School closures, social isolation and uncertainty about the future. All of these things have a direct impact on the mental health of young people. But there are strategies to help them cope. During this episode of Ed Lab Live, Youth Eastside Services therapist Anna Kim talks about the issues youth are facing during the pandemic and strategies that some are successfully using to manage their emotions.
Everyone’s emotional and mental health needs are unique, Kim said. Mental health services are still available during the pandemic and many are offering counseling through telemedicine. You can find help through the resources below.
One issue some young people are experiencing is a feeling of a lack of control of their lives. Three high schoolers are trying to give their peers more of a say through an anonymous online survey. The information they gather will be shared with decision makers. Find out more here.
TRANSCRIPT, LIGHTLY EDITED:
Q: Can you tell us a little bit about what you do?
A: Yeah, absolutely, I’m a youth and family therapist and I work at YES, Youth Eastside Services in Bellevue. We provide myriad different services. It can be like individual and family counseling, psychiatric services, we have a substance use team and some groups and programs for teens. So we do a lot of different things.
Q: So what does that look like now during the pandemic? Obviously, you don’t have clients coming in, so how are you hosting groups?
A: Yeah, it’s definitely been pretty tricky. We’ve had to …
[Kim experiences technical problems. Hillman’s image disappears. Kim is disconnected. When they finally reconnect …]
A: Yes, this does happen sometimes. This is a great example of how virtual services can be kinda tricky. We’ve definitely encountered some technical glitches. I’m sorry, I’m gonna just switch my Wi-Fi really quick. Let’s see if that helps.
[Kim disappears again briefly.]
Q: So for everyone who’s logged on, we’re going to take a technical break, because that’s what happens these days.
A: Oh, I’m back.
Q: Yay (laughing)
A: I’m so sorry.
Q: No, no, I mean, so that is a great highlight. Like, what happens if you’re in the middle of a really important conversation, but your internet cuts out or the video cuts out?
A: Yeah, that’s a really great question. It gets pretty stressful. And I think just as a therapist, I feel pretty bad, you know, ’cause they’re really opening up and it feels like it intervenes a lot.
But, you know, we’re just kinda doing the best we can so oftentimes, we just kinda log out if there’s a chat function, it’s like, my apologies, let’s restart that and we’re able to kinda reconnect.
Q: Is it just like a video chat like this?
A: Yeah, absolutely, so we’re using a platform called Telehealth, and so it allows like a chat and video function. Sometimes I’ve had some clients who have been like, “I haven’t showered yet, can we please drop the video function and just do like a phone call, like audio?”
So sometimes we do that. Other clients, whether they just opt to not do Telehealth, like we just we have sessions via phone and so that’s worked pretty successfully for some of my clients too.
Q: Are you still able to hold group sessions or just one-on-one?
A: Oh, yes, so we have a couple different locations where skill groups are running something called DBT skills group.
Q: Can you explain what that means?
A: So it comes from the therapy, dialectical behavior therapy and it’s a lot about like, tolerating distress or regulating emotion, that kind of stuff so, you know, it’s not like a support group where people discuss feelings, that kind of stuff.
It’s really kind of structured as a classroom, we teach a skill. So like, this is what mindfulness is and this is how we practice it. And then, yeah, so we just kinda teach that.
There are two locations where they’re still operating groups virtually. I co-lead a group in Kirkland, and we like, we’re like kinda in a limbo season with that, ’cause like, trying to get engagement virtually, like as we start up a new round, it’s been kinda tricky. So we’re like, “OK, let’s put a pause on that for now.”
Q: Yeah, that makes sense, kids already have a lot of online things that they’re being required to do. So you have still been seeing clients. What are some of the major challenges that people are talking about now?
A: A lot of school stress. There’s a lot of uncertainty right now and, you know, when we first went to shelter-in-place, a lot of the students were like, “Oh, wow, this feels like an extended spring break.” You know, and so they’re kind of like entering vacation mode and then it went on for a couple of weeks and then all of a sudden, we’re realizing, we’re learning more about the virus and the schools or teachers are trying to act on their feet too.
And so all of a sudden, they’re like needing to get back into mandatory schooling, which has been pretty tricky because all of a sudden, we’re asking these kids to treat their home environments or in their bedrooms as their classroom and learning environments. You know, where there are a lot of distractions and there’s very minimal structure.
