How can you differentiate between normal adolescent behaviors and those that indicate a more serious problem? Here are some guidelines from the American Academy of Child and Adolescent Psychiatry on when to seek help and what warning signs to be on the lookout for.

When does normal teenage angst and moodiness become dangerous depression or anxiety? When does youthful experimentation with alcohol or drugs cross the line to something more serious and when does a teen’s expected preoccupation with personal appearance devolve into the scary beginnings of an eating disorder?

Adolescence can be tough and a little turbulence along the way is more normal than not. For parents, the trick is recognizing the difference between normal developmental bumps in the road and more serious behaviors and emotional states; and knowing when to handle things within the home and when to call in professional assistance.

Of course that’s a lot easier said than done.

With that in mind, here are some guidelines from the American Academy of Child and Adolescent Psychiatry (AACAP) on when to seek professional help for your teen son or daughter..

Signs That Your Adolescent Son or Daughter Needs Professional Help

It’s never easy to know when to seek a professional mental health evaluation, but on balance, it’s probably best to err on the side of caution. According to the AACAP, any of the following warning signs from adolescents and pre-adolescents may indicate the need for a professional mental health evaluation, particularly if worrisome behaviors have persisted for some time and/or if others have also expressed concern about your child’s emotional health.

Warning signs include:

• A sudden drop in school performance
• A sudden change in eating or sleeping patterns
• Your son or daughter seems unable to deal with the normal challenges of life
• Problems with concentration that are affecting your child’s performance at school or which are causing difficulties at home
• Frequent nightmares
• Repeated use (abuse) of alcohol or drugs
• Signs of depression, such as a lasting negative mood and attitude, sleeping problems, low appetite and a preoccupation with death
• Extreme mood swings
• Acting out sexually
• Feelings of anxiety that interfere with your child’s ability to participate at school or in normal social activities
• Making threats of self harm or threats of hurting other people
• Making repeated threats about running away from home
• A strong fear of getting fat, especially when that fear is not grounded in a reality of weight gain and especially when that fear is accompanied by persistent dieting or purging.
• Self injury (cutting, for example)
• Reoccurring acts which violate the rights of others, whether violent or non violent in nature - such as vandalism, theft, skipping school and opposition to legitimate authority
• Reoccurring outbursts of anger or extreme aggression
• Very unusual thoughts, beliefs or behaviors

Seeking a professional mental health evaluation, whether ultimately needed or not, is always preferable to taking the risk of ignoring something serious.

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Parental support is a necessary component of teen addiction recovery, but you can’t have full support until you build real communication; learn how to improve your parent-teen communication skills in 7 easy steps.

Seven steps to better communication with your teen!

You probably already know that you can’t stop a motivated adolescent from using drugs/alcohol and making other bad decisions – all you can do is help them learn from the past and guide them toward better decisions in the future.

However, to guide - you need to communicate. If you can’t communicate effectively, then you limit your parenting abilities!

If you struggle in conversations with your teen, you’re hardly alone – few parents escape the adolescent years without experiencing communication stress.

1. Unfortunately, it’s up to you to learn to bridge the generational gap.
   
2. Fortunately, the payoff of better communication is a better relationship with your child and an improved ability to support your teen's recovery.

So though you’ll have to do the hard work of learning to speak – and listen – in a way that fosters real communication, if you can do so, you become a much stronger ally in your teen’s battle against relapse. Read on for 7 essential skills to practice.

7 Steps to Better Communication

1. Don’t Point out Obvious Negatives

Encourage problem solving.

Don’t point out obvious negatives – turn a negative into a positive by helping your teen use mistakes to learn better problem solving skills.

• Don’t say, “Of course you didn’t make it to work on time when ride-sharing with your unreliable friend.”
• Say, “Wow, that’s too bad…what are you going to do to make sure you don’t get into this mess again?”

The first response closes the conversational door, while the second avoids blame and negative feelings and keeps the dialogue flowing.

2. Stop Asking Loaded Questions

Stop beginning questions with phrases like, “What’s wrong with you….?” Or, “How could you….?”

These loaded questions put your child on the immediate defensive and sabotage your ability to have real dialogue.¹

3. Take an Interest

You work hard to build communication skills and to get your son or daughter to come to you – so don’t sabotage things at the last moment by failing to pay attention.

No one likes to feel like a bore, so try to stay focused and engaged when your teen comes to you (put your phone down!) Give them your undivided attention, make eye contact and avoid hurrying body language.

• Though you may not like the same movies, music, TV shows etc. as your child, by staying up-to-date with their interests you build a healthy neutral ground for natural conversations, which can help a lot when it’s time for more serious discussions.
• Create situations that lead to natural conversations. Rather than calling your son out of his room for special ‘talks’, offer rides and pick-up services. Long car rides lend themselves very well to casual conversation.

If you initiate a ‘serious’ discussion, make sure going in that you have the time, energy and focus necessary to give your all to the discussion – timing is everything…

4. Stay Calm

If you can’t stay calm, get out of the situation.

It's easy to lose your cool with in-recovery teens, especially when your son or daughter comes to you and reveals poor judgment or behaviors!

• But remember, if you blow-up when your child opens up, don’t be surprised if she gets a little more reticent to talk the next time around.

According to the experts at NIDA, If you get too angry/upset to have a calm discussion, get out of the situation – calm down, and then revisit the conversation when you’re able. ²

5. Create a Culture of Respect

Though your teen has made mistakes – treat him or her with respect and allow for positive expectations.

