Tag

intensive therapy

Apr 09
4

The Role of Pediatric Occupational Therapy

By | NESCA Notes 2018

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Community-Based Skills Coach

In order to fully understand the role that occupational therapy can play in pediatric health and wellbeing, it is first important to understand the term “occupation.”  The World Federation of Occupational Therapy (WFOT) defines occupations as, “the everyday activities that people do as individuals, in families, and in communities that occupy time and bring meaning and purpose to life.”  As we know, these activities look different at every age, and our routines, habits, and responsibilities are continually growing and changing.

During childhood, the development of these skills moves more quickly than any other period of life. For example, a two-year old little girl, Katie, is learning to put on her shirt independently, kick a ball, and sort by color.  Within ten short years, Katie may be getting herself ready for the bus, writing a three-paragraph essay, and learning to play the saxophone.  The transition to adolescence comes with even more new experiences and expectations.

So where does occupational therapy come in?

Occupational therapy focuses on the child, the activity at hand, and the environment around them.  By considering all of these factors, OTs work to determine the correct modifications, adaptations, and strategies that may be necessary for success.

What is the goal?

Due to the fact that occupations are incredibly personalized, the goal of OT is often to simply increase independence and participation in valued activities.  One child may be working on learning to independently tie his shoes, while another may need help developing a morning routine to consistently follow.  These goals are only worth focusing on and problem-solving if they are important to the child and his or her family.

How do we get there?

Consider the child’s strengths and limitations. These may include physical, emotional, cognitive, sensory abilities, and much more.  A child’s particular interests, level of motivation, and understanding of themselves all play a role in their ability to engage in the things that are important to them.

Consider the environment. The environment in which a child lives and grows is physical, spiritual, social, and cultural. It is this individuality that makes it nearly impossible for an environment to be a “good fit for all users.”  Occupational therapists often work to modify the environment, or help individuals understand the role that the environment plays.

Consider the activity itself. The list of childhood occupations is seemingly never-ending.  From brushing your teeth, getting dressed, and doing chores, to maintaining friendships, navigating the digital world, and learning to take the bus, these skills all require numerous steps and different abilities.  These activities often must be broken down into small steps to determine how to help a child be successful.

My work at NESCA

At NESCA, I am currently working as a community-based skills coach, using occupational therapy to create experiential learning opportunities, and develop functional living skills.  I love having the ability to work with tweens, teens, and young adults in their own environment to collaborate on creating lasting strategies for participation and independence.

Dr. Bellenis works with a small caseload of clients aged 12-26 who have recently participated in neuropsychological evaluation and/or transition assessment at NESCA. If you have questions about working with Dr. Bellenis for Community-Based Skills Coaching, please email Kelley Challen, Director of Transition Services, at kchallen@nesca-newton.com.

 

About the Author:

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. Dr. Bellenisjoined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. In addition to her work at NESCA, Dr. Bellenis works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs, and visual motor skills must be taken into account to create comprehensive educational programming.

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Mar 19
4

Modern Parenting – Part 1: A Heartfelt Series of Social Media Tips

By | NESCA Notes 2018

By: Jacki Reinert, Psy.D., LMHC
Pediatric Neuropsychology Post-Doctoral Fellow

Prior to entering doctoral studies, my family and I had the opportunity to live overseas for two years. After spending most of my childhood in New England, complete with family vacations to upstate New York, my limited world view left me ill-prepared for the splendor and, at times, sadness of raising our two-year-old without the loving support of our extended families in one of the most beautiful cities in the world. To bridge this gap of time and space, I often looked to social media as a window into the lives of family and friends.

First came Facebook, where old high school colleagues, current English-speaking expatriate comrades, and family could follow our adventures. Then, with the new sensational “Instagram”, I found myself snapping away, first of myself, my son, and of course the Eiffel Tower, quickly followed by Francophiles, family, and new friends. My follower stats quickly climbed and I enjoyed sharing well-cultivated images of perfect macaroons, baguettes, and yes, images of my son, who, thanks to a sweet face, curly hair, and blue eyes, certainly garnished a lot of “likes”. Hashtags embedded into my photos drew strangers in search of #paris, #perpetualtourist. Social media was my connection to family but in my eagerness to share, I never thought about the potential negative outcomes one might experience through sharing photos of their child.

For those of you who do not dabble in Instagram, users have the option of following people and liking their photos. For those with public accounts, users can look at another user’s feed (pictures) without following the person. If someone “double taps” your picture, they “like” it and you are notified. At the time, I saw no harm in having a public account with a small group of followers (375 people) until someone liked a photo I had posted of my son, someone whose name I did not recognize. After clicking on the person’s name, I was horrified to find multiple images of my son in this young girl’s account.

In 2014, a community of teenagers began “baby role playing” which consisted of taking (or stealing) other people’s images of their children shared on social media sites. After capturing the image on their own phones, the teens then rename the child, create fictional information about the child, and engage in reciprocal conversations with other role players. In the comment sections below the images, users have the opportunity to have conversations with one another, pretending to be the child and/or the parent. While some of these users used the images in seemingly innocent ways, others shared photos of children naked or breastfeeding.

After the images of my son were stolen and used for #adoptionrp, I made my Instagram account private. I also stopped posting photos of my son’s face on all social media platforms. I deleted any pictures on Facebook and asked family members to do the same. Over the past four years, we have collectively abstained from sharing images of our son and now our daughter.

Research suggests that by the age of 2, most children in the United States have an internet presence (BusinessWire, 2010). For some children, like Mila and Emma Stauffer, who have over 3.7 million followers on their mother’s Instagram account, social media has led to profitable income.

