Child and Family Center

Bullying in the school setting is not uncommon and may take many forms including physical abuse, taunting, and exclusion from groups and activities. Victims of bullying can develop symptoms of depression, school refusal, and social isolation. Moreover, left untreated, children and adolescents who have been bullied may experience long-lasting trauma. The Center’s interpersonal psychotherapeutic approach is ideally suited to helping victims overcome these symptoms. The interactive and supportive one-to-one relationship with the therapist provides a unique framework for developing new interpersonal strategies and for beginning to heal damaged self-esteem. If you think your child may be a victim of bullying the Child & Family Center’s highly trained child mental health professionals can help.

Research indicates that between 2-4% of all children—from those attending grade school to high school—show signs of school refusal. Characterized by marked reluctance to attend school or claims of feeling unwell, but then feeling better if permitted to stay home, school refusal can progress to a point where the child will only attend school after crying, clinging, or throwing tantrums. Children may also exhibit unusual distress during school days that leads to pleas for future absenteeism; attend school initially, but leave during the course of the school day; or insist on staying home. (This absence differs from truancy, in which children or adolescents do not experience school-related anxiety, but avoid school and conceal their whereabouts from their parents and teachers.).

School refusal is as common among boys as girls and may be either acute and brief, or become chronic due to a combination of problems at school and home. Among those issues related to the school environment are: being bullied by other students; an inability to make social connection to children or teachers; or a learning disability that has not been identified and an associated belief that learning is impossible. In addition, children who have missed some school because of illness may be afraid of never being able to catch up.

Family and personal issues that can lead to school refusal include jealousy of a younger sibling or a sibling who is ill and is permitted to stay at home; or worry that some harm could come to you or another relative at home in his/her absence. Some children also develop severe stress-induced separation anxiety related to illness, divorce, or a recent move.

The Child & Family Center’s highly trained child mental health professionals can help by determining the reason(s) for school refusal and meet with you, your child, and your child’s teachers to address the child’s stress and formulate a plan for a gradual, reintroduction to regular school attendance.

Obsessive compulsive disorder (OCD) is an anxiety disorder characterized by repeated obsessions and/or compulsions that interfere with the child/adolescent’s ability to function socially, occupationally, or educationally. An obsession is defined as a thought, impulse, or image that either recurs or persists and causes severe anxiety. A compulsion is a ritual or behavior that a child/ adolescent with OCD engages in repeatedly, either because of his/her particular obsessions or in an attempt to follow a familiar yet rigid set of rules. Typical obsessions in children/adolescents include:

• Obsessions about aggressive, sexual and harm-related themes with checking compulsions. Checking compulsions refers to a set of repetitive behavioral patterns (e.g., checking light switches, doors) with the goal of seeking reassurance and decreasing anxiety.
• Obsessions about symmetry that are accompanied by arranging or repeating compulsions.
• Obsessions of contamination that result in cleaning compulsions like excessive hand washing and skin picking.

Children/Adolescents with OCD are also more likely to develop chronic hair pulling, muscle or vocal tics, or an eating disorder like anorexia or bulimia. OCD symptoms predispose the child/adolescent to developing other mood problems, such as depression, generalized anxiety disorder, and panic disorder, as well as developing excessive concerns about their bodies.

The Center’s interpersonal psychotherapy approach offers an excellent framework for the child/adolescent to explore the irrational nature of thoughts and behaviors within the safety of the therapeutic relationship. Family members are asked to engage in the treatment in order to support and enable the child/adolescent to experience new ways of interacting with the world. If you think your child is suffering from OCD, the Child & Family Center’s highly trained child mental health professionals can help.

Many families are affected by disordered eating and eating disorders, terms that define a spectrum of problematic attitudes and behaviors related to eating. The Child & Family Center’s highly trained child mental health professionals can help assess the severity of the child’s condition and help both children and their parents better understand these issues.

It is quite common for babies and very young children to have some issues around food and eating. These can range from certain foods causing stomach upset, to a young child’s “picky” eating and rejection of anything green or different from their usual preferences, to a child taking little enjoyment or interest in eating and remaining small for his/her age. In children under ages 7 or 8, these eating patterns may fall into a normal range and lessen or disappear as they mature. In such situations, the therapist will help parents better understand their child and find ways to promote their child’s development. He or she will also consult with your child’s pediatrician to evaluate and monitor the child’s growth.

Disordered Eating includes a range of eating patterns that can both affect and reflect the health and well-being of a child. These eating behaviors may include the range of normal eating patterns described above; however, these patterns reach a higher level of concern if they persist well into pre-adolescence. Contributing factors may include anxiety, stress, unhappiness, or low self-esteem. A therapist can help you, and your child understand and work with any underlying social or emotional issues that are contributing to these eating patterns.

