11 Guiding Principles for Raising a Child with ADHD
(taken from Taking Charge of ADHD:
The Complete, Authoritative Guide for Parents,
by Russell A. Barkley, Ph.D., 1995 & 2000)

“…principle-centered parenting of a child with ADHD means (1) pausing before
reacting to the present misconduct of the child, (2) using this delay to reflect on the
principles contained in this book, and (3) choosing a response to the child that is
consistent with these principles.” (p. 129).

1. Give your child more immediate feedback and consequences.

• Kids with ADHD are “under the control of the moment.”
• To influence these children, you must become a part of that moment.
• When rewarding or disciplining, the sooner the better, and always communicate what they did correctly or incorrectly to earn your response.

2. Give your child more frequent feedback.

• Feel free to reward parts of tasks rather than just whole tasks.
• Provide yourself with reminders (stickers/notes/etc.) around the house and provide feedback on your child’s behavior each time you see one.
• You may even want to set a timer to help you give feedback at regular intervals.

3. Use larger and more powerful consequences.

• Kids with ADHD require more motivation to follow rules or get work done.
• You can use things like physical affection, privileges, treats, or even more material rewards such
  as small toys or money to help reinforce and shape your child’s positive behavior.

4. Use incentives before punishment (positives before negatives).

• Kids with ADHD typically receive many negative consequences, especially by those who do not
  understand their disability.
• When you see undesirable behavior, think of the behavior you’d like to replace it with first.
  Then start looking for that behavior, and praise/reward it.
• “catch your child being good” Praise and rewards should triple discipline or punishment.
• Only punish a behavior if you have rewarded the opposite behavior consistently for at least a
  week. Remember that your child is not “bad” but the behavior you want to correct is “wrong.”
• If you do discipline or punish, keep the consequence in balance with the negative behavior.
• Sometimes the best consequence is a natural consequence that follows from a child’s behavior.
• Never use corporal (spanking) punishment.

5. Strive for consistency.

• Use the same behavior management strategies every time.
• This means across settings, time, and with both parents.
• Don’t give up if you don’t see immediate results.

6. Act, don’t yak!

• Consequences and feedback are much more effective than simply reasoning with your child.

7. Plan ahead for problem situations.

• If you can anticipate where problems may arise, plan for how you should react in those
  situations.
• Before entering a “problem setting”, stop and review with your child 2-3 rules to follow, set up
  the reward/incentive, explain the punishment, and then follow your plan.
• Transitions are triggers for many children with ADHD, they have difficulty shifting from one
  activity or expectation to another.

8. Keep a disability perspective.

• Remember that you are the adult – the child’s teacher and coach.
• Remind yourself of your child’s disability, especially when you’re dealing with disruptive
  behavior.

9. Don’t personalize your child’s problems or disorder.

• If things don’t go exactly as you want them to, don’t think you’re a bad parent or lose your self-
  worth.

10. Practice forgiveness.

• This is the most important – and maybe the most difficult.
• Kids with ADHD can’t always control their actions, and they deserve forgiveness.
• Try to forgive others who don’t understand your child’s disability.
• Learn to forgive yourself for mistakes you may make in managing your child.

11. Time-In or Time-Outs.

• Time-outs alone do not teach emotional/behavior regulation skills. Time-out appropriately used
  involves explaining to the child during a non-crisis time how and why the procedure is being
  used. At the end of the time-out the child should be praised and rewarded for following the
  procedure (a simple hug).
• A general rule of thumb for the length of a time-out is 1 minute for each age of a child.
• After the time- out sit with the child and speak to them calmly and softly about their feelings and
  behaviors. Listen, validate, and then begin to solve the problem.

Additional Parenting Tips

1. Help your child succeed at school, be your child’s best advocate. Talk to the school about a 504
   Plan or Individualized Education Plan.
2. Join a Support Group.
3. Boost confidence by setting aside special time for you and your child. Identify and reinforce your
   child’s strengths, assist your child with social skills, how to make friends and cooperate with others.
4. Have consistent schedules for morning, afternoon, and evening routines.
5. Explain transition times from one activity to another ahead of time. A spike in behavior problems
   often occur at transition times.

Reference and Resources

Barkley, Russell A. Taking charge of ADHD: The complete authoritative guide for parents, Revised Edition. (2005). The Guilford Press.

Barkley, Russell A. Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment, 2nd ed. (1998). The Guilford Press.

National Resource Center on ADHD: www.help4adhd.org.
CHADD.org

www.additudemag.com

Monastra, Vincent J. (2014). Parenting children with adhd: 10 lessons that medicine cannot teach, 2nd ed. APA Press.

NEED MORE HELP? Call The Behavioral Wellness Group at 440-392-2222 to schedule an Intake with one of our clinicians.

