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Consider this:
One of Dr. Walker’s favorite therapy manuals (Barkley, 1997) has an exercise in which Barkley has parents remember both their best work supervisor.
Read more...One of Dr. Walker’s favorite therapy manuals (Barkley, 1997) has an exercise in which Barkley has parents remember both their best work supervisor, and their worst work supervisor in the past. You can do this from where you’re at. While reading this, make a list of things you love about your best supervisor. Now make a list of things you hated about your worst supervisor.
Barkley then asks parents to think about: What was it about your best supervisor that made them your best supervisor? What was it about your worst supervisor that made them the worst?
Barkley then encourages parents to consider: When you are parenting your child, which supervisor are you most like? Our job is to help you be the best version of you that you can be with your children.
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Did you know…
Research has consistently found that a combination of stimulant medication and parent training in behavioral interventions produces best outcomes
Read more...Research has consistently found that a combination of stimulant medication and parent training in behavioral interventions produces best outcomes for children diagnosed with Attention-Deficit/Hyperactivity Disorder (Barkley, 2006). We discuss these options in more detail in the treatment page for Child ADHD and behavior problems on our website.
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Did you know…
Research has found that children behave better when parents monitor their behavior (Barkley, 1997). The take home message: Even if you have not been
Read more...Research has found that children behave better when parents monitor their behavior (Barkley, 1997). The take home message: Even if you have not been formally trained in behavioral techniques, if you know what your kids are doing, they will behave better for you.
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Did you know…
Avoidance is a symptom of PTSD. People experiencing PTSD typically avoid thinking or talking about the traumatic event that happened. They often
Read more...Avoidance is a symptom of PTSD. People experiencing PTSD typically avoid thinking or talking about the traumatic event that happened. They often distance themselves from their friends and family. Many times they experience emotional numbing in which it may be hard to “feel feelings”.
The purpose of exposure-based form of therapy is to reduce avoidance by having survivors work through the traumatic events. The “exposure” in these therapies involves eventually creating a cohesive trauma narrative by talking about what happened in the context of a safe therapy relationship.
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Did you know…
If you suspect that you or your child has Attention-Deficit/Hyperactivity Disorder, part of a best practice assessment for ADHD involves also assessing for
Read more...If you suspect that you or your child has Attention-Deficit/Hyperactivity Disorder, part of a best practice assessment for ADHD involves also assessing for depression, anxiety, and exposure to past traumatic events. This is because concentration problems are also a symptom of depression, anxiety, and PTSD.
Best practice assessments for ADHD also involve separate parent and child interviews (for children) or client and someone who knows them well (for adults). They also include both behavior and mood rating scales, intelligence testing, and computerized tests of attention.
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Consider this:
One of my favorite trauma psychologists is Judith Cohen. She is a co-founder of Trauma-Focused Cognitive Behavior Therapy (TF-CBT) for children
Read more...One of my favorite trauma psychologists is Judith Cohen. She is a co-founder of Trauma-Focused Cognitive Behavior Therapy (TF-CBT) for children and teens. Part of TF-CBT is eventually having kids and teens who have been abused to tell their story about what happened. There are a lot of different options for how to do that. A lot of times we have kids draw what happened while they talk about it.
In one of her books, Dr. Cohen was working with a child who was reluctant to talk about the abuse. Dr. Cohen offered to let the client write what happened on her arm if it would help the child talk about it.
If you are a survivor of physical and sexual abuse, and you need help talking about it, if it helps, you can write what happened on my arm too – Dr. Walker.
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Consider this:
Since avoidance is a symptom of PTSD, many times survivors of traumatic events do not want to come to therapy, even though talking through what
Read more...Since avoidance is a symptom of PTSD, many times survivors of traumatic events do not want to come to therapy, even though talking through what happened is many times exactly what they need.
To help overcome avoidance, we always encourage clients to agree to come to therapy, even if they do not feel like coming. We will never force you to talk about what happened. Instead, on those days, come to your session and tell your therapist why you didn’t feel like coming and talking.
Coming to therapy even when you don’t feel like it and talking about why you didn’t feel like it serves to work against the avoidance and helps you confront what happened. Even if you don’t directly talk about abuse on the days that you come in and do that.
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Did you know…
Barkley (1999) has several helpful recommendations for when parents ground their teenage children. 2 hours to 2 days maximum, During which time the
Read more...Barkley (1999) has several helpful recommendations for when parents ground their teenage children.
- 2 hours to 2 days maximum
- During which time the teen has no access to privileges
- The parent is there to monitor the grounding
- The teen could have some additional chores (like a work detail)
- The teen is informed ahead of time of behaviors that will lead to grounding, and/or that they will be given a warning if they are in danger of it If you need help effectively disciplining your teenage child, we can help you with this and other techniques from Barkley’s Defiant Teen manual.
