All posts by Dr. Christopher Thurber

13 Reasons Why – What You Should Know – Suicide Prevention

If you suspect that an individual is considering suicide, contact:
National Suicide Prevention Lifeline 1-800-273-TALK (8255).

The effects of suicide are not limited to those who die. Suicide is a serious public health problem that has shattered the lives of millions of individuals, families, and communities nationwide. We can all act to reduce its toll.

Everyone has a role in preventing suicide. Suicide is not inevitable. Evidence shows that providing support services, talking about suicide, reducing access to means of self-harm, and following up with loved ones are just some of the actions we can take to help others.

Facts

  • Suicide is the 10th leading cause of death among Americans.
  • More than 44,000 people died by suicide in 2015.
  • More than 1.4 million people reported making a suicide attempt in the past year.
  • Almost 10 million adults reported thinking about suicide in the past year.
  • Most people who engage in suicidal behavior never seek mental health services.
  • Suicide is a serious global public health problem. More than 800,000 people worldwide die from suicide every year.

Know the Risk Factors

Although suicide can affect anyone, the following populations are known to have an increased risk for suicidal behaviors:

  • Individuals with mental and/or substance use disorders and individuals with medical conditions
  • Individuals bereaved by others’ suicide
  • Individuals in justice and child welfare settings
  • Individuals who engage in nonsuicidal self-injury and those who have attempted suicide
  • Individuals who are lesbian, gay, bisexual, or transgender (LGBT)
  • Men in midlife and older men

Warning Signs of Suicidal Behaviors

You can play a role in preventing suicide by being aware of the warning signs of suicidal behaviors:

  • Talking about wanting to die or kill themselves; feeling hopeless, trapped, or in unbearable pain; being a burden to others
  • Looking for a way to kill oneself
  • Increasing the use of alcohol or drugs
  • Acting anxious, agitated, or reckless
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

What You Can Do

If you believe someone is at risk of suicide:

  • Ask them if they are thinking about killing themselves. (This will not put the idea into their heads, or make it more likely that they will attempt suicide.) Take seriously all suicide threats and all suicide attempts. A history of suicide attempts is one of the strongest risk factors.
  • Keep Them Safe – Remove any objects that could be used in a suicide attempt; if possible do not leave the person alone.
  • Be There – Listen without judgement and with compassion and empathy.
  • Help Them Connect – Help them connect to a support system – family, friends, clergy, coaches, coworkers, therapists; or reach out to the National Suicide Prevention Lifeline
  • Follow Up – Make contact in the days and weeks after a crisis. Check-in regularly.

Suicide Prevention Resources

National Suicide Prevention Lifeline
Provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. Learn more.

HelpGuide
Feeling suicidal means that a person has more pain than they feel capable of coping with. Help is available. Don’t wait: Reach out. Learn more.

National Institute of Mental Health
Resources for you if you know someone in crisis. Learn more.

Suicide Prevention Resource Center
Resource center devoted to advancing the national strategy for suicide prevention. SPRC is funded by the U.S. Department of Health and Human Service’s Substance Abuse and Mental Health Services Administration (SAMHSA) under grant no. 1U79SM062297 and is located at Education Development Center, Inc. Learn more.

Crisis Text Line
Free 24/7 support for those in crisis. Text 741741 from anywhere in the USA to text with a trained crisis counselor. Learn more.

SOS
The Signs of Suicide Prevention Program (SOS) offers a 90-minute online course for non-mental-health professionals and unlicensed counselors. The course is called Plan, Prepare, Prevent: The SOS Signs of Suicide®. Learn More.

JED Foundation – Get Help Now
JED’s Mental Health Resource Center provides essential information about common emotional health issues and shows teens and young adults how they can support one another, overcome challenges, and make a successful transition to adulthood. Learn more.

American Foundation for Suicide Prevention – Support
Dedicated to saving lives and bringing hope to those affected by suicide, AFSP creates a culture that’s smart about mental health by engaging in the following core strategies: (1) Funding research, (2) Educating the public, (3) Advocating for public policies in mental health and suicide prevention, (4) Supporting survivors. Learn more.

The Trevor Project
Founded in 1998 by the creators of the Academy Award®-winning short film TREVOR, this project is a national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender and questioning (LGBTQ) young people ages 13 to 24. Learn more.

