Happiness Blog

OPPOSITIONAL DISORDER & CONDUCT DISORDER: TREATMENT, PREVENTION AND WHAT PARENTS CAN DO

Many children and teens display many of the symptoms of Oppositional Defiant Disorder (ODD) and CD at times, but there are some ways to tell whether your child suffers from the disorder. (Click here if you need a description of the symptoms of ODD and CD.) If these behaviors disrupt social and/or academic functioning, and are consistent (do not only happen as a result of an “episode” or mood swing), your child could be diagnosed with ODD. As a parent, you may see some signs that you are dealing with a child or teen with ODD, such as the feeling that you must always be on your toes to avoid an outburst, these behaviors are creating problems in the family, or setting boundaries and consequences does not stop the behavior.

There are many causes of ODD, including biological defects, genetics, and environmental influences such as dysfunctional families and a history of substance abuse. Before taking any action, it is important that a psychologist determines whether your child actually has ODD and identifies what types of treatment to use.

Since there are many similarities between the symptoms of ODD and conduct disorder, it is important that a psychologist determine how serious the symptoms are. Both disorders include defiance, difficulty in school, disobedience, anger and resentment, and disrespect for brothers and sisters. However, one thing a psychologist may look at to differentiate between the two is how the child or teen treats animals. If he or she is cruel or physically abusive family pets, conduct disorder may be the more likely diagnosis. Legal trouble is another indicator of the more serious conduct disorder rather than ODD. Multiple instances of criminal behavior like setting fires, breaking and entering and assault are consistent with a diagnosis of conduct disorder.

Although a psychologist should implement the treatment, parents are often the most effective resource in helping their children deal with ODD and conduct disorder. The most important thing for a parent to remember is never to give up on your child or yourself and to realize that sometimes it is necessary to change some of your own behaviors in order to change your child’s. For example, always be supportive and understanding, and praise and reinforce positive behaviors. Your child’s psychologist can help you determine ways you can be most helpful and be part of the solution. A psychologist can teach you additional skills to elicit cooperation, including setting appropriate limits and developing effective intervention plans. Some helpful tips for parents of children with ODD and conduct disorder include:

• Always focus on positive rather than negative behavior; give positive reinforcement when your child exhibits cooperation or obedience
• Set reasonable, age-appropriate boundaries and be consistent when enforcing them. For example, if your child refuses to do his or her chores, punish the behavior in the same way every time.
• Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child.
• Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don’t add time for arguing. Say “your time will start when you go to your room.”
• Don’t take on the burden of managing your child by yourself; try to get help and support from other adults in the child’s life like your spouse, teachers and coaches. Maintain your other interest so that your child’s ODD doesn’t consume all your time and energy.
• Manage your own stress with exercise and relaxation.
• Make sure your child gets plenty of sleep every night.
• Develop a consistent daily schedule that incorporates your own and your child’s interests, and get into a routine.
• Work with your child to pinpoint the emotions or anxiety that may be maintaining or worsening their symptoms.
• Encourage your child to join extracurricular activities or get exercise to provide an outlet for pent-up energy and stress.

Prevention is a key aspect of the treatment of disruptive behavior disorders such as ODD and conduct disorder. Parents can be instrumental in preventing the disorder from progressing by using parent management strategies recommended by a clinician. Children and adolescents can benefit from psychoeducational programs that help them deal with conflict and regulate their emotions and behaviors effectively. In children, parent management, social skills training, conflict resolution and anger management have been used as effective prevention methods. For adolescents, psychoeducation programs like cognitive interventions and skills training, vocational training and academic preparations can reduce some of the symptoms associated with ODD and conduct disorder.

When choosing an intervention plan, take into account the recommendations of a psychologist because making the wrong decision could be more detrimental than beneficial. For example, residential programs like boot camp are not the right choice for many children and teens. These programs may be overly restrictive and may not enhance your child’s sense of self-esteem and responsibility. School-based programs have showed promising results as well in reducing bullying, antisocial behavior and negative peer influence.

