Different Types of Eating Disorders: Anorexia Nervosa

Probably the most well-known of the different types of eating disorders is anorexia nervosa. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD) statistics, “anorexia has the highest case mortality rate and the second highest crude mortality rate of any mental illness.”

The good news is that anorexia is treatable, and you can get your physical and mental health back on track with medical and psychological help.

What is anorexia nervosa?

Anorexia nervosa (commonly referred to as anorexia) is a dangerous eating disorder with a high mortality rate. Those with anorexia suffer from more than emotional turmoil; their physical health is in jeopardy.

Anorexia behavior includes starvation. This may be a blatant refusal of food or eating minimal food when offered. The most common symptom of anorexia is a gaunt and underweight appearance. Bones may be visible without clothing. The person with anorexia may see themselves differently in the mirror, however. Anorexia is often comorbid with body dysmorphic disorder. They may see themselves as larger than they are or have a deep-seated fear of gaining weight.

According to the ANAD statistics, out of the different types of eating disorders, those with anorexia face an 18% higher suicide rate than their peers without an eating disorder. Those with anorexia can also encounter more degenerate physical health. Medical treatment is a priority for these patients. Once their physical health is stable, the work to heal the psychological damage can commence.

The symptoms of anorexia nervosa.

The symptoms of anorexia include:

  • Refusing to eat.
  • Denying hunger.
  • Only eating specific foods with little to no nutritional value.
  • Adhering to rigid food rules.
  • Starving oneself.
  • Underweight.
  • Protruding bones under clothing.
  • Brittle hair and nails.
  • Dry skin.
  • Severe dehydration.
  • Dizziness.
  • Fainting.
  • Low blood pressure.
  • Slow heart rate.
  • Nutritional deficiencies.
  • Anxiety.
  • Depression.
  • Poor body image.
  • Irregular periods or amenorrhea.

Due to the nutritional deficiencies and extreme weight loss, physical health is a concern. If left untreated, anorexia can lead to organ failure. Medical professionals prioritize physical health to help the patient’s body stabilize.

Treatment for anorexia nervosa.

Once the person with anorexia is stable physically, treatment for the mental disorder can begin. A counselor will assess the person’s behavior and listen to them share their thoughts and emotions before creating a care plan. To treat the compulsions that drive anorexic behavior, counselors must understand the thoughts behind the actions. The counselor and client build a rapport and a safe relationship that allows the freedom to share.

Counselors may use several different types of eating disorder treatments depending on the client’s assessment and level of severity of anorexia.

Individual talk therapy.

There may be a reason that a client turns to anorexia that goes beyond wanting to be a smaller size or not wanting to gain weight. Exactly why do they feel the need? Why are they afraid? A counselor helps the client work through these issues and triggers.


Group therapy.

People are stronger together, especially those who have overcome anorexia, and are willing to share with others. Group therapy is a safe space to share and gain insight from others while being led by a professional mental health care worker.

Cognitive Behavioral Therapy (CBT).

This technique helps clients to identify triggers, emotions, and thoughts that lead to anorexic behaviors. The client then can work with the counselor to learn ways to re-frame those thoughts and actions.

Dialectical Behavior Therapy (DBT).

Although not explicitly created for eating disorders, DBT has proven helpful in helping a client with anorexia (or bulimia or binge eating) manage stressors and relationships instead of turning to the harmful behaviors associated with anorexia.

Nutrition education.

Nutritional education is a must to help the client adapt to a regular eating schedule with proper portions and variety. The menu may change as the client becomes healthier, allowing for a greater variety, but in the beginning, checking in with a nutritionist will keep treatment on track.

A counselor may incorporate several methods to help a client with anorexia. They may meet in person, virtually, or a combination of both.

Counseling for different types of eating disorders.

From the different types of eating disorders, do you struggle with anorexia nervosa? Do the symptoms sound familiar, but you do not quite meet the criteria for a full-blown eating disorder?

We can help. Contact our office today at Huntington Beach Christian Counseling in California to schedule an assessment with a Christian counselor in Huntington Beach. Your counselor will assess your health and help you connect with medical treatment if necessary while you work on the emotional and mental healing from anorexia.

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How to Spot ADHD Symptoms in Teens (and Help them Cope)

ADHD (attention deficit hyperactivity disorder) is a neurodevelopmental disorder that affects a child’s ability to stay focused, sit still, and/or control his or her impulses. It is a legitimate medical condition that requires special care and attention.

ADHD symptoms in teens usually manifest somewhat differently than they do in younger children or adults because of the distinctive aspects of this phase of life. Normal stressors such as rapidly changing bodies, hormonal changes, and the increased academic and social expectations of high school, tend to aggravate ADHD symptoms, making this an especially tough time for a teen with ADHD.

Teens with ADHD, for instance, tend to have lower grade point averages, complete and turn in a much lower percentage of classwork and homework assignments, and are much less likely to be working up to their potential. They are also more likely to be absent or tardy and to drop out of school.

The earlier you recognize the symptoms and get help for your teen, the better the outcome.

Types of ADHD.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5-TR), there are three types of ADHD: primarily inattentive, primarily impulsive/hyperactive, and a combination of the two.

In order to be diagnosed with ADHD, a teen must exhibit six or more of the symptoms in a category (five if they are over the age of 17); the symptoms must have started before they were 12 years old; been present for six months or longer; and impact their functioning in at least two settings such as home, school, or social.

Primarily inattentive ADHD.

Teens with primarily inattentive ADHD struggle to pay attention, stay focused on what they are doing, be organized, and complete tasks, which can have a severely negative impact on their performance at school. On the other hand, they do not usually have a problem managing their impulses or activity level. Symptoms include:

  • Difficulty understanding or following instructions.
  • Failure to pay attention to detail.
  • Making careless mistakes.
  • A wandering mind that seems far away when being spoken to.
  • Failure to follow through on instructions or finish assignments.
  • Inability to organize things.
  • Frequently losing or forgetting things.
  • Easily distracted.

Primarily impulsive/hyperactive ADHD.

Teens with primarily impulsive/hyperactive ADHD have a hard time controlling their impulses and will talk or act before they think; do things without asking for permission first; rush through their assignments, making many careless mistakes; and be prone to emotional outbursts or reactions that are inappropriate or out of proportion to the situation. Symptoms include:

  • Tendency to be restless, fidgety, and have trouble sitting still.
  • Inability to engage in activities quietly.
  • Easily bored.
  • Talking excessively and interrupting others who are speaking.
  • Calling out answers in class before the teacher finishes asking the question.
  • Trouble waiting in line or for their turn.
  • Impatient and easily frustrated.

Combined ADHD.

Combined ADHD is the most common type of ADHD. Teens with this type exhibit both inattentive and impulsive/hyperactive behaviors.

Helping your teen cope with the symptoms of ADHD.

