521840?1348844371
Rebecca Resnik, PsyD  
Female
Bethesda, MD

Specialties: ADHD, dyslexia, developmental delays

Interests: Developmental Disabilities
MindWell Clinical Psychology
Bethesda Office
301-581-1120
Bethesda, MD
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When your child needs a Psychologist, but you can' t convince Dad

Jun 13, 2013 - 0 comments
Tags:

Parenting

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psychology

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child

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Behavior Problems

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ADHD

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learning disabilites

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developmental delay

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psychological

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psychotherapy

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Mental Health

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childrens mental health



“I know there’s something wrong, but my husband won’t listen”

“My son is suffering. His dad says he’s just lazy--that I should stop coddling him.”

“I’m the one getting stuck with all the problems, so of course her dad doesn't think it’s a big deal.”

“He doesn't worry because he’s not home until she's in bed. He doesn't see homework time!”

Sound familiar?

As the director of a private psychology clinic, I spend a lot of time on the phone with parents. One of the most common things I hear is that the spouse that does most of the ‘in the trenches’ parenting is having trouble convincing the other parent that there’s a problem. In heterosexual couples, it is typically the Dad who digs in about getting any help from a psychologist.  (I've observed that the LGBT parents I work with tend to have a much easier time deciding together about mental health care, so this is framed in terms of husband-wife dynamics). And before you write me an angry comment, there are many fathers who make that call and who overcome obstacles to getting their children care. I'm talking about that particular dynamic where a mother wants to seek care but can't convince her husband to take her concerns seriously. Its very common and deserves attention!

So why do so many dads have such a negative reaction? Most of the time it is mothers, both those employed outside the home and mothers who work as full time parents, who are doing most of the everyday parenting tasks. Mothers are still the ones helping with homework, signing the permission slips, doing the projects, driving to endless practices/lessons/clubs, and communicating with school staff. In every couple, one person tends to take on this role, and it is that person who is the one who comes face-to-face with learning or behavioral challenges. It’s no wonder that the ‘in the trenches’ parent is the one losing sleep over a child’s difficulties. That parent is the one who should be respected as the expert in the family as to whether or not there’s a valid concern.

In the DC Metro area, there’s usually one parent who works long hours or travels a lot (as I write this, my husband has been at a conference for a week!). The parent who spends more time at work typically leaves before the kids are on the bus or dropped off at school. That parent is often not home until after all the homework is done, lessons are finished, and practice is over. It is easy to assume the problems at home are not that big a deal when you hear about them second hand (especially after you’ve just arrived home exhausted after a ten hour day). Dads may come home after the problems are already solved for the day. They may not see the meltdowns, tantrums, or tears at homework time. They have little idea what their wife had to go through to get through the day. They may never attend the meeting where the School Principal 'dropped the bomb' that your child is being suspended. It is important to trust the parent who is spending the most time ‘ in the trenches.’ Again, dads need to trust their spouse’s expertise as to whether or not the child’s problem warrants getting help from a psychologist.

Now I’m going to address what I see from a lot of dads. Many men are active problem solvers. They like a problem with a straightforward solution, and they go after it full tilt till its solved. When dads were boys, they heard different messages than girls about having to be strong, independent, and to hide weaknesses. Moms grew up hearing that it’s a good thing to ask for help—that seeking support is part of solving any problem. The legacy of our childhoods is that we have dads who are very uncomfortable with the idea that their child might need to see a psychologist. Dads often have a hard time trusting their spouse’s instincts. Of course, these are the same dads who would not hesitate to call a roofer if their ceiling leaks, hire a CPA to do the taxes, or head to Home Depot for advice on chainsaws. But go to a psychologist? It can be easier taking a cat to the vet.

Many dads see needing psychological care as a sign of weakness or something to be ashamed of. Some can not tolerate the idea that "there's something wrong with my kid." There’s nothing more shameful in seeing a psychologist than there is in getting a throat culture if you think your kid has strep. But time and again, I see dads “dig in” and resist getting their children the help they need. I’m not sure why some dads are more comfortable with the idea that their kid is lazy or spoiled than they are with the idea that he needs some help from a psychologist. Psychologists are there to solve problems, same as any other professional. And contrary to what the guys on MadMen think, psychologists and other mental health professionals offer effective treatments that are well supported by empirical research. Advances in brain imaging and genetic research are providing hard evidence that mental health disorders are biologically based—not imagined.

