Child & Adolescent Therapy
Creative methods of therapy are adapted to each child’s or family’s developmental level.
When working with young children, we believe that talk therapy can be over-emphasized and limiting.
We integrate expressive therapies such as art and sandplay in order to allow children ample strategies for communication, self-healing, and insight.
Therapy for kids and teens often looks different than it does for adults.
Especially for young children, talk therapy alone can be limiting. Therefore other methods such as play and art therapy or mindfulness techniques are used to help kids and teens increase self awareness, self control, empathy, and attentiveness.
These creative methods of therapy are adapted to each child’s or family’s developmental level. It can help children communicate emotions and thoughts in ways they cannot put into words directly.
Play therapy can make internal conflicts or negative thought patterns apparent and addressable.
Concerns Include:
School Problems
Family Problems
Behavioral Problems
Disruptive Behavior Disorders
Addressing difficult feelings
ADHD
Depression
Anxiety
OCD
Eating disorders
Trauma
Therapy can help…
Social Skills
Emotional Resilience
Self-Awareness
Physical Development
Self-Regulation
Self-Esteem
Academic Skills
Logical Reasoning
Concentration/Focus
Language/Literature Comprehension
Creativity
Anxiety
Depression
Distraction
Fixation on Negative Emotions
Behavioral Concerns
Impulsivity
ADHD
PTSD
Volatile Reactions
Stress
Social Conflict
Mindfulness
Paying full attention and being intimately aware of the present moment.
The premise sounds simple, but it is something that requires practice and application. It has been a part of human societies for thousands of years, as a part of meditation, yoga, and martial arts. There are many types of mindfulness, and it may look a little different for everyone. Practices include:
Attention to the present
Focusing on breathing and passing thoughts/feelings.
By consistently focusing on your breathing, the mind often tries to wander. By paying attention to the present you can draw your attention back to your breath while letting thoughts pass by observed, but not engaged. This increases focus and concentration, while decreasing anxiety and invasive thoughts.
Guided imagery
Creating and/or following a narrative often described by an external source (therapist, teacher, Youtube videos, etc.) which enhances concentration on details to promote relaxation.
Fully engaging in a mental scenario (like a walk through a quiet forest or on a beach) and creating/focusing on specific details helps to decrease stress and anxiety, improve sleep, increase relaxation.
It often uses all five senses to “build images in the mind that your body feels are as real as external events.”
Body Scan/Progressive Relaxation
Shifting focus to each part of the body to observe
the sensations present.
Body scans helps to recognize pain or discomfort and assists with pain management. It also increases the mind-body connection by practicing being actively aware of physical sensations that often are dismissed or ignored in daily functioning.
Progressive relaxation allows you to acknowledge where pain and discomfort are felt and to consciously relax/release tension in those areas.
Ex. Anxiety and stress often cause tension and pain in the neck, shoulders, and upper back. By noticing this tension and practicing releasing it when it is noticed can help manage anxiety and stress symptoms when they occur.
And many more
Academic performance
Adaptability
Creativity
Focus/concentration
Immune system
Pain management
Patience
Relaxation
Social skills
Stress management
Time management
Anxiety
Blood pressure
Chronic pain
Depression
Distraction
Fixation on negative emotions
Impulsivity
PTSD
Volatile reactions
Imaginative Play
What is Imaginative Play?
In short, imaginative play is role play.
It is open-ended make believe that allows children to act out scenarios, real or imagined. This kind of play is most common in children ages 2-6 and is highly beneficial in development.
Imaginative play teaches expression of both positive and negative feelings, helps children discover how to make choices (and the associated consequences), and experience the outcomes of multiple choices in a safe environment.
It encourages intrinsic motivation and active engagement, as well as encouraging children to tune in to multiple perspectives and recognize others’ ideas and emotions.
Imaginative play can be a solo or group activity. When playing with others, the child builds skills regarding communication and expectations:
– If the child wants someone to pick up a pretend phone call, they learn they need to explain this to the other person – “Ring, ring! It’s for you!”
– If the child wants to change situations, they have to communicate their idea to the other person too – “You’re a doggy now! Let’s go on a walk!”
By creating and designing their own make believe worlds, children develop social skills, implicate rules,
and interact with multiple perspectives, goals, and feelings.
