Helping Your Children Navigate Their Teenage Yearslibrary.umac.mo/ebooks/b15691743.pdf · HELPING...

Helping Your Children NavigateTheir Teenage Years:

A Guide for Parents

W h i t e H o u s e C o u n c i l o n Y o u t h V i o l e n c e

December 2000

A t the beginning of the 21st centurywe have much to celebrate about our

nation’s young people. Teens of all ethnic-ities are completing high school andenrolling in college at record rates, andmore teenagers than ever before are volun-teering for community service. In addi-tion, many harmful behaviors are on thedecline, including youth violence andgun-related crime, homicide, suicide, teenpregnancy and, in the last few years, druguse. Nonetheless, the rates of youth vio-lence, smoking, alcohol and other druguse, and unintended pregnancy are stillfar too high. And despite a markeddecline in teen homicide over the pastseveral years, far too many communitiesare still scarred by violence.

We know that the best approach to the problem of youth violence is a com-prehensive one, requiring the collaborativeefforts of students and parents, teachers,health care providers, law enforcement,judges, counselors, and religious leaders.That is why, among other initiatives, my Administration created the SafeSchools/Healthy Students Initiative tosupport effective, collaborative responsesto youth violence.

Most importantly, we know that youngpeople continue to need support and guid-ance from their parents as they grow intoadulthood. In May 2000, the First Ladyand I hosted a conference on “Raising

Responsible and Resourceful Teenagers.”At this conference we heard from parents,researchers, professionals who work withteenagers, and from teenagers themselves.The message we heard, loud and clear, andthat has been confirmed by recent studies,is that teens view their parents as the bestsource of information and guidance onserious life issues, and that teenagers ratenot having enough time with their parentsas their top concern.

That is why I directed my WhiteHouse Council on Youth Violence todevelop information resources for parents.This guide provides parents with someuseful communication tips for talking totheir teenagers. It suggests ways to discussdifficult issues—such as violence, guns,tobacco, alcohol, and other drugs—andhelps parents identify the warning signs ofharmful behaviors. In some instances, par-ents may need professional guidance toassist them in dealing with the challengesof raising a teenager, and this guide pro-vides helpful resources.

The great American author and cham-pion of human rights, Pearl Buck, oncesaid, “If our American way of life fails thechild, it fails us all.” In our national strug-gle against youth violence, we must notfail our children. All of us, especially par-ents, share responsibility to keep our chil-dren safe. We’ve all got to do our part,and this guide should help.

— President William Jefferson Clinton

Foreword

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White House Council on Youth ViolenceThe White House Council on Youth Violence was established by President Clinton inOctober, 1999, to coordinate the federal government’s efforts in the research and preven-tion of youth violence. The Council is chaired by the Assistant to the President forDomestic Policy, and the Council members are the Attorney General and the Secretariesof Education, Health and Human Services, Housing and Urban Development, Labor, and Treasury.

Sonia G. ChessenDirector

Marie E. BurkeDeputy Director

Nicholas J. LewinAssociate Director

RADM Susan Blumenthal, M.D.U.S. Assistant Surgeon GeneralSenior Public Health AdvisorScientific Editor

AcknowledgmentsMany individuals contributed to the development of this document. The White House Council on Youth Violence wishes to thank Dr. Robert Schwebel, the primary author of this guide, and Teddi Fine, Charlotte Gillespie, Anne Mathews-Younes, Carole Skog McGeehan, Bill Modzeleski, Carolyn O’Connor, Louise Peloquin, and Farris Tuma, for their assistance.

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T his is an exciting time to be a teenag-er in America. Young people today

are growing up in a rapidly changing soci-ety with hopes for a very promisingfuture. Survey results show that 84% ofhigh-school students plan to attend afour-year college. Teens overwhelminglyshare their parents’ values of honesty andhard work, and are engaged in positiveactivities. More than half of all teenagersvolunteer with a community organization,attend a house of worship weekly, read thenewspaper twice a week or more, andattend cultural events or visit museums.

In spite of this positive outlook, how-ever, adolescence—the transition betweenchildhood and adulthood—is still one ofthe most difficult times for children andparents alike. Growing up is more thanthe physical changes that occur, such asgetting taller or more muscular. This pas-sage is a time for establishing independ-

ence, testing limits, tryingon different roles, exploringnew feelings, and fosteringintellectual growth. Aboveall, adolescence is a processthat takes time to happen.

We have all heard the frightening andheart-breaking statistics about youth vio-lence, depression, tobacco, and alcohol

and other drug use. Even the best-informed young people are constantlytested by social pressures, emotionalneeds, and their peers. The push and pullbetween right and wrong can become atug of war between adolescent and parent.

Being a parent, grandparent, fosterparent, or caregiver of a teen is bothrewarding and challenging. Caring adultscan make all the difference in a child’s life.

This guide provides some useful toolsto improve your communication with yourteenager to help him or her get throughadolescence successfully. Read it all orselect the sections that help you the most. ■ Getting the Conversation Started—

tips for opening up the dialogue, evenafter it has been shut down. (Page 2.)

■ Increasing Responsibility andFreedom—ideas for how to set the lim-its that protect your teens while still giving them room to grow and develop.(Page 6.)

■ Managing Anger: Theirs and Yours—anger-management skills that you canuse, and that you can share with youradolescent. (Page 8.)

■ Handling Tough Situations—examplesof difficult situations, identification of warning signs of trouble, and adviceon how to handle certain problems.(Page 10.)

■ When Parents Need Help First—help-ing your spouse, or yourself, deal withissues that are affecting your ability toparent. (Page 18.)

■ Getting Help for Your Teen—suggestions about how to get helpfor your teen and your family.(Page 22.)

Introduction

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Many parents worry when theirteenagers don’t want to spend as

much time with the family as they didwhen they were younger. This can beboth hurtful and frightening. You worryabout their safety and about their future.It is normal for children to want to spendmore time with their friends during theteen years, but it shouldn’t mean thatteens ignore their families. Parents andteens need to take action to stay connect-ed or to reconnect.

I used to be close with my daughter. Shewould talk with me about everything.Now she’s 14 and avoids me. She isquiet at dinner, and then goes to herroom or talks with friends on the phoneall evening. Sometimes she gets moodyand angry. I want to reach her the wayI used to, but I don’t know how to start.

Sometimes the solution is easy. Spendmore time together. Suggest doingthings that you both enjoy. Talkmore. Dinnertime is an excellent

opportunity for that kind of exchange.Talk about your day. Ask your teen abouthis or her day. Be sure the television isturned off and you and your teen aretuned in.

Most teens agree that they want tospend more time with their parents. Youmay be surprised to learn that a recentstudy indicated that most teenagers rate“not having enough time together” withparents as their top concern. Many will beglad that their parents care enough tomake the effort to spend time with them.

How Do You Get Your Teenagerto Start Talking to You Again?The best way to help teens open up—andstay open—with parents and other adults intheir lives, is by showing your acceptance ofthem. When they make a mistake or misbe-

have, you can lovinglyhelp them learn fromtheir experience. Makesure they know thatyou love them, evenwhen you may be trou-bled by their behavior.