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post PARENTING A CHILD WITH ADHD appeared first on Behavioral Wellness Group.

Domestic violence, also referred to as intimate partner violence, can include: 

• physical violence
• sexual violence
• psychological aggression
• coercive control
• stalking
• behaviors used to frighten, intimidate, isolate, or control a partner.

Abuse can occur in current or former dating relationships, marriages, and other intimate relationships. It may be obvious, such as physical violence, or less visible, such as threats, financial control, isolation, monitoring, or emotional abuse.

The Scope of Intimate Partner Violence

The most recent national data from the Centers for Disease Control and Prevention (CDC) demonstrate the significant and ongoing impact of intimate partner violence. According to the CDC’s 2023–2024 National Intimate Partner and Sexual Violence Survey, approximately 6.7 million women and 2.8 million men experienced contact sexual violence, physical violence, and/or stalking by an intimate partner during the 12 months preceding the survey. Over the course of their lifetimes, approximately 43.5 million women and 20.7 million men experienced one or more of these forms of IPV.

Lifetime physical violence by an intimate partner was reported by approximately 22.5% of women and 13.7% of men, while severe physical violence was experienced by approximately 18.2% of women and 8.6% of men. These findings demonstrate that IPV is not limited to isolated incidents and can affect individuals throughout their lives.

The Health Impact of Domestic Violence

The effects of domestic violence can extend far beyond the immediate incident of abuse. Living in an abusive or controlling relationship can have significant physical and psychological consequences. Survivors may experience anxiety, depression, trauma-related symptoms, sleep difficulties, headaches, chronic pain, substance use, and other health concerns. Repeated exposure to stress and violence can also interfere with a person’s ability to manage existing health conditions and maintain overall well-being.

Domestic violence can affect a person’s ability to seek medical and behavioral health care, maintain employment, access transportation, manage finances, and maintain supportive relationships. Fear of an abusive partner may also prevent a survivor from safely seeking help or disclosing what is happening.

Because the effects of IPV can appear in many areas of a person’s life, behavioral health professionals and other health care providers can play an important role in recognizing signs of abuse, providing support, assessing safety, and connecting survivors with appropriate resources.

Domestic Violence in Ohio

Domestic violence continues to have a significant impact on individuals and families throughout Ohio. The Ohio Domestic Violence Network (ODVN) reported 157 domestic violence-related fatalities in Ohio during the year ending June 30, 2025, representing a 37% increase from the previous reporting period and the highest number recorded since ODVN began its annual fatality reporting in 2015. The fatalities occurred in 108 cases and included 95 deceased victims and 62 deceased perpetrators.

Ohio’s domestic violence service system also serves thousands of survivors each year. ODVN reports that its member programs provided services to 127,006 survivors, including legal advocacy, housing assistance, support groups, transportation, and other services. ODVN and its member programs also responded to more than 123,000 direct crisis communications through calls, texts, and chats.

At the same time, the demand for services continues to exceed available resources. ODVN reports that 9,707 survivors were sheltered, including 3,743 children, while 8,194 survivors—approximately 45%—were turned away because of insufficient shelter capacity.

These numbers highlight the importance of increasing awareness, expanding access to behavioral health and community-based services, and ensuring that survivors have safe and accessible options for support.

You Are Not Alone

Recognizing that a relationship is unhealthy or abusive can be difficult. A person experiencing abuse may feel isolated, afraid, confused, financially dependent, or uncertain about what steps to take. Leaving an abusive relationship can also increase risk in some circumstances, which is why safety planning should be individualized and guided by the survivor’s needs and circumstances.

If you are concerned about how your relationship is affecting your physical or emotional health, consider talking with someone you trust, such as a health care provider, behavioral health professional, domestic violence advocate, friend, or family member.

When it is safe to do so, helpful steps may include:

• Talk with a health care or behavioral health professional about physical or emotional symptoms you are experiencing and about coping strategies that may help.
• Reach out to a trusted person who can provide support without judgment.
• Work with a domestic violence advocate to develop an individualized safety plan.
• Consider reducing access to situations, substances, or behaviors that may increase risk during periods of intense stress.
• Seek professional support for anxiety, depression, trauma symptoms, or other mental health concerns.
• Remember that you are not responsible for another person’s abusive behavior.

Ohio and National Resources

Ohio Domestic Violence Network (ODVN):
1-800-934-9840
ODVN can connect survivors with local domestic violence programs, shelters, advocacy, and other support services throughout Ohio.

National Domestic Violence Hotline:
1-800-799-SAFE (7233)
Text START to 88788
The National Domestic Violence Hotline provides confidential support, safety planning, information, and connections to local resources. Online chat is also available.

