Podcast: Redefining Self-Care in Kids & Teens

Episode Transcript

Jenn: Welcome to Mindful Things.

The Mindful Things podcast is brought to you by the Deconstructing Stigma team at McLean Hospital. You can help us change attitudes about mental health by visiting deconstructingstigma.org. Now on to the show.

Jeff: Hi there, and welcome. My name is Jeff Bell. I am a longtime mental health advocate, and I am thrilled to be working with the folks at McLean on this educational webinar series.

Our focus today, self-care for kids and teens. It is an important topic at any time, to be sure, but I think you’d agree that with the many developmental challenges created by the pandemic, it is an especially pressing one right now.

We adults, we seem to know the value of taking time to take care of ourselves, whether that means going for a walk, listening to some relaxing music, maybe sitting down with a good book, but what does self-care look like for kids and adolescents, and how can we, parents, educators, and clinicians, convey to young people just how important this practice is?

What about age appropriateness considerations? Certainly, one size does not fit all when it comes to self-care options. We have a lot of questions, and we know that you do as well. Fortunately, we have an expert with us today to provide some answers.

Dr. Jennie Kuckertz is a research psychologist at McLean’s OCD Institute. She has extensive clinical experience working with children and adolescents. Jennie, thanks so much for joining us today.

Jennie: Thank you for having me, I’m excited to be here.

Jeff: Well, we’re thrilled to have you, and we want to start with a very basic definition. We often hear the term self-care bandied about in a variety of ways.

Practically speaking, and for purposes of our conversation today, how would you define self-care?

Jennie: Yeah, I think it’s the practice of doing little things that improve our well-being, and that can be both our physical and our mental well-being, but there are things that we do that are kind of signaling to ourself I matter and my well-being matters.

And I think, like you said, it is hard, ‘cause self-care can be a lot of things, and I think that’s both the beauty of self-care and also the challenge of it.

Jeff: Because we’re focusing today on kids and teens, I’d like to ask you to zero in on the role of self-care in healthy emotional development. What does the research tell us about that?

Jennie: Oh, it’s hugely important, and I think that there is a lot of research on a variety of aspects of self-care. So, I think social is one aspect.

Kids’ social development and kind of social self-care and spending time with supportive peers is hugely important. Kids also need, and this is important, I think kids need balance, and I’m sure we’ll get into kind of the pandemic, but the pandemic has kind of disrupted kids’ sense of balance.

So, kids need some balance between structured time but also unstructured time to develop their interests and kind of learn how to be with their selves and attend to their emotions, so that’s very important.

And then we have things like exercise, sleep, nutrition. Those are all make a huge difference and things that I think kind of important for us to zero in on today in this conversation.

Jeff: Well, I’m so glad you mentioned the pandemic, because we’d be remiss not to start there. Anecdotally, we hear stories of kids being isolated during the pandemic losing some of their ability to practice social skills with others, for example.

To what degree are you seeing that in your own practice?

Jennie: Oh, it’s huge, and I think we’ve been seeing it throughout the pandemic, but as things have started to kind of normalize in the external world, I think that it’s really hard because kids are still very impacted by the cumulative effects of the last couple of years.

And so, I, in my practice, have seen a lot of increased anxiety, a lot of increased depression, and it’s been interesting, because I would say even in the last couple of months this semester where, again, we’re seeing fewer masks, we’re seeing fewer kind of external impacts of COVID, but I think it’s really catching up to kids and a lot of them are really struggling.

Jeff: Does it go beyond some of the social interactions? For example, I think a lot of us are feeling a heightened level of anxiety-

Jennie: Yes.

Jeff: No matter who we are and what age we are because of the uncertainty around the pandemic. How does that factor into things?

Jennie: Totally, and I think what you see is that we’ve asked a lot of kids over the last couple of years.

We’ve asked them to be really flexible with school, with social, with, you know, kind of how adults around them are impacted, and I think a lot of kids are feeling like their needs have come last.

And so, it’s hard for them to then prioritize their needs or really pay attention to their emotions, to listen to them, and to respond, and I think, you know, adults are trying to support them and their lives, but adults are still very taxed too.

And so, I think there’s really a sense of stress, and I’ve seen a bit of a sense almost of, like, apathy or helplessness sometimes with kids, and I think when we talk about self-care, part of that is kind of taking control of little things that you can do to help yourself feel better.

Jeff: Can you give me an example of those things that we might do, whether for a child or for a teenager?

Jennie: Yeah, I think, first of all, just kind of talking and labeling your emotions, that things aren’t okay instead of plodding on like they are.

And then I think, you know, it’s choosing to jump into new activities or interests sometimes, so maybe going to a new club at school to meet people if you have found that really challenging over the last couple of years to kind of maintain friendships, especially if you’re transitioning to a new high school.

And that’s hard enough already, but now you’re doing that when you don’t know as many people to begin with. So sometimes it’s that, but sometimes it can be, you know, taking 30 minutes intentionally to play a game or to watch Netflix show.