Create a culture in your home where all people get treated with respect and courtesy. Respect your teen’s privacy (knock before entering his room) and opinions and allow each person a little space for bad moods and silent periods.

When your teen comes to you with opinions that you find ridiculous – try to react as if you were responding to a good friend that you respect.  Your teen may hold different viewpoints, but that doesn’t mean she doesn’t have good reasoning behind her positions.³

6. Listen and Keep an Open Mind (Don’t Accuse)

Listen to your child and keep an open mind about what they’re telling you – don’t automatically jump to reprimands and accusations.

• If your teen feels listened to and respected, he’s more likely to seek your advice.
• If he knows that asking for help probably earns him a lecture or punishment, then he probably won’t come to you.

As a general rule, when your teen starts a conversation, listen much more and talk much less!

7. Be Positive and Encouraging

Be the unending source of unconditional love and positive support that every teen – no matter how defiant, wants/needs/deserves.

• Adolescent life is hard enough; as parents we need to take every opportunity to build-up, rather than tear-down.
• Strive to make every interaction a positive one, or at least partly positive, by offering lots of positive feedback and encouragement.
• Give lots of hugs, celebrate their accomplishments and make sure they always feel included in all family activities.

Counseling Is a Good Option

If you can't improve communication on your own - you should consider getting family counseling to restore a healthier communication dynamic.

When rebuilding an estranged father - son relationship there are 4 cornerstones that fathers or role models must recognize and establish before anything concrete can be created. They are . . .

Like any other structure, a relationship requires a strong foundation upon which to build trust, forgiveness and a willingness to continue. For fathers or want-to-be mentors to be successful in re-creating a relationship with an estranged son they must recognize what these 'cornerstones' are and understand how to repair them, because, as with most things, there are rules to work by.

The one thing that is crucial to remember is - there are never any guarantees anything will work for sure.

The following 4 'cornerstones' are important because they are the foundations that allow trust to become more of a reality. Without the possibility of creating some kind of trust base there is no hope of being able to establish any kind of quality type relationship. This, really, is true for ANY relationship between people who care for and about one another.

I. Gather Knowledge

In this day and age of electronic education there is no shortage of free resources to help people learn what they need to know about parenting. learning simply requires time, patience and a willingness to do what needs to be done in order to begin the process of fixing a broken parent-child relationship.

If the relationship with a son, for instance, is broken, your instincts and earlier practices didn't get the job done so now is the time to consider other options, other opinions and other approaches. Just go to the browser on your computer and type in "parenting" and you will find more information than you thought possible. Look for qualified experts who have a track record of good solid information to provide for you. Read through what's being offered and choose an approach that best suits your abilities and comfort zone. If you try to repair this relationship with fancy words and techniques that don't make sense your efforts will be short lived. Be real with new information to support your efforts.

Most community colleges offer courses where good direction and feedback can be found for very little investment.

II. Limit Expectations

Having unrealistic expectations about what this new relationship should look like or be like is the kiss of death. Remember that you, as a father, are only one part of this equation and that your son is the other part. He may very well see things completely differently and if that's the case right from the beginning you both will be working at cross purposes. This is not how you want to begin this process.

Having hope is much different than expecting things to be a certain way. Repairing and developing a new relationship is a process NOT an event. Fathers need to concentrate on doing all they can do, each day, to ensure that these four cornerstones we are discussing here are demonstrated as much and as often as possible. The rest will take care of itself. If there is pressure brought to bear in order to move closer to the expected outcomes the likelihood of being successful diminishes dramatically.

III. Be Committed

Being committed to the process is something that is demonstrated and not spoken. Telling a son how much you want this to work is not going to be helpful. It could, in fact, alienate him. He may have heard it all before so what would make this time different? My mother used to say 'show me--don't tell me'. Great advice if you are trying to show that you have changed in some way or that you are willing to do things differently.

Being in for the 'long haul' means that you are ALL in--that you are ready to make being a good parent your top priority. But first off you have to decide if that is something you want to do or can do. There is no pre-determined time frame here. In some cases, seeing any progress could be tied directly to the type of damage that was done previously (mental, physical or emotional), whether addiction affected parenting, and how long that situation persisted. There could be any number of reasons why a great deal of time may have to pass before any trust can be established.

If you can't be OK with this then my suggestion is don't start the process in the first place. Tell him you love him and walk away. He doesn't need to be devastated more than he has been.

IV. Be Ready to Adapt

It will be very important that you demonstrate an ability to adapt your life to the type of lifestyle that supports a family type experience - putting family first. It doesn't mean that, as a father, you have to forsake all other forms of personal growth, fun or entertainment. It doesn't mean that you can't enjoy time with your own friends doing things you enjoy that are adult oriented. But it does mean that you need to allow for blocks of time where you spend time with your son, just the two of you. It means that you do what you promised you would do. If you say just the two of you will go to the football game then you make sure that that happens as scheduled. Never make promises that you can't keep.

Sons want to know what their dads know. You are or need to be his teacher. That's one of the things that he wants from you, but he has to trust that you want to teach him.

Creating an environment that fosters the growth of trust is essential to having a strong four-cornered foundation to build the relationship on. Creating that environment demands consistency, honesty, listening to him and being sure that he always knows he is valued and has a place at the table where he can talk about what is going on in his life. He needs to feel connected and that his life has meaning.

Anyways, that's how I see it--James. Please feel free to contact me through the choosehelp.com site if you have any questions or comments about this article.