Emergency: If you are in immediate danger or believe a life-threatening situation is occurring, call 911.

Support Through Behavioral Wellness Group

The Behavioral Wellness Group (BWG) is committed to expanding its capacity to support individuals and families affected by domestic violence throughout Ohio. Our behavioral health professionals can provide a supportive, trauma-informed environment where individuals can discuss concerns, strengthen coping skills, and explore treatment and support options.

Services may include individual counseling and health and wellness Intensive Outpatient Program (IOP) services, when clinically appropriate. Treatment recommendations are individualized based on each person’s needs, safety, and treatment goals.

Talking about abuse does not mean you have to make an immediate decision about your relationship. Seeking support is a step toward understanding your options and taking care of your health.

If you have concerns about domestic violence or your mental health, Behavioral Wellness Group is here to help. Contact our Intake Department at 440-392-2222.

Dr. Halle Worley, Psy.D.
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #854 F: 440 565 2349
hworley@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post October Is Domestic Violence Awareness Month appeared first on Behavioral Wellness Group.

P: Positive Emotion. What makes us feel good? Counter any negative self-talk, watch television programs, movies, listen to music, read books that make you smile, laugh, and relax. Play games with family and friends, get physical exercise and practice breathing techniques, get out in nature and pay attention to the sensations around you, reflect on three good things or what went well each day, keep a gratitude diary of the things you cherish, make plans for the near and distant future-hope, but also live in the moment.

E: Engagement. A flow of activities that make you lose track of time: puzzles or board games, yoga or meditation, writing a story or poem, indulging in creative tasks like drawing, painting, taking part in individual or team sports, working on a new display in your garden, try something new with cooking or baking, make a photo collage of an activity or vacation you have enjoyed.

R: Relationships. Know who brings you joy, peace, and support. Plan get-togethers, show your appreciation of others in your life, share your good times with friends and family, spend a few minutes chatting kindly to a stranger, use active listening and empathy when helping someone with a problem, send an impromptu card to a friend, remind someone that you love them.

M: Meaning. Engage (yes, they can overlap) in causes and pursuits that you find important and worthwhile: spiritual activities (organized or your own inner spirituality), make a donation to charity (your time/volunteering is a donation), send a “care package” to someone who needs it, share your knowledge and teach others about a special interest, commemorate a loved one’s memory.

A: Accomplishment. Have goals and a plan to achieve them: make a “to do” list and prioritize the tasks, keep goals SMART (Specific-clear-direct, Measurable- track your progress, Achievable- realistic and possible, Relevant-goals that matter to you, Time-Bound-have a deadline that is reasonable), Take on new jobs, new experiences, learn and don’t fear failure, change your work-life balance-use a planner to organize your time.

Reflecting on and implementing PERMA will go a long way to support general well-being, flourish in happiness, and build resilience for future challenges.

Feel stuck and need help? Give The Behavioral Wellness Group a call at 440-392-2222 for a full range of services that include individual counseling/psychotherapy, couples and family therapy, Intensive Outpatient Programs, and Medication Management.

References and Further Reading

Frederickson, B.L. (2001). The role of positive emotions in positive psychology. American Psychologist, 56 (3), 218-226.

Hanson, R. (2013). Hardwiring Happiness: How to reshape your brain and life. London: Rider Books.

Seligman, M. (2011). Flourish: A new understanding of happiness and well-being-and how to achieve them. London: Nicholas Brealy Publishing.

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post Well-Being and Happiness: A Positive Psychology Outlook appeared first on Behavioral Wellness Group.

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Parenting around media can feel overwhelming. Technology changes quickly just as children grow and change from infancy to adulthood. The Behavioral Wellness Group hopes to provide some clarity on this important contemporary issue by reviewing the latest research and guidelines from the American Academy of Pediatrics (AAP), The American Psychological Association (APA), and the American Academy of Child and Adolescent Psychiatry (AACAP).

The American Academy of Pediatrics: The AAP published updated guidelines in February 2026. Pediatric experts emphasize that screen time itself is not the enemy. Dr. Katherine Williamson from Rady Children’s Mission Hospital said it best: “I recommend for parents to think and talk about screen time like dessert. Like a food treat, screen time is not inherently bad.”2 The important task for a parent is to ensure that screens don’t replace the daily activities that support healthy psycho-social development.

The AAP Center of Excellence on Social Media and Youth Mental Health developed the 5 C’s as an age-by-age guide to parenting around media and building healthy digital habits as your child grows. The 5 C’s are: 1. Child-Who is your child and how do they react to media? 2. Content-What is worth your child’s attention? 3. Calm- Does media calm your child’s emotions? 4. Crowding Out- What does media get in the way of? And 5. Communication- How can you talk about media to raise a media savvy, responsible child? To learn more about the 5 C’s with each developmental stage go to:

https://www.healthychildren.org/English/family-life/Media/Pages/kids-and-screen-time-how-to-use-the-5-cs-of-media-guidance.aspx?

