All Posts in Category: General

Psychological evaluations

Psychological Evalutations

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.

As part of the evaluations we are conducting now, we will take the following steps:

  • Meet with parents via video conferencing and collect information so we can learn about your child’s emotional, behavioral, and social functioning.
  • Meet with the child via video conferencing to assess if they would be a good fit for a remote evaluation. If so, we will proceed with evaluating cognitive and academic abilities and social and emotional functioning via video conferencing. We will also be able to assess aspects of attention, impulsivity, language, and memory. We may decide that additional in person testing will be helpful.
  • Collect information from your child’s teacher through teacher rating forms and interviews.
  • Collect information from your child’s medical and school records if needed.

This information will help us gain a better understanding of your child and their unique needs and will allow us to provide consultation and recommendations to support your child both at the home and at school environments.

Additionally, we can provide psychological evaluations to help with diagnosis of mental health concerns and to assist with treatment planning.

Schedule a psychological evaluation for your child.

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.

Read More
COVID paradox

The COVID Paradox

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? Much of it comes from the unseen enemy, this virus that is only visible under special microscopes. Some of it comes from the fact that its genetic structure is novel. No human being had been exposed to it prior to its appearance in Wuhan so our immune systems had no defense against its onslaught. It is extraordinarily infectious so that an infected person will infect several people in close proximity over time.

What is the paradox that I am referring to? Actually, there is more than one paradox. The first one involves the media explosion that began last century and has exponentially continued this century. We appreciate all the benefits from being plugged in 24/7 to social media, internet messaging and an abundance of television news all day long. The digital revolution that amazed us has also proved to be harmful to our emotional well being. Multimedia exposure during the COVID pandemic has been like watching a horror movie that never ends! What we valued and embraced has turned out to be a traumatizing process. If you check the Centers for Disease Control website for data on the influenza outbreak for the 2018-2019 season you will find that 35.5 million Americans came down with the flu, 490,000 hospitalizations resulted, and there were 34,200 deaths. Imagine if the media tracked the annual flu season like they have tracked the COVID pandemic. Every flu season would be emotionally traumatizing. We certainly don’t go into lockdown every year for the flu nor do we social distance. We do have a flu shot available, but data on its effectiveness suggests a 45% effectiveness this past season. Our advantage with influenza is that over time, all of us have had some level of exposure to this family of viruses imparting a degree of “herd immunity.”

This brings us to the core paradox. If we stay locked down and isolated indefinitely there will be no herd immunity developing. The concept of herd immunity means that if enough of our population is exposed and develops immunity to this virus, ongoing spread becomes very difficult. For example, smallpox, chicken pox, measles and mumps had been the scourge of society until the administration of vaccines essentially created a herd immunity.

We will eventually have an effective vaccine for COVID-19 but it will be some time before we will be able to provide mass inoculation. If there had been no COVID-19 social isolation our healthcare system would be over run, resulting in a tsunami of fatalities.

So the course that is being taken is to gradually open up our lockdown while we carefully prepare for future waves of illness. Be reassured that there will come a day in the not too distant future that this horrible virus will be no greater a threat than the annual flu. That time will come.

Connect With A Child Psychologist At Our Children’s Center

If your child is experiencing anxiety related to the COVID-19 pandemic, our child psychologists are available for online services. 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.

Read More
teen wearing fack mask

Is The COVID-19 Pandemic Affecting Your Child’s Mental Health?

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?

Why Kids Need Mental And Emotional Support During COVID-19

The stress and apprehension surrounding the coronavirus pandemic has altered children’s day-to-day world in a huge way. We know that natural disasters such as this can have a long term effect on kids, just as they can for adults.

As an example, one researcher, Carolyn Kousky, noted that in studies of children’s mental health after Hurricane Katrina, “researchers found high rates of PTSD symptoms as well as other negative mental health impacts and behaviors, such as aggression in adolescent.”

For older children, the added disappointments that have come along with the safer-at-home orders – such as the cancellation of graduations and proms, no school athletic games or activities, and isolation from friends – is sure to have emotional consequences, too.

In fact, it was reported in a 2013 study that researchers found that kids who had gone through a quarantine for disease control scored four times higher on a post-traumatic stress test than children who had not had that same experience.

How To Help Your Child Through Pandemic Anxiety

It’s important for parents and adult family members to help kids make sense of the pandemic, especially in an accurate way that minimizes their fears.

