Cheryl Martin (Host): Welcome to Healing Heroes, PDX, the podcast series from the Specialists at Shriners Children's Portland. I'm Cheryl Martin. Today our topic is Bullying. Katie Azarow, a Medical Licensed Clinical Social Worker at Shriners Children's Portland joins us this episode. She's here to discuss the different types of bullying that children might encounter, the signs that your child may be experiencing bullying and helpful strategies to implement. Katie, so glad you're here to discuss this vital topic.

Katie Azarow, LCSW, CADC I: Thanks so much Cheryl. So happy to be here.

Host: First, please tell us more about your self and your role at Shriners Children's Portland.

Katie Azarow, LCSW, CADC I: Absolutely. Yeah. As you said, I'm a licensed clinical social worker, and I've been at Shriners for just about four years, and I have the privilege of working with our patients all throughout the hospital. So from the outpatient clinic, to surgical services, our inpatient unit, rehabilitation. I see our patients throughout their stays and their journeys here.

And really just get to meet them where they're at and work with kids on whatever is tough and happening in their life at the time.

Host: Speaking of tough things, do you sometimes talk with the children at Shriners Children's about dealing with bullying?

Katie Azarow, LCSW, CADC I: Unfortunately, you know, it's such a frequent conversation with our patients. Bullying's become so widespread in the United States, with I think about 20% of kids at this point in time reporting bullying within the past year. And so it's something we talk about constantly.

Host: Tell us about the different kinds of bullying you see or you hear about.

Katie Azarow, LCSW, CADC I: Totally. So anything from physical bullying, things like someone hitting or kicking, tripping someone else, pushing them, spitting at them, to verbal bullying, which can be name calling, taunting, threatening, teasing behavior. Psychological bullying. We're thinking more about like spreading rumors, manipulating social relationships, intimidation, any kind of social exclusion. And then of course, as we're all too familiar with cyber bullying, so any bullying that happens over the internet or electronic devices, text, email, social media, gaming platforms.

Host: Let's talk about cyber bullying. What advice would you offer to parents to help protect their children?

Katie Azarow, LCSW, CADC I: Yeah, this is a really tough one and I think there are several steps that parents can take. The first thing really is, is to talk to your child about it before problems begin to arise. If we wait to talk to kids until we're seeing signs or symptoms, it's often too late and they have a preconceived notion about what it's going to mean to talk to their parent about it.

Unfortunately, most kids believe that if they get in a pickle with cyber bullying and their parent picks up on it, then the end result will be I lose my electronics. So kids are really resistant to talk about it once it's a problem. So beginning the conversation early on is great. And then as parents, we really have to work to model good behavior with our own devices.

Bullying isn't just a problem of young people, so if parents are spending lots of time on their own devices and kids are hearing them or seeing them say mean or hurtful things on the internet, that makes a kid feel like they've got that green light to go and mimic that behavior. So we really want to be in tune with how we're interacting with the internet and then making sure we're, we've got an open dialogue with our children about their internet use, making sure we know what games they're playing, what apps they're logging onto, that we or another adult in our circle is friends with the, with our kiddo on the internet.

So that we can have some kind of eyes on what's happening with them, making sure that they've got some screen time allowances, and we've talked to them about their privacy settings so that we can be rest assured when they are engaging online that they're doing it in the safest way possible.

Host: Katie, you talked about beginning the conversation. What would that look like? Can you give an example?

Katie Azarow, LCSW, CADC I: Yeah. I think that when we think about when to start talking to kids about bullying behavior, it's important to know that between the ages of three and about six years old, kids are engaging in a lot of things that might look like bullying, but really is very typically developmental and appropriate.

Whether it's teasing another kid or pointing out somebody's differences. And so I think it's great to begin talking to kids anywhere from five to six years old to start saying, Hey, I noticed that you had something to say about how your friend looked different on the playground, and I wonder if we can talk about that a little bit because they are different, but differences are beautiful and that can open a conversation with your young child so that they understand, okay, I, I am different. Everybody's different. But that doesn't mean that when we point that out, it needs to be said in a mean or unkind way. And sometimes we can notice those differences without saying anything. And then I think, when it comes to cyber bullying, it's important, especially in that pre-teen phase when kids are first starting to get some freedom on the internet, that there are conversations, again, preemptively around, Hey, you know, I know you're a kind person with a good heart and that you want to be on the internet to connect with other people, but there are some folks out there that are not doing all of the right or nice things on the internet. And I want to talk to you about how you cope with that when you see that, what it looks like to stand up for another kid or advocate for them, and what it means to be a bystander to bullying.