AAP emphasizes Balance over Burnout: Screens should not replace sleep, physical activity, family time or free play; device free bedrooms and mealtimes help keep routines healthy. Parents set the tone with co-viewing, talking about content and modeling good digital habits to help children navigate online spaces safely. Tips for Families are: 1. Build digital literacy, 2. Create a Family Media Plan, 3. Choose quality content, 4. Protect sleep and screen-free time, 5. Be intentional about a first phone. For more information go to:

Updated AAP recommendations for screen time: What parents need to know

The American Psychological Association (APA): The APA has addressed three important areas with children, adolescence and technology: 1. Digital guidelines: Promoting healthy technology use for children 3, Health advisory on social media use in adolescence4, and APA resolution on violent video games February 2020 Revision 5.

Digital guidelines: Promoting healthy technology use for children: For children under 18 months, screen time should be avoided except for video chatting with family members. For children 18 months to 24 months, parents should choose high-quality programming and watch with their children. For children 2 to 5, limit screen time to one hour per day of high-quality programming. For children 6 and older, establish consistent limits on time spent using media and the types of media. Parents should focus on teaching healthy media habits, teach children about technology from ja young age, use good judgment about screen time and the content and context of screen time (context example might be occupying a child with screen time on a plane), protect bedtime, pay attention to your child’s online activity and have honest discussions about what sites and type of content are off-limits, teach good online behavior, be sensitive to cyberbullying, discuss digital decision-making-what sites are suspicious, inappropriate, what sites are healthy, foster real-life friendships, and learn more-try to keep tabs on the changing technology landscape.

APA Health advisory on social media use in adolescence: Recommendations from the Health advisory on social media use in adolescence are: 1. Youth using social media should be encouraged to use functions that create opportunities for social support, online companionship, and healthy emotional intimacy that can promote healthy socialization, 2. Social media use, functionality, and permissions/consenting should be tailored to youths’ developmental capabilities; designs created for adults may not be appropriate for children, 3. In early adolescence (10-14), adult monitoring is advised for most youths’ social media use, autonomy may increase gradually as kids age and if they gain digital literacy skills. However, monitoring should be balanced with youths’ appropriate needs for privacy, 4. To reduce the risks of psychological harm, adolescents’ exposure to content on social media that depicts illegal or psychologically maladaptive behavior, including content that instructs or encourages youth to engage in health-risk behaviors, such as self-harm, harm to others, or those that encourage eating-disordered behavior should be minimized, reported,, and removed; moreover, technology should not drive users to this content, 5. To minimize psychological harm, adolescents ‘exposure to “cyberhate” including online discrimination, prejudice, hate, or cyberbullying especially toward a marginalized group or towards an individual because of their identity or allyship with a marginalized group should be minimized, 6. Adolescents should be routinely screened for signs of “problematic social media use” that can impair their ability to engage in daily roles and routines, and may present risk for more serious psychological harm over time, 7. The use of social media should be limited so as to not interfere with adolescents’’ sleep and physical activity, 8. Adolescents should limit use of social media for social comparison, particularly around beauty-or appearance-related content, 9. Adolescents social media use should be preceded by training in social media literacy to ensure that users have developed technologically-informed competencies and skills that will maximize the chances for balanced, safe, and meaningful social media use, 10. Substantial resources should be provided for continued scientific examination of the positive and negative effects of social media on adolescent development.

APA Resolution on Violent Video Games: February 2020 Revision to the 2015 Resolution: In summary and based on years of research, reviews show a link between violent games and increased aggressive behavior, thoughts, and reduced empathy. Attributing real-world gun violence or major crimes to video gaming is scientifically inaccurate, as violence stems from many complex social factors.

American Academy of Child and Adolescent Psychiatry (AACAP): Screen Time and Children: Facts for Families6: On average children age 8-18 in the United States spend 7 1/2hours a day watching screens that include smart phones, tablets, gaming consoles, TVs, and computers. Too much screen time may lead to sleep problems, lower grades in school, reading fewer books, less time with family and friends, not enough outdoor or physical activity, weight problems, mood problems, poor self-image and body issues, fear of missing out, and less time learning other ways to relax and have fun. Like other guidelines AACAP suggests until 18 months of age limit screen use to video chatting along with an adult (for example, with a parent who is out of town), between 18 and 24 months screen time should be limited to watching educational programming with a caregiver, for children 2-5 years old, limit non-educational screen time to about 1 hour per weekday and 3 hours on the weekend days, for ages 6 and older, encourage healthy habits and limit activities that include screens, turn off all screens during family meals and outings, learn about and use parental controls, avoid using screens as pacifiers, babysitters, or to stop tantrums, and turn off screens and remove them from bedrooms 30-60 minutes before bedtime, carefully consider your child’s maturity when allowing access to a new device, familiarize yourself with the content your child sees, to make sure it is age appropriate, talk to your child about what they are seeing—point out good behavior, such as cooperation, friendship, and concern for others, make connections to meaningful events, be aware of advertising and how it influences choices, encourage your child to engage in other activities that do not involve screens such as sports, music, art, and hobbies, set a good example with your own screen habits, teach children about online privacy and safety, encourage using screens in ways that build creativity and connection with family and friends, consider your child or teen’s maturity and habits and realize that a right plan for one family may not be a good fit for another.