There are several effective methods of treatment for disruptive behavior disorders such as ODD and conduct disorder. Treatment programs should be designed by a psychologist and specialized to each individual child and family’s needs. It must last at least several months to be effective and can occur either continuously or in periodic sessions. Treatment may include individual therapy, family therapy and/or school-based intervention. Sometimes medication is used as part of a treatment plan, but it is rarely effective without being paired with behavioral therapy.

• Cognitive-behavioral therapy (CBT) is a treatment technique that involves changing a person’s thoughts and beliefs in order to change his or her problematic behaviors. CBT is a general term for several different types of therapies that meet these criteria. Previous research has proven it and effective and cost-efficient method for treating ODD and conduct disorder. It can be administered to individuals or to groups.
• Individual therapy
• Family therapy
• Community-based therapy – focus on the child or adolescent in the context of different environments. These include family, school and community influences.
• Social skills training

Lepage Associates offers an extensive list of services geared toward children and adolescents. We provide unique options for adolescents, including a media room that allows teens to express themselves using movie clips, CDs or other media. Some may prefer to sit outside during therapy or take a walk on the America Tobacco Trail that backs up to the office. Our therapists specialize in many aspects of counseling for teenagers, including self-esteem and self-improvement, building positive relationships with friends and family, regulating and understanding emotions, and adjusting to the pressures of school.

The clinicians at Lepage Associates also believe children respond to different methods of therapy and a variety of environments, depending on their individual needs. “Play and talk” therapy for children help them develop social and problem-solving skills, expressing emotions in positive ways and adjusting to school among others. We provide services for both children and parents directed at dealing with childhood disorders, specifically ODD and how to manage it a home and at school.

Dr. Tina Lepage has many years of experience in child development and families and has worked in outpatient settings where ODD and CD were prominent to include juvenile courts and residential treatment programs for teens. She is well able to assess delinquent behaviors in children and adolescents, and offer a treatment plan for stopping these conditions before they progress into adulthood.

The therapy, coaching and consulting that Lepage Associates’ clinicians provides to parents can be beneficial in educating them about their child or teen’s disorder and empowering them to help their child or teen help themselves. Meeting with one of the psychologists who specializes in parenting children or adolescents with psychological disorders will equip parents of children with ODD and conduct disorder with the skills to manage it. Early and targeted therapeutic intervention with the child or teen can be quite effective in eliminating the behaviors and helping your child or teen be a happy and symptom-free.

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EARLY INTERVENTION IN TEEN SUBSTANCE USE: NOTICING RED FLAGS,
CLARIFYING THE PROBLEM, AND PREVENTING FURTHER USE
by Tina Lepage, Psy.D., Licensed Clinical PsychologistEarly intervention in teen substance use is part of deterring the problem. People too quickly think that they have missed the opportunity for “prevention” once a teen uses. Yet, there is still the opportunity to prevent continued use, to make this something that happened a few times versus something that turns into an on-going substance use and abuse problem.

Parents must educate themselves about red flags that may indicate substance use, so that they can respond quickly when a red flag occurs. The American Council for Drug Education website provides the following indicators that have been linked to possible drug use. These indicators should motivate you to explore more and clarify if it is substances causing the symptoms:

1. Sudden decline in school achievement.
2. Cigarette smoking.
3. Marked shift in the child’s friends, especially association with known or suspected drug users.
4. Serious erosion of parental trust in the child.
5. Support by the child for the idea of legalizing marijuana.
6. Marked personality changes. (Such as social withdrawal, a new guardedness in communication with family members, depression, changes in sleep patterns, etc.)
7. Withdrawal from extracurricular activities that were previously important to the child.
8. Cutting classes, tardiness or truancy from school.
9. Deterioration in appearance and personal hygiene, or dramatic image changes.
10. Increased secretiveness, unexplained phone calls, heightened hostility to inquiry, sudden onset of hypersensitivity.
11. Going out every night. (Especially “hanging around” as opposed to scheduled youth activities.)
12. Unexplained disappearance of family funds or family and personal possessions (to buy drugs) and/or appearance of unexplained money or items such as new clothes and CDs (from selling drugs).
13. Aggressive behavior such as recurrent fighting, violent hostility, or other evidence of social alienation from the mainstream.
14. Heavy use of over-the-counter preparations to reduce eye reddening, nasal irritation, or bad breath.

