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Helping your child or teen manage suicidal thoughts and/or plans

2/3/2020

 
Tamsyn White, Psychologist
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In our work as psychologists, we often hear from children and young people that they are feeling so distressed that they are experiencing suicidal thoughts. Of course when they hear this, many parents feel extremely worried.

​Such distress in children and going people can manifest in lots of different ways in terms of behaviour, emotions, and impact on relationships and functioning at school, home, and workplaces (where relevant).
​

What to look out for - warning signs:

  • Hopelessness: If a child or young person feels trapped in their circumstances, and as if there is no hope for the future, it can lead to them feeling sad, to having depression, or to think about suicide.
  • Suicidal ideation: Thoughts of taking one’s own life are relatively common amongst teens, but should ALWAYS be taken seriously. 
  • Changes in behaviour: When a child or adolescent experiences significant changes to their eating or sleeping patterns, mood, concentration, or ability to participate at school or home, these signs should be taken heed of.
  • Withdrawing socially
  • Giving away valued possessions
  • Increased drug or alcohol use
  • Disturbing or emotional posts on social media.
  • Acquiring medications or weapons
  • Talking about death or suicide

What can you do?

Talk and listen to your teen:
The expert on how your young person is feeling is your young person themselves. Check in with them often about how they’re travelling and let them know you’re always there for them, even if they don’t want to chat.

Check in on yourself
It’s natural to feel frightened, overwhelmed, or even angry if your teen lets you know they’ve been thinking of harming themselves. It’s important to let your child or adolescent know that you love them and support them, and that you need to keep them safe. Try to communicate calmly, without judgement, and try to help them see that it’s safe to talk to you.

Make sure you ask them directly
Parents are often worried that if their teen or child hasn’t had thoughts of suicide, they will be created if asked directly. This is a myth, and research has shown us that asking directly can be very protective. Avoid using euphemisms such asking if they’ve been thinking about “doing something silly” to themselves. Rather use direct, non-judgemental language. Simple is best: “Have you had thoughts about hurting yourself, or taking your own life?” should be a question we are all comfortable asking our loved ones.

Plan with your child for their safety
If your child or adolescent does let you know that they are having thoughts of harming themselves, make sure you’re prepared to engage in some safety planning. Ask them whether they have a plan to hurt themselves, and ask them to work with you as a team to help keep them safe. This might mean removing access to means, helping them manage their social media time, increasing their connection with supportive family and friends, and seeking professional help.

Be prepared to contact services 
In a crisis where a young person has, or is just about to harm themselves, it is best to present to your hospital's emergency department - via ambulance if necessary. In situations of less urgency, where future potential risk is identified by you, you can gain assistance from your own General Practitioner, the local hospital Child and Adolescent Mental Health Services, and sometimes from school counsellors, if they are available.

Where to go for help:

Kids Helpline is a free, private and confidential 24/7 phone and online counselling service for young people aged 5 to 25. They can be contacted by phone on 1800 55 1800 or website: https://kidshelpline.com.au/get-help/webchat-counselling/


Lifeline provides free, 24-hour Telephone Crisis Support service in Australia. Volunteer Crisis Supporters provide suicide prevention services, mental health support and emotional assistance, via telephone, online, and face-to-face. Call 13 11 44 or visit their website: https://www.lifeline.org.au/about-lifeline/contact-us

Area Mental Health Services (AMHS) triage provides mental health information, advice and referral. Each AMHS has a centralised triage number. www.health.vic.gov.au/mentalhealth/services

ARAFEMI Carer Helpline provides free, confidential information, support and referral for family, carers and friends of people with a mental illness. 1300 550 265, 9am to 5pm weekdays www.arafemi.org.au/family-support/telephone-helpline.html

Australian Centre for Grief and Bereavement provides a range of education, counselling, research and clinical services for those working in and affected by experiences of grief and bereavement. 1800 642 066. www.grief.org.au
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Beyondblue provides information about the signs and symptoms of depression, available treatments, how to get help and links to other relevant services and support groups. 1300 22 4636, 24 hours/7 days. www.beyondblue.org.au

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Tamsyn White is the Principal Psychologist at Hopscotch & Harmony. She sees children, young people, adults, and families when challenges have presented themselves and feel overwhelming. Tamsyn has a strong working history with psychological trauma for people across their lifespan. Tamsyn loves working with people when they want to develop their skills in areas such as: loving and accepting themselves; being a fantastic parent; being a skilled communicator in their relationships;  just as some examples.

How to respond if your child is acting aggressively

24/2/2020

 
Jesse Diggins, Psychologist
Hopscotch & Harmony Psychology
Part of my role as a school psychologist is responding to critical incidents that involve aggression and violence. I’ve learned to be able to face these situations with calmness and confidence. Many of the techniques I employ are taken from Therapeutic Crisis Intervention developed by Cornell University.

