February 2023 – Vol. #20, No. 11

Teen mental health – sadness, suicide and social media; An Uncle’s Wisdom on Love, Work and Play; Some Reflections Four years after I lost my wife.

Welcome to the February edition of Tips and Topics.

In SAVVY, I share some recent news items on teen mental health, especially with teen girls versus boys. Statistics on sadness, suicidal feelings, thoughts and attempts and social media use.

In SKILLS, I reflect on “wisdoms” I shared with my 21 year old niece…wisdoms that I wished I had known at 21 about Work, Love and Play.

In SOUL, my ever evolving grief process and that of my children has been reflections on our past family relationships. They provide an opportunity to remember how life was when Marcia was alive with us. They also allow for healing old wounds that haven’t served us well.


In the health news feeds I get, I have noticed more and more on teen mental health. Here are some concerning statistics and some items about social media that many suppose may be significant contributors to teen mental health concerns, especially in teenage girls.

Tip 1

Nearly Three In Five Teenage Girls Felt Persistent Sadness In 2021, Double The Rate Of Boys.

…”one in three girls seriously considered attempting suicide, according to data” (PDF) released February 13, 2023 by the CDC.

These “findings, based on surveys given to teenagers across the country, also showed high levels of violence, depression and suicidal thoughts among lesbian, gay and bisexual youth.” The CDC report found that “more than one in five of these students reported attempting suicide in the year before the survey.”

Tip 2

Habitual social media use may be associated with heightened sensitivity to social rewards, scan study suggests.

According to the New York Times  “children who habitually checked their social media feeds at around age 12 showed a distinct trajectory, with their sensitivity to social rewards from peers heightening over time,” while “teenagers with less engagement in social media followed the opposite path, with a declining interest in social rewards.”

Researchers arrived at these conclusions after conducting “successive” functional magnetic resonance imaging “brain scans of middle schoolers between the ages of 12 and 15, a period of especially rapid brain development.” The findings were published online in JAMA Pediatrics.

 Tip 3

US Officials Raise Concern Over Impact Of TikTok On Teens’ Mental Health.”

 “In recent months, TikTok has faced growing pressure from state and federal lawmakers over concerns about its ties to China through its parent company, ByteDance.” However, “some lawmakers and researchers have also been scrutinizing the impact that the short-form video app may have on its youngest users.” Still, the app “is far from the only social platform to be scrutinized by lawmakers and mental health experts for its impact on teens.” CNN


I don’t know the cause, effects and solutions to the role of social media like TikTok and Instagram on teen mental health. I have seen the heart-breaking stories of young girls’ eating disorders obsessed with sculpting the “perfect” body to garner more and more “likes” rewards. There is a lot of smoke around social media’s role in the teen mental health fire.

Last year, my niece turned 21. In addition to the material gift, this 73 year old psychiatrist uncle shared “wisdoms” that he wished he had known at 21. Life could have been much sweeter. It will be up to a better informed younger generation of mental health professionals to steer children and teens on the healthy use of social media. My “scope of practice” lies outside of the urgent need to get a handle on social media.

Here’s what I shared in her birthday card on Love, Work and Play with some added reflections:

Tip 1 

In WORK, may you not just have a JOB (making money Just Over Budget).

May you find jobs that you love and you’ll never work another day in your life; and you will work like you don’t need money.

For me, I was fortunate to indeed find a mission-filled rewarding career, from which I am in the process of moving away. I am satisfied that I have done a nice piece of work, ready to shift attention to new horizons.

Tip 2

In LOVE, may you love unconditionally.

That doesn’t mean loving someone regardless of what they do to you or how they are being with you. What it means is to remain in a state of love regardless of the conditions around you – where you don’t need people to BE a certain way for you to remain in a state of love. It is easy to be in love with NRE (New Relationship Energy); or when everything is going smoothly. That is conditional love. May you be in a state of love even when “conditions” are not so easy.

It is amazing to me that I have always thought of “unconditional love” as having to do with how you accept the other person when they are being ‘them’ and acting a certain way. I now have a broader understanding where “unconditional love” has more to do with you, yourself. You are responsible for and empowered to attend to your own happiness and serenity (loving yourself) regardless of the conditions around you. No-one else is to blame or responsible for your happiness.

Tip 3

In PLAY, play continuously.

That means in WORK, LOVE and PLAY, do only what brings you joy. Don’t be with anyone or do anything that does not bring you joy. Joy doesn’t mean you have to be laughing all the time. If a hard workout is tough and hard, but brings you joy, you are in joy.

If you are not living with joy, how can you bring joy and positivity to others? How can you attract people to a better way of being and living if you come to them broken and depleted?


February 23 is the fourth year anniversary of my wife’s passing. If you wish to track my grief process from the initial announcement in February 2019 through the SOUL section each February to last year’s February 2022 edition, here are some linksor you can look at the Archives on the right hand side of the Tips and Topics website.

I am fortunate to have a close relationship with my three children. We are used to sharing thoughts, feelings and ideas. From time to time, we have reflected on what life was like when their mother and my wife was still with us in the “physical”.

