Dr. Lauren Ashley Shapiro

Excessive need for sleep is a symptom of depression as well as a possible side-effect of several psychotropic medications. Speak with the physician who prescribed your medication about the symptoms and side-effects you are experiencing. It may be as simple as adjusting your dose or switching you to a different medication altogether.

I call it "relentless thought torture" but it's formally referred to as 'rumination'.

A skilled therapist should be capable of helping you process the thoughts rooted in unresolved issues and also give you a proactive approach using established therapeutic techniques and strategies.

100% of every client that has ever reported to me that they were experiencing chest pain or tightness or pressure in the chest region in conjunction with their anxiety or panic attacks (or description of their experience with anxiety and/or panic disorder) has ever received a diagnosis more severe then anxiety. Nevertheless, I always advise my clients to be their own advocates, and speak up, especially with regards to medical treatment/care with their providers. I believe that as a [responsible] mental health provider, I have the ethical obligation and moral duty to encourage my clients to bring up any concerning or unexplainable symptoms they experience with their primary treatment providers / general practitioners to rule out serious issues or prevent any condition from worsening.

Based on my clients' experiences and treatment outcomes, I would say that it is fair to assert that anxiety and panic attacks respond incredibly well to psychotherapy. In fact, I can confidently state that I regularly treat clients who suffer from anxiety or panic attacks in fewer than four to six sessions. By equipping clients with essential information about the underlying principles and by showing clients how to implement coping skills and strategies designed to quickly and efficiently prevent, deescalate, and eliminate their anxiety or panic attacks, clients can quickly learn how to independently manage their anxiety and panic attacks.

I'd carefully consider the contingencies that reinforce and discouraged his behaviors, both at home and in school. I'd also encourage you to speak to his teachers about their general assessment of your son and to inquire about whether the teacher believes the behavior that you describe or observe at home is consistent with their observations of his in-class behavior and considered typical of other kids his age.

Based on the minor details provided, I would recommend attending parental consultation for assistance in integrating/understanding your son's treatment plan, especially one that includes "differential reinforcement", which is the most effective and appropriate method for addressing this type of behavior.

A refresher session or booster session might be all you need. However, I'd consider why they have suddenly reoccurred (and re-apply techniques and strategies you previously learned) rather than conclude that your therapeutic progress has come undone. If you've forgotten what to do or no technique or strategy seems to work, I would recommend you consider getting professional help once again.

This largely depends on how you define 'lead' in your question.

Most therapists lead sessions and allow their clients to lead sessions to varying degrees. Clients who experience anxiety or need to practice assertiveness or who struggle to make themselves noticeable might benefit from taking the lead within the safe, accepting, and comfortable context of therapy where the therapist can provide constructive feedback and observe the outcome of non-risky trial-and-error practice.

This is a very common fear and any experienced therapist will likely have had several clients who initiated treatment exactly as you described. I know I certainly have!

And in each instance, it was my responsibility, as a therapist, to establish my clients' trust and help them overcome their reluctance and resistance. It made working with these clients that much more fulfilling for me and strengthened the effectiveness of therapy for the client.

Check with your insurance provider about your health insurance policy's mental health coverage. Note that mental health is often labeled Behavioral Health for insurance purposes and covers therapy services.

I believe there are two distinct reasons people seek out therapy - to treat their mental health symptoms or personal/developmental growth.

By personal/developmental growth, I am describing the type of therapy that clients view as a safe place to vent, get outside perspective, and just check in with a neutral 3rd party while working on the more major themes in their lives. Self-actualization or self-exploration is often the goal of this type of unstructured therapy and usually lasts many sessions (often years) at varying frequencies (weekly to monthly to sporadic bursts of attendance after short breaks from sessions).

On the other hand, the goal is diagnosing and treating mental health symptoms, which usually occur over a set period of time that is determined by the insurance or managed healthcare company paying/authorizing services. This type of therapy tends to be briefer and more focused, particularly because clients want to experience relief from their symptoms as quickly as possible. Between Insurance needing to approve authorized number of sessions and research conducted on various disorders, we have been able to establish timelines and standards for the number of therapy sessions a typical client is likely to need to alleviate their symptoms.

So, in short, most likely yes, but it depends on the client, their goals, and who's paying for treatment.

I definitely agree that most children simply do not grasp what their parents are concerned about when asking for an update on their therapeutic progress.

This question is hard to answer as it really depends on
A) state law (for example, CA gives psychologists the authority to determine whether it is in the child's best interest or would not harm the child to disclose confidential information to their parents that was obtained in session and also gives some preteens and teenagers the right to make decisions about their confidential medical or mental health records/information files under certain circumstances.
B) why or under what circumstances am I meeting the child for treatment can be vital information if it sets the context and content of our sessions together. If 1 parent is favored or elicits sympathy over the other parent during a custodial rights hearing.
C) management of parental expectations relative to their child's understanding of confidentiality and the child's wishes with regards to their confidential information being shared. For example, I would find out what the parents are expecting, demanding, or insisting on knowing about their child's session content and progress as well as assessing whether the child understands the implications of disclosing their confidential information or that they are displaying rational, age-appropriate, or developmentally-congruent behavior that does not warrant parental concern or involvement.

In other words, I handle this on a case to case basis but always prefer that parents trust my judgment to inform them about things they absolutely need to know, whether law enforcement or other agency intervention is needed or may become involved, and if there are easy, simple, or largely. inconsequential adjustments they can make to better support their child or improve their lives overall. I believe in transparency and being straight forward and honest with clients, which begins with a sincere effort at advocating on their behalf, especially regarding maintaining confidentiality.

Where at all possible, give your child and your child's therapist the benefit of the doubt.

Most psychiatrists are far too overbooked and too expensive to provide traditional talk therapy on a consistent basis. The key difference between a psychologist and psychiatrist is the ability to prescribe medications (and they hold different degree types). A psychologist is a better bet for that very reason; however, a well-versed licensed clinical social worker, licensed marriage and family therapist, or licensed professional counselor who is familiar with the issues you want addressed may suffice.

I would say that, in more cases than not, this will actually work against its very intention by pathologizing your daughter's ordinary behavior/routines and ultimately leading her to internalize your misrepresentations of her self-image, -worth, and -confidence. To the contrary, I usually recommend that parents attend therapy themselves in lieu of their teens to develop strategies for opening up the lines of communication with their teenagers.