Anger has no place in discipline. It does not assert authority nor does it ensure that you've been heard. Learn better ways to communicate with your children.

Many people make the assumption that anger gives them authority. I remember hearing several friends and family members indicate that they were scared of their fathers and that it was necessary to respect them. Many of us have grown up within this culture of "anger as respect" and appear not to have suffered harm, but this posture with one's children is a distortion of a more adaptive and functional definition of respect. I feel for anyone today who grew up with parents who believed that children should be seen but not heard. That condescending and disrespectful message can have lifelong effects if not actively countered with a loving and engaging authority figure. 

When Anger Harms

Some of us have experienced the very worst of anger when our parents were trying to make sure that they were being heard. While it may have been intended as demanding of respect, it was more likely experienced with fear of not only consequences but of intimidation. When dealing with this kind of anger on a regular basis, the child learns that anything other than compliance will provoke anger from the valued parent. Anger can come so frequently that the child can come to believe she is unacceptable as she is.

Love can be perceived as contingent on compliance with the authority figure. However, a child's job is to define her own identity, make her own decisions and discover her own preferences - learning in the context of respected adults and peers. When she is treated with disrespect, that learning is at best confused, at worst, the child stops respecting herself and the authority figure.

Making your child afraid of you creates a permanent barrier in the relationship. Your child may listen and comply only because they are afraid of the consequences. If this is the consistent message, your child will come to believe that you don't accept her as a unique separate individual - you simply want control, your own way. Ultimately, you risk teaching your child to rebel. She may begin to define who she is as anything but you. This sort of rebellion without a clear alternative code of behavior leads to an angry, confused and acting out pre-adolescent.

Intimidation cannot support a close loving relationship and respect. Treating your child with anything but love and respect leads to damaged relationships in childhood and risks an impaired child entering adulthood; a child without the skills they need to cope with their own emotions, much less the challenge of life.

Anger Motivators

Parenting is THE most difficult job we will ever face. This is largely because we care so much for our children; our emotions are always involved at peak levels. Managing and making sense of them is indeed very difficult and important. Raising children challenges our emotions more than anywhere else. We are often afraid of how our children will grow up. Will they be polite and caring? Will they be productive and able to produce a living? Will they be loving and caring enough to bring up a new generation successfully? All of these questions rolling through our heads make us fearful of parenting and can interfere with our judgment in parenting.

Squashing Problematic Behaviors

Perhaps you worry their behavior has to shape up quickly before they head off to school or they will find their future compromised. Perhaps you see some of your less desirable traits in your children and worry your children will suffer like you did. in response, you may become excessively persistent and insistent to squelch out the offending behaviors before they have to live with the consequences.

This may seem like an honorable task, however, how you teach your children is as important as what you teach them. Children need a kind but firm, nurturing and encouraging hand while growing up. Punitive approaches will directly impact their self-esteem and their relationships with you and other authority figures. 

Feeling Overwhelmed

You need to have an understanding of why you are having trouble with your role of parenting. Perhaps you are simply overwhelmed with the children's age appropriate behavior. All you want is peace and quiet after a long stressful day at work. If so, then you need to find a way to take care of the children's needs when get home, and still allow yourself a chance to de-stress. One idea might be to allow the children to watch a TV program while you engage in some vigorous exercise.

Protecting Your Reputation

Do you see your child's behavior as reflecting on your reputation? Is their performance a reflection of your performance? Our children have not been placed in this world to meet our expectations or to support our reputation. Any attempt to make that happen is liable to have the opposite of the desired effect. Whatever the underlying issue is, you must ferret it out and learn to address it appropriately while still providing good care for your children. 

Unrealistic Expectations

It is not reasonable to expect children to behave well all the time. Childhood is a time when children must explore and learn the natural consequences of their behavior. Natural consequences are those that happen all by themselves. They are the natural result of anyone's behavior in interaction with the environment. Children can't learn from their environment if you are continually interrupting their learning and imposing your consequences. Children have to make mistakes and learn from them without your intervention. Your job is to protect them from the extreme natural consequences of their behavior, like getting hurt or causing expensive damage.

How to Discipline

Set reasonable limits for your children. Practice assertiveness and let them know when they're out of line but do so only with a gentle tone to your voice.

• Remember that your voice tone addresses your child's personhood. Clearly differentiate between her personhood and her behavior.

Make sure that she gets the message that she's loved but expected to behave differently than she perhaps just did. That's a difficult thing to accomplish without some practice or an appropriate role model from your childhood. Practice using the same tone of acceptance and enthusiasm for your interactions with your child when you're playing with them, teaching them, or correcting their behavior.

For anyone who has understood their anger to be an important message of urgency and authority, this positive voice tone will seem odd at first, especially when used in less than positive circumstances. Just remember that your voice tone and choice of words tells your child of your love and respect and the rest of the message can be about virtually anything else. You'll find that a positive tone will make any message easier to understand and comply with.

Raising children must take a higher priority than maintaining a household. A healthy child's experience will make their parents day more complicated, it's a continual and sometimes exhausting challenge, but we all owe our children our patience. They didn't ask to be brought into this world, we made that choice for them. Thus we have the obligation to give them the most we can give them.

Image Copyright: Giulia di Filippo

If an adolescent acts entitled, grandiose and self obsessed, does that mean she's a narcissist? Maybe...but probably not. Learn the differences between normal traits of teen development and those of narcissistic personality disorder.