  • Let your child know that you are available to talk if they have questions.
  • When talking to your children, do so in a calm voice. Try to be reassuring and also remember that kids will pick up on cues in your body language and tone.
  • Consider reducing or limiting news broadcasts and screen time so your child doesn’t become overwhelmed by news coverage of the pandemic.
  • Remember that this pandemic can affect anyone, so try not to condemn or ridicule someone you know who may have contracted the virus.
  • Remind kids that rumors run rampant on social media and that many stories are inaccurate.

Teach your children how to stay safe during the pandemic (and afterward):

  • They should wash their hands with soap and water for at least 20 seconds (have them sing the birthday song twice as an easy way to count the time). They especially need to do this after sneezing, blowing their nose, or using the bathroom, and before eating or handling food. Hand sanitizer is a great option if soap and water are not available (supervise young children if they are using hand sanitizer).
  • If your child needs to sneeze or cough, they should do it into their elbow or a tissue (then throw the tissue in the trash).
  • Stay away from those who are sick or are sneezing or coughing.
  • Keep things that they touch clean. Wipe down frequently used objects such as doorknobs, light switches, the television remote, their phone or tablet frequently with a disinfectant to avoid spreading germs.

It’s important for parents to take steps to address and reduce any COVID-19 anxiety their children may have, so they can avoid any long term consequences. KidsHealth.org provides some great resources for keeping kids busy during the pandemic and offers some helpful hints for addressing the topic with your child.

Connect With A Child Psychologist At Our Children’s Center

If your child is experiencing anxiety related to the COVID-19 pandemic, our child psychologists are available for online services. 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.

Read More

Coping With COVID-19

The virus pandemic has certainly had an impact on all of us. Not being able to meet with my patients in person has required a major clinical adjustment. Thankfully, telemedicine has provided me with the ability to provide necessary ongoing treatment. But I also know firsthand how difficult and taxing social isolation and sheltering in place can be.

What has made this viral illness so stressful? After all, we have been dealing with annual episodes of influenza for decades. We also successfully made it through the fears of the bird flu, SARS, and swine flu. What makes Covid 19 so special and so scary? Covid 19 is called a novel virus because it is a protein that is totally new to the world’s human population’s immune systems. Our immune systems therefore do not have the capacity to adequately fight off this infection. The elderly and those with chronic illnesses are especially at risk. But 20 to 65 year olds are not immune from infection and risk severe illness if they are not cautious and follow CDC guidelines.

We can all agree that there are reasons to be fearful of this unique virus. We would all agree that sheltering in place and social isolation plays a role in our unease and insecurity. The inability to see loved ones and friends certainly takes a toll. Job loss and the subsequent financial stressors contributes as well. Lack of definitive treatment or a protective vaccine adds to our worries. But the level of emotional unrest seems to be much greater than what these issues would suggest. So what accounts for our level of apprehension?

It is my belief that our emotional upset and fearfulness is being fueled by an incessant level of media exposure, a 24/7 bombardment of our senses by vivid and at times sensationalistic accounts of the impact of this illness on our society. The negativity is inescapable. The drama can be horrifying. I do believe that we are being psychologically traumatized by the effects of this multi-sensory media explosion. Modern theories of post traumatic stress disorder have now implicated the impact of day to day low level traumatic experiences. We certainly deserve to be kept up to date, but non-stop communication of human suffering at this level can be seriously problematic.

So what can we do to minimize the stressors of these times? The answers are rather straight forward and simple. When the world around you seems out of control, frightening and foreign it is important to pay attention to our own personal world and life space. You may not be able to change what is outside of you but you certainly can have the ability to influence your own world. These are some basic guidelines to follow:

  1. Add consistency, structure and predictability to your day to day life.
  2. Go to bed at the same time every night and awaken at the same time the next day.
  3. Schedule exercise, studying, work (if you are lucky enough to still be working), meals, fun etc. at set times.
  4. Get outside while following CDC guidelines on a regular basis, even if it means sitting on a balcony or patio for extended periods.
  5. Do not allow yourself to isolate. Maintain social contacts through phone calls, video chats, emails, etc. Socialize with a friend or family member while maintaining the appropriate safe distance.
  6. Limit your news media exposure. Get the data you need to be adequately informed but don’t give in to the tendency to be a news voyeur. Sensationalistic news coverage can be addicting. Be careful and avoid over exposure.
  7. Attend to your basic activities of daily living that include your appearance and hygiene, maintaining healthy nutrition and caring for your living space.
  8. And most importantly, recognize that this period of difficulty and sacrifice will come to an end.

