Pre/Adolescent therapy
Some signs your teen or tween might need support...
Opening disclaimer: This section was written for parents, since parents are likely the ones reaching out for support for their tween or teen. If you happen to be a tween or teen reading this, I invite you to read through my list below to determine if some of the below descriptors resonate with you. If so and you need support, please reach out to a parent or trusted adult to get yourself the support you need.
If you notice that your tween or teen's mood and behaviors have deteriorated since hitting puberty or frankly, since they entered the lion's pit also known as middle school, and things just continue to devolve, keep reading. Let's start with what you might be noticing, which may or may not indicate a problem that needs to be addressed in therapy:
- increased isolation or withdrawal at home
- appetite or changes in sleeping habits
- increased irritability
- declining academic performance
- school avoidance or refusal
- appearing sad, gloomy, angry, tearful more often than not for at least two weeks
- declining motivation or energy
- spending an inordinate time on electronics and if you try to limit their screen time, you are met with any combination of negative responses
- lack of interest or enthusiasm towards activities that historically made them happy
- preoccupation with peers who are also in the same cycle of existential turmoil
- withdrawal from social activities, especially unstructured ones
- making a lot of self-deprecating or judgmental statements about others
- has been a victim of bullying or has been accused of bullying others
- discovering or hearing them say that life is not worth living or they wish they were not alive
- Noticing your child is wearing clothing that covers their arms AND is inappropriate for the weather. Now this may be just your child wanting to wear their favorite outfit in spite of the weather, but it could also suggests they're hiding their body, which could indicate body dysphoria or self-harm
A common question I hear from parents is whether their child's erratic mood and behaviors are related to 'normal' coming-of-age stressors, or if there's a mental health disorder happening that is bound to worsen if they don't get treatment. My question to parents is then: "what was your experience as a tween and teen?" Nothing really feels 'normal' when you hit this stage of life; it can be a very cruel time to be alive. Some roll through this time relatively unscathed, some crash and burn and need strong support to help them make it to adulthood. A lot of people fall along the spectrum of these polarities. One thing that is constant however is the sheer amount of internal factors and external stressors seemingly inherent during this stage of development that makes it a chaotic, turbulent time. If you haven't already, ask your tween or teen. If they need support, believe them. If they say they don't but you are still very concerned, it is better to have your child evaluated by a mental health professional to be sure. Consider asking them to complete the questionnaires below while you complete one for them based on your observations. This might help you know whether it's time for your tween or teen to be evaluated further:
PhQ-9 (Depression)
https://www.apa.org/depression-guideline/patient-health-questionnaire.pdfPhQ-9
Total scores of 5, 10, 15, and 20 represent cutoff points for mild, moderate, moderately severe and severe depression, respectively. If your teen scored higher than a '0' on question 9, immediate support is likely warranted.
GAD-7 (Anxiety)
https://adaa.org/sites/default/files/GAD-7_Anxiety-updated_0.pdf
score cutoff points listed on link above
Parents, you are not alone with this. There is support to help you and your child get through this tough time. Think about what you want for them and how you want them to feel, while also suspending any beliefs that your hopes for them are aligned with who they are and their deepest needs. While you have the wisdom of age and experience, they are the only ones who look out at the world from their eyes, and as they get older, they will need more space to stretch their wings, while you remain at the ready to provide a soft landing when they get stuck.
With time and support, your tween or teen will learn to better cope with their emotions and the stressors that come their way, they will learn to be more confident in who they are and what they stand for, they will find their motivation and passion to pursue the interests they used to enjoy, be more able to tolerate stress, interact with others in a more authentic way, and feel more confident in their future.
Types of services
Individual and Family Therapy
Dr Caruso-Maxey provides individual therapy services for preadolescents, adolescents, and adults. As appropriate, she may also provide family therapy to help improve relationship dynamics impacting her clients. Dr Caruso-Maxey offers consultation as needed with schools and other providers for care coordination. Many of the issues that arise in families are related to intergenerational attachment traumas that are passed through generations. Dr Caruso-Maxey also offers support to couples experiencing challenges within their relationship related to unhealthy attachment patterns often inherent in intimate relationships.
Individual Therapy:
Initial Intake Evaluation 60 minutes $275
Individual Therapy (per session rate) 50 minute therapy hour $250
Family Therapy (per session rate) 50 minute therapy hour $275
EMDR Therapy (per session rate) 90 minutes $350
Family Therapy:
Initial Intake Evaluation 90 minutes $350
Couple's Therapy (per session rate) 90 minutes $350
Couples Therapy:
Initial Intake Evaluation 90 minutes $350
Couple's Therapy (per session rate) 90 minutes $350
Group Therapy
Currently Offering: Middle School Social Anxiety Group
High School Social Anxiety Group
Eye-Movement Desensitization and Reprocessing Therapy (EMDR)
Dr Caruso-Maxey is certified in EMDR therapy, which is an evidence-based therapy built upon cognitive-behavioral therapy combined with bilateral eye stimulation to help aid in processing of trauma.
Modalities
I use various evidence-based therapies appropriate to conditions treated/managed and patient characteristics. Therapies include:
- Cognitive Behavioral Therapy
- Mindfulness-Based Cognitive Behavioral Therapy
- Trauma-Focused Cognitive Behavioral Therapy
- Acceptance and Commitment Therapy
- Exposure-Response Prevention
- Principles of Dialectical Behavioral Therapy
- Psychodynamic Therapy
- Emotion-Focused Therapy
- EMDR Therapy
Payment and Insurance
Dr Caruso-Maxey accepts Lyra, Modern Health, and Aetna insurance, as well as clients who are our of network. For clients out of network, payment is processed in full after each session. If requested, a monthly superbill can be provided to submit to your insurance provider for reimbursement; please note that anything not covered by your insurance is considered an out-of-pocket expense.
Accepted Forms of Payment:
-Visa, Mastercard, Discover, American Express, and other forms of payment via Stripe
-check
Protecting Your Private Health Information
The Health Insurance Portability and Accountability Act, (HIPAA) was issued by the Department of Health and Human Services to establish a set of national standards for the privacy protection of certain health information. All of your health information is documented and stored through a HIPAA-compliant, data encrypted client portal. All information related to your credit card is encrypted once you enter it into the client portal. If you would like to know more about Dr Caruso-Maxey's privacy practices, please ask.