Supporting & Understanding Children’s Mental Health

00:03 Speaker 1 Okay. Welcome, everybody. Thank you so much for joining us. It's a pleasure to start on time, and I'm really grateful for all of you for coming and joining us on a busy Tuesday night as we approach the Pesach season and things are in full swing. There's nothing greater than taking a moment to talk about our children and how we can help them. I wanna begin by thanking, uh, Mrs. Beyla Rutman for organizing and coordinating this event. This event is dedicated for Yehoshua Elhanan, well, Mishmas Yehoshua Elhanan, Benei of Mordechai, by his family. Um, this is a part of a new series that the Menachem Foundation is hosting. As you may know, the Menachem Foundation has been around for about seventeen years, working in Chabad Moises around the country to better the education that our children are receiving. We train teachers, make conferences, work with principals, really to elevate the chinuch of our children. And recently, we opened up a new division to work directly with parents and bring you engaging and professional webinars and, and content that can help us in our chinuch in raising our children. I also wanna take a moment before I begin to thank all our partnering schools. There are many schools that have partnered with us tonight, and I wanna recognize them. I'm just gonna go through them very quickly. Cheder Chabad of Philadelphia, Shmuel Zavi, Cheder Chabad of Toronto, Tamim Academy of Punta Gorda, Beis Rivkah of Crown Heights, Beis Chaim Mushkah, Cheder Menachem-- Cheder Chabad of Monsey, Cheder

01:34 Speaker 1 Menachem of Los Angeles, Darchei Menachem Torah Day School, Beis Chaim Mushkah, Mugen Israel Schools, Beider Hill Academy, Beis Chaim Mushkah, Chabad Hebrew Academy, Cheder of North Carolina, Lubavitch Hebrew Academy, Beis Rivkah of Crown Heights, Cheder Lubavitch Morristown, and Beis Chanah of Arizona. So thank you all for joining us, and it's my honor to introduce Rabbi Mendel Levin, principal of Cheder Chabad of Philadelphia, to be the host for tonight's webinar. Thank you, Rabbi Levin.

02:05 Speaker 2 Thank you, Rabbi Schneur, and good evening. Welcome to a very important conversation we will be having tonight about supporting and understanding children's mental health. There's nothing more precious to us than the children we're raising, guiding, and loving every single day, giving them the foundations they need to be emotionally healthy and thereby grow as Hasidim, Yeshayahu, and Lambdonim. The different letters of the Rebbe about mental health, and it is clear that there are different roles and methods to help children, including the parent's role, schools, therapists, and others. And my hope is that tonight we will all grow in our understanding so that we could be empowered to better understand and address our children's needs. My name is Mendy Levin, and I'm the principal of Cheder Chabad of Philadelphia. And at our Cheder, we take a student-centered approach to chinuch and to our children's needs, trying to understand what the children need so that they can be as successful as possible. And it is my privilege to moderate tonight's session, and I'm excited about what we will learn. Presenting this evening, we have Mrs. Gittel Francis and Mrs. Gitty Myers, both who are licensed clinical social workers. The format of tonight's session will be, first of all, an introduction of each of our presenters and the work that they do, and then a question-answer style presentation, where I'll present various questions, and the presenters will respond and answer. After which, we'll open up for questions in the chat for all participants. So without further ado, it is

03:39 Speaker 2 my privilege to introduce our presenters. And our first presenter that I'd like to introduce is Mrs. Gittel Francis. And Mrs. Francis and her family are Chabad Shluchim in Houston, Texas, where Mrs. Francis has a pivotal role in mental health services over there. So, Mrs. Francis, can you please share with us a little bit more about yourself and the work that you do?

04:03 Speaker 3 Yeah, sure. Thank you so much, Rabbi Levin, and thank you all for being here. Um, I think it's important. Um, so what I currently do is do a lot, a, of mental health literacy training, suicide prevention trainings, trying to reduce the stigma and reduce the gap of people accessing the appropriate professional treatment when needed. Um, I also work as a psychotherapist, and I counsel couples, families, and adults, um, a few adolescents as well. Um, I currently live in Houston. We've been here for almost about nine years. Um, and my husband is the head of school at Torah Day School. So I'm coming both from, like, the educational approach as well as the psychotherapy approach.

04:43 Speaker 2 Okay. Thank you, Mrs. Francis. And I'd like to introduce Mrs. Gitty Myers. Mrs. Myers and her family live in Westwood, California, where Mrs. Myers works with children, teens, young adults, and families in private practice, and also directs the Department of Student Wellness at Beis Chaim Mushkah of Los Angeles. So, Mrs. Myers, please tell us a little bit more about the work that you do.

05:06 Speaker 1 Thank you so much. Thank you for having me here, and thank you to everyone who's here tonight. Um, I say I have four full-time jobs. I'll speak about the two that are relevant to tonight's talk. Um, the first one is, um, I think the most important one for-- that's relevant here. Um, I-- In my role as Director of Student Wellness at Beis Chaim Mushkah, we're incredibly fortunate. I'm gonna make a little plug for this because I think that the department kinda developed because of parent support. And so if you're a parent and you're listening to this, please do... I want to encourage you to help support such an initiative in your schools. We have, Baruch Hashem, a really robust program that, um, goes into almost every class every week, uh, manages the IEPs, the accommodations necessary for individual students with differentiated needs. But most importantly, it's developed into a real beautiful community resource

06:03 Speaker 4 Where families reach out for resources and support for everyone in the family, not just the girls in Beis Chaim of K three. Uh, and so it's really turned into a community resource. In private practice, I work almost like the flip of Gittel, mostly with adolescents and young adults. Secondary, a small amount of families and couples. You know, the intersection where changes happen, adolescents launching as an adult and as our relationships shift from one dynamic and stage to the next. It's an honor to be here tonight.

06:34 Speaker 2 Thank you very much. Okay. So let's go to some questions, um, that we'd like-- love to hear from our presenters about. And we'll start with Mrs. Francis. A question we have for you is: what are the most common signs of anxiety and depression in children and teens?

06:53 Speaker 3 Great question. Um, I, I, I first wanna invite you, um, to view the words anxiety, depression as clinical jargon. Um, and really, depression and anxiety are verbal constructs, but doesn't really tell the full picture. As human beings, we try to name things so that we could feel like we have some semblance of control of them, and I think that-- I know that it's easier for us to use words like depression and anxiety versus the more vulnerable words that we use as like sadness and worry, right? So I just wanna make sure that we're talking about clinical depression and clinical anxiety, but I also feel that we're talking about sadness and worry, right? And somehow it's easier to talk about the, the diagnostic terms rather than talking about the words that make us feel more uncomfortable. So to ans-- so that's just kind of like my soapbox. But to answer your question, I think that one of the most common signs of any mental health disorder is a some form of disconnection. So disconnection from my work responsibility, disconnection from my schoolwork, generally disconnection from our attachment to others, our relationship with people, right? And then there could be a loss of, you know, an increase of sadness, a loss of interest in doing things. Now, you do say teens, and I do wanna highlight the fact that teens do grow out of things, right? So if I have children that love to play with Lego, and all of a sudden they hit their adolescence and

08:31 Speaker 3 they don't like playing with Lego, that's okay. But if they then go re-- don't replace it for something else that they're interested in. So a loss of interest in things that they've once enjoyed, um, and obviously the maturity thing, uh, as, as well, and also the nervousness and the worry that may interfere with them being able to live. So I think that the picture that I want you to start thinking about, and I invite you and encourage you to look at, is what kind of impact is my child's sadness and worry, um, having on them, and how does it impact their ability to function, um, in their environment?

09:19 Speaker 2 Okay. Thank you for that. And as we move along in the questions, um, if either of you wanna respond also to the previous questions and elabor-elaborate further, please do. Um, and m-moving to Mrs. Myers. So how can parents tell the difference between typical stress and a more serious mental health concern?

