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Archive for Depression

Shadow’s Edge: A Mobile Game for Teens Who Struggle with Chronic Illness

Posted by Gary Yorke 
· November 30, 2018 
· No Comments

 

For young people who struggle with chronic illnesses or emotional challenge, the weight of their trauma is ever-present, yet rarely are they given the opportunity to talk about the dark or scary side of their situations, let alone have a tool to help them move through and grow from their experience.

Enter the Digging Deep Project, with the mission of empowering teens to take charge of their emotional health in fun and engaging ways.

The Project’s newest product, the recently released mobile game, Shadow’s Edge, is designed to build resilience in teens with medical or emotional challenges. Combining psychology and technology, this free app reaches teens with psycho-educational content right where they are—on their mobile devices and playing games!

Shadow’s Edge players are guided through a process of journaling and creative expression, helping these teen players come to terms with their challenges within an immersive, edgy game world.

The quest of the player is to revive Shadow’s Edge, a city that has been decimated by storm.  Through gameplay, teens learn they can rebuild their lives by trusting their feelings and finding meaning in their experience.

Teens struggling with hardship needn’t stay in an isolated or dark world—they have the power to reshape it. They can create beauty where there was once dilapidation: There can be light; There can be colour; There can be hope.

Available for free on the App Store and Google Play. For more information and blog for and by teens visit www.shadowsedge.com.  For parents and professionals, more information on www.diggingdeep.org.

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Categories : Behavior, Conflict, Depression, Feelings, Parenting, Play Therapy Games
Tags : anger, anxiety, board games, childhood stress, counseling games, family roles, feelings, games, Play Therapy, play therapy gams, teens, therapeutic games for teens, therapy games

March Play Therapy Wrap-Up

Posted by Gary Yorke 
· April 2, 2018 
· No Comments

It is easier to build strong children than to repair broken men. -Frederick Douglas

Blog

The internet can be a wonderful source of information and learning for young students, but it can also be a scary place for teens, and a difficult place for parents to monitor.  Fortunately, there are tools to help parents and adolescents.  In this blog about teen cyber-safety, we outline some on the problem areas on the internet, as well as the tools to educate young teens on the dangers of the internet and how to stay safe. Read more here!

Articles

A new study from the School of Communication Sciences and Disorders at McGill University in Montreal, Canada suggests that autistic children benefit from being bilingual. “In the first study of its kind, scientists show that bilingual children with autism spectrum disorders can switch mental gears more easily than those who can only speak one language.” It’s common that autistic children have difficulty transitioning between tasks, and studies shows that being bilingual improves executive functioning. Researchers set out to find if being bilingual could help executive flexibility in children with ASD. Read full article here.

Video gaming among children and adolescents is a much debated topic. Can a person become addicted to gaming? Nancy Petry, a professor of medicine at the University of Connecticut School of Medicine and editor of the journal Psychology of Addictive Behaviors explains gaming disorder, how to identify it, and how to seek help. While gaming disorder effects a very small number of people, gaming as become a very popular pass-time for all ages of players, and it’s important to be aware of potential problems.  Read full article here.

Studies have shown that adolescents who perform non-fatal self-harm are 26.7 times more likely to commit suicide within the next year. Though self-harm is not always performed with suicidal intent, the risks of repeat self-harm and possibly eventually suicide are related and high.  In this article, Molly Walker of MedPage Today highlights studies and statistics on who is more commonly at risk, and what preventative measures can be taken. Self-harm is never simply a cry for attention and should be taken very seriously. Read full article here. 

 

 

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Categories : Autism, Behavior, Depression, Executive Functioning, Monthly Wrap-Up, Parenting, Wrap Up
Tags : child play therapy toys, child therapy toys, childhood stress, counseling games, family roles, feelings, mental health disorders, Play Therapy, play therapy intervention, teens, therapy toys

What are the “Must Have” Toys for a New Play Therapist? By Jennifer Taylor

Posted by Gary Yorke 
· September 11, 2017 
· 1 Comment

Questions about “must have” toys get asked so many times by clinicians new to the field of play therapy.  And, the answers can vary widely.  I’ve given parents some of my favorite toys in the past.

