There’s an app for that: online resources for mental well-being and support

One of the questions I’m freqbooks-484766_1280uently asked by our young clients and their parents is, “What other resources are out there for [insert their concern here]?” I chuckle at how obvious a topic this can be, especially for our blog, but seeking out other resources can be helpful.

First and foremost: if you have any psychological concerns, of course seek out a mental health professional. If you are looking for social skills coaching, Aspiring Youth is a great resource.

What exists as easy-to-access, supplementary resources for adolescents, young adults and their parents? There are many, but let’s take a look at a few I like and, in some cases, personally use.

How to ADHD

Jessica McCabe is a Los Angeles actress who, as an adult, received a diagnosis of 23280349432_a86bbcdc28_zADHD. She researched what that means, the likely effects on her life and how to overcome it, resulting in her very engaging YouTube series: How to ADHD. She is not a clinician, nevertheless her insights are well-informed. This includes tips for living with and overcoming some of the challenges of ADHD and other diagnoses.

Autism sensory simulators

Many who have a diagnosis on the autism spectrum experience sensations very idiosyncratically: some are sensitive to touch, some to lights or sounds and, for others, smell is overwhelming. For those with more neurotypical development, these challenges are difficult to imagine. Thankfully, some wonderful online simulations can illustrate these experiences, often created by someone with an autism spectrum diagnosis. Mashable collected five great representations of these.

Apps for to-do lists

For some (and I’m squarely in this camp), doing routine tasks is a serious challenge. “I’ll do it later,” really translates to, “I fully intend on doing it, and I’ll do it when – oh! I love this song! Did you know that the composer was inspired by – wait. What was I saying?”

Different apps exist for making tasks more enjoyable, or at least memorable. Habitica (my favorite) truly gamifies to-do lists and daily tasks. In this role playing game (RPG), your character gains experience points and levels for completing tasks and takes damage for tasks left unfinished. With group challenges, quests, and bosses – plus an extremely supportive forum community– Habitica provides an opportunity for me to monitor my lists and check off items as I complete them. Oh, and it’s also free to play!

Mindfulness

Mindfulness is a big deal in the psychology world. My colleagues and I use it within a variety of situations.  I checked out Headspace, and the feedback I’ve received from clients has been overwhelmingly positive. The program gently guides you in different mindfulness modules, all in 10-minute portions. While it’s a paid app (with a free trial), I think it’s worth it.

Datingrelationship-1261216_1280

I have written about this topic previously because it is so important and comes up often with adolescents and young adults.  Advice on the internet ranges from laughable to outright scary and misogynistic. I’ve said this before, but it bears repeating: don’t visit websites by people in the pickup artist (PUA) or seduction community. Their advice often relies on negating consent or assuming that one person is owed affection and/or a date, and your curious visit nabs them more site traffic and subsequent income.

My favorite resource in the dating domain is Dr. NerdLove, as he provides straightforward advice recognizing that girlfriends/boyfriends are not titles or prizes, but actual people with different needs and autonomy. Geek’s Dream Girl­ is another resource that offers solid, concrete advice from a woman’s perspective. While it’s no longer updated (though there are hints at its impending resurrection), the info is still there and accessible.

Hopefully, these suggestions give you a start. As I said, there are many resources out there that can be used in conjunction with social skills coaching.

What are your favorites? Feel free to comment below with your suggestions for online resources.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. In addition, he is the clinical director of TakeThis.org, a national nonprofit focused on mental health and the gamer community, runs a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, and provides parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma and games. In his spare time, he enjoys acting, cooking, board games and video games.

I was sitting around bored, one day…

bored-16811_1280Boredom can be a good thing, and summer is a great time for it. This may seem counter-intuitive advice coming from a social skills coach for a program with a thriving (and awesome) summer camp program, but your kids need some boredom and unstructured time. Structured activities are beneficial, especially if you have concerns about your kids spending too much time with video games, phones and tablets (i.e., “screens”)–but don’t go overboard!

