Author: BPS Staff

10 Tips to Support Your TGNB (Transgender/Nonbinary) Loved One

Considering the recent increase in anti-trans legislation across the U.S., I wanted to write this post to show our direct support of transgender, nonbinary and gender-diverse people, who make up a large portion of our clients at BPS. The impact of these bills can be understood as an example of traumatic invalidation, which ie extreme or repetitive invalidation of an individual’s significant private experiences or characteristics, resulting in damage to their self-construct and pervasive insecurity (Harned, 2022). Sources of traumatic invalidation can be macro (institutional, systemic) or micro (among important relationships, especially parents and family of origin).

When Possible, Choose Joy over Grief

Many parents experience a period of grief, sadness, or shock when adjusting to their child’s gender disclosure. This may be related to hopes or expectations that parents formed about who their child would be; which may extend beyond their gender. Similarly, we often expect our children to participate in specific activities, achieve certain grades, or pursue a particular career. While these emotional reactions are common, they can be effectively processed alone, with one’s co-parent or partner, with one’s therapist, friends or other sources of social support, and not their transgender nonbinary (TGNB) child. These reactions can be emotionally burdensome to children who may internalize negative reactions from their parents as evidence of their own failures or rejections of their identities. Research indicates familial support, more than any other source of support, as the number one protective factor against suicidal ideation and attempts (Travers et al, 2012; Matsuno & Israel, 2018).

Once the grief is less pressing, you may have more emotional capacity to join in on the joy. How many new moments of connection might you enjoy with your child once you can celebrate their gender? How many might you miss during a period of non-acceptance?

In the spirit of dialectics, I believe we are all doing the best we can to support our TGNB friends and relatives, and we all need to try harder, do better and show up more for our TGNB loved ones. These include the people in your life that might not even be out to you as TGNB. (There are at least 1.4 million of us in the U.S. alone) (Flores, Herman, Gates & Brown, 2016; Wilson & Meyer, 2021). The tips below are here to help you show up in a validating way.

10 Tips for How to Show Up for Your Transgender / Nonbinary (TGNB) Family Member

1. Use their pronouns and chosen name. There are many ways to “transition:” medically, legally, and socially. Not everyone has the option or interest in transitioning medically, so correctly acknowledging social aspects of people’s gender may be even more important as a means of communicating your support.

2. Get them a gift with their chosen name or initials on it (a cup, a key chain) and tell them you love the name they chose. These are great ways to celebrate this step with them.

3. If you’re not sure what pronouns to use for someone, ask! “What pronouns should I use for you?” is not an offensive question. However, refusing to use someone’s pronouns communicates that their gender is not valid or you don’t perceive them as they experience themselves. Misinterpreting and ignoring are forms of traumatic invalidation (Harned, 2022).

■ Challenge question: Can you remember the last time someone misunderstood or ignored something about you that is fundamental to your self-concept? How did this affect your subsequent interactions? 4. Practice, practice, practice! Practice pronouns with this free (and addicting!) online game. Practice using they/them pronouns with your pets, your friends, yourself, or practice when you are talking about the TGNB person when they are not in the room.

5. Don’t give up. What happens when I mess up? It’s ok! And, keep trying to do better. Forgive yourself internally, acknowledge the mistake briefly, and move on with the conversation. Mistakes happen, especially when we’re learning something new. Dwelling on this moment by apologizing multiple times or trying to explain how it happened is generally more overwhelming to the person who has been misgendered.

○ “She, I mean he, loves skateboarding. My bad. Where should we go for lunch?”

6. Get outside support. Tap your community, including online support threads (linked below) for advice and resources. It’s okay to be struggling, and it’s best to process your challenging emotions away from your trans or nonbinary child.

7. Familiarize yourself with trans culture, media, and narratives. Who does your child look up to and why? Celebrate their role model’s successes and keep an eye out for potential mentors to hire for additional support.

8. Diversify your sources of information. Direct your questions and research to trans-led organizations and doctors who are trans and/or have extensive experience working with TGNB individuals.

9. Practice radical acceptance. In order to avoid intentional or inadvertent rejection of their gender-diverse children, parents can practice the DBT skill of radical acceptance of both their emotional reactions and their child’s gender.