There is no value in looking back only to judge and berate oneself for shortcomings that are clear now in hindsight. But I have discovered that there is value in looking back and reflecting on our marital relationship and our parental styles in a way that would not be as possible were she still here in the thick of daily living.

To give an example, my son was sharing how his relationship to money and career was impacted differently by his relationship with his mother versus his father (me). “I always knew mum loved me unconditionally” he said. “While I knew you loved me, I also experienced expectations that affected how I saw myself in light of your career, attitudes about money and what success looks like”.

Taylor went on to explain further:

  • Making money meant working long hours at a career that took his father away from him ‘on the road’.
  • Stay-at-home mum was there for him.
  • If making money means not having my dad around as much as I wanted, then making money feels negative, not the message that money can bring freedom from having to worry about money.
  • These negative associations about money interacted with a contemplative personality to conclude that I am better suited for a career of preserving the environment or working for causes not rewarded by money. I won’t be wealthy and anyway I don’t want to be.
  • That self image is dissolving as making money gets disentangled from its negative associations.

It is true that making money and having money doesn’t assure happiness and joy.  But as Taylor has worked through his negative associations to money he has tasted and enjoyed the freedoms that having adequate resources bring.

So why have I shared this father-son conversation?

Part of the ever evolving grief process for me and my children has been these reflections on our past family relationships. They provide an opportunity to remember how life was when Marcia was alive with us. They also allow for healing old wounds that haven’t served us well. Part of that healing with my son included the following:

  • Acknowledgement, regret and awareness of the dark side of my career choice that took me on the road. Like anything there is a light side that will also serve his career choices and potential as a leader in personal development, inspiring others to grow and thrive.
  • Accepting responsibility for father-son interactions of yesteryear that were definitely judgmental laced with expectations and concerned questioning from a parent about his motivation to get into college to develop a “successful” career.
  • But today, an opportunity for healing to make it clear that I have no concern for his choices and future. I am certain that he will succeed at whatever he puts his mind and energy into.
  • Today, questions and father-son interactions are all about brainstorming and excited co-creating, not skeptical concern and doubt about his choices on money and career.

While we all miss Marcia still, one of the gifts that she left us was the opportunity to transform her loss into new insights and healing in our already strong family ties.

January 2023 – Vol. #20, No. 10

Responses to the story of the Judge and the Grieving Team; It’s time to retire “graduation” and “treatment completion”; My four words for the year ahead.

Welcome to the January edition of Tips and Topics.

In SAVVY, It’s time to retire terms and concepts like “graduation” “treatment completion” and embrace terms like “transition” and “commencement” after having done an initial piece of work on the path to recovery.

In SKILLS, what to say to Orient Participants to entering Drug Court and about “graduating”. Rename the Graduation or Treatment Completion Ceremony.

In SOUL, my four words to encapsulate the year ahead. What words do you see?

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December 2022 – Vol. #20, No. 9

The story of the Judge and the Grieving Team; What does “going high” mean (keep an open mind on these excerpts).

In SAVVY, STUMP THE SHRINK and SKILLS,  this is the story of the Judge and the grieving Treatment Court team. Relapse and a deadly overdose is sad at any time for anyone with addiction. But it is all themore stinging when the participant has been in long-term recovery and then relapses and dies.

In SOUL, I feel sad, confused, and sometimes hopeless about the way we deal with our political differences. But keep an open mind to review what solutions Michelle Obama offers when she explains what “going high” means.

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November 2022

Dr. Ken Minkoff on “Welcoming” and “Skills-based learning” when serving people with complex needs; 70th birthday and 50th wedding anniversary and Thanksgiving week

In SAVVY, guest writer and psychiatrist, Ken Minkoff, M.D., highlights the importance of designing services expecting to see people with co-occurring mental health, substance use and other complex needs. But most importantly, organizing ourselves and services in a welcoming manner in everything we do.

In SKILLS, Dr. Minkoff addresses another important principle in helping people with complex needs, what he calls “Adequately supported, adequately rewarded, skills based learning for each condition.” As simple as you may think this needs to be, it needs to be even simpler!!!!

In SOUL, I reflect on what would have been my wife’s 70th birthday, our 50th wedding anniversary. Thanksgiving Day is an opportunity for pain or joy.  I choose to make it a week of Thanks and Giving.

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October 2022

Clients who don’t want inpatient treatment – What to do; Individualized, accountable care; Right turns on red.

In SAVVY, STUMP THE SHRINK and SKILLS, Amber asks a couple of questions about what to do when clients are recommended for inpatient treatment but decline and only want outpatient services. This edition explores how to meet the client where they are at, but also hold them accountable to the outcomes of whatever plan they agree to work on, even in outpatient services.

In SOUL, I am grateful for the “Right turn on red” law and ponder why we can’t have an “everybody wins” attitude to lots of challenges and problems.

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September 2022

Brief But Spectacular take on telling the whole story; Solutions Journalism; COVID and Things are always working out for me.

