Monday, August 3, 2026

James Donaldson on Mental Health - Teens and Online Gambling

James Donaldson on Mental Health - Teens and Online Gambling

What to know and how to talk to kids about the risks



Writer: Sam Brodsky


Clinical Experts: Megan Ice, PhD , Matt Missar, LCSW


Key Takeaways


- Despite age limits, many teens are gambling online. And because their brains are still developing, they run a higher risk of developing a problem.
- Teens may be “primed” through things like loot boxes in video games, social casino apps, fantasy sports, or watching streamers gamble.
- Talking openly to kids about gambling doesn’t encourage them to do it — it helps protect them.
- How are kids gambling online?
- Why are kids gambling online?
- What is gambling disorder?
- Signs a teen might be struggling with gambling
- How to talk to kids about online gambling
- If you think your teen might have a gambling problem
- How gambling disorder is treated?

When adults worry about what keeps kids entertained in this digital age, they might not picture gambling. Despite legally binding age restrictions — in states where online betting is legal, players must be at least 18 or 21 years old — it is becoming increasingly common among teens, particularly teenage boys.


Matt Missar, LCSW, a therapist and certified gambling counselor, says the number of young people he treats for gambling issues is steadily growing. And even as he treats teens for other mental health concerns, he’ll later learn that they’ve placed bets.


While the majority of people who gamble don’t develop an addiction, participating in online gambling has been associated with an increased risk of gambling issues, especially in boys and men, according to a systematic review of research involving young people between ages 10 and 25. And studies suggest the earlier kids get exposed, the higher the chance of these behaviors yielding a problem.


Young people are specifically at risk for gambling addiction because their brains are still developing. Teens are often impulsive and think they have more control over outcomes (in this case, betting outcomes) than they really do, says Megan Ice, PhD, a psychologist at the Child Mind Institute. And their sensation-seeking and risk-taking tendencies can set them up for excessive online gambling, adds Suzanne Allen, PsyD, a psychologist who primarily works with children, adolescents, and their families.


How are kids gambling online?


In some cases, parents allow access to their own accounts with or without realizing how frequently their kids use them, Missar says. But children and teens are also finding loopholes and dodging safeguards meant to keep them from gambling virtually.


Kids may use someone else’s ID (or fake IDs), VPNs, or older friends’ accounts to bypass age restrictions. And offshore crypto casinos or other gambling sites operating outside of the United States aren’t as stringent.


Underage people may have indirect access to online betting by watching streamers gamble or by placing bets with peers who have found a way in. High school students with access to accounts like FanDuel or offshore platforms will, essentially, act as bookies and take bets from other kids, Missar explains.


“Teenagers are already very resourceful in circumventing restrictions, and so they’re pretty easily available if a teenager is looking in the right place,” he notes.


Saul Malek, now a public speaker on gambling addiction, says he gambled virtually for the first time as a 19-year-old college sophomore. Bookies hooked him up with online sportsbooks (he imagines they were offshore accounts but can’t confirm), and he started down what he describes as a “rabbit hole” — losing money on one online sportsbook, blocking the bookie’s number once he owed them, and then finding another bookie to repeat the cycle.


It got to the point where he couldn’t sit through entire games anymore; he had to bet on individual rounds during a match, then move on. Over the span of two years, Malek amassed about $20,000 in debts. It’s been six years since his last bet, and the 28-year-old is still paying off what he owes.


Why are kids gambling online?


When you’re winning, gambling can be exciting, especially now that you can wager on anything, anytime — even the color of Gatorade poured on a coach or the length of the national anthem. Malek says part of the fun was “living in the daydream of the next big win.” Young people may also see online gambling as a way to relieve stress and cope with hard things, says Dr. Allen.


There’s a social component as well, offering teens a way to fit in and make new friends. “Anything that’s going to help you get accepted by your friends is going to be very, very reinforcing,” says Dr. Ice.


Kids may naturally transition into virtual gambling after participating in certain activities that “prime” them for it. For one, they can download apps that mimic casino-style gambling and sports betting with virtual currency — some of which are advertised as “social casinos” and “social sportsbooks” (think: Fliff).


Additionally, features in video games can mimic gambling. Kids, for instance, can pay for loot boxes that hold mystery prizes; it’s the luck of the draw in exchange for cash. “I’ve seen families be out tons of money on a video game based on their kids’ purchases. And that’s kids as young as 6 or 7,” Dr. Ice notes. (Some countries are regulating these types of boxes due to their resemblance to gambling.)


Similarly, young people place bets on outcomes of their own or others’ video games using “skins” — physical features that customize how an avatar/character looks — as currency. It’s not the exact same thing as betting money, but skins have real-world value, says Missar. (Skins gambling sites are also largely unregulated.)           


Some argue that, just as social casinos and video game features may prime kids for online gambling, so can fantasy sports simply by exposing youth to sports betting content on those platforms. Missar notes that he thinks fantasy sports can be completely separate from online sports betting (and, legally, they are), but “there’s a potential gateway” for kids due to gambling ads.


What is gambling disorder?


Gambling in general can become addictive because of the “dopamine rush” of betting, says Missar. Eventually, you can develop a tolerance, where you need to bet more money and gamble more often to get the same effect. “Gambling is absolutely as addictive as substances,” Missar adds. Gambling disorder, when a persistent preoccupation with gambling majorly interferes with your day-to-day life, is included in the DSM-5 alongside substance use disorders.


