All Posts Tagged: children’s therapist

Darbi Miller, MS, LMFT – Consult The Expert About Increasing Relational Self-Awareness

In this month’s Consult The Expert interview, we spoke with Darbi Miller, MS, LMFT. She is one of the marriage and family therapists here at The Center For Treatment Of Mood And Anxiety Disorders. Although she likes working with all ages, she enjoys the dynamic surrounding family and relationships.

“One of my favorite things to work with is increasing clients’ relational self-awareness,” she said. “I also enjoy exploring peoples’ Families of Origin, which is connected to self-awareness from my perspective.”

What Is Relational Self-Awareness?

What does she mean by “relational self-awareness”? “Family of Origin and self-awareness are related,” she answered. “In any experience with another person, relational self-awareness can look like asking ourselves, “What is mine? What is yours? What is ours?”

“We each have our own stories, beliefs, and experiences,” she said. “Relational self-awareness looks at what each person brings to the table and how this affects the interaction between us. If we are self-aware, we have a compass for ourselves which translates into tolerance. We are able to share our personal values and beliefs and hear the other person’s.”

“If we are not self-aware, our interactions are based in fear. We begin looking for approval or we get defensive because we may feel we will “lose” in some way if we are vulnerable with the other person. When you have self-awareness, however, you can be vulnerable and can create more intimacy in all of your relationships.”

Ms. Miller talked about a Harvard study that has been following certain individuals over an 80-year period. One of the surprising things it has found is that the quality of our relationships has a higher impact on our health than even our cholesterol levels. “It turns out that surrounding ourselves with positive, close relationships creates a better sense of community within ourselves, which in turn, has a better health impact,” she reported.

So, how does relational self-awareness help with anxiety treatment? “With anxiety, behind that is usually fear on a basic level. Our thoughts are powerful. If you can get to the core and understand the fear (how can I feel more connection with myself?), connecting to your body and grounding yourself, allows this to be part of the healing process.”

How Does Family Of Origin Fit Into Mood Disorder Therapy?

Ms. Miller explained how Family of Origin can impact the treatment of anxiety and other mood disorders. “We come from our own system that was learned in childhood. This is the Family of Origin,” she explained. “This system has patterns, beliefs, and values that we can sometimes see, but sometimes aren’t aware of. We all have a family role – maybe we’re the funny one, the responsible one, or the nurturing one. This role can carry into our adult lives and play out between couples.”

“Sometimes people go into a relationship expecting it to heal their Family of Origin wounds,” she said. “Although it can happen that a new relationship can be good and healing, if we enter it expecting our partner to instinctively know what we need to heal, that may not be the case and we’re disappointed. If you are expecting your partner to heal you, where is this coming from? The answer leads back to relational self-awareness.”

How Can We Use These Concepts To Improve Mood Disorders?

We discussed how knowing what we bring with us from our Family of Origin can be used to help when dealing with mood disorders.

“Knowing what you have “inherited” and what you can change can be very empowering,” Ms. Miller told me. “You don’t have to operate out of same system you inherited. You have control. The realization that you don’t have to follow the same patterns – and you get to decide – can help with anxiety and trauma.”

“I mainly use this work for people who feel stuck in their life, work, and relationships,” she continued. “During therapy, my approach is always to start at the top. We begin with something action-focused, like behavior organization, and getting back into routines that can have a positive effect on the person’s mood and decrease anxiety.”

“I also use cognitive behavioral therapy to challenge negative thoughts. Taken together, these give people some relief. But if they are still looking for more, this is when we explore other things like Family of Origin and relational self-awareness.”

“When we look into Family of Origin, we can choose to do the work for ourselves and also within the family roles, with siblings and parents,” she said. “I typically go three levels up within the family to look at the generational dynamic. Doing this work can uncover patterns that influence a person’s mood, narratives, and the core beliefs that influence mood, which can be healing.”

“People want to explore these concepts, but in a safe space,” Ms. Miller said. “So, we balance a safe space with these tools, allowing them to go deeper to uncover the aspects that may be underlying their anxiety, depression, or trauma.”

