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Cognitive Behavior Therapy for ADD

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ADHD is characterized by impairing levels of inattention, hyperactivity, and impulsivity, and can occur and be diagnosed in both children and adults. Cognitive behavior therapy (CBT) was originally developed for the treatment of depression and anxiety disorders and is focused on identifying problematic ways of thinking, i.e., cognitions, that contribute to problematic behaviors.

Once problematic ways of thinking are identified, the client is encouraged to evaluate whether their cognitions are accurate and to consider alternative ways for thinking about their situation. As faulty thinking patterns are altered, more adaptive ways of behaving can begin to take shape.

CBT therapy sessions at the Sachs Center focus on psycho-education about ADHD and training in organizing and planning; learning skills to reduce distractibility; cognitive restructuring (learning to think more adaptively in situations that cause distress); and relapse prevention. Everyone needs to have some structure or plan for the day in order to be optimally effective in achieving goals.

Adults with ADHD have difficulty in setting up and maintaining this structure because they are easily distracted by many outer and inner stimuli and impulses and are unaccustomed to planning. This is why we devote considerable effort in the program to the regular use of a planner for scheduling activities and tasks, as well as prioritizing and planning activities for the day, week, month, or longer, and remaining focused on long-term goals.

Many adults who struggled throughout their schooling because of undiagnosed ADHD might think of themselves as stupid, lazy, or unable to learn. One can imagine how these thoughts could lead to poor self-esteem, depressive symptoms, and avoidance of situations that are linked to schooling and education.

At the Sachs Center, our CBT therapists work with clients to develop a more realistic explanation for their academic struggles. In conjunction with helping the client embrace this more reasonable way to think about their academic history, our therapists help the client develop new and more adaptive behavior patterns.


ADD/ADHD Men and a Lack of Impulse Control

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I Can Resist Anything but Temptation – ADD/ADHD Men and a Lack of Impulse Control

Is your garage full of thousands of dollars’ worth of useless products that your ADD/ADHD husband bought while watching late-night infomercials? Have you had to extricate yourself from one too many time-share purchases he locked you into when you briefly turned your attention to one of his other fires that you have to put out? Do you cringe every time your husband walks out of the house and heads to the mall, wondering what strange purchases will accompany your husband when he returns home?

If any of these situations brings up a knowing sense of dread, then you are already familiar with another challenge faced by the wives of ADD/ADHD husbands: Lack of impulse control.

To be sure, your husband’s constant need for something new and exciting to focus on may not always extend to needlessly spending your hard-earned cash. The lack of impulse control exhibited by ADD/ADHD men extends to a number of areas, including how they act at work, with friends, and in social situations. However, many wives fear their husband’s lack of control in the financial realm more than anything else, because it leaves them feeling particularly vulnerable, because once the money is gone, it’s really gone.

Repeatedly, wives of ADD/ADHD men describe their personal horror stories related to their husband’s lack of impulse control, particularly in the financial realm.

“One day, my dear husband decided we needed a Grand Piano, “ recalled Ann Marie R., a physical therapist from Red Bank, New Jersey. “I have no idea where the idea from, but believe me, he had it all figured out. He was going to borrow half of the money from the bank, based on my parents co-signing the loan, and the rest was going to go on the credit card. Thank G-d I was able to talk him out of it – this time. This is the kind of thing I have to deal with constantly!”

Marla W., who owns a consignment shop in Windsor, Ontario, didn’t get off so easy. Her ADD/ADHD husband wound up buying a $35,000 minivan that turned out to be a complete lemon.

Others report even more harrowing experiences due to their husband’s lack of impulse control. Lori N., a Physician’s Assistant in Austin, Texas, tearfully recalled how her husband bought a three-bedroom house on an Island – sight unseen. Getting out of the deal cost them thousands of dollars in legal fees.

And perhaps most heartbreakingly, Cheryl W., a homemaker living outside of Chicago, Illinois, woke up one day to discover that her husband had, on the “advice” of a salesman, purchased a Laundromat. They lost more than $200,000 in the venture, which ultimately when out of business.

