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We provide individual & group counseling, play therapy, and Theraplay® for children, teens and families.  We also have therapists that specialize in working with young adults and adults.  We enjoy working with a range of emotional and behavioral issues, and specialize in specific areas of concern listed below.  Although a key aspect of therapy is challenging "stuck" or unhealthy patterns of thinking or being, therapy will always progress at a speed that you are comfortable.  When working with children, parents and caregivers are an integral part of the therapy and communication will occur frequently. We operate using treatment grounded in an understanding that neuro-developmental concepts and relational aspects throughout a child's earliest life experiences have a direct correlation to current levels of functioning, adverse behaviors and strained relationships.  We offer a highly personalized approach tailored to each individual or family in order to help you attain what you are seeking in therapy. 


We specialize in diagnosing and treating the following issues.  Please click on the link for more information. 


Treatment methods are chosen based on individual needs, age of child(ren), and are assessed throughout therapy.  Together we will discuss the type, length and intensity of treatment based on the child or teen's needs.  Often times several methods are utilized throughout therapy.  Here is a list of the treatment methods we utilize.  Please click on the link for more information. 

 

  • Traditional talk therapy
  • Play therapy
  • Theraplay®
  • Sandtray
  • Expressive arts
  • Filial therapy
  • Bibliotherapy
  • Cognitive behavioral therapy (CBT) and Trauma focused-Cognitive behavioral therapy (TFCBT)
  • Dialectical behavior therapy (DBT)
  • Solution focused therapy 
  • Family therapy
  • Group therapy


Part of therapy includes a thorough intake and assessment of the issues bringing you to therapy.  Some of the assessment tools we use are listed below.  

  • Marschak Interaction Method (MIM)
  • NICHQ Vanderbilt Assessments for teachers, parents, and individual
  • Beck Youth Inventories- Second Edition
  • Child Behavior Checklist (CBCL)
  • Sentence completion
  • Adult Attachment Inventory (AAI)

 


 

Further information about our areas of specialty:

Depression

Grouchiness, moodiness, reluctance to spend time with family are all typical phases that young people experience at some point during their childhood; however, sometimes these behaviors can indicate something more serious than "growing pains"--an illness such as depressive disorder.  Because normal behaviors vary during each developmental stage, it can be difficult to know the difference between "a phase" and something more serious.  According to the American Academy of Child and Adolescent Psychiatry, an estimated 2% of young children, and 4% to 8% of adolescents, suffer from depression. While depression definitely exists in some younger kids, it's much more common in teenagers.  We know that the years between 15 and 24 represent the most common time for the onset of a depressive disorder, and occurs twice as frequently in girls after puberty.  

The key is to know your child. If your usually quiet and well mannered 9 year old suddenyl begins behaving aggressively, or your boisterous teenager suddenly becomes silent and withdrawn, it may be time for an assessment from a professional.  Children are actually less likely than adults to admit they feel depressed. They may be unable to recognize the symptoms of the illness, or they may incorrectly conclude that what they are experiencing is something to be ashamed of. This makes it even more important for parents and other concerned adults to be watchful for the symptoms of depression in children and adolescents. 

What is depression? 
Depressive disorders in children and adolescents include disruptive mood dysregulation disorder (DMDD), major depressive disorder, and persistent depressive disorder. Bipolar disorder is a mood disorder not included in this category; due to the potential for overdiagnosis in children, children up to age 12 experiencing similar sypmtoms of persistent irritability and frequent episodes of behavioral dyscontrol will be treated as having DMDD.  Parents can help their child by recognizing the following symptoms of a depressive disorder: 

Symptoms in children:
  • Excessive crying
  • Anger and aggression
  • Temper outbursts
Symptoms in adolescents:  
  • Irritability or anger
  • Continuous feelings of sadness/hopelessness
  • Social withdrawal
  • Increased sensitivity to rejection
  • Changes in appetite -- either increased or decreased
  • Changes in sleep (too much or too little)
  • Vocal outbursts or crying
  • Difficulty concentrating
  • Reduced interest in hobbies and extracurricular activities
  • Feelings of worthlessness or guilt
  • Conflict with authority 
  • Thoughts of death or suicide
What causes depression? 
Studies show a combination of environmental factors, child temperament, biochemical distrubance, and genetics contribute to depressive disorders. Childhood risk factors include parental loss or separation or other significant disruptions in caregivers, co-existing diagnosis of ADHD or anxiety, and chronic irritability in infancy.  While not all children with depression have experienced adverse childhood experiencing, heritability of depression is approximately 40%.  Certain lneuro-transmitters and a number of brain regions have been implicated in depressive disorder as well.   

What is the typical approach to treating depression?
The first step to successful treatment is a comprehensive and thorough assessment of functioning.  The assessment includes:
  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues
Then the best course of treatment is decided together with the caregivers.  Parents and caregivers play a crucial role in treatment because family plays a crucial role in helping to reinforce learned coping skills, reduce triggers, and alter family dynamics that contribute to an imbalance of perceived security.  Treatment may include a combination of the following:
  • Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore and/or challenge existing family dynamics 
  • Traditional "talk therapy" to create a space of unconditional acceptance
  • Dialectical Behavioral therapy to learn the connection between mind and body 
  • Cognitive behavioral therapy to replace negative thought patterns
  • Psycho-education with family to learn causes, symptoms, and treatment of depression
  • Medication is discussed and referred as needed

 

 
When you bring your child to us for an intake assessment, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms.


Click here for further reading


   
Anxious feelings, worries, or fears are common among children and adolescents.  Most children experience a normal amount of apprehension in certain situations, whether it is an upcoming test, change in schools, or a thunderstorm.  Anxiety is a normal part of childhood, and every child goes through phases of apprehension and worry, but a phase is temporary and usually harmless. Children who suffer from an anxiety disorder experience fear, nervousness, and shyness, and start to avoid places and activities and may even skip school.  These children tend to get "stuck" on their worried thoughts and have a hard time doing normal daily functions like going to school, playing, falling asleep, or trying new things.  Getting "stuck", when it begins to interfere with daily functioning, is the key.  This is what separates normal childhood worries from an anxiety disorder that requires professional intervention. 

Anxiety is very treatable, but 80% of kids with a diagnosable anxiety disorder and 60% of kids with diagnosable depression are not getting treatment, according to the 2015 Child Mind Institute Children's Mental Health Report.  Anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse.

