A Psychologist’s Guide To ADHD Organization: Part 1

A Psychologist’s Guide To ADHD Organization Part 1

Hello, everyone! Whether you’re cooped up inside during the cold winter months or trying to get outside on those warm summer days, it always seems difficult to stay on top of everything. How do you organize?

We’ve been getting a lot of questions lately from parents about ADHD organization tips. . We asked one of our psychologist providers, Dr. Ann Marie, to give us some pointers. Ann Marie works with families whose kids have ADHD, and, through years of experience with many parents and their children, she has quite a bit of insight into how to get you on track. Read on for simple, specific tasks that you can start implementing now to change your daily routine.

A Bit About Ann Marie…

Dr. Ann Marie is a New York State Licensed Psychologist who has built her career around helping children, teens, young adults and families thrive. She has collaborated with and worked in multiple settings, including residential centers, outpatient clinics, schools, law enforcement, hospitals, nanny agencies, and foster care. She specializes in working with clients who have experienced stressors such as being bullied, intense work pressures, major life changes, loss of a loved one, separation from family members, family conflict, sexual assault, and relationship violence.

Utilizing client-centered and cognitive-behavioral techniques, she works with her clients to facilitate healing. She has helped children and young adults gain coping strategies to overcome depression and anxiety. Trained in Structural Family Therapy, Ann Marie has assisted families in improving communication and enjoying their time together. She has also guided families with support for the caregiver-child match and the nanny-parent relationship.

Ann Marie holds her Master’s from the Minnesota School of Professional Psychology. She provides training to student therapists and is a guest speaker for many groups in and out of the wellness industry.

ADHD Organization Tips From Psychologist Ann Marie

Whether school is in full swing or you’re gearing up for another year, parents of children who have an ADHD diagnosis may find themselves stretched thin and with worn patience during many times throughout the year. The first half of the year brings substantial change and newness in daily routines and classroom expectations. The second half of the school year brings harder classroom work, longer homework assignments, and higher expectations from teachers that students will be at their best, as they should be used to the school routine. It always seems to feel like a demanding time for any student, but for children with ADHD who often have difficulty with organization, focus, and social interactions, this can be a particularly difficult. Parents may feel exhausted, but worry that they don’t have the tools to help their child succeed. What can be done?

Caregivers should first go back to basics. Ensuring their children are eating healthy and balanced meals, getting enough sleep, and releasing physical energy every day can go a long way in fostering success in any child, but especially in children with ADHD. If children are prescribed medication that seemed to work during another transition time but is not as effective now, parents should check in with their child’s physician to see if adjustment is warranted due to a growth spurt or greater demands on the child’s concentration. For children who have sleep problems, medication may need to be adjusted in terms of timing or type so that sleep comes more readily.

Once the basics are taken care of, there are several areas caregivers can focus on to make routines more successful and pleasant for the whole family. Focusing on improving organization and planning may go far. Including the child in some of these tips can help to instill some pride and ownership, which may lead to more cooperation and success!

Mother and daughter reading together at home.

Part 2 of this article, which can be found by clicking here, lays out the specific steps to help turn your family’s home into a productive ADHD Organization workspace!

Just a reminder about venturing into new endeavors in your daily life: It’s important to note that it’s often better to make drastic changes one step at a time, and not try to jump into trying to include tons of new tasks all at once. Focus on one brand new idea (and only that brand new idea!), and gradually build up into a rhythm that works for you and your family. You’re more apt to stick to something if you really give each step a good try, and if you truly work on learning how to incorporate that one new thing into your body and mind. We recommend one new task per week. Life is already crazy enough — don’t be too hard on yourself!

Interested in learning more about working with a family psychologist? You might be looking for a children’s psychologist, marriage psychologist, couple’s psychologist, or someone to work with the whole family. If you would like some recommendations on the best family psychologist in your area, please reach out to us! We can connect you with any of the health and wellness services you need, which includes top notch therapy! We’re happy to help. If you would like me to connect you with one of our expert therapists or dietitians, please contact me. I look forward to hearing from you!

Read Part 2 of this article for specific skills that you can start implementing in your house.

Do you have any tips? What works for you with ADHD organization in your family? Let us know in the comments!

Good luck organizing, wellness warriors!