10. Be intentional about your observations, comments, and questions. The following is a table of common TGNB microaggressions. A microaggression is a seemingly inconsequential comment or action that is invalidating or hurtful. These are usually accidental and have a significant negative impact, especially cumulatively and over time. The negative impact on the person receiving the comment is often unknown to the person who committed the microaggression (Sue & Spanierman, 2020).

Common Microaggression	Example & Affirming Replacement	Rationale
Misgendering	“Charlie was born as a girl and now is a boy.” → “Charlie is a boy.” If you must reference someone’s assigned sex at birth and you have their consent to share this information: → “Charlie was assigned female at birth.”	Comments about who a person “used to” be can be invalidating because people are often aware of their gender before coming out to others about it – the fear of rejection might have kept them from disclosing widely. It’s best practice to retroactively refer to people with the pronouns and gender they currently identify with.
Unwanted body commentary	“You used to have such nice (body-related comment)” “But you’re such an attractive/beautiful/handsome girl/boy!” → “I love who you are becoming.” → “Let’s go shopping for some new clothes!” → “What words would you like me to use to refer to you? (handsome, beautiful, intelligent…)”	Comments about someone’s physical appearance, body, or attractiveness in regards to their assigned gender can be really hurtful to TGNB people. When uncertain, always frame compliments or observations in the context of their present sense of gender.
Dismissing / controlling transition-related goals	“I’m scared that you’re going to want surgery/hormones.” “I’ll support you as long as you don’t medically transition.” → “If you feel open to sharing, what are your goals for transition? → “How can I support you?” → “What do you like to receive affirmation about?” → “What gives you gender euphoria?”	Not everybody wants to medically transition, and people’s gender related goals are personal and change over time. It’s important to ask questions about medical transition with sensitivity and an openness to not receive an answer. They might not be ready to share details about their body, goals for transition or current gender affirmation processes. Depending on your relationship (sibling, parent, etc.) certain questions may be more or less appropriate.
Projecting fears	“I feel sad/worried for you” “You must feel trapped in your body.” “I’m scared of how people will treat you.” → “I’m so proud of you.” → “I’m going to be right by your side through this process.” → “I have some questions, and I’m going to do research on my own.”	While there are higher risks of distress and negative psychosocial outcomes associated with being TGNB, these risks come from social stigma, invalidation, and barriers to resources, not from one’s gender identity! Instead of sharing your concern for their anticipated difficulties, decide to be an ally and ask how you can support them.
Ageism	“You’re too young – you won’t know what’s real or best for you until you’re older.” “You’re too old – if this were real, you would have known about it since you were a child.” → “I’m honored you decided to share this with me. It’s never too late/too early to come out as trans.” → “I believe you, let’s get more information together about potential options for affirming your gender.” → “Thank you for telling me, that was really brave. I’m excited to get to know more about you and who you’re becoming.	TGNB people are told they are either “too young” or “too old” to be trans quite often. This shows that ageism exists across the spectrum of transness. There is no “right” age when we “truly know” what our gender is. At the same time, our readiness to make decisions about which gender affirming steps to take may shift depending on a number of factors, including our age. Regardless of these decisions and readiness factors, validation and support are necessary every step of the way.

Additional Resources

APA: Singular “They” Is Grammatically Correct

Practice pronouns with this free online game

How parents can support a child who comes out as trans – by conquering their own fears, following their child’s lead and tolerating ambiguity

Free and low-cost letters of support from therapists for clients seeking gender-affirming medical care

Gender-affirming tele-health care Counseling groups for TGNB youth/parents

Sylvia Rivera Project & Lambda Legal – Trans legal collective and legislative support

References

Flores, A.R., Herman, J.L., Gates, G.J., & Brown, T.N.T. (2016). How many adults identify as transgender in the United States? Los Angeles, CA: The Williams Institute

Harned, M. S. (2022). Treating trauma in dialectical behavioral therapy: The DBT prolonged exposure protocol. The Guilford Press.

Matsuno, E. & Israel, T. (2018). Psychological interventions promoting resilience among transgender individuals: Transgender resilience intervention model (TRIM). The Counseling Psychologist, 46(5), 632-655.

Olson, K.R., Durwood, L., DeMeules, M. & McLaughlin, K.A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), 1-8.

Sue, D. W., & Spanierman, L. B. (2020). (2nd ed.). John Wiley & Sons, Inc.

