Therapy

Therapy services are offered for children and parents, with the mode and process of therapy varying depending on the age and issues of the child.

Play Therapy
Play therapy is offered for young children (3 to 8 years old) and older children who would prefer work in a nonverbal mode. It is most frequently used in cases of abuse, trauma, and attachment issues. Play therapy helps children deal with their sadness, confusion, traumatization, anger, and other volatile emotions through an interactive, age-appropriate mechanism of change. Essentially, children are allowed to communicate with the therapist using toys rather than words, and the therapist is able to return the communication, and sometimes help the child to reframe the issue in words. Learning to "contain" our concerns in language is one of the foremost human coping mechanisms; rather than feeling overwhelmed by a diffuse sense of heaviness, discomfort, or the feeling that things "just aren't right," we can often feel a great deal of relief and hope if we can encapsulate or understand our concerns within language. (for more info, please read my article on play therapy in the Articles section). Hence, with children who are older...

Verbal Therapy
Talk therapy varies depending on the issue addressed. I most frequently resort to narrative therapy in dealing with most childhood issues. In narrative therapy, children converse with the therapist to help view the problem as something "external" to the child, not as a necessarily internal problem, a disease or "something wrong" within the child herself. The child then works with the therapist to excavate her internal hope and various strengths and resources to extricate herself from under the influence of the problem. Eventually, she is able to view herself as being in control of the problem, rather than the other way around, and she begins to map a new narrative about herself and her resounding resources, strengths and abilities. This narrative inevitably involves important "others" in the child's life who can help to draw out and "re-author" the child's ongoing life story.

Cognitive-behavioural therapy is often used when helping children with depressive concerns, anxiety-related difficulties, or similar difficulties with "thought-shaped-feelings." This approach involves a mutual exploration with the therapist of what cognitions and perceptions the child is using to understand his world, and to detect the thoughts that are causing, exacerbating, or influencing the affective problem. The therapist and client work to translate those thoughts into more adaptive, encouraging, and hopeful cognitions.

Filial or Child-Parent-Relationship therapy is used in adoption, abuse, or other attachment concerns in which the therapist helps the child and parent develop an attachment bond that allows for profound and life-giving nurturing within an environment of consistent healthy limit-setting. I offer two modalities: Gary Landreth's play-based Child-Parent-Relationship Therapy, and the less play-based Parent-Child-Interaction-Therapy. For more information, I encourage you to look up either or both on your favorite internet search engine (or simply e-mail me a question, and I'll try to answer).

Parenting Consultation
Parents are often included in all therapy, in as much as they and the children are willing. In my clinical opinion, the most effective therapy requires active parent involvement, though there are cases in which children (usually older children) request a more exclusive, neutral "safe ground" to unload and deal with some of their problems without necessarily worrying or angering their parents. This type of agreement must be coordinated beforehand with parents offering informed consent for this exclusive confidentiality, and entrusting the therapist to use sound professional judgment regarding what and when to disclose. From my own stance as a professional, it should be stated that in the end, my aspiration will always be to improve and ameliorate the relationship between the child and his family, even in situations of exclusive confidentiality.

Parents often meet with me for seperate sessions regarding how to most effectively respond to their child's concerns and meet their child's needs, and how to be the best parent to their child.

Report-Writing
Although most clients are not interested enough in an official written report of progress to pay for the two hours of preparation and debriefing involved, some organizations and individuals request a closure report or a summary of therapy. This is available upon request, and can be tailored to demands, given the expressed informed consent of all consenting parties.

Assessment

I am able to offer a comprehensive array of official assessment services. A list of assessment tools I own and have been trained to use can be found if you scroll down to the bottom of this section. Any assessment should be undertaken from a developmental perspective (looking at your child's current functioning in comparison to expected functioning for his age and developmental level, as well as in comparison to your child's previous functioning), and should include information from various sources and contexts (for example, parents, teachers, the child himself, and others who may know the child well). Psychological assessments will often include the administration of a test (such as those listed below), in addition to direct observation of your child in a natural environment, and interviews with parent, child, and teachers or other adults in the child's life.