What You Must Know Before Hiring a Sleep Consultant

What You Must Know Before Hiring a Sleep Consultant

Before we get to the juicy stuff, let’s answer a question that may be entering your brain right about now: “What is a sleep consultant?”

A sleep consultant helps you sleep better… that’s pretty obvious. But what wasn’t clear to me until I got into the wellness world was the fact that sleep specialists are medical doctors who have completed additional training and education in the field of sleep medicine. (And while we’re here, sleep medicine isn’t just a bunch of over-the-counter-knock-you-out-pills. The term “sleep medicine” refers to a specific field that focuses on sleep, sleep disorders, and sleep-related conditions.) We all know we’re supposed to get more sleep. We’ve been told since we were two years old that sleep is good for you. It’s a well-known fact that sleeping well makes you happier and healthier! Sleep medicine specialists diagnose and treat a number of sleep-related conditions, including excessive snoring, insomnia, sleep apnea, narcolepsy, and circadian rhythm disorders.

Carolina’s bio: You never thought you could be so excited yet so exhausted with your new child. Sometimes it takes a little extra coaching to get your new baby on the right sleep schedule. Carolina is a Certified Child and Family Sleep Consultant, specializing in pediatric sleep hygiene and behavioral coaching. Carolina is based in New York City and has dedicated her career to reducing sleep deprivation. She has written for many popular parenting blogs, and has even used her own methods to help her own family get a good night’s sleep! Carolina is the go-to-expert for many new and working parents. So whether you’re returning to work or you just want a bit of shut-eye, Carolina will get your family on track for those Zzz’s. She has 2 toddlers of her own. And yes, they sleep. A lot.

And, without further ado, here is a guest post written by our wonderful provider, Carolina!

Firstly, before even considering hiring a sleep consultant, you need to understand the process and what an actual sleep consultant does. It is still a fairly new industry that is on the rise because of its huge demand. If you are thinking or currently actively looking for a sleep consultant for your family, there are several things you should look into before hiring one. Currently, this is an unregulated industry and more and more sleep consultants are emerging.

Sleeping woman

Sleep consultants are non medical sleep health professionals who help their clients with achieving healthy sleep. We come in all different shapes and sizes, specializing in a vast number of areas. Some focus primarily on infant sleep. Some focus on infant and toddler sleep. Some focus on all ages, from pediatric to geriatric sleep. All the while utilizing sleep hygiene and behavioral coaching to help their clients achieve their sleep goals. A sleep consultant doesn’t and cannot perform treatments on sleep disorders such as sleep apnea and any other neurological issues. That needs to be communicated to a board certified sleep specialist that will be conducting sleep studies on how to properly treat the issue.
So how do we maneuver through the vast growing weeds of sleep consultants and specialists? How do you hire the RIGHT person for your family?
I will walk you through a few key points that will have you feeling confident in moving forward with the perfect sleep consultant for you.

Firstly, jotting down the qualities that you are looking for in a sleep consultant. Who is also your coach during the process. You want to make sure you can connect with them. That you mesh well 🙂 Not just through the help with sleep, but also in parent coaching. Their ability to call you out if you are going back to your old patterns. Many times, when parents reach out to a sleep consultant, it is because things have really hit the fan. They have exhausted all of their options, including waiting it out and hoping it will resolve itself. For example, one day your child miraculously slept through the night and you will hold that day on a shiney diamond platter and pray to the sleep gods that it continues and that it wasn’t a fluke night. Which then, in most cases it will not continue and you’re back to square one. So the first thing, is taking out a sheet of paper, and writing down verbatim what you expect in your sleep consultant.

Do you want them to sleep over and show you how to actually go through the entire process with you?

Do you prefer to learn through communication virtually, such as Skype or email sessions?

Do they need to speak another language because your nanny does or will google translate be sufficient?

Do you have other children, and you need help to create a schedule that will balance the entire family?

Are you the only one that can implement all the techniques or is their someone else that can be involved during the process?

Are you looking for someone that specializes in infant sleep, toddler sleep, multiples, or special need cases?

Do you want a sleep specialist that resides locally. Such as a sleep specialist in New York or New Jersey?

Do you live in another time zone and would like to find a sleep consultant virtually? Understanding the time difference is important when you are communicating.

How much communication and hand holding are you needing during the process?

