The New Danger Ecigarrets Pose to Teenagers

Many teenagers have started vaporizing or using ecigarettes because they believe they are not as dangerous.  They believe because they are not smoking nicotine and tar that are in cigarettes that vaporizing is healthier.

However, the reality is that vaporizing is still dangerous to their health.  Teenagers have also started using a substance called "wax" because they feel that is safer too.  Wax is a highly concentrated form of marijuana.  It is advertised that all the harmful aspects of marijuana have been removed.  However, that is not true either.

Now ecigarretes are being sold in flavors such as strawberry and bubblegum.  Marketing the ecigarettes this way makes them sound safe and like candy.  However, this is not the truth.  UCSF has released a report regarding teenagers and ecigarretes and vaporizing.  I have a link below and I encourage parents to read this report and learn the facts.

Read the Facts about the dangers of ecigarretes  https://www.universityofcalifornia.edu/news/vapers-beware-ten-things-know-about-e-cigarettes‬.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families.  For more information regarding Dr. Rubino's work or private practice visit his website at www.rubinocounseling.com or his Facebook page at www.Facebook.com/Drrubino3

Autism and Sexuality

‪A webinar clinicians and parents should participate in. This is a topic we ignore but it is real. People are autistic do have sexual feelings and desires. 

However, because of society's attitude about autism we never discuss the issue with autistic teenagers nor do we even consider the possibility that they have sexual feeling.  

I work with many autistic teens and they have sexual feelings. They are also able to express them in an appropriate manner and enjoy a sex life with a partner as an adult, if we discuss the issue with them.

Please sign up for this webinar. https://www.linkedin.com/pulse/autism-sexuality-webinar-shannon-crozier‬

Allowing Teenagers to Make Decisions

Working with teenagers, I hear very often from parents that they feel their teenager is not responsible and they have concerns about trusting their teenagers.  I also hear from teenagers how they are upset with their parents for not trusting them and not allowing them to make decisions.  I understand the parents' concerns, but at times they are being unfair and unrealistic about their ability to control their teenagers' decisions.

We routinely tell teenagers that they need to be responsible for their choices and actions.  However, we seldom allow teenagers the ability to make their own decisions.  It is not uncommon that parents have set rules and curfews for their teenagers.  Also with the advancement in technology many parents have software installed on their teenagers' cellphones so they can read their teenagers' emails or texts.  Also they have GPS programs so they can determine where there teenager is and try to figure out what they are doing.

Teenagers are aware that their parents have software programs on their cellphones so they can read their emails or texts or use a GPS program to determine where they are and what they are doing. This usually makes teenagers upset that their parents do not trust them.  Teenagers' tell me if they want me to be responsible how can I be responsible if they do not give me a chance?

The other fact that parents need to accept is you cannot control everything your teenager is doing.  You can monitor your teen all you want, but if a teenager wants to do something they will figure out away to do it.  Also if you want your teen to be responsible you have to learn to accept their decisions and the consequences that may result from their choices.

What parents need to do is have a calm conversation with their teenager.  During this conversation you discuss issues that your teenager will be facing such as alcohol, drugs, sex and their futures.  Explain what you expect and what you are willing to do or not to do.  Therefore, they understand what consequences they will face depending on the decision they make.

This is an important lesson for teenagers to learn.  They need to understand that their actions have consequences and they are responsible for dealing with these consequences.  One consequence may be that as parents you may be upset with their decision.  This is a consequence that they need to be able to accept.  Not everyone is going to always accept or approve of your choices.  Teenagers need to learn this fact.

It is important that parents learn to accept the fact that they cannot control their teenager's choices.  Allowing them to learn from their choices is the best way for them to learn responsibility.  It is also away for parents to learn to allow their teenagers to grow up and be responsible adults.  Yes at times this may be difficult, but parents need to be realistic that you cannot control their teenager.  Part of your teenager becoming an adult is allowing them to make choices and to learn from those choices.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families.  He is considered an expert working with teenagers.  For more information regarding Dr. Rubino's work and private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/Drrubino3.

