playgroups and discussion but third graders were not, implying that the early age is the most influential when it comes to racial constructs.

1. The truth bias- Kids lie way more often than parents think, and they are better liars than they think. Parents often fail to address early lying (ages 3-4), and the strategy of focusing on how bad lying is doesn’t have much of an impact on future lying. Alternately, emphasizing the worth of telling the truth has the biggest impact on decreasing children’s lying. In one study, lying on a task significantly decreased when read “George Washington and the Cherry Tree” over “The Boy who Cried Wolf” because the character received praise and worth for telling the truth, rather than punishment for lying (they used a control of replacing George Washington’s name with a neutral one so it wouldn’t impact the final outcome).

1. Sibling relationships- the single most impact on improving siblings relationship was teaching kids conflict prevention rather than conflict resolution. Teaching them how to enjoy playing with each other (how to find common activities, how to read when what other siblings is feeling and when he or she doesn’t want to play, etc) had the biggest impact on early and future siblings relationships. Despite books and TV programs that portray sibling squabbles with “happy endings”, kids were more likely to start conflict with their siblings after such media. Why? Simply by hearing the types of verbal insults used in the books and TV programs.

1. TV and aggression: Any type of child-programming TV is related to an increase in aggression and bullying; the type of programming, whether it violent or PBS, is irrelevant. Power Rangers is actually less likely to impact verbal aggression/bullying than are non-violent child-targeted shows like Arthur. Why? Children aren’t like adults- they don’t simply get the “take home message” of a show. Instead they absorb all that occurs, and they are more likely to learn and use verbal insults and bullying tactics displayed in non-violent programs (“you’re not my friend anymore”). Ninety-six percent of children’s programming contains verbal insults. “When we changed the channel from violent TV to non-violent fare, kids ended up learning the advanced skills of clique formation, friendship withdrawal, and the art of insult.

1. Parents who pause mid-argument to “take the conflict upstairs” can actually make the situation worse. Pro-social behavior in kids increases when exposed to parental constructive conflict when they can witness the final resolution.
   

1. Children who watched Baby language DVDS (Baby Signing, Baby can read, etc) on a semi regular basis had significantly poorer vocabularies in future years than babies who did not. The single most way to encourage language development is not even talking continuously to your baby. It is responding promptly to any and all babble sounds that your child makes.

 

Work It, Baby Part II

Continuing on from my previous post, I'm becoming acclimated to doing a large portion of my work at home. In theory, this sounds super convenient and easy. In reality, it can be very frustrating. In order to write, I need complete uninterrupted time. Otherwise, the tons of puzzle pieces and statistics I'm trying to juggle around in my head get lost in one split second of, "Mommy?" or "Lisa?"


Because our computer is in our main living space, it was not providing the type of environment that I needed to focus and be efficient. We don't have space for an office in our home. We didn't know we would need one at the time that we bought it. If we knew I would be working from home, we would have definitely made an office a priority. But oh well. After thinking and talking about as many different options as we could, there seemed to be only one solution that was acceptable to all of us. We had to turn one of the closets (particularly, the guest room closet) into a workspace. I did not want to make the guest room or the play room a half-office, and there wasn't room for that anyway. BUT there was a small space in the closet that held promise. After lots of digging around, I found a desk that was the perfect fit for the closet, and with the attached hutch, it made use of as much space as possible. So we picked up the little guy (Micke from Ikea), and after I cleaned out the closet we created my workspace! I can close the doors when I'm done and you don't even know it's there. And it's at the end of the house so I can hole up for a couple of hours at a time, which is what I need most. I had to run an extension cord into the closet to create an outlet. I also had to get a laptop, something I really did not want to do. I hate laptops, but I really need one for this job. I found an HP on Craigslist and so far it seems to be working fine. Fingers crossed.


Here's my new space! I love that I can write all my stats and norm ranges on the white board, so I don't have to look them up each time.

