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Dr. David Callies, Child & Adolescent Psychologist
 

Welcome to Gyro Psychology Services!

We provide psychological testing, assessment and treatment services to children, adolescents, young adults and families with a wide variety of mental health and behavioral needs. Gyro Psychology Services is committed to providing effective and compassionate psychological care that is grounded on sound research, practice and discipline.

We’ll collaborate with professionals who are involved in your child’s health care and education so that your child can reach their full potential in all areas of their lives.

Join us! We would be honored to be your partner in the behavioral healthcare of your child, adolescent and your family.

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Improving your Child’s Self-Control

Improving your Child’s Self-Control

It can be frustrating and embarrassing when your child has a temper tantrum while shopping in a crow[...]

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GYRO’S DAILY WELLNESS TIP

Keys to Helping Socially Anxious Teenagers

It comes as a surprise to many parents and educators that anxiety is the most prevalent mental health problem in children. According to the US Surgeon General's report on mental health, 13% of children and adolescents suffer from anxiety disorders, which is 1 in 8 children aged 9 to 17. Social anxiety is the most common anxiety disorder in teenagers, and is associated with significant impairment in functioning and long-term negative outcomes such as depression and alcohol use. Unfortunately, many teenagers' social anxiety goes undetected and without appropriate treatment. Therefore, being able to identify the warning signs in youngsters is important to early detection and intervention efforts.

A typical case of a teenager with social anxiety disorder

Sean is a quiet 17-year-old who is easily "lost in the crowd." His grades are above average in school and he is compliant and well-behaved in class. He keeps to himself and does not speak to many peers. He has one or two friends he made in first grade. Sean avoids being around his peers and seems to be intensely uncomfortable in situations where there are large numbers of students, such as in the cafeteria or gym class. He has not joined any school clubs and goes home immediately after school. The teacher has encouraged him to speak up but he withdraws more or becomes angry.

Common symptoms of social anxiety disorder

~Intense fear of social and performance situations

~Avoids social situations or endures them with intense distress

~Fears situations such as unstructured interactions with peers, initiating conversations, performing in front of others, inviting others to get together, talking on the telephone, and eating in front of others

~Minimal interaction and conversation with peers

~Appears isolated and on the fringes of the group

~May sit alone in the library or cafeteria, or hang back

~Excessive shyness

~Concern about negative evaluation, humiliation or embarrassment

~Difficulty with public speaking, reading aloud, being called on in class, gym class

~Anticipation of a social event may provoke a panic attack

What treatment approach is most effective for social anxiety disorder?

The scientific literature supports the use of Cognitive Behavior Therapy (CBT) for treating social anxiety disorder. CBT uses practical and logical strategies directed at changing the factors that maintain anxiety such as negative thoughts or expectations, physical symptoms, avoidance, and the reactions and responses of adults to an anxious child. Children learn to think more realistically about fears and to confront the feared social situations. Training in social skills such as initiating conversations, inviting others to get together, and being assertive are also incorporated into treatment.

How can parents help to manage social anxiety in their children?

Reward Brave, Nonanxious Behavior:
Provide praise and attention and small rewards.

Prevent Avoidance:
Refuse to engage in your child's behaviors that allow him/her to avoid the situations s/he fears. For example, refrain from ordering your child's food, speaking for your child in stores, making phone calls for your child, or taking care of other things that your child is avoiding due to social anxiety. Gradually encourage your child to handle social tasks on his/her own to foster more independence and confidence.

Prompt Your Child to Cope Constructively:
Encourage your child to come up with his/her own solutions, Help your child to brainstorm ways to handle the anxiety and to independently decide how to cope more constructively. Prompt your child to use the cognitive and behavioral skills being learned in treatment.

Limit Reassurance:
Anxious children will constantly ask for reassurance that things will turn out okay or that they will be alright. This prevents them from learning how to cope with anxiety on their own and maintains the belief that they are unable to do so.

Help Your Child to Use a Problem Solving Approach:

o Summarize what your child has said,

o Help your child brainstorm possible ways in which the anxiety may be reduced,

o Make sure not to take over the task for your child or tell him/her what to do,

o Go through each idea that the child has generated and ask questions such as, "What do you think would happen if you did this? Do you think that would help to reduce your anxiety in the long-run? What would be the worst that would happen? What is the likelihood that it would happen?"

o Praise your child for discussing possible solutions and outcomes,

o Prompt your child to select the strategy that allows him/her to approach feared situations rather than avoid them and is most likely to have a positive outcome.

