A multi-disciplinary practice offering a broad range of services to children, adolescents, adults, and families. Our team of highly skilled psychologists bring decades of experience in understanding and treating a range of neurodevelopmental, clinical and interpersonal issues across the lifespan.
We have all been there. A stressful week at school, important meetings and deadlines at work, a busy
week with the family, or perhaps exciting travel plans disrupting your sleep schedule.
The NIH recommends that adults sleep for seven-eight hours per night, yet more often than not, sleep is the first
thing to go in order to sustain our busy schedules. Sleep has many important physical and psychological
benefits. In fact, regular, consistent sleep decreases the amount of stress hormones in circulation,
improves our immune system, maintains cardiovascular health, lowers the risk of obesity, improves
mood, and consolidates memories.
Even with all of these vital health benefits, we often deprive ourselves of sleep to accommodate our busy schedules. While our many demands during the week cost us valuable hours of sleep, it would seem intuitive then that we try to make up for it on the weekends when we have more time. However, a recent study out of the University of Colorado funded by NIH’s National Heart, Lung, and Blood Institute (NHLBI) debunked this myth. They found that a research group who were deprived of sleep (maximum five hours per night) during the week but were allowed to sleep
in on the weekends fell victim to the similar consequences of a group who faced consistent deprivation.
In particular, they experienced weight gain and a decrease in insulin sensitivity
This was also the case for adolescents. A 2016 study evaluated 56 adolescents, ages 15-19 years old who
studied in top high schools. Participants went through intermittent nights of sleep deprivation and
subsequent cognitive testing. Researchers found that the group who had their sleep restricted
demonstrated deterioration in sustained attention, working memory and executive functioning, an
increase in a subjective feeling of sleepiness, and decreased positive mood. The effects of decreased
attention and increased sleepiness remained the same even following two recovery nights
Dr. Rachel Dawkins at Johns Hopkins All Children’s Hospital highlighted the important benefits of
consistent sleep for children and adolescents. These included:
Better overall mental and physical health
She noted that lack of sleep can lead to high blood pressure, obesity, and depression. In order to avoid
falling into a state of sleep deprivation, the recommended amount of sleep per age group is as follows:
One year of age and younger: 12-16 hours
1-2 years of age: 11-14 hours
3-5 years of age: 10-13 hours
6-12 years of age: 9-12 hours
13-18 years of age: 8-10 hours
The death of a loved one to suicide brings a unique, complicated grief. Those left behind are left to grapple with difficult questions: Why did they end their life? What could I have done? How will I bear this? And perhaps most difficult of all, how will I help my children understand and cope with this event?
While some might worry that talking to children about the suicide could cause them further distress, The American Foundation for Suicide Prevention (AFSP) recommends being honest and direct about the cause of death. Children need to trust the people who take care of them to feel safe. If information is withheld from them, they might imagine worse things than the reality or worry that it was their fault.
Children have a way of knowing more than we think they do—by overhearing adults talking or seeing things on social media. Being in charge of the information your child receives about the death will ensure they get accurate information in a supportive way. Furthermore, holding back about the cause of death can unintentionally communicate that this is a taboo topic and discourage your child from asking questions or sharing their feelings or concerns in the future.
According to the AFSP, tell the child as soon as possible in order to make sure they hear the news from you first. Use short sentences, simple language and
developmentally appropriate explanations. Click on this link for specific recommendations of how to talk with each of these age groups: ages 3-5, ages 6-8
and ages 9-12, in the immediate aftermath of a death by suicide. Remember, you are also likely overwhelmed and trying to come to terms with this difficult loss. If you need help talking to your child, ask for a friend or loved one to be with you when you talk to your child. It’s ok to get the support you need, so you can be there to support your child.
