Biting, Pushing, Pulling Hair — Helping Children with Aggression

All people have aggressive feelings. As adults, we learn how to control these feelings. Children, however, are often physically aggressive (e.g., they hit, bite scratch, push, pull, etc.). These behaviors are fairly common and often appear by the child's first birthday. Parents often struggle over how to manage their child's aggressive and/or destructive behavior.

While some biting can occur during normal development, persistent biting can be a sign that a child has emotional or behavioral problems. While many children occasionally fight with or hit others, frequent and/or severe physical aggression may mean that a child is having serious emotional or behavioral problems that require professional evaluation and intervention.

Persistent fighting or biting when a child is in daycare or preschool can be a serious problem. At this age, children have much more contact with peers and are expected to be able to make friends and get along.

BITING

Many children start aggressive biting between one and three years of age. Biting can be a way for a child to test his or her power or to get attention. Some children bite because they are unhappy, anxious or jealous. Sometimes biting may result from excessive or harsh discipline or exposure to physical violence. Parents should remember that children who are teething might also bite. Biting is the most common reason children get expelled from day care.

What to do:

• Say "no", immediately, in a calm but firm and disapproving tone.
• Do NOT bite a child to show how biting feels. This teaches the child aggressive behavior.
• If biting persists, try a negative consequence. For example, do not hold or play with a child for five minutes after he or she bites.
• For a toddler (1-2 years), firmly hold the child, or put the child down.
• For a young child (2-3 years) say, "biting is not okay because it hurts people."

If these techniques or interventions are not effective, parents should talk to their family physician.

FIGHTING AND HITTING

Toddlers and preschool age children often fight over toys. Sometimes children are unintentionally rewarded for aggressive behavior. For example, one child may push another child down and take away a toy. If the child cries and walks away, the aggressive child feels successful since he or she got the toy. It is important to identify whether this pattern is occurring in children who are aggressive.

What to do:

• Do NOT hit a child if he or she is hitting others. This teaches the child to use aggressive behavior.
• For a toddler (1-2 years) say, "No hitting. Hitting hurts."
• For a young child (2-3 years) say, "I know you are angry, but don't hit. Hitting hurts." This begins to teach empathy to your child.
• If a child hits another child, immediately separate the children. Then try to comfort and attend to the other child.
• It is more effective to intervene before a child starts hitting. For example, intervene as soon as you see the child is very frustrated or getting upset.
• Parents should not ignore or down play fighting between siblings.
• When young children fight a lot, supervise them more closely.

When hitting or fighting is frequent, it may be a sign that a child has other problems. For example, he or she may be sad or upset, have problems controlling anger, have witnessed violence or may have been the victim of abuse at day care, school, or home.

Research has shown that children who are physically aggressive at a younger age are more likely to continue this behavior when they are older. Studies have also shown that children who are repeatedly exposed to violence and aggression from TV, videos and movies act more aggressively.

If a young child has a persistent problem with fighting and biting or aggressive behavior, parents should seek professional assistance from a child and adolescent psychiatrist or other mental health professional who specializes in the evaluation and treatment of behavior problems in very young children.

Understanding Violent Behavior In Children and Adolescents

There is a great concern about the incidence of violent behavior among children and adolescents. This complex and troubling issue needs to be carefully understood by parents, teachers, and other adults.

Children as young as preschoolers can show violent behavior. Parents and other adults who witness the behavior may be concerned, however, they often hope that the young child will "grow out of it." Violent behavior in a child at any age always needs to be taken seriously. It should not be quickly dismissed as "just a phase they're going through!"

Range of Violent Behavior

Violent behavior in children and adolescents can include a wide range of behaviors: explosive temper tantrums, physical aggression, fighting, threats or attempts to hurt others (including homicidal thoughts), use of weapons, cruelty toward animals, fire setting, intentional destruction of property and vandalism.

Factors Which Increase Risk of Violent Behavior

Numerous research studies have concluded that a complex interaction or combination of factors leads to an increased risk of violent behavior in children and adolescents. These factors include:

• Being the victim of physical abuse and/or sexual abuse
• Brain damage from head injury
• Combination of stressful family socioeconomic factors (poverty, severe deprivation, marital breakup, single parenting, unemployment, loss of support from extended family)
• Exposure to violence in media (TV, movies, etc.)
• Exposure to violence in the home and/or community
• Genetic (family heredity) factors
• Presence of firearms in home
• Previous aggressive or violent behavior
• Use of drugs and/or alcohol

What are the "warning signs" for violent behavior in children?

Children who have several risk factors and show the following behaviors should be carefully evaluated:

• Becoming easily frustrated
• Extreme impulsiveness
• Extreme irritability
• Frequent loss of temper or blow-ups
• Intense anger

Parents and teachers should be careful not to minimize these behaviors in children.

What can be done if a child shows violent behavior?

Whenever a parent or other adult is concerned, they should immediately arrange for a comprehensive evaluation by a qualified mental health professional. Early treatment by a professional can often help. The goals of treatment typically focus on helping the child to: learn how to control his/her anger; express anger and frustrations in appropriate ways; be responsible for his/her actions; and accept consequences. In addition, family conflicts, school problems, and community issues must be addressed.

Can anything prevent violent behavior in children?

Research studies have shown that much violent behavior can be decreased or even prevented if the above risk factors are significantly reduced or eliminated. Most importantly, efforts should be directed at dramatically decreasing the exposure of children and adolescents to violence in the home, community, and through the media. Clearly, violence leads to violence.

In addition, the following strategies can lessen or prevent violent behavior:

• Early intervention programs for violent youngsters
• Monitoring child's viewing of violence on TV/videos/movies
• Prevention of child abuse (use of programs such as parent training, family support programs, etc.)
• Sex education and parenting programs for adolescents

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Below is an excerpt from instructional DVD series for teachers of young children titled: Facing The Challenge. For more informaiton contact: www.devereuxearlychildhood.org/

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More Tips on Managing Childhood Aggression—

• Ask someone to listen to you while you talk about the feelings you have about the child’s aggression. Hurtful behavior kicks up lots of feelings--fears, anger, guilt--that freeze our warmth and make us react in ways that frighten our child further. Talking to a good listener, and offloading your own feelings, will prepare you to help your child.

• Decide who you are going to listen to first. Both the aggressor and the victim need your help. You will be more effective if you concentrate on one child at a time, giving just a moment to the other child. Try to go to the aggressor as often as you go to the victim. Of course, the victim needs someone to check the damage done, and to care. If it's the aggressor you are going to focus on, you can tell the child who was hurt, "I'm sorry. I know that hurt. I'm going to spend a minute here with you. Then I need to see Marla and help her--she must be pretty upset to do this to you." You might want to try keeping the crying child close to you while you attend to the aggressor child, although it will be harder to keep thinking straight.

• Don't blame, shame, or punish. These actions further frighten children, and further isolate them. They add to the load of hurt that makes children aggressive.

• Don't expect your child to be reasonable. She probably won't use words to tell you how she feels. Her body language and tone while crying or screaming will speak to you. Show your caring as you let her writhe with upset, cry, and struggle. Keep both of you safe by managing her movements when you need to—a hand on her wrist so she can’t grab your glasses, or an arm around her waist so she can’t kick your legs. When she's finished, she will feel relieved and close to you.

