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Dr. Rosen and Dr. Spinner recently presented a session on The Uses of Virtual Reality in Social Anxiety Treatment for the National Social Anxiety Center.
View the presentation on The Uses of Virtual Reality in Social Anxiety Treatment.
We Can Help
If you are worried about your child’s social anxiety, discuss your concerns with our clinicians, who specializes in childhood anxiety. For more information, contact us or call us today at 561-223-6568.
Dr. Jerome Siegmeister, the Center’s newest clinician, is an expert on the psychiatric concerns of children and adolescents. A former high school teacher, he is in a unique position to help children through mental health resources that are tailored specifically for kids or teens in need.
Since the pandemic, parents and children have had to adapt quickly as schools shut down for periods of time. Virtual classes have become routine. An online learning environment can be difficult enough for kids, without being isolated from their peers. “Covid has really devastated these kids,” Dr. Siegmeister says. “Though some children can do well in this environment, virtual learning causes an issue for most.”
“The virtual learning modality is basically a lecture modality,” he continues. “What do you and I do when listening to a lecture? If we are honest, most of us listen to it in the background while doing other things, so we miss a lot of the information.”
“Children are no different,” he says. “From a developmental standpoint, it is clearly better for kids to attend in-person schooling, but the unfortunate reality is that we need to be worried about public health, as well. In many cases, virtual learning is all we have right now, but this isn’t workable for many kids.”
Aside from the loss of knowledge, the pandemic has affected our children’s social interactions. “Virtual classes have their place because kids need to be learning, one way or another, but it comes at a price,” he explains. “It is very obvious that our children’s socialization has been affected and will be for a long time to come.”
“At this point, we have lost at least eighteen months of socialization,” he says. “Society pushes the idea that we need others to validate us, so kids rely on social acceptance for much of their self-worth. Covid took away much of that.”
Even older teenagers are being tested by this new normal. “The pandemic has been very hard for kids who are transitioning to college,” he notes. “Life is drastically different for them, especially if they are having to do their first year of college virtually. They are missing out on the social aspects that help them adjust to college life.”
Nevertheless, Dr. Siegmeister is optimistic. For most kids who are struggling, “it isn’t too hard to stabilize them and they can do really well,” he says. “Counseling and working one on one with kids will make things better in the majority of cases.”
When it comes to mental health concerns, Dr. Siegmeister believes in treating the whole person. He often uses a team approach and commonly involves the child’s parents, teachers, or college faculty. He also may combine two or more treatment methods for children whose needs that are not being met by one single approach. For example, he may use cognitive behavior therapy along with medical treatments if the child has an underlying psychiatric concern.
And, although a pandemic silver lining would seem unlikely, Dr. Siegmester says there is one. “Mental health is often swept under the rug,” he says, “but depression is now pretty pervasive in both children and adults and people recognize this. In fact, many so called “sick days” happen because the person is depressed and really needs to take a mental health day. The positive outcome from covid is that people are now much more aware of anxiety and depression because they’ve experienced it themselves. This means it has become much more acceptable to seek help.”
Jerome Siegmeister, MD, MaED, is a South Florida Native. He has worked with clients of all ages, and believes that the whole person needs to be treated. Consequently, he evaluates all aspects of the situation, from medical to situational, to determine the best initial course. He has a background in both individual and group therapies, employing supportive, behavioral, and insight oriented approaches, as appropriate to best fit his client’s needs, as well as comfort with medical treatment of any underlying conditions that might manifest psychiatrically. He has significant experience in all forms of psychiatric issues, including mood symptoms, thought disorders, anxiety, phobias, attention deficits, behavioral issues, insomnia, compulsive disorders, emotional lability, substance abuse, and trauma.
Dr. Siegmeister graduated with his Bachelor’s from Florida International University, after which he spent a number of years teaching, and obtained a Masters from the University of South Florida in Career and Technical Education/Adult Education. Upon deciding to pursue medicine, he initially completed a Post Baccalaureate Pre-Medical Certificate program at the University of Miami, and then obtained his MD from the University of Miami Miller School of Medicine, staying there afterwards for his specialty training in Psychiatry, followed by a fellowship in Child and Adolescent Psychiatry, where he served as Chief Fellow, and was awarded with a Research Distinction. After training, he has worked providing Emergency care, with additional work in inpatient settings, both in mental health and as a consultant to medical units at multiple hospitals. He is currently Board Certified by the American Board of Psychiatry and Neurology in both general Psychiatry, and Child and Adolescent Psychiatry, and by the National Board of Physicians and Surgeons in Psychiatry.