Depression and Bipolar Support Alliance
Provides hope, help, support, and education to improve the lives of people who have mood disorders. Learn more.

Active Minds
A nonprofit organization that empowers students to speak openly about mental health in order to educate others and encourage others to seek help. Information, leadership opportunities, and advocacy training to the next generation. Learn more.

Anxiety and Depression Association of America – Find Help
A guide to the treatment of anxiety, depression, OCD, and PTSD; resources for support; and tips for helping friends and relatives. Learn more.

APA American Psychological Association – Help Center
An online consumer resource featuring information related to psychological issues affecting your daily physical and emotional well-being. Refer to our fact sheet series to learn how psychologists can help. Learn more.

ANAD – National Association of Anorexia Nervosa and Associated Disorders – Get help
Anorexia Nervosa and Associated Disorders resource page. Learn more.

Mental Health America – Finding Help
Mental Health America resource page. Learn more.

To Write Love on Her Arms
A nonprofit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury, and suicide. TWLOHA exists to encourage, inform, inspire, and also to invest directly into treatment and recovery. Find resources by state.

Didi Hirsch Mental Health Services – Suicide Prevention Center
Includes Spanish and Vietnamese assistance. Learn more.

Find local support and treatment options: https://startyourrecovery.org/treatment.

Favorite Things To Do With A 3×5 Card

My Three Favorite Things to Do with a 3×5 Index Card

This time of year, I use a lot of 3×5 index cards to prop up the legs on LCD projectors. In the past, I’ve used them to shim stair treads, prop doors open, jot to-do lists and outline articles. The humble cardstock rectangle can also serve some powerful educational functions, three of which I’d like to share with you.

#3 The Bunk Nametag

The infamous Name Game has many variations, all designed to increase familiarity among campers and staff. Most staff work hard to memorize their campers’ names, hometown and personal detail. These get-to-know-you practices are a great way to help kids feel comfortable and at home.

However, the children themselves are less motivated to learn names and deets. Most of them want to, but their mnemonic strategies are typically unsophisticated and they become embarrassed asking one other, “Tell me you name again.” For staff, it’s our job. But for campers, they simply revert to “Hey, kid!” to get one another’s attention.

Having grown weary of the impersonal “Hey, kid!” imperative and wanting groups to feel more like families, I initiated the camp-wide practice of having campers block print their first name, home town, year at camp and favorite movie on a 3×5 index card. Each cabin has a stack of cards, a box of washable markers and little bag of push pins. Campers complete their cards as soon as they move in to the cabin and quickly learn each other’s names.

The ever-versatile Index Card. Used wisely, it can build a sense of belonging, cure homesickness, and keep you grounded. Who knew?

A customized, hand-made name tag also serves to personalize one’s space and cabin leaders set a good example by posting one as well. It’s a great way to increase feelings of belongingness and familiarity. Day camps can mimic the practice, except the 3×5 cards get attached with tape or poster tack to children’s lockers or cubbies. Say goodbye to the days of sheepishly asking—or simply not asking—people to repeat their name.

#2 The Adjustment Calendar

All people missing something about home when they are away. The added challenges for young people include: little previous experience away from home, underdeveloped coping strategies and an inability to make an abstract concept, such as time, concrete.

To diminish the potency of these risk factors—and therefore the intensity of homesickness—I am always reminding parents to arrange practice time away from home before opening day. I also spend a good amount of time teaching staff how to coach campers on the most effective coping strategies. However, it’s the staff themselves who must help youngsters keep time in perspective.

To help a young homesick camper keep time in perspective, I’m fond of pulling out a 3×5 index card and making a grid that represents the days of their stay at camp. Each row of seven boxes represents a week; each column a different day.

I anchor this homemade calendar with opening day and closing day and then landmark it with upcoming special events, opportunities to do their favorite activities and other experiences to look forward to. I then reiterate how lucky they are to have the opportunity to attend camp and give them the card to begin crossing off days. The homesickness-reducing effect of concretizing time is almost magical.

#1 The Humility Reminder

Someone once asked Mary Pipher, the author of Reviving Ophelia, the secret to a long, happy marriage. She replied that she’d learned nuptial longevity from her mother, who had been married to her father for more than 50 years.

