Category Archive Child & Adolescent Mental Health

ByStacy Garcia, MA, LPC, NCC

What is Disruptive Mood Dysregulation Disorder?

Have you heard of DMDD, or disruptive mood dysregulation disorder in children? Unless you work in the mental health field, are a pediatrician, or a parent of a child who struggles with DMDD, it’s quite possible that you haven’t heard of this relatively new diagnosis.

13 Facts About Disruptive Mood Dysregulation Disorder (DMDD)

  1. Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnosis (newly found in the  DSM-5, published in 2013) that describes children who have frequent explosive outbursts that seem grossly out of proportion to the situation and inconsistent with a child’s developmental level; in between the outbursts, these children are chronically irritable. The angry or irritable mood should be observed by parents, teachers, and peers (in more than one place, in other words). So if a child only exhibits such behaviors at home, but not at school, then it’s not DMDD. If a child shows symptoms only at school, but nowhere else, then it’s not DMDD.
  2. The DMDD diagnosis was created to more accurately categorize some children who had previously been diagnosed with pediatric bipolar disorder but do not experience the episodic mania or hypomania symptoms of bipolar disorder, and they don’t typically develop adult bipolar disorder. Years ago, many children were diagnosed with bipolar disorder because there really wasn’t a better descriptor of what was going on with the child, but not all of these kids had true pediatric bipolar disorder.
  3. A clinician considering a DMDD diagnosis for a child would look for severe temper outbursts that occur, on average, three or more times per week. Additionally, the child’s mood between outbursts must be consistently and observably angry or irritable. The child must experience this pattern of frequent outbursts, plus conistent anger or irritability between outbursts, for 12 or more months. During this 12-month period, the child must show symptoms consistently, meaning that he doesn’t experience a break of three or more months without DMDD symptoms.
  4. Outbursts, or elevated or expansive moods that last for longer than a few hours or for days on end, are more likely to be signs of mania, which would rule out disruptive mood dysregulation disorder.
  5. The diagnosis of DMDD cannot be made before age 6 or after age 18. The onset of symptoms typically takes place before age 10.
  6. Parents should work closely with their child’s doctor to learn what works best for their child, but in general, medication or psychological treatments (e.g., psychotherapy, parent training, computer based training) are primarily used to treat DMDD. The National Institute of Mental Health (NIH) recommends that psychological treatments be considered first, with medication added later if necessary, or psychological treatments can be provided with medication from the beginning.
  7. The diagnostic criteria for disruptive mood dysregulation disorder are meant to separate children who have chronic trouble regulating their moods from children who are afflicted with other mental disorders that may also express themselves in intermittent outbursts, irritability and anger, including bipolar disorder, autism, intermittent explosive disorder, or oppositional defiant disorder. But DMDD can occur alongside ADHD, a depressive disorder, conduct disorder, an anxiety disorder, posttraumatic stress disorder (PTSD) or substance use disorder.
  8. Children with DMDD may find it hard to participate in activities or make friends. DMDD can impair a child’s quality of life and school performance and disrupt relationships with his family and peers.
  9. Having DMDD increases the risk of developing depression or anxiety disorders in adulthood.
  10. DMDD has a prevalence of 2%-5% and occurs mostly in boys; bipolar disorder affects boys and girls equally and affects less than 1% prior to adolescence.
  11. Before diagnosing DMDD, it is important for the clinician to assess for a history of psychological trauma. Trauma affects many aspects of a child’s life; in the case of outbursts, it is emotional resilience that is impaired.
  12. It is important to recognize that the child is not “just angry,” but very distressed.
  13. Hugging and verbally consoling the child’s distress is sometimes effective and does not reinforce the behavior unless the parent also yields to demands. But once outbursts begin, you can liken them to a bomb going off – there really isn’t a good intervention at that point. Instead, the task of the family, and over time that of the child, is to recognize and better manage the triggers.
ByStacy Garcia, MA, LPC, NCC

How to Help Kids Deal with Their Feelings

Imagine that you’re at work. Your boss asks you to do something extra, and he wants it to be ready by the end of the day. You mean to take care of it right away, but things start coming up throughout the course of the day and you forget. As soon as you get ready to go home, your boss comes to you and asks for the finished piece of work. Oh no, you completely forgot! You try explaining to your boss that things came up, things that couldn’t be helped.

He interrupts you. In a loud, angry voice he shouts, “I’m not interested in your excuses! What I’m interested in is you getting it done! What am I paying you for?!” As you open your moth, he says, “Save it,” and walks off to the elevator.

You finish gathering your things and leave the office. On the way home you meet a friend. You’re so upset that you find yourself telling her about what just happened.

picture courtesy of Pixabay

Your friend tries to “help” you in eight different ways. And as this example from “How to Talk So Kids Will Listen & Listen So Kids Will Talk” by Adele Faber and Elaine Mazlish asks, as you read each response, tune in to your immediate “gut” reaction:

Denial of Feelings

“There’s no reason to be so upset. It’s foolish to feel that way. You’re probably just tired and blowing this whole thing out of proportion. Surely it’s not as bad as you make it out to be. Come on, smile…”

The Philosophical Response

“Look, life is like that. Things don’t always turn out the way we want. You have to learn to take it in stride. In this world, nothing is perfect.”

