Want to Improve Adult Mental Health? Prevent Bullying in Childhood

I recently had the opportunity to hear Dr. Tracy Vaillancourt from the University of Ottawa present fascinating research on the effects of bullying.  Her research suggests that bullying has far more long-reaching consequences for some youth then previously thought.  The now archived webinar, “Bullying Gets under Your Skin” is a must view for anyone who cares about preventing child maltreatment in general and bullying specifically.

Of particular note is that bullying is now being recognized as a form of trauma that impacts the stress response and even alters gene expression in some individuals which leads to long term physical and mental health issues.  In the webinar Dr. Vaillancourt describes how depression is the leading cause of disability world-wide and the majority of mental health problems among adults began in childhood or adolescence.  While it is easy to assume that internalizing problems precede a child being targeted by bullying, research demonstrates that the reverse is frequently true.  The majority of youth who experience depression and anxiety related to bullying did not have internalizing problems prior to their being targeted by bullying.  While there are moderators that impact negative outcomes for youth such as a supportive home environment, it is clear that bullying is a public health issue that warrants our attention.

Psychologist Alfred Adler theorized many decades ago that children have a fundamental need to belong and when this is interrupted healthy functioning decreases.  Dr. Vaillancourt also posits in the webinar how fundamental the need to belong is and suggests as bullying interrupts this sense of belonging the consequences are far-reaching.  In summary, if we are committed to preventing depression and other mental health issues among adults we need to focus more heavily on preventing bullying among children.

Making the Connection between Trauma and Bullying at IBPA 2014

I was pleased to note that the 2014 International Bullying Prevention Conference in San Diego, CA provided several sessions that made the connection between bullying and trauma. SAMHSA defines trauma as a “highly stressful experience in the face of a perceived threat to one’s self or to one’s physical integrity or to that of one’s family member, close friend or environment. “ The definition of bullying as a repeated, intentionally negative physical or psychological action involving an imbalance of power seems to suggest an overlap with trauma and the research appears to bear this out.   Amy Wolferman’s presentation on “Trauma as a Context for Bullying” noted that a study by Idsoe, Dyregrov & Idsoe (2012) found that for all bullied students, 27.6% of boys and 40.5% of girls had PTSD scores within the clinical range. The fact that bullying continues overtime suggests that many youth may experience complex trauma that is continuing as they attend school. Thus it is critical that schools create physically and psychologically safe places for students to learn. Student Support Team staff also need to screen for trauma symptoms with their students in general and in particular with students who report being bullied. While all students can benefit from universal SEL skills training, having trauma-informed interventions for bullied youth is also part of creating a safe and positive school climate.

Thus I was delighted to see a session on Mindfulness and Meditation led by high school students who were involved in a program at the UC-San Diego’s Center for Mindfulness. Many of these students shared that previously they had struggled with anxiety and depression but that regular practice of meditation and mindfulness had decreased their symptoms significantly. I would add that they seemed to have increased their resiliency to negative emotional experiences, something that all of us can benefit from in our daily life and traumatized youth in particular need these skills. This doesn’t mean that students learn to avoid negative emotions, but instead they learn to notice, accept, and work through difficult feelings without engaging in harmful defense mechanisms. As someone who has practiced meditation and mindfulness for the past year and a half and seen its benefits first-hand,  I enthusiastically support more mindfulness programs for youth and the adults who work with them.  

The International Bullying Prevention Conference – An Amazing Learning Opportunity!

I have been involved in some manner with the International Bullying Prevention Association  (IBPA) since its beginning eleven years ago in Atlanta, Georgia.  Each year I have watched the organization grow and I joined the Board of Directors in 2010.  The annual conference has become arguably the best opportunity world-wide to learn cutting edge strategies to prevent and respond to bullying and also a place to gain new research insights to inform our practices in the schools and community.   As I review the program for this year’s conference in San Diego, I marvel at the breadth and depth of the sessions and realize that for many attendees the biggest challenge will be deciding which session to attend as there are so many great offerings.  Fortunately handouts and slides will be shared online afterwards for those who wish to be in two (or three!) places at once as I do.

In addition to the conference, IBPA hosts monthly webinars that provide continuing education on hot topics such as legal issues, cyberbullying, restorative justice, identity-based bullying, and more.  The membership fee allows access to these webinars free of charge.  I recommend anyone interested in the field of bullying prevention and positive school climate take advantage of the membership opportunity.  By staying abreast of research and learning about effective and promising approaches to reduce bullying, we can all make a difference in our schools and communities!

Recommended Guidelines for Bullying Prevention Assemblies – Patti Agatston, PhD

– This article was originally featured in the spring 2014 International Bullying Prevention Association Newsletter.

