Watch Dr. Bellet interview Scott Leshin from SJ Health Insurance Advocates about how to increase insurance coverage for outpatient mental health treatment. *Neither BHBA, nor SJ Health Insurance Advocates receive fees or financial gain from this connection. This video is solely for public education and was provided for free by SJ Health Insurance Advocates.
PHOTO BY KATE GLICKSBERG
Erica Sava, LMSW, a DBT child specialist at BHBA, shares these great strategies to help your child with distress tolerance! Practice these strategies with your child as often as you can (age-dependent). Think of practice like a fire drill to prepare for a real emergency. Role-play and pretend play the likely triggers as much as possible, always ending with modeling distress tolerance skills as well as fully relaxing the body. As always, reward your child with warmth, attention, and praise when they do this!! They are working hard, especially when their emotions are high! Erica recommends:
Creating A Comfort Box:
Create a box with your child and fill it with their most comforting items to increase the use of the distress tolerance skills of self-soothing with 5 senses. Show enthusiasm for how soothing each item is and model how they would use it by focusing on the senses that are engaged. Consider all five senses and pick multiple items. If your child gets a lot of comfort from, say petting a pet, then place a picture of the pet in the box with a note reminding your child to go pet the animal. It is very challenging for us all to remember to self-soothe when upset, so remind your child often to engage with their soothing items often so that they become attuned to the feelings of comfort and how to attain it. Common items: cozy blanket, sentimental pictures or mementos, slime, fidget toys, stuffed animals, pictures of family members, pets, vacation, candy, lotion, or cards/ games.
Encouraging / Positive Self-Talk Projects:
Create something that provides encouraging words and also boosts self-esteem! Write encouraging statements "I've got what it takes to cope with my emotions!" or "I can cope with any stressor that I face now and in the future!," in order to boost inner strength and grit. Encouragement is an essential DBT distress tolerance skill. They can also write things about themselves and what they are good at on homemade hearts and place them in a jar or bag. When they are feeling incapable, worried, or sad, they can read their own words to boost themselves up. For children who like to craft or draw, use a pillowcase to decorate with their hearts. Get creative!
Staycation:
Have a vacation at home by gathering items that put you in a vacation mindset. Go to the beach! Gather beach towels, sunglasses, an umbrella, beach balls, a frisbee, sounds of waves or seagulls, and lemonade with an umbrella straw. Again, creativity is key! Not only will this help increase the use of the distress tolerance skill of ‘take a vacation’ by stepping away from stressors, it will also help increase imagery skill and accumulate positive emotions.
Contributing Cards:
Contributing to others’ happiness and well-being can help increase our own happiness. This is an often overlooked and very powerful distress tolerance skill. When your child is sad or worried, have them write cards, send pictures, or other creative projects to family members or friends. If your child does not want to make something, they can also bring food to someone’s house, call them on the phone, or donate their own savings to charity. This also provides an opportunity to praise your child for being thoughtful or generous.
Retain Medicare Telehealth Services Coverage Flexibilities for 12 months
Thank you for taking part in the more than 10,400 messages sent in March asking for audio-only telehealth services coverage in Medicare. Through your messages you and your colleagues convinced the Centers for Medicare and Medicaid Services (CMS) to begin covering these services, enabling patients to get the treatment they need during the COVID-19 crisis.
CMS is now indicating that Congress must step in to extend coverage, and we need to preserve Medicare’s behavioral services telehealth coverage expansions for 12 months following the end of the COVID-19 emergency period. Telehealth is helping to ensure that Medicare patients receive timely and crucial mental health services. Older Americans are especially reliant on this telehealth expansion as it allows for audio-only services, treatment of beneficiaries in their homes and removes restrictions of care due to location. Many Medicare patients are isolated at home or in nursing facilities and living in rural areas without adequate provider networks or reliable broadband service. Clinical psychologists have shared heart-wrenching stories with us about how important these services are to their patients.
Because need for telehealth and audio-only services access will remain long after the COVID-19 emergency period, we are urging a 12-month extension of telehealth coverage of psychological services to continue providing flexibility to patients, and to give CMS and Congress time to collect and evaluate data and potentially make some telehealth expansions permanent.
Whether or not you are a Medicare provider, we urge you to contact your members of Congress. We strongly encourage you to put this message into your own words as much as possible, and to include an example or two from your own practice about the importance of telehealth services coverage.
Hello Community -
My friend and colleague, Tara Liddle, who is a pediatric physical therapist, interviewed me for her blog.
I am sending these pointers directly to you and have added more advice here using the DBT framework.
Thank you for reading!
1) Validate By Being Honest: Shielding kids from facts expresses that you don’t believe in their ability to cope with reality. This is inherently invalidating. Tell your child the truth about what is happening in the world in age appropriate ways. For example, turn on responsible news feeds (BBC World Radio is one I like for my pre-teen) in the background and dialogue with your partner, family members, older children in well regulated and mature ways. Model distress tolerance, emotion regulation, good communication (stating facts rather than using extreme language - stay out of extremes), and problem solving skills.
2) Model Resilience: Describe your own emotions and then encourage! “This makes me feel so sad and angry at the injustice in the world”, followed up with encouragement, "coping with these realities is very very hard and I know we all have what it takes to cope and move into action.”
3) Teach Ethical Living: A fair and equitable world requires making personal sacrifices to help others. Talk openly and often about how this lines up with your family values. Discuss what it means to be ethical. Decide as a family on ways to affect change like giving money, food, and spending time helping people in need. Model making sacrifices and compromises within your own family. This also increases distress tolerance and commitment to ethical living when you can show that you are making personal sacrifices in the spirit of generosity, as a parent.
4) Come up with ways as a family to be consistent with activism and giving and make a commitment. Following through speaks volumes to kids about what you believe is important.
5) If you go to a protest, put safety protocols in place prior to entering the protest and role-play emergencies (for getting separated, etc.). Attend rallies with friends (there is less chance of a child wandering off if they are with friends) or create your own peaceful protest with neighbors and friends.
6) Know your child. For example, If crowds are scary, keep them home. If they are prone to being a moth to a flame and finding trouble, encourage other ways to affect change.
7) Educate: Engage in consistent family education and discussions about social injustice. Develop an educational resource list from books, documentaries, inspiring fiction and even tv shows and movies to expose your family to different ideas, cultures, images and realities in the world. Schedule these events and follow through. Engage in moderated discussions and encourage learning by modeling listening! Let kids explore without your judgments or need to teach them. “That’s interesting! Tell me more! I love that! I will think about that! What you're saying makes sense! I love that you are thinking about this in depth!” You want to foster their excitement and passion to learn, rather than teach them what is “right."
Let me know if you have any questions, and please feel free to discuss, troubleshoot or provide me with feedback.
Warm regards,
Belinda Bellet
Brooklyn Heights Behavioral Associates offers effective, affordable, private psychotherapy in a convenient downtown Brooklyn location. We specialize in Adults & Adolescents, Family, Couples and Group practice.
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