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  • Psychologists are starting to talk publicly about their own mental illnesses – and patients can benefit

    Photo: Person looking into camera

    (THE CONVERSATION) From sports and entertainment celebrities like Simone Biles, Ariana Grande and Ryan Reynolds to everyday social media users on Facebook, Twitter and TikTok, more people are talking publicly about mental health.

    Yet both students and professionals across fields have long been advised that talking openly about their own mental health experiences risks negative judgments from co-workers and supervisors, which can potentially damage their careers. Ironically, even professionals in mental health fields are advised to conceal their own experiences with mental illness.

    This culture of silence is counter to what psychologists know to be true about battling stigma: that talking openly about mental health can help reduce stigma and encourage others to seek help.

    Stigmatizing openness about mental illness can also result in the systemic discrimination against and exclusion from mental health professions of people who can make valuable contributions to the field – whether in spite of or because of their unique mental health experiences.

    We are a doctoral candidate and an assistant professor of clinical psychology who have both experienced mental illness. In a recent study, we explored how common mental health issues are among clinical psychologists and trainees, and whether those issues affected them professionally.

    In a related commentary, we and our psychology colleagues wrote openly about our own experiences with mental illness to show others that success in mental health careers is possible for people who currently live, or have lived, with mental illness.

    Psychologists are people, too

    In a forthcoming peer-reviewed study, almost 1,700 psychology faculty members and trainees completed an online survey that asked about their mental health experiences. This is the largest study to date on the rates of mental illness in graduate programs that train clinical, counseling and school psychologists.

    Our survey asked participants two separate questions: whether they had ever experienced “mental health difficulties” and if they had ever been diagnosed with a mental illness by a professional. Asking both questions was important because some mental health difficulties are not labeled as specific conditions, and not all respondents may have had access to a mental health provider who could make a formal diagnosis.

    Over 80% of all respondents reported having mental health difficulties at some point, and 48% reported having a diagnosed mental illness. These rates are similar to rates of mental illness in the general population.

    Our findings show that, far from being immune to the conditions they treat in others, psychologists grapple with mental health difficulties or illnesses just as much as their patients do.

    Mental illnesses are leading causes of disability worldwide. This fact may partly explain why there’s a stigma among psychology professionals about disclosing them: Some may see mental illness as an insurmountable handicap to being effective at researching mental illness or treating it in others.

    However, in our survey of psychology faculty members and trainees, 95% of respondents with mental healthdifficulties reported having “no” or “mild” professional problems related to these experiences. Over 80% of those with diagnosed mental illness reported the same.

    This finding highlights that experiencing mental illness is not by any means a barrier to being a capable and effective psychologist.

    Stigma as a barrier to inclusion

    Through another upcoming study, we identified some of the structural barriers within clinical psychology that may discourage psychologists from talking about their own mental illness.

    One key barrier is that – again, ironically – stigma toward mental illness exists from within the mental health profession. We have found that psychologists and trainees with mental illness may be unfairly viewed as damaged, incompetent or hard to work with by their colleagues. We based this conclusion on our personal experiences in the profession, combined with the large body of research on the dynamics of disclosing mental illness.

    Previous research has found that sharing one’s mental health difficulties, disability or illness in a training setting may result in lost professional opportunities, such as being hired or promoted or winning an award.

    However, research also shows that sharing one’s mental illness may open up other opportunities to receive support and accommodations on the job, such as adjustment of job tasks, work schedules and time and performance expectations.

    Lived experience counts

    As therapists ourselves who have worked with hundreds of clients, we have found that our mental health struggles help us understand and empathize with the challenges faced by our patients.

    Research suggests that we are not alone. Studies show that therapists may use their experiences to inform how they work with clients. In fact, some widely used and scientifically backed therapies were developed by psychologists with lived mental health experience – such as “dialectical behavior therapy,” which aims to help clients live in the moment, deal with stress and emotions in healthy ways and improve relationships.

    As research scientists, we have found that our mental health experiences not only inform our ideas but also help us grapple effectively with the inevitable setbacks that come with a profession defined by endless hours of data collection, grant writing and a publish-or-perish culture.