Advice

“You know what I think you should do? Tomorrow morning go straight to your boss’s office and say, ‘Look, I was wrong.’ Then sit down and finish your work, and don’t get trapped by those little things that come up. And if you’re smart and you want to keep that job of yours, you better make sure nothing like that ever happens again.”

Questions

“What exactly did you have to do that could have possibly caused you to forget a special request from your boss? Didn’t you realize he’d be angry if you didn’t do it? Has this ever happened before? Why didn’t you follow him when he got mad and left so you could explain again?”

Defense of the Other Person

“I can understand your boss’s reaction. He’s probably under a lot of pressure. You’re lucky he doesn’t lose his temper more often.”

Pity

“Oh, you poor thing. That is terrible! I feel so awful for you, I could cry.”

Amateur Psychoanalysis

“Has it ever occurred to you that the real reason you’re so upset by this is because your employer represents a father figure in your life? As a child you probably worried about not pleasing your father, and when your boss scolded you it brought back your early fears of rejection. Would you say that’s true?”

Empathic Response

“Boy, that sounds like a rough experience. To be yelled at like that in front of those other people, especially after having been under so much pressure, must have been pretty hard to take!”

What was your “gut” reaction?

Okay, so what do you think? What was your “gut” reaction after reading each of the different types of responses your friend gave you? Did you leave your friend feeling better or worse? Heard or unheard? Like your friend had your back or not so much?

Maybe you’re thinking Adele Faber and Elaine Mazlish were being a little extreme. But were they? Though the situation might be different, I can recall so many times when I’ve responded to my own kids in each and every one of these ways!

Fortunately, one of these responses is more helpful than the others. Whether you’re listening to your child tell you about how awful it felt to have to go in from recess today or how terrible it felt when their science teacher unwittingly singled them out when they called upon them in class or even just listening to a friend talk about their rough day at work, using an empathic response will always prove most helpful.

The Language of Empathy

An empathic response demonstrates that you’re really trying to tune into the feelings of the other person. Kids (and adults) can usually help themselves if they have a listening ear and an empathic response. Kids don’t always need advice or pity, and they’re probably not going to be ready for you to defend the person that hurt their feelings when they first come to you after something as such has happened. And denying their feelings is going to affect them for the worse, whether it be in the short-term or long-term (or both).

picture courtesy of Pixabay

Unfortunately, the language of empathy doesn’t come so naturally to us. Most of us grew up having our feelings denied, often unintentionally by well meaning people. As “How to Talk So Kids Will Listen & Listen So Kids Will Talk” delves into, to learn a new language of acceptance, we have to learn and practice its methods. It might not sound natural to you when you first start trying to use an empathic response, but keep with it… It’s well worth it.

More important than any words we do use is our attitude when we respond. “If our attitude is not one of compassion, then whatever we say will be experienced by the child as phony or manipulative. It’s when our words are infused with our real feelings of empathy that they speak directly to a child’s heart.”

Stay tuned in, I’ll be giving you some helpful tips on communicating with your children in future posts. And if you’re interested in learning more yourself, I highly recommend the book “How to Talk So Kids Will Listen & Listen So Kids Will Talk” by Adele Faber and Elaine Mazlish. You can find a link here.

ByStacy Garcia, MA, LPC, NCC

Spend Meaningful Quality Time with Your Child while Instilling Kindness: 45 Random Acts of Kindness You Can Do with Your Child This Week

While checking out Facebook one day, I found a great video by Kristina Kuzmic in which she suggested an awesome activity to do with your kids. The video showed her and one of her children spending some good quality time together driving around town (which in itself is a good way to connect with your kid) and finding different ways they could do random acts of kindness together.

If you don’t know who Kristina Kuzmic is, I strongly recommend checking her out! Kristina is energetic and she’s really funny while she offers her perspective on issues of parenting and life in general. She does “mom-centric” videos about raising children and juggling all of life’s challenges. She really is great! And the video I watched about how she spends some good one-on-one time with her kids (individually) especially inspired me!

We all hope to instill kindness in our children. And we all know the benefits of spending good quality one-on-one time with our kids. Kristina’s idea offers both! After watching her video, I knew I had to give it a try with my own children. I have two kids – both boys – who are always vying for mom’s attention. Spending one-on-one time with each child can be challenging. Either we don’t have the opportunity or we aren’t quite sure what to do together – at least this is a roadblock I’ve found in raising only boys.

Okay, enough introduction. Let’s get to the acts of kindness ideas, right?! The following ideas are all free or pretty affordable, hence why you can do most of these acts this week if you want to – there’s no prerequisite of having a lot of money.