09:43 Speaker 4 So I think to kind of just continue off of what Gittel was saying, if you kind of imagine, very visual, if you have four quadrants, four corners, there are four areas of life that kind of look at to see how well we're doing. And like any growth chart that you've seen at the doctor's office, there are many different lines. The main thing is we want a kid to stay on their own curve consistently. So let's look at the four quadrants, and let's see how they're functioning in each. So the first one is their work life. They're a student. That's their job, right? As a child or an adolescent. How well are they doing at school? If they-- It doesn't matter if they were always a C student or an A student, but are they staying in that zone, or are they suddenly dropping off? Um, the next quadrant I would say is their relationship with their friends or their cousins or their siblings, depending on if you're, like, in a, in your own town on shluchos or if you have a whole, you know, big school where you're at. Are they disengaging from their friends suddenly? Are they stopping to go out to their friends on Shabbos to meet up and hang out, and all of a sudden just wanna stay in pajamas reading a book in their room all day? Um, the third quadrant I would say is the relationship with family. So to go back to what Gittel said, that connection, um, what

10:55 Speaker 4 is their relationship like with the family? Are they suddenly angry at everybody? Is everybody picking on them? Does nobody understand them suddenly? Um, and then the fourth quadrant I would say is the daily function. So really, how are they functioning? Are they sleeping? Are they oversleeping or not sleeping enough? Are they eating too much or eating too little? Again, remember what their own curve was compared to what their normal was. If you see any drastic changes in any of those things, if they're an adolescent, if their dress is changing too much, like they were always really put together looking, and now they're just always in pajamas all day or vice versa. If there's a very sudden change in any of these four quadrants, that's when we start to worry, okay, maybe this is a little too much.

11:38 Speaker 2 Okay. And just to follow up from that, is it only if it's a sudden change, or could it also be something that's not sudden?

11:50 Speaker 4 That's a great question. I think that sometimes, you know, we watch our kids growing, and we don't notice it till the pants are three inches too short, right? So sometimes it happens that a few months pass, and we're like, "Wait, something is really different here." Great. So just start asking questions. I think that's probably a really key important point is before we jump to worry, which is kind of, you know, our job, our nature as parents- Just ask questions. You might be surprised. It might not be as big or as bad. They might be just changing overall as a person. So just start with questions, and I notice that.

12:24 Speaker 2 Okay. And also going back to the first question, um, i-in terms of common signs of anxiety and depression, would there be signs that are more indicative of anxiety or signs that are more indicative of depression? Either of you wanna jump in on that?

12:43 Speaker 3 Well, I could, I could jump in, and I also wanna add to what Gitty was saying that, um, a men-- s- often we polarize mental health conditions, and it's either you have it or you don't. But there's a very, very big spectrum of it. And somebody could be living with mild anxiety, right? And it doesn't necessarily affect their functioning overall, or they could be in recovery, and they could be managing it well, and then you could be living with very severe anxiety and maybe not being able to leave the house or having fo-- Right? So there's, there's a spectrum of it. Um, and I think to answer your question about the... Just remind me what it was again. Sorry.

13:25 Speaker 2 So my, my last question was, is there a, a-- is there a difference one may see in a child between anxiety and depression? What would the signs of each of those-

13:35 Speaker 3 Oh.

13:35 Speaker 2 -respectively be?

13:36 Speaker 3 Oh, yeah, for sure. Thanks for repeating that.

13:39 Speaker 2 No problem.

13:39 Speaker 3 Um, I think that obviously with depression, there's more of like a sadness and a hopelessness, and, you know, maybe feeling that things, they themselves or other people are a burden to them. Um, and I think that with anxiety, um, it could show up in other forms, like kids not being able to sleep or regressing to behaviors that they've outgrown, maybe bedwetting, um, maybe, you know, chewing things or having kind of like just an overall sense of nervousness, not being able to sit still, um, and just like an overall sense of being uncomfortable.

14:16 Speaker 2 Okay, great. So we're not just having the-- looking at a child and seeing fear, or they're not just saying, "I'm afraid." We might be seeing some of these other signs as well, like you were saying, not sleeping or restlessness or discomfort, and they might be indicative of that.

14:29 Speaker 4 Can I add something to this?

14:31 Speaker 2 Please.

14:32 Speaker 4 I think one thing that I see a lot with the littles, and when I say littles, I mean kids ages five to nine, is that very often anxiet-- depression will come across looking as aggression, so they'll be angry all the time, slamming doors, throwing things, hitting, punching. Um, very often it won't come out in school, it'll come out at the parents. And there is no shame in admitting, "My kid comes home and beats me up." Uh, y- sometimes you're their only punching bag. Um, this is the space where they can let it out, but it's telling you that something's not okay. Um, another thing that sometimes, uh, Gittel was speaking about how, you know, we can be high functioning and still carry around a lot of anxiety or sadness within us. Um, some kids who kind of learn how to, like, mask all of it, they might find socially acceptable ways of worrying. So they might be really, really worried about their baby and jump every time mommy says, "Where's Alman?" Um, and, and go into a mini panic. Or they might be the ones who are still awake when you come home from babysitting. Um, so there's, like, an excessive amount of worry that's not typical for their age.

15:38 Speaker 2 Okay. And also back to your previous point where you said that we might see, um, anxiety or depression or other, um, conditions come up differently in different environments. Like you said, at home it might come out more than at school or vice versa, and that still might be indicative of something that needs further addressing.

15:57 Speaker 4 I almost feel like, you know, we-- everyone needs to have like a, uh, what is it? A rofé yadid, right? And we have our mashpia, and we have a rav, and it's always good to have a friend who's a therapist in your back pocket to just be like, "Is this normal?" Chances are they're okay with you asking.

16:15 Speaker 2 Great. That's a great, um, tip for everybody to have. Thank you. Okay. And, and so, you know, looking at a bit of a bigger picture question here is, or maybe even zooming in a little bit here, when we look at kids today and the kids that both of you are seeing, um, what are the biggest stressors for kids today? What are things that you are seeing that might, um, provoke more anxiety or even more depression? And then the second part of that is what can parents do to help?

16:50 Speaker 3 All right. So I, I, I think that we could break it up, and I can use, um, Gitty's words, the quadrants, but I wanna break it up into, you know, what are the components of what the kid's life are. And, you know, one of the biggest component is school-related challenges, right? So it could be, you know, academic challenges, it could be social challenges, um, it could be bullying challenges, it could be maybe our parents not getting us to school on time, and that means that I have to deal with, you know, the principal or that, you know, I don't-- I'm not happy with the lunch, right? That's, that's happening, right? So and, and for kids-- For adults, stressors are stress, and we're able to have the tools to manage it. Kids, small stressors feel like really, really big stressors, partly because they don't have the tools to manage it, and also because one of the hardest things about stressors is that sometimes we feel like we don't have any control over it. And if you think about children, they really, really... I mean, for the most part, they're growing and they're functioning, but they don't really have control over what time they go to sleep and, you know, what time-- And obviously, parents' job is to set those boundaries, right? So, so the school-related challenges. And then there's also family-related challenges, right? Like moves, deaths, health concerns, you know, um, maybe divorce, maybe a sense of belonging You know, being the middle child or being