There's my beloved DSM-V desk reference on the shelf:

Work It, Baby: Part I

I have been at my new job for three months now, and I love it. It's not a perfect job, and it has its frustrations. I don't get compensated nearly enough for the time I put in. But I truly enjoy it. It's like this part me that has been dormant for a long time is alive again. I always thought that I should be fully satisfied with only staying at home with the girls. And don't get me wrong, I love being with them and am so thankful that I've had the opportunity (and still have) to be here as much as possible. But now that I've started working again, I realize that it is important to me. To have that part of myself that can help the 'outside' work, to be able to use my skills and learn and grow and get better. I think one of the reasons that I never realized this before was because I never had a job that I truly enjoyed and was good at. So it was a relief for me to stay home and get away from things that I didn't enjoy. But I always knew that once the girls were in school, I didn't want to stay home all day. I wanted to be able to drop them off and pick them up; to be there after school and for all of the special school events. But not stay home all day. I knew that if I stopped working for too long, especially in my field, that I would have to find a different kind of job, one that wouldn't use my degree.


I love talking about my job. This might be boring to some. But most people don't know what I do, so it's fun to explain because it's something I'm passionate about. I work for a child psychologist. When parents bring their kids in, they have either been referred from a doctor, the school, or sometimes, they make the decision to bring them in themselves. Kids are brought in because it is suspected they might have Autism, because they are having trouble paying attention in school and might have ADHD, because they have extreme anxiety, or depression, or have been through a trauma. They come in because they are failing in school and seem to have problems that they shouldn't; they can't read properly. Numbers don't seem to make sense to them. The psychologist meets with the family, and gets all the pertinent information from them. Then I get a referral, and I get to evaluate, or 'test' the child. Most people think testing involves giving a child a piece of paper and having them fill it out. It's so much more than that. Giving an intelligence test, to see at what level a child is functioning, can tell you so much. And they are so hard to give. You have to do a million things at one time and it all has to be done perfectly to be valid. I get to do observations, play sessions, achievement tests (testing their listening skills, oral language skills, phonetics), and I have an intern do a school observation and their teachers give me information.

I haven't been able to come up with a term that describes exactly what I do. Some descriptions get at part of what I do, but not all: psychometrist, psychological evaluator, psychological diagnostician, to name a few.

The WISC-IV

The WISC-IV

The Stanford  Binet

I also talk to the child and get their own thoughts about what's going on. They complete tasks that reveal whether they are experiencing anxiety symptoms, and to what to degree. And so on and so forth. Then I score and interpret the results, and write a report stating what I found, and what we believe is going on with the child, which sometimes (often) includes a diagnosis, and other times doesn't. Then I give treatment recommendations and the the psychologist reviews everything and signs off. Then she presents the report and discusses everything with the family. It's technically considered the psychologist's report, because they have the license and the degree, but I don't mind. I love doing the work. When I see a child who has been struggling in school for years, and it has made them depressed and anxious, and I can help try to figure out what is causing their difficulty and communicate that to the parent, I feel like I'm helping that child get the treatment that they need so badly.

Each child is so different. There are so many pieces to the puzzle. It's challenging each and every time I work on a child's report. I learn so much. And the cool thing is, I have one of the best psychologists in the world (my sister) who is always available to advise me when I get stuck (which happens all the time).

Ok so some of these are more adult problems, but you get the idea

The great thing about my job is that I set my own hours. I put on the schedule when I'm available, and I change it as necessary. So right now, I work while the girls are at preschool, which is two mornings a week. Then I do the rest of the work at home. When the girls are off for a holiday, I don't have to work. When I have an extra Saturday and I feel like working, I can put myself on the schedule. I don't have to ask for time off or answer to anyone. It's awesome!!! And as the girls get older, if I'm able to keep the job, I can work only when they are in school, as many days as I want, so that I can still take care of all the things that are important to me about being a mom and a wife.


I realized recently that my work is included in the score of practice of professional counseling (yay!), which means that after three years, I can obtain my full licensure as a counselor. Even with working part time, and with (free!) supervision from my psychologist. Words can't express how big of a deal that is! It's so hard to get licensure, and I had given up that I would ever get it. It opens so many doors for the future.


One other really cool thing is that my psychologist specializes in trauma counseling- a specific type that is proven effective and being endorsed by the government (for people coming back from Afghanistan). I have always wanted to do this kind of therapy, and now I have someone who will teach me. I can start to do it myself whenever I'm ready and however often I want. And once I have my full license, I can bill insurance for my sessions. I know how important trauma counseling is, particularly for children, from personal experience. So even though I love the evaluating process, I'm excited about the future prospects of counseling again., in the way that I want.


I spend about 4 hours testing, and then 5-8 hours writing the report over the course of several weeks as information comes in. I do all of that at home, so technically I'm considered work-at-home.