While a red flag does not provide enough indication on its own that your teen is using, each of these red flags should result in some action by the parent to explore what has caused it. Substance use can be ruled out, and early intervention can occur to help fix the problem, whether the problem is substance use or something else.

Parents should keep their eyes and minds open; for example, a teen that keeps Febreze or mouthwash in his or her car or room may very well be using these to mask the odor of cigarettes, marijuana, alcohol, etc. Similarly, a new interest in colognes, incense or scented candles can be used to mask odors. The following practical pointers are provided by the students of Summit School, a Chapel Hill high school for students dealing with maintaining sobriety:

1. If you think that your child is using drugs they are.

2. No one “holds onto” drugs for anyone else. If you find drugs among your child’s possessions it is because they belong to your child.

3. If your child’s friends are using drugs it is likely that your child is as well.

4. Cough and cold products are highly addictive and commonly abused. If you find them in your child’s room and you have not purchased them (or if more has been taken than you know to be reasonable) you have very good reason to suspect that your child is abusing them.

5. Do not wait to get help. Seek the assistance of a certified drug and alcohol specialist as soon as you have suspicion.

Parents often say that after noticing a red flag and confronting their child, they are left feeling totally confused as to what exactly the problem is and how serious the problem is. The teen denies use, or fesses up to using ‘just this once,’ or provides reasons for using, such as to lessen academic pressures and anxiety, social pressure to use, depression, frustration with schoolwork, boredom, etc. Very often the teen promises to never use again. The parent is left with little to no clarity on what the scope of the problem entails, and uncertain about whether or not to believe their child’s assertions that they have used only this once (or a few times), and will never use again. Linda Hammock, a Licensed Professional Counselor and Certified Addictions Counselor who specializes in teens and families notes, “In my 20 years of substance abuse counseling, I have found most parents believe that they have a good idea of what their teen does. When I work with the teens who abuse substances, it becomes crystal clear that their highly functioning and loving parents have been frighteningly in the dark.”

Studies have shown that early intervention is key in preventing a deepening of the problem, yet often parents are not yet concerned enough at that early stage to utilize the two main tools for early intervention: seeking professional help and support, and strong consequences for substance use.

Parents are often very reluctant to utilize an outside professional at this early stage, thinking, “my child doesn’t need therapy just because he or she drank once,” or “this problem is still at a level that I can handle.” However, there are some ways in which a professional can be helpful at this early stage:

(1) It sends a clear message to the teen that the parent takes this behavior very seriously and is highly concerned, and
(2) A licensed mental health professional trained in adolescent substance abuse assessment can evaluate the teen and provide the parent with suggestions for successful early intervention.

It is important to be certain the mental health professional you use specializes in adolescent substance abuse assessment. While at first glance it can seem confusing to determine this, knowing a few important questions can help.

You want to know four main things:
does the person specialize in
(1) teens and families,
(2) teen substance use, and
(3) assessment of adolescent substance abuse.
(4) If the person answers yes to all three, a good follow-up question might be to ask what percent of their practice is spent doing adolescent substance abuse assessments.

One helpful certification to notice is that of certified clinical addictions specialist (still ask the above questions though, because some certified addictions specialists work only with adults).

The parent may utilize the professional for only one or a few sessions, not therapy per se, but to assess the depth of the problem, whether there are issues in addition to substance use that the teen is struggling with, and what treatment resources are most appropriate if needed. In this manner the mental health professional provides assessment of the problem and coaches the parent through the problem. Such an assessment also looks at any factors that may have contributed to the choice of the teen to use, such as social problems at school, depression, academic anxiety, family conflict, etc. While teens may be reluctant to talk openly with their parents about these topics, or may even lack insight as to the effect such feelings or situations are having on their decision-making, a professional assessor can often uncover these. Thus early intervention by a professional can help clearly define the problem in its’ entirety, making parental reaction/intervention more targeted and successful. The assessor can also suggest whether intervention beyond parental reaction is likely needed and act as a resource for treatment information if so.