18:15 Speaker 3 the oldest child and too much responsibility and too much burden or too little responsibility for possibly being the youngest, right? So there's the family-related stressors. And then there's unfortunately, and, and I know that you'll probably all agree with me on this, there's just the stress of being in the world today, right? And, and, and, and knowing, you know, kind of thinking about their autonomy and their own locus of control is our sense that we have a certain level of control in our worlds. And the reality is I, I feel that for us, it's hard as adults to accept it, and you almost have to do this like radical acceptance as adults. And like I'll throw in the kav haChaimer, thinking about kids who are, who are constantly kind of thinking about their autonomy and thinking about what they do, and they don't have control over them, it's very stressful. And, and what plays a role in the stress? So there is some genetic component to it, right? There's more-- kids that are more sensitive by nature, right? And then there's also things that happen to a child, like the stressors of being bullied, or like a death in the family, or a divorce, or a health concern, right? So some of it is environmental, some of it is genetics, and then other, other than that is the sensitivity of the child. So here's the question. What is it that we can do to help relieve the stress around us, right? Because we ourselves are feeling

19:50 Speaker 3 stressed out as well, you know. We're kind of very, very, very, you know, glued to certain things, right? And that it creates stress, right? So we're like very, very highly engaged. At the same time, we're also burnt out. And I feel like a lot of the kids' stressors come from that high, high, high engagement, and then just being around different stressors at home, at school, and in the world today. So I, I think that one of the most important tools that we can give our children is the reassurance. To provide the reassurance that they're safe, you know, when they are safe, hopefully. Um, but also to-- that you'll be there and that you're not alone and that they can talk to you about things that are bothering them. I think an important component as well is creating boundaries. You know when you, uh, when you go bowling, and I know when I go bowling with my kids and like, you know, I'm the adult and like I'm wishing that my kids put up those bumpers so I know I won't completely fail at the game of bowling, right? I think that all of us as adults, we need those bumpers, but certainly kids need those bumpers, and they need to learn how to be able to live within the boundaries that are set, and then they are able to explore anything in their worlds within those boundaries. Um, and also it's about... The important thing is our kids are watching us, and it's about modeling

21:24 Speaker 3 what happens when things don't go right, right? When things are-- When our stress level is high. Let's talk about Pesach, right? When our stress level is high, how do we model that? And how do we have compassion for ourselves and thereby teach our kids to understand that they are human and that it's okay and that they're feeling uncomfortable, and these are things that you can do to help assuage some of that discomfort and some of that emotional dysregulation. But it's really about really, really getting to know yourself, um, and having kids learn how to recognize the signs in their own selves and what their bodies are telling them in order for them to kind of know what to do next.

22:11 Speaker 2 Okay. Thank you for that. So those were a lot of different, um, both stressors that-- to pay attention to, um, whether it's at school, this in the social arena, arena, at home, in different areas that might, um, create stress for our children, and then a few different ideas or tips that you shared, including being there for our children, the reassurance that they are safe as long as they are or being with them when they're experiencing whatever emotion they're experiencing, creating the boundaries, and then modeling and us ourselves noticing our own signs of stress and how we, um, how we deal with that. And one other thing that you said which will, I think, segue to the next piece is also the communication with our children and, and, um, h- understanding them, talking to them, and listening to them. And so my next question would-- is into Mrs. Myers, and again, both of you can answer, um, all of the questions, is how can parents encourage the open communication about feelings from their children? Um, and just before you address that, I'm, I'm noticing different questions coming in in the chat, and I very much appreciate those. At the end of our conversation here, we'll go back to those questions, Im yirtze Hashem, and ask it to our, um, to our panelists. So the question is: how can we encourage our children to be more communicative about their feelings?

23:37 Speaker 4 Okay. So, you know, I prepared, uh, I kind of-- I had heads up about some of these questions, and I kinda thought through what my answers would be for some of them. And then just before I came on, I asked a bunch of seventeen-year-olds who are hanging around here in this house right now, um, door closed and noise machine on, no worries. But I asked them, I said, "I'm just curious about this one question. What would you say about how your parents could have encouraged better communication from you?" I got a lot of eyebrows, a lot of laughs, and like, "Are you for real? Do you really want the answer?" So I'm gonna share that one first 'cause it's probably most relevant, and also because it was so surprising for me too. They said, "It would, it would have really meant a lot if our parents would share with us, would communicate with us." I said, "What do you mean?" They said, like, "I don't know, like they don't tell us about their day. Like they'll tell us when they're stressed and when they need us to hurry, but like can you communicate with us? Tell us about you. Because if you do that, then I know you're here, and I can talk to you too." And another one cut in and was like, "But maybe not right away. But be persistent. Try again. And if we say no, and we walk off to our room, ask again a little later or say, 'I'll be

24:55 Speaker 4 here whenever you're ready. I can see your stress.'" So, um, that's the teenagers of LA's contribution to tonight's, uh, forum. Um, and, and I think it really is an important point, um, and it's sometimes hard in the hustle to remember to slow down enough, like Itel said, it's so busy, to slow down and, and show up as a human, and then to be able to turn. I think, um, we, we wear so many hats. There's so much going on. We schedule time for our kids to eat, to sleep, to go to the dentist and to the doctor, but we don't actually schedule time to talk. It's almost like an extra. And, um, a while back I learned, um, a little piece of Gemara that comes off of Rashi talking about Avraham Avinu walking the guests to the door. And it says that, um, someone... I ho-hope I won't butcher this up because I'm not super fresh with this. But something to the extent of, um, someone who doesn't walk their guest-- Someone who feeds their guests, hosts their-- gives them a place to sleep, but doesn't walk them to the door, gives them harm. And the question is, what do you mean? I'm giving-- I'm harming them? I, I, I hosted them. I gave them a warm bed. I gave them food. I gave them attention during the visit. Now, I don't walk them to the door, that's it? I caused them harm? And, and that's kind of the, the weight that emotional care, walking

26:21 Speaker 4 them to the door says, "I care about you, and you meant a lot to me. It meant a lot to me that you came." Um, we take so much time, and we care for our children physically. W- If you are a parent here who is working multiple jobs or very long hours just to put bread on the table and to pay the rent, if you are a single parent and doing it all yourself, if there is a parent in your home or a child in the home who is not well, and it takes everything just to keep the basics going, then please, please receive this hug from me and know that you are doing your best, and you and the kids will be okay. Um, and if that's not your current state of crisis, then let's try to do that walking to the door and making that intentional time to talk. So if that's supper time, where you'll turn to each kid and say, "So tell me something special or something cool that happened today," great. If supper time is when your toddler's throwing food and your son is going to Yishuv Eretz, then maybe not the time. Maybe it's bedtime, maybe it's walking to school. Find a time. Every day is wonderful. It doesn't have to be every day. Once a week is better than none. Uh, but I think being intentional and making time to really check in with our kids, maybe it doesn't work the first time. Like the team said, try

27:41 Speaker 4 again and try again. If you try enough times, we'll start talking.

27:46 Speaker 5 Hey, thank you so much for that. And, you know, if-- just to the two main points were modeling it ourselves and, and being vulnerable ourselves in front of our children, showing that we also have emotions, and we're comfortable to talk about them. And then also scheduling times or being intentional in our time with our children, that there's conversation about how they are doing and being present to them, which is probably one of the hardest things to do today, is being present and being present to our children and to ourselves, uh, for that matter. Um, and if I could just add to one idea that you shared where you go around the supper table and, you know, tell us a highlight of the day. Um, i-it-- perhaps even fine-tuning that and each day choosing a different feeling. Um, can you share something that you felt happy about today and/or something that you're f-were frustrated about today and just normalizing the m-more specific emotions there as well? Um, and if I could also ask on, on this, um, what about the child that is just quiet and not willing to speak and, and any advice about that? How do I get into his or her head and know what's really going on and what they really are feeling?

29:04 Speaker 4 That's a great question. I think before we get to feelings, if we have a really touchy kid who doesn't maybe want to share, facts are a really safe space to start. So... And very specific questions. "So who are you hanging out with these days at recess time? At recess, when everybody goes to the gym, do you play ball, or do you read, or do you play card games? What do you do? Do you walk around and get water?" Like, try to ask specific questions that would give you at least a little bit of a picture. If they open a little hole, you don't have to widen it right then, that's threatening. But then over time, you can open it and widen it. So maybe not, "How was your day at school?" But, uh, "What did you do to-- What have you been doing in science lately?"