What are anxiety disorders?
There are many types of anxiety disorders including generalized anxiety, social anxiety, separation anxiety, panic disorder, selective mutism, specific phobias, obsessive compulsive disorder, and post traumatic stress disorder. However, these all share the symptom of excessive fear and cause significant distress interfering with ability to maintain daily functions for at least 6 months.  Anxiety is the anticipation of real or perceived fear and is reduced by pervasive avoidance behaviors.  The most common symptoms in children and teens are:
  • Excessive worry and apprehension that is difficult to control 
  • Feeling restless or "on edge"
  • Easily fatigues
  • Difficulty with concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbances
What causes anxiety disorders?
Research has shown that they are caused by a combination of temperament, environmental factors and genetics.  While this is true, only with a careful evaluation can you determine the underlying thought patterns that fuel the anxiety. 
  • Temperament:  Children with a tendency towards behavioral inhibition, negative affect (neuroticism), and harm avoidance have been associated with anxiety disorder.  
  • Environmental:  Although adverse childhood experiences and parental overprotection have been associated with anxiety disorder, no factors have been identified sufficient enough for making the diagnosis without additional criteria.  
  • Genetics:  One third of the risk of experiencing anxiety is genetic, and these genetic factors overlap with the risk of neuroticism and shared with other mood disorders, specifically depressive disorder.  
What is the typical approach to treating anxiety disorders?
The first step to successful treatment is a comprehensive and thorough assessment of functioning.  The assessment includes:
  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues
Then the best course of treatment is decided together with the caregivers.  Parents and caregivers play a crucial role in treatment because family plays a crucial role in helping to reinforce learned coping skills, reduce triggers, and alter family dynamics that contribute to an imbalance of perceived security.  Treatment may include a combination of the following:
  • Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore and/or challenge existing family dynamics 
  • Cognitive behavioral therapy to replace negative thought patterns
  • Mindfulness training to learn grounding skills to cope with anxiety 
  • Psycho-education with family to learn causes, symptoms, and treatment of anxiety
When you bring your child to us for an intake assessment, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms.

Click here for further reading


Adjustment disorder

What is adjustment disorder?
An adjustment disorder is a short-term emotional or behavioral reaction to a known stressful event or change in a child’s life that is considered maladaptive or an unhealthy, unexpected response to the change or event. Adjustment disorder is often called “situational depression” as children who have an adjustment disorder may be fearful, hopeless, and lose interest in school or friends. However, unlike major depression, adjustment disorder is triggered by an external stimuli and remits once the child has processed and adapted to the situation. The response must occur within three months of the identified stressful change or event in a child’s life and tends to resolve within six months following the event. These events may be anything from the birth of a sibling to parental divorce. Other changes include adjusting to a diagnosis of a chronic illness, loss of a pet, or change of schools.  If symptoms continue to persist after 6 months of the stressor, other diagnoses must be considered. 

What causes adjustment disorder?
Children who experience frequent and severe stress are more likely to develop an adjustment disorder.  When there is a change to the child's sense of safety, whether it is real or perceived, we must address and treat it the same.  

What is the typical approach to treating adjustment disorder?
The first step to successful treatment is a comprehensive and thorough assessment of functioning.  The assessment includes: 
  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues
Then the best course of treatment is decided together with the caregivers.  Treatment helps because the child's brain can learn to connect the event to a specific coping skill, which becomes the life skill of resilience.  Resilience is what combats tendency to develop mental health disorders in adulthood.  Treatment may include a combination of the following:
  • Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore and/or challenge existing family dynamics 
  • Cognitive behavioral therapy to replace negative thought patterns
  • Sandtray therapy to allow child to develop sense of self and process concerns non-verbally
  • Bibliotherapy to help normalize child's concerns
  • Psycho-education with family to learn causes, symptoms, and treatment of anxiety
When you bring your child to us for an intake assessment, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms.


Conduct/behavioral issues

Children at a young developmental age or with poor verbal communication skills act out their feelings and communicate through their behaviors. Once a child is labeled as a "troubled student" or "bad kid" life can be a downward spiral for the child emotionally, and the challenges of your child getting along with others may seem daunting. 

What are behavioral disorders?
ALL children will test boundaries and exhibit temper tantrums throughout childhood.  This is their way to develop emotional regulation. But when the symptoms become persistently harmful to the child or others, and they are occurring in several different domains of child's life such as home, school and with peers, there may be a bigger underlying problem.  Severe behavioral disorders include problems in the self-control of emotions and behaviors and exhibit issues with disruption, impulse control and conduct.  They may be diagnosed as oppositionial defiant disorder, intermittent explosive disorder, conduct disorder, pyromania and kleptomania.  While they range in severity of symptoms, the similarities across the board are two types of self control: poorly controlled behaviors, and poorly controlled emotions.  The symptoms of behavioral disorders often are part of a pattern of problematic interactions with others, and children tend to justify their behaviors as a response to others rather than understanding their role in conflicts.   You may look for the following symptoms:


What causes behavioral disorders?
The causes vary with each individual case. However, there is a combination of environment, temperament, and physiological contributors to behavioral disorder. Poor emotional regulation, poor frustration tolerance, and limited pro-social emotions have been predictive of the disorder.  Environment is the largest factor- harsh, inconsistent or neglectful childhood experiences are common in families of children with oppositional defiant disorder.  While individuals with a history of physical and emotional trauma during first 2 decades of life are at increased risk for intermittent explosive disorder.  Family level risk factors include harsh discipline, abuse, frequent change in caregivers, and familial psychopathology; and community risk factors include peer rejection, association with delinquent peer group, and neighborhood exposure to violence.

A number of neurobiological markers have also been linked, such as lower heart rate, reduced cortisol reactivity, and abnormalities in the amygdala. 

Unbiased, non-judgmental clinical attention to reducing the contributing factors of the environment is key in determining individual causal factors to behavioral disorders.  

What is the typical approach to treating behavioral disorders?