Gambling — and the financial, academic, and social strain that may come with it — can also lead to stress, anxiety, depression, shame, low self-esteem, and even suicide, Missar notes. In fact, gambling disorder has the highest suicide risk of any other substance use or addictive disorder.


Signs a teen might be struggling with gambling


All this said, gambling doesn’t have to be a full-blown addiction to impact a teen’s mental health. “We see negative impacts on mood, damage to relationships, and financial consequences occur even when an individual doesn’t meet the criteria for a gambling disorder,” says Missar.


Red flags specific to kids include:


Preoccupation with a new sport

Kids might not openly talk about gambling, so one warning sign is that they’re frequently checking stats on sports they never used to care about, says Dr. Allen. If they’re overwhelmingly upset about a random volleyball match they usually wouldn’t be interested in, that might be an indication they had a stake in the results.


Strange money behavior

If large sums of money seem to be missing or showing up out of nowhere, it’s worth looking into, says Dr. Allen. And if your kid lies to conceal the extent of their gambling, it might be cause for concern, says Missar.


Failure to take care of themselves

Kids might be staying up gambling, skipping meals or showers, or not taking care of their bodies because they’re so preoccupied, says Dr. Ice.


Academic struggles

Grades can fluctuate for many reasons, but they can certainly tank due to gambling. “I’ve had clients skip school because they’re so depressed, so anxious, from losing however much money they had in their checking account,” says Missar.


Withdrawal from relationships and activities

When teens start to build an obsession with gambling, they can disengage from friends, hobbies, and extracurriculars, says Missar. This isolation can snowball into feelings of loneliness, he adds.


How to talk to kids about online gambling


Talking to kids about online gambling will not encourage them to do it or continue doing it, health educator and prevention specialist Brittany Sue Hines, MEd, said during a National Council on Problem Gambling webinar on youth gambling. “It just gives them the information that they need in order to make informed decisions.”


Here are some tips for getting started:


Bring it up at a relevant, appropriate time

An easy way to broach the topic is when you hear an ad for a gambling site or leading up to Sunday night football. You could ask them about loot boxes when they take a break from gaming. For older kids, you can flag gambling lawsuits in real time.


But if your kids have friends over during a game, it might not be a good time to dive in, says Missar. Hines even suggests bringing gambling up during other prevention talks about sex, drugs, and alcohol, because it’s just as important.


Lead with curiosity instead of judgment

You don’t want your kids to get defensive and tune you out, which might happen if you start rattling off all the risks of online gambling. Whether you know they’re gambling or not, ask questions. Missar suggests saying something like, “Man, I see these DraftKings commercials all the time. What do you and your friends know about it? Have you guys ever bet on sports online?” Then, if they’re upfront with you, you can ask what they or their buds get out of it. Your kid may say their friends gamble online to gauge how you’ll respond to their own betting habits. So be careful how you react if you’re looking for honesty, says Dr. Allen.


Level set on the realities of gambling

Kids might have a hard time getting perspective when they’re basking in the highs of winning. You can remind them that just because they know a lot about sports doesn’t mean they’ll find actual success as a sports bettor, notes Malek. You can also underscore that even if someone wins one day, the odds are still against them, and it’s not a sustainable way to make money, says Missar.


Plus, things are not what they seem. Even if it looks like popular streamers are winning a ton, they’re often playing with an online casino’s money. And, when you’re seeing influencers and celebrities promoting gambling, “you’re not seeing the person who has gambled away their paycheck and has to tell their parents that they stole their credit card,” says Dr. Allen. “That’s not a glamorous commercial.”


Name the risks

Highlighting the financial, social, and emotional toll gambling can take is fair game, as is talking about why gambling can be addictive, says Missar. When addressing his teen clients, Missar will reinforce the fact that their brains are still developing and are naturally wired to be highly impulsive — so gambling can seem more appealing even though it can have serious consequences. (He’ll show young clients this short animated video that depicts what addiction can look like.) Ultimately, “youth who understand that gambling has risks are less likely to develop a gambling problem,” says Hines.


Talk about your own experiences

If you gamble virtually or in person, be mindful of what you’re modeling, says Dr. Ice. Talk about financial responsibility, then bring up times where you may have lost more than you’d hoped. (Dr. Ice cautions against being too honest, but gauge what’s best for you and your kids.) Touching on your relationship with gambling can lower their guards.


If you think your teen might have a gambling problem


Consider the context

Underage gambling is illegal; there’s no denying that. But take a beat to assess, suggests Hines. If your kid is spending a small amount to join a fantasy league, that’s one thing. If they’re in major debt and can’t seem to stop betting despite the financial, social, and mental toll, that’s another. 


Try not to shame them

If you lead with anger and frustration, they will shut you out, notes Hines. Shame is dangerous because it teaches kids that they, rather than just their actions, are bad, says David Tzall, PsyD, a psychologist who treats adolescents and adults struggling with addiction. It’s ideal to give off the vibe that your kids’ gambling issues are separate from their identities. That way, they’ll feel like they can get help and fix things. 


Encourage professional support

Even if you’re on board with therapy, your kid may not be. Seeing a mental health professional can be scary, so you have to find the right selling point. Dr. Allen suggests being specific. Try, “‘You’re losing a lot of money,’ or, ‘I’ve noticed you’re not having as much fun watching games anymore,’ or, ‘You lost your friends’ money and now they’re all pissed at you,’” she says. It’s difficult for them to argue with the truth.


