Resources for Parents and Youth
National Suicide Prevention Lifeline 800 273 TALK
Dial 988 - If you need help...
DO NOT WAIT - CALL THEM!!!
If your child is LGBTQIA BE SURE to check the data, solutions and advocacy pages for links to critical information and organizations making the biggest difference for LGBTQIA youth in schools, communities, as well as on the state and national level.
Things you have the power to do:
1. THERAPY!!!!If they are self harming, having suicidal idealogy, get them into therapy with someone who specializes in those issues and who understand the unique pressures and risks faced by LGBTQIA youth. Consider medication, even if only for a temporary period, until they are feeling better. Always consult with a professional who is knowledgeable about finding the right medication. Be sure to work with a licensed therapist who uses DBT (Dialectical Behavior Therapy). This is the form of treatment apparently showing best results for addressing these struggles. If your child has experienced trauma, EMDR, Neurofeedback and NeuroMeditation can all help with processing and recovering from trauma. JUST TALK THERAPY is not enough. So search for therapists offering those services.
Read the NYT article below! - "Don't minimize the feelings."
Here is more information on DBT https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy
Link to find a licensed therapist, psychiatrist, treatment center or support group near you! Click the 'find a therapist' button at the top of the page. https://www.psychologytoday.com/us
2. Ensure they feel safe at school - if they do not, address it with them and with the schools. Find out how they are handling bullying, discrimination, and mental health in the school. If they are not covering all areas of the Necessary Components, work with a therapist to determine how toxic the environment is and what the risk level is. If your schools are not doing enough, change schools (if you have that fortunate option) or PULL THEM OUT!! Seek other options, other schools or online/homeschooling until they feel stronger or the situation improves. Be willing for this to take as long as is necessary. Decide about returning to school with them and with their therapist.
**This is the number one thing I wish I would've done. I I believe firmly that Lily would be alive if I had! - it is a critical time and if addressed won't last forever.
3. Be Willing to Make Tough Choices Change your life situation so that you (or someone) can be home with them. If they are self harming do NOT leave them alone. They will downplay it and say they are "fine," but if they are NOT fine, being alone could open opportunities for self harming or worse. Someone being there and noticing behavior and mental state, could save their lives.
** I also wish that I had dropped my two college classes I was taking. She was, or seemed to be, improving so it seemed okay. However, many things can pile up on them quite suddenly on any given day. I do question if I would've noticed more that night if I hadn't been busy with my day of teaching and then my class that evening.
If they are struggling, find a way to ensure that they are your focus... as much as possible. Cover time you can't be as attentive or must be gone. Don't leave them alone. When they are doing better ease into things. Give it time... you won't regret it if they make it through and get past it.
4. Limit and Monitor Screen time and ACCESS. Don't give your child a phone with internet access if possible until over 16. If this is not possible, talk with your provider and phone company to ensure there are appropriate restrictions to their access and monitor what they are viewing. This may seem or feel like an invasion, however, again this is something I did not do. She always showed me what she was watching and I had some restrictions but clearly she looked at things which I was unaware of and that she should not have had access to. Ensure you have the control password for the phone and they cannot change it. Do NOT let them view sites that are dark or make them more depressed and BE WATCHFUL of youtube. We believe Lily viewed one of the many posts of live streamed suicides. Although they try to take posts like that down, there is an enormous amount of toxic material available. Or other streams made by predators lure depressed people and target them. Some even encouraging them to take their life. It is important to explain to your child that you are not trying to invade them, rather that you are trying to do your job and protect them from things that are not appropriate or helpful for them, and may even be dangerous. I had no idea what was truly out there then... it has only gotten worse. Luckily protections are better, but content and predation is worse.
*** TAKE DEVICES AT BEDTIME – especially under 16 years old! ***
*** Watch “Social Dilemma” on NETFLIX with your child! ***
*** READ the NYT Article below! ***
SEE ALSO STATE AND SCHOOL ADVOCACY FOR GROUPS DOING WORK TO PROTECT LGBTQIA YOUTH and for other Resources
IF YOUR CHILD IS STRUGGLING - YOU MUST READ THIS!
NYT Article: ‘The Best Tool We Have’ for Self-Harming and Suicidal Teens by Matt Richtel
‘The Best Tool We Have’ for Self-Harming and Suicidal Teens
Studies indicate that dialectical behavior therapy offers greater benefits than more generalized therapy. But treatment is intensive, and expensive.
“There’s no medication for suicidal behavior,” said Michele Berk, a psychologist at Stanford University. “The patient needs to learn other behavioral skills that the medication does not teach you.”
By Matt Richtel, NYT, Aug. 27, 2022
This article examines the increase in anxiety, depression, self harm and suicide among U.S. adolescents. Parents and teenagers dealing with these issues can find resources here.
Parents seeking therapy for teenagers who self-harm or suffer from anxiety, depression or suicidal thoughts face an imposing thicket of treatment options and acronyms: cognitive behavioral therapy (C.B.T.), parent management training (P.M.T.), collaborative assessment and management of suicidality (CAMS), acceptance and commitment therapy (ACT) and others.
