Description of Common Mental Health Disorders in Children and how to teach social skills to them.

1. Wor king with Youths’
Mental Health
Dia gnosis

2. Mental Health
Disorders
• A mental health diagnosis is defined as the
identification and labeling of a disease based
on it’s signs and symptoms.
• One of the main purposes of diagnosis is to
guide treatment planning.
• Based on the diagnosis, treatment providers
can apply treatments that have been proven
effective.

3. Diagnosis vs. Labeling
• Diagnosis may have unintended effects of labeling.
• Many youth feel affected by the label the disorder has
been given.
• Youth may feel stigmatized which may impact how
they view themselves.
• Therefore, it is important when working with youth to
see them as a person and not a diagnosis.

4. What can you do?
• Avoid labeling terms including words that are
used as part of their diagnosis.
• Help the youth understand he/she is not the
diagnosis.
• Help youth see how they can overcome the
symptoms associated with the diagnosis.
• Teach skills that will help reduce the
symptoms.

5. Common diagnosis for
the youth we work
with
• Oppositional Defiant Disorder/Conduct
Disorder
• Attention Deficit/Hyperactivity Disorder
• Post Traumatic Stress Disorder
• Reactive Attachment Disorder
• Major Depressive Disorder/Mood Disorders
• Disorders related to sexual abuse and
sexual offending issues

6. Oppositional Defiant
Disorder
• Associated behaviors/symptoms:
– Often loses temper
– Often argues with adults
– Refuses to comply with requests from adults/rules
– Blames others for his/her behaviors
– Touchy or easily annoyed
– Often angry and resentful
– Behaviors cause significant impairment
in social or academic functioning

7. Oppositional Defiant
Disorder
• Remember that these youth can be distrustful
of authority figures.
• Often the behaviors they display are what was
modeled for them.
• This is not a disorder they were born with.
• It is treatable and does not have to be a life
long diagnosis.

8. Oppositional Defiant
Disorder
• Skills that you can teach:
– Following instructions
– Accepting consequences
– Controlling emotions
– Communicating honestly
– Following rules
– Seeking positive attention
– Disagreeing appropriately

9. Oppositional Defiant
Disorder
• Other things you can do:
– Build positive relationships with your youth
– Set clear expectations
– Be consistent in what you teach to
– Maintain low tolerances
– Praise when youth engage in behaviors opposite of
presenting behaviors

10. Attention Deficit/Hyperactivity
Disorder
• Associated behaviors/symptoms:
-Often fails to give close attention to schoolwork
-Has difficulty sustaining attention in tasks or play
-Seems not to listen even when spoken to directly
-Often does not follow through on instructions and
fails to finish schoolwork, chores, or other tasks
-Has difficulty organizing tasks
-Often forgetful in daily activities

11. Attention Deficit/Hyperactivity
Disorder
• Associated behaviors/symptoms:
-Often avoids, dislikes, or is reluctant to engage in
tasks that require sustained mental effort
-Often loses things necessary for tasks or activities
-Is often easily distracted by extraneous stimuli
-Often fidgets with hands or feet, squirms in seat
-Often leaves set in classroom or other settings
-Often talks excessively

12. Attention Deficit/Hyperactivity
Disorder
• Associated behaviors/symptoms:
-Seems to be driven by a motor
-Often runs about or climbs excessively in inappropriate
situations
-Has difficulty playing or engaging in leisure activities
quietly
-Often blurts out questions before questions have been
completed
-Often interrupts others’ conversations or activities
-Has difficulty awaiting turn

13. Attention Deficit/Hyperactivity
Disorder
• ADHD can be treated with medication and
therapy
• Boys are more likely primarily hyperactive
• Girls are frequently undiagnosed as they tend
to be quietly inattentive
• Most children and adolescents with ADHD
grow up to be normal adults

14. Attention Deficit/Hyperactivity
Disorder
• Skills that you can teach:
-Following instructions
-Accepting criticism
-Appropriate voice tone
-Ignoring distractions by others
-Waiting your turn
-Sharing attention with others
-Time management

15. Attention Deficit/Hyperactivity
Disorder
• Skills that you can teach:
-Seeking positive attention
-Completing tasks
-Dealing with frustration
-Listening to others
-Delaying gratification

16. Attention Deficit/Hyperactivity
Disorder
• Other things you can do:
-Work as a team with therapists, teachers, parents,
and physicians
-Try to keep a regular schedule with meals and
bedtime
-Work on organization
-Be realistic with your expectations
-Identify difficult situations
-Be patient

17. Posttraumatic Stress
Disorder
• Associated behaviors/symptoms:
-Flashbacks or reliving the traumatic event for
minutes or even days at a time
-Upsetting dreams about the traumatic event
-Trying to avoid thinking or talking about the
traumatic event
-Avoiding activities that were once enjoyed
-Hopelessness about the future
-Memory problems

18. Posttraumatic Stress
Disorder
• Associated behaviors/symptoms:
-Difficulty falling or staying asleep
-Irritability or outbursts of anger
-Difficulty concentrating
-Being easily startled or frightened
-Hearing or seeing things that aren’t there
-Overwhelming guilt or shame
-Self destructive behaviors

19. Posttraumatic Stress
Disorder
• Remember that for a youth to have this diagnosis
means they experienced, witnessed, or were
confronted with an event that was threatening or
resulted in injury
• The youth experienced intense fear, helplessness or
horrors during the event
• Events such as domestic violence, sexual, physical, or
sexual abuse can create trauma
• Symptoms may come and go