I know sometimes we don’t like to encourage, you know, screen time and TV for kids, but I think it’s more about, okay, I need to spend some time doing something for me, and that can be a variety of things.

Jeff: Jennie, I want to ask you about how we communicate all this to kids, especially the younger kids. We need to speak to them in a language that they can understand. That’s not always easy to do.

Jennie: Yeah, yeah, that’s true. I think it’s important, first of all, that adults model this.

So, if adults and parents, in particular, are really talking about their own self-care and what’s important, that’s the best way to sell it to kids.

Because if you see adults that are very stressed and either, you know, are not talking about that or not doing anything for themselves, then it’s hard for kids to feel like they have permission to do that.

But I think that we just say it’s important to take care of your brain and your body and it’s okay to have emotions, it’s okay to talk about emotions, and we need to listen to our emotions.

Jeff: To what degree do parents sort of dictate what this self-care should look like for a kid or for a teen?

Because it’s tempting, perhaps, for us to define that for them, and yet there is an argument to be made that they need to define that for themselves.

Jennie: Yeah, I think that it is true for kids that a lot of times adults have to figure out what kids need and teach them how to practice self-care, and, you know, that’s because kids are still learning.

They’re still learning how they feel, how to identify emotions, and they’re still learning different ways of self-soothing, for example. But I also think that adults, maybe sometimes out of, like, their own really caring and anxiety, can kind of decide for kids.

And so maybe, you know, on the one hand, you have a parent who really cares a lot about their kids’ social development and sense of self-esteem and mastery, and maybe they, you know, structure a lot of things for them, right?

Well, you then sometimes have kids who are kind of like tired and overwhelmed and burnt out if you push that too far and they need more free time.

And on the other hand, you know, I think especially if a kid is struggling with anxiety, it can feel very much like a parent, like, okay, I need to give them a little bit of space, and sometimes some of that is good, but sometimes actually kids need more structure and support.

And so, I think we’re looking for a healthy middle ground. Parents should be helping support their kids and kind of helping them structure their time, think about self-care activities, but they also, I think, can give their kids a little bit of space to kind of decompress and figure some of that out for themselves.

Jeff: I want to dive a little deeper on this whole concept of modeling for our kids. Talk about some of the dos and don’ts, ‘cause that can be tough for a parent as well.

I mean, again, we’re all stressed right now with this pandemic, and we need to be showing our kids that we can navigate this okay, and yet that adds a separate level of anxiety to this whole challenge at times.

Jennie: Yeah, yeah, it is. It’s really, really hard for parents, and on one level, like, kids pick up on that, right? But, you know, I think just acknowledging it is okay with our kids.

So if you are stressed or worried, you don’t have to kind of, you know, get into all of the reasons why you’re stressed and worried with your kid, but it’s okay to say, “Hey, you know, like, I am having kind of a hard day,” or, “I have a lot of things going on, and that’s okay right now to feel a little bit sad or to feel a little bit worried.”

Just saying it’s okay to have those emotions, I think, goes a long way because it makes it okay for kids to talk about when they’re scared, or they’re anxious, or stressed, or angry. So that, I think, is a basic thing that all parents can do, and it’s good for parents’ well-being too, I think, to acknowledge that.

But then it can be little things too. You know, we could say, “Okay, I’m going to get a snack first for myself before I respond to these emails.” That’s a form of self-care.

Or “I’m going to, you know, take a little break in my room before I come back and do laundry,” but it’s just labeling the little things that we maybe already are doing and explaining to our kids why that’s important.

Jeff: It sounds like communication is a big part of what you’re advocating there.

Jennie: Absolutely, yeah.

Jeff: Let’s talk about age appropriateness, because I realize we’re talking about a broad group of youngsters, anything from young kids to teens.

Can you give us some kind of general guidelines as to where we might draw the lines for what’s appropriate for one age group and what’s not?

Jennie: Yeah, in some ways I actually think that it’s similar. We’re just going to do certain things differently. So socializing, huge aspect of self-care.

If you have a pretty young elementary school kid, parents are going to be really helping facilitate that a lot, whereas for adolescents, they’re going to be navigating it more on their own.

And maybe it’s something that, you know, parents are reminding kids, like, “Oh, I’m, you know, wondering if you want to invite so-and-so to do something with us this weekend.”

I think, you know, watching a show, that might be something that, like, with a small kid, maybe it’s, you can watch that show with your kid and then you’re getting some family time as well. Or maybe for an adolescent, you know, they kind of need a little bit more time to decompress on their own, but, again, I think it’s really similar.

Pets, pets are little micro doses of self-care, which I love for kids, and so sometimes I’ll have kids come up with a list of little, tiny things that they can do when they’re stressed or overwhelmed, so little, tiny self-care nuggets.

And a really common one for kids who do have pets is, like, go pet your dog, and that’s something, again, adults can model, kids of any age can do.

Jeff: Absolutely, pets to the rescue. You mentioned screen time.

Can you speak a little bit to the balance that we might find between using screen time for healthy downtime versus, well, getting glued to our screens for hours on end, which we know, of course, is not healthy for any of us?

