Episode Transcript

Welcome to Health Matters – your weekly dose of the latest in health and wellness from NewYork-Presbyterian. I’m Faith Salie.

Whether you’re a parent, caregiver, or just any adult with kids in your life, we all know that children face unique challenges growing up today.

So what can we do to best support children and build resilience? To explore this question and more, I talked with Dr. Anne Marie Albano, co-clinical director for the Center for Youth Mental Health at NewYork-Presbyterian and a child psychologist at Columbia. We talked about how to foster confidence and independence in children and how to keep communication lines open.

Faith: Dr. Albano, thank you so much for joining us.

Dr. Albano: Thank you. And please. It’s Anne Marie.

Faith: Thanks so much Anne Marie. So to get right into our conversation, how would you describe the challenges that kids are facing today when it comes to their mental health?

Dr. Albano: Oh boy. There are many, many pathways that are converging to make things much more difficult for children today and teenagers today than ever before, and there are huge barriers to getting kids access to the therapeutics, the medications when necessary, that could be helpful to them. The thing that we wanna do to help parents to see is the sobering statistic is about children having an anxiety condition for upwards of two to seven years before it’s noticed enough to bring them to treatment. So yeah, your eyes are popping out as you’re hearing this. I’m, I’m sure. And that is because the anxieties kind of can look very, you know, typical: dropping out of activities because I don’t like this anymore having to go to, um, an afterschool program or sport. I’m getting too old for these things. Kids can come up with excuses to cover for their anxieties until they’re not controlling it anymore. And so it takes a long time for parents to clue in, especially if kids are doing well, let’s say in school, that they’re getting decent grades or they’re following along OK. And in fact, they’re suffering in silence.

Faith: So what can parents and caregivers do?

Dr. Albano: One of the things that’s so important we always want parents to focus on, is that we want to raise our children from the earliest time possible to be as independent as they can be.

Faith: Wow. Does that feel different than what so many parents think is good parenting these days?

Dr. Albano: That’s exactly right. So when you think about this, this starts with your infant being able to play by themselves in the crib, put themselves to sleep. This is where, sure, you have bedtime routines with your children, but you are leaving the room before they fall asleep and they go to sleep by themselves. It is your four-year-old who can get up in the morning and come downstairs with a tutu and say, I wanna wear this in the middle of winter. But it’s OK because they’re starting to pick out their own clothes. They’ve gotta struggle with things to become independent and make some mistakes. One of the big things I always work with parents on is your child needs to get up to an alarm clock on their own by the time they hit sixth grade. I want parents who are listening, how many of you have high school students, especially in the junior and senior years, where you are dragging them out of bed in the morning. Well, what we need to do, unfortunately, is you need to let them be late for school if they oversleep. These are things that they have to do on their own to become independent.

Faith: So as kids, especially little kids, learn these skills, it, it might be filled with lots of messy emotions. How can you tell if their behaviors are developmentally appropriate or actually cause for concern?

Dr. Albano: The thing there is if your child can’t adapt over the course of several days to a week with any new situation. In fact, we look at giving kids a good two to three weeks to settle really into the routine of going to school. You know, give them a couple of weeks of settling into the beginning of the school year, but that means they might be crying a bit or whining, but you’re taking them, or they’re getting on the bus and they’re going, not that you’re giving in and letting them stay at home.

The next thing is, are they upset so much that it’s interrupting and interfering with their functioning, their ability to sleep well, their ability to separate from you, is it getting in the way of what are their daily activities, and yours? That interference issue is big. And then the time duration is another. Does it continue for more than those two to three weeks? That’s what we wanna make sure we’re paying attention to.

Faith: So if parents are noticing these things, how should they react?

Dr. Albano: We’re helping the parents learn how to reinforce for the child self-regulation of these feelings, but then going into the situations and learning how to manage them for themselves so the parents become real good coaches and also cheerleaders for engaging.

The first thing we want any of our parents to do, and we all had to learn this ourselves as we’re parenting is just listen to our kids.

Faith: Yep.

Dr. Albano: And, and really catch them at those moments when they are calm and say, you know, I noticed you were upset earlier. Can you talk to me about that? And not put words in their mouth. Not ju- they don’t, they can’t feel judged. If they feel that you’re judging them, they clam up.

Faith: Or if they feel that you’re too quick as soon as they start expressing themselves to offer a solution.

Dr. Albano: That’s you. You nailed it there.

Faith: Yeah, because so many parents think, I gotta, I gotta fix this, I gotta fix this.

Dr. Albano: That’s exactly right.

