00:00-01:25 Silence as Intro slides described below are shown. Title Slide: LOGO centered on top: Anne & Henry Zarrow School of Social Work. Continuing Education - The University of Oklahoma. Below LOGO: Having Conversations About Mental Health With Your Adolescent. Presented by Dr. Carisa Wilsie. Tuesday, June 11th 12:00pm-1:00pm A couple of rotations of 6 CE Intro Slides with the following information: LOGO in upper left corner. Top right: Virtual CE Having Conversations About Mental Health With Your Adolescent. Tuesday, June 11th 12:00pm-1:00pm Slide 1: Thank you for joining us today. Slide 2: For Those Seeking CE Credits: instructions to verify attendance Slide 3: We Want to know your thoughts - online evaluation https://bit.ly/45asA7X Slide 4: Continuing Education Certificates CE Database https://bit.ly/3VsaNWB Slide 5: Today's Session Will Be Recorded Resource Database (Google Folder only contains video): https://bit.ly/3x6e4l7 Slide 6: Links & Information will be provided in an post-event follow-up email. Presentation slides, polls and video clips are shown throughout the video. ::Attendees visible:: [Bonni Goodwin] Welcome, everyone. We're so glad you're here with us today to hear Dr. Carisa Wilsie share about having good conversations about mental health with adolescents, Sarah or Sierra, do we have anyone doing introduction today, or should I go ahead and jump in? [Sierra McClendon] I think that you are welcome to go ahead and jump in. Bonni, I don't think that we pre-discussed that, so please take, take the lead. [Bonni] Excellent. All right. Yes. Thank you all so much. Um, we, you've got some good information about CEUs in the chat now. Um, thank you School of Social Work, Megan, for putting that information out there. Um, Dr. Wilsie, welcome. I'm so excited to have you here with us. Um, I just wanna make sure, do you have, uh, ability to share screen as you need to? [Carisa Wilsie] That is what I was just, um, testing, so that's why I wasn't sharing my, oh, I wasn't on video yet, but, um, I think so. [Carisa] I think I can. [Bonni] Okay. Excellent. Well, um, I would love, uh, for you to share more about, um, what your multiple roles are, but I just wanna say thank you, um, as, uh, a colleague and a friend, uh, for joining us today, both from professional experience, um, as well as, uh, personal experience. And so we're just so grateful, um, for you spending the time with us. Um, everyone on here, this, uh, this series is brought to you by the post-adoption department with, uh, uh, Child Welfare, Department of Human Services, and, um, also in collaboration with the Center for Adoption and Family Wellbeing at the University of Oklahoma. So a lot of what we talk about is we, we cover all different types of, uh, perspectives and topics, um, but a lot of it is grounded and connected to, uh, working with adoptive and foster families. So, uh, we call it adoption-competent mental health, and there's a whole lot of things that go into that, into that bucket of information, including attachment and, um, adolescence, child welf-- uh, I'm sorry, child development and being able to have conversations and openness, uh, within developing a, um, an atmosphere of, of communicative openness within the family. So, Dr. Wilsie, I would love to, to pass it to you. [Carisa] Absolutely. I'm excited to be here today and excited to talk about, um, this topic in particular because, uh, I, um, I live this at my home, so ::Slide - Title Slide:: I'm an adoptive parent myself. Um, my husband and I adopted a sibling group of three from foster care, um, almost nine years ago now. And, um, so they are all around these ages. Um, so I'm getting to live having these conversations, and unfortunately, in today's day and age, uh, it is something that is so pivotal, um, for us to be talking through and, um, learning about. And so I am, I'm excited to be able to dive into this topic today and chat more about this. ::Slide - Agenda:: So, our just kind of brief agenda, uh, we're gonna start just talking a little bit about brain science, um, just a little, I promise I won't bore you too much, but because it provides a lot of the context of how we really think about, um, how to approach adolescents, um, how their brains are changing and developing and what that looks like. And then we're gonna talk a bit about adolescent development and just what sort of ways and trajectories they are on, um, and their kind of focus of, of where they are in their development and how that influences, um, having these conversations. We're gonna talk specifically about having these conversations around mental health, um, and then specifically digging a little bit more on, um, mood and anxiety. ::Active Poll - How comfortable are you having talks about mental health with your adolescent?:: So I wanna start off with having, um, a little interactive. So if you can, um, you can either go on your computer to slido.com and put in that code, um, number, or you can use your phone and go to that QR code. And, um, you will, we'll have three questions that we'll do throughout today. So if you'll just stay on that screen, um, you'll be able to go right back to it. But I wanna know, um, how comfortable are you having talks with, about mental health with your adolescent? What does this look like, um, for all of you? So let's, um, give it a couple minutes here. I'll talk a little bit more, um, about my background. So, like I said, I, I am, um, an adoptive parent, so I live this, but I am a clinical psychologist, and, um, I specialize in the area of child abuse and neglect. So I spend, um, most of my time working within the area of child welfare and how we make sure that we are taking care of our kids, um, that are in trouble for custody, as well as those who are moving towards, um, permanency models as well. And so, um, so in that, um, it's a lot of, uh, my time is spent with a specialized team, um, who are looking at using specialized assessments for looking at level of care that's appropriate for kiddos to get the level of treatment that they need. Um, so that's where I spend a lot of my time. So I spend a lot of time talking about adolescents, um, and then I get, like I said, I live it at home too. Um, so we get to do a lot of this. Um, so it looks like a lot of you guys are starting out just kind of occasionally you're talking about mental health, which is really great. Um, so I'm glad to see it's not like pulling teeth for anybody. Um, of course I didn't, I wasn't sure anybody would say that one, but, you know, it's nice just to know that you're already starting to engage in this. And then the, a group of you are als-- already talking about these things daily, which is so great. Um, one of the things my kids know is, um, when I'm saying to them, "You know, I'm gonna ask, right?" Um, and so they know, they know, right? Uh, they already know what's coming. Um, and so we're already asking these things. ::Slide - Brain Science for Adolescence:: Um, so let's kind of start talking through, um, some of this brain science, um, that we can get into a bit. ::Slide - Physical Brain:: and the ways in which our, um, adolescents are kind of forming, um, the prefrontal cortex, right? This front area right here that we, we end up talking about this a lot when we get into brain science, but the prefrontal cortex is what's used for planning and organizing and putting, um, information together, um, putting instruction that's given to us and organizing, how do we answer those instructions? Um, it's also the impulsivity center, right? Um, of course my dog wants in my lap as soon as we start. So my apologies. Uh, it's also that, that impulsivity center, so how we, um, are able to control our behavior, stop and think before we do something. So a lot of these factors are influenced by this prefrontal cortex because of all these executive functioning skills, right? That are forming. So through that, um, we have learned that, uh, the, the prefrontal cortex is the last part of the brain to develop. So it's not going to develop until really into the mid