Jennie: This is one of the most common struggles that I hear from parents.

And, again, if we think about the pandemic, you have kids on screens even more than normal for a couple of years, and it’s super hard to transition kids off of that when they have spent so much time for their entertainment, for their socializing, for their school.

So, I am not anti-screens. I think screens are, you know, a part of life, and there’s a lot of beautiful things that come with screens, including for kids, but if your kid is really anxious when they aren’t with the screen or there’s just a strong urge to always be in front of the screen, that’s a really good cue that it’s time to step back and try to scale it down.

That can be really hard, but it’s really important that kids do have time not in front of screens so that they can attend to their emotions, so that they can do other social things, other activities, play, art.

If your kid’s really struggling, one thing that can be helpful is if there’s even, you know, an hour a day, maybe it’s right after dinner or right before dinner, that’s kind of a no screen time.

And you can start with that and then expand it out a bit if you need to, but I also tell parents, you know, I wouldn’t overly stress about exactly how many minutes your kids are on the screen, because I just think it’s super hard.

And talking about parent self-care, it’s hard when you feel like you have to set, you know, a rule for your kids that feels impossible to manage when that’s how kids are spending a lot of their time. So, I’d say start with something small.

Jeff: You mentioned family time and family activities. I’m a big believer in those. Can you give us some examples of what they might look like?

Jennie: Mm-hmm, yeah, so, again, it’s going to kind of depend on what parents and the rest of the family have going on in their lives. It’s not always realistic for, you know, family to have dinner and then watch a movie together every night.

That sounds really nice, right, but it’s not going to happen for most families, and so I think having a meal together is really nice, if that’s possible. You can have, like, a little almost self-care ritual.

So, some families like to go around and say, like, one thing that was really good for them that day and then one thing that was hard, and it models that vulnerability and self-care, self-attentiveness.

If that’s not possible because you have kids and they’re at different activities and parents are coming home from work at different times, that’s okay too.

And maybe it’s not that the whole family does something together, but, you know, maybe one parent comes in, and they come and have, like, a little routine right before a kid goes to bed of checking in with them about their day.

Or, you know, maybe it is that they kind of watch half of a Netflix show together, but I think it’s more the practice of showing that we’re doing something, even if it’s little, every day because family matters and you matter to me.

Jeff: Let’s talk about education for a few minutes. Kids and teen spend so much of their time in classrooms. How do you feel, overall, educators are doing when it comes to providing self-care opportunities during the school day?

Jennie: Oh my gosh, I think educators have done an amazing job given the circumstances.

They have so, so much on their plates and really have had to practice so much flexibility and really haven’t had the choice but to attend to kids’ self-care, because I think it’s so showing up in their classrooms, all of these kids who are really struggling with anxiety and big emotions.

That being said, I think it’s a super hard task and teachers are overwhelmed too. So, you know, one conversation that I’ve had with teachers and then also with parents is just the need for some flexibility and grace for these kids.

I think when you see a kid struggling in your classroom, just pausing a moment and remembering that, you know, like, things are hard for this kid. They’re maybe catching up, you know, with kind of what it’s like to be in the classroom and have all of these demands, social and academic, all day.

So, I think stopping and just even asking kids, like, “How do you feel right now? What emotions do you have?” Some teachers I know have those really nice emotion charts with all of the different faces and then the labels for the emotions in their class.

And I think that that’s a really nice way of just having kids orient to that because they can see it on their classroom every day and it gives them the opportunity to think about emotions and different nuanced emotions, and then a little bit of permission to share that too when they’re struggling.

Jeff: What are your thoughts on the appropriate level of dialogue between a parent and a teacher or an administrator at a school in terms of self-care?

If I know that little Johnny needs to take some time during his day to sit down and read a book, whatever the case might be, beyond the schoolwork, is it appropriate for me as a parent to talk to the school?

Jennie: Absolutely, I think that parents should be talking to teachers, and sometimes it can feel like, you know, the teachers have a lot on their plates, which is true, and parents, you know, can feel a little bit like they don’t want to bother their teachers.

And I understand that, but I think it really comes down to being collaborative, right, because the teacher is with your kid all day long every day, and they really want to know what little Johnny needs to succeed too.

Maybe, you know, Johnny does really well with little wiggle breaks, right, like he gets, so parents could say, “You know, when he’s kind of moving around a lot and seems kind of agitated, something we’ve found at home is to get up and just shake it out, so he can even walk, you know, right outside the door to the classroom and come back. Would that work well for you in your classroom?”

But I think giving teachers suggestions is wonderful. That way, they don’t have to do all the work of kind of figuring out what the kid needs, especially if it’s working at home.

Jeff: In the bigger picture of all of this, at a macro level, is the field of education embracing self-care? Do you see a trend line there?

Jennie: Yeah, and it’s so cool, because more and more I’m hearing the kids, I work with talk about how they learned yoga at school, or they learned mindfulness, or they learned deep breathing.