    Having personal experience with mental health challenges reminds us why our work has meaning and is worth the struggle: to help and improve the lives of real people dealing with real traumas and real emotional struggles.

    Psychologists ‘coming out’ proud

    Although we have chosen to make our struggles public, we are not saying that others like us should feel that they must talk openly about it – or that all psychologists must have had mental health experiences in order to treat patients or do research effectively.

    Rather, we believe that psychologists who have chosen to talk about their mental illness may be able to use their positions to destigmatize openness about these health issues – for other mental health providers as well as the patients they serve.  

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  • Up-beats: A playlist for down days

    Illustration of person with headphones on, musical notes in air and gray weather outside window.

    How many times have you gotten into your car after a particularly challenging day, turned on the radio, and suddenly felt your mood improving? Believe it or not, there’s actual science behind this phenomenon. Music’s rhythm and repetition engage the neocortex of your brain, and research supports the use of music therapy for various mental health conditions, including depression, trauma, and anxiety. Creating a “rainy-day” playlist can be a lot of fun and might just save the day tomorrow! Here are a few of our favorites...

    Five foot-tapping fan favorites

    1. I Can See Clearly Now by Jimmy Cliff — This transcendent, joy-inspiring song perfectly encapsulates the jubilance that comes from a bad day that’s suddenly turned itself around. Look straight ahead; there’s nothing but blue skies!
    2. I Got You (I Feel Good) by James Brown — From the iconic “Whoa!” that sets the tone for James’ buoyant lyrics, this ultimate “feel good” song will have you singing along in no time (and you knew that it would now).
    3. Happy by Pharrell Williams — Seems as if Pharrell knows a thing or two about turning lemons into lemonade when he sings, “Well give me all you’ve got, don't hold back. Well, I should probably warn you — I'll be just fine.” Clap along if you know what happiness is to you!
    4. Young Folks by Peter Bjorn and John — Sometimes we just need to feel accepted, imperfections and all. Young Folks tells the tale of two friends who turn a blind eye to one another’s pasts and choose to live in the moment. If the whistling doesn’t turn your frown upside down, the message certainly will!
    5. What a Feeling by Irene Cara — If you grew up in the 80’s, three things are true: You used waaaaay too much hairspray (yes... you did), you got up early every Saturday to watch cartoons, and you kicked and stomped your way through this song like a champ. Your hairstyle may have (drastically) changed and cartoons are now available on-demand, but this song will ALWAYS inspire you to dance right through your life.

    We hope we’ve inspired you to create your own rainy-day playlist! If you enjoyed our list of up-beats for down days, check out Five easy-to-implement habits for improving your mental health at work.

     

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  • Five easy-to-implement habits for improving your mental health at work

    Person in a zen pose with stacks of paper around

    You may be feeling the added pressure at work these days, and most days it probably feels like everyone wants some of your time. Here are a few easy tips for maintaining your positive attitude and protecting your headspace in your professional life. After all, you can’t pour from an empty cup!

    1. Set manageable boundaries. Blocking your calendar for lunch or focus time and not responding to emails after hours are great ways to protect your “downtime”. Last-minute meetings, impossible deadlines, and covering staffing shortages are all common occurrences in today’s world but reducing as many of them as you can and setting clear boundaries for your valuable time can help give you some sense of control over your day.
    2. Take regular “brain breaks”. While our smartphones are often dubbed “tools of mass distraction”, they can be an invaluable means of temporary escape. Taking short, regular breaks can help reset your brain, increasing your overall productivity. Download a few quick games that interest you or keep a light read loaded on an e-reader app and allow yourself a few minutes to decompress when the opportunity strikes.
    3. Tackle one thing at a time. If your to-do list should be relabeled as a “must-do-NOW" list, remember that the best way to eat an elephant is one bite at a time. Prioritizing your tasks, writing them down, and crossing them off in order of importance can give you some sense of control over your day and keep you focused.
    4. Help your neighbor. While this advice may seem counterintuitive to #1, taking some time to voluntarily help a coworker — instead of being “voluntold” to do so — feels good! If you see someone struggling under the weight of their obligations, ask if there’s anything you can do to help them. Even if you simply shine a little light on a task that seems overwhelming to them, the resulting sense of community will brighten the day for both of you!
    5. Keep your visual spaces clear. Much like the chair full of clean laundry mocking us from the corner of our bedroom, we’ve all got “that pile” of paperwork on our desk that’s begging to be dealt with. Just looking at it probably makes you stressed! Schedule 15 to 30 minutes every day to tackle that pesky pile, and (if possible) keep it out of sight.