Each approach can benefit a particular subset of people. But for teenagers at acute risk for self-harm and suicide, health experts and researchers increasingly point to dialectical behavior therapy, or D.B.T., as an effective treatment.
“As of this moment, it’s probably the best tool we have,” said Michele Berk, a child and adolescent psychologist at Stanford University.
In a 2018 study in the Journal of the American Medical Association, Dr. Berk and her colleagues found that D.B.T. led to sharper drops in suicidal attempts and self-harm among adolescents than a more generalized therapy did. A 2014 study by researchers in Norway found a similar effect, noting that the therapy also has a relatively low dropout rate, and concluded that “it is indeed possible for adolescents to be engaged, retained, and treated” using D.B.T. The therapy is also identified as a key evidence-based treatment by the American Academy of Pediatrics. If anything, Dr. Berk said, D.B.T. “is not available enough.”
How D.B.T. works
Dialectical behavior therapy is a subset of cognitive behavioral therapy, which aims to reframe a person’s thoughts and behavior. D.B.T. focuses initially on behavior and raw emotion, helping the individual surmount moments of crisis and understand what prompted the behavior in the first place.
D.B.T. is intensive. The fullest version of the program, which can take six months to a year to complete, has four components: individual therapy for the teenager; group therapy; training for teenagers and their parents to teach emotional regulation, and phone access to a therapist to help during a crisis.
The initial step is to teach a patient to recognize the feelings in the body when dangerous impulses arise, like “a lump in the throat, racing pulse, tense shoulders,” said Jill Rathus, a psychologist practicing in Long Island. In the 1990s, Dr. Rathus was part of a team that adapted the adult version of D.B.T. for use by adolescents and their families.
Patients then learn to put those feelings into words. It is vital, Dr. Rathus said, to “put language” to a physical and emotional experience; this engages parts of the brain, like the prefrontal cortex, that help regulate emotions. In young people, these brain regions are not fully developed and can easily become overwhelmed.
The next step is to learn to lower the arousal state with specific, often simple techniques: splashing the face with cold water, doing brief but intense exercise, putting an ice pack on the eyes — to “tip the body chemistry,” in the language of D.B.T.
Jill Rathus, a psychologist in Great Neck, N.Y. “The mistake parents make, even well-meaning and loving parents, is to minimize the feelings,” she said.
The overwhelmed brain
The intensive nature of D.B.T. reflects the difficulty of the challenge it confronts: regulating the emotions of teenagers who are so overwhelmed that they struggle to reason. At that age, Dr. Rathus said, the adolescent brain is often not developed enough to process the flood of incoming news and social information.
“The brain just goes into overload, flooded with high emotional arousal,” Dr. Rathus said, “and you can’t learn anything new, can’t process incoming information and so suggestions of what to do or to try just bounce right off you.”
This is why teenagers appear to their parents to be unable to hear suggestions for curbing their dangerous impulses, no matter how well-intended or compassionate the delivery, Dr. Rathus noted. Some adolescents are unable to start D.B.T. without a medication, like an antidepressant or anti-anxiety drug, to calm the brain enough for treatment to take hold.
How to Help Teens Struggling With Mental Health
Card 1 of 6
Recognize the signs. Anxiety and depression are different issues but they do share some indicators. Look for changes in a youth’s behavior, such as disinterest in eating or altered sleep patterns. A teen in distress may express excessive worry, hopelessness or profound sadness.
Approach with sensitivity. If you are seeking to start a discussion with a teen who might be struggling, be clear and direct. Don’t shy from hard questions, but also approach the issue with compassion and not blame.
Offer healthy ways to manage emotions. Children who are emotionally struggling are at risk of turning to self-harm to redirect the pain they feel. To prevent that, encourage practices known to help our psychological well-being, such as exercise, meditation and journaling.
Get the correct diagnosis. Find the right doctor for your child by asking for recommendations. Ask the specialist about her experience treating specific conditions in children and the measurement tools she uses to make medical assessments.
Carefully consider medications. Press doctors on their experience treating children with specific drugs and make sure you understand their side effects and interactions with other treatments, as well as how to tell if a medication is working and how hard it is to wean off of it.
Don’t forget the basics. Young people, with developing brains, need eight to 10 hours of sleep to promote mental and physical health. Lack of sleep can interfere with development, and can dramatically impact mood. Physical activity is also vital.
Medication is a source of tension among experts in adolescent mental health, who note that drugs can be too easily prescribed, or prescribed in combinations with unknown side effects. But they can be vital as one tool to stabilize an adolescent.
“The medication really helps take the edge off,” said Dr. Berk of Stanford. “But there’s no medication for suicidal behavior. The medication is for depression and anxiety, and the patient needs to learn other behavioral skills that the medication does not teach you.”
Not without a cost
Therapists trained in dialectical behavior therapy can be expensive and hard to find, and are often booked solid.
