Evidence Based Therapy
Azza and her team are passionate about improving the learning, behaviour, emotional and social development of children and adolescents whilst working closely with families, educators and referring agents. We work with you and your child in planning the intervention sessions, for you in providing evidence based interventions and by your side to support your journey to reaching the outcomes desired.....
All our clinicians ensure the application of the most up to date therapy techniques and strategies. Through ongoing training and professional development, our clinicians implement evidene based therapies to complement individual, family or group programs delivered to their clients.
The following lists some of the main therapies used- depending on the child/adolescent's presentation and needs:
The process of providing children, adolescents and their families with education regarding their presenting symptoms is called psychoeducation. Specifically, it involves education about the challenges and difficulites children and adolescents may be facing including; emotional difficulties, social challenges and behavioural concerns.
The benefit of psychoeducation is that it allows individuals and their families to gain a more comprehensive understanding of experienced difficulties in order to empower them to see the possibility of change and gain 'control' of their situation. It is mainly a discussion around the following:
- nature of concerns and identification of possible underlying causes/ contributing factors
- impact of the reported concerns on the individual and their family
- helpful tips and strategies to assist in supporting the individual
- possible assessment and suitable interventions to assist the child/ adolescent
According to psychological research, CBT has been shown to be very effective in the treatment of a range of disorders including anxiety and depression. It is very helpful in empowering individuals with coping skills and mechanisms by teaching new skills through strengthening their ability in identifying and challenging their dysfunctional thoughts and/or behaviours.
Some of the CBT techniques used at our clinic include (but are not limited to), the following:
Cognitive Restructuring/ Challenging Thoughts:
Teaching individuals the ability to identify their thoughts, which may be impacting on how they feel, and guiding them to think in a more realistic/ rational manner in order to improve their emotional stability and resilience.
Encouraging children to face their fears in a controlled and guided manner in order to reduce their emotional reactions to things they fear. This is organized in a step by step process with the individual and their families.
Improving emotional regulation:
Individuals who are emotional benefit from understanding their feelings, expressing their feelings and learning how to regulate how they feel and gain insight as to how others feel. This enables individuals in being able to understanding themselves and others rather than remaining emotionally reactive.
Teaching Problem solving:
Assisting individuals in identifying problems, finding solutions to problems and in the decision making process as to what may be the best choice in a specific situation. This is helpful in gaining new skills in independently managing and effectively coping with future problems, which may occur.
Parent Assistance Training:
Working closely with parents to ensure improved communication between parents and their children, and provide an in-depth understanding of functions of behaviour, effective use of reinforcements and implementation of individually tailored behavioural management systems. We use CBT in working with children and adolescents with a range of emotional, social and behavioral difficulties.
At Azza's clinic, in order to maximize our results, we tailor our CBT techniques to suit our clients' individual needs. We aim to teach clients new ways of viewing situations through our active-participation sessions by teaching practical strategies to overcome their challenges.
Acceptance and Commitment Therapy (ACT):
According to psychological researcg, ACT has been shown to be effective in the treatment of a range of disorders. ACT is unique in that it combines aspects of cognitive behavioural therapy with aspects of mindfulness whilst focusing on the development of psychological flexibility, that is, connecting with the present moment, gaining a deeper understanding of self and matching our behaviours to our inner values.
Some of the ACT techniques used at our clinic include (but are not limited to), the following:
- Expansion/ Acceptance: sitting with thoughts and feelings, noticing their feeling and experiencing them as they pass
- Connecting with the present moment: being aware and interested of what is currently happening to engage in our current actions.
- Accessing a Transcendent sense of self: understanding that our thoughts, feelings, memories and body are always changing, thus do not determine who we are
- Understanding values: for the purpose of gaining meaning, motivation, purpose and direction. AND
- Making committed action: one that is effective and guided by our values
At Azza's clinic, we use ACT based programs in working with children and adolescents with a range of emotional, social and behavioral difficulties.In order to maximize our results, the thereputic techniques are individualized in the aim of providing specific strategies to tolerate thoughts and feelings and skills to cope with long-term and/or future problems.