Do you want to move gradually with the methods or something more direct such as extinction (AKA CIO)?

These are just a few questions you should Think about before hiring a sleep consultant.

You want someone that is a good fit, that will hold you accountable and someone that will say, “ hey, you know. I am seeing that you are going back into your old habits. “ Being willing to thoughtfully call you out. That is the KEY thing you need when you are in the mist of sleep fog and just going through the changes.

Now. Go ahead. Write down your questions. I’ll wait.

baby sleeping well through the night

Ok. You good? Great. Now that we know what qualities we want in our sleep consultant, let’s open up google or the mommy group you belong to and let’s find you your perfect sleep consultant. Now remember how I mentioned earlier that this is an unregulated industry? So when you start googling or getting recommendations. Please keep in mind that qualifications is KEY. Since it is currently unregulated, there are sleep consultants out there that may have their own wonderful children and maybe they have done pretty well sleep coaching their own children or their friends kids. Which may think that may qualify them to dive into this field. It’s like me saying, I have a car, but that doesn’t make me a mechanic.

You need to look into the other things that they can potentially bring to the table and what they have received in the form of sleep education. Here are a few questions you should ask during your get acquainted call with them. Or in my practice, our sleep strategy session 😉

What kind of specialized sleep education do you have with working with children? How many hours were invested in the education?

You would be surprised that some have a weekend crash course, or zero at all. This includes health professionals such as pediatricians, nurses and therapists in the health industry. Shocking, I know. Especially since they are the number one person you go to regarding your babies health.

Shocking Fact … “Surveys were completed by directors of 152 pediatric residency programs across 10 countries…Overall, the average amount of time spent on sleep education is 4.4 hours (median = 2.0 hours), with 23% responding that their pediatric residency program provides no sleep education.” Read the full study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621514/
I studied over 126 hours through Family Sleep Institute while pregnant with baby 2 and my oldest was 1 year at the time and working full time at a financial securities investment firm. I got you covered in sleep 😉

Is there continued education you are required to receive?
What ages do you work with?
What is your success rate?

If you get someone that says 100% success rate, run for the hills because that isn’t realistic. Sleep training is a team effort and some parents may feel that they are ready to begin when working with a consultant, and the process maybe not quite what they envisioned and they need to pause. Every family dynamic is different. This isn’t a race and your sleep consultant should never make you feel like it is.

5. What kind of health scenarios do you work with? Such as ADHD, epilepsy, autism,

Your sleep consultant should have a good connection, a good network affiliation with medical doctors in the field. It is important that they can refer out when the situation is out of their scope. Such as psychological or neurological sleep disorders for children. That needs to properly be evaluated by a medical practitioner that studies that in the field.

6. What is the follow up support they will provide you?

Sometimes it’s not so helpful to have a one time call or once a week check in when your current case is short naps, constant night wakings, rocking to sleep, or feeding to sleep. Within a weeks time, a lot of things can change and if they are not tracked on a daily basis, you might not see the results you expected. So a really great sleep coach will be available to you daily. Know what you need and don’t be afraid to ask for it. So if it isn’t included in the package, it doesn’t hurt to ask.

One main thing that I can attest for in being in this industry for several years now and a 98% success rate 😉 is that understanding your WHY, in why you want to hire a professional to help you in the first place is the biggest thing you need to. Because that is what will keep you motivated and on target to achieve your goals.

So, with ALL of this said, well, written in this case, there is some homework for you, my love, when hiring the right person to become a part of your family in getting you healthy sleep.

Wishing you sweet dreams,

Carolina, Sleep Consultant

We hope you enjoyed this blog by our fantastic provider, Carolina! If you would like me to connect you with one of our expert specialists, please contact me. I look forward to hearing from you!

Drive Away Your Nail Biting

How To Find A Psychologist To Drive Away Your Nail Biting

How To Find A Psychologist To Drive Away Your Nail Biting

In the past few years, I have noticed that so many people, both children and adults, bite their nails or pick the skin around the nail. As a teenager and during part of my twenties, I also had nail biting issues, and I never paid any particular attention to it. This week, while speaking with my 13-year-old, I noticed that she had some scabs around her nails, but I didn’t want to bring attention to it just yet. However, noticing the behavior in my own daughter, combined with seeing so many other kids and adults over the years who have had challenges with nail biting, it made me realize how this is an issue that doesn’t get talked about enough. It can seem harmless — and sometimes it is — but it can also be quite serious. In the following blog, I will address the questions that I have gotten from many of my clients, their parents, and readers over the years related to this topic.