twenties. Um, for females that's closer to 22 to 25. For males, that's closer to 25 to 28, somewhere in there. And we've, I mean, car insurance companies even figure this out, right? Um, and that's the reason why people can't rent a car until they're 25. Um, it's real simple. It's brain science. That's the reason why. Um, they have put that together that way because they're worried about if we don't have our brains fully functioning in that way with a prefrontal cortex, we might struggle. Um, we might struggle to make good decisions with a, a very expensive piece of equipment, right? So our adolescents are not quite there in their executive functioning skills. That's something they're still forming, they're still working through. Um, that's something that's going to continually be forming for them, um, throughout this time period. But we also know from our trauma research that that also can stunt the growth of the prefrontal cortex. And so they may be even more behind than other adolescents their age. So we've got a couple different factors there, um, that come up in that way. Sorry, I was just seeing that there was some, some chat on, so I was making sure no one had any, any trouble hearing me or anything. So I'm glad you guys are introducing yourselves. Thanks so much. The limbic system, um, is really working with, um, the amygdala and how the ways in which, um, our brain is communicating the, with the rest of the body. And so aspects of that go into the neural pathways. So in adolescence, at puberty, half of our brain, um, neural pathways die off. So those are, those go away. Um, and that's the reason why almost overnight, it feels like all of a sudden they're a different person, right? Um, and it's because a lot of those neural pathways have died off, but for good reason, they were ones that they weren't utilizing a whole lot. And so because of that, it's, it's helping the brain to be more efficient so that the things that I need to know are there, but the things that I don't need to know aren't very strong. So I'm realizing that, um, multiplication facts might not have been strong enough for my kiddos because they're starting to die off. I'm like, "Whoa. They start letting you guys use calculators way too early in school." Uh, those neural pathways are not strengthened enough, right? Uh, they're starting to die off. So it's one of those things that if we're not using it, it's gonna die off in adolescence, but then they start to learn so much in this period of time. And so through this, they feel different. They're, they act different. So they're struggling in many ways to figure out themselves, um, as well as the people around them to try to figure out them as well. Um, and these neural pathways are so integral in helping them learn, um, so many aspects in, in moving forward. And then the other thing is that, um, they found in looking at the dopamine levels in our bodies, right? We all love dopamine. Whenever I eat a piece of chocolate, it's activating dopamine in my body, right? It feels good. It reinforces it. That's what I'm gonna continue to do, um, whenever I wanna feel that, is I go and get chocolate. Um, so clearly I'm a sweet, not salty person, right? But those, that dopamine activity for our adolescents, what we've learned is that they have an increased dopamine activity. So their surges are, are much larger than ours as adults, but they also start at lower baseline levels than we have as adults. So they're starting at these lower levels, and then they're shooting up whenever they have any sort of experience that feels good. So, wow, that, if I am gonna be reinforced to eat chocolate, um, right, whenever I'm having a rough day and I need a little dopamine surge, imagine what it feels like for them when those surges feel even stronger, right? Even more powerful, something that is really reinforcing and feels good. So that's why we see this increased impulsiveness happen in adolescence. They start to become and exist, um, and start to exhibit more risky behaviors than they had when they were younger at times. Um, we start to see that they engage in some of the behaviors that maybe we, they had learned not to do when they were little. Like, "Oh, don't touch, it's hot!" Now I'm gonna test it and I'm gonna see, right? Because these dopamine surges are, are a lot larger. We also see this documented increase in susceptibility to addiction. That's where our bodies start to feel really good. Um, and so because it feels really good, I might get addicted to certain substances. And so with the age of, um, you know, by statistics, right? Um, that many children are trying drugs and alcohol, um, they are still at that age where this, these dopamine surges are really large. And so that's going to increase that susceptibility to addiction. And then this hyperrationality of just really struggling, um, to see this, you know, I'm really, it's, it's like it's gotta be real black and white, right? I, I'm really gonna struggle to see the in-between. Um, and so how we kind of see that in, in this hyper part, right? In our, our physical brain. So if we think about, you know, what are, what are we gonna do about that? Um, what are we gonna do with our adolescents? ::Slide - Ways to Strengthen the Brain:: Um, what are we gonna do with our adolescents? Um, so here are kind of some, from some of our research ways that we can strengthen the brain during the adolescent stage. Um, and I'll be honest, when I think about my kiddos' days, because of how much they have going on at school, it's hard to fit all this in. So when I go through this, I don't mean that it has to be on that all of these have to happen on an everyday basis, but it's, how can we think about this on the weekends? How can we think about this once a week, right? So how can we kind of figure out how to balance these? Um, so one part is adequate sleep, um, and then adequate nutrition and hydration. Many of the aspects around adolescent development go back to making sure that they have adequate sleep and adequate nutrition and hydration, drinking enough water. Um, just this weekend, that's what I said, "You have a headache? Oh, I'm so sorry you have a headache. That really sucks. I think we should drink more water tomorrow," right? Um, because I think that that was probably something that, that contributed to it. So I'm gonna make sure, I'm gonna remind you tomorrow to drink some more water. So all these different aspects, um, of, of development often are, are couched in, in these things, but also the body starts to only crave salty processed foods. Um, and that, again, is brain science. That's the way that their brains are developing. They're seeking out those dopamine surges and sugar and salt taste a lot better than, than our brussels sprouts. It's just true, right? So with that, it's, it's a struggle sometimes to get them, um, to engage in adequate nutrition, hydration, and sleep because of, they're no longer wanting to listen to our their parents, they're no longer wanting to do what we say all the time. And so it's, sometimes it's finding those, those buy-ins of how they will do it and decide to do it on their own. Um, so working through that and figuring out how that works out. Um, having time to journal, um, which not all kids like to write, and so it doesn't have to be a written journal. It can be, um, a, a video diary that they keep just for themselves. Um, it can be, um, different aspects where they can speech to text, um, to, to kind of write out their feelings. Or it can be writing or it can be drawing, um, or engaging in, in kind of, um, some way of kind of putting, um, my thoughts from the day out there. And when I put my thoughts from the day out there, it helps to solidify some things for me. It helps to bring some things down. And journaling is, um, sort of a, a way in which we are being proactive in, in thinking through, um, how we're going to kind of think these through, things through throughout the day, how we piece them together. Whereas jumping on social media and airing out all my feelings on