20. Posttraumatic Stress
Disorder
• Skills that you can teach:
-Expressing emotions
-Coping with sad feelings
-Asking for help
-Structured problem solving
-Stress management
-Stress management
-Relaxation strategies

21. Posttraumatic Stress
Disorder
• Other things you can do:
-Build a positive relationships with your youth so
they will feel safe in talking to you
-Create a safe environment for the youth
-Encourage physical exercise or meditation
-Help redirect the youth when they appear anxious
-Encourage rest and a proper diet
-Take care of yourself so you can support
the youth

22. Reactive Attachment
Disorder
• Associated behaviors/symptoms:
-Withdrawing from others
-Avoiding or dismissing comforting comments or
gestures
-Acting aggressively towards peers
-Watching others closely but not engaging in social
interactions
-Failing to ask for support or assistance

23. Reactive Attachment
Disorder
• Associated behaviors/symptoms:
-Obvious and consistent awkwardness or discomfort
-Masking feelings of anger or distress
-Alcohol or drug abuse in adolescents
-”Push away” behaviors such as limit testing to see
if you will “reject” them
-Seeking attention from everyone including strangers
-Difficulty forming and maintaining
healthy relationships

24. Reactive Attachment
Disorder
• Beyond childhood years, the disorder may lead
to delinquent behaviors, difficulty with peers
• After childhood years, adolescents who have
been diagnosed with RAD often shift to the
diagnosis of oppositional defiant disorder
• While treatment can help, the disorder is a
lifelong problem

25. Reactive Attachment
Disorder
• Skills that you can teach:
-Seeking positive attention
-Accepting “no” answers
-Appropriate boundaries
-Following instructions
-Choosing appropriate friends
-Displaying appropriate affection

26. Reactive Attachment
Disorder
• Other things you can do:
-Use comforting physical contact to help develop a
relationship
-Model healthy relationships
-Provide a safe, stable, and predictable living
environment for the youth
-Help develop the youth’s self esteem
-Remember that you may give more than
you receive

27. Depression/Mood
Disorders
• Associated behaviors/symptoms (Depression):
-Depressed mood most of the day
-Loss of interest in pleasurable activities
-Insomnia or excessive sleeping
-Irritability or angry outbursts
-Changes in appetite
-Agitation or restlessness

28. Depression/Mood
Disorders
• Associated behaviors/symptoms (Depression):
-Feelings or worthlessness or guilt
-Trouble thinking, concentrating, making
decisions, and remembering
-Frequent thoughts of death, dying, or suicide
-Frequent crying spells for no clear reason
-Unexplained physical problems such as
headaches, stomachaches, or back pain

29. Depression/Mood
Disorders
• Associated behaviors/symptoms (Mood
disorders):
-Same as depression plus…
-Impulsive behaviors
-Abnormally high energy levels
-Talking fast or switching topics rapidly
-Racing thoughts
-Poor judgment
-Mood swings

30. Depression/Mood
Disorders
• These disorders may be hereditary
• Certain life events can trigger the disorders
• Complications of these disorders can include
alcohol abuse, problems with relationships,
suicide ideation or attempts, health problems
• Medication and cognitive behavioral therapy
may be used to treat symptoms

31. Depression/Mood
Disorders
• Skills that you can teach:
-Identifying and expressing feelings appropriately
-Coping with change/sad feelings
-Self-talk or instructions
-Decision making
-Use of leisure time
-Accepting self/positive self statements
-Thought stopping

32. Depression/Mood
Disorders
• Other things you can do:
-Encourage your youth to get sleep and exercise
-Get your youth involved in activities outside of the
home
-Follow the treatment plan including prescribed
medication and therapy
-Help the youth structure his/her day
-Encourage journal writing/expressing
feelings

33. Sexual abuse, reactivity,
offending
• Many of the youth we work with have been
sexually abused
• This may result in sexual reactivity or sexual
offending behaviors
• It is important not to label the youth based on
sexualized behaviors which are learned
• With proper treatment, many youth go
on to live healthy lives

34. Sexual abuse, reactivity,
offending
• Associated behaviors/symptoms:
-Bed wetting
-Engaging in sexual play with toys or friends
-Regression in behaviors to younger years
-Waking up during the night due to nightmares
-Secretive behaviors/lying
*This will be discussed in more
depth in another class

35. Sexual abuse, reactivity,
offending
• Skills that you can teach:
-Expressing feelings appropriately
-Appropriate boundaries
-Developing healthy relationships
-Appropriate interaction with members of the
opposite sex
-Reporting whereabouts/self reporting
-Communicating honestly

36. Sexual abuse, reactivity,
offending
• Other things you can do:
-Monitor your youth and natural children
-Model appropriate touch/affection
-Provide a safe and nurturing environment
-Encourage honesty, discourage “secrets”
-Be consistent with boundaries/rules
-Take your youth the therapy weekly

37. In conclusion…….
• Remember that the child is NOT a diagnosis
• Your job is to teach to the symptoms
• Teaching skills will help reduce the behaviors
• Your consultant can help you identify skills that will
be most beneficial
• Let the youth’s therapist deal with the underlying
issues
• Be patient, change will come
• You are making a difference!