What is Nail Picking? Nail Biting?

Nail picking or biting is a problem that plagues a lot of children and adults. When we talk about nail biting, the problem actually encompasses more than just what we typically think of as chewing on nails. Rather, there are several related behaviors, like cuticle picking and even toenail biting. Toenail biting might sound a bit strange, but I have seen several kids do it and heard from numerous parents who are concerned about their children biting their toenails. All of these behaviors are real problems, and having a stigma and shame associated with them does not help anyone stop. Bringing awareness to what is going on and speaking to a professional about ways to help and resolve these issues is extremely important. But first, I think it’s necessary to get a better understanding of what it is and why people engage in these types of behaviors.

With some people, it is obvious that they are nail biters (or pickers, etc.), but others become experts at hiding it. Often people assume that this is something that affects people who are insecure and nervous, but in the many years of working with people who suffer with these issues, I have seen people of all levels of functioning, ages, and professions struggle with these problems. Now, when I write about these behaviors as characterized as a psychological disorder, I want to be clear and state that I am not referring to the kind of little bites of rough nails or cuticles that everyone picks at or chews on from time to time. It’s also not the occasional blemish that you might pick or squeeze. The nail biters/pickers I am talking about will continue to bite their nails past the nail and pick their cuticles until they bleed. These people constantly walk around with red, sore, and sometimes infected fingers.

Is there a psychological term for that?

Many people might not know how to refer to these behaviors or even think of nail biting or skin picking as a psychological disorder. As a psychotherapist, I like to refer to the group of behaviors that include nail biting, hair pulling (also called trichotillomania), and skin picking as pathological grooming. These behaviors become automatic activities that have no relationship to external stimuli at all. Years ago, the DSM, which is the bible of psychology, treated pathological grooming like an afterthought and put it in a catch-all category called “not otherwise specified.” However, the new DSM 5 added a disorder called excoriation (skin-picking) disorder. It is estimated that between 2-4 percent of the population could be diagnosed with this disorder, but I personally think that the percentage is a lot higher.

If you start paying more attention to what people are doing with their hands when you are around them, you might be surprised to find out how many bite their nails, pick their skin, or do other related behaviors that damage their nails in other ways. Those who are clinically and medically affected have results such as infections, skin lesions, scarring, and even physical disfigurement. According to the APA (American Psychological Association), individuals with excoriation disorder must have repeated attempts to decrease or stop the skin picking, which must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. They also add that these symptoms can’t be better explained by another mental disorder.

Nail biting and other related behaviors were categorized into another group of disorders called other specified and unspecified obsessive-compulsive and related disorders. These disorders can include conditions such as body-focused repetitive behavior disorder and obsessional jealousy, or unspecified obsessive-compulsive and related disorder. For the purposes of this article, let’s talk about body-focused repetitive behavior disorder. There is also a medical term that is called onychophagia, which involves repetitive biting, chewing, and picking of one’s fingernails and the cuticles around them. What’s important to note is that there are now several accepted terms and classifications because these behaviors have been recognized in the medical and psychological fields as actual disorders.The terminology can get a bit confusing, but it might help to read through the different classifications when determining whether you or your child has formed a bad habit or has a serious problem that requires treatment.

Why Do People Do It?

Person nervously playing with their hands and nails.

Different experts have varying opinions about why people might start biting their nails. For Sigmund Freud, known as the founding father of psychoanalysis, or the talking cure, which is a method for treating mental illness as well as a theory that explains human behavior, nail biting is an oral fixation that is a form of stimulation. Many experts believe that nail biting is associated with stress and anxiety and is a way for people to distract themselves from bad thoughts or feelings. The function of the behavior is to manage negative feelings. It is generally benign and learned as a habit, and may work as a way to manage distress.

Why Should You Want To Stop Doing it?

