The initial assessment appointment lasts from 75-90 minutes. Depending on the presenting concerns, the age of the child, and relationships between family members, the initial session may be conducted with either parents and children together or just parents.
Assessment starts with a structured, clinical interview followed by a brief discussion of impressions, initial treatment plan, and strategies to begin addressing problems as time allows. Assessment also includes any brief, initial contact with school staff or other healthcare provider (if you have signed a release of information, and the contact would benefit care). Additional appointments, questionnaires, or testing may be recommended following the initial interview. As with any treatment, ongoing assessment is part of the treatment process.
Therapy sessions typically range from 30-60 minutes, averaging about 45 minutes per session across treatment. Sessions are scheduled for an hour, but length of sessions are determined by goals of the session, addressing issues occurring in between sessions, and progress. For example, sessions may last longer in the initial stages of therapy in order to "jump-start" progress and build foundations but may be shorter as treatment progresses. Dr. Danda will discuss goals and treatment plan with you on an on-going basis to ensure she is providing the most cost-effective and efficient treatment.
Dr. Danda uses an evidence-based, cognitive behavioral therapy (CBT) as her primary approach but incorporates other therapeutic approaches into her work as appropriate (e.g., mindfulness, DBT, communication training). She also provides Parent-Child Interaction Therapy (PCIT). Therapy is evidence-based but tailored to the individual and situation.
Therapy begins with education about processes and factors leading to current problem areas. Strategies based on changing thoughts, feelings, and behaviors are introduced and practiced in session. "Homework" is often assigned to children and/or parents to practice what is learned in session and to generalize use of strategies in real life. Homework and important points are written out at each session, and Dr. Danda makes frequent use of handouts.
Parents are typically included as part of the treatment process for children and adolescents as deemed appropriate by Dr. Danda. The degree of parental involvement depends on the age of the child and presenting concerns. Goals of parental involvement may include helping parents understand a child's diagnosis or presenting problem, strengthening the parent-child relationship, helping parent reinforce the strategies children learn, and developing effective behavior management. Parents may meet at the beginning or end of a session and/or meet privately with Dr. Danda to discuss their child’s progress and any concerns.
Despite parental involvement in a child’s therapy, confidentiality between the child and the psychologist is an important aspect of most therapeutic relationships. Specific details regarding what the child has shared with Dr. Danda are kept private unless the child feels comfortable sharing the information with parents. Exceptions to this general “rule” include situations in which Dr. Danda believes the child is in danger of hurting him/herself, being hurt, or may hurt others. In all cases, Dr. Danda strives to involve parents at a level that is most productive in improving the child’s or teenager’s relationships, functioning, and self-esteem.
Parent coaching involves parents’ seeking consultation about specific, targeted concerns about their child or their parenting. Examples may include tantrums, discipline, self-esteem, social interactions, sleeping issues, fears, feeding concerns, and questions about typical development. Parents may also seek coaching in order to develop a more consistent and coordinated approach to parenting. The focus of coaching is development and implementation of strategies to reach parent-identified goals based on specific concerns. Coaching is best used when parents have questions that can be answered without the usual comprehensive intake and evaluation procedures. Standard psychological services may be recommended should coaching not be sufficient to meet your needs or should more serious or more complex concerns arise. Coaching differs from regular psychological services in that no diagnoses are provided and coaching is never reimbursable by insurance.
Initial assessments are often in person and last 20-60 minutes, depending on the amount of information needed to provide effective coaching. Parent coaching can be conducted in person or via televideo. Services will vary in length depending on your question and will be billed according to time, with a minimum charge equal to 15 minutes.