Child, Adolescent & Teen Counseling NYC

Playing Sherlock Holmes

Minors cannot always express what is wrong. They don’t yet have the emotional or cognitive apparatus to verbalize their inner worlds. Instead, they tell their story by acting on and reacting to their environments.

As a child and adolescent psychologist, Dr. Rosenthal is skilled in the science and art of detecting and understanding children’s behavior. He gathers information using several modalities (e.g., diagnostic interviews, written assessments, behavioral observation, play therapy, and family therapy) and treats children and adolescents with ADHD, Asperger’s Disorder, phobias/fears, OCD, oppositionality, Bipolar Disorder, anxiety, depression, school difficulties, social skills problems, excessive anger, and behavioral problems.

Indicators of Distress

Children in distress may show their symptoms in a similar or varying fashion from adults. Below is an outline of what parents should look for:

• Mood changes – depression and anxiety can manifest as sadness, irritability, and/or aggression.
• Changes in behavior – children may show less/increased energy levels, less interest in fun activities, and/or isolating behavior.
• Physical complaints – children will often complain about physical ailments such as stomachs and headaches.
• Difficulty detaching – some children will become unusually upset when separated from their parents, which can indicate severe separation anxiety.
• Concentration problems - children in distress can have difficulties with focusing, sitting still, and impulsivity.
• School refusal – children who refuse to go to school are communicating that they are in severe emotional distress and must be treated to return to school as soon as possible.
• Academic decline – unusually low or falling grades may indicate emotional distress or learning difficulties.
• Behavioral problems – children will often act-out by throwing excessive tantrums or becoming oppositional / aggressive with parents, peers, teachers, and/or siblings.
• Excessive fears – children who become obsessed with or fearful of specific objects or people, bedtime, the dark, and/or toileting may be expressing emotional distress.
• Toileting problems – sudden problems controlling their bowels either at night or during the day is often indicative of regressive behavior due to some form of distress
• Sleeping problems – children may refuse to go to bed or try to sleep with siblings or parents beyond what is developmentally appropriate.
• Eating problems – children who refuse to eat, eat significantly less, or become very picky with what they eat may be expressing emotional distress.
• Adoption issues – adopted children tend to have behavioral problems, difficulties with attachment, developmental delays, and emotional confusion about their biological parents.
• Substance Abuse – while experimenting with drugs and alcohol is quite normal, adolescents who use substances to the point that it interferes with their functioning are expressing some form of emotional distress.

Early Intervention

Children and adolescents show greater gains and less long-term difficulties when they receive intense and early intervention. Problems that go untreated tend to worsen overtime and become more intertwined in the child’s thinking, feeling, and behavioral patterns. Frustration tolerance, for example, is a key skill for children to learn at an early age. Parents who fail to teach their children how to accept “no” are creating a breeding ground for larger problems as the child matures. Overtime, tantrums can transform into increasingly aggressive or defiant acts.

In addition to teaching parents behavior management techniques, Dr. Rosenthal uses play, talk, and behavior therapy to help children address underlying emotional issues. When children and adolescents experience trauma or severe stress (e.g., birth of sibling, starting new school, parental discord, death of a family member, bullying at school), they show their fear, sadness and/or anger via changes in behavior and mood (see symptom list above). Such distress does not resolve itself naturally, but rather must be processed in therapy, thereby freeing the child emotionally to learn more effective ways of coping.