Faith: And you know what I, when my kids express to me, some tough things that are happening at school, I also always thank them because I want them to keep telling me, even if it’s so hard to hear.

Dr. Albano: That is so right, because you wanna be their place, their refuge, right? For them to come to you, fall apart. You validate the way that they are feeling and how they’re expressing themselves, and then you listen to them and say, okay, how would you like things to go? What do you think are some things you might try? And this is the biggest thing for our kids today. We have to let them mess up. We have to let them make mistakes. You know, not, this is why I say they sleep in, they don’t wake up to an alarm. It’s not gonna hurt them, if in the eighth grade, they go in late. We’ve gotta let natural consequences that are reasonable take hold when they’re young.

Faith: Because every time you let your kid not deal with something, their imaginary fears are confirmed. Is that right?

Dr. Albano: That’s exactly right. They live then in the counterfactual, which isn’t actually true and you don’t know. And they also, there’s two things that happen. They’ll miss out on things that may have gone okay, but they also miss out on learning how, how things actually go in the world. So it’s no matter what you’re, they’re missing opportunities. If you are non-judgmental with your youth as they are growing, you will hear about higher risk situations. They’ll be more comfortable telling you about this, so then you can, as a family, you can talk about how to manage better and take care of yourself.

Faith: As kids move into middle and high school, what are some of the natural things that parents might start to see at this stage as kids start to assert their independence?

Dr. Albano: Yeah, that’s like first and foremost, you want them to be asserting their independence. Remember, as you move into middle school, the expectations change dramatically. The youth is expected to change classes, multitask, um, manage many different things at once, right? And it only gets worse as they move into, uh, into high school. There’s, you know, there’s evaluation expectations and then the social expectations are that mom and dad shouldn’t be, uh, arranging your play dates anymore. You’ve gotta be in charge of your social life.

Faith: Appropriate development is asserting independence as he or she or they enter middle school and high school. But what would you say to parents when there’s family conflict because their child is starting to assert independence in ways that are very challenging to parents expectations and the family dynamic?

Dr. Albano: What I’m asking parents to do a lot of times is think about yourself and how the times have changed in some ways, but also how much trust do you have in your adolescent? I’ll give you some good examples of what we have, uh, worked with our parents on. When your child no longer wants to go to religious services with you. And you’ve been a family of faith, and they are asserting themselves. We find this a lot with high schoolers and what I, I often work with the parents and the kids around here is your high schooler is going to start thinking, your young adult is gonna start thinking for themselves, obviously. And the thing there is, don’t take it as a rejection of your lifestyle and your beliefs and such. It’s this is the period of them figuring out who they are. What I say to the kids is, if your parents are willing to let go of you attending services with them, what are you gonna give them that’s a family activity or things you do together because that’s what we wanna do is make sure you’re all staying connected in a way that you do some things together, but we’re giving to the adolescent. Uh, maybe for now they’re not gonna go to, to services. So it might be that you do a dinner together or you’re cooking together or doing something. So that’s number one. When the youth are asserting themselves in a way that is different from the beliefs, religion, or values of the family in this kind of a sphere. Other things might be they wanna date a little earlier than the parents are comfortable with. And there I have, you have to think about, well, what is the age and what is the parameters? What are they talking about with dating? What time they wanna be out at night for, for curfews. So these are just, these are some of the things that kids push back on in independence.

Faith: With every stage, I think parents have the same question, which is, what can we do ourselves? Which sounds like listen, meet them with respect, connect before you correct all these things. Right? But when do we seek outside help for our kids?

Dr. Albano: If, if you are having to do everything and they are not picking up independence and running with it, that’s a problem. I really say the big thing is if your youth is more and more stuck at home and not doing things with other kids their age outside of the house, we question that. What’s happening there?

Faith: The real sort of red alert is when their world is contracting.

Dr. Albano: That’s right.

Faith: So, let’s wrap up with a question for the adults listening. Helping kids through difficult moments can be so hard on caregivers. I know this, everyone knows this. What can adults do when we are the ones that are on our last nerves, right?

Dr. Albano: Yeah, and this again has to start from the time your kids are young. That you are a living, breathing, human being who also needs sleep, nourishment, exercise, social connections, intimacy. You need that for yourself. Um, what you wanna be able to do is model for your children’s self-care. And I also think it’s very important for us to turn our screens off. We too tend to be online too much or absorbing things through media, too much visual media or, you know, social media. So take time away from that for yourself, too.

Faith: Dr. Albano, thank you so much for sharing these insights with us.

Dr. Albano: My pleasure to be here.

Our thanks to Dr. Anne Marie Albano.

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