With a thorough assessment, we seek to understand the experiences your child had beginning intrauterine and throughout childhood.  This helps us understand how the brain developed and pathways we can work on in therapy to help re-build relationships and teach the child to regulate big emotions. Our focus is on creating a therapeutic environment of trust and openness to change.  Dealing with behavioral disorders is challenging and requires a great deal of openness into history of family functioning and childhood development.  The assessment includes:
  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues

Then the best course of treatment is decided together with the caregivers.  Parents and caregivers play a crucial role in treatment because family plays a crucial role in restoring balance to a child's perceived sense of insecurity.  There are 4 dimensions of attachment that we will assess to determine where the imbalance has occurred for the child:  Nurture, Engagement, Structure and Challenge.  Coping skills and emotional attunement will be learned together with the parents and child, in order to assist in instilling coping skills with the affected child.  Treatment may include a combination of the following:

  • Theraplay® to learn emotional attunement and regulation 
  • Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore and/or challenge existing family dynamics 
  • Traditional "talk therapy" to create a therapeutic environment of safety and unconditional acceptance
  • Parenting support
When you bring your child to us for an intake assessment, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms.

Click here for further reading
 


ADHD assessment and treatment

What is ADHD?
Attention deficit hyperactive disorder (ADHD) is a neurodevelopmental disorder.  It is NOT a mood or behavioral disorder.  There are certain neurotransmitters in the part of the brain linked to attention, memory, sleep and learning that work differently in children with ADHD.  While some would argue that ADHD is overdiagnosed, it is one of the most common childhood brain disorder affecting 5-10% of children today.   It is really difficult to diagnose ADHD before the age of 4 due to variable normative behaviors, and is most commonly identified during early elementary years once adherence to social norms becomes crucial to learning and making friends.  

Often times, once a child has started school, the teacher will gently bring up ADHD and suggest your child get evaluated.  In comparison to your child's peers in a social setting, the teacher can be a good gauge of your child's ability to focus and stay on task.  The symptoms of ADHD must be present in more than one setting of a child's life, so it's important to know what is going on in your child's classroom.  

Inattention, hyperactivity, and impulsivity are the hallmark problematic behaviors in children with ADHD.  Your child may need an evaluation for ADHD when the symptoms are inconsistent with normal developmental levels, symptoms interefere with child's ability to function at home or school, and symptoms are present before the age of 12. 
 
There are 3 subtypes of ADHD: 
 
Predominantly Inattentive Type 
6 or more symptoms must be present
Predominantly Hyperactive and Impulsive 
6 or more symptoms must be present
Combined Type, Hyperactive-Impulsive and Inattentive
  • Fails to give close attention to details, makes careless mistakes
  • Difficulty sustaining attention in tasks or play
  • Often doesn't listen when spoken to directly, fails to finish school work or chores
  • Difficulty with organization
  • Poor time management
  • Avoids tasks with sustained mental effort such as school work
  • Often loses things
  • Easily distracted by external stimuli
  • Often forgetful in daily activities
  • Often fidgets or squirms in seat
  • Often gets up from seat without permission
  • Often runs or climbs about where it is inappropriate
  • Often unable to play quietly
  • Is often "on the go", trouble sitting still for extended period of time
  • Often talks excessively
  • Often blurts out an answer before question completed
  • Often has difficulty waiting turn
  • Often interrupts others
  • 6 or more symptoms are met from both categories (12 total)


What causes ADHD?
Scientists are not sure what causes ADHD, although many researchers have studied this and have determined several probable causes.  Studies have shown that genese play a large role.  Like many other illnesses, ADHD probably results from a combination of factors.  In addition to genetics, researchers have linked possible environmental factors, brain injuries in childhood, and the social environment as contributors to ADHD.  Furthermore, studies show that the number of children being diagnosed is increasing, but it is unclear why.  

Genes
Studies have shown that ADHD does in fact run in families.  There are genetic characteristics that seem to be passed down.  If a parent has ADHD, their child has more than a 50% chance of having it.  If an older sibling has ADHD, the sibling has a 30% chance of having it. 
 
Environmental Factors
Children born pre-mature or at a low birth weight have a higher risk of developing ADHD.  Children who have had head injuries to the frontal lobe, the area that controls impulses, may develop hyperactivity as well.  Brain injuries as a result of having a fever above 104 degrees in infancy may also contribute to brain damage resulting in symptoms of hyperactivity and poor impulse control.  Studies show that pregnant women who smoke or drink alcohol may have a higher risk of having a child with ADHD.  Exposre to lead, PCBs or pesticides may also have a role.  Although much debate has occurred, there has not been a link to watching too much TV and ADHD as of yet.  

Nutrition
Although sugar and certain food additives is a popular suspect in causing ADHD, there is no reliable research to support these claims.  However, if your child does already have ADHD, it is important to evaluate nutrition to make sure it isn't exacerbating symptoms.  

Neurobiology
Certain brain messengers, called neurotrasmitters, have been proven to work differently in children with ADHD.  Certain regions of the prefrontal cortex, which controls behavior, judgement, impulses, and attention, may not function properly in people with ADHD.  

What is the typical approach to treatment for ADHD?

With a thorough assessment and accurate diagnosis, ongoing treatment can help individuals with ADHD to be successful in school and lead extremely productive lives. Treatments can relieve many symptoms of ADHD, but there is currently no cure for the disorder.  We conduct an extremely thorough assessment for ADHD, often taking up to 4 sessions, communicating with teachers, and conducting a school visit. 

Additional recommendations may occur prior to completing a diagnostic evaluation to rule out other contributing factors to a child's symptoms.  These may include a formal speech and language assessment, formal cognitive testing, and/or a vision and hearing screening.

Treatment for ADHD is crucial because living with ADHD and not knowing how to recognize and control the symptoms can make life extremely difficult for a child or teen. Children with ADHD:
  • Often struggle in the classroom, which can lead to academic failure and judgment by other children and adults
  • Tend to have more accidents and injuries of all kinds than children who don't have the disorder
  • Have poor self-esteem
  • Are more likely to have trouble interacting with and being accepted by peers and adults
  • Are at increased risk of alcohol and drug abuse and other delinquent behavior

Together we will proceed with a treatment approach, and it may include some or all of the following. 
  • Parent skills training to help parents learn tools to successfully manage the child's challenging behaviors, and to learn how to structure routines in a way that allows a child's self-esteem to flourish. 
  • Individual therapy with the child, which may include play, sandtray, talk therapy, or bibliotherapy to boost self-esteem and normalize symptoms of ADHD
  • Family therapy to help a family learn how to manage the dynamics involved in living with a person with ADHD
  • Theraplay® to help parent learn attunement to child's subtle cues of dysregulation
  • Group therapy to teach children with ADHD social skills
  • Behavior therapy to help with executive functioning skills such as organization, study skills and self-monitoring
  • Dialectical behavior therapy to teach self-regulation skills and learn how to modulate arousal 
  • Cognitive rehabilitation (brain training) to practice tasks designed to improve attention, concentration and memory with repetitive practice

When you bring your child to us for an intake assessment due to attention concerns, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms before making a diagnosis.