Every parent, caregiver and teacher has heard (and probably used) the adage: “You get what you get, and you don’t get upset.” The idea is to express to the child that they must learn how to handle disappointment and not getting their way, which we can all agree is a critical lesson for their healthy development. As therapists, we disagree, however, with the message that the child can’t get upset. The child might get upset. They might feel disappointed, angry, sad and hurt. And that is ok. In fact, it makes sense and is normal. As adults, we also get upset when we cannot have things are way. We have just learned how to manage our disappointment, which is our job as adults to teach children to do.
The first step to helping children manage their feelings is to accept and validate them. Feelings are not right or wrong, they just are. Telling a child they don’t or shouldn’t feel a certain way leads to confusion, sadness, anger and typically an increase in unwanted behaviors. Think about how you feel when someone tells you not to be mad or it isn’t a big deal. You likely feel even more furious and want to convince the person you have a right to be upset.
When you validate the child’s feelings, it is important to label them so they can develop a language to describe and understand their experience. “Oh, you are feeling disappointed. You couldn’t have that train and you really wanted it. Bobby is playing with it right now. You can play with this truck while you are waiting for the train or come to do a puzzle with me.” Naming the feeling and giving them choices of how they can manage it will help them develop their own ability to manage feelings over time.
Knowing that your child’s emotions are normal and valid can also help diffuse parents’ worry and reactivity to their children. Parents do not need to convince children that they “don’t get upset,” a futile, frustrating job. Instead, parents can acknowledge that sometimes you do get upset, and you will be there to support them through it.
“My 3 year old son is terrified of the dark and refuses to sleep in his bed. We are all exhausted and have no idea what to do.”
“My 6 year old child has explosive outbursts whenever we ask her to do something. Is that normal?”
“My 9 year old doesn’t seem to have any friends. She is always refusing to do new things. What can we do?”
“My teenager won’t talk to me and is always on his phone. Every time I try to talk to him, I get silence or an argument. Help!”
Perhaps, you hear yourself in these questions. Or perhaps you have experienced another challenge that makes you wonder if there is a problem that could benefit from a professional’s support. When you become worried that a minor issue has become a major problem or you have tried to ride out a challenge and nothing seems to change, parenting work could be a helpful tool for you. At Georgetown Psychology Associates, our clinicians work with families with a range of behavioral and emotional concerns. Parenting work aims to meet each individual families’ needs and can take place over one consultation session, in a series of parenting sessions or in conjunction with your own child’s individual treatment. We offer a safe, non-judgmental space to hear your concerns, share your frustrations, and brainstorm how to utilize everyone’s strengths to resolve issues and develop a happier, more peaceful household. It might be time to listen to the voice wondering if there could be a different way and to reach out for the support you need to start making a positive change for your family.
The brain is a very complex organ and the activity within the brain determines everything that humans feel and do. Oftentimes, brain imbalances result in emotional, behavioral, social, and physical concerns. The typical “go to” treatment to address these brain imbalances has been medication. Medication is a great way to treat the chemical imbalances in the brain by directly affecting neurotransmitters. But, what about the electrical imbalances in our brain? This is where neurofeedback comes in.
Neurofeedback is a way to train the electrical impulses within our brain. It is a non-invasive form of biofeedback that teaches the brain to function with optimal brainwave patterns. It is like physical exercise for the brain, strengthening its ability to regulate activation patterns and neural pathways. This can lead to improvements in concentration, relaxation, activities of daily living, and overall state of mind.
How does it work?
Neurofeedback begins with a brief evaluation utilizing a clinical interview, rating scales, and an EEG assessment. The EEG assessment involves placing sensors on the scalp to measure the activity going on underneath. With this information, a targeted, individualized protocol is created to help train your brain into a comfortable, efficient state.
The neurofeedback training sessions begin by having electrodes placed on the scalp to read brainwave activity. Nothing is going in or out of the electrodes. They are simply measuring what goes on beneath, similar to the way a stethoscope measures heartbeat.
