Services We OfferChildhood Anxiety Social Work Services, LCSW, PLLC offers a full array of therapeutic services to meet your child’s individualized needs. We use evidenced based and multi-modal treatment approaches, which are considered best practice when working with anxious children.
Individual / Family Therapy
Anxious children often need to be with their parents initially when they begin therapy. At Childhood Anxiety Social Work Solutions, LCSW, PLLC we understand that need. We start where the anxious child is most comfortable and then gradually help the child to face his fears in small doses as we fade out the parent. In the meantime, the parent can learn and utilize the interventions learned in the parent/child sessions to help their son and daughter in the home, at family gatherings, at school, and in the community. Siblings can learn when to help and when “not to talk” for their brother or sister. Siblings can learn what questions to ask to help their brother or sister to feel comfortable speaking. Siblings can encourage their brother or sister to do their therapy homework and to wait before washing their hands or to go to a movie for the first time.
Selective Mutism Group Therapy
At Childhood Anxiety Social Work Solutions, LCSW, PLLC we have ongoing selective mutism therapy groups for all age groups. We run the same group model developed by Marian Moldan, LCSW-R over 12 years ago. This group model has proven successful over and over by helping youngsters to speak and support each other. Within these selective mutism groups they learn to use language to negotiate conflict, to solve problems, to explore their fears, and to talk. This group model gives selectively mute youngsters many opportunities to practice using language to regulate their behavior appropriately. They learn social skills and pragmatic language here. They develop long lasting friendships and acquire self-esteem.
- The youngest groups are parent/children groups.
- There is a kindergarten / first grade group.
- There is a Third / Fourth grade group.
- There is a Teen Group.
- An adult group is currently in the process of being formed.
Parent / Teacher Consultation Sessions
Part of treating an anxious child is working with the school personnel. School personnel want to help anxious students, but often don’t have the current information to do so. Working together with the parent and the teachers often helps the child to do best because appropriate behavior is being reinforced in all of the child’s worlds. Also, everyone has a good understanding of each child’s particular anxiety and how they can be most helpful. Furthermore, the child will feel most comfortable when he senses a comfortable working relationship between all of the helpers in his life. At Childhood Anxiety Social Work Solutions, LCSW, PLLC we understand the importance of this parallel process and how if we want to enhance the anxious child’s ability to interact appropriately with his peers that we have to model that for him. We will do everything we can to make that happen for him and for you.
Disorders We Treat
Selective Mutism is defined as when a person is not able to speak in specific situations where speaking is expected. Most often, this situation includes, but is not limited to, the school setting. This disorder interferes with educational and occupational accomplishments and/or with social communication. This anxious behavior lasts at least one month and is not limited to the first month of school when many children are quiet and withdrawn as they adapt to the first month of school. The failure of being able to speak is generally not due to a lack of knowledge of, or comfort with, the spoken language required in social settings. Co-morbid disorders may also exist (e.g. ADHD, OCD, Generalized Anxiety, Separation Anxiety, etc.). Selectively mute children tend to be picky eaters. Many of these children have toileting difficulties while in the school setting. A number of selectively mute children recoil when the focus is placed on them abruptly. They can have difficulty regulating their behavior, especially once they begin to speak. They tend to be bright, creative, and perceptive.
When people think of childhood anxiety, separation anxiety comes to mind. Often people think of a young child who clings to his mother on the first day of school. Separation anxiety is the developmentally disproportionate and enormous anxiety related to separation from home or loved ones. The child may become obsessively worried when separation from home or loved ones occurs or is announced. The child may have a continual worry about losing or about harm occurring to a major attachment figure (e.g. family member). The child may worry about getting lost, being kidnapped, or being abducted from home. In severe cases, some children can not go into a room alone at home without the parent. There may be a reoccurring inability to go to sleep alone, remain sleeping alone, or to sleep away from home alone. Nightmares containing themes of separation can accompany this disorder. The child may complain of being sick when he/she thinks the major family member will be leaving him or her.
