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Bullying is not just a part of growing up; it's a serious relationship problem that can lead to long-term consequences for young people's mental, physical, and social well-being. In recent years, research has made it clear that bullying affects a large number of children and youth in Canada, and we all have a role to play in creating safe, inclusive spaces where kids can thrive. Whether you're a parent, teacher, coach, or caregiver, you may be wondering how best to recognize bullying, respond when it happens, and prevent it from occurring in the first place. Over the past several months, I’ve had the opportunity to support many young people who have experienced bullying. In this blog, I’ll share some of the key insights and lessons I’ve learned along the way, in the hopes that they might guide others working to support children through similar challenges. What Does the Research Tell Us About Bullying in Canada? Bullying is harmful and far-reaching.  Young people who are bullied are more likely to experience anxiety, depression, and health problems like headaches and stomach aches. Long after the bullying stops, many children continue to carry the emotional impact into adulthood (Pepler & Craig, PREVNet, 2024). Bullying thrives in unsupervised areas . Bullying is more likely to occur in unsupervised areas of the school, such as hallways, playgrounds, cafeterias, and washrooms. Without the presence of adults, children may feel emboldened to engage in aggressive or harmful behaviours, and victims are less likely to receive immediate support or intervention (Craig, Pepler, & Atlas, 2000; Olweus, 1993). Bullying doesn’t stop on its own.  Without intervention, children and teens who bully are likely to continue this behaviour as they grow up, potentially leading to more serious forms of aggression, including dating violence, workplace harassment, and abuse in adult relationships. Bullying affects everyone.  In any given classroom of 35 students, up to 13 may be involved in bullying, either as targets, aggressors, or witnesses. When bystanders step in, the bullying often stops within seconds, but many students don’t know how to safely intervene or may fear making things worse. Fighting back isn’t the answer.  Contrary to the old advice of “just fight back,” research shows that aggressive responses tend to escalate bullying. Instead, teaching children and teens assertive communication and how to seek adult support is much more effective (PREVNet, 2024). For example: If a peer repeatedly teases or mocks a student, children can use a calm, firm voice and say, “ I don’t like that. Please stop ,” or teens may say, “That’s not cool, can you not?”  or “I’m not okay with that.” Then they walk away without feeding the attention. If a rumour is being spread , a student might say to the person involved, “I heard what you said. It’s not true, and I’d appreciate it if you stopped.” Then they can speak with a school staff member or counsellor for support in addressing the situation. When excluded from play, a group project or a social hangout, a child might say, “That’s not fair, I’d like to join too. ” If they are a teen, they can try, "Hey, I’d like to be part of this too. Can we figure something out?” Practicing tone and body language helps the message land without sounding aggressive or passive. If someone makes inappropriate jokes or comments online , a teen can take a screenshot, report it to a trusted adult, and say (in person or text), “That wasn’t okay. I don’t want that kind of stuff sent to me again.” In a group setting where a student feels cornered or ganged up on, they can stand tall, stay quiet, and walk away confidently, then debrief with someone they trust rather than reacting impulsively in the moment. If a peer pressures them into doing something that feels wrong, a simple, assertive response might be: “No thanks. That’s not for me,” or “I’m not getting involved in that.” Bullying is a human rights issue.  According to the United Nations Convention on the Rights of the Child, all children have the right to be safe and treated with dignity. Adults have a responsibility to protect them from all forms of abuse, including peer-to-peer bullying (UNCRC, 1989). What Can We Do? Be proactive, not reactive.  Talk with your children regularly about their social experiences. Ask open-ended questions like, “What happens at recess?” or “Have you seen kids helping each other lately?” Build emotional skills.  Help them practice empathy, emotion regulation, and problem-solving. These are key skills for managing conflict and navigating peer relationships. Model respect and responsibility.  Children and teens are always watching. When adults demonstrate respectful communication and step in when someone is mistreated, kids learn that everyone deserves to feel safe. Teach them the difference between teasing, aggression, and bullying (PREVNet, 2024) . Support all roles in bullying.  Whether a student is experiencing bullying, using bullying behaviours, or witnessing it, they need support. Bullying is a relationship issue, not just a behavioural one. Involve the whole community.  Effective bullying prevention requires partnerships among families, schools, and communities. Programs like WITS and Second Step work best when adults are aligned in their messaging and actions. Below, you’ll find reliable resources and evidence-based tools designed to support your efforts in advocating for, addressing, and preventing bullying. Trusted Resources and Programs 1. PREVNet (Promoting Relationships and Eliminating Violence Network) PREVNet is Canada’s national authority on bullying prevention. With over 130 researchers and 60 partner organizations, PREVNet offers evidence-based tools, publications, and strategies to help communities promote safe and healthy relationships. Website:   https://www.prevnet.ca/bullying 2. Teach Safe Schools This user-friendly resource supports school staff in creating safe learning environments. It offers step-by-step guidance on preventing violence and promoting student well-being through a whole-school approach. Website:   https://www.teachsafeschools.org/ Evidence-Based School Programs Second Step Bullying Prevention Program This program helps students build empathy, regulate emotions, and assertively stand up for themselves and others. It’s widely used across North America and focuses on recognizing, reporting, and refusing bullying in respectful ways. Learn more:   https://www.secondstep.org/ WITS Program (Walk Away, Ignore, Talk it Out, Seek Help) Designed for children in Kindergarten to Grade 6, WITS empowers kids to respond to conflict and bullying using simple, age-appropriate strategies. It also involves schools, families, and communities in the process. Learn more:   https://witsprogram.ca/ A Classic Read Bullying at School: What We Know and What We Can Do  by Dan Olweus. This influential book, grounded in decades of research, laid the groundwork for many of the anti-bullying programs still in use today. Olweus underscores the importance of a whole-school approach and highlights the vital role that consistent adult intervention plays in preventing and addressing bullying. A Helpful Podcast “My Kid is Being Bullied. What Should I Do?”  with Dr. Lisa Damour. This episode explores the difference between conflict and bullying, when adults should step in, and how to support kids in a way that empowers them without making the situation worse. Listen here:   https://drlisadamour.com/resource/my-kid-is-being-bullied-what-should-i-do/ Final Thoughts Bullying is scary and preventable, but it takes all of us, parents, educators, coaches, and peers, to create environments where respect, safety, and inclusion are the norm. By staying informed and using evidence-based strategies, we can protect our children’s well-being and help them develop the healthy relationships they deserve. About the author:  Dr. Juliana Negreiros   is a registered psychologist and the founder of Beacon Psychology Clinic. With over a decade of experience, she is dedicated to supporting children, youth, and their families in building strong relationships and navigating emotional and behavioural challenges. Dr. Juliana collaborates with parents and educators to create safe and nurturing environments where young people can thrive.