We Are Here For You

If you are concerned that your child is struggling emotionally or showing signs of anxiety or depression, contact The Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

About Darbi Miller, MS, LMFT

Darbi Miller is a Licensed registered Marriage and Family Therapist. She has extensive training in Integrative Systemic Therapy however, does not believe one model fits all. Her approach is strength-based, collaborative, holistic, and geared to meet her client’s specific needs and goals. She works to truly understand each client and the systems that surround them. She believes therapy is a courageous step and feels privileged to bear witness to their journey. Through her authenticity, empathy, and compassion, she provides a safe space for exploration. Darbi works to integrate her knowledge into meaningful and collaborative sessions with individuals, couples, and families. Her areas of interest include walk/talk therapy, the mind/body connection, increasing relational self-awareness, high-conflict couples, and full family work. 

She holds a Bachelor of Arts in Psychology from Michigan State University and a Master of Science in Marriage and Family Therapy from Northwestern University, where she received academic distinction. She is also certified as an Eating Psychology Coach and a Prepare/Enrich Facilitator. Darbi has worked in a variety of settings including schools, hospitals, university clinics, and in-home. She also published an article in the Encyclopedia of Couple and Family Therapy on conjoint sex therapy.

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Jamie Levine, Psy.D – Consult The Expert On Psychoeducational Evaluations For Children

In our first Consult The Expert article for March, we had the opportunity to speak with one of our clinical psychologists, Dr. Jamie Levine. One of her areas of specialization is working with children who have school-related difficulties.

“So many components can negatively impact a child’s learning and performance in a school setting,” she explained. “These could be things like attention concerns, learning challenges, developmental difficulties, social or emotional concerns, and even challenges within the home environment. Sometimes there is an overlap of these aspects, as well.”

When working with a child who is challenged, Dr. Levine often recommends a psychoeducational evaluation. “This type of evaluation is very comprehensive,” she says. “It looks at many areas that could be affecting the child’s ability to learn.”

Indeed, an evaluation can reveal some of the challenges that can impact learning, including:

  • Cognitive (ie: what underlies the child’s learning concerns? How does the child approach new problems?)
  • IQ
  • Academic ability (reading level, math, writing)
  • Task abilities (for example: ability to focus, attention to a task, impulsivity)
  • Language skills
  • Memory

“A psychoeducational evaluation helps me understand what is at play for that particular child, so I can provide the correct support or interventions for their unique situation,” Dr. Levine said.

When Is A Psychoeducational Evaluation Done?

A psychoeducational evaluation may be requested for many reasons. An educator might ask for an evaluation if they notice the child struggling to learn or acting out in the classroom. Maybe the child’s parent wants an evaluation to find out why their child seems to be having a hard time staying focused or is resisting going to school. Perhaps the pediatrician picks up on a parent’s frustration when the child won’t sit still or seems overly anxious or fearful.

Whatever the reason for testing, Dr. Levine says the evaluation will help to identify the child’s strengths, along with the areas that are impacting their learning ability. “Once we have the evaluation results, we can make recommendations for how to work on building these strengths and providing interventions for areas of concerns within the classroom or through services outside of school.”

Who Performs A Psychoeducational Evaluation?

A psychoeducational evaluation can be conducted in a school setting or private setting, according to Dr. Levine.  “In a school setting, the testing will likely be completed by a school psychologist. Outside of school, a comprehensive evaluation should be performed by a clinical psychologist who specializes in evaluations.”

But, is there a benefit to having the child evaluated in a private setting versus a school setting?

Although a school can evaluate a child, Dr. Levine discussed the benefits of testing in a private setting. “When a teacher picks up on concerns, the school may do some testing, but it may be limited in scope,” she says. “It can take a while to start the evaluation process. Often, schools try to provide some intervention first and testing waits until they see the results of the interventions.”

She also points out that, while schools may use some similar evaluation measures to the assessments that are used in the clinic, school testing typically does not provide a specific diagnosis. “The child can be struggling academically, but a school usually won’t diagnose something like ADHD or a specific learning disorder. Because of this, they may provide accommodation and support for the child’s challenges, but not interventions or treatment. If the parent wants an understanding of the specific diagnosis, so a targeted treatment plan can be implemented, it is helpful to have the child evaluated in a private setting, such The Children’s Center.”

How Long Does A Psychoeducational Evaluation Take?

“These evaluations are extremely comprehensive,” Dr. Levine says.  “I tailor the testing to each child, based on his or her concerns. When I do an evaluation, I first meet with the parents for about 1.5 hours to get background information about the child. After I have this preliminary information, there are typically three additional appointments with the child for 2-3 hours each.”