The Children’s Center for Psychiatry, Psychology and Related Services is pleased to again offer psychological evaluations to the community. To best serve the need of our clients we will be offering both in person appointments or remote video conferencing to get a better understanding of your child, their strengths and weaknesses, and what accommodations and interventions they would benefit from.
We are able provide our typical in person evaluations with procedures and materials to ensure safety during COVID-19 concerns. Additionally, while the evaluation process is typically a hands-on experience and the assessment tools require face-to-face interactions, we have also made adaptations to provide remote evaluations via video appointments.
Never before in modern memory has the human race been faced with such a stressful and anxiety provoking foe. The novel coronavirus or COVI-19 has resulted in untold emotional unrest and fear among all nations and peoples of our world. There has been a lot of talk about the “invisible enemy,” an RNA based complex protein that looks like a World War 2 anti-ship mine with spikes sticking out of its surface. We are informed daily by the media that young and old victims of this virus are ending up on ventilators for weeks at a time if they survive. To “flatten the curve” and avoid overwhelming our hospitals we have had to become socially isolated, settle in place in our residences, wear masks when going out and remembering to wash our hands and not touch our faces. And after three months of dealing with this enemy of grown ups we are now being informed that children who we believed were not at risk of being made seriously ill have suffered as cases of a strange multi system inflammatory syndrome much like Kawasaki disease began to appear at hospitals.
The reality of this plague is bad enough to fathom by any rational person. The facts we are presented with certainly evoke fear and apprehension. Our frontline healthcare providers who are by their profession somewhat desensitized to run-of-the-mill suffering as they treat patients with terminal illness, heart attacks, metastatic cancer or debilitating strokes, find themselves traumatized by the COVID crisis.
So what is generating this degree of emotional suffering?
Schools have been closed for the last couple of months since the coronavirus pandemic began to spread across the country. Stories about the virus’ effects and death rates abound on the news and on social media. Usually, we wouldn’t expect children to be too affected by broadcasts about a new disease unless someone close to them gets sick. In this case, however, their lives have been upended by school closings, parents working from home (or losing their jobs), the requirement to shelter in place and wear masks, and the inability to gather with friends or go to familiar venues.
Children are also likely tapping into their parent’s own fears and concerns. In turn, they may worry that they, their friends, or their family will catch COVID-19. We can estimate how this affects American kids by reading through the studies that were done on children in China, where the outbreak began.
In an article on Psychology Today, Jamie D. Aten, Ph.D., founder and Executive Director of the Humanitarian Disaster Institute at Wheaton College, reports that, “due to uncertainties surrounding the outbreak and ongoing scientific research, it’s estimated that 220 million Chinese children are at a risk of facing mental health issues due to potential prolonged school closure and home containment.”
If this is true for the children in China, why would it be any different here for kids in the United States?
Studies have shown that children in the United States have many mental health needs that remain unidentified. In 2015, the Centers for Disease Control and Prevention (CDC) reported that about 20% of the nation’s youth have or will have an emotional, mental, or behavioral disorder. Only about 7.4% of these children report having received any type of mental health services, however.
A 2014 National Center for Biotechnology Information (NCBI) study by Jane Burns and Emma Birrell noted that many mental health problems escalate in adolescence and young adulthood. The effects of these under treated childhood mental health issues can be higher rates of substance abuse, anxiety, and depression, as well as suicidal ideation and self harm.
There is a stigma surrounding mental illness and its treatment. This disapproval is a barrier that keeps young people from seeking assistance. The consequence is that they are not receiving appropriate care, which translates to an increased chance of dropping out of school, employment or relationship problems, future incarceration, or even suicide.
The nation has been horrified to hear about another school shooting. For many in South Florida, however, the trauma surrounding school violence has hit particularly hard because this week’s shooting happened right in our own backyard. Many people likely know someone or know of a family with a child who attends the Marjory Stoneman Douglas High School in Parkland, FL. Because of this, you might find it challenging to deal with your feelings about the event.