The techniques and principles in this model are highly generalizable and can be applied by families. The beauty of this is that as complex and daunting as aggressive behaviour can appear, the way to respond can be simple and involves answering 3 questions:


1. What emotions am I feeling right now?
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If we are not emotionally regulated when we respond to a child there is a high likelihood that this will only perpetuate the situation. The child’s need remains unmet and they now also have additional stress. As the saying goes (and neuroscience attests to), ‘when we are at our angriest… we are at our stupidest’. 

Speaking of, when children are highly emotionally dysregulated they don’t have access to their pre-frontal cortex which is responsible for problem-solving, reasoning and perspective taking. So, asking them to ‘make a good choice’ at the height of aggressive behaviour probably isn’t going to work.

We should try and emulate what we can see a duck in a pond look like; on the surface it is calm and graceful, underneath is a little more frantic but that is hidden from view. 

2. How are environmental factors influencing the situation?

Many times, behaviours are influenced by those observing it. Removing other children or adults can be the catalyst for de-escalation. Similarly, removing yourself partially or fully as a responder (when safe to do so) can also be what is required for de-escalation to occur.

3. What does my child feel, need or want?

Behaviour is almost always a form of communication that expresses a need. Identifying and reflecting back your child’s need or feeling goes halfway to solving the problem. There is a difference between caving into unrealistic demands and simply demonstrating to your child that you can hear and understand their frustration.  

Children may need up to a few hours to recover and return to a baseline state. This is the time to have that conversation about what they can do to get their needs met next time in a more adaptive way. 
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​Jesse Diggins
 is a Hopscotch & Harmony psychologist who works closely with children, teens and parents to make sense of emotions and challenging behaviour. He has been recognised at local and state levels for his counselling work and his passion to empower young people and enable them to flourish. You can make an appointment with Jesse at Hopscotch & Harmony's Belmont practice by clicking here. ​

Managing your stress bucket through self care: A strategy for teens

4/2/2020

 
Alyce Galea, Psychologist
Hopscotch and Harmony Psychology | Self-care for Teens
Early on in therapy, teenagers often find it hard to identify the stressors or triggers that might be contributing to their difficulties.

One way that you can start to identify your current stressors is by doing the stress bucket activity.

I often like to conceptualise our wellbeing as a bucket. 
  • We all have a level of stress that we can tolerate healthily, and this is determined through our genetics, our general attitude towards life and how stress management has been modelled to us by our caregivers. 
  • The everyday stressors in our life can be considered as glasses of water pouring into our bucket. Over time, the water level in our bucket will increase. 
  • In order to avoid the water from overflowing, we need to find ways to poke holes into our bucket...this can be achieved by identifying and implementing problem solving, coping strategies and regular self care.

Stressors can be categorised into three domains:

  1. Interpersonal (difficulties or stress that you experience in your relationships with other people such as a parent, teacher or boss)
 
  1. Intrapersonal (difficulties or stress that is a result of thoughts or feelings within you, as well as any physical health issues)
 
  1. Environmental (difficulties or stress that is a result of your external world, including the school or work environment, the temperature in your classroom, the lighting, and things happening in the wider world such as natural disasters)

Once we have determined what our current stressors are, it is important to identify those stressors that you have some control over, and those that you have absolutely no control over. That way, we can then focus on problem solving ways of relieving the stress of situations that you may be able to change, even slightly.​
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Two ways we can learn to relieve stress are:

  1. Problem focused coping strategies: these refer to strategies that help change the source of the stress. 
  • Can you change something about the situation? 
  • If you had more skills or resources, would you feel less stressed about this situation?
For example: Can you speak to a teacher to clarify a question on an assignment? Can you drop a few shifts at work?

  1. Emotion focused coping strategies: these refer to strategies that help alleviate the negative thoughts and feelings associated with the stress

For example: Regularly practicing relaxation or deep breathing, exercise, starting a journal, listening to music.

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Alyce Galea | Hopscotch & Harmony Psychology

​Alyce Galea is a psychologist at Hopscotch & Harmony who works with adolescents and young adults across a wide range of settings, including schools and community mental health services (Headspace). She is particularly interested in supporting young people experiencing mood and anxiety disorders, low self-esteem and interpersonal difficulties; and has a particular interest in working with young women exhibiting traits of Borderline Personality Disorder. ​

Taking your child to see a therapist? Read this first.

31/1/2020

 
​Hillary Sanders, Psychologist
Hopscotch and Harmony What to say when taking your child to see a therapist

If you’re considering taking your child to see a therapist, it pays to prepare them. Here are 10 useful pointers to consider: 

1. Involve them

The important point to raise here is to actually ensure that your child is aware of their session, prior to attending. A common mistake parents make is not telling their child, or telling them at the last minute (such as when driving to the appointment). This is often with the best of intentions, as parents hope to reduce any undue worry or resistance about attending, however it is often counterproductive. 

Like all of us, unfamiliar situations can trigger worried thoughts. If your child has no idea what the appointment is about, or what a therapist does, their brains will attempt to make sense of it, which often results in negatively distorted beliefs or assumptions. For example, your child may see a therapist in the same way as an authority figure, like a teacher, and believe that they are getting into trouble because they are "bad". Or they may see a therapist more like a doctor, and worry they will be subjected to medical tests, given medication or a needle. 

