Get started with group therapy for your child or teen. Complete our intake form to get started here. 
Download Flyer (PDF)

My practice is offering the following groups:

Parents in Transition:
These are support groups for moms and dads who are recently going through separation and/or divorce.

Mindfulness Based Stress Reduction for Teens:
This is an 8 week group. It will be primarily psycho-educational and practice-based. Teens will learn about stress and how to talk about it. In addition, they will hear about the stress of other teens which will help them to feel less alone and can empower them to help others with similar struggles. All participants will develop specific strategies to help them manage their stress more effectively.

Managing Friendships in Person and in Cyber Space:
This group is open to middle school girls who are grappling with friendship issues and how to deal with the added burden of cyber relationships. In conjunction, I will offer two sessions for parents to help educate them on these issues and provide guidance and support with regard to monitoring usage, setting limits and establishing expectations.

Therapeutic Group for Preteens/Teens with OCD, Panic and Social Anxiety:
Participants will learn about anxiety and how it works. They will develop cognitive and behavioral strategies to manage their strong feelings, and they will learn to understand and support others with similar struggles.

Social Skills Groups:
These groups are for elementary age children and will address Social Problem Solving, Conflict Resolution, Perspective Taking, Self-Awareness, Coping Skills and Self-Regulation.

Social Skills for preschool age children:
This group will focus on facilitated play and social interaction for children who are struggling socially within the preschool settings.

*Start dates and specific dates and times of groups are subject to participant availability.

Please contact me to signup or if you have further questions!

The post Group Offerings appeared first on Dina Cagliostro, PhD.

The brain actually thinks it is doing a good thing, and protecting your child from some perceived danger. In typical situations, when there really is danger, this is an extremely adaptive functional response. (Yay brain for sending me messages to do what I need to do to keep myself safe!)

However, with anxiety, the brain sends messages of danger when there actually is no danger, and every time we listen to the message and do what the brain is telling us, the more the brain thinks it is right, and the more that particular situation becomes ingrained as a situation to be feared.

Essentially, your child (with your help) needs to reteach his/her brain the truth–that there is nothing to fear in that particular situation. In order to reteach the brain, gradually and, with love and encouragement, expose your child to what he/she fears.

Here are some basic tips to help your child push back against his/her anxiety and reteach his/her brain the truth.

1. Educating your child about how the brain is working, how it is a little confused and sending messages that are not true. Explain about the fight or flight response and how adaptive this response is normally but sometimes worried (anxious) people can have an exaggerated response to situations and feel there is something to fear in non-threatening situations.
2. Talk to your child about reteaching their brain by creating a new message for the brain that helps it to understand there is nothing to fear.
3. Then gradually expose your child to the feared item or situation so the brain begins to learn the truth. While initial unsettling, this can be an empowering experience.
4. Exposure needs to be gradual and at a pace that is comfortable for your child. You can create a list with steps towards the end goal. For instance, if the goal is for your child not to fear dogs, you might create a list like:

• Look at pictures of dogs online or in magazines or books
• Read stories about dogs
• Learn about different types of dogs
• Go to the dog park and look at the dogs from afar
• Go the home of a friend or family neighbor with a friendly dog keep the dog in the other room
• Bring the dog into the room on a leash
• Gradually move the dog closer until your child can touch the dog
• Expose your child to other friendly dogs with a similar approach so he/she can begin to generalize

5. Talk back/fight back/get angry at the anxiety. Try to have fun with this and help your child take charge. Sometimes it helps to develop a mantra or two that your child can use when fighting back and not listening to their anxiety.
6. Teach your child breathing and relaxation strategies that can calm and distract him/her. See below for apps and websites.
7. Help your child EXPECT to feel anxious. Rate the anxiety and keep rating it as it comes down. Show them they can live with anxious feelings but they don’t have to fear and avoid them. The goal is to be able to live with feeling a little anxious, not to expect to avoid anxiety entirely.
8. As tempting as it may be, try to avoid simply reassuring your child.(everything is going to be OK) Ironically, this actually can back fire and have the effect of fueling the anxiety. Have your child do the talking back. Be your child’s cheerleader! Encourage them to fight back and talk back to the anxiety.
9. Don’t give in! If they cannot do the exposure you have set up, try to get them to do at least one aspect of it.
10. Have fun with it—use humor to diffuse the intensity, role play talking back to anxiety to provide your child a model.
11. Reward progress!!
12. Check your own feelings and be mindful of your own fears and reactions.

