Treatments to Boost Skills and Grow Possibilities
At Possibilities our treatments are always informed by science, clinical expertise, and caring. Research shows that specialized treatments that are integrated work best. Integrated treatment means more than one treatment is often needed to address the different challenges that come with one or more diagnoses. At Possibilities, experts on our Treatment Teams come from various fields of medicine and health, and offer a range of services. Here are some of the services we offer:
Children, adolescents, and adults with ADD/ADHD and Learning Disabilities often have difficulties with skills like planning, organizing, and strategizing their work consistently to accomplish goals and get tasks done. Psychologists call these skills Executive Functions. The brain’s prefrontal cortex is largely responsible for mobilizing these skills to support success. When these skills are compromised they can topple even the strongest intentions—no matter how smart, curious, or driven you are! On report cards for children and teens, ratings of satisfactory or needs improvement on Learning Skills and Work Habits can signal weak executive functioning skills. In adults, missing deadlines consistently, forgetting to complete chores, or working really hard to keep up with career demands at the expense of all else, can also signal executive functions that are compromised.
At Possibilities, our coaches are licensed health professionals from psychology, psychotherapy, and social work. In coaching, you or your child will work on specific goals with agreed-upon strategies—all with support from a coach who understands the neuroscience of attention, learning, and executive functions. We offer Coaching Programs for children, teens, and adults, scaling our approaches based on age and interests. For example, we offer our Doodle! Do! Done! coaching format for anyone who likes to draw their way through task completion. No matter what format works best for you or your child, Cognitive Behavioural Therapy (CBT) forms the foundation of our ADHD Coaching Programs—informed by the empirically-based model of ADHD Coaching developed by Dr. Frances Prevatt and Dr. Abigail Levrini—to tackle unhelpful patterns and support meaningful change.
ADD and ADHD affect individual strivings and success; any checklist outlining the core symptoms of Attention Deficit Disorders makes this fact clear. But the profound effects ADD and ADHD can have on relationships is often missing from symptom checklists. Attention Deficit Disorders can strain even the strongest of bonds between family members, loving partners, and cherished friends. Families affected by ADD/ADHD can fall into dysfunctional patterns of expectations and reactions. When that happens, conflicts between partners, siblings, and parents and children can become the norm. That’s when couples and parents often seek therapy—when family distress is enormous or when all hope of reconciliation is gone. At Possibilities, we offer Couples and Family Coaching to help shape expectations and behaviours moving forward—long before dysfunction and distress have swelled to a point of psychological no-return. Our Couples and Family Coaches are licensed social workers who have a deep understanding of family dynamics, emotion regulation, and attachment—and they’ll work with you to strengthen meaningful bonds.
Anywhere we find ourselves—whether at home, work, school, or play—communicating effectively with those around us is critical to our health, happiness, learning, and success. This fact is no different for children. Our ability to understand information—and to be understood—makes the world more predictable and less confusing as we grow. Children who struggle to be understood by others, communicate their ideas, understand information, or use appropriate social skills, could have a speech and/or language delay that can affect their development and well-being. Our Speech-Language Pathologist (SLP) uses evidence-based practices to help improve your child’s overall communication skills and provide strategies to target these skills in your child’s everyday environment.
Cognitive Behavioural Therapy (CBT) for ADD/ADHD is an effective and proven treatment for adolescents and young adults with Attention Deficit Disorders. Cognitive Behaviour Therapy emerged from scientific findings showing that thoughts, feelings, and behaviours are all connected. Thoughts about who you are and what you can do can influence your mood and actions. When ADD or ADHD makes completing tasks seem impossible—again and again—it’s easy to develop thoughts about yourself that are unhelpful and defeating. When the actions you need to take aren’t very clear either, your mood, thoughts, and actions are affected too. CBT adapted for ADHD—with techniques developed by Dr. Mary Solanto at the NYU School of Medicine, and strategies from the empirically-based model of ADHD intervention developed by Dr. Frances Prevatt and Dr. Abigail Levrini—can help you or your teen counteract the daily effects of attention difficulties. With CBT for ADD/ADHD, you or your teen will learn to challenge unfair and unhelpful thoughts, and develop strategies for breaking down actions into smaller steps for a clearer path to action. Successes will start to accumulate when you or your teen functions more effectively, and changes in esteem, confidence, and actions can follow. Our clinicians also use CBT to treat symptoms of anxiety and depression that can develop in individuals with ADHD. A specialized form of CBT for Obsessive-Compulsive symptoms, and for compulsive hair-pulling and skin-picking disorders, is also offered by our clinicians.
At Possibilities, clinicians offer Acceptance and Commitment Therapy for ADHD, also known as ACT for ADHD. ACT is a mindfulness-based behavioural therapy with evidence to support its effectiveness for people facing a variety of challenges. The acceptance in Acceptance and Commitment Therapy means becoming more realistic about challenges—and what you can do—to help you move forward, rather than being stifled by distorted and unhelpful thoughts that keep you stuck. Commitment means making a plan of action and trying it out. For many people with ADHD, avoiding action or doing things impulsively become habits that are hard to break. Commitment is the opposite of both impulsivity and avoidance, and can develop with clinician support through ACT. Our therapists will help you identify goals, develop an action plan, and commit to achieving outcomes that are most meaningful to you.