As you can see, it’s important to ensure that your child knows what the appointment is about and what a therapist does, to avoid any misconceptions. We want to ensure they have a positive experience of help- seeking; if their first experience of help-seeking is one fraught with confusion, anxiety, and negative beliefs, then you may encounter resistance to them attending further sessions. 

2. Use simple explanations 

To explain the role of the therapist, keep it clear and simple. Introduce the role of a therapist as someone who can help people of all ages with things like big feelings or difficulties at home or at school. Explain that the therapist helps people find ways to cope with these feelings or difficulties, as well as helping them to feel better within themselves and within their relationships (i.e. friends, home, school). For children, point out that they will have fun with the therapist too! They will get a chance to play and be creative. 

3. Gently touch on the difficulties

Add what you have noticed they are struggling with. For example, you might have noticed they are avoiding school, or perhaps they are finding it hard to manage anger at home. Gently mention what your concern is, but ensure the conversation is not a disciplinary one, meaning that you do not demonise their behaviour or send the message that "something is wrong with you", which places the weight of the issues on them. Phrase your concerns as "difficulties". For example, "I have noticed you're having difficulty with (state the challenge) at the moment, and a therapist can help us with this". 

4. Normalise

Every human being experiences emotional, behavioural, and social difficulties throughout their life. Normalise your child's struggle as part of being human! It can help to share your own experience of difficulties with your child, for example, "Hey I was nervous about school too", or "Sometimes I have days I can’t control my anger too". This normalises and humanises their experience, and helps them to see that everyone struggles, even grown-ups. If you have seen a therapist yourself, it can help to share this with them, and tell them a couple things it helped you with. 

5. Give them a "mental map" of what to expect

To alleviate nerves about attending a new place and meeting a new person, give your child an idea about what to expect from their session, such as what time their session is, how long it will go for, where you will be (i.e. in the session with them, or in the nearby waiting room), and the name of their therapist. If you have already met with the therapist, you might like to share your impression of them (e.g. "they were easy to talk to", or "they go for the same football team as you!"). Most clinics have photos and a brief description of therapists on their website, which you could share with your child if they are curious. 

6. Comfort tools

Some children like to bring toys, games, or sensory tools with them to the session as a way to help them feel more at ease, and self regulate if needed. You may wish to ask your child if they'd like to bring something along as a comfort tool, or even as a bit of "show and tell" to enable their therapist to get to know them better. 

7. Working together, not in isolation

It’s important for your child to know they are not doing this alone. I often talk about working together as a "support team", where the child, parents, therapist, and sometimes other people like siblings, are all going to work together to get a better handle on the issues. The issues do not resolve simply through the attendance of therapy sessions; an important part of the work occurs outside of session, based on the implementation of strategies at home, school, etc. So remind your child that you're in this with them! 

8. After the session

It's okay to check-in with your child about how they’re feeling, and whether or not they would like to talk about anything from the session, but make sure not to interrogate or push them to disclose (if you require more information about how privacy and confidentiality works for child clients, please speak with their therapist). If your child requires a calming activity to transition from their session into the next task of their day, such as returning to school, it can help to go for a short walk outside, play a game, or enjoy a snack or drink together. 

9. Resistance

Therapy can be difficult for all ages, as it often involves working on behavioural changes, sitting with discomfort, and processing painful memories, feelings, and insights. It makes sense then, that some people would resist it, especially children who are geared towards pleasure and reward! So naturally, some resistance is to be expected. However, if you notice an ongoing pattern of resistance to attending sessions, ask your child about it. There could be other reasons to explain it. Perhaps they don't think they need help, and feel resentful that they are being "forced" to go. Maybe they are not ready to reveal their thoughts and feelings. Or perhaps they just don't "click" with the therapist. All reasons are valid and worth hearing. So rather than ignoring the resistance, listen to your child, and raise any concerns about their engagement with the therapist. 

10. Don't aim for perfect! 

As a parent, you are not expected to know exactly how therapy "works", or to give the perfect description of the therapy process to your child! Keep it calm, kind, and simple. Leave all of the finer details to the therapist. 

Overall, the pointers I have raised here simply ensure that your child has some awareness of what they'll be walking into, rather than it being a big "unknown". This goes a long way to reducing any unnecessary worry, and promoting positive engagement in the very beginning. 
​

A final note: Therapy is a useful tool, yet your love, care, and non-judgmental "noticing" of your child's distress is the first and most important step in the therapy process.
​
Hilary Sanders - Hopscotch and Harmony Psychologist
Hilary Sanders is a psychologist at Hopscotch and Harmony Werribee and Belmont who is passionate about supporting people of all ages, however has a particular interest in working with adolescents and adults. Hilary values diversity, and encourages individuals to celebrate their uniqueness- she believes human difference is what makes life interesting! An LGBTIQA+ advocate, Hilary acknowledges the complex nature of sexuality, and is driven to support individuals experiencing challenges arising from sexual diversity