Is your teen unhappy, lacking in close friends and totally self obsessed? Is this a normal developmental stage of adolescence or do these symptoms indicate narcissistic personality disorder (NPD)? How can you tell the difference?

Firstly, don’t panic! Many teens seem totally self obsessed at some stage and most simply grow-out of their behaviors. As time passes and teens mature – and as responsibilities increase – you may notice that the worrisome behaviors diminish. Perhaps you will observe the formation of healthy interpersonal relationships and behaviors which demonstrate increased awareness, empathy and compassion.

• In effect, these egotistical adolescent ‘narcissistic’ indicators may merely represent a developmental stage in a teen’s personal growth and maturity – and nothing more.

It should be pointed out that – contrary to popular notion -- those with NPD actually do not love and adore themselves excessively rather they are void of self-love and self-worth and can be dangerous to both themselves and others.

NPD is much darker:

• Those diagnosed with NPD often suffer depression, have thoughts of suicide, and exhibit a pattern of repeated failed interpersonal relationships. A swirl of trouble and high conflict at work and at school constantly surrounds them.  

Diagnosing Narcissist Personality Disorder

The DSM-IV-TR defines narcissistic personality disorder as:

• “An all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation, and lack of empathy, usually beginning by early adulthood and present in various contexts.”¹

A list of traits associated with NPD are listed below. In order for an individual to be diagnosed as NPD at least five (5) of the traits identified must be present.

1. Is assuredly convinced that he or she is special, unique and can only interact and associate with other special, uniquely qualified or high-status people (or institutions).
2. Insists on being treated with excessive adulation, admiration, attention and  affirmation.  Or, if not, then desires instead to be feared and viewed as infamous or notorious.
3. Demonstrates a sense of grandiosity and self-importance (e.g., grossly exaggerates skills, accomplishments, talents, connections and personality traits to the point of lying; demands to be recognized as superior without demonstrating actual achievement to support the claim.)
4. Exploits personal relationships focusing only on his or her own goals at the expense of others.  
5. Demonstrates characteristics of at least one of the two narcissistic types: 'The Cerebral Narcissist' is driven with fantasies of boundless success, notoriety, tremendous power or omnipotence and incomparable brilliance. 'The Somatic Narcissist' is obsessed with his or her bodily beauty or sexual performance or ideal, everlasting, all-conquering love or passion.
6. Believes he or she is “above the law” and all knowing (omnipresent). Behaves in a superior, invincible, immune way, and when questioned or frustrated by people he or she views as either inferior or unworthy – rages.
7. The individual presents as arrogant and haughty, possessing a strong sense of entitlement and demanding full and unquestionable compliance with his or her unreasonable expectations for special favor and exemplary treatment.
8. Possesses a severe lack of empathy. Cannot accept - or even acknowledge - the  needs, feelings, desires, choices, preferences or priorities of another.
9. Demonstrates continuous examples of envy and jealously. Sets out to hurt and demolish the source of his or her frustration. Experiences paranoid delusions believing that others feel identically about him or her and will act in the same manner toward them.

To further determine whether or not an adolescent suffers NPD, consider these developmental and environmental factors, which are thought to contribute to NPD:

• Unreliable or unpredictable caregiving from parents 
• Experiences in childhood, such as loss of a father figure
• Suffers severe childhood emotional abuse 
• Excessively condescending or critical environment - Is overindulged and over-praised by her parents
• Possesses an oversensitive temperament from birth 
• Learned manipulative behaviors as a way to get what she wanted

Note that chronic insomnia, over-work, ongoing exposure to high levels of stress, substance abuse, medical problems, and difficulties with family or other interpersonal relationships can exacerbate the symptoms of a personality disorder.

Treating Teen Narcissistic Personality Disorder

As teens are generally in a fragile mental state it makes it especially difficult to treat teens who suffer narcissistic personality disorder. Treatment attempts are often met with disdain making it impossible to develop the proper and necessary therapeutic therapist-client alliance. The teen’s own self-perception often interferes with this essential process.

• A therapeutic objective is to teach the teenager to value him or herself on a more realistic level and to adjust one's thinking about others' value in relation to his or her own. Exercises designed to assist the teen in developing empathy for others would be an aspect of treatment of this personality disorder.
• In general, medication is not part of the treatment plan, except in those cases where depression and anxiety emerge as the teen struggles to cope with his or her new reality of self.
• Group therapy (such as Dialectical Behavioral Therapy), somatic experiencing, anger management, sleep management, psycho-education and individual psychotherapies can help.
  
• Neuro-feedback techniques can also be utilized in conjunction with the other therapies.
• Holistic remedies such as yoga, meditation, acupuncture and massage therapy can support and enhance treatment and healing.
  
• Family therapy groups that incorporate family members and significant others into the therapeutic treatment plan are advantageous.
  

This combination of treatments can show good result in dealing with personality disorders.

Factors That Slow Recovery

Keep in mind, though, that:

1. Narcissists rarely enter treatment and when they do they often view it as a ‘waste of time’. Depression – as well as substance abuse, specifically alcohol, marijuana or cocaine -- are prevalent among persons with this disorder and negatively impact psychological and medical treatment.
2. Individuals with NPD typically have interpersonal problems with family, loved ones, classmates and co-workers – therefore, their impaired social support structure adds another layer of difficulty regarding their entrance into and continuation of treatment.
3. NPD’s who are excessively impulsive or self-destructive will require more intensive therapy and resolution will come at a slower pace.

