social anxiety

Blog Update: Intensive Therapy

By | NESCA Notes 2018

By: Ryan Ruth Conway, PsyD
Clinical Psychologist, NESCA

Earlier this month, the New York Times published an article about intensive therapy, a type of treatment that is more accelerated and condensed than traditional once weekly therapy. The author described a “new wave” of therapy programs popping up around the country designed to help clients with all types of anxiety experience relief more quickly. The article cited new research to explain the growing popularity of concentrated treatment, which shows that the approach is generally just as effective, and in some ways more effective, than longer-term care for both children and adults. Also noteworthy is that fewer clients dropped out of the intensive treatment, which suggests that clients are more likely to “stick with” therapy when it is delivered in a shortened, consistent format.

In short-term therapies, clients have the opportunity to practice using newly learned skills to face their fears in all different situations and environments that elicit anxiety. For instance, a client with social fears might be instructed to order for himself at a restaurant, ask a stranger for directions or purposely do something embarrassing in public. By practicing daily in session and also for homework, you see a lot of carryover from day to day and faster acquisition of skills, which is a huge confidence booster! Exposure and Response Prevention (ERP), a technique often used in Cognitive Behavioral Therapy (CBT), helps clients approach anxiety-provoking situations and learn that anxiety eventually habituates, or dissipates, on its own over time, and those other behaviors they have been using to manage their fears (e.g., excessive washing, checking, seeking reassurance from parents or avoidance) are neither helpful nor necessary.

NESCA offers intensive CBT “boot camps” for children and adolescents with anxiety, including (but not limited to) social anxiety, phobias, OCD and generalized anxiety. NESCA clinicians thoroughly enjoyed helping clients build coping skills and feel better through intensive treatments this past summer, and received a positive response from children and their families! Our treatment programs are individually tailored for each client and also include parent sessions in order to teach caregivers the tools they need to best support their child. Summer or school breaks can be the perfect time to focus on mental health without the distractions of the academic year or other extracurricular activities.

To learn more about intensive therapy and NESCA’s program visit: http://www.nesca-news.com/2018/03/intensive-cognitive-behavioral-therapy.html

For any questions about NESCA’s intensive treatment program or to sign up please contact Ryan Ruth Conway, PsyD at rconway@nesca-newton.com or (617) 658-9831.


About the Author: 

Ryan Ruth Conway, PsyD, 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.





Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, 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.

Social Creativity and ASD – Challenging the assumption that autistic people are not social

By | NESCA Notes 2018

Photo from the documentary, Autism: The Musical (2007)

By: Rebecca Girard, LICSW, CAS
Licensed Clinical Social Worker

The New York Times recently published an opinion piece titled, How to Meet Autistic People Halfway, an article that challenges the common belief that people on the autism spectrum are avoidant of social interaction and do not desire social connections. The authors, Vikram K. Jaswal and Nameera Akhtar are psychologists and researchers who study the social lives of people on the autism spectrum. They assert that while core deficits of autism may make social interaction more challenging, it does not mean people on the spectrum do not desire meaningful social connection. For years, many in the ASD community and their allies in the neurodiversity rights movement have attempted to combat this anti-social stereotype, but the notion stubbornly persists. Counter-narratives of the autistic social experience often reflect autistic people as extremely emotionally sensitive, hyper-aware of the feeling states of others, and indeed motivated to experience social success in the form of friendships and social acceptance. Additionally, an increasing number of people believe those on the spectrum may actually display more creative and interesting ways to connect and choose to describe autistic individuals as “socially creative” rather than having “social deficits”.

If we then acknowledge the desire to connect is present, how can we best facilitate social learning and promote social success? First, we can acknowledge that a person on the spectrum will have a myriad of ASD-related challenges that will likely make socializing difficult. These include trouble reading and interpreting social cues (eye contact, body language, facial expressions), attending to and managing sensory challenges during interaction, and repetitive and inflexible thinking (getting “stuck”, echolalia), all of which can lead to preemptive social rejection by peers and a lack of social opportunities to practice and improve upon their social interaction skills. These challenges require multi-disciplinary supports, including (but not limited to) occupational therapy, speech therapy, and cognitive-behavioral therapy. Second, we can provide positive social learning interventions that address and ameliorate the impact of these factors, while providing opportunities to explore and understand the social world.

A popular method of intervention is that of “social knowledge”, or didactic social skills training. This entails imparting concrete social skills, in the effort to explicitly teach what a person may not know about socializing. Think – programming a social computer with many algorithms; if a person does A, you do B. While this may be great at teaching the basics, it often does not adequately prepare ASD individuals for the unpredictability and fluidity of everyday interactions. Another approach is that of “social performance”, a dynamic method of encouraging social pragmatic development by providing semi-structured socialization opportunities in small group settings with immediate, in vivo feedback on what’s working or not. Think – flexing a social muscle. Drama-based social pragmatic groups are gaining in popularity as a method for not only promoting social connections but as a fun way to create an encouraging and supportive space to finds one’s own intrinsically motivating social style.

But enhancing individual social skills and providing adequate social opportunities is admittedly a one-sided approach. Equally important is challenging the stigma and bias that plague the ASD community. We need to be allies to this community by promoting greater acceptance of a wide-range of social styles and approaches to social engagement. To honor the neurodiversity mission, which “rejects the idea that autism should be cured, advocating instead for celebrating autistic forms of communication and self-expression, and for promoting support systems that allow autistic people to live as autistic people.” (What is Neurodiversity? [Website]. (2011).  National Symposium on Neurodiversity at Syracuse University)

As a therapist who has worked with ASD individuals across the lifespan since 2004, I know firsthand that autistic people feel the same loneliness and isolation when chronically socially disconnected, and feel the same anxiety and unease when experiencing social rejection. I have also had the pleasure of witnessing individuals find their own distinctive social style and the joy of connecting with others who appreciate what is different as interesting and exceptional, rather than off-putting or strange. The autistic people in my life, both professionally and personally, have challenged me to rethink narrow and strictly defined social expectations, and have made all my relationships richer as a result. Autistic people are often credited with “out of the box” thinking and innovation, which can be applied to their social lives as well, as they are uninhibited by social convention. For example, Asperger’s are Us are the first all-autistic sketch comedy troupe, and their performances reflect their original and offbeat sense of humor, as well as their deep connection to one another as friends. A great example of what is possible.

The New York Times article said it best in its conclusion, “improving the social lives of autistic people will require putting aside assumptions about how social interest is expressed and recognizing that it can be shown in unexpected ways.” As parents, professionals, and allies, let’s commit to challenging this very basic and long-held assumption and appreciate and embrace the unique and creative ways autistic people chose to engage the world around them.


About the Author: 

Rebecca Girard, LICSW, CAS is a licensed clinical social worker specializing in neurodivergent issues, sexual trauma, and international social work. She has worked primarily with children, adolescents, adults with Autism Spectrum Disorders and their families for over a decade. Ms. Girard is highly experienced in using Cognitive Behavior Therapy (CBT) as well as Socio-dramatic Affective Relational Intervention (SDARI), in addition to a number of other modalities. She provides enhanced psychotherapy to children with ASD at NESCA as well as to provide therapeutic support to youth with a range of mood, anxiety, social and behavioral challenges. Her approach is child-centered, strengths-based, creative and compassionate.

Reach out if you would like to work with Rebecca: Email rgirard@nesca-newton.com or call 617-658-9825





Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, 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.