Category Archives: Stress

A Special Conversation On Talking to Your Teens About Weight

Are you the parent of a tween or teen? Do you worry about your child’s weight? Does your child worry about their weight? Have you ever heard your child say “Ugh! I’m so fat!”? Did it leave you speechless and panicked? Are you worried that your child has an eating disorder or is over-weight? Are you at a loss when it comes to talking to your child about health, weight, and the importance of being active? Well, then I suggest you grab a cup of tea, get comfy, and have a listen to this wonderful conversation I had with Dr. Dianne Neumark-Sztainer, a researcher and professor at the University of Minnesota. She is the author of “I’m, Like, SO Fat”: Helping Your Teen Make Healthy Choices about Eating and Exercise in a Weight-Obsessed World.

Over the summer I read an article in the NY Times which hi-lighted the importance of avoiding commentary on your child’s weight. Dr. Neumark-Sztainer was featured in the article, and it reminded that I had read her book a while back. I decided to reach out to her to see if she would be willing to chat with me. Of course, I was thrilled when she said yes, and excited to share our conversation with you. We discuss how to talk to your teen, how to create a health-promoting environment at home, how to approach teens that want to be vegan,  the importance of family meals (of course!), and much more.

I hope you enjoy our conversation, and as always, I welcome your comments, feedback, and suggestions.

With Love,

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Helping Children Through Grief

A few weeks ago I happened to catch  Episode 557 (Birds & Bees) of This American Life.  The show focused on having difficult conversations with kids. It covered topics such as race, sex and death. The last segment was particularly interesting to me because it provided a unique perspective on helping children manage grief. They featured the Sharing Place, a grief support center for families in Salt Lake City, Utah. I contacted the center to see if they would be willing to continue the conversation with me. Jill Macfarlane, their Development Director and Family Placement Coordinator, was kind enough to share some of her time with me and answered a few of my questions that came from listening to the piece.




I was really impressed by how direct some of your conversations with kids about death and grief are. Can you speak a little bit about your approach to talking to children?

I want to preface the answer by saying that here at the Sharing Place, despite what the piece portrayed, we don’t focus just on “how the person died” but rather, on the person and the memory of that person. We say over and over again that it does not matter how someone died but just that we loved them.

We do talk about the ways in which people die when kids have questions so that that they can process it in the correct way. Developmentally, kids, especially for the younger ones, tend to have imaginative thinking such that they feel they caused the death of a parent or that they are going to catch their little brother’s cancer.

We advise parents that if the child is not asking the questions, don’t give them information that they may not be ready to hear. They will ask you the questions when they are ready. We just have to be there to answer them when they are, not when we are ready to “tell them” but when they are ready to listen.


I can imagine that when a parent or another adult is dealing with their own grief that there can be a tendency to sometimes over-share.

So often, the questions will come in stages. The child may ask “how did dad die”. The parent might say, “he died from suicide”. Then the child may ask “what does suicide mean?”. And the parent can offer that suicide means that he chose to make his own body stop working because he had a sickness called depression. Then maybe six months to a year later the child may ask, “well how did he make his body stop working?”. And that may lead to more questions. As the child is ready to learn more, they will ask more questions. You don’t need to sit a four-year-old down and talk about suicide but if the child asks the question, you should definitely answer it truthfully.


What’s the best advice you can give for someone that may be more peripherally involved in a child’s life, such as a teacher, friend or even a pediatrician, to express their concern in way that is helpful for the child?

I would say don’t ask questions. Just be validating and supportive vs. peppering them with questions. Using reflective listening is really important so that the child feels heard. Instead of asking questions, we just listen and validate so they feel heard. Sometimes it’s scary for adults to hear children use big words like suicide so they just ignore it and change the subject (maybe to protect other children in the room). So the kids don’t feel heard, and in fact, they feel like their feelings don’t matter.

Another thing I’ve heard from families over and over again is how much they appreciate when you bring their person up and use their name. It can be scary because you don’t want to upset someone or open up a wound. Often times people just won’t mention their person. But really it can be so meaningful to families. So instead of saying “how was it for you on Johnny’s birthday, was it hard for you?” offering “ hey, I just remembered that it was Johnny’s birthday last week and I wanted you to know I was thinking about him”. Again, it’s the questions. People don’t want questions; they just want to know that their person is remembered and that they are loved.


I’ve often seen situations where parents will feel they need to keep their emotions in check in front of their children. What’s the best way for parents to support their children when they are dealing with their own feelings of grief and loss?

I think it’s important for parents to normalize emotions in front of kids – “mom’s sad and it’s ok for mom to be sad because mom loved dad very much”. We talk a lot about all of your feelings are ok. The behaviors that may come along with the feelings may not always be ok, but every feeling you have is ok.

