This morning in my mailbox I found a new edition of a book I had co-edited in 1993. It’s called DEPRESSION IN CHILDREN AND ADOLESCENTS , published by Routledge Library Editions. My first thought was “How did I do this when my son was born in 1992?” I’ve either gotten lazier, older (no chance) or possibly more mindful.
It’s called “Depression in Children and Adolescents” and it is co-edited with Harold Koplewicz who, by the way, has NOT gotten older or lazier! (see his C.V.). The contributors to the volume, which was written with pediatric colleagues in mind, are among the most esteemed in the field and some are even good friends and some have left a wonderful legacy in the next generation of child-centered mental health professionals.
It was fortuitous because my first patient of the morning is a boy with diagnosed depression. I am aware that I want him to be happier and I turned first to the treatment chapter which I co- (I think I see a pattern here) wrote with the extremely busy Richard Gallagher, (see HIS C.V.).
The chapter outlines how children with depression often look, theories about why it comes to be and treatment suggestions. It’s based on the research of the time and I only saw one typo. (in MY chapter!).
I wish that treatment studies had made for tremendous strides in this field and that it was crystal clear how to set about treatment, through both the body and mind.
There are new, well-researched forms of psychotherapeutic interventions:
ACT – an acronym for Acceptance and Commitment Therapy is the “third-wave” of cognitive-behavioral therapy along with DBT – Dialectical Behavior Therapy.
A basic assumption of ACT is that sadness and pain are a normal and unavoidable part of human experience. Some of our attempts at handling these feelings are more workable than others. Avoidance or short-term means of coping might actually end up causing even more suffering in the long term.
There are differences with techniques in ACT and our group of psychologists at The Psychological Health Collaborative is studying hard and it seems like a natural fit to us. Check in with us for readings and to discuss.
Looking forward to the next 20 years of developing the understanding of children’s health.
Teachers, peer pressure, mountains of homework, confusing schedules, bullying – whether you’re in your first year of middle school or your last, the list of challenges goes on and on! For many pre-teens, middle school can come with accompanying social anxiety, which is most likely to emerge in late childhood or early adolescence (Beesdo, Dipl-Psych, & Pine, 2009).
The primary feature of social anxiety disorder is the fear of doing something embarrassing in front of others, or something that will result in negative judgment from others (Albano & DiBartolo, 2007). Other notable symptoms of the disorder include avoiding social situations, and anxiety interfering in everyday life. Put simply, social anxiety occurs when kids learn to feel anxious in and avoid social situations often, and it gets in the way of doing things that are important to them.
According to the National Comorbidity Survey performed by the National Institute of Health (2011), 12% of adolescents in the United States meet criteria for social anxiety. Many more children and adolescents are considered subthreshold, which means they experience some but not all of the symptoms required for the diagnosis.
The good news is that social anxiety can be un-learned through cognitive behavioral therapy (CBT)! Research has shown that children and teenagers who engage in these strategies through individual or group CBT significantly improve (Spence et al., 2000; Herbert et al., 2009; Garcia-Lopez et al., 2012).
Because of PHC’s commitment to both collaborative care and evidence-based treatment, one study in particular has inspired our social anxiety treatment program – that of Australian researchers Spence, Donovan, and Brechman-Toussaint (2000). These researchers built upon existing social anxiety treatment studies by adding a “parent involvement” condition. In this treatment condition, parents were taught to reinforce coping skills, encourage social participation, and model socially proactive behavior. Meanwhile, their children met with another group leader and engaged in social skills training, relaxation techniques, social problem-solving, positive self-talk, and gradual exposure to social situations. At the end of treatment, this group of children were less likely than children in the non-parent CBT group or waitlist group to meet criteria for a social anxiety diagnosis. Furthermore, treatment gains were maintained one year after the group ended.
At PHC, we are incorporating parent involvement into our social anxiety and social skills groups. Facing social anxiety takes practice and support, and we feel the parent-therapist collaboration is key for success. If you think your child could benefit from therapy for social anxiety, don’t hesitate to give us a call.
We were so happy to recently host the first of a series of Mindful Nutrition workshops led by Dr. Jill Silverman. This week Dr. Jill led an important discussion covering topics of serving sizes, smart grocery shopping and the importance of whole foods. She shared some of her favorite brands with us and even brought in samples for us to try. Dr. Jill gave us pointers on how to be a more knowledgeable consumer when shopping and reading nutrition facts on food labels.
“In this fast paced world of smart phones, deadlines and countless responsibilities, many of us are eating on the run – or eating mindlessly” remarked Dr. Jill on the auto-pilot eating methods to which many of us have become accustomed. Dr. Jill explained that eating is a sensory process that requires our full engagement and attention. We can cultivate better awareness of this process by eating mindfully and really noticing how our food looks, feels, smells, and – of course – how it tastes. Dr. Jill introduced some small steps we can take to become more present with this process and have more mindful eating experiences.
