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Liz Unruh (Host): I'm your host Liz Unruh, and joining me today are Jessi Otto and Kelcie Pomaranski, who work in Pathways, which is our outpatient mental health program here at Riverside. Thanks for joining us today.

Jessi Otto, LPC: Thanks for having us.

Host: So today we're going to be talking to these two about back to school and navigating the mental health challenges that come with that. But first, Kelcie, can you tell us a little bit about yourself?

Kelcie Pomaranski LSW: So I am an outpatient clinician. I, through Riverside, I work with the littles, ages like six to seven to like 11, 12 year olds, depending on their, um,

Jessi Otto, LPC: Mental capacity.

Kelcie Pomaranski LSW: Mental capacity, age functioning and things like that.

Host: Perfect. And, Jessi, can you tell us a little bit about yourself?

Jessi Otto, LPC: Yes. I have been with Outpatient Pathways at Riverside for three years. Been a clinician for the last 10 years. I work with adolescents, which is ages 12 to 17. We work on just different strategies, coping skills, stress.

Host: Great, so you two are great resources from both the littles and the older kids to talk about what we're going to be discussing today. So kind of to jump right into the topic, I know back to school, we're kind of starting back to school now and things are getting rolling.

Are there some common mental health challenges that children face when they're going back to school?

Jessi Otto, LPC: Diagnosis wise, ADHD, you know, they go from like summer to having like the freedom of doing what they want, acting like they want, and then they go to school where it's going to be rules and every day, same time, routine.

And I think that the biggest deal even with kids that without diagnosis for going back to school is because, oh my gosh, now all of a sudden my whole day is going to be written out for me. Like one out of five children and adolescents, they experience the mental health during like the school year, stress, bullying, family issues, disability, substance abuse sometimes. And then the schools are also dealing with the diagnosis of the ADHD, anxiety, the socially heightened way that they feel and other behavioral disorders.

So, I think that it's just the routine is such a big deal. It heightens anxiety where you wouldn't even know a kid would have anxiety. It's a big change. You know, three months to nothing, to, oh my God, this day. So.

Host: Yeah. For sure. I could see that, like, scheduled, every moment of your day scheduled going from, like, no schedule at all could definitely be a shock to some kids schedules.

Kelcie Pomaranski LSW: Yeah, and then with the disabilities, like the learning disabilities and stuff like that, trying to like advocate for your kid or your student to get like a 504 plan or an IEP to kind of help them with those needs that they might have to help those accommodations throughout the school day.

Host: That's true. Getting those resources in place to help them would definitely be beneficial. Along with that, are there ways that parents can help children emotionally prepare for the transition back to school after a break? Not only summer, but, you know, Christmas is going to be here before we know it. Are there ways that people can help their children prepare?

Jessi Otto, LPC: I think the biggest thing is to make sure your child has a daily predictable routine. Kind of start them off like that. You know, give them a little time, like regular time for meals at home, adequate sleep. Just knowing what they can expect at home helps them to cope at school too.

Also getting them involved in the process of transition. So, you know, letting them know step by step, giving them reminders. This is what's going to happen. Hey, we got two days of this. Let's do this. And going back to school, even like helping them shop, plan their routines, what their route is going to be home.

Because I think a lot of kids are stressed out, like, how am I going to get home at the end of the day? How am I going to get to school? And give them something to look forward to. Hey, there's events. There's activities. When kids have something to look forward to, they tend to do better with like, okay I'll do this week, next week I get to do this. You know, they get like real excited. So those are just some ways to help prepare.

Kelcie Pomaranski LSW: I think also providing them with like that like safe space and like helping them feel like supported and heard like it's really hard to kind of like talk about those things like with your parents because you feel like it's just going to be like oh, I went through it, like you're fine.

You're going to be all right. Like it's really no big deal. Like actually like listening to them, listen to hear them, not just to respond and give your point because what they're feeling may not be what you're feeling and understanding that.

