“Too hard to say NO”

It is too hard to say “no” to your intensely protesting child even though in your heart of hearts you know it is the right answer? Given that a blog on this question is being posted, at least you know that you are not alone with this dilemma. First, children are very good at what they do. Indeed they are wired to be experts in survival. And while we are also wired to be caretakers, the challenge of parenting is much more complex and demanding than being the child. All that having been said, when children are fighting hard against their mother’s and father’s wishes and using every possible strategy they can find, from screaming in the middle of a crowded store to telling you adoringly how much they love you (with a kiss kiss here and a kiss kiss there) to get what they want, you needn’t be fooled. These brilliant young folks are likely testing your strength as the parent and the one in charge as much, if not more than trying to get their way.

It is hard to be a child and so dependent upon others for security. Not surprisingly, these smart little people need to test the limits of their security – when they learn their environment is safe, they can relax and engage more deeply in their environment – a good thing for healthy development. How do they test the limits of their security – by seeing how far they can push you – who is stronger, me or you,

Who is in charge here, how much distress can you tolerate and still prevail?

To test this theory, try refusing your child’s unreasonable requests with this in mind. Hopefully, this discussion will make saying “no” easier. After the initial “storm” do they seem calmer, more at ease, more solicitous of your affection? And how are you doing? Do you feel more “in charge” and self confident? Are you feeling more affectionate towards your child rather than resentful of their victory?

We hope this little experiment is helpful as setting limits effectively with you child not only greatly enhances the quality of your relationship with them, but it is an important component in healthy development, internalized security and respect for others. Another good reason to do this sooner rather than later is that it makes the adolescent years much more enjoyable for all.

Dr. Barbara Mazer

Clinical Psychology Resident and soon to be MindWorks clinician!

Me First and the Gimmie Gimmies*

The holidays are supposed to bring out the best in all of us, but it can bring out the worst in our children and in us as parents. The winter holidays is a time of stress and high expectations, and both are hard for children to handle. Pretty much all humans, except for Gandhi or Mother Theresa, are insatiable beings. We all have limitless wants and wishes. Our desires can lead us to great things and achievements, and they can also lead us towards greed and envy. Children have those same feelings, but unlike adults, they don’t understand why all of their wants can’t (and shouldn’t) be granted.

This time of year, children are bombarded with toys, Santa, treats, and commercials. We really can’t blame them for craving all the terrific things they see, especially when so many of them believe that Santa will bring whatever they want. While we would love to curb their greed, the usual methods reasonable parents try don’t work very well against the holiday hype. We try to explain to children about limited budgets, how we need to save for college, and how it’s impossible for grandma to know exactly what Barbie is the perfect one. But kids don’t understand, not really. You can talk yourself blue in the face to a four-year-old who wants a toy NOW, and he’s not going to understand anything beyond what his experience tells him. He knows that you could buy whatever it is he wants (you’re his parent, you can do anything right?), but you won’t until he convinces you that he really, really needs it. We parents all know that this becomes a cycle. First the child demands, then the parent refuses. The child gets more upset, and the parent starts feeling guilty, then frustrated, then angry. The child escalates until the parent punishes, leaving both people feeling terrible. Another awful situation arises when you give a child a beautiful gift, only to have him cry that he doesn’t like it. The holiday combination of stressed-out parents, too much excitement, and unrealistic expectations sets our kids up for meltdowns.

So here are some ideas for the holidays that might help take the edge off a bit:

1. Avoid the danger zones. Try not to take your child to the toy store, the mall, and turn-off the Saturday morning cartoon line-up (where all of the toy commercials are). The stores are overwhelming and crowded this time of year. All those toys are just too tempting for a child to ignore gracefully. If you must take your child shopping, let her know at the outset what you will and will not be purchasing. Be ready to leave the store if your child is not cooperative.
2. Focus on the giving. Keep your child’s attention directed towards all of the things he is going to give to others. Take him to the craft store and get lots of supplies for making ornaments, menorahs, scrapbooks, paintable coffee cups and cards (get lots of glitter). Help your child buy gifts online so you won’t have to go to the stores. Shoot for having your child have a gift or card for everyone who will be giving him a gift. Teach your child about giving to charities. A child can pick out a Toys-For-Tots (just have him pick out one for a child of a different age or gender so he can part with the toy without tears) or help choose items for a care package to a solider in Iraq (www.anysoldier.com). Don’t forget your child’s teacher!
3. Limit the Loot. Limit yourself and your relatives in the gift giving department. Keep it to one or two gifts at any one occasion, and put a cap on the amount people will spend. Don’t let a young child see a gift that he can not open and play with immediately (such as one that takes hours to assemble), otherwise you are sure to provoke tears.
4. Practice how to accept gifts. Role play how to accept a gift, even if you don’t like it or already have it. Teach the child to say a warm ‘thank you’ and to write or color thank-you notes.
5. Empathize. Children sometimes do get disappointed at the holidays; we can’t ever get them every wonderful, expensive gift they desire. Part of our job as a parent is helping our children deal with disappointment. Resist the urge to lecture or call your child ungrateful. Instead, find that part of yourself that can relate to being a sad little kid who didn’t get what she wished for Christmas morning (I never did get a pony). Give a hug, give some cocoa, and then gently help steer your child’s focus back on all the things to be grateful for. Empathy is one of our best gifts we can give a struggling child.

Dr. Rebecca Resnik, mom and psychologist, and fellow Target goer.

* Title inspired by the rock band by that name

Why should I have a private psychological assessment?

