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DECEMBER 2006 ■ EDUCATION UPDATE ■ Special <strong>Education</strong>19FROM THE NYU CHILD STUDY CENTER: ASK THE EXPERTWhat is the Best Treatment for MyChild’s Psychiatric Disorder?By Glenn S. Hirsch, M.D.The Churchill School301 E. 29th St., NYC 10016(212) 722-0610 www.churchillschool.comDespite advances, there are still many psychiatricdisorders in which the symptoms are perplexing,the progression of the illness is confusing,and the treatments are less than satisfactory. Atdifferent points throughout the year, I will behighlighting focused, effective, well-researched,and tested treatments for various disorders, startingwith Dialectical Behavioral Therapy (DBT).DBT is a specialized cognitive behavioraltherapy used with adolescents and adults whoexhibit the following symptoms: an unusuallyhigh number of mood changes, suicidal thoughtsand/or attempts, difficulty managing anger, chaoticrelationships, impulsive actions, and selfinjuriousbehavior (such as self-cutting). In ourcurrent nomenclature, psychiatrists often use theterm Borderline Personality Disorder (BPD) tosignify this constellation of symptoms. Whileboth males and females can exhibit characteristicsof BPD, the majority of teens who have BPDare female.DBT is a research-supported therapy that isbased on a two-part theory. First, individuals whoexperience characteristics of BPD are particularlysensitive and emotionally vulnerable to eventsthat occur in their lives. Second, these individualsmay feel that the people in their lives (suchas teachers, parents, and friends) misunderstandthem and don’t allow them to express certainemotions. When a teen feels that it is not acceptableto express certain emotions, and experiencesthe world with heightened sensitivity, s/he mayexhibit BPD behaviors as a way of regulatinghis/her own emotions.DBT itself consists of several elements thatinclude a weekly individual therapy session, aweekly skills training group, and phone consultationswhen the teen is in crisis. The individualsessions focus on the teen’s behaviors, such asself-injury, and address suicidal thoughts andchanges in mood. As a part of these sessionseach week the teen is expected to complete adiary card, which monitors these behaviors.These cards are meant to identify the triggers andconsequences of a particular behavior, and arethen used as a basis to replace the dysfunctionalbehavior with healthier skills and, by extension,more constructive behavior. The groupsessions are designed to teach skills that help theteen develop practical coping strategies, such asimproving interpersonal communication, buildingtolerance of emotional distress, managingemotions more effectively, and employing strategiesto help the teens become more aware of thechanges in their moods.DBT is a highly effective program for teens withBPD characteristics as compared with conventionaltherapeutic methods. Since the symptomsof these youngsters are often also found in individualswho meet criteria for Bipolar Disorder,DBT is starting to be investigated as a treatmentfor this condition as well. Because these teensoften experience a sense of chaos and instabilityin their lives due to an elevated number of moodchanges, conventional therapy that consists onlyof individual therapy sessions tends to address the“crisis of the week” rather than helping the teento learn valuable behavior management skills.DBT is successful because it combines a traininggroup that teaches essential coping strategies thatthe teen can use to regulate his/her emotions moreeffectively with individual sessions structuredto treat and prevent life-threatening behavior.This monthly column provides educators, parentsand families with important informationabout child and adolescent mental health issues.Please submit questions for ASK THE EXPERTto Glenn S. Hirsch, M.D., Medical Director atthe NYU Child Study Center at glenn.hirsch@med.nyu.edu. To subscribe to the ASK THEEXPERT Newsletter or for more informationabout the NYU Child Study Center, visit www.AboutOurKids.org or call 212-263-6622.<strong>Education</strong> <strong>Update</strong>’s Special Ed Conference Coming in April 2007.Email us for details: ednews1@aol.comThe Churchill School is a K-12 school of approximately 400 students that educates children withlearning disabilities in a full day program that gives these students full access to a general educationcurriculum. Students acquire the essential academic and social skills expected of all elementary,middle and high school students in New York State. Students learn how to learn, to find strategiesthat fit their learning styles and to set realistic personal, social and academic goals.Building on the knowledge and expertise of The Churchill School, The Churchill Center offerseducational programs and professional development in the field of learning disabilities to students,parents, teachers of general and special education, and related services providers. Its purpose is todisseminate the knowledge, skills, proven strategies and techniques learned in operating a schoolfor children with learning disabilities and to bring to The Churchill School and Center research andexpertise from the outside community to enrich its knowledge base.The Churchill Center program for Enhancing Social Skills Development is an example of a programopen to the public. The goal of the program is to help children learn how to effectively interact withtheir peers and handle social situations. The Social Skills program, led by Churchill psychologistsand social workers, places students ages 5–14 in groups based on their ages, interests and needs.Each group session runs 45 minutes, and the program lasts for ten weeks. If you are interested inenrolling your child in the Enhancing Social Skills Development program, please call Jane Gertler,(212)722-0610, ext. 2111.The Churchill School and CenterThe 1301 East 29th Street, New York, NY 10016ENHANCING SOCIAL SKILLS DEVELOPMENTSPRING/FALL 2007• Children learn how to effectively interact with peers and handle social situations• Boys and girls ages 5-14 in small groups based on age, interests, and skill-based needs• Offered by The Churchill School psychologists and social workers• Program includes two private meetings to discuss child’s progress and one parent workshop• Ten-week program, Mondays or Wednesdays 4:15 - 5:00 PM beginning in March 2007Call Jane Gertler, (212) 722-0610 ext. 2111www.churchillschool.comNeuropsychological, learNiNg Disability aNDatteNtioN Deficit DisorDer evaluatioNs aND treatmeNtExtended time evaluations, Cognitive Remediation,Neurofeedback, Tutoring, PsychotherapyChildren, Adolescents, AdultsJ. Lawrence Thomas, Ph.D. DirectorFaculty, NYU Medical CenterInternational Dyslexia Association, Board of Directors19 West 34th st., peNthouse, NeW york, Ny 10001 • 212.268.8900Nurosvcs@aol.com • WWW.thebraiNcliNic.comNYU CHILDSTUDY CENTERDOES YOUR CHILDWORRY TOO MUCH?Does your child get nervousabout going to school?Is your child tooconcerned aboutwhat others think?Is your child too shyto make friends?Does your child’s anxietyinterfere with participating inactivities or pursuing goals?Free anxiety evaluations are availablefor kids ages 8-17 as part of a study ofdecision-making in youth.Participation is voluntary and compensation is provided.For further information, please contactKristin Gotimer at 212 263 0661.NYU Child Study Center • 215 Lexington Avenue • New York, NY 10016 • 212 263 6622 • www.AboutOurKids.org

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