December 12, 2022
Cindy Lopez:
Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen. Today’s episode is proudly sponsored by Adobe, and we’re so thankful for their support of this Voices of Compassion podcast. The American Psychological Association or APA defines emotion regulation as the ability of a person to modulate an emotion or a set of emotions and emotional regulation is not something we’re born knowing how to do, it’s actually something we learn. So how can we help our kids develop the ability to regulate and monitor their emotions so that they can be successful in relationships at school and in life? So listen to today’s podcast episode as we talk with Leeanne Merritt and Karen Moos both Licensed Clinical Social Workers at CHC who work with children and teens and their families every day. In this episode we discuss emotional regulation, what it looks like at different ages and how parents and caregivers can help children and teens learn critical emotional regulation skills. Welcome Karen and Leanne.
Karen Moos, LCSW:
Thank you Cindy. Um, this is Karen, and I have been working at EBC School as part of the Children’s Health Council for many, many, many years. I started as a behavior specialist in the classroom here, and then moved on to a therapist and was then running the clinical program in South Bay for the past five years, six years, and now, I’m the Site Director at our South Bay Campus at EBC. So I’m excited to be here.
Leeanne Merritt, LCSW:
This is Leeanne Merritt. I’m excited to be here as well. I have been working with children and families for over the past 20 years. I’ve been on board here at CHC and EBC School for several years now, initially as a clinician and more recently in the Clinical Program Manager role.
Cindy Lopez:
Thank you Karen and Leeanne for being here today with us and for our listeners EBC is Esther B. Clark School at Children’s Health Council, and it’s a school for students with social emotional challenges, and Karen and Leeanne have been working at EBC for a number of years, and they really get this whole topic we’re talking about today, emotional regulation. So let’s just jump right into our conversation, and let’s start by first defining, what is emotional regulation?
Karen Moos, LCSW:
Yeah, so emotional regulation is basically one’s ability to control our emotional state within any given situation. So basically what that means is matching our emotional state to the situation. So for example, in some situations having a increased emotional response is really appropriate, like if we’re in danger or we’re in a really exciting situation, it’s appropriate to have a increased emotional response, but in many situations we might feel that we are having a larger emotional response than the situation calls for, and I think that is really what we’re focused on here today is more about down-regulating our emotions to fit a situation. So you know, for example, we’ve all been grocery shopping and seeing the toddler in the aisles wanting something from their parents and, you know, screaming and crying over a cookie or a piece of candy. So that’s a situation in which it would be helpful for the parent to be able to teach the toddler how to down regulate their emotions so that they’re reacting more appropriately to the situation. In order to do that it takes a lot which is why it’s difficult for toddlers to do that. So it takes being able to really rethink the situation, and really consider how we’re reacting and then consciously reducing our emotions, whether that be anger, frustration, anxiety, whatever that emotion is that we’re showing maybe more than we want to. And then in addition to doing that, we really need to focus on speaking calmly, acting calmly, even when we’re not feeling that way. So, being able to regulate emotions is showing something on the outside that you might be feeling different about on the inside. I think, you know, we all can work to regulate emotions both before and after situations occur. As adults we know that we all have predictable triggers for strong emotions. For example, somebody who’s really anxious around flying in an airplane, you know, they’re gonna do a lot of preparation to regulate that emotion of anxiety before they get on the plane because if they don’t do that they’re either not gonna be able to get on the plane or maybe have to get off the plane or maybe even have a panic attack on the plane. So, you know, we’re all working really hard to recognize those situations for ourselves, which is partly what makes that more difficult for children because they just don’t have, you know, as many life experiences as adults do. And I guess the last thing I just wanna say quickly about emotional regulation and the definition is just to keep in mind that it’s a learned skill. None of us are born with this skill. It’s something that we learn over time.
Cindy Lopez:
Yeah, that’s really important that it’s something we learn. So when parents are wondering why their toddler is having a meltdown, you know, as you described Karen at the grocery store, well that shouldn’t be surprising, right? Cause they haven’t figured out how to deal with that kind of disappointment or they could get mad even, right? So they’re trying to figure that out. So, and what parent hasn’t been in that situation? I don’t know.
Karen Moos, LCSW:
Yep.
Cindy Lopez:
So…
Karen Moos, LCSW:
Agreed. We all have been there.
