55 Chapel Street, Suite 202, Newton, Ma 02458
www.nesca-newton.com
617-658-9800

75 Gilcreast Road, Suite 305, Londonderry, NH 03053
603-818-8526


Thank you for visiting. NESCA Notes has moved!

For articles after June 4, 2018 please visit nesca-newton.com/nesca-notes/.


Search This Blog

Showing posts with label Communicating. Show all posts
Showing posts with label Communicating. Show all posts

Monday, June 4, 2018

The Struggle is Not Only Real, It is Necessary


By: Angela Currie, Ph.D.
Pediatric Neuropsychologist

From an early age, we are subliminally taught that stress is a bad thing. Whether frustrated because your LEGO tower broke or confused about which two paint colors to mix to get green, you were more likely to hear “Calm down – no reason to get stressed,” than you were to hear “Let’s use your stress to help us make a plan for how to solve this problem.”

For most adults, the natural, well-meaning response to a child’s expression of stress, or most any unwanted feeling, is to try to fix it, make it go away, avoid it, or make it seem like it isn’t such a big deal. We do this by saying things like:

“Don’t be sad.”
“No need to worry about it.”
“It’s not as bad as you think it is.”
“Just try thinking about something else.”
“Let me do that for you.”

We all say and do these things, and the good intention is clear. Nobody likes to see a child struggle or experience discomfort. Unfortunately, manageable stress and discomfort is necessary for growth. When we minimize, distract, or dismiss a child’s emotional reaction, we are sending the message that feelings are unimportant, untrustworthy, and bad. This means that we are also missing the opportunity to teach the child about why we have feelings, and how even the unwanted ones are incredibly useful.

Stress and anxiety are at an all-time high nowadays. It is important to think about small things that we can do each day to help children feel more confident and competent in their ability to navigate this stressful world. One of the best ways we can help them to become more resilient is by creating an environment where emotions are acknowledged, accepted, and used in a functional manner. To start doing this, here are some basic things to keep in:

1) Feelings are information. They are telling us that something is important and may require our attention.
2) Feelings are never bad or “negative,” though they may be unwanted.
3) Stress is often a good thing – without it we would not prepare for tests, show up to work, or care about our relationships. Life without stress would be pretty unfulfilling.
4) The goal is not to control stress or other unwanted feelings – the goal is to recognize, use, and cope with them.
5) Acknowledging and accepting unwanted emotions is one of the best ways to reduce their impact.
6) Regular, casual discourse about wanted and unwanted feelings is healthy and normal. If we talk about the day to day feelings, it will make it easier to talk about the “big ones.”
7) Let children struggle sometimes. Don’t feel the need to fix things right away. Help them express how they're feeling, gently guide them toward problem solving, and praise their persistence in the face of challenge.

About the Author 

Dr. Currie specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

Monday, October 23, 2017

The Great Masquerader

Anxiety and School Refusal


By: Ryan Ruth Conway, PsyD

Everyone experiences anxiety at some point in life. It is a normal, adaptive human emotion that helps us prepare for important events and optimizes performance – think upcoming tests, ballet recitals, sports playoff games – and alerts us to danger in situations that threaten our safety. However, some individuals experience anxiety so intensely and so frequently that it becomes impairing, hindering their daily functioning. In fact, according to the National Institute of Mental Health (NIMH), it is the most common mental health disorder in the United States among adults and children. In my work with children and teens, I have seen anxiety become such a powerful force that it gets in the way of having sleepovers at friend’s houses, limits social engagement, results in marked physical discomfort, impairs concentration in class, and even contributes to flat out refusal of school.

Anxiety is an inward focused feeling, meaning that we experience it internally. As a result, it is often unrecognizable to parents and teachers and can go easily undetected for a long time until it becomes a problem. Children might be ashamed to talk about it, try to push it away to avoid distress or be limited in their ability to fully articulate what is happening. Behaviorally, anxiety causes a fight-flight-freeze reaction. It leads to acting out and aggressive behaviors (i.e., “fight”) as well as running away and escaping (i.e., “flight”). Anxiety can also be an underlying source of noncompliance, disguised as unwillingness to engage and shutting down in overwhelming situations (i.e., “freeze”).