When the brainwaves are functioning within a predetermined threshold, a reward is provided to reinforce these more optimal brainwave patterns. The reward is typically a particular sound or visual stimuli provided through a ‘game’ on the computer. For example, many individuals choose to watch a movie. When the brainwaves are functioning within the limit that it set, the movie is clear. However, as soon as the brainwaves exceed the limit, the movie becomes cloudy, which is the signal to the brain that it needs to adjust.
Neuroplasticity, the ‘muscle building’ part of the brain, strengthens these new, more optimal connections, resulting in numerous positive benefits. This process occurs unconsciously, so all you have to do is sit back, relax, and your brain will learn. Over time, the brain learns to self-regulate and these benefits generalize to everyday life.
What does it treat?
Neurofeedback has been used to treat a variety of different symptoms, including those associated with ADHD, anxiety, depression, sleep challenges, PTSD, concussions, migraines, and more.
Check back for future posts in the neurofeedback blog series to learn more. In the meantime, watch this short YouTube video to familiarize yourself more with neurofeedback.
Everyone experiences some form of anxiety at some point in their life. Evolutionarily, it is a necessary and adaptive feature for survival. A certain level of anxiety can help raise our arousal levels so that we are able to appropriately respond in high stress situations. However, when anxiety symptoms become so overwhelming that they interfere with our daily functioning, an anxiety disorder may be the source.
Anxiety disorders are the most common mental illness in the United States. In fact, 28.8% of adults and 31.9% of adolescents qualify for an anxiety disorder diagnosis at some point in their lifetime (Kessler et al., 2005; Merikangas et al., 2010). This includes individuals with a severe diagnosis who are unable to engage in daily life activities, people with more mild symptoms who can participate in daily events yet struggle with racing thoughts and physical over arousal, and even more individuals that have difficulty sleeping and are seemingly unable to shut off their brains.
Of the adults diagnosed with an anxiety disorder, less than 50% of them are receiving treatment (Wang et al., 2005). Perhaps just as concerning is that of these individuals receiving treatment, less than half of them are only receiving minimally adequate treatment (Wang et al., 2005). So, what do we do about all of the individuals out there unable to sleep, shut off their brains, or enjoy life due to untreated anxiety symptoms? Neurofeedback may be able to help lesson these symptoms.
How can neurofeedback help treat anxiety?
Anxiety is the result of suboptimal brainwave patterns and irregular physiological functioning. It produces an excess of high beta brainwaves that trick us into perceiving safe situations as threatening, which triggers an anxiety response. This results in an inability to think and behave logically, which in turn increases the power of these anxiety-provoking brainwaves. Neurofeedback can put an end to this cycle.
The individualized neurofeedback protocol is programmed to foster the growth and connection of brainwaves that promote relaxation and inhibit these anxiety-producing high beta waves. As the brain self-regulates and begins to function in this more optimal zone, we are able to interpret situations for what they really are: non-life threatening. When our brains aren’t processing from a place of fear, rational thought can be utilized and the physiological symptoms of anxiety are reduced.
Whether anxiety is experienced as a constant state of over arousal or only in certain situations, neurofeedback can assist in putting the anxiety to rest. Neurofeedback results, like all forms of treatment, vary from person to person with some people noticing improvements immediately, while others require several weeks of training before noticing effects. Some people experience an “a-ha moment” while others notice gradual advances. On average, positive effects tend to be experienced in approximately twenty sessions. Often times, people with anxiety report that they first notice improvements in their sleep, as they are better able to shut off their minds and fall asleep more easily.
The development of neurofeedback provides an opportunity to change the way anxiety impacts us. It can once again be that adaptive, survival feature it was meant to be without infiltrating daily life.
Kessler, R.C., Berglund, P.A., Demler, O., Jin, R, Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry.62(6), 593-602. doi:10.1001/archpsyc.62.6.593
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., . . . Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980-989. doi:10.1016/j.jaac.2010.05.017
Wang, P.S., Lane, M., Olfson, M., Pincus, H.A., Wells, K.B., & Kessler, R.C. (2005). Twelve month use of mental health services in the United States. Archives of General Psychiatry. 62(6), 629-640. doi: 10.1001/archpsyc.62.6.629
Years of anticipation have led up to this. You picked out the perfect dorm decor, you organized your favorite high school photos, you texted and video chatted with your roommate anxiously awaiting meeting in person, and, of course, you got ready to say goodbye to your friends and family.