There will be life after Coronavirus. At some point in the near future, this virus will be treated no differently than the annual influenza virus. The same way that pharmaceutical companies formulate the year’s flu vaccine by taking into account the types of flu viruses prevalent that year, it will also include the coronavirus as part of the vaccine recipe.

The real challenge for the future will consist of what we can learn from this experience. How can we be better prepared? How can we improve our healthcare system and its inequities? How can we maintain the improvement in our environment that has resulted from reduced pollution, crowding overuse of natural resources? How can we return to person to person human contact and minimize communication through digital media only? How can the media learn to balance coverage with more hope and support? I wish that I had the answers. We shall have to wait and see.

For more information or to schedule an appointment call us at (561) 223-6568 or contact us here.

Read More
Telehealth

A Message About Telehealth Amidst COVID-19

We hope that you, your children and families are doing well in the midst of this unprecedented time. After carefully considering the CDC guidelines, we at The Children’s Center have decided that we will no longer be conducting therapy in our office at this time.

In good news, we have the capability to conduct appointments either over the phone or via Telehealth. We are happy to keep all appointments during this time. If you already have a scheduled appointment but you would prefer to postpone your to a later date or an alternate time, we are happy to do that as well.

We greatly appreciate your understanding during this difficult time. Please do not hesitate to contact us with any questions or to schedule an appointment at (561) 223-6568.

Read More
woman talking on a cell phone

How Being On Your Phone Affects Your Child

woman talking on a cell phoneWe are all so “connected” nowadays. Everywhere you look, you see people of all ages engrossed in the online world. Children are asking for cellphones at younger and younger ages, while parents often seem so attached to their devices that they barely pay attention to their children. This brings up the question of how being connected to your own phone and devices might be affecting your child.

A colleague recently told me what she had witnessed during her last dental visit: a father came in with two young children under the age of 6. All three of them were on their own devices (dad had a phone, each child had an iPad).

When the little boy was being examined, he was told he had his first loose tooth. The child was so excited and he kept exclaiming, “Daddy! Daddy, my tooth is loose!”

The father barely acknowledged this milestone, even after several attempts by his son to get his attention. Finally, although he did not even look up from his phone, he muttered, “Uh huh, that’s great.” My colleague’s heart broke when she saw how disappointed the little boy was with his father’s lack of response.

In effect, the father had just told his son that whatever he was looking at on his phone was much more important than his child.

Are Parents Addicted To Their Phones?

Several studies and many experts say the answer is “yes.”

A 2015 study done by the online security company, AVG Technologies, found that more than 50 percent of the children who took part in the research ”felt that their parents checked their devices too often (54 percent); and their biggest grievance, when given a list of possible, bad device habits, was that their parents allowed themselves to be distracted by their device during conversations (36 percent) – something that made a third of the complainants feel unimportant (32 percent).”

How does this affect a child’s development? Children learn things like social cues, how to regulate emotions, and how to have conversations by watching and copying their parents. If a parent is hardly interacting with their child, it stunts the child’s development in these social skills.

In a recent opinion article in USAToday, Theresa H. Rodgers, a speech-language pathologist and the 2020 president of the American Speech-Language-Hearing Association (ASHA), stated that, “Many of my colleagues across the nation say they are seeing more children entering kindergarten with limited communication and social skills. Older children, they say, are unable to handle formal social interactions, like ordering from waitstaff at a restaurant.”

What Are The Effects Of Cell Phones On Family Relationships?

According to an article on NPR, after watching a mother ignore her smiling, babbling infant in favor of viewing a YouTube video, Dr. Jenny Radesky, a pediatrician who specializes in child development, began to wonder about the effects of cell phones on family relationships. This led her to conduct a study (albeit an unscientific one) with the help of two colleagues over one summer. Together, they observed 55 family groups who were eating at fast food restaurants.

What they found was “forty of the 55 parents used a mobile device during the meal” and seemed to focus more on their devices than on their kids.

