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Seeing the whole gifted child

By Lindsey Phillips November 30, 2020

Assessing symptoms and determining a treatment plan for clients is never a simple or straightforward task. That can be especially true when it comes to working with gifted and twice-exceptional clients.

Imagine that a second-grader who is highly intelligent comes to your counseling office. The child has some intense interests, which is not uncommon with individuals who are gifted, and they struggle with emotion regulation, which appears to be related to the child’s perfectionism and low frustration tolerance. You might assume that this client’s struggles are just a natural consequence of being gifted.

Emily Kircher-Morris, a licensed professional counselor (LPC) at Unlimited Potential Counseling & Education Center in O’Fallon, Missouri, made this assumption. It wasn’t until her client entered the fourth grade that Kircher-Morris learned that giftedness alone couldn’t “explain away” the student’s emotional struggles. After experiencing a major event, the client’s problems increased to the point that Kircher-Morris referred him to a psychologist for a full differential diagnosis. Upon receiving the results, she was shocked to find out that her client was not only gifted but also autistic.

“I had fallen into the [common] beliefs about giftedness: That the [emotional struggles] were just sensory intensity or perfectionism,” says Kircher-Morris, an American Counseling Association member who specializes in gifted and high-ability individuals. “I missed how intense his meltdowns were and that his intense interests were related to autism, not giftedness.”

It’s true that individuals who are gifted may possess an intense interest, but they can communicate about other topics in addition to that passion, whereas someone with autism spectrum disorder can’t easily talk about other topics, Kircher-Morris explains.

To make an accurate assessment of a gifted client, professional clinical counselors must first know what “giftedness” even means. The problem is that the exact determinants and measurements for giftedness vary from state to state and even school to school. But according to the National Association for Gifted Children (NAGC), individuals deemed to be gifted or talented have the capability to perform at higher levels than their peers, and they require modifications to their educational experience to learn and to realize their potential.

Neither Kircher-Morris nor James Bishop, an LPC at Blank Slate Therapy in Frisco, Texas, distinguish between “gifted” and “high achieving” because they say some individuals need to be cognitively challenged regardless of whether they meet the formal definition of being gifted. And sometimes gifted individuals have learning disabilities or mental health issues that require them to get help — a concept that can be difficult for individuals who are used to having things come easily to them, Kircher-Morris points out.

(Mis)Identifying giftedness

There is also a substantial amount of anecdotal information, as well as misconceptions, about giftedness, and Bishop, executive director of the Passionate Mind Institute, warns that even mental health professionals can fall prey to pseudoscience on the topic. For example, some counselors too easily embrace overexcitability as a common characteristic of gifted individuals even though there isn’t much current research to support the belief, he says.

People may incorrectly assume that someone cannot be gifted if they are not doing well in school or that gifted individuals never need help, Bishop continues. Some also believe that individuals who are gifted are more prone to depression, but research shows they are as well-adjusted, if not more so, than their peers in the general population, he adds.

Such misconceptions, as well as concern about clinical misdiagnoses, led Bishop, a member of ACA, to conduct a study to test the ability of mental health professionals to recognize gifted characteristics in presenting clients using vignettes that illustrated common issues and characteristics related to giftedness. Half of the 330 participants were prompted that giftedness could be a factor, but regardless of that prompting, Bishop found the majority of participants still clung to the diagnosis of a disorder over an assessment of giftedness. (See “The potential of misdiagnosis of high IQ youth by practicing mental health professionals: A mixed methods study” in the journal High Ability Studies.)

Bishop’s study suggests that even mental health professionals, not just educators, have trouble factoring giftedness into their clinical assessments. “Being mindful and educating yourself on the real struggles that gifted [individuals] face can make you a better clinician in terms of assessing a gifted [client] and being able to determine whether their problems are the result of a disorder or are simply part of their gifted nature,” says Bishop, who chairs the NAGC Social and Emotional Development Network.

But finding training in this area can be challenging for counselors. Bishop says he had to get a doctorate in educational psychology to become formally educated in the subject. He isn’t aware of any counseling program that offers a concentration in giftedness.

The lack of adequate training is a problem because, according to Michelle Tolison, a licensed clinical mental health counselor in Charlotte, North Carolina, giftedness should be a specialty just like trauma. In fact, she believes that without being adequately trained, counselors can do extensive damage if they work with clients who are gifted.

Bishop, author of a forthcoming book on anxiety and giftedness for parents, recommends that counselors attend national and state gifted and talented conferences for opportunities “to dive into the subject, meet people in the field and get a sense of how they [as counselors] can play a role.” In addition to the resources provided by Supporting Emotional Needs of the Gifted (sengifted.org) and NAGC (nagc.org), Bishop and Tolison, owner and lead therapist at Dandelion Family Counseling, recommend reading Giftedness 101 (by Linda Kreger Silverman) and Misdiagnosis and Dual Diagnosis of Gifted Children and Adults (by James T. Webb et al.).

The gifted gap

Most gifted children are identified through testing or teacher referrals in elementary schools. The problem is that there is no one standard test used in schools to determine giftedness. On top of that, many school districts don’t test every student. Instead, they rely on teacher referrals, which, as Renae Mayes, an associate professor in the counseling program in the Department of Disability and Psychoeducational Studies at the University of Arizona, points out, introduces bias.

To highlight this potential bias, Mayes, an ACA member whose research focuses on gifted education and special education for students of color in urban environments, poses several insightful questions: How are teachers trained to recognize giftedness? How are they trained to recognize that giftedness exists in many different kinds of bodies? Will teachers see a Black student who can’t sit still in their seat and has lots of energy as someone who is gifted and excited about learning, or will they perceive the child negatively — as someone who has a behavioral problem or wants to disrupt the learning environment?

The sad reality is that the current method of identifying giftedness has led to an underrepresentation of individuals from marginalized backgrounds in gifted programs. Researchers at the Thomas B. Fordham Institute recently found that in schools that feature gifted programs, only three states enroll more than 10% of their Black and Hispanic students in such programs; in 22 states, that figure stands at less than 5%.

Black and Hispanic students are also overrepresented in special education, Mayes points out. When children are put in special education, it often becomes the only lens through which they are perceived, she says, and the likelihood of them also being identified as gifted dramatically decreases. As Mayes notes, these children tend to be viewed through a deficit perspective, which often incorporates stereotypical understandings of culture and disability rather than allowing children to be seen for their gifts and talents.

According to the article “Myths and research regarding the socio-emotional needs of the gifted,” published in the September issue of The Gifted Education Review (of which Bishop serves as co-editor), individuals from different cultures may not be as readily identified as gifted. Among the reasons highlighted in the article are because these individuals’ cultural norms differ from those of the prevalent culture (e.g., what might be viewed as positive assertiveness in one culture might be perceived as too aggressive in another) or because they are gifted in their first language, which differs from the English language programs in their schools.

