psychology services in South Charlotte

When working with children, we often ask parents to partner with us.  A set of skills parents can help build at home are emotion regulation skills. Emotion regulation skills include being aware of, describing, and managing feelings. These skills play a key role in healthy emotional development. I encourage parents to talk about feelings, role model emotional control, and use visual aids to label emotions. One young child I’ve worked with has very special parents. What they came up with is a great inspiration. Check out this dining room that has been converted to a state-of-the-art emotion regulation skills building center. Bravo!

Photo published with family permission.

Children and teens with a new diagnosis of AD/HDl may feel confused about what AD/HD means for them. Luckily, there are many books out there that are written in age-approapriate language. As part of a psycho-educaitonal evaluation or treatment for AD/HD, we often recommend some of the following books:

For Children:

• Learning to Slow Down and Pay Attention by K. Nadeau, Ph.D. & E. Dixon, Ph.D. (2004)

• Putting on the Breaks by P. Quinn, M.D. & J. Stern, M.A. (2008)

For Teens:

• The ADHD Workbook for Teens: Activities to Help You Gain Motivation and Confidence by L. Honos-Webb, Ph.D. (2011).

• The Girls' Guide To AD/HD: Don't Lose This Book! by B. Walker (2009)

 

For Young Adults:

• Survival Guide for College Students with ADHD or LD, by K. Nadeau, Ph.D. (2006)

• ADD and the College Student: A Guide for High School and College Students with Attention Deficit Disorder by P. Quinn, MD. (2001)

For more resources, talk to a psychololgist at Child and Family Development at either of our Charlotte offices.

Lost homework? Messy room and book bag? Cramming the night before a big test? Does this sound familiar?

Most teens can benefit from learning organization skills. Teenagers with ADHD have specific neurological differences that often affect executive functioning, or the pre-frontal cortex area of the brain that “executes” tasks. Executive functioning refers to fundamental brain-based skills of getting organized, planning, staying on task, and inhibiting impulses. Fortunately, parents and teenagers can work together to improve executive functioning.

Regardless of whether your child has ADHD, teaching him or her executive functioning skills can foster independence and success. The first step often involves becoming aware of one’s strengths and weaknesses. The knowledge of one's own cognitive skills is called “metacognition.” Developing metacognitition can actually help improve executive functioning. The primary purpose of identifying strengths and weaknesses is to be able to design and implement interventions to address these weaknesses. A psychologist at Child and Family Development often works with families to formulate such a plan. One book that is often recommended is Smart but Scattered (2009), which has easy-to-read information, charts and tables, and plenty of real-world examples for home and school.

Source: Smart but Scattered by Peg Dawson, Ed.D. and Richard Guare, Ph.D. (2009).

Bipolar disorder is a condition in which people go back and forth between unusual mood changes. Mood swings are a normal part of life. However, the mood swings in Bipolar Disorder are intense. Moods vacillate between mania (very elevated mood) and depression (very sad mood). The feelings are strong and happen along with extreme changes in behavior and energy levels. The "mood swings" can last days to weeks or change within a day.

Bipolar disorder affects men and women equally. It usually starts between ages 15 - 25. The exact cause is unknown, but there is a genetic link. Right now, there is no cure for Bipolar Disorder. However, symptoms can be effectively managed, usually through a combination of medication and therapy. Effective treatment begins with accurate diagnosis. If you think you or a loved one has Bipolar Disorder, talk to your physician or speak with a psychologist.

To find out more about Bipolar Disorder in teens and young adults, visit this link: http://www.halfofus.com/disorder/Bipolar.aspx

I’m pleased to announce that I’m now offering two Social Skills Groups for girls. 

Each group is designed to be a fun, interactive way for girls to build strengths in a safe setting. Topics will include friendships, communication, bullying, and social intelligence, among others. Groups are held on an every other week basis on Tuesday or Thursday from 4-5 p.m. at our South Charlotte office, as follows: 

Tuesday, ages 12-14 years old, every other week beginning Nov 1^st, 2011

Thursday, ages 9-11 years old, every other week beginning September 1^st, 2011

Families can pay privately or use available insurance.  Our front office team can verify your benefits.