Click here for further reading
 


What is anger?
Anger is a normal human emotion; however, it is also one letter away from danger. Recognizing when your child has crossed the line from anger to a dangerous rage is important.  Children communicate their unmet needs through anger at times, but when children continue to have regular emotional outbursts, it can be a symptom of internal distress.  They may sometimes lash out if they're frustrated or be defiant if asked to do something they don't want to do. But when kids do these things repeatedly, or can't control their tempers a lot of the time, it may be more than typical behavior. Here are some signs that outbursts should concern you:
  • If your child's tantrums and outbursts are occurring past the age in which they're developmentally expected (up to about 7 or 8 years old)
  • If his behavior is dangerous to himself or others
  • If her behavior is causing her serious trouble at school, with teachers reporting that she is out of control
  • If his behavior is interfering with his ability to get along with other kids, so he's excluded from play dates and birthday parties
  • If her tantrums and defiance are causing a lot of conflict at home and disrupting family life
  • If he's upset because he feels he can't control his anger, and that makes him feels bad about himself

What causes the dangerous anger?
The first step is understanding what is triggering your child's behavior.  There are many possible underlying causes, including: 
  • ADHD:  Many children with ADHD have trouble controlling their behavior.  They may find it hard to comply with instructions or switch from one activity to another, and that makes them appear defiant and angry.  "More than 50 percent of kids with ADHD also exhibit defiance and emotional outbursts," says Dr. Vasco Lopes, a clinical psychologist at the Child Mind Institute. Their inability to focus and complete tasks can also lead to tantrums, arguing, and power struggles. That doesn't necessarily mean they've been diagnosed with ADHD—in fact, ADHD is sometimes overlooked in kids who have a history of severe aggression because there are so many bigger issues.
  • Anxiety: Children who seem angry and defiant often have severe, and unrecognized, anxiety. If your child has anxiety, especially if she's hiding it, she may have a hard time coping with situations that cause him distress, and she may lash out when the demands at school, for instance, put pressure on her that she can't handle. In an anxiety-inducing situation, your child's "fight or flight" instinct may take hold—she may have a tantrum or refuse to do something to avoid the source of acute fear.
  • Trauma or neglect: A lot of acting out in school is the result of trauma, neglect, or chaos at home. "Kids who are struggling, not feeling safe at home can act like terrorists at school, with fairly intimidating kinds of behavior," says Dr. Nancy Rappaport, a Harvard Medical School professor who specializes in mental health care in a school setting. Most at risk, she says, are kids with ADHD who've also experienced trauma.
  • Learning Problems: When your child acts out repeatedly in school or during homework time, it's possible that he has an undiagnosed learning disorder. Say he has a lot of trouble with math, and math problems make him very frustrated and irritable. Rather than ask for help, he may rip up an assignment or start something with another child to create a diversion from his real issues.
  • Sensory processing issues: Some children have trouble processing the sensory information they are getting from the world around them. If your child is oversensitive, or undersensitive, to stimulation, things like "scratchy" clothes and too much light or noise can make her uncomfortable, anxious, distracted, or overwhelmed. That can lead to meltdowns for no reason that's apparent to you or other caregivers.
  • Autism: Children on the autism spectrum are also often prone to dramatic meltdowns. If your child is on the spectrum, he may tend to be rigid—needing consistent routine to feel safe—and any unexpected change can set him off. He may have sensory issues that cause him to be overwhelmed by stimulation, and short-circuit into a meltdown that continues until he exhausts himself. And he may lack the language and communication skills to express what he wants or needs.
What is the typcial treatment approach for a child with anger?

With a thorough assessment, we seek to understand the experiences your child had beginning intrauterine and throughout childhood.  This helps us understand how the brain developed and pathways we can work on in therapy to help re-build relationships and teach the child to regulate big emotions. Our focus is on creating a therapeutic environment of trust and openness to change.  Dealing with behavioral disorders is challenging and requires a great deal of openness into history of family functioning and childhood development.  The assessment includes:

 

  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues
Learning coping skills to control anger, and developing mindful awareness of the mind-body connection are skills that can be learned in therapy. We often use dialectical behavior therapy and relaxation skills in conjunction with traditional talk therapy to treat children and teens with anger issues. Many parents also require some support with techniques to help manage their child's big feelings. When angry outbursts persist and interfere with relationships with family or friends, it is time to consider more serious possible causes: ongoing threats to a child’s safety, deeper tensions in the family, a developmental delay in language that leads to frustration, or a delay in social skills that brings on aggression. 

When you bring your child to us for an intake assessment, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms.

Stress management, PTSD and trauma

What is trauma?
 