The Difference Between an IEP and 504 plan

WHAT EVERY PARENT NEEDS TO KNOW ABOUT AN IEP and A 504 PLAN

By
Dr Michael Rubino

School are starting their annual (Individualized Educational Plan) IEP reviews and testing children for an IEP or 504 plan. Many parents need to decide between an IEP or a 504 plan for their child and I receive many questions about the differences and which one is more appropriate for a child.  Parents here is important information about Individualized Education Plans (IEP) and 504 agreements.  Besides ensuring that your child receives a good education, you do not need to pay for items such as special computer programs that the school district should be paying for not you. If your child has an IEP the school district is responsible for most educational expenses even a private school if necessary. Please read this article so you understand your rights and your child's rights.

The beginning of the school year is fast approaching.  Besides the mad dash to get ready for school and schools are going to start assessing students to determine if they qualify for an Individualized Educational Program (IEP). I am already hearing from parents how school districts are misleading them and pressuring them to sign an agreement for a 504 before the parents clearly understand the difference between an IEP and 504 plan.  The definition for both is further down in this article. An IEP and 504 are not the same. An IEP is legally enforceable and has legal guidelines and time frames. An IEP follows a student from school to school or state to state. A 504 is not legally enforceable and doesn’t follow a child nor are there legal guidelines.

An IEP will not stop your child from getting a job or from getting into college. In fact and college because they still would be entitled to assistance and the State of California may pay for their books. Also educational records are confidential therefore, no one would know your child had an IEP in school.

Many schools say your child must be two grades below in order to qualify for an IEP.  If you said your child had a math or reading disability this is true. However, if they have ADHD, Bipolar, school anxiety etc. they can qualify under OTHER HEALTH IMPAIRMENTS. All your child needs is a diagnosis such as ADHD which would interfere with their ability to fully benefit from their learning experience in the classroom. The 2 grade below level qualification doesn’t apply to this category.

Also if you have a child in private school and they would benefit from additional assistance, contact your child’s public school district. Even though they attend private school the public school district is legally obligated to provide your child with services.

One more issue, never pay for outside testing before the school district tests your child. They have the right not to accept any outside testing until they test the child. If you disagree with the district’s testing then you can request an objective testing from an outside professional and you can request that the school district pays for the testing and you can select the evaluator.

An IEP or an Individualized Education Plan is a document that outlines the specialized education services that a student will receive due to their disability. It ensures the student will receive the assistance necessary so they will receive an education.


When most parents hear disability, they usually think of a person in a wheelchair or a student wIth a learning disability. There are various condItions that can qualify as a disability. Depression, Bipolar Disorder or even diabetes. The disability is any condition that will interfere in the student receiving the same education as other students. The students who qualify for an IEP need accommodations which meet the criteria of needing specialized education. As I stated above their are numerous conditions which may qualify a student for an IEP.


if a student does qualify for an IEP, they also qualify for Special Education. Many parents hear this and are afraid or embassies. There is nothing to be afraid of or embossed about. If a student qualifies for Special Education, if the student needs speech therapy or special computer programs, the school district is obligated to provide the services to the student at no expense to the student’s family.


There is also an option called a 504 Plan. This was established in the Rehabilitation Act of 1973. The 504 plan ensures that a student with a disability will receive accommodations so they will receive the same education as other students. However, the 504 plan does not qualify a student for Special Education services and It is not overseen as closely as an IEP plan.
Currently, many districts are telling parents that their child does not need or qualify for an IEP and a 504 plan is just a good. This is not true. Many school districts are telling parents that their child does not qualify for an IEP because the IEP is more expensive for the district and most districts are trying to save money.The districts take advantage of the fact that as parents, you do not know all the differences between an IEP and a 504 so they can talk a family into a 504 plan easily.


If you find that your child is having difficulties at school due to a learning disability, health issue or emotional issue, consult an outside professional before you automatically assume that the school is giving you the appropriate recommendation.


