School Based Mental Health

I continue to consult to schools for mental health programs, although I have changed school districts. Naively, I anticipated fewer mental health problems in the new, more affluent,school district. On my first day at the high school I was warned: "Just because our kids live in nicer houses, don't be fooled. They have the same problems you saw in your previous job, especially drugs." They understated the case. During my first seven weeks I have seen more meltdowns, crises, suicide threats, and psychiatric hospitalizations than I saw in six months at the last school. Is it the recession? I don't know. A check at my ol,\d school revealed no more than the usual frequency of such incidents.

I see a large number of kids with panic disorders. It is a diagnosis I enjoy working with, using cognitive behavioral approaches and resilience techniques. The school counselors appear to be exceptionally caring and knowledgeable--more than willing to work with a clinical psychologist. One is particular has sent the largest proportion of referrals to me. I took exception, however, to how she was dealing with the fourteen year old with daily panic attacks related to her history of physical abuse at home and PTSD. She provided the girl with a meditation/relaxation tape, which was fine with me and consistent with what i was doing with her. I was not pleasd, however, when I saw the girl clutching a fluffy, soft, red satin pillow that the counselor uses to comfort stressed out and depressed teenagers. The girl does need nurturing, but from her mother. I did not not make a fuss over it but mentioned that I was trying to toughen up the girl while she was catering to her dependent needs. My resilience training was sandpaper in contrast to her satin The pillow looked and felt (yes, she asked me to squeeze it) like a gigantic breast. I kept my association to myself.

A mother of a very bright but underachiving sixteen yesr old insisted that her child, who had a questionable (to me) diagnosis of ADD also had "exexcutive functioning" disability. Executive functioning problems are associated with
ADD, although not mentioned in DSM-IV-TR. Without revealing details here, I have the following reservations. ADD is a sufficent diagnosis; we don't need a second. School psychs are using the BRIEF, a symptom checklst for parents and teachers is a group of behaviors seemingly reflecting poor impulse control, attention and memory deficits, poor planning abiilty, and distraction by irrlelevant stimuli. Behaviors such as failure to complete assignments, cutting classes, and underachievement meet all these requirements but can have a variety of other determinants. Furthermore labeling a behavior or symptom is not the same as explaining it. This has been called the "nominalistic fallacy." I don't doubt that executive function is real and is a forebrain activity but if it is there we need to demonstrate it by appropriate testing. In this case I did just that. The boy showed extremely high executive functioning by the best tests I could find. Moral--you can't judge a book by its cover.

I am seeing a fair number of kids on the autism spectrum as well as others with social anxieity and social skill deficits. Many of them ask for help in making friends. I am treating these teens in dyads or small groups for socialization in a very structured way dealing with communication, relationships, social mores and niceties. Role playing is a poweful technique. It is an interesting and useful endeavor. One boy who scares people by his angry facial expression is learning to smile with the use of a mirror.

Mental health is sorely needed in schools, especially the high school and middle school. It is still relatively rare. I was fortunate to receive a Pennsylvamnia Department Of Education grant last year to initiate a program, which continue today without special funding. IEPs frequently pecify counseling for emotinal problems but schools psychs and counselors are overloaded with testing or just puttingout fires. Clinical psychologists are a valuable addition to schools to supplement educational psychology approaches. Teachers need to be trained in mental health concepts and strategies.

Poor excuse

This is by way of an apology for my failure to make entrees here for several weeks.
Not an excuse but a reason is that I have devoted a great deal of energy to writing for a website titled ezinearticles.com. Ezine will publish short articles (250 to 5,000 words) about almost any topic. There is no payment for these articles. The trade off is that you are allowed to append each article with a commercial for any business enterprise you are promoting. Since they allegedly have thousands of readers on the web there is great potential for spreading your message. They literally have hundreds of thousands of writers (they publish their names arranged by the number of pblished articles. Many authors have done over 2,000 articles. They do require minimum writing skills. The number of people who do this is so large that some people have got to be benefiting. Ezine benefits by selling advertising that goes along with each article. Most of the topics seem to be "how to..." in content, e.g., how to tune up your Volkswagon." I have sent them a dozen articles of a psychological nature, using my previous publications as source matierial. So far eleven have been published. I am trying to promote this blog, my website, my books, and my private practice. Have I benefited? Not yet that I can see, but the jury is still out. I have risen from Basic,to Basic plus, to Expert author in their rating system. I'll do a few more submissions and see how it goes without neglecting this blog and then we'll see it it's worth the effort.

Update

It has been a while since my last blog. I've been expanding my business--providing mental health services to schools. I am now consulting to Marple Newtown School District as well as Elwyn, Inc. I did some grant writing for Interboro School District this summer. I've also been expanding private practice in Chester Springs. None of this serves as a legitimate excuse for not blogging. However, I have been writing articles on line for Ezinearticles.com. They don't pay for these articles, which I provide gratis, butthe "take" comes in the form of advertising I add to each submission They sell ads on my writing. I hope to stimulate some interest in my website and this blogsite as well as to promote my books and private practice. My first article is claimed to have had over a thousand hits and I've had eight articles published so far. They are all of a psychological nature. The jury is still out as to whether all of this is worth the effort. In any event, it has taken me away from blogging for a while. Type my name into Ezine's web page to see what I've been up to.

