Why Online Therapy?

A client stopped a recent session and said, “I need to weed my garden.”  And then she showed me how high the weeds were.

No, she didn’t live next door to my office.  We were doing a video session online, and she was sitting on her back deck.  She turned her phone’s camera toward the yard to show me the weeds.  (For the record, they weren’t that high.)

I’m always looking for ways to make therapy more accessible for families, and switching to an online practice is the best thing I’ve done to make that happen.  At my old office, families often showed up frustrated by fighting through traffic and stressed by juggling activities just to be there in the first place.  Add the hassle of gathering everybody in one place and herding them into the car, and it’s a wonder they ever made it to the session.

The online approach changes all that.  Clients schedule sessions when they have a free hour in their day. They schedule family sessions in the evenings when they’re settled in at home. Flexibility for them is also flexibility for me; I offer more flexible times because I just go down the hall to my office instead of rushing to one several miles away.

The online practice doesn’t change the kind of sessions I offer, though.  Many online, web-based therapy services offer short contacts, even through e-mails or text messages, to work through your problems.  Those can be helpful, but they’re often insufficient.  At Grody Online Family Counseling, sessions will still average 60 minutes for individuals and 90 minutes for families or couples, and the sessions will be the same as if you’re in a traditional office with me.  I’ll still see and hear you; you’ll still see and hear me.  The sessions are like using FaceTime or Skype, only our sessions will be HIPPA-compliant to protect your confidentiality.

Sessions are simple to access.  When it’s time for our appointment, I’ll send you a link that invites you to the session.  You’ll click on the link using your computer, tablet or phone, and then we’re face-to-face and ready to get to work.

Another advantage of online sessions is that clients don’t have to be local to Columbus.  Instead of opening offices in other towns (and passing those expenses on to you), I can offer video therapy to families, couples or individuals anywhere in the state of Ohio.  If you travel for work within the state, you can participate even when you’re out of town.  And if you live in the country or in a small town with limited resources, you can still access quality therapy without driving to the nearest city.

If you’re interested in trying online sessions, call me at (614) 477-5565 or e-mail me at carlgrody@grodyfamilycounseling.com.  You can also schedule an appointment online at carlgrodylisws.clientsecure.me; click on a time that works for you, and I’ll contact you with the paperwork we need to get started.

If you have any questions, give me a call.  In the meantime, I’ve got a break between sessions, so I’d better check the weeds in my own back yard.

(Carl Grody, LISW-S, runs Grody Online Family Counseling based in Columbus, Ohio.  He has 12 years experience working with children, adolescents, families and couples.  He’s a trained group leader in the Incredible Years parenting program, and he’s also the family therapy columnist for Columbus Parent magazine.  For an appointment with Carl, call him at (614) 477-5565 or e-mail him at carlgrody@grodyfamilycounseling.com.  To schedule online without the middle man, click here: carlgrodylisws.clientsecure.me.)


When Cheering Really Isn’t

Imagine you’re at a local high school watching a baseball game on a lovely spring afternoon.  The sun is shining, birds are chirping, the smell of cheap hot dogs teases you from the snack cart run by the local boosters …

And then you hear it.

“Catch the stinking ball!  I can’t believe you made such a stupid play!”

Oh.  That guy.  The one who screams at his kid like a drill sergeant wearing down a fresh recruit.  Most parents shy away from him.  On the field, the guy’s son hangs his head and wonders if there’s enough room to hide under second base.

Now, we’re not here to trash this guy.  Yes, he’s over-involved, and yes, he’s making things harder for his kid and for himself.  But we have to understand that he doesn’t see it that way.  He’s trying to do the right thing.  He cares about teaching his kid to work hard, to put forth his best effort, and to never give up.  He wants his son to be a leader.  And, yes, sometimes he just wants his son to be a star player because it makes Dad feel good.

But whatever the reason, this approach does more harm than good.

I’ve seen this problem from every perspective.  I started my career as a sportswriter covering high school sports, and then I became a baseball coach as my kids got older.  Eventually, I made another career change to clinical social work, where I specialize in family therapy with some sports psychology on the side.  I know this problem coming and going, and unfortunately, this approach drives kids away from the game.