• Don't lecture or explain. Even very young children know right from wrong. But when they are wild with feelings, they can’t listen to their own best thinking, or yours. After the unhappy feelings are gone, they will remember, on their own, the important principles you have taught them.

• Encourage her to come to you when she's upset. Children don't do this easily when they carry a big knot of tension, but offering the idea that you want her to ask for help indicates the direction things will go in over time, after many cries have released some of her fears.

• Give her eye contact, a warm voice, and kind physical contact. She needs some sign that it's safe to show you her feelings. You can say things like "I know you don't feel good," "I'm right here and I'll keep things safe for you," "Something's not right. Can you tell me about it?" "No one's mad at you. I want to stay with you right now.”

• Give up the hope that "this time it might not happen.” Mental preparation is important. If your child bites you suddenly when you're doing rough and tumble play, then every time you play this way, be mentally prepared for biting to occur!

• If you child can cry or tantrum at this point, healing has begun. Listen. Sometimes, your presence breaks the crust of isolation and the child’s bad feelings can pour out. The feelings that she expresses are the root cause of the problem. She will probably be showing feelings of anger toward you, or fear of touch and closeness. These fearful responses indicate that your child feels safe with you, and trusts you to handle her wildest, scariest feelings. Let her feel intensely for as long as it takes. She'll decide when she's done enough.

• Intervene quickly and calmly to prevent a child’s hand from landing in someone's hair, or her teeth from fastening onto you, or her fist from landing on her friend. Because she's not in control of her behavior, she needs you to keep her from hurting someone. You can say something like "I can't let you hurt Jamal," or "Oh, no, I don't think I want those teeth any closer," while holding her forehead a few inches above your shoulder.

• Make generous contact. It helps children connect if you apologize for not having kept things safe. You can say "I'm sorry I didn't see that you were upset with Ginger. It's my job to make sure things are safe. I know you didn't want to hurt her.”

• Make things safe immediately. Take away the toys being thrown, or open the child's fingers to release her sister's hair.

• Observe. Under what conditions do the child's fears overtake her? Is it when Mommy has been at a meeting the night before? When there have been arguments at home? When other children crowd close? When left to play with a sibling in a separate room? Generally, you can come up with a good guess as to when your child might lose his sense of connection and become aggressive.

• Remember that children who hurt others don't want to do it. Losing control makes them feel guilty and even more separate than before. Guilt erases the child’s ability to look like he cares. The "I don't care" look is deceiving--underneath, the child is heartbroken that she became so desperate.

• Sometimes, a child who has hurt someone can't feel anything. The feelings of guilt button a child up tight. She doesn't feel safe at all. Your best course of action is to make contact with her by spending some moments--perhaps five or ten--paying attention and doing what she wants to do. This isn't rewarding your child for "bad" behavior. Instead, you are helping your child to reconnect. She has feelings she needs to offload, and in a short while, she will have an upset that gives you another chance to help. She won’t be able to find her favorite toy, or will hate how you cut her toast. The little upset gives her a chance to do the crying she couldn’t do earlier.

• Spend playtime with her and elicit laughter when you can. Connecting with a warm adult in play can be a powerful means of keeping a child’s sense of closeness alive. It's that sense of fun and closeness that will help her stay on a good track with her friends and siblings.

Points to consider--

Don't expect your child to be reasonable. She is feeling badly, you're telling her it's OK to feel, so she probably won't explain anything or use words to tell you how she feels. It's a mistake to expect children to verbalize their feelings while they're releasing them. Just let her writhe with upset, cry, and struggle. If she tries to hurt you, gently keep yourself safe by parrying her blows or using gentle restraint. Keep trying to let her know you care about her. The combination of you keeping things safe and you caring will let her cry long and hard about how awful she feels. When she's finished, she will feel reasonable, close to you, and relaxed.

Don't lecture or explain. Children know right from wrong. And they can't process your logic while they are wild with feelings. When they've blasted the feelings away, their own inner logic will be operating again, and they won't need you to tell them that you don't hit babies, or that biting hurts. Hitting or hurting will be the farthest thing from their minds.

Intervene quickly and calmly to prevent her hand from landing in someone's hair, or her teeth from fastening onto you, or her fist from landing on her friend. Because she's not in control of her behavior, she needs you to keep her from hurting someone. You can say something like, "I can't let you hurt Jamal," or, "Oh, no, I don't think I want those teeth any closer," while holding her forehead a few inches above your shoulder.

Observe. Under what conditions do the child's feelings overtake her? Is it when Mommy has been at a meeting the night before? After Mommy and Daddy have had an argument? During her little sister's time to nurse? When other children are crowding close to her? When playing with just one child? After being left to play with a sibling for 3 minutes? 5 minutes? 10 minutes? When wrestling and cuddling with Daddy or Mommy? Generally, you can come up with a good guess as to when your child might go "off track" and try to hurt.

Reach for her with eye contact, a warm voice, and physical contact. She is far away, trapped in a knot of feelings, and she needs some sign that it's safe to show you what those feelings are. It's better not to move her away, or to get busy talking to her. The busier you are "fixing" the scene, the less safety she can feel. You can say things like, "I know you don't feel good," "I'm right here and I'll keep things safe for you," "Something's not right. Can you tell me about it?" "No one's mad at you. Can you look over here to see that I love you?"

If a child feels safe, he will show how he feels. When it feels safe enough to show their feelings, children who feel upset don't hurt anyone. They feel a bond with their parent or caregiver, and run to the nearest loved one for help. They cry, and release the knot of fear and grief they feel. The adult who listens and allows the child to "fall apart” gives the child a huge gift—enough caring and love to allow the child to heal from the feelings that make life hard for him.

If a child doesn’t feel safe, he may signal for help by becoming aggressive. The child who lashes out feels sad, frightened, or alone. He doesn't look frightened when he is about to bite, push, or hit. But his fears are at the heart of the problem. Fear robs a child of his ability to feel like he cares about others. His trusting nature is crusted with feelings: "No one understands me, and no one cares about me." If you watch carefully, you will see that this kind of feeling drains a child's face of flexibility and sparkle in the seconds before he lashes out.

-OPS Newsletter

How To Talk To Your Child About War And Terrorism

In today's world, parents are faced with the challenge of explaining violence, terrorism and war to children. Although difficult, these conversations are extremely important. They give parents an opportunity to help their children feel more secure and understand the world in which they live. The following information can be helpful to parents when discussing these issues:

Listen to Children:

·Create a time and place for children to ask their questions. Don't force children to talk about things until they're ready.

·Help children find ways to express themselves. Some children may not be able to talk about their thoughts, feelings, or fears. They may be more comfortable drawing pictures, playing with toys, or writing stories or poems directly or indirectly related to current events.

·Remember that children tend to personalize situations. For example, they may worry about friends or relatives who live in a city or state associated with incidents or events.

Answer Children's Questions:

·Acknowledge and support your child's thoughts, feelings, and reactions. Let your child know that you think their questions and concerns are important.

·Avoid stereotyping groups of people by race, nationality, or religion. Use the opportunity to teach tolerance and explain prejudice.

·Be consistent and reassuring, but don't make unrealistic promises.

·Be prepared to repeat explanations or have several conversations. Some information may be hard to accept or understand. Asking the same question over and over may be your child's way of asking for reassurance.