Resources

Apps

Calm
iPhone/iPad | Android

OMG I Can Meditate!
iPhone/iPad | Android

Headspace
iPhone/iPad | Android

Websites

mindbodygreen.com
leftbrainbuddha.com
innerhealthstudio.com
kidsrelaxation.com

The post Outsmarting Your Child’s Anxiety appeared first on Dina Cagliostro, PhD.

Tai Chi instructs us NOT to meet brute force with brute force. On the contrary, Tai Chi is all about promoting calmness and freedom from stress, and gauging and adjusting your response in reaction to the outside force. I am not claiming expert status, but I can tell you that the martial art of Tai Chi places emphasis on relaxed muscle positions and the use of the opponents momentum, as contrasted with the “hard” styles or martial arts, which employ muscles in a high-state of readiness, and meeting an opponent’s force with one’s own force. The core of Tai Chi could be described as simply learning to be prepared and react appropriately to whatever is offered, and practitioners of Tai Chi usually find that within a relatively short period of time, they are better equipped to handle stressful situations, and find themselves less prone to being caught off balance either physically or mentally. Tai Chi philosophy promotes the idea that, if one uses hardness to resist force, then both sides are certainly going to be injured. It is not about a direct fight or resistance of incoming force, but rather a meeting the force with softness and following its motion while remaining in contact, until the force exhausts itself and can be redirected. *

As I delved a little deeper I began to see many similarities between the practice of Tai Chi and how I might advise parents who are going through a divorce. But first, some thoughts about divorce in general…

It’s complicated. I know. No two divorces are the same, and there are at least two sides to every story. There are usually plenty of reasons for both sides to be angry, hurt, disappointed and sad.  I am not trying to imply that it’s simple, and if you simply do as I suggest that everyone will be happy. When divorce happens, and children are involved, you will always have a relationship with your (ex)spouse. While the relationship with your “ex” will be different, and likely difficult, it is necessary. When kids are involved there are many things that require ongoing and continuous communication, and interaction. This is just the reality.

Therefore, you must decide– do you want to live in a life where there is constant muscle tension, with your dukes up and ready to fight at any given moment, or do you want to do your best to make the relationship as palatable and healthy as possible? How does one go about making a relationship with someone who, in many cases, is personally unbearable and intolerable? I do not pretend to believe that there is any easy answer to this, but I am pretty certain that constant bickering and battling and “tit for tat” is not going to make anyone feel good, let alone be productive.

One thing that divorcing parents have in common is that they no longer can tolerate each other well enough to live in the same home. They have gotten into a particular pattern of behavior that is not working for them, and is therefore causing them to feel distress, unbalance and all sorts of negative emotions. In an effort to create a new life for yourself your efforts might be better focused on attempting to switch things up a bit, change the pattern, dampen the fire a bit, let go and move on to forge a new kind of relationship with your (ex)spouse, one that attempts to alter that problematic dynamic and keeps the focus on what’s best for your children.

How does one get to the end of a bumpy road without too many casualties? After all feelings are feelings. They are real, and often valid, and they are often very difficult to manage and keep in control. Everyone has their own story to tell. I truly GET all of this. However, what I say to parents who are in the midst of this agony is that the sooner they are able to get a hold of their emotional reactions to their (ex)spouse, so that they can deal with their spouse in a respectful, civil and rational manner, the better off their children will be, and they will be. I remind parents that their children did not CHOOSE to get divorced, most likely did not WANT the divorce, and they have NO CONTROL OVER what happens as a result of the divorce. They still in most cases want and NEED a relationship with BOTH parents, and one which is conflict and guilt free.   Furthermore, it is crucial for their own healthy self-development that children, whenever possible, maintain a positive and healthy relationship with both parents. I tell parents, they can be angry and sad, disappointed and hurt, but let’s think carefully about how you want to express those feelings, to whom you want to express them, and more importantly, how you want to react to your spouse’s expression of strong emotions. Use These Tai Chi guidelines to make change:

• Simply learning to be prepared helps you to not be caught off balance and allows you to react appropriately to whatever is offered. Be prepared for the worst, so when it happens you are not surprised, and you are not thrown off balance. Understand that these experiences are emotional for all, we are all human. This doesn’t mean waiting around with tense muscles and your dukes in the air ready for a fight. This means, expecting there to be times of conflict and disagreement, times when you don’t see things the same way. It makes sense because this is part of the reason that you are divorced (even the most happily married couples have these times of disagreement). Just knowing that these times are bound to happen prepares you for a more measured, calm and reasonable response and reaction.
• If one uses hardness to resist force, then both sides are certainly going to be injured. Find times whenever you can to be an ally with your (ex)spouse. When your spouse is complaining about how expensive summer camp is, instead of thinking or saying, “You are such an (expletive), don’t you want what’s best for the children?,” take a moment to validate the truth in this, “Yes things are very expensive, it’s tough making these ends meet, but this is why I am thinking this particular expense is important, what do you think?” Try not to react immediately to something your (ex)spouse does that makes you crazy or irate. Take some time to mull it over, consider where they are coming from, and why they might be having the reaction they are having. CHANGE your reaction and the dynamic. You don’t need to fight fire with fire or shout your angry feelings from the rooftop. You can process your feelings with people who are there to support you.
• Meeting the force with softness and follow its motion while remaining in contact, until the force exhausts itself and can be redirected. Try to get away from this idea that you need to drag your s (ex)spouse through the ringer with you (remember, you want a DIFFERENT relationship with that person, this is the reason for the divorce), because what purpose would that really serve? Is that getting you any closer to putting closure on your marriage so that you can both move on to live happy and healthy lives? I do not believe so. You have made the decision that you do not want to be in a marriage together, that you want to separate from the anger and disappointment and sadness that your marriage has created for each of you, so why keep dredging that up again? Let the forces and your energy behind them be redirected towards positive ends—what is best for your children. Make a pact yourself, and each other, to do everything in your power to help your children get through the divorce with as few battle wounds as possible. Understand that the energy you give off is the energy you will receive. Make a conscious effort to be positive and communicative and respectful. Find peace and balance within yourself and outlets for yourself to express some of the negativity that you feel (whether it be exercise, meditation, hobbies, therapy, talking with family and friends, or Tai Chi!).

I KNOW this is not easy, and it may seem like what I am asking is impossible to achieve. But I truly believe that whatever you put out into the world is what you will find in return. YOU want a different life, a different relationship, make it happen! Even when you are the only one of the two trying to lift up the discourse, you need to be steadfast. Only YOU get to define how you behave in the world. Remember to go easy on yourself. Don’t expect to have the perfect reaction every time. Use these principles as a guide, something to strive for. You can do it!

*For more information on Tai Chi, go to these sites:

• http://www.chebucto.ns.ca/Philosophy/Taichi/what.html
• http://thewaytowellness.com/pages/Tai-Chi-Chuan-And-Chinese-Philosophy.html
• http://www.yiheyuan.co.uk/Pages/TaiChiPhilosophy.aspx

The post The Tai Chi Approach in Divorce appeared first on Dina Cagliostro, PhD.

Therefore, when we are dealing with anxiety in children, our gut instinct is to reassure them, tell them to relax and do whatever it takes to relieve them of the anxiety, and spare ourselves the stress that goes along with trying to support them. Unfortunately, this approach is only a short term fix, and often serves to make the anxiety worse. I know this sounds crazy, but what a child with anxiety really needs is to be able to FACE the anxiety head on, as often as s/he can tolerate.

A brain’s response to an anxiety provoking situation is normally a functional one that keeps us out of danger. When the brain senses danger it reacts with the “fight or flight” response. This causes the body to respond either by fighting off the danger or fleeing from it (to avoid it). However, in the anxious brain there is often no REAL danger—only a perceived danger. The brain is confusing things and misfiring. It is either over reacting to the situation or sensing danger where there is none. Every time a child reacts to the brain’s message as if s/he is in real danger, a connection between the alarm center of the brain (the amygdala) and the thinking part of the brain (the prefrontal cortex) gets stronger with regard to the feared situation, and the fear become reinforced. The child’s reaction to the feared situation will continue to grow stronger as long as that connection is maintained, and the brain thinks it is doing the right thing by having this fear reaction. The anxiety reaction will happen again and again until the connection is broken, rerouted, and changed, and the false alarm no longer elicits anxiety.

An effective way to disrupt the connection from perceived fear to anxious reaction is to face the anxious situation and DO NOTHING. Allow the anxiety to happen and allow oneself to get through it. The child needs to feel the anxiety, but not react to it and then let it subside. This facing and doing nothing essentially retrains the brain that the anxious feeling does not need to create an anxious reaction. Eventually and overtime that initial anxious reaction will diminish in scope, and the feared event will no longer cause fear. Then the message to the brain is, “No, brain, you were wrong, I was NOT in real danger in that situation and I am not going to let you trick me again into thinking that I am, I am stronger than you think I am.”

Along these lines, the following are some basic ideas for helping your child overcome the anxiety.