Why boredom?

One important developmental task milestone for teens is learning to create their own sense of autonomy. As they grow, children need to make the decisions of how to responsibly fill their free time. As parents, it’s easy to feel pressure to fill their schedules with activities. It’s important though to recognize that boredom is also a gift that allows them to fill their own “schedules”. Though they may be resistant at first, self-discovery and creativity are often born of boredom.

“Brad” and the Scotch tape roll

In one recent Aspiring Youth social skills group, teenaged “Brad” fiddled for quite some time with the empty, plastic center of a Scotch tape roll. I watched him absentmindedly fiddle with it as he described proudly how he entertained himself with it all day.

Inspiration struck very suddenly as he flicked it across the table. I took five coins from my pocket and placed them in a line on the table. Each coin marked a different zone. I challenged him to flick the plastic roll in such a way as to get it as close to the opposite table edge as he could while not going over the edge, with double points awarded if he flicked it with enough backspin to roll back to him. The closer he could get it to the opposite edge, the more points he received. The other teens trickled in and one by one took turns with this game. Everyone ended up playing an hour-long tournament which I refereed. The guys enjoyed it so much that the following week several asked if we could do it again.

Boredom as a skillchild-241749_1280

While the guys were pretty impressed that we came up with that fun game so quickly, it became a teaching point about how creativity can spring from boredom, and how being bored is actually a skill one has to practice. We have to generate our own interests. Not coincidentally, I love tabletop games because they are both fun and social. I would never have tried them if my parents hadn’t limited my video game exposure and allowed me plenty of unstructured time in which to fill.

Here are a few ways to facilitate productive boredom:

  • Limit your kids’ recreational screen time to no more than two hours every day (as recommended by the American Academy of Pediatrics). This includes use of smartphones for purposes other than directly communicating via text or phone.

  • Schedule some structured or semi-structured activities (Aspiring Youth’s summer camps are a great example of a mixture of structured and unstructured time).

  • In order to create more autonomy with your adolescent, discuss the structured activities that they would like to do.

  • friendship-1081843_1280If they’re used to an abundance of structured activities and/or screen time, be prepared for push back!

  • If and when they say, “I’m bored!” work with them to come up with some activities–but don’t lead too much.

  • Encourage them to explore new activities that they have never tried.

Aside from the fact that this can help them develop their autonomy and creativity, giving them unstructured time can also make it easier on parents since you don’t have to schedule every minute for them.

In any case, have fun! Who knows? Maybe your teen will come up with their own fun games in the process.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. In addition, he is the clinical director of TakeThis.org, a national nonprofit focused on mental health and the gamer community, runs a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, and provides parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma and games. In his spare time, he enjoys acting, cooking, board games and video games.

Achievement unlocked: relationship

With a lot of the teenage guys with whom I work, dating is a serious goal and a serious headache. Most of them have a lot of misperceptions about what it takes to—in their words–“get a girlfriend.” There are many misperceptions about this process—and it is a process…an ongoing one. My hope is that teenagers (and parents) walk away with a few tips on how to approach dating—whether it’s a boyfriend or girlfriend being sought.

It’s a process, not a destination

joystick-1216816_1280The most common misconception that I encounter seems to be the idea that a girlfriend/boyfriend is a prize awarded, as if one were playing a video game and finding this elusive, magical unicorn called “girlfriend” somehow gives one enough experience points to attain a new social level (this is a gamer thing—ask your kids).

You can hear this in how the guys with whom I work talk and strategize: “How do I get a girlfriend if I like Dungeons & Dragons?” or, “Do girls like guys who are smart or dumb?” and even, “Should I have six pack abs? Will that work?”

Additionally, we often talk about how much work it is to maintain a romantic relationship. This is difficult as teens often don’t think further than “Girlfriend Achievement: Unlocked,” and when they do talk about it, it’s often about what they can do to keep a girlfriend: “I can buy her gifts,” or, “I will need to take her on a lot of dates, right?”

