My Approach to Helping Children
For children under 12, I work with parents to help their child.
Siblings can be included so the whole family supports new
learning. Child behavior therapy shows parents, teachers,
and peers how to react so that a child can learn new behaviors.
Mastering new skills produces the good feelings of accomplishment
and pride in being grown up. I encourage younger children
to focus on successes and show them that succeeding at doing
something new and difficult can feel great.
For older children, I focus more on the individual. These
children want to separate from their parents and respond to
a challenge to "do it themselves." Peers are major
influences. Helping requires a delicate balance to support
independence and to maintain trust and respect for adults.
Helping parents stay involved to promote good independent
decision making is the greatest challenge. Helping teens feel
competent without losing perspective is the major goal.
Many of the problems I address require close collaboration
with the child's medical team. I work closely with family
practitioners, pediatricians, pediatric urologists and gastroenterologists,
and child psychiatrists.
Some children have bowel problems that lead to soiling. They
need thorough medical evaluation. Most often they are constipated.
Soiling is caused by repeated efforts to hold back. Behavioral
treatment breaks this cycle. The goal is to establish regular
toileting to prevent accidents. Many will need medical help
first to clear the bowels. Treatment includes dietary changes
and use of laxatives or stool softeners. Treatment can take
4-6 months and will involve 10-15 consultations.
Anxiety and Phobias
Fears are part of normal child development. When a fear prevents
a child from succeeding at school or play, seek evaluation.
Behavior therapy teaches the child to control mental and physical
reactions to get through and past anxiety reactions. The key
is showing the child that the fear can go away by experiencing
the fear without running away from it.