“There’s a big push in gifted education to modify how we identify students and make it tied to what kids need academically,” says Kircher-Morris, the president and founder of the Gifted Support Network, a nonprofit dedicated to helping the families of gifted and high-ability learners. “And schools are getting better about identifying kids younger, and they’re doing more universal screening,” which helps remove issues of bias that can arise with teacher and parent referrals.

Twice-exceptionality

Gifted individuals may also have a special need or disability. According to NAGC, the term twice-exceptional (also known as “2e”) describes gifted children who have the potential for high achievement but also have one or more disabilities, including learning disabilities, speech and language disorders, emotional/behavioral disorders, physical disabilities, autism spectrum disorder or other impairments such as attention-deficit/hyperactivity disorder (ADHD).

“People don’t often think that individuals who are gifted can also have [a] disability,” Kircher-Morris says. “It’s kind of counterintuitive, so you end up with kids who are exceptionally cognitively able but perhaps they have ADHD or are autistic and they need a 504 plan or perhaps even an individualized education program.”

Kircher-Morris, chair-elect of the NAGC Social and Emotional Development Network, has noticed that sometimes teachers don’t feel as though they have to make accommodations in environments such as advanced placement classes. These teachers just expect that if a student is in such a class, they should be able to do the work. She often reminds educators that not taking a challenging course is not an accommodation. Twice-exceptional students still need to be challenged; they just need some help along the way.

It can be easy for counselors and other mental health professionals to miss a diagnosis of twice-exceptionality, says Kircher-Morris, who hosts the Mind Matters podcast, which focuses on the development of high-ability and twice-exceptional people across the life span. She is also the author of the forthcoming book Teaching Twice-Exceptional Learners in Today’s Classroom.

Kircher-Morris has had several clients get psychological evaluations and come back with a misdiagnosis. She recalls an example in which one of her elementary-age gifted clients was having meltdowns at school, becoming emotionally dysregulated and having trouble understanding nonverbal cues. Kircher-Morris knew the client was gifted, and she strongly suspected he was also autistic. The boy’s parents were reluctant to accept that label because of the stigma surrounding autism. It was easier for them to just say, “He’s quirky because he’s gifted.”

When Kircher-Morris finally convinced the parents to get a psychological assessment for their son, she wrote a letter to the person doing the assessment and told them the child was gifted to ensure that would be factored in. But the person doing the assessment did not specialize in giftedness and ended up diagnosing the child as depressed because sometimes when he had meltdowns, he would say, “I hate myself. I wish I could die.”

Kircher-Morris knew the client wasn’t clinically depressed. Instead, he was having big emotions and wasn’t sure how to talk about them, she says. She adds that one day of testing and questionnaires is not enough to fully understand and diagnosis a person.

Kircher-Morris still works with this student, and now that he is in high school, his autism is more pronounced. When his schedule shifted and he had to start showering in the mornings instead of the evenings, he didn’t handle it well at first. Kircher-Morris worked with him on regulating his emotions around this change. The student also has some issues with friends at school, but other people in his life often view him solely through a lens of giftedness and assume that he shouldn’t have any trouble communicating, Kircher-Morris says. They don’t realize that as a twice-exceptional adolescent, he sometimes does have certain challenges.

Trying to identify a client as twice-exceptional is even more difficult because of the concept of masking. As Tolison notes, gifted individuals with a learning disability can fall into one of three categories:

1) The individual’s advanced intellect compensates for their learning disability.

2) The learning disability or special need overshadows the person’s giftedness.

3) The giftedness and learning disability mask each other to the point that the individual appears to have average intelligence.

Research shows that twice-exceptional children are often diagnosed later than their peers because their struggles aren’t as noticeable initially, Kircher-Morris says. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders states that individuals with autism, for example, may be able to compensate for their comparative lack of social skills until social expectations exceed their abilities, she notes. A gifted child who is also autistic may not have a language delay when they are little, but by the time they get to middle school or high school, their emotional and social struggles and rigid thinking become more problematic.

“And we’ve now lost all of that time to be proactive and to support them and to help them build the skills they need to be successful, confident and happy,” Kircher-Morris adds.

To avoid mislabeling clients, Tolison, a registered play therapist who works with children who are twice-exceptional (particularly those with ADHD), advises counselors to always consider what the client’s behavior is communicating. Are they fidgeting in the classroom because they are understimulated, or is it a symptom of ADHD?

Therapists need to recognize “the blend of symptomology between gifted and diagnosis,” Tolison continues. For example, mental health professionals shouldn’t presume a client is autistic just because the client is smart and struggles to socialize with peers, she says. Instead, she advises digging deeper and considering whether the symptoms decrease or dissipate when the client is in an ideal setting, such as being around others who have interests similar to theirs.

Giftedness and special education are often seen as being opposite ends of the continuum, Mayes says, but she asserts they are separate continuums and can exist simultaneously. “The disability is the how you do something,” she explains. Even though an individual may need to do a task or skill differently or may need help, they can still possess a higher cognitive ability, notes Mayes, who has published several articles on this topic, including “College and career readiness groups for gifted Black high school students with disabilities” in The Journal for Specialists in Group Work.

Mayes recounts a real case example of how these continuums can overlap in a client: A Black student who was in a gifted program in middle school had an accident and suffered a traumatic brain injury. The injury caused the boy to get bad headaches if he sat for long periods of time, and his vision became blurry. But his cognitive ability was unchanged. He just needed some accommodations to help him at school. His teachers didn’t believe he was actually having headaches, however. They assumed he was just trying to get out of doing the work. The boy internalized their disbelief and told his mother the teachers were looking at him as if he were a “lazy Black kid,” a stereotype he knew was prevalent at the school. Soon thereafter, the boy’s grades started to suffer.

His mother became a big advocate for her son and pushed for a special education and gifted label for him. Even so, the school refused. It wasn’t until the boy entered high school and the school counselor joined the mother’s fight that they finally got some accommodations for the student. When the boy translated his talent for STEM (science, technology, engineering and math) into a passion for band, the band director also advocated for him.

This student had to reconfigure his identity as not just a gifted student but as a gifted student with a traumatic brain injury, and he had to learn to self-advocate, Mayes says.

Asynchronous development

Gifted children’s cognitive, emotional and physical development are often asynchronous, meaning that their intellectual development outpaces their maturity or emotional development. Even though their intellectual skills are advanced, their social and emotional skills may lag behind.

“Cognitive giftedness is not necessarily the same as emotional maturity,” Kircher-Morris says. Because gifted children are often highly verbal and speak as if they are mini-adults, people incorrectly assume that their behavioral and emotional regulation skills will also be advanced, she explains. So, counselors should consider clients’ emotional development along with their cognitive development.

