Practical Help for Kids from Psychologist Dr. Cristina Sevadijon

May 14, 2020

Jennie Allen

Bible teacher, founder of IF:Gathering

Today on the podcast you'll get to hear from someone who has absolutely shaped my book, Get Out of Your Head. When I started working on this project, I went to dinner with Dr. Sevadijon and it was supposed to be an hour long. We were there for way longer than an hour. I was so moved by what I learned during that dinner, and I asked her to jump on the podcast for this episode because of how much it has shaped this book and because she's a cognitive behavioral therapist. I hope you enjoy this episode! 

I remember being drawn to your job title when I heard about you, because it was literally what I was talking about with the book. We can change the way we think with our behaviors. I'm really excited for you to be here today and help process what this looks like with kids. Because you work at Sparrow Counseling here in Dallas, and majority of your clients are kids, right? What does that look like on a day to day basis? 

We're a large practice with about 30 team members, and everybody specializes in different things. So we have a whole team that's dedicated to working with children and adolescents and their parents. I help kind of run that team. Then we have a team that works with adults, marriages, trauma, and lots of other experiences. We all get to work together, learn from each other, encourage each other to grow, and we're all believers, which is really cool.  

I actually told the story of our conversation in the book, because what you told me shaped so much of it. You told me there were three specific lies that you learned in Psych 101, and I didn't believe that could be true. I was like, there has to be more than three lies! Every single lie we have fits into those three buckets. So why don't you talk about that a little bit, because you're getting to work with such an array of people at Sparrow. What's the age range?

From about three years old to senior citizens. The younger kids we are doing a parent-based approach and we also work with whole families too. Part of my focus and passion is working with the family, because that shapes so much of what kids think, how they view themselves, how they act, and what behaviors are encouraged by parents. 

I get excited, because we're talking about how we can help kids as adults. Whether that's counselors, teachers, youth workers, aunts and uncles, teachers, and all of us have kids in our lives. So what does it look like to fight for them specifically? I want to hear a little bit more about those lies because that's the part that has shaped me and sent me on a hunt, honestly. It surprised me so much. I work with women all the time, and I have my own kids, and I just thought there was more to it. Tell us a little bit about those three core lies. 

A lot of the time, these three core lies, or as we like to say, our beliefs about ourselves, fit into these three categories. We all have these beliefs, but they get activated when we're anxious or depressed. The first one is that we're unlovable. At the root, there's just something about us that people can't love. People who are experiencing that might describe it a lot of different ways. They may say, "I don't feel like anybody has ever really, truly liked me" or "maybe if they really got to know me, they wouldn't love me." The second one is, I'm incompetent. I can't get things right or I make a lot of mistakes. The other lie is I'm just somebody who is just morally bad. In the Christian sense, we all believe we're sinners, but this person might believe that to a really extreme level that's unhelpful. The other lie someone might believe is, I live in a really dangerous world. I am so vulnerable that I wouldn't be able to cope with things that come my way. People will describe these lies in lots of different ways, but they all fall into these buckets. Aaron Beck is the doctor who created cognitive behavioral therapy. It was during a time when people still were not very keen on psychology. He was the first person to ever really say that the way we think about things matters. He's actually still alive and I got to go to a training with him once, which was incredible. 

So explain cognitive behavioral therapy, for those of us that aren't in the psychology field. 

It basically just means that what we think impacts how we feel and what we do. And our feelings impact our thoughts and what we do. Then what we do impacts how we feel and what we think. So there's a lot of interplay with those three things, and it's actually really biblical. God talks a lot about our thoughts. 

You can imagine when we're sitting over dinner and it was so hopeful to me that this idea could be proved by science. It was already the premise of my book that all of those things you just mentioned are swirling together and causing a mess sometimes. But that scripture gives us authority over our thoughts. Romans says transformation comes from the renewal of our minds. That scripture is really clear. Cognitive behavioral therapy backs up that verse scientifically and says, this is possible. It's not a Christian idea necessarily, but it backs up what the Bible says. Our minds can change things! 

Absolutely. When I was in grad school and I was being introduced to it, one of the things that my professor said is, "all truth is God's truth." So sometimes through science we uncover these truths, but it's a truth that God already knew it doesn't surprise him 

Isn't that fun? I think that was my biggest surprise of the book. I thought as I went down this road that the Bible and science would be at odds somewhat. Yes, the end of what it is we think about is different. How we find hope and peace and joy is different. But, at the end of the day, the brain works the way the brain works because God built it. So talk to us a little bit about what you're seeing. Let's talk about the kids you minister to. What are you seeing? What are themes that you're seeing in the last five years in this generation? 

