Making your initial appointment
If you decide that you want to make an initial appointment after your phone consult, you can schedule an appointment directly with me. This initial appointment also known as an intake is an hour meeting. If the client is a child, both parents are encouraged to attend. At this time, we will discuss the reasons you are seeking help. It will be helpful for you to explain to me what specific behaviors you observe and what the school is reporting to you. It will be also helpful to know if any environmental changes have occurred. These can include things like a move, divorce, death, new sibling, new school, recently injury, or illness. I will also ask about your child’s developmental history and your parenting strategies to understand what works and what is not working. Lastly, I will inquire about family medical, psychiatric, learning, and work history.
Individual and family therapy appointments
If you want to begin individual and/or family therapy these appointments can be scheduled. It is recommended that the same day and time be utilized on a weekly basis. That way we all get into the routine of knowing you are coming to see me for therapy and I can expect to see you and your child. Please feel free to provide me with updates on your child’s progress or concerns before, at the beginning, or the end of a session.
You are encouraged to participate as much or as little as you would like. Together, we can determine the level of parent participation and be sensitive to issues such as your child’s age and particular therapy goals. Parent sessions can also be scheduled in addition to your child’s sessions so that you can remain informed of treatment progress and so that you can provide me with information about progress and challenges you see, and keep me updated on important changes in living or school situations.
Monitoring Progress
As we proceed through therapy, we can all monitor your child’s progress and often come to a collaborative agreement when your child is ready to terminate or “graduate” from therapy. We can plan and celebrate this accomplishment, usually with a certificate of completion and a goodbye party for our last session.
Psychological Testing
If you are interested in psychological testing services rather than counseling, please be aware that my practice is limited to intellectual testing for young children. The length of testing session is approximately 2 hours. Prior to testing sessions, it is important to ensure your child is well rested, has a good night sleep, and eats a good meal, so that your child can perform at his or her best.
Consultation
If you are seeking a short term consultation, this may occur over one or three sessions and recommendations will be provided.
Commonly treated conditions or issues:
- Separation Anxiety. Your child refuses to sleep in his/her own room, refuses to be alone in a room without a parent present, refuses to go to school because of fears something bad will happen to you or their own safety.
- Health/ Illness Anxiety. You or your child worry about getting sick and get overly preoccupied with body sensations and sounds.
- Social Anxiety. You or your child worry about being embarrassed, rejected, and feel like everyone is watching, judging, and harshly criticizing you.
- Test Anxiety. You worry about test performance and failure and over-study or procrastinate too much.
- Phobias. Some common examples include you or your child have an intense fear of needles, blood, and getting injured at the doctor’s office, you may have an intense fear of vomit, called emetophobia and avoidance issues are taking over your life.
- Generalized Anxiety. You worry about everything including money, work, friends, romantic relationships, performance, getting sick, or anticipating feeling anxious and panicky.
- Panic. Extreme dizziness, hyperventilation, numbness, chest pain with no medical cause. Intense fear and anticipation that these symptoms or attacks will come on at certain or unpredictable times or situations. Avoidance behaviors begin to increase.
- PTSD (Posttraumatic Stress). You have intrusive thoughts and fears, avoid situations, memories, and feelings, or react in extremely anxious or angry ways, related to a past event or series of events that caused you to feel intense fear, helplessness, and horror.
- OCD (Obsessive Compulsive) You have intrusive thoughts, images, and urges and feel strongly compelled to repeat behaviors that may include: checking locks, arranging things so they are just right, washing hands, counting, asking for reassurance and don’t feel like you can stop until the urge passes, only for the cycle to repeat with worsening discomfort.
- Depression. You or your child feel very sad, irritable, or just don’t care and have lost motivation to do things you need to do. You may be overly tired, have difficulty concentrating or making decisions and feel helpless about things improving and hopeless that you can help yourself.
- Self injury. Your teen may cut or injure their body to feel relief from emotional pain.
