Dr. Clatch is Featured in NLU’s Top 30 Over 30
Michael Clatch ’00 | Founder, Courage to Connect Therapeutic Center
Young Adults and Relationships – Shifting Attitudes
When it comes to the views of young adults on relationships, it is evident that a marked shift in attitudes has occurred. Statistics regarding relationships in younger adults indicate that fewer young adults are seeking marriage, more young adults believe in co-habitation and young adults seeking marriage are doing so much later in life.
Young adults are also highly sexually active. Statistics show that 90 percent of 20 to 24- year-olds report having sexual intercourse even though they are not married or in a longterm, committed relationship. The changes in attitude of young adults regarding their relationships are quite significant when compared with older generations. Even though older generations were delaying marriage until their late twenties or early thirties, many supported the idea of marriage as a principal foundation for raising a family. Young adults today believe that cohabitation is the only requisite for starting a family. If two individuals love each other and live together, this environment is suitable. These changes in attitudes have created some concern over the future of marriage and the ability of couples to provide for their children over the long-term. However, even though more young adults are eschewing marriage, many believe in having committed relationships.
For parents of young adults, new attitudes regarding marriage and family life may seem quite shocking and surprising. Many parents may believe that in order for their children to have happy and successful families, marriage is needed. For some parents and young adult children, this difference in values may prompt conflict. Parents that adhere to their values may find it difficult to accept the views of their children.
This may create notable barriers to successful communication and positive relationship outcomes. For parents faced with this difficult situation, moving forward can be a challenge. However, it is necessary for parents to recognize their role in their adult children’s lives and attempt to accept the decisions made by them. Although adult children are often seen as still in need of support and guidance, parents need to recognize that their role in shaping outcomes for their children has changed. As adults, children have the right to explore their worlds, determine what is right for them, make mistakes and learn from these mistakes. As adult children follow through these processes, parents must respect their children’s decisions and recognize that their adult children have the right to determine and direct the course of their own lives.
Although this advice can be presented in a logical and rational manner, the emotions involved in parents letting go of their children can be quite intense. Parents, because of their natural desire to protect their children, want to spare them from harm and provide them with the benefit of their wisdom. As such, even when parents see their adult children making a mistake, their first response is
to intervene and to stop the mistake from happening. Emotions involved in this process will typically drive behavior, and in the end, action from parents may result in a broader set of problems and more conflict. Even when parents have the best intentions, the outcomes may not reflect these intentions. The view of relationships held by young adults clearly challenges the views of parents and society, especially when it comes to marriage and building a family. While the views of young adult children on relationships may be much different than those held by their parents, young adults have the right to express their opinions and live their lives in a way that they believe suits their needs. Parents that must come to terms with differences in opinions regarding marriage and family may find it difficult to avoid conflict on the issue. In order to overcome this conflict, parents have to recognize the need for their young adult children to make free and autonomous decisions. While allowing this process to occur may create internal conflict for the parent, it will ensure that parents are able to maintain positive relationships with their adult children.
Dr. Clatch practices at the Courage to Connect Therapeutic Center, 2400 Ravine Way, Suite 600, Glenview. For more info, call 847-347-5757 or visit couragetoconnecttherapy.com.
The Challenge of Helping Children Through Divorce
Statistics regarding marriage and divorce are quite grim: nearly 60 percent of all marriages end in divorce. While divorce can be a painful and challenging process for spouses, children often suffer extensively as a result of their parents’ separation.
From a psychological perspective, divorce alters the child’s sense of security, even if both parents remain committed to parenting following separation. Divorce also creates considerable upheaval and changes in schedules, which can make it difficult for the child to adapt. Each of these issues can produce a challenging environment for children and parents, one that creates notable barriers to accepting divorce and constructing positive foundations for moving forward.
While general efforts to address insecurity and adaption can be effective, divorce is a unique event for each family. Recognition of divorce as a common social event and unique family event represents a different position on understanding the process of divorce and its impact on adults and children.
Even though hundreds of divorces occur each day, the way in which the family responds will be unique. Although simple cause-effect understanding of divorce suggests that children may be negatively impacted by the event, there are instances in which children grow more resilient as a result of their experiences.
Understanding why such a broad range of responses occurs requires an understanding of systems thinking and its application to the family. Systems thinking is a process whereby individuals must consider the reciprocal interaction between themselves and the environment in which they live, e.g., their interaction with the whole. When examining the process of divorce, it is not plausible to argue that Mom and Dad being angry with each other will produce anger and animosity for the children.
