Cognitive Behaviour Therapy

Hair-Pulling, Skin-Picking, and Other Repetitive Behaviours: Can the cycle be broken?

Max is 14 years old. Max has been picking at the skin around his fingernails for two years, particularly when he is stressed, anxious and bored. His repetitive picking has caused bleeding and scarring, despite Max being routinely told to stop by parents and his family doctor and despite his many attempts to stop (e.g., putting Band-Aids on all fingers to prevent picking). Max feels alone, ashamed, frightened, and confused about his picking. After some googling, Max thinks he might have a Body-Focused Repetitive Behavior disorder. What are Body-Focused Repetitive Behaviours (BFRBs)? BFRBs is a term used to describe a number of ongoing repetitive behaviours (including hair-pulling, skin-picking, nail-biting, teeth-grinding) that result in physical damage (e.g., bleeding, noticeable hair loss, skin lesions) to the body despite considerable efforts by the sufferer to try and stop these behaviours. BFRBS cause lots of distress (e.g., shame, isolation) and impairment (e.g., avoidance of social situations, missed school) despite efforts to try and stop these behaviours. BFRBs are not simple habits that are easy to just stop if one tries hard enough (or else all youth I see with BFRBs would have definitely stopped!). Instead, BRFBs have underlying brain mechanisms and factors that cause urges (e.g.,...

Helping Your Child with ADHD: Techniques to Regulate Emotions
Helping Your Child with ADHD: Techniques to Regulate Emotions

ADHD and Emotion Regulation: Emotion regulation is our ability to provide adequate control over emotional responses. While difficulty with emotion regulation is not a symptoms of ADHD, individuals with ADHD tend to get flooded or overwhelmed with emotions. Strong and intense reactions can sometimes have positive consequences, such as getting really excited about a family trip, but these reactions can also make getting through the day a challenge. Emotion regulation is a skill that can be learned, often with the help of parents or other adults. Here are some strategies that may help at home or at school: Provide as much consistency as possible. Regular mealtimes and sleep schedules are essential for children's emotional and physical development. Talk about your feelings when appropriate. Encourage your children to talk about their feelings. Label your child’s feelings and discuss emotions as they arise in books or television shows. Model emotion regulation. What strategies do you use when you are feeling frustrated or worried? Practice deep breathing. This is a tool that the whole family can practice and it can be used anywhere! If you are looking for more support, psychotherapy using collaborative problem solving or cognitive behaviour therapy may help your child and family. What is...

Cognitive Behaviour Therapy for ADHD

Cognitive Behaviour Therapy or CBT was developed over 40 years ago and has empirical support in proving effective in treating depression and anxiety. More recently CBT has been shown to be an effective addition to medication in treating ADHD. Unlike regular supportive therapy, results come more quickly with CBT. Benefits accrue even after a dozen therapy sessions. The focus of CBT is on the way momentary thoughts and long-lasting beliefs about ourselves and others control how we feel and behave. CBT is a tool for getting organized, keeping focused and becoming better at controlling anger and improving relationships with others by tackling the illogical thoughts and unfounded expectations that stop us from interacting the way we want. CBT explores the “distorted thinking” that keep us from doing what we want. Some examples: Over-generalizing. Making a broad conclusion based on a small misconception. This small faulty conclusion becomes the basis for looking at other situations which may have nothing to do with the situation which cased the initial misconception. For instance, “I’ll never be able to pass the physics exam, if I can’t remember what movie I saw last night.” All or nothing thinking. (also known as black or white thinking). Interpreting a situation we...