  • Educate yourself about ADHD symptoms in teens and the challenges they create so you can better understand and support your teen.
  • Accept your teen for who he or she is.
  • Stay positive and encouraging.
  • Recognize that your teen’s symptoms cannot be fixed by rigid rules or parenting styles and that they are not due to a lack of discipline on his or her part.
  • Set clear expectations with consequences.
  • Praise and reward good behavior.
  • Don’t punish your teen for behavior he or she has no control over.
  • Target the ADHD and not your teen.
  • Focus on solutions to ADHD-related problems and helping your teen achieve them.
  • Help your teen with scheduling and keeping things organized.
  • Minimize stress and overstimulation in your home environment and keep distractions to a minimum.
  • Help your teen create and stick to regular routines that provide structure to his or her day.
  • Make sure your teen has access to any necessary accommodations in school.
  • Seek counseling for your teen and remain involved and supportive in his or her care.

Benefits of counseling for ADHD symptoms in teens.

A trained mental health professional can help your teen understand ADHD and equip him or her with the necessary skills to cope with the challenges created by his or her symptoms.

If you are interested in learning more about ADHD symptoms in teens or would like to set up an appointment to meet with a faith-based counselor specializing in teenage ADHD please give us a call.


David Perlstein. “Attention Deficit Hyperactivity Disorder (ADHD) in Teens.” eMedicineHealth. emedicinehealth.com/adhd_in_teens/article_em.html.

Katie Hurley. “ADHD & Teens: How to Help Them Cope with Their Struggles.” Psycom. Updated October 17, 2022.

Zia Sherrell. “What to know about ADHD screening?” MedicalNewsToday. July 30, 2021. medicalnewstoday.com/articles/adhd-screening.

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When to Be Concerned about Child Behavior Problems

When should you be concerned about child behavior problems in your home?

We all have our moments of “cringe-worthy” behaviors. We say things we later regret or lie to get out of awkward situations. When we consider how difficult it is to control our own behaviors, just think of what a child goes through – with a brain that is still developing, and lacking the maturity and experience to understand all the consequences of negative behaviors.

Even children who are usually well behaved may encounter a situation where they are so overcome by emotion that they “lose it” and engage in inappropriate behaviors. This is especially true of very young children whose emotions are still in the early stages of development.

Nevertheless, there are negative behaviors that should not be ignored in children, or they may become ingrained, interfering with the child’s relationships and daily life. Taking quick action to nip these problems in the bud will avoid them developing into serious issues that require professional intervention.

No matter what behavior issues you are going through with your child, take confidence! Your child can learn to control his or her emotions and behavior. As a child’s brain is still developing, the child has a surprising ability to learn new concepts and develop appropriate behaviors, under the guidance of parents and other caregivers.

In their book, No Drama Discipline (2014), authors Siegel and Bryson recommend that we “chase the why” when considering a child’s behavior problems. Rather than jumping to conclusions as to why a child is misbehaving, instead engage in some detective work and find the true answer.

Let’s take a look at ten child behavior problems that are common in children, yet absolutely cannot be ignored. These behaviors require swift intervention to bring them in check before they escalate. By exploring the reasons why your child may be engaging in these unwanted actions, you can devise an action plan of how to deal with them.

Child Behavior Problems You Shouldn’t Ignore

1. Telling Lies

We all know it’s wrong to tell a lie, but we all do it from time to time. No matter what age, lying is a significant problem when it becomes habitual – so ingrained that the person’s word cannot be trusted. Some children become repetitive liars, which can make it difficult for parents to know when to believe the child. This could even put the child in harm’s way.

Why does a child lie? A child may lie in order to avoid a feared or disliked activity. Children struggling with self-worth might tell stories in hopes of being admired by others. A child might lie to avoid being punished. When a child has failed at doing something, they might actually say that they were able to do it, in order to feel more self-confident.

Children with ADHD (Attention Deficit Hyperactivity Disorder) may be impulsive liars, where their mouth engages before their brain, according to Carol Brady, Ph.D., (ADDitude Magazine).

2. Stealing

When parents teach their children boundaries between what is theirs and what belongs to others, most children quickly learn that taking something that doesn’t belong to them is unacceptable. Unfortunately, some children develop a habit of stealing, for multiple reasons.

Perhaps they enjoy the thrill of swiftly taking something without being noticed and the adrenaline release. They might be attempting to gain control over a situation – such as when they perceive a disparity between what they have and what others have. Stealing may be a way of getting something parents don’t allow – such as candy.

3. Bullying, Harming Others, Self-Harming, and Property Destruction

No one wants to be the parent of the neighborhood bully. Rather than facing the fact that their child is hurting other people or purposefully breaking things, some parents simply ignore this violent behavior. Parents need to immediately address why their child is violent or destructive.

Violent or destructive behavior often results from deep-seated anger. The child may be receiving abuse from another child or adult. The child might be jealous if the parents’ attention is diverted to a new baby or to their career, and feel that negative attention is better than no attention.

Self-harming (hitting, scratching, or cutting themselves) is alarming behavior. Children may talk about hurting themselves or even committing suicide. Never ignore such talk or behaviors. It often indicates depression or other serious emotional issues. Immediately seek professional help if your child has suicidal ideations, is self-harming, or is violent toward others.

4. Temper Tantrums

Almost every small child has temper tantrums. Their brains are still growing rapidly, and they are learning how to regulate their emotions. When they encounter a stressful situation, such as getting tired and bored in the supermarket or getting over-stimulated, it might result in a “meltdown.”

Children who have sensitive natures – who experience strong emotions and take longer to recover from anger or sadness – are more prone to temper tantrums, even at an age when most of their peers have become relatively adept at emotional regulation.

When your child is having a meltdown, give the opportunity to regain control in as calm an environment as possible. Maintain your own composure, speak in a soft and matter-of-fact tone and try to remove the child from an over-stimulating environment. Don’t goad overwrought emotions further by reacting in exasperation.

If tantrums are occurring frequently, or it takes a long time for the child to regain control, or if the child is causing harm to self or others, or destroying property, then counseling is recommended. If you feel helpless and worn down by all the meltdowns, you will benefit by having someone come alongside to support and guide you in helping your child regulate emotions.

5. Belligerence and Defiance

If your child is usually cheerful and compliant, then abruptly begins to question your directives, or refuse to obey, this defiant attitude may be a way of asserting himself or testing boundaries. Your child may be disrespectful to you or other authority figures. Many times this behavior is picked up from peers or even TV shows.

You may be noticing your child has become combative and quarrelsome with his or her siblings, with friends, or even you. This may be a sign that the child is suffering from anxiety or depression, or may be feeling out of control.

6. Ignoring Others

If a child is habitually ignoring authority figures, it may be a display of defiance. If the child is ignoring even non-authority figures, it could be due to a hearing disorder, or the child could be going through internal struggles, withdrawing inwardly, and simply less aware of what is going on around him.

It could also be a sign of ADHD. With ADHD, children have trouble filtering the other sounds around them, in order to concentrate on what one person is saying. They also tend to get lost in a “dream world” and not focused on the matter at hand. If you’re seeing a lot of ignoring behaviors, you probably need professional help to determine if there’s a physical or emotional reason behind it.

