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Frequently asked Questions
Question: Do I have to do homework?
Answer: The short answer is yes, absolutely. The only way for you to change your circumstances is your willingness to help yourself. There is a lot to say for trusting your therapist and being a part of that caring relationship, but it's not enough. You will get out of therapy, what you put into therapy, and that does mean working at home too. However, the decision about your homework is collaborative, so your opinion matters.
Question: What is CBT?
Answer: CBT stands for Cognitive Behavioral therapy and it's an evidence-based approach that helps people overcome depression, anxiety, eating disorders, marital problems and other issues. It has been found to be as effective and sometimes more effective that psychopharmacology (medication), and other forms of psychotherapy.
The basic principle is that many psychological problems actually stem from faulty thinking patterns and unhealthy learned behaviors. The aim of the therapy is to teach the client to recognize their patterns, change those thinking and behavioral patterns and learn coping mechanisms, so that when they terminate therapy, they have the tools to help themselves in the future.
Question: If I come to you for help with my child, or teenager, when do we speak?
Answer: Depending on the presenting issue, I meet with the parent or parents monthly, or I update them over the phone, or, after getting to know the issues of the child, I just work with the parents. This is very much dependent on what the issue is, but I always make time to speak to a parent if they're not part of the actual therapy sessions.
Question: I have been informed that my child is overweight. Should I put her on a diet?
Answer: It is not advisable for children to be on diets, even if they are overweight. Instead, speak to a nutritionist to redesign a family meal plan for good general health. This is a plan for the entire family, not one family member. You are allowed to include desserts or treats, but within moderation. This should be a gradual shift, so as not to cause resentment from other family members, within the context of everyone needs to eat healthier. And of course, integrate fun family oriented exercise into this plan.
Question: My child is always hungry. Is this normal? I don’t want her to get fat. She’s four.
Answer: It is normal for children to be hungry because they are growing and because they are little, they cannot eat so much at a time, so they need to refuel more often. Children should eat three meals and 2-3 snacks over the course of the day. Without this they can experience mood swings, loss of energy, headaches and poor concentration. It’s ideal for meals and snacks to be regular and routine, and home cooked meals are ideal. As parents, we need to listen to our children’s needs, but also help them recognize their hunger signs. Additionally, we control what food we give them, but should let them control how much they eat. Try to offer a balanced diet of carbohydrates (ideally complex carbohydrates with fiber), protein, fruits and vegetables. Limit salt, sugar and fat. Some good snack ideas: yogurt mixed with cereal and fruit; apple; fruit smoothie; cheese and crackers, cucumber; whole wheat bread with peanut butter and banana.
Question: My teenage daughter has become a strict vegetarian and is trying to lose weight, by exercising non-stop. Does she have an eating disorder?
Answer: This is a very delicate question, which is hard to diagnose, but your daughter is definitely showing indications of disordered eating, which can be a precursor to an eating disorder. It is very common for girls to become aware of their bodies and desire to make changes/improvements (in their eyes), but excessive exercise and restrictive diets are both red flag behaviors. This doesn't mean she has an eating disorder, but it does mean you should keep a careful eye on her. Teenage girls want to feel trusted and independent, so maybe some health information would be the right approach to take in this case. "I have noticed that you have taken a serious interest in your physical health, which i am really proud of, and I wanted to make sure that you are still getting all the nutrients that your growing body and brain need. Let's consult with a nutritionist or dietitian together to make a healthy plan for you." This acknowledges what she is trying to do, and validates her, but as a parent she needs to know that you see her, and that you are watching out for her. This gives her the space to take control of her body, but do it armed with knowledge and support.
Question: My child eats almost nothing – should I be worried?
Answer:This is a very common problem that parents encounter, because so many children, even those who used to eat well, go through a phase where they are extremely picky about what they will eat. This usually occurs between the ages of two and six. Understandably, this is an aggravating situation, but as parents it’s important to know that this is usually normal and to not be alarmed. It's also important that your child does not sense that this bothers you, because for them, some of the incentive to be picky, is to assert control.
Another thing to keep in mind is that despite our worry and consternation, they are very little, and may be eating enough to thrive. One way to alleviate some of your concern is to write down all the different foods they eat in a day (without them knowing you are keeping track), and over the course of a week, so you can get a solid idea of what they actually consume. You may be pleasantly surprised to realize that it evens out to a varied diet that consists of more than air. If they are growing and developing as they should, there is also less reason to be concerned.
Question: My daughter hasn't slept well for the last two weeks. I think she is overly anxious, and I don't know how to help her.
Answer: Anxiety can be very difficult, and not sleeping only exacerbates the situation. Sometimes the worst part of anxiety, is that anxiety begets more anxiety; just thinking about not being able to fall asleep, can make the anxiety greater. For this reason, it is very important to address the anxiety and not to avoid it, which is out natural inclination. Try and get to the route cause. Why is she feeling this way? This is often best achieved in therapy. Therapy, usually cognitive behavioral therapy and learning relaxation techniques can help tremendously.