Beyond the anxiety and the aggravation that comes from watching their ADD/ADHD husbands careen through life, many wives are at a loss to explain why their husbands cannot simply control themselves.

“It’s one thing to have to pick up his dirty clothes all the time,” said Cindy A., who has been married to her ADD/ADHD husband for seven years. “I get it. He can’t stop himself from dropping his socks.

“But how does this translate into spending hundreds or thousands of dollars on stuff we don’t need?”

 

Lack of Impulse Control or Poor Decision-Making Strategies?

When it comes to ADD/ADHD, some research appears to support the notion that the lack of impulse control is actually linked to faulty problem-solving abilities. In other words, rather than giving into their impulses (which may in fact be the case), ADD/ADHD men fail to take their brains through the normal problem-solving steps that other people use as a matter of course. This, in turn leads them to give up too early in the process, and the result winds up looking like a lack of impulse control.

A study tacking this subject by Susan Young, PhD., a clinical psychologist at the Institute of Psychiatry in London, was published in an addition of Neuropsychology. The study called for participants to solve a series of on-screen puzzles at varying levels of difficulty, requiring an increasing number of moves on the part of the participants. One of the components tracked by Dr. Young and her team included planning time between the appearance of the puzzle and a participant’s first move.

As the puzzles became more difficult, participants with ADD/ADHD failed to allocate additional time to planning. Instead, they plowed through the puzzle at the same pace they used for the easier puzzles. Predictably, their success rate declined as compared to a control group.

According to Dr. Young, the ADD/ADHD group favored speed over accuracy, resulting in what she termed ineffective, haphazard strategies.”

Making a big purchase is essentially a complex problem-solving exercise. Someone willing to put down thousands of dollars on a business venture without properly reviewing the different facets of the deal is likely to be skipping a series of important decision-making steps. The need to have resolution to the problem has overwhelmed logic – a classic ADD/ADHD challenge.

While it is unwise to draw definitive conclusions from one study, the results of Dr. Young’s research may offer some hope to wives who wish to help their ADD/ADHD husbands conquer their lack of impulse control. Instead of trying to constrain her husband’s spending habits, for example, a wife may achieve better results but working with her husband to improve her husband’s decision making process. This helps tackle the problem closer to the source, rather than after it has already expressed itself in behavior.

In other words, once a husband changes the way he solves problems, the problem of impulse control is less likely to wreak havoc on a marriage.

 

One Approach to Improving Decision-Making Strategies – Help Him Color Code His Thoughts!

One way to wives can help their ADD/ADHD husbands gain a bit more control over their impulsive behavior is to color-code the decision-making process. The brain-child of Maltese physician, author, inventor and consultant, this strategy is known as “six-hat thinking,” which he described in his book, Six Thinking Hats.

When it comes to ADD/ADHD men, one of the benefits of this system is that it includes a built-in method of changing perspectives. Thus, instead of skipping the uncomfortable process of linear decision-making, adults with ADD/ADHD can purposely shift focus.

In brief, the technique assigns a color to six distinct methods of processing information:

White Hat: This style of thinking centers in on the information available at the moment. This is the opportunity for your husband to quickly gain a sense of costs, stated benefits, and other relevant facts and figures. It also offers a chance to become mindful of gaps in the information that need to be filled in.

Red Hat: The color of emotion, red-hat thinking draws on emotion, gut reaction, and intuition with regard to a proposed course of action. This is a chance to factor in other people’s reactions to a decision as well, which may already put a break on following through.

Black Hat: Like the bad guys in the cowboy movies, black-hat thinking focuses on the negative and bad points of going with a certain decision. For ADD/ADHD men who are also mis-matchers, this offers of chance to be their own personal devil’s advocate.