Is Excessive Internet Gaming Considered a Disorder: The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), which is used by mental health professionals to diagnose mental disorders included Internet Gaming Disorder in a section recommending conditions for further research; so it hasn’t made it in yet. Criteria identified include preoccupation with gaming, withdrawal symptoms when gaming is taken away or not possible (anxiety, sadness, irritability), tolerance, the need to spend more time gaming to satisfy the urge, inability to reduce playing, unsuccessful attempts to quit gaming, giving up other activities. Loss of interest in previously enjoyed activities due to gaming, continuing to game despite problems, deceiving family members or others about the amount of time spent gaming, the use of gaming to relieve negative moods, such as guilt or hopelessness, risk, having jeopardized or lost a job or relationship due to gaming.

Have concerns: The Behavioral Wellness Group is here to help. Contact our Intake Department at 440-392-2222.

____________________________________________________________________________________

1 Munzer, Tiffany, Parga-Belinkie, Joanna, Matile Milkovich, Libby, Tomopoulos, Suzy, Ajumobi, Taiwo, Cross, Corinn, Gerwin, Roslyn, Madigan, Sheri, Council on Communications and Media (2026). Digital ecosystems, children, and adolescents: Policy statement. Pediatrics (2026) 157 (2): e2025075320.

2 https://choc.org/medical-staff/pediatrics/katherine-williamson-md

3 American Psychological Association (2019, December 12). Digital guidelines: Promoting healthy technology use for children. https://www.apa.org/topics/social-media-internet/technology-use-children.

4 American Psychological Association (2023, May 9). Health advisory on social media use in adolescence. https://www.apa.org/topics/social-mediq-internet/health-advisory-adolescent-social-media-use

5 American Psychological Association (2020). APA Resolution on Violent Video Games: February 2020 Revision to the 2015 Resolution. American Psychological Association. https://www.apa.org/about/policy/resolution-violent-video-games. Pdf.

6 American Academy of Child and Adolescent Psychiatry, (2015, updated/accessed). Screen Time and Children, Facts for Families, No.54. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post KIDS, TEENS, AND SCREEN TIME:WHAT’S THE LATEST NEWS appeared first on Behavioral Wellness Group.

How prevalent is anxiety in children and teens?

Data collected from 2021-2022 in Ohio determined that almost 12% of Ohio children, ages 3-17 had anxiety.¹ The Center for Disease Control (CDC) data from 2022-2023 found that an anxiety disorder was found in 2.3% of children ages 3-5, 9.2% of children 6-11, and 16% of children 12-17.²

What are the types of anxiety in children and teens?

Separation Anxiety Disorder: As referenced earlier, separation anxiety (not disorder) is a normal developmental phase. Separation Anxiety Disorder is extreme and continues beyond the typical developmental period. Kids may be worried about parents or other family members and have difficulty going to school or being away from home or may have difficulty falling asleep. If your child shows extreme distress with separations that is a sign to seek professional help.

Specific Phobias: Fear when in danger is good, fear helps us to survive. Specific phobias are extreme fears that are out of proportion with an actual threat of danger. A thunderstorm becomes a fear of a tornado, or any other circumstance that becomes catastrophized and blown out of proportion. For example, an intense fear of insects, a fear of elevators, escalators. Sometimes a child or teen will say “What if” this or that happens.

Social Anxiety: This is an intense fear of being judged or rejected in social situations. A child may avoid interacting with others at school or have a hard time speaking to people.

Generalized Anxiety Disorder: This is excessive worry or fear about a range of different things that happen in daily life. A child worries about the future more than other children.

Panic Disorder:  A panic disorder is a type of anxiety that also has intense physical symptoms like a racing heart, dizziness, feeling like they can’t breathe. A panic “attack” can come without warning and can go away within minutes to hours.

What can I look for if I think my child has anxiety?