The importance of a strong consequence to the teen cannot be emphasized enough as the most important component of preventing further use. Parents may give a consequence, though often not a strong enough one that sends a message to the teen, and sometimes even just give a “talking to” the teen, telling the teen not to do it again. When you consider the ‘benefits’ the teen gets from use (looking cool in front of their peers, fitting in with peers, trying something new and daring, relief of boredom, ‘feeling good’ from the high, etc.), a “talking to” is not a deterrent. In the cost-benefit analysis the teen does to determine whether or not to use again, the consequences for continued use must be quite high for use to be deterred. Your reaction to your teen’s first time caught using alcohol or drugs will send the message of just how serious you are about alcohol and drug use not being permitted. Your message should be clear: no alcohol or drug use, in any amount, at any time, for any reason. (The article in this series on setting limits and following through on consequences can help you determine and stick with consequences.)

Many families deal with teen substance use at some point, and parents experience a lot of anxiety wondering whether or not they are doing the right things to prevent further use when it happens. Early intervention is key in preventing a deepening of the problem. Clarify the problem when you notice red flags; inaction is worse than overreaction. If it turns out your teen was not using after all, your child still will have gotten the message along the way of how seriously you will react to substance use should it happen. If your child was using, determine the level of the problem, give strong consequences, and if needed, enter your child into treatment.

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Limits, Consequences, and Follow Through For Teen Substance Use
An article written for the Herald-Sun Newspaper
by Tina Lepage, Psy.D., Linda Hammock, LPC/CAC, and Lynne Johnston, LCSW“Your teen will be offered drugs and alcohol at times throughout his or her middle school and high school years, even if your teen does not seek them out. In these situations it will be of tremendous help to your teen’s decision making if you have set clear limits, and if your teen can predict with certainty that when you set limits, you then enforce consequences when those limits are broken,” advises Dr. Tina Lepage, a licensed clinical psychologist who has worked with teens across the spectrum of alcohol and drug use. She continues, “Many parents struggle with setting appropriate limits for their teens, determining appropriate consequences when teens break the rules, and following through on enforcing consequences. Particularly given the dangers inherent in alcohol and drug use by teens, it behooves parents to prepare themselves with these skills.”

The earlier these limits are set, the easier the parent’s job will be. If firm limit setting is not your area of strength, here are three resources:

1. Positive Discipline for Teenagers: Empowering Your Teen and Yourself Through Kind and     Firm Parenting, Nelsen, J. Lott L
2. Setting Limits: How to Raise Responsible, Independent Children by Providing Clear     Boundaries, MacKenzie, R.J.
3. Parenting Your Out-of-Control Teenager: Seven Steps to Re-establish Authority and     Reclaim Love, Cells, S.P.

Also, we recommend that you seek out a therapist skilled in teen limit setting.

Linda Hammock, a licensed professional counselor and certified addictions counselor, added the following advice, “One of our most important parenting jobs now that our children are teens is to set the rules and apply consequences when they choose not to honor them. That doesn’t mean we don’t expect them to ignore our rules from time to time and test those limits. In fact, it is more likely that they will! In reality, messing up provides really important learning experiences. It forces them to be accountable by experiencing the consequences of their poor decisions and the rewards of their good decisions. It is the rules we set and whether we hold them accountable to them, which communicate our values and teach our kids how we believe they need to take care of themselves.

One of the challenges our progressive community faces is that there are no community norms around our teens’ behavior. There is no agreement as to whether kids should be using substances or not, there is no agreement as to what time is an appropriate curfew, there is no agreement about what level of supervision teens need or where they should be allowed to hang out. This forces each individual family to figure it out alone.” The boxes accompanying this article are a starting point to think about limits and consequences for supervision, substance use, curfew, and car riding.

Written contracts. Every family needs to develop their own set of expectations, rules, privileges, and consequences. It is much more effective if the six (or less) most important rules are written in the form of a contract with everyone’s signature.

Linda Hammock comments, “I consistently recommend that parents choose Zero Tolerance for substance use as their number 1 rule“. However, the parents choose the rules, the teen and parents negotiate the consequences and privileges that are most meaningful and motivating to them. Written contracts that clearly state the rules, the consequences and the rewards up front are helpful. Each rule should state a concrete goal, when and how often it will be monitored, a specific consequence for non-compliance and a specific reward or privilege for compliance. We all too often take compliance for granted and forget to validate it.