Rather, understanding divorce and its outcomes requires a consideration of how parents interact with one another, what social supports are available to the family and the children and how children respond to changes in their family and their environment. For parents, putting systems thinking into perspective can be a daunting challenge. As such, parents should keep several things in mind when helping their children navigate the process of divorce.
First, parents need to communicate with children – before, during and following the divorce. Communication before and during the divorce process can help calm a child’s fears about what will happen once the separation is complete. Communication can also provide a foundation for reassuring the child the he or she is still loved. In the aftermath of the divorce, communication will remain a central foundation for interaction. Research demonstrates that children separated from a parent as a result of divorce often feel as if the parent does not love them or does not think about them. Providing reassurance through communication can help children feel more secure and better able to cope with the situation.
Second, parents should be mindful about fighting in front of their children. Divorce often brings about a wide range of negative emotions for spouses, emotions that can erupt into conflict. By keeping conflict to a minimum in front of children, parents will be able to help reassure their children that the situation is under control. Fighting, yelling and arguing in front of children can further damage the child’s sense of security. By keeping conflict to a minimum, parents can do wonders for improving their child’s sense of wellbeing even in the wake of a challenging situation.
Finally, establish routines as soon as possible. Following a divorce, spouses will typically choose to live in different places, creating logistical challenges for children to visit with both parents. Schedules and routines can help reduce uncertainty for children and provide a sense of comfort. While this tactic works well with younger children that may feel completely overwhelmed by changes in the schedule, for older children routines can provide a foundation for security; one that will be essential for their wellbeing.
Helping children through divorce can be a diffi cult challenge that parents may at first underestimate. By assuming a systems perspective on the issue and addressing issues that are important to the well being of children, parents can make this difficult life transition easier.
While these steps may not ameliorate all of the problems that arise for children, they can provide a foundation for building support and security during an emotionally demanding time.
Determining the Right Diagnosis- ADHD, Depression, or Both?
Older children and adolescents that seek help for psychiatric issues often have a number of general complaints that can be difficult to diagnose. For instance, if a 10-year-old seeks help for symptoms of agitation, difficulty concentrating, insomnia and forgetfulness, profession
als may at first believe that the child is suffering from attention deficit/ hyperactivity disorder (ADHD).All of the symptoms noted here are hallmarks of the disorder and, in the absence of other issues noted by the child or parents, may be considered grounds for diagnosis. Although ADHD may be a viable diagnosis, it is important to remember that the symptoms reviewed here are also commonly noted when patients describe experiences with depression.This prompts a most important question: Is it ADHD, depression or both?
Determining the right diagnosis for the child is important because both ADHD and depression are two markedly different diagnoses. While the pathophysiology of both conditions has not been clearly delineated in the literature, ADHD has been shown to be tied to dysfunction in the frontal cortex and temporal lobe while depression has been shown to be integrally tied to changes in neurotransmitter function in the brain, primarily serotonin. These different pathways for disorder development can result in similar symptoms. However, treatment of the disorders typically requires different approaches to achieve success.
If your child notes symptoms that are common to both depression and ADHD, getting help to determine the diagnosis will be imperative. Clinicians that work with your child will focus on determining the root cause of your child’s distress. If your child notes that he or she has deep feelings of worthlessness, it is probable that your child may have depression. If, on the other hand, your child’s symptoms cannot be attributed to depression, he or she may have ADHD.
Clinical guidelines for the diagnosis of ADHD require that the symptoms of the disorder must not be better described by another mental disorder, such as depression. Following this recommendation, it may be possible to determine if your child has depression or ADHD.
Clearly, the overlap between symptoms of ADHD and depression can make it difficult to determine the right diagnosis. While determining the correct cause of the child’s distress is important, there are other issues to consider when it comes to the overlap between ADHD and depression. Specifically, research has demonstrated that the initial diagnosis of ADHD can, over time, lead to depression for the child.
Labeling a child with a clinical diagnosis can create a number of negative feelings. Children with ADHD may view themselves differently from their peers, may feel as if they are not as smart as others or may believe that they are worthless. Negative feelings that persist over a period of time can lower self esteem and, if left unaddressed, may result in the development of depression comorbid with ADHD.
If your child develops both ADHD and depression, choices about treatment will need to be made. In particular, a decision regarding which condition to treat first will be needed. If ADHD is causing the child’s depression, treatment of ADHD symptoms will take precedence over the treatment of depressive symptoms. By treating the ADHD symptoms first, it should be possible to resolve the symptoms of depression. However, if depressive symptoms are contributing to or exacerbating symptoms of ADHD, the depressive symptoms should be treated first. By treating depressive symptoms first, it should be possible to reduce the impact of ADHD symptoms for the child.