Call or e-mail me to find out more details at (704)541-9080 ext. 217 or ahypes@childandfamilydevelopment.com.

Therapy for adults and children alike often involves forms of cognitive therapy. This therapy focuses on how thoughts (cognitions) affect mood. Some are described below:

1. Dysfunctional automatic thoughts. These thought seem to “pop into” your mind and appear true. However, they are distortions of reality. Examples include:
   1. Labeling: “I’m a failure”
   2. Catastrophizing: “I’ll never survive if I fail this exam”
   3. All-or-nothing thinking: “I don’t do anything right” “Nothing works out for me”
2. Maladaptive assumptions. These include ideas about what you assume things should be like or how you should be. Examples include:
   1. “I should always be happy”
   2. “If I’ve had this problem for a long time, then I can’t change”
   3. “I shouldn’t ask for help”
3. Negative core beliefs. People who are depressed often have core beliefs about themselves that are negative that underlie much of their distress. They may see themselves as weak, unlovable, stupid, or helpless.

 A psychologist at Child & Family Development often uses cognitive approaches in therapy. To schedule an intake call 704-541-9080. More to come on behavioral treatments for depression…

Before the movie Mean Girls, Rosalind Wiseman wrote a book called Queen Bees and Wannabes about all the things that can happen in adolescent friendships. She focused on gossip, rumors, reputations, and the like, which is now called “relational aggression.” If your teen is struggling with friendships at school, she or he may be the victim of relational aggression. Here are a few strategies they can use to help:

• The first step is to write or discuss exactly what happened with someone. Bottling up negative feelings and experiences usually only makes it worse.
  
• Practice having the conversation with the bully. Role play with a parent or in front of the mirror. Rehearsing ahead of time is a great way to minimize anxiety.
• When you’re ready, speak directly with the bully. Talk to them in a situation where you feel safe. (Don’t use e-mail or text!) Tell them exactly what it is that you don’t like, using “I statements.” For example, “I am hurt by the rumors you’ve started.”
  
• Tell the bully exactly what you want to have happen. For example, “I want you to stop” is very clear.
  
• End by offering a way for the two of you to co-exist in the future. You can suggest that you don’t have to get along, but you both stay away from each other peacefully.

Of course, if the bullying is severe or your teen does not feel safe, an adult needs to be involved. Parents should notify the school of the bullying in these cases. Individual or group therapy can be used to help your teen feel more confident and deal with any negative feelings that have resulted from the bullying. Luckily, awareness of relational aggression is growing, and professionals, parents, and teens are working together to develop effective ways to handle it.

What is it?
I’m pleased to offer a teen summer camp! Each camp is a week-long program designed to promote healthy adjustment and psychological wellness among adolescents. Groups will be a fun, interactive way for teens to build strengths in a safe setting. As part of a group, each participant will build social skills, learn about themselves, and discuss concerns honestly and openly. Immediacy and feedback from peers are primary motivators for many teens. I have experience leading groups in clinical and after-school programs. I am always amazed by the benefit of a group experience for participants.

Topics addressed will include: 

• Emotion regulation
• Healthy relationships
  
• Communication
  
• Social skills
  
• Self-esteem

When is it?
Groups are organized by age and grade level.

Tweens ages 10-12

Teens ages 13-15

Teens aged 16-18

The week-long groups cost $300. Groups run Monday-Thursday, from 1-3 p.m. on the following dates:

June 27-30th

July 11-15th

July 18-22nd

Interested?

Please e-mail me ahypes@childandfamilydevelopment.com or call the front office (704-541-9080) to schedule a free phone consultation with me to find out more.

