Raising Resilient Kids: Lori Butterworth Of Center for Child and Adolescent Mental Health On Strategies for Nurturing Emotional Strength in Children
An Interview With Dr. Kate Lund
Let the Children Play. Recently, I asked a mother why she wouldn’t let her 11-year-old daughter walk two blocks from her school to my office for therapy. Like so many other parents, this mom shared her fear of a stranger taking her daughter. I asked the mom if she knew how long her daughter would have to stand alone on a street corner before, statistically speaking, she’d be kidnapped by a stranger. You could almost hear her jaw drop when I told her it was 750,000 years. Here’s the irony: her daughter has a smartphone.
In today’s fast-paced world, children face numerous challenges that can impact their emotional well-being. Developing resilience is key to helping them navigate these obstacles and grow into emotionally strong individuals. How can parents, educators, and caregivers foster this resilience in children? As part of this interview series, we had the pleasure of interviewing Dr. Lori Butterworth from the Center for Child and Adolescent Mental Health.
Dr. Lori Butterworth is the Co-Founder and Associate Psychologist at the Center for Child and Adolescent Mental Health. Alongside her colleague, Dr. Ramona Friedman, Lori is working to make mental healthcare accessible to all kids where and when they need it. Based in the Bay Area of California, Lori has more than 25 years of non-profit experience and more than 10 years of experience as an educator.
Thank you so much for doing this with us! Before we dig in, our readers would like to ‘get to know you’. Can you tell us a bit about your background and your backstory?
I grew up in a lower-middle-class family, and my parents’ divorce was dramatic and damaging to my brothers and me. After noticing my knotty hair and dirty clothes, my 4th grade teacher, Miss Ashcraft, taught me how to brush my hair and bought me five dresses — a different dress for each school day. Miss Ashcraft also noticed that I was a smart, but sad and confused kid. She helped me after school not with academics, but with life skills and self-care. Her support helped shift something inside of me. I wanted to be like her. I wanted to become the kind of person who would notice and support kids like me.
I didn’t know it then, but Miss Ashcraft became a protective factor for me. Protective factors and risk factors are situations or people that influence a young person’s development and well-being. As a child, I had plenty of risk factors, but in Miss Ashcraft, I had the #1 protective factor for youth mental health: a trusted adult.
I worked hard, put myself through college and graduate school, and taught high school for 13 years. During that time, a friend’s five-year-old son was diagnosed with a deadly form of cancer. I took notice and stepped in to help, something Miss Ashcraft would have been proud of. I founded Jacob’s Heart Children’s Cancer Support Services and over 25 years, built it into a thriving family support network helping thousands of families who have heard the devastating words, “Your child has cancer.” I co-founded the Children’s Hospice and Palliative Care Coalition using both litigation and legislation to address access to end-of-life care for seriously ill and dying children and their families.
When COVID hit, I stood in the counseling center at Jacob’s Heart, and the realization of the damage the isolation would have on youth mental health hit me…hard. The youth mental health crisis had already begun, and now the pandemic was exacerbating it. With the growing need for youth mental health support, the workforce shortage of therapists was expanding, especially for therapists prepared to deliver quality, evidence-based care to kids.
I remembered something my dad always said, “Somebody’s going to have to do it; it might as well be you.” That “you” became two when I met Dr. Ramona Friedman. Dr. Friedman had been practicing as a clinical psychologist for about 15 years, and I had 25 years of experience as a nonprofit CEO and founder. The synergy became immediately apparent. So, Dr. Friedman and I rolled up our sleeves and co-founded the Center for Child and Adolescent Mental Health to expand access to quality, evidence-based youth mental health care as quickly as possible. We’ve opened two centers to bridge the gap in access to care in a little over a year with a specific focus on first-generation immigrant youth, thanks in large part to the strategic investment of $100,000 from Morgan Stanley through its Alliance for Children’s Mental Health Innovation Award.
Can you share a story with us about what brought you to your particular career path?