The problem assumptions

There are a few problems with the above mentality:

  • It assumes that people are not independent, but machines where one may press certain buttons or pull certain levers to achieve a desired outcome.

  • It assumes there are universal answers to what people find attractive. Yes, there are certain things that people tend to find attractive (confidence and authenticity often being two biggies)—but it varies from person to person.

  • It assumes that the teen, as a pursuer, is somehow owed a relationship if they do all the right things.

These are problematic—especially when the last assumption is violated. The guys can become creepy or occasionally scary that their advances were denied. To make things more difficult, dating today has less overt rules (such as not using titles like “boyfriend/girlfriend” or “relationship”), which can be antithetical to the rigid way teens who need help with social skills think.

What can be done?

relationship-1261216_1280First, I teach my social skills clients that they need to change how they think, starting with the following rules:

  • A girlfriend is not an achievement. She is a person with the same independence, rights and feelings as you.

  • She doesn’t owe you anything—even if you’re being nice to her. (Additionally, if you’re being “nice” to only get something, that really isn’t very nice.)

  • Developing a relationship is not that different than making a normal, platonic friendship. You need to get to know the other person buy engaging in small talk and responding to their verbal and nonverbal cues. You need to learn about common interests so that the relationship can deepen.

  • Despite what some websites tell you, there is no one formula of behavior to “get a girlfriend” because every person is different.

  • You have to learn to fail and get rejected (and coping with rejection is a learned skill) in order to develop a socializing style that is authentic for you.

  • You need to learn to enjoy the process of getting to know people.

  • Be willing to walk away from the relationship if you don’t have things in common.

These rules add up to one thing: flexibly enjoying the process of getting to know someone.

Ideally, it should be like a good video game. Your focus should be about the person and the process, not just the end result or achievement. You should enjoy the journey of getting there—if the ending is good, that’s wonderful!

What else is out there?

If you are looking for other resources, or if you have concerns about your (or your child’s) dating skills or approach, I recommend the Aspiring Youth individual social skills coaches. This is a great topic to discuss with us, and one we enjoy helping our teenage and young adult clients with.

Other than that, I tend to recommend author Harris O’Malley, better known by his screen name Dr. NerdLove. Aside from his brilliant blog, he has books on dating, including:

What I definitely don’t recommend are any websites or books written by those in the “pickup artist” (PUA) community. Don’t even look at PUA websites (visiting gives them web traffic and, consequentially, income)—they tend to objectify and dehumanize women to a frightening degree, and that’s no way to learn about and enjoy the process of building relationships.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. In addition, he is the clinical director of TakeThis.org, a national nonprofit focused on mental health and the gamer community, runs a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, and provides parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma and games. In his spare time, he enjoys acting, cooking, board games and video games.

Developmental vs. Chronological Age: What’s the difference?

A psychologist at my first internship rotation hammered into all the students who would cross her path the concepts of developmental age and chronological age. She emphasized how important they would be in all of our future careers—she was right.

background-84678_1280But how are they important to parents?

Chronological age is pretty straightforward: it is simply how physically old your child is. When a small child holds up her fingers and says, “I’m this many old,” she is telling us her chronological age (if she’s right, of course).

Determining a child’s developmental age is trickier.

Developmental age measures someone’s behavioral, cognitive and physical development in contrast to the typical person in the same age range. Consider behaviors and learning tasks that a typical 1st grader displays: learning to read, basic addition, cooperative play and taking turns. If a person’s developmental and chronological ages match, we tend to not notice because it’s expected.

However, it can be a problem when the two don’t match.

Stevie and his different “ages”

Recognizing that a child’s developmental and chronological ages can be different is an important first step.