We’ve often heard kids say mom didn’t’ care about dad because she never cried, and then, the kids don’t cry. There is a huge disconnect because everyone’s hiding their feelings from one another. Now if the parent isn’t getting out bed in the mornings, that may not be okay, but it’s ok for them to know you’re sad.


What’s the typical way in which you work with families in terms of time frame?

It really does vary from family to family. Some families call us two hours after the death, others may call after the funeral, and some families may not reach out to us for a year after the death. I would say after the first 6 months is when we usually see families. There are exceptions but we do have a waiting list for services so that’s when we typically start to see families. The average family stays in our program for about two years, and we’ve really found that kids do their best grief work about a year after the death. That’s when life is beginning to come back to a routine, and that’s when it really hits kids that they are not coming back.


Do you manage crisis type situations and what do you do when a family’s needs are outside of the “normal” grief process?

We do not provide therapy. We are a support group, which is completely different from therapy. Therapy and support groups work well together. We have an incredible list of therapists and resources in the Salt Lake area and we refer out for that acute, crisis management. The Sharing Place is here for long-term grief support and not necessarily the acute management. We do also have lots of community resources such as local food banks and mental health specialists.


It’s wonderful how you are able to facilitate some of these really difficult conversations with families and be such a resource and support for them during a challenging time.

This American Life did a great job on the piece but in terms of the editing I just wanted to say that with regards to the “way people die”, we don’t speak to every family about how someone died. Many, many families have already done a wonderful job talking to their kids. There are some situations, though, where families have a hard time, and they just can’t find the words. That’s when we are able to help them with the conversation.


Are the conversations usually pretty heavy or are you able to bring any joy or laughter into the groups?

That’s the beauty of the group sessions. You have these families that are new and so raw, and then you have these families who are 2 or 3 years out and at point where they can smile and laugh. It’s such a great mentoring system, that these families on this end say “wow, I can get there” and the families on the other end are saying “look how far I’ve come”.

I tell kids all the time, especially the teens, that we have fun here. Our teens tend to stay the longest. They are the hardest to get here but they stay the longest. Our groups always focus on the memories of the people. Sometimes we cry but most of the time we share, we laugh and really get to know one another.


Is it hard to say good-bye to the families once they’ve completed the program?

Yes, it is hard. We have a process called a closing. The families have to tell us three times that they are leaving before they leave group. We have a really wonderful ritual where we say good-bye. It’s sad to see them leave but at the same time, we are happy to see them move on without us.


Who decides when it’s time to leave group? Once they leave, do they come back?

They decide. There’s no time frame on our end. Once they leave, they’re done. Leaving is about a 6-week process and we are very thoughtful about it. If a new loss occurs, they can get back on the waiting list but that is very rare.


What do you think is the biggest misconception surrounding grief, and what do you think kids would want us to know?

I think they would want you to know that they want to talk about it. That they want you to remember their person and acknowledge them. They don’t want their person to be forgotten and they don’t wanted to be treated any differently. Especially for teenagers, they feel like they’ve become “that person whose brother died” and they don’t want to be treated any differently but they still want their person to be remembered.


Do you have any suggestions on helping children with loss, perhaps not at a personal level but a more global level like a death in the community or for instance the earthquakes in Nepal?

I would say it’s the same basic message – be honest in a developmentally appropriate way. Little kids may not understand earthquakes and school shootings. When they ask questions be prepared to answer them. If they aren’t asking the questions you don’t necessarily have to sit them down to talk about it. If they do ask, it’s important that the questions are answered truthfully and in language that they can understand.


At what age do those sorts of question tend to come up?

Usually 5th and 6th grade — the pre-teens are the ones that ask those sorts of questions. The younger kids are usually focused on their four walls. The pre-teens are beginning to see that there’s this whole world around them.


Do you have any resources for parents that may not be in the Salt Lake City Area?

The first group support center for children was The Dougy Center located in Portland, Oregon. We are a Dougy Center model. They have training centers all over the country. They have a tremendous amount of resources on their site – tip sheets, how to talk to kids, a teen section, etc. There’s also the National Alliance for Grieving Children and they have a resource at that helps families find local support groups.


I hope that this piece brings some insight into the ways in which we can help children manage grief and to encourage families to seek out community resources. I thank Jill Macfarlane for taking the time to speak with me and for the wonderful work that centers like hers do every day. I’m sharing some of the links that Jill provided below, and of course, I encourage you to listen to the original piece from This American Life.

Find local support groups

About Childhood Grief

Should Kids Attend the Funeral?