Going off to college is an enormous milestone; however, the excitement surrounding this transition can also be accompanied by feelings of loss associated with leaving home. If you find yourself feeling down after watching your parents pull away post move-in day, you are not alone. In fact, you are in good company.
An article by NBC News in 2015 cited a study conducted by the Higher Education Research Institute (HERI) at the University of California, Los Angeles (UCLA) which estimated that 69% of first year college students report experiencing feelings of homesickness.
A recent study indicated that while a certain degree of homesickness is expected upon transitioning to college, severe homesickness can have detrimental effects on a student’s academic performance. Therefore, if you are feeling the homesick blues, here are 5 things you can try that may help you feel a bit more connected as you settle into your new home away from home:
Keep your door open when you are in your dorm room and hanging out. This sends the message to neighbors that you are looking to meet others—and if your dorm is comprised of all freshmen, they are likely looking to meet new friends, too.
Start to find a community.
Check out your school’s list of student activities and groups. Most colleges and universities have clubs for every interest imaginable: from religion, to politics, movies, music, dance, art, fraternities, sororities, etc. If you have an interest, considering joining a group with other like-minded students.
Keep your family updated about how you are you doing, but also try practicing your independence. Of course, tell your family if something noteworthy happened in your day, but consider beginning to use your peer community for social support.
Plan trips home and visits with your family, and schedule them in advance. This way, you know exactly when you will be able to see your family and friends next, which will allow you some freedom to explore your new college home in the meantime.
Grant yourself grace. It is OK to take a day or two to be sad. That said, if you find yourself struggling to go to classes or social activities, consider seeking mental health services. Your college counseling center is a wonderful resource—they could connect you with a counselor onsite or a therapist in the community.
September is National Suicide Prevention Month, an opportunity to raise suicide prevention awareness in our communities, schools and families. Many parents wonder how to address suicide with their teens. Some parents might worry that talking to their children about suicide might “put the idea of suicide in their head” and will increase the likelihood of them attempting suicide. The fact is, however, talking to teens about suicide does not increase suicidal behavior and can actually reduce the risk of suicide among teenagers (Gould et al, 2005). Just as parents would talk to their children about driving and texting, substance use and safe sex, parents should consider suicide a health and safety issue that needs to be discussed.
The statistics on suicide among young people are sobering. Suicide is the third leading cause of death for youth between the ages of 10 and 24, resulting in approximately 4,600 lives lost each year. Furthermore, a nationwide survey of high school students in the United States found that 16% of students reported seriously considering suicide, 13% reported creating a plan, and 8% reporting trying to take their own life in the 12 months preceding the survey. (CDC)
Here are some tips for talking to your teen about suicide:
Ask direct questions
“I have been hearing about suicide in the news and wanted to hear your thoughts. What do you think about suicide? What do your friends think? Have you ever thought about suicide? Have your friends?”
Listen without judgment
You want to let your child know that you are a safe person to talk to about suicide. With sensitive material, it’s natural for parents to become emotional, react and want to protect their children. Listening more and talking less will allow your child to open up to you.
Be honest if this is hard for you to talk about, “I understand that this might feel uncomfortable to talk about, but I think it’s important to know we can talk about hard things together.” If you are unsure of what to say, concerned about something they share or don’t know the answer to a question, you can be upfront about this too: “What you are saying is important and it is making me want to get some more information. I am going to find some resources for us to learn more about this.”
Make this the beginning of an ongoing conversation. “I am so glad we could start talking about this and we can come back to this again.” Come up with a specific plan together if your teen ever feels helpless or hopeless or if your teen is worried about a friend: “Who is a trusted adult you can go to if you need help?”
