Therapy for Children

Click Here For Therapy For Adolescents
As child psychologists with several years experience providing child therapy and child evaluation services to children and families in Raleigh, Durham, Chapel Hill and the greater Triangle, we recognize children present with unique needs with regard to therapy and testing services. And we recognize parents are often worried when they bring their child in for help, and often the child doesn’t know what to expect. From the moment you enter you will feel our dedication to providing a child-friendly and family-friendly environment, from our comfortable setting with specific play space and family space, to the warm welcome you will receive.

We believe children often face unique challenges and problems. For some, these challenges stem from a biological or psychological problem. For others, they simply need help during a difficult time or transition in their young life. Still others just need a little extra help developing everyday life skills. Child therapy provides a safe place for children to address problems. We involve children in the goal-setting process, and allow them time in therapy to become comfortable with their therapist, the process, and with actively addressing their problems. As each child and family are unique, we decide with parents on a case-by-case basis whether the child’s care should involve individual therapy, family therapy, individual parent sessions/coaching, or some combination.

We set goals early in treatment with children and their families, in an age-appropriate way that children can understand and get excited about, so that we can find successful solutions and change behavior problems, emotional difficulties, academic difficulties, or family issues as soon as possible. As a group of strong diagnosticians, our early understanding in treatment of the problem results in more targeted interventions and thus more successful treatment. We subscribe to a solution-based philosophy, in which we strive to address the problem as quickly as possible, but with also enough depth to avoid it reoccurring again in the future. In addition we incorporate a positive psychology and strength-based approach, in which we not only focus on ‘fixing the problem,’ but also focus on what the child already does well – their natural strengths, the ways in which they shine. We teach the child how to use their natural strengths and talents to improve problem areas; this helps build the child’s self-esteem and sense of competence while new skills are developed. Our child resources are excellent and include age-appropriate therapeutic games and activities, specific indoor child and family space, a game room with a pool table, a media room, outdoor therapy space, and walking trails (see bottom of page for more on Play Space at Lepage Associates).

WHAT CHILDREN NEED HELP WITH & HOW WE CAN HELP

Children present with distinct concerns including academic difficulties, behavioral difficulties, temper tantrums, social skills awkwardness or deficits, sibling and peer difficulties, and separation anxiety. There are also many disorders that are child specific or are typically diagnosed during childhood including attention-deficit/hyperactivity disorder (AD/HD; “ADD”), learning disabilities (LD), communication disorders, developmental disorders, and disruptive behavior disorders. In addition to those, children also experience disorders commonly seen in adults such as childhood depression, childhood anxiety, childhood posttraumatic stress disorder, childhood onset bipolar disorder, and childhood onset eating disorders.

Childhood disorders are frequently misdiagnosed or mistreated. For example, childhood anxiety may be mistaken for AD/HD (“ADD”) due to their similar presentations. In addition to therapy, psychological evaluations, including AD/HD (“ADD”) specific evaluations can be conducted to differentiate symptoms. Similarly, childhood depression often presents as irritability, and therefore may go unrecognized and untreated because it is misunderstood. Learning disabilities are another frequent problem that goes unnoticed and untreated in children, with children instead labeled lazy or inattentive. It is important to consult with a child psychologist as their in-depth knowledge of child development can be used to determine age-appropriate expectations, skill mastery, and developmental needs in treatment. The child psychologists at Lepage Associates are able to provide comprehensive services including: educational testing and psychological evaluations if needed to correctly diagnose the problem; development of recommendations for the child, parents, and teachers as needed; child therapy interventions that are age appropriate and child sensitive; and parent coaching or family therapy as needed.

Because of children’s unique development, traditional talk therapies often need to be combined with expressive therapies, including play therapy, art therapy, and sand tray therapy, to have optimal effectiveness. The psychologists at Lepage Associates are able to facilitate all of these interventions. The use of expressive therapies allows children to communicate their concerns through play, which is their natural mode of communication. Due to normal developmental linguistic limitations, children often have difficulty clearly expressing their thoughts and feelings to others; therefore, the use of expressive therapies is necessary… and children then actually enjoy coming to therapy and find it a fun way to improve!