I see many parents who have been told that their child is better with a 504 plan and that is not the truth. You can consult an educational consultant or a therapist who works with children. You can contact me at via my website www.rcs-ca.com. I help many families at their child’s IEP meeting. The main thing is, do not be afraid to ask if your child should have a 504 or an IEP. Also don’t let the district make you feel guilty because you want time to think and investigate the options. This is your child and you should never sign anything until you are sure it is in your child’s best interest.


I have added a link to a chart that will help you compare the two and understand the differences.

504 Plan vs. IEP - Education Centerwww.ed-center.com/504This pages lists the differences between an IEP and a 504 plan.

I have also added a link to a video which helps to explain the differences between an IEP and 504 plan.

Dr. Michael Rubino has over 20 years experience working with children and teens. He also has over 20 years experience working with children in Special Education and was an Intern for the AB3632 program which works with children in Special Ed and IEPs. For more information about Dr. Rubino’s practice visit his website at www.rcs-ca.com or his new website that deals specifically with IEPs, lucascenter.org.

The Facts about Teenage Boys and Cutting

As a psychotherapist who works with teenagers, I have observed the increase in teenage cutting over the years.  I have also observed that a behavior that once was believed to occur mainly in girls is also occurring in teenage boys.  From what I have seen it appears that just as many boys are cutting as girls.

The first question I often receive when I mention cutting is, what is it?  Cutting is any behavior that a person engages in with the goal of self-mutilating.  Teenagers cut with razors, knifes, paper clips, staples, using erasers or even scratching themselves.  These are just a few ways teenagers have found to self-mutilate themselves.  Since this is an activity associated with a great deal of guilt and shame, I am sure there are more ways that we have not learned about yet.

Also because cutting is associated with a great deal of guilt and shame our statistics on how many teenagers cut are not entirely accurate.  Most recent studies indicate that approximately a third of all teenagers have tried cutting or actively cutting.  If you noticed the research shows a third of all teenagers, which means boys too.  I have more and more teenage boys who say they are cutting, have cut or are thinking about it.  Cutting occurs in boys too.  We need to be aware of this fact.  Cutting can lead to accidental suicide attempts if an artery is cut or permanent damage if nerves in the arm or legs are severely cut.  These are things that teenagers and parents don't think about.

Why do teenagers cut?  The reasons I commonly hear is it is easier to deal with the physical pain than the emotional pain they are feeling.  Teens who are severally depressed state that cutting reminds them they are alive.  They are so depressed that they feel nothing, but when they cut they feel.  Also teenagers cut as a way to punish themselves because they are ashamed about something they did or they feel they have let their parents down.  Cutting is a way to deal with the guilt and shame they are experiencing.

If we look at how boys are raised, cutting is a good fit for boys.  Most boys grow up learning that boys can't cry and if you express feelings of sadness or disappointment you are weak.  Teenage boys are always supposed to look like life is perfect and they can handle anything without help.  Cutting allows them to express sadness, fear or embarrassment in private.  No one knows they are cutting or how they are feeling.  Unfortunately, this leads to a vicious circle where emotions can get out of control and a boy may end up doing something he never indented to do.

At this point, most people working with teenagers consider cutting an epidemic and the little research we have about it supports this idea.  When I mention cutting to a teenager now, they don't look shocked and discuss it like the weather.  They often tell me about friends who are cutting too.

Cutting can be a very dangerous behavior and does need to be treated with psychotherapy.  If you feel your teen may be cutting talk to them in an understanding manner.  Do not give them any reason to feel guilty or ashamed if they say yes.  As I stated above, the teen already feels a great deal of shame and if they feel they will be looked at in a shameful manner or that you will be shocked they will never open up to you.  You need to reassure them you love them and you only care about their safety.

I said it needs to be treated with psychotherapy.  Find a psychotherapist who specializes in treating teenagers and in treating self-mutilating behavior.  This is very important because if the therapist acts negatively or shocked, the teenager will shut down and therapy may not work with any other therapist.  I have had teens test me in various ways because of what a previous therapist said about their behavior or what the therapist said to their parents.  They need to feel safe and accepted by their therapist if therapy is going to work.