7. Refusing To Go to School

If you child frequently complains of headaches or stomach aches on school days, has meltdowns right before the school bus shows up, or simply takes hours getting out of bed and ready for school, these are all signs that the child is resisting going to school. Now it’s time for you to play detective and figure out what’s going on.

Perhaps someone is bullying your child at school, or the teacher is unpleasant. Your child may be bored by lack of challenge, or suffering anxiety because of difficulty learning the material. Your child may simply not want to leave you or your secure home environment. The child may feel nervous about tests. If a child is depressed, they often lose interest in activities they once loved.

8. Laziness

When a child seems unusually unmotivated to do schoolwork or engage in sports or other activities, there’s probably something going on under the surface. Fatigue and lack of enthusiasm or interest in activities a person once enjoyed are signs of depression. If the child has a high level of anxiety about something stressful, this may have an immobilizing effect.

9. Smoking, Drinking, or Using Drugs

Children begin to experiment with cigarette smoking, drinking alcohol, or smoking marijuana around the age of thirteen. But children much younger than this engage in substance use, especially if it is readily available at home or from a friend or relative. Obviously, this behavior demands immediate attention before addictions develop or other serious issues ensue.

Once again, it’s important to explore the reason why a child is using cigarettes, alcohol or drugs. Is it peer pressure? Is the child copying the behaviors of the adults in his or her life? Is the child trying to cope with overwhelming emotions?

10. Premature Sexualized Behavior

All very small children explore their body. However, if preschool or elementary children are demonstrating overt sexual behavior or language, this is reason for concern.

Parents need to determine if the child has been exposed to pornography, or has observed teens or adults in sexual situations, or has even been the victim of sexual abuse. Consulting with a professional can help you discover what is going on with the child, and what to do about it.

What Should Be Done About These Child Behavior Problems?

Most negative behaviors are indicators of deeper, less obvious problems. Before you can help your child with the unwanted behavior, you first have to determine why the child is doing it. Finding the root cause is the key to effectively eliminating the problem.

This requires calmly investigating what the underlying issue is. Is it an immature and unregulated emotional system? Are there changes in the family that may be causing stress? Are there any problems at school – with learning the material or with peers or teachers? Is there any chance that the child is being bullied or exposed to inappropriate things or harmed by someone?

Often, child behavior problems are a way of coping with emotions or challenges the child can’t control. For instance, the child may feel jealous and neglected when parents bring a new baby home that demands a lot of attention. The child might act out with tantrums or defiance or even hurting others.

Just as adults cope with disappointments or hurts with unwise behavior – such as binge eating or drinking too much – children also choose incorrect ways to cope. Children don’t clearly understand the consequences, and their brains and emotions are still developing, thus they are more prone than adults to engage in problematic coping.

Understanding why children display unwanted behaviors does not mean we permit the behaviors to continue. But knowing the “why” behind the behavior helps us to determine issues that should be dealt with, and enables us to guide the child toward emotional control and equip the child with skills to overcome negative behavior.

A therapist trained in child development – especially development of the brain and emotions – can offer invaluable guidance and support. A counselor can help you determine issues underlying the problem behaviors, and suggest a plan of action.

When Should I Seek Help?

You don’t need to be in a crisis situation to seek counsel from a professional therapist on child behavior issues. In fact, the earlier you seek help, the better so that the problem behaviors don’t become worse.

However, there are several circumstances when you should immediately seek professional help:

  • if your child is harming self or others or destroying property,
  • if the problem behavior is very frequent or is escalating,
  • if the behavior is interfering with daily life – with school, family life, or friends,
  • if you suspect the child has been abused – physically, sexually, or emotionally, or
  • if you are exhausted and feel hopeless and don’t know where to turn.

We’re here to come alongside you. Please don’t hesitate to contact us to get started in the right direction for your child.

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Behavior Problems in Children: What to Do

While behavior problems in children are common, attitudes towards them are varied. Christian Counselors are often contacted by parents who are concerned by their children’s behavior.

Examples of common behavior problems in children include: talking back, lying, fighting, hitting, kicking, being disrespectful, and so on.

It can be exhausting to deal with behavior problems in children. Parents often feel angry and confused about their child’s behavior. It can be terrifying when you don’t understand what’s happening with your child, don’t know how to help, but feel totally responsible for making things better for them.

For example, how do you handle the situation when your child is having a meltdown? Or when they are sobbing inconsolably? Perhaps your child seems to react to the slightest thing and become aggressive, and you have no idea what to do in that situation. Children who don’t listen or refuse to comply with rules are equally difficult to deal with.

Counselors who deal with children with behavior problems and their parents consider the most important word associated with behavior problems in children is interpretation. This is because behavior is regarded as 90% about the way it’s interpreted.

Interpretation covers:

  • Why we think a behavior is happening
  • The level of control we think the child has over the behavior
  • How we think the child feels

Thinking and assuming are part of interpretation, and interpretation is not the same as understanding. This is one of the reasons why it’s important to engage in therapy with a Christian counselor. Therapy opens the door to move from assuming to understanding why your child is behaving in ways that you consider to be problematic. It also helps to decide whether the behavior is actually ‘normal’ or not.

A Christian counselor with experience in therapy with children and their parents has created a list of behaviors that parents regard as problems and the root feelings that are causing – or contributing to – the behavior.

Feelings Associated with Behaviors

Behavior Feelings Questions to Ask
Hoarding food;





A need to hide

Who or what is causing the fear?

What are they ashamed of other people knowing? What is causing their need to hide, or for what reason do they feel not good enough?

Talking back; hitting; kicking Anger What is causing the anger?
Sexualized Behavior Confusion Have they seen or experienced sexual behavior first hand?
Self-harm or putting themselves at risk Sadness What loss have they been enduring? Have they experienced harm or trauma?

For parents struggling to deal with their child’s difficulties, the principle question that needs to be considered is What is my child’s need that’s being unmet? When we talk about unmet needs, however, it’s important to remember that these are deep, emotional needs, not issues regarding toys or other material things.

Parents need to understand the issues that their child is wrestling with, and why they’re struggling. It may be that your child has something that they long to talk to someone about, but they don’t know how to express it. Similarly, children who are exposed to traumatic situations suffer confusion and it may be that their behavior is their way of trying to sort through the confusion – probably unsuccessfully.

The primary questions that bring parents to Christian family counselors are, “Why is my child behaving like this?” and “can you make it stop?” While these questions are important, in counseling it is beneficial to reframe the questions. Reframing is a way to take the concern and uncover the root issues and needs. The reframed question is often much more complex than the questions that bring parents to family counselors.

Most frequently, the root concern is more likely to be “Am I a bad parent since I can’t get my child to behave right?” It’s not uncommon for parents to see their child’s behavior as a reflection of their ability to raise children well. For family counselors, the next stage of therapy is to normalize the behaviors parents are seeing as problems and help to reduce the child’s need to display those problem behaviors.

Functional Behavioral Analysis

An important technique in helping parents and their children is Functional Behavioral Analysis (FBA). This is a method that is based on the idea that While every behavior has a cause, not all behaviors are interpreted in the same way. For example, a parent might approach a counselor and complain that their child is disrespectful because they couldn’t sit still throughout a movie. In the parent’s eyes, the child’s behavior was an intentional attempt to disrupt the enjoyment of the movie for the rest of the family.