My grandfather earned his PhD when he was 73. I remember going to his graduation ceremony when I was just starting college. The realization that there’s no set timeline for education stuck with me. Fast forward to 2020, when COVID-19 isolation threatened the social and emotional health of an entire generation of youth, I realized that one way to bridge the gap between the growing youth mental health crisis and available therapists was to become one myself. So, I returned to school, finished my doctorate, and turned 65 in the same month. The graduation party invitation read: Dr. Butterworth gets Medicare.
Over the years, my life’s work has focused on what Miss Ashcraft taught me: to improve the quality of life for children who are hurting. My research and practice have centered around post-traumatic growth in adolescents and evidence-based treatments for adolescent anxiety. Many people are familiar with PTSD, but the truth that humans can emerge triumphant, even heroic, after a traumatic event is the idea behind post-traumatic growth. Like my grandma used to say about my parents’ divorce, “This can make you bitter or better.”
Dr. Friedman and I are researching access to evidence-based youth mental health care. As I mentioned earlier, this has been our vision in co-founding the Center for Child and Adolescent Mental Health. The youth mental health crisis ignited in us an interest to investigate ways to prepare youth-focused therapists to deliver scientifically grounded treatments for the most common youth mental health disorders. For example, cognitive behavioral therapy (CBT) is the gold-standard, evidence-based treatment for adolescent anxiety, so we are training new therapists in the delivery of CBT and parents in using CBT principles at home. The efficacy of our CBT-informed clinical training on preparing the workforce of youth mental health providers is the thesis of my doctoral dissertation and our future research.
Can you share with our readers a bit about why you are an authority on raising resilient kids? In your opinion, what is your unique contribution to this field?
I would say that Dr. Friedman and I have synergistic expertise, and the sum of that expertise is greater than the sum of its parts. Dr. Friedman is one of, if not the most skilled and informed clinicians I have known (and I’ve known lots). My public policy experience, child advocacy, education, and organizational leadership, and her clinical expertise are what drive the success of the Center for Child and Adolescent Mental Health. I think the synergy of experience behind our idea to expand access to youth mental health care for underserved youth, and first-generation immigrant youth in particular, is what caught the attention of the Morgan Stanley Alliance for Children’s Mental Health team, which recently named the Center for Child and Adolescent Mental Health as an Innovation Award winner. This program will help us continue to scale our first-generation immigrant mental health services to have a greater reach in our communities.
But, for Dr. Friedman and me, our “authority” in raising resilient kids comes from doing it. We’ve both raised resilient kids and know that none of us is truly an authority when it comes to raising resilient kids. No amount of training, education, or professional experience makes one an authority when it comes to love.
Do you have a favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life or your work?
I write Socrates’s quote, “Know thyself,” on the whiteboard in my office at the beginning of therapy with each young patient. This sets a tone that I’m not there to “therapize” them but to help them get to know themselves. As parents, we, too, can take the opportunity to get to know ourselves and our kids.
Next, I also write Walt Whitman’s quote, “Be curious, not judgmental, “ on the whiteboard, which becomes our mutual agreement in therapy. The patients who have seen Ted Lasso love this!
Ok, thank you for all that. Now let’s move to the main focus of our interview. How can parents handle situations when a child faces failure or disappointment? What strategies can parents use to help a child bounce back?
I’ll draw from two evidence-based therapies we use at the Center for Child and Adolescent Mental Health: Cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) to provide strategies that align with well-researched approaches to treating psychological challenges such as anxiety and depression. .
CBT helps children manage their thoughts, emotions, and behaviors. You can teach your child to recognize and challenge a negative thought by asking, “Is this thought really true?” or “What evidence supports this thought?” Then, you can help your child reframe the thought by asking, “How can we think about it differently?” When facing a challenge, CBT teaches how to help your child create small, achievable goals to build confidence gradually and guide them through problem-solving steps. These steps can include gradually and safely exposing your child to something they fear. Over time, with repeated exposure, the fear will likely lose its power.