When children feel ignored, they often act out to get their parent’s attention. In her book about parenting, called The Big Disconnect: Protecting Childhood and Family Relationships in the Digital Age, psychologist Catherine Steiner-Adair talks about how parents who ignore their kids in favor of their devices are telling their children “they don’t matter, they’re not interesting to us, they’re not as compelling as anybody, anything, any ping that may interrupt our time with them.”

Further, when Dr. Steiner-Adair did the research for her book, she interviewed 1,000 children, ages 4- to 18-years old. She kept hearing from the kids that they felt “sad, mad, angry, and lonely” when their parents were on their cell phones. This was so upsetting to them that some kids made a point of hiding or damaging their parent’s smartphones.

Help For Parent’s Cellphone Addiction

It can be hard to break your dependence on screen time, even though it’s what is best for your children (and, frankly, yourself). Try these ideas:

  • Limit your use of your cell phone and devices to just 10 percent during the time you are with your child. You can dash off a quick text if it is important, but for the most part – put the phone away.
  • Keep bedrooms, mealtimes, and parent–child play times screen free for children and parents.
  • Use phone apps to remind you when it’s time to stop using the phone.
  • Turn off the majority of your notifications.
  • Delete or limit your social media apps.
  • Stop using your phone as an alarm clock because it’s too easy to get caught up in checking for updates from friends, scanning texts, and reading emails if you pick up the phone to turn off the alarm.

Contact Us To Learn More

For more information and help with breaking your cellphone addiction, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

 

Read More
Overcontrol and social anxiety

What Is Overcontrol And Is It Contributing To Your Social Anxiety?

One of the most quickly growing areas of clinical research and treatment implementation is for people who are considered to be overcontrolled. What does being overcontrolled mean, and what does it have to do with feeling socially anxious? The concept of self-control refers to the ability to inhibit problematic behaviors. This is generally accepted by our society as a positive thing to have! It is true that to an extent, being overcontrolled can be very adaptive and helpful. Overcontrol is associated with the ability to delay gratification, follow rules, and valuing accuracy and fairness. However, when these traits are very pronounced and overemphasized, they can become problematic and affect our mental health. It’s like having too much of a good thing.

Social and Emotional Impact of Overcontrol

There are common difficulties with people who have maladaptive levels of overcontrol. The first is low receptivity and openness. This can result in avoidance (a hallmark of anxiety disorders) and an aversion to having new or novel experiences. Also, there tends to be a strong need for order, structure, and rules. There is a focus on right and wrong, which we know is not conducive for more flexible thinking (which is important for decreasing anxiety symptoms). The third feature is reduced emotional expression and emotional awareness. This means that people who are maladaptively overcontrolled may not display emotions that one would expect (having a flat face when someone tells a joke), making it difficult for others to feel connected to them. The final trait that tends to cause difficulties for people is feeling a lack of closeness to others, and/or feeling different from other people. Loneliness and isolation are often experiences of those who are overcontrolled.

 

Given these features, it is not uncommon for people with chronic social anxiety to also be overcontrolled. The reliance on emotional and situational avoidance makes it difficult for people to learn new things (challenging their social anxiety) and feel connected to others. Their difficulty in successfully social signaling to others often results in them being disliked or rejected (a self fulfilling prophecy). People who are more overcontrolled also tend to engage frequently in social comparisons, which is also frequently observed in the socially anxious population.

Learning to Open Up and Connect

The most effective treatment for disorders of overcontrol (which include chronic depression, treatment resistant anxiety, obsessive compulsive personality disorder, and anorexia nervosa) is called Radically Open Dialectical Behavior Therapy. It is a skills-based protocol to help people struggling with overcontrol to be more open to experiences, and more emotionally expressive in order to connect with others in a more meaningful way. We are a social species, and when we feel disconnected from others, this impacts our mental health. RO-DBT is conducted both individually and in thirty-week classes. For more information, check out www.radicallyopen.net.

How to Get Help for Social Anxiety

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.

Read More
person typing on a laptop

Technology, Screen Time, And Children’s Mental Health

It’s no secret that people are somewhat “addicted” to their screen time. Just look around you at any restaurant and you’ll see families and friends interacting more with their phones than with each other. The same hold true for almost anywhere you go: some people can’t even take their eyes off their screens when driving or walking, which has resulted in numerous accidents and deaths.

In a 2018 study done by the Pew Research Center, 54 percent of teens aged 13 – 17 said they were concerned about the amount of time they were spending online and on their phones. In fact, they were so alarmed about it that “Some 52% of U.S. teens report taking steps to cut back on their mobile phone use, and similar shares have tried to limit their use of social media (57%) or video games (58%),” according to the researchers.