Another example could be a parent who, in a therapy session with their child, remarks that the child doesn’t care and isn’t listening, on the basis of the fact that the child is sitting playing silently in the sandbox. In both situations, the parents are viewing their child’s behavior as disrespectful and wanting help to ‘correct’ this. However, FBA questions the evidence that the parent is basing their interpretation of the child’s behavior.

Here’s a reproduction of an FBA chart that visualizes a means of talking about these examples:

Behavior (bx) Possible Functions of the bx: Analysis
Child won’t stop moving While the movie is on A: Intentional disruption


B: Moving to deal with anxiety or because of ADHD

My child is disruptive


My child is anxious

Child playing in the sandbox during therapy session about their behavior. Child neither talking nor making eye-contact A: Child playing in the sandbox because they don’t care


B: Child playing in the sand as a calming or coping mechanism, to deal with shyness or anxiety

My child is disrespectful


My child is ashamed

It’s clear when looking at this Functional Behavioral Analysis chart that it’s possible to come to entirely different conclusions about the behavior when you consider the function of the behavior. It’s not always as clear cut as parents assume it to be, meaning that problem behaviors are not always problems but rather dysfunctional coping mechanisms.

Look deeper into the roots of the behavior and you might find, for example, that these two hypothetical children had both experienced a significant loss in the past year, such as the death of a family member or being abandoned by one parent. They might come from families with a history of trauma, where security wasn’t a certainty.

Children who are responsive to correction or who are compliant are children who have experienced an adequate level of empathy, warmth, and care that leads to feelings of security and trust in their caregiver.

When these things are less than adequate, or entirely absent, there is no such security and trust, and “problem” behaviors are a child’s way of dealing with their uncomfortable feelings. They don’t feel able to turn to their caregiver for comfort and regulation.

Issues to Consider

Therefore, when it comes to the question of “why is my child behaving like this?” there are issues that need to be considered before labeling a behavior as problematic:

1. Family of origin

Many children who end up in family therapy come from homes that are broken or dysfunctional. Often, they live with one parent, While the other parent has died, is in jail, has become an addict, or is otherwise absent. Children need caregivers who are available to meet their needs on a consistent basis, and in many cases, this is lacking.

2. Frequency of Play

How frequently does the child have the opportunity to play, and with whom? Children benefit considerably from play, particularly when their parent(s) get down on the floor with them and build with Legos and other toys. Similarly, children need the opportunity to play with other children and don’t do well when they’re forced to assume an adult role in the home.

Play is vital for a child’s development, particularly psychologically. Many parents see play as optional, but actually, it’s a necessity. Play helps children to develop self-esteem, creativity, self-awareness, self-regulation, patience, distress tolerance, and much more. Children with behavior problems often don’t have opportunities to play or have never had a parent play with them.

3. Control

What do they have control over? This is a massive determining factor in child behavior. Adults have control over a lot of things – such as where you go, what you do, what you eat, and so on – but children have much less control. Children are told what they have to do, where they have to go, what and how much to eat, what to wear – the list is endless.

In children whose problem behavior relates to bodily functions, it is sometimes the case that the child feels they have so little control in their life that they develop problem behaviors with their bodily functions because that’s one thing they do have control over.

In therapy, parents are taught the HALT technique before they assume that their child’s behavior is a problem. Is the child Hungry, Angry, Lonely or Tired? Think about your own behavior when you are affected by these feelings.

We excuse our own behavior due to tiredness but are less willing to attribute a child’s behavior in the same way. It’s really important to see whether HALT is causing unwanted behavior rather than jumping to the conclusion that the child is simply unpleasant.

4. Caregivers

What do the caregivers believe they know about parenting? As harsh as it sounds, parents can often have misconceptions about best practices in parenting, and this can impact on how they interpret their child’s behavior.

Questions to ask parents of children with behavior problems include their understanding of attachment styles, their parenting styles, the way a child’s brain functions when they’re having a tantrum, and how to discuss behavior with their child.

There are two really great resources that parents can use to build their knowledge and understanding:

  • The Whole Brain Child by Dan Siegel – which is available as a book, workbook, and video – helps parents to understand how to handle their child’s behavior.
  • Helping the Non-Compliant Child by Robert McMahon – which helps parents bring consistency into their relationship with their child and build the child’s self-awareness.

5. Environment

What is the child’s environment? A difficult issue to raise in therapy is the impact of socioeconomic status on stress levels within the family unit. Other environmental considerations might include families dealing with addiction, and families with a large number of children where kids have to compete for attention.

6. Family Relationships

What is the child’s relationship with family members like? An example of the impact of broken family relationships might be the parent who comes to therapy with a child who is depressed, anxious and is acting out at school, but who later reveals that the father has recently moved out. Young boys need a dad, and young girls need a mom. Problems often emerge when one parent is absent.

Siblings can also contribute to difficult behavior. Older siblings who bully or tease their younger siblings can cause the younger child to resort to bad behavior.

The question of whether a child’s behavior is normal is not easily answered. The best answer that a counselor can give is probably not the one that parents want to hear: it depends. There are a lot of factors that can influence behavior, so there’s no simple yes or no answer to the question of what is and isn’t normal.

If you want to help your child with their behavior, it’s necessary for you to have an open mind in order to explore the root causes and be willing to engage in education on family dynamics. Christian counselors can really help with gaining a full understanding of your child’s behavior and give you resources to help handle it.

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How Therapeutic Activities for Children Can Enhance Your Home Life

Though taking care of a child is a real blessing indeed; sometimes things can become difficult. Such difficulties, however, are not necessarily results of bad behavior. A child, who is still growing and adjusting to life, may encounter troubling experiences, minor or major, that they do not know how to react to, affecting them deeply.

As stewards of the child, parents or other guardians are naturally concerned. But though they may desire to get to the root of the problem so that a solution can be found, the child might not be able to properly express their feelings or might not wish to do so. Rather than becoming frustrated and angry at the child for not saying what they feel, parents or guardians should try other ways to get the child to open up and share what is bothering them, such as the following suggested therapeutic activities for children.

Therapeutic Activities for Children to Open Up

While these methods are generally used at home, they may also be done in school or other social settings as deemed appropriate.

Expressing Themselves through Drawing

Not everyone, including mature adults, is able to easily express how they feel. Sometimes the words are just not there, which can be particularly true for very young children. But just because there are seemingly no words to describe what is happening inside, it does not mean that there are no visual representations in the mind.

Through drawing, a child may be able to show what may be troubling them through pictures, shapes, lines, and colors. This can then give parents or guardians a clue as to what may be going on.

For this to work, however, it helps to have a variety of materials available for the child to work with such as crayons, markers, colored pencils or pens, chalk, water colors, or paint. Paper is the usual choice for a working canvas; but it can also be done on a whiteboard, chalkboard, the sidewalk, or the walls of the house (if such is okay!). Kids love to have choices so allowing them to choose what to use can make the process easier and more inviting.