5 ways to support your child’s mental health when they are overwhelmed about bushfires

13/1/2020

 
Natcha Limpianunchai, Provisional Psychologist
Hopscotch & Harmony Psychology
It is common to feel overwhelmed about the current bushfires. Children may not fully comprehend what they see on the news or smell in the air, however they may still experience distress and anxiety. 
​

You may find yourself feeling helpless about how to help your child, particularly if you feel overwhelmed yourself. Here are a few starting points to consider: 

What could be going on? 
If your children have seen the news or heard conversations about bushfires, they may be feeling helpless, sad or worried. If your children have experienced direct effects of the bushfires (e.g. evacuating from their home, seeing bushfires first-hand), they may also feel unsafe and uncertain. Take notice on any changes in behaviour, such as fear about sleeping alone, wanting to stay close to parents more than usual, nightmares, increase in tantrums, or withdrawal from play. Engage with a health professional if there has been drastic change in behaviour. 

Every child may need something different
Everyone has a different way of coping with stress. Some children may want to share their concerns with you straight away whereas some may not. Don’t feel like you need to make your child talk about it, but reminding them that they can talk to you about anything they want anytime they would like, can be very helpful in this situation. 

Explain the truth with age-appropriate language
You can ask your child how much they understand what is going on ("What do you think is happening?", and help to foster their understanding using different means such as drawing or story books. Some story books about difficult experiences or bushfires are ‘a terrible thing happened’ by Margaret Holmes, and ‘Bushfires’ by Marguerite Hann Syme. 

Shift the focus to hope
Children may have seen pictures and videos that are scary to them. Showing pictures or news of people who are helping, such as donations, help from overseas, and volunteers, can help to alleviate some of the distress. You can also discuss ideas on how they can help, such as making craft items for animal rescue or participating in a fundraising. 

Don’t forget to look after yourself 
It is difficult to support others when you are overwhelmed yourself. Pay attention to your emotional state and what you need to feel supported, to help you to feel more confident in supporting others around you. 
Although most children can recover from distressing experience over time, some children may experience ongoing distress, and those who have experienced the bushfire first-hand or have lost loved ones are more particularly at risk. Signs such as frequent, continual emotional outbursts, prolonged preoccupations with the bushfires, or severe anxiety can help to indicate the impact on their wellbeing. 
​

We hope that you stay safe during this stressful time. Please reach out to your doctor or to a mental health professional if you need further support.
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​Natcha Limpianunchai is a provisional psychologist at Hopscotch & Harmony with a particular interest in Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder. In order to help children develop communication skills, functional skills, and confidence in daily living, Natcha works closely with parents to set goals, discover a child’s strengths, and design strategies to support challenges.

​

Is your child struggling with the transition to school? 5 ways to help

21/2/2019

 
Emily Vujicic, Psychologist
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Christmas seems so far away now, and we are already back in full swing at school. Most children will be settled back into routine of the school term with bed times, after school activities, and being responsible for home learning activities.

For many children and parents, it can still be a very tiring and tense time. There may be extra adjustments like a change in friendship groups, an unfamiliar teacher, or things in their family life that are affecting them. This may lead to difficulties with sleep, tears in the morning, and possibly reluctance or refusal to go to school.

I have put together a small collection of ideas could help ease the transition process.

Being organised can help take the load off the mornings. Making lunches, packing bags and
getting clothes out ready the night before can all mean there is less to do in the morning when there is more time pressure. This helps make the morning the most relaxed and positive it can be. Utilising check lists can help give your child independence in these tasks, and help prepare them for the following day.

Routines can be helpful to get the children settled, and having a nice balance of activities
and rest times. It is important not to have all of the fun things at home, and school is then seen as
missing out. This might mean ‘fun’ snacks are for school, not letting the children know what
interesting things you will be doing while they are at school, and not using school or teachers as a negative or threat.

As you go back to work and your children are back at school, you may need to make
additional effort in having positive time with them, giving them opportunities to talk. Often, children and adults alike, worry right before we go to bed, when we don’t have things around us to distract us from our thoughts. Many families find that after dinner time is a good time to check in and see if there is anything to talk through.

If there is something troubling your child, be optimistic, realistic and empowering. It may
mean that you spend some time helping them to think realistically about a situation, or find the
positives if they can only see the negative. Helping them to come up with their own strategies to
cope is a good life skill that can be strengthened in all of us. It may even lead to activities you do
together, like some deep breathing or a calming walk.

Dr Ross Greene encourages the idea that children are doing the best they can. If there is a
problem, lets try teach them the expectations, and make sure they have the skills to do it.
By talking with children proactively and collaboratively, we help instil a sense of responsibility in them. It helps children feel heard, and like they are a part of changes, rather than changes just happening to them.. If you are interested in this, I encourage you to read any of his books, or The Explosive Child for more depth info.