If you are one of those people who practices pathological grooming, then you might not be aware of how it looks from the outside. I suggest that you either record yourself doing it and then watch it, or watch a YouTube of someone who does it in public. Sometimes people don’t recognize it as a problem until they view it from a different lens. From clients and from personal experience of biting my nails and picking skin, I remember being very aware of how insecure or stressed I might seem to others while doing it (and I was under a lot of stress at the time!) but for some reason I couldn’t stop. It seemed like the act of doing it actually served as a form of self-soothing and stress reduction that was out of my control. Or so I thought at the time. When I realized that there were actually proven ways to help individuals stop nail biting or skin picking, I was excited to share this with others and help in any way I could.

These compulsive behaviors can also have a significant negative impact on your emotional and physical well-being. Emotionally, self-mutilation behaviors can produce feelings of shame and low self-esteem. You might also feel guilty for being engaged in behaviors that are compulsive that you know are not within the normal range of behaviors. Also, in some serious cases, the physical injuries can take their toll in the form of lesions, infections, and scarring that may also carry risks of life-threatening complications. So while I’ve seen people be quick to dismiss the problem, I strongly suggest learning more about the behavior and looking for a solution to the underlying issues. It might seem like a fairly low-impact way to manage stress, but there are much healthier options out there, and getting to the root of the stress or other stimulus is important for overall well-being.

How Do I Treat It? (Best Treatments)

The most effective type of treatment for compulsive self mutilation behaviors is cognitive behavior therapy (CBT). You will probably read about CBT in many of my blogs as I am a strong advocate of this type of therapy. Sure, sometimes you will need to include other types of therapeutic methods or modalities, but CBT is one of the most effective and evidence-based techniques. Understanding and practicing it helped change my life. I will write more about it in other blogs, but for now I want to briefly explain what it is and how It can help you stop biting your nails.

The goal of CBT is to help you identify unhealthy and irrational thought patterns and “re-wire” your thinking. By doing so, you will learn to replace self-harming behaviors (like nail biting or skin picking) with healthy ways to cope with your anxiety, emotional pain, or other triggers that cause you to do the behaviors you wish to stop. Research has found that CBT is more effective than only using medication. In one study from Johns Hopkins, CBT was found to be more effective — and have longer lasting implications with fewer side effects — than traditional antidepressants when used to treat social anxiety disorders in adults.

This doesn’t mean that I think all medication is bad. Of course, in some severe cases, clients might need medication to help with reducing or eliminating symptoms. Antidepressant Fluoxetine, for example, may help reduce compulsive skin picking. People who struggle with nail biting or skin picking often have other psychological issues, though, so it’s important to have a full assessment in order to get the best diagnosis and treat with the appropriate methods. Since self mutilation behaviors can lead to physical symptoms, it is important to also work closely with a medical doctor who can help and treat the physical symptoms. Besides working with professionals who can help reduce and eliminate the symptoms, there are some self-help strategies that you can employ as a starting point.

Stress has been found to be one of the most common factors that leads to these behaviors, so stress management is key in treatment. Try turning to activities like yoga, meditation, and breathing exercises to help lower stress. Even things like volunteering or spending time on a hobby can provide your brain with some physical and emotional relief that will help with the urge to perform the destructive behaviors. Another great place to start is learning to express your emotions. Talking to a professional can definitely help, but also talking to a friend or family member whom you trust to start learning to identify what feelings cause you to pick or nail bite can be really useful. I’ve personally always found that journaling helps me manage stress. It’s a way to express myself emotionally. It also involves using your hands so it can serve as a form of physical and emotional release. That brings me to another important thing to try: Keep your hands busy! Look for other ways to keep your hands stimulated and release stress or tension. Things like a fidget spinner or a stress ball will keep your hands busy and redirect your focus.

how to treat nail biting

I want to reiterate that just because someone is ashamed of their behavior or embarrassed by how their hands look, it’s usually not enough to get them to stop. Awareness is definitely a necessary first step, and often these actions are done without really thinking about them, but simply knowing it’s abnormal or destructive won’t fix the problem. Be careful when talking to your children about it, as you don’t want to make them feel shame. If you have more questions about how to approach your child or the best ways you can help someone in this situation, we at LW Wellness would love to help. If you have found something that has worked for you or someone you know, we’d also love to hear about it, so leave a comment or send us an email.

If you would like me to connect you with one of our expert therapists or dietitians, please contact me. I look forward to hearing from you!