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Clinical (Psychodiagnostic) Assessment (prior to intervention or psychotherapy) - Dr. Godbout
Clinicial assessments always include an initial assessment with parents (without the child). Ideally, this first appointment is an opportunity to clarify the question or concerns that you have about your child, to take a developmental history (social, physical, medical, academic, etc), as well as a family history. Should you wish to continue with the assessment process, a second appointment is scheduled for the psychologist to meet your child and a third feedback appointment is arranged, where formulation and intervention recommendations (as well as diagnosis if appropriate) are discussed with the parents. The assessment includes:
- the use of standardized questionnaires for parents and teachers (the latter when appropriate) in order to gather a wider base of information about your child
- interview in a manner that is appropriate for your child’s age and presentation, the goal being an overall positive experience for the child
- feedback appointment with parents where formulation, that is, understanding of the child is shared and where elaboration of an intervention plan is discussed. When appropriate, a diagnosis is provided.
- written report or written summary report can be provided at additional cost when needed
Psychoeducational Assessment (Neuropsychological Assessment) - Dr. Tuff
Sometimes concerns center around school where a specific learning or attention challenge has been described and interferes with acquistion of one or more core subjects, or where the child is felt not to be working up to his potential or spends far more time and effort to achieve the same results as his peers. The goal of the assessment is to provide an explanation of the child or adolescent’s learning style including cognitive and academic strengths as well as weaknesses in a formulation that leads to an appropriate intervention program. It includes the following:
- initial interview with parents including the use of standardized questionnaires for parents and teacher in order to gather a wider base of information; an older child may be included in the initial interview
- psychological testing carried out one on one with the child and Dr. Tuff; the process is typically described to the child as activities (verses tests)
- feedback appointment where the child’s learning profile is discussed with the parents (and older child when appropriate), along with recommendations for interventions and diagnosis if appropriate
- comprehensive written report including recommendations, teaching strategies and assistive technology when appropriate (framework for IEPs). The report is available at the time of the feedback appointment.
Intervention: Psychotherapy - Dr. Godbout
Every child and family has a unique experience and the process of psychotherapy must be respectful and non judgemental of each child and family dynamics. In general, the mode of intervention will take into account the child’s age, personal psychodynamics (or diagnosis when applicable) and the best port of entry (intervention) for bringing changes. The intervention may include one or more of the options described below - the goal being to enhance progress and change. There is a strong orientation for parents to be involved.
Cooperative and Proactive Problem-Solving Approach is particularly helpful for children and their families where concerns are around self-regulation, including outbursts, poor frustration tolerance, impulsivity, inflexible problem-solving or high level of reactivity. The premise is that children are motivated to do well and challenging behaviours are triggered when they can not meet expectations. The reactivity is better understood in terms of lagging skills versus a motivation to do so. The mode of intervention focuses on therapeutic and parenting strategies that assist children in building skills as well as addressing unsolved problems.
Cognitive Behavioural Therapy has the most benefits in population of children that are experiencing a high level of fears, anxious thinking, including ruminating or obsessive-compulsive reactions. The focus in on the relationship between one’s thoughts, feelings and the responses to situations that trigger and maintain anxious patterns. Understanding the role of one’s thoughts is central to this intervention modality.
Narrative Therapy is particularly helpful for a child and family to develop a story (a mental narrative) to organize, predict and understand the complexities of their situations. The way we solve issues is largely shaped by the meanings we attribute to events and to the options we are considering. Young people and their families may not have control over whether a certain problem or condition is in their life, but how they live with it is still within their choice. Narrative therapy is a method that separates the person from the problem and encourages people to rely on their own skill sets to build resiliencey around the problems that exisit in their everyday lives.
Watch, Wait and Wonder is a modification of Play Therapy, where the parent is trained to Watch, Wait and Wonder as they play in a non directive manner with their child. The intervention is mainly used with a younger preschool population where communication, insight and problem-solving are carried out through play with the parent as a full participant and reflecting on the meaning of the child’s play.
School Consulation (by phone) can often be useful in promoting a strong understanding of the child in their school setting that allows for increased empathy as well as a cooperative working relationship between parents, educators and psychologist to enhance changes.