I use an ACT mindfulness technique called anchoring, in which kids use their senses to anchor into the moment. They focus on what they see, hear, taste, touch, and smell. Kids can tend to resist closing their eyes and breathing. When we say mindfulness, they think we’re going to make them meditate. But most of them will anchor, and many like to guide their parents in anchoring through their senses. ACT also teaches the act of accepting uncomfortable thoughts or feelings without trying to eliminate them. So often, parents try to remove uncomfortable thoughts or feelings from our kids’ lives. This robs them of the opportunity to put problems in perspective. Instead, parents can reinforce the idea that it’s okay to experience discomfort while still moving forward in meaningful ways.
What role does parental modeling of resilience play in the development of emotional strength in children? Can you share an example of a resilient parenting moment that you experienced directly or that you have come across in the course of your work?
At the Center for Child and Adolescent Mental Health, we host free monthly Parent Drop-In Zoom sessions where parents can just “drop in” and ask a question of a youth mental health expert. One of the most common questions parents have is about how to motivate their kids.
We encourage parents to shift their focus away from trying to “get a kid motivated” to demonstrating persistence and motivation when facing difficult tasks in their own lives. By setting goals, tackling difficult tasks, and openly sharing how to stay committed even when it’s tough, parents show children the value of hard work and perseverance. Sharing openly about our own setbacks can help children understand that motivation isn’t about always feeling enthusiastic but about pushing forward despite obstacles.
We teach parents the importance of practicing imperfection as a way to role-model the value of being uncomfortable. The power of role modeling imperfection is often much more impactful than teaching our kids the skills directly. We encourage parents to learn a new skill that requires them to practice errors in front of their children.
How can parents balance providing support with allowing their children to experience and overcome difficulties on their own?
I was working with a family of an anxious pre-teen whose parents, according to the child, “never let her out of the house.” I asked the child why she thought her parents wanted to protect her. The girl stared at me with wide-eyed pre-teen incredulity. “I have no idea,” she snapped, clearly angry at her parents and me. I went on, “Ok, why do you think any parent would be protective of their child? Why do parents want to keep their children safe?” Again, she quipped, “I have no idea.” I calmly continued, “Ok, I’ll give you a hint: the word starts with an ‘L’’ can you guess?” She replied, “Liability?” She was serious. When I said “love,” she was surprised.
I encourage parents to visit LetGrow.org, an organization that was co-founded by Lenore Skenazy, who caught an enormous backlash when she wrote an article entitled, “Why I Let My 9-Year-Old Ride the Subway Alone.” Of course, her daughter was fine, but Lenore was accused of child abuse. So Lenore and like-minded, free-range parents have started a grassroots movement of parents who believe in giving kids the independence they need to “grow into capable, confident, and happy adults.” LetGrow.org is full of free resources to help parents let go and let grow.
What self-care practices would you recommend for parents to maintain their own resilience while going through the everyday challenges of raising children?
I get asked about self-care a lot, and to be honest, the question often rubs me the wrong way. There is a simple, evidence-based formula for self-care: good sleep, good food, exercise, and social connections. The rest of self-care is personal and different for everyone, so recommending a particular self-care style misses the point.
To overcome the challenges, exhaustion, and burnout of parenting, try reconnecting with your kids in a new setting. Outdoors is best. Running, playing, and having fun with your kids outside can be great self-care because it connects you back to your values.
Can you please share “5 Strategies To Raise Children With Resilience and Emotional Strength”?
To help parents build resilient kids, I’ll refer to three well-researched, go-to resources for parents: SPACE (Supportive Parenting for Anxious Childhood Emotions) developed by Eli Leibowitz from Yale; Triple P (Positive Parenting Program) developed by Matt Sanders at the University of Queensland in Australia; and The Anxious Generation, NYU professor Jonathan Haight’s last, well-researched bestseller.
1 . Resist the Urge to Fix. Validate your child’s emotions but resist the urge to solve every problem for them. Our parental instincts are to protect our kids and keep them from harm. But often trying to fix our child’s problems for them sends the message that they’re not capable of fixing things themselves. Try saying things like, “I can see you’re upset, and that’s okay,” to show you understand their distress. Then, offer support without taking over, saying, “I’m here if you need help, but I know you can handle this.” The SPACE program helps parents of anxious children learn to avoid doing things to accommodate our kids’ fears while unintentionally fueling their anxiety. For example, parents of kids who are afraid to sleep alone will try to avoid their child’s discomfort by sleeping with them well into adolescence. Every night the message “you’re too weak and afraid to sleep on your own” gets reinforced. In short, jumping in to keep our kids from experiencing pain can undermine their ability to build self-confidence and resilience.