Cognitive behavioral therapy is also often successful with working with children, specifically those diagnosed with AD/HD, ODD, disruptive behavior, and anxiety. Given their age, their primary function is learning. Cognitive interventions assist children in altering their thinking patterns to develop healthy coping skills and thought processes. Children naturally learn through rewards and consequences. Behavior therapy assists with identified desirable behaviors and behaviors that need to be extinguished. Our child psychologists are an excellent resource to assist parents in identifying age appropriate behavior, developing age appropriate expectations, identifying effective rewards and consequences, and provide parent coaching to successfully implement behavior modification plans.

Children are involved with multiple systems including school and family, which significantly impact their daily functioning. The use of family therapy in conjunction with individual therapy can assist the child in mastering problem areas more quickly and return to an adaptive level of functioning. In family therapy, our psychologists work with parents on developing behavior modification plans to address symptoms of AD/HD, ODD, and other behavior problems. A strength-based approach, with focus on improving communication skills and coping skills, is also common at Lepage Associates. We also have excellent couple’s therapists if problems in the adult intimate relationship need to be addressed.

Attention-Deficit/Hyperactivity Disorder (AD/HD;”ADD”)

In addition to providing behavioral interventions for inattentiveness and hyperactivity commonly seen in childhood AD/HD, our child psychologists can assist children with AD/HD in developing social skills and coping skills to improve daily interactions with peers and teachers. Child therapy also provides support in coping with the emotional impact of AD/HD.

Academics: Learning Disabilities, AD/HD, and other Psychological Problems that Can Impact School Performance & Learning

Academic achievement is also an area of high concern for children and their parents. The full range of academic testing offered at Lepage Associates can provide parents with the information required to understand the child’s needs, identify resources, and advocate for their child in the school setting. Common focus areas of educational testing and evaluations include intelligence testing, achievement testing, AD/HD testing, and testing for learning disabilities. Additionally, child psychologists can complete further psychological testing to determine if factors such as childhood anxiety, childhood depression, Oppositional Defiant Disorder (ODD), or other such disorders are impacting the child’s learning process.

Childhood Depression

When childhood depression presents as anger rather than sadness, it often puzzles those around the child. The child is often viewed as cranky, oppositional, aggressive and angry. The acting out behavior is often addressed while the depressive symptoms go unrecognized and untreated. Parent education regarding childhood depression is an essential part of treatment. Psychological testing may also be beneficial in determining the severity of the child’s depression as well as intervention strategies. There can be many root causes to childhood depression. A sensitive child may become easily saddened and therapy can focus on building resilience. If peer rejection is an issue, social skills can be improved. Low self-esteem and lack of confidence can be addressed through building sense of mastery and competence. Sadness over a recent difficult life transition, such as divorce, can be addressed through supportive therapy and building coping skills.

Childhood Anxiety

A child may experience anxiety in a variety of forms. Some children experience a general nervousness with no one specific fear, while others experience anxiety targeted in one area, such as test anxiety, school refusal, or fear of the dark. Anxious children may be shy, reluctant to leave their parents, require a long time to fall asleep (due to anxious thoughts), have trouble making friends, or dread speaking up in class. Some anxious children are described as “perfectionists” who may erase and redo homework several times. A child experiencing anxiety also may report experiencing frequent physical pain, such as headaches and stomachaches. Obsessive Compulsive Disorder (childhood OCD) is another form of childhood anxiety and can include a child repeating thoughts or behaviors many times a day that prevent them from completing daily tasks. Some of these repetitive behaviors may include washing hands, smoothing fabric, turning lights off and on, counting steps, and constantly erasing and redoing homework answers. Parents often feel at a loss when their child is experiencing anxiety, because the child seems to require constant reassurance, yet the reassurance doesn’t quell the anxiety. The child specialists at Lepage Associates can evaluate your child to determine if your child is experiencing a higher than normal level of anxiety. Our child psychologists can then provide therapy to your child to help decrease the level of anxiety your child is experiencing, so they can have more energy and lightheartedness to enjoy their young life.