You know how sometimes you feel like all the good things happen to someone else? Well, for the first time in a long time, I feel like something unusually good has happened to me. To ME!!!!


This was probably boring to many people; I just felt like sharing :) I'll write a Part 2, where I'll talk about the aspects of working from home that have been a challenge, and how I've been managing it and finding ways to make it work best. It's not as easy as it might sound.


Hope you all had a wonderful Thanksgiving!

Counseling and Christianity

I thought I would write a post about counseling and Christianity. The reason for this is that I often get questions from friends like, "how does a Christian go about receiving appropriate counseling?" or "can Christianity and counseling really go hand in hand?"

I've also recently encountered some material that says psychotherapy is at odds with Christianity- all the time. Specifically, I listened to this mindset in a series by a Christian world speaker who Ben and I generally enjoy. The problem is he had no background in counseling and didn't understand it properly, therefore he sent out some incorrect messages in his teaching. It saddens me, because counseling can be a valuable tool in the lives of many who are not able to "pick themselves up by their bootstraps" and need extra help to come through a hard season victoriously.

Though there is a lot I could say, my attempt is to make this post brief.

There are lots of ways people use the word "counseling." I'm not referring to pastoral counseling, mentoring, or support giving. I'm using the term "counseling" in the terms of psychotherapy: going to see a counselor or psychotherapist with a degree (a Masters or Doctorate) in counseling psychology, community counseling, or professional counseling. The word "psychotherapy" does not imply some weird, Freudian psycho analysis stuff. It's simply a term implying that the type of "therapy" a person is receiving is "psycho"- has to do with the inner individual's thoughts, emotions, and behavior.

The common misconception I hear is that counseling is at odds with Christianity because it blames one's problems on the person's environment and encourages them to not take responsibility for their own actions. Also, that all psychotherapy is humanistic and not supported scripturally. This is not the case. I believe most of these misconceptions stem from what people know about the founding father of psychology, Sigmund Freud, and what they learn in introductory psychology classes. It is rare that a counselor uses Freudian technique nowadays.

The misconception also comes from lack of knowledge about the counseling technique called "insight." In some therapies (not all), value is placed on the process of discovering where one's wounds stem from. Contrary to popular belief however, the purpose of insight is not to claim someone to blame. The purpose is so a person can acknowledge the how and why, then choose to forgive, and finally shift the responsibility for their actions to themselves. It is actually more likely that a person will assume responsibility for their own beliefs/actions once they move through this process than if they remained in a state where they subconsciously blame the "wounder" but have no idea they are doing so. Essentially, how can you choose to forgive when you don't even know you are holding an offense? Knowledge can be power. Of course, this is just one tiny part of some types of psychotherapies. Many place no emphasis on insight and skip it entirely.


Rabbit trail aside, there are many types of psychotherapy. A few common types are Behavioral, Cognitive-behavioral, Person-centered, Existential, Gestalt, Narrative, Motivational Interviewing, Psychoanalytic, Rational-emotive, and Cognitive Processing Therapy (specifically for those who have experienced trauma).

It is true that not all of these types of psychotherapies are completely in line with scripture. But if you are looking for counseling that fits with your Christian beliefs, and you can find a counselor who IS a Christian (there are lots out there) there are at least three types of counseling that are in line with scriptural concepts and, contrary to mainstream belief, are not about blaming others and shirking responsibilities.

They are:
Cognitive-behavioral
Rational-emotive
Person-centered (depending on how the counselor approaches it)

To avoid turning this into a lengthy post, I will mention how the first two are supported by scripture. Interestingly, Cognitive-behavioral therapy is one of today's most common forms of counseling and is a best practice, meaning it has been proven to be the one of the most effective therapies in dealing with problems like depression, anxiety, some phobias, etc. Cognitive-behavioral is a therapy that focuses on changing the way you think.

In essence it resembles 2 Corinthians 10:5. This scripture tells you to take captive your thoughts and make them obedient to Christ.  Take captive your thoughts to what you know is true.

Cognitive-behavioral therapy is when a trained therapist first teaches you how to identify when your thoughts are not truth. Then you work on changing them actively through various exercises until they become natural. As your thoughts shift, so do your emotions. As your emotions change, so do your actions. Thus, it is the opposite of "blaming others" and "not taking responsibility for change." It is the very essence of diving in and working towards believing truth and letting it transform you. It is practicing filtering what you let into your mind. If you are Christian, then your truths may look a little different from someone else's. The nice thing about counseling is that it's tailored to your values.