So how do you advocate for your child?  Here’s a couple of ideas:

1. Look up the problems on trusted web sites (mindwell.us is one that has lots of information, medhelp.org of course, as well as National Institute of Mental Health, American Academy of Pediatrics, or Mayo Clinic), and do your homework. Find out what the experts recommend as treatments.

2. Ask for referrals to psychologists from people he respects—like your colleagues, Rabbi, Coach, School Principal, friends, or relatives (e.g. “Tony and Gail said this psychologist really helped. Lets just go meet her.”)

3. Keep a data log (just like Captain Kirk) or a video diary. Record things like how long it takes to get through homework or video a meltdown. If problems are happening at school, get your teacher to document the problems.

4. Remind your kid's Dad that he/she trusted you enough to have children with you and to care for the children day in day out. If you can be trusted with that awesome responsibility, than your opinion matters!

Talking to Kids about Tragedies

Dec 15, 2012 - 3 comments
Tags:

tragedies

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child anxiety

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school shooting

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communicating with kids

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talking to kids

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coping with crisis



As much as we all want to protect our children from the harsh parts of life, talking to them about tragedies is part of modern existence. Our children are media consumers now in ways they never have been, so when a horrible incident like a school shooting occurs, you can expect that they will hear about it. Yesterday's shooting was thornier to talk about because so many children were killed. Here are some tips for talking to your children when bad things happen.

1. Ask first before you talk:  Bring up something general about the new story to gauge how much your child may have heard. Don't assume they know the details or have much understanding. For example, "Have you been hearing anything in the news today that you want to talk about?"

2. Let your child describe his understanding of events: Even very smart children have a limited understanding of tragic events. For example, a child may think that just because a plane hit a building in New York that it is not safe to go up in skyscrapers. You can gently correct their misperceptions.

3. Less is more:  Some parents, especially those with very bright or older children, feel the need to give more information than kids are ready for. Keep the information very limited, very concrete, and simple. Limit your child's exposure to the news so you can be in control of what they hear and see. News is often very sensational--running cycles of bodies and crying people. This is frightening and distressing for all of us. Turn off the tv for a while!  Of course its best to tell the truth, but kids don' t need all the awful details. A simple statement like, "Two boys hurt a lot of people in a school yesterday" is better than "They shot other kids and teachers and people were screaming and trying to get out." Your goal is to help the child manage his anxiety, not feed it with troubling images.

4. Emphasize that your child is safe:  Kids often believe that if something occurs once, they need to be afraid that it will happen to them. Remember that the odds are that your child will never be a victim of violence, in fact, the risk of getting into a car every day is greater than many of the scary things we imagine. Communicate explicitly to your child that he is safe, and that you are protecting him. Let your child know he is safe at school and that the adults are taking good care of him.

5. Turn fear and sadness into action: If a child is very bothered by tragic events, you can help him gain mastery over fear and anxiety by taking some positive action. I am not talking about letting her sleep in your bed again or stop going to school--I'm talking about doing something positive. Acts such as collecting warm clothes for Pakistani earthquake victims, trick or treat for Unicef, or helping to collect funds for Hurricane Sandy Relief or make a care package for Anysoldier.com are a good way to help kids feel more in control.

6. Consult a professional: If your child becomes preoccupied with fears, consult a professional. Most of the time children will go through a short phase of anxiety, but for some kids the anxiety starts to interfere with daily life. I once met a girl who watched her brother choke on some food (adults quickly helped him) and decided it was best to stop eating, and a teenager who began sleeping with her parents again during the DC Sniper attacks. Psychologists, counselors and social workers can help your child learn effective ways of coping with their anxieties.

7. Be honest. If your child asks why such things happen, its best to say that we don't really understand why. You can tell them that most people are good, and most would never hurt children, but that sometimes, very rarely, some people do bad things. It is fine to express your own sadness and anger, though best if you don't make it your child's responsibility to comfort you! Finally, Its ok to say you don't know why bad things happen, just pair it with a reassuring message that your child is safe.