According to Tolison, “There can be upward of a 12-year spread between a child’s intellectual age … [and] their social/emotional age.” For example, a twice-exceptional child with ADHD could be 8 biologically, but with the intellectual capabilities of a 12-year-old and the social and emotional development of a 6-year-old. And at times, the child might have emotional outbursts that are on par with a 4-year-old, Tolison adds.

Tolison often helps her clients first understand emotional language. She finds the “anger iceberg” exercise helpful for teaching emotion identification and awareness. Because some clients might be gifted in empathy, this process is less about identifying emotions and more about learning how to express them, she adds. Tolison then helps clients focus on executive functioning skills such as planning ahead, organizing one’s thoughts, flexible thinking and demonstrating self-control — all of which can be challenging for individuals who are twice-exceptional. She may play chess or Othello with clients to help them work on impulse control, for example.

Kircher-Morris engages clients’ higher-level cognitive skills by adjusting her counseling approach. This can be as simple as using a more advanced technique with a younger client (similar to grade skipping in school), or it may involve tailoring a technique to make it more analytical and creative.

The emotion wheel, which describes eight basic emotions and their varying degrees, is a great tool for helping clients identify and name their emotions, Kircher-Morris says. But this tool may not stimulate gifted clients enough to keep them engaged, so she alters it to make it more cognitively challenging. Her emotion wheel is mostly blank. She leaves a few emotion words in different places around the wheel and works with clients to fill in the blank spaces. Sometimes they look up words in the thesaurus or online to find the “just right” word, and then clients evaluate and determine which words should go on the wheel. This activity builds on the higher-level vocabulary that gifted clients often possess, and it provides them with some autonomy in session, she says.

Letting gifted clients direct (but not dictate) sessions

Kircher-Morris finds that gifted children are often unaware that anything is “wrong.” They can be skeptical of counseling at first, especially if their parents are the ones who initiated it. And because these children are gifted, she says, they often want to know the “why” before they completely trust and participate in different counseling approaches.

For that reason, Kircher-Morris encourages these clients to ask questions and takes time to explain the psychology behind the interventions. She also allows clients to explore what works best for them and to develop their own ideas about what would be helpful.

When Kircher-Morris introduces the cognitive triangle exercise (which emphasizes the relationship between one’s thoughts, feelings and behaviors), she moves beyond just drawing the diagram on a dry-erase board. She also poses a hypothetical example to help clients better understand the underlying principle behind the activity.

An example she often uses is a student who has an upcoming math test. She asks, “What uncomfortable emotions might they be experiencing?” After she and the client brainstorm some possible feelings, she asks, “If they’re experiencing those uncomfortable emotions, then what thoughts might they be having?” She draws speech bubbles on the board, and she and the client fill them in together.

Then they discuss how these thoughts might influence the hypothetical student’s behavior, where the student could intervene and how this would change the outcome. Running through this hypothetical allows clients to better understand the way the exercise works before they apply it to their own situations, Kircher-Morris says.

The fact that gifted individuals have higher-level thinking skills also means they are more likely to find fault in others’ logic, Kircher-Morris says. In fact, because these individuals are often brighter than their parents, teachers and others with whom they interact, counselors might find themselves trapped in a logical corner when a gifted client pokes holes in their reasoning. Should this happen, Kircher-Morris advises counselors not to engage in a power struggle.

“Don’t try to assert your intelligence or the information that you have because that’s going to damage the rapport,” Kircher-Morris says. Instead, her approach is to acknowledge the valid point the client has made. For example, she may say, “I hadn’t thought about it that way. I’ve seen this counseling technique work with other clients, but maybe it won’t work with you. Let’s figure out what will work. Do you think any part of that activity might be relevant for you?”

Tolison agrees that gifted clients benefit from being able to have some control over their therapy, but she cautions counselors not to let them dictate the direction of treatment. She says she often has parents who come to her because they previously worked with another therapist who allowed their gifted child to take control to the point that they weren’t making progress. 

Often, gifted clients are excited to engage in a topic they are passionate about, but that can dominate the session. However, as Tolison points out, counselors can turn that passion into a therapeutic intervention. She once had a client who wanted to talk about the dwarf planet Pluto for most of their sessions. She seized on that as an opportunity to teach the client about mindfulness and social awareness.

She used the phrase “I noticed” to stop him from discussing Pluto: “I noticed you’ve talked 20 minutes now on Pluto. I love that you are sharing your passion with me, but can we take a break because I’m a little exhausted from learning that information right now. Let’s talk about something new.” This statement set a limit for the client while also helping them become more mindful of the passage of time and of other people’s feelings, Tolison says.

Tolison also encourages clinicians to be humble when working with gifted clients. “Sometimes the most therapeutic thing you can do for a profoundly gifted kid is be excited about what they can teach you because in that [process], they are also learning,” she says.

Embracing neurodiversity

Kircher-Morris’ goal is to help normalize the fact that different types of brain wiring exist. People with this brain wiring might be divergent from the norm, but that doesn’t mean something is “wrong” with them. Being gifted or twice-exceptional is simply part of the human condition. Normalizing neurodiversity will encourage people to realize that they need help and give them the courage to ask for it, she says.

Counselors are great at understanding the individual needs of clients, she continues, but unless they consider all the factors, including a person’s cognitive ability, then they may misread the situation and the client’s true needs. For example, if a cognitively gifted child is having a hard time making friends, a counselor might focus simply on helping the child build social skills and self-confidence. But then the counselor would be missing the opportunity to consider other possible factors such as bullying, the child’s high stress levels, their feelings of isolation or others’ upward expectations of them — all of which could inhibit the child’s ability to form authentic relationships, Kircher-Morris explains.

So, she advises counselors working with this population to make sure they view their clients’ struggles through a lens of giftedness. How does giftedness or twice-exceptionality influence these clients’ experiences and reality? Clinicians must also figure out how to leverage clients’ strengths with their cognitive abilities to work through any issues they are having, Kircher-Morris says.

Mayes says counselors must be more holistic in understanding clients and see them as more than their struggles or even their giftedness. “We need to take a broader approach in our professional development,” she says, “so we can start understanding more fully individuals’ identities beyond giftedness to include culture, class, gender identity, affectional identities and so much more.”

 

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Techniques for helping children navigate anxiety related to COVID-19

By Celine Cluff and Victoria Kress September 29, 2020

Counselors are working hard to help children and families navigate the uncharted territories the COVID-19 pandemic has introduced. Many children, especially those who are already managing stressful situations, have experienced an uptick in anxiety this year due to the pandemic, the spotlight on racial injustices and ensuing conflicts, and the various related challenges 2020 has presented.