There are several reasons.  First, it simply embarrasses the kid, especially if he’s already a teenager, when being embarrassed by parents is a normal part of growing up.  When that goes to an extreme, the teen feels extra anxiety, which makes him less likely to want to play, and less able to succeed when he does hit the field.

These behaviors also make the kid a target of extra teasing.  A teenager would rather walk across hot coals without his cell phone than be scolded by his parents in front of his friends.  If he feels like he’s going to look stupid in front of everyone and have to hear about it from his buddies later, he’s more likely to just quit playing.

There also can be damage to the child’s relationship with his coach, who’s not immune to being embarrassed by the parent as well.  That often leads to conflict between the parent and coach, possibly leading to less playing time for the child — sometimes because embarrassment causes the player to make more mistakes, and sometimes because the coach just wants to give the kid a break.

Sometimes these parents even contradict the coach, which means the player has to pick between two important authority figures.  If he listens to his coach, he might catch grief at home.  If he listens to his parent, he could lose playing time from the coach. This puts him in a classic double-bind — “damned if he does, damned if he doesn’t.”  He feels anxious, confused, and like he can’t please anybody.  Since he can’t make a “right” choice, he’ll often make no choice at all, like the proverbial deer in headlights.

I remember a high school freshman baseball game.  Our pitching coach was in the bullpen with our pitcher as he warmed up.  Before too long, the pitcher’s father strolled to the bullpen and started coaching his child as well, openly contradicting whatever the coach said.  Not knowing what to do, the pitcher didn’t last through the first inning.

You really can’t blame the kid for that.  He already felt pressure to pitch well.  He felt embarrassed by his father.  He was stressed, anxious, and confused, and he felt like he couldn’t win no matter what he did.  It’s no wonder he symbolically yakked all over the pitcher’s mound.  Imagine if his dad felt that way at his job – he’d want to quit, too.

So what’s the solution?  Here are a few things that can help:

First, leave the coaching to the coach.  His job is hard enough when the players want to listen to him.  If a parent really wants to have a say, he can volunteer to help; then the player (and his teammates) will see the parent as an appropriate authority figure on the field.  When I coached, I loved when parents volunteered.  I always found something for them to do, even if it was just hitting fungos to the outfielders.

Second, focus on the positive.  Repeated studies show that giving attention to behaviors that you like is more effective than giving attention to mistakes.  If the player boots a ground ball, for example, remind him of what he does well when he catches the ball.  I once had a player who dropped his hands during his swing when he was in a slump.  If I told him not to drop his hands (negative approach), he’d focus so much on them that he’d drop them even more.  But if I reminded him to take his hands directly to the ball (positive approach), his hands never dropped.  That reminder during an important tournament game resulted in a game-winning double that had the kid smiling for a week.

Third, the parent should ask himself what his goal really is.  If his goal is to help his child, he could try this approach to see if it gets better results.  And if the parent realizes that he cares so much because it makes him feel better about himself  . . . well, nobody’s perfect.  He may count on his child to fill a void in his own life, but the first step toward changing that is to recognize it.

If you or someone you know wants to make these changes, call me for an appointment.  Change always feels overwhelming, and I’ll help you work through it.  Positive change is always possible; I see it every day in my office.

(Carl Grody, LISW-S, specializes in family therapy at Grody Family Counseling in Worthington, Ohio.  He’s also a regular columnist for Columbus Parent magazine.  For an appointment, call Carl at 614-477-5565 or e-mail carlgrody@grodyfamilycounseling,com.)

Why it Helps to Stick to Reward Programs

I recently read an article in a parenting magazine by a frustrated parent who’d had enough of using stickers as a reward. In desperation, he decided to go “old school” and insisted that his child go to bed because he said so and not because she was getting a sticker.

As a parent, I understand that frustration. And as a clinical social worker specializing in kids, teens, and families, I often hear from parents that they feel like they’re bribing their children for good choices and good behaviors. They often feel like their kids should make good choices simply because it’s the right thing to do.

But as parents, we also need to realize children aren’t born knowing what to do. Like most things in life, they learn by experience, natural consequences and parental guidance. When we insist children do something just because it’s the “right thing” to do, and then we show that we’re frustrated when they refuse, we’re giving attention to their negative behavior. The attention for the negative behavior rewards that behavior, and it increases. That also sets up the dreaded power struggle, and then children are much more likely to refuse you.