Rates vary by state and provider, but clinicians said it is not uncommon for a single hour of individual counseling to cost $150 to $200 or more, with group therapy roughly half that cost. Over six months, treatment can cost as much as $10,000 for someone paying out of pocket. But the out-of-pocket expense can also vary widely depending on the type of insurance plan being used, and whether or not the treatment is covered by Medicaid, the state insurance plan.
Only two states — Minnesota and Missouri — provide broad support for D.B.T., according to Anthony DuBose, the head of training for Behavioral Tech, an organization that trains D.B.T. therapists. He cited another reason for the relative scarcity of D.B.T. counseling: Some therapists fear that the therapy is too intensive and might overtake their available time. “We need to convince mental health providers they can do this,” he said.
The up-front costs can be worth it in the long run: Several studies compiled by researchers at the University of Washington suggest that D.B.T. interventions, while initially costly, can reduce the need for expensive, repeated emergency room visits. According to the university’s Center for Behavioral Technology, D.B.T. is cost-effective, and “accumulating evidence indicates that D.B.T. reduces the cost of treatment.”
D.B.T. books and manuals on Dr. Rathus’s shelf office. Credit...Gabby Jones for The New York Times
Slimmed-down versions of D.B.T. exist, and they may also work for adolescents experiencing self-harm and suicidal tendencies, experts said. But, these experts cautioned, many of these emerging variations have not been studied with the same rigor as the fuller treatment.
Anecdotally, adolescents who have had some D.B.T. or C.B.T. training appear better equipped to deal with distress and suicidal feelings, according to Dr. Stephanie Kennebeck, a pediatric emergency room doctor at Cincinnati Children’s Hospital who has researched therapeutic approaches to suicidal impulses.
Dr. Kennebeck said she had witnessed the value of the training firsthand in cases when adolescents arrived at the emergency room overcome by their intense emotions. Teenagers who had not had therapy and had no training to fall back on often needed to be kept at the emergency room longer, until they could be placed in a treatment program, Dr. Kennebeck said. She added that she felt more comfortable sending a child home if they had some sense of how to navigate difficult emotional situations.
“Those patients who have already had some C.B.T. or D.B.T. have the ability to name what their emotion is, tell me how their emotion can translate into what they’re going to do next,” Dr. Kennebeck said. “That is invaluable.”
There are many therapeutic models that help address different emotional issues including anxiety, depression and trauma. When acute behavioral risk, like self-harm and suicide, is a concern, the American Foundation for Suicide Prevention recommends a number of options beyond D.B.T., including CAMS, which has been shown in studies to be effective at reducing suicidal thoughts, and cognitive behavioral therapy for suicide prevention, or CBT-SP, which has been shown in studies to be effective in preventing further suicide attempts in adults with at least one prior attempt.
Therapy for parents, too
In D.B.T., the adolescent isn’t the only one learning. Parents are trained to validate the feelings of their teenagers, as irrational as those feelings may seem.
“The mistake parents make, even well-meaning and loving parents, is to minimize the feelings,” Dr. Rathus said. Telling a distraught adolescent “to just go for a walk, or focus on schoolwork, is like telling them to climb Everest.”
She said that the adolescent cannot hear the words, and they quickly “learn not to trust” strong feelings or emotions. Parents take group classes where they are guided to understand what teenagers are going through and taught specific ways to address the distress.
Valerie, an executive in Silicon Valley, described her family’s experience with D.B.T. (She asked that her last name not be used to protect their privacy.) Midway through 2021, Valerie’s 12-year-old daughter grew increasingly distraught; once a solid student, she began acting out in school, suffered seemingly uncontrollable meltdowns and became obsessed with her appearance and weight.
The girl started D.B.T., and Valerie took the parental instruction, which taught her more effective ways to respond to her daughter, she said — for instance, by first validating the girl’s painful feelings rather than immediately proposing a solution.
If her daughter is afraid to deal with a difficult subject or teacher in school, Valerie tries to reframe the fear: “I’ll say, ‘OK, you’re going to have this bad experience. So, beforehand, get some good sleep, have some good snacks, arrange to meet a friend after, bring a little fuzzy bear to class.’”
Valerie added: “It’s like filling up your gas tank before you go on a long trip.” She said the concepts were ones she had begun to adopt in her own life as she examined “worry thoughts,” such as, “Will I be lonely after I sell my business?”
She said that her daughter was improving. “It’s helped her get out of feeling hopeless or stuck in things,” Valerie said. “She’s catastrophizing things less” and “no longer going down rabbit holes she can’t get out of.”
Support and Info for
Self Harming Youth and their Parents
Trans Affirming peer crisis line
US (877) 565-8860
Canada (877) 330-6366
Short and excellent explanation of Anxiety for Teens
Helpful website with tips for shutting off the fight/flight Response:
If your LGBTQ+ child is struggling with trauma related issues, body image issues, self harming/suicidal ideation, alcohol/drug abuse, and many other issues; these organizations offer services and help in a safe and supportive environment. DO NOT send your child to any recovery or treatment center that does not clearly state and outline their protections and treatment approach for LGBTQ+ youth.
The Recovery Village
Rehab Spot : LGBTQ friendly