Those are kind of some classic self-care strategies we haven’t talked about yet, and I think that it’s awesome that kids are learning how to make that a practice in their school. I’ve had some kids come to therapy and teach me that, which has been super awesome.

Jeff: Well, let’s talk a little bit more about some of those practices.

As you mentioned, for adults, mindfulness, mindful breathing, meditation, yoga, these are practices that we have found as adults to be very helpful. Can they be adapted for kids?

Jennie: Yeah, absolutely. I think that usually, like in terms of mindfulness, you’re going to keep it a little bit simpler for kids.

So, for elementary school kids, really the best way of practicing mindfulness is just paying attention to breathing, so reminding kids to kind of practice breathing in through your nose, and then you’re going to put your hands on your tummy and you’re going to breathe into your tummy and your tummy’s going to expand, and then you’re going to breathe out through your mouth.

And so, we’ll teach kids how to do that and pay attention internally to what’s happening in their body, and it also helps kids relax too. That’s one of the biggest kind of signs of stress for adults, but also kids, is, you know, we’re not really remembering to breathe appropriately.

So that’s very simple thing for young kids, and then you can do things that are a little bit more advanced as you get older.

Jeff: As you referenced at the beginning of our conversation, nutrition and sleep are important factors here as well. Let’s talk about sort of the holistic approach to self-care for kids of any age.

Jennie: Yeah, so hugely important. I think that, you know, if you not sleeping well and you’re not eating well, it’s actually really hard to feel good.

You’re going to feel bad, and so it’s almost like the first things that you do before anything else is try to work on nutrition and sleep. With nutrition, it’s hard, right?

Like if you are eating, like, the super balanced plate with all the fruits and veggies, that’s wonderful, but I think that the most important thing when it comes to kids is make sure that they’re eating consistently and they’re having snacks.

Especially when you have high school students who are running around to school, to activities, they’re taking the bus, they’re taking care of themselves after school. I see a lot of kids who just forget to eat.

And I will see them for therapy at seven o’clock and they’ll tell me they’re in a horrible mood, and then when we think about it, like, they’ve forgotten to eat anything all day because they’ve been so busy, and so we could stop and we could practice mindfulness and we could practice deep breathing, but they’re going to feel horrible until they eat.

So, the intervention is, you know, okay, let’s get some granola bars and you’re going to put them in your backpack right now and you’re going to have them with you. So that’s something that parents can help kids with too is just making sure that they have snacks available for them.

Jeff: And modeling that behavior as well, I imagine.

Jennie: Yeah, exactly, I think even just saying, “I’m going to have a snack right now,” or like, yeah, like, “Do you need a snack too?”

Jeff: Jennie, you are a clinician. You see a lot of kids with anxiety.

And I’m wondering, are there signs that parents and educators should watch for that suggest that the typical self-care practices such as the ones we’re describing here might not be enough for a young person who is struggling?

Jennie: Yeah, there’s a lot of signs, and I think it’s really important if your kid is struggling to try to connect them with a therapist.

Parents don’t have to do this all by themselves, and they shouldn’t. That’s why there’s people, you know, trained who really specialize in that.

I think, one, if your kid is having a lot of really big emotions that don’t come and go but are pretty persistent, so they’re not just anxious about, you know, a test or a specific friend situation but, like, anxious a lot of the time, then that’s a good time to think about getting some more help.

If your kid is spending a lot of time by themselves, so a lot of time in their room really struggling to kind of do things socially or get, you know, out, hang out with family, that’s another good sign that they might need more support.

Or if you see them, you know, kind of wanting to quit activities or not doing as well in school with grades, that’s another kind of telltale sign.

Jeff: Can you walk us through what’s next for a parent who does notice those warning signs? Are there phone calls that should be made, conversations that should be had?

Jennie: Yeah, so I think the first step is to try to find some names and phone numbers or email addresses of therapists that work with kids with anxiety, if that’s what we’re talking about. So, there are a couple of good resources online.

So, one is Psychology Today, which is a search engine of therapists. You can say what age of kid you’re looking for, what you want help with, anxiety or depression, and that will give you a database of people in your area.

There’s also Anxiety and Depression Association of America, or adaa.org, and they have specialists in anxiety and depression, including those that work with kids, and you can put in your ZIP code and get suggestions for people to reach out to.

Jeff: As we mentioned, Jennie, you work with kids specifically with OCD, and I wonder, because that is an identifiable anxiety disorder, what’s the trend line there? Are folks in classrooms getting better at acknowledging and recognizing something like OCD?

Jennie: Yes, it is getting hugely better, but there’s still such a long way to go. So, one of the other hats that I wear is in OCD advocacy with the local affiliate at the International OCD Foundation.

And one of their big projects right now is called Anxiety in the Classrooms, and so we’re reaching out to schools in our local areas and across the country to educate them on signs of OCD and anxiety and then also resources for the schools.

So, if schools are struggling, they have, you know, a bunch of materials that they can look into, and they also know that the IOCDF is there to kind of help guide schools in diagnosing this and directing them to therapists who can help.