Why Do Teens Stop Talking? Sometimes they’re trying to be inde-pendent. Sometimes they’re embar-rassed about their own thoughts andfeelings, such as anger, or their sexualdesires. Sometimes, teens shut downbecause of pressures they feel at home,at school, or in the community. One ofthe most important reasons teens stop talking to you is thatthey’re afraid to speak honestly with their parents. They believeif they talk openly about things they have done that might bewrong, they’ll be given a lecture, punished, or criticized.

Getting the Conversation Started

Some teens have a hard time expressinganger and upset feelings. They keep theirfeelings bottled inside. Parents need to draw such children out. Try to start a con-versation by saying “I can see you’ve beenupset. Let’s talk about what’s happening.”

Some teens, however, may give parents the cold shoulder. If that hap-pens, be patient, and be persistent until you break through. If you can’t breakthrough, there could be a more seriousproblem than embarrassment or a difficulty communicating.

Listening to Your TeenLet teens know you will listen and try tounderstand their point of view, withoutputting them down or trying to controlthem. Being open-minded sometimes canbe difficult for adults. But to communicatewith teens, parents need to do more thanjust talk; they need to listen, and really hearwhat their teens are saying. They also needto notice which issues are not being dis-cussed and have the courage to start a dia-logue about those issues.

When disagreements arise, listening doesnot mean that you give up your authorityas a parent. It does mean giving teens avoice in matters that concern them.Through family dialogue, parents get toknow what their teens are thinking andfeeling, and teens get to know where theirparents stand. Sometimes parents and teenscan reach agreements when none seemed

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HELPING YOUR CHILDREN NAVIGATE THEIR TEENAGE YEARS: A GUIDE FOR PARENTS

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The pressures you felt as an ado-lescent have been magnified forteens today. You will recognizesome of these as issues that con-cerned you during your youth.Others are unique to today’s teens.

■ Wanting to be part of a group■ HIV/AIDS■ Changing family structures■ Gangs and violence■ Insecurity about the future■ Money pressures■ Teen sexuality and pregnancy■ Media influences■ Concern about body image■ School pressures■ Easy access to alcohol, tobacco,

illegal drugs, and guns

possible. Even when agreement cannot be reached, teens are more likely to dowhat their parents wish if they feel thattheir parents listened to them with anopen mind.

Tough TopicsParents can become frustrated when theytry to start a conversation with theirteenager and he or she just isn’t interested.There are tough topics, however, thatneed to be discussed. Teenagers face pres-sures and temptations aboutalcohol and other drugs, sex,tobacco, guns, and violence.They need and deserve adultsupport. Don’t wait for a cri-sis. Ideally, parents shouldfind times andways to talkwith their teensbefore seriousproblems occur,preferably earlyin the lives oftheir children.But it is nevertoo late to start.

Sometimes, you can simply begin adialogue about these issues as part ofnormal conversation. Often, “teachablemoments” happen during day-to-dayactivities. For example, you could discussunderage drinking when someone getsintoxicated in the presence of your family,or in a movie, or when you see a newspa-per story about an accident caused byteenage drinking. You could discussviolence, and better ways of solvingproblems, after watching a TV show ormovie that portrays violence as a solution

to a disagreement. If your teen doesn’t want to

talk, try to be clear that yourpurpose is to build under-standing and to be supportive,certainly not to find fault orto punish. If you can’t nudgeyour child into a dialogue,back off for awhile. This strat-egy can be disarming. Then,give your son or daughtersome time to think it over. A few days later, you can tryagain to start the discussion.Parents can be flexible in get-ting the dialogue going, butshould not give up on theneed for this discussion toeventually begin. Although itmay be harder to get boys toopen up, parents shouldengage in dialogue with theirsons and daughters alike.

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Being Sensitive to CulturalDifferencesTeens in minority ethnic and racialgroups may face particular pressuresrelated to their status as minorities.Parents of these teens should be espe-cially sensitive to these pressures, as wellas cultural and language differences thatmay affect your teen’s interactions atschool, with peers, and with others.

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Today’s teens, more than ever before,need to connect with adults—if not a parent, then a coach or teacher, grand-parent or foster parent, clergy member, or other trusted adult in their lives. Teensneed an adult with whom they can talkopenly. They should not be left to relysolely on other teens for important infor-mation, conversation, and help with prob-lem solving about how to grow up wisely.

SOMEONE YOUR TEENS CAN TALK TOTry to establish strong commu-nication with your teen, butremember that some teens maytalk more openly about sensi-tive topics with someone whois not their parent or guardian.If you are a parent, try not tolet this hurt your feelings;remember that your child willrespect you more in the longrun if you encourage him orher to talk with someone else,if that is what works best.Single parents, and other par-ents, may want to find a men-toring program that can be asource of support, and can pro-vide someone with whom yourteen can talk. Your teen'sschool guidance counselor mayknow about such programs.


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You don�t trust me . . .But they�re my friends . . .Everyone else is doing it . . .

T eens need their independence, buthow do you make sure they are safe?

It’s tough to decide when to give your teenmore freedom. Do you hang on to the

kite string for as long as youpossibly can, or give the kitefree air? The decision isn’teasy. One parent’s decisionfor his or her teen may notbe right for other parentsand their teens.

Although every adolescentis different, there are manyexperiences common to theteenage years. The most com-mon may be the pull andpush between dependenceand independence.

Teens, at younger andyounger ages, are puttingthemselves at risk for sexuallytransmitted diseases—includ-ing AIDS—and for pregnan-cy. And some teens, and even

younger children, smoke tobacco, drinkalcohol, use other drugs, or commit acts ofviolence and other crimes. No wonder somany parents are concerned, even fright-ened; no wonder so many try to controlthe behavior of their teenage children.

It is important for parents to makerules for their young children. As childrenget older, however, they need to learn tomake some of their own decisions and lifechoices. Teens need the chance to practicegood decision-making skills, and to man-age new life experiences. Parents need togive teens the freedom to do just that. Butthere is a catch: teens must be ready. They

need to agree to behave in responsibleways and show that they can handle thefreedom. They also need to keep their par-ents informed. That way, parents knowwhen to lend guidance and supervision,and how to support their teen’s progress.

That’s where respect, responsibilityand reliability come in.

RReessppeecctt:: Respect is a two-way street, butit starts with you. Give your teens therespect that you would like to be given.Give them credit for their knowledge andabilities; pay attention and listen to them.That means showing confidence in yourteens, and being supportive.

RReessppoonnssiibbiilliittyy:: Teens are learning to takecare of themselves as they prepare foradulthood. That’s what growing up is allabout. Give them an appropriate amountof freedom and independence. Encourageand promote responsibility and good deci-sion-making, offering support and gentlehelp with difficult decisions. Let yourteens know they can gain more freedomas they demonstrate increasingly respon-sible behavior.

RReelliiaabbiilliittyy:: Part of growing up is learningand adapting to rules—rules about drivingand work, rules about drinking and dating,social rules and family rules. Teens will testthe rules, but over time most will makethese rules part of their lives. This kind ofreliability is worthy of recognition andpraise. When you can rely on your teensbehaving responsibly, it may be time togive them more freedom.

Parents should believe in their teens; sethigh standards for them, encourage them,expect them to achieve their goals, andprovide consistent love and support—including practical help—so they canachieve the promise that lies within them.