Another effective method for young children is role-playing. Sometimes the child knows how they feel, but they are afraid to say it. Role-playing allows them to act out their inner emotions and thoughts from the “safety” of pretending to be someone else.

Aside from revealing what is disturbing them, role-playing is also a good way to teach a child how to deal with certain situations in school (e.g. bullying at school, peer pressure, overcoming anxiety in class) or their immediate community (e.g. asking for help, dealing with strangers).

For this to be effective and fun for the child, the parent or guardian must act along as well. It helps to try to vary one’s voice and actions so that the situation seems more realistic. When processing the results, however, the parent or guardian must be very discerning as sometimes not everything mentioned during the play-acting may be true. But still, it is a good method to get a child to open up.


For children who prefer to write, it may help for them to pour out their thoughts in a journal. Journaling allows them to really think deeper about their thoughts and experiences, especially since they can read them later on, allowing them to reflect even more.

What they write does not have to be organized; it can just be a series of rants or praises about something in particular. Even if they are still “unsure” about how they feel, the process of journaling may allow their unclear and hidden emotions to be revealed later on as one thought may lead to another.

The challenge here is for parents or guardians to get the child to try, since they may feel like they are doing additional homework. But if they can be encouraged to give it a try, even if their first attempt only results in a few phrases written down, they might eventually see how helpful journaling can be. Privacy is another issue, especially for older children. In such cases, a heart to heart talk about the need for a trusted adult to know what is going on may be needed.

Therapeutic Activities to for Children to Relax


Meditation is being used by many adults to relax, especially after a stressful day at work. The same can also be done by children, after first explaining the purpose behind it as they may wonder why.

The following are some simple meditation steps to follow:

  • In a quiet place, ask the child to slowly breathe deeply. Closing the eyes is preferred, so they can focus on their breathing, but it is not required.
  • After some moments, tell them to think of a happy place for them to be in.
  • Then tell them to imagine that they are there, relaxing or having fun. They should think about the details of the place, such as what they see, hear, or smell.
  • Once “relaxed,” suggest that they are now thinking about their emotions while sitting in this place. If they wish, they may even think about their “worries.”
  • Tell them to keep breathing slowly as they think of these emotions.
  • Inform them that when they are ready to open their eyes they can do so.
  • Then ask them about their meditation experience.

The goal is for them to be calmer inside and hopefully more willing to share what is bothering them.


Prayer is another important way to get the child to relax and open up as they commune with God. Even though they might not fully understand their faith yet, it is still good for parents or guardians to get them to become more dependent on God, even at a young age, as this will help them even more in the future.

Initially, the child may need some help in how to pray so the parent or guardian can first model a prayer where God’s almighty power is acknowledged; thanksgiving is declared, and then prayer requests are made. After some sessions, the child can then be asked to pray, out loud or silently. The objective here is for the child to become more relaxed as they begin to depend on and trust in God.


Similar to adults, children need exercise, enough rest, a healthy diet, and leisure time to be strong enough to deal with the challenges in life. As their protectors and guides, parents or guardians need to ensure that the child knows the importance of taking care of themself.

As they are still young, they will not be able to balance such things on their own. It helps to establish a routine for them to study, play, and rest. Parents or guardians may also need to reiterate the importance of eating well as many children prefer junk food nowadays. The proper use of gadgets is another vital lesson to prevent gadget addiction.

Seeking Christian Counseling for Children

Despite all the above-mentioned therapeutic activities, some children may still have difficulty coping with whatever is bothering them. In such instances, it is best to seek a Christian counselor to discover the underlying issues and give them the help they need.

In Christian counseling, the latest counseling methods will be used to get the child to open up. But most importantly, the child will be connected to God through prayer and meditation on Scripture so that they may experience God’s healing power. If needed, other family members may also undergo Christian family counseling to improve the family’s relationship with one another and with God.

If you or a friend has a child that may need professional therapeutic activities for children, seek Christian counseling soon. Help your child live the life they are meant to have by connecting them to God.

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How to Find the Best Family Counselor for Your Needs

There are a number of considerations you need to make when you are looking for a family counselor that is a perfect fit for your family. The options can seem overwhelming, and it is important to know what you’re looking for so as to have the greatest chance of healing family issues.

One common reason why people are reluctant to seek out a family therapist is that they’re not sure what to look for in a counselor. Unfortunately, another common reason comes down to bad experiences in the past with counselors, which causes anxiety about having a repeat experience.

This article will equip you to make the right decision regarding a family counselor that meets the needs of you and your family. We’ll look at different types of family counselors so that you can make an informed choice, go over the qualities that make a therapist a good fit for your family and look at some of the costs of family therapy.

When Should I Start Looking for a Family Counselor?

A lot of people make the mistake of waiting until there is a crisis before they seek help. Usually, by this point, a number of failed attempts to resolve problems will have been made, and a considerable amount of psychological damage will be been done.

It’s important for you to know that you don’t have to be in crisis in order to approach a family therapist. In fact, it is better to seek out therapy while the issues are still in the early stages because getting help means that you’ll be able to learn skills to handle all the issues that come with family life.

Family counseling has been shown to help in reducing the severity of family problems, and even removing the problems entirely. Central to the success of family therapy is a counselor that meets the needs of all the family members so that every member is able to express themselves honestly during therapy sessions. To find the right family counselor you have to understand your family’s needs.

What are You Looking for in Family Counseling?

People enter family counseling for a variety of reasons and it is vital to understand why you are seeking help. It may be because you are struggling with parenting issues, having communication difficulties with your spouse, or want to support your child through the process of therapy. Some family therapists can address all of these issues, but many will have specialties in different areas, so are more suited to providing specific kinds of therapy.

Couples Therapy

Many people see couples’ therapy as something which married couples engage in when their relationship has already broken down. It’s seen as a last resort to save the marriage. However, couples’ therapy is not only for couples who have reached this level of breakdown.

Rather, couples’ therapy can help people in relationships whether married, engaged or just dating. One benefit of couples’ therapy is that it increases the level of positive functioning in the relationship. Some people only require a few sessions in which they explore effective communication, conflict management, and handling abusive behavior.

Behavior Intervention

This type of therapy is perfect for families with children who are struggling with relationships with peers or adults in the community, at school or having difficulties at home. Behavior intervention includes both children and adults in the family.

In this type of family therapy, children are able to learn about acceptable and unacceptable behaviors. Methods such as rewards, praise and consequences can be utilized. Parents are taught the importance of boundaries, and how to build appropriate reward systems, as well as other important techniques.

Family counselors will often ask parents to describe what happens before, during and after the child’s problem behavior, and use this information to find solutions that will modify the behavior of both the child and the adults in these three areas.

Parents need to be part of behavior intervention sessions as they can learn skills from the therapist that can be later implemented at home.

Parent Coaching

Parent coaching differs from behavior intervention in that this type of family therapy in that this type focuses on the parents’ behavior. Children may be involved in the sessions, but do not have to be present for parent coaching to take place.

