By teaching children the true meaning of gratitude, we can enhance their emotional wellness.

“What are you grateful for today?” This question was difficult for 14-year-old “Claire” – a patient of mine whose real name I’m not using to protect her privacy – to answer when she first started coming to see me at the clinic. Diagnosed with obsessive-compulsive disorder and anxiety, she often grappled with finding the silver linings in her life and had begun to refute positive thinking altogether.

Claire viewed her life in absolutes. If she failed at one thing, she considered herself to be a complete and utter failure at all things. Her OCD and anxiety increased for her what are called cognitive distortions, which manifest in polarized thinking – she was unable to perceive any middle ground on things. A cognitive distortion is like wearing a patchy blindfold over your eyes; your vision of reality becomes darkened, and you can only see the negative parts of a situation.

Polarized thinking blindfolded Claire, and aspects of her life or events, such as school, friendships, family or piano performances, were either perfect or a complete disaster. The puzzled expression of disbelief Claire made when I handed her a prescription that read, “Start a gratitude journal – today,” will forever be etched into my memory. She was completely skeptical. But I reassured her that research supports looking at the positive aspects of her life could ultimately help her see situations in vibrant color, rather than just in “black and white.”

According to a national survey on gratitude commissioned by the John Templeton Foundation, respondents tended to think others’ levels of gratefulness were going down (though most didn’t feel their own levels of gratitude were decreasing). Sadly, the national survey also indicates that 18- to 24-year-olds were less likely to express gratitude than any other age group; and when they did display signs of appreciation, it was usually for self-serving reasons. A Cisco Connected World Technology Report found one-third of college students were more grateful for their mobile devices than their access to food, shelter or safety. When youth value their iPhones, MacBook Pro computers and GPS systems more than the necessities for survival, we can understand how this generation came to be viewed as being so entitled.

Why are children becoming more entitled and less grateful? Perhaps, it’s because they’re growing up without really learning what gratitude is. In the national survey commissioned by the John Templeton Foundation, 8 to 10 percent of respondents indicated that no one has ever taught them the meaning of gratitude. Research shows that a child’s gratitude has its roots in a nurturing family environment. Given this, a good question for parents is whether gratitude is an attitude we’re promoting for our children?

Let’s think of the perfectionistic “tiger” parent for a moment. I think it would be difficult to foster gratitude in an overscheduled, hyper-competitive, be-No. 1-at-all-costs tiger environment. Tiger parenting tendencies to build a child’s resume take priority over developing the child’s internal character and values. Can you imagine the tiger parent telling their child not to focus on results, like winning a game, for example, but to have gratitude for the opportunity to learn to play?

As an adolescent psychiatrist, I’ve treated countless patients who have achieved their cherished external goals, such as acceptance into a dance academy, making a sports team or getting to go to the college of “their choice,” but whose lives are utterly devoid of internal joy. They tell me they feel that they’re just going through the motions of life for a fixed result, rather than relishing the journey.

The research is clear: Gratitude leads to better sleep, less depression, less perceived stress, better coping skills, improved relationships and increased happiness. Here are some things you and your kids can do to practice gratitude:

Create a gratitude journal. A gratitude journal is a wonderful and scientifically proven way to guide your child toward health, happiness and internal motivation. I used to be skeptical of prescribing a gratitude journal to angry or anxious teenagers, because I thought they would reject the idea. However, my patients have proven me wrong, and over the years, I’ve seen firsthand how a gratitude journal has been a consistent, highly effective tool to shift my patients’ thinking from negative to positive.

Be a role model, and guide your kids toward gratefulness. At Thanksgiving, it’s always nice to talk about what you’re grateful for with your children around the dinner table. In addition, doing things like writing thank-you cards, phoning friends on their birthday and modeling other small acts of kindness in front of your children will demonstrate some ways gratitude can be expressed personally and toward others.

Serve others. Making a contribution to one’s community is a powerful tool for health, happiness and self-motivation; and it’s something I “prescribe” for all my patients. There is a reason why it feels so good to give. Connecting, sharing and giving all stimulate powerful reward centers in the brain. The wisdom of ancient sages and saints is now verified by science.

Your role as a parent has a major impact on your child’s understanding of the word gratitude. Take the time to reflect on your own “attitude of gratitude” and how you project your views onto your children.

Claire’s OCD and anxiety didn’t magically go away after she began journaling about what she was grateful for. But she did start to see the cup as half full and generally display more of an optimistic attitude when things didn’t go as planned. She stopped taking things for granted. By asking herself, “What are you grateful for today?” on a daily basis, the blindfold slowly started coming off, and she began to create her own silver linings.