The Challenge:To help teens learnabout the world andaccept new challengeswith the least amountof danger and harm.Parents must walk afine line between con-trolling too much andbeing too relaxed aboutrules. When parents aretoo restrictive, they canpush teens towardrebellion. When theyare too permissive, teensmay get out of control.It’s a balancing act.

Increasing Responsibility and Freedom

Clothing and hair . . . where do Idraw the line?

Jason is doing well in middle school. He’sgreat with his younger brothers and helpsaround the house, but I’m concerned aboutsome of his new friends. Some have dyedtheir hair odd colors; they wear baggy jeanswith their boxer shorts showing. A few havepierced tongues and tattoos. A while ago,Jason asked about getting those baggy jeans.I said no, because the gang kids wear them. Ihoped he’d forget about them, but he hasasked again. Between the drugs in ourneighborhood, baggy jeans, and new friends,I’m worried. I want to steer him away fromproblem kids. Should I let him buy thejeans? What should I do about his friends?

Adolescents are striving for independence. Asteens prepare for adulthood, parents shouldencourage independence, while making suretheir teens don’t drift too far from a positivecourse. How should parents react to the choicesof their teenage children? In general, extendtrust and give children as much freedom ofchoice as they can handle. Be sure to set limits,too. Your decisions about the baggy jeans andabout your son’s friends require careful evalua-tion of all the details. You need to think aboutyour own values, look realistically at whereJason seems to be headed, understand what heis doing or wants to do, and determine howbest to promote his safety and growth.

Jason is doing well in school and not get-ting into trouble. Success in school gives chil-dren a sense of accomplishment. They can seea positive future for themselves and are less

likely to want to join a gang. These facts arguefor giving him more freedom. When it comesto his friends and his preferences in clothing,you need to gather more information if you’regoing to make a smart decision. You need toknow more about your son’s friends: What arethey like? Do they use alcohol or other drugs?Are they in gangs? How does your son feelabout these kids? How does he feel about druguse? How does he feel about gangs?

Get to Know Your Son�s Friends

Ask your son to invite his friends to yourhome so you can meet them. You’ll show thatyou have an open mind. If his friends behavepoorly in your presence, your son will notice.

You also need to understand what thebaggy jeans mean to Jason. Are they just astyle he likes? Or is wearing them a way toidentify with a gang? Sometimes teensdress differently just to harmlessly showsome independence from the family.Think back to your own adolescence,and remember the fashion changes.There may be some similarities.

Have a discussion with your sonabout his friends and about the cloth-ing he likes to wear. Sometimes discus-sions can bridge differences. Maybeyour son will be swayed by what yousay about the jeans and gangs, or maybe hewill convince you that baggy jeans havebecome a style that has little to do withbelonging to a gang.

A conversation with your teen can helpyou decide whether there is a real problemor it is just a question of fashion.


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Warm family relationships can helpprotect children from acting

violently, abusing alcohol and other drugs,or engaging in other high-risk behaviors.But family members—even in the mostloving families—get angry at one anotherfrom time to time. When families com-municate well and work cooperatively,anger can be resolved without a problem.Handled poorly, however, anger gets inthe way of good communication betweenparent and child. Anger without controlcan sometimes be dangerous and mayeven become violent.

Many adults are not good at managinganger, and expressing this emotion in ahealthy way. Some adults see anger as anemotion that should be suppressed,because it leads to trouble. Some grew upin families in which anger generally led toexplosive behavior and even violence.Others were taught that it is not “nice” to be angry. It’s important that parentsknow how to manage anger successfully in family life, at work, and in the com-munity. And that same knowledge needsto be shared with children, so that theylearn this important skill.

My teenage son doesn’t know how tohandle his intense feelings. He talks backto us and even swears at us. He doesn’tdo what we ask him to do. He seems tobe trying to aggravate us. I get so angry Iblow up. We end up screaming at eachother and saying things we regret. I feellike things are out of control.

With the many changes that occur duringadolescence, it’s not unusual for teenagersto feel anger and resentment toward par-ents. Adolescents struggle to establish

their own independent identities as theyprepare for adulthood. Sometimes anger istheir way of asserting independence. Thiscan wear thin on parents, who may fightback with their own anger, creating avicious circle of escalating resentment.

The best solution to out-of-controlanger—whether from a parent or from ateen—is to step back, and identify morepositive, healthy ways to deal with strongfeelings. We do this when we can calmdown and respond in a disciplined andthoughtful way. By maintaining compo-sure, parents can be good role models andopen the door to constructive communi-cation with their children.

But how do you keep calm when you feel pushed to the limit? Here aresome suggestions:

Tips for CalmingDown■ Pick your battles. Sometimes the issue

is not worth the anger, or worth argu-ing about.

■ Take a deep breath; count to ten.Think about the issue before a singleword comes out of your mouth.

■ Go for a walk.

Managing Anger: Theirs and Yours

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■ Use “self-talk” to calm down. That is,say something soothing to yourself suchas: “I need to relax and stay calm. I can’tafford to blow up.”

■ Reframe the issue. For example, whenyour son says something rude to you, itmay be less a matter of him disrespectingyou than a sign that he has a problemwith his anger. “Framing” it this way, youfocus on the fact that he needs your helpin overcoming this problem.

■ Use humor. Humor can sometimes be a good way to calm anger, but be surenot to use sarcasm, which can sometimesbe hurtful.

Sometimes the hardest part of helpingchildren learn to manage their anger is thatparents have to look at their own practices.Parents need to ask:

■ Do I express anger in positive andconstructive ways?

■ Do I resolve conflict well?

■ Have I taught my children to accept and express their anger?

Resolving ConflictResolving conflict constructively may bea huge challenge, but it’s an absolute necessity for the sake of every member ofyour family.

Once you are calm, you are in a better position to address the issues that causedthe conflict. Here are some tips:

■ Give your point ofview. State theproblem as you see it;speak clearly and calm-ly—don’t yell.

■ Ask to hear your teen’spoint of view.

■ Pay attention, listen,and carefully considerwhat your teen is saying.

■ Discuss ways to solve the dis-pute without a battle.

■ Practice the art of compromise.Find the middle ground youcan both live with comfortably.

■ Assert your authority, whenappropriate, but in a calm, yet firmmanner.

What If the AngerDoesn�t Stop?When anger becomes a chronic problem forsomeone in the family, the underlying issuemay be larger than you or your teen canmanage. If you even think your family is atthis crisis point, or if you even think you orany member of your family has a seriousproblem with anger management, it’s timeto seek help from a mental health profes-sional. Recognize that this situation necessi-tates counseling, and sometimes that meansthe entire family will need help. Refer tothe sections on “Getting Help for YourTeen” (page 22).


T eenagers, like all of us, sometimesneed help and guidance, but it can

sometimes be difficult for parents to rec-ognize when to intervene in their teenag-er’s life. You know about the challengesthat today’s teenagers face—some ofwhich are different than those you experi-enced as a teen. Understanding these chal-lenges, and knowing when and how to

intervene to help your child overcomethem, is an essential role for parents.

It is also a difficult role. Being able totell the difference between normal teenagebehavior and self-destructive, hurtfulbehavior is critical. The following exam-ples are designed to help youunderstand some of thewarning signs that your

What If Your Teen Is Being Bullied?Bullying is a serious problem, affecting many children.A recent study indicated that nearly 1 in 10 students ingrades 6 through 12 have been bullied in the past year.