social media is really reactive. Um, and so it's going to, um, cause them some issues. Um, if that's the way that they wanna air out all of their feelings, um, is all through social media, just the way that it's structured. I'm not saying social media has to be banned. What I'm saying is help them to develop these good habits, um, of journaling and in the different ways that work for them instead of always jumping towards first going on social media and being really reactive. They need times, um, when they're very focused. And so thinking about how they can be focused on a task. They can, this can be schoolwork, but it also can be other things. So anytime where they can be really focused, um, and, and kind of have, um, a time where they're focused on one thing and not making their brain do more than one thing at a time. So I'll often say, if we're going to engage in watching some sort of TV show, let's do it, but let's not do it while we have our iPad in our hands playing a game. Plus also chatting with our friends, like, and they're, they're figuring out that they can do some of those things more than one things at a time, but they need some time where their brain is just learning to focus. And so we need to find those times where we can help them, uh, to just focus on things. They need downtime, they need time where they are just chill. Um, and they are able to just, um, just be able to chill. And so sometimes that's built in, um, where it's like the thir-- first 30 minutes of the day. We're not gonna get on screens, we're just gonna chill, you know, eat your breakfast. Find ways, um, to do that. And for some kids, that might mean it connects into some of these other things with like, physical time. Maybe they like to do yoga or something like that. Um, but it also might mean for some kids it is literally just chilling. Um, so helping them to find ways in which they can do that. Um, having play time to have fun, um, is important for all of us. I mean, research shows us, even as adults, it's good to have time just to play. And so that includes for adolescents as well. And so time when they're not having all of these demands on them, but time just to, just to play, just to enjoy. Sometimes that is through an organized sport, because that is helpful for them and it feels like play to them. But for others that, there's a lot of pressure on that. And so you have to think about it and balance, um, how they feel and how they respond to that. Um, physical time where they do engage in some sort of physical activity. That does not mean that every kid's gonna be an athlete, and that is absolutely okay. That might mean taking a walk. That might mean doing yoga. That might mean engaging in a sport, whatever it is for that kiddo. Finding ways to be physical, um, can be super helpful for their brain development. And then time to connect to others. And, um, there a lot of the research out there is like connect to parents, um, but also connect to, um, friends and peers. And so, and we'll talk a little bit more, um, about what that can look like in different ways, but finding ways that they're able to connect with others, um, and engage with others in that way is gonna be real important too. ::Slide - Adolescent Development:: All right, so let's go into just a little bit on adolescent development. ::Slide - Need to Belong:: So there's a lot of different, um, developmental stages, um, kind of ways. And so I, I found, um, that this way puts it into three different developmental stages, and it's really incorporating a lot of the different developmental theorists, um, and putting those all kind of together. So that's the reason why I kind of go through it this way. Um, so starting kind of in young adolescents, um, the, the primary drive is the need to belong. Um, we start to see, um, the shifting attachment figure, right? Going from, um, parents, um, and shifting to peers and shifting to other people in their lives, other mentors or, um, teachers or people, um, that are, they're involved with. And so thinking about how, um, they belong often is by shifting, um, these sorts of attachments, um, away from parents. Thinking about best friends forever, and thinking about how they are starting to make friends. And some of those friendships are gonna last, but some of them aren't. Um, and so some of it is as they're changing and their brains are changing and that we've got all these neural pathways changing and all of that, it may mean that they shift away from what, um, you know, what it was like to relate to one friend. And so sometimes they're shifting kind of away from that, um, and into some other friends. And, and that's okay. Um, 'cause we'll talk about in the next stage how they get through that. Um, conformity starting to want to look like everybody else. Um, starting to want to be like everybody else. I cannot get 'em out of hooded sweatshirts, um, or a hundred bracelets, um, on their arms, right? Like, that's, that's who everybody else is. And so they look like everybody else. Um, and so oftentimes when I'm seeing what they're doing, um, I look at school drop off and look at all the other kids, right? And I see, I see that conformity. I see the ways in which they're wanting to look like their peers and act like their peers in many ways. And it's all related to this need to belong and feeling like they want to belong. This membership self of, of, within themselves they're trying to figure out "Where do I belong?" Um, and so because of that, they're looking like, "Where am I a member of?" And what does that look like? And so trying to figure that out and trying to find that, um, is a way in which they're kind of looking for this need to belong. And in this real concrete role thinking, um, of how I'm working through, um, what are my, what's my role here? What's my role at home? Um, what's my role at school? What's my role, right? Um, at therapy sometimes, like church, wherever it is, um, where are these roles and what does that look like? ::Slide - How Do We Support Them at This Stage?:: So how do we support them? Um, one, make sure they have at least one peer group or just one friend where they feel accepted. Having acceptance at this stage is so important. And so finding a way in which they feel this acceptance with someone or some group, um, can be really helpful to support them during this stage. We appreciate that that belonging may be even more important, um, for students in more marginalized groups as well. So feeling like I'm marginalized, I'm on the outside and I need to belong, um, can further that feeling and that need to belong. Um, and I feel like I kind of repeated myself in that, but it's that idea of if I'm marginalized, I have an even stronger feeling that I need to be in that. Make sure that they have time in their schedule, um, to engage in these peer activities, and then offer space to process these kind of social bumps in the road of where I'm looking, um, how I'm trying to find myself, um, where those social bumps that happen, offering the space. And we're gonna talk through some of those ways to talk through that, um, in the mental health section. ::Slide - How Do We Challenge Them Beyond This Stage?:: How do we challenge them to go beyond that, though? One is adult modeling. So ab absolutely, it's gotta be age appropriate. I'm not gonna say, you know, "Oh, I'm really afraid I'm gonna lose my job." That would be shocking to them and scary and make them further anxious, right? But I might say, you know, "I think I hurt someone's feelings today and I felt really bad about it, so I had to go to them and talk to them about that, um, and apologize, and that didn't feel very good. I feel kind of icky about that. I don't like it, right?" So how do we model that? How do we show them that, um, whether it's in conversation with them or them watching us do it, um, how do we, we model these things? How do we invite them to join multiple groups, maybe even some with differing values. Um, so, you know, allowing them to see that I may, uh, associate with this group, but I