Wednesday, October 10, 2018

Bullying and Our Kids

Patricia Calabrese, PMHNP-BC

“What’s happening to our kids?” is a question that I hear all the time. The news is filled with children demonstrating all kinds of violent behaviors that we never encountered in our childhood, behaviors that are typically associated only with adults. There seems to be a line that has been crossed somewhere, assisted by violent video games and movie actors using aggression to solve problems. Consequently bullying has also become more prevalent and more mean-spirited in our society. In the recent past it was not unusual to hear about teasing and taunting, but today it seems more impulsive, more violent, and even more sophisticated as kids use technology to inflict emotional and psychological pain. Solutions are going to need to involve school, home and the kids themselves in order to be effective.

Olweus (1991) describes bullying as involving harmful behaviors from either one individual or from a group, being prolonged and chronic in nature. Today children of all ages (perpetrators, victims and bystanders) are being involved in more violent, relentless and personal forms of bullying. Schools, parents, professionals are struggling with this issue all the time, not only in middle school, but in grade school, high school and college. Bullying is generally categorized into four areas. They include direct-physical bullying (assaults or thefts), direct-verbal bullying (threats, insults, nicknames), indirect-relational bullying (social exclusion, nasty rumors), and cyber-bullying (Hinduja, & Patchin, 2009). Studies indicate that bullying and its consequences are not limited to gender, sexual preference, age or whether or not the child is being bullied or is the bully! The consequences of bullying can be poor self esteem, academic failure, school refusal, hopelessness, anxiety, isolation and suicidal thoughts, attempts, and completions. “In most studies, the most disturbed group were those who were both bullies and victims” (Klomek, 2010). One study (Kim et al., 2009) found that not only children who are bullied but the bully themselves are at increased risk for suicidal thoughts and behaviors, often times not evident for years later. Professional mental health evaluations of adults might benefit from a childhood bullying assessment in light of these findings.

Klomek (2010) also has studied gender differences in response to bullying. Long-term effects differ by sex. Boys who are associated with bullying seem to have eventual suicidal behavior if they also suffer from prior psychopathology, especially conduct disorders. But girls have suicidal behavior after being bullied, regardless of whether or not that had any prior emotional problems. Studies also find that bullying within relationships have been found to have a much greater impact on emotional stability than overt or direct victimization.

Attempts to try to curtail these problems are difficult and slow, especially when compared with the instantaneous insults that can be twittered or placed on Facebook to a huge, wide audience. A relatively small group of programs are available, and have been used by schools to stop bullying. “Social scientists have found that programs that build from within schools and work both with victims and bullies have more success than programs that ridicule bullies from the outside. One proven strategy is for (school) districts to invest in a school resource officers (SRO), whose main duty is to patrol the halls and connect with the kids” (www.time.com, Oct. 24, 2010 issue).

Intervention is difficult, time intensive, and does not involve a quick fix. Many of the current approaches are aimed at the child being bullied, but the root cause may be with the bully themselves. Children with low self esteem, chaotic lives, or who experience violence will lash out at others. The bully’s violent nature causes others to fear them, and then “just go along” or become a quiet bystander. These bystanders become fearful and then choose to not help the child being bullied, not report the bullying or worse, become a party in the bullying. The latter is exemplified in cyber-bullying, when kids forward nasty messages or photos.

“Where are the adults?” is a central question in this discussion. Adult role modeling of bullying behavior is a major factor in whether or not our children consider bully behavior to be acceptable. “Do as I say not as I do” is no longer acceptable. Some children are not getting the direction they so desperately need at early ages. Adults (parents & teachers) need to model good behavior that instill positive values, strong ethics, and provide a clear message that violence and disrespect will not be tolerated.

Awareness of bullying, whether in a school, on a team, or in a neighborhood is the first step in stopping it. Many children do not tell their parents or teachers for fear that the spotlight will be on them, and the bullying will get worse or more violent. Adults need to be sensitive in addressing the situation. The best intervention comes from someone in more “power” than the bully, and from someone who can truly keep the other children safe, such as a teacher. Bullies, once identified can be “separated” in class, but also need to be monitored in class, after class and on school buses. Treatment for the bully may be warranted, focusing on anger management, home problems, or emotional problems. Secrecy and camouflage from adults is the mainstay of bully behavior. Just protecting bullied children in class cannot be enough, because most bullying then is channeled somewhere else, such as the internet. Teachers need to be constant observers, and apply logical consequences to a specific behavior displayed. If a teacher would give a consequence for cheating on test (i.e., suspension from the basketball team), then they must also give a consequence for bullying. Any behavior will continue as long as it is tolerated by those in authority. Bringing together the entire “system”, such as the class, and empowering the bystanders can work in taking the secrecy and power away from the bully.

