The Dirty Little Secret

Woman making silent gesture

Many of my childhood friends were active in sports and some of them broke a bone or two in the process. I remember autographing their casts with well wishes such as, get well soon or sorry you got hurt. As parents, we know that if our children have a fever, it is best for everyone if they stay home. Physical illness is a natural and expected aspect of life. My friends did not act ashamed or secretive about having their casts signed, and kids view a fever like a snow day with plenty of rest and chicken-noodle-soup. In most cases, there is very little shame, or secrecy attached to physical illness.

In the world of mental health, the opposite is true. Individuals tend to conceal their depression, anxious thoughts, or self-defeating beliefs. Often, they prefer to work out their personal problems in private. Therefore, much of my work, by law, is confidential.  My professional standards require that I adhere to the promise “what is said in here, stays in here.”

When people come to see me, they are usually not proud and have no visible casts or fevers to prove that something is wrong. In fact, most of my client’s are mandated by the court system or social services and have drug, behavior, and academic problems. Many of the youth I treat, believe that people who have to see a counselor are crazy. However, I share with them that counseling is better described as a resource to keep you from going crazy.

As professionals, parents, and others who care about youth, it is important that we pay as keen attention to their mental health needs as we do their physical health needs. Undetected and untreated mental illness can lead youth down the road to delinquency or provoke self-harming behavior. Since mental health problems are not always as obvious as a bloody nose or a broken bone, it is important that we know the signs. Teens may not want to open up and discuss it, but if they are struggling their behavior will eventually reveal the presence of mental unrest.

Below are five major signs that may indicate a need for mental health treatment or evaluation.

  1. Withdrawal– isolation from family and friends or from activities that are typically enjoyable is an indication that something is out of the norm.
  2. Extreme changes in mood– everyone experiences and expresses anger, sadness, anxiety and fear at some point. However, if a young person has frequent and intense outbursts or changes in their emotional state, it is a strong indication that he or she is experiencing some type of distress.
  3. Poor concentration/attention– if a young person begins to have extreme difficulty staying alert and focused, it is possible that something more prominent is occupying their mental space.
  4. Use of substances– often youth who are experiencing a mental disturbance will attempt to self-medicate with marijuana, alcohol or other substances. At best, these drugs provide an immediate but temporary relief that can lead to drastic long-term consequences.
  5. Changes in eating and energy– sudden changes in eating and sleeping habits can reveal that something is mentally amiss. If a youth starts eating more or less than usual or sleeping more or less than usual, it could mean that their mental state is beginning to impact their physical health.

As a culture, we often treat mental illness like a dirty little secret that we strive to keep hidden until something extreme and even tragic happens.   After a murder-suicide or school shooting, it is too late to begin to ask what went wrong or what was wrong with the person who perpetrated the act. The more we talk about the realities of mental illness and the fact that in many cases it is treatable, the more we can relieve the stigma. If we notice the five signs above or other behavior or attitude changes in youth, it is important that we begin the conversation about how they are doing. These conversations are keys to helping raise a culture of youth who are healthy both physically and mentally.

For more information about mental health and treatment consult the information and resources on these sites:

American Counseling Association                              

American Psychological Association                           

National Association of Social Workers                      

American Association for Marriage

and Family Therapy                                                     




Youth Counseling and Relationships

It’s All About Relationships

I remember my counseling professors drilling home the point that the therapeutic relationship was the most vital component in delivering effective therapy. As an experienced therapist, I now know they were right. However, my experience has taught me that quality relationships form the basis for interactions in a variety of settings. Often, the better our relationships, the better the outcomes we can expect in the workplace, on the home front, and even in some difficult and volatile situations.

Last week, I spoke at the 10th Annual Youth Violence Prevention Conference in Charlotte, NC. My presentation focused on practical ways to de-escalate violence among youth from the front line.   Through my work with potentially violent and aggressive kids, I have learned that the best de-escalation technique is often a positive and mutually respectful relationship.