Welcome to the September edition of Tips and Topics from Australia.

In SAVVY, watch David Bornstein make the case for Solutions Journalism to activate people to be powerful players in a participatory democracy.

In SKILLS, be part of telling the whole story, not just focusing on the problems. “It is as if your parents were always criticizing you about what you were doing wrong and never letting you know where you have possibilities to grow.”

In SOUL, I have adopted more robustly the attitude of “Things are always working out for me”. A number of events on my Aussie trip would seem to contradict that. But as I reflect on the events midway through my trip, and my week of COVID, I’m sticking with my story.

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August 2022

Jaclyn’s story about a mother and son in her own words – Applying the therapeutic alliance to any relationship; What is ‘young’ anyway?

In SAVVY, SKILLS, SHARING STORIES & SOLUTIONS, I depart a little from our usual format to let you enjoy and learn from a mother’s story about how she applied the principles and practices of the therapeutic alliance to restore her relationship with her son. Not only did it rebuild the relationship but it empowered Leo to reach his full potential.

In SOUL, I am choosing to focus more on the joy of living than on my biological age. Even though I hit 73 this month, I don’t feel anywhere near that. How about you?

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July 2022

How smart are you about SMART Recovery and its Family & Friends Program? Wisdom on coming together from social media

In SAVVY, we all know about AA and other 12-Step programs. But Joe Gerstein, Founding President of SMART Recovery, gives us an update on this complementary alternative community mutual assistance organization started in 1994.

In SKILLS, Joe explains how SMART Recovery runs and what skills and goals are the focus; as well as how the Family and Friends Program is integrated with CRAFT [Community Reinforcement And Family Training].

In SOUL, I share some of my favorite quotes and images from social media that helped me think about how to come together in an era of division and information bubbles.

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June 2022

Helping families with addiction – Residential treatment is not the gold standard; Intervention, Tough Love or CRAFT?; Exercise training is hard work. How do those athletes do it?

In SAVVY, STUMP THE SHRINK and SKILLS, I share a colleague’s request for recommendations for a residential program on behalf of a family affected by addiction. The family wanted their son in long-term residential treatment. But is residential treatment the gold standard? We have to use the whole continuum of care to give long-term, life long addiction treatment if necessary.

What should be done for a son who the parents are financially supporting and who doesn’t follow through with treatment?

In SOUL, I recently started strength and core exercise training. Better late than never, but it is hard. I have a new found admiration for all those athletes who workout everyday to reach their peak performance

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May 2022

Pandemic Parenting: Do you have Parental Burnout?; Strategies to help with Parental Burnout; 13 million pounds of discarded soap.

In SAVVY, an online survey of 1,285 working parents was conducted between January 2021 and April 2021. Earlier in May, the researchers from Ohio State University published their report, Pandemic Parenting: Examining the Epidemic of Working Parental Burnout and Strategies to Help.

In SKILLS, after describing what Parental Burnout is, the report went on to provide some strategies to help parents deal with burnout. So whether you are a parent yourself, or helping parents cope, the report has strategies for you.

In SOUL, In 2008, Shawn Seipler was staying at a hotel in Minneapolis and wondered what happens to all the unused hotel room soap? This got me thinking about what would be the ‘wasted hotel soap’ of the healthcare industry? What better systems could we build that could save as many lives as 13 million pounds of discarded soap?

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April 2022

My three career bridge-building targets; Where to start in helping people change; 50 years for Elon Musk and me.

Welcome to the start of my 20th year of writing Tips and Topics. The first edition was published April 2003.

In SAVVY, this edition of Tips & Topics begins the 20th year of publication. I look back at what I’ve written before in three areas of bridge-building: Addiction as an illness – the general public and health care in general; Addiction and mental health – Co-Occurring Disorders; Justice and Treatment teams.

In SKILLS, it requires skillful bridge-building to attract people into lasting, accountable change, and cross the bridge from expecting compliance to treatment to collaborating in person-centered care planning: Start with what the person is at Action for, not what you are at Action for; Hold the participant accountable to their goal and track their engagement, good faith effort and outcomes.

In SOUL, this year is 50 years since I graduated from medical school and started my career. See my ASAM Educator of the Year award photo and video bio. Elon Musk is 50 years old. I’ve had a good career, but find out what drives Elon and what someone who was one year old when I started my career has achieved.

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March 2022

What to report to Probation and CPS; Dilemmas about drug testing; Client-centered doesn’t mean client anarchy; Win, lose and win

In SAVVY, SKILLS and STUMP THE SHRINK, treatment providers can be confused about their role when clients are referred by Probation, Child Protective Services and other mandating agencies. Focus on improved function and skills, not compliance with assignments and phases in a pre-determined program. How to be “client-centered”.

In SOUL, increasingly I make no distinction between ‘wins’ and ‘losses’. A ‘win’ is an opportunity to discern what works and what doesn’t; and a ‘loss’ is an opportunity to discern what works and doesn’t.

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