Best wishes and love to all the families who lost their little ones. Hold your dear ones close everyone!
Rebecca



Psychological Assessments for Adopting Parents: Tips for finding the right psychologist

Dec 14, 2012 - 2 comments
Tags:

adoption

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adopting

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adoptive parents

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international adoption



The path to parenthood can take many unexpected twists and turns. For some of us, the dream of having a child is realized with relative ease, but for many of us it’s a rocky and sometimes painful road. If you decide to start the adoption process, there is often more involved than just a wait. Couples can go through periods where there are flurries of activity followed by long periods where nothing happens. The details can be overwhelming, as bad as an IRS audit, but add in the emotional roller coaster too!  Part of what you may need to do before you begin a family is have a psychological assessment.


Having to have a psychological evaluation to start a family can feel strange, and perhaps unfair. After all, there’s no scrutiny for those who start a family with a pregnancy! The requirement to have a psychological evaluation is just one of many ‘hoops’ that you will jump through to make your dream come true. Hopefully, it will be one of the easier ones. This blog will let you know a bit about the process.


The key to making sure this process goes well is to pay careful attention to what your agency or your child’s country of origin requires. Each country has a set of requirements for who should conduct the assessment, psychological tests to administer, and what the assessment report should include. Before making an appointment, check that:



1. The provider has the appropriate credentials as specified in your paperwork
2. The provider is licensed in good standing
3. The provider has the psychological tests your agency/country requires (e.g. the MMPI, Millon Scales, NEO or PAI)
4. The provider can complete all the work by your deadline
5. The provider knows in advance what is needed to comply with assessment requirements


It is often wise to have the psychologist communicate with your case manager if there is any question about what information he or she should collect.



So once you have your psychologist, what can you expect? First, you should expect to be treated with every courtesy and dignity, the same as any expectant parents. You should expect your emails answered, phone calls returned, and report completed in a timely manner. When you go to see the psychologist, remind the psychologist of what information is needed. Share sample report templates or procedure lists from your agency/country. Be aware if the psychologist is following the guidelines or not! These details are critical.



The psychologist will conduct what is called a ‘Clinical Interview.’ During this time, she will ask questions about your journey that brought you to choosing adoption. You will answer questions about your own history as well as your psychological health. Don’t get upset if the psychologist asks questions about your substance use habits, the health of your marriage/partnership, or if you have ever been in legal trouble—this is all important information for her to collect from anyone she sees. Some questions may be unexpected, but keep in mind, you want your psychologist to be thorough.



Be ready to discuss some difficult issues. For example, you may be asked about infertility or pregnancy losses (believe me, its ok if you cry in a psychologist's office). Your psychologist may also ask you questions about child development, such as the impact of institutional care on children’s cognition and emotional well being. The psychologist may spend time educating you about children who come from traumatic backgrounds, or who have special needs. Finally, you may be asked for your thoughts on how you will talk to your child about the adoption, biological relatives, or his cultural heritage.



One last piece of advice—do not try to make yourselves look perfect! Perfect is not the standard. Of course you do want to make a good impression (dress nicely, come on time, pay your bill), but be yourself. If you take a personality inventory, avoid trying to answer the questions as if you are someone else. Just be honest.



Hopefully the psychological evaluation will be just another item you check-off in your journey towards finally holding your child for the first time!



Best wishes

Rebecca

A Child with Autism: Jody and Philip's Story

Oct 01, 2012 - 0 comments
Tags:

Autism

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parents

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Special Education

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early intervention

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pervasive developmental disorder

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autism spectrum

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child developmentay

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developmental milestones




Jody and Philip’s story–having a son with an autism spectrum disorder

Tyler was born to Jody and Philip after years of trying for a baby. His arrival was a dream come true. He was an incredibly easy baby. He was beautiful and healthy. Tyler did not cry much, but liked to be left in his crib to stare at his mobile. Since he was their first baby, Jody and Philip did not notice that he babbled and smiled less than most babies. They did not notice that he preferred to look at objects instead of faces. Jody sometimes felt frustrated that it took so much work to get him to smile or respond to her ‘mommy-baby games.’