·Don't confront your child's way of handling events. If a child feels reassured by saying that things are happening Avery far away,@ it's usually best not to disagree. The child may need to think about events this way to feel safe.

·Give children honest answers and information. Children will usually know if you're not being honest.

·Let children know how you are feeling. It's OK for them to know if you are anxious or worried about events. However, don't burden them with your concerns.

·Remember that children learn from watching their parents and teachers. They are very interested in how you respond to events. They learn from listening to your conversations with other adults.

·Use words and concepts your child can understand. Make your explanation appropriate to your child's age and level of understanding. Don't overload a child with too much information.

Provide Support:

·Children who have experienced trauma or losses may show more intense reactions to tragedies or news of war or terrorist incidents. These children may need extra support and attention.

·Children who seem preoccupied or very stressed about war, fighting, or terrorism should be evaluated by a qualified mental health professional. Other signs that a child may need professional help include: ongoing trouble sleeping, persistent upsetting thoughts, fearful images, intense fears about death, and trouble leaving their parents or going to school. The child's physician can assist with appropriate referrals.

·Coordinate information between home and school. Parents should know about activities and discussions at school. Teachers should know about the child's specific fears or concerns.

·Don't let children watch lots of violent or upsetting images on TV. Repetitive frightening images or scenes can be very disturbing, especially to young children.

·Help children communicate with others and express themselves at home. Some children may want to write letters to the President, Governor, local newspaper, or to grieving families.

·Help children establish a predictable routine and schedule. Children are reassured by structure and familiarity. School, sports, birthdays, holidays, and group activities take on added importance during stressful times.

·Let children be children. They may not want to think or talk a lot about these events. It is OK if they'd rather play ball, climb trees, or ride their bike, etc.

·Watch for physical symptoms related to stress. Many children show anxiety and stress through complaints of physical aches and pains.

·Watch for possible preoccupation with violent movies or war theme video/computer games.

Most children, even those exposed to trauma, are quite resilient. Like most adults, they can and do get through difficult times and go on with their lives. By creating an open environment where they feel free to ask questions, parents can help them cope and reduce the possibility of emotional difficulties.

War and terrorism are not easy for anyone to comprehend or accept. Understandably, many young children feel confused, upset, and anxious. Parents, teachers, and caring adults can help by listening and responding in an honest, consistent, and supportive manner.

Helping Children After A Disaster—

A catastrophe such as an earthquake, hurricane, tornado, fire, flood, or violent acts is frightening to children and adults alike. It is important to explain the event in words the child can understand. Parents should also acknowledge the frightening parts of the disaster when talking with a child about it. Falsely minimizing the danger will not end a child's concerns. Several factors affect a child's response to a disaster.

A child's age affects how the child will respond to the disaster. For example, six-year-olds may show their worries by refusing to attend school, whereas adolescents may minimize their concerns, but argue more with parents and show a decline in school performance.

A child's reaction depends on how much destruction and/or death he or she sees during and after the disaster. If a friend or family member has been killed or seriously injured, or if the child's school or home has been severely damaged, there is a greater chance that the child will experience difficulties.

Following a disaster, people may develop Posttraumatic Stress Disorder (PTSD), which is psychological damage that can result from experiencing, witnessing, or participating in an overwhelmingly traumatic (frightening) event. Children with this disorder have repeated episodes in which they re-experience the traumatic event. Children often relive the trauma through repetitive play. In young children, upsetting dreams of the traumatic event may change into nightmares of monsters, of rescuing others, or of threats to self or others. PTSD rarely appears during the trauma itself. Though its symptoms can occur soon after the event, the disorder often surfaces several months or even years later.

The way children see and understand their parents' responses are very important. Children are aware of their parents' worries most of the time, but they are particularly sensitive during a crisis. Parents should admit their concerns to their children, and also stress their abilities to cope with the disaster.

Parents should be alert to these changes in a child's behavior:

·Behavior problems, for example, misbehaving in school or at home in ways that are not typical for the child

·Loss of concentration and irritability

·Persistent fears related to the catastrophe (such as fears about being permanently separated from parents)

·Physical complaints (stomachaches, headaches, dizziness) for which a physical cause cannot be found

·Refusal to return to school and "clinging" behavior, including shadowing the mother or father around the house

·Sleep disturbances such as nightmares, screaming during sleep and bedwetting, persisting more than several days after the event

·Startled easily, jumpy

·Withdrawal from family and friends, sadness, listlessness, decreased activity, and preoccupation with the events of the disaster

Professional advice or treatment for children affected by a disaster--especially those who have witnessed destruction, injury or death--can help prevent or minimize PTSD.

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Dr. Kliethermes explains trauma and trauma focused cognitive/behavioral therapy (TFCBT). He discusses how he utilizes trauma focused cognitive/behavioral therapy in assisting children and adolescents work through the residual effects of traumatic experiences in their lives.

Tobacco & Kids

Children's addiction to nicotine from cigarette smoking, smokeless tobacco (chew), and cigars is a major public health problem.

The Facts about teen smoking:

• Approximately 3,000 teenagers start smoking every day and one-third of them will die prematurely of a smoking related disease (American Cancer Society).
• Cigarette smoking and tobacco use are associated with many forms of cancer.
• High school students who smoke cigarettes are more likely to take risks such as ignoring seat belts, getting into physical fights, carrying weapons, and having sex at an earlier age.
• Most adult smokers started smoking before the age of 18.
• Nearly 3 million U.S. teenagers smoke.
• Smoking is the main cause of lung and heart disease.
• Smoking worsens existing medical problems, such as asthma, high blood pressure and diabetes.
• The earlier a person starts smoking, the greater the risk to his or her health and the harder it is to quit.
• Tobacco is considered to be a Agateway drug@ which may lead to alcohol, marijuana, and other illegal drug use.
• Tobacco use continues to be the most common cause of preventable disease and death in the United States.

Children at MOST risk for Tobacco use:

• are very influenced by advertisements that relate cigarette smoking to being thin and/or suffer from eating disorders
• deny the harmful effects of tobacco
• exhibit characteristics such as toughness and acting grown up
• have fewer coping skills and smoke to alleviate stress
• have parents, siblings, or friends who smoke
• have poor academic performance, especially girls
• have poor self esteem and depression

What Parents can do to prevent Tobacco use:

• Ask about tobacco use by friends; compliment children who do not smoke.
• Ask whether tobacco is discussed in school.
• Discuss with your children the false and misleading images used in advertising and movies which portray smoking as glamorous, healthy, sexy, and mature.
• Do not allow smoking in your home and strictly enforce your No Smoking rule.
• Do not allow your children to handle smoking materials.
• Do not allow your children to play with candy cigarettes. They are symbols of real cigarettes, and young children who use them may be more likely to smoke.
• Emphasize that nicotine is addictive.
• Emphasize the short-term negative effects such as bad breath, yellowed fingers, smelly clothes, shortness of breath, and decreased performance in sports.
• Help children to say "No" to tobacco by role playing situations in which tobacco is offered by peers.
• Make tobacco less readily available to children and teensCsupport higher taxes on tobacco, licensing of vendors, and bans on unattended vending machines.
• Parents are role models. If you smoke, quit. If you have not quit, do not smoke in front of your children and tell them you regret that you started.
• Support school and community anti-smoking efforts and tell school officials you expect them to enforce no smoking policies.