Coaching is a means of developing the skills that parents need to be able to support their child’s emotional, physical and social health. Parenting skills such as effective discipline, boundaries, and communication can be hugely beneficial.

Difficulties Between Parent and Child

Relationship difficulties between parents and children can have a severe impact on family dynamics. Family therapy can be effective in dealing with issues such as disrespect and fights and arguments. Children with mental health issues or who are going through puberty may also be helped by family counselors so that more positive relationships can be forged.

There’s no doubt that raising children can be challenging, and because children are individuals, parenting techniques that worked with older siblings may not work with other children.

This can be particularly frustrating and make relationships between parent and child fraught with stress. Family therapy can offer a means of rebuilding difficult relationships and finding the right skills to deal with issues that arise.

Navigating Systems Involvement (CPS, Police, Schools)

People in crisis often struggle in various different areas of their lives, and this may include education, legal and child protective services. Having the involvement of these systems can cause confusion and raise even more difficulties. You may feel that these outside organizations are taking over and pushing you around.

If you are having trouble dealing with the involvement of outside systems, and feel that you are not being listened to, it can be helpful to consider accessing therapy from a clinical social worker. These specially trained social workers have the skills necessary to navigate systems, provide advocacy, and give you the kind of therapeutic support that you and your family need.

What is Important in a Family Counselor?

The most crucial thing to consider when looking for a family therapist is that they are someone with whom you feel comfortable. Every therapist is different in some way or another, and sometimes a therapist’s manner or approach just won’t fit well with you.

For example, some therapists have a kind of “tough love” approach, which might not work for you, but a therapist who has a gentler approach may be a better fit for you – or vice versa.

Knowing the type of personality or manner in a therapist that would best fit your family is equally important as finding someone with the right kind of specialized skills for your difficulties. It is helpful to read a therapist’s website and articles or blogs they have written, as these will give you clues to the therapist’s personality and approach to therapy.

When you make an appointment with a family counselor, it is a good idea to ask questions about their working methods and their practice. This, too, is an effective way of seeing whether the therapist will be a good fit.

If you have doubts about whether you and your family will be comfortable with the counselor, then remember that there are other therapists who will be a better fit. It may take a little time, but you will find the right therapist for you.

It is helpful to take into consideration the type of practice the counselor has. Some are based on religion, others focus primarily on children or adults. These considerations are important because they are factors that impact the way the therapist is used to working.

Faith-based practices can help by bringing faith into sessions, as part of the healing process, and this is not for everyone. Other practices that cater mainly for adults may not have skills in play therapy or involving children in sessions. Likewise, practices who work primarily with children may not have all the tools needed to work with adult aspects of family therapy, such as adult children.

Other Things to Consider

In addition to issues regarding the type of therapy and the therapist, you should consider the costs involved in family therapy. Family therapy can be expensive, but when you put it into perspective and consider the costs of other failed attempts at healing, it may not seem so expensive.

Therapy is a little like preventative medicine. Investing in therapy now can save a lot of expense and pain in the future. Therapy can also be made more affordable with a little knowledge.

Some therapists will bill insurance directly, classed as in-network providers. This means that they will take payment from you and bill your insurance on your behalf.

However, a lot of therapists will not take insurance directly, because there are high costs involved in their kind of business. They operate as “out of network providers”. This means that they will bill you for the session fee and give you a receipt. This receipt can be given to your insurance provider, and you will get back a percentage of the fee paid.

It is a good idea to ask your insurance provider how much they will reimburse you, and what limitations there are on what they will pay for. It is unwise to assume that your insurance will pay for your therapy and then find yourself in debt because your insurance won’t pay out.

An alternative to paying for therapy as part of insurance (if you don’t want to use your insurance or don’t have insurance) is to pay for therapy “out of pocket”, which is paying the therapist their fee each session. Rates can range between $150 and $200 a session. Fees do vary considerably, so it is vital that you ask your therapist their fee before deciding about therapy.

Many families will pay up to 25% of their combined income on therapy. This may seem like a lot, but don’t forget that therapy is preventative, and can substantially increase functionality in families.

Some therapists offer what is known as a sliding scale for people who may struggle to pay for therapy due to limited income. The therapist changes their rate according to the client’s income. Not all therapists offer this, and the amounts charged can vary considerably. Often their sliding scale will be based on things such as their business operating costs, and the size of their practice in addition to client income.

If you feel that you cannot pay for therapy or that private practice isn’t for you, then there are some non-profit agencies that will accept state insurance if you have it. Other practices may offer discounted therapy from trainee therapists who are not yet fully licensed.

Where Can I Find a Therapist Near Me?

Once you know the type and style of therapist that your family needs, you can start looking in your local area for a therapist that meets your requirements. If you want to find “in-network providers”, your insurance provider may be able to give you a list of therapists who bill directly to them.

If you’re looking for providers who accept state insurance, look for a non-profit in the area who may be able to help.

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What Makes Teen Depression Different from Depression in Adults?

Picture this – everything is changing. Your body is maturing. You are being given more and greater responsibilities. Fun and friendships are a big focus, but you seem to have neither.

You know tons of people your age, but can you trust them? Do they even really like you? Just who are you anyway? Suddenly, you are second guessing everything and everyone, even yourself.

Even the normal things you did are not the same. The insatiable appetite you once had has dwindled to barely being hungry at all.

You find it next to impossible to fall asleep yet it’s a grueling task to drag yourself out of bed the next morning. You find yourself in a low or bad mood much of the time. Nothing feels right anymore. Does this sound familiar?

If the symptoms above describe how you are feeling, chances are you are either a teenager, you are suffering from depression, or both. Given the body’s chemical changes and the challenges faced in general, just being a normal teen can resemble depression in many ways.

The teenage years are full of highs and lows. The rollercoaster ride of the turbulent teens can be rocky enough without adding depression to the equation. The combination of being a teenager and being depressed at the same time can be overwhelming.

Teen Depression

The fact is that depression in teens is different from depression in adults because teenagers are different from adults. Some of the differences are as follows:

The Social Scene

A sense of low self-worth is a common indication of depression. Feelings of unworthiness are often all-consuming. Negative self-talk tends to be a huge part of the cycle. The stress and anxiety that these struggles cause is heightened even further by a lack of drive or motivation.

One way in which we all tend to decide how we measure up is by comparing ourselves to others. Have we accomplished all that she has? Will we ever be as good as him? When comparing physical traits like weight, body proportions, and looks, it can easily get out of hand.

Comparing ourselves is a natural thing to do but a very destructive one too. Think about it – when comparing, you will either come up on the high or low end of the stick. Neither is conducive to a healthy self-image.

Depression has a voice that speaks to our heart and minds. The message is never a positive one. It tells us things like that we are not good enough, not attractive enough or not smart enough. We are easily deceived into believing lies, especially when we are comparing ourselves to others which only fuels the fire. As we look outward to set our standards, we are passing judgments inwardly.

