Most children will develop fears and worries throughout the course of childhood. Some of these are developmentally typical, such as a fear of the dark in younger kids and fear of being socially rejected in teenagers. Generally, because the techniques that we use at the NOAC have cognitive components (that is, children are asked to challenge their thoughts), the treatment is most effective for ages 6 and above.
However, anxiety and OCD symptoms can appear before this age, and we have worked with kids as young as 4. Please contact us to help us determine if we can be helpful for your child.
The family environment is an important factor in children's behaviors and emotions. Therefore when kids are in treatment parents are expected to be active participants. The nature of this participation depends on a number of factors, including the age of the child, the severity of symptoms, and the extent to which parents are involved with the child's symptoms.
For example, for very young children, having a parent in most or all of the sessions is helpful. For kids with separation anxiety, the goal is to foster increased comfort with distance from loved ones. Therefore, parents may be asked to gradually attend less and less over time. For teenagers, privacy and autonomy are increasingly important. Thus, parents may be minimally involved but given updates on how best to support positive growth at home.
Every individual who receives treatment at the NOAC will go home with between-session assignments. It is often helpful for parents to be aware of homework assignments so that they can monitor and increase accountability. Another area of import to anxiety and OCD is family accommodation. This refers to a set of behaviors that family members engage in that foster avoidance or directly engage with children's rituals. For example, allowing a child to take a "mental health day" off from school when the child is anxious about attending school may initially seem helpful but actually serves to strengthen anxiety and avoidance in the future. Additionally, catering to children's symptoms (e.g., opening doors for him/her, speaking for him/her at restaurants, allowing only "safe" foods) can undermine treatment. Therefore, family accommodation will be assessed and addressed for all pediatric clients.
Although most therapy with kids has some kind of family component, sometimes it is helpful to treat the "family system" as a whole rather than to focus on an individual in the family. Family therapy addresses patterns of communication and behavior in the home that contribute to interpersonal conflict and symptoms. It is important to note when entering into family therapy that the therapist must identify an individual who will be the "primary" client for purposes of billing and insurance.
For family therapy sessions, multiple family members join for the sessions but this combination may depend on the nature of the presenting issues (e.g., whole family, child plus one parent, child plus siblings, etc). For more information about whether family therapy is a good fit for you, please contact us.