Child, Adolescent, & Family Services
Mood and Anxiety Disorders
Depression & Mood Dysregulation
CBT/DBT Associates offers treatment for children and adolescents struggling with depression and other forms of mood dysregulation. Symptoms of youth depression include continuous feelings of sadness and hopelessness, feelings of worthlessness or guilt, social withdrawal, increased sensitivity to rejection, changes in appetite and/or sleep, difficulty with attention and concentration, physical complaints that don’t respond to medical treatment (stomach aches, headaches) and thoughts of death or suicide. Cognitive Behavioral Therapy (CBT) addresses this by educating children and adolescents about their feelings and about depression, teaching effective skills to help change distressing thoughts, reduce avoidance of pleasurable activities and engage in effective social problem solving.
Generalized Anxiety/Social Anxiety/Separation Anxiety
We also provide CBT for children and adolescents presenting with many different forms of anxiety disorders. Presenting concerns frequently include chronic worry, perfectionism, fears of failure and fears of embarrassment in social situations. We work with children who are engaging in avoidance behaviors related to going to bed and/or going to school, which often involve some form of separation anxiety. CBT for youth anxiety begins with educating children and adolescents about the nature of anxiety and giving the child or adolescent skills to change his/her anxious feelings, fearful thoughts, and avoidant behaviors. Typically, CBT with children and adolescent includes some form of homework exercises to help kids apply the skills learned in treatment to their lives, particularly at home and in school. Often in CBT, with the help of a therapist, children and adolescents learn to face situations they fear. It is important that the child or adolescent is motivated to maximize benefits of treatment and developing this motivation is an integral part of treatment.
Obsessive Compulsive Disorder (OCD)
CBT for children with OCD is based on a technique called exposure plus response prevention (ERP). The first step in treatment consists of developing a list of all of the child’s fears and rituals along with the situations in which these symptoms are most likely to be prompted. Following this, children are gradually exposed to these feared situations starting with the least anxiety-provoking situation and progressing to those that are more difficult. During these systematic exposures, youngsters are encouraged to resist their urges to engage in ritualized behavior in order to experience an initial increase in anxiety. When the feared consequence of not engaging in the compulsive behavior does not occur, the child learns that their fear is unlikely to occur and there is a resulting reduction in the intensity of the fear.
In addition to exposure with response prevention, children are assisted in modifying faulty assumptions and automatic thoughts associated with compulsive behavior. A behavioral reward program, in which children are systematically rewarded for completing in-session tasks and homework assignments, is also used to enhance compliance with treatment requirements. This reward program is especially important for younger children who are less able to balance the future benefits of OCD treatment against the increased initial anxiety associated with exposure treatment.
We offer short term, exposure-based treatment to help children and adolescents overcome fears that are currently interfering with social and academic functioning and/or daily living. Presenting phobias include but are not limited to fear of elevators, animals/insects, needles, heights, darkness, loud noises, vomiting, and flying.
Helping children and families adjust and adhere to prescribed medical treatments and self-care routines via behaviorally oriented individual and family therapy. We offer short term interventions focused on teaching and strengthening skills for coping with stress, anxiety or pain associated with medical conditions and procedures, as well as identifying and overcoming barriers to adherence with health care regimens. Presenting concerns frequently include medication adherence, pill-swallowing, receiving injections and blood draws, bowel and bladder management, restricted diet, pain management, and adherence with exercise programs.