Travers, R., Bauer, G., Pyne, J., Bradley, K., Gale, L., & Papadimitriou, M. (2012). Impacts of strong parental support for trans youth: A report prepared for Children’s Aid Society of Toronto and Delisle Youth Services. Retrieved from http://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong- Parental-Support-for-Trans-Youth-vFINAL.pdf

Wilson, B. D. M. & Meyer, I. H. (2021). Nonbinary LGBTQ adults in the United States. Los Angeles: The Williams Institute.

May 6, 2022

There REALLY is No Place Like Home for the Holidays
Perry Como wasn’t wrong when he sang those iconic Stillman lyrics. “There’s no place like home for the holidays.” Really. And whether it’s your biological family, your chosen family or your new partner, home (for the holidays) carries a weighty pressure that perfectly encompasses Dialectical Behavioral Therapy’s (DBT) core dialectic of acceptance and change.

(‘What the heck is a dialectic?’ you may ask. Head here for a deeper dive into this term.)

As much as I love my family, and I really, truly do, there’s an unshakeable reversion to childhood patterns that the holiday season, and subsequent return home, can provoke in us all. (Adding another escalating ingredient to the mix is COVID-19.) I’ll spare my family the indignity of revealing too much about our interpersonal dynamics on the internet. However, I will say that we all come home for the holidays carrying our own baggage — both literally and figuratively. This can be baggage that’s been simmering for a few days, months, or years. Sometimes it’s baggage that’s entirely irrelevant to the individuals sitting around that open fire roasting chestnuts — I’ve literally never roasted chestnut, and I simply couldn’t begin to tell you how to do that. Other times, it’s baggage that has absolutely everything to do with a very particular scenario, involving a very specific individual, who’s watching that ball drop beside you on New Year’s Eve.

And, it’s at this moment that DBT’s core dialectic comes into play. Accept? Change? Sometimes, we accept. For those who are considering this course of action, because yes, acceptance is a choice, I recommend reviewing some of DBT’s Distress Tolerance Skills. In other circumstances, perhaps when we’re looking to obtain a specific goal or objective, we pursue change.

This holiday season, if you have a specific goal or objective, once you’ve clarified your priorities, consider DEAR MAN. This is one of my personal favorite skills in the entire DBT repertoire, as I have found it to be particularly effective for me. Surely, contacting your individual therapist, or diving more deeply into DBT Skills Training at BPS will support this process in greater depth, and, for now, with just a few days before heading ‘home,’ I’ve included a very quick primer on DEAR MAN.

My sample situation? My sister repeatedly takes my clothing from my closet. My objective? Get my sister to stop taking my clothing.

D – Describe the Situation

Ex: I’ve noticed that you have taken a few articles of clothing from my closet without asking me in advance.

E – Express Clearly

Ex: I feel anxious when I can’t find a missing clothing item. I wonder where it has gone, and whether I’d brought it back home in the first place.

A – Assert Wishes

Ex: I would like you to stop taking my clothing.

R – Reinforce

Ex: My hope is that we can figure this out so that we can minimize our bickering during this trip.

(Stay) M – Mindful

This is the part of the conversation where I would emulate a broken record, continuing to express my opinion in spite of any diversions or deviations from my sister.

A – Appear Confident

While I might be nervous to make this ask, using a confident tone of voice and physicality will better support my efforts to obtain my objective.

N – Negotiate

If my ask or refusal appears to be hitting a wall, I must be willing to give to get. For example, if I’m comfortable with this alternative, I might ask my sister to, at the very least, ask me before taking my clothing.

As with every skill, practice, practice, practice!
December 21, 2021
What the Heck is the Biosocial Theory?
What the Heck is the Biosocial Theory?

We’re talking about the biosocial theory today, and as with the concept of dialectics, the biosocial theory is a fundamental underpinning of Dialectical Behavior Therapy (DBT). Therefore, whether you’re considering DBT for yourself, or you’re interested in learning more about this treatment in general, an elementary grasp on the biosocial theory of Borderline Personality Disorder (BPD), and other problematic behaviors associated with emotional dysregulation, is a good starting point for all that follows in treatment. In fact, it may provide a healing and illuminating explanation for why one functions the way one does!

Let’s start with a definition, shall we?

Dr. Marsha Linehan posits that problematic behaviors, adapted and adopted to regulate emotions, are rooted in the evolving interaction and transaction of biological and environmental factors.