Repeated studies show rewards are effective in teaching behaviors to children. Notice that I didn’t say rewards are effective in making children do what they should every time (nor are they the only way to teach a child), but rewards work when used consistently. Learning is a process of trial and error, and kids have to make some of the errors. But in the long run, rewards help in two scenarios — to help a child learn a new behavior, and to influence a child who knows a behavior but refuses to choose it.

A reward is different from a bribe. If the child has to do something before getting what he wants, it really is a reward. Follow the “First, Then,” rule developed by Dr. Carolyn Webster Stratton, creator of “The Incredible Years” parenting program. Here’s an example: “First you clean your room, and then you can have a cookie.” If, however, the child gets what he wants without performing the desired behavior first, there’s no true incentive to make the good choice. That’s when it becomes a bribe.

Here’s the toughest part of using a reward system. If your child chooses not to earn the reward, you have to let them do that. If you try to force them to do what you want anyway, it’ll undermine the reward system, it’ll give attention to the negative behavior and it’ll set up — here it is again — the dreaded power struggle. If your kid chooses not to do what you want, they’ll only learn their lesson if they experiences the natural consequences of their choice.

Here’s an example: “I know you want to go to the movies with your friend, but you chose not to clean your room, so you chose not to go. If you’d still like to go, first you clean your room, and then you can go to the movie.” And that’s all you say. You’ve set your boundary clearly; you’ve offered the child the chance to earn the reward; and you’re not giving attention to the child’s attempts to argue because that attention will — you’ve got it — encourage more of that negative behavior.

Children will test this approach because they have to test it; otherwise, they’d never learn that you mean what you say. If you stay steady and true to the “First, Then,” rule, your child will eventually learn that making even worse choices won’t get them what they want, and that’s when they’ll start choosing the reward. This process is called an “extinction burst.” It’s also known as, “Things get worse before they get better.” But things do get better.

Parents also worry they’ll have to reward kids to the end of time. That’s not true, but it seems logical. What actually happens, though, is that you reward a positive behavior every time until it becomes consistent. At that point, you reward the behavior every now and then to reinforce it. (Training a dog works much the same way, but we don’t tell the kids that.) Again, repeated studies show this approach is effective in creating true, lasting change.

As for the writer in that parenting magazine who’s had it with stickers, I imagine he’s preaching to the choir. Lots of parents can’t stand them. Parents hate finding stickers on the walls, on the bumper of the car or on the bumper of the dog, but the reward doesn’t have to be stickers. It just has to be something the kid really wants — his currency, so to speak. My guess is stickers didn’t mean as much to the writer’s child as the attention they got for not going to bed. If attention is what the child wants, I’d suggest a routine of snuggling with Dad reading a book at bedtime before settling in for the night. That just might do the trick.

(Carl Grody, LISW-S, works with families through Grody Online Family Counseling in Columbus, Ohio. Carl has 12 years of experience working with children, teens, families and couples. Carl’s a trained group leader in the Incredible Years parenting program, and he’s also the family therapy columnist for Columbus Parent magazine. For an appointment with Carl, call 614-477-5565 or schedule directly online at carlgrodylisws.clientsecure.me.)

Q&A: How Do I Get My Child To Apologize?

Q: My child got in an argument during a play date recently, and I made him apologize. He didn’t want to, of course, and it was like pulling teeth to get him to do it. Why is it so difficult for children to say they’re sorry? Are they embarrassed? Stubborn?

A: Yes to both, but we should also add confused to the list.

Kids don’t wake up in the morning thinking, “How can I mess up today?” They genuinely want to do the right thing. But they’re not born knowing what we expect from them or what we define as “good behavior,” and they’re often confused about what they did wrong. For example, if a child isn’t sharing a toy, he’s often confused when he gets in trouble for that. In his mind, he had the toy first; why should he give it away when he’s not done with it? When he gets in trouble, he’s often thinking, “What’s up with that?”