Courtesy of the Child Study Center, NYU
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12 hours ago  ·  

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GYRO’S DAILY WELLNESS TIP

Why Teenagers Act Crazy

Adolescence is practically synonymous in our culture with risk taking, emotional drama and all forms of outlandish behavior. Until very recently, the widely accepted explanation for adolescent angst has been psychological. Developmentally, teenagers face a number of social and emotional challenges, like starting to separate from their parents, getting accepted into a peer group and figuring out who they really are. It doesn’t take a psychoanalyst to realize that these are anxiety-provoking transitions.

But there is a darker side to adolescence that, until now, was poorly understood: a surge during teenage years in anxiety and fearfulness. Largely because of a quirk of brain development, adolescents, on average, experience more anxiety and fear and have a harder time learning how not to be afraid than either children or adults.

Different regions and circuits of the brain mature at very different rates. It turns out that the brain circuit for processing fear — the amygdala — is precocious and develops way ahead of the prefrontal cortex, the seat of reasoning and executive control. This means that adolescents have a brain that is wired with an enhanced capacity for fear and anxiety, but is relatively underdeveloped when it comes to calm reasoning.

You may wonder why, if adolescents have such enhanced capacity for anxiety, they are such novelty seekers and risk takers. It would seem that the two traits are at odds. The answer, in part, is that the brain’s reward center, just like its fear circuit, matures earlier than the prefrontal cortex. That reward center drives much of teenagers’ risky behavior. This behavioral paradox also helps explain why adolescents are particularly prone to injury and trauma. The top three killers of teenagers are accidents, homicide and suicide.

The brain-development lag has huge implications for how we think about anxiety and how we treat it. It suggests that anxious adolescents may not be very responsive to psychotherapy that attempts to teach them to be unafraid, like cognitive behavior therapy.

Of course, most adolescents do not develop anxiety disorders, but acquire the skill to modulate their fear as their prefrontal cortex matures in young adulthood, at around age 25. But up to 20 percent of adolescents in the United States experience a diagnosable anxiety disorder, like generalized anxiety or panic attacks, probably resulting from a mix of genetic factors and environmental influences. The prevalence of anxiety disorders and risky behavior (both of which reflect this developmental disjunction in the brain) have been relatively steady, which suggests to me that the biological contribution is very significant.

Of course, we all experience anxiety. Among other things, it’s a normal emotional response to threatening situations. The hallmark of an anxiety disorder is the persistence of anxiety that causes intense distress and interferes with functioning even in safe settings, long after any threat has receded.

We’ve recently learned that adolescents show heightened fear responses and have difficulty learning how not to be afraid. In one study using brain M.R.I., researchers at Weill Cornell Medical College and Stanford University found that when adolescents were shown fearful faces, they had exaggerated responses in the amygdala compared with children and adults.

The amygdala is a region buried deep beneath the cortex that is critical in evaluating and responding to fear. It sends and receives connections to our prefrontal cortex alerting us to danger even before we have had time to really think about it. Think of that split-second adrenaline surge when you see what appears to be a snake out on a hike in the woods. That instantaneous fear is your amygdala in action. Then you circle back, take another look and this time your prefrontal cortex tells you it was just a harmless stick.

Thus, the fear circuit is a two-way street. While we have limited control over the fear alarm from our amygdala, our prefrontal cortex can effectively exert top-down control, giving us the ability to more accurately assess the risk in our environment. Because the prefrontal cortex is one of the last brain regions to mature, adolescents have far less ability to modulate emotions.

Fear learning lies at the heart of anxiety and anxiety disorders. This primitive form of learning allows us to form associations between events and specific cues and environments that may predict danger. Way back on the savanna, for example, we would have learned that the rustle in the grass or the sudden flight of birds might signal a predator — and taken the cue and run to safety. Without the ability to identify such danger signals, we would have been lunch long ago.

But once previously threatening cues or situations become safe, we have to be able to re-evaluate them and suppress our learned fear associations. People with anxiety disorders have trouble doing this and experience persistent fear in the absence of threat — better known as anxiety.

Courtesy of The New York Times & Richard Friedman
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3 days ago  ·  

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GYRO’S DAILY WELLNESS TIP

8 Tips for Parents of Teens with Depression

The teenage years are notoriously turbulent. Adolescents are establishing their own identities, doing more things independently, trying out different roles, taking more risks socially, and possibly experimenting with drugs and alcohol, and all this can come with emotional costs.