My challenge for you is to pick a time this week that you can spend some one-on-one time with your own child, then together choose at least three random acts of kindness to do during your special time. Brownie Points: Do something like this once or twice a month if you’re able! Hope you have fun!

photo courtesy of Pixabay

Random Acts of Kindness You Can Do with Your Child This Week

  1. Leave happy notes around town.
  2. Go to a fast food restaurant and grab a bite to eat. If you see someone sitting alone, strike up a conversation and maybe even eat lunch with them!
  3. Help an elderly neighbor take out the trash, mow their lawn, or shovel snow.
  4. Bring a box of donuts to the school custodians or drop them off at a local fire station.
  5. Spend time together making and/or filling out cards to send to soldiers serving in the military.
  6. Bake cookies together and deliver them to a neighbor.
  7. Donate warm coats or blankets to the homeless shelter.
  8. Surprise an older person or couple with dinner. (Drop it off, don’t stay.)
  9. Find someone who looks like they’ve had a bad day and give them a gift card. ($5 for coffee or an ice cream cone)
  10. Offer your child’s teacher your services and help clean or do other tasks for him/her together for the day.
  11. With your child, go through their old toys and donate those in good condition to a charity or local children’s hospital.
  12. Put together care packages for the homeless and distribute them together (either to a shelter or on the street handing them out to those you see in your own town).
  13. Put together care packages for children who have to stay in the hospital (a small stuffed animal, a coloring book, some crayons, etc.); distribute them together.
  14. Put together care packages for parents of children who have to stay in the hospital (toiletries, a word search book with a pencil, a $5 gift card for coffee at the hospital’s cafeteria).
  15. Make breakfast together and bring it to your child’s school teacher.
  16. Fulfill an angel tree request together.
  17. Go to a nursing home together and visit – if it’s a holiday, take something related to the special day and pass them out to tennants (like candy canes).
  18. Leave one dollar bills around a dollar store.
  19. Donate coloring books to a hospital or doctor’s office waiting room, distributing them together.
  20. Take the neighbor’s dog for a walk together.
  21. Challenge each other to smile at every single person you see for one whole day!
  22. Write thank you notes to special people in your lives.
  23. Have a bake sale and donate your earnings to a local charity.
  24. Leave some extra money in vending machines (or tape it to the outside) with a note that says “This treat’s on us!”
  25. Have your child go with you while you donate blood, showing them how easy and how important it is to do it.
  26. Babysit for a single parent or for a couple who desperately needs a date night; babysit together!
  27. Pick up litter together.
  28. If you both can carry a tune, go door to door and offer to do some Christmas caroling.
  29. Challenge each other to compliment at least 5 people in one day.
  30. If it’s Christmastime, help someone (or some place) in your area wrap Christmas gifts.
  31. Go to a local grocery store and together, round up carts and put them in the cart bins or take them inside so they’re not scattered and wandering around the parking lot.
  32. Recycle together.
  33. Wash someone’s car together.
  34. Go to the animal shelter together and offer to walk the dogs.
  35. Bury treasure at a local playground.
  36. Write positive chalk messages on the sidewalk together so you can brighten others’ day.
  37. Donate food to the food pantry.
  38. Tape change to parking meters.
  39. Go to the children’s hospital and offer to read books or otherwise volunteer together.
  40. Sing songs together at a nursing home.
  41. Make get well cards for children at a local hospital.
  42. Make kindness stones together and leave them at a local park.
  43. Volunteer at a soup kitchen together.
  44. Collect books for the library.
  45. Participate in a YOU MATTER Marathon. Click on the link to learn more!
ByStacy Garcia, MA, LPC, NCC

An Interactive Study Skills Activity for Teens with ADHD

I have worked with a lot of kids and teens with ADHD (Attention-Deficit/Hyperactivity Disorder) who have a really hard time in school. Whether they have combination type (difficulty focusing/paying attention and hyperactivity/fidgeting) or inattentive type ADHD, I learned quickly that just reading over a list of study skills for these kids to try was hardly effective. Teaching study skills, especially to kids with ADHD, requires more than providing them with a list and reading over it with them, then hoping for the best. You have to get creative, and you have to make learning more interactive.

I came up with this activity for that very reason. When I would teach study skills to a teen sitting in my office who was struggling in school, I could literally see the boredom in their faces and the lack of focus in their eyes. I would lose them within mere minutes. It was hardly effective. Just as teachers often have to make learning more interactive for all their students, I had to come up with a way to make learning study skills interactive for kids who were already struggling with their schoolwork due to ADHD symptoms.

Let’s Get On to the Activity…

GOAL: Help students learn helpful study skill tips and choose which strategies would work best for them.

“PLAYERS”: Student + a counselor, teacher, or parent

AGES: Middle school through college aged students

ACTIVITY: You can actually divide this activity into three separate activities. This is what I frequently do, as let’s face it, giving anyone a whole bunch of any material to learn at once isn’t always effective. Click on the links for the printable pdf forms of the packets and cards.

Materials – Activity #1:

Materials – Activity #2:

Materials – Activity #3:

Materials – All Activities:

Before the activity, laminate (optional) and cut one copy of the Study Skill Cards for that particular activity. Cut apart each section/block on the Categories sheet; glue each block onto separate envelopes. Each block should be designated its own separate envelope:

  • “Tried it, but it’s not good for me”
  • “Already doing it, and it works”
  • “I’m interested in trying this”
  • “I’ll commit to trying it this week”

ACTIVITY:

Both student and counselor (or teacher or parent) each get a packet for the particular activity you’ll be doing. Each person also receives an uncut copy of the Study Skill Cards page. Each player needs two highlighters of different colors. The laminated, cut study skill cards can be placed between the student and counselor.