So that’s been really tough for teens I’ve seen. I feel like I hear every day, “I’m so stressed out with school.” “I’m not sure how to learn these new concepts that are being taught in chemistry” or what have you.
Q: And the stress is just coming ’cause they feel like they can’t absorb the material in this environment?
A: Yeah, yeah, it seems that way. Just kind of from what I’m getting, it just feels like, you know, like needing to log into like a 30-person Zoom session, where you can totally be like, looking other things up on the internet, you know, reading like comics or what have you. It’s just, it’s very different, the level of engagement and participation virtually for students. At least that’s just kind of what I’m getting.
Being in a classroom and sitting like everyone’s like, that’s, we associate that with learning, right? Like people are sitting at their desks, have their phones away and there’s a teacher at the front teaching a concept on the board, you know, that kind of thing.
And students don’t have that anymore and it feels like all of a sudden we’re asking them to like learn almost independently. I can’t imagine the stress that teachers are facing and they’re doing the best that they can, of course, and also, I think just on the flip side, like teens are really kind of struggling with the change.
Q: You see a lot of younger kids, too. Are they having the same kinds of stressors?
A: Yeah, you know, they just have, I think, a lot more flexibility with their school. It’s not like something as rigorous and intensive, like chemistry or physics or bio, right? And so their learning seems a lot more manageable and parents are able to help them out a lot more.
There’s a lot more structure because they’re so young, like 6, 7 years old, and, you know, you don’t need to be logged on for more than two hours from what I’ve seen so far, I think.
So yeah, I think just my younger clients like my younger kiddos like they’re definitely pretty bored.
Q: Outside of academics, are people facing mental health challenges or they’re kind of adjusting?
A: From what I’ve been seeing, definitely academics is like the main stressor. And then there are things like I mean, at this point we’re like two months in or something, right? Like quarantine fatigue as they’re calling it. It’s just, it’s definitely tough being locked in, in your home. I mean, we love our families and also like these teens are teenagers, right? It’s like that stage of development where they need their space and privacy. And they’re not getting to see their friends and they’re needing to be like, just really close in proximity with their siblings and their parents 24/7, and that’s definitely putting some strain on some family systems.
Also, I’ve seen just a lot of disrupted sleep schedules. When they went into more of that vacation mode, right? Of course, like, I mean, hey, if I were a teen and I were in the situation, I would be watching Netflix till like 3 a.m. or something all the time.
And then once teachers were like, “Oh, hey, we’re actually gonna be learning remotely for an extended period of time, please get back into the academic mindset and all.” It’s just been kind of tricky for teens to snap out of that.
I feel like I chat like 25% of my time in sessions about nighttime routines. I’m reviewing psychoeducation on like the importance of having regular sleep-wake schedules and maintaining that regularity so our bodies can function optimally.
Q: Because if your sleep schedule is off it affects all of you, right? Like our physical, mental, emotional health, everything’s kinda, you know, intertwined there. So then how do you get that back on track?
A: Yeah, that’s a great question. I mean, I’m sure there’s so many different ways out there but for me I help my clients kind of set up a very general skeleton, like a guideline of what we want to include in their nighttime routine.
So you know, something as simple as — so we’re trying to like train our brains here, right? Like this is when I need to start getting ready for bed. Stop doing like super stimulating activity, like put away all electronics. Maybe dim the lights and doing something that’s regulating for stress and emotions like deep breathing or drinking decaf herbal tea. Just a little bit, you know, going to bathroom all night. But you know, sometimes that’s very relaxing for teens.
I have some clients who do very, very light yoga and like stretching maybe 45 minutes before bed.
So every time I get a new client, and regardless of their diagnosis, but especially with anything related to depression, anxiety or trauma, or trauma stressor-related diagnosis, I definitely tackle sleep first.
And I’ve seen successes over and over and over again, just trying to restore that pattern.
Q: How do you get young people, like if people are really resistant to following a routine? How do you overcome that?
A: Yeah, absolutely, yeah, that’s a really good question. Honestly, some motivational interviewing could come into play here, especially if I feel like they’re a lot of resistance.