Contact us to find out more about upcoming events with Dr. Jill or to meet with one of our clinicians who provide mindfulness training.
Scientific research supports the use of “bibliotherapy” and emotionally, we know, that books can decrease our distress. (I think I read Little Women 100 times in the 5th grade). So, our wise minds lead us to know that introducing stories to our children when they need a bit of help is valuable. A priceless new book called Some Bunny To Talk To by Cheryl Sterling, (our own) Paola Conte, and Larissa Labay. It is a story about going to therapy. The back note reads:
Little Bunny has a problem and he doesn’t know how to solve it. Sometimes things in a little bunny’s life can feel so hard. So Big Bunny has an idea. “I have an idea. I’d like you to talk to Some Bunny. Some Bunny is a therapist”…
Published by Magination Press of the American Psychological Association, Some Bunny To Talk To helps to answer the question asked by so many of us parents of how to describe therapy to our 4-8 year old children. Take a peek at it if you can, and here is a link to other “bibliotherapeutic” books.
“I’m so stressed!” “How will I ever make it through the application process?” “I’m completely overwhelmed!” “What if I don’t get in anywhere?” “I wish people would stop asking about college!”
These are just a handful of comments we have been hearing from many seniors in high school lately. College applications often feel like the biggest mountain that you’ve ever had to climb. From visiting and selecting schools, to taking standardized tests, to determining financial feasibility, to completing endless forms (including everyone’s favorite: the personal essay) – the tasks pile up higher and higher. All in addition to the regular stress of being a high school student.
When stress levels are high, our natural instinct is to avoid the cause of stress. This instinct has kept humans alive on this planet for hundreds of thousands of years. But while it has proved helpful in avoiding say saber-toothed tigers, it’s not so helpful when it leads to procrastination or feeling trapped by anxiety.
During these moments, try to remember that the stress you feel is an indication of how much you care about your future. Why else would you be putting yourself through all of this?! Think about what college represents for you as you move through your path in life. The application process is one of many mountains on the journey you are taking. Keep in mind the ultimate destination – independence, education, career satisfaction, or whatever you are seeking – as you create a meaningful life for yourself.
And if you find yourself stuck on your path, try taking the tiniest step you can think of: just pulling out the stack of applications, or reviewing 1 SAT question. Then pat yourself on the back for making progress up that mountain. We all get stuck sometimes and it’s often helpful to get feedback from someone at a distance who might be able to see your climb from a different angle. All of us here at PHC are standing by to offer that support.
We are excited to begin The Psychological Health Collaborative (PHC) blog series with a simple introduction to who we are, what we do and why we do it.
Several years ago, three seasoned psychologists had a dream of creating a group practice that not only would allow them to collaborate with each other but also with other expert professionals in fields closely related to psychology. Each having worked in medical centers at various points in our careers, all three of us value the opportunity to work directly with others who can help our patients achieve better mental and physical health. Additionally, because all three of us work with children and their families, we well know the value of collaborating with anyone who impacts the family system and the individuals within it. Communication is key in collaboration. Thus, we began our quest to create a practice that would allow skilled, science-based professionals of different disciplines, under one roof, to help children, adolescents and adults who struggle with psychological issues.
We value empirically based treatments (i.e., therapies that are supported by scientific data) and know from our years of experience that when flexibly applied to psychological issues, these approaches work! Whether our patients are attempting to better deal with issues related to chronic pain, OCD, socialization or learning differences, we want to offer them state of the art help. We and our team of collaborators strive to stay abreast of current treatment recommendations and enjoy attending trainings and workshops to sharpen our skills.
Our current team includes the primary partners (Drs. Conte, Klass and Velting) as well as a psychoeducational specialist, a nutritionist, a college coach/organizational consultant, an ABA specialist, and an integrative educational/mindfulness specialist. We also are fortunate to have three psychologists (Drs. D’Accordo, Perret and Shockey) working with us whom hold permits to practice psychology but are still working towards their required licensure hours in New York state. We hand-picked these psychologists because of their dedication to empirically validated, collaborative approaches to treatment, and we individually supervise them to help fine-tune their already superb therapy and assessment skills. Including our permit holder psychologists in our practice allows us to help those people we can’t see ourselves because we are already filled to capacity, as well as to help those who cannot afford the full fee. We are very proud of our group and the work we do. Please feel free to contact us with any questions through our website link or even by phone! We also have an amazing assistant who will guide you through the process of choosing a therapist in our practice or help you find an appropriate outside referral.
We look forward to writing future blogs that will inform you of our work and also others’ work that may help you in your own quest for mental and physical wellness! Check back here regularly or like us on Facebook to receive notices when we post new blogs.