The student draws a card form the pile in between them. They then read the study tip. The counselor can also choose to take turns drawing cards from the pile if she wants, but it’s important to keep the student as focused an involved as possible. Don’t “just read” to them.

Next to the study skill tip is a number in parentheses. This number corresponds to the number matching on the packet for the particular topic. For some cards, a more thorough explanation may be found in the packet whereas the card generally holds only a brief description of the strategy.

The student, upon reading the card, determines which envelope they want to place the card in. For example, they might place the “Copy the notes. (4)” card in the “I’m interested in trying this” envelope. The student and counselor then, using a designated color highlighter for this category, highlights the study skill tip on their Study Skills Card page so that they both can remember that the tip is something the student may be interested in trying. If the student chooses to place a card in the “I’ll commit to trying it this week” envelope, the student and counselor would use the other colored highlighter to mark those tips on their individual Study Skill Cards pages.

Encourage the student to commit to trying 1-3 skills in the upcoming week, particularly if they don’t already have very effective study habits. Take note that some strategies are better tried separately and not together with another skill tip (for example, “start with the hardest” and “start with the easiest” are probably best not tried during the same week).

After all (or a majority) of the cards are drawn and designated to their appropriate category, spend the remainder of the time discussing the week’s commitments and forming short-term goals. The student then can take their cards sheet and packet with them to help remind them of the skills and their commitment(s).

For the skills highlighted and designated into the category of “I’m interested in trying this,” keep the Study Skill Cards sheet handy for that student and refer back to it as necessary in the future.

The individually cut skill cards and envelopes can be saved to use with other students.

To all the students out there, happy studying!

ByStacy Garcia, MA, LPC, NCC

Separation & Loss Jenga for Kids (free printables included)

Losing a parent or caregiver is difficult for any child, whether the loss is through death, separation, or removal from their home. Working with these children, they are often found to be struggling with grief and adjustment issues that might show up as a significant change in mood or acting out behaviors. Working with children who have been temporarily separated or sometimes permanently removed from their home can sometimes prove particularly difficult when trying to find creative ways to help them work their way through the loss of their parent or caregiver who has been a significant part of their lives for some time, often since birth.

Losing someone is never easy. While I certainly am not wanting to downplay the loss any child feels when a parent or caregiver dies, children who are separated from their homes, whether temporarily or permanently, face a unique challenge in itself. The child knows their parent didn’t die, so why can’t they still be with them? In cases where there has been neglect or abuse, a child may especially have difficulty understanding an array of confusing feelings… “I love my mom, but I didn’t like how she hurt me. But I feel guilty for not being with her but it’s kind of nice that I don’t have to worry so much or be so scared.”

In some cases, children aren’t even particularly sure why they’ve been separated from their parents or caregivers at all. They may not be given much information or they may not even realize that their parent’s neglect or other inappropriate behavior was ever wrong in the first place. From these kids’ perspectives, they have a really hard time understanding why or even how their lives seemed to suddenly be turned upside down. And sometimes, depending on the age of the child, it isn’t appropriate to offer a lot of details; regardless, it still doesn’t make up for the intense hurt and pain they feel from being separated from the only home they ever knew.

Photo courtesy of Pixabay

Child-centered play therapy, I’ve found, is especially helpful for these children when they are particularly young, but I’ve found that a more directive approach is often needed for middle and older elementary children and pre-teens. Seeking out ideas for techniques to work with these children has continued to result in dead ends. With the exception of a few specific techniques out there on the internet and in books for children who have lost their parent or caregiver not by death but by separation, therapists frequently need to adapt general grief activities for these vulnerable children. While this is certainly not a major problem, I began creating some of my own games, art, and other play activities myself.

The Idea Behind Separation & Loss Jenga

I came up with the idea of creating a Jenga game to help kids who have been separated from their parents or caregivers not long ago. The Jenga game has been a popular therapy tool for many therapists for years, as it can be easily adapted for a multitude of therapeutic purposes just by gluing question strips onto the individual blocks or marking the blocks with various colors and creating corresponding card decks filled with questions to ask or prompts to give children for anything from identifying feelings to learning and practicing social skills.
Coming up with questions for the individual Jenga blocks came easier than I anticipated. There are so many thoughts and feelings in these children’s minds when they’ve been separated from someone they love; pulling these thoughts and feelings out by using traditional methods of talk therapy only tend to work well for some kids (and usually these are the older ones). But give kids an activity or game, and suddenly the same things that a therapist has been trying to help the child express becomes less threatening for that child. There is a lot of psychology behind why and how play (such as playing games or doing other activities) works in the healing of children. Play is a child’s language.  It helps them express what they cannot express in words, whether it be because they don’t yet have the language or because they have been more reluctant or it has been too difficult to talk about such painful feelings.