Yellow Hat: On the other end of the spectrum, yellow-hat thinking focuses on the upside of the decision. It allows your husband to dream the dream, but since he will be changing focus momentarily, you do not have to worry that he will get locked in this state of mind with regard to the decision being considered.

Green Hat: Green means go, and in this case, it stands for creative thinking. Green-hat thinking focuses on other ways to solve a problem. This also fits well with the ADD/ADHD mindset, because it allows for free-thinking without limits.

Blue Hat: Blue hat-thinking creates an overall process to this decision tree. If your husband can agree to the process of going through the steps any time he faces a major spending decision, then he is successfully employing blue-hat thinking.

The beauty of six-hat thinking is that it can be easily incorporated into your husband’s routine. For example, any time he goes shopping, he can carry six color-coded cards and allow himself to flip through each card – at whatever speed he wishes – prior to making a final decision. The shift in focus may be sufficient to overrule the momentary desire to act on the buying impulse (or other impulses as well).

It can also be easily incorporated into your ongoing communication habits. Instead of nagging or expressing concern, you and your husband can agree beforehand to simply do the six-hat dance. This will put a more enjoyable face on the issue and reduce tension all around.

 

The Sachs Center is New York City’s premier center for the evaluation and treatment of ADD/ADHD in children, teens and adults.  We believe in holistic full-service approach that includes therapy, testing, medication, nutritional and organizational coaching.

 


Effects of Playing Video Games

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The effect of video games playing is a research area that is constantly being analyzed by psychologists and scientists, as the percentage of children and adults who play video games is increasing. Over the years studies have shown that playing video games can increase heart rate, blood pressure and obesity. Playing too much video games can also make children and adults more socially isolated and they may spend less time in other activities such as reading, sports and interacting with family and friends.

Many psychologists and other health and educational professionals believe that playing violent video games can have a negative impact on a child’s or adult’s behavior. Educational professionals have noticed that children tend to routinely skip their homework to play games and they tend to mimic scenes from violent games in the playground. They also report that children sometimes can confuse reality with fantasy.

Previous studies done around the negative impact of video games indicated that violent video games may be related to an increase of aggressive behavior, thoughts and feelings (Anderson & Dill, 2000 & Gentile, Lynch & Walsh, 2004). However other professionals argued that the evidence gathered was never conclusively tested through experiments. In May 2011 the University of Missouri performed the first experimental research that showed that the brains of violent video game players become less responsive to violence images and this diminished brain response leads to an increase in aggression. The line between appropriate behavior and inappropriate behavior become indistinct.

The most recent study, done in October 2012 by the research team at Brock University in Canada, found that teenagers who play violent video games over a number of years become more aggressive towards other people. These research findings were said to be the first indication of a clear link between playing violent games and aggression. Evidence suggests that long-term players of violent games may become more likely to react aggressively to unintentional provocations.

Research has also shown that some non-violent video games are excellent teaching tools because they can actually enhance mental ability by helping a child or an adult follow instruction and by enhancing problem solving and motor skills. For example, researchers at the Michigan State University’s Children and Technology Project found a relation between video game playing and greater creativity. Another study done by Daphne Bavelier, professor of brain and cognitive sciences at the University of Rochester, found that those who play video games have improved skills in vision and attention to detail.

When choosing a video game, parents and adults need to be aware that their decision can have a positive or a negative impact on behavior.

 

To enhance and consolidate learning, Sachs Center offers Educational Tutoring.

We also offer Play Therapy to show how much children understand about what is happening around them or within themselves.

We also have Parent Training to help parents develop the skills and coping mechanisms necessary to manage their child’s behavior and development.

 


Career Assessment

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Almost everyone experiences difficulties when it comes to choosing their career path. Career Assessment can give you the information you need to make important career decisions and to gain a better understanding of yourself.

A Career Assessment can help students or individuals who want to make career choices identify a career path that is relevant to their specific attributes. It can help you choose your major, change your career path or if you are retired, it can help you find ways of spending your time.