This type of therapy is based on a concept, which was developed by Buddhists about 2.5 thousand years ago and has become a well known practice in psychological interventions during our present time. In summary, it refers to the notion that we are able to develop skills to maintain a moment-to-moment awareness of our thoughts, feelings and experiences without the need to judge them by being- "aware:, "accepting" and "In the present"
Some of the identified benefits of mindfulness may include (but are not limited to): the improvement of; overall well-being and emotional regulation, and the reduction of negative feelings (i.e. sadness, stress, anger/ anxiety) whilst increasing positive feelings (i.e. happiness, enthusiasm, interest).
At Azza's clinic, we may use mindfulness techniques to compliment other therapies including; CBT and ACT as well as social skills training. Our techniques are often chosen based on the individual's understanding and age level and are tailored according to the needs of each individual's difficulties.
This type of training allows our clients to explore their strengths and weaknesses in their emotional and social development. Once we work with the individual and their family around the skills required, and an individualised plan is formulated based on the individual's age, language skills and ability level, sessions are then organized to ensure the commencement of teaching appropriate skills, which may include (but are not limited) to the following:
Psychoeducation on Social rules:
Building social cognition and understanding
Improving conversational skills:
Building social communication and reciprocity
Teaching Friendship Management:
Assertiveness training, dealing with conflict
Teaching Emotional regulation:
Identification, understanding body signals, strategies for calming down
Learning appropriate Play skills:
Understanding social rules and building skills
At Azza's clinic, some of the strategies used to teach emotional and social skills include psychoeducation, modelling, role-play, observation and direct instruction are based on a mixture of therapies including (but not limited to) Cognitive Behavioural therapy (CBT), ACT and mindfulness.
We often provide families with activities and practice exercises in the home environment to ensure skills are generalized in environments outside the clinic setting. We often encourage our clients to commence individual sessions and progress into one of our group programs running at the time to ensure the generalization of skills and promote application of knowledge gained.
CPS is the non-punitive, non-adversarial, trauma-informed model of care Dr. Greene originated and describes in his various books, including The Explosive Child, Lost at School, Lost & Found, and Raising Human Beings. The CPS model is recognized as an empirically-supported, evidence-based treatment by the California Evidence-Based Clearinghouse for Child Welfare (CEBC) and has been applied to numerous families, schools, inpatient psychiatry units, group homes, residential facilities, and juvenile detention facilities. It has been shown to be an effective way to reduce conflict and teach kids the skills they need to function adaptively in the real world.
What is CPS all about?
Collaborative and Proactive Solutions is designed to help families with children with challenging behaviours. CPS assumes that such children are challenging because they're lacking the skills not to be challenging. If they had the skills, they wouldn't be challenging.
The main premise of the model is that ‘kids do well if they can’, and that if a child is being challenging, it is because they are lacking the skills not to be challenging. These lagging skills (such as problem solving, communicating, flexible thinking, etc.) lead to situations where the demands and expectations placed upon the child exceed their capacity to respond adaptively; which leads to unresolved problems. Of course, that's when everyone looks bad: when they're lacking the skills to look good. For example, if a particular homework assignment demands skills that a kid is lacking, then that homework assignment is likely to set in motion challenging behaviour.
What behaviours do challenging kids demonstrate when they don't have the skills to respond adaptively to certain demands?
Challenging kids let us know they're struggling to meet demands and expectations in some fairly common ways: whining, pouting, sulking, withdrawing, crying, screaming, swearing, hitting, spitting, kicking, throwing, breaking, lying, stealing, and so forth. But what a kid does when he's having trouble meeting demands and expectations isn't the most important part (though it may feel that way)…WHY and WHEN s/he's doing these things are much more important.