If your child or teen has already begun to use tobacco, the following steps can help him or her to stop:

• Advise him/her to stop. Be non-confrontational, supportive, and respectful.
• Assist his/her efforts to quit and express your desire to help.
• Enlist the child's pediatrician or family physician to help the child stop smoking.
• Help your youngster identify personally relevant reasons to quit.
• If the child is abusing other drugs and/or alcohol or there are problems with mood or other disorders, evaluation by a child and adolescent psychiatrist or other mental health professional may be indicated.
• If you smoke, agree to quit with your child and negotiate a quit date.
• Provide educational materials.

Nervous or Depressed?

Scientists are learning how tobacco and nicotine affect teen smokers. Studies going on for 25 years show a link between heavy teen smoking and fear of going outside (agoraphobia). Teens who smoke were 6 times more likely to get agoraphobia. And, teen smokers were 15 times more likely to have panic attacks than teens who did not smoke. Scientists think the reason is that nicotine hurts blood vessels to the brain, and also blocks air from the lungs. Whatever the reason, teen smokers are more likely to have panic attacks, anxiety disorders, and depression.

Teen smoking: 10 ways to help teens stay smoke-free

Teen smoking can become a lifelong habit. Help your teen resist that first puff. Here's how.

Teen smoking might begin innocently enough, but it can become a lifelong habit. In fact, most adult smokers began smoking as teenagers. Your best bet? Help your teen resist taking that first puff. These 10 tips can help.

1. Appeal to your teen's vanity. Smoking isn't glamorous. Remind your teen that smoking is a dirty, smelly habit. Smoking gives you bad breath. Smoking makes your clothes and hair smell, and it turns your teeth yellow. Smoking can leave you with a chronic cough and less energy for sports and other activities you enjoy.

2. Do the math. Smoking is expensive. Help your teen calculate the weekly, monthly or yearly cost of a pack-a-day smoking habit. You might compare the cost of smoking with electronic gadgets, clothes or other teen essentials.

3. Expect peer pressure. Friends who smoke can be convincing — but you can give your teen the tools he or she needs to refuse cigarettes. Rehearse how to handle tough social situations. It might be as simple as, "No thanks, I don't smoke." The more your teen practices this basic refusal, the more likely he or she will say no at the moment of truth.

4. Get involved. Take an active stance against teen smoking. Participate in local and school-sponsored anti-smoking campaigns. Support bans on smoking in public places.

5. Predict the future. Teens tend to assume that bad things only happen to other people. But the long-term consequences of smoking — such as cancer, heart attack and stroke — may be all too real when your teen becomes an adult. Use loved ones, friends or neighbors who've been ill as real-life examples.

6. Say no to teen smoking. You may feel as if your teen doesn't hear a word you say, but say it anyway. Tell your teen that smoking isn't allowed. Your disapproval may have more impact than you think. In one study, teens who thought their parents would disapprove of them smoking were less than half as likely to smoke as those who thought their parents wouldn't care.

7. Set a good example. Teen smoking is more common among teens whose parents smoke. If you don't smoke, keep it up. If you do smoke, quit — now. Ask your doctor about stop-smoking products and other ways to quit smoking. In the meantime, don't smoke in the house, in the car or in front of your teen, and don't leave cigarettes where your teen might find them. Explain how unhappy you are with your smoking and how difficult it is to quit.

8. Take addiction seriously. Most teens believe they can quit smoking anytime they want. But teens become just as addicted to nicotine as do adults, often quickly and at relatively low doses of nicotine. And once you're hooked, it's tough to quit. Consider this: Of adolescents who've smoked at least 100 cigarettes, the American Lung Association reports that most would like to quit but are unable to do so.

9. Think beyond cigarettes. Smokeless tobacco, clove cigarettes (kreteks) and candy-flavored cigarettes (bidis) are sometimes mistaken as less harmful or addictive than traditional cigarettes. Hookah smoking — smoking tobacco through a water pipe — is another alternative sometimes touted as safe. Don't let your teen be fooled. Like traditional cigarettes, these products are addictive and can cause cancer and other health problems. Many deliver higher concentrations of nicotine, carbon monoxide and tar than do traditional cigarettes.

10. Understand the attraction. Sometimes teen smoking is a form of rebellion or a way to fit in with a particular group of friends. Some teens light up in an attempt to lose weight or to feel better about themselves. Others smoke to feel cool or independent. To know what you're dealing with, ask your teen how he or she feels about smoking. Ask which of your teen's friends smoke. Applaud your teen's good choices, and talk about the consequences of bad choices.

If your teen has already started smoking, avoid threats and ultimatums. Instead, be supportive. Find out why your teen is smoking — and then discuss ways to help your teen stop smoking, such as hanging out with friends who don't smoke or getting involved in new activities. Stopping teen smoking in its tracks is the best thing your teen can do for a lifetime of good health.




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Help For Your Teen

When To Seek Help For Your Teen/Pre-teen

Parents are usually the first to recognize that their child has a problem with emotions or behavior. Still, the decision to seek professional help can be difficult and painful for a parent. The first step is to gently try to talk to the child. An honest open talk about feelings can often help. Parents may choose to consult with the child's physicians, teachers, members of the clergy, or other adults who know the child well. These steps may resolve the problems for the child and family.

Following are a few signs which may indicate that a child and adolescent psychiatric evaluation will be useful.

YOUNGER CHILDREN

• Frequent, unexplainable temper tantrums.
• Hyperactivity; fidgeting; constant movement beyond regular playing.
• Marked fall in school performance.
• Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures.
• Persistent nightmares.
• Poor grades in school despite trying very hard.
• Severe worry or anxiety, as shown by regular refusal to go to school, go to sleep or take part in activities that are normal for the child's age.

PRE-ADOLESCENTS AND ADOLESCENTS

• Abuse of alcohol and/or drugs.
• Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism.
• Depression shown by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death.
• Frequent outbursts of anger, aggression.
• Frequent physical complaints.
• Inability to cope with problems and daily activities.
• Intense fear of becoming obese with no relationship to actual body weight, purging food or restricting eating.
• Marked change in school performance.
• Marked changes in sleeping and/or eating habits.
• Persistent nightmares.
• Self-injury or self destructive behavior.
• Sexual acting out.
• Strange thoughts, beliefs, feelings, or unusual behaviors.
• Threats of self-harm or harm to others.
• Threats to run away.

If problems persist over an extended period of time and especially if others involved in the child's life are concerned, consultation with a child and adolescent psychiatrist or other clinician specifically trained to work with children may be helpful.

Where To Find Help For Your Teen/Pre-teen

Parents are often concerned about their child's emotional health or behavior but they don't know where to start to get help. The mental health system can sometimes be complicated and difficult for parents to understand. A child's emotional distress often causes disruption to both the parent's and the child's world. Parents may have difficulty being objective. They may blame themselves or worry that others such as teachers or family members will blame them.