also may associate with this group and they're very different, right? So I might play soccer, but I also might like to be on the robotics team. And those groups of kids might look really different, and that's okay. Um, and so inviting them to think about being in more than one group, uh, if that's something that's isn't too, doesn't add too much time and is too taxing onto them, um, just helping them to see that they can be a part of that as they start to form this need to belong. Um, self-reflection practices of helping them to kind of think about for themselves, what does that look like, and helping them, um, to kind of look at, um, what sorts of ways do they feel like they fit, and what sorts of ways do they feel like they don't? And processing that with you or with themselves. Um, and that goes back to that journaling, right? Having them and showing them the ways in which they can do that. And then, I mean, I hate to say it, but debunking authority, right? We, my generation was grown up to not ever question authority, but what's happening in today's day and age is that the information out there for our kids is far and wide. And so, especially with the internet, right? I don't want them to trust the first website that they get to when they Google, right? I want them to question that website. I want them to say, "Where do they get this information? Is this true or accurate? How does this line up with other websites, right? That I have looked at." The same thing actually goes, um, towards our kids. I actually had, um, one of my kids' teachers at kind of, it was the, the student led, um, parent-teacher conferences this year. And so my kiddo went in and the teacher started talking about, um, anxiety and ADHD. And she kind of went off on this thing of, she feels like it's a crutch and she feels like these kids aren't doing very well. And I just kept looking at my daughter, like, kind of like, "Look at me, look at me." And as soon as we walked outta the room, I said, "I don't agree with everything that she said. I respect her as your teacher, as your math teacher, but I don't agree with all the things that she said, and we're gonna talk more about that at home." Um, so I let her know immediately, like, these things are not accurate. She's not an expert on mental health. Um, and so it's okay for you to question that side, but also when she tells you how to do a math problem, it's okay to believe in that authority, right? And so helping her to understand the differences in those. ::Slide - Desire to Achieve:: The second stage is that desire to achieve. So need to belong, and then it moves into desire to achieve. And this looks widely different across our kids. Um, so achieve doesn't mean we're all gonna be shooting for all A's, it's just not gonna happen, right? That's not all of our kids. Um, but it's thinking about the social sensitivity and comparison and engaging in, um, these sorts of, um, ways in which we can compare ourselves, but only on even playing field. So things like GPA, those aren't things that we all agreed to compare, right? Because not all kids are able to achieve the same grades as others. But things like where we all go and try out for a soccer team, like in this picture, right? We all go and try out for a soccer team, we're agreeing to be compared to one another, right? And so that comparison game is actually helpful for them. Um, I, I knew one of my kiddos wasn't gonna make it on the team that she was trying out for. And, and I said, "I'm so proud of you for trying, right? And it's okay if you don't get picked because we're gonna learn a lot from this." Um, and so it was, we were able to kind of really engage in those conversations about how it's okay that we don't always get picked. Um, but it's also really great to try because we don't know until we try. Um, and we don't know kind of where, where we fit in, um, that social mobility of how they're able to move around, um, and be friends with other people. Um, and so kind of like learning that I can be friends, um, on the debate team, and I can be friends, I can have friends on, um, the student council and I can have friends, right? And so helping them to see that there's social mobility where they can be moved, move around. Um, but then having this desire to win, um, in some ways. And so feeding into that and helping them sometimes, um, can help them, but again, in healthy ways. Um, and then this growing sense of agency where they start to see that I am in control of some things, whereas in the past in my life, I wasn't as in control. And this really comes into, um, a lot of the conversations we have about mental health comes down to a lot of this desire to achieve, um, that a lot of times it's down on themselves and not fully ready, um, to have these sorts of feelings. And so engaging in some of these conversations about, "It's okay to compare yourself to others, but also you have to do it in ways that are safe. Um, and that are, um, ways that are fair. Um, we're not gonna compare in GPA, we're not gonna do that, but here's some things that we can think about the things that you're really good at, at, right?" ::Slide - How Do We Support Them at This Stage? (2):: And growing in that. So make sure that there's one pursuit that they have where they can feel very valued, skillful, on their way to mastery, getting close to that, help them clarify these rules of different games of life. Again, the debate team and student council might look very different. So helping them to see that they're kind of different games for achievement in those different areas, and then helping them to experience healthy competition. This is what life looks like. And so in this stage, they're looking for that. They have this desire and there is healthy competition in life. So helping them to see that. Um, and so sometimes it's my husband and I having a little healthy competition. Um, and sometimes it's even incorporating some of those things that they needed, like adequate nutrition. Like, "Ooh, who's going to eat the most vegetables tonight?" Right? Uh, so sometimes we incorporate silly little competitions, um, and then sometimes, um, we're doing it in, uh, ways in which we help them to see, um, some different aspects of competition. ::Slide - How Do We Challenge to Go Beyond This Stage?:: How do we challenge them to go beyond, help them to see games as games, right? And this isn't your value as a person. Um, and you do have a desire to achieve, but that does not mean that you're not a good person in the ways that you want to be good, right? As by, defined by themselves and by us. Um, having them to question the assumptions of the games. Um, so of the games that we kind of get into with the different groups, having them to question those assumptions, show them these differing examples of success, and helping them to see, um, you know, what success can look like. And so sometimes it's, um, engaging in, you know, recently the, the football player that kind of talked at the, the college graduation and kind of bashed women, um, in some ways, and I know there's differing opinions on what that looked like, but that opened up a lot of conversation about what is success for a woman and what does this look like for you as you're growing into this role? Um, and so getting into some of those conversations, thinking about, um, for men, um, that sometimes, um, the success that's valued and honored in society might not be the definitions of success that our family wants. Um, and so thinking through, you know, what is, what are those different examples of success? What does that look like in, in discussing that? And then build the confidence, help them to build the confidence to wonder what's worth doing. Um, maybe it's not worth it, um, to engage in some of these things because it's not something that helps me feel, um, like, like I should. Um, and so helping them to wonder and, and explore and think through what does that look like? ::Slide - Authenticity:: And then the third and last stage is this authenticity, um, that adolescents get