Friends and Family Can Accelerate Treatment

It may be very difficult and challenging for friends, family and loved ones to help and support because persons with NPD have great difficulties with interpersonal relationships.

1. Family and friends can help by educating themselves about NPD in order to interact emphatically and with compassion for the person who has NPD.
   
2. Family and friends are an indispensable resource when it comes to monitoring symptoms and watching for dangerous maladaptive behaviors.
   
3. There are some treatment centers that specialize in working with individuals with NPD and friends and family can provide emotional support and financial resources.

The Prognosis

1. NPD is generally a chronic life-long disturbance with periods of remission and exacerbation (worsening) dependent on changing life circumstances.
   
2. Psychotherapy over time, coupled with sleep and stress management, and psycho-education, can address related problems.
   
3. When a person with NPD develops depression or substance abuse, treatment becomes imperative.
   
4. Clients who do receive effective treatment will experience significant improvement in their ability to function normally in their daily lives, with improvement in their interpersonal relationships.

Image Copyright: Anna Marie Gearhart

Supporting our adult children in this day and age often means allowing them to move back home for a time. In the case of addictions and mental illness, we sometimes find that the love of parents is exploited or simply taken for granted. Here are tips on thriving as a family when adult children come back home again.

For myriad reasons, it often happens that our adult children move back home for a time following financial hardships. We welcome them with open arms, nostalgic and happy to be supportive. We assume the move is temporary and that in short order they will resume independent lives. However, in the context of addiction recovery and severe mental illness, many of us find ourselves incurring long term financial costs and imposition without an end game in sight.

Relating to Our Adult Children

The transition from adolescence into adulthood is rough under the best of circumstances. There is usually a profound change in how we relate to one another once we are no longer in a position of authority. While our relations become far more egalitarian in nature, on an emotional level, they remain our kids. There’s a residual protectiveness that makes setting and maintaining boundaries difficult.

Mistakes to Avoid

Not Establishing Limits

The biggest mistake parents of adult children tend to make is offering support without clearly established limits and mutually understood expectations. When we fail to be clear early on, we may feel as though we have no right to revise arrangements later. Resentment becomes inevitable and progressive when we choose not to communicate our wants, needs, and feelings. At any juncture, we are free to revise our arrangements, but doing so often feels awkward and stressful.

Revisiting Old Wounds

Whatever dysfunction or difficulty existed prior to our adult children moving home assuredly remains and can be problematic. While dealing with both the needs that brought them to return home and finding the solutions to current problems, now is not the time to revisit old wounds. I encourage folks to maintain a focus on today forward. Addressing the past with people who are overwhelmed never creates positive outcomes. First we attain stability and security, then we seek to reconcile the past.

Making Assumptions

As in any other part of life I caution family members: assume nothing. It’s entirely possible that our adult children want some level of involvement from us in addressing current needs, but we need to ask what that looks like. We must not take ownership of their struggles nor can we presume to know what is best. Presumptions and assumptions are made individually or in tandem with our partners and spouses. They are not made collectively. Open and honest dialogue ensures clarity and prevents rescue attempts, enmeshment and/or inadvertently crossing boundaries (even with good intentions).

When our expectations are not met (needs unmet, issues that brought them home remain unresolved) levels of stress individually and collectively increase. The pitfalls here are many. We can easily become angry with one another and often threats and ultimatums follow. In this way, emotional distance becomes relational divide.

Approaches to Embrace

Working as a Team

In working with families I consistently find that whatever happens to one person in a family will affect all members of a family, directly and/or indirectly. Living together amplifies these affects. Those of us who have partners or spouses need to be a unified front. If we work as a team we won’t feel isolated or allow our partnership to be negatively impacted by the needs of our children. United we support one another. Divided we choose sides.

Making Clear Plans

Accountability is key to any change process. Whatever plans are being established, they need to be communicated in very specific terms (who, what, where, when) and they need to be measurable (defined outcomes). Tolerating descriptions from our adult children regarding overly vague goals (examples: “I’m gonna look for a job.” Or “I’m going to work on getting sober.” or “I’m going to try to take better care of myself) does nothing to promote our understanding of what to expect.

Getting Outside Help

To the greatest degree possible, utilizing outside resources ensures not only better outcomes but also reduces stress on the family unit. While many of us struggle to accept support from people outside of our families, we need to be realistic regarding the scope of our challenges and our ability and willingness to overcome them. Our goal is to promote autonomy and reduce dependence. Achieving this often requires incrementally reducing the support we offer and requiring that it be sought elsewhere.

Feeling Trapped & Obligated

What we most want is an outcome that meets everyone’s needs. Sometimes this simply isn’t attainable. The mistake that parents and caregivers most often make is to hang in there until they’re burned out. What follows is almost assuredly regrettable. If we find that we cannot afford to continue (financially, emotionally, physically) to maintain status quo, then we have a responsibility to ourselves and our loved ones to determine and to share very clearly what the limits of our support will be.

Sometimes the people we love stay stuck. They fail to make necessary changes, follow through with treatment, or otherwise remain overwhelmed. While our love for them endures, our loyalties are stretched. It’s completely disheartening and the solutions are often counterintuitive.

Sometimes the very best thing we can do for our adult children is require that they move on. Think of it as catapulting someone out of quicksand. It would not be their preferred method but it will certainly help them get unstuck. Leaving our comfort zone is not something we do without sufficient motivation. There are myriad conditions and circumstances that rob people of motivation (depression, addiction, anxiety/fear).

