Online Health Chat with Ellen Rome, MD, MPH

December 5, 2012


In a culture of excessive consumption, you may find it difficult to teach your teenager to appreciate and give back to the community they are being raised in. 

Encouraging your teens to participate in community service is a very important thing you can do for them as a parent. According to the Corporation for National and Community Service, 55 percent of youth between the ages of 12 to 18 years old participate in volunteer activities. This is nearly double the adult volunteering rate of 29 percent. Of those youth volunteers, 39 percent volunteer on a regular basis. 

The holidays provide an array of opportunities for your teen to volunteer their time. Community service provides your teen with a sense of belonging and giving, especially during the holiday season. Teens can acquire other values from volunteering, including appreciation of their own lives and increased self-esteem. Through volunteering, adolescents can gain a feeling of being valued, the opportunity to meet new people, the acquisition of valuable new skills, and a lifetime of wonderful memories and experiences. 


For More Information

On Cleveland Clinic
The Center for Adolescent Medicine at Cleveland Clinic Children’s Hospital encourages all activities that lead to positive youth development, including volunteering in the community. In addition the Center provides primary care and specialized care for tweens (preteens, generally between 10 to 12 years old), teens and young adults up to 22 years old. We offer specialized referral services and a wellness approach to preventive medicine, including: reproductive healthcare (period problems, gynecologic nonsurgical needs and comprehensive counseling), obesity counseling, eating disorder prevention and medical management.

Our adolescent medicine clinicians are dedicated to providing quality, evidence-based care for all of our adolescent patients. We use an evidence-based, multidisciplinary approach in treating our teenage patients with complex medical problems. In this way, as a parent, you know we are using all of our resources and knowledge to ensure we are treating and caring for your child at every level.

On Your Health
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A remote second opinion may also be requested from Cleveland Clinic through the secure Cleveland Clinic MyConsult® website. To request a remote second opinion, visit

For Appointments

If you would like more information on Cleveland Clinic Children's Hospital or our adolescent medicine program, visit us online at To make an appointment with a pediatrician or pediatric specialist at one of our 30 convenient locations in northeast Ohio, please call 216.444.KIDS (5437) or call toll-free 800.223.2273, ext. 5437.

About the Speakers

Ellen Rome, MD, MPH, currently serves as Head of the Center for Adolescent Medicine at Cleveland Clinic Children’s Hospital. Dr. Rome helped spearhead the Cleveland Clinic's Pediatric Obesity Initiative, ranging from clinical, education, research, community, and public health efforts at Cleveland Clinic, in partnership with the Department of Public Health and Research. She co-directs the Eating Disorders program at Cleveland Clinic Children's Hospital, doing evaluations and medical management of children, adolescents and young adults with disordered eating. Dr. Rome initiated and teaches one of the core courses on adolescent  development in the adolescent health track at Case Western Reserve University's School of Public Health.

Dr. Rome is a board-certified pediatrician who was also among the first in the United States to be board-certified in Adolescent Medicine. She completed her fellowship in adolescent medicine at Children’s Hospital, in Boston, during which time she also obtained a Master's Degree in Public Health at the Harvard University School of Public Health. Dr. Rome completed her residency and internship at John Hopkins Hospital, in Baltimore. She received her medical degree from Case Western Reserve University’s School of Medicine and was initiated into Alpha Omega Alpha Medical Honor Society, after receiving her undergraduate degree in psychology, magna cum laude, from Yale University, in New Haven, Conn.

Dr. Rome currently serves on the Medical Task Force for Eating Disorders for the Academy for Eating Disorders, chairs the Committee on Eating Disorders for the Society for Adolescent Health and Medicine, serves as Vice President for the North American Society for Pediatric and Adolescent Gynecology, and as the President of FIGIJ, or the Federation Internationale Gynecologie Infantile et Juvenile.  Dr. Rome’s research interests include eating disorders and obesity, preventive medicine and reproductive health. 

Among many other publications, Dr. Rome is the author of two books collaboratively with Dr. Mehmet Oz and Dr. Mike Roizen, You: The Owner’s Manual for Teens, and You Raising Your Child from First Breath to First Grade.