to. And honestly, not all adolescents get here, um, particularly ours that have been through, um, abuse and neglect in their past and have been adopted and, um, have, have lots of different aspects to think through in life. They may not get to this stage of adolescence. Honestly, there's not a lot of adults that get to this stage, right, of development. We've learned that, um, in the past as well. But it's this authenticity of, "I want to be me. You do you right? I'm gonna be myself. Um, I know who I am. I know who I want to be. Um, and you don't have to be the same as me." You do you, right? That's kind of a saying. We, which that the, the kids say now, which I love. Um, 'cause I'm like, well, at least you're pretending that you're at authenticity while you're trying to fit in. But it's this idea, right, of you do you, you're, you're gonna do your thing, I'm gonna do mine. And this skepticis-- skepticism towards the game, right? Like I start to think about is this, um, is this really what I want to engage in? Is this worth it? Um, many times that's when we get to this career aspect, um, we start to think about, "Is this even worth it?" Um, I played a sport up until my senior year and then I quit. Um, and it was like, I just, I kind of got to this point as an adolescent. I was like, I just, I don't wanna do this anymore. This isn't something that I'm gonna do in college and I'm done. Um, right? And so this just sort of this idea of it's okay, um, for them to be skeptic, um, about some of the games that they might've been engaging in, um, within, within their adolescence. Um, and trusting quirky people. Starting to see that they, um, and when they get to this authentic self of they, they start to see the value in each person and they start to find the ways in which they can trust each person in different ways. Um, and finding the ways in which each person has their own little quirks, um, that are gonna help me to relate to them, um, and help me to also, uh, work together. ::Slide - How Do We Support Them in Reaching This Stage?:: So how do we support them in reaching this stage? Um, is be authentic adults around them. Um, and surround them with other authentic adults in their lives. So we need to, as parents, be authentic and we need to surround them with other adults. Model that achievements are important, but it's not the end of the road. They have that desire to achieve in something, but it's not gonna be the end of the road. If we don't get there, we learned something. And through that, we allow ourselves to be more vulnerable. We allow ourselves to open up and learn, um, and be more adaptable in life. Um, and then start to offer choices. Have them start to see that it's okay, um, to do certain things and engage in certain, um, ways that are new, um, and scary and, um, might be different than everybody else. Um, but it's gonna be great. And so ways in which we think about this stage. Um, and again, not all of our adolescents are gonna get here. This is gonna be up in their upper, upper years of high school. Um, but how we can support them in many ways, um, can help shape what's going forward. ::Active Poll - What are those tricky spots that make it hard to engage in conversations about mental health?:: So here's the next question, 'cause we're gonna engage now that we've kind of talked through development, talk through brain science, we're gonna talk a little bit more about mental health. So I want you to jump back on Slido, um, and think about, what are those tricky spots. And this is just like a text field. Um, and as you answer, some of these are gonna come up on here. Um, so we can see maybe as other people, um, maybe are thinking some of the same things, um, that I'm thinking. It's scary, um, as caregivers to engage in conversations about mental health, we're often worried about, will I say the wrong thing? Um, will that wrong thing, um, create other aspects of, um, the ways in which, um, my child is feeling? What's that gonna look like for them? Um, and so thinking about, um, how we are approaching it oftentimes, um, feels like it, it can be difficult to kind of think through, um, and think about, uh, what sorts of impacts we're going to have. That, um, imposter syndrome, that's a great one. Especially as parents. Like oftentimes I'm like, "Well, I have anxiety and I have mood issues, right? Um, and so because of that, like maybe I'm not, maybe I shouldn't be talking to them about it." Um, so that can be something, um, putting an idea in their head. Absolutely. That's what often parents will say is, "I don't wanna talk about self-harm. I don't wanna engage in talks about suicide, um, ideation. 'cause that might put ideas in their head." And that's scary to think about. Um, so you are not alone in thinking that. Yeah. When your adolescents think you won't understand. And they won't-- uh, or they will, they'll think that you won't understand. Uh, they think that you won't understand. We're gonna talk about that. Um, afraid of bringing up something they haven't thought of. Yeah. Trying to say the conversation um, so defenses don't go up and that person shuts down. That's absolutely right. That oftentimes we are afraid those walls are gonna be, um, gonna go up and being open to the truth when it's hard to hear it. I think that's true for adolescents and true for us as parents. Sometimes we don't wanna hear the truth either. So, um, and then if they think about talking about feelings, makes people weak, um, that definitely is a, a big thing, a big factor that can go into that. Um, and then condescending. Yeah. Um, which we're gonna talk about some strategies for sure. Um, about how to work through that. So thank you guys for sharing. If you've still got some, absolutely continue sharing and I'll improve this as we go along. ::Slide - Having Conversations about Mental Health:: So having conversations about mental health, what does this look like? Um, so I've got a couple different videos, but then I've got a couple of, um, exam-- I've got a quite a few slides also to kind of go through and think about. But just wanna give us like a varied look at, um, what these look like. And I'm realizing I'm gonna have to stop my share real fast because I bet I did not share the sound. ::Attendees visible:: 'Cause you know, you have to do that. Uh, so share sound. There we go. I got it now. All right. So let's watch just a short little video clip, um, here that starts us off thinking about this. ::Video - Listening to Young People:: [Video plays] [Father] Hey, what's been going on? I wanna check in with you if that's okay. [Teen] Uh, what's up? Am I in trouble? [Carisa] Can you hear it? [Father] No. No. Just the pandemic is getting me down. I feel overwhelmed, anxious, and exhausted. I'm feeling some type of way. So I wanted to see how you're doing with school, friends, and everything that's changed over this year. [Teen] I'm fine, you know, everything is good. [Father] Oh, it's good to hear. I just wanted to check in because sometimes we're struggling and might not even realize it. Like, I noticed that you've been up all night, eating less, hanging out with your friends less, too. It's important that you know that I'm here for you. [Teen] Yeah, whatever. When I tried to talk to you about stuff before, it seemed like you weren't really listening or like you felt my issues were small. Like you said that because I don't have to pay bills and because I'm young, I don't have a reason to be depressed or anxious. And that just makes me not wanna say anything. [Father] I'm sorry I made you feel that way. I grew up thinking about struggles very differently. It wasn't a thing to talk about mental wellness with family because they would call you crazy. Say all you have to do is pray on it. We were raised the way we were raised, you know, you have to be strong and deal with it. I thought, okay, you have to hide your feelings and ignore them. But I wanna change now. I've learned more because that's not healthy for either of us. [Teen] Well, okay, I guess I've had more anxiety and don't wanna do much. [Father] I get what you're going through. I wanna help you get through this tough time and learn how to listen and support you better. [Teen] Okay? But I still feel like you don't get it. 