cbt Archives

Jul 12 0

Social Anxiety In Toddlers

Posted by Dr. Andrew Rosen

Toddlerhood is defined as the age range from 12 to 36 months. During this period, a child’s emotional and cognitive development grows by leaps and bounds, as do their social skills. This also coincides with the time when children are likely to go into a daycare environment or head off to preschool. As they engage more often with other children and adults, it may also be the stage when a toddler’s social fears begin to emerge.

Just as with adults, some children are comfortable with social interactions while others may not be. Each group of kids will have the social butterfly as well as the “shy” child who quietly observes and doesn’t interact as much. It is one thing to be shy, however, and another to be intensely fearful and anxious in a social setting. Because we know it can show up early in life, a toddler who shows such strong reactions in a social environment is often regarded as having social anxiety.

What causes social anxiety in toddlers?

Jun 14 1

Autism Spectrum Disorder: ASD And Anxiety In Children

Posted by Dr. Andrew Rosen

Autism Spectrum Disorder (ASD) comes with a variety of challenges. For many children, it can mean issues with compulsiveness and repetitive behaviors, learning and social deficits, and a resistance to change. ASD also can manifest with various emotional difficulties – although not specifically linked, we know that ASD and anxiety frequently appear together in children.

Kids with ASD and anxiety can have physical symptoms (example: racing heart or a stomach ache) or their anxiety may also show up in the form of rituals that can help calm them (for instance: shredding paper). Because many autistic children are either non-verbal or have trouble communicating, an outward display of anxiety may be their only way of telling you that they are distressed.

May 20 0

Intensive Outpatient Therapy Helps Children With Depression And Anxiety

Posted by Dr. Andrew Rosen

We all have our anxious moments or times when we are depressed. It’s normal to feel these emotions when we are in stressful situations. In children, anxiety and depression can manifest differently than it does in adults. We often see more dramatic signs of frustration, irritability, and even anger. Kids might be restless, withdraw socially, or lose their appetite.

Usually these conditions go away once conditions improve. For many children, however, anxiety or depression can drag on and on. It may get worse over time and might even start to interfere with their school life, social relationships, or daily activities. When it reaches this point, it is likely that the child has an anxiety or mood disorder that requires treatment from a child psychologist. Be assured that these conditions are highly treatable.

Traditionally, children who are undergoing treatment for anxiety or depression will see their therapist once or twice a week for 30-60 minute sessions. These sessions often continue for three to four months, but could go on much longer depending on the severity of the child’s disorder. However, a relatively new concept in psychotherapy, called intensive outpatient therapy, is showing promise for helping kids get better faster.

Feb 14 0

School Violence and PTSD

Posted by Dr. Andrew Rosen

This week marks the first anniversary of the school shootings at the Marjory Stoneman Douglas High School in Parkland, FL. On February 14, 2018, 17 students and teachers were senselessly killed and 14 more were wounded.

Reflecting on the tragedy and remembering those who lost their lives will no doubt bring up strong emotions in some children. Even those who weren’t personally connected to the event may feel sad and re-experience a sense of loss. For some kids, the anniversary may even trigger or worsen symptoms of post-traumatic stress disorder (PTSD).

Distressing events such as school shootings can affect children just like they can affect adults. In fact, it’s normal for kids to go through a range of emotions when they hear about a tragedy – they might have trouble sleeping or may express fear, sadness, anger, and grief.

Aug 10 0

How Does Virtual Reality Therapy Help School Anxiety?

Posted by Dr. Andrew Rosen

The start of a new school year is just around the corner. While many children are happy about heading back to the classroom and seeing their friends again, for some kids, a new school year embodies fear and school anxiety. But, what if your child could go into their classroom in a non-threatening way, interact with a new teacher and classmates, and learn effective methods for coping with the anxiety-inducing situations they dread in school? With virtual reality therapy, they can do just that.

This innovative treatment is emerging as a high-tech solution that lets kids challenge their fears in a safe, realistic environment, but in a way that gives them control. VR therapy can be used across age groups and can be adjusted to the child’s developmental age as they mature.

Additionally, this therapy can be tailored to vary the complexity of school phobia scenarios. For example, one child might be apprehensive about taking exams, while another dreads interaction with their peers. Both can be helped with virtual reality therapy, which is a combination of cognitive behavioral therapy (CBT) and in-vivo exposure therapy, but with a state of the art twist.

For example, if your child has a high level of test anxiety, as studies indicate anywhere from 15% to 25% of students do, virtual reality therapy will allow them to mimic test taking in a non- or less stressful environment (just like in-vivo exposure does) in order to overcome their negative thought patterns (“I always fail tests.”) through cognitive behavioral therapy. In a test-taking scenario, the virtual reality simulated distractions and stresses of taking exams would be minimal to start with, and then slowly be increased as the child learns to process and adjust to them. At the end of the therapy, the child will be able to face an exam with reduced or minimal fear.

What Happens During Virtual Reality Therapy?

Because most kids relate so well to video games, virtual reality exposure therapy seamlessly integrates treatment with real-world interface. It helps children retrain their brain so they have a defense against problems like meeting a new peer or being bullied, which makes them feel more comfortable about situations at school. VR therapy has also been successful in teaching or improving social cognitive skills and emotion recognition in high-functioning autistic children.