I recently spoke with a very happy father. He told me that he was cancelling our appointment for psychological testing because his insurance company was going to arrange for him to have his child tested for only $15. And as I wished him well and hung up the phone, I understood why he sounded so excited. Fifteen dollars compared to the cost of a private assessment, well who wouldn’t be thrilled? And if you get an assessment though the school system its free. Free sounds awfully good compared to expensive private testing, but the problem is that like with many things in life, if it sounds too good to be true to be, it probably is.

So what are you paying for when you invest in a private assessment? You are paying for time, expertise, and information you can trust. One of the first considerations is time. There’s no getting around the amount of time that a psychologist spends producing a quality report, and ideally it is the psychologist’s time. Some psychologists do not do their own testing, instead they pass you off to a technician or a student after the initial interview. The test administration, consulting, scoring and writing is very labor intensive, and it should be. No one wants to be treated by someone who is in a rush or taking short-cuts. Its worth paying for someone to make your case a priority. A private psychological evaluation should be custom designed around what you want to determine, as well as your child’s strengths and weaknesses. Tests and procedures should be thoughtfully selected, not simply used because they are the only ones you have. It is crucial to find a psychologist who has many tools at his or her disposal and the expertise to know how to use them.

It is unlikely that a psychologist will make useful recommendations unless he or she takes the time to study how an individual solves a variety of problems in the form of tests, tasks and even play. When you walk out of a psychologist’s office, you should have a large document in your hand that gives you insight into how your mind (or your child’s mind) works and lays out a plan for what steps to take next. A comprehensive assessment should lead to specific, concrete recommendations that address educational interventions, therapy, strategies for home, parenting advice, and information to inform medical treatments as appropriate.

When I do a psychological evaluation, I begin by budgeting six hours of ‘face to face’ time with the individual and his/her family. This is as much as three times the amount of time many people spend doing a psychological evaluation. My psychological evaluations resemble the neuropsychological assessments that I learned to do as in intern at a pediatric hospital in Baltimore. I study the person’s functioning exhaustively until I’m satisfied that I understand the problem, both what it is and what I can safely determine that it is not. After those six hours, I start calling everyone I have permission to consult with (physicians, teachers, tutors, even relatives) to get a complete picture of how the person is doing across home, school, and work. I review old testing reports and work samples. Then I set up to work writing your evaluation that takes me hours upon hours. I do not fill your name into a template. I do not dictate my reports to a transcription service. I do not cut and paste ‘cookie cutter’ recommendations into the report. Finally, the family and I sit down and have a feedback session, where we talk about the findings in detail and spend time problem solving. People who come to see me generally complete the entire process in a month or less.

Rebecca Resnik, PsyD - Licensed Clinical Psychologist

If your car is making a screeching noise, do you only want the battery checked?

We often get requests for "ADHD testing."

I understand that there is a lot of media attention (excuse the pun) on ADD, ADHD, impulsivity, inattention. However, symptoms of inattention or restlessness are common in many learning and emotional problems such as learning disabilities, anxiety, moodiness, and motivational issues.

So if I go to the car mechanic and ask him or her to check only my battery because of the screeching noise, I would be remiss in not also having the whole car looked at. The engine, brakes, and all that other car stuff that I know very little about but may in fact be part of the problem. Thus, I have to trust that the mechanic should look at the whole car so he can ultimately not only fix the screeching sound but also make the car run more smoothly.

After years of doing different types of testing, we have now made it a MindWorks policy not to do "just ADHD testing." If you really want to find out why your child is having certain symptoms that may be affecting him or her at school and at home, we need to understand how the child learns, processes information, rule/out learning disabilities, and make sure that anxiety or depression is not creating these symptoms.

In the past, when we have only done "ADHD testing" (an IQ test, a checklist for attention symptoms, and a computerized test for viglilance and reaction time), we are often left with unanswered questions about why the child is struggling to read or is not doing well in geometry.

Like everyone, I am always a little suspicious when the car mechanic needs to check the entire car and am afriad that he is going to tell me that I am going to have spend money on x, y, and z, when I was only expected x. However, our testing comes from a health based perspective, so that we are identifying the strengths in your child to help overcome and compensate for the possible relative weaknesses.

So, next time you call ask for ADHD testing, expect me (or one of the other clinicians) to talk about why we feel it is important to take a whole child approach and not just focus on the battery. : )

-Rachna Varia, PhD; Director of Testing

Our Mission Statement and Philosophy

MindWorks Philosophy and Mission Statement
What Makes MindWorks Work.

MindWorks, Clinical Psychology is committed to providing the highest-quality therapy, consultation, and assessment services by having specific standards for its:

1. Clinical Services
2. Staff
3. Environment

1) Clinical Services. MindWorks believes in a family systems model of therapy where children are not treated in isolation, but parents are made active participants in creating change. Assessments are based on creating a roadmap for clinical concerns and are individualized and thorough. MindWorks believes in communication with other parties and a collaborative model of care.

2) Staff. MindWorks believes that high quality services can be provided to clients by having excellent clinical staff. Staff is carefully selected to have a combination of professional acumen, personal warmth, sincerity, and approachability. MindWorks offers contractors a flexible schedule, steady stream of clients, and the ability to focus on clinical work instead of administrative and insurance tasks. MindWorks’ contractors are encouraged to create niche clinical services for professional and business satisfaction and growth. In addition, MindWorks is dedicated to a family friendly work environment where personal needs are prioritized (time off, child-care, pregnancy, professional development).

3) Environment. MindWorks provides a client-friendly office atmosphere where both adults and children feel comfortable. MindWorks strives to create an environment where clients are not anxious about receiving services and rather experience the clinic as a secure place. This Environment is created through clinician warmth, speedy communication and coordination, and a décor that is inviting and colorful.