Victims of bullies need help and support inresponding to this aggressive behavior. Many parentsgive their children conflicting messages about how torespond to physical aggression. Should you encourageyour teenager to “fight back” or not? We do not wantto resort to violence, but we also do not want our chil-dren to be victims and to feel powerless. Most expertsagree that children should not hit back, other than forself-defense and survival. Retaliation perpetuates a cycleof violence. It may also lead to escalating physical con-frontation, which can be very dangerous, especiallyconsidering the possibility that weapons might be used.

Parents can help their children who have beenteased or bullied learn to be powerful, withoutresorting to violence. You could start by letting yourteenager know that you seriously disapprove of taunt-ing and other types of bullying behavior, and that youthink no one should have to put up with this. You canempower teens by asking them if they have any ideasabout what might end the bullying.

Parents can teach teens some powerful, non-violentways of responding when they are bullied:

■ Demonstrate strength by using eyecontact and positive, self-assured bodylanguage, with head held high andshoulders back.

■ Practice “verbal self-defense,” using any-thing from humor toclever comments to de-escalate tension.

■ Proudly walk away from provocation, andignore taunting.

Young people are entitled to a safe learning environ-ment in their school. Another way to empower yourteenagers can be to encourage them to speak withschool administrators about the problem. In part theymay want to raise the issue of their own situation, andtheir own safety fears. Sometimes, it is most empower-ing to discuss the situation as a school-wide problem,without focus on particular perpetrators. Parentsshould back up their children by also voicing the sameconcern. School/community partnerships can lead toeffective programs that reduce bullying behavior.

If teenage children have been picked on for a longtime, they probably have some intense emotions fromthat experience, and could benefit from talking aboutthem. Victims of bullies may experience anger, anxi-ety and even depression. Being the victim of a bullycan also be a risk factor for engaging in violentbehavior. Your teens need and deserve help copingwith these feelings. You or a mental health profession-al can give them opportunities to express themselves,and resolve these feelings.

Handling Tough Situations

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teenager may need help. Read through theseexamples and see if any sound familiar.

Remember, though, that every teenageris different and there is often no clearanswer to your specific situation. If you areconcerned, talk to your teenage children. Ata minimum, let them know how you feeland tell them that you would like to talk. Ifyou are still concerned, or if you think thatyour teenagers may hurt themselves or oth-ers, you should get help immediately. Referto the sections on “Getting Help for YourTeen” (page 22) for assistance in finding theright resources.

BullyingI was called to my 13-year-old son’s schooltoday because he stole some money fromanother boy during lunch. This wasn’t thefirst incident. A few weeks ago, the prin-cipal called because Keith made anotherboy take the blame for graffiti he wroteon the school bus. No matter what we tellhim, he constantly seems to get in trouble.What can I do?

You certainly have reason to be concernedabout your son’s behavior. He is acting like abully and needs your help to put on thebrakes. The principal was right to call. Theschool can set a clear standard—no bully-ing—and make sure that your son under-stands the consequences for violations of thisrule. You, too, need to make clear that youdisapprove of bullying. You need to helpyour son develop empathy—which is the

ability to understand how other peo-ple feel—and to care about others’feelings. You will probably want toimpose consequences on your sonfor his unacceptable behavior. Befirm, but do it in a loving way. Rightnow your son needs yourempathy, understanding, andlove. By providing this, youcan show the power of caringabout others in a positive way.

This still leaves the biggerpart of the problem—gettingto the reasons for your son’sbehavior. You have to talk with him to deter-mine why he is being a bully. What leadsyour son to behave in such hurtful ways?

With your help, or with the assistance ofa professional, your son can understand hisown motives for bullying. Some young peo-ple are bullies because they are bored andcrave excitement; some do it to feel power-ful; some engage in this behavior as aresponse to family problems; some do it forattention and to be popular with their peers.You need to ask him very detailed questions:

■ Did you plan to take the other boy’slunch money beforehand, or was it asudden urge?

■ Why did you pick on that particluarperson?

■ What were you thinking when you did it?(Ex: I need the money; I’ll look cool.)

■ How did you feel when you did it? (Ex:Excited, thrilled, frightened, powerful).


■ How do you think the other boy felt?

■ What’s happening in your life or in ourfamily that may be upsetting you?

When you understand the details ofwhat happened, you can determine how tohelp your child. For example, if your sonstole money because he saw it sitting on alunch tray and had a sudden urge to grabit, he will need to learn to recognize hisimpulses, and to stop them. If he plannedto steal money, pre-selected a victim andstole because he wanted to look impor-tant, he will need to learn positive ways tomake friends and gain peer acceptance.

We have to help our children learnhealthy and socially acceptable ways tocope with urges and anger, and to satisfytheir emotional needs appropriately. A bigchallenge? Yes. But it’s part of growing upand becoming a good citizen.

Drug Use and Failurein School

Our 16-year-old daughter, Julia, wascaught drinking at a party. We suspectthat she has smoked marijuana, too. She has been doing poorly in school—in fact, now she’s neglecting her school-work and failing one subject. We set up required study time, but it hasn’thelped. She misses curfews and hasn’tbeen doing her chores. We’ve talked withher about alcohol, drugs, and sex, andwe’ve been clear about the rules andconsequences when she has broken them.Obviously, it hasn’t worked. She says I’m a nag. What else can I do?

Alcohol and Substance Abuse

Julia's drinking and possible drug use maybe the tip of the iceberg. Alcohol and other

drug use often occur alongwith other serious problems.

First, you need to talk to Julia and find out what drugs she is using and how often she is using them. Don't con-front her when she seems to be under the influence of alcohol or other drugs.Wait until she is straight and sober. Thendiscuss your suspicions with her calmlyand objectively, as you begin a dialogue.Bring in other members of the family to help, if necessary.

Second, impose whatever disciplineyour family has decided on for violatingthe rules, and stick to it. Don't relentbecause she promises never to do it again.Make sure that she knows that her use ofalcohol and other drugs is a serious prob-lem and that she is harming herself.

If Julia has developed a pattern of druguse or has engaged in heavy use, youshould get immediate help. If you do notknow about drug treatment programs inyour area, call your doctor, local hospital,or county mental health center for a refer-ral. Your school district should have a sub-stance abuse coordinator or a counselorwho can refer you to treatment programs,too. Parents whose children have beenthrough treatment programs can also pro-vide information.

Many young people lie about theiralcohol and drug use. If you think Julia isnot being truthful and the evidence ispretty strong, you may wish to have her

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evaluated by a health professionalexperienced in diagnosing adolescentswith alcohol- and drug-related prob-lems. Refer to the sections on “GettingHelp for Your Teen” (page 22) forinformation about how to find some-one who can help.

Listed in the box at right are signsthat may indicate problems with alco-hol or other drugs. They could alsoindicate other problems, not related todrugs. In either case, if you observesignificant changes in your teen'sbehavior, something is wrong. Start adialogue with your teen about theproblems. If you are still confusedabout whether alcohol or other drugsare part of the prob-lem, or if you recog-nize that a substanceabuse problem exists,get professional help.