1. Do your best to stay calm when your child is feeling anxious. If you need to take a time out for a minute to help ground yourself, DO SO!
2. Listen to and observe your child’s feelings, and talk with him/her about them. BUT try not to reassure your child. You can validate his/her feelings, but ultimately you need to help him/her tolerate the feelings without solving the problem for them. The long term goal is to help your child learn that s/he can live with some anxiety, fear and discomfort. The goal is NOT to help him/her be anxiety free, that’s just not realistic for anyone. The better able they to tolerate some discomfort and to know that they will be ok, the more equipped they will be in dealing with anxiety if/when it crops up again.
3. Gently encourage/challenge your child by exposing him/her to the feared situations in gradual steps, slowly and overtime. Eventually this will allow your child to see that that s/he need not be afraid (i.e. look at photos of dogs, if they can do that, can they stand 10 feet from a real dog? And then can they stand closer? Can they touch a dog?, etc.).
4. Praise(and reward) any accomplishments/efforts your child makes towards overcoming their anxiety, and encourage your child to take one step each time, no matter how little, towards combatting the anxiety.
5. Use humor and try to have fun with it! Humor can lessen an anxious moment by defusing it. Encourage your child to talk back to the anxiety, role play talking back, make it fun and funny! Personify the anxiety, make it a mean bully or an angry monster, and talk about how one would respond to a bully, by standing up to it.
6. Prepare your child ahead of time for new situations. Help them understand what to expect, show them pictures, tell them about what it will be like.
7. If you know a situation is going to be particularly stressful, modify your expectations so the child does not feel like s/he has failed. Set the expectations ahead of time so your child knows what is expected.
8. Establish a support system for your child for when s/he is not with you. Identify people to help him/her in situations outside of the home.
9. Educate yourself and your child on how anxiety works and what it is (see below for helpful books and websites on this).
10. Set aside a prescribed time each day for “worry time” (15 minutes), and allow your child to discuss whatever s/he is worried about at that time. At other times, encourage your child to put the worries away until the allotted time frame.
11. Seek treatment when strategies such as the above mentioned are not working on their own.

For more information, please see:

Websites:
www.kimberlyjoymorrow.com
www.adaa.org
www.worrywisekids.org

Books:
Chansky, Tamar (2004). Freeing Your Child from Anxiety
Huebner, D. (2005). What to Do When You Worry Too Much.
Huebner, D. (2007). What to Do When Your Brain Gets Stuck.
Marsh, John S. (2006). Talking Back to OCD.

The post Parenting Anxious Children appeared first on Dina Cagliostro, PhD.

1. Know your rights and come prepared for meetings with the school. The State of New Jersey has a document entitled NJ State Special Education Code that is the state’s interpretation of the Individuals with Disabilities Act. It also publishes a special parent guide that you can download from the website: nj.gov/education/specialed/info/. Each state has its own interpretation of the federal law. It can be accessible than the actual code and answers many questions about the Law. There are specific criteria for classification and categories of classification that are delineated in this document, and in order for your child to be eligible for services, a series of test need to be administered to establish eligibility. You should also familiarize yourself with the laws the govern Section 504 of the Rehabilitation Act, so you are aware of some options you have if your child requires accommodation in school but is not eligible for special education classification and services. In addition to knowing the law, make a list of questions and concerns you have about your child’s school experience so that you can refer to it during the meeting. Often parents feel very emotional during these meetings and it is difficult to think clearly and remember everything that you want to cover. If you are part of a two-parent household, it is helpful if both parents can attend the meeting so that you have an extra set of eyes and ears, or perhaps each of you takes on different responsibilities during the meeting. One person can be a note taker, and one can ask and receive questions.

2. Make it a point to understand how your school addressed Intervention and Referral Services: If this is the first time you are seeking services, it is required by law in New Jersey that your child is first referred to a PRE-referral process, usually labeled Intervention and Referral Services. Every school district handles this process in a slightly different fashion, and so it will be helpful if you know how it works in your child’s school. Typically the Student Assistance Counselor or an Administrator is the head of this committee and different staff members are asked to be a part of it. It is helpful if you know who the players are and how they run the process in your school so that you can manage your own expectations and determine whether they are adhering to the timeline that they have established. To that end, be sure to understand the hierarchy of your school system and who performs the various functions within your child’s school and district.

