The psychotherapy that I do with children, adolescents and their parents is informed by cognitive-behavioral theory and the focus is on solving problems and building skills. The goals of psychotherapy for young people generally relate to the development of an understanding of the self, so that the child or teen can act in their own best interest. For parents, the focus is to develop an understanding of both self and the child so that the parent can more effectively coach a child to regulate his/her own behavior and respond effectively to the environment, both at home and at school. In my experience, working with parents and children together is the most effective treatment model. Although the length of treatment varies and depends on the needs of the clients, 1 hour/week for 5-6 months is average.
When parents are concerned about any aspect of their child’s behavior, my first recommendation is a visit to the child’s pediatrician or family practitioner for a discussion of the problem and a complete medical evaluation. This way, the physician can identify and treat any complicating medical condition before the initiation of therapy.
In addition, a teacher's observations about a child's behavior in school are an invaluable part of a pre-referral investigation by the parents. A team approach, involving the child, the family, the school, the physician and the psychologist is more effective than uncoordinated treatment efforts on several different fronts.
A child or adolescent whose behavior poses a dangerous threat to himself, others or to property requires an evaluation in the emergency room, so that the threat can be evaluated by a pediatric psychiatrist and appropriate containment of the threat can be implemented.
The following are a few of the concerns that can be addressed effectively in outpatient psychotherapy:
• Lack of behavioral control at home and/or at school
• Social skills deficits
• Mood disorders
• Anxiety disorders/obsessive thoughts/compulsive behavior
• Explosive behavior
• Temperamental "mismatches" between a parent and a child
• Concerns related to divorce or emotional loss/trauma