Jeff: Such a great effort, such a great organization, the IOCDF, but Anxiety in the Classroom. I mean, this is a perfect example of where it can be very confusing for an educator.

Little Johnny is not doing well on tests, and it might seem that he has some learning difficulties when, in fact, little Johnny might just have trouble arranging everything on his desk perfectly before he can get started answering those questions.

Jennie: Yeah, yeah, and I am seeing more and more collaboration, too, with the schools in trying to figure this out with parents, with external therapists.

So, I’ve been contacted a lot more in the last year or so by teachers or kind of counselors at school to try to work collaboratively. ‘Cause I think you’re right, it’s really tricky if you’re just seeing the kid at school and they’re struggling to get through the test.

Is it ‘cause some numbers are good or bad or they’re worried about it being perfect, or is it ‘cause they’re spacing out and it’s an ADHD thing or there’s a learning disability thing? So, I think just talking to everybody in the kid’s life to try to get as much information as possible is where you start.

Jeff: I want to ask a few questions here for clinicians who might be on the call with us today. You are a clinician, you are working with younger clients. What do you do if you find that the parents of a client perhaps aren’t really fully grasping the importance of self-care?

Jennie: Yeah, well, I want to say, first of all, that by nature of bringing their kids to therapy, I think parents are really attending to their self-care.

That’s the first step, right, and so I always start with that when having a conversation with parents about, you know, their kid’s self-care needs, is just commending them for doing that, because it’s not always easy to identify that your kid needs therapy.

And then to find a therapist, and then make the commitment to kind of get them to therapy every week. So, we always want to start with, like, what parents are doing really well, and then I think sometimes parents need a little bit of reassurance that it’s okay, you know, to focus on the big picture with kids.

And what I mean by that is, you know, I might have a parent who’s bringing their kid to me for ADHD and OCD, and they’re really, really worried about making sure the kid can kind of get to school on time and get through all of their morning routines, you know, and not be late, but the big picture is, you know, the kid is generally doing pretty well at school.

The kid has friends. You know, the kid is getting to sleep, and we can focus on kind of those things too, not just the things that aren’t going right. So, let’s just try to increase the amount of positive things in this kid’s life.

Jeff: Again, from a clinician’s perspective, are there tools that you use, are there approaches that you use to try to convey in an age-appropriate way to kids how important it is for them to take care of themselves?

Can you give us an example, pull back the curtain a little bit, and tell us how you might do that?

Jennie: For kids specifically, not for parents?

Jeff: For kids specifically, correct.

Jennie: Yeah, I think telling them that their emotions are okay and make sense, so I might say, “You know, you’ve been, like, really anxious.

That’s been something we’re talking about, and that makes sense, ‘cause a lot of things have been, you know, kind of hard, and you’re learning how to do things and have a lot of transitions, but it’s also important that we focus on some things that will kind of help you feel better and will be fun for you or help you feel relaxed.”

So, some of it is acknowledging the emotion but then shifting to something that is kind of positive as well to move their attention and to insert that little dose of positivity on top of the stuff that’s hard that we can’t always change immediately.

Jeff: What are some of the yardsticks that you use to measure the success of these self-care approaches?

Jennie: So, there’s a lot of, you know, measures out there of kids’ kind of negative emotions, so the Screen for Child Anxiety and Related Disorders, or SCARED, is good.

And I do include measures like that in my practice just to see is anxiety decreasing, but the bigger yardstick for me is, is this kid living, like, a good life for them? So, am I starting to see that they’re spending more time with their friends?

Do they have things that they’re excited to do in the evenings or over the weekend? And if not, can we work on exploring things that would be exciting or fun for them?

Maybe it’s a Netflix show, right, but maybe it’s an art project that they’re excited to do at home or they’re, you know, like interested in learning how to dye their hair, you know, if parents are okay with that, or paint their nails.

So, there’s a lot of fun creative things, but, like, are there positive things happening in this kid’s life that they enjoy?

Jeff: I want to ask you a question about a kid who might have special needs, and by that, I mean maybe living with asthma, or diabetes, or a mental health challenge that’s been diagnosed.

How do you go about working self-care into the mix of day-to-day coping strategies for that individual?

Jennie: Yeah, I think hugely important, and, again, it’s focusing on the big picture. So, management of the illness, anxiety, asthma, is really important, and management is going to look different depending on the disability.

So going to the doctor regularly, making sure you have your inhaler, that you’re staying away from triggers, you know, in the case of one of those physical disabilities you mentioned.

So that’s really important, because if your physical health, you know, if you’re struggling in that area, it’s really hard to emotionally be healthy, but then I think it’s stepping back and looking at the bigger picture, right?

We don’t want kids to be defined by their disability or diagnosis. We want them to really be thinking about living a full life in terms of sports, or friends, or family, or hobbies, activities, and spending a lot of time paying attention to those things because, guess what?

If we don’t talk about those things in therapy, if we only talk about the diagnosis or disability, that is not teaching kids how to think big picture, so we have to teach them how to do that by talking about that.