3. When working with your child’s school it is always best to start with an open mind and optimistic approach. While it is always comforting to talk with other parents who are going through similar experiences, try not to listen too much to grumblings from other parents. Assume the best of the staff that are working with your child, and attempt to create an open, trusting, communicative and collaborative relationship with them. Every child is different and therefore, you cannot assume that one family’s experience will be replicated. If you attempt to remain positive, you are likely to have a more productive experience with your child’s school. Adhere to the old adage, “You catch more bees with honey than you do with vinegar.” It is just human nature to want to be more inclined to help someone or go the extra distance for someone who is treating you with kindness and respect. Remember, the staff at your child’s school is working with your child. You want them on your side. You do not want to create enemies if you can avoid it. Seen too many times parents come in with advocates who walk in the door with their “dukes” up. This approach puts people off, it makes them feel under attack and it does not open the door for productive collaboration. When I attend a meeting with a parent, one of my main goals it to try and set a tone of collegiality.

At the same time, don’t be afraid to advocate. This is a fine line, and you need to walk it. While first trusting the trained and experienced professionals at your child’s school to implement a program that suits his/her needs, if you find that things are not getting done as they promised, or the program is not working as you had hoped, speak up. Stay on top of the school, and keep communication consistent and ongoing so that you are certain your child’s program is successfully implemented.

I have heard too many parents say, “I don’t want to be THAT parent.” (the one that complains or the squeaky wheel). While it is important to be respectful when working with your child’s team, no one is going to be more of an advocate for your child than YOU. You are a member of your child’s team, and should be an active participant in its planning and execution.

The post Navigating the School System and Advocating for Your Child With Special Needs appeared first on Dina Cagliostro, PhD.

On my way to the workshop, I was dealing with a rather stressful situation. I found myself becoming increasingly upset by the situation, as I was talking on the phone with various involved parties. To further complicate my morning, I was also running late for the workshop. By the time I entered the room where the workshop was being held, my heart was beating pretty fast, and I was upset, stressed, worried, (maybe angry) about what had transpired just minutes before. As I am clumsily trying to settle myself into a seat next to a dear friend of mine, the workshop presenter asks for a volunteer to come to the front of the room and “try out” the first technique—remember, I am at a workshop on strategies to help people deal with difficult emotions. Without a second thought my hand shot up and I was on my way to the front of the room.

As I sat there, waiting to be manipulated, my heart was still pounding, I was feeling a little uneasy about being “on stage” and having to potentially air my dirty laundry in front of 30 other professionals I had never met before. At the same time, I was eager to see whether I could be calmed at the hands of this very nice, and seemingly well informed, woman.

The woman began working with me, and, amazingly, I rather quickly began feeling calm. Not only was my body calming down, but I felt my thoughts about the stressful experience calming as well. They were shifting from negative, perhaps even defeatist thoughts, to gradually more neutral and then even somewhat positive. My whole notion of the morning’s events shifted from one of dread to one of openness and confidence. I moved from heart pounding to feeling relaxed and calm.

Over the next 5 hours at this workshop, as all of the professionals in attendance practiced with the technique on one another, I was impressed by the marked shift in my state. I felt as I can often feel after meditation or massage. It was pretty remarkable. My friend sitting next to me seemed to have a similar reaction to the process. We were both happy we came.

The techniques about which I am referring are a part of a growing field within mental health, called energy psychology or energy medicine. The two techniques I learned at the workshop are Heart Assisted Therapy (HAT) and The Emotional Freedom Technique (EFT), aka the Tapping Method. The techniques work with your body’s meridians and acupressure points to help balance the body’s energy system.

I am a huge proponent of the importance of healing mind and body to achieve mental health. I am always looking for strategies to help my clients manage anxiety and other difficult emotions, and I am keenly aware of the importance of working with both the mind—and how we think about things that causes us angst, as well as the body. Calming the body has such a tremendous impact on how we think about and approach the world. I had done a fair amount of reading about this work, and had been experimenting with its use in my practice prior to attending the workshop. I had seen some benefits with the children with whom I have used this, and similar, techniques. Since then, I have been incorporating both HAT and EFT with more regularity with both children and adult clients. Initially, children and teens need more convincing of its benefits, but they become eager participants once they have started to feel the positive effects. These techniques, and others like them, can have more impact when you open up your mind to their possibilities. While they can seem hokey at first, they are worth a second glance.

The woman presenting at the workshop, Robin Bilazarian, is a LCSW who practices in Mount Laurel, NJ. She recommends several websites. I will list a few here. Also, if you search for any of these people on YouTube, you will find numerous demonstrations of how the techniques are done. I plan on investigating more advanced training in these techniques. I have already been using them myself, and on my clients, and they appear to be beneficial. Happy Tapping!

Websites:

www.thetappingsolution.com
www.heartassistedtherapy.net
www.emofree.com
www.innersource.net

The post Strategies to Help With Stress, Anxiety, Anger May be Promising appeared first on Dina Cagliostro, PhD.