Divorcing Parents

Many children today are having to confront the stress of parents separating and divorcing.  We aim to help families set aside their anger and hurt in order to find ways to put the children’s best interest first.  Children often need to work through feelings of sadness, disappointment, anger, frustration, and confusion with someone other than a parent.  Some children need strategies for managing their feelings, for handling many changes and  for coping with new time-sharing agreements.  Individual therapy or family therapy may be recommended.

Eating Disorders

Eating Disorders are a complex combination of physical and psychological problems.  There are various forms of eating disorders, including anorexia and bulimia.  People with eating disorders are obsessed with food in one way or another beyond their voluntary control.  Over time, this obsession leads to deterioration in physical health, relationships, concentration, dealing with feelings and daily functioning.  The focus on appearance, body image, calories, and weight eventually becomes all-encompassing.  Proper treatment can make a difference.  At Silber Psychological Services, we have therapists who have experience in the treatment of eating disorders.  Establishment of normal weight and healthy eating patterns is the priority;  later, the resolution of psychological, social and family issues that may be contributing to the eating disorder can be addressed.  The treatment package may include Individual Therapy, Family Therapy, or Group Therapy.

Family Issues

We live in a time where there is no standard definition of family. Families today take on many shapes and sizes. Sometimes, as families go through various stages and changes, adjustment problems arise. Problems related to separation and divorce, blended families, moving, and births and/or deaths of family members are among top reasons children and families are referred to a psychologist. Sometimes, problems arise with communication and with making adjustments to normal life stage transitions. Family members may notice either increased conflict between members or detachment from one another. Problems within the family may affect a child's behavior at school, as well as his or her emotional state. Parents may feel helpless and distressed when faced with managing serious family issues. When family issues arise, it is important that a psychologist conduct a comprehensive diagnostic interview with family members to determine the presence of other factors that might be attributing to family functioning problems, including the presence of depression, anxiety, or other disorders. Your therapist can discuss with you the best treatment options. Typically, the optimal treatment for family issues is family therapy.

Fears and Phobias

Some children have excessive fears and phobias which the child experiences as extremely distressful and affects the child's ability to handle school, family, and friendships. Children may show fears by crying, freezing, temper tantrums, or clinging behavior. Children may be afraid of social situations, animals, natural disasters, and other such situations. Treatment may be needed to help your child manage and conquer their fears or phobias, as well as handle stress more appropriately. Treatment may involve individual therapy, parental consultation, group, or family therapy.

Learning Disability (LD)

A Learning Disability is a condition that interferes with a child’s ability to learn, understand and produce information.  Parents may first suspect a LD when they recognize difficulty in a specific subject area or may sense more generally that their child is not working up to his or her potential.  Learning Disabilities can be diagnosed in areas such as reading, writing, mathematics, visual processing, auditory processing, language processing, and memory.   Learning Disabilities are, in part, diagnosed when there is a discrepancy between overall ability level and a particular set of skills.  We do not know with certainty what causes learning disabilities,  but they are often present in children with average and above average intelligence.  Sometimes other problems can be related to Learning Disabilities, such as social deficits, extreme frustration or self-esteem struggles.  If an LD is suspected, a thorough evaluation and assessment are critical.  Diagnosis of an LD requires the collection from multiple data sources and clinical judgment by  a psychologist.  If an LD is diagnosed, there are a number of strategies which can be put into place in the home and school environment which can assist the child.

Obsessive-Compulsive Disorders

Obsessive-Compulsive Disorder (OCD) is characterized by recurrent, unwanted, and unpleasant thoughts (obsessions) and/or repetitive, ritualistic behaviors which the person feels compelled to perform (compulsions). Usually people with OCD recognize that their obsessions and compulsions are irrational or excessive yet continue to find that they have little control over them. Oftentimes, the OCD causes either marked distress, is time consuming, or interferes with a person's normal routine. The most common obsessions are repeated thoughts about dirt, germs, and contamination; a fear of acting on violent or aggressive impulses; feeling overly responsible for the safety of others; or needing to have things in a particular order. The obsessions are not simply excessive worries about real life problems such as school problems but usually are more frequent and intense. Typical compulsions involve excessive washing, cleaning, checking, or repetitive actions such as touching, counting, arranging, ordering, hoarding, and ritualistic behaviors. A person may have few or many of the symptoms. An individual assessment with therapy and on some occasions medication may help lessen the intensity and frequency of OCD and allow the person to lead a normal life.