Patricia Calabrese, PMHNP, is a graduate of Adelphi University in Garden City, New York. Patricia received her Master of Science in Nursing from the University of Maryland and completed her post graduate studies at the University of Southern Mississippi. Patricia is a licensed mental health nurse practitioner in Mississippi. Patricia joined the Pine Grove Staff in 1992 and currently treats child and adolescent patients at Pine Grove Outpatient Services with special interest in ADHD and parenting education.

Pine Grove Behavioral Health and Addiction Services is an extension of Forrest General Hospital, located in Hattiesburg, Mississippi. Pine Grove’s world renowned programs focus on treating gender specific chemical addiction including a specialized track for co-occurring eating disorders. Additionally, Pine Grove offers a focused substance abuse healing program for adults age 55 and over. Other Pine Grove specialty programs include a dedicated professional’s treatment curriculum and a comprehensive evaluation center. Pine Grove also features a program for patients with sexual and intimacy disorder issues. Pine Grove was established in 1984 and has provided nationally and internationally recognized health care for over 30 years.

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.

Pine Grove Treatment

Saturday, September 8, 2018

Warning Signs of Suicide

Suicide is a devastating act that almost always seems to friends and family members like a bolt from the blue. But people often give clues that they are thinking of suicide. Recognizing the warning signs of suicide could result in a life being saved.

Giving away cherished possession, making a will and being preoccupied with death are red flags for impending suicide. Furthermore, the old saying that people who talk about suicide don’t do it is simply not true. Often such talk is a cry for help before it’s too late.

Another warning sign of suicide is depression. Any of these changes could indicate depression:

- Feelings of hopelessness or helplessness
- Changes in eating or sleeping patterns
- Poor performance at work or school
- Poor concentration
- Withdrawal

Anyone who is depressed or has been depressed is at risk for suicide. Other risk factors include:

- Alcohol and drug use
- History of physical or sexual abuse
- Death of a friend or family member
- Previous suicide attempt
- End of a relationship

If you suspect someone is considering suicide, take the warning signs seriously! Don’t assume it will blow over. Share your concerns with someone who is a position to take charge or contact your local health professional.

Pine Grove Behavioral Health & Addiction Services is an extension of Forrest General Hospital, located in Hattiesburg, Mississippi. Pine Grove’s world renowned programs focus on treating gender specific chemical addiction including a specialized track for co-occurring eating disorders. Additionally, Pine Grove offers a focused substance abuse healing program for adults age 55 and over. Other Pine Grove specialty programs include a dedicated professional’s treatment curriculum and a comprehensive evaluation center. Pine Grove also features a program for patients with sexual and intimacy disorder issues. Pine Grove was established in 1984 and has provided nationally and internationally recognized health care for over 30 years.

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.

Pine Grove Treatment

Wednesday, February 28, 2018

Warning Signs of Eating Disorders

Over 30 million Americans have some type of eating disorder and while each problem is unique, eating disorders do have warning signals.

Here are some signs that might indicate a problem in you or someone you love:

- Fear of being unable to stop eating once you start
- Abusing drug or alcohol before “binge eating”
- Intentional vomiting after meals
- Constant low-calorie or crash dieting
- Compulsive exercise with strict “exercise rules”
- Using body weight and being thin to measure self-worth
- Thinking or talking constantly about food
- Refusing to discuss food at all
- Using food to hide anger, loneliness, or feelings of rejection

If you are concerned about your eating behaviors or attitudes, or even a friend or family members, consider professional help.

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.

Pine Grove Treatment

Tuesday, January 23, 2018

Recovery and Emerging Adulthood

by Next Step Clinical Director Vanessa Cox, Next Step Counselor Lejejuande Magee, and Next Step Counselor Associate Susan Hinton

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 22% of young people ages 18 to 25 in 2015 participated in illegal drug use, this population misused pain relievers, tranquilizers, and stimulants more than any other age group (Bose et al., 2016). And while they are recognized by society as adults, some statistics indicate they are not yet operating as adults. As of 2016, data from the U.S. Census Bureau shows that more 18-25 year olds live with their parents rather than with a spouse or partner. This prolonging of adolescence or emerging adulthood presents a unique array of circumstances when seeking treatment for a substance use disorder, and Pine Grove's Next Step program is here to help.

The Next Step program at Pine Grove Behavioral Health & Addiction Services provides comprehensive treatment of substance use disorders for men ages 18 to 40 years old. Patients live in a therapeutic community that provides structure and promotes accountability, honesty, inclusion, respect and responsibility. Next Step has both residential and partial hospitalization levels of care with lengths of stay varying from 30, 60, to 90 days and provides an environment where men can find a way to live a life of recovery while gaining skills necessary in establishing adulthood.