Generalized Anxiety Disorder
Generalized Anxiety Disorder is when a child worries more often than not. The child can not control the worry and people around this type of child often feel like they are “walking on eggshells” as they try to keep the child’s anxiety at bay to no avail. This child seems to be always keyed up and hyper-vigilant. Eventually, such a child exhausts herself and just falls asleep from worry. Such a child will complain that she or he has difficulty concentrating or will go blank at times. Children with GAD tend to be irritable. Their muscles are tense. They tend to have sleep disturbances (e.g. difficulty falling and staying asleep and/or restless, unsatisfying sleep). The constant anxiety and stress, along with the co-morbid physical complaints tend to create deterioration in important areas of this child’s functioning (e.g. school, home, social life, etc.).
Obsessive Compulsive Disorder
A child obsesses when he or she has reoccurring thoughts or impulses that are disturbing and shameful and cause the person to be anxious. Such obsessions don’t have to be about real life events. Often the child tries to ignore or forget these thoughts and images with another thought (obsession) or behavior (compulsion). When a child does a behavior over and over (e.g. hand washing, tapping a certain number of times, counting,) as a response to try to stop an intrusive and persistent thought (obsession), it is called a compulsive behavior. A compulsive behavior is intended to wipe out or prevent a dreaded event. Such compulsions are unrealistic and unrelated to the obsessive worry. However, they take up an enormous amount of time and they begin to interfere with age appropriate functioning (e.g. socializing with peers, concentrating on school work, carrying out family chores, etc.). Sometimes, other family members feel like they have become hostage to the child’s compulsive behaviors because if they don’t allow the child to do them, the child will have “a meltdown”. In its extreme, the family’s routine revolves around the child’s compulsions.
This child has an excessive fear about school to the extent that it causes him and the family a great deal of torment. Not only are school mornings torture, but anxiety about attending school may begin the evening before. This child will watch the clock, have physical complaints, visit the nurse, vomit before school, and eventually stop going to school altogether. Such a phobia is often triggered by an unpleasant event or separation anxiety, social phobia, emetophbia (fear of vomiting), generalized anxiety and/or a combination of these types of anxieties. This type of avoidance behavior can have lifelong implications for other learning situations later, e.g. college, adult night school, license exams, etc. It also can effect structured group activities in the community and social gatherings.
A child with social phobia tends to fear social situations and/or performance situations whereby he or she may be judged by peers in some way. This child also worries about being in the presence of people he may not know. Socially phobic children are prone to tantrums, crying, frozen affect and withdrawal when in the presence of unknown people. Some children seek to avoid these situations or people or become panicked with enormous anxiety and discomfort.
Emetophobia (Fear of Vomiting)
Some children fear they will throw up in school. This can be brought on by an earlier act of vomiting themselves or having witnessed someone vomiting in school. Such children will avoid school; avoid the place where they fear they will vomit in school (e.g. the cafeteria); or the time of day during the school hours they fear they will vomit. It is not uncommon for these children to restrict what they eat or drink out of fear that they will throw up what they have ingested. These children avoid anyone or any place where they could get sick and always worry about having an escape plan in case they have to vomit. Their world and their family’s world shrinks to nothing in order for the child to avoid getting sick and vomiting. Such a small world negatively impacts social, emotional, and educational development in the child as well as healthy family dynamics.
Adult Anxiety Therapy
We have recently added another service for Adults with Selective Mutism or who had Selective Mutism as a child. We understand how a childhood of silence may have left gaps in a person’s social and occupational communication skills. We provide individual and group therapy for this population. In addition we help with job interview practice, social communication practice, and practice in any other area of your life whereby your lack of verbal communication has held you back.
We also have treatment for Adults with Panic Disorder. We used evidence-based methods to assist you in overcoming the paralyzing anxiety that panic can create. We provide individual and group therapies for adults with Panic Disorder.
New Low Cost Option
Adelphi University currently has Childhood Anxiety Solutions, LCSW, PLLC as a field placement for social work interns. Anyone qualifying for low cost treatment for their selectively mute and otherwise, anxious child can receive low cost individual and family therapy. Our interns are supervised weekly with Marian Moldan, LCSW-R. In addition, interns participate in case conferences. They receive field instruction class instruction at Adelphi. Marian Moldan is SIFI trained as an approved social work supervisor for New York Universities field placements.