Specializing in Anxiety, Autism, and Parent Training
Anxiety is a normal human experience. Children and adolescents experience different forms of anxiety that range from excessive worry, significant fear of negative evaluation, and specific phobias. I use an integration of cognitive-behavioral therapy (CBT) and exposure therapy to target anxiety related disorders. Cognitive behavioral therapy emphasizes how the thoughts, physical sensations, and behaviors are related in the maintenance of anxiety-related problems. CBT helps clients identify their unhelpful patterns of thinking that maintains anxiety and teaches them tools that clients can use to challenge their thoughts and respond in a more effective manner. Exposure therapy involves facing one’s fears in a gradual manner until they are experienced as less anxiety provoking and are more tolerable. Theoretical foundation of exposure therapy indicate that in order to decrease our anxieties, we often have to face anxiety provoking situations that help us learn that we are safe.
Obsessive- Compulsive Disorder (OCD) Treatment
Children and adolescents with OCD experience intrusive thoughts or obsessions and engage in ritualized behaviors. Exposure and response prevention (ERP) is a specific kind of exposure therapy that is used to treat obsessive-compulsive disorder (OCD). In ERP, clients not only face their fears, but they also learn to prevent the usual OCD rituals and compulsions that maintain OCD.
School Refusal and Avoidance Treatment
Several children and adolescents experience difficulty in attending school on a regular basis due to their anxiety related concerns. Functional behavior assessments are used to assess factors contributing to school refusal and avoidance. An integration of cognitive behavioral therapy and exposure therapy is used with children and adolescents to help decrease their anxieties in response to attending school. Additionally, a behavioral approach is used to provide parent training and collaboration with school systems is provided to help support the "whole" client.
Parent Training for Children with Anxiety
Recent research has indicated interpersonal nature of anxiety that highlights how accommodations made by parents result in maintained anxiety symptoms of their children and adolescents. Additionally, several parents of children with anxiety disorders often feel that their own personal boundaries have been encroached due to their child's anxiety symptoms. Parent training for children with anxiety disorders focuses on teaching parents how to change their own behavior so that they can avoid escalation of their children's behaviors and thereby decrease their children's anxieties. Evidence-based treatment, Supportive Parenting for Anxious Childhood Emotions (SPACE) is provided to parents of children with anxiety disorders.
Parent Training for Challenging Behaviors
Sometimes kids have big feelings and they struggle to regulate their emotions and behaviors and demonstrate behaviors that are non-compliant and disruptive. Caregivers often find themselves using strategies that are either reliant on punishment or they unknowingly reinforce children's problem behaviors. Decades of research has indicated that focusing on positive reinforcement strategies not only decrease challenging behaviors but also empower caregivers in their ability to parent their children. Evidence-based treatments such as Incredible Years and Helping the Noncompliant Child are used in parent training for challenging behaviors.
Additionally, children with autism spectrum disorders and co-occurring challenging behaviors sometimes show a combination of non-compliant behaviors and lags in adaptive skills (e.g., delayed toilet training, sleep difficulties). Evidence-based treatment such as Research Units in Behavioral Intervention (RUBI) and components of Applied Behavior Analysis is used with families of children with autism and challenging behaviors.
Evaluation & Assessment
Evaluations may include diagnosis and/or diagnostic clarification and update, assessment of specific skills and skill areas, identification of functional levels, and more. Evaluation goals include answering questions brought by families, and identifying each child’s individual profile of strengths and challenges. Specific recommendations for how to use the information obtained through the evaluation is provided. Assessment information provided may also be used for application to private schools and to specialized programs within public schools (such as Highly Capable and other “Gifted and Talented” programs), and accommodations for standardized testing.