We're really seeing a huge increase in anxiety disorders. In the 80's, we did not think children could have anxiety disorders. We didn't think they could worry like that. Then in the 90's, we realized kids can have anxiety disorders too. There's a lot of women I work with that have never gotten treatment because nobody identified it that way. We used to just call them worriers. Today, what's awesome is we're working with pediatricians in our community that are able to give parents really good information about children and anxiety. We know if they go untreated, there are some really negative consequences that last into adulthood and worsen in adulthood. People getting treatment for anxiety disorders has increased 17% in 2018 from 2007. That's a huge increase. Depression has increased as well. From 2007 to 2017 it went from 8% of kids struggling with depression to 13%. The other really sad statistic is that suicide has increased 54%. That's the saddest one. Some of that is untreated depression and anxiety. 

Okay so now I'm going to tell you where every adult listening is right now, because I'm here too. Tell me what is the line to know when to get help. Because all of our kids worry. How do I know what's beyond the realm of what a parent should be handling, and they should seek out help in counseling or medicine?

That's a really good question. Depression can be a little easier to spot, but anxiety is harder. We try to think about how much this is impacting a child's life. Sometimes I notice parents will make excuses for behavior - they're introverted, they're this number on the enneagram, things like that. That's when I start to question a little bit. It might come out in how they're feeling about school, not wanting to go to school, not wanting to do things with their friends. They might be unusually concerned about thunderstorms or being dropped off at daycare or Sunday school. You might look around and start to see behavior that differs from other kids. What's helpful at that point is to just start talking about it. Talk to your pediatrician, because they understand child development. I've got some kids that were scared of everything but they ended up working through it over time. They just had to overcome fears. That's different than when you see a paralyzed kid that's constantly spiraling and can't come up. We usually say if something has been going on for over a year, it's not just a phase. It might be something that's problematic. What we know is treating it at a younger age helps kids stay on their developmental course. As an adult, if we're having some anxiety, we can push it off for awhile and not deal with it, and that won't have a major impact on our life most likely. But for kids, it can have a much bigger impact. 

Yeah, that's really interesting. To all of those people asking, do I need to call a counselor? What do I need to do? Just do it. My view is that if you can find a Christian counselor that works with your age range, you'll pick up tools that you'll use the rest of your life. We've always told our kids that we save for their counseling. We're big believers in them talking to us first and letting us be in the process of counseling with them. We don't ever want them to feel like there's something they can't tell us. Counseling can sound scary or not Biblical or unhelpful, but some of the best Christian tools I've gotten have been in counseling offices. They are trained to help me think through my emotions and relationships. Those tools have helped me mature and grow later in life too. That's why I'm such a huge fan of counseling. I don't think every kid needs a counselor, but I don't think we need to be afraid of it. It doesn't need to feel like this huge chasm from healthy to counseling. They're just going to build tools into your life that will be helpful for that season. Some of you are thinking you can't afford it, and that's really real. But there are a lot of different ways to get it, but I can't get into that right now. I just wish everybody would be not so afraid of it. You don't need to feel shame that you or your kid needs to get some help. Most healthy people are healthy because they've done the work.

I think what holds parents back sometimes from getting their children help is the shame. They think there's something they didn't do well enough as a parent, and now their child has this problem. That's rarely ever the case. These disorders are all very biological and based in genetic vulnerabilities. It's not something that a parent has or has not done. Good parents get their child what they need. If they need a math tutor, you get them a math tutor. If they need speech therapy, you get them speech therapy. It's the same thing. 

Definitely. I also want to say to those of you that have screwed up your kids, we all have. Nobody is a perfect parent. We're all doing our best. When you get in a counseling office with your kid, you'll see the ways you've let them down. Sometimes with my kids it has just been complete misunderstandings. So we got to go back and undo some things that were done. We don't have to be perfect parents. Even if our kids are in therapy because of decisions we've made, the fact that they're in a therapy office is a win. The fact that we're admitting our weaknesses is a win. That's going to cause greater thriving than us being perfect parents. 

That's a really good point, because there's so much pressure in parenting. Screwing up in parenting is the last thing anybody wants to do. They'd rather be super bad at their job than to be really bad as a parent. 

That's right. And that's the grace. I've said this before, but almost every parent I know is doing the absolute best they can. And they want to do the best they can for their kid. Let's talk about a parent's heart and mind journey, what that does, and how that plays into a child's emotional and psychological journey. One desire I have for this is people who are listening that maybe don't have kids yet, but who are trying to be as healthy as possible, so that if they have kids, their kids are healthy. What does that look like to do the work as parents, or hopeful parents? 

