This book was inspired by a true story of a real polar bear friendship at the Central Park Zoo in New York City. ida ALWAYS presents love and loss in a deeply touching and insightful manner. It taps deep into the human (and bear) experience of connection and the deep feelings that illness and death elicit in all of us. Ms. Levis describes intense sensory experiences of sounds, sights, touch, smells and taste to gently, but deeply, address the human emotion. They are successful in explaining death and dying in a clear, matter of fact way rather than resorting to abstract concepts that confuse children further. The use of sensory experiences, along with a well done, age-appropriate explanation of death and dying sets this book apart from other books on loss. It is a true lesson for adults to understand the importance of informing and including children in the process of death of a loved one or their own impending death. 

As adults, our knee-jerk response in dealing with a child's experience of the death and dying of a loved one, or their own impending death is to shield them from it. After all, our role as parents, teachers, family members is to protect children. Shouldn't we then continue this role when it comes to death and dying? One of the most difficult things in this world is seeing a child in pain, whether it be physical or emotional. It's easier for us to pretend with the child and give them false hope.

However, the reality is that in trying to protect the child, as adults we are actually causing the child to feel more pain in the long run. We must allow our children to feel and understand throughout the process.  We cannot protect our kids from the realities of life. We can offer them age-appropriate, clear explanations that make life less mysterious and less scary. We can prepare them intellectually and emotionally. Even though they will go through the pain, as we do as adults, they will have the opportunity to express their strong feelings throughout the process and begin to grieve. They will feel safe asking questions and expressing their love to their loved ones in their last precious days together. This book is an excellent way to start this conversation. 

Gus and Ida, the bear friends in the story, are granted the opportunity to feel. The very caring and compassionate zookeeper, Sonya, does a beautiful job explaining Ida's illness and impending death to Gus in a gentle but straightforward manner. The story moves forward with Gus and Ida expressing their very strong feelings together. They show their anger at the situation by growling, howling, stomping and snarling together. They express their sadness together and the unknown and the wonderings of what will be. Through Charles Santoso's beautiful illustrations, you can feel the deep connection between the bears and the intense feelings they experience. 

The story oozes with compassion and empathy through all of the characters. Gus's knowledge of Ida's impending death allows him to be part of the care-taking process. He is able to do what he can to help care for her in the last days of her life. This care-taking process is crucial and helps tremendously with our feelings of helplessness in the situation. As I remember back to the deaths of my grandparents and parents, a very warm memory that I carry with me, is the small things I was able to do that made me feel like I was playing a role in helping them feel comfortable in their dying moments. 

The story goes on to show the transition of Gus's life after Ida's death. The sadness shown through Gus's character allows the readers to sit with the sadness. The quote in the book that feels the most important to me is "You don't have to see it to feel it." This quote has a double meaning in the story describing the sensory experiences of the bustling city around them, in addition to Gus's ability to feel Ida with him after her death. 

I highly recommend this book for children, and adults, who are experiencing any loss, especially one through illness or their own impending death. I have included an activity below to help personalize this grieving process for the child. 

A very useful exercise to assist with grieving is to write a letter to the loved one that has passed. This can be done repeatedly to express feelings, things remembered and missed, and as a way to feel you are updating them with ongoing life.

I have composed a letter template that can be completed through writing or drawing or both, that can be used with your child, client or student to assist them through the grieving process. The template focuses on the ideas expressed in the book. It might be very helpful to first have the child answer the questions as Gus might answer them if he was writing a letter to Ida. Then, they can personalize to themselves. 

I recommend encouraging children to draw pictures for the loved one. This has the added benefit of providing the child with expressing these thoughts and memories through the sensory experience of drawing and coloring, which is therapeutic in itself. This letter likely will need to be done over several sessions as to not be overwhelming. Younger children may need reminders of some of their memories and more prompting. 

The letter ideas are written below and I have included a link to a printable pdf file with room for pictures below. 
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Dear_________________________, 

​1. I remember when we: 

2. When you were sick, it was so sad when:  it was so scary when:

3. I wish we could have:

4. You made me laugh when:

5. I liked helping you with: 

6. The things I miss the most about you are: 

7. These are the things I hear, see, taste, smell, touch, that remind me of you:

Love, _________________

Learning words for feelings, how they feel in your body, and how they look on others is crucial to social-emotional development. This skill is not something that children learn quickly, but a concept that requires frequent repetition and practice. The reason for tantruming in toddlers and young children is the fact that they have not yet learned to regulate their own emotions. Many adults continue to struggle with identifying and modulating their emotions. The lack of this skill can cause problems with relationships as well as behavioral problems throughout life. It is important to start the learning process about feelings as early as possible. 

