Cindy Lopez: Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen.

Today’s teens face unprecedented pressure to excel academically, socially, and in extracurricular activities, which contributes to the rising states of stress and mental health challenges among our young people. The pressure can stem from competitive college admissions, our social media comparison culture, peers, and unrealistic expectations just to name a few. So, while healthy motivation encourages growth and learning from mistakes, harmful pressure creates chronic stress that’s focused mostly on outcomes and perfection. Parents can support their teens by emphasizing effort over results and creating safe spaces for open conversation and modeling balanced approaches to challenges. Understanding the difference between supportive encouragement and damaging pressure is crucial for helping our young people develop resilience, rather than burnout. Join us in this conversation with CHC’s clinical psychology doctoral interns, Michelle Hull and Roxanna Flores, and we’ll explore practical strategies for fostering healthy motivation while protecting teen mental health.

Hi Roxanna and Michelle. Can you take a minute just to tell our listeners a little bit more about yourselves before we get started?

Roxanna Flores, MA: Absolutely. My name’s Roxanna Flores. I am currently a doctoral intern here at the Children’s Health Council. I always love to introduce myself with where I come from personally because that impacts my experiences and my perspective. So I am Puerto Rican of Puerto Rican and Dominican descent. And I have many years of living in the states in different major cities like Miami, New York, Chicago, and I just recently moved to the Bay Area. So, it’s exciting that I have had the opportunity to have those different experiences in different cities, that really inform kind of how I see the world.

Cindy Lopez: Yeah. Thank you.

Michelle Hull, MS, MA: And I’m Michelle. I use she/her pronouns. I am also a doctoral intern here at CHC. And yes, some identities that are salient to me that impact how I move through the world and how I’ll approach this conversation: I think about my whiteness being, kind of an element and a really integral part of how I move through space and think about different topics and can really impact how I think about things. So, that’s an identity I think about. I’m a lesbian and I really love that part of my identity. And, it’s such a gift of mine to be part of the queer community and, have really, really loved my graduate school journey. I’ve been in the Bay Area for the past 10 years and before that was living in Austin, Texas. So, I’m really happy to be here with you both.

Cindy Lopez: Thanks so much Roxanna and Michelle for making the time to be with us today and for sharing your expertise and your experiences with us. As we jump into this topic of youth under pressure, let’s kind of step back and look at the current landscape. So, could you help our listeners understand what the current landscape is from your perspective?

Roxanna Flores, MA: Absolutely. I’ll say I think teens today, and this is coming not only from just knowing the research and reading, you know, articles and all of that, but firsthand experience with working with children, adolescents, teenagers, clinically for the last five years. Teens today are saturated with messages about performance and just all of this pressure to be a certain way, to act a certain way, to achieve a certain way. And this pressure is coming from classrooms, and peers to colleges, social media and the larger culture. And I really think when we think about landscape, we have to think about the different systems that are at play here, starting from the larger systems, like the larger culture, the nation that we live in to down to the micro level, which can be, you know, their peers, their family, and themselves, and teenagers are hearing day in and day out that they need to strive to become something, to do better and that they’re only as good as their next accomplishment. Interestingly enough, research in the last couple of years, research at Harvard actually found that 81% of American teens are reporting negative pressure in at least one area, and most commonly related to pressure around future plans, achievements, appearance. And so that’s kind of like the big picture of what the landscape looks like and this pressure is showing up also academically around appearance, around fitting social norms around extracurriculars beyond academics, right? Being involved in sports and fitness, showing up in friendships and social life and even activism. And for many, that’s also on top of pressure to stay safe in what can feel for many like hostile sociopolitical climates and environments, where going to school might not even feel safe.

And there’s notable differences across children, depending where their context, right, where they’re at, geographically and socioeconomically. But that’s kind of big picture what we’re seeing. There’s all of these pressures at play. And why it matters is because they have a pervasive impact on the wellbeing of youth. We know about alarming rates of anxiety and depression and loneliness showing up in youth. And this has also left families and parents worried about what do we do? This is an issue that we have to pay attention to that is not talked about enough.

Cindy Lopez: As you were talking, Roxanna I’m sure that our listeners are thinking like, okay, yes, I know there’s all this pressure around teens and youth, and how can I as a parent help, and we are going to get to that in this conversation. And, one of the things that keeps coming to my mind is how much is too much? Are we pushing our kids too much and all those kinds of things that I’m sure our listeners are thinking about now. You mentioned some data, from Harvard, about 81% of American teens who report negative pressure. Is there additional data that you want to share?