• Some kids will say what they are afraid of: “I don’t want to go to school because the teacher might call on me in class?”
• Worry and/or cries more than other kids
• Complaints about being sick; upset stomach, headaches
• Trouble sleeping, nightmares, does not want to sleep alone
• Restless, jittery
• Anger easily
• Difficulty focusing
• Shaking
• Refusing to go to school
• Uses the bathroom a lot

What causes anxiety?

Some kids are just more sensitive and might have a hard time coping with change. These kids may have a biological or family tendency to be anxious. Anxiety can also develop after stressful life events such as:

• Death of someone close to them
• Moving to a new house or school
• Poverty: getting enough to eat, difficulty having a safe place to live
• Parents who fight and argue, or separation/divorce
• Abuse/neglect, bullying

Are there complications from anxiety?

Children with an anxiety disorder are at greater risk for depression and substance use disorders later life. There is also a higher risk for self-harm and suicide.

What can I do as a parent?

• The 3-3-3 Rule: Name 3 things you can see. Name 3 things you can hear. Move 3 body parts. This strategy incorporates multiple senses, distracts from the thoughts causing anxiety, and grounds the child in the present moment. Make this playful, practice when not anxious.
• Daily exercise
• A safe and supportive home and school environment
• Good sleep habits
• Well balanced meals
• Monitor screen time and social media
• Teach meditation and breathing techniques: Here are some free apps:

• Anxiety Free: iCan Hypnosis – Developed by hypnotherapist Donald MacKinnon, this app is designed to use self-hypnosis to help teach techniques for relaxation and altering subconscious thoughts.
• Sanvello* – Designed to be used in conjunction with therapy, this app teaches deep breathing and behavioral exercises. Users learn how to identify negative thinking patterns and replace them with positive ones. It focuses on the cause of anxiety and personalizes itself using voice recordings.
• Panic Relief*– This easy-to-use app uses evidence-based coping tools to help calm and safely move through a panic attack. Coping tools include muscle relaxation, rest, breathing and more.
• Self-Help Anxiety Management*– This app for older teenagers and adults focuses on mindfulness, or self-awareness. It helps users understand the causes of their anxiety and aids in monitoring them. It focuses on anxious thoughts and behaviors, and provides exercises to deal with them and private reflection.
• MindShift* – This app for adolescents and young adults teaches basic skills to manage anxiety disorders. It also helps manage performance anxiety, test anxiety and perfectionism. Users can choose among the coping strategies and “favorite” the methods that work for them. It also features a “Chill Out” tool, which uses breathing exercises, mental imagery and mindfulness. “Quick Tips” are included to assist with anxiety in the moment.
• Stop, Breathe & Think- Another mindfulness-driven app, Stop, Breathe & Think uses the foundational methods of meditations. This app allows users to track feelings before and after meditation and view yoga videos. The goal is to offer the chance and skills to breathe and think. Meditations are goal-oriented and constructed to help users calm down.
• Live OCD Free*– For children and adults with OCD, this app is designed to help aid cognitive behavioral treatment. It includes ERP (exposure response prevention) exercises and reminders, and offers personalization.
• Breathe2Relax*– This is an app, by the National Center for Telehealth & Technology, teaches breathing techniques to manage stress. The pace can be personalized for what is most relaxing to the user and includes a map to track personal progress. It helps manage fight-or-flight responses during panic attacks, aids in mood stabilization and anger control.
• Calm – Combining mindfulness and meditation to manage anxiety symptoms, this app is noted for its serene interface. It uses relaxing sounds and guided meditations to help the user stay calm.
• 7 Cups – This app functions as a confidential therapy chat room, allowing the user to talk about problems causing stress or panic, and connect with others dealing with anxiety disorders. It also has hundreds of mindfulness exercises and licensed therapists available.

What about professional help?

There are two main ways to treat child and teen anxiety: cognitive behavior therapy and medication therapy. Both of these treatments may work on their own, but they work better together; “pills don’t teach skills.”

The Behavioral Wellness Group has “one stop shopping” for help with your child or teen. We have therapists skilled in treating kids with anxiety, prescribers for medication, and if needed, an Intensive Outpatient Program (IOP) for Adolescents. Here is the link to our practice.

WEBSITE: https://behavioralwellnessgroup.com/

ADOLESCENT MENTAL HEALTH IOP: https://behavioralwellnessgroup.com/intensive-outpatient-programs/adolescent-iop/

____________________________________________________________________________________

¹ “Ohio Child Mental Health Project: Factors contributing to child and youth mental health struggles.” Health Policy Institute of Ohio, July 2025.

²Child and Adolescent Health Measurement Initiative. (2022-2023). National Survey of Children’s Health. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post ANXIETY IN KIDS AND TEENS appeared first on Behavioral Wellness Group.

How prevalent is depression in children and teens?

