Every family experiences hardships, conflict, and struggle. When tension and stress begin to impact how family members relate or connect to one another, family therapy can be a valuable tool to support the entire system.

Benefits of Family Therapy

Family therapy at The Midtown Practice (TMP) can support families dealing with various issues, including but not limited to:

• Communicating through Points of Difference and Conflict
• Mental Health Diagnoses
• Gender and LGBTQIA+ Topics
• School Difficulties
• Child/Adolescent Behaviors
• Marital Issues
• Divorce
• Grief and Loss
• Intergenerational Patterns or Legacy Issues

How Family Therapy Can Help

A family therapist provides a safe and structured environment for family members to approach each other with curiosity and respond empathetically. This creates space to form new ways of connecting and relating.

Setting Goals in Family Therapy

The goals of therapy are often identified by the family members and therapist within the first few sessions. Generally, family therapy seeks to deepen individuals’ understanding and connection to one another. Through therapy, families can:

• Improve Communication: Learn effective communication skills to express thoughts and feelings constructively.
• Resolve Conflicts: Address and work through conflicts in a healthy manner.
• Support Mental Health: Navigate mental health diagnoses with the support of the entire family.
• Embrace Diversity: Discuss and understand gender and LGBTQIA+ topics in an inclusive environment.
• Tackle School Difficulties: Address academic challenges and support children’s educational journey.
• Manage Behavioral Issues: Develop strategies to handle child and adolescent behavioral problems.
• Navigate Marital Issues: Strengthen the marital relationship and address issues impacting the family.
• Cope with Divorce: Support the family through the challenges of separation and divorce.
• Grieve Together: Process grief and loss collectively, providing mutual support.
• Break Intergenerational Patterns: Understand and change legacy issues affecting family dynamics.

Taking the Next Step

If your family is experiencing tension and stress that impacts your relationships, family therapy at TMP can help. Our experienced therapists are dedicated to providing the support and guidance needed to foster understanding, empathy, and connection within your family. Contact The Midtown Practice today to schedule an appointment and start the journey towards a healthier, more connected family dynamic.

Understanding Psychiatric Treatment for Children and Adolescents

For a long time, the psychiatric community treated children and adolescents as “little adults,” using the same assessment and treatment methods as for adults. However, in the past two decades, our understanding of child and adolescent psychiatry has grown exponentially. High-quality, randomized controlled trials have expanded our evidence base for pharmacological treatment in young people, examining the effects of various psychotropic medications.

Addressing Concerns About Psychiatric Treatment

Despite these advances, many parents and guardians remain hesitant about psychiatric treatment for their children. Negative media reports about the increase in prescription psychotropic medication use among minors have fueled fears of over-diagnosis and overprescription. Additionally, Black Box Warnings on antidepressants and psychostimulants contribute to the stigma around psychiatric treatment for children. To address these concerns, psychiatric providers must offer families evidence-based information, perform thorough assessments, and practice judicious prescribing to allay fears, enhance outcomes, and dispel misconceptions about treating psychiatric disorders in children.

Medications for Treating Anxiety, Depression, and OCD

Antidepressants, particularly SSRIs (selective-serotonin reuptake inhibitors), are commonly used as first-line therapy to treat depression, anxiety, and OCD in children and adolescents. Some SSRIs approved for use in young people include Prozac (fluoxetine), Lexapro (escitalopram), Zoloft (sertraline), and Luvox (fluvoxamine). These medications enhance serotonin signaling by preventing serotonin from being cleared out of the intercellular space too quickly, leading to improved depressive symptoms and reduced anxiety.

Medications for Treating ADHD

The first-line treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) is psychostimulants, with the most commonly prescribed being methylphenidate (Ritalin) and amphetamine (Adderall). These medications work in the prefrontal cortex to improve attention and reduce distractibility, impulsive behavior, and hyperactivity. Another class of medications, alpha-agonists, can help reduce hyperactivity and impulsive aggression. Common alpha-agonists for treating ADHD include guanfacine (Tenex or Intuniv) and clonidine (Kapvay). Other medications, like Strattera and Wellbutrin, can also be used when psychostimulants are not tolerated or are contraindicated.

Understanding Side Effects of Antidepressants

Common side effects of antidepressants include gastrointestinal upset, headache, changes in sleep, tremors, and increased bruising or bleeding. These side effects are usually immediate but temporary, improving as the body acclimates to the medication. Antidepressants should not be stopped abruptly; doing so can lead to withdrawal symptoms such as flu-like symptoms, dizziness, dysphoria, sleep problems, and headache. Gradual reduction of the medication, guided by a prescriber, ensures discontinuation is easy and well-tolerated.

Black Box Warning on Antidepressants

Many parents fear allowing their children to take SSRIs due to the FDA’s Black Box Warning, which states that young people taking SSRIs may experience increased suicidal thoughts or actions. While this risk is relatively low, it can be mitigated by regular follow-up with a psychiatric prescriber, close monitoring, and ensuring support from friends, family, and mental health professionals. In practice, SSRIs are generally well-tolerated and can offer life-changing relief from anxiety and depression symptoms.

Duration of Antidepressant Treatment

The American Academy of Child and Adolescent Psychiatry recommends that if a young person achieves recovery using an SSRI for 6-12 months, they can seek to reduce and eventually discontinue the medication. However, if there is a relapse, the duration of SSRI treatment may need to be maintained longer to prevent future relapse.

Non-Medication Treatments for Depression and Anxiety

Yes, depression and anxiety can be treated without medication. Cognitive Behavioral Therapy (CBT) is one of the most researched psychotherapies and has been shown to be as effective as SSRI treatment. Combining SSRIs and CBT is often more powerful than using either treatment alone. Additionally, several other therapeutic modalities can help young people develop coping skills, learn to self-regulate, and maintain wellness. In some cases, adding medication to psychotherapy can yield significant benefits.

Taking the Next Step

If you’re considering psychiatric treatment for your child, contact The Midtown Practice to schedule an appointment. Our team is dedicated to providing evidence-based, high-quality assessments and treatments to support the mental health and well-being of your child.