Trauma is defined by the way a person reacts to events. So a trauma to one person may not be a trauma to another. It is important to remember that some children might see an event as traumatic even when the adults around them do not. Any time a child does not feel safe and protected, the event could be seen as a trauma. These experiences usually call forth overwhelming feelings of terror, horror, or helplessness.  Because trauma is defined by the person who experiences it, no single list can include all the causes of trauma for children. The following list, though, will explain some of the more common traumas children face.
  • Surgery or Serious Illness – The child or a caregiver is in the hospital for a serious illness or surgery.
  • Accidents – The child has experienced an automobile accident, a serious fall or sports injury, a house fire or other major accident that threatens his or her feelings of safety and security.
  • Constant and Intense Bullying – The child is bullied by one or more people over a period of time. The bullies could be classmates, teammates, neighbors or others in the child’s life. Bullying can begin as early as preschool.
  • Separation from Loved Ones – A child might be separated from loved ones due to military deployment, a divorce, a prison sentence or even removal of a child from home due to an investigation of abuse or neglect.
  • Natural Disasters – A child is affected by a severe event such as a tornado, hurricane, forest fire, flooding.
  • Emotional Abuse – A parent or other adult in the household often swears at the child, insults the child or humiliates the child. Emotional abuse might include the adult acting in a way that makes the child afraid that he or she might be hurt physically.
  • Physical Abuse – A parent or other adult in the household often pushes, grabs, slaps or throws something at the child. Physical abuse can also include hitting a child so hard it leaves marks or causes injuries.
  • Sexual Abuse – Any sexual activity between an adult and a child. Sexual abuse can also occur between children. This sexual activity can include obscene phone calls, fondling, exposure, pornography, prostitution or rape. Specific legal definitions can be found in the Texas Penal Code.
  • Neglect – The child does not have enough to eat, has to wear dirty clothes and has no one to protect him or her. Parents might be too drunk or high to take care of the child or take the child to the doctor when needed.
  • Loss/Abandonment – The child loses a loved one through divorce, abandonment, death or other reason.
  • Isolation within the Family – No one in the family appears to love the child or consider the child to be important or special. The family does not look out for each other, feel close or support each other.
  • Domestic Violence – Domestic violence is a behavior used by one person in a relationship to gain power over or control the other. Abuse includes physical, sexual, emotional, economic or psychological actions or threats. This includes any behaviors that frighten, intimidate, terrorize, manipulate, hurt, humiliate, blame, injure or wound someone. 
  • Community Violence – A child either is hurt by violence or witnesses it. Sometimes a child only needs to hear about violence to experience trauma.
  • Substance Abuse – Someone in the child’s household abuses alcohol, street drugs or prescription drugs.
  • Mental Illness – Someone in the child’s household is depressed, has another mental illness and/or has attempted suicide.
  • Terrorism – A child either experiences or hears about terrorism, especially when it happens in a place the child believes should be safe. The child could experience even more traumatic stress if there are children among those who are injured or killed.
  • Flight from Home as a Refugee – A child has been uprooted from home, often after experiencing violence or intense fear of harm.
Learning how to cope with adversity is an important part of healthy childhood development, but when a child is exposed to a traumatic experience, it causes stress on brain development that needs to be addressed and "re-wired".  We understand that how the brain develops in regards to stress is a crucial aspect to understand in order to be able to differentiate when a child is experiencing normal, healthy stress versus toxic stress.  When the stress levels aren't regulated, a child can become cognitively impaired under stress, experience physical symptoms, rage, panic, or dissociation.  The behaviors caused by trauma sometimes depend on a child’s age when the symptoms appear. However, some symptoms can affect all children, including:
  • Major changes in eating or sleeping
  • Nightmares
  • Anger or rage
  • Unreasonable fear
  • Unusually strong startle reactions
What is Post Traumatic Stress Disorder (PTSD)?

An acute post-traumatic change in feeling, thinking and behaving is normal – persistence or extreme symptoms are not. Many clinicians working with traumatized have noted that the persistence of symptoms beyond three months is associated with increased risk for problems. If symptoms of re-experiencing, avoidance, fearfulness, sleep problems, nightmares, sadness or poor school or social functioning persist beyond three-six months, they need to be addressed.  For reasons that are basic to survival, traumatic experiences, long after they are over, continue to take priority in the thoughts, emotions, and behavior of children, adolescents and adults. Fears and other strong emotions, intense physical reactions, and the new way of looking at dangers in the world may recede into the background, but events and reminders may bring them to mind again.  There are three core groups of posttraumatic stress reactions.
  • First, there are the different ways these types of experiences stay on our minds. We continue to have upsetting images of what happened. We may keep having upsetting thoughts about our experience or the harm that resulted. We can also have nightmares. We have strong physical and emotional reactions to reminders that are often part of our daily life. We may have a hard time distinguishing new, safer situations from the traumatic situation we already went through. We may overreact to other things that happen, as if the danger were about to happen again.
  • Second, we may try our best to avoid any situation, person, or place that reminds us of what happened, fighting hard to keep the thoughts, feelings, and images from coming back. We may even "forget" some of the worst parts of the experience, while continuing to react to reminders of those moments.
  • Third, our bodies may continue to stay "on alert." We may have trouble sleeping, become irritable or easily angered, startle or jump at noises more than before, have trouble concentrating or paying attention, and have recurring physical symptoms, like headaches or stomachaches. 
What is the typical approach to treating trauma?

When we conduct our thorough assessment, we will learn about traumatic events that may also contribute to current levels of functioning.  Research has shown that it is never too late to build resilience and process past traumas.  This helps us understand how the brain developed and pathways we can work on in therapy to help re-build relationships and teach the child to regulate big emotions. Our focus is on creating a therapeutic environment of trust and openness to change.  Therapy is a safe place to work together with your child to build new neural pathways that can help your child learn how to stay in a window of tolerance when faced with stressors.  The assessment includes:
  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues

Then the best course of treatment is decided together with the caregivers.  Parents and caregivers play a crucial role in treatment because family plays a crucial role in restoring balance to a child's perceived sense of insecurity.  There are 4 dimensions of attachment that we will assess to determine where the imbalance has occurred for the child:  Nurture, Engagement, Structure and Challenge.  Coping skills and emotional attunement will be learned together with the parents and child, in order to assist in instilling coping skills with the affected child.  Treatment may include a combination of the following:

 

  • Theraplay® to learn emotional attunement and regulation to promote a child's sense of safety
  • Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore existing family dynamics and support a child's post traumatic growth
  • Traditional "talk therapy" to create a therapeutic environment of safety and unconditional acceptance
  • Trauma Focused Cognitive Behavior Therapy (TF CBT) 
  • Sensory based structured interventions to promote awareness of mind-body connection in healing trauma
  • Parenting support and psycho-education as needed to learn about common responses to trauma
 
When you bring your child to us for an intake assessment, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms.

Click here for further reading.  
 

School related issues

Why does my child have academic struggles?
No matter how hard you try to help your child, he/she may continue to struggle in school academically.  Children struggle academically for numerous reasons, but with early intervention and support, children can overcome these difficulties.  