#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-teens-and-online-gambling/


James Donaldson on Mental Health - Teens and Online Gambling
What to know and how to talk to kids about the risks

Writer: Sam Brodsky

Clinical Experts: Megan Ice, PhD , Matt Missar, LCSW

Key Takeaways

- Despite age limits, many teens are gambling online. And because their brains are still developing, they run a higher risk of developing a problem.

- Teens may be “primed” through things like loot boxes in video games, social casino apps, fantasy sports, or watching streamers gamble.

- Talking openly to kids about gambling doesn’t encourage them to do it — it helps protect them.

- How are kids gambling online?

- Why are kids gambling online?

- What is gambling disorder?

- Signs a teen might be struggling with gambling

- How to talk to kids about online gambling

- If you think your teen might have a gambling problem

- How gambling disorder is treated?

When adults worry about what keeps kids entertained in this digital age, they might not picture gambling. Despite legally binding age restrictions — in states where online betting is legal, players must be at least 18 or 21 years old — it is becoming increasingly common among teens, particularly teenage boys.

Matt Missar, LCSW, a therapist and certified gambling counselor, says the number of young people he treats for gambling issues is steadily growing. And even as he treats teens for other mental health concerns, he’ll later learn that they’ve placed bets.

While the majority of people who gamble don’t develop an addiction, participating in online gambling has been associated with an increased risk of gambling issues, especially in boys and men, according to a systematic review of research involving young people between ages 10 and 25. And studies suggest the earlier kids get exposed, the higher the chance of these behaviors yielding a problem.

Young people are specifically at risk for gambling addiction because their brains are still developing. Teens are often impulsive and think they have more control over outcomes (in this case, betting outcomes) than they really do, says Megan Ice, PhD, a psychologist at the Child Mind Institute. And their sensation-seeking and risk-taking tendencies can set them up for excessive online gambling, adds Suzanne Allen, PsyD, a psychologist who primarily works with children, adolescents, and their families.

How are kids gambling online?

In some cases, parents allow access to their own accounts with or without realizing how frequently their kids use them, Missar says. But children and teens are also finding loopholes and dodging safeguards meant to keep them from gambling virtually.

Kids may use someone else’s ID (or fake IDs), VPNs, or older friends’ accounts to bypass age restrictions. And offshore crypto casinos or other gambling sites operating outside of the United States aren’t as stringent.

Underage people may have indirect access to online betting by watching streamers gamble or by placing bets with peers who have found a way in. High school students with access to accounts like FanDuel or offshore platforms will, essentially, act as bookies and take bets from other kids, Missar explains.

“Teenagers are already very resourceful in circumventing restrictions, and so they’re pretty easily available if a teenager is looking in the right place,” he notes.

Saul Malek, now a public speaker on gambling addiction, says he gambled virtually for the first time as a 19-year-old college sophomore. Bookies hooked him up with online sportsbooks (he imagines they were offshore accounts but can’t confirm), and he started down what he describes as a “rabbit hole” — losing money on one online sportsbook, blocking the bookie’s number once he owed them, and then finding another bookie to repeat the cycle.

It got to the point where he couldn’t sit through entire games anymore; he had to bet on individual rounds during a match, then move on. Over the span of two years, Malek amassed about $20,000 in debts. It’s been six years since his last bet, and the 28-year-old is still paying off what he owes.

Why are kids gambling online?

When you’re winning, gambling can be exciting, especially now that you can wager on anything, anytime — even the color of Gatorade poured on a coach or the length of the national anthem. Malek says part of the fun was “living in the daydream of the next big win.” Young people may also see online gambling as a way to relieve stress and cope with hard things, says Dr. Allen.

There’s a social component as well, offering teens a way to fit in and make new friends. “Anything that’s going to help you get accepted by your friends is going to be very, very reinforcing,” says Dr. Ice.

Kids may naturally transition into virtual gambling after participating in certain activities that “prime” them for it. For one, they can download apps that mimic casino-style gambling and sports betting with virtual currency — some of which are advertised as “social casinos” and “social sportsbooks” (think: Fliff).

Additionally, features in video games can mimic gambling. Kids, for instance, can pay for loot boxes that hold mystery prizes; it’s the luck of the draw in exchange for cash. “I’ve seen families be out tons of money on a video game based on their kids’ purchases. And that’s kids as young as 6 or 7,” Dr. Ice notes. (Some countries are regulating these types of boxes due to their resemblance to gambling.)

Similarly, young people place bets on outcomes of their own or others’ video games using “skins” — physical features that customize how an avatar/character looks — as currency. It’s not the exact same thing as betting money, but skins have real-world value, says Missar. (Skins gambling sites are also largely unregulated.)           

Some argue that, just as social casinos and video game features may prime kids for online gambling, so can fantasy sports simply by exposing youth to sports betting content on those platforms. Missar notes that he thinks fantasy sports can be completely separate from online sports betting (and, legally, they are), but “there’s a potential gateway” for kids due to gambling ads.

What is gambling disorder?

Gambling in general can become addictive because of the “dopamine rush” of betting, says Missar. Eventually, you can develop a tolerance, where you need to bet more money and gamble more often to get the same effect. “Gambling is absolutely as addictive as substances,” Missar adds. Gambling disorder, when a persistent preoccupation with gambling majorly interferes with your day-to-day life, is included in the DSM-5 alongside substance use disorders.