While depression was often seen as an adult problem, according to the Centers for Disease Control (CDC) based on data from 2022-2023, an estimated 4% of children between 3 and 17 years old have been diagnosed with depression (3% of males and 6% of females). If teen years are only taken into consideration, according to the National Institute of Mental Health 20.1% of the U.S. population aged 12-17 have had at least one episode of major depression. Depressive episodes were higher in females (29.2%) compared to males (11.5%).

What to watch for:

• Behavior changes that last persistently for at least two weeks
• Mood changes like sadness, feeling “sluggish,” irritability, anger
• Loss of pleasure in previously enjoyed hobbies and activities
• Insomnia or sleeping too much, chronic lack of energy
• Excessive self-criticism or statements of worthlessness: “I can’t do anything right.”
• Persistent hopeless or helpless attitude
• Suicidal thoughts or self-harm (cutting)
• Dramatic changes in grooming
• Unusually erratic or impulsive behavior
• Appetite changes: weight loss or weight gain
• Preoccupation with song lyrics, books, poetry, or art that suggest that life is meaningless
• Physical, digestive complaints

Teenage blues vs. Depression

A good rule of thumb to determine whether a teen is suffering from typical teenage moodiness or something more is to look at how their moods are affecting daily functioning in school, with friends, and family relationships. If you notice a drop in grades, increased isolation-doesn’t want to hang out with friends, spends most of his/her time in their room away from family, there is a cause for concern. A teen who is sad or moody but not really depressed will still go out with friends or participate in activities. If your child is feeling down most of the day for more than 2 weeks and is withdrawing from social relationships and activities he/she once enjoyed, depression could be to blame.

Risk factors for childhood and teen depression

• Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems
• Having been the victim or witness of violence, such as physical or sexual abuse
• Having other mental health conditions such as anxiety, attention-deficit hyperactivity disorder
• Having a learning disability
• Having certain personality traits such as low self-esteem. Or being overly dependent, self-critical or pessimistic
• Being gay, lesbian, bisexual, or transgender in an unsupportive environment
• Having a parent, grandparent or other blood relative with depression, or other behavioral health or substance use problems
• Having a family member or relative who died by suicide
• Having a family with major communication and relationship problems
• Having experienced recent stressful life events, such as parental divorce, parental military service, death of a loved one, break up of a romantic relationship

Need help?

The Behavioral Wellness Group can help with evidence based individual and family therapy as well as an Intensive Outpatient Program for Adolescents:

www.behavioralwellnessgroup.com/intensive-outpatient-programs/adolescent-iop/

Our practice also has medication management for child and teen depression if needed.

Call us for an Intake Consultation at 440-392-2222 to help determine how we can best help your child/teen and family. their financial sacrifices, even if you have student loans, family are making sacrifices for your future.

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post Is Childhood and Teen Depression Different than Adult Depression? appeared first on Behavioral Wellness Group.

The transition to college can be streamlined by categorizing your preparation into actionable, day-to-day strategies.

📚 Academic & Study Habits

• Treat study as a full-time job: In college, you may only be in class for about 15 hours a week, but you are expected to spend roughly 35 hours studying outside of class. Treat this out-of-class time as a scheduled job. Most college students report studying about 10 to 17 hours per week. However, professors and the U.S. Department of Education expect students to dedicate roughly 2 to 3 hours outside of class for every 1 credit hour, which translates to a recommended 30 to 45 hours per week of total out-of-class study time for a full-time, 15-credit schedule.
• Actual study time varies widely depending on your major, the nature of your classes, and whether you work.
• The Academic Rule of Thumb: According to the CollegiateParent guide, you should budget 2 hours of study time for every 1 unit of a humanities or non-science course, and 3 hours for every 1 unit of a science course.
• STEM vs. Humanities: Students in Engineering, Nursing, or Physics typically study longer—often 20 to 30+ hours a week—while those in certain Humanities or Education majors can average 10 hours or fewer.
• Community Consensus: On platforms like Reddit, students acknowledge a massive discrepancy between faculty expectations and real-world study habits. Many note that heavy-reading classes or STEM lab work drastically push up their hourly totals, while other lighter seminar classes barely require any outside studying at all.
• Always attend class & sit up front: Sitting in the first three rows keeps you engaged and helps your professors learn your face and name.
• Utilize office hours: Your professors’ office hours are the ultimate “cheat code”. Going to ask questions, even if you don’t need help, is how you build relationships that lead to recommendations, research opportunities, and internships.
• Avoid all-nighters: Cramming and pulling all-nighters are highly correlated with burnout and poor academic performance. Break large research papers and projects into smaller, manageable chunks.