There’s an adage that folks most often change when the fear of staying the same outweighs the fear of change. My experience is that those scales can stay balanced for a long time so give them a push, give them 30 days notice; give them help in getting their own home if you can. Give them all of the ongoing support and encouragement you can; just don’t make it comfortable for them to stay stuck.

Image Copyright: Michael Tapp

After getting into trouble with drugs or alcohol (or behavior problems) your teen child needs you more than ever. Unfortunately, the negativity that accompanies these situations often poisons the parent-child relationship to a point where it’s hard to effectively parent. Here are 10 easy ways to repair the damage.

Whatever happened to those magical days when your child looked up to you, wanted your advice and begged to spend time with you!!?

The truth is, adolescence is tough at the best of times, but when your son or daughter gets in trouble with drugs or alcohol - and with all the behaviors that tend to accompany these problems, it’s just so easy to get mired down in the quicksand of negativity and mistrust.

And once negativity becomes a habit, communication and understanding disappear - just when your teen needs you most.

So wherever you are with your teen, take a step back and consider if there’s anything you could do to improve your interactions - and by doing so, improve your parenting. As a way to get started, here are 10 clear (but not necessarily easy) ways to improve your parent teen-child relationship, starting from today.

10 Ways to Improve Your Parenting ....

Adopting the following 10 guidelines won’t fix all your problems, but it might just repair the relationship enough to give you a place of trust and love to start from.

1. Listen, but don’t judge

Few things quiet an already recalcitrant adolescent faster than feeling unfairly judged.

Adolescence is basically a period to make and learn from mistakes. You will see your teen son or daughter messing up. This is what they’re supposed to do! Listen to them and help them if you can, but never judge them for the error of their ways.

2. Make sure you show the love you feel

You know how you feel…but do they still know?

3. Make time to spend time with your teen son or daughter

When they were little you had to be around, watching and teaching. Now, they don’t seem to need you as much and you’re more free to pursue your own goals and hobbies.

But though they don’t need you around the clock as they once did, they still need your attention and guidance, so make sure you make time to spend time - even when you don't seem to have to...

4. Make it a routine to have a routine

What happened naturally a few years ago takes concerted effort today. Your teen son or daughter may want to spend more time alone or with friends (rather than in your company) so you may have to work to make this happen.

Make a routine out of spending time together - like a weekly fun outing - to help you stay connected.

5. Don’t solve your teen’s problems, but support them in their efforts to problem-solve

Your teen needs to learn healthy problem solving skills - it’s a necessary developmental task of adolescence. When you intervene to solve their problems, they don’t learn to fend for themselves, or worse, they internalize a sense of inability at the cost of their self esteem.

6. Make sure to praise your teen child when he or she deserves it

Does it feel like all you do is correct and complain? Well, then make sure to seize every legitimate opportunity to praise positive behaviors!

If you only complain or bring negativity, you’ll soon get tuned out.

7. Discipline when necessary, but always criticize the behavior, never the person

And if you say something you don’t mean in the heat of the moment, make sure you apologize and correct your mistake.

8. Be the one that sets the bar high – be courteous and polite

It’s too easy to get pulled into a spiral of negativity:

1. He’s rude to you so you respond curtly.
   
2. The next time you see him, you worry he’ll be rude again so to protect your own feelings, you close yourself off.
   
3. He feels this and responds to your emotional-shunning with further negative behaviors.
4. And so on...
   

You have to be the one that breaks this negative cycle!

9. Ask questions and try to stay involved

Show your interest and caring by asking questions and staying aware of what’s important.

10. Help your teen learn to delay gratification

It’s often easier to just give-in, but teaching delayed gratification is so important, so pick your battles, and help your son or daughter learn the value of patience.¹

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The needs of children in families of addiction are easily overlooked. Here's a quick guide to helping the children through, with specific recommendations based on age and developmental stage.

He’s trembling in his seat, 30 days clean and trying to convince himself that the worst is behind him. I agree that physically this is true but otherwise the work is just beginning. We talk about his family. He has a wife and three children. I ask what their involvement in treatment could look like. He studies my floor and stammers, “I was kind of hoping to keep them out of all this.” I ask if they were protected from seeing him active. He begins to cry and shakes his head.

I’ve heard a lot of nice sounding theories from other parents: “They never saw me drink. We hid it from them.” “They thought I was just sick. They didn’t realize it was because of drugs.” “I only used when they were at their dad’s.”

Kids bear witness to insanity even when they don’t witness abuse of substances. We hope they come out unscathed, but this is never the case. 

Whatever impacts one person in a family affects all members of a family. Kids may be angry, scared, and/or hurt but they are always powerless. They want mom/dad to be healthy and they have control over neither what they want nor what they fear.

Support Guidelines - By Age Group

Kids always know more than we want to believe they do. What they can make sense of varies due to their age. A crash course in human development allows us to consider how to best support them. This is a crude outline but in a nutshell it’s what I advocate:

Under Six

We refer to the person in recovery as having been “sick” and understand that at best their understanding of addiction is limited to cause and affect. They grasp that the person in recovery behaves differently at times and/or was unavailable to them (emotionally or otherwise). We look for signs that a child may not have bonded or may struggle to feel comfortable/safe with the person in recovery.

Seven to Eleven

We look for kids to have a concrete understanding of addiction but we understand that a lot of the abstract aspects of competing needs, feelings, and relational issues may not make sense to them. Developmentally they still learn and understand the world in very black and white terms. We are honest with them about what the problems are and we look for signs of anxiety, a tendency to hide their emotions, and conflicted feelings over why their family functions as it does.