Cindy Lopez:
I’m wondering, why do kids have difficulty regulating their emotions?
Leeanne Merritt, LCSW:
So, some experts view challenges with emotion regulation as stemming from a combination, if you will, of temperament and learned behavior. A child’s intrinsic or innate capacities for self-regulation are often thought to be personality and temperament based. So as an example, some children from a young age may become very agitated and display a low tolerance for essential daily routines. For example, nap time, meal times, completing their grooming routines, and might experience significant difficulty with self-soothing. It’s possible that children who struggle to emotionally self-regulate in this manner, they may experience trouble in this area in the future. And additionally, we’ve also got to consider a child’s surroundings and how those surroundings may play an important role in the development of these skills.
Leeanne Merritt, LCSW:
So, for example, when caregivers find themselves surrendering to their child’s emotional outbursts, sort of overcompensating and working to excessively do the regulating and the calming for their children when they become distressed, these children might have a harder time developing self-control on their own, right, in the future and in these types of situations children are counting on their caregivers to do the regulating for them. And if this rescuing and problem solving by the caregiver becomes established and sort of an entrenched pattern, and a child doesn’t learn to self-regulate independently, this could become a learned behavior, a non-desired one in future.
Cindy Lopez:
I also wonder about the child who may have a hard time accepting comfort, right? So they’re not necessarily able to self-soothe because they’re still escalating, but they’re also not able to accept comfort or reassurance from their caregiver, and so they just continue to escalate. Do you have any thoughts about?
Karen Moos, LCSW:
That’s a good point. I mean, some children are really independent and so the pendulum could swing that way where they don’t want any help. I think in those situations, parents can be there to model and kind of give that help without it being obvious that they’re giving the help, meaning, the parent could model their own emotional regulation skills. And I’m gonna talk about this a little bit later on in the podcast too, but while they’re doing those strategies, they could kind of talk through them and say, “oh, I’m feeling really frustrated right now, I need some time away.” And they could walk away while they’re saying what they’re doing. So they’re modeling that without actually saying that they’re helping the child. In fact, they’re helping themselves, right, and then the child could see that and, you know, children learn through modeling, so they might pick up on that and do it themselves thinking it’s their own idea.
Mike:
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Cindy Lopez:
So is the ability to regulate your emotions developmental, and what does that look like?
Karen Moos, LCSW:
So, yes, it definitely is developmental and just because a young child might struggle with emotional regulation at the age of three or four does not mean that they will always struggle with it. You know, like I mentioned before, it’s a learned skill that improves over time, just like any skill that we have and you know, it’s a milestone, developmental milestone to even learn how to start to regulate emotions. It’s not something that like I said, we’re born with. We talked a little bit about toddler’s moods that can swing like a pendulum, um, you know, where they can be crying one minute and really happy the next minute. And I have to say being the mother of two teenage boys, teenagers can kind of go back to that place, you know, being super sweet one minute and then just slamming doors and yelling the next minute. So, it does get better over time, but somehow teenage years, they seem to regress to being toddlers or something, but I know in the end that they do have their own emotional regulation skills. I mean, I think the difference is that, you know, for toddlers they’re gonna need somebody there modeling for them and walking them through it the whole time. By the time that they become teenagers they’re gonna be able to do it themselves and they’re gonna recognize, so they could come back and say, “oh, sorry, I did that.” While a toddler is gonna need someone to kind of scaffold that apology for them. And I just kind of also wanted to go back to what Leeanne was saying a minute ago about the importance of allowing children to practice the skills and practice emotional regulation because, you know, we as adults, parents and caregivers, we tend to wanna jump in and fix a problem or help our children to calm down and, you know, which is fine up to a point but at a certain point too, we need to let the children really experience the emotions that they’re having and not try to jump in and solve it or make those feelings change or go away. Sometimes they just need to sit with the feeling and eventually figure out themselves how to regulate.
Cindy Lopez:
So it’s that kind of developmental trajectory probably starts with the parents doing more, it sounds like or caregivers, right? The adults kind of helping to front load or scaffold and initially model, right? As you’ve already mentioned with the goal we want our kids to be able to regulate on their own and be independent with that. As you noted though with teens, even though they go back and forth, so they probably need some reminders too that don’t sound like reminders, especially if you’re talking to a teen.