An undiagnosed learning disability
Children with learning disabilities are intelligent with strong cognitive skills but struggle in specific areas. Children who struggle in specific areas may compensate for the frustration or embarassment by being disruptive.  If parents, teachers, and other professionals discover a child’s learning disability early and provide the right kind of help, it can give the child a chance to develop skills needed to lead a successful and productive life. A recent National Institutes of Health study showed that 67 percent of young students who were at risk for reading difficulties became average or above average readers after receiving help in the early grades. Common learning disabilities are:
  • Dyslexia – a language-based disability in which a person has trouble understanding written words. It may also be referred to as reading disability or reading disorder.
  • Dyscalculia – a mathematical disability in which a person has a difficult time solving arithmetic problems and grasping math concepts.
  • Dysgraphia – a writing disability in which a person finds it hard to form letters or write within a defined space.
  • Auditory and Visual Processing Disorders – sensory disabilities in which a person has difficulty understanding language despite normal hearing and vision.
  • Nonverbal Learning Disabilities – a neurological disorder which originates in the right hemisphere of the brain, causing problems with visual-spatial, intuitive, organizational, evaluative and holistic processing functions.
ADHD
Children with problems in the areas hyperactivity, inattention, and impulsiveness will struggle in school academically and socially without the proper intervention.  

Social skills
Some children may struggle with understanding social cues necessary to make and keep friends.  Social skills don't come naturally to all kids. Impulsive and hyperactive children often act in ways that stymie their strong desire for friendship. They often have trouble taking turns and controlling their anger when they don't get their way. More inattentive kids may act flighty or hover at the margins of playgroups, unsure of how to assert themselves. When a child's mind becomes pre-occupied with what happened at recess or at lunch, her grades may start to suffer.

Bullying
If a child is a victim of bullying, he may not always speak out and tell you what is going on due to the shame and blame that victims tend to place on themselves. Bullying can threaten a student's physical and emotional safety at school and can negatively impact their ability to learn.

Life circumstances
Whether you notice it or not, children are greatly affected by the things going on at home and all around them. They are incredibly perceptive, and just because you don’t talk to them about any struggles that are happening does not mean that they are not aware that something is wrong. If there is a lot of stress, fighting, or other unhappy things happening in the home, or if there has been a death or even the birth of a new baby, children are impacted. You often are not aware they anything is wrong, but their feelings are reflected in their grades and school performance. If a once perfect student and happy child is suddenly acting out and failing classes, it may be time to take a look at your home situation and how it is affecting them.

Boredom
Sometimes the brightest children are the ones who suddenly struggle the most. You know that they know the material; they just seem to give up and take absolutely no interest. Many children struggle because they are not being challenged enough; they are completely bored and tired of doing mundane things that they already know how to do. 

What is your typical approach to academic struggles?
While we do not specifically provide assessments for learning disabilites, we can help by providing a thorough assessment of all other areas of functioning in order to determine possible causes of academic struggles.  If we suspect a learning disability, we will refer you for a cognitive battery of formal educational testing.  

With a thorough assessment, we seek to understand the experiences your child had beginning intrauterine and throughout childhood that may contribute to current levels of functioning. The assessment includes:

 

  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues  

Then the best course of treatment is decided together with the caregivers. Treatment may include a combination of the following:

  • Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore existing family dynamics 
  • Traditional "talk therapy" to create a therapeutic environment of safety and unconditional acceptance
  • Psycho-education on learning disabilities in order to normalize concerns and teach coping skills
  • We can also help you learn how to be an advocate for your child in the educational system because with a background in school social work, we understand a child and parent's rights to accessing services in the school.


Foster and adoptive parenting/ Attachment issues

Common concerns
If you are a family that has foster children or adopted children, chances are that child has experienced attachment issues in their past.  Many children who have suffered early maltreatment have a faulty belief that they are not worthy and are bad or defective. In their minds, caregivers treated them poorly or their birth parents abandoned them because they are intrinsically faulty or deficient. Given that belief, children may consciously or subconsciously think, “Since I am basically defective, what’s the point in improving my behavior?” Individuals act in accord with their primary beliefs about themselves, their life, and others. Actions will give clues to a person’s beliefs. For example, a troubled child’s actions might indicate these beliefs about self-worth: “I’m only worthwhile when I have your undivided attention.” “I am only loved when I get my own way.” “When someone corrects me, it shows me that she does not love me.” If a parent does not address these faulty beliefs, few parenting strategies or methodologies will help. Most parenting guidance assumes that a child’s core belief is positive and, therefore, the child will choose good things for himself. A negative core belief inspires very different choices. A secure attachment to a primary caregiver can help a troubled child change faulty beliefs. 

What is Reactive Attachment Disorder?
Attachment problems fall on a spectrum, from mild problems that are easily addressed to the most serious form, known as reactive attachment disorder (RAD). RAD is relatively rare, but occurs when there has been gross neglect in infancy and childhood with a failure to form an attachment with a caregiver before the age of 5.  Common signs and symptoms of reactive attachment disorder include:
  • An aversion to touch and physical affection. Children with reactive attachment disorder often flinch, laugh, or even say “Ouch” when touched. Rather than producing positive feelings, touch and affection are perceived as a threat.
  • Control issues. Most children with reactive attachment disorder go to great lengths to remain in control and avoid feeling helpless. They are often disobedient, defiant, and argumentative.
  • Anger problems. Anger may be expressed directly, in tantrums or acting out, or through manipulative, passive-aggressive behavior. Children with reactive attachment disorder may hide their anger in socially acceptable actions, like giving a high five that hurts or hugging someone too hard.
  • Difficulty showing genuine care and affection. For example, children with reactive attachment disorder may act inappropriately affectionate with strangers while displaying little or no affection towards their parents.
  • An underdeveloped conscience. Children with reactive attachment disorder may act like they don’t have a conscience and fail to show guilt, regret, or remorse after behaving badly.
Inhibited symptoms of reactive attachment disorder
This child is extremely withdrawn, emotionally detached, and resistant to comforting. The child is aware of what’s going on around him or her—hypervigilant even—but doesn’t react or respond. He or she may push others away, ignore them, or even act out in aggression when others try to get close.

Disinhibited symptoms of reactive attachment disorder. 
This child doesn’t seem to prefer his or her parents over other people, even strangers. The child seeks comfort and attention from virtually anyone, without distinction. He or she is extremely dependent, acts much younger than his or her age, and may appear chronically anxious.

What is your approach to treating attachment issues?

