The effects of sleep on a child's mental health can sometimes be underrated. Getting an adequate amount of sleep is an integral part of a healthy life, especially when it comes to our emotional and behavioral health. Now that the new school year is upon us, check out these handy charts to help set your child's bedtime!  

​Consider the daily messages you send to your child. What does your child believe is your most important expectation? Making good grades? Being happy? Having fun? Although these things certainly have value, it is most important that children understand the significance of caring about others. Before dropping my daughter off at kindergarten each day, I remind her to do her best, to have courage, and to always look for ways to BE KIND to others. When she gets home from school I ask her to share how she showed kindness to others, then praise that behavior. Then I ask her to share about when she noticed others being kind to her, and we talk about being grateful for kindness. This is a vital part of teaching high moral and ethical expectations, and when reinforced daily, a child is well on her way to becoming a proficient empathizer. 

​It can be difficult (if not impossible) to practice empathy without understanding specific emotions and being able to identify them in others. Whenever possible, help your child put a name to his or her feelings. When he’s angry, you can say, “It seems like you are feeling really angry right now. It’s okay to feel angry. We all get angry sometimes.” If your son grabs a toy from his sister, you could say “Your sister is crying. It seems like she is sad that you took her toy. What could you do to help her feel better?”

Use books as opportunities to ask your child to identify emotions in the characters of the story. You can also make a game out of it; when you’re out on the playground, try sitting together on a bench and observing others awhile. Pick a person and have your child try to guess what he/she is feeling, and why. Take turns. For instance, “See that little girl standing at the top of the slide? She looks like she doesn’t want to go down. Maybe she is feeling afraid. What do you think?” Sesame Street has a great segment called “Name That Emotion.” Check it out. Watch it with your kids!

​You’ve heard it before but it’s worth repeating: your kids are constantly watching you and learning how to behave by your actions. Even when you think they don’t notice, they are observing your every move. Ask yourself how you are practicing empathy and compassion in your daily life? Take your child to volunteer at a charitable organization. Explain that some families struggle to have enough to eat, and some children don’t have many toys. Encourage your child to give to others less fortunate and emphasize the feelings that accompany giving (joy, pride, worth) as well as receiving (grateful, happy, etc). 

​Don't be afraid to show your child your emotions—even the negative ones. We all get angry. We try to stay in control, but don’t beat yourself up if you lose your temper and yell at your child every once and awhile. Everyone makes mistakes! What’s important is showing your child that you’re a real person who sometimes gets angry, makes mistakes, and is able to apologize for them. That leads to an excellent opportunity to role-model how to give a sincere apology, which is also an important skill (unfortunately with which many adults still struggle-- save that for another post!)

​I’ve had many parents ask me if it’s okay for their children to see them cry, or if it’s appropriate for them to attend a family member’s funeral. The answer is yes, it’s fine. Most often it can ultimately be a positive experience. Be honest and authentic with your child. In kid terms, share with him why you’re sad and the different emotions you may be feeling. Share with him what helps to get you through difficult and sad times. These are all teaching opportunities that will not only help him learn empathy and coping skills, but will also foster insight, courage, authenticity and trust.

​As a therapist, I have seen many children and adolescents with academic problems, school and family conflict, aggression, anxiety, depression and more because they haven’t been routinely taught the skills to learn empathy. With the influx in bullying and violence beginning earlier now than ever, it’s time that we as parents make teaching empathy a priority. By making your parental expectations clear, teaching to identify feelings, and consistently monitoring your own behaviors as a role model, you can make a lasting positive change throughout the world. It starts with you. It starts with our children. 

