Editor’s note: All names of the children in this story have been changed to protect their identities.
At the age of 7, Heather said she hated herself.
Kevin had been moved from foster home to foster home, was sexually abused and witnessed scenes of domestic violence. His behavior at school alienated him from everyone else, and he lacked all familial support at home.
In high school, Steve has struggled with anxiety significant enough to prevent him from speaking in public, socializing with friends on weekends, going out on a date or volunteering in class. Because it affects certain required coursework, it may keep him from graduating.
What do these three have in common? They are all students in Lincoln Public Schools.
In his recent book "Far From the Tree," Andrew Solomon wrote about children who were different from their parents in a significant way: those who, in lieu of inheriting “vertical identities” from their parents, instead possessed "horizontal identities” – or identities they shared with others, be it a disability, a condition or giftedness.
"Our parents," Solomon wrote, "are metaphors for ourselves: we struggle for their acceptance as a displaced way of struggling to accept ourselves."
While Solomon focused on the family, educational professionals play an important role for children with disabilities or with mental health difficulties – and sometimes the only place kids can get the help they need most is in school.
Jeff Melvin and Reed Hindmand are two such educational professionals. Both are psychologists with doctorates who have researched the difficulties children face in school, and both are part of Lincoln Public Schools’ effort to improve its students' mental health.
As a child, adolescent and family psychologist, Melvin has been in private practice in Lincoln since 1992. For the last five years, as well, he has worked with students through LPS.
For Melvin, helping kids with anxiety can be the most rewarding. "I like working with those kinds of kids," he said, "because there are things you can change and see success."
Quite a few of his teenage clients, including Steve, struggle with anxiety. These types of issues, Melvin said, usually respond best to talk therapy.
Hindmand, who has been working in LPS as a school pyschologist for more than 15 years, has found that therapy can go a long way.
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"Just knowing that an adult in their world really cares about them and believes that they can succeed can be a huge support for any student, but particularly those that are struggling with life issues," he said. Therapy helps "manage their problems and emotions both inside and outside of school."
For Steve, a patient of Melvin's, anxiety affects nearly every part of his life – and in virtually every social situation. He can't apply for jobs because the interview process is too daunting. "Steve has trouble accomplishing things in his life that other teenagers take for granted," Melvin said.
Anxiety is often confused as a problem that can be thought away – that just "relaxing" can do the trick.
"The most frustrating thing about it is that often these kids can't help themseves," Hindmand said. "It's not conscious or on purpose. They can't control it."
Anxiety can also affect children who may not respond as well to talk therapy – such as children with autism. Autistic children face specific problems adjusting to new routines.
"Starting a new school year can be very anxiety-inducing for kids with autism," Melvin said. "Everything is different."
While children with autism may often act out, it is usually more clear what they are doing. It's more difficult to diagnose and help kids like Kevin, who was referred to Melvin by school counselors for lying, impulsivity and passive-aggressive behavior, among other issues. With help, it became clear Kevin's issues in school were not a function of his excuses – which included that teachers were not "teaching correctly" and that he was "dumb" – but instead of his overall mental health.
Frequently, children with Attention Deficit Hyperactivity Disorder (ADHD) also act out. Kids with ADHD have difficulty with motivation and with starting and finishing tasks.
Heather, for example, was diagnosed with ADHD initially, Melvin said. More recently, she has been diagnosed with Disruptive Mood Dysregulation Disorder, a newly recognized disorder that is characterized by frequent, severe outbursts grossly out of proportion to a given situation. From a very young age, Heather was defiant, extremely disrespectful, impulsive and often destructive of property. Because of her behavior, she had to be frequently isolated from her peers.
Ultimately Heather, like Steve and Kevin, is on the road to betterment: she is now mainstreamed and no longer has to be isolated. The best hope for positive change, Melvin said, is usually only accomplished by a collaborative effort. Not only must the school provide support, but parents and physicians must as well. Both Melvin and Hindmand agreed that early invervention is critical.
"It's a challenging profession," Melvin said. "If you're not able to separate your personal life from your clinical life, it can really drag you down and cause trauma vicariously. If you didn't have some successes, there is just no way you could keep going."
Fortunately, both have had their share of successes – and only hope to continue that in the future.