Genetics

I need no further evidence of the significance of genes in determining behavior. Witness my wife and her side of the family. Now, I love my wife dearly. but she has one flaw. She is an incurable telephonalolic--about four hours a day. There is little doubt that this is a genetically determined behavior, gender related. All the female members exhibit the behavior. Its most extreme manifestation is when they talk with each other, which is frequent. I have seen this pass through four generations of females. No males in the family exhibit the trait, although they are certainly carriers. They endure, complaining only poccasionally about the telephone bills. The behavior is resistant to extinction, pervasive as to geographic location, and of lifelong duration. No one has identified this gene as yet, only because no one has looked. There is also likely to be a brain area, close to where language expression resides in the left hemisphere (more generalized in females). I therefore challenge any neuroscientist or genetic types who stumble on thois blog to begin the task of identifying and eradicating this pernicious trait before it spreads further.

Charitable giving

I spent ten years as a fund raiser for a non-profit, although it was never a labor of love. So I am not completely naive about giving. Our own contributions are primarily earmarked for cancer rsearch since both my parents and my wife's favorite aunt succombed it the Big C. I dopn't respond to telephone solicitations and certaily not to unsolicited requests at my door. So it is surprising to me that I contributed to an African American lady who rang our doorbell to solicit a magazine subscription to a shelter for the homeless.

She herself was a resident of one, she said. Her husband shot her, she explained. She was earning points earn tuition to study criminal justice and become a police officer. The materials she produced were shopworn and suspect. The magazines offered did not seem relevant to homeless and abused people. Why would they benefit from Psychology Today? It was something about her manner, I suppose. She seemed genuine, sincere. I wrote the check to some magazine distributer and designated a local depressed area for the target of my gift. I chose Parent and Child magazine. There was a hefty surcharge that significantly increased the subscription price she originally mentioned. My charitable giving has turned to charitable misgiving. I hope she was what she presented herself to be. "I'll be back to see you next year," she called over her shoulder as she started for the next house.

Not picture perfect

"Shrink" and "Finding Jackson" are now out there but not burning down any bridges with sales. Last week I resurrected a story I first wrote for my grandchild Becca, then around age five. "Becca in Cyberland" describes the adventures of Becca, age five, who is pulled into her father's computer to Cyberland, has many adventures, and proves herself sufficiently worthy to be transformed into a Cyber princess. With apologies to Lewis Carrol, the story has its merits. I sumbitted it to PublishAmerica, which did "Finding Jackson." They accepted it. They are a traditional publisher and do not charge. I haven't done a stellar job in marketing my books--not my forte. I am ready to put the final touches on "Becca..." but I realize that the book, geared toward four to six year olds, needs pictures. PublishAmerica will do the cover but not internal pictures. Nor will they pay for them. The illustrators I found on the Web are top notch, but expensive. They mostly work for publshers and do their own writing. I e-mailed one who wanted $7,000 for my book. That's why they work mainly for publishers. I have contacted a retired artist through a friend who may be more reasonable. But as an author of books that have sold poorly I am not optimistic. I think I need a marketer.

Capturing the hill

Our house in a development in Chestersprings has three porches-front, side, and back. We can choose where we sit depending on the season and the position of the sun. In the winter we choose the warm front porch, facing east, in the morning and the rear porch in the late afternoon. In the summerwe choose the shady back porch in the morning and the front porch in the late afternoon. Regardless of the season we like the side porch best. It is cool even on the hottest days because it is shaded by a large tract of woods on a hill to the south of us.

One day in this past spring while we were having a drink in the late afternoon, my wife remarked about the hill fronting the wooded area. There are some large rocks at the bottom, she noted, that would look nice if there were flowers behind them. I took her words seriously and began uncovering two or three rocks which projected pointy prominences upward. As I dug I realized that , like an iceberg, the rocks were largely buried undergroup. I moved away years of earth and weeds covering them and planted some heather that I purchased at Lowes. They were striking with purple blooms and made a statement behind the rocks which could now better be described a boulders. I began exploring and found that there were not two or three but 25 hidden boulders spread out in a large semi-circle at the base of the hill. It required several weeks to uncover them all. Returning to Lowes I brought a dozen more heather and planted them and them a dozen lavender, also with purple flowers. The hill was beginning to look very good. I persuaded the gentleman who mows our pitiful quarter acre lot to also weed whack the hill. We had already appropriated the large area beneath the woods by erecting four bird feeders, attracting a wide variety of species, not only birds, but squirrels, chipmonks,rabbits, and occasionally even deer and foxes. The Development gardeners would no longer mow where we planted and bird fed so our mower took it over. I did not own the property but believing it is easier to apologize than ask permission I kept planting on what we now called Bunker Hill, Heather Hill, or simply Marvin" Hill.

Along the crest of the hill was a deep thicket or honeysuckle, barbed wild roses that never bloomed and various unattrtactive weeds. I, for a penny, in for a pound. I began to chop away at the unattractive mess, hoping to expose the contour of the crest.. As I pruned, at the expense of numerous thorn cuts and two tic bites, the hill was assuming a new personality. Behind the thicket were large oak tess that I knew existed because we could see their branches, but had never seen the trunks. I felt myself a sculptor who envisions a form hidden in a block of marble and chisels away the excess until the form is realized. I, too, would slice away the excess and create a living panorama. Slowly and carefull I cut vines and brush, dumping the waste deeper in the foliage and creating creating depth to my masterpiece.
We now had a three dimensional view into the darkened woods and could see the goldfinches, blue jays and cardinals well before they approached our feeders. Deer came onto the property at dusk. We learned to recognize the families of squirrels and chipmonks and their habitats. My work is now cut out for me. Eventually I will extend the manicured forrest edge along the entire length of my driveway. Neighbors stop by and comment on the project and thank me for improving the neighborhood. I have, indeed, captured the hill. We sit and sip our vodka tonics and i recall Robert Frost's "Stopping by woods on a snowy evening"-- The woods are lovely dark and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to before I sleep.