​Chantal D. Hayes, MA, LPCA, NCC, CLC
Licensed Clinical Therapist

References:
 
Dewar, Gwen, Ph.D. (2009-2014). Teaching empathy: Evidence-based tips for fostering empathy in children. http://www.parentingscience.com/teaching-empathy-tips.html#sthash.HsaVK1hh.dpuf
 
Joyce, Amy. (July 18, 2014) Are you raising nice kids? A Harvard psychologist gives 5 ways to raise them to be kind. https://www.washingtonpost.com/news/parenting/wp/2014/07/18/are-you-raising-nice-kids-a-harvard-psychologist-gives-5-ways-to-raise-them-to-be-kind/
 
Lahey, Jessica. (September 4, 2014.) Teaching Children Empathy. http://parenting.blogs.nytimes.com/2014/09/04/teaching-children-empathy/?_r=0
 
VanClay, Mary. (2008). The caring child: How to teach empathy. http://www.babycenter.com/0_the-caring-child-how-to-teach-empathy_67146.bc
 
Weissbourd, Richard, and Jones, Stephanie. How Parents Can Cultivate Empathy in Children. Harvard Graduate School of Education. http://sites.gse.harvard.edu/sites/default/files/making-caring-common/files/empathy.pdf

What exactly is anxiety? If you’ve ever heard of the “fight or flight” response then you’re halfway there. Imagine you’re alone walking through the woods and suddenly come face to face with a bear. Your heart starts pounding fast, your muscles tense, and your senses become intensely alert. For a split second you're paralyzed with fear. You must make a decision: defend yourself or run.

This is the fight-or-flight response.
 
And it's a completely normal reaction (we humans wouldn't be here without it.) Hundreds of years ago, when we were faced with a physical danger on a daily basis, it was a very important and well-needed response (for instance, to keep ourselves from getting mauled by a bear). In today’s world, most of our dangers are not physical. They’re psychological. And they can’t always be addressed the moment they come up. The longer our fight-or-flight response remains active, the more physically and emotionally drained we become.

​Long ago when there was an imminent physical threat, it usually passed quickly and our fight-or-flight response was deactivated. In our world, since there are so many potential psychological endangerments, sometimes the fight-or-flight response never really gets turned off. This is when a child may begin to see the world as a fearful place. They are stuck in “survival mode.” Not a fun place to be.

​Many parents believe that talking about anxiety will make their child even more anxious. The reality is, providing your child with information about anxiety can help reduce his or her confusion or shame. Understanding what causes anxiety can help children to overcome it. Use "kid terms" to help explain the fight-or-flight response. Discuss why it was helpful back then, how it can be helpful now, and how it can be equally detrimental. Helping kids understand that feeling afraid isn't the same as actually being in a dangerous situation is empowering and can help them feel more in control. 

​Always validate and show acceptance of your child’s worried thoughts and anxious feelings. Make sure your child knows you truly believe what they are saying and that having those scared/worried/anxious feelings is okay. Share some things you were anxious about as a child, and then ask them what their biggest worries are. If they don’t want to talk right away, give them ample opportunities to open up with you through play or downtime during their favorite relaxing or fun activities. 

​Anxiety manifests physically. Ask your child to show you where in their body anxiety occurs, and where it feels the worst. It can be helpful to have your child name their anxiety. For instance, a child could call his anxiety “Mr. Worry Monster” and learn to talk to that anxiety as if it were a person and tell him to go away when not welcome: “Mr. Worry Monster is back this morning, Mom, but since it’s time for school I’m not listening to him. I told him to go away!” Once kids are less afraid, it becomes easier to approach events and situations that have been previously avoided.

​Many children have little time to just “be.” They are easily distracted and tired, juggling school, family, community activities, sports, etc. Sometimes it can just be too much. By practicing mindfulness, kids learn to hit the “pause” button and become aware of how they are thinking and feeling in the present.  There are countless studies showing the benefits of mindfulness and it’s positive effects on our physical and emotional well-being, for both children and adults.​
​ 
One basic exercise I use with my clients is called “Balloon Breaths.” I ask the child to pretend there is a balloon in his belly. Ask him to place his hands on his belly and breathe in slowly in through his nose to fill his lungs all the way up. Meanwhile, blow up the balloon to demonstrate how the “balloon in the belly” gets fully expanded. Next, ask your child to open his mouth and slowly blow all of the air back out, letting his belly sink down flat, as you slowly let air out and deflate the balloon. Some of my clients even carry a little deflated balloon around with them, in their pocket or backpack, as a simple reminder to take “balloon breaths” when they feel anxious thoughts and feelings coming on. By learning a few techniques like this, your child can be well on his or her way to overcoming anxiety. 