We have sometimes words like, you know, the parents dragging the teenager into our center or something like that.
So it’s like, “Oh my gosh, of course, you don’t wanna be here.” And so just trying to build that rapport and relationship with them. And just letting them know it’s not about me wanting to tell them what to do, me trying to be their parent or trying to control them or anything like that. It’s just like, how’s this working out for you? Really taking an inventory together and having them process through together. And it’s been interesting but even the more resistant clients where they’re like, crossing their arms like, “I really don’t wanna be here right now.” I’ve seen them really just buy into the whole importance of having regular sleep patterns. I’ve seen them buy into it and then when it starts working for them and they start feeling better they’re like, “Oh my gosh, you weren’t lying, the psycho ed and research is true.”
Q: What are some of the other coping skills? Are there coping skills that teens and parents can keep in mind during this time?
A: Yeah, absolutely. So again, I’m sure there are a ton of therapists doing a lot of different things out there.
For me, what I’ve seen to be pretty successful with my clients that I’m turning to a lot, one of them is gratitude.
So gratitude, it can be very simple, but it’s also very powerful. You know, it’s like really about like turning the mind to noticing the positive, right? And especially in such a scary tumultuous time, just things that maybe normally we weren’t really grateful for, like having a home to shelter-in-place in or like having a laptop that works for us to be able to do school or therapy or food security, just things like that.
I’m finding it is helpful for them to focus on the things that they do have, that they are very thankful for and it helps to kind of lower stress in, like anxiety. So definitely gratitude.
Also, just activities that kinda like calm the mind and body in general. And so some of these things are like mindfulness. Mindfulness skills can be super helpful, just bringing your attention to the present moment and without judgment. Just participating in life where we are, just in the present moment, and just letting things be as they are and not trying to control things that are really out of our control. Because so much is in general, but especially during a pandemic, right?
Deep breathing can be super regulating for stress, regulating for stress in the body and just emotions in the body, too.
Also, I’ve seen activities that involve our hands, you know, something that can be differently engaging and stimulating for our minds.
Like, you know, gardening. I’ve seen some clients pick up knitting or gardening during this time. Like working on some kind of like art project. Art therapy is always great. And like coloring, listening to music, journaling, those kinds of things can be really helpful.
Yeah, so those are definitely like the coping skills and then like some cognitive coping skills, like taking inventory of how we’re thinking. I feel like this is a conversation that I have a lot with clients right now.
Are we engaging in really unhelpful, irrational thought patterns? While that’s probably understandable given all that’s going on, also at the same time that only like exacerbates and perpetuates our anxious state, right? Or our depressed mood.
And so kind of figuring out what is probably a more effective way to think about a situation and be mindful of where our thoughts are at and just focusing on what is within our control at this time, as opposed to dedicating so much energy and emotion to what is out of our control. And like radical acceptance, like radically accepting that this is our current reality, but kind of cheerleading ourselves. Like knowing that we’re gonna get through this together, that kind of stuff.
Q: So it sounds like there’s this huge array of things people could try, just because people’s mental health conditions are so individualized and what we’re going through is so individualized. How can people who really need to talk to someone directly, how can people seek help now? I know through you, but are there other options?
A: Yeah, absolutely. So we are accepting new clients and we’re providing intake services virtually via a HIPAA compliant platform. And there are a number of other centers that are operating as we are as well.
And 2-1-1 is up here, it’s the resource call center. You can call them and learn about what mental health resources are out there for you in your area. And then there are crisis lines, a lot of different types of hotlines like suicide prevention hotlines. Teen Link also has a hotline for teens to text to or like talk to someone in the middle of the night.
Q: Are there any last words or last specific thoughts that you think people should be really keeping in mind right now?
A: I mean, I think just being kind to ourselves right now. I mean, it’s great that everyone’s trying to do what they can with work and managing families and all these obligations and that’s really important.
And also just recognizing that we’re living through really unprecedented times and just taking it one day at a time and leaning on the people that we experienced support from and doing our best to take care of ourselves.
Really just taking it one day at a time, one thing at a time and yeah, we’ll get through it together. Give ourselves a little space.
Q: Thank you so much for your time today, Anna, and for all of your insights.