Parents don’t do much better. The study reported that, “36% say they themselves spend too much time on their cellphone.”

Because of all the time spent watching screens, research is being done to find out the physical and emotional effects it might be causing for us.

What Does Too Much Screen Time Do To Your Brain?

Since phones and computers have only been easily accessible and affordable for people in the last thirty years or so, we don’t yet know the long term effects of screen time on the brains of kids or adults. But, we do know that, because children’s brains are still in the process of developing and growing, it seems likely that they would be affected by this technology.

The Adolescent Brain Cognitive Development (ABCD) study by the National Institutes of Health agrees. It has been following more than 11,000 kids, ages 9 and 10 years old, at 21 different areas throughout the United States. According to an article on Healthline, the initial results of the research show that:

  • MRI scans found significant differences in the brains of some children who reported using smartphones, tablets, and video games more than seven hours a day.
  • Children who reported more than two hours a day of screen time got lower scores on thinking and language tests.

The scary thing is that it will take many more years to discover whether these effects are the result of too much screen time or whether the differences were from something else.

So, does that mean adults are safe from the adverse effects of too much screen time? Actually, no.

Today’s adults have been estimated to spend more than 10 hours a day in front of screens (Harvard T. H. Chan School Of Public Health). Because the activity is sedentary, this exposure has been linked, in part, to higher obesity rates (which can lead to diabetes) and sleep problems.

Additionally, when asked, 15 percent of adults reported that they were more likely to lose focus at work due to checking their cellphone, which is double the number of teens who have trouble focusing in class for that same reason.

And, the Pew Research study indicates that more than half of teens (51 percent) say their parents are “often or sometimes” distracted by their own phones while in conversation with their child, leading to feelings of unimportance in the child.

What Are The Emotional Effects Of Too Much Screen Time?

For kids, anxiety, depression, and loneliness are often the result of too much screen time. A 2018 population-based study by Twenge and Campbell showed that after an hour of screen time per day, “…increasing screen time was generally linked to progressively lower psychological well-being.” The researchers also noted that, “High users of screens were also significantly more likely to have been diagnosed with anxiety or depression.”

But maybe screen time isn’t bad if kids are texting or gaming together? After all, they are interacting with each other and developing social relationships, right?

Again, the answer is ‘no’. According to a Psychology Today article by Victoria L. Dunckley M.D., “…many parents mistakenly believe that interactive screen-time—Internet or social media use, texting, emailing, and gaming—isn’t harmful, especially compared to passive screen time like watching TV. In fact, interactive screen time is more likely to cause sleep, mood, and cognitive issues, because it’s more likely to cause hyperarousal and compulsive use.”

In addition to the physical and psychological effects, too much social media time can lead to problems with social skills and their application, as well as a decrease in self-esteem – in both children and adults. Furthermore, kids can be bullied online while sitting right next to their parents and they can’t get away from it.

How To Limit Screen Time

For parents who are wondering how to limit their child’s screen time, the American Academy of Pediatrics set out updated media guidelines based on the latest research. They suggest:

  • Don’t use screen time as a way to calm your child down or as a babysitter.
  • For children under 18 months old, no screen time.
  • For children 18 to 24 months old, parents should choose only high-quality media and watch it with their child.
  • For children 2 to 5 years old, less than one hour per day of high-quality programming is recommended, with parents watching along.
  • No screens 1 hour before bedtime, and remove devices from bedrooms before bed.
  • Keep bedrooms, mealtimes, and parent–child play times screen free for children and parents. Parents can set a “do not disturb” option on their phones during these times.

For adults who are trying to limit their own screen time:

  • As with the suggestions for kids: Keep screens out of the bedroom and stash them somewhere else during mealtimes and parent–child play times.
  • Use phone apps to alert you when it’s time to stop using the phone.
  • Turn off the majority of your notifications.
  • Delete your social media apps.
  • Stop using your phone as an alarm clock because it’s too easy to get caught up in checking for updates from friends, scanning texts, and reading emails if you pick up the phone to turn off the alarm.

We Can Help Break The Screen Time Cycle

If you are concerned about your teen or ‘tween’s screen time amount – or your own – we can help you take steps to “disconnect.” 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.

Read More
Call Us (561) 223-6568