Let’s Chat About ‘Creating a Sense of Community and Giving for your Teenager During the Holiday Season’

Cleveland_Clinic_Host: Welcome to our Online Health Chat with Cleveland Clinic expert Dr. Ellen Rome. We are thrilled to have her here today for this chat on teens and volunteering.


Countering Selfishness During the Holidays

Sheldon: My four-year-old feels like he should get everything he asks for Christmas. How can I explain to him that it is also a season of giving and you don’t always get what you want?
Dr_Ellen_Rome: Whether he believes in Santa Claus or not, your child should know that Santa and relatives are not supposed to give you all that you wish for. In speaking with your child, you should emphasize the following: There is a role in life for always having something out of reach, worth striving for as a goal. If you always get every heart's desire, then life becomes dull or tarnished. Instead, if there is always the chances for a little future hope, then you get the chance to learn how to keep striving, wishing and hoping, and have that be OK. As a parent, you thus teach your child how to handle disappointment without allowing it to be crushing. Hope and resiliency are both important constructs for your child. Speak more about the former, and role model and help him handle the latter.

64txt: How do you suggest handling the temper tantrums of a child who does not get everything they want for Christmas?
Dr_Ellen_Rome: Temper tantrums are always better to avert than to have to handle (that is, always better to be proactive than reactive). To that end, make sure Junior knows that it is not Santa or anyone else's job or desire to give them every little thing their heart desires. Start gearing them for that one special present, big or small, not for an overwhelming sampling. If you get a temper tantrum, assume your child is feeling over stimulated, is potentially overtired and reacting. Try to remove him from the stimuli into a quiet room, and say something calming, like, ‘I know this may be disappointing. Have a good cry, and then let's talk together about the good things that are happening today.’ Once he has had a timeout and a good cry, and then try redirecting, kind of like keeping a soccer ball in play. Comment and reward him for the socially desirable behaviors he shows. Kids do better when you react to the positive, and say, ‘Do more of that!’ rather than reacting to the negative, and saying, ‘Do less of that.’


Encouraging Community Service

scenic: My son has to record 60 hours of volunteer service for his high school in order to graduate, but he has not yet started. He seems too hesitant to go out and seek opportunities. How do you suggest I persuade him to go out and find opportunities? Are there skill sets I can tell him he’ll learn that will one day be beneficial for a resume or college application?
Dr_Ellen_Rome: What are your son's interests? What makes him get up in the morning? What drives him? Talk to your school's guidance counselor, and ask for suggestions based on your son's interests. If he is mechanically gifted, he may look to local service stations or engineering firms for volunteer opportunities. If he likes animals, the local rescue center or animal protection league has all sorts of options. Is he great with kids? What about tutoring or helping kids learn to read? Is he great with grandparents? How about a nursing and assisted-living facility? Is he a great handyman? Nursing and assisted-living facilities and community centers always have a need for an extra set of hands that can help do the heavy lifting, literally or figuratively. Your church or temple may also have volunteer opportunities for adolescents.

howdy: When encouraging my children to do volunteer work, is it more beneficial for them to do it by themselves or with us as a family?
Dr_Ellen_Rome: Either can work, it's whatever works best for your kids and you. Getting the whole family involved makes for whole family ‘warm fuzzies,’ and gives you something to talk about at that next family get together. You may discuss the most surprising event, the funniest thing that happened, the ‘my heart strings were pulled when’ moment, and so on. When done individually, your child will get a personal sense of accomplishment that is priceless, just through that act of doing and giving. There are valuable lessons in both. If done as a family, make sure your children have the starring role.