Changes to the contract should only be made in family meetings with everyone present and calm…no reactive decisions in the heat of a conflict. A contract enables parents to stay calmer when the teen makes poor choices because the tough decisions are already made. The parent’s entire job becomes implementing the rewards and consequences consistently.”

Privileges. Parents today have much more power than they use. Parents are in charge of many privileges that can be earned for appropriate behavior. Too often parents forfeit their control by giving their teens the message that they are entitled privileges without the responsible behavior that should be expected.

The opportunity to earn privileges is an excellent technique that can be used by every family. Even if you can financially afford to indulge your teen, doing so is a disservice. The world will not be so kind. Here are some privileges that can be awarded for responsible behavior and removed for irresponsibility:

· Cell phone
· Phone
· Allowance
· Management of one’s own money
· Parental signature on work permit
· Transportation to a job
· Overnight stays at your house or at another teen’s home
· Friends visiting
· TV use
· Computer use
· Weekend and evening social activities
· Privacy. Yes, this should be earned with trustworthy behavior! Untrustworthy behavior   can result in random searches of your teen’s belongings. (This is not a violation of privacy if teens are making decisions that put them at risk when you are still responsible for them.)
· Parental signature for off-campus lunch
· Use of car to and from school
· School parking space
· Gas in the car
· Transportation for social events
· Use of a parent’s car
· Parental coverage of teen on family car insurance

Consequences and Follow Through. Dr. Tina Lepage provided the following thoughts on how parental follow-through on consequences helps their teen to make good decisions. “Utilize immediate consequences for inappropriate behaviors of any kind, and stronger consequences for behaviors that are considered highly problematic, typically such as behaviors related to safety issues (drug and alcohol use, physical aggression, threats of violence, driving without a license, etc.). It is best if a teen has learned over the years that his or her parent(s) give immediate consequences when rules are disobeyed, and has learned that some rules (the ‘safety issues’) evoke a very high consequence. Then when confronted with the decision of whether or not to use drugs and alcohol, the teen knows from experience that if caught, he or she will be saddled with a very large consequence. This makes it less likely for a teen to make the initial choice to use.

It is a cost-benefit analysis for the teen, and parents should realize that the perceived benefits to teens may be many, such as looking cool in front of their peers, fitting in with peers, trying something new and daring, relief of boredom, ‘feeling good’ from the high, etc., and those ‘benefits’ are experienced immediately. Thus the teen must also know that the costs will be many and immediate as well.”

Please refer to the four boxes for additional strategies for parents; each box contains suggestions of ways to approach your child on a few key issues and some ideas about words you can use:

Supervision

· If you are spending the night, going to a party or social event or spending a teacher workday at another friend’s house, I will need to speak to the adult in charge to make sure an adult will be home.
· I will not go out of town and leave you and this home unsupervised.
· If you plan to have friends over to our home, please check with me first.
· If you are having friends over to our house when I am not home, here are the conditions:
· I need to have a parent’s name and phone number for each of your friends who is visiting or spending the night in our home.

Substance Use

· Drugs and underage alcohol use are not allowed in this house.
· I am the adult paying for this home, and I am legally responsible for anything that happens here – whether I am home or not. Parents in this community have been prosecuted for permitting use of illegal substances in their homes, as well as legal substances by underage persons.
· I am going to trust that you understand the seriousness of this and that you would not want to put our family at risk by violating my trust.
· If you do violate my trust and I find evidence of illegal substances in this house, I will call all parents (if friends are here) immediately no matter what time of the day or night.
· I will then call the police narcotics officer to meet with us and discuss the seriousness of your actions.
· I always have the right to search your room.
· If I suspect you are using drugs or alcohol, you will be expected to participate in a substance abuse assessment with a professional.

Curfews

· I will set the curfew based on your age and the level of responsibility you show in honoring your curfew.
· I expect you to be home by the time of your curfew.
· If unforeseen circumstances delay you past your curfew, I expect you to call before your curfew.
· Changes in your curfew will occur gradually, in a step-by-step fashion, as you demonstrate compliance with the current curfew.
· “Nothing worth doing happens after midnight.” The primary things that happen after midnight often involve sex, alcohol, drugs, illegal activity, or rebellion of some kind.