The fear of death is a common experience that humans have. It can vary from person to person as they respond to the realization of their own mortality and its inevitability in different ways. Some people may react by being more introspective and questioning about life's meaning and values. Others may respond with denial, avoidance, anxiety, or depression. When such fear becomes too intense, occurs frequently and starts to affect one’s daily functioning, like their ability to sleep, pay attention, or engage in meaningful actions, it may be a sign that this fear has now become a problem. Regardless of whether fearing death has come up in your life or become problematic, it is worth exploring some of its roots as well as the approaches and tools that might help to cope with it if it starts getting in the way. - How does fear of death show up in mental health conditions? Interestingly, fear of death is a common thread present in many mental health disorders. These include specific phobias (such as tanaphobia or agoraphobia), certain Obsessive-Compulsive Disorder (OCD) compulsions (like washing hands, checking to make sure you’re safe or you didn’t leave the stove on), health anxiety and panic disorders. Research has shown that although the fear of death is a central component of these conditions, frequently, this fear is not addressed in the treatment. For example, when engaging in exposure exercises derived from Cognitive Behavioural Therapy (CBT), one might tackle the fear of heights by gradually visiting a building and exposing oneself to higher altitudes within the building little by little. Nonetheless, often, there are no conversations or exposures around the core fear of dying if they were to fall off the building. Thus, asking yourself the question about what the core fear is and addressing the root of the worries can be very helpful and guide the treatment course toward positive results. - What helps us face the fear of death, and what does not ? Research tells us that there are a few factors that contribute to the fear of dying, including early experiences of death, grief and loss, and intergenerational trauma. There are also certain elements that exacerbate them, such as feelings of meaninglessness and isolation. Generally, engaging in avoidant behaviours related to (a) things that remind us of death, such as cemetery, films, conversations, thoughts, and sleep) or (b) things perceived to have an increased risk of death, such as germs, flying, certain foods, or heights can be problematic. In addition, reassurance seeking, hypervigilance to physical sensations and compulsive behaviours (checking, tapping, rituals or repeating phrases) increases the fear of death. Research suggests what helps us face the fear of death is to develop a more neutral acceptance of it. Thus, in addition to making room for thoughts and feelings associated with death, we provide you below with some examples of actions you can take to better manage these worries: 1. striving for achievement and self-esteem (through academics, sports or arts) 2. engaging in health-conscious behaviours (like exercising, wearing sunscreen, sleeping well) 3. participating in activities that offer a sense of meaning (such as volunteering or being in nature) 4. being part of a value-driven movement or cause (e.g., related to religion or environmental initiatives) 5. attempting to build a legacy (like creating a photo album or recording a song) - What are the treatment approaches that work? CBT has proven to be the most effective intervention to treat fear of death. In particular, exposure work, cognitive restructuring, and acceptance have shown to be the treatment components that have the largest efficacy across studies. Below are some examples of each CBT component: 1. Examples of exposure exercises to help people get used to the fear and maybe leave it in the background: Reading obituaries Discussing end-of-life preferences Pretending to organize your funeral (including a music playlist for that day), Visualizing your death (and maybe writing down a story about it) 2. Examples of cognitive restructuring to help thoughts become more realistic and less scary: Targeting unhelpful thoughts such as: “Death will be painful, lonely and scary” Being aware of those thoughts and identifying the thinking traps in place (e.g., catastrophizing, fortune telling, discounting the positive) Asking some of the following questions to cognitively challenge the thought: What evidence do I have for and against that thought? What would you tell a friend to help them if they had that thought? Are you worrying about an outcome that you can't control? Is there any point in this type of worry? What good things would you gain if you gave up the thought? How would your life be different if you didn't believe the thought? Embracing uncertainty and using coping statements. For example: “I can’t predict nor control how my death will be. Regardless of what happens, I will cope with it in the moment surrounded by the people who love me.” Acceptance and Commitment Therapy (ACT) also offers some tools to reframe your relationship with death through acceptance. Below are some ideas to help you make room for these thoughts: Normalize death: engage in open conversations about this with people around you, attend a death cafe , listen to podcast s and watch videos or movies related to death. Lighten attitudes towards death: Play games about death, such as death deck or listen to music on this topic. Reframe the death fear as an opportunity to make the most of the “now”: watch videos or do this interesting exercise: draw a line on a piece of paper, with one end representing your birth and the other representing your death. Put an X on the line to mark where you are right now. Reflect on this image. - Practical tips Focus on creating a meaningful life that is true to your personal values. Remind yourself that the work to overcome death fear isn’t easy. The goal is to create a neutral acceptance of death. Try to make the journey to cope with the fear of death playful and fun! Some of the ways in which this fear can be alleviated are through acceptance, fulfilling relationships, finding or creating meaning, belonging to a larger group (i.e. through religion or sports) or creating a legacy (i.e., writing a book or making a movie). If needed, work with a therapist who can help you gradually face some of these fears and unpack the individual experiences as well as your cultural and personal beliefs that have shaped the way you think of your own mortality. Thanks for reading this blog. I would like to end it with an inspiring quote about this topic: “Life should not be a journey to the grave with the intention of arriving safely in a pretty and well-preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming "Wow! What a Ride!” ― Hunter S. Thompson, The Proud Highway: Saga of a Desperate Southern Gentleman, 1955-1967 About the Author: Diana Franco Yamin is a Canadian Certified Counsellor who holds a Master's in Clinical Psychology and has 9 years of clinical experience in community agencies and hospital settings. S he received training in CBT)for OCD and anxiety at the OCD Clinic at BC Children’s Hospital, where she also coordinated multiple studies, provided individual and group treatment and supervised Ph.D. students. For more information about Diana, please check out her profile . References - Furer, P., & Walker, J. R. (2008). Death anxiety: A cognitive-behavioral approach. Journal of Cognitive Psychotherapy, 22 (2), 167–182 - Menzies, R and Menzies R (2023) Workshop on The Relevance, Assessment, and Treatment of Death Anxiety in Mental Health Conditions. Bespoke Canada Mental Health.