An individual’s particular biology may predispose them to struggles with emotional vulnerability and emotional modulation. For example, research has shown “…hyperactivity in the limbic system and decreased activation of the prefrontal cortex…may contribute to affective instability in BPD” (Niedtfeld & Bohus, 2018, p. 1). Say it with me (and I know this can be very, very hard!): It is what it is. This is how your biology, how your brain, functions. There is not something wrong with you. This is just how you are!

Likewise, an invalidating social environment occurs when figures in one’s life “…consistently and persistently fail to respond as needed to primary emotion and its expression” (Koerner, 2012, p. 6). Raise your virtual hand if any of the below applies to any interaction you’ve ever had with anyone (ever):

You’ve been told you’re overreacting to a situation.

You’ve been told your emotions are, in some way, stupid, wrong, or manipulative.

You’ve been ignored during a state of emotional distress, and then lashed out at by that same individual when your distress became too overwhelming for that individual.

These are just some examples of invalidation, and over time, invalidation may impact an individual’s capacity to regulate emotion.

Breaking it down even further, we have the bio and we have the social, and when one pairs biological vulnerabilities with invalidating social environments, it would be reasonable (and quite natural!) to assume the development of maladaptive patterns of behavior.

As a final and important note, if we envision a scale, one’s biological vulnerabilities may weigh more than one’s invalidating social environment, and vice versa. Regardless of the source, the fallout from managing these interactions can be unbearable, and this is something that DBT seeks to address through both individual therapy and skills groups. After all, it is a DBT Assumption that, while you may not have created your problems, you do have to solve them anyway.
October 28, 2021
Mindfulness of Others: Through a DBT Lens

Mindfulness of Others: Through a DBT Lens

By Nikita Patel, Psy.D.

“Don’t judge a book by its cover.” The moral of this infamous metaphor we’re told as children is to be curious to those around us rather than assuming we know everything about everyone.

Sounds pretty simple, no?

Heightened emotions and inflexible beliefs can make it difficult to meet new people or be vulnerable with others. Mindfulness of others is a skill from DBT that helps us to be more present in our interactions with others in order to help build new relationships and strengthen existing ones.

Marsha Linehan, the creator of DBT, outlined what we can do in order to be more mindful. She defines mindfulness as the act of being fully aware and present in each moment. The following three skills are what to do to be more mindful:

Observe:

Notice through your five senses and pay attention to your internal world without holding on or pushing away emotions or thoughts

Describe:

Stick to just the facts and label what you’ve observed

Participate:

Throw yourself fully into each moment as it comes

We can incorporate these skills into interactions with others.

Imagine being invited to a birthday dinner where you only know the host and one other person. You are seated next to someone you don’t know and would love to get to know them.

Observe: Be curious and open. Take in through your senses, nonverbal body language, and facial expressions, what the other person is saying and doing. If you notice judgments about yourself or the person, notice them and let them go. Sometimes when we experience intense emotions when speaking with someone new, our focus turns inward. This can reflect outwardly like we are uninterested and negatively impact the dynamic of the interaction. Additionally, we can lose sight of what the other person is saying or doing because we are too focused on ourselves. Refocus your attention back to them, observing what you see and hear, and let go of urges to plan what you’re going to say or do next. Put down the phone! In order to be more present with others, we need to let go of distractions.

Describe: Once you’ve observed what you are seeing and hearing from the other person as well as your own emotions and thoughts, label them as just that. “I’m having the judgment that this person does not think I’m funny;” “I’m feeling anxious;” “I see that they started talking to the person across the table.” It can be easy to jump to assumptions about yourself or the other person. Stop! We can’t observe another person’s inner workings, including how they feel, their thoughts, or their intentions. Given that, avoid interpreting the situation and give the other person the benefit of the doubt. Go back to being curious and open. Judgments and assumptions take us out of and skew the current reality. Acting on assumptions often makes the situation worse and hinders the ability to get to know the other person.

Participate: Allow yourself to go with the flow. Keep at the conversation and let go of judgments, worries, and control. Be one with the interaction.

October 19, 2021
What The Heck is a Dialectic?
What the Heck is a Dialectic?

By Avery Carmichael, BPS Social Work Intern

Undergirding all that is Dialectical Behavior Therapy (DBT) is the eponymous concept of dialectics. I will start by saying, in full transparency, that the term ‘dialectic’ is an oft-intimidating word to define. Especially when considering its rich philosophical roots, one can easily dive deeply down the rabbit hole of Marx, Engels, Popper, and Bunge. For now, I suggest you don’t.