In this article, we discuss several strategies that counselors can use during these difficult times to help children manage their anxiety.

Clear communication

Children have many questions about the challenges we are currently facing. Adults should explain things to children in clear, concrete terms. For example, in trying to educate a 5-year-old on safety and the pandemic, it would be best to say something along these lines: “There is a virus that can make people sick, and we can catch it. It is important to wash your hands and to keep space between you and other people that is as long as your bed.”

Clear, open communication is key. Children are inquisitive by nature, and it is important to show them that an adult or caretaker is available for exchanges of information. Keeping that exchange simple and age appropriate will help set the child’s mind at ease without causing them unnecessary stress.

On the other hand, shutting down a child’s request for information (out of fear of upsetting them, for example) is not helpful to children. Having a dialogue with a child is always a good idea because it can alleviate some of the tension and turn it into an opportunity for connection and care.

Taming worry dragons

Jane Garland and Sandra Clark — creators of the Taming Worry Dragons: A Manual for Children, Parents and Other Coaches — provide one approach that can help children manage anxiety. A “worry dragon” is characterized by negative or unpleasant thoughts, scared feelings and worries that will not go away.

For some people, worry dragons show up only occasionally. For others, these creatures are constant companions. The dragons might even present themselves in a herd with some frequency.

It can be very tiring to spend so much energy worrying. Having worry dragons means that a person (or child) has a special talent, which is worrying all the time. These individuals are likely able to imagine the worst possible scenario for any situation and to see it in vivid color, with all the gory details.

Children can be taught that tame worry dragons do not scare people and, in fact, can even be useful. What follows are some tips and tricks on how to hone dragon-taming skills.

Scheduling

Children can learn to better manage anxiety through thought-stopping tools — such as dedicating time to worry. When children start worrying actively about topics such as death or the possibility of losing a caretaker or other loved one to COVID-19, this skill can prove useful. Note that this type of worrying typically starts around the ages of 4 or 5; this is when children become aware of mortality (nobody lives forever) and other realities. Mixing this realization with the active and vivid imagination of a child can lead to the creation of worry dragons.

Using an egg timer for “worry time” works well. If a child is repeatedly asking if they are going to be OK because they have been directly or indirectly exposed to news about the coronavirus, a parent or caretaker would get the timer and tell the child they can dedicate five minutes to worrying about the virus. Afterward, they are to leave worries about the virus behind and start doing something else. Because children like to know what happens next and respond well to routines, this technique can help them feel in better control of some of their unpleasant or unwanted emotions.

By using scheduling to integrate worrying into daily activities, the anxious child can take a proactive approach in taming their worries instead of the worries taking hold of the child’s mind at random times throughout the day (or night). 

Creative imagination

Another interactive way of helping children manage anxiety is to have them write or draw their worries on a piece of paper and toss them into a worry jar. By shrinking, harnessing, locking up or trapping worries in a small space such as a jar, the child can make the worries more approachable.

Another option is to buy some colorful miniature pompoms for the child, which they can then place into the jar. When the time comes to work with the jar (e.g., the child is worried about something in particular and cannot relax), the parent or caretaker would extend an invitation to the child to pick a color (or multiple colors) and talk about it as if it represented the worry they cannot let go. This approach helps distract the child (through the texture and visualization of the soft, fluffy, colorful pompoms) while still allowing them to process whatever is bothering them.

Creating a routine

Children thrive on routine, and they require scheduled downtime. Scheduling time to relax and recharge is vital to harmonious home life. A good place to start would be using some of the tools covered in this article in combination with giving the family time to connect, restore and feel love (preferably without the use of a tablet or other device).

The deepening of a connection to a loved one can be a reassuring experience when a child’s sense of safety has been compromised due to the unforeseen circumstances families find themselves in currently. The suggestions in this article were curated to help families navigate these challenging times together while equipping children with helpful tools to combat anxiety. These methods can be applied regardless of the source of anxiety because they are designed to increase the level of control in children who experience anxiety. Helping children hone these skills from an early age can equip them with valuable coping mechanisms to last a lifetime.

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Related reading, from Counseling Today columnist Cheryl Fisher: “The Counseling Connoisseur: How to talk to children about the coronavirus

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Celine Cluff is a registered clinical counselor practicing in Kelowna, British Columbia, Canada. She holds a master’s degree in psychoanalytic studies from Middlesex University in London and is currently completing her doctorate in occupational psychology. Her private practice focuses on family therapy, couples therapy and parenting challenges. Contact her at celine.cluff@yahoo.com.

Victoria Kress is a professor at Youngstown State University in Ohio. She is a licensed professional clinical counselor and supervisor, national certified counselor and certified clinical mental health counselor. She has published extensively on many topics related to counselor practice. Contact her at victoriaEkress@gmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The costs of COVID-19: Parental anxiety syndrome

By Rebekah Lemmons September 8, 2020

As counselors in the age of COVID-19, we have seen a lot. We have been on the front lines of treating a new wave of counseling crises, from broad-reaching trauma symptoms to an increase in panic attacks.

One such example is related to parental anxiety. This is a term that stems from an increase in parental stress and accompanying anxiety related to the reopening of states, businesses and schools.

COVID-19 has changed the day-to-day lives of many parents and caregivers. These individuals have been forced to make adjustments in major areas of life, including child care, schooling for children, work dynamics and social supports. These changes create deeper concerns and uncertainties for many adults.

To best help clients effectively manage parental anxiety, we need to understand this phenomenon, who is at risk, what contributes to higher risks, how to effectively cope with these issues, and how to maintain overall health as the pandemic continues.

What is parental anxiety?

Clinically, parental anxiety is comparable to separation anxiety. It includes a high level of anxiety around opening up schools, day cares and related activities in which parents leave their children in the care of others. It has added components of stress and worry that derive from our ongoing transition to a new normal.

For some parents, this leads to increased panic attacks, decreased stress tolerance, sleeplessness, irritability, head and body aches, and exhaustion. It can also lead to increases in family conflict or parental conflict, largely based on disagreements about parenting in a pandemic. Conflicts about transitioning back into school, work or social situations can create tension and magnify existing areas of disagreement.

Who is at risk?

Any parent or caregiver is at risk for parental anxiety. From full-time working parents to stay-at-home parents, any caregiver can develop symptoms of this condition.

Parents who have been keeping their children at home and are preparing to transition children back into child care or school settings outside of the home are at higher risk. Parents and caregivers are also at risk for parental anxiety if they are preparing to return to the office themselves and transition children out of the home.

Any additional stressors or traumatic events can further complicate this condition. For example, if clients have lost a loved one during the pandemic or known someone with COIVD-19, their symptoms of parental anxiety may become stronger. In addition, Black, Indigenous and people of color (BIPOC) may be at increased risk for parental anxiety because civil rights violations and racial trauma from current events have a layered impact on the effects of the pandemic.