De-escalating volatile situations became a norm for me when I worked with youth in the juvenile justice system. However, one situation left a lasting impression on me because of its potential volatility. When you are in the trenches, it is not always easy to recall specific techniques and training. However, I believe the quality of the relationships I formed with the young men in that facility prevented a disastrous situation.

One afternoon, after dismissing a group therapy session, I noticed that one of the students gathered a crowd of about 8-10 others. I glanced down the other end of the hall to see another student approaching, followed by a group of his peers. I soon realized that these two groups represented rival gangs. I turned to the leader of the group closest to me and asked him if he had the power to call shots. He responded with pride and said that he did. Next, I simply asked him if he would be willing to call off the fight. He complied and this simple request thwarted a potential melee. I did not yell, threaten or beg. I simply asked and he complied.

The results of that situation may have appeared amazing and even magical to the casual observer. Closer observation revealed that my success at that moment began months earlier as I took the time to get to know this student. I realized that along the way I had done five key things that allowed me to build a positive relationship with that youth. These principles are applicable to any relationship, even if you are not working with potentially volatile young people.

  1. Find common ground

It may take some effort, but seeking commonalities will create bridges to strong relationships.   Often we focus on the areas that cause division, but finding common ground helps unify us with other individuals. It serves as a way to lower the barriers that may otherwise keep us separate.

  1. Focus on the strengths

Very few people respond well to having their weaknesses exposed and exploited. Think of how empowering it is for others to highlight our strengths and what we do well. Sure, we all have weaknesses, but choosing to focus on the strengths can be the key to building a positive connection with another person.

  1. Authenticity

Trying to be something you’re not is exhausting and eventually erodes trust in any relationship. Seeking to over relate to someone appears disingenuous and ultimately makes it difficult to establish the foundation needed for a strong relationship. When in doubt, be yourself, which will allow others to see a consistent and genuine person.

  1. Listen

Listening is a skill and it takes practice to develop. However, being an effective listener is crucial to building strong relationships. It communicates to others that their thoughts and words are valid and valuable.  Listening to truly hear will create a forum for honest dialogue and honest dialogue produces deeper and stronger relationships.

  1. Show genuine interest

Showing a genuine interest in others will put you on the fast track to developing a strong relationship. Whether we are parents, counselors, teachers or supervisors, asking sincere questions and seeking to know our children, clients, students and supervisees communicate that we care. Many of us know the famous quote “People don’t care how much you know until they know how much you care.” I have found this to be a true statement and showing interest is a great way to show you care.

It is all about relationship. Even if you are not in the middle of a potentially volatile situation, developing positive relationships is vital to success in our day-to-day interactions with our significant others, co-workers, clients, or even our own children.

10TH YVPC Website Part 1

ADHD Kids Exercising

ADHD: We Know Better

A quote by the late Maya Angelou that says, “Do the best you can until you know better. Then when you know better, do better” has had a great influence on me over the past year. Improving the odds for troubled youth is not an easy task, which is why events such as the National Youth-at-Risk Conference are so important for professionals who work directly with young people and their families.   I felt honored to present as a featured speaker at this year’s conference. My topic focused on attention deficit hyperactivity disorder (ADHD) and how the classic symptoms of inattention, impulsivity and hyperactivity served as strengths in hunter-gatherer societies. We discussed this theory in detail and how it might help change the way parents, teachers, and helping professionals view youth with ADHD or it’s symptoms.

The response from participants reinforced that this was a topic we must address in the coming years. People are looking for hope and solution focused approaches for youth with attention and behavior problems. Some believe that ADHD as a fictitious diagnosis designed by pharmaceutical giants to boost their billion dollar businesses.   Others attribute the symptoms to poor parenting or to teachers who “can’t teach.” Blaming does nothing to create solutions, which is what we really need.

Regardless of what causes ADHD symptoms, it is time to engage in the research and focus on developing innovative approaches. It was a breath of fresh air for me to provide training to other professionals who were hungry for hope. Harvard’s Dr. John Ratey wrote a book called Spark. In chapter one, he highlighted a case study about a school district in Illinois that created an exercise program before school. The goal for each participant was to maintain 80-90% of their maximum heart rate throughout the exercise routine.  The focus was fitness not competition between the students. The results revealed that students in the program performed better academically. In fact, they scored 1st in science and 6th in math on an international test where Asian countries usually outpace the US.