Instead, in this moment, as you read this text — presumably because you are interested in, fascinated by, or curious about DBT — let’s take things easy and begin with the following definition: Dialectics is a worldview that stresses that reality is made up of polarities. Two things, regardless of whether they are wholly opposites, can exist at the same time. For example, one can lose a loved one after a long illness and feel at once sad for the loss, and relieved for the alleviation of that loved one’s suffering. Likewise, dialectics emphasizes the interconnected nature of the world, as well as the constancy of change. You’ve probably heard it before, and you’ll surely hear it again: Change is the only constant.

DBT exists in the pursuit of synthesizing and integrating these polarities within the self, of engaging in an ongoing reconciliation of dialectics. It is a search for balance, an attempt at finding the ‘and’ rather than the ‘but.’ The most notable dialectic at play, within a DBT-focused therapeutic relationship, and DBT in general, is the effort to balance acceptance and change.

Here are some more examples of dialectical thinking and circumstances:
- I am doing the best I can and I can do better
- I want to live and I want to die
- I want to quit drinking and I want to have a drink
- I love my partner and I hate my partner’s tone of voice when she’s angry
I know. A lot to take in, and that’s okay! Dialectical thinking, in its assessment of the inherent complexity of the world, is a complex concept. I just summarized an impactful and timeless philosophy, the core component of Dr. Marsha Linehan’s groundbreaking treatment, in a couple of paragraphs. Certainly, the work only starts here, and (see what I did there?) take some time to notice dialectics that exist in your day-to-day life. Speak them aloud to yourself, write them down, or point them out to a friend. Observe how it feels to insert ‘and’ in place of ‘but.’ Seek out the shades of grey, moving away from the binary.
September 23, 2021
Understanding Executive Functioning

By: Dr. Nikita Patel, Psy.D.

Do you find yourself putting off errands or tasks unless there is an immediate deadline? Is it difficult for you to organize your thoughts and clearly explain them to someone else? Time management and organization are examples of executive functioning.

Executive functioning refers to the cognitive processes that help us meet the demands of our life. This can look like getting started on an assignment, tolerating anger that intensifies during an argument, and problem-solving when things go wrong. These processes sit in the prefrontal cortex, which is located at the front of the brain. This area is the last to fully develop in your mid 20’s.

According to Thomas Brown (2005), there are six major areas of executive functioning that work together to help us meet a goal or accomplish a task:

1. Activation This is everything that we do before initiating a task. For example, getting to work requires you to prioritize the task of getting yourself to work on time by getting dressed and ready, organizing your bag, checking the weather, checking traffic or train delays.
2. Action This occurs during the task. For example, when commuting to school or work, it’s helpful to engage in self-monitoring to ensure that you’re on the right train and on time. In addition, you have to be ready to course-correct if your train suddenly goes express by evaluating the change and redirecting to another route.

3. Working Memory This factor is helpful with short-term memory tasks that require us to take in information and manipulate it. Taking notes requires both the capacity to remember what is being said as well as being able to jot down the information for later review. Imagine how much memory is required to engage in a back-and-forth conversation with a friend.

4. Emotion Regulation Can you imagine what would happen if we leaned into all of our emotional urges? The ability to manage and tolerate difficult emotions is important in staying effective towards meeting both short- and long-term goals without derailing from the task at hand.

5. Sustained effort Have you ever found yourself full speed ahead on a task and fatigued halfway through? Effort helps us to sustain our pace while working so we can get through a task.

6. Sustained focus We’ve all drifted into our thoughts during a work meeting or during class. This area helps us to shift our attention to what’s important in the moment and maintain that focus to help us effectively achieve that task.

You may find yourself having trouble in some areas and not others. However, weakness in any of these areas tends to generalize to different aspects of your life. For example, you may find yourself struggling with managing your time at work, with friends, and at home.

You may have noticed that you probably struggled with many of these areas as a child since the prefrontal cortex was still developing. Parents and teachers often took the role of being the source of our executive functioning to help us meet tasks. Think back to all of the reminders you received from parents and teachers to complete chores or homework assignments. If you find yourself having difficulties in any of these areas, there are skills and strategies that you can use to help such as, keeping planners to organize deadlines and events, keeping to-do lists, setting alarms to manage time, and using coping skills to manage intense emotions.