Let’s consider 10-year-old “Stevie,” who has a diagnosis of autism spectrum disorder. While he has the vocabulary and memory of a typical 10-year-old, his ability to read body language and control impulses (such as interrupting people or angry outbursts) is more typical for a 6-year-old. Stevie is going to have a challenging time in school and in making friends.

child-929935_1280Often, adults and other kids expect Stevie to “act his age” because they see a 10-year-old and expect 10-year-old behavior. This potentially creates a problematic cycle:

  • Adults expect 10-year-old behavior when he legitimately cannot give it in all ways

  • They get angry at him for not meeting that expectation

  • Stevie gets frustrated that, despite his attempts, he continues to fail and get punished

  • Stevie starts viewing himself as “broken” or “dumb” and stops trying

  • Adults get more angry as his skills continue to fall behind

What can parents do? Think in different domains.

Parents and professionals should work together to identify what areas correlate to the child’s chronological and developmental ages. I often coach parents on how to think about their child’s developmental age in different domains.

For Stevie, his parents can expect him to use the language of a 10-year-old. Their behavior should reinforce, challenge and support his behavior in that domain. However, they shouldn’t expect a 10-year-old’s emotional or behavioral control.

An important clarification is this adjustment of expectations is not done to convince them that Stevie cannot succeed in the future. Quite the opposite, in fact. It can help parents have realistic expectations of where his challenges are right now, in order to help build foundational skills for future success.  If they are looking for him to master typical 6-year-old skills, they can praise them instead of being frustrated at Stevie’s lack of “obvious” skills. Ironically, this lowering of (certain) expectations can lead to the increase of skills that parents are seeking.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. In addition, he is the clinical director of TakeThis.org, a national nonprofit focused on mental health and the gamer community, runs a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, and provides parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma and games. In his spare time, he enjoys acting, cooking, board games and video games.

Dungeons & Dragons & Social skills

What is Dungeons & Dragons? Why does Aspiring Youth use it in one of our social skills groups? And why is it one of our most popular groups?

While some of our students’ parents have played it themselves, many don’t really know what it’s all about. Read on if you’re either unfamiliar with the game or how we use it.

rpg-468917_1280The game

Dungeons & Dragons (or D&D) is the best-known table top role playing game in the world. It has been around since the early 1970s, though it has changed and evolved over time. The basic concept is fairly simple. Each player has information about a customized character, and the leader (or Dungeon Master) is essentially a combination of narrator and referee. She or he tells an imaginary story while the players decide how their characters interact within that story – and act it out.

The game evolves each week and takes on the personality of the group as players progress and encounter consequences. Some games are serious or cartoonish. Some are filled with diplomacy and intrigue, or with epic battles that the characters race to stop. All require collaboration and symbiosis between the players and the leader.

Why use it for social skills?

Role playing has been used by mental health clinicians for decades to help people rehearse interpersonal interactions and coping strategies. When moderated by professionals, D&D can serve the same function.

Aspiring Youth social skills groups (the first in Washington to use D&D in an organized way) accomplishes these same goals:

  • Players think about how someone else would act through coaching and creating a (generally prosocial) character whose motivations and personality are different.

  • They have to mimic the behavior and words of that type of person.WP_20160328_003

  • The game provides a safe, flexible framework in which a person can practice those social skills.

  • What’s more, the players are rewarded with in-game prizes for successfully doing so.

In addition to that, we often co-facilitate the game to track player’s behaviors. With a white board, we visibly tally various behaviors such as raising one’s hand and waiting to speak versus disruptively talking out of turn. We also track whether a player is ready on his or her turn or there is a delay in the game due to the player being distracted. The target behaviors are collectively rewarded with in-game points and the opposite behaviors are penalized. The peer pressure to exhibit target behaviors for rewards (and avoiding penalties) leads to significant improvement.

How parents can help

How can you support your student’s efforts? Here are five tips to practice in your home:

  1. Basics: Learn about his or her character and the motivations that drive the character. Ask about personality, class/job, race, physical skills – learn all you can.