Jeff: Let’s zero in on teens for a few minutes. They can be complicated animals sometimes in the best of situations.

Jennie: Yes.

Jeff: How do we deal, as parents and educators and clinicians, with the specific challenges of dealing with teenagers who perhaps might think that they know everything already and certainly don’t need Mom or Dad or an educator or a clinician telling us what to do?

Jennie: Oh my gosh, yeah, what a wonderful question, and it’s a big question too. I think giving teens some space just to listen to them is important.

Kids get a lot of information thrown at them and they have the experience of, you know, a lot of adults telling them things, or what to do, or what they should be doing, and I think that just stepping back and, like, asking, like, “How are you feeling?” or, “What do you think about this?” and just listening.

Even if you disagree, that’s okay. I think a lot of kids just need space to talk and to feel like that’s okay, and you’re showing them that, like, you’re a safe person for them to come to if there are things in their life that are hard, so I like to just start there and keep it simple.

Jeff: I can tell that some of the questions that are resonating with folks out there right now are specific examples of what we might do for self-care with kids and teens.

Since we’re talking teens, let’s start there. Can you give us any specific examples of a self-care practice that might work well for a teenager?

Jennie: Yeah, so if we go back to sort of, like, mindfulness and meditation, I think there’s some apps like the Calm apps that some kids I work with really like.

And so, some of them will have that on their phone and they will have a habit of listening to one kind of mindfulness or imagery exercise before they go to bed, and some kids find that that’s really helpful for calming down their brain and just being able to relax enough to get to sleep a little bit easier.

So, I think that’s one that, you know, maybe is a little bit harder for young kids but works well for older kids, and, you know, I think also just having, like, a craft that they do like once a week. I mentioned the nails before.

I have one kid who on Sundays does her nails, and it’s a kind of simple thing, but it’s fun for her. She gets excited about, like, how she’s going to paint it, and she enjoys, like, collecting all of the different types of nail polish and coming up with design ideas and feels, like, really proud about that too ‘cause people compliment her.

She’s gotten really good at it. So, like some little dose of either relaxation or excitement.

Jeff: What about relationship challenges for teenagers? How do they factor into all this?

Jennie: Oh my gosh, it’s so hard at any time, I think, navigating relationships. As teenagers, there’s so many changes to your social group and yourself.

Again, I think just giving teenagers some space to talk about it, if they want to, is good, and also trying to provide the support as parents for them to develop new social relationships.

The other thing I’ll say, and this is a trap I’ve fallen into as a therapist and I see parents fall into, maybe the reason your kid is struggling to socialize is because they actually don’t have a lot of, you know, people who are good friends in their circle.

And what I mean by that is, you know, they may be with kids who, like, they don’t have enough options for kids who they want to be friends with, and so part of it is, like, helping take your kid into new social circles and new exposure.

So, for example, you know, if you have a kid who’s LGBTQ and they’re in a kind of small school where people, you know, are not very validating of that or their peers are not very supportive of that, just asking them to hang out and socialize more with those kids isn’t necessarily going to be good for their self-care or well-being.

And so, sitting down and trying to figure out with your kid why is socializing, you know, kind of challenging in that environment, and validating them, and trying to find other spaces for them that are going to be safer and more supportive and validating.

So that’s just one example that I think that happens a lot for teens, you know, as they’re starting to share their identities and really know themselves too in a variety of ways.

Jeff: I have to ask out of curiosity, do you find that kids or teenagers are more or less reluctant to do therapy with a professional?

Jennie: It’s kids and teenagers compared to adults or compared to what they were before?

Jeff: Compared to what they were before.

Jennie: Oh, I see a huge amount of openness. I mean, I am so impressed with kids and teens oftentimes being the ones to tell their parents, “I want to go to therapy,” and I think that a lot of it is actually a positive effect of social media and TikTok.

You have a lot of teens who are on these platforms who are talking about therapy in kind of a positive light, are really normalizing it, and I think it makes it okay for kids to do that.

So, for all I think there’s many things that, you know, aren’t great about social media and TikTok for teens, but I’d say that that has been, like, a hugely positive influence and has changed really rapidly in just a couple of years.

Of course, there’s still a lot of work to go, but I’m super encouraged by it.

Jeff: That is encouraging, and I think you’re speaking specifically to the stigma aspect of seeking treatment, correct?

Jennie: Yes, yeah, absolutely.

Jeff: What about getting a teen versus getting a child to open up to you? What are those unique challenges of those two groups?

Jennie: Yeah, I think it’s different, and, look, it depends so much on the kids too, like I’ve had teenagers who come to therapy and they’re like, “Okay, like, here’s my agenda. Like, this is what’s going on for me that I want to talk about.”

And some kids kind of, like, know as a general idea therapy is good and they want to do it, but they have no idea how to, you know, even start, and so I try to really be patient, like it’s okay if kids aren’t opening up about their emotions or the hard things, you know, in the first, you know, session or even, like, the first month.

I think, you know, you just have to, as a therapist, meet the kid where they’re at and keep creating space to share emotions and, you know, asking questions about their life, but really just getting to know them so that they feel comfortable enough.