Host: Yeah, that's for sure. I know I just read something on social media where a parent said, I now ask my child, do you want me just to listen, to be here, to ask advice? Are you asking me advice? Those types of things. I think that goes along with what you guys are saying. Kind of, meet the kid where they're at. See if they actually want the advice or if they just want to vent.

Kelcie Pomaranski LSW: We've had, uh, one of the littles, their parents, they kind of gave us the idea of asking the child, like, do you want help or do you need time? Do you need time or help? And then, so that kind of gives them like that power play of like, I now get to make this choice. And also I know that they're asking me for help, but maybe I do just need time to like cry it out, to like yell it out for a minute. And when I do need that help, I know that they're there and I can ask them.

Host: Yeah, for sure. It's good to get them, like you mentioned before, Jessi, to get them actively involved in planning and being able to cope with their emotions.

Jessi Otto, LPC: It gives them that sense of independence. You know, that sense of independence and how to figure out their own way to cope on their own so they're not always asking or someone having to tell them. Because they need to regulate themselves sometimes.

Host: Yeah, for sure. So why do you guys think it's important for a parent or a guardian to address these types of challenges proactively? So if there's like a mental health challenge that they're seeing with their child, why is it important that we proactively work with them?

Jessi Otto, LPC: I think it reduces the stress of the new year coming. Um, it allows children to know that they have support at home. It's important for a child to feel prepared. Though, kids don't want to have a schedule, you think they don't. They do need that. They do want you to show understanding. Like, I understand I get anxious when I do new things, too. It's a thing. You know, I start a new job. I'm anxious. I meet new people. I'm anxious, I think that it's important to let them see those emotions that you have too, they think that emotions, a lot of kids, they shouldn't show them or they just want to be rid of them, but emotions help us, and I think that when a parent can share that and be proactive and be, I'm listening to you and I hear you, it helps them prepare like, Oh, if my parents do it and I see they're okay, I'll be okay. And I think that's a big help for them.

Host: I know my daughter is going to, she's only eight months old, but she's going to know that I don't like going to new places because parking. Parking situation freaks me out. So, like, as an adult, that's something that a child cannot really relate to, but they can relate to that anxiety of going to a new place and not knowing everything about the new place.

Kelcie Pomaranski LSW: I totally understand. If there's, like, a parking spot and I can't get into it and my husband's in the car, I will literally park the car and get up and switch him spots. So, I, I, I hear ya.

Host: Yes. So, I know, Kelcie, you mentioned creating that safe space for children to discuss their feelings and concerns. Are there some tips you can give parents to help create a safe space?

Kelcie Pomaranski LSW: I think, like I said, like, listening to listen, not just to respond. Giving them that free space to kind of, like, vent and say what they say without judgment. Because, I mean, honestly, parents can be kind of judgmental, so kind of try, try and have on that like poker face. Like, just listen to them, without interruption, showing feelings, like Jessi said. I mean, we all have feelings. Feelings are not bad. We may try to associate, like, anger, sadness, like with bad, but feelings are feelings and they deserve to be felt.

And just even asking, like, the kid, like, how do you want me to communicate to you right now? Do you want advice? Do you just want me to listen? Do you want me to ask questions? What do you need from me? So kind of giving them, I used the word power earlier, but like Jessi said, independence, giving them that independence over their emotions and how they want them to be felt and how they want them to be communicated as well as, like, responded to.

Host: Yeah, for sure. With that and getting that safe space for parents to create that safe space for children; are there some strategies for addressing some of that back to school anxiety or nervousness or some of those other emotional responses that come with going back to school?

Jessi Otto, LPC: When I asked that, I did ask the adolescents, I did ask some kids like what they thought about this and what could help, what helps them the most. And a lot of them said like, not overthinking it. Like, I know that's easier said than done, like that's simple, but they, that's what they do. Not overthinking it and just kind of try to live moment to moment, explain how one incident doesn't need to be carried to the next moment, you know?