During his doctor’s visits, he was growing and gaining weight. The physician did not note anything amiss. Tyler’s first word appeared a bit late, but since he was a boy, nobody was very concerned. Tyler did begin speaking at 18 months, so that was a relief. What Jody did not realize for a while was that he was not speaking like most children, but repeating things other people or TV characters said. He said words, but did not actually seem to be using them to communicate. When he did not know how to say something, he did not point or make gestures to show her what he wanted. At playgroup, he sat by himself playing with trains. “At least he’s not biting like some of the other kids!” she thought. But she watched the other children, and noticed that they were talking more, interacting more, and playing different kinds of games than Tyler. Jody began to wonder if everything was ok.

Over time, Tyler became more and more different from his peers. He developed sensory hypersensitivities to noise and textures, and started having temper tantrums. Jody had a hard time figuring out what would bring on a meltdown. She took him to the doctor, but during his visit he played happily with the otoscope and sang songs, so the physician did not get to see anything unusual. The next couple of visits he had ear infections and strep throat, so he just clung to his mother like all children do when they are sick. Again, the pediatrician could not see anything of concern. Philip told Jody to relax. He said, “If the doctor says nothing is wrong, than we are just being  typical first time worried parents.” Jody began to second guess herself. She told herself that Philip was right, that she was just inexperienced.

But Jody’s worries did not go away. She began to talk to her mother and her friends, asking them what they thought. “He’s just a boy,” or “He’ll grow out of it” said the relatives. Philip’s mother told her she should stop spoiling him and he would become more self-sufficient. Jody and Philip enrolled Tyler the best preschool they could afford. They had high hopes that the teachers would be able to help him talk more and play with other children. Preschool was a nightmare for Tyler. He became so stressed he withdrew to the train corner and screamed when anyone touched him. He was soon expelled for hitting other children who tried to touch ‘his’ trains. Jody quit her job to stay home full-time with Tyler.

After a few months break, they tried another preschool, hoping this time that a Montessori school would work. Tyler was able to stay for a few months before the teachers told him he would not be asked to re-enroll next year. Jody and Philip were stunned, they had thought everything was going well. “He’s very bright” the teacher’s told them, “but our program can’t meet his needs. We think you should have him tested” “There’s nothing wrong with him!” said Philip, “This is just the wrong school.” They found themselves spending more time arguing about what to do for Tyler.

Jody and Philip were facing increasing behavior problems at home. Philip worked long hours holding down two jobs. He didn’t understand why Jody was such a wreck when he came home.  Jody knew that things were getting worse, but felt all alone. She was so stressed she began losing weight and having trouble sleeping. Tyler started banging his head on the wall when they tried to stop him from playing with his trains or watching his favorite video. He would spend hours pacing and talking to himself–reciting whole episodes of tv shows. When he was upset, he rubbed the skin on his lips until it was raw. Jody and Philip could no longer go out to eat or to visit friends without fearing Tyler’s meltdowns. Jody began avoiding the playgroup. She no longer took Tyler to her friends houses. “How on earth is he going to be ready for Kindergarten?” they began to ask. “Are we just bad parents?” they worried.

Then one of Jody’s old friends called out of the blue. “My daughter was just diagnosed with a developmental delay, “she said, “She’s smart, but somewhere ‘on the spectrum.’ We have been so overwhelmed with all this that I thought I was going crazy!.”  When she heard about her friend's daughter, a light bulb went off in Jody's mind. "She's so much like Tyler!" she thought. Jody realized it was time to get some help. Her friend told her about psychological testing and how to find a good team of professionals. Jody took Tyler to a psychologist, speech language pathologist, occupational therapist, and developmental pediatrician. They received an Individualized Education Plan through the local school system. Philip wasn’t happy about having his son 'labeled',  but he was done arguing. They were finally getting good advice about what to do.  The reports from the psychologist, speech pathologist and occupational therapist opened the door for Tyler to attend the local public preschool program for children with developmental delays. He was finally in a classroom where he could thrive. Parent coaching from the psychologist helped Jody and Philip manage Tyler’s meltdowns, and an individual therapist for Jody helped her manage her own stress.

“We have come a long way” said Jody, “and so has Tyler.” Tyler received special help for a couple years at his school. By second grade, he was ready to go back to the regular classroom with some support. He made friends and even started playing weekend soccer. “Having a child certainly didn’t go as we expected,” said Jody, “But he’s still the best thing that ever happened to us.”