So that kids have an idea before they really have that free reign on the internet that they need to be looking out for these things or aware that they can happen.

Host: What do you think is a biggest misconception about bullying that you want to see changed or you want to set the record straight on?

Katie Azarow, LCSW, CADC I: Yeah, for me, this is a twofold. Part one is really this idea that it, it happens to other kids, but it doesn't happen to my kid, or it happens to other people, but not to me. I think it's really important that we all know that regardless of our age, our gender, our sexual orientation, our disability status; we all can potentially be victims of bullying.

And it really bullying behavior does not discriminate on any of those things. So that would be the first. And then the second thing is really that our role in relationship to bullying is not static. So a kid can, in one situation, be the bully, and in another situation, be the victim of bullying or be a bystander to bullying.

And so oftentimes I hear people talk about a child that tends to exhibit bullying behavior. And I think it's important that we remember that that kiddo could very easily be the one being bullied in another setting. We, as humans, we are prone to take advantage of power imbalances when they show up.

And especially young kids who don't have a prefrontal cortex built into their little brains yet. It's just a very natural progression in life to say to ourselves, I noticed something different about this kiddo. No one else has that difference. So that's something I can now talk about or bring up and quickly it can turn into being unkind or mean. And so I think just keeping in mind that we all are impacted by bullying and our relationship to bullying can change based on the day and the situation and the way our identity kind of lines up in, in that power structure.

Host: I am so glad that you brought up bullying behavior, because we're talking about bullying and a lot of times we're talking about the resources for the parents whose kids are being bullied. But you brought out a good point. What about the person? You have a child who's actually being the bully in a particular situation, even though they may be bullied.

So is it easy for parents to identify that maybe their child could be the bully in certain situations, and if so, how to confront that or deal with that?

Katie Azarow, LCSW, CADC I: Absolutely. That's a great question, Cheryl. I think the short answer is that no, I don't think any parent wants to come to that realization that their child is being the bully. And I think that's just because, inherently we all love our kids and we all believe that our kids are doing their best.

And so it can be really disheartening to recognize that our kiddo is, is someone who is exhibiting bullying behavior and that leads parents to oftentimes kind of keep themselves in the dark about it. But I do think that it's important that we all work to become parts of communities who are open and vocal and are talking about these things.

And so as a parent, thinking about how do I maintain a really good relationship with my child's school and if I'm getting phone calls and I'm being told that my child is engaging in bullying behavior; instead of sweeping it under the rug, or instead of saying to myself, oh, they, that kid probably did something to provoke them, or they weren't actually bullying, they're being targeted; how can I sit down with my child and have a really open and frank dialogue about bullying? Because the truth is, the statistics show that there's no one in our country who has not been somehow involved in a bullying situation in their lives, especially during elementary, middle, and high school. And so just to kind of normalize it.

We don't want kids to believe it's okay, but I do think kids need to know, Hey, this is something that tends to happen when groups of people get together, and school is a place where groups of kids get together. So bullying will happen, and sometimes you might fall on the wrong side of that situation. And when you do, how do you repair with another kid when you go home and you realize Ooh, I made a mistake. I shouldn't have done that. Or that wasn't kind of me to say. What do you do afterwards? We talk so much to kids about what we hope that they do, but I think we often miss out on the fact that as human beings, we all make mistakes and kids are not immune from that. And so I think for parents to be able to talk to their kids in the framework of, I know you're going to make mistakes, because we all make mistakes. But afterwards, what do you do about it when you realize that it was a mistake? How do you go and repair? I think the repair piece is huge and is really ripe for good relationships and positive emotional experiences for young people.

Cheryl Martin (Host): Katie, I would imagine that many kids don't tell their parents if they're being bullied. I know I didn't tell my parents when I was bullied in junior high. Why is this? And then what are some of the signs that they should look for?

Katie Azarow, LCSW, CADC I: Yeah, I think, so many kids tell us that they are worried that if they say something, especially to an adult, it will escalate the situation. Kids don't have a ton of faith in the adults in their lives handling things in a cool or nonchalant way. And so I often talk to kids about worries that their parents will go to the school and throw a fit or start something, make some big commotion and that that will either make the bullying worse or make that kid a further target with other bullies, give them a bad reputation at school. All of those things that they're worried might escalate their bad situation and make it even worse.