Critics argue that poor school districts are not privileged enough to purchase some of the cardio equipment used by the district in the case study. Some complain that their schools are too poor or their principals too rigid to allow the use of treadmills or exercise programs. However, one gentleman who attended my presentation last year, returned to share that he did not have the expensive cardio equipment. Instead, he took his class to the gym for exercise before class. He explained that the behavior disruptions were much less and that he planned to continue the program this year. I commended him because he was doing the best he could until he knew better and then he did better! Our at-risk youth need individuals in their corner who refuse to make excuses for the problems and focus on answers. I look forward to sharing this information with many others so that we can offer hope to youth who are so hungry for it, and I pray for more individuals who will take it and run.


Reference: Ratey, J. (2008). Spark: The Revolutionary New Science of Exercise and the Brain. New York, NY: Little, Brown and Company.

ADHD Kids Bad or Brilliant

ADHD Kids: Bad or Brilliant?

ADHD Kids Bad or BrilliantI am looking forward to presenting at this year’s National Youth at Risk Conference in Savannah.   The title of my presentation is ADHD: Maladaptive Disorder or Evolutionary Adaptation. According to researchers the symptoms of attention deficit hyperactivity disorder (ADHD) at some point may have served a purpose in society. Studies of ancient hunter-gatherer societies suggest that the symptoms were essential for survival.

Numerous researchers contend that evolutionary adaptation may explain the presence of ADHD symptoms in some children. However, the researchers acknowledge that other intervening variables such as trauma, abuse, and developmental disorders may also contribute to the symptoms. We currently call ADHD a disorder, yet this research may prove that in certain environments the symptoms played a highly functional role.

However, research is only as valuable as our ability use and contextualize it to problems that people face on a day-to-day basis. One of my first private practice client’s had been diagnosed with ADHD and oppositional defiant disorder (ODD). While reviewing the medical record, I used the terms ADHD and ODD throughout my evaluation. After about 5 minutes, the client’s grandmother looked at me and said, “I don’t care if he has ABC DEF or G the boy is just BAD and he needs a butt whooping.”   At that point I remembered that my assessment had to make practical sense to those who needed the services I had to offer. Fortunately, I was able to develop a treatment plan that benefited him and his family.

His grandmother reminded me that my knowledge and skills are only useful to others if they effectively address real world problems. As was the case with that first client, many people think that kids with ADHD are bad when they are often quite brilliant. I look forward to engaging this important issue in Savannah this week.

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Diversity in Culture and People as a Concept

Beyond Black and White

As an alumnus of the University of North Carolina at Greensboro, I have some fond memories of my many years in Greensboro both as a student and a professional. It was a special moment to return as the keynote speaker at this year’s North Carolina Counseling Association Annual Conference.

My speech focused on diversity and the fact that it encompasses so much more than just black and white. One participant reveled that some of my personal accounts lead her to recall an incident in her own life. She explained that when she moved from a Northern state to a Southern state, that one of her new Southern neighbors hung a sign that said “Yankee go home.” She described the incident as hurtful, but it gave her more insight into the pain of others who have experienced prejudice throughout their lives.

Another member of the audience explained that my focus on the importance of active listening resonated with her as a counselor educator. She discussed the fact that listening is one of the basic tenets of counseling that she emphasizes to her students. Listening is a process that requires effort and counselors and counselor educators are in an excellent position to model active and effective listening.

We live in one of the most diverse countries in the world, and it is important that we understand how powerful it is to honor those who differ from ourselves. Tolerating differences is not the same thing as celebrating and valuing those differences. Our ability to truly listen will forge an understanding between diverse groups and construct bridges that will connect us and reduce the gaps that keep us divided.

2015 National Youth at Risk Conference

Jeremiah will be a featured speaker at the 2015
National Youth at Risk Conference!