CHILDREN AND ADOLESCENTS

The Behavioral Change Clinic, PLLC specializes in working with children and adolescents. The therapy room is designed to make them feel comfortable and welcomed - from colorful artwork on the walls to fidgets and Legos to play with. While some children are eager to share their hopes and problems in a safe space, others need to alternate between mild distraction and addressing the issues directly. Both are healthy approaches - and often the way adults healthily cope with difficult emotions, too. If you’ve ever laughed at a cherished memory during a wake or tidied up the living room before having a difficult conversation with a spouse, then you can relate to the idea that sometimes the mind needs a brief escape from challenging emotions. As much as The Behavioral Change Clinic, PLLC is about confronting difficult emotions head on, small amounts of avoidance behaviors are not always maladaptive.

Despite the use of a colorful atmosphere with various manipulatives, The Behavioral Change Clinic is not a traditional “play therapy” practice. Play is incorporated into the therapeutic work, as it is a natural part of how children (and teens…and adults!) interact with the world. But rather, The Behavioral Change Clinic, PLLC is about creating proactive changes - both empowering your child or adolescent to enact desired changes in their life and helping them learn to hold themselves accountable when they make mistakes. The goal is for the child and parent to recognize the behavioral patterns that keep them stuck in the negative cycle of withdrawing, refusing, yelling, procrastinating, etc. and use that as a way to move forward with new behaviors, new thinking patterns, and (eventually) new emotions.

One of the great things about working with children and adolescents is that their maladaptive behaviors are not as ingrained as with adults. It’s like a record player that keeps skipping because the grooves were not deep enough - only in this case, that’s a good thing, because it’s about time that we started to play a new song.

Parent/Guardian* Involvement

Parents and guardians are involved throughout the entire process of assessment and treatment at The Behavioral Change Clinic, PLLC. The intake session is the first in-person meeting at the clinic. Some parents/guardians choose to come in by themselves without their child. This is the best choice when the parents/guardians need to speak openly without censoring themselves. If you do not know how to phrase things without hurting your child’s feelings, if you need to share information about other household members without your child knowing, or if you are still trying to decide if psychotherapy is the best option for your child, then it is best to come to the first appointment without your child.

However, other parents/guardians choose to come to the first appointment with their child. This is the best choice if your child has a good understanding of the problem area, if you have had multiple conversations with your child about the problem, or if child has been asking for help and needs assurance that their struggles are being taken seriously. We can always schedule a separate parent/guardian-only session later.

Once psychotherapy has started parents/guardians are actively involved in The Behavioral Change Clinic, PLLC. Sometimes they attend weekly parent sessions without the child present. Sometimes they attend monthly sessions. Sometimes they attend the first five minutes of the child’s session and only meet without the child on occasion. It all depends on your child’s needs. Whatever is most effective for your family. Sometimes YOU will be the agent of change in your child’s life. Sometimes your CHILD/ADOLESCENT will be the agent of change. Sometimes you BOTH will be. It all depends on the specific sets of behaviors, thoughts, and emotions that create the challenges your family is facing. Importantly, who is the agent of change has little to do with what is to the cause and maintaining factors of the problem.

Of course, if you ever want more sessions or fewer, just let your therapist know. And, your therapist will have an open discussion about how best to meet your family’s needs.

*For brevity, the word parents will be used to mean any guardian who is actively raising the child. This includes, but is not limited to, mothers, fathers, stepparents, grandparents, aunts/uncles, and much more (whether genetic or chosen family).

Problem Areas

Common Problem Areas

Below are my biggest specialty areas.

  • Anxiety, Panic

    • Not texting/messaging/calling peers; trying to get out of sports competitions or class presentations; refusing to speak to neighbors or grandparents; refusing to order their own food at restaurants; only eating certain foods a certain way***

    • School refusal

    • Avoiding getting their driver’s license (e.g., disinterest in signing up for driver’s edu; refusal to practice driving with their permit)

    • Frequent complaints about headaches, stomachaches

  • Repetitive, unpleasant thoughts and behaviors

    • Constant worrying about germs, things catching on fire, offending God, how things are arranged, if they’ll receive an A- instead of a 98% or better

    • Washing their hands over and over again; touching objects repeatedly; arranging their placemat or dinner in an overly rigid fashion; spending hours on homework assignments that you know that they know the right answer to; putting on their makeup “just right”; changing their clothes several times a day; checking to make sure that the door is locked

    • Reassurance seeking (e.g., repeatedly asking if certain foods are safe to eat or who is going to pick them up for school)

    • Refusing to touch the carpet where the dog vomited a week ago

  • Uncontrollable muscle contractions or vocalizations

    • Frequent head jerking, stretching of arms and/or legs, touching objects

    • Frequent sniffing, coughing, k-sounds, t-sounds, repeating words

  • High amounts of anxiety and/or rage when certain sounds are made (e.g., in response to sniffing, coughing,

*** If you believe that your child may have a genuine eating disorder (ED), then The Behavioral Change Clinic, PLLC is not the right fit for you. EDs require specialized training that Dr. Moceri has not obtained. Eating disorders are very serious and require a trained specialist in that area.

How to Talk to Your Child or Adolescent about Starting Therapy

Many parents ask how they should bring up the topic of therapy with their child. In short, you want to communicate that you’re bringing them to therapy because you care about them deeply and you want to find new ways of helping them with their struggles. Here are sample scripts to help you discover the right words for you and your child.

Sample Young Child Script: “Next week, we’re going to meet a special type of doctor. Just like how you see Dr. [Pediatrician’s Name] for checkups and for when you have a cold or your stomach hurts. This is a doctor who specializes in emotions and behaviors. He is an emotions doctor. Like other doctors, he has special training to help with big emotions like sadness, worry, and anger. We’ll see him on a weekly basis. He’ll provide you with tools and strategies for helping you with your emotions so that you can control your actions better. In that way, he’s like a coach. Only, he’s an emotions coach. Sometimes he’ll even give me coaching tips to help you better. Do you have any questions?”

Sample Adolescent Script: “I recognize that you’ve been having a harder time lately. You’ve said that you’re unhappy at school and we’ve been fighting a lot. I’ve also noticed that you have been spending a lot of time in your room, have been complaining about headaches and stomachaches, been stuck doing tasks over and over again, and having difficult focusing on your schoolwork. We’ve been unable to fix the problem on our own. So, I’ve scheduled an appointment with a therapist. He specializes in working with adolescents and he should be able to really help you with your challenges. We’re going to figure this out as a team. Do you have any questions?