So lots of reasons that kids don't want to talk about it. And then I think kids also believe that, okay, you're going to listen to me, you're going to tell me that it's all going to be okay because you're my adult. You love me and that's what you're supposed to do. But I don't know that you really have the power to change it.

So I think their lack of trust in adults really showing up for them in the way they need, can lead to some of that hesitancy. But there are lots of signs that we want to be on the lookout for and be aware of. So things like if your kiddo is coming home from school and they're suddenly missing personal items, or they've got lots of physical complaints, all of a sudden they've got headaches and stomach aches and they're begging to stay home from school.

If they suddenly have unhappiness regarding school or their behavior is starting to become problematic when it wasn't before. Any defensive behavior or attitude, especially if you see any unexplained injuries, that's a huge sign to look out for. Any changes in their eating habits, like suddenly they're skipping meals, they're not eating lunch in the cafeteria, or they come home after school and it almost seems like they're binge eating potentially because they didn't eat all day at school.

Difficulty sleeping or having frequent nightmares. I oftentimes, call it a case of the Sundays when things seem to go really great Friday, Saturday, and most of the day Sunday. And then you get to the end of the day on Sunday and kids start having all these physical symptoms and worries about going back to school.

That's a huge sign. Any, declining grades or loss of interest in schoolwork. Loss of friends or avoidance of social situations. Any self-destructive behaviors like running away from home. Self-harm, even talking about suicide in more extreme cases, and then any sadness that seems unexplained or out of the ordinary, feelings of helplessness or any decreased self-esteem.

These are all really good indicators that bullying could be a potential in your child's life.

Host: So if the parent sees some of these signs, any suggestions for then how to approach the child?

Katie Azarow, LCSW, CADC I: Yeah, I think the open dialogue is really the most important place to begin because these are important signs and symptoms, but you could easily say that these are signs and symptoms of lots of different things, right? And so I think if we notice any behavior in our kiddo, that just seems to be not their baseline or not what we could, would consider quote unquote normal for them; it's really important that we sit down and have an intentional conversation with them. Not an interrogation, but a conversation where we can just kind of ask questions. Open up a safe space for them so that they're hearing from their parents or their family and loved ones that we want to support you.

We're not quite sure what's going on, but we also know that, you're suddenly eating like four meals right when you get home from school, which leads us to believe you might not be eating at school. And if you ever want to talk about what's going on, we're here. I think just kind of laying that foundation and that groundwork is super important because if we're trying to do it all at once, for example, our kid comes home, we're seeing all these signs and symptoms, and now we want to sit them down. We want to build trust with them, and we want them to tell us what's going on; that all can't happen over one conversation. And so it takes time to slowly build up the trust and slowly plant the seeds that I'm a supportive adult and I'm here to help you and I can help you in ways that are not going to school and, making this really embarrassing for you.

Kind of letting kids come to that on their own, that, Hey, my parent cares and I think that my parent is savvy enough to help me deal with this. So now after three or four talks with them, maybe I am going to start opening up to them about what's been going on for me at school and just knowing that it's a slow going process. But as soon as we can start that, the better.

Host: That's great. Now, what bullying resources do kids and parents have that they might not be aware of?

Katie Azarow, LCSW, CADC I: Yeah. The first place I always encourage people to really dig in at is school. Most states, and Oregon is one of these states have legislation around bullying. So schools are legally required to address this behavior in specific ways. And so a lot of times schools are written off as not being able to be helpful, especially in regards to cyber bullying, which might be happening outside of school, but, all of this is included in state legislation, and so it's really important that schools, from the principals to the guidance counselors to any trusted teachers, know that our child is dealing with this behavior because they very well could be helpful even in just supporting the kid working through the situation.

The other thing for parents to remember is that most apps and online gaming platforms do have simple ways to report any bullying behavior that's, that happens online. And so if your child tells you that they saw something that happened to someone else or that they were being bullied online, it is important to report it on that gaming platform or on that Instagram or Facebook platform so that that can be addressed there.

And then there are several websites that I think are really helpful, stopbullying.gov is a great place and accessible enough for a kiddo to go on by themselves. They wouldn't even necessarily need help from a parent to understand the content, but parents can utilize that website as well. Mental Health America, mhanational.org has a ton of great information about bullying and even some scripting that parents can use to talk to their kids about it.