Along these lines, Rational-emotive therapy helps you identify which of 12 commonly held core irrational beliefs about the world (similar to the Christian concept of "strongholds") are negatively affecting how you feel and what you do. By "tearing down these strongholds" (2 Cor. 10:4) you learn to stop living out of fear, anxiety, and depression.

An example of a core irrational belief that many people act out of: Events in my past are the cause of my problems – and they continue to influence my feelings and behaviors now.

The goal is to replace this, through counseling work, with the belief:  The past can’t influence me now. My current beliefs cause my reactions. I may have learned these beliefs in the past, but can choose to change them in the present.

Another of the 12 irrational beliefs: I need approval from others at all times and I must avoid disapproval from any source.

With time, this gets replaced with the belief:  Approval feels good to have, but is not a necessity – I can survive (even though uncomfortably) without it.

As you can see, this is far from blaming others for your state of mind and shifting responsibility.

Rational-emotive therapy is my favorite and I used it a lot in the hospital setting. I feel good about the 12 irrational beliefs and never had to compromise my Christian values when using them, yet I could help someone who did not want anything to do with Christianity. In essence, I could teach truth in a secular setting. If I had a Christian client, I could teach truth more directly and use scripture as support and encouragement. Since the world is full of both Christians and non-Christians who need help, it is encouraging that you can counsel truth regardless.

While it's true that not every aspect of every type of psychotherapy is in line with scripture, most counseling these days is integrative. Therefore, if you can find a christian counselor with a strong background and training, good discernment, and the ability to leave the aspects of psychotherapies that are not in line with scripture, he or she can be quite effective. Many people cannot overcome mental illnesses or similar difficulties without help, and often Christians feel that there is something wrong with them if they can't "pray it away" and are afraid to go to counseling because it's taboo for Christians. Unfortunately, there is a lot of information out there to support this mindset. Well-meaning, but often from those who have never experienced a problem like chronic depression or anxiety and don't understand the process of therapies.

I hope this is an encouragement to those who could benefit from psychotherapy. As in many professions, there are both good and bad counselors. Similar to the way a bad teacher or a good teacher can color your view of a subject, a good or bad counselor can do the same for counseling. It is difficult to progress with a poor counselor, so it's always good to get personal recommendations.

In need of a Doctor

I've been meaning to write this post for a long time coming, but haven't been able to quite verbalize what it is I'd like to say. So here's my best shot..... a post about what I spend 8 hours a day, five days a week devoted to. This month marks one year of working at a hospital for the state's most mentally ill individuals.

I received my graduate degree in counseling; more specifically, school counseling. I thought I would end up in a high school or perhaps a middle school, working with kids as during my internship. Kids whose parents have recently divorced, lost a family member, kids who are being bullied, or even abused within the family. These were the types of things I dealt with during my year-and-a-half long internship and practicum. In the end, I felt compelled to take the NCE (a national exam thatcertified me as a National Counselor and made me eligible to get my license). Typically, people do not pursue this if they are going to into school counseling because it's not necessary, but like I said, I felt compelled. And of course now, two years later, I know why. I didn't end up in a school like I thought. When we came back from India, it was inconveniently the middle of the school year (not an ideal time for school counselor positions). I found that I wasn't too disappointed at the prospect of finding something else. I think deep down, working with school teenagers wasn't as close to my heart as I had once anticipated.

When I applied for, interviewed, and accepted the position of a counselor at a state-run hospital for the mentally ill, I had little idea what I was getting myself into. I did know there is a big difference between counseling the "worried well" (psychology slang for those who are in many ways well-off but struggle with typical issues like finding meaning in life, anxiety, insecurity, etc) and the seriously mentally ill. I wouldn't say I was quite prepared for the type of population I was going to be working with, but I was drawn to it. I had this inner peace about taking the position. I knew it was where I was supposed to be. And despite the danger associated (yes, actual danger, as in people get hurt!) I knew God was in it.