So something, so you stub your toe, it doesn't mean it ruined your whole day. It's like just explain to your kids like, oh, that bad thing happened. I understand. I understand. You know, I understand you. What can we do to help you get, move past that? Showing understanding to move past things, thinking about other things that I think are good strategies for anxiety and nervousness is like again, thinking about something that you're looking forward to, maybe going through the school, you know, you get like a printout of what goes on during the school year, go through that and pick the things that interest you. Practicing skills too. Some parents I know they look up like things to do like deep breathing or they'll look up like, oh, I'll give you a fidget or let's find interests.

But I think that a lot of times what doesn't go on is practicing those coping skills when you're already regulated. So when your emotions are like your everyday emotions, you're, you're feeling good. You practice those skills and which are your interests, things that you like to do that make you feel happy, do it while you're happy and practicing every day all day.

And it'll help your like, like, kind of like muscle memory and it'll help you remember that when your emotions are high, because when our emotions are high, it's hard for us to think of like, what do I do next? Because your emotions are overrunning. So I think like practicing those positive daily affirmations. Finding the positives in a day time, okay, well, you said that you stubbed your toe earlier, but what's something positive that happened to you today? Cause I think a lot of people miss that step in life. Like they miss finding something positive that's happened to you. So I think that, I'm sorry, I just talked a lot, but I feel like just finding positives and explaining that it's just a moment, not your whole day. You know, that's a big deal with anxiety and nervousness.

Host: Those are really good tips for dealing with the anxiety and nervousness that come with back to school. So, when a child has those bad moments that maybe have taken over their bad day and they need some self care or something to kind of turn their day around once they get home; can you talk a little bit about why it's important for a child's mental health, that we show them what self care is and how they can practice it?

Jessi Otto, LPC: So health care, I think a lot of times people think of health care, they think of hygiene. Though hygiene is important for someone, hygiene is good for you to feel good about yourself, and self care, but it also means finding interests and finding something that you can complete, like completing a task that you like to do.

I think self care also is like you're knowing that you're accomplishing something that builds your confidence and that pride that you have at finishing it. Self care is just, it's just something like, what do I, what can I do for school? It's like some kids that learn or they are in sports and they can finish, they finish practice, they feel good about themselves.

Right? So maybe your kid's not sportsy. Maybe they want to just completely listen to their favorite song and be by themselves and dance in their room. Not crafts. I'm not, that's not what I mean. It's just. Maybe they want to finish a book to learn something about, like maybe their favorite thing is dinosaurs.

So they want to get home, learn a little more about this dinosaur, and then have their favorite snack. So self care is just doing something for yourself, right? It's for yourself and how you, and just to make you feel good that you like to do it and practicing that every day, again, it helps you when you are stressed out and when you are overly emotional.

Kelcie Pomaranski LSW: And I think if, like, a kid is really struggling to, like, find something that they can do for themselves with, like, self care, like you said, like, finding their interests, but also, like, we as, like, adults and parents, like, we also have to take care of ourselves too. And we typically, I mean, I don't know, like you see like on Instagram and Facebook and stuff, like everybody gots like these like skin care routines or like, they're like hygiene routines and stuff like that.

Like trying to like include your kid in like things like that because then maybe that might spark interest too because in those moments you are taking care of yourself and you're taking care of yourself in a good hygienic way too. So it might build up a kid's like hygiene routine too, to get them to be clean. Because I mean, there are some stinky teenagers.

Host: Just teaching them that that's part of, you know, feeling good is not that, yes, not that beauty comes from inside as well, but taking care of your actual body is also important.

Jessi Otto, LPC: Yeah, it helps with that social ability too. We see that a lot in our groups. If there's a kid that has poor hygiene, the other kids tend to not talk to them. So then that makes them feel self conscious and have that paranoia. So at school, same thing, and I know that some kids don't have the things that they need, but I know there's a lot of places you could go to get those resources, and we've been trying to do put together hygiene packets too for kids, and I think a lot of schools are doing that. I see like outside the classroom, so it's just kind of that social ability too.