For individualized help, there are executive functioning coaches who can tailor skills to your specific needs. Below are two resources for both children and adolescents and adults:

Children, Adolescents and Adults

Children and Adolescents

August 20, 2021
Enhancing the Parent-Child Relationships with PRIDE
By: Dr. Emily Nichols, Psy.D.

Have you ever found yourself giving your child the same direction multiple times to no avail? Do you find yourself getting into power struggles with your teen more often than you would like? It’s no secret that these negative interactions can have quite a toll on the parent-child relationship. When arguments happen, caregivers often feel like they are trapped in an endless cycle that leaves them feeling frustrated and defeated. The good news is research has shown that spending just 5-10 minutes of “special time” with your children each day can improve the parent-child relationship.

So how does one do special time? With PRIDE! The PRIDE acronym represents some handy skills to keep in mind when spending quality time with your child. Here’s a breakdown of the various PRIDE skills and how to use them:

Praise your child’s behavior

Praise is all about expressing approval to your child. When giving praise, aim for it to be specific, sincere, and process-based. The idea is we want children to become flexible learners who are encouraged to develop a growth mindset and try new things, which is why it’s more helpful to praise the process of your child’s efforts over the actual outcome. Here are some do’s and don’ts when praising your child:

Do…

Use specific and descriptive praise (e.g. “ I like how you’re carefully putting your toys into the toy bin”).

Sincerely praise behaviors you want to reinforce (e.g. “It’s generous of you to share your snack with your sibling” or “I appreciate how flexible you were when we made a change of plans”).

Praise their efforts and process (e.g. “Great job using different strategies to solve that math problem”).

Don’t…

Use generic language (e.g. “Good job!” or “Nice work!”).

Be overly lavish or praise easy tasks. Overpraising can actually reduce intrinsic motivation and lead to entitlement. Kids may feel they are superior to others and will be unwilling to work unless praised.

Focus solely on their achievement or ability (e.g. “You’re so smart; you should definitely be valedictorian” or “You’re the best soccer player on the team!”).

Reflect your child’s talk

When we reflect, or repeat back what we hear children say, it demonstrates that we are listening and that we understand them. It also gives them an opportunity to lead the conversation. For children and teens, this fosters their sense of autonomy and boosts their confidence. It also provides validation, which further strengthens the parent-child connection. Here are examples of how to reflect:

Child: “I did it all by myself!”

Caregiver: “Yes, you did it all by yourself!”

Teen: “I’m so mad at her; she completely betrayed me!”

Caregiver: “It’s so frustrating to feel like you can’t trust a friend.”

Imitate your child’s play

It’s easy to get caught up in making sure children are doing things the “right” way. One of the most common instances this comes up in is when kids are coloring. Adults are quick to encourage children to color in the lines. When practicing PRIDE skills, we encourage you to actually imitate your child’s creative play as a way of bonding. Is she coloring outside of the lines? Join her by scribbling a little on your own paper and watch your child light up. Are they pretending that a spatula is a paddle they can use to row down a river? Grab some tongs and start paddling too! There’s a reason they say imitation is the sincerest form of flattery.

This applies for teens too! Next time you catch them playing Candy Crush, download the game and start swiping! Doing so will demonstrate that you are interested in what makes your adolescent happy and it will also give you some common ground to discuss.

Describe your child’s behavior

For young children who seem to move a mile a minute, taking the time to describe their behavior can actually slow down their play and help them organize their thoughts. Think of yourself as a sportscaster narrating a play-by-play of your child’s actions. Behavioral descriptions lead to mindful moments where you and your child become more focused on the activity. Describing your child’s behavior can be as simple as saying, “You’re blowing bubbles” or “You’re rolling the play-doh.”

Enthusiastically engage with your child

When we show enthusiasm while playing with our kids it tells them that we are enjoying this special time with them. Not only will your enthusiasm demonstrate a vested interest in your child, it will also help model positive emotions and further strengthen the relationship.

You can demonstrate enthusiasm with teens too! Did you go on a special outing together? Let them know you enjoyed yourself by saying, “That was so fun!” or “I’m really glad we got to spend some time together.”