It is also important that everyone is giving the children the same message, so communicating with the school can help ensure that your child may need a little extra TLC, encouragement or support as they transition into the year.
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​Emily Vujicic
 works with adults, children and families to assist with a range of difficulties including the management of stress, anxiety, depression, school difficulties, emotional development, behavioural and parenting challenges.  Experience as a School Psychologist has helped her develop an understanding of the challenges that can be experienced by school aged children, and the feelings and behaviours that can develop.

4 Ways to Set up a Morning Routine for Your Sensory Child

18/2/2019

 
Alexandria Emmett, Occupational Therapist
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When you wake up in the morning, your level of arousal can vary. You may be feeling just right and bounce out of bed, you may be feeling low / slow and lethargic or you may feel irritable or in a bad mood.
 
The light may be blazing through the window, the alarm is ringing in your ear, you can feel how cold it is outside and all this sensory information is overwhelming for a moment. However, you have had many years of experience, you know what you need each morning to be able to adjust your level of arousal to the ‘just right state’ that allows you to function, concentrate and perform. Having a hot shower, drinking a cup of coffee, listening to the radio or going for a run are just some common sensory strategies that we have learnt to use to enable us to begin our day right.
 
Now consider what it would be like for your child, who may have an existing diagnosis, who is still very much developing physically, emotionally and mentally, coupled with the fact that they do not yet have their own sensory strategies to use when first waking up. Now that would be a challenge!  
 
So, what are sensory needs?
 
The way we make sense of the world is via our senses. Sights, tastes, textures, sounds, smells and movements turn into information that our body requires to regulate, develop and learn. And in that order. If our sensory system is not processing sensory information efficiently and effectively, higher processing skills like learning, behaviour and skill attainment will not happen.  
 
Our sensory system, to use an analogy, can be likened to a set of cups. Each cup represents one of the seven senses and the goal is to keep each of them at a just right level of fullness so the body stays regulated and calm.
 
Having too much stimulation in one sensory cup can cause it to overflow and therefore would create dysregulation. Further to this, once a single cup does overflow, it is highly possible that the others will become unbalanced and then the effect of this is a downward slope of distraction, negative feelings and behaviour.
 
The same then holds true for cups that have too little stimulation. If a child doesn’t receive enough sensory input, the cup will be under filled and may then cause a child’s focus to be diverted to filling that cup i.e. seeking input to establish a more balanced level.
 
Often over the course of a typical day at school or kindergarten, our children’s sensory cups can be flooded and or deprived which, as you can imagine, will create a chaotic and challenging day for them.
 
So how can we make the mornings, easier for our sensory children?
 
1. Make your Mornings Predictable
 
If your child is a sensory child, majority of the time they may feel overwhelmed and not in control. Therefore, it is important to give your child a greater sense of power so they feel less anxious about the day ahead.
  • Create routines that your child can achieve, i.e. wake up, have breakfast, get dressed. You may like to try using a visual schedule to help support your morning routine.
  • At night, talk about the events of the day ahead so that they know what to expect.
  • Give your child options where possible (like what to have for breakfast, what colour toothbrush to use or what cup to drink from).
 
2. Remember Behaviour is a Form of Communication.
 
Next time your child is acting out, take a step back and try to understand what it is your child needs. For example, if your child is jumping around, then they are likely craving more opportunities for movement or if they are continuously clinging to your leg they may be seeking tactile stimulation. Understanding your child’s sensory preferences will enable you to use strategies to readjust their levels of arousal and prevent a tantrum from occurring.
 
3. Add Sensory Experiences to Existing Practices
 
You may not have an existing ridged routine but have tasks that you and your child attempt to complete each morning. Making these tasks more sensory focused and specific to your child’s preferences may provide your child with what they require to self-regulate.
 
Some examples of sensory routine experiences are:
  • Eating crunchy cereal or drinking a cold smoothie through a straw
  • Using a vibrating toothbrush
  • Jumping on the trampoline
  • Playing the piano
  • Completing exercises or stretches
  • Giving your child a big bear hug
  • Having a warm bath or shower
  • Listening to music while getting dressed
  • Reading their favourite book/ colouring in a picture/watering the garden or going for a walk, as a reward or opportunity fully in their control if time allows.
 
4. Practice and Persistence
This will take practice, trial and error and you probably won’t achieve a smooth sailing morning each time. However, with good insight into your own and your child’s sensory preferences, you will be able to help enhance their ability to self-regulate their sensory demands throughout their day.
 
If you wish to meet with one of our occupational therapists to help you and your child with sensory regulation and create a sensory diet, please contact 5241 6462.
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Alexandria Emmett is a compassionate, down to earth and driven occupational therapist who strives to achieve the best results for clients. Her love for working with children is motivated by her understanding of the important links between childhood participation in occupations and their physical and mental development. Alexandria consults Monday to Friday from our Belmont clinic.

The importance of noticing the ‘grey area’ children in a black and white education system.

29/1/2019

 
Stella Franzese, Psychologist
Hopscotch and Harmony - Educational Psychology
In a funding based educational system, it can be challenging for teachers to adequately support students who they have identified as having significant educational needs, however were not eligible for funding under their education system.