For older, responsible high school students 12:30 am (which is really midnight but allows 30 minutes for dropping off friends and transportation) is our upper limit curfew recommendation. Our community norm is much later at this time, so most of our teens will not think this curfew is reasonable. We are responsible, however, for determining the community norms, and only we can change them.

Car Riding

· You are absolutely not to get in a car with anyone who:
– Has had any drug or even a drop of alcohol in his/her system. (This includes marijuana, which does affect eye/hand coordination and speed of reaction – contrary to teenage myths.)
– Isn’t a licensed and safe driver.
– Does not have a seat belt space for you.
– Has other passengers without seat belts.
· You need to have the gumption to ask the driver to reduce speed or anything else necessary to be a safe driver or to let you out of the car.
· If you ever need a ride because you or another driver are not able to drive safely, you may call me at anytime of the day or night to get a ride, no matter where you are – no questions asked.
· Your safety is what is most important to me!

Most parents need support with this process. For more information consult Parent Power Prevents Substance Abuse Before It Starts on www.chhsptsa.org

Tina Lepage, Psy.D., Licensed Clinical Psychologist
Linda Hammock, LPC, CAC
Lynne Johnston, LCSW, Parent and Parent Educator

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Dr. Tina Lepage Answers Questions from Carolina Parent Magazine on
Children and Body Image
(1) Given today’s powerful and omnipresent cultural and media stereotypes about bodies and beauty, do you think parents have any control over how children and adolescents feel about their bodies? Please explain.

Actually, parents have a lot of control over how children and adolescents feel about everything, their bodies included. For example, studies have found that the messages that parents give to their child have more influence on the child’s thoughts and behaviors than messages they get from peers. So parents can help combat unhealthy media and cultural messages about body image by providing healthy messages within the home.

(2) In what ways do a parent’s body image “issues” affect and/or determine those of his or her children? Is it more common for children to have the same or different body image issues as their parents?

In terms of overall self-image, on an internal level children see themselves as half mom and half dad. Thus if mom or dad has a poor body image, the child is at risk for having concerns about his or her own body, and for having low self-esteem around this issue. More specifically, children identify closely with the same sex parent in terms of their vision of what it means to be a man/boy or woman/girl. Since girls are more vulnerable to body image issues (due to societal pressures), and girls take their primary cues from their mom’s attitude about body image stuff, it is especially important for moms to reflect in their words and actions a healthy attitude about their bodies. Conversely, if mom and dad have a positive and healthy body image, the child is more likely to feel good about his or her own body, even in the face of cultural and media images that hold up unrealistic and sometimes even unhealthy body images. However, even with the best body images within the home, parents do need to also provide information to counteract the media and culture.

(3) What are the keys to establishing/nurturing a child’s healthy body image? How early should parents start? Is this a planned process or does it just happen?

There is both some planning and “it just happens” around nurturing a positive body image for your child. The “it just happens” part is what I spoke of above, wherein the parents’ body images have an effect on the child’s developing sense of self. In terms of when to start, it is never too early to nurture a positive body image (and positive self-image overall), though the key is to not have a high focus on the body and instead chose things that flow naturally into conversation. Here are some hints: (1) refrain from making negative comments about people’s bodies in general, and instead focus on the positive and on compliments versus tearing people down, (2) focus on health versus body size, for example, talk about healthy eating versus dieting and exercising for heart and body health versus to lose weight, (3) institute healthy eating and exercise into your family routine, (4) talk about looking healthy versus looking skinny, thin or fat, and (5) compliment your child regularly.

(4) Thinking specifically about ages 10-14, what are the major body image issues and how can parents best support a healthy attitude?

By this age of 10-14, children are very aware of the societal pressure to be thin and attractive, and this includes both boys and girls. The major body image issue for girls is thinness, which can be very difficult to deal with at this age as puberty sets in. This is also an issue for boys, and though there is less pressure to be “rail thin,” there is still pressure to be thin in general and to be “good looking.” The second major issue is more a broad area of the pressure to be attractive, which goes beyond the issue of thinness to things like nose size, acne, wearing clothes that are “in,” etc. Parents can support a healthy attitude by:

(1) having a healthy body image themselves,
(2) having a healthy family lifestyle,
(3) regularly providing information to counteract what the children see in the media, and
(4) teaching the importance of character, personality, and accomplishments over external looks (for example, focusing more on compliments and positive feedback around positive character behaviors, such as helping a friend, doing one’s chores, trying one’s best at school, etc., and accomplishments, such as learning to ride a bike, or doing well in school, etc.).