Roxanna Flores, MA: So, one thing that comes to mind is that obviously, we mentioned the alarming rates of anxiety and depression. And you know, the quest to stand out, leading to self-criticism and feelings of unworthiness, depression, which we see right at the clinical level showing up because of that pressure. Interestingly, also, there’s a quarter of teens, or actually over a quarter of teens who have reported to actively be struggling with the concept of burnout and feelings of burnout, and basically that feeling of, I’m doing too much, and I’m not engaging enough in self-care activities like sleep, exercise, fun, time outdoors, relaxation. And so with this, in mind is a significant rate of teenagers struggling with burnout, a significant rate of teenagers struggling with this negative pressure, which leads to mental health outcomes. And I think a key question that comes to mind for me leading from this because, right, we have to look at the data and do something about it, is what are the questions that as adults we’re asking ourselves, particularly parents. I encourage and invite the question during this conversation of, are we pushing our kids or our teenagers too much? And, we’re going to talk about this throughout, but do they know that they’re valued more than their accomplishments? And so, what can we do to be a part of changing those stats, bringing them down and supporting youth knowing that it is such a pervasive issue statistically and in lived experience.

Cindy Lopez: So, where do you think the pressure this performance pressure is mostly coming from? Is it parents, schools, social media, peers, where is it coming from? What do you think?

Roxanna Flores, MA: Yeah, it’s definitely, and Michelle, also would love for you to add on to this because it’s multi-source, right. It’s coming from different places. We know that parents can become the messengers basically of broader and larger cultural anxieties, such as rising cost of living, income inequality, and competitive job markets. But pressure also comes from schools, activities in school, peers, and the wider environment. Many teens also put intense pressure on themselves, and there’s this kind of like never enough feeling that is felt everywhere across settings. Michelle, anything you wanna add to where this performance pressure is primarily coming from?

Michelle Hull, MS, MA: Yeah. I’ll maybe focus in just for a moment on the cultural piece because I think that’s just so important as we think about our teenagers as cultural, intersectional beings. And, some factors that I’m thinking about are families and individuals, cultural values around performance and education as we kind of zone in for a moment on this academic pressure, kind of component of what the performance pressure can manifest as and there can be cultural values around performance and education. Also, just a real piece here, you know, grounded in reality of high levels of performance as a survival mechanism, and education as the key to financial stability and security, a feeling that failure really isn’t an option, from a financial perspective. Thinking as well about cultural norms around effort, sacrifice, obedience, ways that taking a break might be viewed through a cultural lens within folks’ family systems. I touched a little bit on security, but just to kind of zone in on that a little bit more, thinking about tuition, and cost of living, raising the stakes of academic success, and thinking about performing at a certain level, academically being the only pathway to accessing scholarships or job security or a higher level of education that folks are really, you know, trying to access. And lastly, I’ll highlight a generational responsibility that some individuals might feel around supporting their parents or extended family and education being the pathway to being able to do that from, again, from a financial perspective. So, there’s a lot that’s kind of working underneath the surface here, that may not be apparent to the, you know, to the eye, but that really plays a major role when we think about performance pressure.

Cindy Lopez: Michelle, you alluded to the fact that college may not be the path for some youth. And so, understanding that and supporting your kids in that space is important too. And that, you know, not applying the pressure that you’re going to go to this four year college or Ivy League. And I think that especially here where CHC is in Silicon Valley, that kind of pressure definitely exists for our youth. As we think about all of this pressure, what’s motivating and what’s healthy motivation and what’s harmful pressure? Can you talk a little bit about that?

Michelle Hull, MS, MA: The two questions that I consider from kind of therapy perspective when I’m working with parents or working with teenagers, the first question is, what’s driving a teen’s academic effort? So, is their effort motivated by their interest, by their curiosity, by their personal goals? Or are they really more motivated by a feeling of fear or comparison, a sense of conditional approval within their family system or their larger social dynamics. What’s kind of the driver there? 

And then the second major question is, how does the teen’s effort impact their overall wellbeing? So, we might ask questions like, is there short-term stress before deadlines that we’re noticing in our teen, but is that relieved pretty immediately after the deadline or does the stress persist? And then kind of more notably, does the teen’s level of stress escalate? So, are we noticing the stress really morphing into more of an anxiety presentation or even a depression presentation or is it really more of that kind of short-term, to be expected stress that kind of comes and goes as an important and values aligned project or an exam or a test that someone really wants to do well on as that’s coming up.