Behavioral change can happen simply by “fake it until you make it” – i.e., your child apologizes not because he wants to but because you’re making him do it. In that approach, it doesn’t matter if he’s sincere about the apology; it just matters that he gets in the habit of doing it. Any insight about the benefits of an apology will come later.

It’s common, though, for parents to feel frustrated when their kids’ apologies aren’t sincere. It’s not enough for those parents that their kids say the words, “I’m sorry.” They also want their kids to mean it.

But if you really want your child to understand and accept why he needs to apologize, it won’t do any good to force him. He’ll just resent it and still not understand why it’s such a big deal. (Remember, “What’s up with that?”)

Before a child can give a sincere apology, he has to learn empathy. A sincere apology simply can’t happen if your son doesn’t see things from the other child’s point of view. In the earlier example of the child with the toy, the parent could help his child explore times when he felt left out when he wanted to play with a toy. These are teaching moments, not punishing moments. The empathy might take awhile, but if you stay patient, your child will eventually get the idea.

Parents sometime ask me when they should just let the apology slide (they’re almost always asking about teenagers). The answer is that there’s no age where you have to “let it slide.” You’re the parent no matter how old your child is, and it’s important that you have expectations, rules, and boundaries for kids of every age. You set expectations about apologies because it’s important to you as a parent. And while teens sometimes seem like the most stubborn people on the planet, the values that you’ve taught them are still there somewhere. Set the expectation and then give them the chance to do the right thing. They normally will.

(Carl Grody, LISW-S, specializes in child, adolescent, and family therapy. He’s been in private practice for more than five years, and he’s a trained group leader in the Incredible Years parenting program. He’s also the family therapy columnist for Columbus Parent magazine. For an appointment with Carl, please call 614-477-5565.)

Squaring Off With Chronic Pain: A Family Battle

In the first session with a client, I emphasize that there’s no right or wrong way to feel.  Your feelings are what they are, and nobody can tell you that you shouldn’t feel that way.

But that’s sometimes easier said than done, especially when working with families influenced by Chronic Pain.  Much of the work with those families involves helping them resolve confusion about whether the Pain is actually real.  (The people suffering Chronic Pain aren’t normally confused about it; they’re feeling real Pain, even if others in the family doubt it.)

Friends and family try to be supportive, but often they get frustrated and say things like, “Suck it up already!” (By the way, that’s not normally helpful.)  But don’t judge these frustrated friends and families too harshly. More often than not, doubters simply can’t process what Pain actually means for their loved ones.  Is there an illness that’s being missed?  Is the person “faking it” to get out of doing something?  Is Pain psychosomatic?  (For the record, psychosomatic Pain is still real Pain.)

Denying the existence of Pain is, in an odd way, a coping skill.  The doubter doesn’t know how to help their loved one reduce Pain’s influence, so it’s just easier to deny Pain altogether than to admit that you can’t help someone that you love.

Here’s an example. Let’s say a teenage girl (let’s call her Jane) comes to see me because she’s trying to cope with Sadness related to Chronic Pain.  Sadness combines with Pain to make Jane miss a lot of school.  As a clinical social worker, I believe family sessions are important because everything that happens to one person also affects the rest of the family, so the family is involved in sessions, too.  Eventually, the dad (let’s call him Dad) says in session, “This is silly.  There’s nothing wrong with her.  Jane just needs to suck it up and go to school.”

Again, that sounds pretty harsh, but this attitude is common in families influenced by Chronic Pain.  Someone in the family – not always Dad, but often – feels overwhelmed about how to help Jane.  This happens a lot with dads because Chronic Pain thumbs its nose at Dad’s traditional job, which is to protect his family.  If there’s a problem, Dad think it’s his job to fix it; if he can’t, he thinks that makes him a “poor protector” and “a poor excuse for a man.”  But there’s no way for Dad to protect Jane from Pain.  He can’t control it, can’t threaten it, or even take it outside for a “chat.”  Dad can’t see Pain, can’t tell where it’s coming from, can’t smell it, and can’t even appreciate the experience of it.  Only Jane knows how it feels.

If Dad accepts that he can’t make things better for Jane, he also has to accept that he doesn’t meet his definition of what a father is supposed to be.  So he goes the other way, denying that Pain exists at all.  If Pain doesn’t exist, then Jane doesn’t need protecting, and Dad can focus on making Jane get off her “lazy butt” and go to school like the other kids.