Photo courtesy of Pixabay

Though I created the game with the idea of being used in therapy between a child and therapist, it can also be played in the child’s new home with their current caregiver(s). Either way, when the therapist or caregiver chooses a question block, they can read the question out loud to the child for him or her to answer or if you feel comfortable in self-disclosing a separation or loss (even if it was through the death of someone you once knew), this can be done also. Regardless of how you adapt the game, just make sure the child you’re playing with knows the rules and what you’re doing before you play. The child may not respond well if they find out after you draw your first question block and direct the question to them if they didn’t know ahead of time that this was what you had planned to do.
It’s also important to validate the child’s answers when he responds to a question. If the child discloses that he feels sad, for example, that he is no longer living with his abusive mother, it will not help for you to say something like, “What do you mean you feel sad? She did nothing but hurt you!” Just. Don’t. Really, don’t.
Even if you think the child’s answer is “wrong” (which by the way, there are no “wrong” answers in this game), validate what they’re telling you because what they’re saying is very real to them. For the earlier example, you could say something like, “It can feel sad when you’re away from a person you love and care about.” Then. Stop. Really. Don’t try to put a “but” at the end of that sentence. Just leave it there. Trust me, not validating something like this isn’t going to help build your relationship with the child. At all. This isn’t the time to refute the child’s beliefs. Please leave that up to after you know more about the child and they are further along in their healing process and have built more trust in you.
(There are no “wrong” ways to feel anyway, regardless of how we might think they “should” be feeling; it’s not up to us to tell anyone how they should or shouldn’t feel. Don’t refute a feeling, even if you’ve known the child for a really long time and you have a good relationship. Give the child permission to feel the way they’re feeling and validate those feelings, even if you disagree or can’t totally understand why anyone could ever feel such a way. Empathize.)
By the way, it’s important to let the child know before you begin playing, that they should only share what they feel comfortable sharing. If they look like they’re struggling to answer a particular question, especially, give them a pass or allow them to answer another question instead. I don’t like forcing children to rush through any healing process. This will also help build your relationship with the child and plant the seed that you’re someone that isn’t going to push him any faster than he is able or willing to go, and that helps to build trust in your relationship.

Photo courtesy of Pixabay

Creating Your Own Separation & Loss Jenga Game

To create your own game, simply click below and print the Separation & Loss question strips. After you print the questions, I recommend laminating the page for durability. Then simply cut out your questions, and glue each individual question onto a Jenga block. The blocks that are left over can be used as “free pass” blocks, blocks that allow the player a turn without answering a question or they can be rapport (relationship) building blocks.

I find “free pass” blocks to be helpful over utilizing each and every block for a question, as it seems to make kids more comfortable and feel less overwhelmed. Rapport, or relationship, building blocks are ones in which you can use questions such as those found below, to lighten the mood and discuss something a little more fun and less heavy. The topic of losing or being separated from someone you love can be pretty sensitive, let’s cut the child a break! I personally use some of the rapport (relationship) building questions AND a few “free pass” blocks.”

In regards to the rapport building questions I have included in this post, you obviously wouldn’t use all of the strips for this particular game or you wouldn’t have many blocks left for the separation and loss questions. You can pick and choose which of both sets of questions you would like to use. Or you might also decide to glue two questions onto each Jenga block, with one side having a separation and loss question and the other side including a rapport building question. This is what I choose to do. This way, if a child does feel particularly uncomfortable about answering a separation and loss question, there’s a “back up” question they can choose to answer instead.

Separation & Loss Jenga Question Strips

Relationship Building Jenga Question Strips

Enjoy playing!

ByStacy Garcia, MA, LPC, NCC

70 Silly Art Journal Prompts for Kids, Teens, and Adults

In my last post, I gave you 55 Art Journal Prompts for Teens, a collection of some of my favorite prompts to use with my clients, as well as for myself. Art journaling can be incredibly therapeutic, and you don’t have to be Picasso to do it. Everyone has some creativity living inside them!

For this post I want to give you some silly art journal prompts, which I also make sure to give to my clients in addition to the more serious ones. It’s important to have fun. It’s important to allow yourself to be silly sometimes. Not everything in therapy (or outside of therapy) has to necessarily have some deep meaning attached to it except for the mere fact that it’s just something fun to do. Seriously, this is an important part of taking care of you. Everyone should make time for play (and I’m not just talking about kids and teenagers right now)!

So here are some of my favorite silly art journal prompts – be sure to definitely give some of these a try!