Roxanna Flores, MA: Yeah. Thank you Michelle. That was so well said. And I think for me, what comes to mind in distinguishing between healthy motivation and what’s harmful is that achievement and this pressure for achievement becomes more toxic when we tangle up our entire sense of self and value with achievements. And when worth is tangled with outcomes, when you have to achieve in order to matter, right. This is where it gets tricky in terms of healthy versus harmful. We know that teachers in schools have their own metrics for performance and they have to perform. They have this pressure to also have their students perform a certain way. Families feel kind of a guarantee, more safety, and want to create safety nets for their kids, right? And so, there are these pressures that can be coming from motivation that, we understand where it might make sense, but when it’s, you know, jumbled up with our sense of worth and mattering, that’s when it becomes a sticky situation, right? And cultivating a drive can absolutely provide purpose and meaning and joy and well-being. So, we’re by no means saying, don’t push kids, right? Don’t motivate kids to be the best versions of themselves and to achieve high because kids have so much potential and they absolutely can do great and awesome things, but this pressure turns harmful when teens feel like they cannot live up to expectations or feel a disconnect in their self-worth from anything but perfection. That’s where the risk of perfectionism comes in. So, yeah, and Michelle, I love those questions, right? It’s like asking yourself, what’s driving the effort and how is it affecting my child?

Cindy Lopez: Yeah. And I think, Roxanna, what you said earlier about having value apart from the accomplishments, I think that’s really important, obviously for our youth, that’s important for us all, for our youth, especially as they are growing and developing and transitioning into more independence and young adulthood. I’m wondering, how are you seeing that this pressure is affecting teens and youth? Obviously, it’s mental health. We’re talking mental health today, but there’s also sleep and relationships and connectedness and well-being. So, can you comment a little bit on that?

Roxanna Flores, MA: I think, something to pay attention to and some of the signs to pay attention to is stress signals. So, you mentioned, Cindy, sleep loss, and we also see mood swings and loss of interest, and then also more, like, somatic or bodily complaints like stomach aches, headaches, and that’s just kind of like the clearly presenting signs. There’s also, you know, other warning signs include focusing on kind of results over the process, and kind of that hyper-fixation on what is the outcome of certain situations and there being a fixation on not being able to make mistakes, for example. 

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Cindy Lopez: So, what does it look like to support a teen’s independence, while they’re navigating these pressures? So as a parent, or an educator, like, you don’t want to step in and fix it for them. You want to support them enough so that they feel the confidence and that you trust them to do that. But what does that look like?

Michelle Hull, MS, MA: Yeah, I think about a few parents that I’ve had the opportunity to work with over the years, and I have been so moved by, and have been really struck by, how effective it has been when parents really start with their own emotion regulation. Because this can be so activating for all of us. I mean, even just talking about this, like I have my own memories coming to mind of moving through high school and college years into graduate school. And, I’m on my 25th year of education, which is such a massive privilege and has also come with my own kind of story with this topic, and I think about parents who really start with their own emotion regulation. And we know that teens’ brains and nervous systems are still maturing, and so they rely on co-regulation, which really, when kind of we break that down, that’s really, the parent or the caregiver serving as that anchor and modeling the kind of regulation that we hope our teens emulate. 

So, what that looks like in a really practical way is, teen comes home from school, teen enters the car and you’re driving home, teen shares a story about maybe not performing as well on an exam or they didn’t get cast in the play or whatever it is that’s really important to that teen. They share something and then that triggers for the parent a memory of maybe not meeting the mark for themselves when they were young or their own feelings about like, oh, there’s something about my worthiness that’s being activated or triggered when I hear this story about my teen. And really just taking that moment to observe that that’s happening. And then, even though I wish that this was not the answer, taking those initial calming breaths, to really just calm down your body, so that you can be a mirror for your teens so they know that what they’re experiencing is actually not a threat. It’s not an emergency. It doesn’t mean that anything is, you know, capital W-wrong and the teen can really kind of latch onto the regulatory anchor that the parent is offering.

Some other really practical strategies that come to mind are trying to create a safe and open place for connection with your teen, which can look like listening first to what’s coming up for them without problem solving, really, really validating the teen’s experience, their emotions, and emphasizing that they’re valued for who they are, rather than what they’re achieving. Another practical strategy is to collaborate with your teen to identify their values, acceptance and commitment therapy has a great values card sort that could be used as a tool for this.

And then you can backtrack from there to create really actionable goals with your teen. What does enough actually look like to your teen? What does success mean to your teen and how can you use your teen’s values to inform how you’re thinking about these goals and then putting in place that structure to support your teen to get to that place. Can you encourage them to meet with a teacher? Can you encourage them to work with a peer to engage in peer tutoring? Something to really scaffold them and meeting those values aligned goals. 