Without dedicated funding and limited resources to support the particular student, teachers often report feeling somewhat helpless. In these cases, teachers tend to feel that the demands of the curriculum are forever exceeding the level of the student’s abilities and that the child is not receiving a satisfactory amount of support in accordance with their educational needs.

In addition, the students themselves begin to feel discouraged at school, as their academic successes are inconsistent and subpar compared to their peers. This can lead to feelings of stress, poor self-efficacy and poor self-esteem.

While acknowledging that each student and their circumstances are unique, there are some simple steps that school staff alongside parents can take to facilitate discussion about the student’s needs and begin planning for appropriate interventions within the resources available.

1: Be self-forgiving. In most cases, it is a reality that the level of adjustments required to extensively support this child may be beyond what you as one person (with 20+ students to simultaneously support) can achieve in a classroom setting. Be prepared to accept that your absolute best efforts as a teacher may only account for a portion of the adjustments that the child requires.

2: Assessment. The first step to providing individualised support to a student with educational needs is to understand what their unique learning needs are.

The type of assessments that will be completed/sought will depend on the presenting concerns (medical, language, cognitive, sensory etc.). For example, children who experience difficulties with comprehension/with their expressive vocabulary may benefit from a language assessment.

It is more than likely that if a child has been identified as having significant educational needs that standardised assessment would have already been completed to identify the specific strengths and targets for intervention of the child.

Usually children with identified difficulties in school systems are referred for a cognitive (or psychoeducational)/language assessment (depending on the presenting concerns) which is usually completed by the Psychologists/Speech Pathologists in the Student Support Services team.

This service is of no cost to the family/school, however waiting periods may vary. Once school staff and parents are aware of the child’s level of functioning in the relevant areas, individualised support planning can commence.
 
3: Plan. A collaborative support system (containing teachers, parents and external service providers if any) for these children is essential in supporting the student’s unique needs. It is important that this support system discuss each area of development and who/what will be responsible for this aspect of intervention.

For example, if it was identified that the child has complex sensory needs, then a classroom sensory diet can be developed in conjunction with an external Occupational Therapist and implemented by the classroom teacher daily. In addition, a Psychologist may suggest appropriate social-emotional strategies that can be implemented in a classroom setting.

To facilitate discussion about the unique needs of your student, I have summarised just a couple of general examples of recommendations that may be suggested in a planning meeting. However, it is important that the support team maintain their unique goals to one or two important objectives at a time and do not overwhelm the student with too many interventions at any one time. 

Communication
  • It is recommended that the student’s teaching team be very realistic as to what the child is expected to comprehend and what level of work they can achieve. Students may take twice the amount of time to grasp certain concepts and there may be some things that they will not be able to learn. At this point alternative curriculums may be considered.
  • It is recommended that teacher’s aim to reduce the overall amount of visual information to be stored in visual and verbal memory across all areas of the classroom to ensure that the student’s limited short-term memory does not become overloaded. For example, cut down the amount of pictures on worksheets for them, amount of text to read or highlight the important parts of the text for them to quickly locate.
  • It should be the aim of the teacher to allow the student to meaningfully encode and retain information which can be achieved in a number of ways:
    > sitting the student away from distractions to minimise competing sensory information
    > weaving their interests into the curriculum to increase engagement and meaningful understanding of the information.
    > using concrete and real life examples from the student’s own life and relating it to the concepts being discussed.
    > using a multi-sensory approach to learning rather than simply verbal discussion
  • It is recommended that the student be provided with repetition of concepts and examples with every discussion.
  • These students can create a ‘self-help guide’ that’s meaningful to them which can outline how certain tasks are tackled and they can refer to this when they are expected to complete something similar in the future. Eg: Youtube is popular with children these days, so the child could film a self-help video with their teacher on their iPad that they believe is a ‘Youtube tutorial’ that they can refer to later.
  • Students should be provided with more time to complete work or complete even simple class transitions. During class discussions, is recommended that he/she be allowed to take photos of the board with his iPad to alleviate pressure to rapidly take notes OR record sessions so that they can listen to sessions, pause, rewind and review sessions. Transitions can be visually mapped or pre-discussed before the class begins.
  • If additional time cannot be provided, it is recommended that the quality of work be the sole focus of the teacher rather than quantity.  
  • The student may benefit from being provided with practical alternatives to abstract tasks.
  • It is important that the student’s parents provide the student with opportunities to practice and work on their area of development at home (for example, placing word cards around the house or implementing a ‘word of the week’ for students with limited vocabulary).

Sensory
  • It is usually recommended that the student’s teacher collaborate with an Occupational Therapist to assess the student’s motor and sensory needs. Should the child exhibit sensory seeking or avoidant behaviour that inhibits their ability to participate in the classroom, it is recommended that a sensory diet be developed as well as remedial writing strategies if required. 