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ASK THE EXPERT
By: Tina Lepage, Psy.D.Q: Are there dangers of Internet pornography use by adults? Should adults be concerned about their own use of Internet pornography, or even of sexual “relationships” with other adults in chat rooms? For example, I have little time to get out of the house with raising a child by myself and find myself being lured by all the chat rooms for companionship. Do you think developing friendships that could even be considered sexual “relationships” with other adults in chat rooms could be ok?

A: There are two different issues in this question: pornography use by adults and chat room sexual relationships. Let’s look at each of these briefly and separately. To some extent the question of whether an adult should be concerned about their own use of pornography is a personal values question that is not best answered by a neutral, outside expert. However, I will speak to some concerns one might want to keep in mind. Internet porn can be limitless and thus more likely to draw one into an addiction. Unlike a pornographic magazine or video, Internet usage is limitless, and one can spend hours barraged by images. If your child mistakenly learned of your Internet pornography use (and kids are better with computers than we are!), not only would it open up the world of pornography to your child’s awareness, it would also put you in the position of having to explain to your child why you chose to view porn. Pornography tends to give one an unrealistic view and expectation of sex, and it can cause distance, dissatisfaction, and raise concerns within relationships. Whether viewing porn or engaging in an on-line sexual relationship, both take you away from the real world, that is, from getting out and meeting people and pursuing a real relationship. Two dangers of Internet chat room relationships are that with anonymity comes deception, and with anonymity boundaries are more quickly crossed. You never really know who you are talking to, or even if the self-photo they sent is real! This fantasy world can give you a false sense of intimacy and attachment, which in the long run will not meet your needs for a healthy attachment and relationship with another person. Perhaps the most important question here is how to address the problem of having so little time to yourself out of the house that you feel lonely and thus look for Internet relationships. For suggestions on how to provide time for yourself to pursue “real, live” friendships and intimate relationships, see previous Ask the Expert question that addressed this issue. (That question was: I have school age children. How can I make time again for me and find my own identity when I have to often play both roles of mother and father as a single parent? Can you give me some suggestions before I pull ALL of my hair out?)

 

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ASK THE EXPERT
By: Tina Lepage, Psy.D.Q: How do I check on my teens’ activities on-line without making them feel like I don’t trust them or have invaded their privacy?

A: Teenagers are at an age when developmentally it is appropriate for them to want and be given more privacy than they had as children. However – though they might argue to the contrary! – there still must be limits to their privacy, particularly when safety issues are involved. The Internet has not only become a wonderful information resource for teens in a positive way, but has also become a place to easily access pornography, and a place where pedophiles solicit unsuspecting teens, often by pretending to be children themselves, or by pretending to be a caring adult who is interested in the child. Teens generally understand that safety concerns have more boundaries around them than activities that have no harm potential. Explain to your teens that their computer use is not monitored because you disrespect their privacy, but rather because as a parent you are responsible for their safety. Have the computer in a public place in the house so that you can make fly-bys while your teen is on the computer (no different than checking in on them when they have friends over). Review the websites that your teens have visited or even restrict certain websites. This is no different than being familiar with any place your child may spend time, such as friends’ homes, the Mall, or a sports facility, and just as you might restrict your child from going places that you view as unsafe or not in line with values you want them to learn, restricting some websites makes sense. Again, communication is key, so explain to your teen why you are checking on their “whereabouts” on-line. Not computer savvy? Visit a local computer store to learn more ways to set healthy limits on Internet use. Regarding trust, think of the Internet just as you would any place your teen goes. If your teens are honest with you about the “where/with who/doing what/why/when-time spent” then you trust them more and give them more leeway; if your teens lies about the where/who/what/why/when of their activities, then they have earned less trust and get less leeway. Though teens balk at it at times, again, they do understand the concept of trust being earned, and that their actions affect your trust. Lastly, let your teens know that the issue on Internet use is not a you-against-them issue, but rather is something you can become savvy about together. Take time to learn, with your teens, information about safe Internet use, so that they can make healthy decisions on their own too. Many teens, who know what to be aware of, will make appropriate choices.