In a recent New York Times Magazine article (see link below), writer Benoit Denizet-Lewis takes a closer look at the increasing prevalence of adolescent anxiety as well as a residential program, Mountain Valley Treatment Center, that provides services for more severe cases. In an information age, many teens, parents, educators and mental health professionals are citing social media as partly to blame for the uptick in anxiety. The constant comparing to peers through social media is problematic in that it makes teens feel like they aren’t good enough, which can greatly impact their self-esteem. In my clinical work I see an overreliance on smartphones due to the reinforcing function they serve – whether it be a text back to hang out or a “like” on an Instagram post – and I will often work with youth on self-reinforcement and finding alternatives that are intrinsically rewarding to them.

Many of the students interviewed for the New York Times Magazine article who attended Mountain Valley had histories of significant difficulty attending their regular school due severe anxiety and/or depression, a presentation known as school refusal. School refusing behaviors exist on a spectrum, from the mild (e.g., missing gym class every now and then due to fears of changing in front of classmates) to the more severe (e.g., missing entire weeks of school due to persistent worries about having panic attacks). Early intervention is key. The longer the child or adolescent is out of school, the more pressure they feel about “catching up” academically. The more they feel like they are falling behind, the more depressed and anxious they become. The more upset and stressed they are, the more difficult it is to get back to school. And the cycle continues.

Understanding this cycle, NESCA offers a special program for youth who refuse school because of emotional distress, called Back to School (BTS). In this program, clinicians use a comprehensive evidence-based treatment approach and work closely with parents and school faculty to figure out the most effective plan that will help the student reenter school.

  • Given the importance of catching school refusal early, here are some warning signs to look out for:
  • Test-taking anxiety
  • Peer bullying
  • Ongoing visits to the nurse despite no apparent signs of illness
  • Frequent requests to phone or go home during the school day
  • Somatic complaints without a medical explanation (e.g., stomachaches, headaches, etc.)
  • Absences on significant days (e.g., tests, speeches)
  • Sleep problems or resistance to leave bed in the morning
  • Changes in mood – anxiety, irritability, sadness 
If you have any questions about the BTS Program or NESCA’s therapy program in general, please contact Dr. Ryan Ruth Conway at [email protected] or 617-658-9831. Dr. Conway will additionally be speaking at several workshops this fall on the subject of School Anxiety, School Phobia, and School Refusal. Information regarding upcoming NESCA events can be found on our web site at http://www.nesca-newton.com/events.html.

Article: 
Denizet-Lewis, B. (2017). Why Are More American Teenagers Than Ever Suffering From Severe Anxiety? The New York Times Magazine. Retrieved from https://www.nytimes.com/2017/10/11/magazine/why-are-more-american-teenagers-than-ever-suffering-from-severe-anxiety.html.


About the Author:

Dr. Ryan Ruth Conway is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal. 

Thursday, October 5, 2017

Catch Them When They're Good!

A Positive Parenting Tool


By: Ryan Ruth Conway, PsyD

If your child’s go-to response to your requests is typically “no,” then keep reading…

Children who tend to disobey rules, become easily agitated, experience temper outbursts and argue with authority figures are known to display a pattern of behaviors called disruptive behaviors. These behaviors can cause significant family turmoil and become quite challenging for schools to manage. Children who have trouble regulating their emotions and behaviors may be pinned as “the bad kids.” This is unhelpful, because it does not explain what exactly is underlying the acting out. This type of reputation can also impact a child’s self-esteem, resulting in feelings of inadequacy and self-doubt. Disruptive behaviors could be masking other issues that are not obvious to teachers and parents. Consider the possibility that the kindergarten student who shuts down and refuses to engage in class is not oppositional, but instead experiencing anxiety about being away from his mother or father. Maybe the second grader obtains his parents’ attention most often at home when she lashes out. In trying to control disruptive behaviors, children get a lot of attention from adults for what they are doing wrong, often times unintentionally.  