What creates these risks?

Collectively, we have all experienced a crisis. This has been described using many terms, including “collective grief” and “collective traumatization.” As we look at how individualized coping is in general, it is no surprise that during major societal shifts and global-scale issues, there is no one way to manage all that is being thrown at us. Even those with higher supports and increased levels of stress tolerance can struggle with parental anxiety.

For this reason, counselors need to be attentive to clients who appear to be doing well despite the circumstances as we transition to normalcy. As with other types of trauma and toxic stress, it is common for people to release feelings when they are in a safe space. With the transition back to routines and schedules, some parents and caregivers may feel increased stability and become able to release deeply suppressed feelings related to the collective grief and traumatization from recent events.

Clients may have been put in positions in which they had to push through difficulties to continue working, parenting and performing in the various roles they played. Even parents and caregivers who report being ready to return to work or to have children return to school can experience this unexpected flood of traumatic symptoms.

How can we help parents manage these symptoms?

In one sentence, healing from collective trauma requires collective compassion. It is important to promote connection and healthy attachments to recover from the negative impacts of compounded events and societal issues.

We can provide a safe space for clients to unload difficult emotions and worries by being empathic, demonstrating patience and providing psychoeducation about trauma. Counselors can also assist clients with increasing their awareness of feelings related to these issues and provide them with stress-reduction interventions.

Additionally, empowering clients to talk to their employers, child care providers and children’s schools about transition plans can help to alleviate fear of the unknown. This also assists parents and caregivers in making informed choices that will best work for meeting their needs and the needs of their families. With education on transition plans and safety precautions in place, parents and caregivers can focus on areas that they can control.

In response to the array of physical, psychological and sensory impacts from this symptomology, integrated psycho-sensory therapy may be beneficial. This therapeutic model includes using aspects of physical wellness such as recommending and referring clients to engage in yoga, exercise classes and related supportive services (e.g., physical therapy/occupational therapy, chiropractic care, massage therapy). It includes aspects of psychological wellness (the theoretical model of choice). Then it adds sensory considerations based on the client’s needs. These considerations may be related to lighting and colors (low lights, wearing and having a background with calming colors or nature), gentle music, and the presence of calming smells (lavender, lemongrass, etc.). See the visual (below) for model components. The diversity of each component added to the next assists clients in minimizing the impacts of how trauma is felt in the body and how it affects our functioning.

Even with telehealth sessions, counselors should consider creative ways to engage clients by giving them options to move around throughout sessions.

Click on the image to see it full size

Other considerations

For many clients, feeling prepared and having a plan can help to eliminate some of their added stress and anxiety. However, it is crucial that counselors continue to help clients maintain flexible thinking and increase adaptability because much about life today is unpredictable.

On a final note, counselors have experienced this pandemic too. We have also taken on the brunt of addressing mental health needs in a time unlike any other. Furthermore, many counselors are also parents or caregivers. It is vital that we take care of ourselves and commit to our own overall wellness. We must embody the level of integrative and holistic self-care that we communicate to our clients.

One thing I have encouraged others to do in these times is to give grace — to themselves and to others. We must have grace as we navigate these challenges so that we can rise above our circumstances and emerge resilient.

 

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Rebekah Lemmons strives to improve outcomes for children, emerging adults and families. For the past decade, her practice and research primarily has been based in the nonprofit sector, with an emphasis on program evaluation, teaching, service leadership, consulting and providing supervision to clinicians. Contact her at rebekahlemmons@yahoo.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Supporting families with engagement strategies during COVID-19

By Carson Eckard June 18, 2020

To combat the toxic stress caused by the COVID-19 pandemic, I have created a list of activities to positively engage children during this time. The following list includes a description of what each activity is, what materials are needed (with an understanding that many families are under financial hardship) and the possible psychological benefits of the activity.

These activities are designed for entire families, including adults, to reduce stress and promote healing during the pandemic. Most of these activities can be done either inside or outside and can be tailored to individual interests, ages and ability levels.

 

Obstacle course

This activity will get the whole family moving. Use objects around the house to get the family involved. This could include climbing under or over chairs, throwing a bundle of socks into a laundry basket, spinning, using paper strips in place of lasers, and so on.

Inside, a slower pace can be taken to ensure that nothing gets broken and no one gets hurt. If you have access to an outdoor space or a sidewalk in front of your home, you can create an obstacle course out of chalk. Here’s an example.

This website includes a list of materials to use.

This slideshow has ideas for children in wheelchairs.

Materials: Whatever you have in the house

Ages: Toddlers and early elementary-age children

Psychological benefit: Obstacle courses can target many aspects of a child’s brain, including sensory input, motor planning, coordination, sequencing and problem-solving. They can also reduce psychological stress and anxiety. When more people participate, the teamwork and competition can provide some of the social interaction children have been missing from environments such as school.

 

Broadway play

This activity allows children to engage in imaginary play by creating plots to their own stories. When the story is written, have the child cast the characters in the story, find props (or imagine them) and direct the scene. If there aren’t enough family members to act out the scene, consider playing multiple parts at once or having the child draw the characters instead. Children may need direction and prompting, but allow them to be in control of constructing their own narrative. Activities that could be added include constructing sets and props and making movie posters.

Materials: Whatever you have in the house — paper, markers, drawing materials, prop-making materials and so on

Ages: Toddlers through early middle school age

Psychological benefit: During the pandemic, children may be struggling with an inability to control the situation. When they are able to control a scene and story in a healthy way, it can reduce their stress and promote individuality and resilience. Furthermore, creativity reduces anxiety and depression and can help children process toxic stress.

 

Board games and card games

When everyone is stuck at home, board games and card games are a great option for helping the entire family to connect. For younger kids, games such as Go Fish, Candy Land, and Guess Who? could be hits, whereas older kids may like Monopoly, Clue, and Sorry!

If you don’t have any board games at home, use paper or cardboard to create your own. WikiHow has information on steps to take when you’d like to create your own board game. Make sure your child is part of the creative process of creating the game if you choose to make your own.

For more information on why board games are good for a child’s mental health, as well as a breakdown of age-appropriate games, check this link from Manhattan Psychology Group.

Materials: Cardboard, paper, markers, small toys, etc.

Ages: Any

Psychological benefit: Playing fun games decreases anxiety and can increase confidence in children. Some games include aspects of problem-solving and can access the cortex for children who feel safe. Board games allow for healthy cognitive and social development for children.

Mazes and finger labyrinths

Mazes and finger labyrinths are easily made at home. They are a great brain teaser for kids and can also be extremely relaxing. Finger labyrinths are just like mazes, but instead of drawing a line to the exit, a finger is used to follow the path. When paired with deep breathing exercises, this can have a meditative quality.