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Time For Self
By Tina Lepage, Psy.D.Q: “I have school age children. How can I make time again for me and find my own identity when I have to often play both roles of mother and father as a single parent? Can you give me some suggestions before I pull ALL of my hair out?”

A: Juggling being “mom” and “dad,” plus work, can be a challenge! But as your question implies, there is still an importance to finding time for yourself, both for relaxation and so you do have a sense of your own identity separate from your Self as a Parent. Three helpful hints:

(1) Let go of any guilt you have about time for yourself! I don’t say this just for the sake of letting guilt go, but because time to yourself is ultimately also in the best interests of your child. A little adult time or personal time or relaxation time goes a long way to improving mood and thus allowing you to be an even better parent. Plus if you always ignore your own needs, you are role modeling for your children that self-care is not important, and that being an adult and parent is all work and no play.

(2) Plan ahead, and one general plan that can be used regularly is best, otherwise planning itself can get put off. That is, build your personal time into your weekly schedule, don’t wait for there to be “time” for it. People do best with routines and schedules. Be creative and find what works for you and your family. Maybe Saturday mornings are your time to read and relax, or Sundays you go to evening church services, or every other Saturday you go hiking, or every Friday after work you go to happy hour, or Saturday night you participate in a game night or night out with friends… Whatever you do for yourself, build it into your schedule. A regular “me time” schedule, whether weekly, every other week, or once a month, allows you to plan your time more easily.

(3) That brings up the question of child care for some people. Be creative! If you can afford a regular sitter (every other Saturday night for example), then advertise and find one. It is actually easier to find a sitter to work a regular schedule than to scurry to find a sitter for occasions as they come up. If you cannot afford a sitter, perhaps you can barter with a friend. For example, if you like to cook, maybe you can make a favorite meal in exchange for a night of child care. Or the most direct exchange is to swap child care services between yourselves. Also, accept all of the help that you can get! If a friend or family member offers free child care, graciously accept. By taking time for yourself, you will feel better and be role modeling a more balanced lifestyle for your child.

 

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Children Left Alone
By: Lepage Associates’ Staff Psychologist

Q: “What is an appropriate age to leave your child home alone, and how long should you start initially leaving them alone?”

A: Most states do not have regulations or laws about when a child is considered old enough to care for him/herself or to care for other children. Currently, the few states that do have guidelines or recommendations state anywhere from age 8 to age 12 as appropriate. According to Child Protective Services (CPS) of Wake County, there is no written guideline as to what age is appropriate for a child to be left at home in North Carolina. CPS did state that due to fire regulations, a child under the age of 8 is not to be left alone in a dwelling.

However, the decision is generally left to parents to make on an individual basis. Parents are reminded to consider the following before leaving a child alone:

• How mature is this child?
• How long will the child be left alone?
• What does the child have access to in the home that might be dangerous?
• Does the child know what to do in case of an emergency?

If you feel comfortable leaving your child alone after answering the questions above, it is typically best to start with a short period of time, such as an hour, and increase the time from there as you feel comfortable. Make sure children always have a list of phone numbers to call in case of an emergency.

 

ASK THE EXPERT SERIES
By: Lepage Associates’ Staff Psychologist “What is an appropriate age to leave your child home alone, and how long should you start initially leaving them alone?”

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“I have school age children. How can I make time again for me and find my own identity when I have to often play both roles of mother and father as a single parent? Can you give me some suggestions before I pull ALL of my hair out?”

Click here to download the article as a PDF

“How do I check on my teens’ activities on-line without making them feel like I don’t trust them or have invaded their privacy?”

Click here to download the article as a PDF

Are there dangers of Internet pornography use by adults? Should adults be concerned about their own use of Internet pornography, or even of sexual “relationships” with other adults in chat rooms? For example, I have little time to get out of the house with raising a child by myself and find myself being lured by all the chat rooms for companionship. Do you think developing friendships that could even be considered sexual “relationships” with other adults in chat rooms could be ok?”

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