If you are worried about your child's emotions or behavior, you can start by talking to friends, family members, your spiritual counselor, your child's school counselor, or your child's pediatrician or family physician about your concerns. If you think your child needs help, you should get as much information as possible about where to find help for your child. Parents should be cautious about using Yellow Pages phone directories as their only source of information and referral. Other sources of information include:

• County mental health department
• Department of Psychiatry in nearby medical school
• Employee Assistance Program through your employer
• Local hospitals or medical centers with psychiatric services
• Local medical society, local psychiatric society
• Local mental health association
• National Advocacy Organizations (National Alliance for the Mentally Ill, Federation of Families for Children's Mental Health, National Mental Health Association)
• National professional organizations (American Academy of Child and Adolescent Psychiatry, American Psychiatric Association)

The variety of mental health practitioners can be confusing. There are psychiatrists, psychologists, psychiatric social workers, psychiatric nurses, counselors, pastoral counselors and people who call themselves therapists. Few states regulate the practice of psychotherapy, so almost anyone can call herself or himself a “psychotherapist” or a “therapist.”

· Child and Adolescent Psychiatrist — A child and adolescent psychiatrist is a licensed physician (M.D. or D.O.) who is a fully trained psychiatrist and who has two additional years of advanced training beyond general psychiatry with children, adolescents and families. Child and adolescent psychiatrists who pass the national examination administered by the American Board of Psychiatry and Neurology become board certified in child and adolescent psychiatry. Child and adolescent psychiatrists provide medical/psychiatric evaluation and a full range of treatment interventions for emotional and behavioral problems and psychiatric disorders. As physicians, child and adolescent psychiatrists can prescribe and monitor medications.

· Psychiatrist — A psychiatrist is a physician, a medical doctor, whose education includes a medical degree (M.D. or D.O.) and at least four additional years of study and training. Psychiatrists are licensed by the states as physicians. Psychiatrists who pass the national examination administered by the American Board of Psychiatry and Neurology become board certified in psychiatry. Psychiatrists provide medical/psychiatric evaluation and treatment for emotional and behavioral problems and psychiatric disorders. As physicians, psychiatrists can prescribe and monitor medications.

· Psychologist — Some psychologists possess a master's degree (M.S.) in psychology while others have a doctoral degree (Ph.D., Psy.D, or Ed.D) in clinical, educational, counseling, developmental or research psychology. Psychologists are licensed by most states. Psychologists can also provide psychological evaluation and treatment for emotional and behavioral problems and disorders. Psychologists can also provide psychological testing and assessments.

· Social Worker — Some social workers have a bachelor's degree (B.A., B.S.W., or B.S.), however most social workers have earned a master's degree (M.S. or M.S.W.). In most states social workers can take an examination to be licensed as clinical social workers. Social workers provide different forms of psychotherapy.

Parents should try to find a mental health professional who has advanced training and experience with the evaluation and treatment of children, adolescents, and families. Parents should always ask about the professionals training and experience. However, it is also very important to find a comfortable match between your child, your family, and the mental health professional.

Understanding Your Mental Health Insurance

Insurance benefits for mental health services have changed a lot in recent years. These changes are consistent with the nationwide trend to control the expense of health care. It is important to understand your mental health care coverage so that you can be an active advocate for your child's needs within the guidelines of your particular plan. Here are some useful questions to ask when evaluating the mental health benefits of an insurance plan or HMO:

• Are there limits on the number of visits? Will my provider have to send reports to the managed care company?
• Do I have to get a referral from my child's primary care physician or employee assistance program to receive mental health services?
• Does the plan exclude certain diagnoses or pre-existing conditions?
• Does the plan have a track record in your area?
• Is there a "lifetime dollar limit" or an "annual limit" for mental health coverage, and what is it?
• Is there a "preferred list of providers" or "network" that you must see? Are child psychiatrists included? What happens if I want my child to see someone outside the network?
• Is there an annual deductible that I pay before the plan pays? What will I actually pay for services? What services are paid for by the plan: office visits, medication, respite care, day hospital, inpatient?
• What can I do if I am unhappy with either the provider of the care or the recommendations of the "utilization review" process?
• What hospitals can be used under the plan?

The following section explains terms and procedures commonly used in health plan. Managed care refers to the process of someone reviewing and monitoring the need for and use of services. Your insurance company may do its own review and monitoring or may hire a "managed care company" to do the reviewing. The actual review of care is commonly known as "utilization review" and is done by professionals, mostly social workers and nurses, known as "utilization reviewers" or "case managers."

The child psychiatrist treating your child may have to discuss the treatment with a reviewer in order for the care to be authorized and paid for by your insurance. The reviewers are trained to use the guidelines developed by your health care plan. A review by a child and adolescent psychiatrist reviewer usually must be specially requested.

The review process often takes place over the telephone. Written treatment plans may also be required. Some plans may require that the entire medical record be copied and sent for review. Reviewers usually authorize payment for a limited number of outpatient sessions or a few days of inpatient care. In order for additional treatment to be authorized, the psychiatrist must call the reviewer back to discuss the child's progress and existing problems. Managed care emphasizes short term treatment with a focus on changing specific behaviors.

Preferred providers are groups of doctors, social workers, or psychologists which your insurer has agreed to pay. If you choose to see doctors outside of this list, (out of network caregivers), your insurer may not pay for the services. You will still be responsible for the bill. Similarly, care given in hospitals designated as "in network" is paid for by your insurance, while care given in hospitals "out of network" is usually not paid by your insurance and becomes your responsibility. Even when using preferred providers and in network hospitals, utilization reviewers still closely monitor treatment.

Another change is the variety of services and diagnosis paid for by different plans. In the past, only inpatient care and outpatient care was covered by insurance. Now, depending upon your particular plan, other services such as day hospital, home-based care, and respite care may also be covered. These lower cost services may offer advantages to inpatient hospitalization.

A limiting feature of some mental health care plans is a low lifetime maximum or a low annual dollar amount that can be used for mental health care. (i.e. Once this amount is used, plan coverage ends.) You, as parent or guardian, are responsible for paying the non-covered bill. If your child/adolescent needs continued care, you may need to seek help from your state public mental health system. This usually means changing doctors which may disrupt your child's care.

It is important to understand as much as possible about your particular insurance plan. Understanding your coverage will put you in a better position to help your child. Sometimes you may need to advocate for services that are not a part of your plan, but which you and your child's psychiatrist feel are necessary. Advocacy groups may provide you with important information about local services. The support of other parents is also useful and important when engaged in advocacy efforts.

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Self-Injury in Children: Cutting, Burning & Secret Scars--

Services In School For Children With Special Needs: What Parents Need To Know

Some children experience difficulties in school, ranging from problems with concentration, learning, language, and perception to problems with behavior and/or making and keeping friends.

These difficulties may be due to one or more of the following:

· behavioral problems

· emotional problems

· learning disorders (or disabilities)

· physical disorders

· psychiatric disorders

These children with special needs are usually entitled to receive special services or accommodations through the public schools.

Federal law mandates that every child will receive a free and appropriate education in the least restrictive environment. It also entitles children with special needs to receive extra services. To support their ability to learn in school, three Federal laws apply to children with special needs:

• Section 504 of the Rehabilitation Act of l973
• The Americans with Disabilities Act (ADA) (l990)
• The Individuals with Disabilities Education Act (IDEA) (1975)

Between states, there are different criteria for eligibility, services available, procedures for implementing the Federal laws, and procedural safeguards. It is important for parents to be aware of these laws and regulations in their particular area.

What Are The Laws?