That makes perfect sense.  Dad’s not a bad guy; he’s just overwhelmed.  His denial is actually his coping skill – not a healthy one, but a coping skill nonetheless.

This escalates problems in the family, of course.  Someone else (often Mom, but not always) defends Jane and the existence of Pain.  Jane’s brothers and sisters often get involved, taking sides with either Mom or Dad, and Jane is left in the middle of it all, feeling more and more rotten with each conflict.

Chronic Pain, meanwhile, is a bullying dictator.  It likes being in charge of the entire family.  Jane wants to ignore Pain just as much (or more) as her family wants her to ignore it, but Pain insists on being noticed.  It hammers Jane repeatedly until she’s ready to give in.

Chronic Pain craves family turmoil because the chaos helps it become even more entrenched in the family system.  The constant conflicts increase Stress on everyone, especially Jane, and Pain feeds off that Stress.  Picture Chronic Pain as the man-eating flower in Little Shop of Horrors, and Stress as the human flesh that it needs to eat.

Thankfully, family therapy can help Jane and her family.  It won’t make Pain go away (although we can work on relaxation techniques that might take the edge off Pain while reducing Stress on Jane and her family).  But the role of family therapy is to help families make positive, lasting changes that reduce Pain’s influence on their thoughts and behaviors, and I’ve seen many families take control back from Chronic Pain.

Pain hates that, by the way.  Too bad for it.

(Carl Grody, LISW-S, works with families at Grody Online Family Counseling based in Columbus, Ohio.  He’s a trained group leader in the Incredible Years parenting program, and he’s the Family Therapy columnist for Columbus Parent magazine.  For an appointment with Carl, call 614-477-5565 or e-mail carlgrody@grodyfamilycounseling.com. You can also schedule directly online at carlgrodylisws.clientsecure.me.)

Q&A: Can I Trust My Kids Online?

Q: I want to trust my children with their phones and social media, but I also want to make sure they’re not getting in over their heads. My daughter says I’m controlling and don’t trust her. I’m not sure what to do.

A: Let’s pretend that you take your daughter to the mall because one of her favorite bands is making an appearance to sign autographs. The mall is packed with people, but your daughter will be “embarrassed” if you stay with her. What would you do?

Your answer to that will probably be the same as your answer to this question. You would never throw her into that chaotic mess alone; you’d wade through the crowd with her to be sure she’s OK.

I hear this question a lot because parents want to trust their kids. They want to think that their kids will do the right things, and most of the time, they will. But sometimes that puts too much responsibility on them. There are a lot of positives that come from smart phones and online access (and for many tweens and teens, their social life “would be ovvvvvvvver” without them). But the internet and social media also offer new ways to make kids vulnerable to predators and inappropriate interactions with peers (for example, online bullying).

That’s why parents should have access to their kids’ social outlets. And if the kids refuse to allow that, they shouldn’t have access to social media.

There’s another reason for parents to monitor their kids’ online access – because no matter what they say, deep down, most kids really want you to do it. They crave rules and boundaries from parents, even if they’d never admit that. Your expectations serve as proof to your kids that you still love them enough to protect them and to make them do the right things. Even teens realize that they don’t know everything, and they still need you to be in charge (at least, on the big issues). Parental boundaries create a box of sorts for your kids, and when they understand where those boundaries are, children of all ages – yes, even tweens and teens – can feel safe exploring inside that box, knowing that you’ll keep them safe.

One last thing: Some parents don’t like the feeling of “stalking” their children online, but you don’t have to watch their accounts 24 hours a day. Just tell the kids that you will be checking their accounts, and then make sure to do it every now and then. The fact that you’ve done it before, and that you might randomly do it again, will give your kids pause when they’re tempted to try something online that they shouldn’t.

(Carl Grody, LISW-S, specializes in family therapy at Grody Family Counseling in Worthington, Ohio. He’s a trained group leader in the Incredible Years parenting program, and he’s also the family therapy columnist for Columbus Parent magazine. For an appointment with Carl, call 614-477-5565.)