Dr. Landreth’s “Must Have” Toy Categories:

The foundation for play therapy training for a lot of clinicians is Dr. Garry Landreth and Child Centered Play Therapy.  He advises that play therapists include several toys from each of three categories.  Note that this list does not include everything that would fit into each category (they are just examples) and also that you do need everything on any list

Real Life

  • Play kitchens and play food
  • Doctor kits and band-aids
  • Dolls and Dollhouses
  • Animals, Cars, Trucks, People
  • Cash Register and Play Money

Expressive/Creative

  • Art supplies
  • Paint
  • Play-doh
  • Dress Up
  • Puppets and Puppet Theater

Aggressive/Emotional Release

  • Toy guns 
  • Foam swords
  • Rubber knives
  • Rope
  • Soldiers
  • Aggressive puppets or figures (sharks, dinosaur, alligator, etc)

Directive Play Therapists “Must Have” Toys

When doing  more structured or directive play therapy interventions, you usually need things like:

  • Books
  • Therapeutic games
  • Traditional board games
  • UNO cards
  • Playing cards
  • Cooperative Board Games

“Must Have” Elements of a Play Therapy Space

It can be quite easy to find excellent toys everywhere you go.  And Dr. Garry Landreth reminds us all to beware of the urge to get everything.  He says in his book, The Art of the Relationship, “Toys should be selected, not collected.”  

And I created this infographic to summarize my thoughts on creating the perfect play therapy space that you might find helpful.

Reframing The Question

But, I just recently heard it explained in a wonderful way by a colleague, Dr. Jessica Stone, who responded to this very question during a discussion board about the Play Therapy Summit.   She gave me permission to share it with you:

Hi all, I like to take an approach of collecting gems along my way in this field. I am not sure I could identify the one thing my office couldn’t live without. It is complex. Is that my personal favorite thing? Or my client’s? Or the majority of my clients? What comprises a favorite thing?

I believe what we have in our offices needs to be a balance of 1) what is congruent with who we are, what we believe, what our theoretical foundation is, what our space allows comfortably, etc. and 2) what speaks our client’s language, what helps our clients speak, what speaks to our clients, what allows them to experience feeling heard, seen, important, and understood.

I like to take a gem from Maria Montessori and think of the tools in my office as a way of scaffolding within the office. There are items that fit where they are in this moment, items that help them move forward, and items that work when they need to regress a bit.

Sometimes these tools aren’t our preferred or favorite. Sometimes they are. As I look around my office in response to your question I think about the clients who use the majority of the tools in my office on any given day but I also think about that one client, the one who found the tool that meant the most to them and they used it in the most amazing way – whatever that meant for them – Jessica Stone, Ph.D., RPT-S”

As I was packing up my office to move out of the state this week, I found Dr Stone’s words especially helpful.  I usually play loud music when doing tasks like this, but this time, I held each of the toys and remembered the children that used them and how they used them.  It was a mix of joy and sadness as I reflected on all of those shared moments in this specific playroom.

Final Thoughts:

In the end, I would recommend selecting a few items from each of Dr. Garry Landreth’s categories and then considering Dr. Stone’s advice about seeing the value of all the different toys in the playroom. But, know that whatever you have is enough.  As long as you are in the room,  focusing on the relationship with the child and responding in an authentic manner

 

**The post What are the “Must Have” Toys for a New Play Therapist? appeared first on Jennifer Taylor Play Therapy.

 

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Categories : ADHD, Anger, Anxiety, Art Therapy, Behavior, Books, Child Development, Communication, Conflict, Depression, Feelings, Intervention Ideas, Play Therapy, Play Therapy books, Play Therapy Toys, Reader Submissions, Sandplay/Sand Tray Therapy, Social Issues

August Play Therapy Wrap-Up

Posted by Gary Yorke 
· September 1, 2017 
· No Comments

“Men should learn to live with the same seriousness with which children play.” – Nietzsche (philosopher, writer)

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Netflix has released an original show about teen suicide.  13 Reasons Why is about a teen girl who commits suicide and how she choose to share her decision with her peers and family. The show has been praised and criticized for it’s portrayal and highlighting of the tragic issue of teen suicide. If you have a child/teen who has seen, is watching, or is interested in watching the show, Jennifer Taylor has some tips on how to put the fictional show in perspective and discuss with them the key points of the story. Read Jennifer’s full article here!