Oppositional Defiant Disorder

Oppositional Defiant Disorder is a recurrent pattern of defiant, disobedient, and hostile behavior toward authority figures. Typical behaviors include arguing with adults, refusing to follow directions, persistently testing limits, and failing to accept blame for misdeeds. To be qualified as Oppositional Defiant Disorder, these problems must be more frequent and severe than in children at a similar level of development. Treatment of Oppositional Defiant Disorder typically involves providing behavior management strategies to parents for increasing compliant behavior and decreasing arguments and power struggles. Interventions may include parenting classes, compliance training, and individual or family therapy.

Parenting Issues

Parenting can be a very daunting task, whether your children are preschoolers or teenagers. Striking the balance between being loving and nurturing and providing rules and limits is especially challenging, particularly if your child has learning, behavioral, or attentional problems. Treatment is available for parents who are seeking solutions for managing difficult behavior or fine-tuning their parenting skills. Together with your therapist, decisions can be made as to whether parenting classes, compliance training, or family therapy may be most helpful in honing your parenting skills and making things run more smoothly in your home.

Self-Esteem

Self-esteem is essentially the way in which a person feels about him or herself.  Self-esteem affects the way someone lives, thinks, acts, gets along with others and succeeds in life.  Parents often become understandably concerned if a child exhibits symptoms of a poor or negative self-esteem over any period of time.  There may be various issues at the root of a poor self-esteem, including traumatic experiences, depression, social problems, or family conflicts.  Low self-esteem can sometimes lead to other problems as well.  Treatment for self-esteem issues will often be aimed at uncovering the causes of the difficulties, as well as also finding ways to encourage the child to view him or herself more positively.  Psychological Testing may or may not be warranted, depending on the extent and length of the difficulty.  Therapy in an individual, family or group format may be indicated. 

School Problems

A child or adolescent who comes to see a psychologist may be experiencing any of a number of school problems.  Problems at school may be academic, social, emotional, or motivational.  On a larger scale, problems may arise from a “goodness of fit” issue between teacher and student, student and peer group or student and a particular academic setting.  In many cases, addressing school problems begins with a comprehensive evaluation of the child.  This type of evaluation allows the psychologist to assess the child’s cognitive, academic, attentional, and emotional strengths and weaknesses in order to determine the appropriate course of action.  In some instances, a psychologist may be sent out to the school (after obtaining consent from parents and teacher) to observe the child in his or her natural environment and obtain further data to shed light on the root cause of the school concerns. 

If the problems appear to be academic in nature, the psychologist will make recommendations for effective interventions and, when warranted, advocate for the child within the particular school system.  If the difficulties seem more related to social or emotional functioning, a course of therapy may be recommended and the psychologist may consult with teachers and administrators to make suggestions about appropriate responses to the child’s behavior.  If there is a goodness of fit issue, the psychologist may assist by improving communication between the family and school personnel and as a last resort make recommendations about alternative educational settings.  To effectively address the factors that contribute to poor school functioning, the psychologist will collect detailed information from multiple sources, devise strategies to optimize the child’s success at school, and advocate for parents and school personnel to work together to highlight the child’s individual strengths, acknowledge his or her weaknesses, and facilitate improved functioning overall.

Social Skills Deficits

Some children have a social, communication, and/or relationship problems. They may be too shy, react impulsively, continually create conflicts, seem unaware of interpersonal cues, have few social skills, or simply find it hard to make or keep friends. Adequate social skills are vital to getting along with others and forming satisfactory relationships with peers. Peer rejection or lack of positive peer interactions impact negatively on children’s functioning at school, their moods, their attention to other life tasks and general self-esteem.  For children experiencing such problems, social skills training or group therapy may be the treatment of choice.

Tics and Habits

In going through normal stages of development, some children may develop an ongoing habit such as thumb sucking, hair pulling, head and shoulder jerking, lisping, and biting nails. If the habit involves recurrent pulling out of one's own hair or eyelashes, it is called trichotillomania. While pulling out hair can occur under stressful circumstances, they can also occur in states of relaxation and distraction such as when reading a book or watching television. For children experiencing such problems, individual therapy using behavioral intervention strategies can oftentimes help in reducing the manifestations of the problem. If there is a neurological problem, medication may also be useful.