Maggie McKay (Host): Welcome to the Sinai Chicago Health and Hope podcast, where caregivers from Sinai Chicago share insights, updates, and important advice on the health topics impacting our communities. From the latest in medical research to practical tips for improving wellness, our doctors, nurses, and health professionals are here to help you and your families take control of your health.

I'm your host, Maggie McKay. May is Mental Health Awareness month, a time to shine a light on the importance of mental wellbeing and remind ourselves that seeking support is a sign of strength, not weakness. Mental health affects every one of us, and yet too often, it's a conversation that gets pushed to the sidelines, especially when it comes to children and teens.

Dr. Greg Staszko is the manager of behavioral health at Under The Rainbow, a clinic dedicated to supporting the mental and emotional health of children and families in our community. Greg and his team are on the front lines every day, helping young people navigate anxiety, depression, trauma, and so much more.

In this episode, we'll talk about the real mental health challenges kids are facing today, how caretakers can recognize when something might be wrong and what it really looks like to start that first often difficult conversation. We'll also explore the stigma that still surrounds mental health, especially in communities of color and the power of early intervention.

It's so great to have you here, Doctor. Can you tell us about your role at Under The Rainbow and what kind of support the clinic offers to children and families?

Greg Staszko, Psy.D.: Thanks so much for having me. So, I'm Dr. Greg Staszko. I'm a licensed Clinical Psychologist and I'm the Manager of Under The Rainbow, which is essentially a community mental health agency that's located in the middle of Mount Sinai Hospital on the west side of Chicago. So our clinic is a traditional outpatient clinic. We provide, individual, family and group therapy services to youth and their families. Case management as well, and also some medication management. We typically start seeing kids around three years of age. That's about the youngest kids that we work with. And then we work with them through, into early adulthood, often. If they're connected to a therapist even after they turn 18, and they want to continue receiving services, they're able to do that into the young adulthood with the, with their therapist at Under the Rainbow.

Essentially our specialty, or one of our main focuses is complex trauma. So many of the families that come to us for services have experienced trauma in some form. Although we see kids who are presenting with all different needs and, and issues related to social issues, school, family issues, and, and a whole range of mental health diagnoses, depression, anxiety, trauma, as I mentioned.

We're a multidisciplinary team, psychologists, social workers, licensed clinical professional counselors, a psychiatrist and a nurse practitioner as well. In addition, we have a training program. We also train Master's, interns and doctoral externs who are pursuing advanced degrees in psychology or social work.

And we do so quite a bit of engagement with the community as well, presenting on different topics related to mental health, doing some direct services in schools in the community, and then also teaching the mental health first aid curriculum, developed by SAMSA.

Host: So you mentioned a few, but what are the most common mental health challenges that you're seeing in kids and teenagers right now?

Greg Staszko, Psy.D.: Our specialty has really always been the assessment in treatment of complex trauma. So a lot of the youth that come to us for services are seeking services because they have experienced either, acute traumas, so child sexual abuse, physical abuse or neglect, sometimes, disruptions in caregiving.

 These are youth that are maybe in foster placement or, you know, have experienced kind of chronic traumas often that are the consequences of living in communities that have been traditionally underserved, and experienced systemic oppression. So, communities that lacks often adequate resources, adequate housing, food insecurity at times.

The impact of those traumas, the acute traumas and the chronic traumas, are things that create disruptions in all different areas of functioning for youth. So often when they're coming to us for treatment, that's what's kind of underlying some of the symptoms that they're experiencing.

A big issue that we're seeing a lot in our population and the communities that we serve. There has really been a lot of really ugly rhetoric and action around immigration and immigration status. A lot of the youth that we serve and the families that we serve, in addition to some of the other stressors and potential trauma that they've experienced, are experiencing a lot of anxiety and real fear around family separation, around

deportation and it's really compounds, the symptoms that they're already experiencing and creates, you know, additional anxiety and stress in youth.

Maggie McKay (Host): I can't imagine that. I mean, that's a whole another topic for another day for a podcast. Just, that segment of the population. I was also surprised to hear that you see kids, little ones as young as three years old. Wow. So how can parents or caregivers recognize when their child might be struggling with their mental health?

Greg Staszko, Psy.D.: A phrase that we use that's part of a treatment approach, that we utilize here at Under The Rainbow and it, it says, get curious, not furious. This is something that we try to teach parents a lot, right? I think it's a nice slogan to latch onto.

But really we want parents to really be curious about their child's experience. I think this is really where it starts, right? To identify changes, to identify anything about their functioning, about their engagement in school or with friends or activities, that changes or that, is different than what it typically is, right?

So, a lot of times what we see is the behavior that a child experiences is really just the tip of the iceberg. And we actually use an iceberg graphic sometimes with families to really illustrate this well, that the behavior that you're seeing is really just the tip, the surface of what's happening with the child.