IDEA is a federal law (1975, amended by the Office of Special Education Programs in 1997) that governs all special education services for children in the United States.

Under IDEA, in order for a child to be eligible for special education, they must be in one of the following categories:

· autism

· learning disabilities

· mental retardation

· physical disabilities

· serious emotional disturbance

· traumatic brain injury

· vision and hearing impairments

Section 504 is a civil rights statute (1973) that requires that schools not discriminate against children with disabilities and provide them with reasonable accommodations. It covers all programs or activities, whether public or private, that receive federal financial assistance. Reasonable accommodations include un-timed tests, sitting in front of the class, modified homework and the provision of necessary services.

Typically, children covered under Section 504 either have less severe disabilities than those covered under IDEA or have disabilities that do not fit within the eligibility categories of IDEA. Under section 504, any person who has an impairment that substantially limits a major life activity is considered disabled. Learning and social development are included under the list of major life activities.

The ADA (1990) requires all educational institutions, other than those operated by religious organizations, to meet the needs of children with psychiatric problems. The ADA prohibits the denial of educational services, programs or activities to students with disabilities and prohibits discrimination against all such students.

Should I Have My Child Evaluated?

As a parent, you may request an evaluation of your child to determine his or her needs for special education and/or related services. These are the steps you need to take:

• All requests for evaluations and services should be made in writing, and dated. Always keep a copy for your records.
• Initially, meet with your child's teacher to share your concerns and request an evaluation by the school's child study team.
• Keep careful records, including observations reported by your child's teachers and any communications (notes, reports, letters, etc.) between home and school.
• Parents can also request independent professional evaluations.

The results of the evaluation determine your child's eligibility to receive a range of services under the applicable law. Following the evaluation, an Individualized Education Program (IEP) is developed. Parents are entitled to participate in the development of the IEP.

Examples of categories of services in IEPs include:

· Occupational Therapy

· Physical Therapy

· Speech and Language Therapy

· The provision of a classroom aide

Parents do not determine whether their child is eligible under the law. However, the findings of school's evaluation team are not final. You have the right to appeal their conclusions and determination. The school is required to provide you with information about how to make an appeal.

As a Parent, What Can I Do?

Children with special needs are guaranteed rights to services in school under federal and state laws. Parents should always advocate for their child. The process, however, can be confusing and intimidating for parents. Here are some tips:

• If the school district does not respond to your request, you can contact a U.S. Department of Education Office of Civil Rights Regional Office for assistance.
• If the school district refuses services under the IDEA or Section 504 or both, you may choose to challenge this decision through a due process hearing.
• It may also be necessary to retain your own attorney if you decide to appeal a school's decision.
• Other resources for parents include: the State Department of Education, Bazelon Center for Health Law at www.bazelon.org.
• Parents must be proactive and take necessary steps to make sure their child receives appropriate services.
• Parents should request copies of their school district's Section 504 plan. This is especially important when a school district refuses services.

Children & The Internet

The Internet is becoming an exciting new presence in our family lives, offering opportunities unheard of only 5 or 10 years ago. Without ever leaving home, our children can explore museums, play games, check weather forecasts or sports scores, and exchange instant messages with friends from all over the globe. Education, entertainment and information are all at their fingertips.

This phenomenal global network is not regulated by anyone, which opens the door to some risks children may encounter when they go online. You may have heard about kids finding things they don't understand or are not old enough to cope with, and of adults using the Web to prey on children who are naive and unaware of the dangers.

As parents, we know the world is not a safe place. Disney World is wonderful, but we don't let our children travel there by themselves. They need our guidance, our protection, and our wisdom. The Internet is no different. It's loaded with art and knowledge and humor and opportunities for cultural exchange, but it's also infected with junk - pornography and crackpot conspiracy theories and unsubstantiated nonsense.

Despite this, forbidding children from using the Internet is both impractical and shortsighted. Children need to learn how to access information electronically - how to find useful information (and not just play games) - how to assess the good and credible from the false and half-baked. As a concerned parent, you will want to provide guidance to your child about the use of this global resource. There are ways to minimize the risks and maximize the benefits.

Most parents teach their children not to talk with strangers, not to open the door if they are home alone, and not to give out information on the telephone to unknown callers. Most parents also monitor where their children go, whom they play with, and what TV shows, books, or magazines they are exposed to. However, many parents don't realize that the same level of guidance and supervision must be provided for a child's online experience.

Parents cannot assume that their child will be protected by the supervision or regulation provided by the online services. Most "chat rooms" or "news groups" are completely unsupervised. Because of the anonymous nature of the "screen name," children who communicate with others in these areas will not know if they are "talking" with another child or a child predator pretending to be a child or teen. Unlike the mail and visitors that a parent sees a child receive at home, parents do not see e-mail or “chat room” activity.

Unfortunately, there can be serious consequences to children who have been persuaded to give personal information, (e.g., name, passwords, phone number, email or home address) or have agreed to meet someone in person.

Some of the other risks or problems include:

·children accessing areas that are inappropriate or overwhelming

·children being invited to register for prizes or to join a club when they are providing personal or household information to an unknown source

·children being mislead and bombarded with intense advertising

·hours spent online is time lost from developing real social skills and from physical activity and exercise

·online information that promotes hate, violence, and pornography

What Parents Can Do—

Point children to some of the thousands of excellent sites for children and teens on the Web -- keep them busy with choices that really interest them. We don't start a trip to the library by telling our kids where they can't go. We direct them to the sections they might be interested in, where they can roam under our supervision.

Should your family filter the Web?

The decision of whether or not to use a filter in your home is entirely related to your values, needs and family. Many filters are on the market, and are capable of vastly different things, from blocking chat and transmission of information to monitoring your hard drive and keeping history lists. Some commercial online services, such as America Online, and Internet Service Providers allow parents to limit their children's access to certain services. While child-protection tools are worth exploring, they are not a panacea.

The best way to assure that your children are having positive online experiences is to stay in touch with what they are doing. At the very least, keep track of any files your children download to the computer, consider sharing an e-mail account with your children, and occasionally join your children when they are in private chat areas.

Chat rooms—

One of the most appealing features of the Internet for kids are "chat rooms." Unlike bulletin boards or newsgroups, chat rooms allow live communication among Internet users.

There's a funny cartoon, originally published in the New Yorker, of a dog sitting at a computer and saying, "On the Internet, nobody knows you're a dog." The fact is, there's really no way for a person participating in chat to really know who they are talking to. Someone claiming to be a 12-year-old girl may, in fact, be a 40-year-old man.

Teach your kids what information is private, what questions are inappropriate, and how to double-check things like offers for free merchandise. Tell your kids to never give out identifying information and never allow a child to arrange a face-to-face meeting without parental permission. If a meeting is arranged, make the first one in a public spot and be sure to accompany your child. If they are empowered to be suspicious and to check what they read, they are less likely to believe everything they see in a chat room.

There are, however, monitored chat rooms where an adult is listening in on the chat and making sure it does not go beyond certain guidelines. America Online, for example, monitors children's chat rooms and if conversations get too rough, the monitor breaks in.