The “Bill of Rights” for Grieving Teens

Tip Sheets from the Dougy Center: The National Center for Grieving Children & Families


An Interview with Author, John O’Sullivan on Youth Sports and Changing the Game

I was thrilled to collaborate with Your Teen Mag to bring this interview to you. You can check out a briefer version of this interview on their site by clicking here.

Participating in organized youth sports offers many potential benefits for children including physical activity, building self-esteem, leadership and organizational skills. On the flip side, as a parent I’ve often found the whole scene to be quite stressful at times. The shuffling and herding of children from practices and games, the year-round schedule of some sports and the nagging feeling that everyone is just over scheduled. As a pediatrician I’ve often seen young athletes with recurrent concussions and families that find it difficult to keep up with the demands of their children’s sports schedules.

In his book, Changing the Game, John O’Sullivan writes passionately about helping parents and coaches create more positive and rewarding experiences for kids participating in youth sports. Sadly, he states that more than 70% of young athletes drop out of organized sports before reaching high school, largely because kids lose their enthusiasm to participate and it no longer is fun. The corporatization of youth sports and the myth that sports will provide scholarship opportunities or entry into elite universities has created a culture of sports where kids are being pushed to “be on the travel teams by age 7, have a private coach by 8, and be committed to a single sport by age 10”. In addition to providing a summary of the state of youth sports and outlining a framework for athlete education and development, his book provides action steps to help parents make positive changes in their child’s athletic experiences. I spoke with him recently about his book and the role of parents in helping their children successfully navigate the world of youth sports.



You outline this very nicely in your book but could you briefly describe the best way for parents to introduce their kids to sports?

Early on, it’s important to introduce our kids to the ABCs – agility, balance and co-ordination as soon as possible. That doesn’t mean signing them up for soccer at 1½ years of age but rather spending time with them at the playground and teaching them how to run and jump. There’s a myth out there that kids are either born athletes or they’re not. But agility, balance and co-ordination are learned. Some kids pick them up quickly and others take more time. It’s just like saying if your 5 year old was struggling with reading – you wouldn’t say “let’s just forget about reading and move on” you’d say that reading is an important life skill. So if your 5 year old is getting the athletic movements down, enroll them in tumbling, martial arts or something where they are learning the basic movements or just kick a soccer ball around with them. As kids are progressing onto team sports, it’s important to keep them in a good learning environment with little competitive pressure for as long as possible.

Speaking of low competitive pressure and not making early participation about keeping score or winning, what do you do when the kids are actually the ones that are keeping score?

It’s fine if the kids keep score because the thing about 6 or 7 year olds is that one minute after that game, the only thing they care about is what the snack is. It’s usually the parents that are really caught up in the fact that “we lost 6-0”. Keeping score isn’t intrinsically good or bad; it’s just important to know what the purpose of keeping that score is. If we want to make sports enjoyable for as many children as possible and teach them athletic skills, then cutting kids, making all-star teams and emphasizing winning at these early ages doesn’t make any sense. In fact if you look at all-star teams at these early ages, it has more to do with what calendar month the kids are born in rather than actual skill level. It’s ends up being more about who is older because at those young ages, a few months make a big difference.

So how do parents decide when, if at all, their kids should specialize in a particular sport?

It’s important for parents to determine what the values and goal of any program are for their child. Playing travel soccer at 9 or 10 isn’t a bad thing; it’s just important to recognize it for what it is and try to maintain some balance. So, maybe play travel soccer in the fall and then rec basketball in the winter and either take some time off or make time for other things. It’s also important to recognize that while parents may try to avoid having their child be a single sport specialist that they often become a “multi-sport specialist” where they are playing multiple travel sports at the same time. In a way we’ve lost that middle ground where a multi-sport athlete can find a good level of play; everyone gets funneled into “the rec league that doesn’t care” or the ultra competitive teams. We end up losing a lot of athletes.

What if the push for early specialization comes from your child? Should you allow early specialization or try to “hold them back”?

When your child is the one that’s really driving it, then it’s ok to follow their lead but with the caveat that parents need to find a balanced approach that provides adequate rest and time for other interests.

There is already an existing infrastructure existing in youth sports that prevents kids from being able to participate in organized sports at the high school level if they haven’t specialized early. How do parents navigate around the current system so that their children are still having fun without limiting future participation opportunities?

Going to a high school with 3000 vs. 1000 kids, there’s a big difference in terms of the level of competition for sports. Having said that, regardless of your situation, it doesn’t change the science of how to best develop an athlete. From a physician’s perspective, the science says DO NOT specialize early unless you are a female gymnast or figure skater because you are very likely to get injured and suffer overuse injuries. From a psychologist’s perspective, the science says that early specialization will more likely lead to burnout and maladaptive behaviors. From an athlete development viewpoint, playing multiple sports at young ages develops better all-around athleticism, which in the end usually trumps early specialization. So, you’re better off having a child who plays lots of sports, finds the one that’s the best fit and then during the middle school / high school years, putting a lot into that sport.