But underneath that, you have all the thoughts and feelings that kind of accompany that, and that really lead to the changes that we're seeing. So we want, you know, especially if the behavior, sometimes the behavior is disruptive or it's not desirable maybe to a parent or to a teacher; what we really want people to do is to be curious about that behavior.

What does that behavior, mean, right? What does it signify for them? As a child psychologist, I react a lot to the phrase attention seeking when people say that a child is attention seeking. And I like to really try to flip that and have people think about behavior as connection seeking rather than attention seeking.

So if we can get curious about why a child is acting in a certain way, what are they trying to meet? What needs are they trying to meet through that behavior? We can really understand it in a different way. And then it takes us and our, especially, you know, as parents or guardians, right, it takes our emotional reaction out of the equation, and allows us to really, seek connection with children.

 That connection and that attunement is really what will allow us to understand our children better and to understand when they might need help or support in different areas.

Host: So on a basic level, what are some signs? Just like three very common signs that a child is struggling.

Greg Staszko, Psy.D.: Yeah. I think school is such a great predictor. I think of children's functioning, they spend a lot of time in, in school. And I think their school functioning and, and achievement and behavior is not always connected directly to their mental health.

But, when children are struggling and when they're overwhelmed and when they're stressed or they're experiencing depression or anxiety, we often see a corresponding decrease in their school performance, right, or school functioning. And so I think, you know, that's one thing, that the parents and caregivers can be aware of.

I also just think, you know, when children, like, we see in adults as well that when they are not as interested or engaged in the things that they used to be interested or engaged in. So this could be hobbies or sports or other interests. This could be social relationships, hanging out with peers. If they're becoming more withdrawn or they're less interested in those things, that can often also be a sign, that they might be needing some support or needing some help in some area.

Host: So on a practical level, Dr. Staszko, what advice do you have for families who want to support their kids but they just don't know how to start the conversation? Because that can be awkward and it could go south very quickly.

Greg Staszko, Psy.D.: Yeah, for sure. Again, as I mentioned earlier, it's really all about connection, right? It's all about relationship and attunement. What we really hope for and what we really work with families on is to try to really foster that attunement and connection, so that we can have hard conversations with our kids.

 Nobody teaches you how to be a parent. And in case you were wondering, being a child psychologist does not necessarily make one a better parent. It's really hard. Being a parent is really hard and it's hard because we are bringing to that relationship generally what was done to us and what we experienced as a child.

And if we're fortunate to grow up in a family where we had most of our basic needs met and we were loved and attuned to properly and supported and nurtured in all those ways, our communication was easy and you're able to kind of talk with your parents about things; then generally people are able to bring that to parenting, right?

They're able to do that and meet the needs of their children, in the ways that they need. If we had an experience of growing up in a family where maybe communication was not great, or communication was hostile, where maybe we didn't have some of our basic needs met at times, or we weren't attuned to properly; we often don't know any different and we don't know how to necessarily meet those needs for our own children. So, you know, this is something that is a big part of how we think about therapy and how we work at Under the Rainbow. It's really so important to have caregivers involved actively in this process.

Sometimes it's counterintuitive for parents. I think that parents who maybe are drawn or utilize a more kind of authoritarian parenting style, like a little more strict and kind of less of that nurturing style; think that if they loosen that, right, or they approach their child with more kind of a nurturing and more permissive at times, but authoritative at times parenting style that they're going to lose something, right? They're going to lose some control or power in that situation. And really what we find is it's, it's really the opposite. I think that kids, when they feel connected to you, when they feel attuned to, they listen better and they talk more, right?

So when, sometimes it's as simple as again, like kind of being curious, right about our kids' experience and talking to them, engaging them around their interests. And when that connection is there and the connection is strong, the words and the communication, usually follows from that.

Host: So if you don't have that open communication, how would you start the conversation?

Greg Staszko, Psy.D.: I'm a big fan of transparency, in my therapeutic work, but also, you know, as a parent, right? When we explain upfront to people what we are feeling and what we're wanting to accomplish, it really builds trust and it builds connection with people, right?

So I think that, you know, none of us are perfect as parents and I think that, it's okay to admit that. And I think it's okay sometimes, for a parent or caregiver to say, to their child, that they maybe haven't had that connection always right. But that's something that they want.

And trying to figure out together how they want to achieve that. Right. But I think putting those things on the table and showing your vulnerability as a person right, as an adult, can also be very powerful. Again, it's counterintuitive sometimes to parents.

I think they sometimes feel that, that is going to, you know, make it harder for them to parent effectively. And really what we find is it's the opposite. It really makes it a lot easier when that trust is there and the connection is there.

Host: So there's still stigma around mental health, sadly, especially in communities of color. So what are some ways we can break that down?

Greg Staszko, Psy.D.: I think one of the main things is just keep normalizing and talking about therapy as an aspect of wellbeing and health, as something that is not something that we turn to as a last resort, that we don't need to access only when we're in crisis or really at our lowest points.