Articles

Racial tensions in America are high as opposing movements are vying to be heard. It is so important to discuss these matters with your children so they understand what racism is, and how to cope with it. According to Erlanger Turner, Ph.D., children often model adult behaviors, so it is also important to understand your own feelings on the issue of racism, and present ways to cope with disappointment or anger.  Read the full article here!

Adults are no strangers to stress. we face stressors and challenges everyday, and hopefully, we know how to cope and combat that stress. Children also experience stress, but it may manifest itself in as a physical affliction rather than emotional distress. Stress in children is often misinterpreted as illness or bad behavior.  The Psychology Foundation of Canada has some tips and signs to help you identify when a child is stressed. Read the full article here!

As with any publicized violent or traumatic events, it is important to discuss with your children what it means and why it happened. The events in Charlottsville, VA. have sparked many concerns and discussions. LA Times reporter Sonali Kohli discusses tips from professionals about how to broach these difficult topics with your children, and why it is important to do so.  Read full article here!

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Categories : Anxiety, Depression, Feelings, Monthly Wrap-Up, Parenting, Social Issues, Trauma and Grief, Wrap Up

The Parents’ Guide to Discussing ’13 Reasons Why’ With Your Child by Jennifer Taylor

Posted by Gary Yorke 
· August 24, 2017 
· 1 Comment

 Netflix launched a new show at the end of March 2017 called ’13 Reasons Why” that has drawn a lot of buzz in therapy circles and parenting groups.

Like most popular culture, it succeeds at keeping you in suspense enough to watch multiple episodes in a row. In fact, your teens are probably staying up late watching it now (if they haven’t already).

Premise of ’13 Reasons Why’

According to Netflix, the premise of the show is

“After a teenage girls perplexing suicide, a classmate receives a series of tapes that unravel the mystery of her tragic choice.”

So, basically a girl (Hannah) commits suicide but instead of leaving a note, she leaves a series of tape recordings explaining how the other kids at her school contributed to her decision to take her life.

Each of them gets a piece of the responsibility or blame. The show combines snippets of Hannah’s life prior to the suicide with interactions of the remaining students afterwards told from the point of view of her “friend” Clay.

**Possible Spoiler Alert

Criticism of ’13 Reasons Why’

As you might guess, this show has elements that make some parents uncomfortable.  Like most high schools around the country, this school has issues that parents don’t always like seen displayed so graphically.

Among the concerns are:

  • Underage alcohol use & binge drinking
  • Marijuana Use
  • Profanity
  • Sexual Content and Language
  • Homosexuality
  • Sneaking/Lying
  • Violence
  • Bullying
  • Rape
  • AND the big one: the suicide scene

Examples:

The show opens with a typical house party with kids drinking alcohol (one of many alcohol scenes). Later in the show, a girl is raped while passed out from drinking too much. Those who know about it do nothing.

One main character is frequently smoking weed from a bong and is often high at school.

Another group of kids come to the school costume contest dressed in scuba gear and call themselves “muff divers.”

In one scene, characters refer to Hannah has being “DTF” – which for my friends who have not had the guilty pleasure of watching MTV’s Jersey Shore shenanigans means “Down to F@ck”

And don’t forget, there is the rape and then it specifically shows Hannah’s suicide.

Cautions Against “13 Reasons Why’ From Experts

Despite the array of Tweets and the press that says that this show brings positive attention to the topic of suicide, experts are not convinced.  In fact, many of the agencies or foundations that focus on depression, mental health and suicide are concerned that this show sends the wrong message about suicide.

Not The Right Way To Handle Suicide Coverage

This article explains how the show violates nearly all of the recommendations about media coverage for suicide from ReportingOnSuicide.org.  These recommendations include NOT sensationalizing the suicide, NOT talking about the suicide note, AND not describing (or showing in graphic detail) the suicide method.  ’13 Reasons Why’ gets it wrong on all counts.