  1. 14543462957_c0a257e3ef_zMotivations: While you may not understand at first (What is a lawful good, dwarf knight who wants to bring justice to the world?), all of these details such as morality and background impact how a character would act in a given situation. Coach your student on how that type of person might act. That’s what we want the players to think about.

  1. Reviewing the rules: If your student doesn’t have answers about his or her character, it’s probably time to read the rule book a little better, which you can do together.

  1. What’s new: Ask about new developments each week. Players love to talk about their experiences. Maybe the character succeeded at a seemingly impossible feat and saved the day! Or perhaps, the character is trapped and in need of rescuing by the party.

  1. Check in with us! Stop inside when picking up your student and chat with us, the facilitators. While teens might groan a bit, this is a great way to catch up on behavior goals among parents, students and facilitators.

Hopefully, this gives you some tips and a better idea of how Aspiring Youth brings growth to students’ social skills in a dynamic, captivating and unique way. If you have any questions, please visit our website or call 206.517.0241.

Our Spring 2016 Dungeons & Dragons social skills group meets Tuesdays in Seattle and Fridays in Bellevue.

If you liked this article, please check out our how board games can also become a valuable way to teach or reinforce skills.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. In addition, he is the clinical director of TakeThis.org, a national nonprofit focused on mental health and the gamer community, runs a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, and provides parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma and games. In his spare time, he enjoys acting, cooking, board games and video games.

Photo credit: D&D characters

So, they play video games. But what does that mean?

Video games have grown up – as have those who play them (average gamer age is 35). Some classics like The Legend of Zelda or Super Mario Brothers are at least 30 years old, so it’s safe to say that video games are part of our culture.

joystick-1216816_1280Despite this, I routinely encounter clinicians and parents who use the term “video games” as if the media are homogeneous. They’re unaware of the differences among games, as well as what people gain from playing them. In other words, they are missing the “why” someone plays the games they do.

Someone who plays Minecraft does so for different reasons than someone who plays role playing games such as Skyrim or Dragon Age: Inquisition. A teen who plays stealth action games like Metal Gear Solid V: Phantom Pain does so for different reasons than those who play massively multiplayer online (MMO) games like League of Legends.

These differences are clinically important. When clinicians wants to help someone eliminate a behavior (perhaps like an adolescent playing video games too much), we cannot just tell them: “Stop it.”

Why? Finding a substitute behavior that fulfills the initial need of the other behavior is absolutely vital. Here are some examples:

  • Social connection: If you gain a sense of social connection by playing a MMO game, then simply stopping cuts yourself off from social inclusion (plus the fun!).

  • minecraft-1106252_1280Creativity: If you enjoy the accomplishment from building creative worlds in Minecraft, then stopping has the potential to leave you unfulfilled.

Success lies in offering a similarly fun, in-person social activity that you can do instead of the MMO – or a creative building activity instead of Minecraft.

Have a child who plays an excessive amount of video games? Take some time and ask in a nonjudgmental way about the games they’re playing. Go at it with the mindset of just learning for the purpose of learning. Maybe even play the games. Don’t pretend to be an expert on them. Just let your child teach you. Over time, the info helps you…

  • Monitor the appropriateness of the games your child is playing.

  • Bond with your child or teen

  • Understand their motivations and the rewards they experience playing their games of choice.

If you believe their playing is excessive, this will help you brainstorm alternative activities. Remember, video games are a diverse and rich form of media—with motivations for playing as diverse as the games we play. In the process of learning your child’s preferences, maybe you’ll discover one you like.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. In addition, he is the clinical director of TakeThis.org, a national nonprofit focused on mental health and the gamer community, runs a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, and provides parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma and games. In his spare time, he enjoys acting, cooking, board games and video games.

 

Like this post? You may like “Why games? Why not?”

