Mindfulness and Self Regulation for Children and Adolescents

Foreign. I'd like to welcome everybody today's presentation on mindfulness and self regulation for children and adolescents. I'm your host, Dr. Donnelly Snipes. Now this is obviously not going to be a end all, be all course on mindfulness and self regulation, but it should hopefully, hopefully give some tips for things that you might be able to do with older and younger children. And I'll try to talk about each one as we go through the presentation. We're going to talk about core mindfulness, walking the middle path, distress tolerance, emotion regulation, interpersonal active effectiveness. Obviously those should sound very familiar if you're familiar with dbt. So you know, obviously there are some elements of DBT we're going to talk about today. Then we're going to talk about resilience activities, mindfulness activities and DBT activities. So it's important to help children recognize that there are three states of mind. And depending on the age of the child, you may have to talk to them and explain the reasonable mind as either their school brain or their scientist brain or a robot brain, something that is relatively intellectual, non emotional, that they can, that, that they can think about. Not that emotions are bad, but we want them to recognize that their head says one thing, their heart says something else, and their gut may still give them a little bit more information. And, and children can often relate, even young children, with head, heart and gut honesty, because sometimes they know when they're getting ready to do something that they're not supposed to do in their head and their heart tells them, well, I really want to do it. And their gut, but their gut may say no, you got to listen to your head. So the gut is almost like the, the Jiminy Cricket or the conscience, so to speak. A lot of times your spidey senses, when I'm talking to younger kids, we talk about Spidey senses reside in their gut. So helping them understand that the brain is theoretically the reasonable mind. Now it's important to remember that up until the age of 24 or 26, depending on which paper you read, the prefrontal cortex, which is involved in organization and planning and impulse control and you know, patience and waiting your turn and all that other stuff that's not fully developed yet. So there are certain things that as adults we don't have any problem doing that children may have more problem, more problems with, they may have more problems with impulse control and things we want to help them identify the, the fact that they do have an emotional mind. And their emotional mind kind of comes, it's what their heart is saying, and then their wise mind is the logical choice that makes them as happy as possible. So when processing things with children, it's important to talk with them about, you know, what are the facts in the situation, what does your heart say, and what is the best possible choice in this outcome? You know, when it's. When we're talking about extracurricular activities, for example, maybe the child wants to go out for football or cheerleading or, you know, chess club or something. Okay, so the reasonable mind, what are the. What are the reasons, what are the facts supporting this decision? What are the reasons you might want to do it, and what are the reasons against it? You know, so let's look at the information for and against doing this right now. And I remember going through this with my son when he was enrolling in college for the first time, whether or not he wanted to be in the honors program. And he made a list of the pros and cons of joining the. Joining the honors program. And then we had to talk about, you know, what does his heart tell him to do, what is. What does he want to do, you know, based on the information that he has, and then what is the best possible choice for him in this situation at this point in time? That's a lot easier to go all the way through with. When you're talking to adolescents with smaller children, it's a little bit harder to help them decompress quite as quickly, but it's possible the key is teaching them effective distress tolerance skills. So when they are upset, they're in their emotional mind, and we can acknowledge that, you know, that you're really upset right now, and you're. You're in your emotional mind or you're in your heart mind. So, you know, what can we do to help you feel more in control of that? With wise mind skills, in order to help children try to figure out what needs to be done and the facts in this situation, we want them to observe, describe, and participate. And this all comes out of DBT101. Encourage them to be a detective. And a lot of kids like being detectives. A lot of their shows, like, I don't know if Dora the explorer is probably not even popular anymore. My children are much older now, but a lot of the cartoons that they used to watch involved being a detective. So finding the facts in the situation and identifying the whole situation, have them name their experience. You know, if they are scared about it, if they are excited about it, if they're confused, confused, encouraging them to name what they're feeling, you know, what their emotion is, label that emotion and why, name their experience and then participate by being actively involved in the moment. So if they are anxious about a test they've got coming up, they're naming their, their experience. Being a detective, we want to look at why are you anxious about this test, what things are making you anxious and what things might support the fact that you got this. You know, let's look at all of the information, not just all of the reasons for your anxiety and then encourage them to be actively involved in the moment. And I'll give the example of, of my daughter. She is, bless her heart, she is a little driven critter and she's trying to get into her upper division right now and she's really stressed out about it. And we had this discussion at the dinner table the other night and I asked her to name, name