Not An Accurate Depiction of Mental Health

Moreover, the show fails to address depression or mental health/illness in any significant way. Among the ’13 Reasons’ is not a history of mental health or depression (the most common risk factor in completed suicides). This is especially disappointing given that the executive producer, Selena Gomez, has been quite vocal about her own struggles with anxiety and depression.

Not Helpful For Perpetuating Survivor’s Guilt

Another big complaint is that it perpetuates the belief that the other students are to BLAME for Hannah’s suicide.  While, it does an “okay” job of discussing the concept of survivors guilt, the students involved are mostly more concerned about keeping the story a secret and avoiding any consequences or repercussions.

Can Be A Trigger For People With Mental Health or Trauma

Due to the content, the discussions and images have reportedly been a negative trigger for some people who watch the show.  This is not to say that people who watch ’13 Reasons Why’ will take their life; but more that it can trigger additional feelings of depression, loneliness and hopelessness.

Reasons Why You Might Want To Watch It

This show has prompted a lot of discussion among my therapist friends about the value of watching the show.  There’s really only two main reasons that are cited:

  1. It is helpful to be “in the know” about things that are popular with teens. (That’s the reason that I watched it)
  2. The show can be a prompt for deep and meaningful discussions between therapists and clients and between children and parents.  *Note: I said it CAN BE.  In the actual show, teens and parents failed to have any significant positive discussions about Hannah’s death or the aftermath.But in real life, there have been meaningful discussions about it.

’13 Reasons Why’ Discussion Questions

My recommendation is that if your child is remotely interested in this show, that you watch it with your child.

Really, together. On the same couch at the same time! Then spend some time talking about the key points in each episode.  Because this show is based on Jay Asher’s book of the same name, there are dozens of book club lists with discussion questions available if you look for them.

The Jed Foundation has also released this great list of talking points. 

What Therapists Discuss

If you want discussion questions specifically used by child counselors, you can borrow some of the ones that came up in our discussion board.  Included are:

  1. What impact does Hannah’s suicide have on her parents, the school and her classmates?
  2. Why do you think none of the students discussed the tapes with their parents?
  3. What is the difference between shame and guilt? Which characters feel guilty for their actions and which are ashamed?
  4. What might have happened if Hannah had responded differently to Tyler in the very beginning-could there have been a different butterfly effect?
  5. What could Courtney have done differently or how could she have handled the situation differently rather than throw Hannah under the bus?
  6. Does Hannah’s use of the tapes create risks for additional suicides? How do her actions affect the lives of the people on the tapes?
  7. How does keeping a secret affect people? How do the characters change when they start to talk about or reveal their secrets?
  8. How does the school counselor let the students down? What can you do if an adult doesn’t do their job well or isn’t helpful?
  9. Who can you go to for support when you are stressed? What it is about that person/people that is the most helpful?
  10. Have you ever thought about hurting yourself or taking your life?

AND BONUS – My Favorite Discussion Question of All Time

’13 Reasons Why’ is basically an updated version of one of my most memorable group activities from my Bachelor’s program at the University of West Florida.  I vividly remember being asked to complete “The Drawbridge Exercise” and subsequently being labeled as “oppositional” due to my response.

’13 Reasons Why’ & The Drawbridge Exercise

The Drawbridge exercise tells a story about a woman who is told by her jealous husband not to leave the gates of a castle or she will be “severely punished.’ Shockingly, she leaves.  And, of all places, goes to visit a lover.  On her way back, a gateman is waiting and says if she attempts to cross the bridge, she will be killed. She then returns to the lover for help and he refuses.  She asks several other characters for help and all refuse.  Receiving no help, she returns to the bridge and is killed by the gateman.

The Question is “Who Is To Blame?”

In class, our group was then instructed to assign levels of responsibility for her murder to all of the people in the story that refused to help her, the husband that ordered the murder and the gateman himself.  You are to rank them from 1-6 in order of “most responsible” to “least responsible.”

And that is  a great discussion question for the cast members of  ’13 Reasons Why.’

Who is the most responsible or least responsible for Hannah’s death? Can you rank the characters in order of blame? Are any of them at fault? 

Now, obviously, there is a HUGE difference between homicide and suicide.  I think we can all find it easier to assign blame in a murder.