Why it might not be ADHD

Difficulties with a child’s attention or ability to sit still are significant concerns for a lot of parents who come to my office. They hope to find answers, and at the same time avoid over-pathologize their child. However, psychiatric diagnostics is a complex concept, and even if there is significant difficulty paying attention or holding still, it may not be Attention Deficit Hyperactivity Disorder, or ADHD. There may be something else going on.

23280349432_a86bbcdc28_zI hope to provide a little clarity on the intricacies of psychological diagnoses, and how difficulty concentrating doesn’t always lead to a diagnosis of ADHD.

Every mental health provider in the country uses the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as the official basis of their diagnoses. This next part is really important: every single diagnosis is a collection of different symptoms. There are a lot of overlaps in diagnostic symptoms because no one symptom defines any single diagnosis, or they might not be severe enough to warrant a diagnosis. Being sad doesn’t necessarily mean that a person is depressed. Being nervous in large groups doesn’t necessarily mean a person has an anxiety disorder.

Likewise, difficulty paying attention is a symptom, not a diagnosis, and there are many diagnoses that can affect attention. Coupled with the way kids express distress, this is why I’ve only diagnosed ADHD once or twice.

Diagnosis by elimination

Rule out everything else that could interfere with attention. This might include stressful events to which children might react. Symptom overlap is so significant that most DSM-5 diagnoses I commonly encounter affect attention in some way.

  • road-sign-663368_1280Post-traumatic stress disorder can result in a need to constantly scan one’s environment for danger.

  • To a differing degree, other forms of anxiety can cause distraction from preoccupation with the source of anxiety.

  • Distractibility is overtly a symptom of bipolar disorder.

  • Major depressive disorder can result in slowed cognition and impaired concentration, and can even manifest as a secondary reaction to other diagnoses, complicating things further.

When young kids are in emotional pain, they tend to act out (especially boys) instead of being able to talk it out. Kids often look like they have ADHD, whether it’s true or not.

Autism and attention

Impairment in concentration, distractibility and hyperactivity are all extremely common in those who carry an autism spectrum disorder (ASD) diagnosis. I generally expect to see these symptoms. Additionally, the DSM-5 makes it clear that both ASD and ADHD diagnoses are supposed to take into consideration a child’s developmental (not chronological) age.

What does this mean for those with ASD? It means that a combo diagnosis of ASD/ADHD should be fairly uncommon. But why?

“Stevie” and autism

Let’s say that 10-year-old “Stevie” has a diagnosis of ASD. Stevie is likely going to have some difficulties with attention and with social skills. Based on his symptoms and behavior, we estimate that he has the social/developmental age of a typical 6-year-old. Comparing the attention span of a typical 6-year-old to a typical 10-year-old (Stevie’s chronological age), watercolor-portrait-1050714_1280you’ll see a big difference. However, because Stevie has an ASD diagnosis we can’t make that comparison in order to give him an ADHD diagnosis. We expect him to act like a typical 6-year-old, so that’s where the measuring stick needs to be used for his attention level.

It’s only when Stevie’s concentration and attention is significantly impaired compared to a typical 6-year-old that we can start to consider an ADHD diagnosis as a possibility.

I could write a lot more about this, but what I hope you take away is that sometimes a label (or additional label) isn’t needed. There are many reasons someone’s attention can be affected, and those still might warrant clinical attention, regardless of diagnosis. The problems are what they are.

If you’re concerned about someone in your life, consult a local mental health professional. In the meantime, I hope this brings some clarity to a potentially confusing and stressful situation.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. In addition, he is the clinical director of TakeThis.org, a national nonprofit focused on mental health and the gamer community, runs a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, and provides parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma and games. In his spare time, he enjoys acting, cooking, board games and video games.


Photo credit: ADHD

Why Games? Why Not?

chess-775346_960_720When I consult with parents about our Aspiring Youth groups, they often ask me why I use so many board and card games. Most Aspiring Youth participants are dealing with challenges from social anxiety or something called executive functioning (more below) – or a bit of both.