1. Recognize the limits of the school assembly approach in changing behavior. It may be beneficial to utilize assemblies to generate awareness and build enthusiasm for preventing bullying, however ongoing prevention efforts are necessary to bring about changes in behavior and school climate. Have a plan for follow up activities in place prior to providing an assembly activity. (See Misdirections in Bullying Prevention and Intervention at www.stopbullying.gov to learn more about using resources wisely.)
2. Preview performances and scripts to ensure that the messages are based on sound theoretical knowledge, research, and best practices in bullying prevention. Avoid performances that promote stereotypes regarding the type of youth who are bullied or engage in bullying. Also avoid messaging that implies that youth who bully always have low self-esteem, are big and tough, or that “standing up to a bully” is always the best solution. See research by Phillip Rodkin on the socially connected bully (Rodkin, 2012) to understand more about the socially connected versus the socially marginalized bully. See also information from the Youth Voice Project (Davis & Nixon, 2013) to learn more about which strategies are most helpful for youth who are targeted by bullying.
3. Put the focus on the positive behavior that we want students to demonstrate. Performances that focus on positive ally actions are more effective than scare tactics or numerous examples and inflated statistics regarding bullying. Social norming theory (Berkowitz, 2004) posits that behavior is influenced by inaccurate perceptions regarding how other members of the peer group think and act. Individuals tend to overestimate the number of their peers involved in negative behaviors. Correcting such misperceptions can lead to positive behavior change. Thus youth are more likely to engage in pro-social behavior when they understand that the majority of their peers share their desire to or are engaging in positive behavior. Use local survey data and youth leaders to help spread the message that most youth are engaging in pro-social behavior or have pro-social beliefs. When possible allow students to create the assembly, share local statistics, and have ownership of the messages and actions requested of their peers.
4. Be very cautious with messaging around bullying and suicide. Messages that imply simplistic causal relationships between bullying and suicide are misleading and potentially harmful to prevention efforts. The following was noted in the Journal of Adolescent Health’s Special Supplement on the Relationship between Youth Involvement in Bullying and Suicide: “A critical difference distinguishes an association between bullying and suicide from a causal relationship, with significant implications for prevention. Conveying that bullying alone causes suicide at best minimizes, and at worst ignores, the other factors that may contribute to death by suicide” (Hertz, Donato, & Wright, 2013 p.S-2.)
5. Be aware that student audiences may include “suicide-receptive” youth. Assemblies that focus on explicit details, methods and dramatizations of suicide rather than the importance of reaching out for help should be avoided. (NIHM, Recommendations for Reporting on Suicide)

Berkowitz, A. (2004). The Social Norms Approach: Theory, Research, and Annotated Bibliography. Retrieved from http://www.alanberkowitz.com/articles/social_norms.pdf

Davis, S., & Nixon, C. (2013). The Youth Voice Project: Student Insights Into Bullying and Peer Mistreatment. Research Press.

Hertz, M., Donato, I., & Wright, J. (2013). Bullying and Suicide: A Public Health Approach. Journal of Adolescent Health Supplement, 53(1), S1-S3. Retrieved from http://www.sciencedirect.com/science/article/pii/S1054139X1300270X

NIMH • Recommendations for Reporting on Suicide. (n.d.). Retrieved January 7, 2013, from http://www.nimh.nih.gov/health/topics/suicide-prevention/recommendations-for-reporting-on-suicide.shtml

Misdirections in Bullying Prevention. (n.d.). Retrieved January 6, 2013, from http://www.stopbullying.gov/prevention/at-school/educate/misdirections-in-prevention.pdf
Rodkin, P. (2012). Bullying and Children’s Relationships. Education Matters, 8(2).

Reflections on the 10th International Bullying Prevention Conference, Patti Agatston, PhD

The International Bullying Prevention Association recently celebrated the 10th anniversary of its organization with its annual conference in Nashville, TN, November 10–12, 2013.

As an attendee for the past 10 years and a board member for the past four years, I am excited to see the growth of the organization and the evolution of the bullying prevention field. There is a growing recognition that we need to move beyond labels and use comprehensive school-wide approaches that build connectedness in our schools and communities.

In fact, many of the speakers, including Ernie Mendez, Emily Bazelon, and Stan Davis, highlighted the idea that we need to move from thinking of youth involved in bullying in black and white terms, such as bullies and victims (or bad versus good). Adults need to keep this in mind as we develop our approaches, recognizing that the aggressor one day may be the target on another occasion, and the single best predictor of youth engaging in pro-social behavior is how connected they feel to the adults in their life, as well as to their school and communities. In short – are we making sure that we have ways to ensure that all kids feel connected to at least one adult in the school?

We also need to take time to develop the capacity of our youth to deal with the very real challenges of navigating the social world. Life is hard. All of us will be challenged at multiple times in our lives. So increasing our capacity to deal with the challenges — developing resiliency — is another emerging area that is gaining traction in the bullying prevention field. Including social-emotional learning (SEL) in our schools is key, a fact highlighted by Marc Brackett of the Ruler Approach, a model that facilitates the development of emotional intelligence among youth.