29:53 Speaker 5 Great.

29:53 Speaker 4 "Any fun projects coming up for Pesach?"

29:58 Speaker 6 I, I think it's also important to scaffold things. And I know I do this with my clients a lot when I know that there's gonna be a touchy subject that I wanna hint on the next session. I'll say, "I just wanna let you know, like, thinking about the trauma-informed care, like, next week, I really wanna address your whys. Why me? Why this? Why that? And is that okay for you? Is that prepared?" So, you know, obviously, you know, Gidi's talking about a process. So if, if every night we sit down, and we say, um... My daughter, we would say, "Let's talk about the day." So my daughter would always be, "Let's talk about the day." And sometimes my husband and I were like, "Oh my gosh, this is choking us," right? But that they come to expect that, and that if you have a child that's more quiet, which I do, you know, we can say, you know, "I'd like you to share something today," right? "You don't have to share something every day, but I want you to think about one thing in your day that you can share with us as a family." So kind of like giving them that expectation and being able to scaffold that for them so that they have the ability, because some kids are not good with on-the-spot stuff And especially the quiet ones. And then the other thing that I-- You know, back to the original question, one of the things about depression and anxiety, and more

31:15 Speaker 6 so for depression, is the disconnection, but it's also quiet kids. And more often, we fail to recognize the signs in the generally quiet kids becoming quieter, right? A-and I think that as teachers and, um, you know, people in social situations, you know, your attention automatically turns to the kids that are the loudest. Um, I have the opportunity to, to teach once in a while. I do davening, and I teach Parsha once a week. My husband knew my schedule, so he knew my weaknesses, so he just inserted me in where he needed it. I'm sure you could imagine Rabbi Levin that-

31:51 Speaker 5 Absolutely.

31:51 Speaker 6 I... Yes. So-- But I think that the focus is on the louder kids and not necessarily the quieter kids becoming even quieter. And I think that it's important for parents and for whoever's on the Zoom to recognize that if my child is quiet, I wanna know what his baseline for the quietness is, and then know that if there's something wrong, if they go even quieter.

32:17 Speaker 4 And I guess to springboard off what you were saying about giving them heads-up, if we have a really quiet kid who doesn't like talking in public, they might feel really sensitive about sharing something that's so not an issue for anyone else in the family, but they're very-- feeling very sensitive and self-conscious about it. So we can notice, and we can say, "Hey, I, I saw you kind of opening your mouth and closing and then saying you don't have anything to say. Can I come to your room later? Can we talk about it after I'm done with bedtimes?" Um, so kinda giving them that heads-up to maybe, uh, you know, prepare themselves to talk about it. And if they don't wanna talk about it, there are plenty of times I have, like, stacks of notebooks in my cabinets, and I'm like, I'm handing them out like water bottles. I'm like: "Just write it down," because getting it out is better than not.

33:08 Speaker 6 And kids will always welcome the opportunity to talk during bedtime when they're sneaking your own time, and they know they're also getting later and later to bed.

33:20 Speaker 5 Okay. So note, at bedtime, talk about feelings. Um, and, and-- But also building on the point of children not comfortable to speak, it also brings me back to one of the earlier questions about stresses for kids today and perhaps children that have, um, signs of anxiety. Um, s-some of those might be children when they need to, um, perform or speak up in school. Um, even answering a question for some kids in the classroom can be, um, can create anxiety. And likewise, at home, for some kids, speaking in front of the whole Shabbos table with guests and saying Kidduš HaYayin can be-- Or having to sing a song. Um, and moving on from there, there are other things that we often see in children which, um, um, bring up anxiety could be tests that come up. I know with the Chidon tests, it's always the night before is anxiety night for the entire world of Lubavitch. Um, not the entire, but many, many children. And, um, so that could be another example. And then another one that comes to mind that was mentioned before is the, um, social arena where if there are-- if there is drama with classmates or with friends or with neighbors or with siblings, for that matter, um, but more so, I, I mean, I've seen it in more so in the classroom where, um, then there's that fear of even showing up to school or even coming to, um... And so as a principal, you know, maybe a sign of anxiety

34:47 Speaker 5 will be a child doesn't wanna go to school, um, might be a sign of, of anxiety.

34:53 Speaker 6 Sure.

34:54 Speaker 5 Um, so moving on to another question is, um, so what can parents do to help build, um, help their child build coping skills, build resilience? And on the other hand, what are some common mistakes that a parent might make when addressing their child's anxiety or depression?

35:17 Speaker 6 Okay. This one was mine.

35:19 Speaker 5 It's yours. You got it.

35:22 Speaker 6 Um, I think that the first thing that we have to recognize is that helping your children build strengths is not something that's gonna happen overnight. You know what it's like when you go to the doctor, and they tell you, "You have strep," and you say, "Yay," 'cause now I can take antibiotics, and I have to change my toothbrush, and I know I'll be good, and I'll be feeling good. And then you go to the doctor, and they say, "You have a virus." And, you know, we don't know. It might take a day, or it might take ten days. You know, kinda like getting the flu. It might-- You, you might-- It might hit you really bad, it might not. And I think that we have to know that when we're building strengths in our children, that there's going to be a lot of non-closure moments, and that the path is not a linear path, and that there's no real easy fix for that. There's many, many studies that talk about adverse childhood experiences, and anyone with mental health knowledge or some knowledge in terms of, you know, trauma knows that adverse childhood experiences could affect the children on their entire lifespan. But then there was one guy who made a chap, and he said, "I wanna figure out what does good experiences have to do with the child if they've suffered or if they've had adverse childhood experiences. What about positive childhood experiences? And how is it that ten people could go through something very,

36:58 Speaker 6 very similar, and three of them walk out okay without the professional help? And then the other three of them maybe would be categorized or fit the criteria for being diagnosed with post-traumatic stress disorder." So it's like a third, a third, a third. So what differentiates that third? Is it because they didn't have adverse childhood experiences? That might be. Is their genetics different? That might be. Is the support that they're getting from home, from their communities? Surely that is the case. And one of the things that the study for Positive Childhood Experiences showed was that a child needs a good relationship with one trusted adult to make that difference between resilience and flexibility and emotional regulation. So if you think about the Rebbe's concept of a mashpia, and, and obviously-- I mean, it was when we started, it was still Hofei HaDerin, the Rebbetzin's birthday, right? And acknowledging that the Rebbetzin looked at every single person, the stories that we know about the Rebbetzin that she, she came in contact with, as a way to boost them and as a way to empower them. So who is that person in my child's life, besides for me as a parent, who gives them that support and adds to their protective factors in order for them to build resilience? And besides for, um, the, the one individual, we cannot estimate enough the power of the community that the child is in. So it could be the school community, um, it could be the shul community, and that they

38:52 Speaker 6 overall get-- feel support, and more importantly, that they feel a sense of belonging. Because when you belong somewhere, then you can go with what the punch is what happens to you. Now, obviously, if there are many, many, many adverse childhood experiences, right, then it's going to have an effect on even the most strongest kid. But the reality is, is that it doesn't mean that there's no hope. As long as there are options, there's hope. And when you create hope, you're creating options, right? So building resilience is about what does the child have in their life, their support system, um, the mentors in their life, and the sense of the community, as well as it's us as parents or as caregivers being able to acknowledge that it's not an easy quick fix, and that it's something that we give to our children over time. And then again, like we were echoing before, it may look different for different kids.

40:07 Speaker 5 Great. And, and to bounce off the trusted adults, um, just to clarify, you're not just talking about the teenager who has a mashpia. I think we're talking about at all ages, even a five-year-old child having, whether it's tati, mami, an older, older sibling or a teacher that is really there for them that they could trust and feel comfortable around, right?

