Treatments

Cognitive-Behavioral Therapy (CBT) is a form of psychotherapy based on the theory that thoughts, behaviors, and feelings interact and that changing our beliefs and actions can lead to changes in our emotions. In CBT, children and teens learn how to recognize and challenge unhelpful thoughts that contribute to unwanted feelings and behaviors. They also learn to recognize triggers for maladaptive behaviors and parents are taught how to increase the frequency of adaptive behaviors in their child.

CBT is one of the most researched forms of psychotherapy, and has the most research support for its efficacy. The effectiveness of CBT has been well-established for many childhood disorders, including ADHD, depressive disorders, and anxiety disorders. In fact, CBT has been shown to be as effective as medication for individuals with depression and anxiety and is superior in preventing relapse. 

CBT-E stands for Enhanced Cognitive Behavioral Therapy. It is based on a transdiagnostic view of eating disorders, which looks at the underlying and common factors of all the eating disorders we treat. Within its concept and structure lies the capacity to understand and address and array of eating disorder problems in an effective way. 

CBT-E is the leading evidenced based treatment for eating disorder care for adults. It uses the foundational elements of classical CBT and applies them to eating disorders. Focus on behavioral changes around food and body image are key components, as are the dysfunctional thoughts and beliefs that maintain eating disorders. CBT-E is collaborative and entails active participation both within and outside of the session. CBT-E is intended to be short term. While we can't guarantee the exact number of sessions, we will ensure that we hope to help in shorter time frame that CBT in general allows. Therapy can last from anywhere to 3 months or more, depending on a host of factors. 

CBT-ARFID is one of the most recent adaptations of CBT for eating disorders. Current research suggests this will be a robust treatment, as the principles and theory of treatment align well to our understanding of ARFID. 

Treatment entails gaining a comprehensive understanding of how ARFID developed, how it is maintained, and what categories are triggered (e.g. sensory, fear of something bad happening, displeasure in eating, or all three). 

Treatment begins with nutritional deficit and weight restoration, alongside reintroduction of previously liked and new foods. Exposure based therapy is employed, whereby we will create together a hierarchical list of fear/disliked foods and begin reintroducing them in a collaborative and purposeful way. 

Family Based Treatment or FBT, and previously known as Maudsley, is the gold standard for the treatment of anorexia nervosa in adolescents. It is also an evidenced based treatment for adolescents suffering from symptoms of bulimia nervosa and OSFED, and most recently has been adapted for children and adolescents with AFRID. 

FBT is atheoretical and agnostic, meaning it is not grounded in any one theory of psychotherapy and it does not purport to know the root cause of the eating disorder. FBT firmly holds that the parents and guardians are the key to long-lasting eating disorder treatment success. It holds that eating disorders are multi-systemic, meaning they can occur for a myriad of reasons, including social, environmental, familial, and biological reasons. We believe you as parents are the key to your child's health and recovery from their eating disorder. 

FBT highly engages the family in treatment, in unison and fight against the eating disorder. The therapist's role is to help support the parents/guardians in refeeding their child and when the time is appropriate, helping the parents give back autonomy of food choices to their adolescent. 

FBT does required engagement and commitment from all parents/guardians. 

If your child is suffering from symptoms of an eating disorder, we are here to talk with you more about FBT and how it can work for your family. 

DBT is now being utilized for a wider variety of problems, including substance abuse, eating disorders, impulsivity, and self-injury. DBT has also been adapted to be utilized with adolescents. Teens who may benefit from DBT have experienced several of the following:  

• Recurrent suicidal behaviors, threats, and self-injury  
• Anger problems  
• Relationship problems  
• Mood swings  
• Impulsive behaviors  
• Poor sense of self  
• Fears of abandonment  
• Family conflict  

To discuss whether DBT is right for your teen and how DBT can help, please contact us. 

We are not a full service DBT clinic, and do not offer family skills or adult DBT skill groups or phone coaching. Dr. Hirsch is well trained in DBT, and we do implement DBT skills with foundational knowledge and skill where applicable.

You may also visit the site from Behavioral Tech below to learn more about DBT.

This treatment was co-designed by Dr. Hirsch, Co-Founder of Integrated Psychology.  It is based on the evidence-based behavioral and cognitive interventions derived from CBT, DBT, ACT and other behavior therapies. It's an integrative approach to treatments that work, along side instrumental handouts for families and adolescents.  

Our parenting support sessions provide parents with the tools and strategies they need to navigate the challenges of raising children. We help parents develop effective communication skills, set boundaries, and build healthy relationships with their children.