Collaborative and Proactive Solutions Therapy (CPS) is a remarkably effective and research proven approach that addresses behavioural issues that often occur together with ADD/ADHD. From this perspective, challenging behaviours happen when the expectations we place on children or teens exceed their abilities to carry out those tasks because of lagging skills. In CPS, parents and children work together to set agreed-upon goals. These goals focus on what children and teens can do—rather than expecting more from them than their current skills allow. By setting fair, mutually agreed-upon goals, children and teens can become less resistant and more likely to complete tasks, while learning new skills along the way. Our psychologists will work with you and your child to help identify strengths, lagging skills, and mismatched expectations. This CPS perspective can help children, adolescents, and their families deal with common challenges such as oppositional behaviour, difficulties with impulsivity, and setting limits for computer and screen time. Collaborative and Proactive Solutions Psychotherapy was developed by Dr. Ross Greene at Harvard Medical School.
Applied Behaviour Analysis (ABA) is a type of therapy that uses scientific principles to help make meaningful changes in behaviour happen. ABA can be particularly helpful for young children—from 18 months to 12 years of age—who are struggling to control their emotions and behaviours, or who lack the skills they need to meet expectations smoothly and without resistance or tantrums. With ABA, your family works with a Board Certified Behaviour Analyst (BCBA) to help determine 1) what behaviours to target for change, 2) what level of skill your child has in different areas, 3) what factors are keeping specific behaviours going, and 4) what function specific behaviors are serving for your child. With this information, a BCBA will develop an individualized Behaviour Intervention Plan (BIP) for your family with research-driven strategies to build adaptive skills and reduce challenging behaviours. Next, the BCBA can support you—and other adults who play important roles in your child’s life like teachers and school administrators—with administering the plan.
Tics are sounds, words, or actions that emerge in Tic Disorders like Tourette Syndrome. Tics are neurological, but they are also affected by what happens around them. The fact that tics can be influenced by factors both inside and outside the brain makes tics interesting—and responsive to behavioral treatments to help manage them.
Comprehensive Behavioural Intervention for Tics (CBIT) is an innovative and effective non-medication treatment for Tics and Tourette Syndrome administered by psychologists. Children and teens who are motivated to manage tics that are frustrating and bothersome for them can be great candidates for this approach. When CBIT is effective, the number of tics children experience can drop significantly. CBIT doesn’t teach people to suppress tics; suppression is ineffective. Instead, clients learn how to respond to the urge to tic in ways that can dissolve the bodily feeling that a tic needs to happen. When the urge to express a specific tic decreases, so does the need to perform that specific tic. CBIT isn’t a cure for Tic Disorders or Tourette Syndrome, but tics can decrease when CBIT strategies are practised consistently between sessions. The Possibilities Clinic is one of the few centres in Ontario to offer CBIT, a research proven method that gives control to individuals who are motivated to take charge of their tics!
At Possibilities, physicians with expertise in ADD and ADHD consult with doctors in the community about medication treatments for our clients. Our physicians are involved in every single ADHD and Learning Disability Assessment that we do, because our physicians need to understand—to the fullest extent possible—what the challenges, safety concerns, and co-morbidities are in order to decide how to treat ADD/ADHD effectively. Since our physicians work within Assessment Teams to determine individualized treatments, they are unable to provide single consultations to individuals who have not received a multidisciplinary comprehensive assessment with us. However, doctor-to-doctor e-consultations are offered by our experts if you are looking for a publicly-funded option, at no cost to you, so we can support individuals who have had comprehensive assessments at other centers. E-consults are convenient and do not involve in-person visits with our physicians.
With ADD and ADHD, gaps in learning can happen. When Learning Disabilities co-exist with attention challenges, gaps can widen quickly beginning in early elementary school. At Possibilities we use academic interventions supported by science to boost skills in reading, spelling, and written expression. Direct Instruction (DI) programs form the foundation of our approach, with added activities to support skill-building. All of our methods use a principled process for introducing challenges, so students aren’t asked to attempt complex tasks until more basic, foundational skills are mastered. Repetition is also built into what we do to help newly learned skills ‘stick.’ Programs in Rewire 4 Reading use proven methods to help change brain circuits in students struggling to sound out words. Our reading programs can turn dyslexic brains into reading brains! Children and teens do not need to be assessed at Possibilities to work with our academic interventionists.
Appointments with non-physician treatment staff—like coaches, psychologists, psychotherpists, social workers, speech-language pathologists, and academic interventionists—as well as the cost of psychometric materials used in all assessment and treatment services, are not covered by OHIP. These costs may be covered by your private insurance plan. Please contact us at info@possibilitiesclinic.com if you require a written quote for your insurer.