- Attention Deficit Hyperactivity Disorder (ADHD). Your child may not sit still, complete tasks, or pay attention for as long as other kids their age and have difficulty functioning in home, school, and in relationships. They may also feel bad and worry about these behavioral challenges and the consequences that follow.
Below, I describe the evidenced based methods of therapy I use:
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is based on an integration of cognitive (initially developed by Aaron Beck) and behavioral theories. This theory explains a person’s experiences as occurring in a relationship among thoughts, feelings, and behaviors. We develop core beliefs of ourselves, others, the world, and the future based on our early life experiences. In an optimal environment, we learn that we are competent and lovable, that others are dependable, the world is safe, and the future is bright and we develop positive behaviors as a result. Unfortunately, we don’t always grow up in a stress free environment and we do what we need to do to survive. As a result, we may develop unhealthy behaviors that were likely helpful under stress, but no longer useful later in life.
CBT can help a person understand the ways they process information and learn skills to understand their thoughts, feeling, and behaviors, with the ultimate goal of feeling better. Exposure/ response prevention is part of CBT in which you would create a hierarchy (picture a ladder) of feared situations and learn how to face, accept, and manage uncomfortable feelings of fear, anxiety, and uncertainty while resisting compulsive actions or avoidance behaviors.
Research has found that CBT is often known as the gold standard “treatment of choice” and is highly effective for many adult and childhood behavioral mental health disorders.
Dialectical Behavioral Therapy (DBT)
DBT came from CBT and is basically an extension of CBT that incorporates additional skill building. DBT (developed by Marsha Linehan) was initially developed to treat suicidal behaviors and Borderline Personality Disorder and has more recently been modified to treat Bipolar, Depression, and Anxiety disorders.
DBT includes the eastern practice of mindfulness, which is learning to be present in the moment, without judgment and with acceptance by utilizing your senses and increasing your awareness. Mindfulness teaches you how to have a different relationship with your thoughts and how to observe and notice your thoughts, rather than react to them.
Other DBT skills called emotion regulation, distress tolerance, and interpersonal communication skills teach you how to regulate your feelings and choose emotional responses from an balanced emotional and rational perspective through what is called the “wise mind.”
Acceptance and Commitment Therapy (ACT)
This is also known as the third prominent type of CBT. ACT (developed by Steven Hayes) is integrated into modern CBT and helps to teach you to be less critical and judgmental of yourself, with the understanding that you are doing the best you can given the life experiences you have had. The idea is that with nonjudgmental compassion, we can learn to accept our challenges and motivate ourselves to make behavioral changes based on what we value and what is important in our life.
Cognitive Behavioral Play Therapy (how I combine the 2 approaches)
I use an integrated CBT and Play therapy approach. Play therapy follows the belief that “the child knows the way.” Using this approach the child may lead the sessions, choosing what toys and symbols he or she relates to and connects with. Children will communicate their experiences, beliefs, thoughts and feelings through play. Through the process of play therapy children can work though conflicts and distress using toys as tools to express themselves. Play therapy toys usually include animal and people figures, houses, doctor kits, army men, legos, clay, stories, and art supplies. By creating a safe and secure space in the therapy room, the therapist may guide the child in identifying protective figures, for example, and can help the child explore solutions to the problems in his/her outside lives through the chosen symbols and play themes the child creates. Learning how to identify, express, and regulate feeling are CBT skills that are incorporated in the play.
Relaxation Training
This is an integral part of treating and alleviating the stress caused by anxiety, anger, and depression. I use relaxation training in work with kids and adults. As we know, we carry tension in our bodies and our nervous systems may be wired so that we are more vulnerable to experience intense symptoms of anxiety and physical tension. Diaphragmatic or deep breathing and progressive muscle relaxation are proven methods in stress reduction.
Take the first step today to help yourself or your child feel better
Call now at 303-747- 4014 for a free consultation
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