'cause like you don't know what I'm going through. Sometimes my thoughts are just outta control and I can't focus on stuff. I don't even know why. [Father] You're right. I'm sorry. I wanna understand where you're coming from, what's making you feel that way. [Teen] I don't really wanna talk with you about it right now. I don't want a whole lecture. [Father] You don't have to share everything with me. Maybe there's someone in your life you do feel comfortable talking to. What will worry me is if you ignore your feelings and hope they change on their own because they can come out later in bad ways. I've looked into some helpful things like counselors you could talk to or group sessions where you talk about it with other people who sometimes feel anxious even just so you know, you're not alone. As long as you're talking to someone, I'm happy. [Teen] I feel you. I guess I appreciate that you brought this up in such a chill way. I was expecting something completely different, but this felt good. But yeah, it's helpful to know that I have options. I don't know if it's that bad where I gotta talk to a therapist or whatever, but since you're cool with it, maybe I'll consider it. [Father] Yeah, I'm looking at getting my own support. I tried free online counseling. You can call or text someone who's trained to talk about this stuff, and they don't even need to know your name. You can chat with them about whatever, but I want you to choose what works best for you. [Teen] Yeah, okay. I think it would be dope to check in with you next week to see what I'm thinking, if you're down for it. [Video ends] [Carisa] All right. So he had some, um, really great responses in there. He had some that didn't work, right, um, where she kinda shot him down, uh, um, and he had to back up and re-approach it. Um, and that was okay. Um, so the conversations might not always go this easily, um, or they might not start easily, um, but it might, uh, can progress the more you stick with it just like he did. Um, and so we're gonna talk through some of the aspects that he used in this video as well as some, some additional ones, um, as we talk through here. So let's go to the next slide. ::Slide - How to Normalize Mental Health Conversations with Your Teen:: So thinking about how do we normalize having these mental health conversations with your, your teenager, with your adolescent. Um, first of all is like setting the stage, um, of like opening up. The ability to have these conversations is often not a one-time thing. Um, it's something that we have done for days and weeks, um, and months coming up to this. And so setting the stage is making sure there's an open dialogue. Um, we often call it constant conversation, um, uh, with our, with our teens, adolescents. So that might mean that you, um, set it up so that the rule is no phone. You know, you're not using phones in the car so that in the car where it's a really easy place to talk as an adolescent, because I don't have to make eye contact with you, I might start to talk to you more, um, in the car. Um, it might mean, um, that you have a conversation before bed every night, um, and you open up the conversation before bed. It might mean that you have some sort of conversation before school to set them up well, um, for the day. But if that's a part of the routine, then they know that it's coming and they know that it's there. And so sometimes it's, um, uh, they might not talk in this moment, but they know you're gonna go back to it and then they know and they're ready, um, to maybe talk later. Um, and so setting that stage, having this open way, um, and doing it in a way where there's not as many distractions. Um, so not doing it in front of the tv, um, although sometimes TV or YouTube videos, different things like that, social media posts might like, um, spur a conversation, right? Where you can bring up some things. Um, what I try to do is I try to pause it, um, right? And I try to then have that conversation, um, while it's paused. And so, you know, different aspects like that. But thinking about how we can setting this stage of having this openness, um, in this conversation. Um, second, ask open-ended questions. Um, so asking those questions that are not going to get yes or no answers. Um, so how did you feel about that? Um, what sort of aspects, uh, or what sort of feelings came up for you, um, when she said that to you, right? Different aspects like this. Um, so thinking that, you know, that if we just ask yesor no questions, um, sometimes that might be good to open up a conversation to just get it started, um, because it's easier for them to say yes or no. But then we need to shift to open-ended questions pretty quickly, um, so that they won't just say yes or no because if they're given that option, that's what they're gonna do. Honestly, that's what I'm gonna do, right? If somebody's talking to me about something that's really challenging for me to talk about, I'm just gonna answer yes or no if they ask me those questions. And then finding that right time for difficult conversations. Um, and this is twofold. You're listening to your own body and then you're noticing, um, your teen's body language, um, as well. So if we're listening to our own bodies, we are, um, knowing, "Am I too tired to engage in this? Am I too frustrated about something that happened at school? Um, are there, am I too emotional about something that I might start to, to get too emotional about it? Do I need to handle my own emotions first, right?" So we need to listen to our own bodies and then notice their body language. Are they closing themselves off? Are they not ready for it? Um, are they, you know, rolling their eyes and, you know, making it difficult, um, to engage in it? You open it up, you give the opportunity. If they're not ready, uh, then you step back. But then you set the stage, right? Because you're already gonna have an the next opportunity that they know are gonna be be there. So knowing that they're not gonna be ready, um, is okay, but starting to think that through and think about what it's like, um, to normalize those conversations. ::Slide - Give Encouragement but Don't Force It:: You want to give encouragement, um, as you're talking to them, but you don't wanna force it too much. So here's some just example statements. Um, "You can talk to me, I'm here for you," right? Just a, a simple encouragement, but not like, "You need to talk to me about this. I can help you," right? Um, instead it's, "You can talk to me about this. I'm here for you." Right? Just a really open encouragement. If you need to talk to someone else, that's okay too. So like he did in the video, like, you can go talk to somebody else about this. We can set you up. I've got a list of counselors. Um, that can be one thing, but also, like, you could talk to this teacher at school, or this coach or this person at church, right? Finding people that you know, um, and, and, and, uh, preparing those people that they may come and talk to them, um, is a great, um, thing to do as well. So letting them know, "I'm here for you, I can talk, but if you need to talk to somebody else, that's okay too. It doesn't have to be me. And if you talk to me about what is worrying you, I can do my best to help." So not promising that it's all gonna go away or anything like that, um, but helping them to see, just encouraging them like you're gonna be able to do your best, um, to help them, even if I don't understand, know that I want to. So oftentimes that's what we hear, that's what we heard in the video. I just feel like you don't understand me. Um, and as many times as we can say, "I was 14 once," um, it doesn't really mean anything, um, to them. So they never feel like we're gonna understand. And honestly, our brains are really different than when we were 14. So we don't fully understand, to be honest. Um, I