1. Responding to Risky Behaviors Supporting students with addiction and emotional issues: Parent Workshop Kate Allen LCSW CADCI

2. Importance of Addressing the Issues in Schools Referrals to social worker increasing. There are 127 new therapeutic schools opening every year nationwide. School as providing basis of relationships for students, both with peers and adults.

3. Three issues of concern: Drug/Alcohol abuse Depression and suicide prevention Fostering resilience in youth

4. Impact of D/A Abuse on Healthy Teen Development Core developmental tasks include: individuation, sense of purpose, social skills With drug and alcohol use teens: Remain emotionally immature (projecting, blaming, grandiose ideas of self, “boring”) Use D/A as primary relationship instead of people. Social life revolves around use. Reorganize priorities to fit using lifestyle

5. Signs of Drug/Alcohol Use Less attention paid to dressing and grooming Loss of appetite or unexplained weight loss Red and glassy eyes and frequent use of eyedrops and breath mints Decreased attendance, performance in class Loss of interest in school, sports, other activity Newly developed secrecy; deceptive or sneaky behavior Withdrawal from family/friends, new friends Lying or stealing Disrespectful behavior, worsening mood Lack of concern about the future

6. Drug and Alcohol Use: Typical or Troubled? Experimentation vs. abuse/dependency Trends at Gresham HS Nationwide trends show overall D/A use decreasing: “While the 2005 survey showed a continuing general decline in drug use, there are continued high rates of non-medical use of prescription medications, especially opioid painkillers”. – National Institute of Drug Abuse

7. Alcohol and Marijuana: Most common drugs of concern Is it possible for teens to be addicts? Tolerance and withdrawal Alcohol: Binge drinking and signs of problem drinking Marijuana: State-dependent learning and signs of trouble

8. What about the Meth epidemic and other uppers? Trends at GHS Other drugs: ADHD drugs, painkillers

9. Interventions for Teen Drug and Alcohol Problems Prepare yourself for how to approach a teen you suspect is high or drunk Address the issue immediately and directly Assessment process, treatment options, UA’s, school support services Confidentiality basics

10. How to Approach Youth with Drug/Alcohol Problems Separate the use/behavior from the teen – do not shame the teen Be clear about your position on D/A use and your responsibility as a parent Build in small rewards for positive behavior Expect emotional instability while recovering, normalize ambivalence about sobriety, acknowledge relapse as part of recovery

11. Topic 2: Depression and Suicide Prevention

12. Prevalence of Self-Harm Behavior Amongst Teens " As many as 40% of kids have experimented with self-injury." - Jennifer Hagman, Medical Director of Psychiatry, Children's Hospital, Denver "90% of self-abusers begin cutting as teenagers." - University of Missouri-Columbia Study "More than half of self-injurers are victims of sexual abuse, and most report emotionally abusive or neglected childhoods... contrary to the stereotype, self-injury is prevalent in all races and economic backgrounds." - Time

13. Why do Some Teens Intentionally Self-Harm? Releases tension/distress Not typically done with suicidal intent Self-soothing coping mechanism Externalizes internal pain Provides way to care for self and regain control over unmanageable emotions

14. Common Characteristics of Students who Self-harm Hypersensitive to rejection Rigid emotionally, reactive, angry, easily irritated Impulsive Strong dislike of themselves Tend not to plan for the future

15. How to Help Teens who Self-Harm Ask if they are self-harming, respond directly. Avoid “why” questions. Refer to a professional as soon as possible. Enforce a ‘no secrets’ policy. Ask, “How would you like me to respond to that?” Say” Let me listen to you”. Build relationships – most often self-harm happens in absence of people. School social worker response to self-harm.

16. Teens at risk for suicide Gender differences Racial/ethnic differences Age differences How Oregon compares to national data

17. Gresham-Barlow SD data Oregon Healthy Teens Survey 2007 Seriously considered suicide in past 12 months: 11 th graders: 12.4% 8 th Graders: 13.1% -- Source: Center for Health Statistics Oregon Dept. of Human Services

18. SAFE:TEEN at GHS 3 part program: staff, parents, students Evidence based program proven to reduce teen suicide Social worker interventions

19. SUICIDALITY 1. Thoughts about death 2. Thoughts about killing oneself 3. Choice of method or developing plan 4. Carelessness 5. Gestures 6. Attempt 7. Completion

20. SUICIDE IS… AN ACT OF DESPERATE HOPELESSNESS AND OVERWHELMING PAIN A CRY FOR HELP PREVENTABLE

21. SUICIDE IS NOT… SELFISH SPONTANEOUS

22. Signs of Depression Withdrawal Sad, angry or irritable for 2+ weeks Loss of interest in usual activities Mood swings - may indicate bipolar depression Difficulty concentrating Substance abuse Sleep/appetite changes Cry easily RESPONSE 03 © Looking Glass Youth and Family Services

23. When to be Concerned Development of a plan Talking, writing and/or reading about suicide or death Terminal Statements Previous Attempts RESPONSE 04 © Looking Glass Youth and Family Services

24. When To Be Concerned Cont’d Refusing help, feeling “beyond help” Giving away possessions Having tunnel vision - focused on pain Suddenly cheerful after period of depression RESPONSE 05 © Looking Glass Youth and Family Services

25. Drugs and Alcohol Use Increased risk if substances involved: Self –medication Self –medication Impact of drugs and alcohol on judgment Impact of drugs and alcohol on judgment 55% of people who die from suicide have alcohol in their bloodstream when they die.

26. WHAT STOPS SUICIDAL TEENS FROM ASKING FOR HELP? Don’t want to rock the boat Don’t want to disappoint parents Don’t want to admit they need help Don’t know what to expect Don’t understand what they are experiencing

27. How to Help Listen without judgment Ask “Are you thinking of killing yourself?” Say “I’m sorry you are in so much pain.” “I’m here to help.” Let them know they are not alone. Seek help together as a family. RESPONSE 06 © Looking Glass Youth and Family Services

28. Video: A Life Saved What two questions does Mary, the mother, ask Bill about suicide? What stops the mother, Mary, from asking for help?

29. 5 Steps to Helping a Teen Stay calm Ask the question, “Are you thinking of killing yourself? If yes, do not leave teen alone Listen and offer calming things to say Get professional help RESPONSE 08 © Looking Glass Youth and Family Services

30. How to get help at school or in the community: Talk to the student’s counselor or the school social worker Call the Suicide Prevention Hotline Call Multnomah County Crisis Line If immediate danger call 911

31. GHS support services Support groups: Chrysalis, Grief/Loss, Guys group, Pre-Options Mental health specialists: Multnomah County MH consultant Drug/Alcohol assessment and treatment: Lifeworks NW Teen advocates: Metropolitan Family Servcies, Asian Family Center, Native American Youth Center, El Programa Hispano

32. Topic 3: Fostering resilience in youth

33. Power of relationships Kids spend on average 23 hours doing “screen time” a week! PADS Educate yourselves and your children about consequences of D/A use and unhealthy coping Spend time together as a family every week

34. Raising Resilient Kids Talk to your child about your values regarding drug/alcohol use, honesty, sexual activity, and school. Set high expectations, enforce limits consistently with appropriate consequences (positive and negative). Help youth identify healthy coping skills when difficulties arise (distress tolerance skills). Go through the 40 assets list with your child!