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Simches Division of Child and Adolescent Psychiatry

Child and Adolescent Outpatient Services

The Child and Adolescent Outpatient Services provide an initial evaluation that may lead to additional services, such as group therapy, individual therapy, medication evaluation and management, parent guidance and support, psychological testing, and neuropsychiatric testing.

Treatment focuses on the diagnosis of developmental problems and psychiatric illnesses. We work closely with each patient and their family to develop individualized treatment plans that may include individual or group sessions, cognitive behavior therapy, dialectical behavior therapy, and medications when clinically indicated.

Individual Therapy

Stock photoIndividual therapy ranges from play therapy for younger children to insight-oriented models for older adolescents. Cognitive, behavioral, and medication therapies are applied when needed. Parent guidance and support educates about their child's illness and helps foster new parenting skills.

As with McLean's other outpatient programs, our clinical services are focused on stabilization. Should longer-term treatment be necessary, assistance is provided in finding appropriate community resources.

Group Therapy

Groups help young people develop social and other skills that can directly benefit them at home, at school and in interpersonal relationships. Group therapy provides adolescents with peer support as well as skills to help them deal with their illness. Membership for each of these sessions requires that the adolescent be in weekly individual therapy.

Dialectical Behavior Therapy Skills Group – Middle School

Thursdays, 4-5pm

This is a 16-week skills group for adolescents ages 12-14 (in middle school, 6th-8th grade) and their parents offered twice a year beginning in March and October. The group aims to treat adolescents who have difficulties managing their strong emotions and who, as a result, may engage in maladaptive behaviors. Adolescents and their parents learn dialectical behavior strategies covering four key areas, each designed to promote acceptance and change in people’s lives—mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The group alternates between multifamily—both children and parents meeting together with group leaders—and separate kid/parent groups to work on skills integration. The child’s participation (intake and group sessions) is covered by insurance and the Parent Group is self-pay.

Dialectical Behavior Therapy Skills Group – High School

Mondays 6-7pm, Wednesdays, 4-5pm

This is a 20-week skills group for adolescents ages 14-19 (in high school) and their parents. The program aims to treat adolescents who have particular difficulties managing their strong emotions and who, as a result, engage in self-destructive behaviors. The groups teach dialectical behavior strategies to adolescents and to their parents. These strategies include five key areas, each designed to promote acceptance and change in people’s lives—distress tolerance, emotion regulation, interpersonal effectiveness, mindfulness, and middle path. Our coed program consists of the Adolescent Group, which is covered by most insurance providers, as well as a required self-pay Parent Group, which runs concurrently with its respective teen group. Both the Monday and Wednesday sections offer rolling admission whenever openings are available and when the groups are between modules.

DBT Skills Integration Group

Wednesdays, 5-6pm

This weekly group is for adolescents ages 14-19 (in high school) who have an interest in further incorporating DBT skills into their everyday lives. Participants must have a foundation in basic DBT skills prior to participation in this group and are asked to practice skills between group sessions. Participants will review skills as necessary while primarily focusing on increased understanding and use of skills in various areas of their lives, as well as working on the barriers that interfere with effective skills use. This group is not time limited (though continued participation will be reviewed periodically) and offers rolling admission whenever openings are available.

Mood Disorder Group for Older Adolescents

Wednesdays, 6-7pm

This group is designed for adolescents ages 14-19 (in high school), who struggle with mood disorders including major depression, bipolar disorder, and dysthymia. Withdrawn, socially isolated, and or anxious adolescent are also appropriate. The group is an open-ended process group intended to promote mutual peer support. Adolescents make a commitment, prior to joining group, of six to eight months of ongoing participation. Members use their group sessions to identify which issues or experiences influence their mood and to offer support to one another with problem solving or CBT/DBT skills. This coed group offers rolling admission to high school students whenever openings are available.

CBT Skills Group

Mondays, 4-5pm

This 12 week skills group is designed for adolescents ages 14-19 (in high school) and their parents, who may be struggling with depressed mood, anxiety, and/or low frustration tolerance. Adolescents who have difficulty managing their strong emotions, feel socially ineffective, and/or have low self-esteem may find this group particularly helpful. This group focuses on identifying thought processes, emotions, and behaviors that occur in response to stressful situations. Once these factors are identified, we work to adaptively change those cognitive and behavioral responses, fostering a positive shift throughout the adolescent’s psychosocial life. Other topics of discussion include the challenges associated with puberty, budding romantic interests, and identity development.

Testing

The Child and Adolescent Testing Service (CATS) offers neuropsychological and psychological testing along with individual and group therapy sessions and evaluations to help young people and their families cope with mental illness at home and at school. CATS is ideal for:

  • Youth ages 5 to 22 who have psychological and/or neuropsychological conditions that are interfering with their ability to manage demands at home, at school, and/or with their peer group
  • Youth who have diagnoses such as ADHD, nonverbal learning disability, social interaction challenges, mood disorders, anxiety disorders, post-concussive syndromes, executive functioning difficulties, and specific reading, writing, and arithmetic disorders
  • Helping parents, teachers, and other professionals better understand why a child is struggling and how to be helpful

Although our evaluations are “diagnostic,” we also see patients who already have diagnoses, but who still need help with treatment and/or educational planning.

Please note that we are unable to accommodate individuals who are not fluent in English, who have significant sensory or motor difficulties that require specialized testing procedures, or who have autism or moderate to severe pervasive developmental disorder, however we will refer these individuals elsewhere.

The evaluations are made up of four or more parts, including these required elements:

  • Parent interview
  • Review of current and previous records, evaluations, and clinical information
  • Review of school information
  • Administration of neuropsychological, psychological, and academic testing

The testing results along with our review of the child’s records inform our recommendations. We share the results via a feedback meeting with parents (and adolescents, if appropriate), as well as in a written report.

A 90-minute feedback meeting will be scheduled for two weeks following the first day of testing so that our evaluation coordinator can talk with parents and guardians about the child’s testing results. The goals of the meeting include using the testing information to address specific concerns and questions, talking about diagnostic conclusions, specifically addressing the educational implications of the results, discussing educational recommendations (such as parent education), and reviewing recommendations about next steps.

If we determine that it is important for an adolescent to have a separate feedback meeting, this will be arranged as well, and is included in the cost of the evaluation.

Parents and guardians receive a written report by mail, approximately a month after the feedback meeting. The report includes information about the testing administered, how the child performed, and conclusions and recommendations for the child, the child’s school, and the professionals with whom the child works.