The Next Step program provides a solid plan of action to put in place skills needed for living a substance free life. The curriculum at Next Step includes the latest research on addiction, tasks of recovery, and brain health while instilling the principles of the 12-step program. Daily activities include morning meditation, therapeutic community with staff and patients, psychotherapy groups, primary addiction groups, psycho-educational lectures, recovery skills groups, specialty groups, as well as AA and NA 12-step meetings. Additionally, the treatment team at Pine Grove includes psychiatrists and other mental health care professionals equipped to meet the needs of patients needing psychiatric or dual diagnosis treatment.

Due to a prolonged adolescence, people who use alcohol and drugs often do not learn a number of necessary life skills. These skills may include vocational planning, going to school, getting a job, paying bills, or establishing and maintaining meaningful relationships. Frequently even more basic living skills such as self-care and grooming within this group are often ignored. The Next Step program helps this population acquire basic life and social skills needed to function as a productive member of society, the program also includes ancillary treatments such as REACH, yoga, and exercise to promote teamwork and positive thinking.

At Next Step patients uncover significant factors that contributed to their alcohol and/or drug use and discover healthy coping skills, spiritual principles, motivation for change and a healthy lifestyle that enables them to establish and maintain recovery from the disease of addiction. Our ultimate goal is to help our patients implement a wholesome foundation on which to build a lifestyle conducive to recovery and to embrace the fact that addiction does not have to continue to consume their lives.

Bose, J., Hedden, S. L., Lipari, R. N., & Park-Lee, E. (September 2016). Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.

Pine Grove Treatment

Wednesday, December 6, 2017

The Holidays are Here!

by Patricia Calabrese, PMHNP
Pine Grove’s Outpatient Services

The fact that holidays are at the end of our calendar year is very apropos. It marks a time to review the year, gather with those close to us and be thankful. And as traditional and predictable as it can be, it is different for everyone.

Much of what we do to celebrate the holidays depends on our stage of life. Holidays with young children are very different than holidays with older, chronically ill family members. The holidays with young children often become a time for the adults to become consumed with surprises, lights, music, bells and whistles! Many of the plans, starting months before, involve lists of gifts, class parties, visiting relatives and decorating. Each event has a special ritual. Young children are difficult to attend to, when trying to give them every holiday experience while not rocking their usual nap schedule. Years ago I started “The Christmas Binder.” This is the holiday essential to every OCD planner. A dear friend, invited me over when our kids were about three to take a small binder, cover it in Christmas fabric (mine is red Santas!) and use perfect paper dividers to create files for gifts, Christmas meal, Christmas cards and Christmas parties. And because our only daughter decided to be born early on December 27th, there were files for her special occasion. (Oh, the joys of being an only child!). To this day, the holidays aren’t official till the binder comes out, my binder is 19 years old this year!

Homes with teenagers and older children are often less hectic, but still complex. Teenagers seem to have less respect or understanding of the traditional rituals of their parents and grandparents. High schoolers get the first taste of trying to please their boyfriend or girlfriend, by attending the other’s family church service or main celebratory meal and also balancing their own mother’s wishes. College age children are often so busy that the Christmas season doesn’t even exist till after finals or that last paper is submitted. Many families don’t start the “real” celebrations till every flight has arrived and every guest bed is filled!

The Holidays with older adults has a different flavor totally. Many families travel to be with elders. This often poses a conflict, when all need to agree upon, who will travel to whom, where the main meal will be held and what grudges are held after all is said and done. In our crazy family, we celebrated “Mississippi Christmas” when our daughter was young. We celebrated every bit of Christmas on the weekend before we left for family in New York. (You can lie easily to little children!) In general, most families try to accommodate the older adults. Older family members want to still be useful, they appreciate when their recipes are being used, or their china is the focal point of the table. And most importantly, that their medical needs be viewed as a privilege not a burden.

When all is said and done, and January arrives, we will not remember the delayed flight, the lost sleep, the forgotten gifts or waiting on late relatives. But we will remember the laughs, the smiles, the lights and music. We’ll be glad we reflected on loss and take time for a tear. We will remember the memories shared and no matter how big or small a celebration, we will remember all the blessings we have this Holiday 2017.

Pine Grove Behavioral Health & Addiction Services in Hattiesburg, Mississippi is known as one of the nation’s most comprehensive treatment campuses. Since 1984 Pine Grove has offered a continuum of services ranging from outpatient to inpatient and residential treatment for adults, children and adolescents suffering from psychiatric and addictive diseases. Specialized services include the treatment of chemical addictions, sexual addiction, co-occurring eating disorders, and professionals struggling with interpersonal difficulties.

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.

Pine Grove Treatment