That is a really great question. I hate this because I feel like a lot of times moms are implicated a lot, but we actually know that a mother who is more anxious really ups a child's anxiety. Parents that model responding in an anxious way are teaching their kids to do the same. For parents or people who aren't parents yet, if you realize there are some anxieties or hard things you need to process through and take care of it, you'll raise healthier children. Or even trying to find another person who has also worked through their stuff to marry because that is such a gift later down the road. 

I'm laughing because I'm thinking about my first born who was a more anxious kid, he's not now, but that makes so much sense. He was my first kid and he was picking up on my anxiety! I was a nervous wreck. I thought he was going to die everytime I turned around! Now with Cooper, who's my fourth, I'm like go do whatever you'll be fine. Turns out kids are pretty resilient. 

I think that's great encouragement. It's never too late! Somebody might think they've screwed it up because their kid is in high school, but it really is never too late. Even if your child is 40, you can take care of things in that relationship. 

And if your kids have kids, then you can be non-anxious grandparents! We're talking about these toxic thought patterns and how we can help our kids through them. I want you to give some real practical cognitive behavioral techniques to help parents. 

I think therapy for kids and adolescents looks a little different because we really are skill building. Parents often think the setup is you're going to tell this person you don't know your deepest, darkest secrets and you're going to love doing it. So their kids come into my office terrified. That's not what we're doing. We're teaching them really practical skills. Negative thoughts for kids are a little more simple, like "I can't do this" or  "this is too hard." They just haven't developed really complex negative thoughts yet. It's helping them identify these negative thought patterns and then replacing them with truth like we talked about. We call them coping thoughts. A lot of times we'll use scripture verses for kids that are believers. That  really is important for them to combat those negative lies. You can start as early as a kindergartner. They might say, "I can't do it right" and you can say "I know it's hard but I know you can." You're teaching them positive self-talk.  

Let's just take a five-year-old as an example. They're spinning out on the playground having an absolute fear attack or whatever. They feel out of control because they can't get what they want or because a kid was mean to them. What would you say? 

The first thing is to help them get calm. We can't look at our thoughts if we're melting down. Take some deep breaths, remove them from the situation, and let them cool down. Whatever it takes for your kid. Deep breathing is a really great one that works very well. Then it's looking at the thought. Sometimes we use a good coach and bad coach analogy, because a lot of the times by pre-school they've had a soccer coach or something. So we'll say, "what was the bad coach saying?" And they'll say, "I can't do this. It has to be my way. Whatever negative thought they had." Kindergarteners are hard because some of them are aware of their thoughts and some of them aren't. If they can, the next step is just helping them change that thought. You might say ask them what they can say to themselves instead of "I can't." It might be, "this is hard, but I can do it" or "if I keep going, I can take a break." Some easy phrase that's short and concrete. Sometimes we might use thought bubbles from cartoon characters to help it feel more concrete to them. You might even draw a thought bubble for them. The Little Engine That Could is such a good illustration of that. 

Alright I'm going to play devil's advocate here. There are some things that we can't do, right? I'm a parent that believes in my kids, but I also don't want them wasting time on things they're not good at or can't do. What's that balance of reality too? 

Right! Because this isn't about positive thinking, this is realistic thinking. In cognitive behavioral therapy, we're not just trying to think more positively. The goal is to think more realistically. So let's take that five-year-old for example. Let's say right now they can't do subtraction. You're sitting with them and they want to be able to do older brother's homework or play the same game. They may say, "I can't do that." And you might say, "buddy, you can't do that yet." Because probably in a year or two, they will be able to do that. They just can't right now. 

I love that. I'm glad I asked that very pessimistic question! Because we don't want to create this culture of "you can do anything!" I want somebody to be direct with me and tell me the truth. That's super helpful as far as what we're telling our kids because I think they know if we're flattering them. Their senses are even better than ours sometimes. Okay let's take the 11 year old. Let's take the preteen because I've got one in my house that is emotional and they're noticing those emotions. But they're too emotional about it to sort things out! They haven't built the skills yet that an adult has to be able to respond without anger. They need more self-control. That's what I've sensed in all of my kids in that phase. So what does that look like?  Because we're not worried about behavior as much as what's going on inside of them. What is going on inside of them and how do we help? 