The teenage years are a time of tremendous transitions. During adolescence, your body is changing from that of a child to one of an adult. Boys’ voices are cracking and changing. Girls are developing chests. While initially, it is a time of pride and excitement, the whole scenario can all change in a heartbeat when the class laughs at the shrieking voice or the girl gets whistled at by a crowd of boys.

Girls are generally the first to undergo visible physical changes. The earlier they do so, the more difficult the adjustments may be. They take note that they are “different” which can make the changes even rougher. Soon enough, boys find themselves in the midst of puberty, too, and begin comparing themselves and their changes to that of their peers. Late bloomers may have the hardest time of all whether male or female.

Teenage girls may feel as if they are in a whirlwind, being pushed into womanhood too fast, too soon. They may long to stay a little girl for as long as they can. Boys can feel left out and lonely if they don’t shoot up in height, begin to talk in a deep voice and no facial hair is surfacing. It’s easy to feel like the boat left without you. Or, that you are the only one in the boat.

Going through the various stages of puberty is enough to deal with but the fact that teens tend to experience them in different time frames can be extremely frustrating and difficult to adjust to. These factors are very challenging for even well-adjusted teens so when depression is thrown into the mix, you can only imagine the complications.

Modern technology, especially social media, hasn’t made the situation any easier either. Although bullying has been around probably since the beginning of time, within the past 20 years, it has taken on a new face. It is ever-present. It used to be that if you were being bullied, you could at least escape within the confines of your own home. That’s not the case any longer, though.

Smartphones, tablets, and platforms like Facebook, Twitter and Snapchat have changed the dynamics of teenage lives forever. Through posts, tweets, texts and messaging, bullies can stalk their prey even in the privacy of the victim’s home.

The hurtful words can come through at any time of the day, anywhere you are. They can rip you apart and bring you so far down that it’s almost impossible to get back up. In times past, you could at least run and hide from bullying but today, that is next to impossible to do. Even when the devices are not around, the implications echo on.

The very nature of social media can be a breeding ground for depression to set in and it can make existing depression much worse. Imagine if your so-called friends were posting unflattering pictures of you or publically taking pot shots at you. Even grown adults would have trouble digesting such cruel things.

Not only can social media platforms open up a sea of opportunities to stage bully battlegrounds, they can also promote the temptation to compare. There’s the popular girl who just got asked to prom, the football jock posing in a photo with his new trophy and your friend showing off the new puppy she’d rather spend time with than you. It’s up close, personal and always in your face.

Being a teenager isn’t easy. It has never been, but it is more difficult now than it ever was before. Even normal teen changes can make it seem like the world is caving in but when you toss in a dose of depression, it can be devastating.

The Teenage Identity Crisis

The teen years are a journey. You are exploring many things that will become your foundation for adulthood. You may be searching for your identity, finding out what your interests truly are and figuring out who you can trust and rely upon. It is a wonderful time of self-discovery. Unless you have depression.

Wondering is a natural and positive part of growing up. It opens your eyes to exploring new options and to seeing things from a different perspective. It is not to be confused with doubting yourself, everything and everyone around you.

Depression steals the wonder from your teenage years. Instead of experiencing curiosity in a healthy way, you are anxious and perhaps even paranoid. You aren’t sure about the world around you so how could you be sure of yourself?

Depression can stunt the natural phase of development in teenagers. It can also cause deep-rooted insecurities that can carry over into the adult years. Athletes face a similar problem when they are trying to become better and stronger. They need to stretch their limits and move out of their zone of comfort in order to get to the next level.

But, if they are injured, they risk suffering even more damage if they push themselves too hard. The same is true for teenagers who are depressed. They are in a weakened state so the natural process of finding themselves can result in a damaged self-image.

Hope Abounds

Now that it has been established how difficult teen depression can be, it’s time for the good news. The situation is full of hope. Not only can finding help free teenagers from depression, it can give them the tools they need to set them up to succeed later in life. Medical recommendations can be addressed as well such as the possibility that an antidepressant is needed.

While the thought of an adolescent taking an antidepressant in such formative years might seem alarming, it is safe when practiced under the guidance of a skilled psychiatrist or a well-trained nurse practitioner. Still, great benefits can result from therapy by itself.

It is quite common for teens to feel as if they don’t have anyone who is there just to listen to them without passing judgment. It would be ideal if adolescents and teens were comfortable talking to their parents but usually, they aren’t. They feel intimidated. That is why talking to a professional can be so beneficial.

Within the state of Washington, even thirteen-year-olds have the right to complete privacy in their counseling sessions. While it may seem a bit strange to parents, it certainly is comforting to the teenagers.

Knowing that their secrets are safe encourages them to open up so they can receive the treatment they need and deserve without fear that there will be repercussions. The exception is when the client’s safety is at risk.

By addressing the issues of teen depression, teenagers can develop a strong self-esteem that will carry over to adulthood. The process of moving through the pain and dealing with the problems head-on means that hope abounds for a positive future.

In therapy, teens learn to set goals for themselves, both short and long-term ones. They also are given the tools that can help them with their current state of depression. These tools also help if they are hit with depression again in the future. Learning coping skills at an early age is priceless.

Teens who experience positive counseling are more likely to seek help if they run into problems when they are adults. They learn that therapy is a safe place where they can get the treatment they need to improve the quality of their life. Teenagers who have positive outlooks about the counseling they receive may very well encourage their friends to go for help. The power of positive peer pressure is amazing.

Taking the First Step

Help can’t begin until the first step is taken. If you’re a teen who is feeling depressed, or if you have a friend or a family member who is, start by seeking help. Talking to a counselor is a safe way to be heard without judgment and to get to know yourself better. You will also learn coping skills so that you can deal with the depression.

If you’ve been waiting for someone to give you a push in the right direction, this is it! Perhaps you are nervous about taking the first step. Fear and anxiety are symptoms of depression. Don’t let depression steal another moment of your life.

Admitting you need help isn’t easy, especially when you are a teenager. In fact, nothing is easy when you’re a teenager. That is all the more reason to take that first step. You don’t have to live in depression another day. There is help. Reach out to a counselor in your area so that you can get started on your brand new beginning today.


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Warning Signs of Self Harm in Teens

Have you ever encountered self-injury in a friend or loved one? Even if you haven’t, chances are you know someone who intentionally harmed themselves. In 2006, researchers estimated that 14-17% of adolescents and young adults have engaged in self-harm behaviors (Whitlock, Eckenrode, & Silverman).

In a 2007 study, over 46% of adolescent participants reported that they had engaged in non-suicidal self-injury (Lloyd-Richardson, Perrine, Dierker, & Kelley).

The results of other studies confirm that adolescent self-harm is an issue that is all too prevalent and needs to be taken seriously. The psychology community refers to self-harm as Non-Suicidal Self-Injury (NSSI). The definition of NSSI is:

The intentional infliction of injury by an individual upon his or her person in a socially unacceptable manner but without the intent of suicide.

What is your gut reaction to the phrase “self-injury”? If you’ve never experienced an instinct to harm yourself, you might feel unable to relate or understand why someone would hurt themselves. You might wonder what the warning signs or and how you can help someone who is self-injuring regularly.