Childhood depression can be difficult to identify. Most people experience occasional sadness and moodiness. Clinical depression is different than typical experiences of sadness. Presenting symptoms of depression can vary across the lifespan, although the essential symptoms of depression are the same for children, adolescents, and adults. Somatic complaints, irritability, and social withdrawal are particularly common in children. Depression in adolescence and young adulthood often co-occurs with disruptive behavior disorders, AD/HD, anxiety disorders, substance abuse, and eating disorders. The DSM-IV-TR diagnostic criteria for depression are as follows:

• Depressed mood or loss of interest or pleasure during the past two weeks
• Symptoms cause significant distress or interferes with major functioning
• Symptoms are not due to a direct effect of a substance or medical condition
• Five (or more) of the following symptoms are present during the past two weeks:
  • Depressed mood most of the day, nearly every day. In children and teens, this can be irritable mood.
  • Reduced interest in most or all activities that used to be enjoyed.
  • Changes in appetite -- either increased or decreased.
  • Changes in sleep -- either increased or decreased.
  • Vocal outbursts or crying.
  • Fatigue or low energy.
  • Feelings of worthlessness or inappropriate guilt
  • Difficulty concentrating or making decisions
  • Thoughts of death or suicide.

A child psychologist at Child and Family Development can treat depression with a variety of approaches, including individual and family therapy. Call 704-541-9080 to arrange a free phone consultation or to set up an intake appointment.

Source: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; 2000).

My previous blog entries have been about what psychotherapy is like and how to get the most out of it. Now here’s a more specific look at the various approaches to therapy.

• Psychodynamic therapies. This approach focuses on changing problematic behaviors, feelings, and thoughts by discovering their underlying meanings and motivations.  This approach is often used to address unhealthy family dynamics and relationships with others.
• Cognitive and/or Behavior therapies. This approach focuses on changing one’s behaviors and thoughts to change one’s mood. This approach is often used to address phobias, anxiety, and depression.
• Humanistic therapies. This approach focus’s on the therapist’s relationship with the client to help the client recognize his or her innate good nature, capacity to make rational choices, and potential for a fulfilling life. This approach is used to address a number of difficulties.

Portions of this post were adapted from The Encyclopedia of Psychology, edited by A. Kadzin (2000). See more at: http://www.apa.org/topics/therapy/psychotherapy-approaches.aspx

• My child will grow out of it. Occasional distress is a part of life. Other times, children and adolescents need professional help to get back to normal. If your child’s distress is interfering with important relationships, causing significant distress, or impairing academic or daily functioning, seeking professional help is recommended.
• Therapy is only for the mentally ill. Many people from all walks of life seek counseling from time to time. Someone who is brave and strong enough to seek help when needed often gets more out of life in the long run. 
• The therapist will fix my problems. With insight, understanding, and acceptance, many people find they become aware of how to change on their own. A good therapist can guide you in that direction. However, it’s your life after all, right? You are ultimately responsible for doing the work required to change. You will also be the one to reap the benefits.

• Stay positive. Continue to provide your child unconditional love. Reframe your child’s mistakes as growing pains inherent in coping with AD/HD. Acknowledge that you are also learning about how to handle AD/HD and may make mistakes.
• Organize your home. Try to minimize hectic schedules and misplaced items.
• Follow a routine. Post a family schedule weekly, and discuss it with your child.
• Break daily expectations and chores down into steps. Write down the steps and post for the child to see (e.g., steps in getting ready for bed posted in the bathroom).
• Break homework time into chunks. Use a timer. You may want to start small (e.g., 10 minute intervals) and work up.
• Use mostly positive reinforcement. Research shows that positive reinforcement (e.g., earning stickers, points, etc.) works better than negative reinforcement (e.g., loss of privileges).  Have your child work with you to develop privileges to earn.
• Speak in a way they can listen. Instead of long, multi-step instructions, use quick, simple instructions. Touch your child before speaking to ensure you have their attention. Avoid harsh tones.
• Allow your child to have some choice whenever possible. Present your child two or three options to choose from for outfits, dinner, recreation activities, etc.
• Take care of yourself. Parenting children with AD/HD can be quite tiring at times.
• Encourage all family members to get on the same page about how to approach your child. Involve step-parents, grandparents, and other caregivers as appropriate.