Imaginative play can help:
Build social skills and increase social-emotional resilience
Develop bonds between parent and child
Develop communication and language skills
Balance emotions of the self with emotions of others
– Increase sharing and negotiation skills
– Increase respect of/toward others
– Increase self-regulation skills
Improve stress management
Lower anxiety/anxiety symptoms
Improve academic skills, including:
– Concentration and focus
– Logical reasoning
– Language/literature understanding
Decrease disruptive behaviors
Foster creativity
Improve physical development such as:
– Hand-eye coordination
– Fine motor skills
CBT
CBT allows for self-reflection and self-correction.
Cognitive Behavioral Therapy (CBT) has been shown to be an effective method for improving mental health and quality of life for concerns ranging from generalized anxiety to depression to eating disorders and more serious concerns.
Unlike other forms of therapy, CBT focuses on the “right now,” rather than deep-diving into the cause of the problem.
It helps clients to recognize their own unproductive thoughts and behaviors in the moment and provides methods to change them.
Core Principles
Psychological problems are, at least in part, due to:
Unhelpful ways of thinking
Unhelpful learned behaviors
Core Goals
Decrease and manage symptoms of presenting concern
Decrease and replace unhelpful ways of thinking
Decrease and replace unhelpful behaviors
Develop effective coping methods
Resolve relationship conflicts
Cope with grief/loss
And more…
Common Strategies
Learn to recognize perception distortions, and reevaluate in the context of reality
Understand behaviors and motivations of others
Develop confidence in self
Adapt problem-solving skills to difficult situations
Face fears
Utilize role playing to prepare for upcoming situations
Use techniques to calm mind and body
CBT has been supported in both psychological research and clinical practice, and has been found to be as or more helpful than comparable techniques and medications.
CBT+ : Cognitive Behavioral Therapy Plus
Cognitive Behavioral Therapy Plus (CBT+) is an integration of multiple therapeutic techniques, specifically:
Cognitive Behavioral Therapy (CBT)
Acceptance and Commitment Therapy (ACT)
Compassion Focused Therapy (CFT)
Dialectical Behavior Therapy (DBT)
All of these therapies are evidence-based and emphasize approaching problems from different perspectives.
CBT+ allows for a broader view of the presenting concern, and incorporates real-world problems into the framework.
For example, CBT+ integrates concerns such as poverty, racism, and marginalization into the approach to treatment.
CBT+ also adds a stronger emphasis to relationships and dives further into the history of the client.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
An evidence-based, modified form of CBT
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based, modified form of CBT which is specifically designed to help children and their parents overcome the negative and often devastating effects of trauma, especially PTSD symptoms.
Taking a trauma-informed approach to child and adolescent therapy incorporates both the child and the parents.
Parents learn optimal ways to support their child and help them overcome the effects of trauma. This includes effective parenting skills associated with handling behaviors that accompany trauma. It can also help parents learn how to handle the emotional distress.
Children learn skills to help cope with and overcome trauma, including relaxation and self-regulation. Therapy also helps children create their own trauma narrative to be able to tell their own story. TF-CBT is adjusted to match the child’s developmental stage.
Improvements developed by TF-CBT have been shown to be long term – parental emotional distress, child’s anxiety, and related symptoms still showed improvement 1 and 2 years after completing therapy.
Trauma may be caused by:
Sexual or physical abuse
Traumatic loss of a loved one
Exposure to violence – domestic, school, community
Exposure to disaster – weather, terrorist attacks, war
Serious accidents
Serious medical procedures, operations, or hospitalizations
And more…
TF-CBT can help develop skills such as:
Stress management
Affect regulation
Problem solving
Safety
Communication
Self-esteem empowerment
Interpersonal trust
TF-CBT can address concerns including:
PTSD
Depressive symptoms
Behavioral concerns
Cognitive distortions
Guilt
Shame
Interpersonal conflict
Internalization of feelings
TF-CBT can be helpful for kids ages 3-18 and their families. This approach can also be used to help couples and individuals overcome trauma. TF-CBT is tailored to each child and family to be developmentally appropriate and conducive to each situation.
TF-CBT approach has three core stages of therapy, Stabilization, Trauma Narrative, and Integration/Consolidation. Each of these stages are broken down into individual steps. The acronym of these steps is PRACTICE.
Stabilization
P – Psycho-Education and Parenting Skills
The therapist helps the family learn about trauma, PTSD, common behavioral concerns associated with trauma, and validation of feelings.