For help on constructing labyrinths made out of materials such as rice, play dough, paperclips and more, go to this website.

The Labyrinth Society offers an online resource for downloadable and printable finger labyrinths.

The All Kids Network has many printable mazes for kids.

Materials: Paper, printer, something to write with

Ages: Whereas mazes are most engaging for children ages 3-6, finger labyrinths are a good mindfulness activity for children of all ages

Psychological benefit: Mazes offer many benefits to a child’s development, including problem-solving and motor control. Children will need patience and persistence to complete the puzzle and, once done, may experience a boost of confidence. Finger labyrinths originated in prayer but are also used as a grounding exercise.

 

Dance party

Turn up your favorite songs and get moving. Be sure to build a playlist the entire family can move to. Only upbeat jams! Spotify is a free service you can use to build playlists if you establish an account. Spotify playlists that might make for super fun dance parties can be found here. You may need to look around to find a playlist without explicit lyrics, but Spotify does offer an explicit content filter in its settings. Other free services include Amazon Music, Pandora, iHeartRadio and YouTube, but most have ads and can incorporate explicit lyrics, so be careful.

Materials: A phone, laptop, tablet or any device that plays music

Ages: Any

Psychological benefit: Dancing is both great exercise and a form of creative expression. Dancing keeps your heart healthy and muscles strong, improves coordination and balance, and provides an outlet for emotions. Music activates the cerebellum, stimulates the release of hormones that reduce stress, and improves self-esteem.

 

Karaoke party

On a similar note to a dance party, a karaoke party could be another viable option for the family. Because you want family members to sing, I recommend using YouTube and allowing each person to pick a song of their choice, unless you have a premium subscription for a music streaming service. As a finale, try singing a few songs that everyone knows together. For an added bonus, try creating a song by making your own lyrics and finding objects around the house to use as instruments.

Materials: A phone, laptop, tablet or any device that plays music; maybe a prop to use as a “microphone”

Ages: Any

Psychological benefit: Singing releases hormones that reduce stress and make us feel happy, improves mental alertness and helps us control our breath flow, which can help us regulate. Singing also helps children’s communication skills and self-esteem. Studies show that singing stimulates the vagus nerve responsible for our senses, motor function, digestion, respiration and heart rate. When stimulated, the vagus nerve reduces stress, lowers the heart rate and blood pressure, and reduces inflammation.

 

Play teacher

Let your child become the expert and pretend to be a teacher of whatever they are passionate about. This can take a more “formal” approach by pretending to be in school, or it can be more informal, simply asking them questions about the things they are interested in. This helps children realize that adults don’t know everything and allows them to develop as individuals.

Materials: None

Ages: Elementary school age (Note: It is beneficial and important to ask children of any age what their interests are to strengthen your relationship with them)

Psychological benefit: Taking on a formal “school” scenario involves imaginative play. Imaginative play allows children to experiment with different interests and skills. Furthermore, children who engage in pretend play are understanding social relationships, expressing and understanding emotions, expressing themselves both verbally and nonverbally, and practicing problem-solving skills. If imaginative play isn’t your cup of tea, have conversations with your child about what they are passionate about or interested in. Having these kinds of conversations will help you and your child relate to each other more.

 

Yoga

Although it may be difficult to practice advanced yoga poses with younger kids, it is possible to find something appropriate for their level. One of the most important aspects of yoga is breathing. Try doing the yoga poses with your child. Model a positive attitude and a willingness to try new poses, and compliment the child when poses are attempted. Make sure the poses are not too advanced for children or they may become frustrated.

Here is a free YouTube video of yoga poses that you can do with children. If you do not have access to a video device or the child would not benefit from structured instructions found in a video, you can find printable yoga poses from Kids Yoga Stories. If you and the child are new to yoga, it is vitally important to follow a guide to ensure that you are not hurting yourself or the child.

Materials: A guide to follow (either pictures or a video)

Ages: Any

Psychological benefit: It is no secret that yoga has therapeutic qualities such as offering a sense of calmness and relaxation. Furthermore, yoga enhances children’s flexibility, strength, coordination and body awareness. Doing yoga can reduce muscle tension held in our bodies and is another activity that stimulates the vagus nerve, which reduces stress, lowers the heart rate and blood pressure, and reduces inflammation.

 

Indoor sports

This category can depend on whether there is space to move around and interact with each other, but there are options for small spaces too. Each activity is meant to allow children to have fun and can be created with multiple objects around the house.

The Fatherly website has many ideas, such as balloon tennis, for bigger spaces. Roll up some paper and make a ball or a puck to kick, throw or hit around the house. Use a balloon to play volleyball or keep-up. If you have a smaller space, perhaps finger football might suit your needs.

Materials: Anything you can find around the house

Ages: Early elementary to early middle school age

Psychological benefit: If your family doesn’t have much space to run around and play, even the simplest games such as finger football increase coordination. In addition, these sports need multiple participants, which assists in the social development of the child.

 

Video games

Many video games are not family friendly or age appropriate for children. However, many options are available for younger kids both online and offline. PBS Kids offers many educational games for young children. Older kids may benefit from playing games online with their friends. Among popular options are Fortnite, Roblox, Minecraft, League of Legends and titles usually found on consoles, such as NBA 2K and Call of Duty. Many of these games are not free (some can be very expensive), and many are not appropriate for all kids. Have a conversation with the children in your life about what their friends are playing, and then set healthy boundaries around screen time.

There are also online video games that you can play with your family and friends. Popular options include Kahoot!, Jackbox Party Pack, digital board games through apps, Mario Kart Tour and others. Many of these games require only your phone or another device with internet access.

Materials: Games to play and something to play on

Ages: Any (as long as you monitor what games they are playing)

Psychological benefit: Your child is likely missing their friends from school and other environments. Allowing children to play video games with their friends online can help them stay connected and have fun. With all ages, video games offer an outlet for motor development, the release of stress relief hormones, social interaction, problem-solving, development of leadership skills, and increased alertness.

 

Call-and-response songs

If you’ve ever been to summer camp, call-and-response songs will be familiar to you. These songs are started by one person and imitated by another person or group. For children, particularly children with special needs, transitions between activities may be challenging. Side note: I worked at a summer camp with children with autism spectrum disorder, and mealtimes were one of the most stressful parts of the day for them. Singing a simple song such as “We put our foot up on the tree, we put our foot up on the tree, we put our feet up on the tree so that we can eat” makes these times less stressful for all.

Performing a quick redirect activity such as a call-and-response song can lighten the mood and offers a fun incentive for completing an activity. Although there are already call-and-response songs that you can utilize, you can also make your own (or change the words to an existing song) to suit the child’s needs. This activity could also be paired with dance moves or even a camp-themed day.