Nevertheless, the concept that there is someone to BLAME is an ethical question brought up in the show.  In ’13 Reasons Why’ the characters struggle with feeling like  ‘we are all responsible for Hannah’s death” and that “Hannah made the decision to take her life and she is the one to blame.”

It is basically a new age version of “The Drawbridge Exercise.”  And it is an interesting discussion about assigning blame or responsibility for tragedy.

But, back to the drawbridge…

Wondering What I Said?

Remember…I was 19 years old and thought the world was simple.

I said, “The only person responsible for the woman’s death is the gateman.  He is number 1 through 6. Everyone else is zero.”  

My instructor did not like that.  He thought I wasn’t taking the discussion seriously. I was labeled oppositional.

Mental health experts will also disagree with a discussion question that assigns blame to survivors for a suicide.  But, I think it is a good way to bring about a discussion about regrets.   In this YOLO / NO REGRETS world that high schoolers are in, it might be nice to talk about how your actions have consequences, even if you didn’t have bad intentions.

Final Thoughts

Now that I am not 19 (thankfully), I see more gray areas than I did in my college Social Justice class. In therapy there are these things called “duty to warn” and “duty to protect” that hold me responsible for failure to act in cases of potential suicide or homicide or abuse/neglect.

But more than that, I see both sides.  Our actions do have consequences.  Too often we fail to see how we influence others (in both positive and negative ways).  We are ultimately responsible for our own choices, but know this….

HOPELESSNESS is the biggest predictor of suicide.  Without assigning blame, make an effort to do what you can to prevent hopelessness in those around you.

*Not sure when take a suicide threat seriously-read more here. 

See more from Jennifer Taylor here: Jennifer Taylor Play Therapy.

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Categories : Anxiety, Behavior, Depression, Reader Submissions, Self-Esteem, Trauma and Grief
Tags : aggression, anger, child therapy, childhood stress, depression, feelings, mental health disorders, teens

April Play Therapy Wrap-Up

Posted by Gary Yorke 
· May 2, 2017 
· No Comments

“Whoever wants to understand much must play much.” – Gottfried Benn (German physician 1886–1956)

Blog

Thanks to Clair Mellenthin for her submission about spring cleaning. Clearing out and letting go of physical, emotional, and mental baggage can make for a cleaner playroom and a happier you! Check out Clair’s tips to a happier, freer space here!

 

Articles

The Southern Sandtray posted 50 free sandtray directives! These are great ideas for building trays with a variety of topics and subjects. Try some or all of these directives with your clients.

The autism spectrum is very broad and interventions vary dramatically from child to child. two key factor that rings true for all intervention plans is: the earlier the better, and make it a team effort! All parties- parents, teachers, and treatment providers- must be in communication and working together to make the treatment effective. Consistency is key.

According to research done by researchers at the University of Rochester Mt. Hope Family Center and the University of Minnesota Institute of Child Development, children benefit from their mother’s therapy. Research has shown that mothers with depression who participated in interpersonal psychotherapy became better at reading and understanding their toddler’s temperament, essentially making them better parents, while the toddlers became less fussy and angry, making them easier to parent. The relationship thrives which is better for mother and child’s development.

Some pediatricians  have started asking their young patients to complete a questionnaire about depression. Early detection of depression in children and teens is crucial to ensure that they receive the care and support they need. Childhood depression is much more common than healthcare professionals knew in previous years. It is important to recognition of mental illness as well as awareness for physicians to always question and screen for mental illness in their young patients.

 

 

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Categories : Child Development, Depression, Intervention Ideas, Monthly Wrap-Up, Wrap Up
Tags : development, family roles, feelings, mental health disorders, Play Therapy, play therapy intervention, therapy intervention

Cognitive Restructuring for Children By Donna Hammontree, LCSW

Posted by Gary Yorke 
· January 4, 2017 
· 1 Comment

 

calm-girl

 

Cognitive restructuring occurs regularly in the playroom as a child experiences the therapist’s full acceptance. Teaching cognitive restructuring, however, may expedite the process of having a child experience heartfelt self-acceptance.  A useful analogy is that of a school teacher teaching classroom rules. The teacher will allow students to learn classroom rules throughout the first week of school through experience, but prior to that experience, the teacher will verbally share the rules, and may even write them out and post them.