What to Avoid When Using PRIDE Skills

Remember, special time is all about strengthening the parent-child relationship. It should be held daily, regardless of a child’s behavior. This demonstrates unconditional positive regard for your child which can be especially powerful when there are a lot of negative interactions. To keep special time fun and child-friendly:

Avoid Questions and Commands

Although well-intentioned, asking kids questions about their school day, friends, or other subjects during special time can disrupt the flow of fun. Questions and commands take away the child-led portion of the play and can inadvertently come off as criticisms. For example, if your child goes for the coloring materials and you ask, “Don’t you want to play with the puzzles?” it may give your child the impression that they are doing something wrong.

Avoid Criticisms and Corrections

Parental criticisms, which indicate a lack of approval, can have undesirable effects on children. Common criticisms include, “You’re doing it wrong” or even “Cut it out!” These statements can create a negative environment and even a power struggle if they trigger child misbehavior.
August 11, 2021
Back To Your Future

By: Michelle Bottone, LMFT

The pandemic has been a lengthy period of uncertainty which can cause increased stressors in many areas of our lives. Given the CDC guidelines and in order to interact with others, most of us have been relegated to socializing via technology platforms, such as Zoom with colleagues, family, and friends.

Recently, the majority of companies have announced their respective employee return to work dates. Does the thought of re-socialization seem daunting? Do you find yourself doubting your ability to navigate this transition? Take a deep breath, help is accessible. Dialectical Behavioral Therapy (DBT) skills can assist in increasing your resiliency and your ability to re-integrate socially whether if it’s back to the office or school.

1. Practice self-validation.

Self-validating is act of practicing self-compassion by acknowledging, allowing and understanding how you are feeling. An example of this could be saying to yourself, “It is okay that I am feeling anxious right now. I haven’t set foot in the office for over a year. All my meetings have been through Zoom, it makes sense that I may be a little nervous.”

2. Check the facts.

What am I assuming? Am I overestimating a potential threat and underestimating my ability to cope? Example: “I am assuming that I might stutter when speaking to a colleague in person for the first time. I speak all the time to my coworkers via Zoom without stuttering. If I do happen to stutter, it’s okay. In my last performance evaluation, my manager wrote that I have strong communication skills. Even the best public speakers, trip up on their words at times.”

3. Cope ahead.

Consider practicing a plan ahead of time so that you feel prepared to cope effectively with the situation. Example: “If I begin to feel anxious when talking to a coworker in person, I will practice using the half smile skill because I know that our facial expressions are partially linked to our feelings.”

Certainly, any change can feel challenging. It is crucial to be mindful that the training of one’s mind is similar to training for a marathon, it does take time. In various ways the pandemic experience has been a detour in many people’s lives. Therefore, realize that DBT skills can help better enable your post pandemic return and put you back on the road to YOUR FUTURE.

July 13, 2021
Managing Family Dynamics by Walking the Middle Path

By: Michelle Bottone, LMFT

It has been nearly a year since many of us have been working remotely along with our children who must also learn remotely in the same environment. It was difficult to navigate both work and family obligations pre-COVID 19. Given the current challenges, the stress level of parents and children have been significantly exacerbated. Do you find yourself struggling with parenting during COVID? When you are in conflict with your child, do you feel like you are playing a game of Tug of War? Well, it is time to drop that Tug of War rope.

Walking the middle path is a skill in DBT (Dialectical Behavioral Therapy) that fosters balance and letting go of polarized perspectives.

Scenario: Mother notices her child curled up and crying.

Be Dialectical.

Stay away from stating extreme responses such as “always and never”. Search for the kernel of truth in what your child is saying to you. The dialectical approach is that there is no absolute truth and many alternative truths. Things are not black and white, there is a grey area, and that change is transactional and inevitable.

Mother: “I see tears. I’d love for you to tell me what’s bothering you.”

Child: “I feel overwhelmed by my schoolwork and I miss my friends.”

Validate your child.

Validation is imperative for all relationships. When we validate someone, we are acknowledging their thoughts, feelings and behaviors based on the current situation. Avoid blaming and judging. Research indicates that a child’s emotional stress can elevate significantly with high levels of invalidation.

Mother: “It makes sense that you are overwhelmed by school and miss your friends.”

Changing behavior.

Reinforce small steps towards the behavior you would like to see. It is crucial to reinforce the positive behavior directly after it occurs and at every opportunity that it presents itself. Decrease undesired behaviors through reasonable consequences. Be mindful that extinction of a behavior leads first to a burst of the behavior and then it will start to decrease overtime. Also, realize that extinction and punishment do not teach a new behavior, therefore, a new positive behavior needs to put it in its place.