Share this resource with your teen so they can access help if they need it:
1-800-273-TALK for a lifeline or local referrals or text START to 741-741, a Crisis Text Line for referrals and crisis survival strategies.
The start of the school year is a busy, hectic time for everyone. First days of school. New teachers. New schedules. Not only can the logistics of new routines be overwhelming, but the transition from summer to fall can also be emotionally draining for everyone in the family. Gone are the carefree days of summer and again we must get used to responsibilities, homework and adjusting to increased structure in our days. While the reality of these challenges cannot be changed, our feelings about them and responses to them can shift. Mindfulness offers parents a way to feel less scattered and more centered with all the changes that come along with the start of the school year.
Mindfulness is the practice of being aware of what is happening in the present moment with curiosity and without judgment. Being mindful need not be intimidating or time consuming. For example, it does not require you to adapt a daily meditation practice. It can be as simple as intentionally taking a PAUSE.
First, set an intention to practice taking more pauses in your day. Then, in any moment throughout your day, use your breath (which is always available to you) to breathe in slowly and deeply. Then take a moment to just NOTICE what is going on around you and inside of you. What you are thinking and feeling? What do you see and hear? Notice without making a judgment that it is good or bad/right or wrong. It just is. Then CHOOSE how you would like to respond to the situation.
For example, in many households, mornings can be stressful and chaotic. Everyone needs to wake up, get fed and dressed, hair and teeth brushed, and out the door on time with everything they need for the day. There may be arguing, stalling, and not listening. Amidst the chaos, make a choice to take a moment to step back and just notice what is happening. Maybe, after you have asked your child to put on their shoes for the fifth time, this is perfect opportunity to PAUSE.
Instead of asking a sixth time or yelling, take a breath. Notice what is going on for them and for you. You might say to yourself: “I’m noticing my muscles are getting really tight. I’m noticing that I’m feeling really worried we will miss the bus. And I am thinking about that work deadline I have today and I really can’t handle this from my kid today. And I see my kid seems distracted and nervous and I’m not sure why.” You don’t need to evaluate or judge these observations. Just notice them and allow them to guide you as you decide how you respond next. Perhaps you will bring the shoes to your child and say: “It looks like one of those mornings when you need a little more help getting ready.” Whatever you decide to do next, being mindful and taking a PAUSE has given you the chance to respond from a more grounded, aware place. Taking this moment to center yourself makes it more likely that you will make a wiser choice than if you had simply reacted. In this way, mindfulness can support parents and their families in feeling more grounded and more at ease with all the changes that lie ahead for the school year and beyond.
With advancements in brain imaging technology, researchers are learning more about the biological basis of Attention-Deficit/Hyperactivity Disorder (ADHD). We now know that ADHD is a biologically-based condition, and individuals with ADHD have differences in their brain wiring. Studies have demonstrated these brain differences in older children and teenagers with ADHD, but until recently researchers had not studied the brains of very young children.
A recent study conducted by researchers at the Kennedy Krieger Institute did brain scans of 90 4 and 5-year-old children, half of whom had been diagnosed with ADHD. None of the children had taken psychiatric medication. Results showed considerable brain differences between the children with ADHD and typically developing children. Specifically, children with ADHD showed a reduction in size of several brain regions, including the frontal lobe. Children with more significant brain differences showed more severe ADHD symptoms.
This was one of the first studies to demonstrate that the brain differences among individuals with ADHD are apparent as early as in the preschool years. The researchers intend to continue to study the children’s brains over time to track changes as the children mature and develop. Future research can also study how treatment may affect brain structures and wiring.
For young children with ADHD, the first line of treatment is often behavioral therapy and guidance for parents. Through work with a therapist, parents can learn effective strategies to manage challenging behaviors, teach children self-regulation skills, and implement structure and routines at home. Contact Georgetown Psychology Associates for more information about the parent consultation services we offer.