Kelcie Pomaranski LSW: And I think like to piggyback off that too, like with you said paranoia, like also like it could get their like, it could almost fuel their anxiety oh if I don't shower, if I don't smell good, people won't want to talk to me and then I won't have to have those social interactions too.

Host: Yeah, I think it can go both ways on that one. It can, yeah, sure. Yeah, we're just going to take a quick break to talk about finding a primary care provider. Riverside knows that health, especially your mental health, is your greatest asset and that your primary care provider is your partner in health. If you are starting out on your mental health journey, a great first step would be talking to your primary care provider.

If you don't have a primary care provider, Riverside can help. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare. And we're back. So we've talked about a lot of the things that parents can do to, you know, proactively help their children, but I'm sure there are times when a parent should consider seeking mental health from a professional for these challenges that their child faces. Can you guys talk a little bit about what situations a parent might want to start considering getting that extra help?

Jessi Otto, LPC: Yeah, I think when a parent recognizes that their child's like daily functioning is severely disrupted, you know, they're sleeping constantly, they have the inability to regulate emotions or they're showing inappropriate responses to unwanted emotions. So maybe something happens like they don't want to do something and the parent says, no, just do it. And then all of a sudden they just like outlandishly outbursts of crying or even kind of aggression, like, okay, you know, instead of talking it out, like not being able to talk things out, maybe an unusual, they present unusual, like this isn't how you were a week ago.

And they're, they're kind of hiding themselves more, just any severe change in behavior, I think is a big deal because kids don't, they tend not to want to talk to their parents. From what I, you know, I've been working with kids for a long time, adolescents anyway, they say it's hard to talk to their parents because they don't want to disappoint them or their parents are just like, nah, suck it up.

Or, you know, they get, so when you notice, like, cause your facial expressions and your body language tells a lot. And if you can see that your child no longer has any interests anymore, is quitting things, isn't talking to their friends as much, that's when you recognize it and you can kind of have that conversation.

Kelcie Pomaranski LSW: And I think being as a parent, like, you need to almost, like, put yourself in check, too. Like putting like your pride or whatever you want to call it to the side, to be open to the idea of getting your child the mental health needs that they might need. And not seeing it as, like almost like a personal attack on your parenting. Like, oh my gosh, I messed up because my kid is like this. Not seeing it as that way. Put it to the side. Get your kid the help that they may need. Reach out to different resources and advocate for that. So, advocate for the kid.

Host: Yeah, for sure. I know there are a lot of great resources in the community for the school age kids. Most schools have counselors. We have Pathways here at Riverside, as well as other organizations in the community. What are some of the benefits of involving a mental health professional such as a therapist or a counselor, with these challenges?

Jessi Otto, LPC: With therapists and counselors, sometimes you, you know, you learn new skills that you may not have known were actual skills. Like people think of coping skills differently, like, oh, it's got to be something that you fidget with, but coping skills are communication and like what your interests are, coping skills are anything that cause you to feel a tinge of happiness, So it's anything possible. Can be establishing, also with counselors, you can establish goals and how to develop them. You know, sometimes you don't realize what kind of goals you need to make and just like talking, you can maybe find a new way to set goals. How to address emotional issues, by building communication. Improve self esteem, promote changes in behaviors, and improve well being. You know, there's a lot of benefits to therapists and counselors, not because they're trying to tell you you did something wrong, but just to give you more ideas that could help. Because when, you know, you learn one way, so you stick with that way, and maybe that's not the best way for the challenge you're having with that child.

Kelcie Pomaranski LSW: So then maybe also getting like that validation of feelings for the kid too. Like i said, so as parents sometimes you're like you know the old school ways of oh suck it up you're fine and when it's like Mom like that really like hurt my feelings, like my feelings are valid. So also getting that validation of feelings and understanding that feelings are okay, and they should be felt and it's our responsibility to know how to cope with them in an appropriate way.

