Therapy for Adolescents and Teens

Cognitive Behavioral Therapy (CBT) is a skills-based intervention that focuses on how a person's thoughts, emotions, and behaviors impact each other. By understanding patterns and then putting skills into place to change these patterns, CBT can help people feel more in control and improve overall well-being. Techniques include a combination of cognitive strategies to reduce unhealthy thought patterns and behavioral strategies to stay calm, better regulate, and respond in healthy ways.

For younger children, Cognitive Behavioral Therapy (CBT) interventions often emphasize goals for and treatment with parents. Parents are taught how to support their child's emotional and behavioral development through positive reinforcement, specific language in interactions, modeling, and problem-solving strategies. By working together, parents and therapists can create a supportive environment that helps children develop positive habits and skills for managing their emotions.

CBT has strong evidence for anxiety disorders, mood disorders, social communication skills, and comorbid conditions.

Behavioral therapy focuses on how behaviors become reinforced in daily life and how to learn or re-learn behaviors that are developmentally appropriate. This is an EBT for individuals across the lifespan, including early childhood and adolescence. Behavioral therapy (BT) is an effective treatment for a wide range of concerns, including anxiety, depression, ADHD, and behavioral disorders. It is also helpful for children struggling with social skills, emotional regulation, or self-control.

Interpersonal Psychotherapy Therapy (IPT) is a brief and time-limited therapy focusing on how interpersonal relationships can influence an individual's mood. By improving communication skills and identifying unhelpful patterns of behavior, Interpersonal Psychotherapy Therapy (IPT) can help your child achieve more satisfying and fulfilling relationships with others.

For adolescents specifically, there is an adaptation of IPT called Interpersonal Psychotherapy for Adolescents (IPT-A). This approach has been developed to address the unique interpersonal dynamics common to teenagers. Interpersonal Psychotherapy for Adolescents (IPT-A) can help decrease depressive symptoms and improve social functioning by targeting issues common to teenagers, such as navigating friendships, conflict with parents, bullying, and peer pressure.

Parent-Child Interaction Therapy (PCIT) is an evidence-based therapy that has been shown to be effective in improving child behavior and strengthening the parent-child relationship. It is highly effective for children struggling with compliance, flexibility, transitions, turn-taking, and impulse control.

Our clinicians are highly trained in Parent-Child Interaction Therapy (PCIT) and can provide adaptations for anxiety disorders such as selective mutism and separation anxiety. We understand that every child is unique and may require individualized treatment, so we offer personalized therapy sessions to address your child's specific needs.

We offer PCIT in various formats to fit your schedule and lifestyle. Our weekly therapy sessions allow for consistent progress and support, while our abbreviated intensive programs during school breaks provide a more intensive approach. Additionally, we offer virtual services to make therapy more convenient and accessible for any adult in your child's life to participate and address behavior right in the home.

We believe that parents play a crucial role in their child's success in therapy, which is why we involve them in the treatment process from the start. During PCIT sessions, parents are coached on how to interact with their children in a positive and effective manner, improving communication and increasing compliance. Our clinicians work closely with parents to help them build strong and healthy relationships with their children.

In Internet-based Parent-Child Interaction Therapy (I-PCIT), children do a quick check-in with their parents and the therapist at the start but spend most of their session directly interacting with just their parents as they play away from the screen. During that “play-time,” they go through various scenarios with their parent to simulate real-life moments. While the child enjoys playing with their parent away from the Zoom platform, the clinician coaches the parent during their child interaction through their headphones. As challenges arise, parents are coached by the clinician who is out of the child's earshot.

This treatment is based on an in-person therapy created in the 1970s with an actual one-way mirror. Our newer form, I-PCIT, was implemented and assessed in the 2010s and uses telehealth as the “in-home one-way mirror.” Parents report feeling just as satisfied, if not more, with the virtual model. Parents are coached to navigate situations most likely to arise at home and learn how to use their actual space for managing behaviors. Furthermore, the virtual model helps children feel at ease in their comfortable environment and makes it feasible for multiple caregivers to participate in or observe sessions remotely. Our intake coordinator and clinical staff can help determine which form of treatment may be the best fit for you and your family.