When children and teens face challenges like anxiety, depression, OCD, or other emotional difficulties, it can be overwhelming to know where to turn. Therapy can be a powerful tool in helping them cope and build resilience, but understanding the different treatment options is key to finding the right fit for your family. This article highlights three gold-standard, research-backed therapies  that have been proven effective in supporting children's mental health. While these are among the most widely recommended approaches, other evidence-based treatments may also be beneficial depending on your child’s unique needs. Cognitive Behaviour Therapy (CBT) CBT is one of the most widely researched and effective treatments for anxiety, OCD, depression, and other emotional challenges in young people. It empowers children and teens by helping them understand the connection between their thoughts, feelings, and behaviours. Key Skills Taught in CBT Building Awareness  – Recognizing thought patterns, emotions, and behaviours that influence how they feel and respond to situations. Relaxation Techniques  – Learning strategies such as deep breathing and muscle relaxation to calm the body and reduce stress. Cognitive Restructuring  – Identifying thinking traps (e.g., "I’ll fail no matter what") and replacing them with more balanced, realistic thoughts. Exposure Exercises  – Gradually facing fears in a structured way to build confidence and learn that they can handle difficult situations. Important Note: Exposure exercises are the key ingredient of CBT. While relaxation techniques like deep breathing or progressive muscle relaxation can help slow down the body in stressful moments, they aren’t enough on their own to create lasting change. Real progress happens when kids gradually face their fears or push themselves to do things that feel uncomfortable but are important to them. This helps their brain learn that they can handle challenges and build confidence over time. Tip : Before choosing a therapist , parents should verify their credentials and experience to ensure they are qualified to address their child's specific needs. Also, make sure you ask if they actively include exposure exercises in their work with clients. Acceptance and Commitment Therapy (ACT) ACT is another research-backed therapy based on CBT that helps young people handle difficult thoughts and emotions while focusing on what truly matters to them. Instead of trying to eliminate uncomfortable feelings, ACT teaches kids how to accept, manage, and move forward  in a way that aligns with their values. How ACT Works Acceptance:  Instead of avoiding or fighting uncomfortable thoughts and emotions, ACT helps children make space for them . By accepting these experiences, they can reduce the struggle and learn to navigate challenges more effectively. Commitment:  ACT encourages kids to take meaningful action  based on their values, even when emotions feel overwhelming. This might include: Spending time with family or friends. Participating in hobbies or activities they enjoy. Setting and working toward personal goals. Key Skills Taught in ACT Being Present  – Learning mindfulness techniques to stay grounded in the moment and reduce emotional overwhelm. Values-Based Action  – Identifying what truly matters to them and taking steps toward those values, even when challenges arise. Cognitive Flexibility  – Developing the ability to adapt and respond  to life’s difficulties with openness and resilience. By teaching kids and teens how to handle emotions in a healthy way , ACT helps them build confidence, reduce stress, and stay focused on what’s most important to them. Dialectical Behavioural Therapy (DBT) DBT is a specialized form of CBT designed for individuals who experience intense emotions  that can lead to impulsive behaviours, such as self-harm, suicidal thoughts, or addiction . It’s especially effective for teens who feel overwhelmed and need practical tools  to manage their emotions in a healthier way. Key Skills Taught in DBT Mindfulness  – Helps teens stay present in the moment rather than getting stuck in distressing thoughts. Distress Tolerance  – Teaches coping strategies to handle overwhelming emotions  without reacting impulsively. Emotion Regulation  – Helps teens understand and manage their emotions so they feel more in control. Interpersonal Effectiveness  – Develops communication and problem-solving skills to navigate challenges in relationships. This approach can be life-changing  for teens who struggle with emotional dysregulation and high-stress situations , giving them the skills to build resilience and create healthier coping strategies. What’s Right for Your Child? Every child is unique, and the right therapy depends on their specific needs. While CBT, ACT, and DBT are all highly effective, they work best when tailored to your child’s goals and challenges. About the author:  Dr. Juliana Negreiros   is a registered psychologist and the founder of Beacon Psychology Clinic. For over a decade, she has worked closely with parents to help them navigate challenges and create a supportive environment that fosters healthy development and emotional well-being.

Choosing the right mental health professional for yourself or your family can be overwhelming. With terms like "psychologist," "psychiatrist," "counsellor," "therapist," and "social worker," it’s important to understand the distinctions in training, qualifications, and expertise to ensure you find the right fit for your needs. Each type of mental health professional contributes unique expertise, and their roles often complement each other to provide comprehensive support. Here is a guide to help you make an informed decision. 1. Psychologists (Ph.D./Psy.D.) Psychologists with doctoral degrees (Ph.D. or Psy.D.) undergo extensive training that typically includes 7+ years of graduate education , followed by a supervised practicum, internships, and rigorous licensure exams. In BC, they are regulated by the College of Health and Care Professionals of BC ( CHCPBC)  and must adhere to high professional and ethical standards. What psychologists offer: In-Depth Knowledge:  Psychologists specialize in assessment, diagnosis, and evidence-based treatments for a range of mental health conditions. Comprehensive Evaluations:  They are trained to conduct thorough psychological assessments and provide formal mental health diagnoses, helping create personalized treatment plans. Be aware that in some provinces, like Alberta, individuals with master’s degrees can register as psychologists and transfer their credentials to BC, where they are grandfathered under the title "psychologist," despite not having a Ph.D. 2. Psychiatrists (MDs) Psychiatrists are medical doctors (MDs) who specialize in mental health. Their training includes medical school, followed by specialized residency training in psychiatry. Key features of their expertise include: Medication Management:  Psychiatrists can prescribe and monitor medications, which can be essential for managing certain mental health conditions. Complex Case Management:  They are often involved in treating more severe conditions such as bipolar disorder, schizophrenia, ADHD, and severe cases of anxiety, OCD, or depression. Psychiatrists typically focus on medical management and may collaborate with psychologists or counsellors for therapy-based interventions. At times, they may also provide therapy. 3. Registered Social Workers (MSWs) Social workers with a master’s degree in social work (MSW) are regulated by their provincial Colleges and often work in various settings, including mental health. Their training and experience in mental health can vary, so it’s helpful to ask about that. What social workers offer: Navigating Systems:  Social workers are skilled at addressing family dynamics and connecting individuals to community resources and services. Counselling and Support:  Many social workers also provide emotional support and counselling to individuals and families facing challenges. 4. Counsellors, Therapists, or Life Coach Titles such as "therapist," "counsellor," and "life coach" are widely used, but it’s important to know that in BC, they are not regulated. This means individuals using these titles may not have formal degrees or extensive training in mental health. Some may have completed short-term certifications, online courses, or informal training programs instead of earning recognized academic qualifications. That said, professionals with designations like Registered Clinical Counsellor (RCC)  or Canadian Certified Counsellor (CCC)  typically hold a master’s degree and have registered with their respective associations. These designations provide an added layer of credibility, indicating that the professional has met specific educational and training standards. What can RCC or CCC provide: Counselling for Individuals and Families:  They offer support for concerns like anxiety, depression, and relationship challenges. Accessible Support:  They are often a great option for families seeking counselling services for everyday mental health struggles. Why Does This Matter? Doctoral-level psychologists (Ph.D./Psy.D.) and psychiatrists (MDs) specialize in comprehensive mental health assessment and evidence-based treatments. Meanwhile, social workers and counsellors bring valuable expertise in areas like systemic support, counselling, and navigating community resources, ensuring tailored care for diverse needs. The key is to ask thoughtful questions about a professional’s education, training, and experience while also ensuring you feel a genuine connection with them. This combination will help determine if they’re the right fit for your family’s needs. For more information about what questions to ask, please see our other blog . About the author: Dr. Juliana Negreiros  is a registered psychologist and the founder of Beacon Psychology Clinic. She has dedicated most of her career to supporting young people's learning and mental health, helping them thrive both in and out of school.

