Anxiety disorders are common, treatable medical conditions that are characterized by persistent, irrational, and overwhelming worry, fear, and anxiety that interferes with daily activities. These are real disorders that affect how the brain functions. Symptoms vary but they can include irritability, sleeplessness, or physical symptoms such as headaches and stomachaches. Cognitive-behavioral therapy has been shown to be effective in treating anxiety disorders.
Obsessive Compulsive Disorder (OCD)
OCD is characterized by unwanted thoughts that take over and interfere with some part of the child’s life. These frequent upsetting thoughts are called obsessions. To try and control the anxiety related to those thoughts, the child or adolescent will feel an overwhelming urge to repeat certain rituals or behaviors called compulsions. These compulsions can vary from observable behaviors such as repeatedly seeking reassurance, washing hands, locking and unlocking doors, or private activities such as counting, keeping unneeded items, or repeating the same steps again and again. Cognitive behavioral therapy that includes exposure and response prevention is especially helpful in reducing compulsive behavior.
Tourette Syndrome (TS)
TS is a neurological disorder characterized by repetitive, involuntary movements (tics) and vocalizations. Onset of tics is before age 18. Tics can vary in kind and character over time and can increase with excitement or stress, and decrease with relaxation or involvement in absorbing activities. In addition to tics, some children/adolescents with TS can have other problems such as difficulty concentrating, poor impulse control, problems with learning, obsessive thoughts, anxiety and mood symptoms. These co-occurring problems may be of more concern or more disabling that the tics. Treatments to reduce tic severity and the symptoms of any co-occurring conditions are the focus of treatment.
Attention Deficit / Hyperactivity Disorder (ADHD)
One of the most commonly misunderstood conditions in terms of diagnosis and effective support, treatment for ADHD has many components that have been substantiated by the research in this field. A thorough diagnostic process may include information from the child, parents, teachers and others involved with the child’s life. Dr. Boller can provide treatment that includes parenting and behavioral strategies for managing related difficulties at home, psychoeducation, and upon request, school consultation. Many families request these interventions before considering medication. Some families choose behavioral treatment, in addition to medication. When requested, consultation with treating physicians is also available.
Autism Spectrum Disorders (ASDs)
ASDs are are a group of related brain-based disorders that affect a child’s behavior, communication and social skills. The number and severity of symptoms can vary greatly. Symptoms may change with maturation and intervention. Research shows that starting an intervention program as soon as possible can improve outcomes for many children with ASD’s. However, interventions that help one child may not be as helpful for another. Dr. Boller is available to provide screenings that can determine if a more indepth assessment for autism spectrum is indicated, and make referrals for that kind of assessment in the community. Additionally, Dr. Boller can assist with the treatment of emotional difficulties that can co-occur with this disorder, as well as family therapy for siblings. Upon request, Dr. Boller is also available to coordinate treatment with autism behavioral specialists and schools.
Depression in children does not always manifest the same as it does in adults. Common symptoms can range from anger to sadness. Symptoms may include one or more of the following: withdrawal, crying, opposition, decrease in functioning at home/school, avoidance, tantrums and loss of interest in previously enjoyed activities. Supportive cognitive behavioral therapy, family therapy and school consultation can all aid in the decrease of distress and development of coping strategies. In some cases, parents consider medication and Dr. Boller is available to collaborate with treating physicians in those individual situations.
Gifted Children with Dual Diagnosis
Discussions of giftedness are often controversial. The most common definition of giftedness includes “ ‘asynchronous development’ in which advance cognitive abilities and heightened intensity combine to create inner experiences and awareness that are qualitatively different from the norm.the uniqueness of the gifted renders them particularly vulnerable and require modifications in parenting, teaching, and counseling in order fo them to develop optimally. (Columbus Group, 1991).” Prior to treatment with Dr. Boller, intelligence testing and assessment may have identified your child as gifted, with co-occurring difficulties of mood or social adjustment. In those cases, Dr. Boller is available to provide treatment that is informed by understanding of the different traits, or issues associated with asynchronous development, that should be considered in the treatment of this population.
Some children experience significant distress after a traumatic event. When traumatic symptoms occur, children may exhibit one or more of the following: avoidance of experiences that remind them of past events, nightmares, intrusive thoughts or images, anxiety, regression, depression, loss of interest in activities previously enjoyed, loss of trust, sleep/appetite changes, or decline in functioning at home or school. Dr. Boller has specialized education, supervision and treatment for the victims of trauma.
Not all children whose parents are divorcing need therapy. However, when relationships become highly conflictual, individual and parent/child therapy can help with the complicated transitions to new family settings. Additionally, even in the smoothest of possible transitions, some children develop anxiety or depression that impairs their functioning. Dr. Boller provides therapy that is individualized to the child’s needs.