her experience, tell me what was going on. And she said that she was stressed out because she was afraid she wasn't going to get into upper division. Okay. So I validated how she felt. You know, we want to go back to consistency, responsiveness, attention, validation, empathy and support for craves for improving our relationships. But I had her name that experience, validated that experience as one she's having. And then we looked at the information for and against her fears and you know, I said, what are the things that could keep you from getting into upper division? And her boyfriend was there and it was kind of funny because the only thing she could come up with is my GPA won't be high enough. And before I could even say anything, he's like, you've got a 4.0 going into this. I'm not sure you can't get any more than a 4.0 at the school that she's at. So he was kind of supporting the facts that, you know, that was in existence. But then we talked about, you know, worst case scenario, you know, if it doesn't happen, you know, acknowledging that her fear is there, you know, what is, what is she concerned about? We played through the whole tape, you know, if she doesn't get into upper division, then she won't be able to figure out what she wants to do for a career and then she's not going to have a job and you know, she just, she spirals. So we wanted to play that out and then look at the talk about what are the facts in the situation that was the observe what does she have control over in this situation? And in this particular situation it was continuing to do her homework and you know, volunteer Work and talking with her professors and making sure that she's, you know, showing up and doing what she's supposed to do to, so she can get good recommendations. So that's in her control. And what is the probability that if she does all those things that are within her control that she's not going to get into upper division? Okay, maybe it happens. What is the probability that if she doesn't get into upper division that she is going to be flailing aimlessly for the rest of her life and you know, she was able to recognize that she was probably catastrophizing. Now she is 16. So that is a obviously an intense intellectual line of thought, not one you're going to have with a five year old. With the five year old it is very basic, have them name their experiences. What are you, what you're feeling and why tell me, you know, kind of what's going on that might be contributing to this. Maybe they were on the playground and. Oh, I'm sorry Angela. A stands for attention. So consistency, responsiveness, attention validation, empathy and support. Craves is the mnemonic device for that. And that's the mnemonic I use for attachment based relationships. So sorry, I kind of got off on a tangent, but I do that when you're working with a five year old though, when you're talking about wise mind skills, you know, really recognizing that they can't even probably do this until they have used some distress tolerance skills and gotten down, regulated a little bit. But then having them observe everything that was going on. So maybe they were on the playground and somebody did something that they thought was mean and it made them angry. Okay, so they name their experience. Johnny pushed me off the swing and it made me angry and hurt my feelings. Okay, so be a detective. What was going on that might have caused Johnny to do that? Does Johnny do this with regularity? You know, if Johnny is always pushing you off the swing, then, you know, we may need to address it differently than if, you know, this was a one off situation. But talking through it with them and then helping them decide through helping the child decide, okay, what are you going to do next time you see Johnny? Or what are you going to do the next time you're on the swing and somebody wants to get on it and, and you're already on it. So helping them be actively involved and identify, even retroactively what parts of the situation that they were in control of. And henceforth in the future when this happens, what parts of the situation do you have control over? You can Encourage children to practice observing, describing and participating. You know, even at the dinner table, having them describe their experience for the day. Tell me some one of the best things that happened to you today and tell me, you know, why it happened, everything that was going on and how did it impact, you know, everybody else and encourage them to participate and tell me what you did next or how you kept that, kept that going, if it was something good. Discuss things that could get in the way of observing, describing and participating. And namely this. This is generally either a feeling of unsafeness, a feeling of disempowerment, or just feelings. You know, when people are highly dysregulated, it's hard to observe, describe and participate. The wise mind how skills encourage us to help children learn how to non judgmentally observe their feelings and acknowledge their feelings. They may be angry, they may be anxious, they may be however they're feeling. And acknowledging how they feel is just is how they feel. It is what it is. And that can go a long way to helping them not be angry with themselves. And struggle, as Hayes calls it in acceptance and commitment therapy, struggle with dirty discomfort, all those ancillary emotions like guilt and, and anger at themselves. So acknowledging how they feel, non judgmentally I feel how I feel. Observing and describing, you know, what's going on, keeping one mind focusing on the task at hand and clearing their mind of everything else. Maybe going back to taking a test and a lot of kids have to take tests or starting the first day of, first day of first grade, you know, that is overwhelming for a lot of kids. You know, helping them nonjudgmentally acknowledge that they're excited or they're anxious or whatever they are. Help them focus on the task at hand. What do you need to do to make today a good day? What do you need to accomplish? How do you