Without getting into too many specifics, the forensic population I ended up working with consists of mostly adult men (some women, but mostly men)... many of them come right off the street, some are addicted to drugs, some have done minor things to get them into trouble, others have done really terrible things (of which I often have to read about in detail). Most have little or no social support. Others have been completely abandoned by their families. All are considered a danger in some way (sort of a pre-requisite to being admitted) and many are in such a state that they are unable to care for themselves safely in the community. I didn't fully believe it until my year spent with this population, but I have come to realize that these people are probably the most marginalized in our society. I have been surprised at how little value is given to their lives by the outside world. At first it bothered me when I would go to a doctor's appointment and the nurse would glance at the "Place of Employment"  section on my record. It never failed: her eyes would get wide, she would look at me and say "You work there?" with this apprehensive, slightly judgmental tone of voice. Or when students from the medical college here would ask where I work and I would immediately sense their disapproval or judgment for 'that place' and 'those people.' Sometimes they would try to hide it, but it usually came through.  At first, I wanted to shake them and say "What's wrong with you? These people need help and care more than anyone else! Are they not worthy of it?" After a while, though, I recognized my own judgment and prayed that God would change my heart. He has in a lot of ways.

I know I've changed from working in this type of environment. When I started, I would say that two of my biggest weakness were 1) Fear of the disapproval of others and 2) Over-sensitivity.  Lack of compassion could have come as an easy third. Not surprisingly, all of these have been significant changed through my year at the hospital. I have learned how to be insulted on a daily basis without losing my sense of self worth and compasson. Sometimes the words are from patients who are so sick they don't understand or have false beliefs (like someone with schizophrenia), sometimes from patients who are angry at their situation or that you cannot do what they would like you to do for them. Despite the reason, their words can be painful and personal (often they know just how to get you where it hurts). God has taught me to let the comments roll off and see the person underneath, usually in desperate need. He has taught me how to let go of my judgments about a person's past and the crimes they've committed and to love them because they are a child of His. In counseling, we have this thing called "unconditional positive regard." It's very similar to unconditional love, and you're supposed to display it to your clients at all times, regardless of their personality or treatment of you. It's not that difficult when you're working with kids, but men who have abused kids? A little harder.

Every week, the counselors run a token economy store and I serve coffee and snacks to the patients. While a lot of my time is spent in groups or individual counseling, the weekly store is one thing the patients look forward more than anything else. Despite their love of this weekly event, only some express thanks... others are indifferent, some are rude and insultive. Some make demand like to get them more sugar or cream or they get upset because they think I got some information wrong on their point sheet. Though I hate to admit it, there was a part of me in the beginning that would sometimes cringe deep down, serving certain men who had done such terrible things (especially if they were rude to me). It's as if our heart tells us some people don't deserve love for what they've done. But slowly God changed me. Even the men who came in with terrible charges and with whom, after reading painful details and witness statements, I would think "There is no way I can even look at this person, much less work with him"..... with time, eventually only days, God would soften my heart and change how I saw him. Someone who is broken, just as we all are. Someone who is sick (whether mentally, emotionally, or spiritually) and needs the true Doctor, just as well all do. He has helped me get past my own pride, judgment, and expectations and learn to love and serve the "least of these." I am weak, and often I fail at this... whether I give a curt response to a patient asking me the same question for the 10th time that day, or whether I hold judgment for a patient's past sin, or even just in withholding some measure of love and kindness, I fail often. But despite that, I know I am gifted with the opportunity to at least try to love those that are viewed as undeserving or unworthy of love.... or those who are simply overlooked. Eight hours a day for the last year, I have been able to pay attention to, serve, and simply love these people who have no hope, no family, and nowhere to go. While staff members are often hit, hurt, or in some way involved in a dangerous situation, God has protected me from harm and removed a lot of my fear. Now, while many people look at the place I work as a sort of "mud hole," I can't help but look there and see beauty. I think if Jesus were here today, he would run to this place, wrap his arms around each and every person there, and call them beautiful.


I was reminded tonight of a verse from Matthew that has much more meaning to me now than it did a year ago:

The Pharisees asked the disciples, “Why does your teacher eat with tax collectors and sinners?” On hearing this, Jesus said, “It is not the healthy who need a doctor, but the sick. For I have not come to call the righteous, but sinners.”

Thank you Papa, for the opportunity to serve the "sinners" of society and I pray that you provide many more opportunities in the future. Thank you for saving me from my sins daily and from pulling me from the same miry pit.