Karen Moos, LCSW:
Yeah. Yeah. And I think for teens the modeling piece goes back to being really important in terms of modeling that emotional regulation. Not saying that you’re trying to help them, but just doing it because again, they’re still observing and if you can do it, you know, use a strategy and you don’t have to talk through the strategy that you’re doing when they’re teenagers, but just do it and then they can see that and hopefully over time will again model that thinking that it’s their own idea cause if they think it’s your idea, they’re not gonna do it.
Cindy Lopez:
Exactly. Plus it empowers them more to know that they can do it on their own. So, and what we want for all of our kids.
Karen Moos, LCSW:
Yeah. Absolutely.
Cindy Lopez:
So we talked a little bit about this, but can you teach emotional regulation skills, and how can caregivers do that?
Leeanne Merritt, LCSW:
Yes. So emotion regulation skills can definitely be taught. There are many different ways. Parents and caregivers can teach these skills by modeling appropriate behavior. So one of the best ways to teach your child to react to strong emotions appropriately is to show them how. We know, right, that children learn best through observation. So showing them what to do rather than maybe just guiding them verbally. This is often gonna generate better results with developing these skills.
Another way is teaching children how to identify their emotions and to build their emotional vocabulary, and what goes hand in hand with that is encouraging, of course, self-expression. So one way to do this is to create a chart that names and labels various emotion states. It would be helpful if it includes examples of illustrated facial expressions. So in other words, like a feelings chart. Initially this may require explaining and some defining of what each emotion means and providing examples for the child, and I would recommend that parents and caregivers join in the process of naming their feelings as well as this can help to normalize the process. Being able to name the feelings they’re experiencing can really help the child to be more vigilant and be aware of their inner feelings, and with practice I think and over time, this can help to reduce the likelihood of future emotional outbursts.
Another strategy I would recommend is by sort of teaching and supporting self-reflection or self-awareness. So you know when parents can address non-desired behaviors, and this isn’t the easiest to do, but in a patient manner and can provide some reflection time, children can often learn to choose better ways to respond again over time. So providing coaching in a manner that’s gonna be non-emotional and non-judgmental can be of great benefit in teaching this skill. So, for example, the caregiver can try exploring sort of what happened and why and how to try to do things differently the next time. So providing this encouragement as well as praise for practicing and participating in this process and for making positive choices that are made can be really beneficial.
Cindy Lopez:
Leeanne, you just mentioned praise as one of the reinforcers basically for a behavior that we want to see continue, right? So would you ever also offer incentive, like a tangible.
Leeanne Merritt, LCSW:
Absolutely. I think for some children that can be a very effective intervention and perhaps thinking about the need to offer incentives on a more frequent basis initially, right? And then as we see certain desired behavior choices or emotional responses developing, then we can sort of space out that incentive, but absolutely, that’s yet another form of encouragement that can be helpful.
Cindy Lopez:
Thank you.
Cindy Lopez:
So Karen, would you like to add to that about interventions?
Karen Moos, LCSW:
Yeah. Actually I just wanted to emphasize one of the things that Leanne said about parents being able to be patient and calm. I think we can all think of a situation where maybe our child got upset and started yelling, and then we started to get upset and started to yell, and then that only escalated the situation. And before you know it you’re both yelling over each other and nobody’s listening to each other, right? So your response really has only escalated the situation. And then hopefully we can also think of times where maybe we have been able to be patient and if our child is really upset, we’ve been able to respond in a much more calm manner. And then that can really deescalate the situation and kind of bring it down to a place where you can actually have a conversation. So I think that sets a really good point. It’s something like Leeanne said that is really hard to do because you are probably not feeling calm in the moment, but if you can, you know, have a calm voice and calm tone, it can really do a lot to deescalate the situation.
Cindy Lopez:
So are there specific interventions that can help and what are your favorites?
Karen Moos, LCSW:
You know, we talked about modeling, but I think some specific strategies for emotional regulations, one that we teach the students here at school, I teach the students in therapy. I try to teach my own kids at home, things like taking time away from the situation, taking a walk, taking a break, listening to music could be a really good one. We all know that music can really influence our mood. You know, doing something that you enjoy, whether that’s art or drawing or painting or just any hobby that you have, building whatever you like or enjoy doing could be really helpful. And then another one that is really big, I think for all kids at all ages and for adults too is spending time with a pet if you have one. You know, pets can be really soothing and just petting them or lying with them, and they could be really emotionally supportive, even if it’s not like a specific emotional support pet. Any pet can be really helpful in regulating emotions.