🕒 Time Management & Organization

• Adopt a scheduling tool: Whether you prefer a paper planner, Google Calendar, or the Notion app, map out your syllabi, deadlines, and study blocks the first week of the semester.
• Prioritize active studying: Simply re-reading notes or highlighting your textbook is largely ineffective. Test your knowledge using Quizlet flashcards, summarize chapters in your own words, or explain difficult concepts to a classmate.

💳 Financial & Life Skills

• Learn the basics before you leave: Make sure you are comfortable doing your own laundry, maintaining a bank account, and preparing a few simple meals before moving to campus.
• Find student discounts: Shopping with an active university email can save you a significant amount on subscriptions, software, and gear.
• Review legal and medical paperwork: Talk to your family about getting a Healthcare Proxy/Medical Power of Attorney, a HIPAA release form, and FERPA Waiver to ensure they can help you if an emergency arises while you are away at school.

🤝 Social & Campus Life

• Go to the activities fair: The best way to make friends and build a community is by attending your school’s student organization or activities fair during orientation week. Join a few things, then narrow your focus to 1 or 2 core groups.
• Communicate with roommates: Address living and cleaning expectations early. Set ground rules so that your dorm remains a comfortable and safe study and sleep space.
•  Friends: Make new friends by being honest, helpful, and supportive. These friendships will last a lifetime. Take romantic relationships slowly, don’t lose sight of a balance between academic responsibilities and romantic relationships. If a relationship ends, try to end it in a friendly manner. I advise not jumping from one romantic relationship to another. Your reputation is important.
• Greek life: I favor fraternities and sororities that emphasize community service and not “partying.” Don’t follow the crowd; be an independent thinker and evaluate choices carefully.
• Need more support: If extra mental health support is needed contact the college counseling center. Also, The Behavioral Wellness Group has a College Wellness Intensive Outpatient Program. https://behavioralwellnessgroup.com/intensive-outpatient-programs/college-mental-health-iop/

Family Life

As a college student you are semi-independent, sort of a transition into adulthood. Be respectful to your family and have gratitude for their financial sacrifices, even if you have student loans, family are making sacrifices for your future.

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

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• Skills training works very well online– With DBTs structured approach-mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance skill sets- all fit naturally into a video format.
• Group participation is often stronger– Many clients feel more comfortable speaking from their homes; this can help people open up sooner.
• Fewer missed sessions– No commute, fewer barriers to attending, easier scheduling that leads to better attendance, one of the strongest predictors of success.
• Privacy- For some people logging in from home reduces the anxiety of walking into a new building and sitting in a new waiting room.
• VIRTUAL DBT IOPs ARE NOT A ‘LIGHTER’ VERSION OF THE REAL THING. THEY ARE THE SAME TREATMENT DELIVERD IN A MORE ACCESSIBLE WAY.

Virtual IOPs Are Just as Effective as In-Person Care: What BWG Research Shows:

The research compared patient outcomes from BWG’s pre-COVID, in-person DBT-based IOP (2019) with outcomes from the rapidly adapted virtual IOP provided in 2021. The programs used the same core curriculum, facilitators, and interventions—only the delivery format changed. This research was conducted by Licensed Psychologist, Dr. Barbara Ballash, who specializes in CBT and DBT.  

• Key Finding: Virtual IOPs Are Equally Effective
• Using validated screening tools for depression and anxiety, the study found no significant differences in symptom improvement between the in-person and virtual groups. In other words:
• BWG’s virtual IOP produced the same clinical gains as the traditional in-person IOP, even among individuals with serious mental illness.

How This Study Fits into the Larger Evidence Base

                  –Recent research aligns strongly with BWG’s findings   

• Telehealth IOPs show comparable outcomes to in-person programs, including similar reductions in depression, anxiety, and substance-use symptoms (Contreras-Schwartz et al., 2024; Bulkes et al., 2021).
• Attendance and completion rates are often higher for virtual IOPs, likely due to fewer logistical barriers (Waite et al., 2022)
• Virtual IOPs show equal improvements in depression, anxiety, and emotion dysregulation compared to in-person programs.
• Studies report high retention and satisfaction with telehealth DBT groups.
• Telehealth DBT is effective for individuals with complex needs, including SMI and chronic emotion dysregulation.

Bottom line:
Virtual DBT IOPs deliver the same outcomes as in-person care — with added flexibility that helps more people stay engaged and get better.

Please contact me with any questions about the virtual DBT IOP.

Cathryn E. Knezevich, M.Ed., PCC
Therapist and DBT IOP Director
The Behavioral Wellness Group
8224 Mentor Ave #208     Mentor OH  44060
P:  440 392 2222 #304    F:  440 565 2349
cknezevich@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post Why Choose A Virtual IOP? appeared first on Behavioral Wellness Group.