Our childhood is the crucial time where we develop positive relationships with parents, siblings, family and friends; develop our creativity, wonder and imagination; learn the beginnings of how to regulate our emotions; develop our sense of self and autonomy; and learn how to conform with rules in society. It is also the time that our inherent temperament is molded by skillful parenting and life experiences into the precursors of adult ‘personality’. Children are often brought to therapy because of:
- o ADHD – impulsivity, hyperactivity and inattention at home and at school
- o Poor conformity to rules; demanding behaviors in public.
- o School reluctance and refusal.
- o Hitting, biting and other aggressive behaviors; extreme anger and rage; Lying and manipulative behaviors.
- o Moodiness; anxiety-like symptoms; (shyness, separation anxiety, phobias).
- o Sleep problems; nightmares; bed wetting.
- o Difficulties with changes in schedule.
- o Eating problems; unhealthy eating and body weight issues.
- o Intellectual and other developmental difficulties.
- o Acting out in response to family relocation, conflicts, separation, divorce, adoption and family blending; illness and loss.
- o The impact of medical issues.
- o Trauma responses related to accidents, injury or a death in the family.
Although it is critical we address and resolve children’s issues quickly, I also use problems and challenges as learning and developmental opportunities to build kids’ resiliency, as well as develop, personality, coping and behavioral skills for the future. My goal is to expand skills that are global and applicable to other situations throughout life. Also, because kids’ therapy sessions are short (50 min) compared to the time parents spend with their children, my therapeutic approach emphasizes the transfer of therapeutic techniques to outside settings. This generally speeds up the therapeutic response, applies skills to the situations where problems occur and builds generalized applicability under parental control.
Play and Games Approaches
Because the ‘language’ of children involves play, I utilize games, construction and creativity toys, role-playing, puppets, drawing and story-telling as enjoyable links between kids’ problems, emotions, reactions and solutions. (My favorite reaction of kids to play sessions is: “This is your job? Wow!”). A goal is to help kids link their instinctive emotional response to what has happened, and then develop healthy ways of responding that they can utilize in other situations to increase long-term adaptabilities.
ADHD is one of the most common childhood diagnoses, but also one of the most misappropriated. More often than not, children become pathologized and over-medicated. My goal therapeutically is to identify the drives for impulsive, inattentive and hyperactive behaviors, reduce their impact, and develop healthy responses. An effective approach involves reorganizing home timetables, developing reward-consequences, limit-setting and adapting parental styles.
Children clearly experience depression and anxiety but manifest symptoms through dysfunctional behaviors and disturbances in personality development. The key here is to identify the presence of mood disorders, identify their causes, facilitate healthy expression and resolution, and remove the primary causative factors.
When kids show dysfunctional behaviors, such as disturbances in sleep, anger and aggression, or social withdrawal and shyness, it is often because of environmental factors such as stress at school (bullies, educational difficulties) or family disruptions. Through careful assessment I will help identify these issues and work to resolve them.
Rule-following and Discipline Issues
I find the key here is to establish and model rules in therapy, explain to kids that our ‘games’ extend to home and school, and then monitor their implementation in home and school settings. I will help you develop timetables, discipline strategies as well as reward protocols. The goal is to lessen the need for excessive instructions, rules, orders and punitive consequences, and expand enjoyable positive reinforcements and rewards to facilitate positive behaviors and emotional connection amongst family members.