need to behave? And then encourage them to do what works. My son had, has adhd and when he was in first grade, you know, that was one of the things that stressed him out the most and gave him Carnotaurus, which is kind of dinosaur in his tummy before school was he was so afraid that he wouldn't be able to contain himself all day long that he would literally make himself sick in the morning. And so we would talk about, okay, what is your, what is your task? What do you need to do at school today? And then what can you do when you're starting to feel antsy, when you're starting to feel agitated in order to help you help yourself? And he had a list of things that he could do that would help him. Walking the middle path is another skill that we can help children learn. And I'm instead of just saying children and adolescents all the time, I'm just going to say children. Helping them balance the ideas of acceptance and change can be really important. And they can start doing it even when they're knee high to a grasshopper. They may not. For example, you know, maybe grandma moves to a retirement home and so that's change. But, and that may feel weird to them and they may be anxious about going to the retirement home, but they also want to see grandma. So they have to accept that this is the way it is now. Same thing going from kindergarten to first grade or changing teachers. When there's change, there is almost inevitably some level of anxiety. As humans, we don't like change. So when there's change, we need to help them identify what parts of the situation that they have control over and move towards an attitude of acceptance of the situation. Okay, I have this teacher that, you know, I really didn't want to have, but I've got them now, so how can I make the best of it? So this incorporates the use of both and for example, I can not want to have this teacher and do just fine in his or her classroom. You know, I can, I can survive it. I can not like it, but I can survive it. So it's the both and that we want to look for and you know, even in adult life there are things that we don't want to do that we have to do and we have to accept change. At for adolescents, you can also get a little bit more meta concept and talk about how change is the only constant. You know, we change as individuals on a day to day basis. We change with every interaction we have. We're not the same as we were last year, last month, or even last week. Recognizing that and recognizing, you know, let's go back to the teacher. You know, maybe you formed your impressions of this teacher based on how they taught last year and what the other student said last year, but you don't necessarily know. Maybe they went to some teacher workshops over the summer and changed their style completely. So accepting what it is in the moment that you have this teacher, you're not thrilled about it, okay, can't fight it, it's the way it is. So how can you improve the next moment? How can you make the best of it, so to speak? We want to validate what's going on through active listening and with children, you know, part of that consistency and responsiveness is being there for them as children. And you know, if you have children, you know, they easily dysregulate and it can be with anger, fear, or even excitement. They get excited and it's zero to 500. You know, it's just wide open for a lot of kids. And you know, with happiness, that's often okay. But sometimes even, you know, happiness has to be reined in a little bit. Like right before when you walk into the amusement park or Chuck E. Cheese or something, you know, they are in, you know, wide open mode. But it's important for them to be able to regulate that happiness enough that they make good decisions when they're there. And, and it can be difficult for children when they're in that dopamine haze to make good decisions sometimes. So it's important to help them identify their emotions, help them learn active listening, help them learn how to tolerate others as well as tolerate themselves. Sometimes they can get angry with themselves. Some of the ways that we can do this are through reinforcement of their positive behaviors. And I've you y' all the story before of, of my son when he was, you know, two and a half, walking up to me at home. I was on the computer and he walked up to me and he said, mommy, I'm over stimulated, and popped his pacifier in his mouth and toddled into his room and sat down in his bed and just stared at the wall for a minute. And you know, that was, you know, great. So I gave him some time and then I went and, you know, talked to him about what was going on. You know, I think I gave him 10 or 15 minutes. He was really young at that point and, you know, that nothing was terribly wrong. He was just feeling, you know, over stimulated for some reason. So reinforcing that that was a good choice to give himself a timeout if he felt like he was going to have a hard time keeping it together. Shaping behaviors, you know, acceptance can be difficult and altering our behaviors to adjust to change can be difficult. So it's important to set goals for children of successive approximations. They may not get it a hundred percent right the first try. And I keep going back to kindergarten to first grade. For in our school district, that was a huge transition from very loosey goosey to very rigid and sitting at a table all day long. So there was, there was a lot of change that was expected, you know, in this just almost overnight for a child. So it was important to work with, you know, any child to help them set small achievable goals and that teachers are usually first grade teachers especially are usually really good with this because they recognize how big of a change it is, so they don't insist on perfection right away. They do reward positive behavior and they do, you know, try to shape the behaviors, encouraging them to do a little bit better tomorrow. All of those things help children develop confidence and a sense of competence in themselves, which are important for resilience. When