With a little thoughtfulness, games help our students work on both. Given it’s the holidays, here are some suggestions for games to enjoy – just in case you want to try them at home!

Think of executive functioning as the manager of our brain that makes decisions. This helps us understand others’ emotions, resist impulses, control emotions, manage mental data, plan tasks, solve problems, and flexibly deal with change. Many diagnoses such as ADHD, autism spectrum disorders and even anxiety and depression can interfere with executive functioning. There’s also evidence that more than two hours a day of recreational screen time is linked to problems in executive functioning. This includes all screens (phones, computers, TV, tablets, etc.).   

How do games help in these areas?

Board and card games bring people face to face to read social cues in a way that electronics do not provide. To be successful, they to take turns and resist impatient impulses like talking over others. They have to remember rules. They have to make plans, and often have to flexibly change plans. They have to control frustration when they lose and not be obnoxious when they win. Board and card games also reduce screen time. What’s more, because our students are invested in the games, they offer a lot of teaching moments that lectures and other activities don’t.

Let’s look at a few of the games we use.

Most of these games are available from Seattle-area retailers like Meeples Games, Mox Boarding House, Games and Gizmos, Card Kingdom, Heroic Knight Games and Uncle’s Games, as well as online retailers like Amazon.

We Didn’t Playtest This At All – (2 to 15 players) – This was, by far, the most popular game in my Wednesday Kirkland group last year. It’s a fast-paced, chaotic, and silly card game that can be played in as little as 30 seconds. It helps our students practice reading skills, mental flexibility, impulse control, and frustration tolerance. The rules are (theoretically) pretty simple: you draw a card, and you play a card, following the instructions on the card you play. This may be something like, “Anyone who uses the words ‘I’, ‘me’, or ‘mine’ loses, starting now,” or, “You Win!… if you are the shortest person in the game.” We often played ten or more hilarious boss monsterrounds.  Fluxx is another, similar game, but with less chaos and more strategy.

Boss Monster – (2 to 4 players) – A very stylistic, competitive game modelled after retro, 8-bit video games, especially the Nintendo Entertainment System. Players must think about strategy and sequencing as they take on the role of a video game boss to build a dungeon designed to lure and defeat heroes from town. This is a very popular game with smaller groups and with my individual coaching clients. Students love the video game theme.

Superfight – (3 or more players) – This hilarious game is all about flexibility of thinking, frustration tolerance, listening skills, and loving to argue. Two people each have a few cards, some with characters, and some with abilities. Each player has to play one character card and one ability card, and they then add a random ability card. For example, it might be Obama, riding a battle tiger, and who violently sneezes versus Justin Bieber, who has an axe, and who lays golden eggs.  The players take turns arguing why their character with those abilities would win in a fight. All other players have to be good listeners and eventually vote on the character they think would win. The winner stays, and new player steps up.

munchkinMunchkin – (3 or more players) – This game involves strategy, math, negotiation, and bluffing. This is the current favorite of the Wednesday Kirkland teen group. It is a parody of other fantasy games like Dungeons & Dragons with a strong love of puns. Players take turns raiding a dungeon, fighting monsters or curses, and getting treasure to help them (such as the Potion of General Studliness). If they can’t beat a monster, they can negotiate with other players for help, trading cards, treasure, or even favors. Alliances shift quickly, as players must stop those about to win.

The Resistance – (5 to 10 players) – This is a game all about deduction, bluffing, and reading non-verbal cues. Each player is randomly assigned a role either as a resistance member or a spy trying to break the resistance. The resistance members do not know who the spies are. Teams are created to go on missions, and it’s the spies’ job to sabotage them without being detected. Accusations fly like crazy as people try to figure out who they can trust and who is a spy. Even if a spy is caught, a clever spy can make misleading accusations to keep other spies safe.

sentinelsSentinels of the Multiverse – (2 to 5 players) – This one is about strategy, planning, and cooperation. Each player is a superhero with a specialty such as speed, armor, martial arts, mystical energy, and so on. They must strategize and coordinate in order to collectively defeat a villain and survive a hazardous environment. A current favorite of mine.