I have included some risk factors and warning signs for you to be aware of in case you think your teen might be cutting:

Risk Factors

Knowledge that friends or acquaintances are cutting
Difficulty expressing feelings
Extreme emotional reactions to minor occurrences (anger or sorrow)
Stressful family events (divorce, death, conflict)
Loss of a friend, boyfriend/girlfriend, or social status
Negative body image
Lack of coping skills
Depression

Warning Signs

Wearing long sleeves during warm weather
Wearing thick wristbands that are never removed
Unexplained marks on body
Secretive or elusive behavior
Spending lengthy periods of time alone
Items that could be used for cutting (knives, scissors, safety pins, razors) are missing.

While this is a scary subject, I have worked with many teens who have overcome this issue.  The important thing is as parents you are accepting and non judgmental.  Also you need to be aware that this issue does exist.  My last point is that boys cut too.  Girls are not the only teenagers engaging in this behavior.

Dr. Michael Rubino has over 20 years experience treating children and teenagers.  He had treated many teenagers who cut and is considered an expert in this area.  For more information regarding Dr. Rubino visit his websites www.rcs-ca.com , www.RubinoCounseling.com , or his Facebook page, www.Facebook.com/Drrubino3

Children Looking for A Kinder World

I have been seeing more and more teenagers who are complaining of anxiety and depression.  Many of these teenagers are also afraid to go to school too.  I have also been seeing more teenagers being placed on home/hospital for school. This means a teacher comes to the house once a week instead of the teenager going to school.  This is an alarming trend.

I have also been hearing more teenagers talking about needing to carry a knife with them for their own safety. They tell me you never know when someone might try to attack you.  These are not juvenile delinquents or gang members, these are average teenagers.  They come from healthy families and are doing well in school and not involved in drugs. This need they feel to protect themselves is an alarming trend.

However, if you take a step back and look at what these children have seen over their lives it makes sense.  Most of these teenagers were very young on 9/11 when the United States was attacked.  Since 9/11 they have also seen two wars and heard on the nightly news about terrorist alerts or attacks around the world.

In addition to terrorism, this is the first generation growing up with mass shootings.  According to ABC News from 2000 to 2015 there have been 140 mass shootings and since January 1, 2016, there have been more mass shootings than the previous 15 years.  According to the statistics on mass shootings every day 36 people are killed in the United States by a gun. This does not include suicides.  For the group we are discussing, suicide is the third leading cause of death for children between 10 and 18 years old and using a gun is one of the most popular methods of suicide.

Now, in addition to these facts stated above, think about what these children see on the news and the video games they play.  Anytime there is a shootings incident in the United States there is pretty much 24 hour news coverage of the event for days.  Also when there are bombing or shootings in Europe there is 24 hour news coverage for days.  And now we have moved on to covering funerals.  When the officers were killed in Dallas the memorial was televised nationally.  If we look at the video games these kids are playing most have to do with killing and death.  And since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about our election results.  They have heard what Trump has said and they are afraid other countries might attack us or Trump may start a war.  Also Hispanic children who are legal citizens are afraid that they will be deported.  This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives.  These teenagers are being traumatized.  They may not be experiencing the trauma personally but they are experiencing vicarious trauma.  With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously.  We have never had a generation of children grow up with the amount of trauma that these children are growing up.  Even children growing up during World War II didn't experience this amount of trauma.  We didn't have instant access to news nor did we have the graphic videos being shown by the news media.