And then the National Bullying Prevention center@pacer.org has great tips for talking to teens, especially about social media. So if parents are looking for support, especially around how to start those conversations, pacer.org is a wonderful resource.

Host: That is great. Just some great information there. Now this occurred to me. Would it be helpful in terms of parents who are establishing a relationship with their kids of just being open, especially if the child is younger, for the parent to sit down, let's say even before an incident has happened, and maybe do some role playing with their children to give them scenarios in case they encounter these things? It's almost like what a parent would do if they were afraid of a sexual predator.

Katie Azarow, LCSW, CADC I: Absolutely. And one of the things I love you brought that up because one of the things we talk to a lot of the kiddos at Shriners about is you might have something different about you that's visible. You might have a physical difference. And because of that physical difference, people might have things to say and mainly they'll have things to say because they don't understand.

But the more you can be prepared with, we always say if you have a great one-liner when someone asks you what's up with your wheelchair or why are you on crutches or what's happening with your arm? We always encourage kids to have a really great one-liner that they're ready to share. And depending on the kid that might be that they're using humor, that might be, that they're extremely factual.

That might be something a little bit sassy or spicy even in response. But preparing kids to have good responses. Because what we know about the human brain is that we are programmed to see differences. Obviously seeing differences doesn't mean or equate with bullying, but it starts that journey for many kids where they see something different in someone else and then they begin to exploit that.

And so we work with kids here all the time to say, Hey, if you're worried that you might be bullied or if you're concerned that people are going to notice this physical difference and have something to say about it; let's make sure you're prepared. And I think that all kids, regardless of differences that they have perceived or non, can be prepared with what am I going to say if someone says something to me that's unkind or someone tries to pick on me, what will my response be? And I think that role playing with parents is huge and, can be really, really impactful.

Host: I think that's great for adults as well.

Katie Azarow, LCSW, CADC I: Yes, yes.

Host: Be prepared to have a gracious response.

Katie Azarow, LCSW, CADC I: Absolutely.

Cheryl Martin (Host): Katie, any other tips, anything else you'd like to share on this topic?

Katie Azarow, LCSW, CADC I: Yeah. You know, the only other thing I think is really important is that we know through years and years of research, we know what doesn't work. And so we don't want to spin our wheels doing the things that don't work when we have better options. And so I just, this would be my PSA to say that putting kids in a room with their bully and then putting an adult in that room and saying, let's all work it out together is highly ineffective. We know 10 outta 10 times this does not work because of the power imbalance that exists between that kid and their bully. And so we don't want to throw everyone in a room and encourage them to work it out, especially if it's happening in school.

We really want to, as the adult in the child's life, work as a team of adults to support an anti-bullying climate in the school as opposed to putting those kids together and encouraging them to do something. We also know that telling students to report events of bullying to school staff works pretty poorly amongst middle and high school students. And that's why we really need parents to be active in their kids' lives because we need that constant feedback loop of what's happening at school. The kids are coming home, they're telling their parents about it, and then parents can go back to the school staff, not in a pointing fingers, you're doing the wrong thing way, but in a, Hey, my child shared this with me.

What can we do as adults to partner together and really help change the culture in the school? And then the last thing would be that making sure you have a really good read on your child's school and social activities because all of this anti-bullying work is great. However, we know that it doesn't work in climates where teachers, administrators, adults, leaders in, in clubs and sports when they're being bullies to kids.

Or even being bullies to others. We know that they don't do a great job in stepping in to stop bullying amongst kids and teens, and so we want to make sure that when we're sending our kids to youth group or to their club sports, that we feel really confident in the adults that they're going to be around, and that those adults have a really strong stance against bullying so that we know our kids, that someone's got their back when they're out there in the community.

Host: Katie Azarow, this has been such great information. Thank you so much for enlightening us on bullying and just sharing just great strategies to put into action. Thank you so much.

Katie Azarow, LCSW, CADC I: Absolutely. It was great to be here with you today, Cheryl. Thanks so much for having me.

Host: My pleasure. And that concludes this episode of Healing Heroes PDX, with Shriners Children's Portland. To learn more, head on over to our website, shrinersportland.org. If you found this podcast helpful, please share it on your social media and check out the entire podcast library for other topics of interest to you.

Thanks for listening.