Exposure and Response Prevention (ERP) is a form of behavioral therapy that is highly effective in treating anxiety and related disorders in children and adolescents. At its core, Exposure and Response (ERP) targets the fears and internal stress responses that lead to avoidance behaviors, helping children and teens develop the skills to overcome their anxieties and build confidence through graduated and systematic exposure to situations that cause distress.

This therapy is particularly helpful for children and adolescents who struggle with anxiety and OCD. Exposure and Response (ERP) is based on the idea that when we repeatedly face our fears, our brains learn that these situations are not as dangerous as we initially thought. Exposure and Response (ERP) is a collaborative and evidence-based therapy involving active participation from the child and their therapist.

During Exposure and Response (ERP) sessions, children and adolescents learn how to develop distress tolerance by gradually and systematically exposing themselves to situations they would typically avoid due to their fears. The therapist helps the child create a hierarchy of feared situations, starting with the least anxiety-provoking and gradually moving towards more difficult challenges. With time, the child becomes more comfortable and confident as they successfully confront their fears.

The "Response Prevention" part of Exposure and Response (ERP) refers to the therapist's role in helping the child resist the urge to engage in compulsive or avoidance behaviors, such as checking or seeking reassurance. By resisting these urges, the child learns that they can tolerate the anxiety and uncertainty that comes with confronting their fears and become better equipped to handle future challenges.

Habit Reversal (HR) is a multi-component behavioral therapy that targets intrusive or bothersome repetitive behaviors through strategies tailored to your child's unique needs and challenges. Habit Reversal (HR) aims to increase your child's awareness of their behaviors, teach them alternative behaviors to replace the unwanted ones and help them build the motivation and skills to maintain these changes over time.

Behavioral Parent Management Training (BPMT) is a proven behavioral training intervention that can help parents and caregivers develop effective methods to improve a child's behavior and tendency to comply with directions. This evidence-based approach teaches parents and caregivers how to identify and change problem behaviors through positive reinforcement, effective communication, and other evidence-based techniques.

With Behavioral Parent Management Training (BPMT), you can learn how to:

• Set clear rules and expectations for your child's behavior

• Use positive reinforcement to encourage desired and expected behavior

• Communicate effectively with your child

• Manage challenging behaviors in a positive and effective way

Parent training is a crucial component of our therapy services at Milestones. We understand that parenting can be challenging, especially when dealing with difficult child behaviors. That's why we offer custom-tailored parent training sessions designed to meet the specific needs of your family.

Our goal-oriented approach utilizes evidence-based techniques that have been proven effective in helping parents manage challenging behaviors and improve their day-to-day home life. We work closely with you to build skills, provide strategies, and empower you to facilitate the improvement you seek in your daily life.

At Milestones, we believe effective parent training is a collaborative process between our therapists and parents. We strive to create a warm, supportive, and non-judgmental environment where you can feel comfortable sharing your concerns and asking questions. We provide parent training sessions in the office, at home, or in the community based on the referral question.

Our parent training sessions are designed to help you develop the skills you need to manage challenging behaviors and support your child's development. We teach you practical strategies that you can use in your day-to-day life to promote positive behaviors and reduce problem behaviors. We also provide you with the tools you need to communicate effectively with your child, set boundaries, and reinforce positive behaviors.

• Anxiety or worries: General feelings of unease, fear, or excessive concerns about future events or situations.

• Social anxiety: Intense fear or discomfort in social situations, often leading to avoidance of social interactions.

• Separation anxiety: Excessive distress or fear when separated from attachment figures, such as parents or caregivers.

• OCD (Obsessive-Compulsive Disorder): A mental health condition characterized by recurrent, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to alleviate anxiety.

• ADHD (Attention-Deficit/Hyperactivity Disorder): A neurodevelopmental disorder characterized by difficulties with attention, impulsivity, and/or hyperactivity.

• Self-regulation skills: The ability to manage one's emotions, behavior, and reactions to various situations effectively.

• Executive functioning challenges: Difficulties with cognitive processes such as planning, organization, problem-solving, and time management.

• Combined anxiety and ADHD or EF challenges: Co-occurring conditions involving both anxiety and ADHD or executive functioning challenges.

• Mood concerns: Emotional difficulties that may include mood swings, depression, or irritability.

• Autism: A developmental disorder characterized by challenges in social interaction, communication, and repetitive behaviors.