Who Sees The Evaluation Results?

“In a private setting, the evaluation results are discussed with the parents,” Dr. Levine said. “The parents are also provided with a full write up of the results, any diagnosis, and our recommendations. We also encourage the parent to share these results with the school so the child can be supported with any accommodations and interventions that may be needed. We are always happy to collaborate with the child’s school.”

Parents may be concerned about a child being “labeled” if the results are shared with the school, but Dr. Levine says there are many benefits to doing so. “Sharing test results can help with teacher understanding of the child and empathy, as well as accommodation that can benefit the child. Also, we can recommend strategies that teachers can use to support the child in the classroom.”

A better understanding of a child’s strengths and weaknesses is also helpful for the parents and child. Children often recognize that they are facing challenges and could possibly label themselves as “stupid” or “dumb” if they don’t have an understanding of their diagnosis.

Once the child knows the reason behind their frustrations, however, it can be liberating. Instead of feeling negative about themselves, the child can address any concerns and work to improve them. “Really,” Dr. Levine pointed out, “the benefits of testing outweigh the risk of labeling by having the knowledge of what is impacting the child.”

If Your Child Is Struggling…

…the child and clinical psychologists at The Center For Anxiety Disorders can help. For more information or to inquire about a psychoeducational evaluation, contact us or call us today at 561-223-6568.

About Jamie Levine, Psy.D – Clinical Psychologist

Dr. Jamie Levine is a licensed clinical psychologist who specializes in the treatment of anxiety disorders, mood disorders, relationship difficulties, adjustment to life transitions, and ADHD. She uses a collaborative therapeutic approach to create a safe, supportive, and open environment to facilitate growth and change. She integrates a variety of therapeutic approaches, including cognitive-behavioral therapy (CBT), psychodynamic, interpersonal, and solution-focused therapy.

Dr. Levine graduated from Emory University with a bachelor’s degree in Psychology. She earned her doctorate degree in Clinical and School Psychology from Pace University in New York City. Dr. Levine received training at Columbia University Medical Center/ New York-Presbyterian Hospital where she provided evidence-based treatment and conducted neuropsychological assessments. She also provided therapy services to individuals across the lifespan at Nova Southeastern University’s Psychology Services Center and Pace University’s outpatient mental health center.

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Jerome Siegmeister MD

Jerome Siegmeister, MD, MaED – Consult The Expert On How Virtual Schooling Is Affecting Children

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.”

About Jerome Siegmesiter, MD, MaED. (Child And Adolescent Psychiatry / General Psychiatry)

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.

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college student studying

Anxiety Rises Among College Students During The Pandemic

Another year of college is in full swing across the country.  In an effort to control the spread of Covid-19 among their students, some schools have gone to strictly virtual learning. Others, however, are combining this option with in-person classes, which creates a higher chance of exposure to the virus. In addition, many campuses are dealing with students who flaunt social distancing guidelines and gather for parties, which spreads it even more. While many young people were eager to get back to college after being fairly isolated during the summer, we are finding that these seemingly reckless situations are negatively impacting the mental health of many students.

Earlier this year, the American College Health Association collected information for their Spring, 2020, National College Health Assessment. At that time, an average of 49.6 percent of the 50, 307 respondents reported moderate levels of stress. Another 24.9 percent said they were experiencing high levels of stress – and that survey only included schools who had begun their data collection prior to March 16, 2020, when many states began shutting down. Today, those numbers are much higher.

In fact, the results of a study done at nine public research universities across the U. S. and led in part by the University of California, Berkeley, Center for the Study of Higher Education (CSHE), shows the incidence of major depressive disorder among college students has more than doubled since Spring, 2019.

Anxiety Symptoms

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pink ribbon for breast cancer

Supporting A Child Whose Parent Has Cancer

It is October – a time for pumpkins, Halloween…and breast cancer awareness. The numerous pink ribbons we’ll see this month focus attention on the many women (and men) who are facing a breast cancer diagnosis and treatment. But what about the kids who have a parent or primary caretaker with cancer? For a child, coping with a loved one’s diagnosis can be particularly traumatic.

In this article, we’ll answer your questions about the best ways to discuss a parent’s cancer diagnosis and give you some ideas for supporting a child whose parent has cancer.

Should I Use The Word “Cancer” When Talking To My Kids?

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