R – Relaxation Skills
Learning relaxation skills helps reverse physiological effects caused by trauma, and includes a variety of techniques such as mindfulness, progressive muscle relaxation, and focused breathing.
A – Affective Regulation Skills
Affective regulation skills help each member of the family to recognize upsetting states and learn to manage their feelings. This includes developing problem-solving, anger management, and positive distraction skills. It’s also a time for the family to build trust and work toward emotional safety.
C – Cognitive Processing Skills
Cognitive processing skills help each individual connect thoughts, feelings, and behaviors and replace unhelpful thoughts and behaviors with beneficial ones (as in CBT). Cognitive processing poses two key questions: Is it accurate? Is it helpful?
This process allows each participant to create a “window of tolerance” for communicating about trauma. Once both feeling and thinking are within a tolerable range and the family members are present and trying, then trauma can begin to be processed.
Trauma Narrative
T – Trauma Narration and Processing
Creating a trauma narrative is a key component to processing a traumatic event, and it includes the telling
of the individual’s story
the who, what, when, where and associated emotions with each component. Creating a comprehensive narrative is often difficult and deeply emotional, but is a core step in understanding where you have been and how to move forward. Once the trauma narrative is complete, each person can contribute their narrative and begin to understand how the trauma impacts their shared experience.
Integration and Consolidation
I – In Vivo Mastery of Trauma Reminders
In life trauma reminders often cause psychological and/or physiological responses. This step helps to recognize the stimuli that cause the trauma response, and learn how to overcome avoiding these reminders and cope with them as they emerge.
C – Conjoint Child-Caregiver Sessions
Sessions with the family help to develop communication about the trauma and moving forward. This step is a time to address topics such as safety plans and trauma responses.
E – Enhancing Safety
The final step is to apply the processing and coping skills and positive insights to current life and your life moving forward. It helps create a comprehensive toolbox of strategies and reminders to handle trauma, stress, and conflict moving forward including co-regulation of emotions and strategies for finding solutions based in emotional support and understanding.
Co-Parenting
Co-parent therapy is designed to help divorced or separated parents work together
It is well documented that the most harm to children during and after a divorce is
how parents handle themselves and their interactions with each other, not the divorce itself.
Co-parent therapy is designed to help divorced or separated parents work together to best meet the needs of the child(ren).
Even when the parents aren’t together, kids still need love and support – this can become interrupted by emotions from the breakup and divorce process.
The relationship between co-parents can have a strong impact on the emotional and mental development and wellbeing of the children. Co-parenting therapy helps parents learn how to develop a new cordial, working relationship to best support the kids.
It helps both parents have an active role in child rearing, problem-solving, and decision-making, and can help eliminate dysfunctional, emotionally-charged interactions.
Co-Parenting therapy helps teach both parents how to:
Cooperate:
Exchange information about the child(ren), support and respect the other as a parent, and divide the labor of childrearing.
Minimize conflict:
Limit undermining, criticism, and blame toward the other parent, as well as minimizing arguments/fights about childrearing.
Triangulate:
Develop the child(ren)’s relationship with each parent individually, while avoiding their involvement in parental conflicts.
This includes avoiding:
– Using the child(ren) as messengers to the other parent.
– Venting to the child(ren) about the other parent.
– Making the child(ren) feel like they have to choose between parents.
Communicate with a child-centered approach:
Separate the anger, resentment, and hurt from the relationship with the other parent in order to prioritize the child(ren).
Treat co-parenting as a business-like partnership.
This allows conversations to be focused on what’s important whether in-person, on the phone, or through email/text.
Keep all conversations focused on the child(ren)’s needs, not yours or your ex-partner’s.
Make requests of the other parent, not demands.
Listen to the other parent. Listening is especially important in co-parenting in order to minimize conflict and prioritize the child(ren)’s wellbeing.
Documented Benefits of Co-Parenting for Children
Children of all ages with parents who have adopted co-parenting practices have been shown to have:
Significant improvements in:
Internalization of symptoms – Ex. Being withdrawn, nervous, or irritable, feeling lonely, sad, unwanted, or unloved, etc.
Externalization of symptoms – Ex. Acting out, lying, breaking rules/laws, showing disregard for others, defiance, and/or vindictiveness, etc.
Social functioning skills
Attachment
Improvement in mental and emotional health
Knowledge that they (the children) are more important than the conflict that ended the marriage
Feelings of security
Consistency between households leading to better adjustment
Improved development of problem-solving and
communication skills
Toddlers with co-parenting parents show increased compliance and decreased aggression compared to those who do not.