• Social skills: A set of interpersonal communication skills and behaviors that enable age typical and effective interaction with others.

• Social stress: Stressors related to social interactions and relationships.

• Confidence: A belief in one's abilities and self-assurance in various situations.

• Academic struggles and stress: Difficulties with school-related tasks and the associated stress.

• Family strife: Conflict and discord within a family.

• Divorce: The legal dissolution of a marriage.

• Parent-child relationship: The bond and interaction between a parent and their child.

• Life transitions: Significant changes in a person's life, such as moving, changing schools, or starting a new job.

• Learning of a diagnosis: The process of being informed about a psychological diagnosis, learning disability, or mental health condition.

• Change of school placement: Transitioning from one educational setting to another, such as changing schools or classrooms.

• Neurodiversity: The range of differences in how people’s brains work. This term is often applied to children, teens and adults who learn or process information differently than what is expected for their age.

There are different types of Evidence-based treatments provided by clinicians at Milestones. These are:

• Cognitive Behavioral Therapy (CBT)

CBT is a widely used therapeutic approach that focuses on identifying and changing negative thought patterns and behaviors to promote emotional well-being and address various mental health issues.

• Behavioral Therapy (BT)

Behavioral therapy is a type of psychological treatment that concentrates on modifying and changing specific behaviors, often through techniques like reinforcement, conditioning, and behavior analysis.

• Interpersonal Psychotherapy & Interpersonal Psychotherapy for Adolescents (IPT & IPT-A)

IPT is a time-limited psychotherapy approach that emphasizes the improvement of interpersonal relationships to alleviate psychological distress. IPT-A is a version tailored specifically for adolescents.

• Parent-Child Interaction Therapy (PCIT)

PCIT is a therapeutic approach designed to improve the parent-child relationship by teaching parents effective communication and behavior management skills.

• Internet-based Parent-Child Interaction Therapy (I-PCIT)

I-PCIT is an online adaptation of PCIT that provides parents with training and guidance in improving their interactions with their children via the Internet.

• Exposure & Response Prevention (ERP)

ERP is a type of cognitive-behavioral therapy that treats anxiety disorders, particularly obsessive-compulsive disorder (OCD). It involves exposing individuals to their fears or obsessions and helping them to increase stress tolerance while preventing the usual compulsive responses.

• Habit Reversal (HR)

Habit reversal is a behavioral therapy technique used to address repetitive, unwanted behaviors (tics, habits, etc.). It involves identifying triggers and replacing the unwanted behavior with a more constructive response.

• Behavioral Parent Management Training (BPMT)

BPMT is a type of therapy that helps parents develop effective strategies for managing their child's behavior and fostering positive parent-child relationships.

• Parent Training

Our parent training sessions are designed to help you develop the skills you need to manage challenging behaviors and support your child's development. We teach you practical strategies that you can use in your day-to-day life to promote positive behaviors and reduce problem behaviors. We also provide you with the tools you need to communicate effectively with your child, set boundaries, and reinforce positive behaviors.

We speak with families every day about when and what type of therapy may be most helpful for you and your child. We invite you to set up a free 15 minute consultation call to help answer this for you.

We typically start with our diagnostic evaluation process which includes a parent-only 90 mins intake, then a 45 mins parent-child observation/intake, and finally a 60 parent-only feedback session.

The length of treatment can vary due to a number of factors. Generally, weekly parent-child sessions take an average of about 4 months. We never want to keep kids or families in treatment for longer than is needed. For that reason, we will make sure your child is responding positively to treatment while always bearing in mind their graduation criteria for treatment. We want to set you and your child up for a positive experience with therapy as needed. Even after graduating from treatment, we are always here for our families to return to and consult with as needed.

Milestones does not work with insurance. We are an out-of-network practice and can provide superbills that you can submit for your out-of-network benefits.

We are a group of social workers, psychologists and neuropsychologists. We are not psychiatrists so we are not able to prescribe medication. However, we work closely with a number of psychiatrists and pediatricians who are trained to prescribe medication. Every family is different. For some children, depending on the presenting concern and what makes the most sense for a child and family, behavioral intervention alone is most effective, some benefit from a combination of medication and behavioral treatment. From our experience in this field, we are here to work with you collaboratively, track behavioral progress through our cognitive and behavioral interventions, and help you navigate those decisions.