Talking about, modeling and reading about feelings with children from a young age can give them a head start in mastering emotional regulation. There are a number of children's books about feelings out in the world, but one of my favorites is The Color Monster, the story of emotions by Anna Llenas. 

The Color Monster is a simple, powerful book. Through the experience of an irresistibly adorable monster and his young helper, kids can eagerly learn about their emotions. Ms. Llenas explains feelings in a clear, supportive, child-friendly manner. The collage-like illustrations and vivid colors bring the words to life. 

The crayon-colored monster starts out confused, with his emotions all mixed together. His young friend helps him sort out his emotions so he can make sense of how he feels. The book explores the main emotions including happy, sad, angry, scared and calm. Ms. Llenas describes clearly how each emotion feels. The illustrations pull you into the story and help you to feel the emotion, along with the monster. The exaggeration of monster's facial expressions and the vivid colors makes this book especially friendly to very young children. The Color Monster is appropriate for kids ages 2.5 - 8. 

There are tender, supportive statements woven into the story to support young children when learning about difficult emotions. The story ends on a sweet, loving note. The take-away from the story is if you sort out those big feelings and try to understand where they are coming from, you can help yourself feel better. This is a good message and reminder for all of us!

Below is an activity to help your own kids, clients or students sort out their feelings. 

Materials Needed: 
7 small clear plastic containers
Large bag of M & M candies or anything small that can be sorted by color
Hand drawn face circles, printed face emojis or colored round labels
Sharpie black marker
Crayons
Scissors
Glue (silocone glue works better on plastic)

Although the main focus of this book is anxiety, it addresses the ancillary problems associated with academic giftedness. Additionally, Ms. Laforet touches on issues of making friends, social skills, experiencing intense feelings, impulsive behaviors and issues with self-control. Therefore, it is appropriate for a wide range of children. ​It is also a helpful read to increase empathy for children who do not experience these particular problems. Incorporated within the story, Ms. Laforet presents many age-appropriate coping strategies that are useful for all children, as well as adults. This book is up-to-the-minute regarding experiences of kids in today's world, i.e. cell phones and video chats. She uses humor throughout the book that makes it fun to read. 

Bree is a  bright, academically gifted girl with a propensity for anxiety. Her thoughts tend to run wild when she is faced with situations that are difficult for her. The plot of the book revolves around a school project for the first day of school, in which Bree is required to create a nametag showing her interests. This activity raises her anxiety about making friends as she begins to think about the upcoming school year. Bree tends to have poor boundaries with peers and can be annoying to others as she tries too hard to fit in. Based on these issues, Bree remembers how she has had difficulty fitting in with peers and the "What if..." questions start to take over her thinking. 

Throughout the story, Bree experiences many failures related to making friends which further heightens her anxiety. She loses her nametag and is forced to make friends without it, a feat Bree thinks is impossible. She models for the reader strategies for calming herself down and controlling her emotions. Ms Laforet weaves these strategies into the story well so that they do not appear preachy. By the end of the book, Bree has learned some social lessons and does make friends.
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Ms. Laforet does an excellent job opening the door to Bree's thoughts and feelings, allowing the reader to empathize with her. Through the illustrations, Lisa Rush creatively brings Bree's spunky and intense personality to life. 
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At the end of the book, Ms. Laforet lists the coping strategies modeled throughout the book. These include:
1. How to Take a Belly Breath 
2. Steps to Calming Down

In the calming down steps, many strategies are mentioned including doing an action to distract from the thoughts, naming your feeling(s), counting, belly breathing, using positive self-talk.

Anxiety among children has become more prevalent over time and affects approximately 1 in 8 children ages 3-17. It is fairly common for children with anxiety to also experience behavioral problems and/or depression. For more severe forms of anxiety, therapy is recommended. Cognitive Behavioral Therapy can be especially helpful. Sometimes medication is necessary. For milder forms of anxiety, there are many strategies that can be used at home, in therapy, or in the classroom that can be especially helpful. Below is a list of activity ideas. 

Being Bree: Bree and the Nametag Worries is the first book in the Being Bree series. Book 2 is currently available and Book 3 will be released soon. For more information, check out the author's website at www.christinesromeklaforet.com.

All kids, like adults, feel worried and anxious from time to time. Sometimes, kids suffer from more chronic, severe anxiety that requires treatment. In addition to the strategies modeled in Being Bree, these activities can be helpful for all children to minimize anxiety and worries. 