teaching children how to walk the middle path, help them open their eyes to seeing things from different angles. And you can do this with, you know, things structures, for example, to help them see, you know, experientially that things look differently from different angles. And one of the activities that we would do is I'd have something on a table and we would look at it, you know, what I would call head on. Then we'd look at it from behind, and then we would get down on our bellies on the floor and we would look up at it, and then we would stand on a chair and we would look down at it. So children can see that literally from different perspectives, things look totally different sometimes. And then we can talk about that later, especially with older children, from talking about different people's perspectives. I remember and I've told you guys about my son's preschool teacher, Jessica, but I used to watch her when she would interact with the children on the playground. And these were very young children, the still very egocentric in many ways, but they would get into, you know, little tiffs on the playground, and she would pull them aside and she would ask them, you know, how. How did you think that Johnny felt when you did that? And if the child wasn't able to empathize, she would say, how would you feel if Johnny did that to you? And, oh, they can figure that out. And then, then she would take it and say, well, don't you think that Johnny probably felt that way when you did it to him? And so she was able to help them, you know, identify how they would have felt and then project that empathy onto other children, which I thought was just fabulous. And, and children really seem to respond quite well to that. Even at, you know, 4 and 5 years old, change is constant. If it's stressful now, change will happen just like the weather in Tennessee. If you don't like it, wait 10 minutes. Helping people recognize that as life changes, we adapt. Whether we want to or not, we do. And it may be stressful right now during that adaptation phase, but once we adapt, it becomes a lot easier. Just like exercise, you know, when we start lifting weights, you know, 10 pound barbells may seem very heavy, it may seem very stressful on our muscles, but if we keep doing it, if we practice and get better at it, then, you know, before we know it, those 10 pound dumbbells will seem very, very easy. The same thing is true with math, with algebra, with spelling, with relationships. Well, relationships can still be difficult even in adulthood. But recognizing that in relationships there are almost always periods that are stressful, but as that relationship grows, then that stressful period will often work its way out. You can have children find both sides of a spectrum of something and use a both and approach. And, and if you have children, multiple children in the house, for example, they may have very different opinions about something. So you can use a both and approach. Maybe it's movie night at the house and one person wants to watch horror and another person wants to watch a Disney princess movie. You know, very opposite ends of the spectrum. So how can you walk the middle path? What's a both and that can happen? How can you compromise and make it work for you? And you know, Disney zombies doesn't actually exist, so that doesn't work. But you know, for in our household when we would want that to happen. Interestingly enough, my daughter is the one that is, you know, way into horror flicks and my son absolutely hates them. So you know, we watch a movie that everybody can agree on first and, and then I'll watch a horror movie with her afterwards. Validate self Walking the middle path is important for people to acknowledge and validate how they feel, what they think, want and need in the moment. Non judgmentally. If they are grieving or they are upset about something, or they're anxious, acknowledging how they feel and saying this is how I feel right now, and then not criticizing themselves for it, figuring out what they can do to improve their next moment. Because just like everything else in the world changes from moment to moment, we change and there's no reason to wait necessarily until tomorrow or next week. You know, what can you do? Every moment is potentially a new beginning. And walking the middle path also means validating others, which kind of goes with that whole assertiveness thing. Acknowledging that my thoughts, wants and needs are just as important as yours and just as valid as yours. And that's really important when working with children, especially younger children that are very egocentric. And that's not a criticism, that is a developmental fact. Go back and read over Piaget stages. But when children are very young, they have a hard time understanding other people's point of view. So it's important for us to help them understand that different people have different experiences and may have a different point of view. Distress tolerance if you again go back to Linehan accepts and improve activities. Have children make a list and you know, if they're really young, you can make a list for them and use pictures, you know, if they're not reading yet, of things that they can do when they are feeling upset, things that can help distract them or help them feel happy. And have that poster or list somewhere that's easily accessible for them. If you are going out in public, create an emergency kit that has a few things that the child can do to help them tolerate their distress. I don't think I have it on this one. It's. I think it's in its own PowerPoint on distress tolerance. But one of the ones I love for children is the dragon breather. Take a red solo cup, one of those little plastic cups and cut strips of tissue paper, tape those, or glue those on the inside of the wide end of the cup and then cut a little hole in the small end of the cup. And when they get upset, they take a deep breath and they blow through the cup which makes all of the tissue paper flap around like dragon fire, which is why it's called a