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Did you know…
Systematic desensitization is an evidence based treatment for treating specific phobias for both adults and children. It involves three steps: The therapist
Read more...Systematic desensitization is an evidence based treatment for treating specific phobias for both adults and children. It involves three steps:
- The therapist teaches the client a response that competes with anxiety (relaxation training)
- The specific events that cause anxiety are ordered in terms of the amount of anxiety they create (an anxiety hierarchy)
- The client repeatedly visualizes the anxiety-evoking events, in order of increasing anxiety, while performing the competing response (the relaxation training)
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Did you know…
It is a medical fact that if you involve your diaphragm in your breathing, you will relax. So, if you are feeing anxious at work or at school, one way that
Read more...It is a medical fact that if you involve your diaphragm in your breathing, you will relax. So, if you are feeing anxious at work or at school, one way that you can help relieve the anxiety is to place your hand on your belly. Breathe slowly in through your nose, then slowly exhale out through your mouth. Keep your hand on your belly to monitor the feeling of your diaphragm moving slowly in and out.
When practicing this, it is important to breathe slowly, and to breathe in through your nose. If you breathe quickly in and out of your mouth, you can hyperventilate!
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Did you know…
Children with autism often have problems with communication and social interaction, including:Making eye contact, Back and forth social interaction
Read more...Children with autism often have problems with communication and social interaction, including:
- Making eye contact
- Back and forth social interaction
- Developing and maintaining friendships
Children with autism also frequently have problems with restricted and repetitive patterns of behavior and activities, such as:
- Repetitive motor movements, objects, or speech
- Insisting on sameness with rituals
- Abnormal focus on objects or activities
- Over or under reactive responses to sensory input
If your child demonstrates some or most of these behaviors, you may want to consider scheduling an appointment for an evaluation for autism spectrum disorder.
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Did you know…
A “best practice evaluation” for autism involves: Completing a thorough parent interview (we offer the Autism Diagnostic Interview, Revised – ADI-R)
Read more...A “best practice evaluation” for autism involves: Completing a thorough parent interview (we offer the Autism Diagnostic Interview, Revised – ADI-R) Intelligence testing Assessment of communication skills Assessment of adaptive behavior Assessing autism specific behaviors (we use the Autism Diagnostic Observation Schedule, second edition – ADOS-2).
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Did you know…
Among adult survivors of childhood abuse, those who maintained some form of relationship with God or their Higher Power afterward, even if it was strained
Read more...Among adult survivors of childhood abuse, those who maintained some form of relationship with God or their Higher Power afterward, even if it was strained due to the abuse, had better outcomes compared to those who did not after the abuse in multiple studies (see Walker, Reid, O’Neill, and Brown, 2009 for a review).
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Did you know…
One review (Walker et al., 2009) found that adult survivors of childhood abuse reported three ways that their spiritual and religious faith changed
Read more...One review (Walker et al., 2009) found that adult survivors of childhood abuse reported three ways that their spiritual and religious faith changed afterward. Some survivors experienced an increase in their spirituality afterward, turning to their faith for help with coping and making meaning. Other survivors experienced primarily damage to their faith afterward. But, the majority of people experienced simultaneous increase and damage to their faith following child abuse.
That is, many people turned to some elements of their faith for help in dealing with it (such as prayer) while also experiencing faith related problems (such as questioning why God would allow abuse to happen). All three reactions are normal reactions to being abused. For many people, therapy can be helpful in working out changes in personal faith after abuse.
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Consider this:
Proverbs 13:24 instructs parents that “sparing the rod spoils the child”. Walker et al. (2013) proposed an alternative interpretation of this passage that
Read more...Proverbs 13:24 instructs parents that “sparing the rod spoils the child”. Walker et al. (2013) proposed an alternative interpretation of this passage that notes that in biblical times, shepherds guided sheep with the crook of the rod rather than striking them with it. When thought of this way, this passage could encourage parents to guide their children rather than striking them with an object such as a switch or a paddle. At TCFBH, in our parent training programs, we can teach you to use parenting skills to guide your children.
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Consider this:
One often cited Judeo-Christian scripture about parenting declares “Train a child according to his way; even when he is old he will not depart from it”
Read more...One often cited Judeo-Christian scripture about parenting declares “Train a child according to his way; even when he is old he will not depart from it” (Proverbs 22:6). Though this verse is often interpreted to mean to “teach children about their faith”, the term “way” in this verse refers to the unique make-up of a child.
Most secular parenting programs emphasize creating a “best fit” between the children and their environment. In other words, helping children to navigate their world based on their unique temperament and abilities. This is one area where Judeo-Christian faith and psychology appear to align in their recommendations for parenting practices.
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Did you know…
Cognitive behavioral therapy is highly compatible with the teachings of spiritual traditions that emphasize changes in thought and behavior as part
Read more...Cognitive behavioral therapy is highly compatible with the teachings of spiritual traditions that emphasize changes in thought and behavior as part of their practice (Tan & Johnson, 2005). In spiritually oriented CBT (SO-CBT) your therapist may refer to your faith to help you challenge ideas that you have had that are making you feel anxious or depressed.