1. Belly breathing is the most important skill to acquire - here are a couple of links to videos to help teach belly breathing to kids
https://www.youtube.com/watch?v=VOnDA6_MAWI
https://www.youtube.com/watch?v=_mZbzDOpylA
2. Yoga - several DVDs are available for kid's yoga and many more kid's yoga classes are being offered in the community. A few of the higher rated DVDs are: 
Storyland Yoga: Yoga for Kids and Families (ages 3-8)
Once Upon a Mat  (ages 2.5+)
Yoga Motion (ages 2.5+) 
3. Relaxation/Meditation/Mindfulness - an abundance of apps are available on Iphone or Ipad with meditation/mindfulness exercises for kids. A few of the higher rated apps are:
Stop, Breathe and Think Kids
Breathe, Think, Do with Sesame Street (for the younger crowd)
Calm (has a specialized kid's section)
Headspace (Has a specialized kid's section)
4. Exercise - rigorous exercise when the child is feeling anxious is very helpful
5. Journaling - if the child is old enough, writing out feelings and worries can be very therapeutic. "Get it out of your head and onto the paper" is one of my favorite lines for kids with many worries/anxieties. 
- A very helpful journaling activity that I strongly recommend is to keep a small notepad and pen next to the child's bed. Before bed or anytime, the child can write their worries, feelings, or concerns that they want to share. The child gives the notepad to a parent in the morning and the parent, in turn, writes back to the child with reassuring statements or acknowledgement of feelings, etc. The parent then places the notepad next to the child's bed again before bedtime and the process is repeated daily or as often as possible. This not only helps the child 'get it out of their head and onto the paper', it helps the parent stay in touch with the feelings of their child. The writing practice doesn't hurt either!

Thanks for reading my blog. Feel free to leave me a comment below and let me know what you think. 

Brianna and the Blue Monster:
​A Cognitive Behavioral Story for Children with Depression
Written by Patience Domowski, LCSW

The rates of depression in children have been rising over the past several years. Most of us don't want to believe that children can suffer from depression, especially severe depression. However, it is a reality.  We are not talking about the minor day to day sadness and disappointments that all children experience. We are talking about clinical depression.  It is crucial to treat depression in children. Untreated depression can pose a risk of suicide at that time or later in life.  As shown through this book, Briana and the Blue Monster, depression can be treated effectively. 

Depression in children can be more difficult to recognize than in adults. As children have not yet mastered how to describe their feelings, they may have difficulty verbalizing their deep feelings of sadness and hopelessness. Below are signs of depression in children. All of these symptoms do not need to be present to meet the diagnosis. The symptoms need to be present for most days and the duration at least two weeks. If you suspect depression in your child, it is important to get therapeutic help as soon as possible. 

 Signs of Depression in Children:
1. Irritability and anger 
2. Loss of interest in activities that used to be fun for them
3. Physical/body symptoms including aches and pains, stomach aches, headaches
4. Restlessness or Fatigue
5. Difficulty separating from parents
6. Withdrawal from social activities
7. Difficulty concentrating
8. Talking about death/dying, giving away favorite possessions
9. Sleep increase or decrease 
10. Appetite/Weight changes
11. Low self-worth
12. Frequent crying and sadness for no apparent reason

In her book, Brianna and the Blue Monster, Patience Domowski presents the common thoughts and feelings of young children with clinical depression.  It is not a traditionally published storybook, but more of a tool for therapists and/or parents to use specifically for children suffering from depression. It explains the concept of depression in a manner that kids can understand and not feel so alone. The book appears appropriate for children ages 4-9.

Ms. Domowski does a great job showing how a child's feelings can manifest in the home and school environment. She does not shy away from the severe symptoms that some children can experience, such as the thought "...maybe I should never have been born." The book portrays understandable concern on the part of the parents and family and how they take action to help Brianna.  I especially like how Ms. Domowski describes, in a kid-friendly manner, the purpose of a therapist and the typical experience in a therapist's office.

The most important part of this book is the skillful way in which this author introduces cognitive-behavioral therapy at a level useful and fun for a young child. She describes negative self-talk as an imaginary monster in your head that tells you bad things about yourself.  She presents activities to help children defeat this lying monster.  It is a very creative approach to applying Cognitive-Behavioral Therapy to young children.  She also introduces role-playing techniques and other helpful activities to help children that are suffering from depression.  

The ending to this book is very hopeful.  There are questions and activities at the back of the book for further exploration and treatment.  I recommend Brianna and the Blue Monster and the presented activities for therapists to use in their practice with children suffering from depression.  I recommend it for parents as a way to help their child understand their problems with depression and to present the idea of going to a therapist.  This book should not be read independently by a child, but rather with a parent or therapist in a supportive manner.  