    If you find these tips to be helpful, check out our previous Five tips for improving your mental health post!  

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  • Is Tech Destroying Kids' Social Skills? Here's How Social-Emotional Learning Can Help

    Photo: Smiling child with headphones on and looking into a tablet

    Technology's effect on children's social skills and well-being has caused a lot of hand-wringing over the years—and parents' and educators' concerns have only grown with the pandemic as students have done more socializing and learning on their digital devices.

    Social media, virtual learning, online gaming, and ubiquitous devices present new social challenges for kids. So, what social-emotional skills do they need to flourish in an increasingly tech-centric world, and are schools teaching them?

    Many schools are teaching key skills such as empathy, perspective-taking, and self-management, said Kelly Mendoza, the vice president of education programs at Common Sense Media, a nonprofit research and advocacy organization that also provides curricula and ratings on media and technology. However, the wrinkle is that educators are not always explicitly connecting those skills with tech use.

    One reason could be that a lot of SEL curricula uses face-to-face examples in instructional materials and in exercises, said Mendoza.

    "And I wonder if there is a generation gap and the adults teaching these skills don't think of all of the challenges that kids face online or are even aware of them," she said. "I'm sure they could make the SEL connections, but [these connections] may not be top of mind because adults are not participating online as much."

    But that disconnect, said Mendoza, means that students may not apply or adapt these all-critical social-emotional skills they are learning in school to their digital lives.

    Their digital lives, too, are fused with their offline lives in a way that is foreign to many adults, said Michael Rich, a pediatrician and the director of the Digital Wellness Lab at Boston Children's Hospital.

    "This generation of young people live in an environment where they move seamlessly from the digital and physical world," he said. Their teachers and parents, however, often see two worlds: one digital and one real.

    How technology influences kids' social-emotional development

    It's in this hybrid digital and analog world that kids are developing their identities, building relationships, learning to regulate their emotions and actions, and navigating an onslaught of false information. They are also spending a lot more time in the digital realm than they were before the pandemic, a recent survey by Common Sense Media found.

    While the social-emotional skills students need to do well in school and the workplace are many of the same they need to be good digital citizens, technology presents new challenges.

    Students need to be self-aware and able to manage their emotions, said Melissa Schlinger, the vice president of practice and programs at the Collaborative for Academic, Social, and Emotional Learning, or CASEL. There is a lot of emotional content on social media that goads kids (and adults) to click first and think later—commenting or sharing a video, meme, or story without evaluating its accuracy or the repercussions of their actions.

    "One component of SEL is to make sure that we are slowing down, and managing those impulses, and understanding what we're reading," she said. "Is this something to share? Is it helpful? And that self-management piece is a key strength that we need in this digital space."

    Teachers also need to coach kids to actively pay attention to how they are using media and technology and how it makes them feel, said Mendoza. Do they feel energized or lonely after playing video games? Do they feel confident or bad about themselves after scrolling through social media? Did they miss sleep, or a chance to interact with friends or family in person because of technology?

    Maintaining supportive relationships and developing healthy identities can also be more challenging online. People often behave differently when interacting with screens instead of face-to-face, which can lead to cyberbullying and can carry over into in-person interactions.

    "What we want to do is bring the personal piece back so that we can tap into our empathy," said Schlinger. "So, remembering that there are people on the other side of this exchange and trying to focus on being empathic and imagining how different perspectives are reacting and different consequences are affecting different people."

    Building that capacity for empathy in the digital space is important for maintaining healthy relationships online, she said.

    Social-emotional learning as it relates to tech shouldn't focus on just the short-term consequences of hurt feelings or sharing disinformation. Another important skill for students: being able to game out the long-term consequences of actions and how what they say or share online today could derail a job application or scholarship award down the line or destroy a relationship.