As parents, how do we prepare our kids so that they are able to reach whatever goals they set for themselves (like being on the varsity tennis team) without overcommitting them and ourselves?

The kids who are going to make it at the high school level are very likely going to be the best athletes. So despite playing year round baseball from age 9, if your kid is not a great athlete, it’s unlikely they will make the varsity baseball team. You cannot get around that.


So how do we capture those kids back into the world of sports? So many opportunities to play sports are lost by the time kids reach high school. If a parent has a child who enjoys sports but doesn’t make the high school team, how can they encourage their child to continue to be involved?

My personal thinking has been changing on this and it’s been influenced a lot by a book called Spark by Harvard psychologist, John Ratey. He talks about the influence of exercise on brain and learning. For the vast majority of kids, by the time they have finished high school, their physical fitness pursuits will be an individual pursuit. They will be a cyclist, a runner or a swimmer and they are pretty much done with team sports. So if you have a child that is funneled off a team by 13 or 14, have them run cross-country, do track or swim. These are the individual sports they will likely pursue when they are older, so why not give them a good basis to start from?


That’s a great point. Is there a role for our school’s physical education programs to take a lead with this sort of thing and encourage kids to continue to stay active even if they are no longer on a team?

I would encourage everyone to look at the PBS special on the Naperville School District in Illinois. They changed their whole focus in their school district away from team sports to individual sports. They got heart rate monitors, treadmills and climbing walls. The obesity rate in the Naperville School District is 3%. It’s unbelievable what they have done. There’s been some criticism that it’s a wealthy school district and that it’s not reproducible but that program has been replicated in non-wealthy districts. Additionally, when they’ve done this, academic performance has actually gone up. Another problem is with the grading system for gym. Of course all of the elite athletes are going to get the best grades. One of the things that came from Naperville was looking at heart rate monitors to grade based on individual effort. So that if you have a fourteen year old girl who seems not be running that fast and might get a C grade – if you look at her heart rate and see that her heart rate is actually at 90 bpm, you can see that she’s really giving all her effort and you can give her a grade based on her effort. It’s pretty powerful – you change the message you give that fourteen-year-old girl from “you’re the slowest runner in the class” to “you are really working hard” and change her perception of herself as an athlete.


In your book you talk about how parents are “chasing the scholarship myth” and often have unrealistic expectations that lead them to push their kids to specialize early with the hope of acquiring a college scholarship. Do you think parents are buying into that myth?

I’ve seen surveys where 30-50% of parents think that their kid is going to get a scholarship. In reality, the numbers are 1-2% or even less. I think there is a lot misunderstanding around the prevalence of athletic scholarships out there, especially when you consider the fact that most schools, such as Division 3 and Ivy League schools, don’t even offer athletic scholarships.


Here’s a reader question: how do you handle all the “drama” on kid’s sports team — as in parents complaining, everyone wanting their kid to be the star, all the “fun” things that go along with being a part of a competitive sport”?

My best advice is to begin with the end in mind. What do you want sports to mean in your kid’s life? If you want sports to be something that teaches your child to work hard, to be confident, to have integrity, work well with others, to be a leader – as long as you keep your eye on the prize I think things like the politics and the drama — you just work past them. Becoming an athlete is not a sprint, it’s a marathon. So every experience is a teachable moment and if you’re on a team with a lot of drama, you need to make the decision of is this the best group to continue on with. If the answer is no, then find a group with less drama. Or, better yet, be an agent of change within your group and introduce my book or the work of groups like positive coaching alliance and work to change the environment on the team because the drama may serve the parents but it doesn’t serve the kids.

How are you working to spread your messages about youth sports?

I founded this organization called the Changing The Game Project in 2012 to get the message out and the book was just a part of it. I travel and speak at schools, clubs and conferences to get the message out about how do we create a player first environment in youth sports? Because when we do and we serve the needs, values and priorities of our kids, that’s when our kids not only stick with it and enjoy it but that is actually the path to raising elite athletes. I have a blog at that is growing everyday with over 2 million views. So it’s a message that is really growing and resonating with parents and coaches.


What’s your final take home message for parents?

Always come back to this: if I were the one playing, what would I like in this situation? How would I like to be coached? How would I like to be cheered for? How would I like to be supported? If you’re ever in doubt of the answer, ask your son or ask your daughter what they want from you and help them find situations to allow them to get what they want from sports.