dragon breather. But that can be a really good activity for children to do because it helps them with that slow deep breathing that can help them re regulate for the moment if they get agitated or bored really easily. Making sure that you have things that they can do from fidget spinners and things that they can do with their fingers when they're on car trips or waiting at the doctor's office or in church or at the line at the grocery store, wherever it is that can keep them occupied. Noise cancelling headphones for some children on for other children they do better if they've got auditory stimulation. So music that is soothing for them or that they enjoy listening to, you know, think about what types of things given whatever setting you're going to, what types of things could I bring with me that might help my child rein it in if they are starting to feel, you know, agitated? And I'll use that as just a great big old garbage term for irritable, anxious, tired, restless, you know, whatever. What types of things, cross cutting measures might work for my child? Keep that with you. Pack it, pack a bag like that, keep it in the trunk of your car or you know, somewhere in your car so wherever you go you've got it handy with you. Contributing encouraging children to Contribute in order to help them get outside of themselves when they are distressed. Sometimes helping mommy, you know, put away the dishes or, you know, helping somebody do something can redirect their attention away from whatever's causing their dysregulation to something else. You can, once they're calmed down, once they're re regulated, then you can revisit whatever the issue is when they're calmer, not in that adrenaline haze. Comparisons, this works better for older children, but sometimes you can use it with younger children helping them compare themselves to other people who aren't doing as well. So maybe there's another child in their class that acts out. I know in my son's class there was a child who, when he would get upset, would start throwing things, including chairs, across the room. And so when we would talk about, you know, what he was doing, what he was feeling, his anger, what he wanted to do, we would talk about, you know, how well he was doing, you know, if he was not throwing a chair, that, that was a good thing. But also comparing the themselves right now to prior times, and this is, you know, this is where it's better for older children when they've gone through something similar. How much stronger are they now? How much more able are they to handle this distress now than they were six months or a year ago? Emotions the opposite. Making a list and having things available that can help elicit the opposite emotions, whether it is Pinterest or Tik Tok. I don't really like them, but my daughter is always on them and always sending me these adorable videos. So I know there are good nuggets in there. But anything that they can do to trigger opposite emotions, when they trigger dopamine and serotonin and, and their pleasure chemicals, it's going to dilute, for lack of a better term, the stress chemicals. It's called going to actually counter those stress chemicals. Teach them how to push the experience from their mind. And children, you know, when they don't want to do something, sometimes will put their fingers in their. In their ears and go, la, la la la la la la. Well, that's what we want them to do. Not necessarily exactly that, but what can they do to push that thought out of their mind? Can they sing? Can they talk to somebody? A lot of times for children, it involves doing something that is verbal or auditory because in order to silence the thoughts, their verbal processing areas have to be consumed with something else. Whether for. For my son, there are certain songs that he sings when he's stressed, and it just keeps him from thinking about what he doesn't want to think about. Think about alternate things. Well, clearing your mind is hard for a lot of adults, let alone children. So telling them just not to think about it is, you know, setting them up for failure because it's almost impossible not to do unless you think about something else. So encouraging them to redirect their attention to positive things that they can think about. If they're anxious about a test that's coming up or they're anxious about a doctor's appointment, you know, get them talking about going on vacation to grandma's house this, this summer or what they're going to do this afternoon or what they want for dinner. Have them think about anything else that can distract their attention for the moment so they can re regulate and the final clue is or thing that we can do. Final intervention is sensations. And remembering that intense sensations like splashing water on your face or doing 15 push ups can distract you yourself from the, from the current distress and you know, going to what you're saying about mindful processes rather than distraction. It's important for children to be able to develop a range of tools and we'll talk about mindfulness exercises in a few minutes. Develop a range of tools to deal with intense emotions and sometimes being mindful and in the moment, especially if it's something that they can't control, like they're in a fight with their best friend or they've got a test coming up in a week, mindfulness might not be completely effective for them. Additionally, if they are already completely dysregulated, they're going to have to reregulate in order to be able to be mindful because they're already spiraling. So it's important to help them get to a place where they can get into their wise mind and be mindful. But when people are dysregulated, it's really difficult to be completely mindful. Teach children how to self soothe with the five senses. What are five things that you see, four things that you hear, three things that you smell, two things that you can feel and one thing that you can taste. I don't always do taste with children because I don't want them to go around and try to taste something. But encouraging them to