Cognitive Behavioral Therapy for Children
Children and teens face many challenges, high levels of stress, and expectation. Working with children and teens requires knowledge of child and adolescent development, attachment theory, expertise in evidence based practice, and the clinical skill to engage children and teens in the therapeutic process. This process requires creativity, compassion, patience, play, and often humor.
We work with a sense of purpose. We provide ongoing supportive counseling to children when they need it, but our real mission is to end suffering and create joy in an efficient manner so that children can enjoy their childhoods and parents can enjoy being parents – without having to attend therapy for years on end.
CBT for Anxiety, Depression, and Adjustment Problems
Many children have a difficult time identifying, labeling, and knowing how to work with their emotions. As a result, they end up either internalizing their emotions (becoming sad, fearful, avoidant) or they externalize them (anger, tantrums, peer conflict, disrespectful behavior at home). In other words, emotion regulation problems lead to internal pain or behavioral acting out. We believe that it is critically important that children to learn to understand and regulate their emotions. We utilize the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders, developed by David Barlow and his team at Boston University to address a range of emotional problems by teaching children to 1) recognize, understand, and be more aware of their emotions, triggers, and behavioral responses to their emotions, 2) learn to be more rational about the thoughts that drive their emotions, 3) learn to counter dysfunctional behaviors that make them feel worse or function more poorly, and 4) learn to accept some negative emotional and physical sensations so that they do not lead to a downward spiral.
CBT for Obsessive Compulsive Disorder
Children who have OCD are typically very difficult to parent. They have an incredibly difficult (you will here the word “difficult” a lot) time transitioning between activities, following instructions, getting out of the house in the morning, going to bed at night, and eating. They are often described as “impossible.” Some wash their hands constantly. Others ask for reassurance about everything. Others won’t wear socks with seams (all socks) or wear pants or shirts in certain colors or textures. Others absolutely melt down when you make an “ing” sound at the end of a word, or you don’t kiss them a certain number of times when you get home from work. These kids are often misdiagnosed with Oppositional-Defiant, Attention-Deficit, Generalized Anxiety, Autism spectrum, or even Bipolar Disorder. The point is, as much as you love them, sometimes you might imaging knocking yourself unconscious in order to escape the frustration of parenting a child with OCD. Don’t do this. There is a better way.
We use Exposure and Ritual Prevention (EX/RP), refined and published by Edna Foa and her team at the University of Pennsylvania, which has been demonstrated to be so much more effective than any other treatment that no other treatment comes anywhere close, demonstrating rates of effectiveness around 70% in controlled studies. This treatment is very gentle, empowering, and adapted for children. You can read more about it here.
CBT for Behavior Problems
Our approach to behavior problems is heavily founded on 1) attachment, 2) emotion regulation, and 3) current research on behavior modification. We believe that all three of these areas are intricately interwoven in that emotion regulation or dysregulation tends to drive dysfunctional behavior and attachment to one’s caregivers and larger support system is the most important emotion regulator that children have. We work with children to build more functional attachment to their parents, while keeping in mind that it can be difficult for a parent to connect to and support a child who has significant behavior problems. For this reason, we sometimes work individually with parents to help them learn to regulate their own emotions during their child’s meltdowns. We also have an in-house marriage counselor, Dr. Rob Young, who can help parents work together and become a unified force for positive change.
CBT for Social Problems
Childhood can be a rough time in a person’s life – even with the best parents, and even in the best school. Bullies can be unavoidable. There is pressure to fit in. Social exclusion is a very really thing. A lot of good kids lack the brain development to truly experience empathy or to use good judgment, and they subsequently hurt other kids without meaning to. The recipient of that hurt needs support and skills to overcome it. The kid who is causing his or her own problems might need additional self-awareness or conflict resolution skills. Kids who are simply lonely sometimes need help overcoming social anxiety so that they can assertively connect with peers. Maybe they need help in social interaction skills so that they do not push other children away. We help children better understand what is causing their social problems and work with them to devise solutions. Sometimes that solution is social skills training. Sometimes it is emotion regulation training. Sometimes it is CBT for Social Anxiety. Of course, there are many other possible causes, and there are usually scientifically proven solutions. Many times, it involves two or more focuses.
CBT for Trauma
We do not assume that everyone with emotional or behavioral difficulties has been through trauma. But many children are legitimately traumatized. While two specific approaches (Prolonged Exposure and Cognitive Processing Therapy) have been shown to very superior to other approaches for adults, one other approach stands alone for children – Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This approach is tailor-made for kids, and has the most evidence of effectiveness in treating people in this age group who have been traumatized. Joanna Magee has specialized training and experience using TF-CBT.
Although we generally see our practice as a force for change, sometimes a person finds themselves in a situation that cannot be changed. Problems with bullies, a not-so-friendly teacher, or an aggressive sibling. We are well-equipped to simply offer support in such situations, in which we will gently offer solutions when we can.