If you are reading this blog, you probably want to find the right help for your child. However, knowing what kind of professional is a good fit for you and your family can be challenging, especially given the high number of therapists with variable qualifications available. Therefore, I want to share some MUST questions to ask this professional before committing to therapy. Question#1. Are you specialized in children and youth? If the answer is yes, follow up with additional questions about how many years of experience they have, how much supervision they received before becoming an independent therapist, and the type of approach they use. Typically, the more age-restricted they are in working with young populations, the more specialized they also are. Be aware that if a therapist indicates they work with all ages or couples and families, they may not be considered "specialized in children and youth." Question #2 . What are your qualifications to work with children and youth? In the past few years, the number of counselling/mental health clinics has dramatically increased in the lower mainland of BC, particularly in the Tri-Cities , where our clinic is located. One of the reasons seems to be that getting an online master's degree in counselling in Canada has become easily accessible for many due to its flexibility, minimal enrollment requirements, and short program duration compared to those offered at traditional and more reputable universities. Thus, when looking for a therapist, it will be essential to know: What kind of degree does the therapist hold? Is it a bachelor's only, a master's or a doctoral-level degree? Be aware that terms like "therapist" or "psychotherapist" can be used by individuals with no graduate-level training who obtained some professional certification from a professional college. What type of program did the therapist attend, and from which university (reputable or not)? The Canadian Psychological Association (CPA) sets high standards for accrediting psychology programs and internships in Canada. Therapists who graduate from CPA-accredited programs typically come from well-recognized universities that require rigorous coursework, extensive research, and hundreds of supervised clinical hours to earn their graduate-level degrees. If you're unsure, check the list of CPA-accredited programs to help you make your decision. What kind of supervised practicum and previous work experience does the therapist have? To determine if the professional has sufficient knowledge to work with your child, you must also inquire about their prior clinical experience in the field. Be aware that many recent grads now have an "RCC" or "CCC" designation and little counselling experience. Just looking at their credential titles can be misleading . Important note! In some provinces, like Alberta, individuals with master’s degrees can register as psychologists and transfer their credentials to BC, where they are grandfathered under the title "psychologist." This difference in registration requirements can create confusion about the qualifications expected of psychologists in BC (who require a doctoral degree), potentially misleading the public about a professional’s training. Psychologists, social workers, and counsellors/therapists have different backgrounds and qualifications. To better understand the difference, click here . Question #3. What type of treatment do you offer? This is a crucial question, as evidence-based treatments are much more likely to be successful than talk therapy. Here are three of the gold-standard treatments for children and youth (however, there are more): Cognitive Behaviour Therapy (CBT) Acceptance and Commitment Therapy (ACT) Dialectical Behavioural Therapy (DBT) For specific information about these modalities, please check out this short article . Question#4. Does my child feel connected with you? Beyond finding a qualified therapist, the therapeutic connection is essential for positive results. While therapists have different styles and experiences, feeling heard and engaged and having fun during sessions are important components for successful treatment. Below are a few more points to consider: Does the approach match my child's developmental level? Young children need much more interactive activities than teens. Thus, the younger, the more active and engaging the sessions should be. Does my child feel comfortable opening up ? Warming up to a new person to talk about personal things can be challenging at first. However, if, after a few sessions, your child continues to have a hard time talking or engaging, it might be a red flag. Is the therapist empathic and a good listener ? Of course, therapists need to talk and teach skills during sessions. However, they should also be curious and listen to what you and your child have to say. If you or your child don't feel heard, you may need to give the therapist some feedback. Does the therapist offer parental support or involve the parent in the treatment process? Even though therapists must be cautious and compliant with protecting their clients' confidentially, it is also essential to have some degree of parental involvement (when possible) during treatment to improve communication between the parent and child and for the child to practice strategies and receive support outside of the sessions. The younger the child, the more parental involvement is recommended, as parents can serve as great coaches to help their child manage their emotions and face their fears. Was the therapist recommended through word of mouth ? Knowing other families who had a positive experience with a therapist can be helpful. A quick Google search can also help you gather more background information about a professional before scheduling a consultation call. However, please consider questions 1-3 while doing your research. Final Words Finding the right support for your child can be challenging. Beyond reviewing a therapist’s credentials, areas of expertise, and experience, it’s just as important to consider the connection they build with your child. A good fit often means your child feels comfortable, engaged, and even looks forward to sessions—despite the tough topics they may need to navigate. I hope this blog helps you make an informed decision about which mental health professional you will choose for your child. Warmly, Dr. Juliana NOTE about the author : Dr. Juliana is the clinic director of Beacon Psychology Clinic and a Registered Psychologist passionate about mental health. She works as a clinician, researcher , supervisor , trainer , consultant , and public speaker . Her clinical approach is grounded in research and based on individual and family CBT and ACT. ​

Using the right strategies to manage your child’s behaviour can make everyday routines much smoother and more enjoyable for everyone. Parent Management Training (PMT) is a proven, research-backed approach that helps parents encourage positive behaviours in kids aged 3 to 12. Whether you’re looking to make mornings smoother or calm down bedtime routines, the eight tips below (mainly based on PMT) offer practical strategies to guide your child’s behaviour while also supporting their emotional and social growth. Tip 1. Label and Praise Appropriate Behaviour Instead of focusing on what you don’t  want your child to do, try highlighting and praising the behaviours you do  want to see. Positive reinforcement is a key strategy in PMT because it encourages children to repeat desirable actions. The trick is to use specific, labelled praise. For example, instead of saying “Good job” when your child is not yelling, say, “I really like the way you’re using a calm voice.” The more often you name and praise specific behaviours, the more likely your child will repeat them. Try to limit phrases like “Don’t…”, “No…”, or “Stop…” as these can lead to frustration. Focus instead on using positive instructions and reinforcing your child's strengths. Tip 2. Give Brief and Direct Instructions Keep your directions short and to the point. Use “effective commands” that are simple and clear, avoiding long explanations, as these can cause confusion and make it harder for your child to stay focused. For example, say exactly what you want them to do in a calm, firm tone, and make eye contact when speaking. Examples include: “Put your shoes on, please” instead of "Can you please put your shoes on?" “Look at me when I’m speaking” instead of "Let's look at me when I am speaking." After giving instructions, pause to ensure your child processes what you said before adding more information. This approach helps them know exactly what’s expected without feeling overwhelmed. Tip 3. Set Clear Expectations Children respond well to clear and consistent expectations. Establish simple rules that are stated in a positive way, such as “Treat others with kindness and use polite language” instead of  “Don’t be rude to others” or “Finish your chores before screen time.” Stick to routines as much as possible to provide structure and predictability, which reduce anxiety and misbehaviour. If changes are necessary, give your child a heads-up with a quick “Just so you know, tomorrow we’ll be going to the dentist after school.” Tip 4. Try Not to Yell Yelling often escalates behaviours and makes it harder to manage the situation. If your child is yelling or upset, respond with a calm and firm voice. Model the calm behaviour you want to see. Take a deep breath, lower your tone, and state your expectations clearly. This approach helps reduce power struggles and teaches emotional regulation. Tip 5. Be Consistent and Follow Through on What You Say Being consistent is one of the most important strategies for effective parenting. In PMT, consistency is all about following through on what you say—whether it’s a promised reward for good behaviour — like earning extra screen time for finishing homework— or a consequence for not following the rules — like losing play time if chores aren’t done. When children know you mean what you say, it builds trust and helps them understand boundaries. However, be aware to avoid the "Big Consequence" trap. It’s easy to promise big consequences in the heat of the moment when we’re feeling overwhelmed or frustrated. Statements like, “You’re grounded for a month!” might slip out, but they’re often unrealistic and hard to enforce. When we don’t stick to what we say, it sends mixed messages and can undermine our authority. So, what can you do? If you’re feeling stressed and tempted to make a big statement, try taking a quick break