“I was having coffee with my mom one morning,” Pipher recounted when I met her. “After a soothing silence, I remembered that the following week was my parents’ 50th anniversary. ‘Mom,’ I asked, ‘how have you and dad stayed married for so long?’” As Pipher tells the story, her mother didn’t hesitate before replying. “Easy,” her mother replied. “You need humility. As soon as you think you’re better than your spouse, the marriage is doomed.”

Pipher’s mother continued. “And so, when I get up in the morning, I go into the bathroom, look in the mirror, and read the 3×5 index card that I have tucked in the corner of the frame. It says, You’re no prize either.”

Pipher’s mother’s observation is brilliant because it reconnected her to her humanity, including her flaws. Wise readers might consider following her lead or writing something else on a 3×5 card that keeps goals in focus and arrogance in check.

Your thoughts? Please post your own favorite uses for a 3×5 index card by replying to this post. Check back in a few days to see what others have written as well.

Bullying Redux

Bullying receives a lot of press, especially schools adopt anti-bullying programs and states pass anti-bullying laws. Witnessing school shootings that were, in part, retaliation for relentless bullying may have increased our empathy toward both bullies and their targets, as well as our motivation to change. But tragic events, additions to curricula, and press coverage have all made it seem as if bullying is new. It might surprise you to learn that camping professionals have been taking a systematic, proactive role in preventing bullying since the 1929.  That year marked the publication of Camping and Character: A Camp Experiment in Character Education.

In Camping and Character, authors Hedley Dimock and Charles Hendry reported on the results of a multiyear study conducted at Camp Ahmek in Ontario. The study sought to uncover the changes evidenced in campers’ behavior during six weeks at camp, and to understand the mechanisms behind those changes. Among the more than 50 behaviors the authors tracked was bullying. Dimock and Hendry recognized that even small increases in bullying behavior needed to be addressed by the camp leadership. They were also encouraged by huge increases in many prosocial behaviors in youngsters. My favorite is: “Making friendly approach to [an] unlikable boy.”

Nearly 80 years later, what are the most important things we’ve learned about bullying? The answer has four parts. First, bullying itself is only half the picture. For every bully, there is at least one target. Second, bullying is cyclic. A recent study by the Center for Disease Control confirmed that about three quarters of bullies are also targets and about three quarters of targets turn around to bully another child. Third, bullying is social. Antisocial, to be sure, but it represents a dynamic, complex, interaction whose origins lie in unhealthy relationships.   Therefore, the solutions lie not in simple punishment, but in the formation of healthy relationships. And finally, there are often bystanders; onlookers who have the power to say something. “Hey, that’s not cool” or “Dude” or “Lay off” or “C’mon” are examples of benign-sounding comments that have the power to derail nascent bullying.

Camps are uniquely suited to deal with bullying because they are such healthy social environments. At camp, leaders supervise children and have opportunities to educate bullies and targets. Leaders can teach the kinds of prosocial behaviors Dimock, Hendry, and their pioneering predecessors saw so often at camps. This is easier to do than most people think, partly because bullying is so often a misguided attempt to make a social connection. If you can teach a bully how to make a social connection without using coercion, threats, or violence, you have actually met that child’s needs instead of simply punishing his or her misbehavior.

Specifically, camps help children in the following ways:

• By having the camp staff set a sterling interpersonal example for all children to follow.

• By seeing beyond the bully alone and including his or her target, plus any bystanders, in an intervention.

• By strengthening bullies’ fragile sense of themselves by providing opportunities for authentic achievement and human connection in various athletic or artistic domains.

• By teaching bullies to make social connections through healthy interaction. We all want to belong to a group…it’s just the bullies go about it in antisocial ways.

• By teaching targets to stand up to bullies in ways that makes bullying unrewarding.

• By setting, early and often in the camp session, strict guidelines for kindness and generosity…and then heaping on the praise when staff witness prosocial behaviors.

• By providing the kind of close supervision that allows both bullies and targets to replay unacceptable or unassertive interactions under the guidance of experienced adult staff.

• By deliberately creating a culture of caring that is perhaps different from school or the neighborhood at home…and then immersing children in that culture.