Go to Ultimate Camp Resource for a list of call-and-response songs. Design Improvised has a great list of themed summer camp ideas to use if you’d like to host a camp-themed day at home.

Materials: None

Ages: Toddler through elementary school age

Psychological benefit: Singing has profound mental health benefits. Singing forces a person to control their breathing. If someone is anxious and having trouble regulating their breathing, singing can help. Singing also improves mental alertness and confidence.

 

Grounding activities

The purpose of a grounding activity is to refocus on reality. It is particularly effective for children who suffer from anxiety, high levels of stress, trauma, dissociation, self-harm tendencies and suicidal thoughts. When children experience these events, they are more likely to enter a state of fight, flight or freeze because they feel they are in danger. Grounding techniques help move the brain from survival mechanisms to a calm state.

Although grounding activities are used in circumstances of higher emotion, they should be practiced often (and even when children are feeling happy) to ensure that children can perform them while in a dysregulated state of mind. You should take time out of the day for all family members to practice these skills together.

Sound search: Sit calmly in a comfortable position. The person lists the sounds they hear. Focusing on other senses helps bring the child back to safety and stabilization.

Coloring break: Although this is most effective for younger kids, it can be used for any age. Even if you do not have coloring pages, encourage the child to draw or color on a piece of paper. Support whatever they need to create in the moment. Crayola has printable coloring pages both for kids and adults.

Sensory bin: A sensory bin is a container filled with materials to stimulate the senses. You must know what types of sensations the child feels are soothing and what sensations may make the child excited. When used with soothing objects such as water or sand, a child may be able to focus on the container instead of overwhelming thoughts. The good thing about sensory bins is that they are easy to make and easy to store when needed. This technique is used mainly with younger kids, but a child of any age may appreciate a sensory bin if it is filled with the appropriate objects. Go to Your Kids Table for a list of ideas on what to put inside a sensory bin.

Positive affirmations: Building a mantra, based on a child’s strengths, that the child can repeat when they are feeling overwhelmed may be beneficial. The idea of having a child repeat a positive mantra when overwhelmed is to help the brain focus not only on the words they are saying but also on the breath needed to form the words. Whenever a family member or friends see the child becoming overwhelmed, they can support the child by guiding the child through the mantra.

Breathing techniques: You can teach children to utilize many different breathing techniques. Breathing exercises calm the brain’s reactions to threats by getting more oxygen. The adult should make sure the child has no anxiety about breath retention and that the child is slow and intentional instead of hyperventilating. If the child is hyperventilating, try to get them to exhale longer than they inhale. Model the techniques for them. Repeat the technique for as long as it takes the child to calm down. Breathing techniques take many forms, such as:

  • Sniff the Flower, Blow Out the Candle: The child imagines holding a flower in one hand and a candle in the other. The child must focus on breathing in through their nose while bringing the “flower” to their face, as if sniffing it, and then exhaling out the mouth while bringing the “candle” to their face.
  • 4-7-8 breathing: The child should breathe in through the nose for 4 seconds, hold their breath for 7 seconds, and exhale out their mouth for 8 seconds.
  • One-nostril breath: The child should place their finger over one nostril and breathe in deeply. The child should then switch to the other nostril and breathe out.

 

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Carson Eckard is a rising second-year graduate student in the community and trauma counseling program at Thomas Jefferson University. He graduated with his B.S. in psychology from Thomas Jefferson University in December 2019. He is passionate about advocating for clients, particularly LGBTQ+ youth. Contact him at Carson.Eckard@jefferson.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

School vaping cultures: Acknowledging the impact of COVID-19

By Zachary Short and Nicole Baliszewski June 4, 2020

This past January, global tobacco conglomerate Altria saw a major drop in its stock value on the New York Stock Exchange, depreciating at a value of almost 40% versus its record-breaking highs in 2017. What caused this sudden dip in one of the biggest-rebounding industries of the 21st century? It would be fair to suggest that the COVID-19 pandemic has caused some major complications for both the traditional and electronic cigarette corporations located across the United States.

As a respiratory-based infectious disease, COVID-19 poses an unparalleled threat to the health and safety of individuals across the age spectrum with significant histories of vaping or smoking. In fact, a recent study in the New England Journal of Medicine found that Chinese patients with a history of smoking were twice as likely to suffer from severe infections associated with diseases such as COVID-19 in comparison with those without any smoking history.

Having always opposed the youth vaping/smoking culture, counselors and community advocates across the nation are currently working to answer a significant question: What actions can we be taking to protect our communities from the combined threat of COVID-19 and recent vaping trends?

The truth is, now is the prime time for considering how we can influence our communities to create better post-quarantine schools for our students.

The loss and revitalization of the smoking industry

Only five years ago, health specialists with the Truth Initiative anti-smoking campaign speculated that the tobacco industry and most of the nation’s smoking addictions would expire with the Generation Z demographic. But vaping, the process of inhaling prepackaged aerosols (also known as vapor), has led to the resurgence of nicotine products within school systems.

Through a combination of peer pressure and social media campaigns, students from all backgrounds have found themselves under the influence of Altria’s newest partner, Juul Labs, maker of the Juul electronic cigarette. Largely as the result of the popularization of this flavored electronic smoking device, the number of high school students who use nicotine products has increased from 3.6 million to 5.4 million in the span of only one year, according to the Centers for Disease Control and Prevention (CDC).

How significant it would be to know that schools were free of the harmful aftereffects of adolescent smoking, leaving school counselors and clinicians available to attend to the important mental health developments that are so essential in our school systems right now. Instead, we find ourselves dealing with another truly concerning issue: According to the Truth Initiative, 1 in every 4 high school students now uses e-cigarettes.

These concerning statistics represent a call for preventative action in middle schools across the nation. A number of schools and organizations have taken such counteractions to trends in vaping by launching interventions such as confiscation, disciplinary action, and even educational programming. But the culture of vaping continues to persist as a significant concern for parents and educators.

The most terrifying thing about the Juul product so far is that it appears to come off as being innocuous to many people. Most students and parents recognize it as the small USB-shaped device that produces fruit-flavored smoke. Very few seem to grasp the long-term consequences of vaping habits. That being said, those consequences might already be here.

The individuals at risk

Based on data collected by the CDC in early March, evidence suggests that COVID-19 poses a serious threat to all individuals ages 65 and older. Fortunately for students under the age of 18, the percentage of those infected and harmed has been relatively low by comparison.

While most parents find some comfort in hearing that the student demographic is the least impacted by the pandemic, the statistics can change drastically if students are part of the vaping culture that is rampant among youth. According to data provided by the CDC for China’s mainland population facing COVID-19, individuals with respiratory issues predominantly associated with even a small history of smoking or vaping have a 6.3% case fatality rate, in contrast to 2.3% overall. Recognizing how exposure to vaping increases a person’s health concerns, imagine the increased risks that our students could face should their still-developing physiques come in contact with both nicotine products and a respiratory infection.