So it can be complicated to tell the difference between the typical turmoil of a teenager, and a depressed teen.

It's difficult for parents to recognize depression in teens, since kids in this age group can have more emotional highs and lows, and they also tend to isolate themselves more," said Dr. Gene Beresin, executive director of the Clay Center for Young Healthy Minds at Massachusetts General Hospital in Boston.

But depression can take a toll on teens. It typically first strikes in late adolescence, some time between ages 15 and 19, Beresin said.
In early adolescence, boys and girls are equally affected by depression.

But after puberty, girls are about twice as likely as boys to become depressed, and this ratio persists into adulthood, according to Beresin.

Exactly why is unclear, he said, but it's likely a combination of genetic vulnerability as well as hormonal and socialization factors, including that girls tend to be more sensitive to changes in relationships, and also more prone to anxiety.

The good news for mom and dad is that "a secure, warm, loving relationship with a parent can be a protective factor against depression, especially for girls," Beresin said.

Here are his eight tips for parents whose teens may be depressed.
Observe changes in your kids. Tune in to behavioral clues that can reveal how teens are feeling. A teen may shut down, or suddenly have a major personality change, such as becoming quieter or sadder. "Even more common than being sad is a teen becoming more irritable," Beresin said.

Other signs include teens who seem more spaced out and can't seem to focus, less interested in usual activities, or may be using substances to self-medicate. "If you see these changes in multiple areas of a kid's life, that's raising a red flag," Beresin said.

Notice patterns.
If you see a major change in your teen's patterns, to the point where your child almost seems like a different person and it cuts across different situations, meaning it's happening at home, at school and with friends, then you have to worry, Beresin said.

Get outside information.
Find out from other people who know your teen — coaches, teachers, friends and parents of friends — whether your teen seems different around them, Beresin said. Teens might feel ashamed and may not want to burden their family, so they may reveal more to someone else they trust than to their parents.

In addition, consider whether a major life stressor — if a family member or someone close has died, gotten sick, lost a job or is going through a divorce — could be triggering the behavior changes. "Think about what could be going on in your teen's life that might upset the apple cart," Beresin said.

Talk with your kids.
Have regular conversations with teens and younger children about what they are doing and how they are feeling. Be sure to ask probing questions but avoid grilling teens. Have these conversations when the two of you are driving in a car, preparing dinner or watching TV. Let teens talk and listen to their responses, and make sure they feel heard and understood.

Open a door.
Share an observation you've made with your teen, perhaps by saying "I've noticed that you're not sleeping as well" or "I've noticed that you're not going out with your friends as much and you're isolating yourself in your room." Then offer up, "If you'd like to talk about it," or possibly tell a story from your teenage years.

Don't give up if teens shut you out initially, because it may be difficult for them to open up about their feelings, or they may be embarrassed to share them.

Discuss seeking professional help.
If your teen begins talking about depression, acknowledge the sadness and pain the child is experiencing, so your teen knows you're taking his feelings seriously. If a teen shuts down, suggest that you understand he may not feel comfortable talking with you, but you would like for him to talk to a health professional because you care about him.

Parents can expect resistance to this idea, Beresin said.

Parents should also make sure they have their own support systems in place to be able to tolerate a depressed teen's anger or rejection, Beresin added.

Don't be afraid to ask about suicidal thoughts.
"It's very important for parents to bring this topic up, and it won't precipitate a suicidal act," Beresin said. If your teen is talking about suicide, hurting themselves, or being better off dead, take it seriously and get help immediately, he said.

Take a stance.
If your teen's depression seems severe, or the teen appears to have a serious substance abuse problem or has made a suicide gesture, it's the role of the parent to take a stance, Beresin said. Insist the child see a mental health professional, and make the appointment.

Beresin has seen no shortage of young people who came to his office "kicking and screaming," who were extremely angry or upset with their parents for seeking help. But once they got there, he's found "most kids want to talk when given the opportunity."

Courtesy of LiveScience & Cari Nierenberg
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7 days ago  ·  

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GYRO’S DAILY WELLNESS TIP

Helping Kids Conquer Worry

Find out what's on their minds:
Be available and take an interest in what's happening at school, on the team, and with your kids' friends. Take casual opportunities to ask how it's going. As you listen to stories of the day's events, be sure to ask about what your kids think and feel about what happened.

If your child seems to be worried about something, ask about it. Encourage kids to put what's bothering them into words. Ask for key details and listen attentively. Sometimes just sharing the story with you can help lighten their load.