One of the hallmarks in teaching caregivers how to effectively manage these kinds of behaviors is positive parenting, which comes from a behavior therapy approach. Among positive parenting techniques is “catching them when they’re good,” which shifts the focus away from what is problematic and towards the appropriate behaviors parents want to see continue. With this technique, parents become more mindful about the behaviors they attend to, and seek out opportunities to let their child know when he or she is on the mark. It feels good for both the giver and the receiver, and can bring you closer to your child!

Positive feedback is a powerful tool at any age. For children, it comes in many forms – a sticker for helping to set the dinner table, a praise statement (“I’m so pleased that you are using gentle hands with your brother”), even a hug! As your child starts to recognize that you are giving more attention to appropriate behaviors, they will similarly shift from negative actions (e.g., sassing off, whining, crying, etc.) to positive ones.

Behavioral parent training empowers caregivers by teaching them specific skills to not only manage their children’s behavior at home, but also to improve communication, build warmth within the parent-child relationship and create a calmer household. The Society of Clinical Child and Adolescent Psychology (SCCAP), a group dedicated to disseminating information about evidence-based therapies for youth mental health problems, sites behavior therapy (individual parent and groups of parents with or without child participation) as the most efficacious treatment for disruptive behaviors in children. The SCCAP website, www.effectivechildtherapy.org, was recently updated and is a helpful resource for parents seeking information and guidance about treatment for children and teens.

NESCA is excited to be offering a new group for parents and children ages 7-10 who exhibit disruptive behaviors and/or ADHD symptoms. This group will have separate parent and child sections – with opportunities for combined parent-child sessions – and utilize both behavioral and cognitive-behavioral techniques. For additional information, visit http://www.nesca-newton.com/events.html.

Or visit our previous article about behavioral parent training and the research backing this approach: /2017/04/parent-training-programs-101.html. 

About the Author:




Dr. Ryan Ruth Conway is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal. 

Tuesday, September 19, 2017

Ron Suskind and The Affinity Project



is excited to announce a new partnership with Ron Suskind and


A strengths-based approach to building social, emotional, practical, and executive functioning skills for people with an Autism Spectrum Diagnosis

The Affinity Method is an exciting new approach that uses your child’s unique interests – or affinities – as tools to expand social-emotional awareness and intelligence. By using their passions as pathways, we meet them where they are, learn more about how they use their interests to navigate the world, and draw out the connections between what they know and what we want to help them learn. 

Meet Ron Suskind, founder of the Affinity Project,
and hear about how this exciting new partnership could benefit you!

Day: Monday, October 2nd, 2017
Time: 7:00p-8:30p
Location: NESCA office
55 Chapel St.
Newton, MA 02458

The method uses ground-breaking technology – an app called Sidekicks - to engage our clients.  The client is called the Hero, Sidekicks are avatars; animated characters that live in the Hero’s smartphone or tablet app who act as the Hero’s friend. Behind the scenes, these avatars are controlled by various coaches - therapists, parents, and other individuals who wish to engage with Heroes through the app. When either a Hero or a Coach searches for video content, it will mirror simultaneously on the other paired device.

They can play, pause, discuss, enjoy, play again!
The Coach controls what the Sidekick says out loud to the Hero.


The Hero responds by speaking out loud to the Sidekick.
This is heard by the Coach through their mobile device or computer console.
The Hero can also choose to text (instead of speaking aloud), and the text will appear on the Coach’s screen.
Ron Suskind, Pulitzer Prize winning journalist and best-selling author of Life, Animated, now an Academy-award nominated movie, used Disney movies to reach his nonverbal autistic son and bring him back to language and relationships. He and leading technologists created The Affinity Project and the Sidekicks app so parents everywhere could do the same, no matter what their child loves.