Finally – we need to be reaching out more to parents to help them understand their role in building resiliency among our kids. The current media attention to bullying, cyberbullying and suicide has frightened many parents to the point that they panic when their children are targeted by mean, cruel, or bullying behavior. I heard an expert on trauma (Brad Reedy, Ph.D) speak recently, and he reminded me that the parents or other adults in a child’s life have a role to play in reducing the impact of trauma in kid’s lives.

We need to become a safe container for our children where we can acknowledge the uncomfortable feelings and difficult challenges they are facing. Our response must also convey that we can handle hearing this in a calm, non-reactive manner. Such a response will support them to work through the difficult emotions dealing with fear and a loss of control. While our messages need to convey that the child is not at fault for being targeted, if the adults in the child’s life panic or react with increasing anxiety or hyper vigilance, we can in fact worsen the impact of the event on the child. Some parents or guardians may need to seek professional guidance to deal with their own stress levels.

Why we need to discourage use of the term “bullycide.”

The link between bullying, cyberbullying, and suicide has generated much attention, and a new term has even been coined to describe a death by suicide when bullying has played a role.  The term is “bullycide,” and I heard it frequently at a national conference I attended recently that focused heavily on bullying.  This term is misleading at best and harmful at worst.  Here is why:

The term “bullycide” is inaccurate because it suggests that the person engaged in bullying (the bully) died by suicide.  Yet it is primarily used to describe a death by suicide of someone who was bullied.  So the term, standing alone, lacks sense and accuracy as it is frequently used.

More importantly, suicide prevention experts remind us that we need to be very careful about suicide in the media in order to avoid “suicide contagion.” Suicide contagion refers to in increase in deaths by suicide in the wake of high levels of media attention and very dramatic publicity after a completed suicide.   It stands to reason that bullying prevention experts who provide simplistic causal messages regarding bullying and suicide may also be contributing to a contagion factor by suggesting that suicide is a direct and common reaction to bullying – particularly if these experts speak to youth.

The term “bullycide” also suggests that an individual died by suicide solely because he or she was bullied.  While the research is clear that being bullied is a risk factor for suicide, it also suggests that a suicide is rarely the result of one factor and almost always is partly due to underlying mental health issues.  Of course bullying has also been correlated with depression and anxiety, which can place an individual at greater risk of self-harm.  Typically many complicated factors contribute to such a death.  But the message that we want to portray to our youth is that help is available when faced with bullying or depression, rather than the notion that suicide is a common or normal reaction, or that it was the only way to escape abusive behavior.

Be especially careful about the issue of bullying and suicide if you are involved in bringing performances, movies, or plays to a youth audience as part of a bullying prevention program or awareness activity.  Suicide prevention experts caution us to avoid presenting or describing the method of a suicide.  Such descriptions may lead to imitation by vulnerable or “suicide receptive” individuals.  Yet I have witnessed performances that share the method and and/or detailed descriptions of an attempted or completed suicide.

My point is not to minimize the impact of bullying.  It can be devastating and lead to health, academic, and emotional consequences.  But as I noted in my previous blog post, our messages to youth need to focus on hope, strength, and resiliency.  Instead of presenting a play to students that dramatizes bullying and includes a death by suicide, let’s share stories, plays, and presentations that demonstrate reaching out for help and positive bystander behavior.  After all, isn’t that the behavior we wish to see in our youth?

Are We Norming Resiliency With Our Kids?

I am excited about the theme of this year’s International Bullying Prevention Association’s Conference: Bullying and Intolerance: “From Risk to Resiliency.” This year’s conference will take place, appropriately, in the city of New Orleans.

Much media attention has been given to the problem of bullying and suicide. Yet when the media covers the sad death of a young person by suicide, they seldom mention that suicide is typically a multifaceted issue involving treatable mental health issues, and that help is available.  Members of the media can help us encourage help-seeking behavior and avoid contagion by following the NIMH guidelines for reporting on suicide.

Social norming theory posits that our messages to youth can norm positive or negative behavior. A positive social norming approach has been particularly effective in changing youth’s views that using alcohol or other drugs is a common behavior among their peers – which in turn leads to reduced alcohol and drug use among the youth population. Research is emerging that suggests that social norming strategies can have a positive effect in reducing bullying behavior among youth as well. (Craig and Perkins, 2011).

I have a particular interest in the concept of norming resiliency rather than cruel or destructive behavior with young people. While the research  indicates that there is a relationship between being bullied and experiencing thoughts of suicide, research also suggests that to prevent suicide among youth we need to norm strength-based messages and help-seeking behaviors. I hope we can get more bullying prevention advocates speaking to suicide prevention advocates so that we can all learn to spread messages of resiliency rather than despair around this important issue. There will be a thought provoking panel at the IBPA conference this year on Social Norming that I will be a part of along with Anne Collier and Larry Magid of ConnectSafely, and Mark LoMurray from the Sources of Strength Suicide Prevention Program. Sources of Strength is making a very real difference in many schools across the country by using strength-based messages and breaking down barriers to help-seeking behavior among youth. I hope you can join us in New Orleans Nov. 6-8th to learn more about Mark’s efforts and the importance of norming resiliency among our youth.