The comorbid development of ADHD and depression can also be proactively addressed through efforts to focus on the strengths of the child. Following an initial diagnosis of ADHD, children may develop a number of negative feelings or perceptions about themselves. Proactively addressing these issues requires the clinician, parents and teachers to help create an environment in which a positive self-image of the child can thrive, despite the diagnosis. This can be done through a number of different supports, which should be considered as integral to the treatment of a child with ADHD:
A strengths-based approach: Treatment of the child with ADHD should focus on the child’s strengths. A focus on strengths will help the child view him or herself positively. Building emotional intelligence: Helping the child to control impulsivity and emotions can be achieved by teaching emotional intelligence (EI). EI can make children aware of the mood states of others, promoting responses that are b
etter suited to a situation.
Consider therapy: Therapy can be a helpful tool to promote coping in children diagnosed with ADHD.
Dr. Clatch practices at the Courage to Connect Therapeutic Center, 2400 Ravine Way, Suite 600, Glenview. For more info, call 847-347-5757 or visit couragetoconnecttherapy.com
Try Biofeedback to Treat Anxiety in Children with Asperger’s
Children with Asperger’s syndrome (AS) typically face significant challenges with social interaction. Even though most children with this disorder have average or above average intelligence, they often lack the basic social skills to “fit in” with their peers. For many 
children in this situation, the increased social demands associated with adolescence can cause anxiety. Anxiety disorders are quite common in children with Asperger’s syndrome and have been estimated to co-occur in 80 percent of children with this condition. What this means is that if you have a children or teenager with Asperger’s syndrome, it is very likely that your child has some type of anxiety disorder. Intervention and treatment of anxiety in children with AS will be imperative to their overall well-being and quality of life.
The treatment of anxiety in children with AS is critically important. Anxiety symptoms that are left untreated can further diminish the ability and willingness of the child to engage in social interactions. This can have systemic implications for the child that extend far beyond the social domain. Children that experience anxiety may not be able to engage with others at home or in the classroom. This can lead to academic difficulties as well as problems or conflicts in the home. Thus, diagnosis and treatment of anxiety is important for improving the child’s overall quality of life and for ensuring that the child is able to maintain his or her education and relationships with family members.
Treatment of anxiety in children with Asperger’s syndrome can be a challenging undertaking. Some research does suggest that a type of therapy known as cognitive-behavioral therapy (CBT) may be effective for helping some children overcome their anxiety. Although this approach may be helpful, CBT does require the child to have some insight into his or her behaviors. For children with AS this may not be possible. Medications can also be used to treat anxiety disorders. However, many children with AS already utilize medication to treat other symptoms of their disorder. As such, parents and children may be unwilling to consider another medication for treatment. Given the limitations of these approaches, biofeedback may provide an alternative treatment option for AS children suffering from anxiety.
Biofeedback is a therapeutic tool that can help a child with AS understand the development of anxiety symptoms. Biofeedback equipment is used to monitor changes in the body when anxiety occurs. Specifically biofeedback equipment can measure changes in heart rate, respirations, temperature, sweating, muscle activity and brain activity. Using the data from biofeedback equipment, children and parents can identify patterns in behavior that may lead to the development of anxiety. The equipment can also be used to identify what techniques work to reduce symptoms of anxiety. For children with Asperger’s syndrome, the concrete data provided through the use of biofeedback equipment can be essential for understanding what works to reduce anxiety.
If biofeedback is chosen as a treatment option, your healthcare provider will require you and your child to complete “homework” assignments. These homework assignments will include training sessions in which you and your child monitor which changes in the environment lead to changes in the way your child’s body functions (i.e., situations that lead to the development of anxiety). In addition, you will need to monitor changes when your child uses certain techniques to relax and calm down. By identifying what works, your child will be better able to control his or her environment and employ techniques that are effective for reducing anxiety. Over time, your child will learn these behaviors and will be able to control anxiety without the help of the biofeedback equipment.
The use of biofeedback in children with AS may provide the additional support that you and your child need to overcome anxiety. Children with AS may not display symptoms of anxiety in the same way that children without the disorder do. Children with AS may not have the ability to express feelings of anxiety and parents may not initially recognize the symptoms of anxiety in children with AS. Anxiety symptoms in children with AS are often unique and can include: increased reliance on routines, a preference for rules, engaging in rigid behavior, engaging repetitive behavior or changes in mood including irritability. If your child experiences any of these symptoms you should seek the advice of your healthcare provider. Diagnosis of anxiety and treatment through the use of biofeedback may provide the additional supports needed to help your child overcome this disorder and improve social interaction.
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