Archive for June, 2009

PostHeaderIcon Psychotherapies For Children/Teenagers

When parents or caregivers bring their children in for psychological counseling, there are a number of different psychotherapies that counselors can use in treatment.  Therapy with children involves either play or having a conversation between the therapist and the child and his/her family.  Psychotherapy with children involves different strategies and approaches and the therapist will use the strategy that best fits your child as well as a therapy that can best treat the particular problem/s.  When choosing a therapist for your child, you may want to ask which approach they typically use in treatment as well as which particular model of psychotherapy they were trained in and are the most familiar with. 

A summary of the different psychotherapies for children/adolescents are as follows:

Cognitive-Behavioral Therapy (CBT)- This type of therapy targets teaching children that their thoughts and feelings can and do influence their behaviors.  CBT teaches the child to identify negative thought patterns and the therapist teaches them how to replace these thoughts with more positive ones.  This treatment is usually used in treating children with anxiety disorders and mood disorders (ie.. depression).

Family Therapy-focuses on helping the entire family function in a more positive way.  The target in treatment is usually on teaching the family members a better way of communicating and psychoeducation is usually involved.

Play Therapy-this type of therapy is usually used with smaller children and the therapist will incorporate using toys, games, puzzles, drawings, etc…  The goal is to observe how the child plays in order to identify how to child copes and deals with everyday problems.  The goal is to help the child lean how to recognize and eventually verbalize their feelings.

Psychodynamic Psychotherapy-this therapy emphasizes helping a child/teen be able to understand the issues that causing them distress and how it affects their feelings, thoughts, behaviors.  This type of therapy is usually used with older children and teenagers and is used with children that have a good deal of insight into their problems as it involves being able to identify behavioral patterns, how they cope with stressors, as well as how they respond to inner conflicts.

While this list of psychotherapies is by no means conclusive, these are some common psychotherapies used when treating children or adolescents in a mental health setting.  When bringing your child/teen in for mental health treatment, be prepared with questions that you would like to ask your child’s therapist about how psychotherapy works and which treatment he or she will use.

PostHeaderIcon Can you get along with your teenager??

Of course the number one problem in getting along with your teenager is the inability to communicate with each other.  The first thing that needs to be done is to improve the steps in order to talk with your teenager.  Before you begin to have a discussion about anything with your teenager son or daughter, first agree on a few simple ground rules.  If the ground rules can not be agreed upon, than most likely the discussion will go nowhere.  Here are some simple rules in having a discussion or communicating with your teenager:

1.) Please, please remain calm.  Nothing ever gets solved by yelling or through anger.  Take an interest in what your teenager is saying.  There is nothing more aggravating to a teenager than feeling that their parents are “blowing them off”, I hear that all that time as a therapist.  Teenagers will tell me, “my parents think they know everything, they don’t even care what I think or feel.” 

2.) Listen to each other.  If both of you are talking at once and continually interrupt each other, then nothing will get fixed. 

3.) If the problem is a big one, then don’t try to fix the problem in just one discussion, sometimes it will take a number of discussions to fix the problem.

4.)  The discussions have to be a give and take between the parties and remember that no one will win here.  Nobody ever wins in a disagreement, compromise is the best solution.

5.) If you notice that one or both of you is getting increasingly angry or frustrated, then take a break and try your discussion later on.

Problem-solving takes these steps:

First, we define what the problem is and we have to agree upon this.  Be on the same page, otherwise you and your teenager may end up not even talking about the same thing.  Between the two of you, come up with some possible solutions.  Both of you need to be reasonable here.  Evaluate all of your solutions and come up with the best one that will work for the both of you.  Lastly, come up with a plan or course of action to the selected solution.  Solutions mean nothing if you don’t implement it and then continue to follow through.

PostHeaderIcon How to work through a child’s fears or anxiety

Children that are often brought in for mental health treatment are seen for excessive worry or fears.  Parents are often confounded as to where the fears started and more importantly on how to help their child combat these fears that seem very real to them.  Common fears that are seen are the fear of water, animals, dark places, heights, and most often having to start school and be aways from their parents.  Of course, all of us feel fear at one time or another and the degree or severity of our fear is different at times.  What I am talking about is irrational fears that are excessive and are interfering with your child’s ability to function.  Here are a list of some strategies that a parent or caregiver can use with their child to help them work through and combat some of these fears. 

1.) Try to get your child to open up and talk about what is going and how they are feeling.  As a therapist, this is our entire goal and we have a number of strategies that we use in order to get a child to open and talk to us to figure out what is going on and how to help them.  Just listen to your child and do not make any judgments, just let them vent their feelings.  If they won’t up to you as a parent, then professional help may be needed.

2.) Research any books that are related to your child’s fears and purchase them in order to help your child learn coping strategies.  By your child having books that are related to their fears, they are able to identify with the characters in the books that are experiencing very similar symptoms to them and eventually work through their fear.

