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Services and Specialties - Children / Teens

To quickly access the description of the Services and Specialties offered, please click on an item in the following list


INDIVIDUAL, MARITAL, AND FAMILY THERAPY

Families:
Years ago I used to push to have everyone in the family come if a child/teen was the focus of concern. Then I became a parent myself. I'm more pragmatic now. Sometimes I still like to meet everyone, but I often work with subsets of the family.

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Couples:
When working with a couple, regardless of gender/sexual orientation, I strongly prefer to have both come to the first session. This reduces the risk of my being perceived as already having taken ďsidesĒ when I meet the personís partner/spouse. I find it counterproductive to assign percentages of blame. Iíd rather focus on what each person can do to foster change.

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Individuals:
My clients come with challenges facing them at home, in the work place, with relatives or friends. Frequently, critical self-talk in their own heads negatively impacts their self-worth, self-esteem, self-confidence, etc. Sometimes an issue is a new one, sometimes it has been present for many, many years. My objective is to help them find solutions that allow them to feel and function better.

At the outset of therapy, I will ask you to:

  • give yourself permission to still be a work in progress.
  • give yourself permission not to already know what you havenít yet learned.

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PSYCHOLOGICAL TESTING

For many years now, most insurance companies have NOT covered "psychological testing" when it includes the kinds of instruments that are used to assess for problems with learning.

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ADHD EVALUATION AND THERAPY

What is ADHD?
Letís start with two definitions to clear up the problem with the acronyms. ADD and ADHD essentially refer to the same condition in different versions of the Diagnostic and Statistical Manual (DSM), a diagnostic dictionary that lists all mental health diagnoses.

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Symptoms
Both of the subtypes in the DSM-IV are defined by nine behaviors with a minimum of six being required to make the diagnosis. As can be seen from the symptom lists that follow, the language remains heavily skewed towards children/teens.

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What else can cause behaviors that mimic ADHD?
Many other conditions and factors present with similar symptoms, so the diagnosis is best made by both inclusion and exclusion. Some of other possibilities include the following:

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What are the components of an ADHD evaluation?
For children and teens:

A careful evaluation includes taking a careful family history, gathering impressions from parents and teacher(s) about the child's behavior in different settings (often using rating scales), reviewing report cards and achievement test scores (preferably over a period of several years), and conducting IQ/achievement testing.

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How is ADHD treated?
For a number of years now the research has been quite convincing that the best treatment strategy for most people who are diagnosed with ADHD includes a mixture of both cognitive/behavior management strategies and medication.

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What is ADHD (in plain English)?
The research points to ADHD being a genetic condition that effects how the brain works. It is not the result of "bad parenting" (though parenting a child with ADHD can be a real challenge at times!) Unlike some conditions like diabetes, there is no such thing as "adult onset ADHD." By definition, the symptoms are evident early in childhood.

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Resources:
The last two decades have seen a wonderful emergence of a wide variety of resources for children and adults. These include books, newsletters, on-line chat rooms, websites, support groups, etc. See Resources.

Some of my favorite strategies for managing ADHD symptoms:
The following list includes some of my favorite strategies for dealing with the kinds of problems that ADHD can cause. While written for teenagers and adults, parents of younger children can modify many of the suggestions for that age.

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THE EVALUATION OF LEARNING DISABILITIES

Before we begin:

When considering having me perform a psychological/educational evaluation for your son or daughter, please remember that the public school system provides psychological services which include testing for learning problems

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What else might explain my child's academic problems?
Academic problems sometimes have their roots in other areas. These include a wide variety of personal or family factors such as the following:

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What are the components of an LD evaluation?
Part of the evaluation involves ruling out other possible factors by taking a careful family and medical history. In addition to having parents complete a detailed history form, I like to meet with them for an hour to gather additional background information prior to meeting with the child to do the formal testing.

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Information I need from you:
Please bring me photocopies of as much of the following as you can locate:

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IQ and achievement testing:
IQ and achievement testing typically requires about six hours spread out over several sessions (usually 45 to 90 minutes each.) My typical evaluation includes the following test instruments as a core battery:

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What will it cost?
The evaluation has 4 components:

  • A diagnostic interview with the parents
  • The actual testing with the student, typically 6-7 sessions 50 minutes each. Note that not all evaluations require extensive testing. I’ll know much better what testing will actually be needed after we have spoken about your child’s particular difficulties.
  • 3 hours to score, interpret the results and prepare a 15 - 20 page report
  • A 90 minute feedback session with the parents (optionally, including the student)

Insurance will often allow the diagnostic interview and the feedback session as “covered services”, but it seldom covers the testing or report preparation. (Yes, I do take Visa, Mastercard, Discover, and American Express.)

Multiple intelligence:
It is important to understand that "intelligence" is not a single construct. Researchers such as Gardner, Armstrong and Phipps have identified seven distinct kinds of intelligence. (My personal opinion is that more will be defined as time goes on.)

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