Child and Adolescent Services
Anxiety
Does your child worry too much? Do your child's worries cause significant stress for them and/or the family? Do they have physical symptoms of anxiety or avoidance behaviors (i.e., procrastinate from getting things done, avoid potentially fun activities due to their anxiety)?
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If the answer is yes, there is help. Cognitive Behavioral Therapy (CBT) is a collection of therapies with specific techniques aimed at changing behavior and emotional responses. CBT works with to identify behaviors and emotional responses that contribute to anxiety. This approach works to understand what is maintaining anxiety and its accompanying behaviors, and how to quiet the anxious symptoms and manage the anxious thoughts. Utilizing this approach, children, adolescents and their parents will work to develop a set of tools, which are practiced in and outside of sessions, to reduce the frequency, intensity, and duration of anxiety symptoms. Over time, youth get better and better at reducing their anxiety on their own and learn how to reclaim their lives by ending the avoidance behaviors.
CBT has been evaluated in a number of scientific studies and has been shown to be effective for many of those struggling with anxiety
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Depression
Depression is a condition that affects your mood and ability to function. Depressive symptoms include feeling sad, hopeless, loss of interest in previously enjoyed activities. It can also cause difficulty with thinking, memory, eating and sleeping. Without treatment, depression can get worse and last longer. Fortunately, treatments can be very effective in improving symptoms of depression.
Different types of psychotherapy can be effective for depression. Cognitive Behavioral Therapy (CBT) is one form of psychotherapy that aims to treat the symptoms of depression. It can help by:
Heling individuals adjust ways of reacting to a crisis
Identify negative beliefs and behaviors and replace them with healthy, more positive ones
Find better ways to cope and solve problems
Identify issues that contribute to your depression and change behaviors that make it worse
Regain a sense of satisfaction and control in your life and help ease depression symptoms, such as hopelessness and anger
Learn to set realistic goals for your life
Develop the ability to tolerate and accept distress using healthier behaviors
ADHD
Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children. Symptoms including inattention, hyperactivity, impulsivity, oppositionality and academic underperformance are often reported from youth suffering from ADHD. These youth may also have coexisting conditions (e.g., anxiety, learning, mood, or sleep disorders) which should be identified and treated. Behavioral and Cognitive Behavioral treatments are recommended for preschool-aged children through adulthood.
The goal of ADHD treatment is to improve symptoms, optimize functional performance, and remove behavioral obstacles. Effective therapies include parent training, classroom management, emotion regulation, self-esteem building, peer interventions, and combinations of these interventions.
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Parent training provides education to improve their understanding about ADHD, behavioral problems, and child development. This training also helps them employ positive parenting strategies (e.g., praise and rewards for targeted behaviors) and reduce disruptive child behaviors (e.g., planned ignoring of behavior and use of consequences). Classroom management focuses on strategies to improve classroom routines and structure, a token economy to shape positive behaviors, and a daily behavioral report card to monitor progress and provide feedback to the child, parent, and team. Peer interventions include social skills training to improve social behaviors.
Sleep Problems
Getting healthy sleep is crucial to the health and development of a young child. However, as many as 50% of children experience sleep issues at some point in their childhood. There are strategies parents can use to improve their child’s sleep. Common sleep disorders in children include sleep apnea and insomnia, as well as parasomnias, which are disruptive sleep-related behaviors such as sleepwalking and night terrors. Other common sleep concerns in children and adolescents include frequent nightmares and Circadian rhythm sleep disorders.
Insomnia is one of the most common sleep disorders and impacts 20% to 30% of children. The primary symptoms are trouble falling asleep, staying asleep, or both, and problems with excessive daytime sleepiness. Insomnia can be challenging for the whole family. However, effective treatments are available.
In young children, behavioral interventions are the standard approach for treatment of behavioral insomnia of childhood. Caregivers play a key role in establishing and maintaining children’s sleep. A behavioral sleep specialist works closely with both the parent and child to resolve the sleep problem. There are several techniques used to address these concerns. Several approaches use extinction, a technique that involves placing a child in bed at a regular time and leaving them there until they can fall asleep without help. The goal is stop rewarding the child with attention for avoiding sleep. Positive routines and bedtime fading are two additional approaches. Positive routines involve positive and rewarding bedtime interactions with the caregiver. Bedtime fading involves delaying the child’s bedtime to match their natural sleep onset time and slowly advancing the bedtime to allow for an age-appropriate total sleep time. Positive routines help the child to establish cues for sleep onset, while bedtime fading increases the likelihood the child will experience quick sleep onset when placed in bed.
For older children and adolescents, a modified version of Cognitive Behavioral Therapy for Insomnia (CBT-I) has been shown to be effective. CBT-I usually combines several clinically proven interventions tailored to each youth’s particular needs. Possible interventions include: stimulus control therapy, sleep restriction therapy, relaxation training, cognitive therapy, bright light therapy, sleep hygiene education and other interventions. CBT-I is often called a multicomponent treatment because it combines several different approaches. Sessions may include cognitive, behavioral, and educational components.
Cognitive interventions: Cognitive restructuring attempts to change inaccurate or unhelpful thoughts about sleep.
Behavioral interventions: Relaxation training, stimulus control, and sleep restriction promote relaxation and help to establish healthy sleep habits.
Psychoeducational interventions: Providing information about the connection between thoughts, feelings, behaviors, and sleep is central to CBT-I.