Frequently Asked Questions Self-Care for Children and Adolescents

Q: What is self-care?

A: Typical examples of good self-care include: getting enough sleep, eating well, exercising regularly, and managing stress. Good self-care impacts both physical and emotional well-being. Self-care is more than focusing on what you should or shouldn’t do. It is also about paying attention and being mindful of strengths, good fortune, loved ones and personal successes.

Q: Why is self-care important?

A: Most people are aware of the mind/body connection, and the impact on emotional well-being. For example, stress can negatively impact many diseases, illnesses, and conditions, including asthma, gastrointestinal symptoms, sleep problems, etc. Stress can also impact the immune system, making young people more susceptible to illness, and similarly a lack of sleep can increase stress.

When a child or teen is confident in their ability to take care of themselves, they may feel empowered and capable of preventing and/or managing a chronic medical and/or mental health problem. Taking good care of one’s self leads to higher personal satisfaction and the ability to deal with the emotional ups and downs that go with daily life.

Q: When should I become concerned about a child’s ability to practice good self-care?

A: It is easy for personal self-care to take a back seat to the needs of daily family life. It is not uncommon for children and teens to think that they have everything "under control," when in fact they are desperately out of balance. If your child or teen is experiencing any of the following physical symptoms, their psychological health could be at risk:³

• Changes in appetite (eating too much or too little)
• Obsession over body image
• Withdrawing from friends and activities
• Sleeping disturbances
• A decline in grades
• Inability to complete simple tasks
• Change in normal behavior
• Frequent stomachaches or headaches that don’t respond to treatment
• Frequent physical complaints
• Play that involves excessive aggression toward self or others, or play that involves persistently sad themes
• Frequent absence from school
• Poor performance in school
• Talk of or efforts to run away from home
• Outbursts of shouting, complaining, unexplained irritability, or crying
• Being bored
• Alcohol or substance abuse
• Irrational fear of dying
• Extreme sensitivity to rejection or failure

When a child and/or teenager begins to have health problems (e.g., diabetes, an increase in dental cavities, insomnia, etc.), it is often a wake-up call for families to make healthier lifestyle choices. Sometimes it is easy to overlook problems with self-care because the negative consequences are not so obvious or immediate. People often discount the more subtle, but powerful impact that emotional problems have on physical health. Stress, for example, is sometimes referred to as a "silent killer" because people are not in touch with how it is affecting their health. If a young person is experiencing emotional problems that are impacting their functioning (academic performance, peer relationships, or behavior), there is a good chance that emotional problems are also impacting general health.

Often, the greatest sign and opportunity to intervene for mental health preventative care is the most often overlooked. Especially when parents’ own demands of daily life impact their own self-care, it is easy for the child’s self-care to slip as well. However, diet, exercise and stress reduction are the most accessible areas for parents’ and children to intervene, and with good training and monitoring can have an enduring impact on good mental health.

Q: What is a parent’s role in helping a child develop good self-care skills?

A: Caregivers are responsible for modeling good self-care for children and teens. Just as academic concepts and moral values are taught, children also need to understand the meaning and importance as self-care, as well as how to structure and monitor activities that promote self-care in their daily life. Children need to understand the meaning and importance of self-care, as well as how to structure and monitor activities that promote self-care in their daily life. For example, if you are concerned that your child is spending too much time watching television or playing video games, you will need to establish and enforce rules about how much time in front of the television is acceptable in your family. Children may not naturally identify the importance of physical activity. They often require a caregiver’s intervention to help them learn to regulate their own behavior. Many children need a gentle but direct push to make another choice. While teens generally have more freedom than younger children, many adolescents still require guidance and positive role modeling in order to learn to make and/or sustain positive self-care choices. With the freedom adolescents have, parents might have a perception of their teen’s activity level, which is inaccurate, so it is important to ask about their activity level on a regular basis (e.g., “So you had practice at school today? What did you work on? How long was practice? You must be tired. Did you eat a snack?”, etc.)

Young people may resist the things that are good for them. That’s to be expected. So, when you say it’s time to turn off the television, your child or teen may be less than thrilled. This is where some creativity helps parents work through tantrums or complaining. Insist on taking a family walk, or play a favorite outdoor game from your childhood with your children. If you are having difficulty getting your child or teen to practice good self-care, parenting information posted on this site may be helpful. Take the lead in helping your child develop healthy habits that will last a lifetime.

Q: Can poor self-care lead to a mental disorder?

A: According to the Diagnostic and Statistical Manual of Mental Disorders-4^th Edition, poor self-care can contribute to mental disorders. Sometimes young people who are struggling with emotional problems choose not to address them. Ignored problems may get worse and can develop into a mental disorder.

Q: How do young people improve self-care?

A: There are a number of self-help resources posted on this site to help young people manage weight and increase exercise, reduce stress, improve sleep, etc. There are also a number of other self-care resources to consider.

References:

¹Center for Disease Control (1996). A report from the Surgeon General: Physical Activity and Health. Accessed 5/24/06.

²Committee on Public Education (2001). Children, adolescents, and television. Pediatrics, 107, 2, 423-426.

³American Academy of Family Physicians (2005). Mind/Body Connection: How Your Emotions Affect Your Health. Accessed 3/23/06.

TRICARE policy for reimbursement requires that services must be medically necessary for a diagnosed psychological disorder. The disorder must be one referenced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and must be of a severity not only to cause the patient distress but also to interfere with the patient’s usual activities. Treatment for school refusal, independent of a diagnosed psychological disorder is not a covered TRICARE benefit.

TRICARE beneficiaries who have a diagnosable psychological disorder are eligible for eight behavioral health care visits per year without a referral or pre-authorization. Active duty military personnel always need a referral for care outside a military treatment facility.