“What they say is about 80% of people feel the flu, but they will be OK. Where we are getting into trouble is that it can lead to severe pulmonary distress,” says Anna Song, an associate professor of health psychology and leader of the Health Behaviors Research Lab at the University of California Merced. “Smoking is a risk factor for having this disease progress, be incredibly severe, and lead to mortality.”

As we know, COVID-19 has posed widespread challenges to the health and lifestyles of the global population. Societal and educational norms have begun to deteriorate, and everyday tasks and responsibilities now come with an unprecedented health risk to individuals and their families. Of great concern to us is that the unattended trends and cultures of our school systems could be having a negative impact on our students right now. To allow these trends to persist beyond this pandemic is to continue putting our students at risk unnecessarily.

A unique opportunity for change

What makes now such an ideal time to invest in removing the harmful vape cultures that continue to linger in our school systems? Students are largely being required to undertake remote learning during this time, and that may continue for many students even as a new school year begins. The changes and circumstances that come with students’ remote learning actually promote our greatest opportunity for the development of an anti-smoking culture.

Society is recognizing that our plans, policies and preparation were inadequate to succeed in the face of an unanticipated global pandemic. Thus, things are beginning to change. Legislation is developing to create preventative actions around practices deemed unhealthy by medical specialists, and educational policy is constantly being reformed to reflect the needs and issues present in our impromptu teaching conditions. If there was ever a time to acknowledge the statistics that point to the harm that nicotine products pose to our adolescents and to advocate for the safety of our children, it is now.

Large systemic changes are challenging and often are out of our hands, but educators and parents currently have the opportunity to make a notable difference in students’ environments. During this time of partial quarantine, most families are now all in one location — the home. Our students currently find themselves in a setting where they are under the watchful eyes of their families and where smoking purchases and practices are essentially impossible.

In addition to that, they are also in a potential learning atmosphere. Through the joint efforts of educators and parents, our youth can be exposed to real educational and intimate conversations regarding the dangerous practices of smoking. These conversations can mean the world to students who currently feel that their futures and health might be dictated by vaping culture.

COVID-19 has had a harsh and unpredictable influence on our way of life, but it also presents us with a rare opportunity to support our students through one of the greatest health issues of their generation. So, making use of the present, it is time that we as a supportive community of counselors consider what we should be doing to help facilitate and emphasize this process of growth for students’ mental and physical health.

Our responsibility to intervene

As of early April, individuals within Rowan University’s Department of Psychology have been conducting their own research to confront the vaping culture that remains prevalent during the COVID-19 pandemic. Their research takes an interesting approach to behavioral analysis with younger age groups, including the development of interesting activities such as mobile- and video game-based interventions that promote smoking abstinence.

Fortunately, this is just the tip of the iceberg when it comes to the collective efforts of universities to combat vaping trends in student populations. Even educational institutions outside of higher education are recognizing the statistically supported danger that vaping is putting our students in when facing the current health pandemic. As a community, it is our collaborative responsibility to provide education and to take the necessary precautions to protect our students’ health. We are just beginning to understand the proper steps to take when working from a remote distance.

Educating the community: Providing knowledge of the increased risks and hazards of smoking behaviors is the first step to reducing nicotine consumption within our school systems. Given the myriad resources available on the consequences of vaping from the CDC, the National Institute on Drug Abuse and even university websites such as Johns Hopkins Medicine, it is the obligation of school counselors and other school personnel to appropriately share this information with our local communities. It is important to remember that this information needs to be given not only to the students we support, but also to our educational partners and to the families who are acting as our immediate support systems in homes at this time.

Promoting real conversations: With the knowledge and statistics being supplied to our students’ homes, it is more important now than ever that school systems promote real conversations with students regarding the present vaping cultures. Whether it is school counselor-to-student or parent-to-student conversations, we need to understand what the student perspectives are when they see products such as Juul in the media while also witnessing terrifying statistics regarding the spread of a global virus.

With those who are currently smoking, it is vital that we understand their concerns and interests so that we can provide them the appropriate support they need. These conversations are the optimal opportunity to promote and communicate resiliency, empathy and community support to our students. And with those who have never touched a vaping device, communicating this information and the associated risks is the best possible preventative action at this time.

Advocating for policies: To reiterate, now is a turbulent time when leaders are reflecting on educational preparations and policy and how they might be applied for future incidents. In addition to redesigning our school’s remote learning policies, we need to be working as a professional community to advocate for anti-vaping policies within our schools. It is essential that school counselors reflect on school policies regarding smoking tolerance, as well as preventative actions to take, so that they can create real opportunities to support student health.

Fortunately, states and health institutions are rallying to create a number of anti-vaping models that can be implemented or referenced by school counselors looking to better their schools. One such model is the Make Smoking History campaign, conducted by the Massachusetts Department of Public Health, to reduce the percentage of vaping disciplinary actions taken in middle school settings. This is the time to ask for and support the voices of the education community to find out what should be done for the development of our educational systems — not just on a school-by-school basis, but from a legislative perspective.

Forming support groups: Finally, acknowledging that this is a difficult time for individuals who have a dependency on smoking tools to which they no longer have easy access, we need to prepare and create remote counseling groups to support them through potential issues such as withdrawal or rehabilitation. A number of counselors may struggle with the concept of remote group counseling, but these students still need emotional and mental health support to cope with their new distancing from vaping. Counselors should utilize the medical resources and personnel within their school districts to support students in their transition to healthier living. Ultimately, it is groups such as these that we should be planning to implement more frequently in our later return to school.

The truth is that in the midst of a global health crisis, most individuals view the issue of vaping in school systems as relatively small. But the fact is that vaping is a real health issue for our youth, and in combination with the threat of COVID-19, it puts our newest generation of students at exceptional risk for loss. In a moment in history when many counselors are at home and wondering what they should be doing to support their students, imagine what significant change could occur if we all directed a portion of our efforts to acknowledging and countering the present vaping culture.

 

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Related reading, from the Counseling Today archives: “Pushing through the vape cloud

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Zachary Short is a master’s counseling in educational settings student at Rowan University. He currently works as a clinical research intern in a high school setting, where his research in student behavioral outcomes is being supported through the Mental Health Grant Demonstration Program. Contact him through LinkedIn: linkedin.com/in/shortzachary/.

Nicole Baliszewski is a master’s counseling in educational settings student at Rowan University. She currently works as a clinical intern in a middle school setting, where she seeks to provide trauma and mental health support to the special education student population. Contact her through LinkedIn: linkedin.com/in/nbaliszewski/.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.