40:29 Speaker 6 Yeah. More so in adolescence, you know, you think about, you know, all of us made it through adolescence, some barely. But I'm saying, like, in terms of age-wise, right? I, I can't see the audience in front of me. But think about who was that person that helped you through. It could have been your parent, it could have been your aunt, it could have been your school principal.

40:49 Speaker 5 Mm-hmm.

40:49 Speaker 6 And then you also think about who's the person that made it harder for you, right? Could be your parent, it could be your school principal, it could be your aunt, right? But the focus is on these are the people that make us, help us get through.

41:02 Speaker 5 Yeah.

41:03 Speaker 6 And, and as long as you have a few people that help you get through all the other adverses, it's has to be dealt with, and it has to be, you know, acknowledged on all that, but it, but it really helps you build that resilience.

41:17 Speaker 5 Great. And I've seen in, in my work, even in younger classes, that when children are given an opportunity to talk without judgment, um, and to-- if something's stressful or something's bothering them or a class-wide thing, they'll jump on it. And especially if you give them options, "Do you wanna talk to me about it? Do you wanna talk to, you know, a teacher or the, the counselor?" And, um, I've seen many times the children will just jump on that and take that opportunity, and, and hopefully we are trusted adults, and we're able to help our children in that way. Do you want to address what are common mistakes that might-- that you've seen or that we might make as parents?

41:58 Speaker 6 Uh, yeah. I think that the mistake we make as parents is kind of the attitude of slow things down, but let's speed things up. Um, just allowing our children, um, the capacity to not be perfect, the capacity to have curiosity for themselves, and the ability for us, as uncomfortable as it is as parents, for our child to be able to failure, to fail, and learn and grow from those failures. It works for us as adults, but this is one of the foundations that the kids need.

42:40 Speaker 5 So that expecting perfection is often could be a, um, something that we, we should look out for. And to-- I, I wanna move to the question of when should parents seek professional help, and what treatment options are available?

42:58 Speaker 6 Okay. So I think that one of the most important things is, it's the question I get a lot, and then it's the question is, "How do I go to medication, and how do I know when I'm done treatment?" And I think that a lot of it depends on how the child is functioning, not only in home Or by themselves, but how they're functioning in all of their environments. Now, one of the most powerful things you could do as a teacher when you call a parent and say, "Hey, how is your child acting at home? Okay, this is how they're acting in school. We just wanna see if this is similar." Right? 'Cause the way a child acts at home and the way a child acts in their environment, so it's about really looking at the whole environment. Now, you know managed care companies don't ever wanna pay out, especially for mental health care. So as diagnosticians, Gitty and I, and whoever else is on the Zoom that's a diagnostician, has to make a case of why the child or the person needs mental health help. And I always think about three things, and they're kind of easy to remember: to live, to laugh, and to love. There's three Ls. So if what's happening to my child or if what's happening to me as an adult is affecting my ability to live the way I wanna live, to laugh, not be laughed at, meaning find enjoyment in my life, and also to love. It's to engage

44:23 Speaker 6 in those meaningful relationships, to love and to be loved, um, to be able to laugh, and to be able to live the way you wanna live, right? So if you think that your child is e-exhibiting, um, signs of not being able to live, laugh, and love, then I would say to seek out the professional help. Um, and, and I think that it's important for you to recognize in yourself as well that for a lot of parents, um, there's blame, there's a sense of weakness, and that I sometimes also recommend that the parents themself go for counseling in order for recognize-- to recognize what it's doing to them. It, it's interesting because I feel like it's a lot easier to put our kids in counseling than it is to put us. Um, and sometimes it's both that need it, so you could do family counseling, and sometimes it's, it's each other that need it. I mean, individual and individual.

45:22 Speaker 5 Okay. And do either of you wanna talk about m- a little more specific when it comes to treatment options?

45:33 Speaker 6 So I don't know what happened to Gitty.

45:36 Speaker 5 Did you-

45:36 Speaker 4 Do you wanna jump in and say here?

45:40 Speaker 5 Go for it.

45:40 Speaker 4 Am I here now? Think we're good.

45:41 Speaker 5 Yes, you are here. We see you, and we hear you.

45:43 Speaker 4 Great. Um, I wanna jump in here and say that, um, although, uh, Gitl and I are both clinicians, um, just like there are probably no two Mishpachah who are the same, there are many different approaches. My personal approach is, um, one that if anyone tells you that they have-- the only one thing that we know is absolutely true is the Torah. And a setting that-- aside from that, anyone who tells you that there is only-- this is the one right way to find health and healing, they're either just not knowledgeable or they're lying. Um, there are many paths to healing, and I think that it's, um, important to consider the options that are available. Okay? So it might be therapy for the child. It might be therapy for the parents. Especially when the child is younger, therapy for the parents often is more effective than for the child themselves. Um, it might be medication. It might be alternative forms of healing. It might be homeopathy. It might be acupuncture. It might be behavioral changes. Um, that's usually the hardest to implement because it takes so much time, effort, effort, investment, sometimes money. Um, but I've seen-- I can just... You know, I've seen cases where very extreme situations that would have definitely been candidates for partial hospitalization were turned around entirely through behavioral interventions only. Of, of course, that had to be under the care of, uh, you know, a clinician who was supervising very carefully. But really don't limit yourself. Find someone who you

47:26 Speaker 4 trust, who is trained and educated. Okay? Sometimes a coach is the right answer, and sometimes it's a therapist. But you need to find someone who is qualified, someone who has experience, someone who has succeeded with people who are dealing with whatever the person you're seeking help for is dealing with.

47:50 Speaker 6 I just wanna add one thing, Gitty, and I, I realized as you were saying this, it kinda came up with me, that one of the mistakes that I find, and I don't know if you see this in your practice, that parents make, is that they jump from therapist to therapist to treatment to treatment and exploring treatments before giving treatment a chance and thinking about the latent messages we're sending our kids. Like, "This professional can't help you. Okay. Okay, so this one can't help me. Okay, let me try the light therapy. Okay, this is not helping." Because we're looking for that quick fix, and we ha-- we're impatient. We're impatient with healing, and we're impatient with recovery. And very often, recovery is not mentioned when you're talking about mental health conditions, okay? It's like we're gonna live with it forever. This is lifelong, right? And I think that you have to think about what you're sending your kids. And if you think something's not working, it could be a conversation between you, the therapist, and the child. Like, what is working? What's not? But not those quick snap judgments or, you know, "Um, I'm canceling the sessions 'cause this is not working." Um, "But what if I really like the therapist?" And then the kids stand up for themselves. So just putting it out there.

49:09 Speaker 5 Okay. So it, it might-- it won't be an overnight fix usually. And if you're not seeing the results right away, hang in there. Don't quit right away. And maybe that goes back to what Mrs. Meyer said before about a refi you did or a-- someone that you could actually consult with to see is it that it's the wrong therapist or the wrong approach, or do I just need to give it a little more time.

49:30 Speaker 4 I, I do wanna say there is a, there is a lot of room for self-advocacy. Um, a qualified helper, whoever the helper professional is, should not be offended if you say this is not working. They should collaborate with you on finding a solution, whether the solution is changing the mode of whatever the work it is that they're doing or whether they're referring you out to somebody who is qualified or certified in a different, uh, method. Um, but if someone says, "No, no, no, no, no, just give this more time, just give this more time," and you're not feeling it, and there's something, there's a defensive posture that's coming up, I would be cautious.

50:08 Speaker 5 Okay. So you should be able to talk to a therapist or a specialist about the process itself and what is and isn't working.

50:17 Speaker 4 We love it.

50:18 Speaker 5 Okay. You could stay on the list. Um, now, next question is, what should you disclose to a school or camp about a child's mental well-being? And Mrs. Myers, do you wanna f- um, start us off here?