In order to make a child's online experience more safe and educational, parents should:

·insist that a child follow the same guidelines at other computers that they might have access to, such as those at school, libraries, or friends' homes

·limit the amount of time a child spends online and "surfing the web"

·make use of the parental control features offered with your online service, or obtaining commercially available software programs, to restrict access to "chat lines," news groups, and inappropriate websites

·monitor the content of a child's personal web page (homepage) and screen name profile information

·never give a child credit card numbers or passwords that will enable online purchases or access to inappropriate services or sites

·provide for an individual e-mail address only if a child is mature enough to manage it, and plan to periodically monitor the child's e-mail and online activity

·remind a child that not everything they see or read online is true

·teach a child never to give out any personal identifying information to another individual or website online

·teach a child that talking to "screen names" in a "chat room" is the same as talking with strangers

·teach a child to never agree to actually meet someone they have met online

·teach a child to use the same courtesy in communicating with others online as they would if speaking in person -- i.e. no vulgar or profane language, no name calling, etc.

Technology isn't the problem. It's how you use it. The Internet is one of the most exciting learning tools of our century. The vast amount of helpful, entertaining and educational material far outweighs what might be considered undesirable. The absolute best way to protect our children is to teach them to make wise choices throughout their lives -- whether it's about books, movies, CDs or the Internet. It's up to parents to provide clear guidelines for their children and talk with them about what they believe is or isn't appropriate. This is how children learn.

Ask your children to read Rules for Online Safety below, or print it out and post it near your computer.

Rules for Online Safety—

1. I will never agree to get together with someone I "meet" online without first checking with my parents. If my parents agree to the meeting, I will be sure that it is in a public place and bring my mother or father along.

2. I will never send a person my picture or anything else without first checking with my parents.

3. I will not give out personal information such as my address, telephone number, parents' work address/telephone number, or the name and location of my school without my parents' permission.

4. I will not respond to any messages that are mean or in any way make me feel uncomfortable. It is not my fault if I get a message like that. If I do I will tell my parents right away so that they can contact the online service.

5. I will talk with my parents so that we can set up rules for going online. We will decide upon the time of day that I can be online, the length of time I can be online, and appropriate areas for me to visit. I will not access other areas or break these rules without their permission.

6. I will tell my parents right away if I come across any information that makes me feel uncomfortable.



==> This Parental Control Software Shows You Everything Your Child Does Online When You're Not There.

Step-family Problems

With the high incidence of divorce and changing patterns of families in the United States, there are increasing numbers of step families. New step families face many challenges. As with any achievement, developing good step family relationships requires a lot of effort. Step family members have each experienced losses and face complicated adjustments to the new family situation.

When a step family is formed, the members have no shared family histories or shared ways of doing things, and they may have very different beliefs. In addition, a child may feel torn between the parent they live with most of the time and their other parent who they visit. Also, newly married couples may not have had much time together to adjust to their new relationship.

The members of the new blended family need to build strong bonds among themselves through:

·acknowledging and mourning their losses
·developing new skills in making decisions as a family
·fostering and strengthening new relationships between: parents, stepparent and stepchild, and stepsiblings
·maintaining and nurturing original parent-child relationships
·supporting one another

While facing these issues may be difficult, most step families do work out their problems. Step families often use grandparents or other family, clergy, support groups, and other community-based programs to help with the adjustments.

Parents should consider a psychiatric evaluation for their child when they exhibit strong feelings of being:

· alone dealing with the losses
· excluded
· isolated by feelings of guilt and anger
· torn between two parents or two households
· unsure about what is right
· very uncomfortable with any member of the original family or step family

In addition, if parents observe that the following signs are lasting or persistent, then they should consider a psychiatric evaluation for the child/family:

·a stepparent or parent openly favors one of the children
·child vents/directs anger upon a particular family member or openly resents a stepparent or parent
·discipline of a child is only left to the parent rather than involving both the stepparent and parent
·frequent crying or withdrawal by the child; or
·members of the family derive no enjoyment from usual pleasurable activities (i.e. learning, going to school, working, playing or being with friends and family)
·one of the parents suffers from great stress and is unable to help with the child's increased need

Most step families, when given the necessary time to work on developing their own traditions and to form new relationships, can provide emotionally rich and lasting relationships for the adults, and help the children develop the self-esteem and strength to enjoy the challenges of life.

Types of Step-Families—

As step-families come together and begin to bond, they resolve into one of three types: the Neo-Traditional, the Romantic, or the Matriarchal family.

Neo-Traditional Families—

These families resemble "traditional" families, but the parents realize this takes time to develop, and will have to include the absent biological parent at times. They are more likely to have open and frank discussions between the parents about discipline, the boundaries and limits step-parent's authority, and each parent's expectations of the other in this second marriage. As a result, Neo-Traditional families were better able to avoid family coalitions and "side-taking" which helped decrease tensions.

Romantic Families—

Romantic families want to be "traditional" families in the most idealistic way; they want instant happiness, cohesion, and parent-child relationships, the perfect home. However, the parents expect it immediately. They often find the absent biological parent disrupts their efforts, reminds them of "the life before" their marriage, and prevents them from seeing the family the way they want. They often want the biological parent to disappear for all intents and purposes. This often leads to criticizing the absent biological parent in an effort to show how much better the step-parent is. This generally results in more step-parent and step-child difficulties, the exact opposite of what the family wants.

Their idealized view of their family's future life makes it much more likely that they will find the stress of the first two years insurmountable. What would not seem overwhelming to the other two types of families is very distressing to them, because their unrealistic expectations set them up to not even consider the possibility of discord clearly and act to prevent or minimize it. They expect the step-family to not just be a family on its own, but to make up for and heal all wounds left from the first marriage. They see this marriage in many ways as "destined" to be. They set themselves up for disillusionment and pain by thinking this way.

The parents in these families are less likely to have open and frank discussions about problems, and their difficulty communicating their expectations can be their biggest problem. They tend to "edit out" parts of their past, like exactly what went wrong in the first marriage. The simply see this as "unnecessary nastiness" to go through it with their partners, and expect that their idealized partner will simply "know" what to and not to do to avoid the same problems. Likewise, regular "couples' nights out" is not instituted, because each thinks the couple is fine and that "the specialness" of the relationship protects them from serious marital problems.

Matriarchal Families—

These families comprised about 25% of the sample of step-families. They are run by a highly competent mom and her companion who follows her lead. While he may easily become a "buddy" to the children, he is not their parent. So long as he is clear on this, and so long as he and the mom share compatible values, they get along well. He seems to be most helpful to the family when he is a "monitor," someone who knows where the children are and what they are doing, but not someone who tells them where to go and what to do. His additional information is helpful to the mother, but he is clear on his role; when parenting problems come up, he excuses himself and lets the biological parent handle her children.

The birth of the "our" child, or the matriarchal mother and her companion's child, usually brings a host of problems. The parent's have to renegotiate their roles.

Mom's career advancement may also cause problems; as she becomes more overwhelmed, she needs more help. Whether or not it is more than the husband wants to provide may determine the future of the marriage.

The Step-Family Life Cycle—

Cycle 1-

This covers the first two years, and entails joining as a step-family, dealing with:

-idealistic expectations (i.e., "This marriage will make everything right in our lives")
-finding ways to avoid taking sides (e.g., choosing to enforce a step-parent's or your child's desires)
-learning better ways to communicate (i.e., unlearning ineffective ways from the last marriage and learning the specific ways your new partner communicates)
-discovering, sometimes the "hard way," where the step-parent is and is not welcome in the biological parent-child relationship (e.g., can they ground the spouse's child? Expect them to do yard work? Withhold allowances?")