Silly Art Journal Prompts

  1. Draw you, as an animal, shooting down the moon.
  2. Draw a cat who’s dressed for an interview.
  3. Draw an agitated dog with aggressive body language.
  4. Draw an internet troll.
  5. Draw powerful spirits disguised as kittens.
  6. Draw your dream pet in his pajamas.
  7. Draw a fruity ninja.
  8. Draw a camel surfing the waves.
  9. Combine two animals to create a new one.
  10. Draw a shark eating a cupcake.
  11. Draw a dinosaur at a birthday party.
  12. Draw a horse throwing a horseshoe.
  13. Draw a koala bear sitting on a trash can.
  14. Draw a squirrel roasting a marshmallow around a campfire.
  15. Draw a butterfuly eating a steak.
  16. Draw a cat chasing a dog.
  17. Draw a dog playing ping pong.
  18. Draw your teacher (or boss) eating pizza while dancing.
  19. Draw your teacher (or boss) as a zombie.
  20. Draw yourself with a super power.
  21. Draw yourself as a fairy.
  22. Draw a Pop Tart lifting weights with a cow.
  23. Draw a food eating another food.
  24. Draw a dancing taco wearing a sombrero.
  25. Draw an annoying orange.
  26. Draw a turkey leg eating a turkey sandwich.
  27. Draw a banana in pajamas.
  28. Draw a donut talking to your teacher (your boss).
  29. Draw a garden of lollipops.
  30. Draw an ice cream cone eating a Popsicle.
  31. Draw yourself as a spoiled brat.
  32. Draw a super scary Valentine’s Day card.
  33. Draw a design for a $3 bill.
  34. Draw a pencil sharpener eating something other than a pencil.
  35. Draw a starfish eating a bowl of cereal under the sea.
  36. Draw a pair of scissors running.
  37. Draw your own version of Mount Rushmore.
  38. Draw your teacher (or boss) as a pirate captain.
  39. Draw a battle elf.
  40. Draw a troll riding a unicorn.
  41. Draw what your imaginary friend would look like if we could see them.
  42. Draw a dragon breathing rainbows.
  43. Combine two holidays to make a new one.
  44. Draw the moon fighting the sun over a turkey sandwich.
  45. Draw a crime scene where a donut lost its donut hole.
  46. Draw something really gross.
  47. Draw the moon howling at a wolf.
  48. Draw your name as an animal.
  49. Draw a modest unicorn taking a shower.
  50. Draw your teacher (or boss) in a fight with a small animal.
  51. Draw something from your pet’s point of view.
  52. Draw a dog taking its human for a walk.
  53. Draw the most adorable animal you can imagine.
  54. Draw the most terrifying animal you can imagine.
  55. Draw your teacher (or boss) as an adorable, cuddly animal.
  56. Draw the oldest thing in your refrigerator.
  57. Draw you, getting the last laugh.
  58. Draw your teacher (or boss) as one of Snow White’s dwarves.
  59. Draw a mysterious man in a sharp business suit.
  60. Draw a ballet dancer in a striking pose.
  61. Draw your teacher (or boss) sitting on a bench with a pigeon as they share an ice cream cone.
  62. Draw a shy mouse doing her grocery shopping.
  63. Draw a vampire astronaut.
  64. Draw an unenthusiastic fast food employee.
  65. Draw peanut butter eating a jelly sandwich.
  66. Draw a girl with chocolate skin and cotton candy hair.
  67. Draw a frantic tiger who sees that he’s losing his stripes.
  68. Draw your teacher (or boss) as a Lego figure.
  69. Draw a goldfish driving a racecar.
  70. Draw a snail on a skateboard successfully getting away from a curious puppy.
 
Have fun!
ByStacy Garcia, MA, LPC, NCC

55 Art Journal Prompts for Teens

In counseling children and teenagers, I must tell you that I’ve seen some incredible talent. Some kids are talented musically, some are talented in sports, some are great writers, others are great artists, and some can tell you every country’s capital as though it were as easy as making a peanut butter and jelly sandwich. In every kid I’ve ever worked with, I’ve found an amazing amount of creativity flourishing inside them.

creativity (noun) – the use of the imagination or original ideas

Everyone is creative in their own way. Don’t believe me? Those kids who can rattle off facts like it’s nothing to them? They had to use some creativity in order to be able to memorize and remember those facts, such as using mnemonics or using music. You have to be creative in different ways if you play a sport, remembering all the moves and such.

I hear a lot of kids (and adults, especially) tell me that they’re not creative. They think that because someone told them back in second grade that their drawing wasn’t “good enough” that they themselves are not “good enough.” I say those people that told you that don’t know what creativity is. Everyone is creative!

 

There’s something cool about using art in therapy. Please note that while I know some various art therapy techniques, I am not a fully trained or certified art therapist. I do, however, use quite a bit of creative expressive techniques in my work as a therapist. One technique I use to help show people that they are creative and that creative expression is remarkably healing is assigning them to journal. Whether it’s through writing, music, art, or any other creative expressive technique, we can find healing in our lives.

Let me say that you don’t have to be an “artist” to do an art journal. There is no “wrong” way to do art; there is no “bad artist.” Art is an outlet for the thoughts from your soul to your hands and onto paper. For art journaling, you can draw, you can color, you can paint, you can collage… the possibilities are endless. I’ve included in this post some of my favorite art journaling prompts that I use especially with teens (and even adults!). Please note that just because the prompt might say “draw,” doesn’t mean you have to draw. If you’d rather collage or do some other form of creative expression (like knitting or writing or sculpting, etc.), you can still use these prompts! Don’t overthink them. Just let yourself be in the moment and do it. Draw in the dark if you think you’re “not a good artist!” Just let yourself be. Just try it.