​Your child constantly observes and emulates your behavior. Your actions lay the foundation from which your is child building his own beliefs and understanding about the world. If you shy away from discussing mental health, so will your child. If you are open and accepting of your own anxieties and how to deal with them, then so will be your child. If you take time to make sure your emotional and physical needs are met, your child will learn that self-care is an important part of life. 
 
Overcoming anxiety can be a long road, but it can be done. With the consistent practice of mindfulness and other anxiety-reduction techniques, as well as practicing good self-care, keeping a positive attitude, your child can learn how to lower his or her anxiety level. Making an appointment with a local child therapist is often the most important first step. He or she can help facilitate this course with the family, and is often an invaluable teacher and guide in the process. 

Resources:
 
Banyan Tree Counseling: http://www.banyantreecounseling.com
 
Anxiety & Depression Association of America: http://www.adaa.org/
 
Child Mind Institute: http://www.childmind.org/
 
Worry Wise Kids: http://www.worrywisekids.org/
 
The Anxiety Disorders Association of British Columbia: http://www.anxietybc.com
 
KidsHealth: http://kidshealth.org/parent/emotions/feelings/anxiety.html

Some photos of Banyan Tree Counseling's space: Suite 203, 1348 Westgate Center Dr. Winston Salem, NC 27103. There is lots of growing, healing, thriving, playing, and difficult yet joyful work happening in this sacred space... Come join us!

The following are some of the many benefits of play that have been described by play theorists. It expands self-expression, self-knowledge, self-actualization and self-efficacy. Play relieves feelings of stress and boredom, connects us to people in a positive way, stimulates creative thinking and exploration, regulates our emotions, and boosts our ego (Landreth, 2002). In addition, play allows us to practice skills and roles needed for survival. Learning and development are best fostered through play (Russ, 2004).

What Exactly is Play Therapy?

Play therapy is a structured, theoretically based approach to therapy that builds on the normal communicative and learning processes of children (Carmichael, 2006; Landreth, 2002; O'Connor & Schaefer, 1983). The curative powers inherent in play are used in many ways. Therapists strategically utilize play therapy to help children express what is troubling them when they do not have the verbal language to express their thoughts and feelings (Gil, 1991). 

In play therapy, toys are like the child's words and play is the child's language (Landreth, 2002). Through play, therapists may help children learn more adaptive behaviors when there are emotional or social skills deficits (Pedro-Carroll & Reddy, 2005). The positive relationship that develops between therapist and child during play therapy sessions provides a corrective emotional experience necessary for healing (Moustakas, 1997). Play therapy may also be used to promote cognitive development and provide insight about and resolution of inner conflicts or dysfunctional thinking in the child (O'Connor & Schaefer, 1983; Reddy, Files-Hall & Schaefer, 2005).

Toys Are A Child's Words

Play therapy differs from regular play in that the therapist helps children to address and resolve their own problems. Play therapy builds on the natural way that children learn about themselves and their relationships in the world around them (Axline, 1947; Carmichael, 2006; Landreth, 2002). Through play therapy, children learn to communicate with others, express feelings, modify behavior, develop problem-solving skills, and learn a variety of ways of relating to others. Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development. APT defines play therapy as "the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development."

How Does Play Therapy Work?

Children are referred for play therapy to resolve their problems (Carmichael; 2006; Schaefer, 1993). Often, children have used up their own problem solving tools, and they misbehave, may act out at home, with friends, and at school (Landreth, 2002). Play therapy allows trained mental health practitioners who specialize in play therapy, to assess and understand children's play. Further, play therapy is utilized to help children cope with difficult emotions and find solutions to problems (Moustakas, 1997; Reddy, Files-Hall & Schaefer, 2005). 