When kids go through VR therapy, they first learn coping skills to help them stay calm under a stressful circumstance. Once they are comfortable with these strategies, they continue on to virtual reality therapy, where they view computer-generated environments and use an avatar to experience interactions with adults and other kids.

As you can see in this Today Show video, the teens have the freedom to pause or review and repeat their avatar’s interaction with others inside the setting until they feel confident about the situation. A therapist listens in on the virtual reality session and offers feedback and coaching to help the child navigate the difficulties that have created their school refusal.

Studies have shown that virtual reality therapy actually “rewires” the brain so that the areas relating to sociability and attention are heightened. This leads to increased awareness and understanding of social cues, enhanced perception of the give and take in conversations, and more control when faced with real-life school issues. In studies done after kids have gone through virtual reality exposure therapy, scans have shown that the regions in the brain associated with social skills and those sections that exchange information during social interactions are heightened.

This interactive and visually stimulating approach to treating school anxiety delivers a dynamic platform that can simulate an unlimited number of phobia situations. By targeting a child’s specific fears, it provides meaningful close-to-life scenarios with immediate feedback, which greatly enhances the child’s ability to cope under stress.

Did You Know?

Our Children’s Center focuses specifically on offering a variety of clinical, therapeutic, educational and supportive services to children ages two through twenty two in a warm and welcoming environment.

For more information about how our child psychologist team can use virtual reality therapy for your child’s school refusal, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

Nov 22 0

Children’s Mental Health – Psychiatric Help for Children

Posted by Dr. Andrew Rosen

While we tend to think of childhood as a carefree time of life, the fact is that many children suffer from mental conditions and disorders, just the same as adults. Among other things, children’s mental health concerns can include emotional, behavioral, and mental disorders such as eating disorders, learning and developmental disabilities, Attention Deficit Hyperactive Disorder (ADHA), and autism. And, similar to adults, children can be impacted by conditions like anxiety, depression, Obsessive Compulsive Disorder (OCD) and Post-traumatic Stress Disorder (PTSD). Additionally, as children grow and mature into young adults, they can develop other problems associated with adolescence, such as underage drinking and substance abuse.

Left untreated, any of these conditions or disorders can result in difficulties with making friends, and behavior issues in school and at home. What is most troubling, however, is that research has shown that a majority of adult mental disorders start early in life. This makes it critical that children’s mental health conditions be caught promptly and treated appropriately.

Symptoms of Child Psychological Disorders

Child psychological disorders and conditions can affect any ethnic group, and income level, and those living in any region of the country. In fact, the Centers for Disease Control (CDC) cites a study from a National Research Council and Institute for Medicine report that estimates about 1 in 5 children across the United States will experience a mental disorder in any given year.

Symptoms often change as a child grows and matures, so the signs of a problem may be difficult to spot in the early stages. Often, parents are the first to recognize that there is an issue with their children’s emotions or behavior, however problems may also be brought to your attention by your child’s educators or another adult who knows your child well. Some general signs to look for include:

Marked decline in school performance
Strong worries or anxiety that causes problems at home or at school
Random, frequent physical aches and pains, such as headaches or an upset stomach
Difficulty sleeping, nightmares
Marked changes in eating habits
Feeling hopeless
Having low or no energy
Aggressive behavior, disobedience, and/or confrontations with or defiance of authority figures
Temper tantrums or outbursts of anger
Thoughts of suicide or thoughts of harming themselves or others

Psychiatric Help for Children

Please get immediate assistance if you think your child may be in danger of harming themselves or someone else. Call a crisis line or the National Suicide Prevention Line at 1.800.273.TALK (8255).

Getting psychiatric help for children, in the form of early diagnosis and receiving the correct treatment, is essential for your child’s well being, both now and throughout their life.

If your child’s problems persist across a variety of settings (for example: home, school, and with peers), some of the steps to get help include:

Talk to your child about how they are feeling. Find out if they would like to discuss a problem with you or another adult. Actively listen to their responses and concerns.
Talk to your child’s pediatrician, school counselor or school nurse, or a mental health professional if you see behaviors or problems in your child or teen that worry you.
Seek evaluation from a specialist who deals with children’s mental health concerns.
Ask the specialist if they have experience with treating the problem or behavior you see in your child.
Don’t delay in seeking help – early treatment generally gives better results.

Children can be treated in a variety of settings that range from one-on-one (or with a parent) sessions with a mental health professional to a group setting with a therapist and the child’s peers. Talk therapy can help change behaviors and may be used in combination with other treatments. Cognitive Behavioral Therapy (CBT) has been shown to be very effective in helping children learn coping strategies so they can change unhealthy behavior patterns and distorted thinking. Additionally, medications may be recommended for disorders such as ADHD or may be given for other types of severe or difficult cases.

Need More Information on Children’s Mental Health?

If you have questions or need more information about psychiatric help for children, we can help. For more information, contact The Children’s Center for Psychiatry, Psychology, & Related Services in Delray Beach, Florida or call us today at 561-223-6568.