School Failure

Failure in school isanother serious issue,but nagging is thewrong approach, andenforcing study timesusually doesn’t work,either. Parents oftenassume that school problems are caused bylack of effort, and thatmaking kids study more will improve their performance.

POSSIBLE ALCOHOL OROTHER DRUG ABUSE

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Research has shown that there are a number of fac-tors that make individuals more likely to initiatedrug use and to progress to drug abuse and oraddiction. Many of these can be identified early byfamily members and friends. It is important to notethat many people may exhibit one or more of thesesigns, but not necessarily use drugs. These signsmay occur in the following areas:

■ Family: deteriorating relationships with family;behavior changes, such as withdrawal or hostility

■ School: truancy; drop in grades; behaviorproblems

■ Social life: deteriorating relationships with oldfriends; developing a network of friends who areusing alcohol or other drugs; loss of interest insports or other favorite activities

■ Emotional life: basic personality changes; inex-plicable and sudden mood changes; apathy

■ Physical: memory problems, fatigue or hyperbehavior; difficulty walking; sleep disturbances;red, blood-shot eyes; carelessness with grooming

■ Physical evidence: disappearance of beer orliquor supply; money or valuables missing; useof cigarettes; signs of drug paraphernalia; use ofincense; excess money or missing money

Source: Adapted from National Instititute on Drug Abuse, National Institutesof Health


Usually there is much more to it. Forexample, children may be having troublewith academic work and need tutoring.They may have a learning disability or theymay need help with study skills (under-standing how, when and where to study).They may also be upset about somethingat home, at school, or with peers, that isinterfering with their concentration. Evenwhen the amount of effort invested inschoolwork is deficient, usually the under-lying cause is discouragement, rather thanlaziness. The remedy is support, not morepressure. We need strategies to get teensthinking and solving problems for them-selves. Dialogue is the most effective wayto get them started.

How long agodid Julia startslacking off inschool? What doyou think has beenholding her back?You need answersto these questionsto determine howto correct the prob-lem. Encourage

Julia to consult with herteachers or the school coun-selor, and offer to partici-pate in these meetings. Ifneed be, you can consultwith the school or get otherprofessional help. Using allavailable resources, you and

your daughter should be able to determinethe causes of the problem. Once you knowthe causes, the solutions should becomeclearer. Your daughter will still have someobstacles to overcome, but at least she willbe headed in the right direction.

Sadness/DepressionSarah has never had much confidence.High school is harder than she expected.My husband and I are divorced, andthis has been very hard on her. Now,she looks and acts absolutely exhausted,doesn’t sleep, and just sits in her roomcrying with her door closed. When shegoes out, she dresses all in black cloth-ing and wears heavy black eye shadow. I have tried to talk to her, but she actsangry and won’t say a word to me. Ican’t tell if Sarah is just “going througha phase” or is truly depressed.

The teen years offer new experiences andchallenges that can be exciting, but alsostressful. The stress of adolescence is oneof many factors that can make young peo-ple unhappy. Teenagers are also experienc-ing hormonal changes which can affecttheir mood. Some sadness and moodswings are a normal part of life. But whenthe “blues” last for weeks, or interfere withschool, home, or other activities, yourteen may be suffering from clinical depres-sion. Depression, a mood disorder that isa real medical illness, is often unrecog-nized, but can be effectively treated.

When teens, or anyone, are very upsetabout things, they need to talk with some-one who cares and can help. Parentsshould be concerned and talk with theirchild about his or her unhappiness,whether it is a temporary state or a caseof clinical depression. We should set anexample of confronting problems, head on.

It is sometimes hard to tell when teensare depressed, because the symptoms maybe hard to read. For example, you maymistake a sleep disturbance, which can bea sign of depression, for a late-night televi-sion habit, or your teen may only reveal

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her sadness in writings that contain morbidthemes. Teens may say they are “bored”when, in fact, they are depressed. In addi-tion, signs of depression may vary amongcultural groups: Teens in some groups expe-rience sadness or guilt; while others experi-ence more physical symptoms, such asheadaches and nervousness.

Clearly, Sarah is unhappy and may besuffering from depression. What is going onin her life to make her feel this way? Thinkabout past and present problems. When didthis crying begin? Did it coincide with fami-

ly tension, or the divorce, or problems inschool? How is she getting along withfriends? How are things in your family, now?Are there any other problems or symptoms?The answers to these questions provide cluesabout what is wrong and how to help her.

Depression does increase the risk ofsuicidal behavior. Many teens think aboutsuicide, and some of them follow through.Parents should be especially concerned andget professional help immediately if addi-tional warning signs are evident, such aswhen a child has a history of previous

DEPRESSIONIf a number of these symptoms persist for two weeks ormore, a person may be diagnosed as clinically depressed.Parents should talk with children if any of these symptomsoccur:

■ Persistent sad, anxious, or “empty” mood

■ Loss of interest or pleasure in activities

■ Restlessness, irritability, or excessive crying

■ Feelings of guilt, worthlessness, helplessness, hopelessness,pessimism

■ Sleeping too much or too little

■ Appetite and/or weight loss, or overeating and weight gain

■ Decreased energy, fatigue, feeling “slowed down”

■ Thoughts of death or suicide, or suicide attempts

■ Difficulty concentrating, remembering, or making decisions ■ Persistent physical symptoms that do not respond to treat-

ment, such as headaches, digestive disorders and chronic pain

Source: National Institute of Mental Health, National Institutes of Health

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suicidal behavior, hints at not beingaround in the future, expresses a desireto die, gives away prized possessions, hasexperienced a recent loss, or makesthreats of suicide. Sarah needs to talkwith someone who cares and can help.Give her an opportunity to discuss herfeelings and what is causing them. If she

won’t open up with you, find an adultwith whom she can talk, such as a familyphysician or a mental health professional.

Anger and Violence My 16-year-old son, James, is failing inschool. He is often angry, has no inter-est in our family, and sometimes doesn’tcome home until 4 a.m. I have no ideawhat he’s doing and worry he might getinto trouble. At home, he spends mostof the time in his room playing violentvideo games and listening to music withviolent lyrics. I’ve heard him plotting“revenge” with friends, and he seems toalways be talking about differentweapons. This worries me, but I don’treally believe he would hurt anyone.What can I do?

You are right to be worried. Although it is difficult to predict who will becomeviolent, there are certain risk factors thatmay warn of possible danger. It is impor-tant to keep in mind that the presence ofthese signs does not necessarily mean thata person will become violent. These riskfactors include: a history of violent or

aggressive behavior, carrying weaponsor access to weapons, the use of alco-hol and other drugs, isolation fromfamily and/or peers, poor grades, andtrouble controlling anger. The more ofthese warning signs we see, the more

we believe that children are “atrisk” for violent behavior. No sin-gle factor indicates a problem, butif we see a pattern of several riskfactors, it’s time to take precau-tions. James exhibits many of thesewarning signs. He is isolated fromhis family, failing in school and

Risk Factors for SuicidePeople most at-risk for committingsuicide are those who have several ofthe following characteristics. It isimportant to note that many peopleexperience one or more of these riskfactors but are not suicidal.