As a teenager, you may hear adults making comments like “You’re too emotional!” or “Why are you over-reacting?” or “Why are you so moody?” You may even feel yourself as if your emotions change quickly, are hard to predict, or are intense. If you are an adolescent with a mood disorder (like depression or anxiety), your emotions can interfere with your ability to live your life. This message is a brief introduction to understanding emotion regulation during adolescence.

Research has shown that brain development is especially important in understanding emotion regulation. During adolescence much is happening to the brain. In essence, the brain becomes remodeled, with neurogenesis, axonal growth, an increase in myelin, and synaptic and receptor pruning (see Sturman, Mandell, & Moghaddam, 2010). These changes help us balance emotional impulses with rational, logical decision making. Emotion regulation is both an organic process and a learned response. In addition to understanding the biological changes happening, skills in emotion regulation can be learned. A few skills include:

• Noticing your emotions. When are you most likely to become angry? Sad? Are there patterns?
• Linking noticeable physical reactions (e.g., upset stomach, headache) to less noticeable emotional reactions (e.g., anxiety).
• Accepting your emotions. Sometimes it is hard to pay attention to how we feel if we are embarrassed, overwhelmed, or ashamed about our feelings.
• Expressing your emotions clearly to yourself and to others (e.g., I feel frustrated when you are late to pick me up from practice).
• Refraining from impulsive and destructive behaviors when upset. We are more vulnerable to engage in unwanted behaviors (e.g., substance use, acting out) when we feel overwhelmed.
• Engaging in goal-directed behaviors, even when upset. Can you change a situation to help improve your mood? What coping tools (e.g., deep breathing, exercise, social support) do you have on hand if you can’t control the situation?
• Developing emotional wisdom. Building and reliably using effective coping tools are skills that can are helpful in becoming an independent person.

During the holidays, we are given an opportunity to reflect on all the things for which we can be thankful. Giving gifts to others is a reminder of loved ones. Donations to charity is a remembrance of the goodness and generosity in others. Spiritual beliefs provide a sense of meaning and awe in the world. Not surprisingly, feeling grateful is often related to feeling happy. As I work with youth, I often ask about what is going well and what they are thankful for as tools to build therapeutic intervention. This post is to elaborate on how gratitude can provide protective effects against feelings of depression in youth.

Recent studies in the field of positive psychology have identified gratitude as a concept useful in therapy. Gratitude is defined as the state of being grateful and thankful. As Froh, Yurkewicz, and Kashdan (2009) explain, people who are grateful tend to experience a greater sense of pride, hopefulness, inspiration, forgiveness, and excitement in life. Individuals who are grateful about what they have, even in the face of adversity, are more likely to think not only about what is going poorly at that moment, but what is going really well.

Adolescents struggling with depression often experience cognitive distortions, including thinking they are a failure or that the future is hopeless. Encouraging gratitude can shift one’s focus onto what is also going well. Research suggests that people with a greater sense of gratitude are more likely to find ask for social support and engage in positive coping behaviors, such as active problem solving (Wood, Joseph, and Linley, 2007), both of which can be helpful in overcoming depression. Psychotherapy is often necessary in helping depressed adolescents learn skills to manage their emotions. I also recommend considering a family gratitude tradition for the holidays. Taking the time to talk as a family about gratitude can not only be a great opportunity to appreciate the holidays, but it may also protect your child from depression.

Hello! I'm a new member of Child and Family Development, and I wanted to take a moment to introduce myself. I'm a clinical psychologist specailizing in treating children, adolescents, young adults and their families. I've lived in Charlotte for the past 7 years as I pursued my Ph.D. in Clinical Health Psychology from The University of North Carolina at Charlotte. I'm so happy to start practicing in the town I call home!

• Mood disorders (e.g., depression, anxiety)
• Impulse control disorders (e.g., acting out, anger, self-harm)
• Substance abuse
• Relational difficulties, peer acceptance, bullying
• Low self-esteem
• Attention Deficit Disorder (ADHD)