    This is true, also, for younger children as more of them join social media.

    "Young children's executive function is not developed enough to understand privacy," said Rich, the pediatrician. "To them, privacy is mom and dad can't see it. They don't think about the rest of the world."

    Much of SEL focuses on identity development, said Mendoza, and how students develop healthy identities online should be a part of that exploration in the classroom.

    "Kids are constantly performing for others on social media, and their identity development is highly subjected to others' feedback," said Mendoza. "Then there is a social comparison, that's huge, where you're scrolling and looking and everything is perfect or airbrushed, and kids struggle with this social comparison all of the time."
    While social media is certainly a dominant technology in children's lives, it's not the only one creating challenges for kids, families, and educators. There's online gaming and also a rise in tech use for schoolwork. Families can struggle with the ubiquitous use of digital devices, said Mendoza.

    "What I heard from some parents is that they felt like the school is sending this device home, and they felt like, well, it's not my device, so they felt like they almost had less authority over it," she said. "I think there is a struggle, and I don't know what the solution is, around having kids do homework, which is all online nowadays, and then so much of their time is on screens already for their personal use, and it's just a heck of a lot of screen time."

    There are a few broad ways schools can start being more conscious about teaching social-emotional skills for tech use.

    To begin with, "schools can deliberately carve out time for these lessons around explicit skill building around SEL and digital citizenship," said Nick Woolf, the social and emotional learning coordinator for the Burlington School District in Vermont.

    However, as schools do this, educators should be aware that there has been rapid growth of online and app-based social-emotional learning programs during the pandemic, warned Woolf, many of which are not vetted. It's important for educators to make sure they are using programs that are evidence-based and age-appropriate, he said.

    As with much SEL programming, secondary students—especially high schoolers—tend to be an afterthought, said Woolf, and it can be hard to find good curricula and resources geared to older students. This is particularly problematic given that this age group needs these supports the most as they navigate technology.

    One way to address this, said Woolf, is to consult high school students on their social-emotional learning needs as it relates to tech. As digital natives, they have a better grasp on their needs than the adults often do, he said.

    Schools should also seek student input on tech policies in their school—such as around smartphone use—as a way both to craft more-meaningful policies and to get students involved in the process, Woolf recommends. Student voice, or giving students avenues to have a say in how their school is run, is a tenet of SEL.

    Easing the tension between technology and social-emotional development

    For a long time, technology and social-emotional learning were thought of as distinct things, sometimes even at odds with one another because technology was seen as undermining students' social skills.

    But the pandemic has forced schools to think about delivering social-emotional learning and other well-being supports in new ways, said Woolf. And while social-emotional learning can help support healthy tech use, the reverse is also true, if often overlooked: tech can also support SEL.

    There are app-based check-in tools—such as mood meters—where students tap an emoji that depicts their current mood and, depending upon what they select, link to a related mindfulness activity. This is less work for teachers than the traditional paper mood meters, said Woolf, and it makes it far easier for the district to collect and see trends across the data.

    Data management programs with dashboards also make it easier for schools to collect and analyze data important to understanding the social-emotional needs and abilities of students, said Schlinger of CASEL. Survey data on whether students feel engaged, connected, or safe in school can be easily broken down by gender, age, race, income status, and other factors.

    As with a lot of other technology products and services, these advancements bring with them significant privacy concerns.

    "I have heard from a lot of parents and teachers, if we're going to ask students about how they are feeling, that could be bringing up sensitive information," Woolf said.

    Technology can help educators in other ways, said Schlinger. Zoom and other video conference tools have made it easier for teachers to meet with parents, building up those all-crucial relationships, said Schlinger, and they have made PD opportunities—including those to improve SEL—more accessible to teachers.

    While technology has created new challenges for kids' social-emotional development—and for educators teaching these skills—it's not helpful to think of the two as distinct or in tension with one another, said Schlinger.

    "Technology is not going away so we need to provide our young people with these skills," she said.  