Because it’s a privilege for kids to share the hard things in their life with you. It’s not something, like, that they are obligated to do just because we’re therapists.

Jeff: Let’s talk a little bit more about the family dynamic and maybe specifically parents in terms of dealing with, maybe, cyclical challenges that come up. The back-to-school cycle, the start of summer activities, and the loss of some social structure.

What can we proactively be doing to sort of anticipate those junctures and provide self-care opportunities for our kids?

Jennie: That’s such a great question, and I think the first thing is just noticing what the patterns are.

So, I know we’re coming up on a holiday break, and breaks are wonderful. Kids need breaks, adults need breaks, but that’s also a time where, right after break, I start getting a lot of phone calls about, like, how things have been pretty hard, ‘cause it’s a pretty consistent trigger for a lot of kids.

And so, I think sometimes, you know, it’s because there’s a lot of family stressors around the holidays, for example, and kids are kind of with a lot of different groups of adults all at the same time and it’s super overwhelming or overstimulating.

And so, if that’s a trigger for your kid, then, you know, we want to then build in breaks for the kid or maybe space out some of, like, the holiday get-togethers if at all possible, or just talking to our kids about, like, how do you feel about doing this?

You know, sometimes I get overwhelmed too when, you know, I’m going to this many things with family, and I just need some space to take a nap or to chill out. So, trying to just identify those triggers and then make little changes to your routines if you can.

Jeff: Let me ask you hypothetical on behalf of a parent who might be watching right now, has a couple of kids, let’s say one’s a teenager and one is an eight-year-old. Family activities, I mean, you’ve stressed the importance of those.

Can you walk us through an activity that just comes to mind that we might all do together just as a practice of good self-care as a family?

Jennie: Yeah, I think having a meal together is really the classic thing, and maybe it’s, you know, I think as much as we love the idea of families eating meals together every day, like, that is just not always possible, and that’s okay.

Maybe it’s like on Friday night you get pizza together, so it could even be like a once-a-week thing. It’s more about the commitment to, like, showing your kids this matters, doing something as a family matters, and this is a time that we spend that we try to do together even though we’re flexible, right?

Like sometimes things come up, you know, on the day that we’re planning to do something as a family, and that’s okay if one person can’t make it, but we’re just doing the best that we can to prioritize this in our very, you know, busy and sometimes stressful lives.

Jeff: Jennie, we’d be remiss not to ask you about the well-being of adults who are caring for kids. That whole notion of putting the oxygen mask on yourself before you put it on your kid, it goes beyond modeling, it goes beyond that aspect of what we’re talking about.

It’s just basic self-care for caregivers. Can we talk about that for a few minutes?

Jennie: Totally, and, you know, I think parents really struggle with this because, you know, there’s this feeling that, you know, if your kid is struggling, that’s where all your attention should be.

And I totally understand that, because parents, you know, love their kids more than, you know, anything else, right, but when kids are really stressed, it’s stressful for adults too, and the oxygen mask metaphor is so true.

If you don’t have yours on, it’s going to be really hard to help your kids, but I think that the more really compelling thing for parents is just the importance of modeling. It is so important, and sometimes that means parents seeking their own therapy too if things are really hard.

I will tell you, and I mean this sincerely, some of the kids who have really benefited the most from therapy are the ones whose parents go to therapy and who tell their kids about it and frame it in a positive way.

There is nothing that destigmatizes therapy more than parents going, and conversely, if parents have never gone to therapy or don’t talk about the idea, you know, of therapy or bristle, you know, if that’s brought up, kids are going to have a really similar reaction.

They’re super smart, and as much as it doesn’t seem like it, you know, they are watching you like a hawk and, like, learning their cues about what’s okay and what’s not okay based on parents.

And so, modeling any type of self-care, going to therapy, making sure you have snacks, doing yoga or meditation or exercise or bedtime, kids are going to pick up on that.

Jeff: Let me circle back to a question that we talked a little bit about. When a child, there are flags that something more than general self-care is needed. What about for adults?

When is that threshold crossed where it might be that they need professional care as well for some of the stresses that they’re dealing with around parenting, for example?

Jennie: Yeah, I think the word burnout is something that a lot of people resonate with, and burnout can be professional, but, you know, it can also be at home too.

And it’s where you just feel like you’re not getting a lot of satisfaction or meaning, necessarily, out of the things that you’re doing, that spending your time where you just feel completely depleted, completely fried.

And I think starting with, like, a lot of basic self-care like we’ve been talking about is really important, but if that feeling is really persistent or you feel overwhelmed by it, then I think that therapy can be super helpful.

Even, you know, it doesn’t have to be that you see a therapist for a super long time, but even seeing a therapist for a really short amount of time, I think, can be really helpful in just, like, showing yourself that it’s okay to struggle and it’s okay to model for your kids that you’re struggling and it’s okay to get help.

And that’s what we want, you know, everyone in our family to be doing.