before responding. Use that moment to ensure you’re thinking with your “rational brain” instead of your “emotional brain.” This way, you’ll choose a consequence that’s both reasonable and enforceable. Tip 6. Share Parenting Responsibilities Using the “Tag Team” Approach When one parent feels overwhelmed or needs a break, have a signal for the other parent to step in (e.g., a subtle wave, a code word, or a wiggling pinky finger). This “tag team” approach helps prevent burnout and ensures consistent responses. Supporting each other in this way also models positive teamwork and problem-solving skills for your child. Tip 7. Teach the “I” Message Strategy Help your child express themselves and solve problems using “I” statements:- I feel… (emotion)- When… (describe the problem)- I would like… (desired solution). For example: “ I feel upset when my toys are taken without asking. I would like it if you ask first.” This approach encourages children to constructively express their emotions and needs, reducing the likelihood of acting out. Tip 8. Focus on What You Can Control PMT highlights an important concept: while you can’t control your child's behaviour, you can  control how you respond to it. Instead of asking yourself, “How do I make my child stop doing this?” try reframing it to, “What can I do differently to manage this situation?” This shift in perspective helps you approach challenging behaviours calmly and more effectively. Use Forced Choices to Encourage Cooperation One effective strategy when your child is resisting a request is to offer a “forced choice,” which provides them with a sense of control while still keeping you in charge. For example, if your child is refusing to get dressed, try saying, “You can choose to wear your blue shirt or your red shirt today. Which one would you like?” This technique helps avoid power struggles, reduces defiance, and increases the chance that your child will cooperate because they feel empowered to make a choice. Respond, Don’t React If your child still doesn’t follow through with a request, avoid repeating yourself or raising your voice. Instead, calmly give them one reminder, then step back. If they continue to resist, walk away and apply a fair consequence that was previously discussed, such as losing a privilege or postponing a preferred activity. Staying calm and consistent is key to showing your child that actions have predictable outcomes. All Feelings Are Allowed, But Not All Reactions Let your child know that it’s okay to feel any emotion—they can feel sad, angry, or frustrated—but it’s not okay to express those feelings in inappropriate ways, like yelling, arguing, or hitting. By talking about how all  feelings are okay, but some reactions aren’t, you’re teaching your child that they can take control of how they respond rather than how they feel. To help them handle overwhelming emotions, offer simple strategies like taking a break, using words to say what’s bothering them, or asking for help. This teaches them healthy ways to cope with their feelings. Communicate Consequences in Advance Before challenges arise, be clear about what will happen if your child crosses the boundaries you’ve set. For example, you can say, “If you choose to yell or argue, you’ll need to take a break in your room.” When children know what to expect, it reduces arguments and makes them feel more in control of their choices. Final Thoughts Change takes time, so celebrate small successes and be patient with yourself and your child. Effective behaviour management is about building a positive and respectful relationship while teaching healthy boundaries. You’re not alone on this journey—keep up the great work! If you want to learn more about resources or free coaching on this technique, check out: ​ ​ ​ Confident Parents: Thriving Kids – Behaviour : The Canadian Mental Health Association in BC offers a free coach-based program to help parents support their children aged 3-12 with behavioural difficulties. ​​ Everyday Parenting: The ABCs of Child Rearing  (by Dr. Alan Kazdin): This free course developed by a leader in the field provides a toolkit of behaviour-change techniques that will make your typical day in the home easier as you develop the behaviours you would like to see in your child.  ​ Collaborative Problem-Solving Approach  (by Dr. Ross Greene): Rather than focusing on kids' concerning behaviours (and modifying them), CPS helps kids and caregivers solve the problems causing those behaviours. Beacon Psychology Parenting Resources : This selection of resources is designed to support parents in navigating various challenges and fostering healthy family relationships. About the author:  Dr. Juliana Negreiros   is a registered psychologist and the founder of Beacon Psychology Clinic. For more than a decade, she has worked closely with parents to help them navigate challenges and create a supportive environment that fosters healthy development and emotional well-being for their children.

Creating good habits can feel overwhelming, especially when you’re juggling school, friends, hobbies, work or other responsibilities. Whether it’s improving your study habits, staying organized, or managing everyday tasks, forming habits that stick doesn’t have to seem impossible! Have you heard about James Clear's popular book  Atomic Habits ? This book is full of simple, easy-to-implement tips to help you build habits that actually fit into your busy life. If you don’t have the time or energy to read the whole book, No worries—here’s a quick summary of the key points so you can get started right away! 1. Make Your Habits Obvious One of the best ways to build good habits is by making them super clear and easy to spot. Know Your Good and Not-So-Good Habits : Start by writing down a list of what you currently do each day, from when you wake up to when you go to bed. Make sure you include both the good and bad habits. Knowing your habits helps you figure out what’s working and what needs to change. Create Clear Plans For Good Habits : Be specific, indicating what, where, when, and for how long you will perform the activity. Instead of saying, "I’ll study more," make a clear plan, such as, “I will study (behaviour) for 20 minutes (duration) after dinner (time) at my desk (location).” Instead of saying, “I’ll work out more,” make it specific: “I will go for a 15-minute walk (behaviour) every day after school (time) in the park (location).” Instead of saying, “I’ll eat healthier,” make a clear plan: “I will eat a piece of fruit (behaviour) with breakfast (time) every morning in the kitchen (location) .” Instead of saying, “I’ll sleep earlier,” say: “I will turn off all screens (behaviour) 30 minutes before bed (duration) every night at 10 p.m. (time) and read a book (location: bedroom).” Stack Habits Together : Link a new habit with something you already do (current habit). For example: "After brushing my teeth at night (current habit), I’ll pack my school bag for the next day (new habit).” "After I finish dinner (current habit), I’ll wash the dishes immediately (new habit)." "Once I get home from school (current habit), I’ll immediately do my math homework for 20 minutes (new habit)." "After I finish my workout (current habit), I’ll spend 5 minutes stretching to cool down (new habit)." 2. Make It Attractive If a habit seems fun or rewarding, you’re more likely to stick with it. Pair Fun with Tasks : Combine something you enjoy (reward) with a habit you want to build (habit). For example: “After I finish my homework (habit), I can watch an episode of my favourite show (reward).” "After I finish reading for 20 minutes (habit), I can play video games for 30 minutes (reward)." "Once I clean my room (habit), I’ll go hang out with my friends or go out for a treat (reward)." "After I practice my guitar for 15 minutes (habit), I’ll spend some time scrolling through social media (reward)." Join a Supportive Group : Hang out with friends who have good habits, like a study group or a sports team. When you’re around people doing the same positive things, it’s easier to stay motivated. For example: If your friends are dedicated to studying after school, you’ll be more likely to study, too. If they play sports regularly, it’ll motivate you to stay active as well. 3. Make It EasyBuilding better habits The easier it is to start a habit, the more likely you’ll follow through. Remove Obstacles : Set yourself up for success by preparing your space. For example: Have all your study materials ready at your desk so it’s easy to start homework. If you want to work out in the morning, set out your workout clothes, shoes, and water bottle the night before so you’re ready to go as soon as you wake up. If you want to eat healthier snacks, remove junk food from your room and keep a bowl of fruit or healthy snacks within easy reach. If you want to practice an instrument, make sure your guitar or piano is easily accessible and not tucked away so you can start practicing without the hassle of setting up. Start Small : Don’t try to do everything at once. Start with something easy like “I’ll read for 5 minutes a day.”  Once you’ve built that habit, you can gradually increase the time. Other examples include: “I’ll do 5 minutes of stretching or light exercise each day.” Once it becomes part of your routine, you can increase the duration or intensity. “I’ll study one subject for 10 minutes after school.” As you get used to it, extend the study time or add more subjects to review. “I’ll drink one extra glass of water each day.” Once this becomes easy, you can gradually add more healthy habits, like including a fruit or vegetable with each meal. 4. Make It Satisfying Getting some kind of reward or seeing progress can help keep you going. Reward Yourself : Give yourself small rewards when you stick to a habit. Whether it’s a snack, free time, or a break with friends, rewarding yourself helps reinforce the habit. Track Your Progress : Use a habit tracker or an app to see how far you’ve come. Watching your progress grow can keep you motivated! Final Thoughts Building good habits takes time and patience, but it’s totally possible. Start small, stay consistent, and don’t be too hard on yourself. Even small changes can add up to something big over time. Stick with it, and soon, those habits will become part of your routine!   Dr. Juliana Negreiros   is a registered psychologist and the founder of Beacon Psychology Clinic. Throughout her career, she has worked towards empowering young people by helping them build meaningful and fulfilling lives.