This time marks a high risk period, and 25% of step-families dissolve during this time. However, 75% of families re-examine their beliefs and ideas about family, and grow to find a new balance in their homes. This happens by carefully walking around and by accidentally stumbling right over issues such as insider-outsider differences, side-taking set-ups, and the problems that families work hard to deny. Honest and clear communication is a key to surviving this phase. Communication over successes, failures, hurt feelings, disillusionment, and more, is crucial to surviving the first two years.

Several keys are:

1)the ability to recognize and express feelings clearly
2) mapping, or asking questions and listening carefully to gain as much information as possible about the situation
3) conflict resolution and compromising skills
4) stating complaints in ways that evoke empathy instead of anxiety and accusations 5) developing real step-family rituals
6) acceptance of turmoil, change, and growth

Some of the more prevalent fantasies step-families can fall vulnerable to are:

Rescue Fantasy -- "I'll save my new partner and children, as well as my children, and make a wonderful new family"

Just Us -- expecting the past marriages and problems will never come into play, or should not come into play to effect the second marriage

Instant Love -- the belief that everyone will instantly get along harmoniously and easily

Better Than -- ideas that the second family will be superior to the first family, and the more unhappy the first marriage was, the more happy and blissful the second marriage will be

Egalitarianism -- the belief, often by the man, that he will join his wife and step-children being an equal in the family, thinking that his needs and emotions will weigh just as heavily as everyone else's. They note that most men realize this and are willing to work to earn their place in the hearts of the family members. However, some don't realize that there will always be some areas that they will never enter

Sometimes children still harbor powerful reunification fantasies, sometimes including the step-father or step-mother. While logically these make no sense, they are still powerful possibilities in the mind of the child.

Cycle 2-

This covers years two through five, and is a time of relative peace and happiness. It also coincides with a relatively calm period of childhood, ages 6 to 10. It is common to see that step-parents and children have built a comfortable relationship and developed rituals together. During this time, ideas about "what a family should be like" may be met easily. It can be a great time for step-parents and step-children to solidify their relationship with common interests or outings together, and for the family to build the "step-family video library."

Cycle 3-

Good Times
This covers years five through nine. It is marked by greater marital satisfaction and stability. However, it is also marked by intense stress and some bickering; adolescence and the resulting turmoil it brings puts an end to the peaceful period in Cycle 2. However, most step-parents found this period was less unhappy and distressing than you might expect. One reason for this is that this period of stress stems from the teen's experiences of developmentally normal changes. Other families get through this, and step-families can too. They have had several years to work out problems, develop stronger ties, and experience considerable success in handling family problems. Another reason these families weather this period well is because they have stopped thinking of themselves as a "step-family" and simply as a "family." It is not so easy to divide the parents, expose wounds from the past, or allow communication problems to cause discord. The children have turned out well in the vast majority of cases, overcoming the stress of the divorce, improving in school, and making and keeping good friendships. They feel a significant sense of pride in their accomplishment.

Bad Times
Some step-families do run into problems in this stage though:

-Teens who want to know more about absent parents, or the real reasons the marriage ended, can bring up long buried but still painful feelings and conflicts

-Matriarchal mothers who find their children growing up into independent teens may have difficulty adjusting

-Teens sometimes become uncomfortable with the opposite-sex step-parent due to their developing sexuality, especially teen girls with their step-fathers. Sometimes this works both ways, and step-fathers suddenly feel like physical contact or kisses with their step-daughters are suddenly wrong. Visits from the step-parent's opposite-sex teen children can also be uncomfortable

-Step-fathers and step-children who never really cemented a strong bond now find their relationship peeling apart and crumbling

When teenage step-children were asked what they called their step-fathers, some interesting results were found:

-32% used "Dad"
-62% used a first name
-6% used a step-father's nickname

This did not change from childhood to adolescence. Most step-fathers realized "Dad" was likely to be reserved for the biological parent and the special bond that existed there. They were OK with a first name, but hated being referred to as "my mother's husband."

20% of adolescents want to move out during this phase and live with the other biological parent. In some ways, this is an easy way to establish independence from the step-family, and allow for greater closeness in the relationship with the other biological parent.

So long as the step-family adopts an "open-door policy" that allows the teen to move back if they want, all can go well. However, often teens move away because of dissatisfaction with the step-family processes, and arguments with the step-parent. Moving may allow them to run from their problems, but parents may feel like they have no other choice but to let the teen move and hope for the best.

Key Tasks—

Step-Families must solve 4 basic tasks to survive:

Integration-

-Integrating the step-father into the step-children's lives

-Integrating the step-family into the step-children's lives

-Developing a shared vision of family life, which must include making a decision regarding how close the step-father and child will be (i.e., buddies or closer, consultant or discipline partner with the biological parent?).

50% of families mishandled one or more of these steps. Romantic families especially are prone to avoid discussing this openly and clearly. Both think from the outset that the step-father is, without any doubt, to be a complete father in every way. Romantic mothers also fail to intervene to clarify things, teach their husbands about the children, and help them understand them better. One mother said that it would be "insulting" to do this for her husband; she would be communicating that she didn't think he could be a good father on his own.

Creating a satisfying second marriage-

This entails taking care of each other, and separating from the first marriage. Happy second marriages help the parents live through the stress of the first two years. This is based in part on the couple's ability to realize that "we" must come before "me" and to make freely the sacrifices this entails. Good listening skills to this, and an ability to see how one's actions are likely to appear to the partner based upon their history.

This also entails keeping ex-partners from interfering, and creating additional stresses and maintaining old dysfunctional patterns. Sometimes mothers feel distressed with their husband's attitudes about her and his children from the previous marriage. Often, men assumed there was a "mommy gene," and that their new wives would automatically know how to handle, care for, and discipline his children. Discussion around this topic had to be clear, setting rules about what responsibilities a step-mother will have and accepts, how this fits into her schedule, and under what conditions she accepts the additional responsibilities.

Managing change in the family-

This is an especially difficult task to manage, since much of the change that step-families must deal with comes from factors beyond their control.

Consider:

-visiting step-grandparents
-rules imposed by ex-partners about parenting
-children's development and changing needs
-integration of non-custodial children
-changing roles of parents and step-parents over time
-the unpredictable results of mixing this many people into the step-family -- people with different experiences, needs, and opinions

Creating good working rules-

This entails creating, trying, refining, rejecting, and finally agreeing on workable rules for handling the cast of peripheral characters (absent biological parents and step-parents, step-inlaws) that enter the family's life from time to time.

Several good coping skills for dealing with the ex-spouse:

1) take a vacation - new spouses can minimize or avoid all interactions with the former spouse, allowing the biological parents to work things out.

2) become deskilled - when the step-mother claimed ignorance for how to handle all the step-sons' problems, they stopped leaning on her as much and became more self-reliant. Ex-partners are also less likely to dump responsibilities for their children on you if you don't seem to be able to do them appropriately.

3) resolve to take ex-partner's comments impersonally - when ex-spouses make comments about the new parent's skills, the new parent can use it as an opportunity to ask the "right way" from the former spouse. It gives the biological parent a way to feel his or her input is valued, and that no one will try to replace them in their child's life.