• By allowing positive peer pressure to exert itself such that children feel appreciated and rewarded for gentleness, honesty, kindness, and unselfishness.

Camps are not a bullying panacea. Outside of camp, there are powerful forces, such as violent media, that infuse children with the notion that violent, even lethal solutions to vexing social problems are both effective and glorious. Nevertheless, camp is a powerful, positive force for change.  Educating bullies, targets, and bystanders is just one of the many ways camp enriches lives and changes the world.

So next time you’re talking with a parent about how your camp handles bullying, provide a better answer than “We don’t tolerate bullying.” Instead, explain how your staff is trained to help children make friends. That is the single best way to prevent antisocial behavior. Give everyone a sense of belonging.

Then, explain how you use a combination of pre-season online training and in-person on-site training to train your staff to spot bullying, teach prosocial behaviors, encourage bystanders to be “upstanders,” and give opportunities for bullies to make amends.  One of the best online training options is ExpertOnlineTraining.com which includes a library of video training modules that I created for summer camp staff and youth development professionals.

There will always be some kinds of egregious misbehaviors that require expulsion from camp, but most instances of bullying are below this safety threshold. Showcase the strength of your camp by outlining how well prepared your staff is to prevent bullying and respond thoughtfully when it occurs.

Take the Pizza Test – There's Just No Limit to Kindness

The tastiest mouthful of any pizza is the first bite of the first slice. You’re hungry. You’ve been anticipating that mouthwatering goodness for an hour or more. Your taste buds are eager and alive. All this perfect pre-pizza preparation transforms ordinary melted mozzarella and pedestrian pepperoni into a sumptuous symphony of gustatory glory.

Ok, it’s not exactly the 4th of July in your mouth, but that first bite of a well-made pizza is pretty tasty. What’s wrong with a little hyperbole when you’re talking about happiness, right? Nothing, really, except that pleasures are short-lived. And they have a satiety point. It is possible to have too much of a good thing. Therein lies the value in distinguishing between what positive psychologists call “pleasures” and “gratifications.”

As we all know, the yumminess quotient for pizza (a pleasure) begins to diminish after that first slice. You may help yourself to another couple slices, but if someone forced you to keep eating, even the hungriest among us would eventually experience eating pizza as aversive. Indeed, if you were forced to woof down several large pizzas, you’d eventually throw it all up. There’s an image we could all do without. But it’s a powerful reminder of the limits to pleasure.

Gratifications, on the other hand, never turn the corner from enjoyable to excruciating. If you hold the door open for someone who is carrying an armload of books, your act of kindness feels good. If another person needs a hand a few minutes later, your unselfish assistance feels just as good. At no point would you say—to that 10th person who needed help—“I’m sorry. I’ve done so many acts of kindness today that I feel nauseated. I’m literally sick of helping.” Holding the door for someone is therefore quite different from eating pizza. There is no satiety point for gratifications, such as unselfish behavior.

What do we do now, armed with a new understanding between pleasure and gratification? According to research, both make contributions to happiness. But because gratifications have no satiety point, they make more reliable contributions to our well-being and the well-being of others than do pleasures. No surprise there. What might surprise you is what research suggests is the most powerful form of gratification: Tapping into one of your signature strengths in service to others.

Here are the 24 character strengths that exist across cultures:

Curiosity             Love of Learning            Critical Thinking

Ingenuity            Social  Intelligence         Perspective

Bravery              Diligence                        Honesty

Kindness            Loving/Be Loved            Enthusiasm

Citizenship          Fairness                         Leadership

Self-control         Prudence                       Humility

Hope                  Gratitude                        Forgiveness

Spirituality           Playfullness                   Appreciation of Beauty

Take a minute to scan this list and discover which two or three character strengths jump out as most characteristic of you. Then ask yourself, What are some things I do each week to exercise this strength? And an even more powerful query, How do I use this character strength in service to others? For example, you might say that bravery is a character strength and that when you teach your lifeguarding class, you model bravery and encourage bravery in others.

