Child Psychology Clinic Illawong  + 61 2 9541 1177

Child Psychology Clinic Westmead  + 61 2 9541 1177

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:

  • Cognitive Behavioural Therapy (CBT)

    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.

    Exposure techniques:

    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 & Commitment Therapy (ACT)

    Acceptance and Commitment Therapy (ACT):

    According to psychological research, 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.

  • Collaborative and Proactive Solutions (CPS)

    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

    											
  • Dialectical Behaviour Therapy (DBT)

    Dialectical Behaviour Therapy (DBT) is a modified version of Cognitive Behavioural Therapy. It was developed initially by Marsha Linehan as a treatment for Borderline Personality Disorder however has been shown to be an effective treatment for a range of conditions where an individual may experience difficulties regulating their emotions.

    Renowned psychologist Carl Rogers said “The curious paradox is that when I accept myself just as I am, then I can change”. Dialectical means ‘working with opposites’ and DBT aims to strengthen two seemingly opposing skills of ‘acceptance’ and ‘change’ by learning tools to accept situations as they are while working to change circumstances to make them easier in the future. This is worked on in the hope of fostering lives that are experienced as fulfilling. The central aim of DBT as a whole is to replace ineffective, maladaptive, or unskilled behavior with skilful responses” (Linehan, 1993).


    Throughout therapy, acceptance skills focus on using Mindfulness training to improve an individual’s understanding and awareness of their own thoughts and feelings as well as improving an individual’s ability to tolerate distress. We focus on strengthening our ability to have a ‘language’ to identify, describe and communicate our inner world of thoughts and feelings as well as strengthen our ability to notice and be aware of these emotions when they are present. Mindfulness training is also a skill which is further applied within the context of our interpersonal relationships, it helps us to tune in to what each person is saying and be physically and emotionally present when interacting with others. This is in the hope of experiencing a more meaningful connection with each other and also having our needs heard and respected.
     
    Change skills on the other hand focus on developing ways to regulate one’s own emotions as well as strengthen interpersonal skills in order to become more effective within our relationships. There is a strong relationship between how we feel and our relationships and the two form a dynamic which impact each other profoundly. Our ability to interact and communicate effectively within our interpersonal relationships has an ability to soothe our emotions as well as have our needs understood and met which is particularly important when working with both children and adolescence and their families.
     
    At the clinic we use DBT principals when working with children and adolescence and their parents to work towards goals of improving mood dependent behaviours that might include:

    • Self- harm and suicidality
    • Aggression
    • Eating disorders
    • Substance abuse
    • Risk taking behaviours
    • School refusal
    • Anxiety
  • Neuropsychotherapy

    What is Neuropsychotherapy?

    According to the International Association of Clinical Neuropsychotherapy: 

    "Neuropsychotherapy is a meta-framework taking into account the dynamic interplay between the mind, body, society, and environment upon well-being. By understanding the mechanisms of our biology/neurology, the processes of our psychology, and the influences of social interaction, it is believed a holistic therapeutic practice can be formulated. The practice of Neuropsychotherapy is an informed way of working with clients, to address a wide range of psychological and physiological distresses, by using the most effective interventions based on a sound understanding of neural processes. In the application of Neuropsychotherapy it is the therapist’s role to use the principles of mental consistency, controllable incongruence and basic psychological needs to move the client’s neural flow toward states of well-being. This may involve any number of techniques, from various therapeutic modalities that are within the therapists competencies, that are effective in modulating neural flow toward well-being"

    In other words, the therapy entails educating the individual about the operations of  their brain in order to provide them with a sense of control of their health, mental health as well as wellbeing. When poor mental health is experienced for a significant amount of time, this can be debilitating for the individual and it may feel impossible to return to mental wellness. Neuropsychotherapy works on the basis of empowering individuals to increase knowledge and understanding of their own brain, mental health and how to regain mental wellness, making individuals feel that it is possible to feel 'well' once again. The aim is to assist individuals to regain control over their debilitating symptoms they are experiencing, by teaching them what is occurring in their brain at the time and what they can do to improve their mental wellbeing to return to their old self and achieve maintenance of their positive wellbeing. 

    “Neuropsychotherapy aims to change the brain, but it does not directly target primarily the brain but focuses on the life experiences encountered by the person. The brain specializes in the processing of life experiences. Life experiences are meaningful with regard to the needs that are embedded within the brain structures of each human being. Neuropsychotherapy strives to shift the brain into a state that enables these basic needs to be fully satisfied. The best method for improving the health of the brain, then, is to ensure basic need satisfaction.” (Grawe, 2007, p. 424)

    Grawe, K. (2007). Neuropsychotherapy: How the Neurosciences Inform Effective Psychotherapy. New York, Psychology Press.

    Adapted from: https://www.iacn.com.au/what-is-neuropsychotherapy/

  • Mindfulness

    Mindfulness:

    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.

  • Emotional & Social Skills Training

    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 evidence based therapies including (but not limited to) Cognitive Behavioural therapy (CBT), ACT and mindfulness , in combination with evidence based programs, which staff are trained in. 

    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.

  • Maudsley Family Based Therapy

    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.

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