We know that supporting children in developing good habits can sometimes feel overwhelming. Whether it's helping your child keep up with homework, pitch in with chores, or build healthy routines, it can be tough to create habits that stick. However, there is good news! It’s possible to guide your child toward better habits using simple strategies! Based on the principles from Atomic Habits  by James Clear, we’ve compiled some easy-to-follow tips to help your child succeed. 1. Make It Obvious The first step in helping your child build good habits is making those habits easy to see and understand. Notice Their Habits:  Start by writing down what your child does regularly, both the good and not-so-good habits. This awareness is the first step to making changes. You might think about things like: Does my child grab their phone or play video games right after school? How do they start their morning – by brushing their teeth or eating breakfast? Do they tidy up their room or leave things out? Do they get started on their homework right away, or do they tend to put it off? Create Specific Plans : Help your child make clear, simple plans for their new habits by identifying what  they’ll do (the behaviour), when  they’ll do it (time), how long  they’ll do it (duration), and where  they’ll do it (location). Here are some examples: “I will pack my backpack (behaviour) before bed (time) in my room (location).” “I will do my homework (behaviour) right after dinner (time) at the kitchen table (location).” “I will read (behaviour) for 10 minutes (duration) after breakfast (time) on the couch (location).” “I will set the table (behaviour) when mom starts cooking (time) in the dining room (location).” “I will walk the dog (behaviour) at 4 PM (time) around the block (location).” Stack Habits Together : Help your child build new habits by connecting them to something they already do (a current habit). Here are some examples: “After brushing my teeth (current habit), I will put my clothes away (new habit).” “After putting on my shoes (current habit), I will grab my backpack (new habit).” “After turning off the TV (current habit), I will tidy up the living room (new habit).” “After closing my homework book (current habit), I will prepare my snack for tomorrow (new habit).” “After coming home from school (current habit), I will read a chapter in my book (new habit).” 2. Make It Attractive If a habit feels enjoyable, your child is more likely to keep doing it. Here’s how you can make habits more appealing: Pair Fun with Necessary Tasks:  Connect a fun activity with a new habit. For example: “After I clean my room (new habit), I can watch my favourite show (fun activity).” “After I finish my homework (new habit), I can play video games (fun activity).” “After I do 10 minutes of reading (new habit), I can play outside (fun activity).” “After I do my chores (new habit), I can call my friends (fun activity).” “After I practice the piano (new habit), I can play with my pet (fun activity).” Join a Supportive Group:  Encourage your child to be around friends with similar good habits. For example: Join a study group with friends who are motivated to do homework. Sign up for a team sport where regular practice is a habit. Start a reading club with friends where they read together weekly. Spend time with friends who are working on similar school projects. Have a “clean-up challenge” with friends to tidy up their rooms at the same time. 3. Make It Easy The simpler a habit is to start, the more likely your child will stick with it. Reduce Barriers : Make it easy for your child to do the right thing. For example: Set up a study area that has everything they need for homework. Prepare gym clothes the night before so they’re ready to go in the morning. Have a packed lunch ready in the fridge so it’s easy to grab for school. Keep a book next to their bed to encourage nighttime reading. Put a calendar in their room to remind them of upcoming tasks. Start Small :  Begin with small, easy tasks before adding more time or responsibility. For example: Start with 5 minutes of reading at bedtime each day. Review one page of homework before moving on to assignments. Practice 2 minutes of meditation before sleeping. Organize one drawer in their bedroom each day. Write one sentence in their journal each night. Take a short walk after dinner daily. 4. Make It Satisfying Children respond well to rewards and praise, which helps motivate them to keep going. Reward Effort : Praise your child or give them small rewards when they complete a habit. Positive reinforcement can make a big difference! For example: Give them praise or high-fives when they finish their chores. Offer a treat or special activity after a week of completed homework. Allow extra screen or reading time when they finish a task early. Let them choose the family movie night after helping around the house. Create a reward jar where they earn tokens for each habit completed. Track Progress : Use a sticker chart or habit tracker to show your child how far they’ve come. For example: Make a star chart to track completed daily tasks. Use a calendar to mark off the days they practice a skill, like reading. Create a habit tracker with colourful stickers for each goal. Track their progress with checkmarks for every day they clean their room. Use a whiteboard to write down their weekly accomplishments and goals. Final Thoughts Building lasting habits takes time, but with these easy strategies, you can help your child create positive routines that will benefit them—and your family—in the long run. Remember, consistency is key! Even small changes, done regularly, can make a big difference over time. About the author: Dr. Juliana Negreiros  is a registered psychologist and the founder of Beacon Psychology Clinic. She has dedicated most of her career to supporting young people's learning and mental health, helping them thrive both in and out of school.