The question now becomes, what do we do?  Well we can not change the world unfortunately. However, we can monitor how much exposure our children are receiving to mass shootings when they occur.  We can monitor the video games they are playing and limit access to games that focus on violence and killing.  We can demand that the Congress pass gun control laws that make sense.  No one needs an assault weapon to hunt a deer.  We can also listen to what our children are saying and talk to them about their concerns.  When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.
Finally, if you start to notice a change of attitude in your child that you are concerned about have them assessed by a psychotherapist.  There is nothing to be ashamed of if a child needs therapy.  We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents.  For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma.  Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 19 years experience treating children and teenagers and dealing with victims of trauma. For more information about his work or private practice visit his website at www.rcs-ca.com or on Twitter @RubinoTherapy

Divorce and Child Visitation Issues

After a divorce there are still issues to address.  One of the major issues is child custody and visitation, especially exchanges for visitations.  The issues usually are addressed in the divorce settlement and the Court Mediation report.  However, even though the Mediation Agreement attempts to address these issues, there are usually still issues.

I have parents who are divorced come in very often arguing about issues that occur during  visitation exchanges.  A majority of times these issues are addressed by the Mediation Agreement.  However, many parents are still fighting with each other after their divorce is final.  Typically I see this when one or both parents are not ready to let go of each other yet.  Arguing over the visitation exchanges is a way to still keep them in contact with each other.  However, parents do not pay attention to the price the children are paying. By focusing on visitation exchanges this puts the children in the middle of the divorce.

By focusing on visitation and putting the children in the middle of the divorce, I see children who become depressed and anxious.  Often these children start acting out at school and home and their grades start to decline.  Also many of these children often start drinking or using marijuana so they can numb themselves out and ignore their parents' arguments.  Most of these children ask me, why can't they just stop fighting? They are already divorced, what else do they want?

Goldberg Jones is a very good divorce attorney who writes articles regarding issues related to divorce and how these issues impact the children and the family.  He wrote a very good article regarding visitation exchange issues.  I found the suggestions very good and helpful.  I would recommend that divorced parents read these ideas and try them.  Therefore, I have included them in this article for you to review and try.  You have nothing to lose by trying and you could help reduce the stress your children experience with visitation. You may also reduce your stress and frustration and allow yourself to let go of the marriage and move on with your life.

How often visitation issues occur often depends on the custody agreement, parenting plan, and level of visitation. It may be a couple of times a week, once a month, or around major holidays, but it’s likely going to be a repeating event.

In the best of times, even if both parents can be civil, custody exchanges will probably still be a little awkward. In less amicable scenarios, prepare for outward hostility that resembles the opening scene in Saving Private Ryan. Pack a helmet and prepare to duck.

In more combative circumstances, it helps to have a strategy in place to keep things civil. That’s easier on everyone, especially the kids. There are ways to cut down the amount of face time and limit the friction. It may never be easy or ideal, but it helps with stress level and peace of mind, for both the parents and the children—no kid wants to watch mom and dad fight.

1. CUSTODY EXCHANGES AT THE BABYSITTER’S
In contentious situations, the more you see your ex, the more potential there is for friction and conflict. Sometimes it’s simply best not to see each other if you can avoid it. There are practical ways to circumvent this. One common approach is to make custody exchanges at a babysitter’s house or at daycare.

One parent drops the kids off and the other parent picks them up. If you schedule it right, the two of you may almost never come face-to-face. Because there are other people involved, you may encounter scheduling hurdles. Clear communication about who is picking up the kids and when is key. But once you iron out the kinks, this strategy helps limit contact and potential fights.

2. CUSTODY EXCHANGES AT SCHOOL
Similar to using daycare to facilitate custody exchanges, you can use your child’s education to the same end. Again, one parent drops the kids off at school in the morning while the other picks them up after. This has the desired effect of not having to see your ex more than is absolutely necessary. It can be useful in situations where parents are prone to fighting.

Like with the child care, you’ll need to arrange this with school administrators. Schools like to know they’re handing kids over to right people. But if there is clear communication between all the involved parties, it’s possible to make these arrangements work.

3. CUSTODY EXCHANGES IN PUBLIC
Many people want to avoid causing a scene in public. If you and your ex can’t handle custody exchanges without fighting, consider meeting in a public place. Choose a neutral spot where neither parent is likely to start a ruckus. If such a place exists. In some situations, nowhere is off limits, but being exposed often encourages both parties to be on their best behavior.