Gambling — and the financial, academic, and social strain that may come with it — can also lead to stress, anxiety, depression, shame, low self-esteem, and even suicide, Missar notes. In fact, gambling disorder has the highest suicide risk of any other substance use or addictive disorder.

Signs a teen might be struggling with gambling

All this said, gambling doesn’t have to be a full-blown addiction to impact a teen’s mental health. “We see negative impacts on mood, damage to relationships, and financial consequences occur even when an individual doesn’t meet the criteria for a gambling disorder,” says Missar.

Red flags specific to kids include:

Preoccupation with a new sport

Kids might not openly talk about gambling, so one warning sign is that they’re frequently checking stats on sports they never used to care about, says Dr. Allen. If they’re overwhelmingly upset about a random volleyball match they usually wouldn’t be interested in, that might be an indication they had a stake in the results.

Strange money behavior

If large sums of money seem to be missing or showing up out of nowhere, it’s worth looking into, says Dr. Allen. And if your kid lies to conceal the extent of their gambling, it might be cause for concern, says Missar.

Failure to take care of themselves

Kids might be staying up gambling, skipping meals or showers, or not taking care of their bodies because they’re so preoccupied, says Dr. Ice.

Academic struggles

Grades can fluctuate for many reasons, but they can certainly tank due to gambling. “I’ve had clients skip school because they’re so depressed, so anxious, from losing however much money they had in their checking account,” says Missar.

Withdrawal from relationships and activities

When teens start to build an obsession with gambling, they can disengage from friends, hobbies, and extracurriculars, says Missar. This isolation can snowball into feelings of loneliness, he adds.

How to talk to kids about online gambling

Talking to kids about online gambling will not encourage them to do it or continue doing it, health educator and prevention specialist Brittany Sue Hines, MEd, said during a National Council on Problem Gambling webinar on youth gambling. “It just gives them the information that they need in order to make informed decisions.”

Here are some tips for getting started:

Bring it up at a relevant, appropriate time

An easy way to broach the topic is when you hear an ad for a gambling site or leading up to Sunday night football. You could ask them about loot boxes when they take a break from gaming. For older kids, you can flag gambling lawsuits in real time.

But if your kids have friends over during a game, it might not be a good time to dive in, says Missar. Hines even suggests bringing gambling up during other prevention talks about sex, drugs, and alcohol, because it’s just as important.

Lead with curiosity instead of judgment

You don’t want your kids to get defensive and tune you out, which might happen if you start rattling off all the risks of online gambling. Whether you know they’re gambling or not, ask questions. Missar suggests saying something like, “Man, I see these DraftKings commercials all the time. What do you and your friends know about it? Have you guys ever bet on sports online?” Then, if they’re upfront with you, you can ask what they or their buds get out of it. Your kid may say their friends gamble online to gauge how you’ll respond to their own betting habits. So be careful how you react if you’re looking for honesty, says Dr. Allen.

Level set on the realities of gambling

Kids might have a hard time getting perspective when they’re basking in the highs of winning. You can remind them that just because they know a lot about sports doesn’t mean they’ll find actual success as a sports bettor, notes Malek. You can also underscore that even if someone wins one day, the odds are still against them, and it’s not a sustainable way to make money, says Missar.

Plus, things are not what they seem. Even if it looks like popular streamers are winning a ton, they’re often playing with an online casino’s money. And, when you’re seeing influencers and celebrities promoting gambling, “you’re not seeing the person who has gambled away their paycheck and has to tell their parents that they stole their credit card,” says Dr. Allen. “That’s not a glamorous commercial.”

Name the risks

Highlighting the financial, social, and emotional toll gambling can take is fair game, as is talking about why gambling can be addictive, says Missar. When addressing his teen clients, Missar will reinforce the fact that their brains are still developing and are naturally wired to be highly impulsive — so gambling can seem more appealing even though it can have serious consequences. (He’ll show young clients this short animated video that depicts what addiction can look like.) Ultimately, “youth who understand that gambling has risks are less likely to develop a gambling problem,” says Hines.

Talk about your own experiences

If you gamble virtually or in person, be mindful of what you’re modeling, says Dr. Ice. Talk about financial responsibility, then bring up times where you may have lost more than you’d hoped. (Dr. Ice cautions against being too honest, but gauge what’s best for you and your kids.) Touching on your relationship with gambling can lower their guards.

If you think your teen might have a gambling problem

Consider the context

Underage gambling is illegal; there’s no denying that. But take a beat to assess, suggests Hines. If your kid is spending a small amount to join a fantasy league, that’s one thing. If they’re in major debt and can’t seem to stop betting despite the financial, social, and mental toll, that’s another. 

Try not to shame them

If you lead with anger and frustration, they will shut you out, notes Hines. Shame is dangerous because it teaches kids that they, rather than just their actions, are bad, says David Tzall, PsyD, a psychologist who treats adolescents and adults struggling with addiction. It’s ideal to give off the vibe that your kids’ gambling issues are separate from their identities. That way, they’ll feel like they can get help and fix things. 

Encourage professional support

Even if you’re on board with therapy, your kid may not be. Seeing a mental health professional can be scary, so you have to find the right selling point. Dr. Allen suggests being specific. Try, “‘You’re losing a lot of money,’ or, ‘I’ve noticed you’re not having as much fun watching games anymore,’ or, ‘You lost your friends’ money and now they’re all pissed at you,’” she says. It’s difficult for them to argue with the truth.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How gambling disorder is treated?