And then two more strategies: really praising effort and persistence rather than the outcome. And recognizing that in that, kind of, efforting that’s a part of all learning processes. There’s frustration that can come up and just really validating that for the teen when the frustration comes up, and encouraging them to keep going. And then lastly, talking about the school stress before it happens. We’re in a really important period right now where our teens are about to go back to school, and there’s the opportunity to cope ahead. So creating a plan for: what are we going to do? Like, what do we know? What are the five strategies we can jump to on that midterm week where we like really need to buckle down on self-care or other strategies that can bolster you during stressful times.

Cindy Lopez: So Roxanna, did you want to add anything here?

Roxanna Flores, MA: Sure. Yes. A couple things come to mind. I think something we need to also acknowledge is these are helpful conversations to have, like Michelle was having, right? Preparing ahead, coping ahead, and also thinking about, what happens after, in terms of, you know, when stress does happen? 

Actually a decade of resilience research has shown that the number one intervention for when a child is feeling really stressed or distressed is ensuring that caregivers are okay, really focusing on strengthening your own wellbeing as a parent – is strengthening your own relationships and really just modeling that. We really talk about this concept of modeling behaviors. Like, Michelle was mentioning before that concept of co-regulation, but modeling to your child, what does it look like to cope with stress and have healthy, supportive relationships on an ongoing basis, and modeling that it’s okay to make mistakes, like kids don’t need perfect parents. They need a steady presence. They need someone that’s consistently there. And that they know that when things happen. They can go to a person that they really trust, who they know has been through it or is doing something to deal with their stress, where it feels a safe place to land.

 And something else I want to add, since we’re in the topic of understanding how the system impacts the child. I think we really need to acknowledge the role of social media as a way of really being proactive and even preventative, right? And understanding that social media can heighten anxiety and social comparison and set up kids with unrealistic expectations. We need to really support our teens in setting healthier boundaries. And a lot of times, teens don’t know how to do that because social media can be addictive and can feel really glamorous and really fun. So, really understanding and sitting down, having a conversation with your teen and saying, This is what healthy boundaries look like. This is what is real, this is what is not, and kind of going back to that values based conversation, what are the values that are guiding you and not necessarily what you’re seeing online? And modeling that self-care, not only in having strong social networks, but even modeling healthy sleep, healthy movement, not you know, giving into burnout and overloading schedules, right? There’s this grind culture that has overtaken our larger culture, where it’s like breaks, what is that, right? Having free time, what is that? So, really thinking about what being intentional with time looks like and how schedule, and how time management emphasizes, you know, taking care around this pressure.

Cindy Lopez: So, all of this that you’ve shared, Michelle and Roxanna has been so helpful and I think you’ve given our listeners enough substance to really consider how they can interact with their teen, perhaps differently, around this topic of pressure.

So, if I am listening, I’m a parent, I’m an educator, I also wonder, what is too much and how would I know when to seek additional help, and what kind of help would I look for?

Roxanna Flores, MA: General rule of thumb and probably one of the main takeaways is get help and know that you need a little extra support when the stress stops being short-lived or only present for a small duration or related to a specific event or something – and when it starts disrupting daily life, or when safety is a concern, right? When we look at these stress signs and they’re persisting, or they’re escalating and functioning drops. At home, at school, or even socially because sometimes it even looks like isolation or not wanting to do the things that, kids or teens typically enjoy doing. That’s something to pay attention to and say, maybe I do need professional or additional help in this situation. And then Michelle, maybe you can share with us, what are specific signs that you have seen in your own clinical experience, that can point to, you know, maybe get some extra help?

Michelle Hull, MS, MA: Yeah. Thanks Roxanna. I think that’s so helpful and is such a great rule of thumb is, what are you noticing that your teen is still able to do the things that they love to do? And if there is some disruption there, then that is really the sign to seek professional help or seek additional support. So, we might think about, if we see our teen for two weeks or longer, again, you might have a circumstance where our teen has a really important values aligned AP exam and they really want to excel – in however they define excelling – on the AP exam because it matters to them, for whatever reason. We might see some anxiety that spikes, some even mood symptoms, some low mood, irritability, sleep problems. However, if we see those symptoms lasting for more than two weeks and that’s really when we might want to consider, more support. We might also think about school avoidance and we might want to think about frequent headaches or stomach aches, a drop in grades despite effort. We want to look and hear about our teen’s thought patterns, if we’re noticing all or nothing thinking. An example of that would be like, I get an A or it’s all over for me, something like that. We want to pay attention to that, rewriting or checking homework, checking assignments, panic when things aren’t perfect, avoidance or procrastination, a loss of interest in previously enjoyable activities or really significant family conflict around homework or grades that’s escalating. 