■ Previous suicide attempt

■ Depression

■ A family history of suicide

■ Easy access to lethal methods (especially guns)

■ Abuse of alcohol or other drugs

■ Loss of a relationship, or a social humiliation

■ A serious physical illness

■ Social isolation

■ Hopelessness

■ Impulsive or aggressivebehavior

■ Being a runaway

Source: Adapted from the SurgeonGeneral's Call to Action toPrevent Suicide (1999)

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staying out much too late at night.He has discussed weapons, has aproblem with anger, and you heardhim plotting revenge. Has Jamesbeen bullied, or excluded, or teasedby peers or family members?Children who have been bullied,mistreated by others, or feel theyhave been mistreated, are also athigher risk for being violent than those whohave not. The same is true for children whofeel rejected or alone.

As you consider various risk factors, bearin mind that these are “red flags,” not pre-dictors of violence. They are warning signsof possible trouble. After some of the recenthigh profile shootings in schools, the mediahas publicized lists of warning signs. Theselists can be used to unfairly label nonviolentyouth as dangerous, because many adoles-cents who will never become violent willshow some of the red flag behaviors.

Still, parents should recognize thesewarning signs and use them as a cue thatsomething is wrong and a child needs help.

When parents see a serious problemaffecting their child and can't seem toresolve it, they should connect with some-one who can. To help James, you shouldlook for a child/family mental healthprofessional who is well-respected in yourcommunity and experienced in working

with adolescentsand their fami-lies. When ateen exhibits anumber of warn-ing signs for vio-lence, as Jamesdoes, parentsshould actpromptly—forsafety’s sake. As a precaution, they shouldmake sure their children do not have accessto firearms, and remove other dangerousmaterials or objects from the home. Referto the sections on “Getting Help for YourTeen” (page 22) for guidance.

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P arents can do much to help theirteenage sons or daughters through a

variety of difficult situations. Depression,violence, substance abuse, and bullying areall serious issues that parents and teens canwork together to help resolve. Sometimes,however, parents need to confront theirown problems before they can help theirteenager. Children who live in violenthouseholds, or homes where one of thecaretakers uses drugs or abuses alcohol,often sustain severe emotional trauma thatcan last a lifetime. Even if a parent’s vio-lent behavior or substance abuse occurredwhen a child was small, the child may stillsuffer during his or her adolescent years.

Domestic violence andparental alcohol or other drugabuse adversely affect children.Research shows that approximate-ly 90 percent of children who livein homes where there is intimatepartner violence see or hear theabuse. Further, children who are

exposed to family vio-lence are much morelikely to become violentthan are children fromnonviolent families.Studies also show that ifa parent uses alcohol ordrugs, his or her children

are more likely to drink or use drugs.Below are examples of situations where

children have been affected by current, or even prior, parental behavior. If thesesituations sound familiar and if you needsome help deciding what to do, read theresources listed at the end of this sectionand reach out for help for yourself or your partner.

Parental Alcohol orSubstance Abuse

I was called to school by my daughter’sprincipal. Apparently, when her mathteacher corrected her in class, Deirdrethrew a book at him and stormed out ofthe classroom. Deirdre’s explanation wasthat “no one else cares, so why should I?”Today was a wake-up call. I have toadmit it: My wife has a serious problemwith alcohol. I’m not home much. I’malways avoiding the chaos. I know thisis serious. What can I do now?

It sounds as though you recognize thatyour wife’s alcohol abuse is affectingDeirdre. This is the first step. Parents withserious alcohol and other drug problemsare often overly absorbed in their ownneeds and problems. They may not pre-pare meals, or be present at them. Theymay not carry their share of the house-hold responsibilities. They may not prop-erly supervise their children’s homeworkand other aspects of their lives. Oftentheir moods dominate the family. Theiranger leaves other family members fearfuland anxious. Roles may be confused andchildren end up taking care of the par-ents. Communication is often muddled.

Teens in such families feel isolated andalone, with no one to talk to. Their hurtand angry feelings may lead to depression,their own abuse of drugs, or may evenerupt in violent behavior, as in your situa-tion with your daughter. Children alsosometimes seek attention and/or act outtheir feelings by shoplifting or commit-ting other crimes.

So what can you do? First, childrenshould not feel alone and abandoned, nor

W hen Parents Need Help First


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should they be caretakers for their parents.Deirdre needs a parent who will take respon-sibility and act as a parent should. Make itclear that you are assuming this responsibili-ty and let her know that you love her. Shealso should know that you are aware that hermother has a problem, and that it is affect-ing the whole family. Take time to talk withDeirdre about what happened in school andabout how she is feeling about things athome. Finally, you should encourage yourwife to get help immediately.

If a family member with analcohol or substance abuseproblem is unwilling to seekhelp . . . Is there any way to gethim or her into treatment?

This can be a challenging situation. A per-son with an alcohol or substance abuseproblem cannot be forced to get helpexcept under certain circumstances, such aswhen a violent incident results in policebeing called, or when it is a medical emer-gency. This doesn�t mean, however, that youhave to wait for a crisis to make an impact.Based on clinical experience, many alcoholand substance abuse treatment specialistsrecommend the following steps* to help aperson with an alcohol or substance abuseproblem accept treatment:

SSttoopp aallll ��rreessccuuee mmiissssiioonnss..�� Family mem-bers often try to protect a person with analcohol or substance abuse problem from

the consequences of his or her behavior by making excuses and by getting him or her out of difficult situations caused by the alcohol or other drug abuse. It isimportant to stop all such rescue attemptsimmediately, so that the person with theproblem will fully experience the harmfuleffects of his or herdrinking or drug use�and thereby becomemore motivated to stop.

TTiimmee yyoouurr iinntteerrvveennttiioonn..Plan to talk with the per-son shortly after an inci-dent related to the alco-hol or other drug abusehas occurred�for example,a serious family argument inwhich drinking or drug useplayed a part. Also choose atime when he or she isstraight and sober, whenboth of you are in a calm frame of mind,and when you can speak privately.

BBee ssppeecciiffiicc.. Tell the family member thatyou are concerned about his or her drinkingor drug use, and want to be supportive ingetting help. Back up your concern withexamples of the ways in which his or herdrinking or drug use has caused problemsfor you or your teenagers, including themost recent incident. If the family memberis not responsive, let him or her know that you may have to take strong action to

*Source: Adapted from National Institute on Alcohol Abuse andAlcoholism, National Institutes of Health

protect your children and yourself. Donot make any ultimatums you are notprepared to carry out.

BBee rreeaaddyy ttoo hheellpp.. Gather informationin advance about local treatment options.If the person is willing to seek help, callimmediately for an appointment with atreatment program counselor. Offer togo with the family member on the firstvisit to a treatment program and/orAlcoholics Anonymous (www.aa.org) orNarcotics Anonymous (www.na.org)meeting. (Consult your telephone directo-ry for local phone numbers.)

CCaallll oonn aa ffrriieenndd.. If the family memberstill refuses to get help, ask a friend to talkwith him or her, using the steps describedabove. A friend who is recovering froman alcohol or other drug problem may beparticularly persuasive, but any caring,nonjudgmental friend may be able tomake a difference. The intervention ofmore than one person, more than onetime, is often necessary to persuade a per-son with a drug problem to seek help.

FFiinndd ssttrreennggtthh iinn nnuummbbeerrss.. With thehelp of a professional therapist, somefamilies join with other relatives andfriends to confront a person with an alco-hol or substance abuse problem as agroup. While this approach may be effec-tive, it should only be attempted underthe guidance of a therapist who is experi-enced in this kind of group intervention.