2 . Model Values-Driven Choices. I use a fun game in therapy to help kids identify what is important to them and what is not. We take about 50 cards with values-based words: Independence, Honesty, Patience, Courage, etc. We sort the cards by “Most Important,” “Somewhat Important,” and “Not Important.” Then, we talk about each selection in the “Most Important” pile and sort the cards again. By the end of the game, the child has narrowed it down to the top five things that matter most to them. This sparks conversations about why knowing what is most important helps us set goals aligned with who we are.
I encourage parents to do this with their kids and talk about the values they share and each family member’s unique values. As parents, knowing our own values allows us to demonstrate how to act in alignment with those values, even when facing difficult challenges. For example, if a family values kindness, a parent can show their child how to remain kind and compassionate, even in stressful situations. If you, as a parent, value “Respect,” you can demonstrate self-respect and show respect to others even amid conflict. This helps children understand that living according to their values is more important than trying to avoid discomfort. It teaches resilience by showing that they can continue to pursue meaningful actions despite difficult emotions.
3. Turn Challenges into Learning Opportunities. When your child encounters a manageable challenge, welcome it. Without taking over, allow your child to face age-appropriate challenges that might involve failure. Gradual exposure to difficult situations helps kids build confidence and learn to manage adversity. Find opportunities for your child to learn from setbacks. Again, validate your child’s feelings and then encourage them to think about what they can learn from a situation. Ask questions like, “What can you do differently next time?” to help them develop problem-solving skills and resilience. Share your own experiences with failure and how you overcame it. Help your child see setbacks as temporary and part of growth.
4. Be a Helicopter-Parent. Yes, you heard that correctly. It’s time for parents to become more helicopter and hover more when it comes to screen time and social media. And, it’s time to stop hovering in the real world. Jonathan Haight describes the disastrous cultural shift from play-based childhood to phone-based childhood and how as parents, we’ve become irrationally fearful of stranger danger in the real world while handing our kids a device that opens them up to predators worldwide. I’ve heard people say that the genie is out of the bottle and there’s nothing parents can do about kids and social media. I disagree. There’s a lot we can do.
Let’s start by considering the primary function of social media. For most kids, social media is a way to connect with friends, and social connection is a healthy, necessary developmental activity. Taking away your child’s phone while “everyone else” has one, isn’t the answer. According to Haight, we must replace phone time with playtime. Haight suggests four new norms for groups of parents to agree to: 1) No smartphones before high school; 2) No social media before age 16; 3) No phones in schools; and 4) More independent play.
5. Let the Children Play. Recently, I asked a mother why she wouldn’t let her 11-year-old daughter walk two blocks from her school to my office for therapy. Like so many other parents, this mom shared her fear of a stranger taking her daughter. I asked the mom if she knew how long her daughter would have to stand alone on a street corner before, statistically speaking, she’d be kidnapped by a stranger. You could almost hear her jaw drop when I told her it was 750,000 years. Here’s the irony: her daughter has a smartphone.
Back in the 1970s, I was a kid running around with my friends until dark without a parent or phone in sight. The crime rate was higher then than it is today. But today, parents are irrationally hovering over their kids in the real world and throwing up their hands when it comes to the digital world. We need to switch on the parental hover button when it comes to social media and switch it off in the real world.
I tell parents, instead of “play dates” and scheduled activities every day after school, give kids time to run around the neighborhood playing freely. Trying to schedule therapy appointments with parents whose children have ballet on Monday, soccer on Tuesday, piano on Wednesday…makes therapy another scheduled activity.
How can mindfulness and emotional regulation techniques be incorporated into daily routines to support children’s emotional resilience?
How many of us have started a daily mindfulness practice only to have it fade away after a few days? Count me in. To make mindfulness practice stick and become a habit, keep it simple and enjoyable.