Social-Emotional / Behavioural
  • Creating boundaries that are clear, predictable and implemented consistently.
  • Blending difficult academic tasks with rewarding activities that the child has selected.
  • Discussing the child’s behaviour with a collaborative strengths based approach or if the child is triggered by “getting into trouble” a role play or discussion around the behaviour with the entire class may be helpful.
  • Individualised learning plans may seek to contain goals around the theme of self-esteem and self-efficacy if they are exhibiting poor self-efficacy and avoidant/anxious behaviours towards academic tasks.
  • It is recommended that the student be provided with a safe place to co-regulate with a staff member of choice.
  • When deemed developmentally appropriate, it is recommended that the student engage with a Psychologist in an individual or group therapy setting to target their emotional and behavioural difficulties.
  • Enrolling the student into an extra-curricular activity that they enjoy/are good at (such as soccer) would greatly benefit the child, as it maintains a sense of mastery and sense of self-efficacy. 

Educational
  • External tutoring can assist students in grasping the foundational skills that they may have missed. Tutoring can allow the student to attain particular skills in an area of academic difficulty at his/her own pace in a 1:1 supported environment. This is particularly recommended for children who are suspected to have a Specific Learning Disorder.
  • If possible and available to the school, the student can spend time with a Learning Support Officer to receive support for particularly challenging school tasks. 

4: Review and Revise
Pay attention to how the student is responding to the planned interventions and seek to implement these consistently for a minimum of four weeks. Review the student’s progress with the support team and make revisions to the approach/interventions as required. It is also important that progress is reflected on and the interventions evaluated by the child themselves. Overall, it is vital that the support team work hard to ensure that the student feels supported and successful in order for them to thrive from appropriate intervention. 

Autism Spectrum Disorder and Holidays: 5 tips to help your child through the holiday period

17/12/2018

 
ASD and the school holidays | Hopscotch & Harmony Psychology
As we come to the end of the school year, it brings about excitement for many. The end of school year also brings many change – change in routines, end of school year events, end of year excursions, celebrations, step-up days, going away on holidays. For some children, these changes can be unsettling and can make them feel anxious.

Here are 5 tips on helping your child through the holiday period:


  1. Maintain routines. Autistic children generally cope best when they have routines. Routines create structure and predictability, which helps children know what to expect. Where possible try and maintain routines, such as bed-time routines or eating breakfast at the same time each day.
  2. Schedule down time during the day. As mentioned above, the holidays often bring about many changes for a child. Scheduling some down time into the day may help your child regulate their emotions and sensory challenges. Down time activities can be activities that your child finds soothing. For example, these might be blowing bubbles, reading a book, or listening to music.
  3. Use visuals. Visuals can help a child understand the changes that are going to occur. Visuals, unlike our words, remain constant for children to refer back to. There are many different types of visuals that you can use depending on your child’s needs. Some examples of visuals that could be used are: a calendar (this can show your child when they are going back to school), daily schedules (these show what is going to happened during the day), and social stories (these are short stories that clearly explain a social situation). A speech pathologist or psychologist can help you understand how and when to use visuals.
  4. Prepare your child for trips. If you are planning on going away, it is often best to let your child know what to expect. Travelling away from the family home also brings many changes for a child; for example: a different room, a new bed, and different foods. Explaining what to expect can be done using a social story. Having some soothing activities (such as a book, snacks, comfort toys) may help your child regulate their emotions during the travel time.
  5. Have quiet time. Visiting relatives or friends and/or attending holiday events can be overwhelming for some children. Let your child know about safe places they can go to have some quite time during these outings. Also, prepare them with some strategies they can use to help them self-regulate, such as taking deep breaths or using noise cancelling headphone.
We hope you and your family enjoy the school holidays! If you wish to meet with one of our psychologists to help you and your family during this period, please contact us.

Having supportive conversations about sexual orientation with young people

9/11/2018

 
Hilary Sanders, Psychologist
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Life as a teenager can be tough. We all remember what that was like, right? Your hormones are racing, your body is changing, you're juggling competing and increasing demands at school and at home, perhaps also sport and work commitments. You want to be unique, yet at the same time fit in. Impress your friends, your parents, your teachers — There's a lot going on!

Now, imagine on top of this, you are also questioning your sexual orientation. You have noticed you're not attracted to the opposite sex in the same way as your peers. However, attraction to the opposite sex (heterosexuality) is the most commonly expressed sexual orientation in society, so what does that mean for you?

Sexual orientation (or sexual identity) refers to the enduring or evolving pattern of one's sexual, romantic, and/or emotional attraction to a particular sex. Commonly used terms to describe one's sexual orientation include, amongst others, heterosexual/straight, homosexual (gay, lesbian), bisexual, queer, asexual, and pansexual. The acronym LGBTIQA+ (Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, Asexual, and others) incorporates sexual orientation, gender identity and intersexuality, and is often used to refer to sexual identities that differ from heterosexual. It is important to note that these "labels" do not rigidly or personally apply to everyone, and some would prefer to not use labels at all. Sexual orientation is diverse, and unique to the individual.