don't understand why it's live or die if he, you know, broke up with you today. Like that, you know, that is kind of hard. It's hard for me to understand, but I do remember that that was hard for me as a, uh, as an adolescent. Um, and "Even if I don't fully understand, know that I want to, I want to." And so that's why I wanna talk to you about this because I want to understand, right? And then saying, "We're gonna get through this together" is another good encouragement that doesn't force it, but just allows them to have this promise of, um, something that can come out of talking about this, right? And that you can engage in this together. And we're gonna get through this, giving them a positive, um, aspect out of it. ::Video - Be Prepared with Appropriate Responses to Encourage Them:: So here's some other, um, appropriate responses that just encourage them. So how in providing this kind of emotional support to them, um, what ways we can be prepared, um, to respond. So some more advice here. [Video starts; music plays] [Speaker 1] Try to avoid emotional conversations at the height of distress. Make it clear that you are there and can recognize their distress, but discuss the cause later. [Speaker 2] One of the most important things is to help validate their feelings and here the word "understandable" is really useful. Rather than saying, "I understand," which can take away from the experience that your child's had and put you in the role of an expert, to say what they've been through is "understandable" can be really helpful because it helps them know that what they felt is right and it's just, and they're entitled to those feelings. [Speaker 3] It is important to have a signal if your child is having a bad day, so they can let you know. So something like a poster on the door or a note under the flower pot will be really helpful days when they're not feeling up to having a face-to-face conversation. There's alternative forms of communication. [Speaker 4] Stay calm, be patient, don't judge. Um, it's really important not to add to the tension of the situation. [Speaker 5] Young people when they're distressed sometimes feel that it's gonna be like this forever. And I think a really good thing to reassure them would be to say, "This is only temporary. You know, we are gonna get you better, that life will get better." I think it's really important for young people to have hope. [Video ends] [Carisa] All right, so I like that. There's several, um, that I really like out of that. Um, one being that, um, the, the comment that she made that they feel like they're entitled to their feelings, um, and helping them to know that it's okay for them to feel that way. Um, essentially like it's normalizing and letting them be like, it is okay that you feel this way, you're entitled to have feelings, right? Normalizing that we all have feelings, that we all have big feelings, um, and helping them to feel that. And then, um, I often use with families, um, that recommendation on having an alternative way to communicate, um, that it can be really helpful, um, for adolescents to have another sort of, um, sign or, um, some sort of aspect that they can, they don't have to put anything into words, um, but putting something out there that they need to talk. And so, particularly if we're talking with adolescents and trying to put together safety plans, that's one of the things that I, I put into place. Um, and so many parents know that if they, you know, if they put, like they said, a post-it note on the door, or, um, for one family, it was, um, that they laid like a stuffed animal on their parents' bed and they knew then they were ready for their parent to come in their room. It was like an invitation, um, to come in their room and talk with them about something. And so having that sort of, um, way that they can initiate that can help a lot. Um, and then again, going back to that constant conversation. Um, and then staying calm. That is not our first reaction. Um, especially if we hear about some really big feelings that they might be having. So let's say somebody, you know, calls us and, and lets us know that they, they heard that our our adolescent might be engaging in self harm or talking about some really big feelings that they're having and they don't know what to do with those, that might be pretty scary for us. And so in that us staying calm, um, and taking a step back and taking a deep breath before we engage in that conversation, um, as I was saying earlier, you know, knowing our bodies first, are we ready to engage in this conversation? And then are they ready? Um, so making sure, you know, those sorts of things. So I just like the way they, they kind of put some of those, um, recommendations out there. ::Slide - Be Prepared with Appropriate Responses to Encourage Them" So being prepared with these appropriate responses, validate their feelings, um, that's gonna be huge. "It's okay, I hear you." Um, "I see that you're, you're saying these things, um, about your feelings, right?" Thank them for sharing it with you. Thank them for letting you be a part of that conversation. Um, be really conscious of our language. Um, so we have to make sure that we don't put some value-laden language in place if the youth hasn't already used those words. Um, so words like depression and anxiety, right? So if they're using the word worry, I'm gonna use the word worry, right? Um, so I'm gonna help them first in having that first conversation, um, by using, um, their, the language that they're already using. Now, later we might introduce them, um, through a counselor or maybe even through us that we introduce them to the word anxiety. But we're gonna start with the words that they use, um, and start with what, um, where they're at. Um, let them know that you love them. Um, you know no, no matter what. Um, and no matter what's going on. Um, and they are gonna roll their eyes to that, right? "I know that mom," right? That's what I got the last time. We had a conversation last week about something big. Um, but spending time together, thinking about what's making them feel this way. So what do you think is contributing to this? What are those aspects that, um, are going into some of these feelings? Um, thinking that through. And a lot of it's, the answer's gonna initially be, "I don't know," right? They're gonna say, "I don't know." But then the more we kind of talk about it, the more we get at, um, some things asking those open-ended questions, going back to that right? Is gonna help them, um, to come at the answers themselves and not something that we have to, to feed them. Ask them if there's anything else that you could do, um, to help. Um, so, so asking them that allows them to kind of open it up, um, and give them any ideas that they might have. Um, let your child know about help that there is out there. So again, coming with counselors, or here's other people you can talk to, um, or what do we do about finding, um, ways to keep you safe? Um, if you're having some really big feelings. So letting them know that there's help out there. Um, and then reminding your child that this is temporary, um, that they're gonna get through it. This is temporary, and kind of working through that. ::Slide - Avoid Shutting Them Down. Don't...:: Avoid shutting them down. Um, so there's that aspect of, we're gonna encourage them, but we also want on the flip side to talk about what are the things that we do that might shut them down? So we don't want to interrupt or speak over them. We want to stop. Take a deep breath. If you wanna jump in, let them speak their piece first, right? Te-- don't tell them how they should feel. Um, we don't wanna tell them how they should feel. Again, we're gonna validate those feelings. Um, 'cause they're real, they're real feelings. Even if we're like, that shouldn't make you feel that way. They're still feeling that way. So we don't wanna tell 'em how they should feel. Instead, we wanna deal with the feelings that they are having. We don't wanna jump in with solutions right away. Um, that's