Jeff: And speak to a parent who might be viewing right now that feels it might be, I don’t know, less than good parenting to go see a therapist right now. Perhaps they’re dealing with some stigma around that. Can you speak to that?

Jennie: It’s so hard, and, look, I think adults, we’ve grown up in a totally different era with a lot more stigma and less understanding of mental health, and, you know, I think we can provide something different to our kids so we can, you know, show that this is okay, and it does take some bravery, and we’re also doing the best that we can.

So, if you have been struggling with some of these things that we’re talking about, welcome to the club. It’s super hard. I try to model this too.

I believe in modeling so much, so I will model some of this with parents, things that, like, I am struggling with or where I don’t always practice what I preach, just to say, like, it’s okay if you don’t feel like you’re doing things well and you want to do things better.

Those can both be true at the same time, and, you know, that’s part of this human experience.

Jeff: You mentioned burnout with adults, and I’m so glad you used the term, ‘cause it’s an important one with not only adults but kids as well.

Do you find that kids and teens experience school burnout or other types of burnout that can be addressed with self-care?

Jennie: Yeah, yes, yeah, and I used the Netflix example a couple of times today because I had, you know, a kid, actually a couple kids recently I’ve worked with where they go to school, and then they go to one sport, and then they go to another sport or activity.

And then they do their homework, and they’re like, “I just don’t, like, I don’t even care about these things anymore. I just want to watch, like, a show. Like, I don’t have any time to watch Netflix.”

And I think if you’re getting to that point, like, it’s a sign that, you know, something is wrong. Something actually we haven’t talked about but is hugely important, so I’m glad we had the space to do this, is self-care can also be saying no or dropping some things from our plate for adults or kids.

Kids do not necessarily have to be in, like, every single, like, AP class, or do every sport or every club. Kids need some downtime. Like, there’s no award for burning yourself out, and that’s hard for adults too.

So, saying things like, you know, “I decided not to do this project so that I can spend more time, like, decompressing at night or so that I can spend more time with my family or so that, you know, I have less on my plate,” that’s okay, and we should talk about that with kids too.

I really feel like that’s a huge contributor to burnout, is just feeling like we have to be running at maximum capacity all the time.

Jeff: We can keep going on about this for another half hour or more. What haven’t I asked you about that else you want to share in the final minutes that we have here, Jennie?

Jennie: So, I just really want to reinforce what we were talking about just a minute ago, that it is totally okay if this seems hard, and, you know, self-care can be kind of a stressful thing to talk about.

I actually don’t use that term all the time with families because it almost feels like, oh, man, I should be doing all these self-care activities, and I’m not doing that, like it’s almost another thing on your plate, and so I think that it’s just, you know, taking little moments to put your well-being first.

That’s kind of how I like to think about it, and those little moments can be little things that we do. Having a snack, talking to a friend, even giving ourselves a five-minute brain break between things, you know, to go on the internet, assuming you’re not doing that for, like, you know, three hours on social media.

But they can also be things that, you know, we don’t do, like saying no to things or taking things off of our plate, so, you know, big, small things we do, things that we don’t do. It’s not one-size-fits-all, and, you know, it’s just little by little.

If you can even do one little, tiny self-care thing and label it as, like, I’m doing this, you know, to take care of myself, then you’re on the right track.

Jeff: Jennie, before we let you go, let’s talk a little bit about online resources, books, apps, other forms of self-help care or self-care tools that might be available to people.

Jennie: Yeah, so the Calm app is great, which I mentioned before. There’s another similar one called Headspace, and they have a bunch of, like, little videos and activities, you know, five minutes or so, and so I think that those are great.

There is a small subscription fee, so if you, you know, don’t have the resources to pay for that or you just want to explore, if you actually just go to YouTube and you type in breathing exercise or mindfulness meditation, there’s a lot of good stuff that comes up, and, honestly, that’s a lot of times what I do with kids to explore, so you could do that.

For more structured resources, Anxiety and Depression Association of America is really awesome. They have a link to a kind of find-a-therapist feature that we talked about, but they just have a lot of general information for about, you know, anxiety in kids, and signs of anxiety, and different strategies that parents can try or that you can do in the classroom.

So, I really recommend starting with that just ‘cause they have a lot of research supporting what they’re doing. The International OCD Foundation is awesome for kids with OCD. That would be the first place that I send anybody who’s thinking about that diagnosis, and there’s a lot of folks there that are really eager to help too.

Jeff: Excellent, I cannot believe this hour flew by as quickly as it did. Dr. Jennie Kuckertz, thank you so much for your time. I learned a lot. I suspect our viewers did as well.

Such an important topic. We really do appreciate your time today, and to those of you who are watching and on behalf of all of us at McLean, thank you so much for tuning in.

Jenn: Thanks for tuning in to Mindful Things! Please subscribe to us and rate us on iTunes, Spotify, or wherever you listen to podcasts.

Don’t forget, mental health is everyone’s responsibility. If you or a loved one are in crisis, the Samaritans are available 24 hours a day at 877.870.4673. Again, that’s 877.870.4673.

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The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.

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