focus on the five senses brings them back to the moment where they can start becoming more aware of what's going on. As that adrenaline clears and they can be more, more present, you can have them go through and make a pro and con list. You know, what are the benefits to making it through the current situation. And what are the benefits to not pushing through the current situation? You know, maybe, you know, dropping out of school so they don't have to take the test. You know, you can look at either thing or what are the benefits to asking somebody out on a date versus not asking somebody out on the date? And you can have them go through those activities to figure out how to make their pro and con list. You can have them imagine a relaxing place. They can often do it, you can narrate it for them. But a lot of times it's really helpful if they create their own relaxing place. Whatever it looks like. It can be on a spaceship, it can be with the dinosaurs, wherever they want it to be. Have them. They can either narrate it to you and you can write it down. This is especially true if they're little kids, but you want to have them identify as many things as they see. And I usually try to do five to start out with what are five things that you see in your relaxing place? What are, you know, four things that you hear and go through that. So it's a multi dimensional sort of immersive experience as you write that down. If the child narrates that, write it down and then you can record it for them. So you are helping them with that guided imagery in the future that can be a great thing to include in your emergency pack. For older children, they can write it down and record it themselves. For children that are in the middle or children that just really aren't into the whole writing and recording thing, they can make a collage that represents that relaxing place that they can look at, that they can focus on when they're stressed out, if they are. If they have a mobile device, once they make the collage, they can take a picture of it so they have it with them and they can visually focus on that when they need to take a mental break. Meaning is another technique helping them identify times when they've survived similar situations. For older children, we do, I have them do a courage journal. So they talk about stressful things that they've gone through. And then when they've gotten through it, I have them write about it and write what they learned about themselves going through that stressful experience, whether it was a breakup or a hard test or an awful teacher or whatever it was that was causing them stress. So they can go back when they're feeling anxious, when they're feeling weak sometimes, and. And look through their courage journal just to see how much strength they actually have. They can also Create meaning by identifying what's important in their life. And again, scrapbooks can be great here. Lists so they have a visual representation, either in words or in pictures of the things that are important to them that they can review when they're feeling stressed out. So it can help them get perspective when something happens. You can say, okay, in the big scheme of things, you know, based all the things that are important in your life, how does whatever this is that's stressing you out, how does it impact all of those things? You know, helping them recognize that a lot of times there is stress in our life and we'll have to deal with it, but there also is are things that are really important to our in our life that whatever this is over here really isn't going to impact that much. You know, six months from now probably won't matter. I avoid saying that to children because as an adult, I can look back on things that were a big deal to me when I was 13 and, you know, I couldn't imagine it ever being not a big deal. And now at 50, I'm looking back going, oh, boy, that, that was. That was nothing. But that's because I've got, you know, 40, 37 more years under my belt now. Whereas children just don't have those experiences yet. So it may seem like it's going to hurt forever. Prayer, relaxation exercises. This can be yoga, tai chi, stretching, painting, anything that helps the child feel physically and cognitively relaxed. Whatever they like to do. One thing in the moment. We already talked about that. Encouraging them to focus on one thing at a time. Instead of getting overwhelmed about all of the homework they've got to do. Let's just start out with biology or history or whatever the child wants to start out with. Focus on that, get it done, then move on to the next thing and teach them how to focus and be mindful to cope with feeling overwhelmed. And you're right, Pat, a lot of these things can actually be done as a family, which is really awesome. Help them figure out how to take a mental or physical vacation. Sometimes they just need a break. So what does that mean? What does that look like to them? If they're feeling completely overwhelmed, how can they take a mental vacation? Maybe it's reading a book so they can get into a fantasy world. Maybe it is painting. What is it that's going to work for them? And encouragement is the E in improve? Encourage them to identify and keep a list of helpful statements about themselves and others so they can provide themselves encouragement. But it's also helpful if we provide as their caregivers, if we provide encouraging statements that they can also look back on so they can hear, instead of having a critical inner voice, they hear that encouraging inner voice that goes, you've got this. You know, it's tough. I know it is. You know, it feels like it'll never end. Right now, I'm here, I'm, I've got your back and you've got this. So they can hear that voice over and over again. Radical acceptance is another skill that we can help children learn that life can be tough. And you know what? Sometimes you're right, it isn't fair. And we can acknowledge, we can validate that feeling. We can empathize with how frustrating it is when things aren't fair. And then we can help