50:37 Speaker 4 I do, and I love this question, but I also come to it with a lot of awareness that not everybody is as evolved as some people are. So over... So I'll be a little more specific. Um, over the course of the last few years, I have seen so many sleepaway camps be so supportive of mental health issues, whereas before parents had to hide that their kids were bedwetting, or that their child had an eating disorder, or was suffering with anxiety or a significant depression. Um, now I think there are, there are a lot of camps that will still accept children, even with somewhat significant mental health concerns as long as there is a plan in place and their long-term therapist is supportive and will s-- they-- I know of camps that will, they set aside a spe-special cabin, and they say, "You can go into the office. You will have your weekly Zoom meeting with your therapist while in sleepaway camp." And that to me is really ideal. Of course, there needs to be clearance by the doctor and the therapist, especially if we're talking about someone with an eating disorder that's... Or, you know, self-harm, that's a l- a little more concerning. And if the th-- if the professionals do not think that it's appropriate for your child to go to camp, please do not cover it up and send them anyways. Their health this year comes first. Let the healing come first. There will be more summers, more camps, more programs, more trips.

52:05 Speaker 4 The world is, Baruch Hashem, tremendous, and there are many opportunities. Um, in terms of school, I would love to say please share with your school. At the same time, I understand that not everybody feels that the school will hold their information confidential. Um, I think a lot of parents are afraid that people will, um, treat their child in a different way once they know of a diagnosis or a condition. Maybe that they won't give the child the same opportunities, or push them as much, or they handle him with, with, with silk gloves or a-anything. Or maybe people, teachers will start talking in the teachers' room. And so I really want to encourage you to think who is your trusted person at the school? Um, if you don't trust anyone at the school, we have a different problem. Um, but really, who is the person you trust, and be very clear about confidentiality. There are certainly many situations where, um, parents share th- information with me, and I do not pass it on to anyone in, in the school. Um, I certainly ask, "What are you comfortable with me sharing with the teachers?" Sometimes parent-teacher-- parents are very comfortable with full disclosure. Sometimes only they want them to know that things are challenging for them at home, but that's it, and we respect that. Um, but it definitely helps inform how we treat a certain child. Um, if we know that there are certain difficulties going on in the home, if we know that a child

53:37 Speaker 4 is struggling with, uh, social anxiety or eating-- disordered eating, maybe we will treat them differently at lunchtime and recess time, right? If we know that a child is super anxious about a te- about test days, and we see them consistently skipping school on a test day, you know what? They might be given an allowance to come to school on a test day and not take the test. That every test day they consistently don't take the test, and we slowly expose them to that stressor so that they can build up to taking the test when they're feeling ready for it. Maybe we give them an accommodation that makes them feel comfortable or feel safer so that they're not daunted by it. The goal is to get them back to their healthy, to their normal. Um, and the more you can share with the school or the camp, I think the better off they'll be. I think you definitely have the right to ask them, "Who will you share this information with?" And please trust and respect our family's privacy, and do not share it with anyone else without our explicit permission.

54:39 Speaker 5 Okay. So finding someone that you trust in the school or at the camp, but once you do that-- And I would say from my end as a school principal, that collaboration is so powerful, that knowledge, that working together with the therapist and the parents and not pretending that there isn't a challenge, but on the contrary, figuring out how to help the child with a challenge helps a child get to, um, a better place quicker and more effectively. Um-

55:10 Speaker 4 Yeah

55:10 Speaker 5 ... and to Mrs. Francis, so how can parents and school teachers support children struggling with anxiety and depression?

55:22 Speaker 7 So I think that as parents we have to believe, and as school professionals we have to believe that we have the best interest of the child in mind, um, as humbling as it sounds. And, um, we have to remain curious. And also as a parent to know that what we see at school as an educator may be very different than what's going on at home, right? Sometimes it's the same, and sometimes it's different. Um, and also, you know, to trust that the school has the best intentions of the child in mind, right? And then once the parent does disclose that a child is struggling, maintaining that open connection Um, you know, I generally push for a release of information, um, that the school should be able to talk to the therapist. I can tell you, and I'm sure Gitty feels this as well, as therapists, we're very limited, right? We're limited to what the client tells us. Um, obviously, we can read body language and whatever in session and stuff, but that if, you know, if we're not hearing from the school and we're-- Therapists focus on the person, they focus on their client, right? Schools focus on the school system. And I think often therapists and schools, fights my husband and I have or disagreements, right? Is that the therapists want the best for their client and only see their client like a tunnel vision. And the school professionals see the entire school and the person in their community and in their environment. And

57:02 Speaker 7 I think as long as we understand that we're coming from different places, parents want the best for their child, and schools want the best for the child as well as the school, then we'll understand how to communicate with each other to have the best interest of the child in mind and be able to give the child what they need, but also not sacrifice the rest of the class, right? Because many times a child that is highly disruptive cannot be ignored, and it disrupts the entire class, and it has the effect of the entire class, right? Or many times, unfortunately, when you ask-- have to ask a child to go home from school or suspend a child, it's not that the school is picking on them, but it's to understand that there's a different perspective. We as a school have a different perspective than you as a parent. Let's work to get on the same page. I wanna acknowledge your perspective. I want you to understand my perspective on how are we going to see our way through it. It's kinda like a model-- It's kinda like a mental shift, right? I, I, I actually had, um... I was trying to schedule a meeting with somebody the other day, and I was saying March sixteenth, and they emailed me back like April sixteenth, and I'm like, "I don't even understand why she doesn't understand March sixteenth is next week." And then over Shabbos, I thought to myself, "Oh my gosh, it's March twenty-third." Like, I'm the

58:33 Speaker 7 one. I'm the one that miscommunicated. So I think sometimes we're so bent in our own ways and the path that we wanna see that we don't understand how somebody else's path could be accepted by us, right? Or that we can understand it. Okay. I hope that answers the question.

58:51 Speaker 5 Yes, definitely does. And I, I think on my end as a school principal, I really appreciate that perspective of trying to get or that idea of getting the perspectives integrated, and we're looking at a child here who we want to succeed. So seeing them both as an individual and within the community that they're in, i.e., their classroom, the school, and all that, and how can they be successful as a yachid or yachida and within their, um, environments. Um-

59:17 Speaker 7 And the, the one, the one more thing I did wanna add, I know we're kind of out of time, but we're gonna do for question and answer, right?

59:22 Speaker 5 Yep.

59:22 Speaker 7 The one thing that I do wanna add is that sometimes it's helpful to bring in a-another party, maybe a mashgiach that the family trusts, right? Um, not necessarily a therapist, but obviously the therapist, that would be my first choice if the child has therapy. But maybe there's just such a miscommunication that if a third person gets involved, like a rabbi or rabbinical consultation, I do feel like in today's day and age in schools, there's gotta be rabbinical consultation because do I, do I let this one kid go for the needs of the other ten kids in the class? And in that, in that regard, there's gotta be that consideration. Okay. That was my addition.

1:00:02 Speaker 5 Okay, great. So we're, we're scratching the surface here, and this is a conversation that could go on and on and on, and there's so much to learn and so much to know and so many things we might be curious about. Um, and at this point, I would like to open up the chat for anyone that has questions, um, and I will share them with our, um, presenters. I obviously will not say your name and just share the question so it can remain confidential. And, um, I, I would also say just a caveat here is that everyone has their very specific, unique situation, and we're not going to be able to fully understand a specific situation and probably answer more in generalities. But I definitely hope that the, the answers or the questions and the answers will still be informal-- informative nonetheless and help everyone with, um, a deeper understanding of their children and, um, their next steps. So, um, feel free to, um, post, um, questions on the chat. One of the questions we received was when we're talking about signs of anx-anxiety is, is chewing on a pen, the habit of chewing on a pen, a sign of anxiety? Um, does a child need to show multiple signs combined?