Where depends a great deal on the people involved. Pick a centrally located park. The mall, a restaurant, or a coffee shop where you know the regulars are all options. Extreme cases may call for supervised visitation centers or even a police station. Then again, if you just kind of rub each other the wrong way from time to time, a supermarket parking lot may work fine.

4. INVITE A THIRD PARTY WITNESS
While people are reluctant to fight in public, they’re also often hesitant to start trouble in front of friends or acquaintances. One strategy that can smooth over problematic custody exchanges is bringing along a third party. A mutual friend or even authority figure can help keep the peace, especially if it’s someone who knows both parents.

If there are individuals both of you maintain a relationship with, that might be the ideal fit. This approach often serves to calm down heated emotions. And if things do escalate, having a witness never hurts.

If you do go this route, it’s important to give some thought to who you bring along. If you have a new spouse or significant other, consider the ramifications of their presence. Is that going to touch on a sore spot and ignite lingering resentment? In some situations, it might be best to ride solo instead of risking a potential fight.

5. COMMUNICATE VIA ALTERNATE MEANS
Visitation, overnights, and custody exchanges often become logistical tangles. With football games, school plays, robot camp, and the many other activities children participate in, scheduling gets complicated. Pulling it off requires regular communication. If there are problems in this area, conflict often arises. When it involved kids, some level of contact must exist. Fortunately, there are alternative means of communication.

You may have mutual friends or family members willing to serve as go-betweens. Though it tends to get expensive fast, enlisting a lawyer or mediator is another potential strategy.

Thanks to modern technology, you have more outlets than ever before. If you can’t talk on the phone or in-person, email, texting, instant messaging, and other online options exist. Websites like Our Family Wizard provide shared scheduling services and online tools for co-parenting. There are even numerous smartphone apps for tracking parenting schedules and children’s activities. 6.

6. PREPARE FOR CUSTODY EXCHANGES AHEAD OF TIME
Preparation in advance of custody exchanges is key. The more prepared you are, the faster and smoother they’ll go. Before your ex picks up the kids, take the time to gather everything they need for this particular stay. Whether it’s a quick overnight or a two-week vacation, make sure to gather the essentials.

Did you pack all of the regular medications they take? Do they have all the school books they need to get their homework done? That report on the solar system isn’t going to write itself. If your daughter has a baseball game, pack the mitt and cleats. If your son can’t sleep without his special stuffed zebra, it needs to make the trip. Knowing you have everything set reduces the amount of time you have to interact with someone you’d rather not see.

Think about what the kids can’t live without and send it with them. Otherwise, you risk a middle-of-the-night call or visit from your ex. If the goal is to limit the amount of contact, that defeats the purpose, doesn’t it?

After a divorce, it may be quite some time before you want to see your ex again, if ever. But when you have kids, that’s not really an option. Custody exchanges can be tough, but it’s something you have to deal with.

For the sake of the kids, for their well-being—as well as your own—it’s important to try to make these encounters as smooth and painless as possible. Have a plan, be efficient, and keep your seething emotions in check for a few minutes. Hopefully, that’s all you’ll need. Taking steps to limit conflict in a custody exchange is healthier for everyone involved.

If you have questions about child custody or parenting plans, feel free to contact Goldberg Jones at his San Diego office.

I think these are all very valid points and important issues to consider and feeling that often occur during and after a divorce.  I often recommend the same approach and encourage parents to consider the same issues in regards to their children and themselves.  Divorce is a very painful experience even when it is handled well and with respect for each other.  However, the truth is most children I see for divorce issues are because their parents are still hurting so they children sense it and take on the family pain trying to solve it.  So please try these ideas.

Dr. Michael Rubino has over 19 years experience treating children and teenagers.  He is an expert in treating children who are involved in a high conflict divorce.  For more information regarding Dr. Michael Rubino or his practice visit his website at www.rcs-ca.com or michaelrubino.tribesites.com or Facebook page at www.facebook.com/drrubino3.