A therapist who has expertise in treating addiction (or gambling addiction) can help. They can formally assess your child’s gambling and mental health, provide resources, and reshape a young person’s relationship with betting.

Therapists may use cognitive behavioral therapy (CBT) to reframe distorted thoughts or beliefs that fuel kids’ gambling, says Missar. These distortions include the illusion of control and overestimating winning. Therapists might also help your teen find good reasons to change via motivational interviewing, says Dr. Tzall. 

Young people can also make independent changes — with or without the help of a therapist — that will decrease their gambling. For example, kids of legal gambling age can sign up for an exclusion program. This means “legitimate gambling apps” they can access from their state will block them, says Missar. Underage gamblers who can’t sign up for those programs can use blocking software instead, he notes.

Then they can work on filling free time with new or old hobbies and unfollowing social media accounts that promote betting, Missar says. As a parent, you can help facilitate this by providing closer financial supervision on shared bank accounts and adding transaction alerts. 

In addition to working with a mental health professional and modifying their lifestyles, adolescents might want to try peer support groups like Gamblers Anonymous (GA), which the American Psychiatric Association recognizes as a resource.

Malek found great success with GA. He saw a therapist briefly in 2019, then felt like he was getting enough support through GA to drop therapy. Healing with like-minded people has influenced him to stop gambling — and “stay stopped.” Malek is actively recovering from his gambling addiction, and he says he’s working with his sponsor on step 10 of a 12-step program.

A young person struggling with a gambling problem can call the National Council on Problem Gambling Helpline (1-800-522-4700) or SAMHSA’s National Helpline (1-800-662-4357) to connect with local resources. Or, you can call on their behalf. https://standingabovethecrowd.com/?p=16475

Sunday, August 2, 2026



James Donaldson on Mental Health - Finding Help Following Suicide or an Attempt
Support related to suicide exists, but it's not always easy to find

By John Bateson

THE BASICS

- Suicide Risk Factors and Signs

- Take our Depression Test

- Find a therapist near me

Key points

- Suicide deaths tend to be traumatic for family members and friends.

- Support groups for those who survive a suicide attempt or parents whose children attempt suicide are rare.

- An hour-long video, “Supporting Parents," is one new resource.

Many crisis centers that operate 24-hour suicide prevention hotlines also provide grief counseling to people who are mourning a death. That’s because many people who have lost a loved one to suicide are more at risk for suicide themselves.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

The crisis center I directed provided individual counseling and also operated multiple grief support groups. Four of the groups were for survivors of suicide—parents who lost children, youths who lost parents, individuals who lost partners, and others who lost siblings or friends because of suicide. Typically, there were 15 to 20 people in each of these four groups, although sometimes the number was greater, and we needed extra facilitators.

The first night of each group was memorable for one main reason. Upon entering the room, many people gasped. They couldn’t believe that so many other people were there, that so many others had experienced the same tragedy they had experienced, the suicide of a loved one. Until that moment, they felt completely alone.

Our grief counseling director, who was a nationally recognized death educator, started every first night the same way: “I’m so sorry that you’re here, and I’m so glad that you’re here.”

Anytime someone dies, it can be traumatic for survivors. Suicide deaths tend to be the most traumatic of all because of the guilt and stigma attached to them. Survivors think back on every interaction they had with the deceased, especially recent ones, questioning what they did or didn’t do—all of the “what ifs.” Did they miss warning signs? Did they take something the decedent said too lightly? Were they slow to act or did they not act at all, even in the face of what, in retrospect, was ominous?

Support groups for people who have attempted suicide are rare. A few agencies operate them, but they are hard to find, in part because leading this kind of group is daunting. Not only is everyone in it at high risk of suicide, but many suicidal people have emotional needs that can be overwhelming for the facilitator.

Support groups for parents whose children have attempted suicide are even rarer. More often than not, parents seek individual counseling for their child and/or counseling for the family with a private therapist. This, too, can be challenging to find, however, because many clinicians don’t have experience or aren’t comfortable providing this kind of therapy.

One new resource is an hour-long video developed by Zero Suicide titled Supporting Parents. It’s specifically for parents whose child has attempted suicide, and recognizes the fears, anxieties, and questions parents have; the helpless feelings they experience; and the fact that they might feel alone in this, but are not. Many others, sadly, are in the same position.

Having a loved one die or attempt suicide is an isolating experience, but a person doesn’t have to be alone. Help exists.

Zero Suicide is a global health care initiative whose goal isn’t just to prevent suicides but to end them. For anyone who is worried about the safety of a loved one, the only acceptable number when it comes to suicide is zero. Four other resources are noteworthy: The national, three-digit Suicide and Crisis Lifeline (988) connects callers seamlessly to the nearest, certified crisis center so that they can receive immediate, free, confidential counseling. The Crisis Text Line (741741) does the same thing for texters. The Trevor Project (1-888-488-7386) provides crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, and questioning youth under the age of 25. The National Alliance on Mental Illness (NAMI) has local chapters throughout the country and provides a variety of support services for mental health consumers and family members. https://standingabovethecrowd.com/?p=16451

James Donaldson on Mental Health - Finding Help Following Suicide or an Attempt

James Donaldson on Mental Health - Finding Help Following Suicide or an Attempt

Support related to suicide exists, but it's not always easy to find



By John Bateson


THE BASICS


- Suicide Risk Factors and Signs
- Take our Depression Test
- Find a therapist near me
Key points
- Suicide deaths tend to be traumatic for family members and friends.
- Support groups for those who survive a suicide attempt or parents whose children attempt suicide are rare.
- An hour-long video, “Supporting Parents," is one new resource.