Cindy Lopez:
I’ve heard that pets when you’re interacting with them actually lowers your blood pressure too, so.
Karen Moos, LCSW:
Yeah. Yeah. Pets are a really good one. And I mean, I find that for the younger kids, they like that, but for high school kids, all of them will talk about pets that they have and the pets just sitting with them or being with them or petting their animals is really, really helpful for them. Another one I wanted to just mention here is deep breathing. I think we all, you know, know about deep breathing and find it very helpful and also it increases the supply of oxygen in our brains and then stimulates the parasympathetic nervous system, which then really promotes a state of calmness for us. So I think that’s a really good one. I think young children often need to be taught how to deep breath. They might not know exactly how to do that. One fun way to do that is outside the moment, not when they’re upset, but outside the moment to teach them deep breathing is to blow bubbles with them cause we’ve all blown bubbles and, you know, if you blow too hard or too fast, the bubble just bursts right? So you need to take like a long deep breath and then let it out really slowly and then you get a bubble. So, you know, teaching them how to do that kind of outside the moment when they’re not upset and then reminding them when they’re upset could be really helpful as well.
One specifically that I do for older kids and that is really helping them to compare the problem with the reaction meaning I’ll have them rate the problem, you know, on a 1 to 10 scale, and then rate the reaction on a 1 to 10 scale. And those should either be matching, you know, the rating should be the same, or the reaction should be a little bit lower than the problem. If they’re rating the reaction higher than the problem, then it’s probably time to go back and think about how they might have handled that differently. And then just to say a little bit about one more of those, which is just movement and not just taking a break, but you know, exercising movement, getting energy out that can obviously be really helpful for any of us when we’re angry or upset if we go take a walk, a bike ride, go for a run or something, come back and you you feel much much beter.
Cindy Lopez:
Yeah.
Karen Moos, LCSW:
Yeah.
Cindy Lopez:
Just as a reminder to our listeners, really important to teach these strategies when they’re calm, right, but not in the middle don’t try to have them rate the size of their problem when they’re in the middle of it.
Karen Moos, LCSW:
It’s gonna be a 10 every time.
Cindy Lopez:
Yeah.
Karen Moos, LCSW:
Yeah.
Cindy Lopez:
So it takes practice and both Leeanne and Karen have said that it takes practice, and we need to teach the skills. So teach them and practice them when they’re not in the middle of some escalating reaction.
Karen Moos, LCSW:
Yeah, absolutely, that’s a good point. Thank you.
Cindy Lopez:
So what if parents, caregivers have worked with their child on teaching strategies and they’re working through the skills, but what if a child needs more intensive help then parents or caregivers can provide? What does that look like?
Leeanne Merritt, LCSW:
if parents and caregivers are observing that their child’s emotions are causing a significant disruption to daily activities of living whether it be attending school or just difficulties making it through the daily routine, then they may need some extra support and meeting with your child’s pediatrician can be a very good starting point and especially so I’d say if your child has a hard time communicating. So maybe you know they’re on the younger end, and the pediatrician can then make recommendations and referrals to the appropriate professional. A complete evaluation is going to help to rule out the presence of any possible mental health conditions, and we know that sort of swiftly addressing any underlying conditions can lead to progress in behavior and improved treatment outcomes.
A child behavior expert or a mental health professional can rule out or identify any mental health issues such as ADHD, attention deficit hyperactivity disorder, anxiety or depression, and can recommend treatment options and strategies, and I just wanted to note that in addition to ADHD, anxiety disorders can lead to behavior problems in children and teens and anxiety can manifest as argumentative behavior or refusal behavior and depression can contribute to behavioral issues as well. Depression can often manifest in children and teenagers as an irritable mood or refusing to complete certain tasks, like getting up in the morning for school or maybe even isolating from others and wanting to stay in their room.