not what they're coming, um, for, honestly, they're not coming for those solutions right away. Now, can we get to those down the road? Yes, but we don't wanna shut them down right away. If we jump in with a bunch of solutions that might shut them down. We don't wanna belittle their feelings, um, which we kind of talked about already. We don't wanna make, make them feel like they're not important. We don't wanna pressure them to speak so that they feel like they have to. Um, instead, we want to give them these opportunities, um, and, and make sure that they feel open, um, opportunities. But we don't wanna pressure them. Um, we don't wanna tell them the illness or the feelings that they have are a choice. Um, so we don't wanna, you know, tell them it's a choice to be depressed or it's a choice to be worried all the time, right? Um, because honestly, it's not, um, it's not always a choice. And so with that, um, they may need some more help to, to kind of work through that. We don't wanna make it simplified, so we don't wanna say, you just need to this, right? Um, and, and we're all guilty of this because it's something that maybe we do. So you just need to do this. Like, I do it, right? Um, but we don't want to do that. 'cause that's gonna shut them down. We don't wanna diagnose them, we're not qualified to do that. We wanna get them to a professional to do that. Um, we don't wanna leave them out, um, of a conversation. So it may be that you have conversations with other people, but I try to go ahead and say, "I'm going to talk to so and so about this," so that they know that that's gonna happen. And then oftentimes I choose, "Do you wanna be present for that conversation or do you want me to have that conversation without you?" Right? So maybe it's a teacher at school, um, or something like that. So helping them to know, um, that we're gonna be talking about this. Don't be scared to speak about feelings. Um, don't be scared to talk about them. It may mean that you feel scared and that's, I'm gonna validate that emotion for you too. Um, but don't act like that. Don't act scared. Um, 'cause then that's gonna make them feel like you're, you maybe you can't handle it, what they have. Um, and then we don't wanna be critical or blaming, um, in the ways that we are talking with them. We wanna make sure that we're not blaming them and we're having these open conversations, so that they will shut down real quick Um, if we engage in those behaviors. ::Slide - As Parents...:: As parents, we're helping develop health for physical, emotional, relational, and then if applicable, um, for your family, spiritual, all these aspects, we are looking to develop health. And in all of these things, they're connected. And so sometimes, um, it's helping, um, them to develop health in all of these ways. But when we touch one, then other things get better too. Um, so if your kiddo is really tired and, and fatigued and really irritable, and then we have these conversations about how they're struggling with the relationship that they have a, a, a friend that they're in a fight with and they don't know what to do and they're feeling really down about it. We have this conversation. We help them, um, come up with some solutions and figure out for themselves what would work. And then oftentimes we see the physical health improve, right? So we see maybe they get more energy and they'll be less irritable and things like that. So we see that as we develop health in one area, um, it will kind of bleed into all of the other areas as well. ::Skipping multiple slides:: All right. We are getting, we are like at time. So I'm not gonna go through, uh, these last just few slides here, um, about mood and anxiety. ::Slide - Did you know that 988...:: But the idea is that we recognize the mood and anxiety is a very big thing, big thing, um, for our adolescents these days. And so, um, I want you to also be aware of a, um, the new mental health crisis line. 988. Um, this can even be programmed into a youth's phone. They can call it on their own. Um, if they want to talk to somebody, that they don't have to seek out somebody that they already know, to do. Um, so that, um, person that they'll be connected to is going to be, um, a trained crisis counselor. And they will answer the phone and they will be working through that. If you are experiencing a mental health crisis, you can also do this. Or if your youth is, is experiencing one, you don't know what to say, you can also call that line and they can help walk you through that. And then they're gonna also help connect you with resources, um, or other counselors in ways, um, that, that they, that you can be reached that way. ::Active Poll - What additional questions do you have?:: So, um, this is just the last slide here, just additional questions that you have. But I know we went right up until time, so if you do have additional questions, feel free to pop those in. Um, but if, um, you also, uh, need anything, just let us know. I think, um, the post-adopt team would be happy to help you continue thinking about this, um, and thinking about how we can continue to support you in having these mental health conversations with your teams. [Bonni] Thank you so much, Dr. Wilsie. Man. I, uh, I took lots of notes for, um, conversations with my kids who are also preteens, adolescents as well. Um, saw lots of people on here who are, uh, professionals, but also parents. So I'm so grateful. Um, really just really great, um, practical application. Um, and we really, really appreciate that. We did have one question in the chat that I'm gonna throw out there. I know it's one o'clock, so if you need to hop off, feel free. Thank you so much for being here with us. Reach out to us if you have any specific questions. Um, but we do have a question from, uh, Schmuel, I think it's how you say it, from Israel. And his question is, "What your recommendations for effective running conversations," so that constant conversation, "about mental health with adolescents from poor and low socioeconomic families." Any, any thoughts and ideas on, um, I know you mentioned reaching out and supporting marginalized uh, populations and adolescents as well. [Carisa] Absolutely. Yeah. So is, um, would that be from a parent perspective or from a provider perspective? [Bonni] I think probably both. [Carisa] Both. Yeah. So as a, as a provider perspective, I think I would, um, really get creative with parents in thinking about, um, how, how those conversations can happen and can be open. Um, sometimes it's a matter of being, um, real ourselves and saying, man, just like in that video I really deal with some of these feelings as well. And so having that be an open conversation all the time. Um, and sometimes it might mean like, "Oh man, I'm having a really tough day on my mood. I'm, man, I'm really feeling down today," right? Where it's just this openness to have these open, um, ways of communicating, um, about these sorts of things. Um, as a parent, I would say looking for, um, the ways in which you get kind of hooks, um, with, with, with the adolescents. And so any ways in which they already like to engage with you. Um, so whether, like I said, if they are talkers in the car, I've got one that's a talker in the car. I've got one that's a talker more so before bed. I've got one that is bright-eyed, bushy tailed in the morning, um, and likes to talk. So that's why those are my three examples, because those are my three kids. Um, and so trying to meet them where they're at and figure out, you know, what are those ways in which um, we can find where this youth might have an, we might have an in with this youth. Um, and then making that conversation be really open, um, all the time. And modeling that, um, for ourselves as parents I think is really good. [Bonni] Awesome. Awesome. Thank you. Alright everyone, we appreciate your time. Hope you have a great rest of your week. ::Attendees Visible:: And Dr. Wilsie, thank you again for your, for your time and your expertise. [Carisa] Thank you all. [Bonni] Bye-Bye.