What should we be doing differently to help these kids better than we're helping them now?
If challenging behavior is set in motion by lagging skills and not lagging motivation, then it's easy to understand why rewarding and punishing a kid may not make things better. Since challenging behavior occurs in response to highly predictable unsolved problems, then challenging kids – and the rest of us – would probably be a whole lot better off if we tried to solve those problems.
But if we solve them unilaterally, through imposition of adult will (something referred to as Plan A), then we'll only increase the likelihood of challenging episodes and we won't solve any problems durably. Better to solve those problems collaboratively (Plan B) so the kid is a fully invested in solving the problems, solutions are more durable, and (over time) the kid -- and often the adults as well -- learn the skill.
We uncover this information using the three steps of Plan B:
- Empathy Step: gathering the concerns of the child and understanding what is getting in their way using drilling strategies
- Define the Adult Concerns Step: entering the adult concerns into consideration clearly and concisely
- Invitation Step: inviting the child to collaborate on finding a solution to the unsolved problem that is realistic and addresses the concerns of both the child and the adult
Who is CPS suitable for?
CPS is designed as an intervention for families for whom traditional reinforcement (rewards/punishment) based interventions have been ineffective. Plan B is a long-term solution to challenging behaviours. Given that we focus on one unsolved problem at a time, it can take months or longer to work through all the unsolved problems. The focus in CPS sessions is to equip the parents and child with the skills and strategies needed to implement Plan B at home, and to then troubleshoot implementation.
Once adults understand the factors (lagging skills and unsolved problems) contributing to challenging behavior in children, many of the intervention strategies that are often applied to modify that behavior (stickers, time-outs, detentions, suspensions, corporal punishment) make a lot less sense...because those interventions couldn't conceivably solve those problems or teach those skills.
-Dr. Ross Greene
What is Neuropsychotherapy?
The practice of Neuropsychotherapy is a mode of working with clients to address a wide range of psychological and physiological distresses by helping clients become aware of how neural processes are linked to their feeling states and perceptions, whilst at the same time aiming to achieve, for the client, a fundamental requirement for safety, in whatever area of life they are experiencing difficulty.
In the application of Neuropsychotherapy it is the therapist's role to raise client awareness and enhance client's control over their perceptional, cognitive and hormonal systems and to work with the client to down-regulate (lessen) the psychological and physiological symptoms of distress. It is also the therapist's role to demonstrate and work with their clients to reveal the links and interdependencies of these perceptional, cognitive and hormonal systems, in both in body and mind.
Research into the effects of Maudsley have shown that it is an effective outpatient treatment for individuals with eating disorders, particularly for adolescents with Anorexia Nervosa.
The principals of Maudsley therapy are that the family play a vital role to the restoration of weight in those affected by eating disorders such as Anorexia Nervosa. The family, and in particular, the parents play a pivotal and active role in treatment.
Maudsley treatment is broken down into 3 distinct phases.
Phase 1: Weight restoration.
When someone is underweight (or has experienced rapid weight loss) their body is under enormous physical stress and they are at risk of experiencing a number of medical complications. In addition to this when someone is underweight (or experiencing rapid weight loss) their ability to engage in 'cognitive' work to address the underlying factors of the eating disorder are diminished. Therefore weight restoration is deemed the most important and first step in treatment to medically stabilise the person and allow for the next phases of treatment to occur. During this phase of treatment the control of eating (what is eaten, how much) is given to the parents in order achieve the first goal.
Phase 2: Returning control of eating over to the adolescent.
Once weight restoration is achieved and the adolescent is no longer medically unstable, control over eating is gradually handed back to the adolescent.
Phase 3: Establishing healthy adolescent Identity.
Phase 3 is initiated when the adolescent is able to maintain their own weight at an ideal weight and self-starvation has ceased. Treatment begins to focus on regaining the parts of life that have been taken away and effected by the eating disorder, such as school, social and family life.