55 Art Journal Prompts for Teens

  1. Draw a picture of yourself as something other than a person.
  2. Draw a picture of your family doing something.
  3. My perfect day looks like…
  4. Draw the monster you struggle with (i.e., anxiety as a monster, anger monster, depression monster).
  5. Make a picture of the person you let other people see and a picture of the person you really are.
  6. Draw a picture of how you think others see you.
  7. What makes me unique…
  8. I feel happiest when…
  9. I wish I could…
  10. Draw or paint your emotions.
  11. Create a picture using only colors that calm you.
  12. Create a collage related to a quote that inspires you.
  13. Create a picture of what freedom looks like to you.
  14. Document an experience where you did something you didn’t think you could do.
  15. Draw or collage someone you admire.
  16. Draw a place where you feel safe.
  17. Create a motivational collage.
  18. Create a timeline and journal the most significant moments in your life, with the most important moments highlighted visually.
  19. Create a picture of an important childhood memory. Try to understand why it was so important to you.
  20. Illustrate a fairy tale about yourself. If you could put yourself into a happily ever after situation, what role would you play? How would the story go? Create a visual story that tells the tale.
  21. Create your own coat of arms. Choose symbols that represent your strengths.
  22. Draw a comic strip about a funny moment in your life.
  23. Create a picture for someone else.
  24. Who are the anchors in your life? Make an anchor and decorate it with the people and things that provide you stability and strength.
  25. Make a mind map that is a visual representation of all your thoughts.
  26. Draw your dreams.
  27. What do you need right now at this time in your life? Draw a picture or make a collage depicting this.
  28. Draw or collage a picture showing what you are currently worried about.
  29. What smartphone app would you like to create or see created? Represent this visually.
  30. If magic was real, what spell would you try to learn first?
  31. What problem are you currently grappling with?
  32. Create a picture of what helps you feel better when you’re feeling down.
  33. What is something you really wish you could tell or explain to your family?
  34. What is something you really wish you could tell or explain to the teachers at your school?
  35. What is something you really wish you could tell the other kids at school?
  36. What do you wish would get better?
  37. Draw your superpower (or the superpower you would like to have).
  38. Create a vision board.
  39. What is your good luck charm?
  40. Draw a picture of something that is better broken than whole.
  41. What do you need help with right now?
  42. What question are you afraid to ask?
  43. What people or activities leave you feeling drained?
  44. Create a picture of how you would like your home to feel.
  45. Draw or collage 10 things that make you feel loved.
  46. Design your own logo.
  47. Create a picture depicting what keeps you up at night.
  48. If I really loved myself I would…
  49. I’m afraid people won’t like/love/accept/want me if they knew ____ about me.
  50. If you came across a genie in a bottle who could grant you three wishes of anything at all in the world that you want, except for more wishes, what would you wish for?
  51. Create a picture of what everything would look like if you woke up tomorrow and everything was better.
  52. I think I’m really good at…
  53. Draw a picture of where you would be if you could be anywhere right now.
  54. What would you do if you weren’t afraid?
  55. Draw a self-portrait WITHOUT drawing your face (make it symbolic).

There you go. Have fun! 

ByStacy Garcia, MA, LPC, NCC

The Worry Worm Game

Children with anxiety sometimes have a hard time opening up about what they’re worried or anxious about. Enter the worry worms. Worry worms are simply construction (or cardstock) paper worms that look like… well, little worms. I use them in play therapy, but you can easily make your own worms at home and play the worry worm game.

The Game

Worry worms are pretty easy to make. Simply draw or trace a worm onto brown construction paper (or cardstock paper works well too). Make several worms, and cut each of them out. Wa-la! Worry worms! I laminate my worms, simply because this allows me to keep them durable for multiple children to play with.

Next I hide these little guys (the worms) around the room for the child to find. For each worry worm the child finds, they are asked to tell one worried thought they have or have had.

Simple right?

It looks like a game of hide-and-seek to them, but let me tell you what really happens when you play the worry worm game:

  • The child is identifying their worried feelings. This is a huge thing. The mastery of this skill is a major foundation to helping children learn how to cope and regulate their emotions.
  • The child is able to begin tolerating the idea and practice of sharing uncomfortable thoughts out loud because they are motivated by the challenge, reward, and fun of finding the hidden worms.
  • The game itself offers a titrated set of exposures to anxiety producing content that is completed while remaining grounded in the safety of the worm prop.
Have fun playing the worry worm game! Do you have ideas or strategies that you use to help kids talk about their feelings? Please feel free to share in the comments. I’m always looking for new ideas to use in the playroom!

 

ByStacy Garcia, MA, LPC, NCC

78 Free and Low-Cost Reward Ideas for Kids!

Here are 78 of my favorite behavior rewards I’ve used with young children I work with, as well as with my own children. And the best part is that they are all low-cost or free!