GGeett ssuuppppoorrtt.. Whether or not the familymember with an alcohol or other drugproblem seeks help, you may benefit fromthe encouragement and support of otherpeople in your situation. The supportgroups listed on this page, offered inmost communities, hold regular meetingsfor spouses, family members, and other

significant adults in the lifeof a person with any sort ofdrug problem. These groupshelp family members under-stand that they are notresponsible for another family member�sdrug abuse, and that they need to takesteps to take care of themselves, regard-less of whether the family member whois abusing drugs chooses to get help.

Support Groups

■ Al-Anon: 1-888-425-2666For family members of a person withan alcohol or other drug problem.

■ Alateen: 1-888-425-2666For children of a person with an alco-hol or other drug problem.

■ Families Anonymous: 1-800-736-9805For family members of a person with asubstance abuse problem.

Source: National Institute on Alcohol Abuse and Alcoholism,National Institutes of Health

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Domestic ViolenceAfter too many years of accepting my hus-band’s abuse, I finally stood up to himabout three years ago. He used to hit me,yell, and pound on walls. I lived in terror.He would always be very sorry after-wards, apologizing to me and promisingthings would change. He never abused thechildren, but I’m afraid they saw toomuch of this. Finally, one day I packed,took the kids, and left for a women’s shel-ter. But now my 15-year-old daughter,Emily, has nightmares about her Dad,and gets very nervous and jumpy at times.My 17-year-old son, Eric, has been gettingloud and aggressive, just as his father usedto get. I think he may even be abusing hisgirlfriend. I feel as though I’m reliving thenightmare through Eric. Is there any hope?

You were wise to get the protection of awomen’s shelter for yourself and your fami-ly. There is likely a connection betweenyour husband’s past behavior, and the pres-ent situation. Children who witness vio-lence are more at risk for a variety of mentalhealth problems, including depression andanxiety, and are more likely to become vio-lent themselves. Your husband was the malerole model for Eric, who saw aggressivebehavior patterns that he may be copying.

Many children who witness violence inthe home suffer from anxiety problems.Emily surely has issues with anxiety and maywell be feeling the impact of the trauma ofwhat she witnessed. Some of the symptomsof anxiety disorder include restlessness, being

easily fatigued, difficulty concentrating, irri-tability, muscle tension, and disturbed sleep.

Have you been in family therapy? Thistreatment could help everyone. It giveschildren an opportunity to identifyand express feelings honestly. Emilycould get help dealing with her anxietyand working out her feelings towardher father. Eric could get help for hisown aggressive tendencies, learn angermanagement skills, and find healthyways of expressing his feelings. If he isabusing his girlfriend, it is even moreessential that he gets help immediately. Thetragedy of violence between adult familymembers is that children who witness suchviolence are more at risk of becoming violentthemselves, and the cycle may continue fromone generation to the next. If you are still ina violent relationship, but need help, you cancall the National Domestic Violence Hotlineat 1-800-799-7233.

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EXPOSED TO VIOLENCEOR ABUSEYoung people exposed to violence, abuse, orneglect, may be traumatized by their experi-ences, and are more likely to be at risk for men-tal health problems, for drug abuse, and forcommitting acts of violence.

Experiencing or witnessing traumatic events ispainful and can hurt your teen as much as aphysical injury. But your teen can recoversuccessfully from trauma. Effective treatment is available. C

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G etting help for your teen is a majorstep in bringing him or her back

from the edge of harm’s way, and promot-ing a healthy future. You should also knowthat sometimes when a child is having seri-ous difficulties, it may be a sign that thereare family issues that should be addressed.When seeking help for your teen, considerwhether the rest of the family could alsobenefit from counseling.

If There areProblems at SchoolIf your teen is having difficulty at school,such as poor grades, behavior problems,or being bullied, it is important to reachout to school officials. They can providesupport, and also may be able to give youadditional information about what hasbeen going on with your child.

You can start with your child’s teacher.If the school has a counselor, social

worker, or school psychologist, you cancontact this person. The school principalis also a good resource and may be able topull together appropriate staff members totalk with you about your child. If youhave concerns about contacting schoolpersonnel, most school districts have des-ignated a parent advocate or have a parentresource center to help parents navigatethe school system.

School personnel are also a good sourceof referrals for mental health services.

If Your Teen AppearsDepressed orAnxiousDepression is more than the blues; it is more than the normal, everyday upsand downs. When that “down” mood,combined with other symptoms (see“Symptoms of Depression,” page 15),lasts for more than a couple of weeks, the condition may be clinical depression.This is a serious health problem thataffects the total person.

Anxiety disorders are illnesses that fillpeople’s lives with overwhelming anxietyand fear that doesn’t go away, and oftengets worse. These disorders can changeyour teen’s behavior by diminishing physi-cal health and appearance, school per-formance, social activity, and the ability tohandle everyday decisions and pressures.

If you think your child has an emo-tional problem (even if it is not seriousenough to be called a mental illness) thatrequires more help than you can give, thesooner he or she gets the needed help, thesooner he or she may feel better.

Connect with Your Child�s SchoolResearch has shown that students whoseparents are involved and connected with them and their schools are more likely tosucceed in school. It can be difficult tofind the time to volunteer, but just build-ing a relationship with your child’s teach-ers, and the school itself,can go a long way in pre-venting your child fromfeeling the isolation thatcan lead to problems.

Getting Help for Your Teen

Mental disorders are real illnesses,just like diabetes or other physical ail-ments. Having a mental illness doesnot mean a person is weak, or a fail-ure, or is not really trying. It means heor she needs treatment. Untreated,mental disorders can result in damageto self-esteem, poor school perform-ance, problems with relationships andeven suicide. Mental health treatmentworks; most people can be helped.Treatment helps reduce the symptomsof the mental disorder, improve rela-tionships, strengthen coping skills andpromote behaviors that make a per-son’s life better.

Neither parent nor teenshould be afraid of what peo-ple might say or think aboutseeking treatment. You shoulddraw upon many availableresources and may even besurprised by the support youreceive from your friends andyour teen’s friends.

I want to get helpfor my teen, but Idon�t know how tofind someone good.

In picking a mental healthprofessional, it’s importantto identify a person who isexperienced in working with youthand families, and highly respected inthe community. School administra-tors, counselors and teachers often know


GET HELPIf unsure where to go for help, check the YellowPages under "mental health," "health," "suicideprevention," "crisis intervention services," "hot-lines," "hospitals," or "physicians" for phonenumbers and addresses.

In times of crisis, the emergency room doctor at ahospital may be able to provide temporary helpfor an emotional problem, and will be able to tellyou where and how to get further help.

Listed below are the types of people and placesthat will make a referral, or provide diagnostic andtreatment services:

■ Family doctors

■ Mental health specialists, such as psychiatrists,psychologists, social workers, or mental healthcounselors

■ Health maintenance organizations

■ Community mental health centers

■ Hospital psychiatry departments and outpatientclinics

■ University or medical school-affiliated programs

■ State hospital outpatient clinics

■ Family service or community agencies

■ Clergy

■ Private clinics and facilities

■ Employee assistance programs

■ Local medical, psychological, or psychiatricassociations

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mental health providers with this expertise,and can usually make recommendations.Family doctors or your local mental healthassociation can also point you in the rightdirection. Ask other parents as well—theyare among the best referral sources.