Social Skills Development Concerns

Developing social skills is integral to a child’s self-esteem and confidence, and plays a role in a child’s overall happiness. However, there are a variety of childhood issues that can prevent a child from developing an adaptive level of social skills. Children with AD/HD (“ADD”), Aspergers, and Autism often have difficulty recognizing social cues or lack the impulse control needed to adequately “screen” their behavior before deciding to act. Children suffering from childhood anxiety can be shy and fearful of taking the risks involved in making friends, and children with childhood depression may also isolate and avoid friendships. Children with Oppositional Defiant Disorder (ODD) may be too aggressive and have difficulty making and sustaining healthy friendships, especially with non-aggressive children. Some gifted children are very focused on academic pursuits and can lack a good balance between school and friendships, whereas conversely some children who struggle academically or who have learning disabilities (LD) may be embarrassed by their poor academic performance and shy away from peers. Also, aside from these various childhood challenges that can result in difficulty in social skills, some children do not suffer from any disorder and yet simply are a bit shy or awkward or lack confidence, and these children benefit greatly from a little guided assistance in their social skill development.

While children often benefit from the social skills they learn in their families, there is a special benefit from in-the-moment practice of social skills with their peers guided by a child specialist, which is the focus of social skills groups run by the child psychologists at Lepage Associates. Importantly, all of our child groups are designed to be lots of fun, so children can learn new skills happily in a non-pressure setting.

Behavioral Acting Out & Oppositional Defiant Disorder (ODD)

When a child is experiencing behavioral difficulties, work with the family on developing behavior plans and coordination will school personnel is essential in seeing change. Common behavioral difficulties include hyperactivity, impulsiveness, aggression, peer conflict, bullying, oppositional behavior, and defiance. The psychologists at Lepage Associates can work actively with personnel in the Durham, Raleigh, Chapel Hill, and Cary school districts to provide comprehensive psychological services, upon the parent’s request.

Childhood Trauma

When a child experiences trauma such as physical abuse, sexual abuse, natural disasters, the loss of a parent, divorce, or being diagnosed with a serious medical condition it is essential that the child be connected to a specialist in this area. Based on their developmental level, children experience and respond to trauma differently than adults. Due to the limited ability of a child to communicate their needs, intervention provided by a psychologist specializing in expressive therapies, such as those at Lepage Associates, is often critical. Such interventions incorporate play therapy, art therapy, and sand tray therapy with more traditional interventions such as cognitive behavioral therapy and family therapy.

The psychologists at Lepage Associates are well versed in the use of expressive therapies, which are seen by many therapists as the most appropriate was to assess and treat traumatized children. The use of creative art therapies, including art, play, and sandplay provides a safe way for children and adolescents to express complex feelings. It is more manageable for psychologists to use nonverbal forms of communication because these are activities children engage in during their daily routine.

At Lepage Associates, the child psychologists use expressive therapies in either an individual setting or a group setting. Group activities lead to group discussion and the children learn to develop through their relationships with peers. Group settings also help by decreasing feelings of isolation due to their experiences. Family therapy using these modes of treatment is similar to the use of other group, in that it requires family members to work together. It provides the child with developmentally appropriate ways to communicate with the adults in the family. In working with the child therapist, the family can explore communication patterns, problem solving, and interpersonal relationships. The therapist will work with the family to determine which of the creative therapies they will use given the child’s presentation and developmental level.