By confronting problems in the clinical Play Therapy setting, children find healthier solutions. Play therapy allows children to change the way they think about, feel toward, and resolve their concerns (Kaugars& Russ, 2001).Even the most troubling problems can be confronted in play therapy and lasting resolutions can be discovered, rehearsed, mastered and adapted into lifelong strategies (Russ, 2004).

Who Benefits from Play Therapy?

Although everyone benefits, play therapy is especially appropriate for children ages 3 through 12 years old (Carmichael, 2006; Gil, 1991; Landreth; 2002; Schaefer, 1993). Teenagers and adults have also benefited from play techniques and recreational processes.To that end, use of play therapy with adults within mental health,agency and other healthcare contexts is increasing (Pedro-Carroll & Reddy, 2005; Schaefer, 2003). In recent years, play therapy interventions have also been applied to infants and toddlers.

How Will Play Therapy Benefit A Child?

Play therapy is implemented as a treatment of choice in mental health, school, agency, developmental, hospital, residential, and recreational settings, with clients of all ages (Carmichael, 2006; Reddy, Files-Hall & Schaefer, 2005).Play therapy treatment plans have been utilized as the primary intervention or as an adjunctive therapy for multiple mental health conditions and concerns (Gil &Drewes, 2004; Landreth, Sweeney, Ray, Homeyer& Glover, 2005), e.g anger management, grief and loss, divorce and family dissolution, and crisis and trauma, and for modification of behavioral disorders (Landreth, 2002), e.g. anxiety, depression, attention deficit hyperactivity (ADHD), autism or pervasive developmental, academic and social developmental, physical and learning disabilities, and conduct disorders (Bratton, Ray & Rhine, 2005). 

Research supports the effectiveness of play therapy with children experiencing a wide variety of social, emotional, behavioral, and learning problems, including: children whose problems are related to life stressors, such as divorce, death, relocation, hospitalization, chronic illness, assimilate stressful experiences, physical and sexual abuse, domestic violence, and natural disasters (Reddy, Files-Hall & Schaefer, 2005). Play therapy helps children:

• Become more responsible for behaviors and develop more successful strategies.
• Develop new and creative solutions to problems.
• Develop respect and acceptance of self and others.
• Learn to experience and express emotion.
• Cultivate empathy and respect for thoughts and feelings of others.
• Learn new social skills and relational skills with family.
• Develop self-efficacy and thus a better assuredness about their abilities.

How Long Does Play Therapy Take?

Each play therapy session varies in length but usually last about 30 to 50 minutes. Sessions are usually held weekly. Research suggests that it takes an average of 20 play therapy sessions to resolve the problems of the typical child referred for treatment. Of course, some children may improve much faster while more serious or ongoing problems may take longer to resolve (Landreth, 2002; Carmichael, 2006).

How May My Family Be Involved in Play Therapy?

Families play an important role in children's healing processes. The interaction between children's problems and their families is always complex. Sometimes children develop problems as a way of signaling that there is something wrong in the family. Other times the entire family becomes distressed because the child's problems are so disruptive. In all cases, children and families heal faster when they work together. The play therapist will make some decisions about how and when to involve some or all members of the family in the play therapy. 

At a minimum, the therapist will want to communicate regularly with the child's caretakers to develop a plan for resolving problems as they are identified and to monitor the progress of the treatment. Other options might include involving a) the parents or caretakers directly in the treatment in what is called filial play therapy and b) the whole family in family play therapy (Guerney, 2000). Whatever the level the family members choose to be involved, they are an essential part of the child's healing (Carey & Schaefer, 1994; Gil &Drewes, 2004).

Who Practices Play Therapy?

The practice of play therapy requires extensive specialized education, training, and experience. A play therapist is a licensed (or certified) mental health professional who has earned a Master's or Doctorate degree in a mental health field with considerable general clinical experience and supervision. With advanced, specialized training, experience, and supervision, mental health professionals may also earn the Registered Play Therapist (RPT) or Registered Play Therapist-Supervisor (RPT-S) credentials¹ conferred by the Association for Play Therapy (APT).

To learn more about Play Therapy, visit http://www.a4pt.org/