3.) Do NOT force a child to confront their fears all of a sudden.  Facing fears has to be at a very gradual pace.  In therapy, we call this systematic desensitization, a fancy word that means we expose a child to their fear very slowly over a period of time.  If you expose your child all of a sudden to their fear, then you will most likely make the situation much worse.  

4.) If you see that after you as the parent have tried talking to them, bought resource books related to the fear, and taken steps to resolve the problem and the problem persists, then consider help from a mental health professional. 

Children require a stable environment that is relatively free from chaos.  We all have chaos and stress in her lives from time to time, however a structured environment is the best in order to allay a child’s fears.  Remember, when children do not know what to expect and their lives are full of chaos, this often brings about anxiety and fears.

PostHeaderIcon Find a happy place, find a happy place

Stress or anxiety seems to be in everyone’s life in varying degrees.  Stress affects children, adolescents, and adults alike and here is a very easy way to manage your stress.  As a therapist, I see lots and lots of patients even children that are suffering from anxiety and a technique professionals often use is visual imagery.  Visual imagery or visualization is a very easy stress management technique that you can use almost anywhere.  This technique, I recommend to all of the children I see and each person makes up their own little “happy place”.  Here is what you do: 

Make up your own place to relax.  Breathe in deep and exhale slowly before you begin.  Now, picture a scene, you sitting in a hammock facing the ocean.  You lost your cell phone so no one will be calling you.  Notice how warm the sun is and the breeze is blowing and feels very nice.  Stay in this picture for a while and notice that the birds are singing in the trees and the cabana boy just brought you a tall glass of iced tea.  You are totally relaxed and feel terrific.  You continue to breathe in and out slowly and you drift off to sleep for a few seconds and are totally refreshed.

Of course, this is my daydream!!  This may seem hard at first to do since we do not train ourselves to relax, but practice this every day and it will become second nature to you.  Give yourself permission to take a few minutes and practice this every day.  Children can even do this at home before they start their school day and their “daydream” can be changed to something that they enjoy or relaxes them.  Now, have a wonderful day!!

PostHeaderIcon You Tube – Understanding My ADHD

PostHeaderIcon How to Start a Conversation for the Asperger’s Child

Social skills or lack thereof, is a key element of the diagnosis of Asperger’s Disorder.  Children struggle with understanding the ebb and flow of conversation and developing relationships are often a struggle and very painful for children.  Here are a few simple tried and true ways for a child to start a conversation:

  1. “Hey”, “How are you doing?”, “What’s up?”, -something simple to get the conversation going.  Even adults have to do this
  2. “How was your weekend?”,  “Did you do anything or go anywhere?”
  3. “What did you watch on TV last night” or “Have you seen any good movies?”

Discussions with adults are a little trickier, but should start with something like, “Hi, Mr. Williams, how are you?”

Yes, these sound very simple, however starting and ending a conversation for an Asperger’s child is not that simple, so we have to start with something simple and work our way up slowly.  To end a conversation, it should be just as easy.  Some things that your child can say, which should be rehearsed with you the parent at home before they try them at school could be:

  1. “I have to get to class, so I will see you later”
  2. “I gotta go and get some homework done”
  3. “I have to catch the bus now”   

Other things to start and end a conversation can be added to this list and whatever is on the list should be age appropriate.  By rehearsing these starting and endings to a conversation, your Asperger’s child will feel alot less anxiety when they are faced with social interactions with their peers. A very good idea would also be to develop social starters and endings that your child can use in any situation such as at school, with adults, when out in public, ie… the grocery store.

PostHeaderIcon How Parents can deal with an ODD child

Children with Oppositional Defiant Disorder exhibit an ongoing pattern of resistant, hostile, and uncooperative behaviors.  These behaviors are often a challenge for parents and make the child’s behavior very difficult to deal with.  Parents need support and undersanding and there are a number of things parents can do to help themselves and their child with ODD.  First of all, build on the positive behaviors that you see in your child.  No child is bad every single second of every day.  Point out good behaviors and praise them and reinforce the behaviors that are appropriate.  Pick your battles!  I can not stress this enough.  If you argue every single; solitary point, you as the parent will be absolutely exhausted.  Yes, I know it is difficult to let some things go as a parent, but you can not address every single thing.  Avoid getting into a power struggle.  Remember, ODD kids love to argue!  Prioritize the things that you want your child to do.  Set up limits/boundaries for your child and stick to them.  Bad behavior is only reinforced by you as the parent when consequences for behavior are not consistent.  Do not change the consequences or become lax on them, just because you are tired of fighting the fight.  Stick to your guns here.  You as the parent should manage your own stress level and try to relax.  Have interests of your own and try to spend time away.  Have a support system in place.  Nobody should feel they are alone with no one to rely on.  Take a time out for yourself if you see that you are about to lose your cool.  Walk away until you can calm down.  Staying in the situation where you are arguing with your child will only exacerbate the situation.  Children with ODD often respond to parenting techniques if used consistently and in a positive manner.  A behavioral contract is often needed with ODD children, but more on this in my next post.