PLAY & TALK THERAPY FOR CHILDREN

• Overcoming Separation Anxiety
• Adjusting to Preschool/Kindergarten Teacher
• Doing Homework & Academic Success
• Learning Disorders: Coping Emotionally & Succeeding at School
• Attention-Deficit/Hyperactivity Disorder (AD/HD and “ADD”): Coping Emotionally and Succeeding at School or Day Care, Plus Managing at Home
• Coping with Test Anxiety
• Oppositional Defiant Disorder (ODD): Managing Kids at Home, School, or Day Care
• Behavioral Problems at School/Daycare/Home
• Getting Along With Teachers and Other Students
• Building Self-Esteem, Motivation & Confidence
• Understanding My Role In Actions, Reactions & Consequences
• Developing and Maintaining Healthy Friendships
• Building Social Skills
• Getting Along With Family Members
• Dealing With Sibling Rivalry
• Coping With Separation or Divorce
• Living With Parents Who Always Fight
• Finding A Way To Be Happy In An Unhappy Home
• Figuring Out Feelings: What Is This Feeling? What Can I Do About It?
• Working Through Painful Emotions: Anger, Confusion, Sadness, Anxiety
• Aggression Isn’t The Answer: Learning to Work Things Through Without Yelling or Hitting
• Developing Healthy Ways To Cope With Stress
• Overcoming Childhood Depression
• Overcoming Childhood Anxiety
• Processing & Healing after Childhood Trauma

TIME-LIMITED GROUPS FOR CHILDREN

• Helping Children Cope with Grief or Loss
• Coping With Separation or Divorce
• Improving Social Skills
• Specific Skill Development for Common AD/HD (“ADD”) Problems

EDUCATIONAL EVALUATIONS

• IQ Testing To determine academic strengths and weaknesses; also identifies giftedness and mental retardation
• Achievement Testing To determine mastery of specific subjects
• AD/HD Testing To determine the presence of Attention-Deficit/Hyperactivity Disorder
• LD Testing To determine the presence of a Learning Disorder
• Full Psychoeducational Testing All of the above plus ruling out the influence of mental health conditions
• (For Preschool Children) Readiness for Kindergarten Testing
•  Click here for more in-depth information on Evaluations

PSYCHOLOGICAL EVALUATIONS

• Testing to help understand what your child is thinking & feeling, & why he or she acts out
•  Click here for more in-depth information on Evaluations

COUPLES, FAMILY & PARENTING ISSUES

Therapy, Coaching & Consulting

• Improving the Couple’s Relationship: Strengthening the Family Foundation
• Family Dynamics: There Must Be A Way To Get Along
• Negotiating Differences in Parenting Styles
• Understanding Your Child’s Developmental Needs & Ways to Meet Those Needs
• Negotiating Differences Between Your Child’s Personality/Temperament & Your Parenting Style
• Setting and Enforcing Age-Appropriate Limits
• Dealing With A Difficult Child
• Developing Healthy Sleep Patterns
• Developing Healthy Eating Habits
• Overcoming Bedwetting & Wetting Clothes
• Coping With Childhood Illness: Physical Illness, Mental Health Diagnoses, Learning Disorders

TIME-LIMITED PARENTING GROUP

• Overcoming Parental Dilemmas

SEPARATION & DIVORCE / FAMILY COURT MATTERS

• Mediation for Separation, Divorce & Custody 
• Coaching for Cooperative Co-Parenting 
• Developing a Parenting Plan 
• Custody & Visitation Evaluations 
  • Click here for our expertise in this area as well as a list of commonly asked questions

PLAY SPACE AT LEPAGE ASSOCIATES

We have a host of accommodations for the children and families we serve! In addition to our compilation of age-appropriate therapeutic games and activities, we also have: a media room; a campus with outdoor therapy space and walking trails; and a game room with a pool table. Our team is highly experienced in connecting with children to make therapy useful. We recognize children need a play therapy approach, but with play appropriate to their age, and our site meets the broad needs of children of all ages. We have an array of games and toys. The media room is useful for children who can better express how they feel using media resources, such as DVDs, CDs, and the computer. We can watch a movie clip that is meaningful to them, or we can show a movie clip we think might help them better express how they feel or gain a deeper understanding of a topic. Similarly we can incorporate listening to a child’s favorite song into therapy, as children often connect to songs that have meaning in their own lives. We also sometimes invite the child to sit outside on the lawn and talk or play versus staying in the office, and, with parent’s permission, we back up to the American Tobacco Trail and can take a child for a walk while we talk. (Some of our parents take advantage of the Trail and get their own exercise while their child is in session!) Our facilities and campus are as good as it gets!