Twelve through Adulthood

We look for adolescent and adults to have an understanding of what addiction is and expect that they have ability, but perhaps not willingness, to consider competing needs and feelings. We are completely honest with them though we may omit details that evoke painful imagery or unnecessarily burden them. We look for signs that they may have knowingly or unknowingly enabled the person in recovery. We examine their attitudes toward alcohol and drug use and are alert to the possibility that they may be abusing substances. We expect that very often adolescents and adults are resistant to change and may unwittingly act to maintain status quo.

I have nearly endless patience and empathy for the kids. I have far less for their parents/caregivers. Helping the kids to understand requires that the adults get right with the truth. Everything else is problematic at best.

Consider Structural Family Therapy

It’s darkly amusing that so many of the recovering alcoholics and addicts I work with are amazed to find that their children have learned to behave in ways that are manipulative and dishonest. They can’t imagine where the kids learned to act this way and they have the audacity to be outraged by disrespect.

I’m a big fan of Structural Family Therapy. It’s a modality designed to ensure that we get the adults on the same page and then work to bring the kids aboard. Divisions and alliances are common in families of addiction. I never look for the kids to do what the adults can’t or won’t and I don’t tolerate a lot of hypocrisy from parents. Families function best with a top down approach. Splitting (divide and conquer strategies) gives kids control they may crave but cannot manage in a healthy manner.

It’s not only the recovering addict/alcoholic that faces change and transition. Involving kids in treatment and maintaining very active and open communication mitigates fears of change and fears of the unknown. I urge caregivers to solicit the views and concerns of kids and to be completely honest with them. Families can be rebuilt, but only when the needs of all members are identified and fulfilled.

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Don't take it personally. Children and their relationships to their parents change as they go through different developmental stages. Being aware of this allows a parent to adapt to this as well as to not take things personally when they shouldn’t.

Imagine the following situation:

Your son is a teenager and has been writing badly about you in a social media forum (such as Facebook) for quite a while. He has been using foul language and misrepresenting how you treat him. Anger is coming from your 13 year old that you are having a hard time understanding. You wonder why he hates you and feel very hurt by the words he is writing.

Why Is This Happening?

For a moment let's take you out of the middle of what is going on. Parenting is dynamic.

Certainly things are different from the time your child is born (and they are dependent on you for everything) to when they are an adult (and if things are healthy they are independent).

Through it all you remain their parent, although this changes a lot in a couple of short decades.

Testing Limits and Becoming Independent

Your son is now a teenager. What are the important developmental tasks for him to engage in at this age?

It is a time when he begins to be more independent. Teenagers test limits and learn ways of being in the world without all the protections they had as a younger child. It is while doing this that a person has to "rebel" and discover their own ways of interacting in the world.

Fortunately, the values you have provided up to age 11 will remain influential in their life.

Changes in Social Relationships

Another change that happens is that his primary social circle is changing. As a teenager, his friends play an important role in his life. Whereas before he would have come to you first with a problem, it is now normal that he turns first to his friends. In this sense, it is not a reflection on you that he is talking to friends and not you about struggles he is having.

Opening a Dialogue

Now, back to your concern. Does he hate you? What is his real concern? Is it you or things that he is pushing against?

As a parent it can be hard to distinguish between these. To really do this, a parent has to set aside their own ego and enter into dialog without being concerned about what you might hear. Open dialog, to the extent you can, is the key.

Finally, know you are not in this alone.

A good parent does not have to be the center of their child's life. A good parent has to know that their child is safe and is developing into a healthy responsible adult. This is part of constructing and maintaining peace and wholeness in your home.

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Parenting a teen can be frustrating. Parents often get frustrated and when they are not thinking clearly may resort to issuing an ultimatum. There are serious cautions around this and better strategies for parents to try.

Parents often struggle with how to draw and enforce boundaries for their teenage child.

For example, consider the following situation:

Imagine your 16 year-old daughter wants to go to a party on a school night – something that you are totally opposed to.

On the night of the party, she walks out the door so you tell her to think about what she is doing. She gives you a look. In reply, you tell her that if she can’t obey the rules then she can’t stay in the house.

She responds angrily to you, and you tell her to not come home if she walks out now.

Not only does she walk out but she doesn’t come home that night nor the next day.

You are worried about her.

She’s been a discipline problem and now you feel boxed in.

Feeling Boxed In

• If you don’t enforce your threat, how can you protect her from bad choices anymore?
• How can you avoid being disrespected by her?
• Is there still a way to not ask her to leave and still get her to change her behavior?

Making threats, especially when angry, is not generally a good idea. This is especially the case when trying to parent a teen.

The problem in this particular situation is that you created a "no win" situation:

Neither you nor your daughter are getting an outcome that is really a win. You find yourself in a situation of having to choose between equally unacceptable options. You are now left not being able to provide the basic care that is a responsibility of parenting; yet you want to do this while also providing reasonable structure.

Avoiding Ultimatum Situations 

Here's a suggestion for situations like the one described above:

Avoid giving teens an A or 'not A' with consequences type of choice.

1. Many parents give this type of choice to children. If they chose A (the desired outcome), all is well. If they chose 'not A' then either the consequences kick in or it weakens the parenting.
   
2. This is especially problematic when the consequences are broad and not really likely or able to be enforced (such as NEVER coming home).