Eating Disorders are a category of diagnoses that include anorexia, bulimia, and binge eating. These disorders involve a preoccupation with food, weight and body shape. Other hallmarks of anorexia are a fear of gaining weight, marked weight loss, or a failure to gain normal amounts of weight in a growing, elementary age child. Young people with anorexia also have a distorted view of their bodies (perceiving themselves as fat when, in reality, they may be quite thin), as well as what a “normal” weight and body shape look like. Similarly, the child with anorexia often has a distorted view of what constitutes a normal amount of food for a meal. Difficulty identifying and regulating feelings frequently accompanies difficulty regulating food intake.

Bulimia and binge eating are less common in elementary-aged children. However, loss of control over eating (binge eating) and binging combined with other behaviors such as vomiting, excessive exercise or dieting to prevent weight gain, together with overconcern about weight and shape, can be signs of bulimia. Early intervention is important.

If you have concerns about your child’s preoccupation or behavior around eating and body image, The Child & Family Center can make referrals to a therapist who specializes in treating eating-disorders in elementary school-aged children. It is also important to consult your child’s pediatrician for a medical evaluation.

Extensive research has demonstrated that children of divorce tend to experience more difficulties in school, increased behavior problems, lower self-esteem, more trouble getting along with peers, and an increased likelihood of difficulties in subsequent relationships.

However, many young people make excellent adjustments after their parents’ divorce, and the way parents navigate the divorce process has a large impact on the ultimate success of their children. The factors that most contribute to a child’s adjustment difficulties are: exposure to parental conflict, increased life stress, and the loss or lessening of contact with a parent. A difficult divorce can leave a child feeling out of control – his/her sense of the world as a safe place can be shattered. The resulting uncertainty can give rise to anxieties that may interfere with normal development. Given what we know about how children process experience, much can be done to mitigate the negative effects of divorce. Parents need to explain the changes in the family in terms a child can understand – a five-year-old has very different capacities than a teenager. Most importantly, children need to be shielded from the toxic conflicts that often accompany separation and its aftermath. They need to know that they can love both parents without being disloyal to either. Parents need to put their children’s needs first, to try to anticipate how the upcoming changes are likely to be experienced by their children, and to be accepting of the variety of reactions they might have. Children may also need to be reassured that they were not responsible for the breakup of their parents’ marriage.

Through psychotherapy and guidance, The Child & Family Center’s highly trained child mental health professionals can help parents to divorce in a manner that minimizes the negative effects on their children and helps them adjust to life after a marriage ends.

In recent years there has been a dramatic increase in the number of children diagnosed with an autistic spectrum disorder. According to some estimates, one in 110 children is diagnosed with a disorder on the autism spectrum. Although the exact incidence of these disorders is an area of debate, one thing that is very clear is that the disorder is found far more often in boys than in girls. The cause (or causes) of autistic spectrum disorders is clearly biological as opposed to psychological. Current research indicates that these disorders are the result of abnormal brain development that likely has genetic origins.
Autistic spectrum disorders are developmental disorders. Thus, it is expected that individuals with this diagnosis will have difficulties throughout their lifespan although the exact nature of these difficulties will shift as the child enters a new developmental era. There is also considerable variability in the severity of impairment from relatively mild impairment to more severe.

Overall, there are three core areas of difficulty associated with autistic spectrum disorders:

• Impairment in social interaction. Although children with the disorder may express interest in friendship, these interests are frequently thwarted by the awkward approaches and their insensitivity to the feelings, intentions and nonverbal signals of others.
• Impairment in verbal and nonverbal communication. Many children display a language delay and/or abnormalities in communication. The child’s speech may be pedantic. Their speech may also contain pronoun reversals, echolalia, and unusual and robotic intonations. The children have difficulty understanding non-literal language. Sarcasm and metaphor are often beyond their comprehension. Children also display difficulties in non-verbal communication such as reading facial expressions or body language.
• Markedly restricted repertoire of activities and interests. As young toddlers, the children often use objects in unusual and restricted ways. They may become obsessed with fans, elevator buttons, garage doors, etc. As the children become older they may become obsessed with various television and toy characters.

Although not a core area of difficulty, the children may display various types of sensory issues. They may be overly or under-reactive to sensory input. Children frequently display gross motor difficulties. They are often viewed as clumsy and as displaying little awareness of their body in space.

At the Center we focus on the emotional and psychological needs of children and adolescents on the autism spectrum and their families. The focus on interpersonal relationships is particularly important in the treatment of autistic spectrum disorders, since many of the difficulties experienced by these children are interpersonal in nature. Common issues that we address in treatment include: peer and family relationships, problematic behaviors at home, school issues and bullying. Issues particular to older children and adolescents include dating, sexuality and supporting and planning for more independent lives.

The Center offers a variety of services to address these needs.

• Individual psychotherapy to facilitate the development of imagination and fantasy, as well as to assist the child in learning to appreciate the thoughts, feelings, and emotions of others.
• Group therapy to assist in the development of peer relationships and social skills;
• Parent and family counseling to assist parents and siblings in coping with the specific demands of having a family member with this disorder. Planning for their child’s future is often a major task for the parents as their children progress and develop.