nystr: Why do some schools encourage volunteer opportunities? Is this something that is viewed favorably when applying to colleges?
Dr_Ellen_Rome: Many schools recognize the value of giving and altruism in getting a teen to feel good about himself or herself. Doing for others can be a great means of enhancing self-esteem. It can help a teen feel valued; it can be a means of meeting new people outside of their regular world. They can acquire new skills, or try on a career hat that they might otherwise not experience. Colleges want students who have learned to think beyond themselves, particularly those kids who have distinguished themselves through their service—not just those who have ‘checked the box’ next to the college application question about volunteer experience. For your teen, find something that he or she is passionate about, and feed that interest. Your local library or church may also have great ideas, as well as the school's guidance counselor and college adviser. This is another means of getting to know your child and helping him or her play to his or her strengths. What makes your kid get up and go to school, or want to go to college? What are their strengths? What areas do they want to cultivate in themselves? (This is an easier way of saying what their weaknesses are). Help your child make it a meaningful experience, and help him or her learn how to share stories of what he or she saw and did.

book_lover: At what age do you suggest starting to have children do volunteer work?
Dr_Ellen_Rome: Children who are toddlers or older can participate. Having toddlers in a soup kitchen or community center or nursing home is always a joyful distraction. (You can call that a joyful noise!) School age children have other gifts to share, and adolescents and young adults can layer further onto the experience. So, there are no age limits, old or young, for the benefits of service and volunteering.

time_lapse: Is there a suggested amount of time that a child should spend on volunteering or charity- type work?
Dr_Ellen_Rome: Giving of your own time, even sporadically, helps. When looking at positive youth development models, the greatest effect was seen with engaging in an activity three hours or more per week. This goes for more than just community service, and includes time spent participating on a team, working on a club activity, and working towards a greater, common goal.

nystr: Would you talk about what positive assets there are to volunteering?
Dr_Ellen_Rome: Volunteering can help develop a child’s set of internal and external assets. In simpler terms, it can help children develop a sense of self—feeling like they are an active participant in their environment, rather than having things just happen to them. Here, they are making things happen in a good way. This can enhance self esteem, create a sense of purpose, and help form their own positive view of their personal future. These are all means of building internal strengths and resiliency. It can also help them find the caring aspects of themselves, and contribute to core beliefs they might have or want to cultivate, including a sense of social justice, honesty, integrity, and responsibility. Externally, it certainly provides meaning to the recipient of their services! And volunteering can expose them to positive role models, as well as positive youth peer mentors.

lucky: How do you deal with a child who is more self-centered and selfish, and has no interest in doing volunteer work? Do you force them? How can you get them to change their attitude?
Dr_Ellen_Rome: An adolescent can be a self-absorbed child. Having community service aligned with his or her own interests certainly makes it more palatable. Forcing it as a parent is less easy than having it mandated by a school, but if there are caring adults in your child's life that can be a carrot rather than a stick, that works better. In other words, having a caring adult or peer mentor who you feel is a good influence and is valuable in your child's life, from your child's perspective, is an easier way to engage them. Having that adult or peer ask your child to come with them is one means of meeting success. To quote University School Assistant Headmaster William O'Neill, ‘A child will believe something is true because a parent said it. An adolescent will not believe something is true because a parent said it.’ So, find other caring adults who make credible resources. This notion gets us to a key concept for your child's success, as articulated by psychologist, educator and author JoAnn Deak, which is the three Cs, or competence, confidence, and connectedness. These are key positive youth development factors for your child. Feeling connected both at home and at school are important. I would add to those three C's a few other factors, including caring adults and community. That's where service enters the picture. Helping your child engage with his village can enhance his or her sense of connectedness, building skills that can improve confidence and competence—which is a 'win-win' all around.

sweetness: I really don't want to just force my child to do volunteer work; I want him to want to do it on his own. How can you build this into a child's character?
Dr_Ellen_Rome: Do it together. Walk the walk, and bring him along. A ‘Do as I say, not as I do’ approach doesn't work very well here. And give high praise for desired behaviors, i.e., praise that is not effusive or gushing. It needs to be authentic. Find role models you emulate to join your family's village. This group can include ‘adopted grandparents,’ kids and families whose values align with yours, extended family, favorite teachers or coaches, or anyone else who you thing could imprint well on your child. Choose wisely!