And of course, you know, we want to encourage you to seek urgent help if there’s any talk of hopelessness, self-harm, suicide, self-injury. If we see rapid weight loss, or other indicators of an eating disorder. If we see, impairing substance use that’s being utilized as a way to cope, or really severe school refusal that’s resulting in a significant number of missed days at school or panic attacks that prohibit an individual from taking an exam or again, like really interfering with that daily life piece that Roxanna was touching on.

Cindy Lopez: So, all of that’s great. There’s so many kind of, you know, I’m going to call them yellow flags that you indicated that our listeners could like, oh, maybe that’s happening. But I also like the caveat, like it’s something you’re seeing over time. So, you’re saying at least two weeks or more. So, where do you start?

Roxanna Flores, MA: I think for many families the first point of contact or easier point of contact is to talk to a primary healthcare provider or pediatrician, someone that they see pretty often. Primary healthcare providers typically screen for anxiety, for depression, for sleep, and other rule – out medical issues that might also, you know, manifest in symptoms that we see, that kind of overlap. But typically, right, if there is something else going on, a primary care provider or pediatrician will make a referral further to a licensed child therapist or a psychologist, which would be a great source of support for ongoing individual therapy or, you know, whatever the case may be. If it’s, maybe they’ll recommend family therapy or group therapy, but specifically, right, seeking out someone who can share with you evidence-based practices for dealing with anxiety or perfectionism such as cognitive behavioral therapy, or Michelle even mentioned earlier acceptance and commitment therapy.

Those are some really great ways to deal with this pressure to perform. And always asking the question of, how are parents included in the intervention? I think it’s just something that’s super helpful to kind of do it, you know, as a family. Also, the school supports are so, so important. School counselors or social workers, any clinician at the school, they can coordinate and support the teenager with academic adjustments and monitoring or even like, check-ins throughout the week to make sure they’re doing okay and managing kind of that load. And for, obviously here at Children’s Health Council, we have a variety of resources, but that individual therapy that I was mentioning before is something that we provide and that we would love for families to take advantage of when they feel like they’re really noticing these symptoms.

And that being said, since we’re focusing on what can I do as a parent, some of the parent frameworks to think about that celebrate progress and reminders is validate your child’s feelings. First, postpone problem solving, really make your home a haven. Predictable routines, protected sleep, boundaries around devices, around socials, unstructured fun. Those things that seem so simple, they would be so important to pair with, not just seeking outside help, but what can I do, you know, as soon as I notice these symptoms at home and, yeah, narrate your own, you know, good enough moments and mistakes and model what balance looks like.

Cindy Lopez: Roxanna and Michelle, thank you again so much for joining us today. As we wrap up, I’m just wondering, what do you hope that our listeners take away from this conversation today?

Michelle Hull, MS, MA: As I was listening to this conversation, I was thinking about the magnitude of this issue and how many different areas of life and day-to-day functioning performance pressure can impact. And so I am really moved by practical strategies and so what I want to share in response to this question really touches on the practical. And what I have found to be most effective when working with parents is talking about school stress before the school stress happens. And I think we’re in a really unique and fortunate moment if you’re listening to this right now, you might have the opportunity to do that with your kids before school starts or before the school year really comes underway.

So thinking about, really practically answering the questions of, when school feels overwhelming, what helps you feel calmer? And what do you know are your warning signs that this school stress has escalated to a level where, you know, we might need to pull in more professional support, or we might need to look at more of our definition of success, within our family and how we can best support you. So, planning ahead, knowing that the school stress is inevitable and not something to avoid or ignore, especially when the opportunity that’s coming up is really values-aligned. The class is really important, just thinking about how you can cope.

Roxanna Flores, MA: I’ll say for me, is understanding that there’s all of these sources of pressure that we discussed earlier is really focusing on letting your home be a haven from all of that external pressure. And let it be a place to recover, and where your teen’s value is never in question and really anchoring your conversations around the message that your teen’s worth is never up for debate, and that their self-worth is not rooted in their achievements and their outcomes.

Cindy Lopez: So important, everything you’ve said and to our listeners, just want to say thank you for joining us today, and we hope that you’ve taken away some practical strategies that you can use. And if you need help, please reach out. CHC is here for you. You can email us at the [email protected], or you can call us at (650) 688-3625.

Thank you again, Roxanna and Michelle.

Roxanna Flores, MA: Thank you.

Michelle Hull, MS, MA: Thank you, Cindy.

Cindy Lopez: Visit us online at Voices of Compassion podcast. Make sure to subscribe to Voices of Compassion so you never miss an episode, and we’d love it if you’d leave us a rating and review. Have a question? Send us an email or a voice memo at Voices of Compassion podcast. We’re here for you when you need us.