And then additionally, some specific services that may be recommended for children and teens may include individual counseling. So, for example, for a child who has endured a significant life event or a stressor, they may benefit from individual counseling, family counseling. A child who’s struggling to adjust to a new family situation or some type of change within their family situation they may benefit from family counseling and then for parents and caregivers coaching from a parenting expert might be recommended. So parenting experts are gonna provide support and training to parents without their children present, and this can often lead to the quickest results when it comes to many behavior problems.
And then over time, as we’ve been talking about during this podcast, right, as caregivers learn how to implement various methods and strategies to reduce these non-desired behaviors, and then are able to implement these in the moment with their children and teens, it can be much more effective than just, let’s say, a therapist working with the child one-on-one, you know, on a limited sort of weekly basis. And then lastly, I’ll just mention home based services. So, these might be recommended when there are significant behavioral difficulties. So if outpatient services are not seeming to be enough, and in these cases sort of bringing in a neutral party can help with modeling how to effectively manage difficult behaviors in a situation where there might be a very high level of emotion involved for caregivers and for their children and teens. And home based programs provide intensive services. So usually a visit more than once a week, and they’re gonna provide that coaching to the caregiver and child and teen.
Cindy Lopez:
Thank you that was really helpful. For our listeners, you know, if you’re doing the modeling, you’re doing the front loading and scaffolding, you’re teaching your child about the skills, and they’re starting to use them, that’s great. If you are interested we offer assessments or evaluations at CHC. You can learn more at chconline.org. You can contact careteam@chconline.org. And an evaluation doesn’t mean you’re trying to label your kid or put them in a box. It’s really that you’re trying to get more information that will really help you and your child respond appropriately and have more positive outcomes.
Cindy Lopez:
Karen and Leeanne, I’m wondering what final advice you might have for our listeners as they work with their kids on emotional regulation.
Karen Moos, LCSW:
It’s important to keep in mind emotional regulation is a skill like we talked about, and with every skill our ability to carry out that skill is gonna ebb and flow with time, with age, with the environment, with various situations, with other things that are going on in our lives, you know, and feeling emotions is what makes us human: it’s healthy, it’s natural. We should, and all do, feel emotions and strong emotions. I think the important part to remember about that is that the most important piece is how we handle or react to those emotions. It’s all a learning process to continue to learn and remember how to respond appropriately to the emotions that we’re having and that even when parents might not feel like they’re modeling or they’re scaffolding or they’re strategies that they’re teaching their children are working, it most likely is. It just takes a minute to settle in and for their children to really use those strategies, even when the parents suggest the strategies to them. I think we all need to be really compassionate with ourselves. You know, we all kind of have tantrums, if you will, and lose control of our emotions at times. It happens to all of us, you know, when we’re on the road driving and someone cuts us off or you know, whatever the situation it happens to all of us. We all learn from those experiences and we just work to do better next time and that’s what we can do. So I think practicing compassion and forgiveness for ourselves and for our children is just really important when it comes to emotional regulation.
Leeanne Merritt, LCSW:
And I would also add that, you know, ultimately helping kids learn to manage their emotions begins with providing an environment that is gonna be validating of their emotions and in which they feel safe to express them. And as Karen was just saying, you know, the role of parents and caregivers and the family environment is it’s largely influential when teaching these emotion regulation skills, and there is great value in sometimes being able to model a skill in a way in which you feel like you did so well, and maybe other times when maybe you could have done a little bit better, right? Modeling in both those manners is very valuable. And children who know that their emotions will be validated and met with empathy, they’re gonna feel safer when expressing them, and they’re gonna be more likely to develop and use appropriate regulation strategies and skills to deal with difficult feelings when they arise.
Cindy Lopez:
Thank you so much Leeanne and Karen. Thank you for sharing your insights and expertise with us today. To our listeners, thank you for joining us. Please contact us at CHC if you need some help, if you want some support for your child, or your family, parent coaching is part of that too and you can reach us at careteam@chconline.org or go to our website, chconline.org.
Leeanne Merritt, LCSW:
Thanks.
Karen Moos, LCSW:
Thank you Cindy.
Cindy Lopez:
Visit us online at podcasts.chconline.org Make sure to subscribe to Voices of Compassion so you never miss an episode and we’d love it if you’d leave us a rating and review. Have a question? Send us an email or a voice memo at podcasts@chconline.org. We’re here for you when you need us.