The “Three Good Things” activity is a simple yet powerful mindfulness practice that you can enjoy with your kids. Each day, perhaps as part of a bedtime routine, reflect on and write down three good things from the day. They can be big or small, such as a kind interaction with a friend, a delicious treat, or completing a task. Parents can model how to keep it simple so kids don’t find it overwhelming. Share your good things, and talk about why each thing happened or how they contributed to the good thing happening. This helps kids focus on positive moments and emotional resilience.
As I mentioned earlier, the anchoring technique helps kids get anchored in the present moment by bringing attention to the physical environment and becoming aware of bodily sensations. Make it a habit, perhaps during a meal, to focus on five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This helps kids connect with the present moment in a fun and simple way.
There are many breathing exercises that can help calm the mind and body. Whatever breathing exercise you use, make sure to focus on a long, complete out-breath. When kids get anxious, and we tell them to “breathe,” they can start breathing quickly in and out, which can exacerbate their anxiety. Think about how you feel after hyperventilating. Slow, steady breathing with extended out-breaths is best.
Are there any specific tools or resources (books, apps, courses) you recommend for individuals looking to improve in this area?
If you haven’t yet had the chance to read Jonathan Haight’s latest book, The Anxious Generation, I recommend you grab it as quickly as possible. In it, Haight makes the strongest case yet for the damage social media is having on our kids. He describes the disastrous cultural shift from play-based childhood to phone-based childhood and how as parents, we’ve become irrationally fearful of stranger danger in the real world while handing our kids a device that opens them up to predators worldwide.
Eli Leibowitz’s book Breaking Free of Child Anxiety and OCD: A Scientifically Proven Program for Parents is all about SPACE (Supportive Parenting for Anxious Childhood Emotions). The philosophy behind SPACE is that to treat child anxiety, we treat the parents. This is especially useful when children are resistant to therapy; the parents go to therapy and learn to reduce the kinds of parental accommodations and reassurance that may be feeding a child’s anxiety.
LetGrow.org provides free resources for parents and teachers. Be sure to download the Let Grow Project and Independence Kit.
Ask Lisa: The Psychology of Parenting, Dr. Lisa Demur’s podcast, is full of practical, science-based parenting tools and strategies. Her book Untangled: Guiding Teenage Girls Through the Seven Transitions into Adulthood is a must-read for parents raising teen and preteen girls.
Angela Duckworth’s Grit (both book and TED ED talk) is a great resource for parents who want to help their children succeed. Duckworth shows that success isn’t about talent but about fostering passion and persistence, or “grit.”
Finally, the Center for Child and Adolescent Mental Health hosts free, 1-hour Parent Drop-In sessions on Zoom where parents can seek guidance from experts specializing in specific mental health disorders. Parents can also connect with others facing similar challenges. Clinical Psychologists who specialize in anxiety, depression, eating disorders, suicidality, and medication host each session. Parent Drop-Ins are held on the last Wednesday of every month at 5:30 pm. Register at ccamh.org to receive the Zoom link and submit questions beforehand.
Wonderful. We are nearly done. Is there a person in the world, or in the US, with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them.
I’d love to have lunch with Jonathan Haight. He’s started a real, no-holds-barred, grassroots conversation about social media’s influence on youth mental health. I meet parents every day who feel isolated and alone, struggling with their kids about screen time and social media. At the Center for Child and Adolescent Mental Health, we are starting to host parent meetings about the four new social media norms and have seen a ray of hope. I’d love the opportunity to thank him.
How can our readers further follow your work online?
Please visit ccamh.org and join us for a Parent Drop-In.
This was very meaningful, thank you so much. We wish you only continued success on your great work!
About the Interviewer: Dr. Kate Lund is a licensed clinical psychologist, podcast host, best-selling author and Tedx Speaker. The power of resilience in extraordinary circumstances kept her thriving as a child. Dr. Lund now helps entrepreneurs, executives, parents, and athletes to see the possibility on the other side of struggle and move towards potential. Her goal is to help each person she works with to overcome their unique challenges and thrive within their own unique context.
Raising Resilient Kids: Lori Butterworth Of Center for Child and Adolescent Mental Health On… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.