For our family, it has led to many awkward requests of, “Can you please take down that photo?” and has fostered an interest in learning about social media, digital footprints, digital citizenship, and media literacy. In this series of blog posts, we will delve into the world of social media and address how parents and professionals can talk to kids about social media.

Read the rest of this series:

Modern Parenting – Part 2: What are Digital Footprints and Where Do They Lead?

Modern Parenting – Part 3: Sarahah, WhatsApp, Snapchat, Oh My! Navigating the Wide World of Apps

 

About the Author:

Dr. Jacki Reinert is a Pediatric Neuropsychology Postdoctoral Fellow who joined NESCA in September 2017. Dr. Reinert assists with neuropsychological and psychological (projective) assessments in the Newton office and will join the Londonderry office in March 2018. In addition to assisting with neuropsychological evaluations, Dr. Reinert co-facilitates parent-child groups and provides clinical consultation. Before joining NESCA Dr. Reinert worked in a variety of clinical settings, including therapeutic schools, residential treatment programs and in community mental health. She has comprehensive training in psychological assessment, conducting testing with children, adolescents, and transitional-aged adults with complex trauma.
To book a consultation with one of our many expert neuropsychologists, complete NESCA’s online intake form.

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Mar 12
5

Intensive Cognitive-Behavioral Therapy (CBT) for Anxiety

By | NESCA Notes 2018

 

By: Ryan Ruth Conway, Psy.D.
Clinical Psychologist, NESCA

Deciding to enroll your child in mental health treatment is a big step in and of itself. Before initiating the process, there is often a trial and error period of interventions to improve the situation, whether at home or in school, and then coming to terms with the fact that they might not be enough to sufficiently address your child’s needs. Finding the right therapy and therapist match for your child can also prove challenging. Not only are there numerous therapeutic approaches available, but there are also varying levels of care depending on the severity of your child’s symptoms and amount of support he or she requires. This ranges from once weekly outpatient therapy to day treatment programs to inpatient hospitalizations for more acute psychiatric issues that may require crisis stabilization (i.e., suicidality, self-harm, etc.)

One type of treatment that has garnered considerable empirical support for treating youth anxiety and depression (conditions we regularly treat at NESCA) is Cognitive-Behavioral Therapy (CBT). CBT focuses on the intersection between our thoughts, emotions, bodily sensations and behaviors. The goal of CBT is to better manage overall emotional distress and reduce physiological symptoms by changing negative thoughts or unhelpful thinking patterns, ineffective coping strategies, and maladaptive behaviors that might be reinforcing uncomfortable feelings. CBT aims to teach children and their parents new, adaptive coping skills while providing opportunities both in and between sessions to practice these skills. CBT is a short-term, targeted treatment that promotes “approach” behaviors (as opposed to “avoidance”) through “exposures,” or exercises designed to practice facing fears gradually, in a safe environment. CBT might also include learning mindfulness, emotion regulation, and distress tolerance; techniques that have been shown to enhance treatment outcomes.

While some youth make progress in meeting with a therapist once per week, others benefit from a condensed, “intensive” format where they receive CBT treatment daily and over a shorter period of time. The accelerated nature of these types of programs, offered in both outpatient and hospital-based settings, allows for quicker acquisition of strategies, substantial exposure practice, and generalization of newly learned skills to other settings in a child’s life. Think of it as a crash-course in CBT.

You may want to consider an intensive therapy program for your child if: 

  • Your child’s symptoms are greatly interfering with his or her life, such as attending school or school performance, family life, and friendships.
  • Your child has tried different therapies in the past but there has been minimal carryover from session to session and/or you haven’t noticed much progress overall.
  • Your child is experiencing distress but other commitments during the school year have hindered attending therapy on a consistent basis, making school breaks or the summer an ideal time to work on it.

At NESCA, we are pleased to offer a highly specialized and immersive therapy experience through our 2-Week Summer Intensive CBT Program for anxiety. We work with children and adolescents who present with all types of anxiety, including generalized anxiety, separation anxiety, social anxiety, specific fears (e.g., dog phobia, vomit phobia, etc.) and obsessive-compulsive disorder (OCD).

What does NESCA’s 2-Week Summer Intensive Program consist of? 

  • Intake evaluation – A meeting is held with the child and parents to gain a comprehensive understanding of the child, provide an assessment of symptoms and discuss goals for treatment, all of which will inform the treatment plan.
  • 1:1 therapy sessions – Individual CBT therapy sessions with the child or teen are conducted 5 days/week for 90 minutes. Homework will also be assigned between therapy sessions to reinforce skills learned.
  • Parent involvement – Parent participation is vital in treating childhood anxiety. Parent sessions are held 5 days/week for 30 minutes. During these meetings, parents will be educated about their child’s anxiety, receive progress updates and also acquire tools to better support their child. Parents might also be asked to help children practice the new skills they are learning.
  • Discharge planning – Families will be assisted in determining follow up support that will be helpful in order to maintain treatment gains.
  • Treatment summary – Following the conclusion of the program, families will receive a written summary that reviews the course of treatment, progress made and discharge recommendations.

There are circumstances in which the frequency, duration and/or structure of the program can be modified to best fit your child’s needs.

For more information about NESCA’s Summer Intensive CBT Program or to find out if the program is appropriate for your child, please contact Dr. Ryan Ruth Conway at (617) 658-9831 or rconway@nesca-newton.com.

 

About the Author:

Conway

Ryan Ruth Conway, Psy.D., 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.

 

If you are interested in working with Dr. Conway or have any additional questions about NESCA’s therapy services, please complete NESCA’s online intake form.

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.