Show you care and understand.
Being interested in your child's concerns shows they're important to you, too, and helps kids feel supported and understood. Reassuring comments can help — but usually only after you've heard your child out. Say that you understand your child's feelings and the problem.

Guide kids to solutions.
You can help reduce worries by helping kids learn to deal constructively with challenging situations. When your child tells you about a problem, offer to help come up with a solution together. If your son is worried about an upcoming math test, for example, offering to help him study will lessen his concern about it.

In most situations, resist the urge to jump in and fix a problem for your child — instead, think it through and come up with possible solutions together. Problem-solve with kids, rather than for them. By taking an active role, kids learn how to tackle a problem independently.

Keep things in perspective.
Without minimizing a child's feelings, point out that many problems are temporary and solvable, and that there will be better days and other opportunities to try again. Teaching kids to keep problems in perspective can lessen their worry and help build strength, resilience, and the optimism to try again. Remind your kids that whatever happens, things will be OK.

So, for example, if your son is worried about whether he'll get the lead in the school play, remind him that there's a play every season — if he doesn't get the part he wants this time, he'll have other opportunities. Acknowledge how important this is to him and let him know that regardless of the outcome, you're proud that he tried out and gave it his best shot.

Make a difference.
Sometimes kids worry about big stuff — like terrorism, war, or global warming — that they hear about at school or on the news. Parents can help by discussing these issues, offering accurate information, and correcting any misconceptions kids might have. Try to reassure kids by talking about what adults are doing to tackle the problem to keep them safe.

Be aware that your own reaction to global events affects kids, too. If you express anger and stress about a world event that's beyond your control, kids are likely to react that way too. But if you express your concern by taking a proactive approach to make a positive difference, your kids will feel more optimistic and empowered to do the same.

So look for things you can do with your kids to help all of you feel like you're making a positive difference. You can't stop a war, for example, but your family can contribute to an organization that works for peace or helps kids in war-torn countries. Or your family might perform community service to give your kids the experience of volunteering.

Offer reassurance and comfort.
Sometimes when kids are worried, what they need most is a parent's reassurance and comfort. It might come in the form of a hug, some heartfelt words, or time spent together. It helps kids to know that, whatever happens, parents will be there with love and support.

Sometimes kids need parents to show them how to let go of worry rather than dwell on it. Know when it's time to move on, and help kids shift gears. Lead the way by introducing a topic that's more upbeat or an activity that will create a lighter mood.

Highlight the positive.
Ask your kids what they enjoyed about their day, and listen attentively when they tell you about what goes great for them or what they had fun doing. Give plenty of airtime to the good things that happen. Let them tell you what they think and feel about their successes, achievements, and positive experiences — and what they did to help things turn out so well.

Schedules are busy, but make sure there's time for your kids to do little things they feel good doing. Daily doses of positive emotions and experiences — like enjoyment, gratitude, love, amusement, relaxation, fun, and interest — offset stress and help kids do well.

Be a good role model.
The most powerful lessons we teach kids are the ones we demonstrate. Your response to your own worries, stress, and frustrations can go a long way toward teaching your kids how to deal with everyday challenges. If you're rattled or angry when dealing with a to-do list that's too long, your kids will learn that as the appropriate response to stress.

Instead, look on the bright side and voice optimistic thoughts about your own situations at least as often as you talk about what bothers or upsets you. Set a good example with your reactions to problems and setbacks.

Responding with optimism and confidence teaches kids that problems are temporary and tomorrow's another day. Bouncing back with a can-do attitude will help your kids do the same.

Courtesy of Kids Health & D'Arcy Lyness, PhD
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1 week ago  ·  

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GYRO’S DAILY WELLNESS TIP

How Can I Improve My Child's Eating Habits?

Balance is the most important thing when developing healthy eating habits.

Teach your daughter to eat healthy foods the majority of the time and to save fattening or sugar-filled junk foods for occasional treats. These treats should not be completely banned or else they will be even more appealing to your daughter!

Encourage healthy habits by:
~having family meals
~being a good role model yourself
~stocking up on a variety of healthy food options
~serving three meals a day, with good-for-you snacks in between
~encouraging your kids to drink water rather than sodas and juices

Give your daughter ways to boost her self-esteem, give her lots of compliments, and encourage her to talk to you if she has any concerns about her body image.

Courtesy of Kids Health & Larissa Hirsch, MD
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1 week ago  ·  

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