Even though there are many valuable activities presented in the book, I have added an additional activity in this post as an extension to the concepts in this book.  

Patience Domowski, LCSW, is a Clinical Social Worker practicing in Chester County, Pennsylvania.  She has written several books with mental health themes for children and a book on parenting.  Check out her website at patiencesbehaviortherapy.com. 

Materials Needed:
Poster board or large paper
markers/crayons 
scissors
glue

Trauma that we experience as children can lead to behavioral, emotional, neurological and physical challenges throughout our lifetimes. For this reason, it is crucial that trauma(s) experienced in childhood (and in adulthood) be addressed as soon as possible. Research has shown that the most important factor in determining resilience to trauma is having a sensitive, caring caregiver to help you through it. I have chosen this book for April's blog post as trauma affects many, many children. Some of those children may be in need of psychological assistance and some may not. If not, it is still crucial that the adults in their lives address the feelings and responses to the trauma. Once I Was Very Very Scared is a perfect book for this purpose. It can be read and discussed by caregivers and/or can be a great resource for therapists. The great news is that there is a Spanish version too!  

Chandra Ghosh Ippen skillfully presents the emotional material of trauma in a fun, non-threatening and relatable way for young children. Once I was Very Very Scared is appropriate for children ages 3-8 but could also be useful to older children and adolescents. The book is quite long and covers an intense subject matter. Therefore, for the younger children, I would suggest reading it in two or more sittings to leave room for processing and discussion. Going through the entire book in one sitting may be emotionally overwhelming for some. 

The book starts out as a group therapy session utilizing adorable animals illustrated by Erich Ippen Jr. The Porcupine character acts as a therapist and works at establishing trust and providing a safe place for the animals to express themselves. This is an excellent book for opening up dialogue about a child's particular trauma and providing them permission to discuss it. It portrays many different scenarios of traumatic events with which many readers may be able to identify. This can help the reader in not feeling so alone with their trauma.  

Through the dialogue and behavior of the animals, Ms. Ippen accurately portrays flight or fight responses and many defense mechanisms in action. She does an excellent job describing how trauma affects us all in different ways and uses many internalizing and externalizing behaviors as examples. 

The book wraps up on a hopeful note by exploring many coping skills. Through the animals, Ms. Ippen makes clear the individual differences in how we can cope with difficult situations in a healthy way. This exploration of coping skills leaves much room for the caregiver or therapist to teach different coping skills and explore with the child what works best for them.  

Frequently in my practice, I utilize Once I Was Very Very Scared  as a starting point to open up the conversation about trauma. I engage the child in many activities throughout the process of reading the book and utilize it throughout the therapy process. It is very conducive to incorporating therapeutic activities personalized to each child.  I have provided ideas below.   
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After reading through the book once, there is a page that states "I wonder what scared you." This is a very important page to return to and open up dialogue on specific experiences of the child. Since there are pictures of various scenarios of trauma experienced by the animals in the book, I ask the child to draw a picture of the time they were very, very scared. After they complete this, it is important to ask many questions about their picture and have the child express as many details as possible about what happened. The sensory process of drawing and/or coloring is also therapeutic. Watch the child's behavior for reactions in discussing their trauma. It may be necessary to go through this process slowly and incorporate some relaxation/meditation techniques along the way.  

There is page near the middle of the book that shows all the animals with different feelings. This is a great page to reference while asking the child to point to which feeling(s) they had during their trauma and what feeling(s) they have about it currently.

In addressing defense mechanisms and coping skills, I find role-playing very useful. Role-playing using puppets, animals or dolls is a great way to engage with young children while minimizing their discomfort as it is a step removed. Making simple puppets of the animal they identify with in the book can be a fun and useful activity for this purpose.  

While reading the book, ask the child what animal in the story acts most like they do when they feel very scared. Google coloring pages of that particular animal and one of a porcupine for the therapist character. A good website for this purpose is www.coloring.ws and click on animals. Print out a coloring page of a porcupine and the child's chosen animal from the book. Printing on card stock can be useful for making a more sturdy puppet. If the animal is a full page, you may need to scale it down to 70% when printing. 

Ironically, while writing this post, I received a notification from Piplo Productions that they now have free downloadable finger puppets on their website! This is another option to carry out this activity. Go to piploproductions.com, click on Our Stories, then Once I Was Very Very Scared, then Resources and you will find the free downloads.

Materials needed
Coloring page 
crayons or markers
craft stick (large popsicle stick found in craft stores)
glue
scissors