Skilled mental health professionalsunderstand that adolescents may be slowto embrace professional help, and perhapswere brought for help against their will.These professionals will carefully buildtrust with your teen, important for aneffective therapeutic relationship. Theyhelp young people understand that muchof their conversation is kept confiden-tial—and also spell out the limits of con-fidentiality.

Language and other cultural issues mayexist as barriers to accessing quality mentalhealth services. Parents should expect thatmental health professionals are sensitive tocultural and ethnic differences, and canaddress issues affecting diverse populations.

If you haven’t found a good referral in your community, the Substance Abuse and Mental Health ServiceAdministration runs a KnowledgeExchange Network (KEN) which can provide help in finding amental health professional. You can visit their website atwww.mentalhealth.org or calltheir toll-free number at 1-800-789-2647 (Monday–Friday, 8:30 a.m. to 5:00 p.m., EST).

For more information aboutculturally sensitive services, youcan call the Office of MinorityHealth Resource Center at 1-800-444-6472.

There are so many differentkinds of mental healthproviders . . . what�s thedifference? How do I knowwhat is right for my child?

Social workers, mental health counselors,psychiatric nurses, psychologists and psy-chiatrists, among others, all have differentkinds of training and skills, and providedifferent types of treatment. In therapysessions, all of these mental health profes-sionals help people talk about their expe-riences, thoughts and feelings, in order tosolve personal and family problems andtreat mental illness.

Psychiatrists and other medical doctors can determine if there are other physical illnesses that may becontributing to the problem and canprescribe medicine when this is deter-mined to be an important part of thetreatment. Medications are available that effectively treat mental illnesses that are severe or disabling. They areoften used in combination with therapy.

Your family physician or school guid-ance counselor can help you assess whattype of professional help you need.

I know this is all goingto be expensive . . .how will I afford it?

You may have some mentalhealth coverage in your healthinsurance plan. But if your abil-

ity to pay is limit-ed, you should beable to accesscommunity-basedservices. Yourstate departmentof mental health

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or local community mental health centercan direct you to these resources. City andcounty mental health services are oftenoffered on a sliding-fee scale, based on yourfinancial resources, and some health centersand mental health professionals in the com-munity may also provide for a sliding scalefee to those who cannot afford the full fee.

What about help for substanceabuse?

Parents are usually the first line of defenseagainst substance abuse. Set a good exampleby not using illicit drugs, and if you drinkalcohol, do so responsibly and only inmoderation. Know your family’s history of alcohol and drug abuse and talk to yourchildren about it. If you have a drug prob-lem (alcohol, prescription drug abuse, or illicit drugs), get help for yourself. Teachyour child or teenager that it is okay to get help. Learn the signs of alcohol andother drug abuse and take action to helpyour children if they have a problem. (See "Signs of Possible Alcohol or OtherDrug Abuse," page 13.)

Teachers, doctors, sports coaches, clergymembers and others involved with youthhave important roles to play in helping torecognize and get help for teens who areusing alcohol or other drugs.

To find the right help, you should startby getting information about substanceabuse and mental health services in yourcommunity. Ask your health care profes-sional for a referral, or contact local hospi-tals, state and local substance abuse agen-

cies, school coun-selors, or communitymental health cen-ters. You can alsocontact national or local substanceabuse treatmenthelplines, such as the Substance Abuseand Mental HealthServices Administration’sCenter for SubstanceAbuse TreatmentNational Helpline at 1-800-662-HELP.

General Tips WhenGetting Help for YourTeen and Your FamilyHere are general tips on getting help foryou and your teen:

■ Get the whole family involved. Familystress and turmoil contribute to the prob-lems of teenagers. Teens’ problems add tofamily stress. The whole family mustwork together to solve those problems.Ideally, the entire family should partici-pate in counseling. The priority, however,is to ensure that your teen gets help. Heor she might first want to meet privatelywith a counselor and may agree to familyinvolvement later.

■ Be patient. Understand that experiencedcounselors take their time with youngpeople who enter counseling against their will. It may take a while to develop

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rapport and a while longer for teens to be ready to make changes. Parentsshould ask counselors to keep theminformed on what to expect and to discuss progress as it is made.Counselors also can help parentsunderstand what to look for in terms of changes and approximately whenthese changes might occur. If yourchild is prescribed medication by aphysician, be informed about the sideeffects and possible adverse reations,and understand that medications maytake several weeks to work.

■ Evaluate your counselor as you wouldany other professional you work with:You should feel good about the person,and you should also get results.

■ Monitor progress. When you areunhappy with progress, talk it overwith the counselor. Sometimes parentsare impatient and expect immediateresults. Counselors should explain theirtimetable and perhaps point outprogress that may not be so obvious. If

progress is not being made, parentsshould ask how the counselingapproach might be modified. If the modified approaches don’t work,parents should consider getting asecond opinion or transferring toanother professional.

■ Be your child’s advocate. Whether youhave private health coverage or you relyon public programs for health care,find out what treatment services arecovered and for how long. Let yourhealth care professional, insurance com-pany, social worker, case manager andanyone else involved in your child’streatment, know what you think yourchild and family need. Make sure youare involved in decisions about yourchild’s treatment.

Conclusion

Parents matter when it comes to helpingtheir children successfully navigate theteenage years to ensure a safe and healthypassage from childhood into adulthood.Being knowledgeable and keeping com-munication open, recognizing warningsigns of problems and seeking help when you think it’s needed, are impor-tant contributions that support your teen’s development.

Above All . . .■ Never give up on your teen.

■ Never relinquish your love and

your hope.

■ Keep the conversations going—

raising children is a lifetime

of learning.

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Youth Violence■ National Youth Violence Prevention

Resource Center (Federal Clearinghouse)1-800-968-8484www.safeyouth.org

■ SafeUSA (Centers for Disease Controland Prevention)

1-888-252-7751www.cdc.gov/safeusa

Domestic Violence■ National Domestic Violence Hotline

1-800-799-SAFE (7233)www.ndvh.org

Alcohol and Other SubstanceAbuse■ Center for Substance Abuse Treatment

Toll-free Helpline1-800-662-4357

■ National Institute on Alcohol Abuse and Alcoholismwww.niaaa.nih.gov

■ National Institute on Drug Abusewww.nida.nih.gov

■ Office of National Drug Control Policy1-800-788-2800www.theantidrug.com

■ Substance Abuse and Mental HealthServices Administration1-800-729-6686www.samhsa.gov

Mental Health Services■ National Institute of Mental Health

www.nimh.nih.gov/publicat/childmenu.cfm

■ Substance Abuse and Mental HealthServices Administration1-800-789-2647(Mon.–Fri. 8:30 a.m.–5:00 p.m., EST)www.samhsa.gov

General Information for Parents■ U.S. Department of Justice

www.parentingresources.ncjrs.org

■ U.S. Department of Health and HumanServiceswww.healthfinder.gov

■ U.S. President's Management Councilwww.firstgov.gov

General Information for Teens■ AfterSchool.gov

www.americasteens.govwww.afterschool.gov

■ Access Americawww.students.gov

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