But it can be a really big part of, of your wellbeing, right? And, and how we think about taking care of ourselves. Shout out to my therapist. I recently, went back to therapy a few years ago, after losing a parent. And, it's been such an important part of just my journey as a parent, as a partner and just healing, you know, from losses. So it's something that I can always turn to, to help support me and to kind of balance all of the different roles and demands that I have and the relationships that I have. Young people are doing a really great job with this too, with the normalizing and the reducing of the stigma, I will say. I'm very impressed, often with how young people are talking about therapy and how much it's become something that's a lot more normal in terms of their experience. Definitely on social media as well. Social media's a mixed bag. That's a whole other conversation.

There's pros and cons to it. It could be dangerous, it could be helpful. There's a lot, it's a really complicated field to talk about, but one of the places that youth are doing this is on social media and kind of normalizing some of the experiences that they have.

I had this kind of a funny experience a few times over my career where, you know, say I was going to a, a client, a young person's school for a meeting, maybe a teacher, a social worker, usually sit down and we prepare the, the child beforehand, like come to your school, nobody's going to know that I'm there for you, except for your teacher. If I see you in the hallway, I'm not going to you know, acknowledge you because I want to protect your privacy. But if you want to say something to me, you can, you know, we go through this to prepare them for this experience and the confidentiality piece.

So many times I've been, you know, walking down the hall of a school, and heard, somebody yelling down the hallway, Hey, everybody, that's my therapist. And it's just a kind of a cute experience and to me, a real sign of how much of that has changed right at for young people and thinking about therapy, not as something that they need to be ashamed of or embarrassed of, but something that, can really potentially be, uh, a positive thing in their life.

Host: Can you tell us a story or an example of something that shows a difference early support can make?

Greg Staszko, Psy.D.: Sure. Yeah. You know, recently I, I've had kind of a unique experience here at, at Under The Rainbow. I've actually been here for a little over 18 years as a staff psychologist and then in more administrative roles. And so I've had this really unique experience a few times recently where a child that I worked with as a client here some years ago, came back to bring their own child to therapy at Under The Rainbow. And sometimes will ask to talk to me or, you know, ask if I'm still here. Things like that. And to me it's just, such a wonderful, I mean, it speaks a lot to the environment and the culture that we want to create in our clinic where somebody feels, they trust us enough to do that, right? And they had a positive enough experience as a child. And I'm not saying that these are all like the most successful, most wonderful examples of therapy that I've ever done.

It's nothing like that. It's that somebody has felt understood in a way or, listened to in a way, supported in a way and were able to recognize, the need in their own child. Right. And as I mentioned before, the ability to really try to interrupt some of these generational patterns, right?

Where this may be a, a person who's an adult now who realizes, you know, because of some of these experiences I had as a child, I'm struggling a little bit to meet the needs of my child, and I'm noticing it in these ways. And for someone to be able to identify those things, first of all, right?

But then to come back and to trust a place and to trust, uh, you know, a clinic or a provider enough to bring their own child, it's just really a wonderful experience. And I think, like you said, kind of speaks to that, the importance of that, early identification and, and just the introduction to therapy and what it is and what it could be.

Host: If a parent or a teen is listening and they're feeling overwhelmed, what's one step they can take today? Practical step to start getting help.

Greg Staszko, Psy.D.: Well, you know, having a or identifying a trusted adult, is something important. Sometimes those are our family members and sometimes they're not. A coach, a mentor, teachers, schools again, are, are a place where kids spend a lot of time, have usually relationships with teachers, potentially with social workers or counselors, but identifying who are those people? Who are the people in your life that you feel like you can get support from when you need it? And, this is not to say that everybody needs to be in therapy when they're feeling stressed or they're feeling overwhelmed, but sometimes it's just having that first conversation with somebody that you trust, and letting them know where you're at and what you're feeling.

And maybe that the next step is to seek some professional help and to seek therapy. A lot of kids receive mental health services in schools as well. That's another place that, again, tends to be a place where those needs can be met and with some ease and reduces some of the barriers to accessing services. So that can be also a place to start.

Host: So in closing, is there anything else you'd like to add that you think, maybe parents or teens, young kids need to know?

Greg Staszko, Psy.D.: Yeah. And like I said, I encourage people to who are curious about the experience of therapy. I think that there's a lot of misconceptions often about what therapy is. And I think that we really encourage people, you know, if they're feeling like they need some extra support, to contact Under the Rainbow, at 773-257-4750, or other mental health providers.

And I think that most people who have maybe some negative preconceived notions about what therapy is; if they meet a provider that's a good fit for them and really kind of meets them where they are, it can feel really good and it can feel really rewarding.

Host: That's awesome. Well, you clearly have a very kind and compassionate heart, and these kids and families are lucky to have you, Dr. Staszko. Thank you for sharing your expertise.

Greg Staszko, Psy.D.: Yeah. Thank you for having me.

Host: Again, that's Dr. Greg Staszko. For all behavioral health services and treatments, visit sinaichicago.org. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. Thanks for listening to Sinai Chicago Health and Hope podcast.