Lost in our consumer culture is the recipe for authentic happiness. That’s nothing new, of course. Socrates said, “He who is not contented with what he has, would not be contented with what he would like to have.” More recently, Henry David Thoreau said, “It is preoccupation with possessions, more than anything else, that prevents us from living freely and nobly.” And in a prescient statement about the evanescence of pleasures, Friedrich Nietzsche said, “Possessions are usually diminished by possession.”

To most youth leaders—especially camp professionals—these aphorisms are intuitive. We enjoy living simply, in nature, as much as possible. But few youth leaders know the way out of the materialism maze. Now you do. It’s free and it feels good. (How many things can you say that about?)

Make the commitment to spend some time with the list of character strengths above and do a little soul-searching to answer the question about the precise ways you tap into your particular strengths in service to others. It’s not only a recipe for authentic happiness, but also a path toward global social advancement. And if you enjoy munching on a slice of pizza while you contemplate saving the world, you’ve passed the test.

Finding Beauty in an Ashtray

“What is it?” asked my cabin leader, gently. We both eyed my clay creation as it emerged from the camp kiln, glazed and cooled. I was 12, so I hadn’t made a something; I’d made an anything. It had just been fun to pinch and push the clay for our hour-long arts and crafts period. Now came the hard part: I needed to identify my project.

“Hmm…” I thought out loud.

Finally, my cabin leader said confidently, “Oh, I see. It’s an ashtray.”

And there it was. The year was 1980, so it was still permissible to make an ashtray. Today, the same object would clearly be a politically correct candy dish or a heart-healthy, hypoallergenic soy nut dish. In any case, it was what it was and there it was. Like most arts-and-crafts projects at camp, it was, more than anything else, an expressive snapshot of my thoughts, feelings, and actions at the time of creation. It was simple and personal. Which is probably why it still sits (sans ashes) on my mother’s writing desk.

Volumes are written about what makes art art and what differentiates art from craft, so instead of writing an essay on aesthetics, I just want to share why I think arts and crafts at camp are so meaningful. In my mind, anything creative and pleasing to the senses can be art. Crafts, on the other hand, are construction skills, often learned through apprenticeship. Naturally, arts and crafts go hand-in-hand. Michelangelo used the craft of stone carving to create pieces of art like David. At camp, children learn crafts such as weaving and woodworking to create pieces of art such as baskets and birdhouses. To what end?

Contemporary conceptualizations of the human mind include the idea of multiple intelligences. (Interested readers can find books by Howard Gardner and Robert Sternberg.) Simply put, we have different domains of cognitive strength—such as mathematical, social, verbal, artistic—and those domains compliment each other. So combining some athletic and social activities at camp with some arts-and-crafts actually feeds kids’ brains. It’s kind of like intellectual cross-training. The trouble with some camp arts-and-crafts programs is they are either marginalized or mechanized.

Marginalization occurs when the leadership at camp fails to create an atmosphere where art is valued. Arts-and-crafts becomes an “uncool” program activity and few campers attend the lame periods that are offered. The campers who do participate are labeled in ways that suggest they must not be athletic, adventuresome, or heterosexual.

Mechanization occurs when the leadership at camp relies on kits rather than creativity. Arts-and-crafts devolves into campers purchasing nearly-assembled moccasins, birdhouses, wallets, etc. The activity periods—if you want to call them that—involve very little activity besides counselors explaining to kids how to interpret the kit’s assembly directions. Creative juices dry up along with the seed for self-esteem: a genuine sense of accomplishment.

At the best camps, arts-and-crafts programs flourish because the leadership recognizes the value of a balanced program of activities—something that includes athletics, adventure, and art. Equally important, these programs flourish because campers are challenged to refine their crafty skills, solve problems, and create new works. The brains and souls of these children are nourished and the camp staff become actively involved in their mission: to nurture positive youth development. And as an added bonus, some lucky parents and grandparents may get an ashtray—I mean paperweight—on closing day.

Coaching Parents On Child Safety

“Will my child be safe at camp?”

Behold the question every parent ponders before and after the camp season. Fortunately, hiring protocols and staff training programs at most high quality camps prevent most people with ulterior or unsavory motives from ever becoming a part of your camp family. Criminal background checks have limitations, but federal law is slowly creating a more reliable system.