In this article, we will explore these issues and work towards an increased awareness of self-injury and how to address it.

What Does Self Harm in Teens Look Like?

Self harm in teens can take multiple forms. Individuals may rely on one primary method or a variety of methods. Counselors often note an escalation in these behaviors, beginning with milder forms of scratching or cutting and increasing to a more severe level.

Researchers have discovered that self-injury often displays addictive features (Nixon, Clouter, & Aggarwal, 2002), which explains why it can be so hard to stop.

Methods of self-injury are distressing to hear about, but it’s important to understand the forms this behavior can take. Researchers have identified the most common forms, including biting, cutting, hitting oneself, and burning (Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007).

Punching objects, interfering with the healing of wounds, pinching oneself, pulling out hair for the purpose of hurting oneself, and breaking bones are more examples of forms of self-injury.

Still, further examples include punching objects, disturbing wounds in the process of healing, pulling hair, and breaking bones. Tools of choice can be razors, pencil sharpeners, scissors, paper clips, etc. Any sharp object can be utilized.

As for the physical location of injuries, we often see cuts on the arms and legs, particularly the upper thighs.

What Causes Self-Injury?

If you haven’t struggled with self-harm, you might find it too hard to grasp why someone would hurt themselves. It’s vital to form an understanding of the reasons behind self-injury. This allows us to offer true empathy and support.

Of course, self-injury isn’t caused by just one factor. Here are a number of possible issues that may lead to a desire to hurt oneself:

  • Self-injury can be a form of manipulation, but it should not be assumed that this is the primary reason.
  • It can be a way to “wake up” from a sense of numbness.
  • It can be a way to punish oneself for real or perceived failure in some other area of life.
  • It can signify a lack of ability to process intense emotions (a common struggle in adolescence); it may seem easier to deal with physical wounds.
  • Along the same lines, self-injury is a way to focus on something other than one’s emotions.
  • It’s often assumed that self-injury is a form of attention-seeking. This can be true, but again, this shouldn’t be the default assumption. And even if it is true, it’s crucial to consider why there’s a felt need for attention along with a lack of ability to communicate this need in a constructive way.
  • Self-injury can serve as a release of tension (Nixon, Cloutier, & Aggarwal, 2002).
  • It can be a way to feel in control when other aspects of life feel out of control.
  • It can signal a lack of ability to express one’s emotions verbally, and a choice to instead communicate them through self-harm.
  • Similarly, self-injury can indicate that an individual feels unable to soothe their emotional pain in any other way, whether it takes the form of depression, anger, or some other condition.
  • When someone is injured, the brain may release chemicals that produce a soothing effect.

Self-injury may seem like a relief at the moment, but it provides false and destructive relief. After an incident, the individual often feels a sense of shame and guilt, which can trigger an even greater desire to self-harm. The behavior then becomes a cycle.

Professional treatment can be a crucial component in breaking the cycle and developing coping mechanisms to avoid the urge to self-harm.

Risk Factors for Self-Injury

What are the risk factors that might lead someone to engage in self-destructive behaviors like cutting? Many possible factors relate to the emotions and how well they are regulated, including:

  • A habit of internalizing emotions, especially anger
  • Low self-esteem
  • Mental illness, including depression, anxiety, PTSD, etc.
  • Having a friend who self-injures
  • A general difficulty with emotional regulation
  • Being abused either now or in the past

Warning Signs of Self Harm in Teens

Self harm in teens is usually accompanied by a strong sense of shame, leading to attempts to hide the outward signs of the behavior. Even so, there are still signs that can indicate the possibility that self-harm is occurring. These signs can be used to assess the situation, but they can also be present in the absence of self-injury.

  • Visible scratches, marks, or other wounds that are explained away or brushed off as quickly as possible.
  • Wearing a lot of bracelets or armbands all the time to hide wounds.
  • Wearing long sleeves during hot weather.
  • Increasing isolation (often linked to depression).
  • Suddenly refusing to wear a bathing suit (this might also be due to modesty or body image issues).
  • In general, wearing unusually concealing clothes.

Suicide attempts

According to research, self-injury is a significant risk factor for suicide attempts. Researchers Klonsky, May, and Glenn (2013) found an association between the two. Moreover, they discovered that self-injury was the second leading risk factor for suicide attempts, suicidal thoughts being the first.

This study also found associations between suicide attempts and impulsivity, anxiety, depression, and borderline personality disorder. Numerous other studies have identified a link between self-injury and suicide attempts.

This doesn’t mean that self-injury always leads to attempted suicide; oftentimes there’s no link at all. However, since there is an increased risk, the possibility of suicidal thoughts should be discussed as soon as possible. If suicidal tendencies are present, seek professional help immediately.

How to Help

Let’s revisit the question of your instinctive reaction to the issue of self harm in teens. You might find it frightening or feel helpless when you realize someone you love is hurting themselves. These are normal reactions.

Your own feelings need to be processed as a first step, so you can respond from a place of calm support rather than emotional reactivity.

The primary need of someone who self-harms is to have a place of compassion and safety where they can find support and empathy and learn to express their feelings.

Self-injury carries medical risks, such as the risk of infection, so if you are not the parent or guardian it’s important to contact them about this behavior. Adolescents may fear this disclosure and might respond better if they are included in the process of telling their parents. Remind them that you are on their side, but that you have an ethical obligation to consider their safety.

Avoid responses that may be instinctive but are probably not helpful:

  • Anything that communicates shame or blame, since these feelings are most likely already present and may contribute to the problem.
  • Demanding that the behavior stop immediately. This might just lead to the teen hiding it better. (Instead, remind them that you are worried about them and available to talk anytime they need it. If the behavior is more serious and risky, immediate professional intervention may be needed.)
  • Not taking it seriously.
  • Punishing them.
  • Discussing it with anyone besides caregivers or professionals.

Treatment for Self-Injury

As we have seen, self-injury can become a pattern that is very hard to stop. The individual may use it as a coping mechanism and a consistent way to ease their emotional pain. When they attempt to stop the behavior, they often experience intense urges to revert to it.

But there is hope! Professional therapy can be a path for healing and recovery from these devastating behaviors. It can take several forms, including individual, family, or group therapy. Medication may be another possible method of treatment.

In therapy, a person who self-injures will develop the ability to cope with and communicate their emotions and needs in a healthy, constructive way. They will learn skills for expressing emotions and connecting with other people in their relationships.

Part of the therapeutic process is also identifying the underlying reasons that led to self-injury, such as anxiety, depression, anger, etc. These underlying conditions will be treated as well.

Therapeutic treatment for self-injury is important and may even save a life. If you or someone you love is harming themselves, don’t hesitate to reach out for help. We want to help you find the path to healing.

Photos“Bird in Flight Over Sea”, Courtesy of Alex Wigan, Unsplash.com; CC0 License; “Girl on a Log,” Courtesy of Sergei Zolkin, unsplash.com; “The Defiant One”, Courtesy of Matheus Ferrero, Unsplash.com, CC0 License; “Breathe,” courtesy of pixabay.com, pexels.com, CC0 License