Here are a few ways a play therapist can teach cognitive restructuring:

  • Identify and highlight for the child’s their cognitive distortion while tracking play.

 “You don’t think you can do it.”  (I am helpless or powerless.)

 “So, nobody likes you?”     (I am worthless.)

“Your teacher should do it your way.”     (I should be in charge.)

  • Discuss how what we think affects how we feel and how we act.
  • Use drawings to illustrate:
    1. Take 2 sheets of paper and draw an oval face with eyes on each sheet. Write Thought, Feeling, and Action on each sheet beside each face.    On the 1st sheet, write “I can’t do anything right” beside the word Thought.  Have the child draw a face on the oval showing how the person would then feel.  Then ask the child how a sad person would act and write a short answer for the child next to the word
    2. Next, write the exact opposite of the cognitive distortion (this is a cognitive distortion too!) at the top of this same sheet. For example, “I do everything right!”  The child will agree that this is not true.  Let the child cross out this statement, or put an X next to it.
    3. On the 2nd sheet write, “I do some things right!” Help the child think of some things they do correctly.  Identify the feelings that go with recognizing what they can do, and encourage the child to illustrate the feelings associated with these abilities on the face. Ask the child how this person might act, and the child’s response next to the word “Action.”
    4. This activity can be repeated with the child’s cognitive distortion(s), followed by a rational thought developed by the therapist and child. spacer  cognitive-restructuring-worksheet-1      cognitive-restructuring-worksht-2     cognitive-restructuring-worksheet-3     cognitive-restructuring-worksheet-4

spry-sparrow-book-cover

  • Use bibliotherapy. Spry Sparrow:  From Drab to Fab illustrates how having a negative cognition contributes to feelings of sadness and anxiety.  In the story, Spry compares herself to others and thinks, “I am not good enough.”  Spry’s mother helps Spry identify realistic, positive cognitions.  Heartfelt change occurs for Spry when she accepts the positive thoughts as real for herself.  Encouraging parents to read the book to a child helps the parent understand cognitive restructuring as well.
  • As the child plays, track the new thought as the child practices it behaviorally in session.  For example, say, “Oh, you did that by yourself!  You can do some things!”
  • At the end of the session, meet with the child and their caregivers and discuss the new thought.  Ask the caregiver to reinforce the new thought: For example, when the child plays with a cousin, the caregiver might reflect that the cousin likes the child and ask the child to repeat, “My cousin likes me!  Some people like me!”
  • Games such as Land of Psymon, The Positive Thinking Game, and Positive Thoughts are also fun ways to engage in cognitive restructuring.

landofpsymon       drplaywellpositivethinking      positivethoughts

A cautionary note:  Some children are truly unloved and taught that they do nothing right. In these cases, these interventions may not be appropriate in the early stages of therapy, and will need to be preceded by other interventions. It is also important to note that Cognitive Behavioral Therapy has two parts:  cognitive restructuring and behavioral change.  Children are able to learn new beliefs about the world, their relationships, and themselves by understanding cognitive restructuring.  They will also need to practice new behaviors, reinforced with new beliefs, to experience heartfelt change.

Celebrate feeling happier!

Donna is a Licensed Clinical Social Worker and Registered Play Therapist/Supervisor in private practice, in Savannah, GA. Visit her website: http://www.donnahammontree.com/

 

 

 

 

 

 

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Categories : Anger, Anxiety, Art Therapy, Behavior, Bibliotherapy, Books, Child Development, Communication, Depression, Feelings, Intervention Ideas, Play Therapy, Play Therapy books, Play Therapy Games, Reader Submissions

3 Ways Parents Can Help Depressed Teens Cope at School

Posted by Gary Yorke 
· December 12, 2016 
· No Comments

This article outlines three ways to recognize and help students who may be struggling with depression. It’s so important to get teens the help they need before more than just grades are effected by depression.

“Teenage depression is on the rise, particularly among teenage girls, but mental health treatment among adolescents hasn’t increased at the same rate, a new study suggests. Depression has far-reaching effects on teens’ ability to be successful in school and beyond if not treated, says Dawn Catucci…”

teen-depression

Read the full article here!

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Categories : Article of the Month, Behavior, Depression
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