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In this episode, I'm speaking with Dr. Jess Shatkin, about preventing mental illness and promoting health in children and adolescents. As a clinician, researcher and educator, Dr. Shatkin is one of the country's foremost experts in adolescent mental health, risk and resilience.
Big Ideas - Extensive research about mental health has led us to a good understanding of what we can do preventatively for young people.
- Dr. Shatkin offers practical strategies for parents and people working with kids to help prevent mental illness:
- Practice authoritative parenting:
- show love and support
- give clear guidelines
- set limits
- reinforce positively
- punish infrequently
- Other parenting styles, authoritarian, permissive or negligent parenting, produce more negative outcomes for children.
- Professionals need to understand and apply these authoritative parenting skills when working with kids.
- Kids themselves can learn these basic tools of behavioral modification, and it would go a long way toward helping them have better relationships, social awareness, and improved mental health.
- These behavioral modification tools are:
- positive reinforcement
- effective commands - brief directives not stated as questions and praise by labeling exactly what was done right
- active ignoring - ignore the behavior you don't like coupled with positive reinforcement for good behavior
- scheduling kids
- using reward programs
- limit setting
- consequences (such as time-outs for little kids)
- Global strategies to address these issues:
- We should support more teacher training in these areas.
- Early education should include teaching behavior modification, emotion regulation, emotion identification, and communication skills.
- Resilience education with college students has lowered anxiety, improved mood, and coping skills, lowered dysfunctional attitudes.
- Dr. Jess Shatkan's triumvirate of good health, three healthy habits that every parent can help their child to develop:
- Exercise
- When people exercise regularly, they feel better about themselves, they feel more competent and more empowered. Too many kids are not getting enough exercise. More physical activity leads to better concentration and overall health.
- Sleep
- Sleep is critical for managing stress and anxiety.
- When people don't sleep their brain patterns are disrupted causing worse decision making, higher rates of obesity, and less empathy.
- Nutrition
- Obesity is a huge problem, as over 35% of children are overweight.
- Parents need to provide healthy meals whenever possible, avoid fast food and pesticides and hormones in food.
- Schools and parents can teach the importance of good nutrition.
- Because excessive screen use is shown to have damaging effects on health and wellbeing, parents should enforce these screen rules:
- parents own the screen and the child uses it as a reward or opportunity.
- parents "friend" their kids on social media
- parents supervise and limit screen time
- screens should be in public spaces (not bedrooms)
- use a blue light blocking device when used in the evening to avoid sleep problems
- An environment like camp, which offers time away from screens, exercise, healthy food options, positive social interactions and well-trained counselors, promotes good mental health for our children.
Quotes Jess: "Mental illness is growing in frequency, it's happening more commonly. The more we study it, the more we see it, the better our practitioners are trained, the more easily we pick it up, the more treatments we have, the better people do. But at the same time, we've learned so much now about mental health that there's a lot we can prevent."
Jess: "Kids who have parents who are authoritative do much better in every way. They become better students. They're more likely to stay in school, less likely to have a premature pregnancy, less likely to get sexually transmitted infections, less likely to get involved in drugs, less likely to have accidents and injuries like automobile accidents. They are more likely to go to college. They're more likely to be healthy adults and not have depression and diabetes and all the rest. It's the amazing power of parenting."
Jess: "I think that we should be teaching the skills that lead to this kind of approach, this sort of behavioral modification, in the earliest of years, that teachers could be using these skills in elementary schools and kids could be learning what these skills are in high school so that all their relationships are better."
Jess: "So it's a mistake to ask your kids for things unless no is an acceptable answer. If you give them a choice, 'would you like to wear a sweater or jacket? It's cold tonight.' You get a choice, but it's not, 'do you want to put on something?' or 'do you want to brush your teeth?' or 'do you think it's time to do this or that?' Or 'how about cleaning your room buddy?' or those kinds of things."
Jess: "Authoritative parenting can be taught through parent training--this is what I mean by prevention. We see a lot more mental illness amongst kids who drop out of school, amongst kids who have premature pregnancy, amongst kids who have accidents, injuries, and sexually transmitted infections. And these kinds of things will help us to manage the behavior of kids better so we don't get to that point."
Audrey: "The camp counselor training that we do is a lot of this stuff that you're talking about. It's using positive words, ignoring things, pointing out the kid that's doing the thing right so that the other kids see that you noticed. It's all this basic stuff but most of them have not experienced it themselves before they've come to camp. And so they will tell us afterward that because of the training they got at camp, they're a better parent. They're great teachers."