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  • How Florida’s ‘don’t say gay’ law could harm children’s mental health

    Photograph of silhouette of family having a picnic
    [Editor's note: This article was published on April 4, 2022]

    Stella, 10, attends a private school in Atlanta, Georgia, and explains to friends that she has four moms. Two of them are the lesbian couple that adopted her. The other two are her birth parents, one of whom recently came out as a transgender woman.

    “I’m so grateful that [Stella] is somewhere that sees” the family “as what it is: her moms just love her”, said Kelsey Hanley, Stella’s birth mother, who lives in Kissimmee, Florida.

    But Hanley, 30, worries that children who have multiple moms or dads or are LGBTQ+ themselves won’t get the same acceptance in Florida.

    That’s because the state recently approved legislation that bans classroom instruction on sexual orientation or gender identity from kindergarten through third grade and prohibits such lessons for older students unless they are “age-appropriate or developmentally appropriate”.

    Hanley and some pediatric psychologists say the law stigmatizes being gay or transgender and could harm the mental health of LGBTQ+ youth, who are already more likely to face bullying and attempt suicide than children who are cisgender and straight.

    “We all have processes around clarifying who we know in our heads and hearts we are and who we are drawn to or attracted to,” said Laura Anderson, a child and family psychologist in Hawaii whose focus is LGBTQ+ youth and their families. “To make an increasingly large percentage of the population’s experience invisible and taboo is just so harmful and unsafe for all kids.”

    The Parental Rights in Education legislation, which opponents labeled the “don’t say gay” bill, is part of a flurry of measures introduced by Republican lawmakers around the country. The Human Rights Campaign, the nation’s largest LGBTQ+ advocacy organization, reports that lawmakers have introduced 300 anti-LGBTQ+ bills this year.
    The wave not only includes laws similar to Florida restricting instruction on gender identity and sexual orientation but also ones that criminalize gender-affirming medical care for transgender youth.

    Child psychologists say that such laws create an unsafe environment for LGBTQ+ children.

    Two-thirds of LGBTQ+ youth said debates concerning the state laws have had a negative impact on their mental health, according to a poll from the Trevor Project, an intervention and suicide prevention organization for LGBTQ+ youth.

    And transgender people, in particular, already often face greater psychological distress than the US general population. The National Center for Transgender Equality’s 2015 US Transgender Survey found that 40% of transgender respondents had attempted suicide, which is nine times the rate of the general population.

    “We have governors – that have no education or basis or expertise in child mental health – that impose such laws that are going to have horrendous impacts on kids,” said Natasha Poulopoulos, a pediatric psychologist in Miami.

    Supporters of the Florida law claim it’s necessary because children are being exposed to “radical concepts regarding sexual orientation and gender identity”.

    “What’s even more concerning about this is that parents are not just not being included but are being treated as the enemy here,” said Terry Schilling, president of the American Principles Project, which supported the legislation in Florida and similar bills in other states. “This legislation is not only good, it’s necessary to protect children and their innocence.”

    But groups such as the Florida Education Association, the state’s teachers union, say that elementary school teachers do not teach curriculum regarding sexuality and that Republicans are just using it as a cynical political wedge issue.

    Rather than protect children, the Florida law stigmatizes gender exploration, which is a normal part of child development, Poulopoulos said.

    “It’s healthy and normal for kids to go out of specific gender roles that have been extremely outdated. Even if a child was assigned female at birth and identifies as female, it’s OK for a child to explore things that may be considered more gender-stereotypical for boys,” said Poulopoulos.

    The legislation puts negative rhetoric “around aspects of gender identity and sexual orientation that are not heteronormative, so for example, if you are not cisgender and heterosexual, you are to be shamed”, said Poulopoulos.

    To prevent that shame, child psychologists say that it’s important for children to see themselves and their families represented in stories.

    For elementary school students, this could mean “using very simple language like: families can look diverse. Some families only have one parent. Some families have a grandparent and a mom. Some have two moms. Some have a mom and a dad,” said Poulopoulos. “That simple language is by no means sexualizing children. It is simply explaining the concepts of family structure, of sexual orientation and gender identity in a very developmentally appropriate way.”