Many crisis centers that operate 24-hour suicide prevention hotlines also provide grief counseling to people who are mourning a death. That’s because many people who have lost a loved one to suicide are more at risk for suicide themselves.


#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy


Click Here For More Information About James Donaldson



Click here to follow James Donaldson's Blog



The crisis center I directed provided individual counseling and also operated multiple grief support groups. Four of the groups were for survivors of suicide—parents who lost children, youths who lost parents, individuals who lost partners, and others who lost siblings or friends because of suicide. Typically, there were 15 to 20 people in each of these four groups, although sometimes the number was greater, and we needed extra facilitators.


The first night of each group was memorable for one main reason. Upon entering the room, many people gasped. They couldn’t believe that so many other people were there, that so many others had experienced the same tragedy they had experienced, the suicide of a loved one. Until that moment, they felt completely alone.


Our grief counseling director, who was a nationally recognized death educator, started every first night the same way: “I’m so sorry that you’re here, and I’m so glad that you’re here.”


Anytime someone dies, it can be traumatic for survivors. Suicide deaths tend to be the most traumatic of all because of the guilt and stigma attached to them. Survivors think back on every interaction they had with the deceased, especially recent ones, questioning what they did or didn’t do—all of the “what ifs.” Did they miss warning signs? Did they take something the decedent said too lightly? Were they slow to act or did they not act at all, even in the face of what, in retrospect, was ominous?


Support groups for people who have attempted suicide are rare. A few agencies operate them, but they are hard to find, in part because leading this kind of group is daunting. Not only is everyone in it at high risk of suicide, but many suicidal people have emotional needs that can be overwhelming for the facilitator.


Support groups for parents whose children have attempted suicide are even rarer. More often than not, parents seek individual counseling for their child and/or counseling for the family with a private therapist. This, too, can be challenging to find, however, because many clinicians don’t have experience or aren’t comfortable providing this kind of therapy.


One new resource is an hour-long video developed by Zero Suicide titled Supporting Parents. It’s specifically for parents whose child has attempted suicide, and recognizes the fears, anxieties, and questions parents have; the helpless feelings they experience; and the fact that they might feel alone in this, but are not. Many others, sadly, are in the same position.


Having a loved one die or attempt suicide is an isolating experience, but a person doesn’t have to be alone. Help exists.


Zero Suicide is a global health care initiative whose goal isn’t just to prevent suicides but to end them. For anyone who is worried about the safety of a loved one, the only acceptable number when it comes to suicide is zero. Four other resources are noteworthy: The national, three-digit Suicide and Crisis Lifeline (988) connects callers seamlessly to the nearest, certified crisis center so that they can receive immediate, free, confidential counseling. The Crisis Text Line (741741) does the same thing for texters. The Trevor Project (1-888-488-7386) provides crisis intervention and suicide prevention services to lesbian, gay, bisexualtransgender, and questioning youth under the age of 25. The National Alliance on Mental Illness (NAMI) has local chapters throughout the country and provides a variety of support services for mental health consumers and family members.


https://standingabovethecrowd.com/james-donaldson-on-mental-health-finding-help-following-suicide-or-an-attempt-2/

Saturday, August 1, 2026

James Donaldson on Mental Health - Does it matter HOW I praise my child?

James Donaldson on Mental Health - Does it matter HOW I praise my child?
a mother and daughter reading a book on a couchPhoto by olia danilevich on Pexels.com

Clinical Expert: Melanie A. Fernandez, PhD, ABPP


Question


I know I should reinforce good behavior, but does it matter HOW I praise my child?


Answer


There are certainly ways to make praise more effective in teaching, as well as encouraging good behaviors and improving self-esteem in children.


The more descriptive your praise is, the better. So instead of saying, “Good job!” caregivers should specify what was a good job. For instance, “Good job sharing your toys with your brother!” When you’re specific about what a child did well, you’re more likely to bring attention to the child’s effort-as opposed to the outcome of the effort.


It’s important to recognize that praising effort is not the same as praising success; praising your child for being smart doesn’t teach what behavior was so smart. More benefit comes from labeling the smart behavior: “It was so smart how you built a base on your tower before starting to add the other pieces.”


When a child is learning a new behavior, it’s important to offer praise whenever the behavior happens; once the child has learned the behavior, continuing to offer praise, but less frequently, helps the child maintain the behavior learned. Caregivers should be looking for opportunities to praise kids’ positive behaviors — even the behaviors they think kids should already know and be doing regularly.


Finally, praise should be genuine.


#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy


Click Here For More Information About James Donaldson



Click here to follow James Donaldson's Blog



a mother and daughter reading a book on a couchPhoto by olia danilevich on Pexels.com

https://standingabovethecrowd.com/james-donaldson-on-mental-health-does-it-matter-how-i-praise-my-child-2/


James Donaldson on Mental Health - Does it matter HOW I praise my child?
Photo by olia danilevich on Pexels.com

Clinical Expert: Melanie A. Fernandez, PhD, ABPP

Question

I know I should reinforce good behavior, but does it matter HOW I praise my child?