Click the video link to learn more about Ron, his son Owen and how the Affinity Project came to life! 


NESCA is proud to be one of the very first providers to offer use of the Sidekicks app in therapy sessions!

To learn more about this exciting opportunity, contact
Rebecca Girard at NESCA
617-658-9800
or
or
Join us on Monday, October 2nd. 

We look forward to seeing you!

Thursday, April 27, 2017

Parent Training Programs 101


Article by: Ryan Ruth Conway, PsyD

April 8th 2017


“Why won’t he listen to me?” 

“Can’t she just sit still?” 

“I don’t know what else to do!” 

These are common statements from parents; particularly parents who are struggling to manage their child’s behavior, have tried various techniques with minimal success, and feel hopeless about the prospect of any solutions.

Disruptive behavior in children are estimated to affect 16% of the general population, and are the most common reason for referral to mental health services in the early years. Examples of such behaviors include argumentativeness, hostility, refusing to comply with adult requests, and temper outbursts, in addition to more severe conduct problems such as destructive behaviors or physical aggression. These behavior problems frequently co-occur with learning disabilities and Attention-Deficit Hyperactivity Disorder (ADHD), characterized by inattention, poor impulse control, and trouble with self-regulation. When left untreated, challenging behaviors in young children tend to remain stable, persist into adolescence, and increase the risk for delinquent behaviors later in life (e.g., substance use, risk taking, legal troubles). 

Thus, early intervention is essential in targeting challenging behaviors. 

Over time various parenting programs have been formally tested through research trials, and behavioral parent training has garnered the most empirical support in addressing youth conduct problems. Recent research has also demonstrated that children with behavioral and attention challenges, particularly those who have ADHD, show quicker symptom improvement when behavioral approaches are attempted prior to medication (https://www.nytimes.com/2016/02/18/health/early-behavior-therapy-found-to-aid-children-with-adhd.html?_r=1).  Behavior therapy has also been shown to be more cost effective than medication over time.


Parent training (or guidance) programs that involve the participation of both parents and children have been shown to be the most effective in fostering a positive parent-child relationship and helping to increase positive behaviors, while decreasing negative or disruptive behaviors. 

.  Parents are taught skills to increase their confidence in setting limits and equip them with techniques for managing their child’s behavior. Skills are then practiced through role-plays and live coaching in order to master and generalize what has been learned. Simultaneously, children learn strategies to help them manage their own behavior, cope with negative emotions, and meet parent expectations.

NESCA’s new parenting groups for children ages 4-6 and 7-10 are informed by one of these evidence-based behavioral treatments, Parent-Child Interaction Therapy (PCIT; www.pcit.org), and have been tailored for a small group format. You can find out more about our groups here: http://nesca-newton.com/Therapeutic.html.

NESCA is currently enrolling participants for both groups.  If you have any questions about our parent-child groups or are interested in joining, please contact Dr. Ryan Ruth Conway ([email protected]; 617-658-9831) for the 4-6 year old group or  Dr. Elizabeth Lops ([email protected]; 617-658-9825) for the 7-10 year old group. 

Wednesday, April 12, 2017

John Pratt Memorial Lecture

You’re invited to attend the John Pratt Memorial Lecture at Ivy Street School!
This is an image of the invitation 
Photo of  Michelle Garcia Winner
Introduction by Michelle Garcia Winner Founder & CEO SocialThinking

Photo of movie cover of Life, Animated
Presentation by Ron Suskinti Pulitzer-winning journalist and best-selling author of Life, Animated

Date:
Thursday, May 11, 2017 

Time:
6:00 pm for Registration and Opening Reception 
7:00 pm for Program

Location:
Whitehead Institute for Biomedical Research 
9 Cambridge Center, Cambridge, MA 02142

More information and complimentary registration is available online at ivystreetschool.org/pratt