THERAPY SERVICES

Whenever possible, we draw from approaches that are evidence-based and align with practice guidelines. Most of our services are offered against the backdrop of a family systems perspective. As we describe elsewhere in more detail, we view parents as a pivotal element of their child or teen’s care with us.

Anxiety & OCD:

Anxiety disorders are one of the most common referral concerns that we encounter. Anxiety disorders can take the form of:

• Generalized worry and anxiety

• Social anxiety / phobia

• Specific phobias (for example, needles or vomiting)

• Health-related anxiety

• Panic attacks

• OCD

When treating anxiety disorders, exposure techniques are an important element of the treatment plan. Exposure involves supporting a child or teen to face their fears as opposed to coping with escape and avoidance. Exposure therapy is a part of cognitive-behavioral-therapy (CBT) for anxiety, and is the central focus in treating OCD with Exposure and Response Prevention (ERP). We also offer SPACE (Supportive Parenting for Anxious Childhood Emotions), a type of CBT / exposure-based treatment for childhood anxiety.

Disruptive behavior, ADHD, anger issues, defiance:

Challenging, or “acting-out,” behaviors constitute another common class of problems that we work with. We use a blend of behavioral and emotion-focused strategies for this domain. Examples of evidence-based approaches that we draw from include Parent-Child Interaction Therapy (PCIT), Incredible Years, Helping the Noncompliant Child, and Collaborative Problem-Solving.

Mood Disorders:

When it comes to depression, we tend to prioritize Behavior Activation (BA), a well-established treatment for depression. When appropriate, we also use family-based approaches (such as Attachment-Based Therapy for Adolescent Depression) to support the recovery of children and teens with depression.

Autism Spectrum Disorders:

We support neurodiversity and do not aim to change individuals who have an autism spectrum diagnosis. That said, autism is associated with an increased vulnerability to anxiety, depression, and behavior challenges. We apply the approaches described throughout this page as needed for autistic persons who present with distress. Depending on the age of the autistic person, the focus may revolve around working with parents on how to more effectively respond to challenging behaviors and support their child or teen’s emotional development.

For families seeking RUBI services, a parent-focused approach to address challenging behaviors in autistic children, please mention this during the inquiry process - Dr. Shelley Barber is a certified RUBI provider.

Sleep Problems:

Bedtime problems and insomnia are common among individuals whom we work with. We customize the treatment plan to address the specific needs of the family. While we may draw from general CBT strategies for anxiety, we often use highly targeted behavior techniques (such as “the bedtime pass,” “bedtime fading,” and “bedtime associations”) that address the bedtime challenges. When insomnia is a part of the picture, we use evidence based strategies from Cognitive Behavioral Therapy for Insomnia (CBT-I).

Mealtime Challenges:

Most families deal with mealtime challenges, especially with young children. Whether the concerns involve picky eating or over-eating, we apply principles from Ellyn Satter’s Division of Responsibility and Eating Competence models, and Katja Rowell’s Responsive Feeding model, as well as more customized approaches as needed. We do not offer programs targeted at weight loss, and we do not draw from strategies that involve pressuring children to eat against their will.

Toileting Issues:

When children present with soiling or daytime wetting, we typically collaborate with the child’s pediatrician in developing a treatment protocol that address the specific underlying issues behind the accidents. Sometimes anxiety is a major driver behind the toileting issues, in which case we use the anxiety intervention strategies outlined above.

Launching Problems:

When older teens struggle to fly the nest, we find that a family-based approach is absolutely critical. Often teens and young adults who are “failing to launch” are grappling with significant anxiety and / or depression, and need the involvement of parents in order for treatment to be effective.