When a child is born with or develops a serious and/or chronic medical condition or physical anomaly, every member of the family—the child, his/her siblings and parents—develops their own special needs and problems. The child who is ill or disabled may feel “different”, and suffer with low self-esteem, depression, anger, or social exclusion. Siblings may limit the expression of their own needs, trying to be “extra good”, and end up feeling neglected. Parents carry the burden of anxiety and added work, and may feel they have no one to talk to.

The Child & Family Center meets these special needs with professionals who are alert to the impact of ongoing medical conditions on the affected child as well as on his or her family. Our approach includes individual therapy for the child with the medical condition, as well as for siblings, as appropriate. We offer support and guidance to parents through counseling, and meet with families to address issues that affect the entire household. The Center’s therapists use a team approach, and coordinate psychotherapy services with those provided by physicians, nurses, occupational, speech, and physical therapists involved in your child’s care. If your family has a child with a medical condition the Child & Family Center’s highly trained child mental health professionals can help.

The Parent Center is a part of the Institute’s Child & Adolescent Psychotherapy Training Program and Child and Family Center. With a focus on community mental health and outreach, the Parent Center provides interactive workshops for parents in local public and private schools where attendees can air concerns and get answers to their parenting questions.

The Parent Center outreach program also makes presentations at schools, helping to develop sound approaches to some of the most pressing parenting issues of the day. There are no parenting manuals that can realistically speak to the unique needs of each family. Our mission is to help parents understand child development and provide new perspectives, tools and strategies.

Workshop topics include:

• BULLY PROOF YOUR CHILD: Empathy in Action
• BECOMING A MINDFUL PARENT: Calm at the Heart of the Storm
• SETTING LIMITS: How to Set Limits and Feel Good About It
• HOW TO TALK TO CHILDREN ABOUT DIFFICULT SUBJECTS, including illness, death, scary situations
• HOW TO TALK TO CHILDREN ABOUT HEALTHY BODY IMAGE in the 21st Century
• SUPPORTING EMOTIONAL RESILIENCE: Building a foundation for the future
• HOW CHILDREN DEVELOP EMPATHY AND WHY IS THIS IMPORTANT?
• HOW DO I KNOW IF MY CHILD IS STRUGGLING WITH SELF ESTEEM?
• HELICOPTER OR OSTRICH? Finding your parenting sweet spot between under-supervised and Overprotective.
• CHILD’S PLAY: The serious job of playing with your child
• CREATING A BALANCED SCHEDULE: How and why to avoid the overscheduling trap.
• STRESS AND ANXIETY: How to help your child develop coping skills now
• ELECTRONICS AND THE MEDIA
• CREATING POSITIVE ROUTINES FOR A SANE HOME

If your parent association would like us to speak to the parent group at your school, please contact either Todd Germain at Todd@Reflective-parenting.com or Lisa Dubinsky at ldubinskypsy@gmail.com. We believe that all parents should have access to parenting support.

In addition to our workshops, we offer our Parent Education & Guidance (PEG) service, and child psychotherapy at the Child & Family Center of the William Alanson White Institute. If you are seeking parenting guidance, bring your concerns to the Child & Family Center. We will support you to further develop skills and improve parent-child relationships. For more information about any of our services or to have a confidential conversation about your needs, please contact Dr. Susan Rose at (212) 787-7016.

To apply for a psychoeducational evaluation download the application by clicking here.

In addition to addressing individual behaviors and conditions through psychotherapy, , the Center provides psychoeducational evaluation. Using an extensive battery of psychological tests, we assess intelligence, academic functioning, neuropsychological issues, and personality features to clarify underlying reasons for problems that perplex parents and teachers. Fees for psychological testing at the Center are substantially lower than those charged by private practices for comparable services.

In all our services, we provide a direct, flexible, active, and collaborative approach to engage the patient, family, and those representing any school or organization. Years of clinical expertise, combined with a warm, open-minded, non-authoritarian approach, enable our therapists to make a difference for the people we serve. We especially value the creation of connections within families, as well as between families and all professionals who are involved with the care of the child.

In addition to working directly with families, therapists at the Center provide regular consultation to schools and various agencies and community sites in New York City. Previous initiatives include work with an after school program for preschoolers and their families, and consulting to an agency providing parental support for older adolescents on the autism spectrum. Center faculty also conduct workshops for staff and parents that focus on important issues of childhood and adolescence.

Center services are billed on a sliding scale. Although Medicaid is not accepted, assistance with maximizing insurance coverage is provided. Fees charged to schools and agencies are arranged on an individual basis.

The William Alanson White Institute established its award-winning, low-cost treatment center in 1948 to provide affordable psychotherapy and psychoanalysis to members of the community. Since that time, thousands of individuals and families have been served by our highly skilled clinicians.

To apply for treatment, please download and print the Child & Family Center application and mail a completed copy to:

William Alanson White Institute
Clinical Services
20 West 74th Street
New York, NY 10023

Upon receipt of a completed application you will be contacted as soon as possible (usually within 48 hours) by our Director, Susan Rose, Ph.D.

To apply for a psychoeducational evaluation download the application by clicking here.

Please call 212-873-7070 for more information.