I think one thing is just understanding a little bit of basic development. I find this to be really important for parents so they can have a little bit more patience to work through this with them. But with brain development, we know in pre-teens, hormones are kind of starting to hit and puberty hormones have already had to hit before puberty happens. What's happening is the part of their brain that's the emotion center is getting really activated. Then in their prefrontal lobe, there's huge development in adolescents, as we know now from research. What's happening is it's a little out of whack. Their emotion system is really sensitive. Then this front part of their brain that's supposed to help them regulate their emotions is not quite developed. Then add in the hormones and it's a recipe for disaster. Part of cognitive behavioral therapy is teaching them how to cope with really big feelings. For example, how do you take a break? They may need to draw, go read their Bible, or go for a walk. They might just need to get away from people. Then after they've calmed down, you can try to talk with them. Again, we can't look at the thought if we're not calm. That goes for the parent too. If the parent is too upset to talk to them, that's okay. Take a break yourself. Then help your kid look at where that negative thinking or anxious thinking came from. You may have told your kid they can't go walk to the park with their friend, and they took that as you not trusting them. Which may be kind of true! But you can talk to them about the dangers that are out there and maybe at 11 years old, you're not ready for that yet. Help them try to change their thought to, "not yet, but one day." 

I'm sitting here internally processing  what you're saying and I've got a lot of free counseling through all this. I'm thinking about one of my kids and their behavior, and I just want to know what's going on inside! I know there's a reason they're acting that way, but there's also the behavior we have to deal with. You're telling me there's a lot of chaos in those years, but we also can't let them act and say everything they're thinking. So what does that look like? To have grace for where they are in development, but also to not let them act that way. 

Parents ask me that a lot. I'm going to break it into two categories. One is our typically developing kids, so they're pretty normal. They're not dealing with an anxiety disorder or depression or things like that. So for them, the behavior happens, they're calm, we talked through it with them. They sort of explained what they were thinking, what they were feeling, and we work through that part of it because that's the heart issue. Then you can say, "Totally get that. I'm glad you explained it to me. We are still going to have these consequences, because all of our choices have consequences." That's a good line, because it's true. So you can still hold to that standard, but deliver it with grace and softness. Then there are some kiddos that are having meltdowns because they were actually anxious. They had a breakdown because they were really nervous about going to a birthday party with the other kids. When these meltdowns happen, kids will say later, maybe they got anxious because they don't know how to talk to their other girls. They don't know what to say. So they had that meltdown so their mom would keep them at home, which is what they wanted. So from there, parenting that situation takes a lot more time. You might say, "let's back up, was there a way you could describe how you were feeling before we got into the car?" Developing some feeling language and then maybe some practical skills. Like what are conversation starters? Let's practice. So that you feel more prepared next time. That meltdown isn't just bad behavior or entitlement. That was a total freak out because they didn't know what to say in front of the other girls. 

Okay let's talk to the college age and upper high school. The 16 years and older group. Can you give them some hope? They're struggling with anxiety so much and it's rampant. What does it look like to struggle with this as they get older and head out into the world? 

One thing I want people to know is there is hope. We know anxiety disorders are the most treatable. So we actually have great scientific treatments for them. We know what works. That's the good news. A good cognitive behavioral therapist is going to be able to really help them with their anxiety disorder. Sometimes it can feel like it's really bad and it's too much to handle and really overwhelming. But there is hope. The second thing is to use resources. College counseling centers are a great starting place to find a good long-term resource in your community. It's easy to feel like there's something really wrong with you if you have to go talk to someone. But if you can feel a little bit better just by seeing someone, isn't that worth it? Be brave and take on that challenge. Some of my clients that are the anxious high school or college person are actually incredibly wonderful, responsible, and intelligent. They get a lot of things done and are very bright. They just struggle in this particular area. Being proactive and seeking out help is so important! 

I hope if you're listening and you do struggle with anxiety, whether you're 16 or 20, talk to your mom. I know as a mom, I have always been delighted to be let into what my kids are struggling with. I'm not scared of that. It's a scary thing to say it, but it's worth it. If you don't have a good relationship with your mom, pull somebody aside that you trust and tell them. Because something about the isolation of it compounds everything that you're feeling. And I would suggest finding somebody older and perhaps a counselor. It's so worth it. 

I really encourage kids to talk to their parents as much as possible. I really feel like that's part of my job is to increase that communication. I know sometimes parents can feel like if they're talking to me as a counselor, their kid will stop talking to them as a parent. That's not really the point, because I'm only in their life for a season. But having a good, open relationship where you can communicate is so important. Secondly, if your parent is just not a person you can reach out to, any type of trusted adult, teacher, doctor, youth minister, or young life leader are all great people to reach out to.  

If somebody wants to find out more about cognitive behavioral therapy and maybe find a practice in their community, where can they do that?

There's a website called effectivechildtherapy.com and it's for teens too. But it gives you different things that kids might be struggling with and it tells you what things are going to be most helpful to treat that particular issue. That's really helpful as a parent because I get a lot of parents that get overwhelmed by all the different types of therapy. This website is very reputable. It's based in science. It is not necessarily a Christian resource, but it is not a resource that would conflict with the Bible in any way.