The bad news is that every summer, a tiny fraction of the millions of boys and girls who attend camps in North America are either mistreated by a camp staff member during the season or drawn into an inappropriate relationship sometime after. I believe that even a tiny fraction is unacceptable, so I frequently coach parents on the best ways to protect their children. Here is what I share:

(1) I am a tremendous advocate for youth camping. Having worked for decades with dozens of venerable professional camp organizations, I understand what a positive and powerful developmental growth experience camp is for young people. I am also a tremendous advocate of child safety. As a clinical psychologist and waterfront director with two children of my own, I’m probably one of the most safety-conscious people you’ll meet. Indeed, every summer, I bet my staff $1000 that they’ll never catch me in any of our 64 camp boats without a life jacket. I’ve yet to lose that bet. Why? Because most staff at high quality camps follow the rules and lead by example.

Parents owe it to their children to discuss personal safety.

(2) Teach your children about safe and unsafe touch so they understand the difference and could stop and report an inappropriate advance. Even if it happened at camp. I have created a library of video training modules for summer camp staff and youth development professionals, hosted on a website called ExpertOnlineTraining.com. This site provides training to tens of thousands of summer camp staff worldwide, and includes titles such as Safe Touch & Safe Talk, Duty of Care, Active Lifeguarding, and Wise Use of Time Off. The fact is that pre-season online training has become an essential supplement to the on-site training you deliver. Given the choice between highly trained and less highly trained staff, the choice for parents is obvious.

(3) Campers do engage in risky activities at camp, such as swimming, rock climbing, and horseback riding, but wise camp directors ensure that every reasonable precaution is in place to minimize the occurrence of accidents. Those precautions are part of what make risky activities fun, not frightening. Those precautions are also what make parents trust high-quality camps. Naturally, smart parents understand that no camp is accident-free, but when they can see the safety equipment in place, they are reassured. If parents were to walk around your camp while it’s in session—and many do—will they see the lifeguards on duty, see the safety harnesses on the climbers, and see the helmets on the riders?

(4) Sadly, nobody could ever see the potential for inappropriate behavior between a camp staff member and a child. But that invisibility should not stop you from protecting your child from predators by asking the right questions and looking for the warning signs of an unhealthy relationship. Begin by teaching children how to protect themselves from unwelcome or unsafe touch. My Summer Camp Handbook or Norman Friedman’s Inoculating Your Child Against Sexual Abuse both provide detailed guidance.

(5) Search carefully for the right camp. This careful search has many components but the three that most parents neglect are:

a) Finding out whether the camp is accredited and by whom
b) Discussing the director’s education and experience
c) Asking about the camp’s hiring protocols and staff training program.

In these three neglected domains, here’s what I coach parents to verify:

a) The camp you send your child to should be accredited. In the US, this means accredited by the American Camp Association. In Canada, this means accredited by the province in which the camp operates. There are some high-quality non-accredited camps, but you’ll need to personally verify hundreds of health, safety, and personnel standards before resting assured you’ve chosen wisely. Use the ACA’s new Accreditation Standards for Camp Programs and Services as your guide.
b) Your camp’s director should have years of youth development experience under his or her belt and should participate in continuing professional education—such as camp conferences—each year. Find out what their professional credentials are, what conferences or seminars they last attended, and what other camp experience they have.
c) The camp should freely share with you its protocols for conducting required background checks. These could include criminal background checks, but that will only uncover whether a person has been convicted of a felony in the state or province in which the check is conducted. More meaningful is the process of religiously checking a staff member’s references. Finding people who have known the prospective hire well and who have witnessed their work with children is better than verifying whether or not they are not a convicted felon. The camp should also freely share with you its staff training program. Whatever training program a director uses should include modules on appropriate touch, discipline, and communication with children.

(6) Finally, lest a parent’s love and concern for their child evolve into protective paranoia, I emphasize that the personal relationships that form between children and the camp staff are typically wonderful. They are what kids remember most about camp and what they crave during the off-season. These relationships are also the necessary foundation for growth. Without those caring relationships, there can be no increased self-esteem or independence, no growth in social-skills or confidence.

The key to a positive experience at camp is a healthy, nurturing relationship between children and the youth leaders who serve them. For this reason, it is my sincere hope that directors will join me in coaching parents toward safe and healthy camp experiences.