Look at immediate environment when helping adolescents cope in changing world

By Catherine Robertson Souter
November 14th, 2021
Eli Lebowitz, Ph.D
Eli Lebowitz, Ph.D, director of the Program for Anxiety Disorders at the Yale Child Study Center and author of “Breaking Free of Child Anxiety and OCD” (Oxford University Press, 2021).

Coming of age is difficult enough. For today’s teens and adolescents, not having the life experience an adult may have to provide perspective, the fear, anger, uncertainty, and all-around negativity flooding our world can be overwhelming.

According to a recent Washington Post / Ipsos poll of Americans aged 14-18, more than half said this is a difficult time to be growing up compared with only one-third when a similar poll was done in 2005.

Teens also reported that political divisions, health costs, racial discrimination, and gun violence are the biggest threats to their generation, followed closely by terrorism and climate change.

With the internet, kids are more aware of news events than those who grew up during, for instance, the social tumult of the 60s and 70s, might have been.

“Children are exposed to a lot more information than in the past,” said Eli Lebowitz, Ph.D, director of the Program for Anxiety Disorders at the Yale Child Study Center and author of “Breaking Free of Child Anxiety and OCD” (Oxford University Press, 2021).

“Technology has a way of making more salient those events or situations that may have seemed more distant to kids in the past because of geography or because of a lack of immediate relevance to their lives.”

The good news, though, is that the overwhelming majority of the 1,349 kids interviewed in the poll remain positive about their future. Ninety percent believe they will achieve a good standard of living and 83 percent said they have as good or a better chance of success in life as their parents.

And, even if a majority feel that this is a bad time to be growing up, there are still 48 percent saying it is a good time.

“By and large kids are profoundly resilient,” said R. Meredith Elkins, Ph.D, program director of the McLean Anxiety Mastery Program, an intensive group-based outpatient program for children and adolescents with anxiety disorders and OCD.

“We studied children’s responses to the Boston Marathon bombing in 2013 and post 9/11 and COVID and hurricanes, and we found that most kids bounce back and don’t show any long-term effects, even over the past two decades.”

As Lebowitz pointed out, adolescents are not a monolith. Although some may experience stress from what is happening around them, others may not feel much pressure at all.

“What will be true for some will not be true for others,” he said. “In general, children are resilient but [some] are more vulnerable.”

Children in disadvantaged groups may see greater impact from stress, just as they have seen greater impact from COVID outcomes, climate change, and racial justice. This area is where psychology can focus more efforts to bring about change.

“For families with ongoing struggles or financial disadvantages or for kids in minority groups, the stress is more amplified,” said Elkins. “If the deck is already stacked against you, it is going to be harder.”

While more children are being treated for anxiety and depression in recent years, it can be hard to tease out whether that is because of greater stress within society or because of a higher awareness and reduced stigma around mental health care.

“One shift I see is more teens who are instigating their own treatment, seeking out their own help,” said Lebowitz. “That was quite rare even 10 years ago.”

Advice for therapists? First, when working with children or families, it is important to look at their immediate environment and how those around them are dealing with issues. Between paying attention to a child’s media intake and keeping an open dialogue about what is happening in the world, to modeling coping and healthy discussions, families can have a huge impact on a child’s well-being.

“Kids are generally not in a vacuum,” said Lebowitz. “Things happening around them are always going to affect them and parental stress is a big part of that.”

In addition to offering training for therapists, the Yale Child Care Center works with parents to teach kids better responses to being anxious. Rather than trying to fix a situation for them, show faith that they can handle it and come out stronger.

“We tend to trivialize it a bit, to say ‘don’t worry about it; it’s not a big deal,'” said Lebowitz, “So the message of confidence is not always there.”

Being aware of where a teen’s interests reside is also important. Some may be more focused on intra-family conflict or identity issues while others may be more intensely affected by a world that seems unfair and even dangerous.

“Recognize what is baseline for this kiddo going into this stressful situation,” said Elkins. “If you are working with a young person for whom issues of social justice are something they are becoming passionate about, it will affect the degree to which they are handling challenges.”

As a profession, psychology may need to push for more mental health screening long before a child is brought to the therapy room.

“There are two huge contexts in which we should be doing more to screen for these issues: in school and in the primary care setting,” said Lebowitz. “In the pediatrician’s office, you have the child there and the parent there and you can check in how things are going. With health insurance rules, pediatricians don’t get paid to do that and they don’t have time. But they also don’t always have resources available to follow up if a child needs more services.”

“We have parent conferences in school but we don’t check in with their mental health,” he added. “Every school has physical education in the core curriculum, but we don’t have a parallel of that, we don’t have any way of teaching emotional regulation skills or teaching feelings. Those things are just not part of curriculum in same way.”

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