For most of my career, I have been working with children and youth with Obsessive-Compulsive Disorder (OCD). OCD is more common in students than many realize, affecting approximately 2% of the population. This neuropsychiatric illness often begins in childhood and has significant consequences in students' lives, affecting not only their academic but also family and social functioning. As parents and educators, understanding OCD and implementing effective support strategies is essential to helping these students thrive. Both my PhD and post-doctoral research focused on better understanding how youth with OCD function at school. I spent over 8 years conducting standardized testing and collecting survey data on hundreds of kids with OCD, their siblings, and those without such a diagnosis (called "healthy controls"). This work was extensively supported by the Provincial OCD Program at the BC Children's Hospital and would not have been possible without the outstanding guidance of Dr. Evelyn Stewart. The findings from these studies, along with prior research, highlight several factors that are crucial for understanding and supporting OCD in schools. The Impact of OCD on School Life Students with OCD face unique challenges that can affect their academic performance and behaviour in the classroom. School avoidance, refusal, and lower academic achievement are common (Geller et al., 1998), so it's important for educators to recognize and address these problems quickly. Academic difficulties are often most noticeable in high school, though some improvement might be seen in college (Pérez-Vigil et al., 2018). These students may also struggle with math (Negreiros et al., 2018) and have difficulties with executive functions (Negreiros et al., 2019; Snyder et al., 2015) and social interactions (Storch et al., 2006). Executive function is a set of skills that help our brains get things done, and it's been widely studied in kids with OCD. Many studies show that children with OCD have more trouble with planning, working memory, cognitive flexibility (switching between tasks or thoughts), and inhibitory control (suppressing inappropriate behaviours or responses) compared to their peers. My dissertation research found that both students with OCD and their siblings struggle with planning (Negreiros et al., 2019). Schools and families might consider providing extra support to help these kids achieve their goals. This could include using organizational tools (like planners and automatic reminders), supportive strategies (like breaking tasks into smaller steps and setting priorities), and skill-building exercises (like time management techniques such as the Pomodoro method). Recognizing OCD in the Classroom OCD can manifest in ways that might be misunderstood as daydreaming, misbehaviour, or lack of interest. Students might seem distracted, engage in repetitive behaviours, or appear excessively concerned about cleanliness, order, "bad thoughts," or doing their work in a "just right" way, taking much more time than needed to complete activities or show their true potential. Understanding these behaviours as symptoms of OCD, rather than simple defiance, inattention, or boredom, is the first step in providing effective support. Building a Supportive Environment Creating a supportive environment for students with OCD starts with knowledge and awareness. Educators should familiarize themselves with OCD symptoms and their impact on students' lives. The following resources can be helpful to start the knowledge-building process: Anxiety Canada: https://www.anxietycanada.com/ OCD Education Station: http://www.ocdeducationstation.org/ OCD in Schools from IOCDF: https://anxietyintheclassroom.org/ OCD at School from ADAA: https://www.adaa.org/understanding- anxiety/obsessive-compulsive-disorder/ocd-at-school/hidden-symptoms OCD in Schools Handout that I created for schools: https://www.anxietycanada.com/downloadables/identifying-and-supporting-students-with-ocd-in-schools/ For books, here are some suggestions: Students with OCD: A Handbook for School Personnel (by Adams) Teaching Kids with Mental Health and Learning Disorders in the Regular Classroom: How to Recognize, Understand and Help Challenged (and Challenging) Students Succeed (by Cooley) Teaching the Tiger: A Handbook for Individuals Involved in the Education of Students with Attention Deficit Disorders, Tourette Syndrome or Obsessive-Compulsive Disorder (by Dornbush & Pruitt) Effective Communication and Collaboration Open communication and collaboration between home and school are vital. In fact, one of the studies I led showed that when families disclosed their child’s OCD diagnosis to the school, such disclosure had positive outcomes for their child (Negreiros et al., 2022). Thus, the collaboration between educators, families, and mental health professionals is likely to foster a more understanding and supportive classroom atmosphere. To achieve this, establish a communication system that ensures everyone under the student's care is on the same page regarding their needs and progress. In addition, collaborating with mental health professionals specialized in pediatric OCD to develop individual educational plans (IEPs) can improve the student’s ability to manage their symptoms at school. Practical Classroom Strategies Implementing practical strategies in the classroom can greatly assist students with OCD. Consider using a prearranged signal system that allows students to discreetly indicate when they need help managing their symptoms or need a break. Designating a safe person and a safe place for students to go when they are struggling can provide immediate relief and support. Additionally, providing temporary accommodations, such as extra time for assignments or a quiet space for tests, can help students manage their workload without feeling overwhelmed. If you want to learn more about why accommodations for students with OCD (and anxiety) should be temporary, check out this Podcast, where I provide the rationale for it. Celebrating Progress Finally, it’s important to celebrate the successes and progress of students with OCD. Recognizing and acknowledging their efforts in managing their symptoms can boost their confidence and motivate them to keep striving. Creating a positive and supportive school environment not only helps students with OCD but also enriches the entire classroom community. Last Words Supporting students with OCD requires a comprehensive approach that includes understanding the disorder, fostering open communication, and implementing tailored strategies. By working together, educators, parents, and mental health clinicians can create a nurturing environment that helps students with OCD thrive both academically and socially. Let's embrace the opportunity to make a meaningful difference in these students' lives, ensuring they feel supported and understood every step of the way. About the author: Dr. Juliana Negreiros is a registered psychologist and the founder of Beacon Psychology Clinic. She has dedicated most of her career to supporting young people with OCD and anxiety.

Increasing research has proved that good and consistent sleep is essential for human beings to function. While some believe that closing their eyes for some hours during the night is enough, we know that our bodies need a certain amount of quality sleep to recharge and maintain our well-being. This article will give you the top 5 tips to improve your or your child’s sleep. Modern life brings lots of brain stimulation, distraction, and stress. Having busy and variable schedules, not following a consistent routine, and spending too much time on screens can affect how well we sleep. In particular, some brains have a harder time turning their systems off when it’s time to sleep, which can have many negative consequences. Insufficient sleep negatively affects our mental and physical health, increasing risk-taking behaviour and our ability to cope with stress. In contrast, consistent quality sleep helps us to manage our emotions, regulate stress, focus better, maintain a healthier diet, and manage daily activities. Therefore, it is important for all of us to sleep well. According to the Government of Canada’s website, children aged 5-13 years old should be getting about 9-11 hours of sleep per night. Those aged 14-17 years old need about 8-10 hours, and adults at least 6 hours of sleep every night. However, new research published in November 2023 suggests that having a consistent sleep schedule is more important than getting a certain amount of sleep every night. This means that sleep regularity, or the day-to-day consistency of sleep-wake timing, is better for certain aspects of our health than sleep duration. Below are our top 5 tips on how to make quality sleep part of your routine. Tip 1: Go to bed at the same time and wake up at the same daily, including on weekends, as much as possible. Your body will get used to it, and this will become automatic. The more you maintain similar sleep times between days, the better your sleep regularity and, consequently, the more positive health outcomes you will experience. Tip 2: Practice sleep hygiene. This means establishing simple daily routines and making sure that you have a cozy and comfortable bedroom environment. Thus, create a relaxing space before bedtime to help you doze off. For example, reduce the stimulation in your room by dimming the lights and lowering the noise around you. Also, make sure that the temperature is cool (18-21 degrees Celsius). Tip 3: Avoid ingesting caffeine from the afternoon on (chocolate, coffee, some teas, soft drinks etc.) and stop exercising at least 2 hours before bedtime. Tip 4: Turn off all screens at least 1 hour before bed. Phones must be kept outside of the bedroom all night. Tip 5: Your bed should be used only for sleep (and some adult activity if you are older). For some, reading in bed is also okay. However, if you want to watch TV, play video games, use your phone or do your homework, you must do it elsewhere. Wait! What if the Tips above don’t work? Firstly, you will likely have to practice the above every day for at least 3-4 weeks to start noticing some improvements in your sleep quality. Also, if you have certain medical conditions, your sleep may be impacted, and you will need more specialized support. However, for most people, there will be nights that you will have a harder time falling asleep. That’s expected! So, if after being in bed for 20-30 minutes you still cannot sleep, get up and do something very boring like reading a tedious history book or listening to a monotonous podcast. Alternatively, you can use a mindfulness app like Headspace, CALM or Smiling Mind, which has specific meditations, sleep stories, or calming music and sounds that help you sleep. Also, if you notice that instead of falling asleep, your worries or thoughts about life circumstances or responsibilities are keeping you awake, get up, write them all down, have some warm de-caffeinated drink, and go back to bed. If your sleep difficulties persist despite trying to establish a consistent sleep routine, I suggest you consult with a medical doctor or health specialist who can provide you with more support. I hope you find these Tips helpful and look forward to bedtime. Sweet dreams. Happy 2024! Warmly, Dr. Juliana Negreiros, R. Psych. Dr. Juliana is the clinic director and a Registered Psychologist passionate about mental health who works as a clinician, researcher, supervisor, trainer, consultant, and public speaker. Her clinical approach is grounded in research and based on individual and family Cognitive-Behavioural Therapy (CBT) and Acceptance and Committed Therapy (ACT). ​