Snake Oil – (3 to 10 players) – Empathy and flexibility are the name of the game here. This game is well-suited for some of my younger clients and is similar to Apples to Apples (another great game), but with a twist. Each round, a player acts as a “customer” of some type, such as a prom queen, gangster, plumber, caveman, etc. Each other player has to think about what that type of customer needs and play two cards from their hand that combine to create a new item. This might be “beard comb”, “pipe rope”, “war ring”, or anything the players can imagine. The “customer” then judges which item they most would want, and that chosen player wins the round.

Forbidden Island – (2 to 4 players) – More cooperation, planning, flexibility, and strategy are needed in this randomized board game. All the players are trying to collect the treasures and get off the island before it sinks. Each player has a different special ability such as scuba diving, navigation, and engineering, among others, which they use to aid the whole party.


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. Additionally, he has a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, as well as parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma, and schizophrenia. In his spare time, he enjoys acting, board games, video games, and weight lifting.

Autism in Love Screening and Q&A in Bothell

Aspiring Youth was recently asked to lead a discussion for King County Public Library. We are honored to have the privilege and are proud to send one of our lead facilitators, R. Boccamazzo PsyD, who wrote the below post:


“Given the prevalence of the autism diagnosis (1 in 68), this movie is for everyone.”

Frequently, I encounter individuals who believe that those diagnosed with autism spectrum disorders have no interest in socializing. While the degree of interest varies widely from individual to individual, the truth is I have yet to encounter someone on the spectrum in either my personal life or psychology practice who has zero interest in socializing with other people.Capture

The trouble is people on the autism spectrum do want contact with others, but it is often coupled with idiosyncratic rigidity about social rules and confusion about how other, more neuro-typical individuals socialize. Imagine being a long-time resident of a foreign country where you are still unclear on the local customs of behavior, or maybe even how to speak the language. You would likely be lonely, confused, anxious and pessimistic. This is how many of my clients view their social lives. They desperately wish to have the sort of relationships that others have, especially romantic, but are unsure how to achieve them. If they are achieved, maintaining those relationships is often a confusing, heartbreaking challenge where one partner does not understand the motivations of the other.

Nevertheless, the longing for human contact is there.

The universal need for love is the focus of the documentary Autism in Love, which will be screening for free on Saturday, December 5th at 2pm at the Bothell library north of Seattle. The film follows the lives of four people with autism diagnoses as they navigate the tumultuous waters of love across the lifespan. The film achieves a remarkable balance in shining a light on both the ups and the downs of relationships for its participants. It highlights the fact that, while they may have different ways of understanding and expressing it, all of the people in this film seek out love, companionship and acceptance. At the same time, the film does not shy away from presenting the significant challenges and struggles that the participants face as a result of their unique way of understanding the world.

Given the prevalence of the autism diagnosis (1 in 68), this movie is for everyone: teachers, parents, mental health clinicians, those on the autism spectrum and the general public. The odds are that you will eventually know someone on the autism spectrum at some point in your life, if you don’t already. Register for the free screening and following question and answer session.

Autism in Love Screening and Q&A

Where: Bothell library

When: 12/5/15 at 2pm

Cost: Free – register here


R BoccamazzoR. Boccamazzo, PsyD, LMHCA

Dr. Boccamazzo is a doctor of clinical psychology and social skills coach with Aspiring Youth. Additionally, he has a private psychology practice in Bellevue offering individual therapy and psychological assessment to adolescents and adults, as well as parent and clinician trainings on technology in psychology. Much of his work focuses on high functioning autism, problematic technology usage, social anxiety, trauma, and schizophrenia. In his spare time, he enjoys acting, board games, video games, and weight lifting.