Low parental cooperation has been linked with passivity, problems with attention, and lower math grades of 3rd grade students.
Additionally, it has been shown to negatively impact the child’s relationship to each of their parents,
and increase negative behavior toward each parent.
It also may be a factor in antisocial behavior in children.
Please note that co-parenting therapy is relational and therefore will not be covered by insurance.
For cash pay rates, please call the office.
Eating Pschology
An exciting and cutting edge approach developed by the Institute for the Psychology of Eating.
Oftentimes, our eating challenges are connected to work, money, relationships, family, intimacy, life stress, and so much more.
It effectively addresses concerns including:
Weight concerns
Binge eating
Emotional eating
Overeating
Body image challenges
Various nutrition related health concerns
According to the Institute for the Psychology of Eating – In America:
- Nearly 70% of adults are classified as overweight or obese
- ~90% of women are unhappy with their appearance
- 81% of 10 year old girls experience a fear of being fat
- 97% of women confess they have at least one “I hate my body moment” each day
- ~75% of all diseases could be prevented with better nutrition
- ~108 million individuals are on a diet
99% of those who diet gain back the weight they lose within a year
Within a decade, 67% of the population is projected to have some form of diabetes
Eating Psychology coaches are able to support you with both strategies and nutrition principles.
For eating psychology articles, look here.
The strategies provided are doable, sustainable, and nourishing and, most importantly, yield results.
DBT: Dialectical Behavior Therapy
What is DBT?
Dialectical Behavior Therapy is a type of talk-therapy and a modified form of cognitive-behavioral therapy.
It was developed by Marsha Linehan in the 1980s and has since been used to address a number of mental health concerns. The overall purpose of DBT is to “learn how to change your own behaviors, emotions, and thoughts that are linked to problems in living and are causing misery and distress,” (Linehan 2015).
This includes:
1. Developing and enhancing emotional and behavioral capabilities.
2. Increasing motivation by reframing inhibitions and reinforcing contingencies.
3. Assuring that new skills are able to be applied to “real-life.”
What does “Dialectical” mean?
Dialectical, as related to DBT, means “two opposite ideas can be true at the same time, and when considered together, can create a new truth and a new way of viewing the situation. There is always more than one way to think about a situation.” DBT encourages a shift from “either/or” thinking to “both/and” thinking. For example, “this is really hard for me, and I’m going to keep trying.” (Rathus 2015).
Who does DBT help?
Intense emotions
Impulsivity
Self-harm
Strong reactions during communication
Feelings of worthlessness
Unhealthy relationships
Borderline Personality Disorder (BPD)
Depression
Anxiety
Anger
PTSD
Eating Disorders
This kind of therapy focuses on adjusting client behaviors to increase quality-of-life. DBT also emphasizes strategies for communication, commitment, and structure.
Who doesn’t DBT help?
DBT is not designed for those with:
Narcissistic Personality Disorder | Active psychosis | Schizophrenia | Violent history | Anti-Social Personality Disorder | Autism Spectrum Disorder, levels 2 and 3
Pride Program
Focused on providing a safe and therapeutic environment
Our Pride Program is focused on providing a safe and therapeutic environment to help foster resilience and compassion with members of the LGBTQ+ community and family members. Therapists are trained in working with individuals, families, and couples in this community from a systemic perspective.
ITS’ Pride Program specializes in working with individuals, couples, and families who are seeking support with:
Transcare
Dysphoria
Coming Out
Relationship Issues
Anxiety
Depression
Trauma
Life Transitions and Stress
Grief or Loss
Parenting
Alternating Groups (ask for more information)
And more…
For some people medical transitions can be a component of mental health care. We take care in providing longer term treatment and coordination with other medical professionals on an as needed basis to reduce gate keeping as much as possible.
It is a sad truth that members of this community experience higher rates of depression, anxiety, suicide, substance use, and trauma. It is our mission to create a space of compassion and safety while working through whatever concerns people bring.
For more information, please call the office.
*This content is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional healthcare services including the giving of medical/ psychological advice. No provider-patient relationship is formed. The use of this information and the materials linked to this website is provided at the users own risk. The content is not intended to be a substitution for individual medical or psychological advice, diagnosis or treatment. Users should not delay obtaining medical/psychological advice regarding any condition they have and should seek the assistance of their medical provider.