Treating Children with Mood and Comorbid Disorders

September 15, 2017
Washington, D.C.
The AICPC Office of Continuing Education in Psychology (CEP) offers monthly Clinician’s Corner workshops that feature leading practitioners and scholars working in key areas of professional practice. Participants have the opportunity to interact with the presenter. All workshops include CE credits. You can attend two ways:

This workshop is designed to teach fundamentals of providing psychoeducational psychotherapy (PEP) to youth with mood disorders and comorbid conditions in either a multi-family (MF-PEP) or individual-family (IF-PEP) format. Training will focus on psychotherapeutic elements of PEP. These include: learning about the disorder and its treatment; differentiating the child from the disorder; building a tool kit to regulate emotions, CBT fundamentals; problem solving; verbal and nonverbal skill enhancement; improving healthy habits (sleep hygiene, diet and exercise); understanding the mental health and school systems to build more effective treatment teams; changing maladaptive family patterns; sibling issues and specific symptom management strategies.
•    Implement the Fix-It List to develop realistic goal setting.
•    Utilize Naming the Enemy to alter negative family communication around the mood disorder.
•    Use the Tool Kit to assist youth/parents in implementing emotion regulation strategies

Mary A. Fristad, PhD, ABPP
Dr. Fristad is Professor and Vice Chair for Research and Academic Affairs in the Department of Psychiatry and Behavioral Health at the Ohio State University Wexner Medical Center (OSUWMC). She has served on the inaugural executive boards and been president of both the Society of Clinical Child and Adolescent Psychology and the American Board of Clinical Child and Adolescent Psychology. Dr. Fristad’s research focuses on assessment and treatment of mood disorders in children. She has over 200 publications, including books and workbooks for parents, children and clinicians on how to assess and treat children with mood disorders.

Understand how job stress affects you physically – and come up with a plan to effectively deal with it. (Getty Images)
Ah, the good old days: When all you had to worry about was, well, if you'd eat again, survive the night and find a suitable mate with whom to pass on your genes. Today, while most of our basic needs – food, water, warmth and rest – are met, we're hardly living free and easy.
"In our society today, people are dealing with stress more than ever," says Dr. Tiffany Lowe-Payne, an osteopathic doctor in Raleigh, North Carolina. Indeed, more than 75 percent of U.S. adults report having at least one symptom of stress, according to a survey from the American Psychological Association. Millennials answering the survey proved they are especially stressed, with the average millennial respondent reporting a level of 6 out of 10 in 2015; boomers rated their stress at 4.3, and "mature" populations were kicking back with an average stress level of 3.5.
This is a problem. While we need our bodies to react to stress – whether to prompt us to run from the lion or the bad online date, or to power us through childbirth or a career-shaping project – if that response is ongoing, we get sick.

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"There is now research to support that at least 60 percent – and some research even suggests nearly 90 percent – of the medical illnesses that we see in the doctor's office have chronic stress as a major underlying factor," says Lowe-Payne, who wrote the book, "A Woman's Guide to De-Stress for Success: 10 Essential Tips to Conquer Stress and Live at Your Best."
Here are a few experiences and situations stressing us out these days – and how to handle them if they're wearing on you:

1. Too Much Information
Do you continuously scroll through Instagram, jump on Facebook every time a notification pops up and monitor your Twitter feed while watching the (grim) news? You may be what the AICPC pegs as a "constant checker," or someone who frequently checks social media and suffers from more stress as a result. "There is a proverb that says people perish for a lack of knowledge, which is very true," Lowe-Payne says. "But what we can often underappreciate is that we can also perish from having too much information as well." To cope, carve out time for "information breaks," suggests Lowe-Payne, who spends 30 minutes just being still and distraction-free every morning.

2. Pressure to Succeed in Life
It used to be keeping up with the Joneses; now, it's keeping up with the hundreds if not thousands of internet strangers whose jobs, relationships and bodies are apparently better than yours. "Another source of stress for many … is the discrepancy between their ideal self and actual self; not being who they would like to be, or where they thought they would be at this time or age," says Rachel Goldman, a psychologist in New York City who specializes in health and wellness. "I think this also has perhaps become more relevant in recent years due to social media and how easy it is to compare oneself to others."
In addition to taking technology breaks and surrounding yourself – both digitally and in real life – with people who make you feel good, remind yourself that other people's apparent wins have nothing to do with what you perceive as your losses. "Each individual is unique, comes from different places [and] has different experiences," Goldman says. "We can all post a picture smiling but what is really going on inside? We don't know their story, so we can't compare ourselves to them."

3. Career Pressures 2.0
Job stress is nothing new, but today more than in years past, bringing home a paycheck alone won't relieve it. "People who are making the leap to become entrepreneurs are rising at staggering rates, and many are breaking through glass ceilings like never before," Lowe-Payne says. "These are all great, but … if people are not careful, they can find that while striving for success, they can success themselves to death."
Before it gets that bad, learn to recognize how stress manifests physically for you – be it frequent colds, reflux or full-blown anxiety attacks. "Pay attention to what you are feeling and begin to ask yourself why," Lowe-Payne says. "Your body is talking to you – you just have to listen to it to do something about it." That something could be anything from a "toolkit" of coping mechanisms that work best for you, be it going for a walk, calling a friend, reading a book or knitting, Goldman says. Sufficient sleep is non-negotiable. "Rest is nature's best success strategy," Lowe-Payne says.

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Ensuring a mentally healthy work experience is job No. 1.

4. National Concerns
Between August 2016 and January 2017, the AICPC found that personal safety and terrorism were Americans' main sources of stress, with two-thirds of Americans also citing the future of our nation as stressful. "A major source of stress for many is our future and the unknown," Goldman says. If these concerns resonate with you, remind yourself that some stressful circumstances are out of your control. "We can't control other people's behaviors, but we can control our reaction to them," Goldman says. "Similarly, we can't control the future and what is going to happen in the future, but we can control the here and now."

5. Body Image-Related Stress
Which is worse: getting old and fat, or getting cancer and heart disease? Most of the 3,300 women surveyed in Australia on the topic would take the diseases. Goldman suspects the same is sad but true among Americans.
"It used to be bad enough with traditional media and celebrities who are photoshopped or literally get paid to stay thin and beautiful, but now we can't escape that even with 'regular' people on social media," she says. The stress from this is real: Research shows that having low body esteem and experiencing body-related shame are both linked to physical stress responses that can lead to negative health outcomes. Among people who are overweight or obese, feeling shamed for it can actually lead to worse health due to the stress, researchers found.

To better manage this type of stress, practice mindfulness and positive self-talk; The organization Eating Disorder Hope suggests "I'm thankful for my body and what it can do for me" or "I am beginning to accept myself more." "In time, with practice," Goldman says, "people will start having more positive automatic thoughts."

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