them figure out how they can live in the end. You know, some things aren't fair, some things can't be changed. How can we accept that whatever that is, is and have a rich and meaningful life? How can I accept that? You know, Graham, we are moving, you know, away from all of my friends to a whole new state because dad got transferred. You know, I don't like that. How can I accept that and have a rich and meaningful life? Doesn't mean you have to like it. And, and that's really true with a lot of children. You know, they don't, there are a lot of things they don't like, but they figure out how to accept that some things can't be changed and identify the parts of it that they can. When they move, you know, they make, they eventually make new friends and get re established and, and that's a process that they have to go through. So encouraging them whenever they are feeling distress about something, when they are feeling upset, you know, help them down, regulate so they can get into their wise mind and then help them identify in this situation at this point in time, what aspects of it can you change and what aspects of it are out of your control? And that really helps them figure out how to direct their energy in a way that is meaningful. Emotion regulation and the mnemonic here is strength. Helping children identify and label their primary and secondary emotions is really important. You can't deal with it until you know what you're dealing with. So starting with the basics and you can use the little emoji faces or colors or animals, whatever works for that child to help them start labeling emotions. With, you know, younger children, you're going to start with a smaller group, you know, angry, mad, sad, glad, scared. And then as they get older, you'll start adding in some of the nuances to, to those emotions so they have a bigger emotional vocabulary. It's also important in regulating emotions to regulate that HPA axis, which means making sure that the child is getting enough sleep when they are not getting enough sleep. Research has shown it's not just, you know, a wives tale that when children are sleep deprived, they have more difficulty regulating their emotions and coping with distress. So sleep is important. Taking care of themselves, which means being mindful of what they need in the moment and living authentically to try to get that. Resist unhelpful behaviors and impulsivity and this is super hard for children and adolescents, but encouraging them to identify ways that they can try to resist unhelpful behaviors like yelling or hitting or biting or, you know, anything else. Exercise. Exercise is great for increasing serotonin, releasing endorphins, reducing cortisol levels and just keeping the child's cardiovascular system healthy. Nutrition. The child's body needs the building blocks in order to make the neurotransmitters that can help them feel happy, that can regulate their immune system, that can keep their gut healthy, keep their vagus nerve all happy and communicating with the brain and keep their neurotransmitters and hormones in balance. G stands for gain mastery. When children have a sense of competence or mastery, then it is often easier to regulate their emotions and they can gain mastery in their emotion regulation and they can also gain mastery in other aspects in life. But with children this often means setting what I call micro mastery goals. What can they do, you know, in a day or what can they do in this situation and then building from there. Not expecting them to learn something and do it henceforth and forevermore, but to start trying to do something new and getting a little bit better each time. Take time for yourself. Relaxation and pleasant activities are so important. A lot of children are over scheduled and they don't have time for relaxation. I know one of my son's best friends gets up in the morning, goes to school, gets to school at 7 o', clock, leaves school at 3pm, comes home, starts on his homework and he literally is doing homework until 10 o' clock at night when he all but passes out and then gets up the next day and repeats. So it is important that we teach children that relaxation is not a luxury, it's a necessity in order to keep ourselves healthy and developing healthy self. Talk can also be helpful for emotion regulation. Cutting out that or silencing that negative internal voice, providing self encouragement, self validation, interpersonal effectiveness, cheerleading Statements are always helpful. Helping people develop their own personal mantras that can encourage them and keep them going even when it gets tough. Linahan came up with the mnemonic Dear Man. So when working with or interacting with other people, encouraging people to communicate by describing objectively what's going on, expressing their feelings, asserting their wants and needs. Reinforce tolerance and and compromise by trying to create a win win. Maintaining a mindful focus on the present. This is not time to bring up a litany of done me wrongs or talking about what the person's going to do in the future. Focus on the issue at hand and talking about that. Appear confident and be willing to negotiate. Another mnemonic that she has is fast, fairly, treat others the golden rule. And you know, we can use this with our families. Apologize when you make a mistake, but not for being you. You know, we are who we are and we are all individuals with our own thoughts, wants and needs. Children shouldn't have to apologize for who they are, but sometimes they need to apologize for things that they do. Stick to values, what's important to you and encouraging children to reflect when they get upset, to go back over what's important to them and how this matters for them. Tell the truth is the T and it's important to encourage children to tell them. Tell the truth not only to other people, but also to themselves. With resiliency, there are six Cs coping, character development, Competence, Confidence, connection and control. So with cope when we want to help children be resilient, we need to help teach