Mother: “I noticed earlier today that you were able to take a 10-minute break and then go back to doing your schoolwork. Great job! If you complete another hour of schoolwork, perhaps you would like to Facetime with one of your friends.”

When we are highly stressed, it can cause us to become reactive. We may become locked into a position of rigidity and unwilling to compromise. Walking the middle path opens up lines of communication between you and your child. By actively making an effort to reduce your own emotional responses, behaviors and ways of thinking, you are directly modeling healthy skills and flexibility. Particularly for a child living through this pandemic, feeling understood and connected can make the critical difference during this time of ongoing uncertainty.

July 1, 2021
Beginning Evidenced-Based Therapy: What is it? & What can you expect?

By Laura Miller, LMSW

Most of us will face challenging and stressful situations at some point in our lives and find ourselves needing more support. This is a normal part of human experience; out of necessity, humans evolved into social beings, as dependence and cooperation with one another enhanced the ability to survive. Although survival threats may be lower today, we still see that people continue to need support from others. In fact, lack of support can actually lead to increase stress.

At times, you may be able to cope with stressful life situations on your own or with the support of a trusted loved one. However, difficult circumstances may also include emotional symptoms such as depressed mood or anxiety or cognitive symptoms such as repetitive and upsetting thoughts or uncontrollable worry. It may be that even with support, that these symptoms don’t resolve. When this happens, it makes sense to consider seeking professional mental health support. The American Psychological Association recommends seeking therapy when a problem has become distressing and it is interfering with some aspect of life. Yet, you also don’t need to have a significant stressor or problem to benefitfrom therapy. If you find yourself curious about the process and can find value in having more support, that is reason enough to begin!

Benefits of Therapy & Evidenced-Based Treatments

While therapy can be a daunting process to begin, there have been numerous advances in the treatment of psychological disorders and there are many research studies to show that therapy is helpful! Treatments known as “evidenced-based treatments” (EBTs) are treatments that have been developed through extensive research and shown to be effective in treating specific symptoms. Not all mental health treatments are equally helpful and some therapies have been shown to work better than others. Due to the extensive research that goes in to developing EBTs and the amount of data showing their effectiveness in decreasing symptoms, EBTs are listed as “best practice” and “preferred” approaches for mental health symptoms by both the American Psychiatric Association and the American Psychological Association. In fact, research has demonstrated that some EBTs actually result in larger symptom improvement than pharmacological treatments, as they teach life skills that last beyond the course of medication. There are several EBTs, including therapies such as Cognitive Behavioral Therapy, Dialectical Behavior Therapy and Acceptance and Commitment Therapy.

What Can You Expect?

EBTs are structured and focused, and they are meant to help improve specific problem areas. In order to best meet a client’s needs, treatment first begins with a therapist conducting a clinical interview to determine problem areas. During the interview a therapist will ask a series of questions to assess overall functioning and may also give specific checklists or questionnaires to further understand the severity of problems.

EBTs require the client to take an active role. Therapy is geared at changing thoughts and behavior, rather than just talking about problems or listening to a therapist give advice. In order to achieve this, a client and therapist will collaboratively develop a plan or agenda for every session. The agenda then acts as a guide to complete several steps that are aimed at solving the problem.

Clients will learn to practice specific skills that are aimed at helping to improve the client’s problem areas. In order for clients to learn skills and integrate them into their day to day life, clients are asked to practice skills in-between sessions. Most EBTs usually involve some form of homework as practice is key to developing new behaviors and generalizing them to outside of the therapy session. Many EBTs will also include some form of self-monitoring, so that clients can learn to observe their behaviors, keep track of interventions and skills to help, and see overall improvement.

Treatment is typically short-term, lasting anywhere from 12-20 sessions. However, many people find it useful to return to treatment after completing the EBT for “booster” sessions as needed, in which clients can continue to refine their skills.

Throughout the COVID-19 pandemic, many EBT programs started to be conducted online through tele-therapy. Check out a previous BPS blog post to learn more about how an evidenced-based treatment can also be delivered virtually!

The decision to begin therapy is personal, however, with so many evidenced-based therapies that have extensive data to show their effectiveness, there is certainly something that could benefit everyone!

June 17, 2021

Author: BPS Staff

Be Dialectical.

Validate your child.

Changing behavior.