This can be done generally by asking you to think about what your faith tradition says about a specific area that is challenging for you. It can also be done in a more in depth way by looking at specific teachings from your faith about these areas.
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Consider this:
Constance Dalenberg is one of Dr. Walker’s favorite therapist/scholars. In her 2000 book, she writes that “trauma is hard to speak and hard to hear” (p. 57).
Read more...Constance Dalenberg is one of Dr. Walker’s favorite therapist/scholars. In her 2000 book, she writes that “trauma is hard to speak and hard to hear” (p. 57). She pointed out that therapists sometimes inadvertently avoid hearing their clients talk about their trauma. Dalenberg also summarized some client responses about helpful therapist responses when therapists had problems hearing their trauma.
Clients said these responses were helpful (p.83): “John: I think the most effective thing was that he always admitted it when I would point it out”. “Sandra: She would catch herself sometimes and say ‘oh now I’m doing it. This is so hard’. It was helpful that she said it was hard”. “Ann: She would be all, you know **** it, I shouldn’t be acting this way’. I could tell she was fighting. She fought for me”. “Kate (a therapist participants): “Because he let me know it was hard for him. It goes against many ideas that I’ve been taught, but one of the most valuable things he said was that if it happened to him, he didn’t’ know if he would be handling it as well as I have”.
At TCFBH, we promise to be brutally honest with ourselves and with you as we try to truly listen to you if you are coming to work through a traumatic event.
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Did you know…
Oppositional Defiant Disorder (ODD) is a pattern of behavior lasting at least 6 months and involving at least 4 of these symptoms, exhibited during
Read more...Oppositional Defiant Disorder (ODD) is a pattern of behavior lasting at least 6 months and involving at least 4 of these symptoms, exhibited during interactions with at least one person who is not a sibling:
- Often losing one’s temper
- Being touchy or easily annoyed
- Being angry and resentful
- Often arguing with authority figures
- Often defying/refusing to comply with requests from authority figures
- Often annoying other people on purpose
- Blaming other people for one’s own mistakes or behavior
- Being spiteful or vindictive
For children and teens, parent training in behavioral interventions are evidence based treatments for ODD.
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Did you know…
Research by Eric Youngstrom and his colleagues supports the following as core components of a “best practice” assessment for pediatric Bipolar disorder:
Read more...Research by Eric Youngstrom and his colleagues supports the following as core components of a “best practice” assessment for pediatric Bipolar disorder:
- Obtaining a thorough family history regarding mood disorders in immediate and extended family
- Thoroughly assessing symptoms that are specific to Bipolar disorder rather than ones that have been suggested they may be part of Bipolar disorder in children
- Looking for evidence of “cycling” between manic and major depressive episodes
- Extending the window of assessment beyond a typical short term psychological evaluation into one’s ongoing therapy
- Using parent and child rating scales, including one’s specific to evaluating Bipolar disorder
We use Youngstrom’s recommendations in our evaluations assessing for the presence of pediatric Bipolar disorder.
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Consider this:
The parent training manuals that we use to help parents improve their children’s behavior all have both a Child Directed Interaction (CDI) phase and a
Read more...The parent training manuals that we use to help parents improve their children’s behavior all have both a Child Directed Interaction (CDI) phase and a Parent directed interaction (PDI) phase. One of the techniques in the CDI phase involves using labeled praises to reinforce desired behaviors. Russell Barkley calls this “catching your child being good”. We have parents practice this and other skills in homework sessions each day at home.
Think about how powerful it would have been for you if one or both of your parents, or another adult had spent five to ten minutes every day of your childhood, tracking every great thing you did, looking for everything that was great about you, and making sure you knew it. What difference would that have made for you? What difference could this make for your child? This is something that we can help you do for your children.
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Did you know…
Christine Courtois and Julian Ford have done research for several years about how to best help adult survivors of repeated trauma, including repeated
Read more...Christine Courtois and Julian Ford have done research for several years about how to best help adult survivors of repeated trauma, including repeated childhood physical and/or sexual abuse. They propose a 3 stage process for therapy with adult survivors of this kind of abuse. The 3 stages are:
- Phase one: Working on issues of personal safety, stabilizing current
symptoms, and engaging in treatment - Phase two: Working on emotional processing of the trauma
- Phase three: Consolidating treatment gains
For many adult survivors, this form of therapy will take between one to two years to complete.
- Phase one: Working on issues of personal safety, stabilizing current
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About our practice
Tidewater Child and Family Behavioral Health is a growing behavioral health practice for children, adolescents, and families. We have been operating since 2013. We provide evidence based therapy and assessment for children, teens, and families.
Evidence based practices are therapy and assessment approaches that have some research support, or evidence base to them. We believe in using therapy approaches that have been proven to work in the context of a warm, safe, therapeutic relationship. In our experience, many children and teens also need some help living in their families, their schools, or in other places in their community. We help children and teens by giving them skills to do so and by helping them make changes in their families, schools, and communities when necessary.
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