Answer

There are certainly ways to make praise more effective in teaching, as well as encouraging good behaviors and improving self-esteem in children.

The more descriptive your praise is, the better. So instead of saying, “Good job!” caregivers should specify what was a good job. For instance, “Good job sharing your toys with your brother!” When you’re specific about what a child did well, you’re more likely to bring attention to the child’s effort-as opposed to the outcome of the effort.

It’s important to recognize that praising effort is not the same as praising success; praising your child for being smart doesn’t teach what behavior was so smart. More benefit comes from labeling the smart behavior: “It was so smart how you built a base on your tower before starting to add the other pieces.”

When a child is learning a new behavior, it’s important to offer praise whenever the behavior happens; once the child has learned the behavior, continuing to offer praise, but less frequently, helps the child maintain the behavior learned. Caregivers should be looking for opportunities to praise kids’ positive behaviors — even the behaviors they think kids should already know and be doing regularly.

Finally, praise should be genuine.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Photo by olia danilevich on Pexels.com https://standingabovethecrowd.com/?p=16466

Friday, July 31, 2026

James Donaldson on Mental Health - What Is Motivational Interviewing?

James Donaldson on Mental Health - What Is Motivational Interviewing?

A deep dive into a form of therapy that helps teens change unhealthy behaviors



Writer: Faith Wilkins


Clinical Expert: Christine Morrissey, LCSW, MSEd


What You'll Learn


- What are the core principles of motivational interviewing?
- How does motivational interviewing work?
- What are the benefits to using motivational interviewing as a form of treatment?
- Quick Read
- Full Article
- What are the core principles of MI?
- What is the process of treatment?
- What are the benefits of MI?

Motivational Interviewing (MI) is a form of therapy that helps patients build the confidence and self-motivation they need to change unhealthy behaviors, like substance abuse or self-harm. MI is more often used with adolescents than children, as they are more emotionally developed, and have more control over their environment.


The core principles of MI are open-ended questions, affirmations, reflections, and summarization (OARS). They’re based on the idea that clinician and patient are equal partners, and the patient should always feel like they’re in the driver’s seat. Clinicians will use open-ended questions to form a better understanding of the patient’s values and goals for treatment. During these conversations, they will offer affirmations to help teens build the confidence to change. Clinicians will also repeat, rephrase, and summarize things the teen has said, allowing them to reflect on their own values and feel heard in the process.


While the OARS are used throughout each session of MI, there is a clear set of phases that clinician and patient usually go through during treatment. In the engagement phase, therapists create a judgment-free space for teenagers to share their feelings and reservations against change. Having established trust, they move on to the focusing phase and work with teens to identify the specific behaviors they’re willing to change. This process usually takes place over many sessions, as it can involve a lot of trial and error. Clinicians will then enter the evoking phase, discussing the disadvantages of maintaining unhealthy behaviors and encouraging teens to see the benefits to change. Finally, they enter the planning phase, in which clinicians help their patients break down goals in a way that feels manageable and discuss potential barriers. This phase is optional but necessary if the patient needs more guidance.


Many therapists find MI to be beneficial because it can be tailored to the patient’s needs. For instance, if adolescents struggle with depression or anxiety, it can be hard for them to find self-motivation. They can take more intensive therapy like cognitive-behavioral therapy (CBT) along with MI.


Many of us can relate to wanting to make positive lifestyle changes and struggling to find the motivation to do so. For teenagers, it can be very difficult to make those changes, especially if their parents are pushing them to do it. The psychologists who created motivational interviewing (MI) believed that a collaborative, patient-centered approach to treatment would help people successfully commit to change. MI is a form of therapy that enables patients to gain the self-motivation they need to change unhealthy behaviors.  


The type of person who would benefit the most from MI is someone who shows resistance to therapy or change in general. They lack self-confidence, and even if they really want to change their behavior, they might not know where to start. The habit that they need to change, whether it’s drug abuse, alcoholism, or self-harm, has most likely become a coping mechanism to deal with other stressors in their everyday life. This can make it difficult for them to justify giving that behavior up, regardless of the negative consequences of continuing.


“When you think about a teenager,” says Christine Morrissey, LMSW, MSEd, a clinical social worker, “they’re undergoing a period of developing their sense of self, figuring out who they are. By the time an adolescent gets to treatment, you want to make sure that they believe they’re in the driver’s seat, which is something that doesn’t happen very often for them.”


Many teens go into therapy feeling angry or resentful, unsure why they need treatment. Therapists use MI to help teenagers overcome that ambivalence, giving them the space to explore their own goals and values and see how change can benefit them in the long run. MI is more often used with adolescents than children, as they are more emotionally developed and have more control over their environment.


What are the core principles of MI?


Motivational interviewing provides guidance for drawing out one’s own reasons and capacity for change. Clinicians are encouraged to act as an equal partner and avoid providing unsolicited advice, confrontation, or direction. To effectively guide their patients, they go by four core principles, which are known as the OARS:


- Open-ended questions
- Affirmations of strength, efforts, and past successes
- Reflections
- Summarization

“The idea of open-ended questions is that you can really get a person not only conversing with you about their life and their values and their goals, but also conversing with themselves,” Morrissey adds. 


Many topics can be covered during these sessions, such as how the adolescent’s behaviors align or conflict with their values, identifying the important people in their life, and why change would be important to them.