1:01:24 Speaker 7 So obviously, again, we're not diagnosing. I don't have the diagnostic criteria in front of me, although I probably have some of it in my head. Um, the answer is yes, there has to be multiple signs, and your other answer is also yes. Chewing on a pen could be a sign of anxiety. It also could be a sign of, like, sensory, some sort of sensory issue, right? Um, and I think that, I think Gitty was saying, and I was saying it too, it's part of piecing together the whole picture, right? And sometimes because we're so bent on, like, ruling things out, we don't forget to realize that it's the chewing on the pen but also the wetting the bed And also the not eating the lunch or these kind of things that put together the whole picture because we say, "Okay, chewing the pen, phew. Okay, he's good." Right? And it's about piecing together the whole puzzle, and it's also about as patients as it-- as, as patient as we have to be, um, to, to, to remain curious, um, and to really, really try to kind of be like those noticers or their, the investigators into what's happening.

1:02:35 Speaker 5 Okay. Thank you for that. Mrs. Meyers, you wanna add to that? Anything?

1:02:41 Speaker 4 Yeah. I think that like Gitl was saying, there's really a big picture that we wanna put together, and it's very individual. So the same symptoms that we might see, the same few behaviors might be anxiety. Um, and by the way, if we have anxiety, there's like what? We're Jewish, you know? We've been in galus for two thousand years. It's not, not a surprise to anyone. Um, it's not, not, not, you know... Uh, but it could be anxiety. It could be sensory, um, sensitivity. It could be ADHD. Okay? And it could be the child's way of self-soothing so that they're not acting out in class, especially, um, you might find with kids who are-- look more obedient, whether it's boys or girls, typically more girls than boys. They hold it together more in class, but then you find all these other things. They're shaking their leg really hard, or they're chewing on their pen, or they're doodling all over the edges of their notebook, and they're really just trying to do these behaviors, um, to kind of, you know, quiet their hyperactivity. Okay? I also wanna say that sometimes we see hyperactivity, and we say, "Oh, a child has ADHD," and really it's anxiety. There's a thousand intrusive thoughts flying through their head every minute. Um, so really kind of looking at the big picture.

1:03:56 Speaker 5 Okay. Thank you for that. And I think one thing that comes to mind for me in this is that we're, again, scratching the surface here, and there are a lot of other things that we could all learn about sensory needs and sensory, um, processing and as well as other things like ADHD and ASD and other, um, things which are beyond the scope of tonight's discussion. And im yirtze Hashem, there'll be another opportunity for, for those. Um, next question that we have is, am-- gonna love this question: Am I a bad parent or old school or doing my kids a disservice if they don't have a therapist? Like, should every kid have a therapist even if they aren't showing signs of needing one?

1:04:37 Speaker 4 No. And even kids who need therapy, and even kids who I know, and Gitl, you might have this too in your practice, kids who come to me in private practice, and I know that they will likely need therapy over the mid-- course of majority of their lifetime, I ask their parents to please bear with me as I-- we do our work, and I graduate them, and I say, "Therapy works best in chapters. Go, fly, and then come back when the next set is relevant." So if that, if that's for a child or an adolescent for whom you see significant challenges that will likely present over a lifetime, certainly it is for someone who is dealing with, um, run-of-the-mill challenges of just trying to get to bed on time and finish their homework and et cetera.

1:05:28 Speaker 5 Okay. And I'm gonna-

1:05:29 Speaker 4 Like I said, the short answer is no, you're not a bad parent if your child is not automatically in ther-- registered in therapy from birth.

1:05:35 Speaker 7 Everybody gets therapy. Everybody. Oh, you don't- Oh, your kid doesn't have therapy? So, no. Um, just to-- I mean, it's, it's, it's, it's good to validate and normalize that as parents we always think that we could be doing better or different and that we're worried about doing a disservice to our children. Um, and I think the way Gitty answered this was spot on, um, but that your child doesn't necessarily need a therapist. Um, what they do is they need you, and they need your presence. And then if you notice that maybe they are showing signs or exhibiting signs, then you'll, you'll know what to do when it's right.

1:06:12 Speaker 5 Yeah. And if I could just build on that for a moment, that, um, where, and Mrs. Meyers mentioned before about how like someone who is suffering, let's say, from, and I'm paraphrasing here, but someone who's suffering, let's say, from severe depression and, and a parent would say, "Well, let me look at the Torah how to heal that." And I think what you were saying before is, well, actually, they might need to see a doctor for that. Similar to if someone has pneumonia, they'll go to a doctor. And but then once you have a healthy child, then the Torah ha-- And, and even on the-- somewhere in between there, the Torah and Hasidism have so much to offer for us and to guide us. I once spoke to a prominent mashpia and, uh, who was, who was also a therapist who shared that once a lot of themes in Hasidism can help someone grow, but that's once they are emotionally healthy, um, that they're able to, to grow and themes such as bitul, which for a depressed person could be, you know, they're not ready for that yet, and so on. Um, I-- So our next question is, and I-- we did address it briefly, but if anyone want-- if either of you wanna address a little further is, if a fifth-grade boy, for example, first wanted to go to camp and then began to doubt, should he be pushed? And obviously, you could apply that beyond camp and to other, um, areas.

1:07:36 Speaker 4 Gitl, do you wanna jump in on this one?

1:07:39 Speaker 7 Um, I think it's always a conversation, and I think there's always a delicate balance, um, between pushing your child to do something and setting your expectations, um, but also allowing them the space, um, to be able to live their life. Um, I think that children in generally, um, wanna push us as parents past our comfort zone, and that we should also be able to push our child past their comfort zone if we know what's happening to them. So obviously, it's part of a larger conversation like, "What changed?" I wonder what made you change your mind. Did something happen? You know, do you wanna spend more time with me? Like, what, what is it that made you change, and what is it that is starting to create that doubt inside of you, right? Because you wanna be able to empower them to recognize what's happening in themselves and also be able to make the best decision for them.

1:08:42 Speaker 5 Great. And I think the fact that whoever's asking the question is asking the question is, is fantastic, that it's not obvious that it's either way, and you have to look at the situation. Sometimes there's room to push, and sometimes no, give the child the space. Um-

1:08:55 Speaker 4 And I think because this speaks to, you know, an element of anxiety, whether it's clinical or not, um, which we all have some kind of anticipatory anxiety before we do something new or something big, um, I like to think that, you know, Gittel answered a question previously about resilience, how we build resilience in our children. And I think one of them is s- exposing them to increasingly more difficult tasks in life. Um, I mean, that's the nature of life. It's going to happen anyways, whether they like it or not. So if we try not-- if we can try not to bubble wrap them and allow them to experience it in increasing increments, um, and when that happens, and they're uncomfortable, I think our tendency as parents is to come in and save them and fix them or tell them it's going-- uh, they're gonna be okay, everything's gonna be okay. I'll take care of it. If you don't like it, I'll bring you home on day two, et cetera. Um, but maybe giving them, like, you know, we, we're not Melachim, we don't have one leg, we have two. We can give them the two-legged stance of like, "This is hard. Yeah, I hear you. You're nervous about whatever it is or about missing home, and I think you'll be okay. And here's how I know. You went to a friend's house, and you were okay. When I went out of town, you stayed at cousin's, and you were fine. So I know this is

1:10:18 Speaker 4 a little further. It's a little bit of a bigger stretch. I know this is hard for you, and I know you'll be okay."

1:10:26 Speaker 5 Great. So building that resilience and not, um, saving them right away from any discomfort. And okay. A, a question was asked about, um, if someone has a particular situation where they need to get in touch with someone, help, where do I turn to for the next steps? There's a-- something huge happened, something at school or something beyond that. Um, where-- can... Yeah, what would be the first step over there?