Psychoeducational Assessment
If a child is struggling substantially in school, the school will often arrange a psychoeducational assessment to help establish specific needs and programming goals. This can involve cognitive, achievement, social/emotional/behavioural, and personality assessments. A comprehensive report will be produced that includes a discussion of cognitive strengths and weaknesses, any learning disabilities that may be present, possible mental health diagnoses, and recommendations for the most effective academic programming, including the possibility of special education coding and provisions. Specific tests used include the WPPSI-III (for children 5 and under) or the WISC-IV (6 and up), as well as the BASC-2 or other tests designed to assess for specific areas of concern (for example, if the child may have ADHD or ASD). This type of assessment typically takes between 6 and 10 psychologist hours to intake, administer, score, interpret, report, and debrief.

ADHD Assessment
Pediatricians and family doctors will sometimes become suspicious that a child may have Attention Deficit Hyperactivity Disorder, but are often unable to take the time to conduct a comprehensive assessment. I offer a comprehensive assessment for ADHD, including standardized forms, observation, interviews with child and parents, and a thorough investigation of possible complicating factors. The primary test used for this diagnosis/assessment is the Conners-3, as well as any other tests which may take into consideration other complex factors, such as central auditory processing or anxiety. This assessment typically takes between 3 and 5 hours to intake, administer, score, interpret, report, and debrief.

Emotional/Behavioural Assessment
Assessment is provided for parents who would like to determine if their child is suffering from anxiety, conduct, depressive, or other emotional or behavioural disorders. The standard test used is the BASC-2. This assessment typically takes between 3 and 5 hours to intake, administer, score, interpret, report, and debrief.

Adaptive Functioning Assessments
On their own, or as part of a comprehensive assessment package, adaptive assessments can be helpful is assessing children with autistic or pervasive developmental syndromes or disorders. These assessments help to look for areas of strength or weakness in daily living tasks, abilities to function in social, communicative, domestic, and community domains. Depending on the specific assessment needs, the instrument used is typically the Vineland-2 or the ABAS-2, and will usually include observation and interviews. This assessment can take between 5 and 10 hours to intake, administer, score, interpret, report, and debrief.

Cognitive Assessments
A thorough assessment of the way your child's brain functions, learns, and processes information can help you cater your child's learning experiences to his or her specific needs and strengths. These can include specific executive functioning tests. The WPPSI-3 or WISC-IV will commonly be used for general cognitive assessments, and the D-KEFS is used to assess specific executive functioning strengths and weaknesses (such as decision-making, planning, and stop-and-start behaviours). A thorough cognitive assessment will take between 4 and 8 hours to intake, administer, score, interpret, report, and debrief.

Autism Spectrum Diagnostic Assessments
Assessing for diagnosis or functioning of Asperger's Syndrome or other Autistic Spectrum difficulties can help parents develop informed treatment plans for their ASD child. The ADI-R is used as an interview scale, and the ADOS is used as an observational assessment. Both of these together are the "gold standard" for diagnosis of ASD. A thorough ASD assessment will also incorporate an adaptive functioning assessment (see above) and will take between 6 and 8 hours to complete to intake, administer, score, interpret, report, and debrief.

Specific Tools Used:
Some of the assessment instruments I use are:
ABAS-2 (Adaptive Behaviour Assessment System, 2nd Edition)
ABC (Aberrant Behavior Checklist)
ADI-R (Autism Diagnostic Interview - Revised)
ADOS (Autism Diagnostic Observation Schedule)
ASDS (Asperger Syndrome Diagnostic Scale)
BASC-2 (Behaviour Assessment System for Children, 2nd edition)
CBCL (Child Behaviour Checklist, and the other Achenbach system assessments)
Conners-3
D-KEFS (Delis-Kaplan Executive Function System)
PAI (Personality Assessment Inventory)
PSI (Parenting Stress Index)
Vineland-II
WISC-IV (Weschler Intelligence Scale for Children, 4th edition)
WNV (Weschler Nonverbal Scale of Intelligence)
WPPSI-III (Weschler Primary and Preschool Scale of Intelligence, 3rd edition)