them coping skills, teach them how to be mindful of what's going on. You know, that goes back to, you know, observing and describing the situation and participating in the moment. Acceptance, you know, that's, that's a difficult tool but accepting those things they cannot change and developing problem solving skills. Character development. When children have a and anybody has a strong sense of who they are, it's easier in many cases to be resilient if they have a solid belief in, you know, what they solid awareness of what they believe in and their values and have, you know, support for that. Setting competence through micro mastery goals. We are more resilient if we believe that we actually can do. If we feel empowered to handle challenges when they, they come our way. But the only way to feel empowered is if we have experienced similar situations or had to deal with things before and felt successful, felt that develops our sense of confidence and confidence. If we feel like we know what we're doing, then we feel like we can handle more things we can Feel more confident and confident in dealing with life on life's terms. Connection is helping people recognize children recognize who is there to support them and what their resources are. They're not expected to deal with everything on their own. They've got got help, they've got people who love them, They've got resources that are available to them. And that's a huge part of resiliency. To help people get outside of their own mind and recognize that they've got a safety net, they've got a support system and control through purposeful action, mindful awareness of what is within their control and goal setting. When children start to feel a sense of control and confidence and competence, it increases their feeling of, of safety. They feel like they can protect themselves and they can deal with whatever life throws at them. In terms of mindfulness exercises, transformation can be really fun. Creative uses for everyday objects like paper clips and duct tape and straws. You know, just get creative and ask them to find, you know, five unique uses for something to help them see alternate perspectives and ways to get outside the box. Help them understand that scents trigger memories. So help them become aware of what memories are triggered by certain scents. Practice mindful eating at the dinner table and wherever else, Identifying spices that are being used or flavors that they like. You can put a blindfold on them and have them identify, you know, what they notice in the room, you know, for three minutes while they're blindfolded. What are all of the things that they notice? Name four things that they see, four things that they hear. We already talked about creating that relaxing place. Having a distress hat can be a fun activity. You take a hat and things that are stressful to the child or to people. You put them on cards in the hat. The child pulls a card, reads whatever the distressful thing is, and then you talk about how to cope with it. You can do an emotions collage. So they are representing the different emotions, which helps them get in touch with, you know, what does happiness really look like? What does sadness look like? To me, nature observation is just Mindfulness101. Have them with open awareness. Notice what's going on. You can have them hold ice, which is one of those sensations that we talked about, and, and notice how it feels. And if you don't want to go with ice, you can do a cold, cold water bath, because ice can be kind of painful. But have them notice how it distracts their attention and it's hard to think about anything else when they're holding that ice. Create a self esteem envelope everybody in the family has an envelope and each day or once a week everybody in the family adds a compliment of some sort, something that they appreciate about that person to their self esteem envelope. So at the end of the week if there's four people in the family, they have four little slips in their in their self esteem envelope. You can have them write a movie about their life or do feeling charades with DBT activities. You know we talked earlier about the self soothing kit, aromatherapy fidget things, noise canceling headphones and media. You can look for examples of people getting dysregulated and then you can pause the pause the show and ask the child what they would do in order to tolerate that distress or re regulate. Adolescents are trying to discover their values, their niche, their goals. They're transitioning from the carefree childhood to trying to become adults. And the prefrontal cortex is still not fully developed. Adolescents almost always have a low to moderate level of stress, making them more vulnerable to emotional reactivity. DBT can help adolescents gain control over their emotions and mindfulness helps them become aware of the what's and whys of their emotions. Most adolescents prefer indirect approaches to learning skills. Instead of having to read a book, they actually prefer to do it or you know, see it. Through skills groups, adolescents can acquire new skills, relate them to something they know, practice them in a safe environment, and come to the awareness for themselves why these skills are helpful. And you can do skills groups at home with the family. All of these activities though need to be processed and brought back around to how they can be generalized in the real world. And remember, the slides for this are in your classroom. You can download the PowerPoint so you can see the mnemonics that we went over. If you want to use those, you can also go to I think it's dbtskills.com but if you do an Internet search for DBT skills and and accepts or improves or DBT skills and distress tolerance and then click on the little images tab. There are lots of images on on the Internet that will define for you again those mnemonics that are so powerful from Linehan's work. Everybody have a wonderful, wonderful afternoon, a wonderful day tomorrow and I will see Thursday. 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