As an example, Morrissey describes one of her patients, whose parents and friends are concerned about their vaping habits. “In more recent sessions, we’ve been focusing on the vaping behavior, and I started by asking open-ended questions about how much they vape and really inquiring about what vaping does for them and what the drawbacks of it are, with a curious and nonjudgmental stance,” she explains. “With time to explore this, we were able to focus on what a goal might be that aligns with their long-term health goals, and also discuss ambivalence and barriers that get in the way.”


During these conversations, clinicians are careful to offer affirmations that will help build confidence in their patient. For example, if a teen describes an instance where they had to make a difficult decision, the clinician will point out the amount of strength it must have taken for them to do so. The goal is to empower the teen to use that strength in all aspects of their life.


Reflective listening is also an essential part of MI sessions, allowing clinicians to show their patients that they really care about what they have to say. Clinicians will often use this technique to repeat, rephrase, and summarize key takeaways from what has been said during each session. This is meant to get patients to really think about what they’ve just communicated and determine if that’s how they actually feel. Do their actions align with their current values and goals?


#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy


Click Here For More Information About James Donaldson



Click here to follow James Donaldson's Blog



What is the process of treatment?


While the OARS are used by clinicians throughout each session of MI, there is a clear set of phases that clinician and patient usually go through during treatment. Depending on the needs of the patient, MI sessions can flow back and forth between phases. It’s just important that each phase is included.


Engagement: In this phase, clinicians want to get to know their patients and establish trust. It is made clear that these sessions are for them and not their parents, and anything they say will be confidential. The idea is to create a comfortable space for teenagers to share their feelings and possible ambivalence towards change. The purpose of this phase isn’t to come up with solutions quite yet, but to allow clinicians to meet their patients where they are and adjust to resistance rather than confront it head on.


Focusing: Once a solid relationship has been established between patient and clinician, they can then come up with the focus of treatment. At this stage of MI, most patients are unclear about the direction they want to take regarding recovery or making the desired lifestyle change. Still, clinicians want to make sure that this is a collaboration. They will often begin each session by discussing agenda items, making suggestions if needed, but ultimately allowing their patients to decide how to focus the sessions. Not only does this provide teenagers with the autonomy they need, but it also serves as a check-in for clinicians. They can assess whether their own goals for the sessions align with their patient’s and adjust accordingly.


This process is often gradual and can take place over several sessions, as clinicians must work with their patients to identify “change targets,” or the specific behaviors that need to change. They can draw upon the teenager’s values, which would’ve been established during the engagement phase, to identify their goals.


Morrissey explains, “The focusing is probably going to start wide and over time get narrower because over time, someone might realize that they kind of overshot their goal. If you’ve ever thought about starting a new exercise regimen and you’re like, ‘I’m going to run 10 miles every single day,’ and then over time you’re like, ‘Oh, that actually isn’t sustainable.’ Focusing would be like, ‘I want to move my body for at least 10 minutes a day.’ That can take a lot of time and trial and error.”


Evoking: The focusing phase can be difficult for teens, and they might display a great deal of resistance to setting goals. At this point, clinicians will begin the process of evoking “change talk.” This refers to any kind of statement that supports making a change. For example, a patient might say that they need to stop abusing substances, but don’t think they can do it. The change talk in that statement would be, “I need to stop abusing substances.” The clinician will keep them from going down a more negative line of thinking by asking, “What are the reasons you think you need to stop abusing substances?” With this technique, clinicians draw out the wants and needs of their patient without providing unwelcome advice.


At this stage, therapists can also work to reduce ambivalence towards change by first discussing the clear disadvantages to the patient maintaining their current unhealthy behavior. Clinicians will then use open-ended questioning and affirmations to encourage their patients to envision the benefits to change and to believe that this change is possible. Throughout these conversations, they remain optimistic and supportive while patients process their emotions towards changing their behavior.


Planning: The final phase of MI is planning. This is an optional phase but necessary when patients need more guidance on the steps that they need to take to change their behavior. It is at this point that they discuss barriers to their goals and how they might get past those barriers. Clinicians help their patients come up with a “change plan,” breaking down goals in a way that feels manageable. They also discuss what they might do if they experience setbacks.


Morrissey further explains this process when describing a session with one of her patients: “We also talked about what would happen if they ‘slipped up’ and vaped and discussed ways of using self-compassion to practice acceptance, combat all-or-nothing thinking, and get right back to goal-oriented behavior. . . there’s a lot of transitioning between stages, especially when there is ambivalence about change or slip-ups that come up that don’t align with the person’s goals.”


What are the benefits of MI?


The benefit to using motivational interviewing for teens is that it’s highly flexible and individualized. Depending on the patient’s needs, it can be used as standalone treatment, or used in tandem with other more intensive forms of treatment like cognitive-behavioral therapy (CBT). This can especially be true for adolescents who havemood disorders. For instance, if they’re struggling with depression or trauma, it could be really difficult for them to find self-motivation without the help of more comprehensive therapy.


“I really think it’s such a benefit to the client that they are the person who is the expert of their life, who knows themselves the best, who if they’re the person coming up with the solutions, they’re likely to be more realistic to their life. I think from a clinician’s perspective, it’s really fun work to do because you’re really tapping into someone’s inherent abilities. I think for the client themselves, it’s really beneficial because they get that autonomy,” says Morrissey.


https://standingabovethecrowd.com/james-donaldson-on-mental-health-what-is-motivational-interviewing/