Keep in mind that it is normal to experience strong emotions, such as anger, fear, sadness, grief, and shock – even if you don’t know someone who is personally connected to the shooting. You might also have trouble concentrating or difficulty sleeping and you may even feel numb when talking about the incident with others. All of these reactions are typical responses of trauma psychology.
It will take a while to move past this heartbreaking tragedy, but we have some tips for managing your emotions during this horrific time. Following these guidelines can help you build resilience – the inner strength that you can draw on when you’re exposed to trauma or adversity.
*If you can’t move past this school violence or another traumatic event that has happened in your life, it may be beneficial to seek out a support group or turn to a qualified, licensed mental health professional in order to move forward. It is especially important to do so if you are unable to carry out the daily tasks of living, such as sleeping, eating, and other functions.
Our Children’s Center has specially trained clinicians on staff to help those who need help dealing with the school shooting or other traumatic situations. For more information, contact The Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
Children with autism and Asperger’s often have phobias that limit their interaction with others. One child may be fearful of any social gathering, another of going shopping, while someone else may be afraid heights or be terrified to be in a crowd of people. These phobias can be so difficult for the child to experience, that often family members will go out of their way to avoid a situation they know will trigger the child’s fears. Additionally, children with Asperger’s syndrome and autism spectrum disorders often have trouble with safety boundaries that others take for granted, such as needing to stay within their own yard or being able to cross a street without harm. But, studies are showing that the new field of virtual reality therapy can help autistic children learn to manage everyday situations, allowing them to live a more normal life.
Virtual reality therapy (VR therapy) is a computer-based simulation of the world around us. It is multi-sensory, providing both visual and auditory environments that can be configured to mimic a setting. By going through VR therapy, an autistic child can challenge and overcome their fears in a safe setting and in a way that gives them control.
With virtual reality therapy, a simulated environment allows the child to use an avatar to interact with others. Reminiscent of a video game, the children move their avatar through the program while a therapist views the session and provides coaching and feedback to the child. The kids have the ability to pause, repeat, or review their avatar’s interaction inside the setting until they feel confident about the situation.
Among other applications, virtual reality therapy is being used to teach or enhance social cognition skills and emotion recognition to help children with autism become more comfortable in social settings. Social interaction is often a source of discomfort for autistic children because the syndrome keeps them from picking up on the subtle social signals most people take for granted. In fact, Daniel Smith, the senior director of discovery science at Autism Speaks has said, “Virtual reality and avatar-based programs may be especially promising for people with autism who are uncomfortable in social interactions where subtle social cues are important.”
Studies have proven that virtual reality therapy can actually rewire the regions of the brain that relate to social skills. VR therapy also amplifies those areas that relate to attention and information exchange. The result is an increased understanding and awareness of social signals and a higher perception of the back and forth exchanges that is the foundation of conversation.
In addition to teaching social skills for circumstances such as attending school, sitting for a job interview, going to the mall, or going on a date, VR therapy has helped teens and children overcome more physical situations involving things like a fear of heights, phobias surrounding crowds, and traveling on a school bus. Because the virtual simulations can be configured to show real-world settings, they can be adapted to conform to each child’s specific fears.
For example: for a child who is afraid of heights, VR therapy can create a situation in which the child – via their avatar – experiences riding an escalator or crossing a bridge. The scenario introduces the child to the situation slowly and increases the stimulus as they learn to desensitize their fear and build up their tolerance. The child is given encouragement and feedback by a child psychologist and has full control of the scene, so they can turn back or go to an earlier (less frightening) version whenever they need to.
After working through these phobias, the children are able to transfer their new skills to real-life situations – something that is usually difficult for autistic children because they focus on details instead of intangible perspectives. By targeting a child’s specific fears, virtual reality therapy provides real world scenarios with immediate feedback, which greatly enhances the child’s ability to cope under stress.
Our warm and welcoming Children’s Center offers a wide range of clinical, therapeutic, educational and supportive services specifically for children ages two through twenty two.
For more information about how our skilled professional can use virtual reality therapy to help with your child’s autism, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
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.
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.
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.