A Better Idea

• A better solution in such situations is to offer the child (especially a teenager) a range of choices, preferably with all of them being acceptable to you as the parent.

A Failed Ultimatum - The Aftermath

However, back to the situation described at the start of this article. You would have a range of options available to you:

1. If your teenager is truly out of control, in a dangerous way, you could talk to your local child welfare office about them being identified as "a child in need of services".
   
2. You could see how your child does in another environment - spending the summer with an out of town relative is an opportunity that may be appropriate, especially if it is timely.
   
3. You could entertain the idea of the teenager returning home conditionally upon discussing boundaries for that - and to be most effective this does need to be a discussion. With as difficult as the relationship may have become, you may want to use a marriage and family therapist to help facilitate that conversation.
   

Considering a Marriage & Family Therapist

If you decide to seek out a marriage & family therapist, that person may even prove helpful over the longer term.

1. Going this route is not just giving in, it still expresses love and caring, and it has the possibility of laying groundwork for the future.
2. With everyone working at it and developing new ways of relating, it is possible to get through these times and establish ways for peace and wholeness in your child's life as well as in your lives.
   

This does not mean that you will be free of the challenges that occur during the teenage years, but you will be able to navigate these in a way that is better for everyone involved and can result in “win-win situations”.

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Having serious trouble with a teen son or daughter that includes heavy drinking or drug use and problems with violence, bullying or law breaking, extreme deceit and a disregard for the rules of the house and even the rules of society? If yes, you may have a child with conduct disorder and the drinking and drug use may be just a symptom of this treatable mental illness.

Children and teens with conduct disorder are at greatly increased risk to develop drug and alcohol abuse problems, and without treatment, they are at greater risk for lifetime substance abuse, legal, mental health, social and academic/vocational problems.

If you have a child with conduct disorder, the earlier you can initiate treatment, the better their ultimate prognosis and the better your chances of minimizing problems to come.

What Are the Symptoms of Conduct Disorder?

Teens with conduct disorder show extreme defiance and a willingness to break the rules of the family and of society at large.

For a diagnosis of conduct disorder, the defiant, deceitful, violent or rule breaking behaviors must be chronic, must infringe on the rights of others and must contravene the rules of society or the family.

While most children and teens will go through developmental stages of poor behavior, what sets those with conduct disorder apart is their willingness to engage in more extreme acts, their more callous disregard for the feelings of others and the enduring nature of their anti-social behaviors.

The symptoms of conduct disorder are broken into 4 categories:

1. Aggression targeted at animals or people

• Frequently getting in physical fights
  
• Bullying or intimidating others
  
• Using weapons that could cause severe harm (knife, gun, bat, etc.)
  
• Forcing sexual activity
  
• Being cruel to animals
  
• Extorting money or objects by threat of violence

2. Destroying property

Examples could include:

• Vandalism
  
• Setting fires with the intent of causing destruction of property
  
• General intentional destruction of other’s property
  

3. Stealing, lying or other serious deceitfulness

Examples include:

• Shoplifting
  
• Breaking and entering
  
• Lying to manipulate or to get out of obligations
  

4. Rule Breaking

Examples include: ¹

• Breaking rules for no real reason
  
• Heavy Drinking or drug use
  
• Skipping school (younger than 13)
  
• Ignoring curfew
  
• Staying out all night

Conduct Disorder Age of Onset

There are 2 forms of conduct disorder:

1. Early Onset
   
2. Adolescent Onset

Children who begin to show conduct disorder symptoms prior to the age of 10 are considered to have the early onset form of the condition, but when symptoms don’t emerge until after the age of ten, the child has adolescent onset conduct disorder.

Adolescent onset conduct disorder is much more common. Children who have early onset conduct disorder often also have ADHD² and conduct disorder at any age is associated with an increased likelihood of oppositional defiance disorder, ADHD, anxiety, depression, communication disorders and Tourettes syndrome.

What Causes Conduct Disorder?

Researchers suspect a combination of environmental and biological factors contribute to the development of conduct disorder.

While genetic causes remain elusive, some hypothesized environmental causes include:³

• Living in a dysfunctional family home
  
• Living with parents who display poor parenting skills
  
• Living with aggressive or violent parents
  
• Experiencing maltreatment in the home*
  
• Living with alcoholic parents or with a depressed mother
  
• Living in a family experiencing major life stressors, (such as major illness, poverty, overcrowding, etc.)
  

Conduct Disorder Treatment

Conduct disorder is treatable, although treatment is generally long running or on-going. With this disorder, what is most important is rapid initiation of treatment – the prognosis for a that child receives prompt and on-going treatment soon after displaying conduct disorder behaviors is far more positive than the prognosis for a child who receives treatment only after negative behaviors are long entrenched.⁴

Some possible treatments include:

• Family Therapy – Especially training parents how to effectively handle and control a conduct disorder child.
  
• Cognitive Behavioral Therapy – Which can help children to learn more effective and non-aggressive ways to interact with others
  
• Skills Training – increasing a child’s competency in areas such as communication and interactions with others can reduce incidences of serious problems
  
• Anger Management Training
  
• Medication – In some cases, medication for co-occurring disorders, such as depression or ADHD - can also help to alleviate symptoms of conduct disorder
  

In general, adolescents with conduct disorder have a better overall prognosis if: They have no other disorders, such as AHDH or substance abuse They exhibit relatively few symptoms of conduct disorder, or exhibit only mild symptoms.⁵

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