With a thorough assessment, we seek to understand the experiences your child had beginning if possible, intrauterine and throughout childhood.  Without this information due to foster or adoption, we gather as much information as we can in order to determine treatment.  This helps us understand how the brain developed and pathways we can work on in therapy to help re-build relationships and teach the child to regulate big emotions. Our focus is on creating a therapeutic environment of trust and connection in order to promote secure attachment.  The assessment includes:
  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of foster/adoption history 
  • Additional important biological and adoptive family background history 

Then the best course of treatment is decided together with the caregivers. There are 4 dimensions of attachment that we will assess to determine where the imbalance is occurring within the dyad:  Nurture, Engagement, Structure and Challenge.  We consistently find that when parent-child attachment grows, many of the behavioral problems disappear because children begin to change their self view and understand that their parents honestly want good things for them. Treatment may include a combination of the following:

  • Theraplay® to learn strengthen parent-child attachment
  • Play Therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore and/or challenge existing family dynamics 
  • Traditional "talk therapy" to create a therapeutic environment of safety and unconditional acceptance
  • Parenting support  
 

 

 
Children are likely to show their grief in less direct ways than adults. Children move in and out of grief. One day they will seem to be fine and another day they will be showing that they are not managing so well. Children often have more needs at times of loss which can lead to demanding behavior as they try to get closeness, care, information, reassurance and support from adults.  Children express grief in a different way than adults. They tend to move in and out of intense feelings, rather than sustaining high levels of one emotion for long periods of time. When adults see a grieving child playing or laughing, they may mistakenly believe that the child is "over it". This perception may influence how much grief support a child receives.

The experience of loss affects each child differently. The child's age, emotional maturity, the circumstances of the loss, and the 'connectedness' with the person or whatever the child has lost are important factors. It is important to look at each child individually and work out what will best help that child.  Preschool children usually see death as temporary and reversible, and children between five and nine begin to think more like adults about death, yet they still believe it will never happen to them or anyone they know. Teenagers grieve in much the same way as adults but because at this stage of their development they often have emotional 'ups and downs' they can become deeply distressed. It is normal during the weeks following a loss for some children to feel immediate grief or persist in the belief that it didn't happen. However, long-term denial of the death or avoidance of grief can be emotionally unhealthy and can later lead to more severe problems. 

INFANTS
Infants grieve the loss of a loved one they were used to being with. Before children can talk, they communicate with sounds of crying, cooing, body language, and physical symptoms such as colic and fretfulness. Grieving babies can be difficult to console. If you are grieving, too, chances are that the baby will sense your distress. It may also be difficult to remember all the needs of an infant when you are upset. Ask family, friends or your church community to help with a toddler's or baby's care when you are in the midst of intense grief.

AGES 3-5
As children learn to utilize our symbolic language of words, they can begin to share feelings verbally. They learn what sad, mad, and scared mean. They communicate about the concrete world: what they can see, touch, hear, taste and smell. The future, the idea of “never”, is outside their understanding. They fully expect the return of their loved one. 

AGES 6-10
Around the age of six, children begin to understand that the loved one is not returning. This can bring about a multitude of feelings at the time of other significant changes in a child's life, including entering first grade. Children who do not remember their parent may feel an acute sense of loss as they see peers with their parents and hear their family stories.

Elementary age children are interested in biological processes about what happened to their loved one. Questions about disease processes and what happens to the body are of keen interest. When asked questions, it is important to clarify what it is the child wants to know. 

Children's worlds are sometimes messy and have a high level of energy. Grief is also messy sometimes. It does not always take a form that makes adults comfortable. Allowing your child to express feelings through creative, even messy, play can be helpful (i.e. finger painting, making mud pies and throwing them, etc). You may want to join in the creative play.

Peer group support is helpful for children of this age.

AGES 11-13
Middle schoolers are faced with a tumultuous time of body changes and increased performance expectations. When a death loss is added to that, it increases their sense of vulnerability and insecurity. 

Grades may be affected by the death. Middle school is also a time when abstract thought begins to accelerate. Children may be considering spiritual aspects of life and death, perhaps questioning their beliefs. Be open to talking with them or support them in finding someone who is comfortable discussing these issues.

AGES 14-18
Teens are usually in a place of growing independence. They may feel a need to hide their feelings of grief to show their control of themselves and their environment. Teens often prefer to talk with peers rather than adults when they are grieving.

Teens are more likely to engage in high-risk behavior, especially after a death loss. One young person expressed that her mom was always careful and followed all the safety rules, but died anyway. She asked, “Why should I be careful?”
Children and teens who are having serious problems with grief and loss may show one or more of these signs:
  • physical pain such as stomach aches or headaches
  • sleeping problems, bad dreams
  • eating problems, eating too much or too little
  • being destructive
  • acting like a younger child
  • angry play or playing the same thing over and over
  • not being able to concentrate for long
  • problems with school work
  • being easily upset
  • being mean to others
  • 'switching off', acting as if they haven't taken in what has happened
  • acting more like an adult
  • showing fears
  • anger or aggression to friends, parents or toys
  • temper tantrums
  • being unhappy and blaming themselves
  • tending to think the person who has gone is perfect
  • crying and giggling without obvious reason
  • not wanting to separate, clinginess, wanting to be near adults
  • running away, avoiding school, stealing.an extended period of depression in which the child loses interest in daily activities and events
*It is normal for children to display many of these signs following a loss, but if these signs persist, you may need to seek professional help.  

What is your typical approach to treating grief and loss? 

With a thorough assessment, we seek to understand the experiences your child had beginning intrauterine and throughout childhood.  This helps us understand how the brain developed and the level of coping skills your child has developed.  Our focus is on creating a therapeutic environment of trust and openness to change.  Dealing with grief and loss is very personal and requires a great deal of trust to engage in the healing process.  The assessment includes:

 

  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues

Then the best course of treatment is decided together with the caregivers.  Parents and caregivers play a crucial role in treatment because family plays a crucial role in restoring balance to a child's perceived sense of insecurity.  Coping skills and emotional attunement will be learned together with the parents and child, in order to assist in instilling coping skills with the affected child.  Treatment may include a combination of the following:

 

  • Theraplay® to promote attachment and balance with a new primary caregiver
  • Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore existing family dynamics 
  • Bibliotherapy to help normalize reactions to grief
  • Traditional "talk therapy" to create a therapeutic environment of safety and unconditional acceptance
Play is a child's language, and in a safe therapeutic environment children are able to heal at their own pace and process their unique experience with the help of the therapist. 
 
