Presenting Problems and Treatment Options
Below are descriptions of several of the evidence-based treatments offered at PAC Psych. Cognitive Behavioral Therapy and play therapy are also offered for concerns that do not fall within the descriptions below.
ADHD and Disruptive Behaviors
Parent-Child Interaction Therapy (PCIT)
PCIT is an evidence-based treatment originally developed for young children with disruptive behaviors and their caregivers. At PAC Psych PCIT is used with children ages 2-7 who have ADHD or other disruptive behavior problems, but can also be helpful for young children experiencing symptoms of anxiety and depression. PCIT is a two phase treatment in which the first phase involves strengthening the relationship between the child and caregiver. The second phase involves setting limits and following a structured and consistent procedure when the child is non-compliant. For the first phase of treatment the parent is taught skills that play therapists use with young children based on attachment theory. Skills taught in the second phase are based on behavior theory. Sessions involve the caregiver and child meeting together with the therapist acting as a coach to the parent from behind a one-way mirror. Mastery criteria are set as a measure of when a family is ready to move from one phase of treatment to the next, and when the family is ready to graduate from treatment.
PAC Psych was the first PCIT treatment facility and private practice in New York City to be set up with a play room, viewing room, and time-out room as recommended by the developers of PCIT.
Sleep Problems
Sleep problems affect 25-40% of children and adolescents. Sleep impacts our children’s overall well-being, including their physical and emotional development, learning, and behavior. Not surprisingly, poor child sleep can negatively impact parent sleep and create a stressful environment at home around sleep and bedtime. Sleep problems in children can look very different and can include sleep onset difficulty, middle of the night wakings, nightmares, anxiety, phase delayed sleep, and enuresis. Though some of these sleep difficulties can be outgrown and improve spontaneously, most respond optimally when treated in a behavioral framework. Rooted in behaviorism and classical conditioning, behavioral sleep medicine is a highly effective strategy in combating pediatric sleep disorders.
Anxiety and Phobias
Coping Cat
Coping Cat and the CAT Project are evidence-based Cognitive Behavioral Therapies for children and teens with anxiety. Children and teens are taught coping skills for managing stress. Children and teens also gain awareness of their feelings and how to manage them effectively. Children and teens learn to identify triggers for their fears, and thoughts that contribute to the fear or prevent them from overcoming anxiety. An essential feature of this type of treatment involves the creating a hierarchy of fears, and facing each fear head-on through graded in-vivo exposure with support of the clinician and involved family members.
Selective Mutism
There are several different types of therapy that have been utilized with children who have been diagnosed with Selective Mutism. At Pac Psych we subscribe to the current research that conceptualizes Selective Mutism as an anxiety disorder. Mutism is a symptom of the anxiety and therefore our focus is on lowering anxiety and teaching coping skills before we begin using behavioral techniques to increase speech. The most important part of treating children suffering from Selective Mutism is working closely as a team with parents, the school, relatives and anyone else involved in the child’s life.
Trauma Therapies
Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)
TF-CBT is an evidence-based treatment for children and teens who have experienced one or more traumatic events and have symptoms of post-traumatic stress. TF-CBT was originally developed for use with children and teens who were sexually abused, but has been used effectively with those who were physically abused, witnessed domestic violence, or experienced multiple traumas. TF-CBT incorporates non-offending parents or caregivers throughout the course of treatment. Treatment includes education about trauma and common reactions, learning and practicing safety skills, assistance with parenting and behavior problems, stress management and coping skills, learning about feelings and ways to manage them, processing unresolved thoughts and feelings related to the traumatic experience, and family sessions to discuss the trauma together. Talking about the trauma is done in a gradual supportive manner after coping skills have been learned to manage any discomfort that arises.
Trauma-Focused Cognitive-Behavioral Therapy for Childhood Traumatic Grief (TG-CBT)
TG-CBT is an adaptation of TF-CBT for children and teens who have experienced childhood traumatic grief through loss of a loved one. TG-CBT involves the same steps as TF-CBT with additional sessions focused specifically on working through the grieving process in a healthy manner.