Audrey: "Some teachers don't know how to relate to kids. They go through their teacher training, they get their credentials, and they know all about physics or English, but they don't know what their kids need in order to feel belonging, connection to the teacher and a desire to learn what's being taught."
Audrey: "I always say like connection before everything else. Connection before correction of course, but also just connection before learning. Your kid on the first day of school is sitting in that class of 30, and they're thinking, who's here am I gonna have any friends? Who's gonna be my partner at this science table? The teachers need to address that. Do a few team building activities like the ones we do at camp. It might take five minutes and then you have this connection and the kids are looking forward to going into that room and feeling part of this community. It's so fundamental. And the same with families. So I'm with you on that. I would love to see universal parent education."
Jess: "When I go into schools and I say to parents, 'what do you want for your child by the time they graduate high school?' they never say 'be great at geometry' or 'be able to speak iambic pentameter.' What they say is, 'I want them to share. I want her to be a good citizen. I want him to do what he says he's going to do. I wanted to have good friends.' They never say anything about academics. Mostly its human qualities."
Jess: "We spend a third of our lives asleep, yet nobody knows anything about sleep except for people who study sleep. And then there's a lot to know about sleep. Now you may not be able to make yourself a perfect sleeper by learning about sleep, but you can do a whole lot better than you're probably doing now. And it makes a big difference for people."
Audrey: "I agree with you that the first thing is just parents understanding communication, how to relate to their child and have this authoritative style. But sleep is so critical and for parents too because when we don't get enough sleep, we are not good with anybody. So it's like everybody is sleep-deprived."
Jess: "Increasingly we're recognizing that there really is an impact from screens. It impacts the brain, it impacts the way we perceive a threat, how anxious we feel. It affects our sleep in a big, big way, and when your sleep is affected, a lot of things are affected."
Jess: "We can look deep into the brain now and we see the effect that being on screens is having on kids. We see less empathy and when the screens are taken away, they all of a sudden become more empathic."
Jess: "Exercise helps our bodies in myriad ways, not the least of which is to sleep and burn calories effectively. You maintain a high metabolism, but also to improve your mood. We know that people who exercise regularly improve mood and we know that exercise works as well as psychotherapy for mild and moderate depression."
Jess: "I always direct parents to do stuff with their kids. Go biking with your kid, take vigorous walks with your kid, go hiking with your kid. There's nothing better than family activity."
Audrey: "I just think if there was one thing parents of young kids could do now is just keep the screens out for themselves too. It seems like that's a simple thing that actually if you're not on your screen as much, you're probably getting more exercise and more sleep."
Jess: "There was an interesting study where they took middle school kids out in the woods for five days and they did school out in the woods and the kids had better eye contact at the end of those five days. They reported more empathy in the surveys that they completed. They were happier."
Audrey: "It's true that when kids are at camp, they report that they feel happier and they feel like they have better friends in those two weeks at camp than all year because it's real connection without distraction. And they're outside, getting tons of exercise and a lot more sleep and nutritious food."
Resources Dr. Jess P. Shatkin, MD, MPH, is a board-certified child, adolescent, and adult psychiatrist, who leads the educational efforts of the NYU Department of Child and Adolescent Psychiatry. He sees patients each day, in addition to running all medical student, resident, and psychology training emanating from the department. In addition, Dr. Shatkin has developed the nation's largest undergraduate program in child/adolescent development at NYU, which teaches 100 courses to over 5,000 students each year. Finally, Dr. Shatkin studies adolescent risk, resilience, and the prevention of mental illness. He has written two books, over 100 scientific articles, and is a popular presenter at meetings and conferences worldwide.
Dr.JessPShatkin.com
Social media: @DrJessPShatkin Facebook
Dr. Shatkin's radio show on Sirius XM
Dr. Shatkin, Born to be Wild book
Dr. Shatkin, Child & Adolescent Mental Health
Alan Kazdin, Parent Management Training Book
Cynthia Whitham, Win the Whining War
Thomas Gordon, Parent Effectiveness Training
Related Ep. 16 about Dr. Shatkin's book Born to be Wild: Why teens take risks and how we can help keep them safe.
Ep. 111: Raising an Exceptional Child in a Conventional World
Ep. 87: The Impact of Camp Experiences with Laurie Browne, Ph.D.
10 Reasons Great Parents Choose Summer Camp for Their Kids
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