Living in a heteronormative society can accentuate a sense of difference when you do not identify as heterosexual. Feeling "different" is especially challenging during adolescence because this developmental stage prioritises social belonging and acceptance. The threat of judgment, ridicule, or rejection from others can be overwhelming for young people during this time, and can influence how they express their sexuality, if at all. Research has also found that non-heterosexual young people are more likely to experience mental health difficulties, such as anxiety and depression, compared to other young people (see this link for more information).

We want to ensure our young people feel supported as they learn about themselves and their emerging sexual identities. How we approach sexuality can have a lasting impact on their relationship with us, and their emotional wellbeing, so it makes sense to reflect and think about it.

It’s never too soon, or too late, to begin the conversation!

If you've been asking yourself "What should I say? What if I say the wrong thing? How do I approach my teen, if at all?", the following tips may help.

  1. Create an environment in which your teen feels loved, safe, and respected. Without this stable foundation, they may not feel comfortable opening up to you, or they may doubt your capacity to be emotionally supportive.
  2. Seek opportunities to discuss sexual orientation. For example, if something relevant arises in conversation or in the media (such as the same-sex marriage debate) talk about it. Ask about your teen's views one-on-one, or facilitate a respectful discussion as a family. Treat this as an opportunity to model and explore values of equality, openness, and appreciation of diversity. Make your stance clear: everyone has a right to experience love, and homophobic attitudes are not acceptable.
  3. It is not always about what is said, but what is NOT being said. Avoiding a conversation about sexuality or changing the subject when it arises, even for good intentions (i.e. you assume they don’t want to talk about it), can inadvertently send the message that it is "taboo", which can feed a sense of shame. Further, one conversation about sexuality is not enough; it is an ongoing, evolving conversation. Remain open and approachable.
  4. Do your research, but learn from your teen. Thanks to the Internet, there is endless information available if you wish to expand your knowledge, however at the end of the day, the only expert on your teen's experience is… them! Be gently inquisitive, and seek to learn from your teen by listening, asking questions, and clarifying your understanding.
  5. Express gratitude for openness. A fear of rejection or negative judgment can motivate kids to keep quiet about their sexuality. The sheer fact they have opened up to you is a good sign they feel emotionally safe and trust you. Affirm this! (for example, "Thank you for sharing this with me. It means so much that you trust me. I am always here to listen").
  6. Respect your teen’s privacy. Seek their permission before you choose to share information about their sexuality with others. Establish boundaries together (what they feel comfortable sharing, and who with, etc).
  7. Don't expect to get it "right" every time! Talking about sexuality with your teen might feel awkward or confronting, or might conflict with your beliefs. You might fumble. You might say or ask something that they disagree with — It’s OK! As long as you come from a place of love, respect, and non-judgment, the rest will work itself out.
  8. All this talk about sexuality… Don’t forget the other stuff! Sexuality is only one part of a person. Your teen has so many other aspects that make up who they are. Embrace their strengths, interests, passions, as well as their fears and insecurities… celebrate everything that makes them who they are, and express your love and pride.
  9. Do they need extra support? Support from loved ones is essential for your teen’s mental and emotional health. Encourage help-seeking behaviour by ensuring they have others they trust and can confide in (friends, family, a teacher, etc). Online services and apps are aplenty, and appeal to their age group (for example, Headspace.org.au or ReachOut.com). If you have concerns for their wellbeing and coping, seek the guidance of a mental health professional, such as a doctor, psychologist, or school counsellor.
  10. Ensure you have support too! Parents often get so caught up focusing on their kids' needs they forget to prioritise their own, but we need to ensure we are emotionally healthy too! For tailored support, speak to a mental health professional as suggested above, or check out the services and online information provided below. 
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Helpful services and links:

- Q Life: QLife is Australia’s first nationally-oriented counselling and referral service for LGBTIQA+ people, offering peer supported telephone and web based services between 3:00pm and midnight every day of the week, all around the country. You can call them (between 3pm and midnight) on 1800 184 527 or chat online: https://qlife.org.au/

- BeyondBlue 'Families Like Mine' resource: 'Families like mine' is a multimedia guide that offers practical advice to families of young gender diverse people, same-sex attracted and bisexual people, and those who are questioning their sexuality or gender identity: https://www.beyondblue.org.au/who-does-it-affect/lesbian-gay-bi-trans-and-intersex-lgbti-people/families-like-mine

- Kids Helpline: Kids Helpline is a free, private and confidential 24/7 phone and online counselling service for young people aged 5 to 25. Kids can call on 1800 55 1800. Their website also has information for parents: https://kidshelpline.com.au/parents/
​
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Hilary Sanders is a psychologist at Hopscotch and Harmony Werribee and Belmont who is passionate about supporting people of all ages, however has a particular interest in working with adolescents and adults. Hilary values diversity, and encourages individuals to celebrate their uniqueness- she believes human difference is what makes life interesting! An LGBTIQA+ advocate, Hilary acknowledges the complex nature of sexuality, and is driven to support individuals experiencing challenges arising from sexual diversity

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