Body-Focused Repetitive Behaviour, or BFRB for short, is an umbrella term used to represent a range of repetitive self-grooming behaviours, such as hair pulling, skin picking, and nail-biting, that end up damaging the body and causing distress or impairment in a person's life. It's a condition more prevalent than you may think, affecting 1 in 20 individuals. In this blog, I will share the main types of BFRBs and science-based resources to explore if you or someone you know needs help. What are the most common types of BFRBs? According to the Expert Consensus Treatment Guidelines Body-Focused Repetitive Behaviors Hair Pulling, Skin Picking, and Related Disorders, there are different types of BFRBs which involve picking or biting (a) the skin (like acne, scabs, or skin imperfections), (b) cuticles or nails, and (c) lips or cheeks. Some people may also engage in repetitive joint cracking and even nose-picking. These behaviours share similar characteristics and can be considered a mental health condition when they result in two negative outcomes. One is damage to the body despite the individuals' many attempts to decrease or stop such behaviour. The other is causing significant distress or impairment in the person's life, such as socially, at work or school. Here are the most common types of BFRBs: Hair Pulling or Trichotillomania is when a person repetitively pulls their hair from the scalp, eyelashes, eyebrows, or other body parts. It usually begins in late childhood/early puberty, around age 13. Having little or no body hair can cause a lot of distress for individuals, especially in social contexts where others may notice and comment on it. Skin Picking or Excoriation Disorder is when one repetitively picks their skin, causing tissue damage. They may pick their faces, arms, legs and other body parts. Sometimes picking may be initiated due to acne or skin imperfections. Other times, dry skin, mosquito bites or scabs can trigger the picking. Cuticle or Nail Biting involves repetitively biting their cuticle or nails and damaging the skin. This behaviour often begins in childhood, and 20-30% of the general population has been shown to engage in chronic and severe nail biting that may result in permanent damage to the nail and skin. Cheek, Tongue or Lip Biting is also characterized by recurrent and damaging biting of the cheek, tongue or lips. Joint Cracking involves repetitively cracking body parts such as the knuckles or neck, frequently resulting in negative feedback from other people because of the sounds cracking joints make. BFRB 101 BFRBs usually occur during sedentary activities, such as when people are watching tv, playing a game, scrolling on their phones, reading, listening to lectures, talking on the phone, lying in bed, riding in a car, or sitting at a desk. However, it can also occur during active activities. There are two types of pulling or picking: one called "focused," which means that the person is aware of performing such a behaviour (like looking in the mirror while picking a pimple), and the other is called "unfocused," or when they are not aware of doing such a thing (e.g., scratching the skin until it bleeds) or the behaviour is automatic. Many individuals report noticeable sensations before, during, and after pulling. Some people may have an urge or sensation that makes them use their fingers to pick or pull from a specific area. These sensations may feel like itching, tingling, or pain. Other people may have no urge or sensation before picking or pulling. Instead, they may seek a sensation by using their fingers to feel certain body parts or searching for a specific characteristic of the hair or skin to remove or fix if perceived as imperfect or problematic. BFRBs can also be triggered by a wide range of emotions ranging from boredom to anxiety, frustration, or depression. Thoughts, beliefs, and values can also affect these behaviours. Be aware As you can see, BFRBs can cause more significant problems than you think. Below are key ones that you should know about: 1. People who pull their hair may also swallow them in excess. As a result, they may experience gastrointestinal distress or have digestive blockage called trichobezoar or hairball. If this occurs, surgical removal may be required. Therefore, please see a medical practitioner if you (or your child) eat hair. 2. Skin picking can cause infections which sometimes can be severe. Consequently, keeping wounds clean and treating them with antibiotic cream will likely prevent infections. 3. Repetitive motion with the same body part may result in body/motion injuries. Therefore, you (or your child) may need to see a professional to help with the injuries. 4. Secrecy about one's condition due to shame and embarrassment may result in isolation and resistance to seek treatment. Thus, secrecy can contribute to a general misperception of BFRBs as being less common than they are and interfere with relationships, work, and school. 5. Avoiding activities and social situations that make people feel vulnerable to being "discovered" is common. Some examples are not going to the beach, swimming, doctor's visits, hair salon appointments, childhood sleepovers, hanging out in a lighted area, and having intimate encounters. What to do if you or your child have BFRB? According to experts in the field, cognitive behaviour therapy (CBT) is the treatment of choice for BFRBs as it is more effective than medication. However, some individuals may need medication before CBT or both medication and CBT. CBT is the umbrella approach to various treatment modalities for BFRB, including habit reversal training (HRT), comprehensive behavioural treatment (ComB), acceptance and commitment therapy (ACT), and dialectical behaviour therapy (DBT). At Beacon Psychology, we have successfully treated many young clients with diverse types of BFRBs. In our experience, being motivated to change such behaviour and having a support system are crucial factors for positive outcomes. For more information about BFRB, please visit the TLC Foundation for Body-Focused Repetitive Behaviors, read its treatment guidelines, or watch helpful and educational webinars. Finally, if you want to access hands-on free self-help resources to help you cope with BFRB, check out the following website. I hope you find this information helpful! Warmly, Dr. Juliana NOTE about the author: Dr. Juliana Negreiros is a registered psychologist and director of Beacon Psychology Clinic. She has many years of experience treating young people with OCD and other related disorders such as BFRB. For more information about her, check out her page on our website.

Summer has turned to fall, and school is back in full swing. This transition can evoke some big emotions for our little ones. For those most impacted, this may look like a morning drop-off routine that consists of welled-up eyes and pleas to stay home. The back-to-school blues may reflect differences in a child's attachment style, their self-regulatory needs, and/or their ability to adapt to changes in routine, to name a few. Just as there are several contributing factors that can give rise to this response to a new school year, there are many things we can do to help walk children through the transition back. Open Communication: Create a safe environment for your child to express their worries leading up to a new school year. Encourage their active involvement in collaborative problem-solving. Aim to be solution-focused to prevent increased anxiety in anticipation of the return. Develop a Routine: Before the start of school, foster opportunities for short separations. Start transitioning back to the school schedule a week or two before school begins. Gradually adjust bedtime and wake-up times to prepare. Make a visual schedule that outlines the daily routine. Set Achievable Goals: Scaling involves assessing a child's current situation, exploring their goals, and determining what steps can be taken to achieve those goals. Begin by asking the child to rate their current feelings or level of preparedness for going back to school on a scale from 1 to 10, with 1 being extremely anxious or unprepared and 10 being completely confident and ready. Work together to create a simple action plan. What specific steps can the child take to move from their current rating to their goal rating on the scale? This might involve transitioning planning with their classroom teacher, planning for a soft start to the school day, and/or practicing relaxation techniques across settings. Emphasize that setbacks are normal and celebrate any progress made, no matter how small. As the school year progresses, continuously reflect and adjust goals to monitor and respond to your child's evolving needs. While the back-to-school blues can be a common experience for many children, it is important to seek help to rule out and treat broader experiences of separation anxiety in cases where these needs persist/increase in severity. In these cases, consider connecting with your family physician or a qualified mental health provider to access more targeted and intensive supports as needed. The start of a new school year is not easy for everyone. I hope you find these tips helpful and your child has a great year! About the Author: Harkiran holds a Masters of Education in School and Applied Child Psychology from the University of Calgary. She has extensive experience providing therapeutic intervention to children and adolescents of diverse abilities in school, community, and home environments as a behaviour interventionist, applied behavioural analysis support worker, and program manager. Harkiran currently works as a Certified School Psychologist in a public School District. For more information about Harkiran, check out her profile.