astro_belt: I want my child to want to do volunteer work and encourage her to do so. However, I have heard of some people who have been taken advantage of (work wise) while volunteering. How do you teach your child the difference between a good or hard day’s work and being taken advantage of?
Dr_Ellen_Rome: Oh, that's a great question. If volunteering detracts from grades or other primary responsibilities, a teen should get the chance to set the limits of community service. This is a valuable learning opportunity that may require some coaching or practice with you before they approach the ‘boss’ or person in charge. You can tell your child that this is a great skill that not everyone in a school or workplace will learn, but those who do learn this skill tend to do better in life. This skill is called boundary setting, and it is useful across lots of regions (for example, when dealing with peer pressure, abuse in a relationship, overuse or abuse in a work setting, and so on). ‘Being taken advantage of’ can mean feeling you are giving beyond your capacity. That can include time limitations, skill limitations that require training rather than time, or responsibility. (An example of the skill limitation and responsibility might be an unskilled person who is volunteering at a rape crisis center or domestic abuse setting. He or she would theoretically never be put on the front line answering calls without appropriate training and mentorship. If the task got overwhelming, the person needs to be able to call a lifeline.)


Local Volunteer Opportunities

gff: Do they still have candy stripers at the hospital? If so, how old do you have to be? How do you get on the volunteer list? My 11-year-old daughter is interested because I told what a great experience I had when I was in school.
Dr_Ellen_Rome: Yes, programs like this still exist. At Cleveland Clinic, we have a Junior Ambassador Program for Teens. The web site is for additional information or you can call 216.445.6986 or 800.223.2273, ext. 56986.

cooper: I live in the Mentor area. Do you know of any local organizations that I can contact on behalf of my teens for volunteering during the holiday season?
Dr_Ellen_Rome: It depends on your teen's interests. If they are an animal lover, you can look online for the local rescue services and animal shelters. For horse lovers, in Russell or Novelty is an equine therapy center called Fieldstone Farm that is awesome. All of the local hospitals need volunteers, and I would certainly check with any of the local nursing homes. Your church or temple may also have volunteer programs in place through their ministries.

great_news: For children who are not very social, are there things that they can do that are done at home? Is this just as good for them as actually going out and working with people?
Dr_Ellen_Rome: It can be. If your child is great at crafts, and he or she makes stuffed animals or blankets or whatever else, these can be priceless gifts to hospitalized children. Cleveland Clinic Children's Hospital's child life program welcomes such gifts and can help distribute. Other behind-the-scenes work might include shopping or cooking for a soup kitchen or homeless shelter. The Cleveland Foodbank provides opportunities for sorting and packing and other less social activities, where a teen can work as a semi-independent, autonomously functioning, and valued participant. These are just a few examples. You could call some of these organizations and ask for other ideas. The military provides other venues for behind-the-scenes work through the USO. Look online at your local military office to get ideas on letters, supplies, or other items that would give thanks and prove useful to the recipient. A good website is


Cleveland_Clinic_Host: I'm sorry to say that our time with Cleveland Clinic specialist Ellen Rome, MD, MPH is now over. Thank you Dr. Rome for taking the time to answer our questions today about teens and volunteering.
Dr_Ellen_Rome: Thank you all for your thoughtful questions! My favorite niece, Lisa Rome, who writes for Cleveland Clinic's wellness site, captured some of my thoughts, available in the following link:

Creating a sense of giving in your child is a priceless gift, especially in this age of conspicuous consumption (i.e., to acquire expensive items to show off one’s wealth or give an impression of wealth). To give of ourselves—either through giving things or providing services that are as meaningful as what we would like to receive ourselves—provides a meaningful framework for your child's life. Gifts of time or thought or prayer can be cost effective yet highly valuable. You can think global or local, or even within the context of your own family. A present under the tree of a simple card, which promises an afternoon of chores for grandma and is delivered as promised, can be a useful way of enhancing family connectedness, especially if grandma is appropriately appreciative in words and actions. Helping your child live with disappointment and cheer on others' successes also create useful learning opportunities. It's all good, and enjoy the process with them!

More Information

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