  1. Take a walk or hike together
  2. Help a parent make dinner one night
  3. Decorate paper placemats for the kitchen table
  4. Assist mom or dad with a household chore
  5. Go swimming
  6. Have a special art session together
  7. Earn art stuff for creative fun
  8. Scavenger hunt
  9. Bake together
  10. A delicious milkshake
  11. A cup of hot cocoa
  12. Read a book together as a family
  13. Out for ice cream
  14. Get a new book
  15. Earn a printable certificate
  16. New toothbrush or toothpaste
  17. Package of stickers
  18. Choose a dessert to make for dinner one night
  19. 30 minutes of extra TV time
  20. Take a trip to the park
  21. Choose a favorite treat to eat
  22. Choose a game to play
  23. 30 minutes of one-on-one time with mom or dad (play a game, do a puzzle, draw, etc.)
  24. Choose what we will have for dinner one night this week
  25. Trip to the Dollar Tree to pick out a toy or something else of your choice
  26. Stay up 30 (or 15) minutes past your bedtime this weekend
  27. Play on the computer (or other electronic) for 30 (or 15) minutes
  28. Pick your favorite cereal on our next grocery trip
  29. Choose a movie to watch together
  30. No chores for a day
  31. Save the change (give your child your loose change every day for a week so they can save it for a rainy day)
  32. Camp out in the backyard with a parent
  33. Play on the playground
  34. Go with a parent to volunteer at a nursing home for an afternoon (or couple hours)
  35. Mystery grab bag
  36. A trip to the library to select a book
  37. Go fishing with a parent
  38. 30 minutes of special outdoor time with mom or dad
  39. Make a craft together
  40. Earn behavior bucks to save up for a special trip to the Dollar Store
  41. Jump on the bed for 5 minutes
  42. Plan one day’s activities
  43. Choose a special breakfast
  44. Sleep in a different place in the house for one night
  45. Make a fort together and play in it
  46. Go bowling
  47. Slumber party with mom or dad
  48. Play with bubbles
  49. Get out of school (or daycare) one hour (or 30 minutes) early for a special treat with mom or dad
  50. Captain for two hours (let your child be in charge for a set time; no bossiness allowed!)
  51. Help mom or dad clean _____
  52. Pick an activity for the family to do
  53. Make sidewalk chalk art
  54. Make slime together
  55. Make play dough together
  56. Buy new play dough
  57. Trip to the pet store to see the animals
  58. Put a model together with mom or dad (such as a model car)
  59. Feed the family pet
  60. Take pictures (then have mom or dad help you print them out)
  61. Color together
  62. Play a video game or computer game together
  63. Decorate your own room
  64. A special after-school snack
  65. Order a pizza
  66. Decorate a room for a holiday (it doesn’t necessarily have to be Christmastime)
  67. Go to a ballgame
  68. Go ice skating
  69. Go roller skating
  70. Chew bubble gum
  71. Set the table
  72. Go for a bike ride together
  73. Popcorn party
  74. Pajama day (wear pajamas all day)
  75. Outdoor water fun
  76. Have a water fight (with balloons or waterguns)
  77. Family kickball or baseball game (or other sport)
  78. Take a nap together
ByStacy Garcia, MA, LPC, NCC

Dinner Time Conversations with Kids

Dinner time conversations can be hard, especially when you have a child who doesn’t like to talk much when you ask things like, “How was school?” or “What did you do at school today?” This would be my child. The one who would rather eat brussel sprouts than to answer questions about his day at school. Now that my own child has been in school for several years, I’ve learned the trick to getting him to talk more about his day is to initiate a conversation about something else first – something they really don’t mind talking about. Even though my child doesn’t necessarily come right out and talk about his day after I do talk about something else, it does seem to increase the likelihood that at some point that day, I get some information about how his school day was.

Here are 39 of my favorite questions to ask my own children. Hope they help initiate more conversation in your home too!

Random Questions

  1. What is your favorite toy?
  2. Who is your favorite superhero?
  3. Who would you say is your best friend?
  4. Who do you not particularly like to play with?
  5. If you had to choose between reading, writing, or drawing, which would you choose, and why?
  6. Would you rather read a book or article from a tablet or from hard print (a hard copy of a book or newspaper)?
  7. Would you eat the gum from under a picnic table bench for $50.00? (Or How much money would it take for you to eat gum from under a picnic table bench?)
  8. What is your favorite thing to do at the park and/or on a playground?
  9. Would you rather go on a swing that does flips or a slide that never ends?
  10. If you could be granted three wishes and you could wish for anything that you want except for more wishes, what would you wish for?
  11. What is your idea of a “perfect day?”
  12. What is your most embarrassing moment?
  13. What is your favorite game/videogame? Why? (Bonus: Ask your child to show you how to play said game/videogame.)

Questions About School

  1. What is your favorite thing to eat for lunch at school?
  2. What is the worst lunch you’ve ever had at school?
  3. Who is your favorite teacher?
  4. What is your favorite subject?
  5. What is your least favorite subject?
  6. What do you think should happen to a kid that gets caught cheating in school?
  7. What is your favorite thing to do at recess, and why?
  8. What would you like to do or be when you get older? Why?
  9. What do you think is the most boring thing about school?
  10. What do you think is the best part about school?
  11. What is the worst part about school?
  12. What is the craziest or funniest thing your friend has ever done in school?
  13. What teacher seems to really “get you?” What teacher doesn’t?

Questions About the Home and/or Family

  1. What is the nicest thing your sibling has ever done for you?
  2. What is the nicest thing you have ever done for your sibling?
  3. What is the nicest thing your parents/caregivers have ever done for you, in your opinion?
  4. What is your favorite meal?
  5. What is your least favorite meal?
  6. What is your favorite thing to do at home?
  7. What is your favorite thing to do with your mom? Your dad?
  8. What is your favorite thing to do with your sibling?
  9. What do you think you most need from your parents?
  10. If you could go anywhere for a two-week vacation, where would you want to go? Why?
  11. What is the most embarrassing thing your parents have ever done in public in front of you?
  12. What is your least favorite chore and/or rule in this house?
  13. What is the most embarrassing thing your sibling has ever done in public with you there?
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