    A 2019 report from GLSEN, an LGBTQ+ advocacy organization, found that two-thirds of LGBTQ+ youth respondents had not been exposed to representations of LGBTQ+ people, history or events in lessons at school. At schools that did have an LGBTQ+ inclusive curriculum, 59% of respondents said they often or frequently heard the word “gay” used in a negative way, compared with almost 80% of students at schools that did not have inclusive curriculum.

    “If you are a family or a child that is figuring this stuff out about your identity and don’t see yourself anywhere, in curriculum, in stories,” that absence means they must “undo the harm of their child having felt othered forever”, said Anderson, the psychologist in Hawaii.  

    If that’s something that can’t be discussed in school, they are going to feel like they can’t talk about it at home Kelsey Hanley

    Two LGBTQ+ advocacy organizations shared the child psychologists’ concern and filed a lawsuit last week challenging the Florida law, describing it as an “unlawful attempt to stigmatize, silence and erase LGBTQ people in Florida’s public schools”.

    A spokeswoman for DeSantis said of the lawsuit: “This calculated, politically motivated, virtue-signaling lawsuit is meritless, and we will defend the legality of parents to protect their young children from sexual content in Florida public schools.”

    But Hanley, the Florida mom, said the law tries to shield students from something they are going to encounter anyways. Hanley, who works in customer service, said she was attracted to women before she was attracted to men and realized she was bisexual in middle school.

    “They are going to go grocery shopping, and they are going to see two women holding hands. They are going to see two men holding hands, and if that’s something that can’t be discussed in school, they are going to feel like they can’t talk about it at home,” said Hanley. "And if their parents think it’s not appropriate to talk about, then their response is going to be: ‘If I have to hide this part of myself, do I have to hide that I’m on substances? Do I have to hide that I have a crush on somebody?’ They are not going to have any kind of openness.”

    Hanley also worries about what rhetoric from advocates for the Florida law – about the need to “protect our children” – will mean for children like Stella.

    “Stella would think that people want to protect children from her,” said Hanley. “And she would think: what do you need to protect yourself from?”  

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  • Five daily habits that reduce anxiety and improve mental health

    Person in a zen pose with musical notes around

    After decades of battling the stigma associated with mental health and anxiety, we are finally seeing a change in the tide. Every day, more people than ever are seeking help and support for these concerns, and those who once suffered in silence are finding their voice and advocating for themselves and their loved ones. Many others are experiencing “situational anxiety” due to increased stressors at home and work. It can be difficult to eliminate these stressors completely, but there are some ways to reduce their effects, beginning with our daily habits. Here are five tried-and-true daily habits that can help.

    1. Dream on. An agile, resilient mind needs its rest. Creating a bedtime ritual (e.g., turn off devices, have a cup of herbal tea, journal, and read a book) can help you “power down” and relax before your head ever hits the pillow. Not everyone requires the same amount of sleep — you might need slightly more or less than eight hours — but ensuring you’re getting enough sleep helps your brain “reset” and prepare for a new day.
    2. Gonna get physical! Well, now that you’ll be singing that song all day, let it inspire you! An exercise routine you can stick to will not only help maintain your physical health, it will also prompt your body to increase endorphins, your brain's feel-good neurotransmitters.
    3. I feel the Earth move... under my feet. If you work at a desk, get up and move as often as you can. If you’re already on your feet, a quick walk is a great way to take a brain break, even if it’s to the parking lot and back. Sometimes a change of scenery is all you need to gain a fresh perspective!
    4. All I can do is write about it. Journaling is a great way to process the events of your day. Find one with some inspirational quotes and prompts to help you get started and keep it on your nightstand and at the ready! Getting your thoughts and feelings out on paper helps to purge the negative and reinforce the positive.
    5. On the radio... According to the National Alliance on Mental Illness (NAMI), music’s rhythmic and repetitive aspects engage the neocortex of your brain, calming you and reducing impulsivity. Lyrics can also affect your mood, so choosing familiar songs with a positive angle can help propel you to a more positive frame of mind. Create a positive mindset playlist and press “Play” whenever you need to change your perspective. Singing along is optional, but definitely adds to the fun!

    We hope this musically inspired list helps you find and maintain your positive headspace. If you find yourself in need of mental health support, please contact a provider in your area. We wish you all the best!

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