Child & Adolescent Psychotherapy

Qualifications:  Ph.D. in Child Clinical Psychology from Columbia University, Internship in Child Psychology from St. Luke’s-Roosevelt Hospital Child and Family Institute, Postdoctoral Fellowship in Parent-Infant Services and Child Psychology from St. Luke’s-Roosevelt Hospital Child and Family Institute, research in parent-infant communication with Dr. Beatrice Beebe at the New York State Psychiatric Institute.

Children and Adolescents

We have evidence that specific psychotherapy treatments benefit children dealing with specific psychological issues. The following is a list of evidence-based Cognitive-Behavioral Therapy (CBT) approaches that I utilize to address psychological difficulties in children and adolescents:

• Exposure Response Prevention (ERP) is an effective behavioral therapy treatment for Obsessive-Compulsive Disorder (OCD) in children and adolescents.  ERP involves gradually exposing a child to the situations and intrusive thoughts that he fears while encouraging him not to engage in rituals (compulsions).  Over time, the intrusive thoughts and anxiety are diminished, and the child learns to manage OCD symptoms so they do not become out of control in the future.  I provide individual ERP and offer supplemental CBT/support groups for those diagnosed with OCD.

Citation: Barrett, P. M., Farrell, L., Pina, A. A., Piacentini, J., & Peris, T. S. (2008). Evidence-based psychosocial treatments for child and adolescent Obsessive-Compulsive Disorder. Journal of Clinical Child & Adolescent Psychology, 37, 131-155.

• Exposure Therapy is used to treat children and adolescents with Specific Phobias, such as fears of the dark, dogs, or elevators.  The child is gradually exposed to the object or situation that she fears until she becomes less afraid.  The child learns that she can handle her fears and stops avoiding the object or situation in her daily life.  In vivo exposure (confronting the actual feared object or situation) and imaginal exposure (confronting the feared object or situation in one’s imagination) are both effective in treating Specific Phobias.

Citation: Silverman, W. K., Pina, A. A., & Viswesvaran, Chockalingam (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents: A review and meta-analyses. Journal of Clinical Child & Adolescent Psychology, 37, 105-130.

• Exposure Therapy and other Cognitive-Behavioral Therapy (CBT) techniques are used to treat children and adolescents with Social Phobia, or the fear and avoidance of social or performance situations.  These situations may include meeting a new person, making eye contact while interacting with others, talking on the telephone, or speaking in front of an audience.  Children and adolescents gradually learn to confront feared social situations.  CBT techniques are used to reduce upsetting automatic thoughts and beliefs (e.g., “the spotlight is on me,” “others are judge and criticize,” “others really notice when I mess up”), which often coexist with avoidance of social situations.

Citation: Silverman, W. K., Pina, A. A., & Viswesvaran, Chockalingam (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents: A review and meta-analyses. Journal of Clinical Child & Adolescent Psychology, 37, 105-130.

• The Coping Cat is a specific CBT treatment program that has been shown to be effective in the treatment of Social Anxiety, Separation Anxiety, and Generalized Anxiety Disorder (i.e., excessive worry) in children ages 6 and older.  The Coping Cat teaches children to identify and label their anxious feelings, to use strategies such as diaphramatic breathing and progressive muscle relaxation to manage anxiety, and to confront feared situations in a more confident manner.

Citation: Silverman, W. K., Pina, A. A., & Viswesvaran, Chockalingam (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents: A review and meta-analyses. Journal of Clinical Child & Adolescent Psychology, 37, 105-130.

• Cognitive-Behavioral Therapy (CBT) is an evidence-based treatment for children and adolescents diagnosed withDepression.  This therapy emphasizes the importance of engaging in pleasurable and rewarding activities, developing adequate social skills, and learning to talk back to untrue thoughts that lead to depressed mood and depressive behavior.

Citation: David-Ferndon, C., Kaslow, N. J. (2008). Evidence-based psychosocial treatments for child and adolescent depression. Journal of Clinical Child & Adolescent Psychology, 37, 62-104.

• Parent Management Training is the treatment of choice for children and adolescents exhibiting disruptive behavior associated with Attention Deficit-Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), or Conduct Disorder (CD).  Parents are taught skills to reduce childhood behavioral problems and implement these skills in a step-wise manner with their child at home.  Skills and techniques include spending time with one’s child, providing positive reinforcement to increase appropriate behaviors, establishing appropriate rules, giving effective instructions, and using response cost and time out techniques in order to reduce maladaptive behaviors.

Citation: Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for child and adolescent with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 37, 215-237.

• Parent-Child Interaction Therapy (PCIT) is a manualized interactive form of parent training that has been shown to be effective in reducing “acting out” behaviors in children 2 to 7 years old.   PCIT involves an initial phase of teaching parents positive parenting skills in order to improve the parent-child relationship.  In the second phase of PCIT, parents are taught to use effective commands, rules, and consequences including time out in order to increase their child’s compliance and rule-following behavior.  The therapist teaches skills to parents and then acts as a coach while parents interact with their young child in the therapy room.

Citation: Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for child and adolescent with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 37, 215-237.

• I integrate elements of Social Skills Training, Coping Skills Training, Acceptance and Commitment Therapy (ACT), Dialectical-Behavior Therapy (DBT), Talk Therapy, and Play Therapy in order to improve socialization, social-cognition, problem-solving, and emotion-regulation.

Infants and Toddlers

I conduct parent-child therapy with young children (0 to 5 years old) and their parents in order to assist with parenting difficulties and to treat psychologically-based childhood disorders that manifest in disruptive behavior, emotional disturbance, and strained parent-child attachment.  I focus on helping parents to understand themselves and their children, and I work with them to become “expert parents.”

Psychotherapy with infants and toddlers addresses the following treatment goals:

• Improved parent-child relationship and attachment security
• Improved ability to manage emotional states
• Improved self-regulation (patterns of eating, sleeping, state transitions)
• Decreased anxiety (separation anxiety, school phobia, excessive worry, and obsessive-compulsive disorder)
• Improved mood
• Increased compliance with adults
• Decreased disruptive, aggressive or dangerous
• Improved social skills
• Decreased risk of child abuse or neglect
• Facilitation of optimal child development