1:10:54 Speaker 7 So, um, if they're asking for, you know, I think that, you know, wondering who in their community, um, if there's any therapist or social workers or mentors that they have in their community. Um, if they're asking specifically for our contact information, they could get in touch with Menachem Education Foundation, and, you know, they can reach out to us if, if, if that's the way that works. I think both of us offer consulting, um, and, and are able to speak to you. Um, I think that it's important for us to, to recognize like, you know, what ha-- like to what-- to recognize what happened and to also try to figure out what it is that you need and what it is that you need the school to do, um, to help your child. And, um, obviously, it's, it's not a question you can answer on one foot because we don't know, um, what the circumstances were.

1:11:46 Speaker 4 I think if we're speaking specifically about a child or an adolescent, it's probably, um, at best to start with either their school or their pediatrician, um, to find someone within their network. I say the school f-first because if the school already has a relationship with certain therapists with whom they've seen results, um, there's a good chance that you can form a partnership with the school and with the therapist and really work together. Um, if it's a pediatrician, they probably are more aware of what's in network with your health insurance. Um, and that can be a good resource, especially if the issue is more significant and would need more than just once-a-week therapy.

1:12:37 Speaker 5 Okay. Thank you. And what comes to mind also what you said before, finding someone that you trust within the school that you can talk to, um, if necessary, to find someone, or as you said, your pediatrician or other communal, um, um, um, services that are available to, to guide you. The next question we have is a, it's a child, a young child, a ten-year-old is causing self-inflicting pain or injury and showing a lot of anger. And the question is: What kind of therapy might this child need, and is parental therapy potentially more effective? Might that par- parental therapy be more effective than child therapy? Um, yeah, so there's another question from the same person, but that's the... We'll start. We'll go, we'll go with that one.

1:13:25 Speaker 7 I think that it's, um, um... I think that for you to know the answer of what kind of therapy the person would need, um, is a little beyond your pay grade in a way. And I think that if somebody came to me as well as a parent and said, "My s- daughter or son is self-inflicting pain," um, I would probably have to meet the child first and see what they present with. Um, and that probably the best information that I can give you is to reach out to a local therapist, um, obviously a child therapist, and be able to meet with them and consult with them and let them meet your child. Um, because inflicting pain on yourself is, um, it's called, ten-year-olds probably the beginning of it, but it's called non-suicidal self-injury. And it's almost always, and I wanna say always, but I have to say almost always, it's almost always due to a underlying mental health condition. There's emotional dysregulation, and the way the child knows how to kind of quell that emotional dysregulation is by hurting themselves. I want you to think about a boiling pot of water that's covered, and it starts boiling, and there's a lot of energy inside of it. There's a lot of dysregulation. And then when the child hurts themself, they feel better, right? And it becomes a cycle because when we hurt ourselves, what happens? Our body rushes to give us adrenaline and cortisol and stress hormones and dopamine in a way to make us feel

1:15:09 Speaker 7 better. So it becomes like this cycle. Um, so generally, when you're dealing withkids or adolescents or adults that harm themselves, you really have to look at the underlying mental health condition, the emotional dysregulation, and teaching the child the skills to regulate their emotions, to respond to what they need, um, without necessarily addressing the self-harm, as funny as that sounds, right? So there are different avenues of treatment, right? Um, and you as a parent, and, and I think that this is more so with anxiety and some with self-harm, is that parents do a lot of accommodations. We want the schools to accommodate, right? And we're upset that the parents don't accommodate. But parents do a lot of accommodations. "Oh, you forgot your lunch? Okay, I'll bring it. Oh, your shirt is dirty? Oh, you didn't put your clothes in the dirty clothes pile? Okay, I'll go wash it really, really, really early in the morning. You'll have clean pants in the morning," right? Because we don't want our, our, our kids to be uncomfortable. And I think that more important that you seek professional help to know how you yourself can deal with it, having a child, and to accept the fact that you have a child that is causing, inflicting harm to themselves, but not necessarily as a way of accommodating them, but that they also certainly, certainly need the professional help.

1:16:38 Speaker 8 Okay. Thank you for that. Um, so another question. This is from an educator. "I have a student who constantly chews her shirt, and the parents are wondering if it's anxiety. And she also has challenges with missing the bathroom often." We're talking about a child, um, who just turned six. So would the assumption be that it's connected and/or anxiety?

1:17:04 Speaker 7 I, I, I think in this situation is it's best, like Gidi said earlier, to consult the child's pediatrician, um, because there may be something going on. Uh, maybe a simple blood test could show that they're missing some sort of something. Um, it could, it could be have to do with sensory. Sometimes children with sensory needs or differentiating sensory, you know, disorders, um, do sometimes miss the bathroom. Um, and also chewing the shirt. And certainly the pediatrician, especially as a six-year-old, would be the first place that I would start with this child and not to assume that it's connected to anxiety. I mean, the parent can bring it up, and the parent can say, "You know, the teacher has noticed this. I'm wondering if it's connected," but allowing the, the pediatrician to do, um, to make that full assessment.

1:17:56 Speaker 9 I would also just be curious about is this happening in school or at home or across the board everywhere. Okay? So that might also be a, an important indicator of what's going on.

1:18:08 Speaker 8 Okay. We're gonna do one or two more questions and then wrap up, wrap it up. We're not gonna get to everyone tonight. Um, but so the next question is a, is as follows: "I speak every night to my teenagers. The problem is their favorite time to speak to me is at eleven thirty. My husband thinks it's crazy, and they really need their sleep, so he says I should put a stop to the late-night conversations. The problem is, this is the time my teenagers wanna speak to me." Go.

1:18:40 Speaker 9 I'm so happy your teenagers wanna speak to you. First of all, consider yourself very blessed, very fortunate. That is a huge beracha. You've done something really well if they want to talk to you. And nighttime is a great time to talk. There's something about the darkness that takes away our inhibitions. Think about all those late-night schmoozes and farbrengens you had in yeshiva or seminary. They don't happen during the day, okay? Daytime is a time for activity and productivity, and the nighttime is the time for our thoughts, our feelings, our fears to come out. So it's really a great time to talk. That said, they also really need their sleep because the sleep is probably the first thing I address when any adolescent comes into therapy. Probably their food is the second one because it's a little harder to get them to eat than to get them to sleep even, if you can believe it. Um, but I don't know. I'm curious. Would your teenager like to leave school in the middle of the day? Um, would they be okay having, uh, an early dismissal from school? Is there another time that could work as well or in addition to? Could it be one late night or two late nights a week instead of every night? Um, I love Friday nights and Motzei Shabbos for, you know, open forum where everyone can schmooze. If you can keep your eyeballs open, that's great as parents. But, you know, free, free rein at that point. Uh, so first,

1:20:15 Speaker 9 I guess I'll go back to isher kef to you that they wanna talk to you and see if you can strike a balance.

1:20:24 Speaker 8 Okay. We're gonna wrap it up over here, and, um, and we do have a few more questions, and, um, unfortunately, we're not gonna get to them tonight. But that was a fantastic conversation, and really, really appreciate, um, both Mrs. Francis and Mrs. Myers for your expertise over here and everything you have shared and you've offered. And, um, thank you to all the parents that have joined us tonight. The fact that you've given time Erev Pesach and, um, on a Tuesday night to think about our children and to discuss some heavy questions is really a testament to your dedication to your children. And I'm very hopeful that we all, um, that this is the beginning of a conversation, beginning of thinking about our children in a, in a more holistic way. And my beracha for everyone is that we should all have emes and nachas from our children and the strength to give them what they need, the presence to be with them. And im yirtze Hashem, we should see them in the front lines of Mashiach, where we'll have the-- everyone will have the geulah shleimah for all of us. Thank you, everyone, for joining, and have a, have a good night.

1:21:37 Speaker 9 Thank you. Good night.