Click here for further resources


Sexual abuse

What is child sexual abuse?
Child sexual abuse is a form of child abuse that includes sexual activity with a minor. A child cannot consent to any form of sexual activity, period. When a perpetrator engages with a child this way, they are committing a crime that can have lasting effects on the victim for years. Child sexual abuse does not need to include physical contact between a perpetrator and a child. Some forms of child sexual abuse include:
  • Obscene phone calls, text messages, or digital interaction
  • Fondling
  • Exhibitionism, or exposing oneself to a minor
  • Masturbation in the presence of a minor or forcing the minor to masturbate
  • Intercourse
  • Sex of any kind with a minor, including vaginal, oral, or anal
  • Producing, owning, or sharing pornographic images or movies of children
  • Sex trafficking
  • Any other sexual conduct that is harmful to a child's mental, emotional, or physical welfare
Childhood sexual abuse is all too common. One in four girls and one in seven boys experience sexual abuse during childhood. Child sexual abuse crosses ethnic, racial, religious, and socioeconomic boundaries. It happens to children in every kind of family, neighborhood, and community. Many children keep sexual abuse a secret, sometimes until they become adults. Some children never tell, or do not tell right away. There are many reasons children do not tell about sexual abuse. Children may be afraid they will be blamed for the abuse, or that they will not be believed. Some children care about or have loving feelings for the abuser and do not want him or her to be punished even though they want the sexual abuse to stop. Other children have been threatened that something terrible will happen if they tell. It takes much courage to disclose sexual abuse. It may be frightening or difficult for many children when they begin to disclose the sexual abuse. Children may disclose only a little bit at a time, their stories may change, or they may take back ("recant") what they previously said happened during the abuse. Some children may even deny that the abuse has occurred at all. This is not unusual and may be confusing and frustrating for parents and caregivers. 

It is normal for parents and caregivers of children who disclose sexual abuse to feel very upset, angry, or guilty or even want not to believe that the abuse has happened. However, one of the best predictors that a sexually abused child will recover is the presence of a supportive parent or caregiver. There is hope for children who have experienced sexual abuse. With the right kind of help, children can recover completely and live normal and happy lives.

What is your typical approach to treating child sexual abuse? 
This is a very specific type of trauma and requires a very knowledgable and sensitive treatment approach at any age.  We begin with a very thorough assessment of current levels of functioning, symptoms, and family history.  The actual facts of the abuse are not disclosed immediately by the victim, as working towards this is part of the treatment process.  Many coping skills are learned before the abuse story is told in therapy. The ultimate goal is to help the victim turn their story into one of a survivor. Through the assessment, we seek to understand the experiences your child had beginning intrauterine and throughout childhood.  This helps us understand how the brain developed and the level of coping skills present. The assessment includes:
  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues

Then the best course of treatment is decided together with the caregivers.  Parents and caregivers play a crucial role in treatment because family plays a crucial role in restoring balance to a child's perceived sense of insecurity.  Coping skills and emotional attunement will be learned together with the parents and child, in order to assist in instilling coping skills with the affected child.  Treatment may include a combination of the following:

 

  • Theraplay® to restore healthy attachment to a caregiver 
  • Play Therapy, including sandtray, to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
  • Family therapy including play to explore and/or challenge existing family dynamics
  • Trauma Focused cognitive behavioral therapy, when appropriate due to high levels of safety and cognitive functioning
  • Traditional "talk therapy" to create a therapeutic environment of safety and unconditional acceptance
  • Psycho-educaiton with family to help learn normal reactions to trauma
  • Bibliotherapy to help normalize reactions to abuse 
Click here for further reading
Couples counseling (coming soon)
 

 
TREATMENT METHODS
 

Treatment methods are chosen based on individual needs, age of child(ren), and are assessed throughout therapy. Together we will discuss the type, length and intensity of treatment based on the child or teen's needs. Often times several methods are utilized throughout therapy. Here is a list of the treatment methods we utilize. Please click on the link for more information. 

  • Traditional talk therapy
  • Play Therapy
  • Theraplay®
  • Sandtray
  • Expressive arts
  • Filial therapy
  • Bibliotherapy
  • Cognitive behavioral therapy (CBT) and Trauma focused-Cognitive behavioral therapy (TFCBT)
  • Dialectical behavior therapy (DBT)
  • Solution focused therapy
  • Family therapy
  • Group therapy


Play Therapy
"Toys are the child's words and play is the child's language" 

 

 

Initially developed in the turn of the 20th century, today play therapy refers to a large number of treatment methods, all applying the therapeutic benefits of play. Play therapy differs from regular play in that the therapist helps children to address and resolve their own problems. Play therapy builds on the natural way that children learn about themselves and their relationships in the world around them (Axline, 1947; Carmichael, 2006; Landreth, 2002). Through play therapy, children learn to communicate with others, express feelings, modify behavior, develop problem-solving skills, and learn a variety of ways of relating to others. Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development.  

 


For Parents: About Play Therapy
This video was produced by The University of North Texas Center for Play Therapy for viewing by parents who may be interested in seeking play therapy services for their child.  We encourage parents to watch this short video prior to taking their child to play therapy. 
 


For children: About Play therapy
This video was made by the University of North Texas Center for Play Therapy for kids to watch prior to entering their first play therapy session. 
 

Theraplay is a child and family therapy for building and enhancing attachment, self-esteem, trust in others, and joyful engagement. It is based on the natural patterns of playful, healthy interaction between parent and child and is personal, physical, and fun. Theraplay interactions focus on four essential qualities found in parent-child relationships: Structure, Engagement, Nurture, and Challenge. Theraplay sessions create an active, emotional connection between the child and parent or caregiver, resulting in a changed view of the self as worthy and lovable and of relationships as positive and rewarding.
 
In treatment, the Theraplay therapist guides the parent and child through playful, fun games, developmentally challenging activities, and tender, nurturing activities. The very act of engaging each other in this way helps the parent regulate the child’s behavior and communicate love, joy, and safety to the child. It helps the child feel secure, cared for, connected and worthy.
 
We call this “building relationships from the inside out.”