Host: Yeah and kind of going with this question, so we've talked a lot about parents helping in ways that they can help their children. But are there some tips that you can give about building resiliences and coping mechanisms to deal with those ups and downs that happen during the school day?

Jessi Otto, LPC: When I asked the, I asked the kids this question in my group again, that he, one of my kids, gave the best answer to tell parents; instead of trying to fix their children's problems for them, help them solve their problem with them. So he says a lot of times kids don't know how, he was built on that. He was saying, I think we don't know how to be resilient for ourselves in the ups and downs of the day to day because somebody's always fixing it for us or someone's always there to tell us what to do. So it's hard to build resilience when someone's always like, no, do this instead.

So he said, sometimes, like I said, get involved and do the process with your kids because resilience is a big deal. Like when we can see, that's how, when we can see at the counseling center, we put that on their notes, like, kid is being resilient with their emotions. You know, they were able to bounce back and that's a positive thing that we can see growth in our for their programming. So.

Kelcie Pomaranski LSW: We should be really trying to like work with our kids and not just having that power of control. Like, these are my kids, this is the way that it is. More just working with them, taking that time. Yeah, it may take a little bit longer, but, you can take five minutes away from scrolling on Facebook and scram TikTok or whatever to work with your kid and to help them with their needs instead of just almost just wasting time on social media.

Host: Yeah, like, being able to fix your own problem is a huge thing in becoming an adult is because you have to deal with your own problems eventually. So if you start teaching young how to correctly interact with other people and fix issues that come up could definitely benefit.

Kelcie Pomaranski LSW: And I mean, you hear parents sometimes saying like, you're like 16, like, it's time to grow up. They don't know how to grow up because you've been there, literally, I can't even say, holding their hand right in front of them, fixing every block along the way. They don't know how to do that because you haven't shown them how to do it. You've just done it for them.

Host: Yeah, definitely helping by example. Yes, exactly. Thank you. Helping by example, that is exactly what I am, the phrase I'm looking for here.

Kelcie Pomaranski LSW: And letting them see the example though, not just doing it behind closed doors.

Host: Yes, for sure. So we've had a lot of really great conversation and information shared here, but are there some final pieces of advice or tips for parents or guardians as they support their children's mental health during this back to school transition?

Jessi Otto, LPC: I think the biggest advice that I also would like to give, we talk about by example, is parents also, you know, when they're dealing with their kids, like their kids are upset. It also takes a toll on the parent, you and I understand that. So building that structure and set your own boundaries too.

Like you come home from work, we get it. Parents work all day and they're like, oh man, I can't deal with their stuff right now. But let your kid know that shows them to set boundaries. Like, you know what mommy needs? Or Daddy, sorry, needs 15 minutes of self care, to be alone, to kind of let mommy just like take a break, and then I'll help you with what you need, and then you know that I need to transition from to home too, okay?

So I think that my biggest advice for parents, because it is difficult and it's stressful for the parents also, you know foster that independence, encourage that connection, and lead by example, you know be that positive role model for behaviors. And I think it's helpful that way.

Kelcie Pomaranski LSW: Yeah, I think modeling the positive behaviors is like really important. Like, modeling like appropriate communication, how you appropriately cope with your big emotions, as well as like some of the habits that you have. You want your kid to have all of these healthy things, then you should be modeling that for them as well.

Host: Yeah, I think that's really big. Being able to model and show, show by example, what you can do to help with your mental health is really big. Well, thank you for joining us today. And thank you for tuning into the Well Within Reach podcast with Jessi Otto and Kelcie Pomaranski with Riverside Behavioral Medicine and your host Liz Unruh. To learn more about the services provided by Riverside Behavioral Medicine Department, visit our website at riversidehealthcare.org or call our Central Intake Department at 844-442-2551.