You can find many career assessment tools on the internet. However, if you want valuable help in considering your options and narrowing your search, you should complete a career assessment with a psychologist. A professional will use tools and resources such as standardized career assessment to find a range of careers best suited for you by exploring your interests, skills, and values.


Testing for Extended Time on SAT, GRE, etc.

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Before a student is accepted in graduate level schools and universities of their choice and pursue their dreams, part of the admission process of colleges include the LSAT, MCAT, GMAT, GRE, SAT, ACT, USMLE, among others.

Testing for Extended Time is one of the most requested testing accommodations given to students with learning, physical, emotional, cognitive and attention disabilities. Extended time can be requested for reading, mathematical calculation, speaking and written tests such as the SAT, ACT, GRE, LSAT and MCA.

Standardized exams like these makes a significant contributory factor on what future may bring for them.  One must realize like any structure, this requires groundwork.  The test scores on these areas are often taken into account when applying to top corporations and firms.  Like learning many other skills, exam taking is a skill that is acquired and teachable for a lot of students.  However, if you have a learning disability, you may be able to gain extra time on these tests.  It may be very helpful to consider professional guidance through the help of the professional team here at Sachs Center.

Students with diagnosed disabilities can be tested for Extended Time by a specialized professional here at Sachs Center. This testing must be conducted under standardized procedures by a professional with the relevant credentials and experience. The results should be written in a comprehensive report that is interpreted within the context of other diagnostic information such as school and college academic transcripts, as well as any documentation of special accommodations you have.

Sachs Center offers Neuropsychology Testing which is also known as Psychological Testing.  This is an assessment that measures and identifies cognitive, motor, behavioral and linguistic impairment and functioning in individuals.  We can do great arrangements of testing for applications for extended time on these high stakes exams.  The requirements for applying for an extended time on standardized tests are highly demanding and variable.  You can find out what are the specific requirements and expectations specifically on the testing organization’s website.  We consider talking about the strategies that will work for each student.

Extended time during testing can give students with disabilities and deficits a better chance of showing their true potential. Time frames for tests with Extended Times can vary from 100 to 420 minutes approximately. It is very important to remember to submit information on time as it may take up to four or more hours to complete this test and one to two weeks to prepare the reports.

In order to build a case for your request which includes extensive testing, a detailed report of other resources such as old school records, letters from doctors, tutors, family members and teachers is needed.  We do not hold the testing organization’s decision but Sachs Center assistance and full support in your request for extended time is guaranteed 

 

George Sachs PsyD
Clinical Psychologist


Testing for School Accomodations

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School accommodations are changes to materials or procedures that enable students with disabilities to access grade-level learning and testing. If your child has a documented disability, you may be eligible for accommodations. Accommodations are not intended to change or lower the standards of the content being assessed. They are used to reduce or eliminate the effects of a student’s disability.

The law that guides who gets accommodations is the Americans with Disabilities Act (ADA), Section 504. This section of the law protects individuals with disabilities from discrimination. Students with disabilities may receive special education services during the K-12 years as defined in a “504 Plan”. Accommodations can be given for timing, presentation, response, setting, test scheduling or for others such as proving special test preparation or focusing prompts.

There are many different kinds of learning disabilities (LD) and attention deficit problems that can require testing accommodations, but the four most common forms are reading disabilities, written language disabilities, math disabilities and Attention Deficit Hyperactivity Disorder (ADHD).

Nationally standard tests and a DSM-IV-TR identified learning disability are required to obtain accommodations. Generic diagnoses such as “learning disability” and “auditory processing disorders” are not considered recognized diagnoses. The report obtained from the specialist should be around 15–25 pages long, with supplemental forms, and it should take at least two weeks for the professional to complete it.

It is especially important to be tested by an expert in the area of accommodations. As once a committee has denied an applicant for insufficient evidence the chances of actually being able to reapply for accommodations and get them accepted is reduced significantly. So it’s critical for you to conduct your research before choosing a professional.


ADD/ADHD Evaluations

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There is no single medical or physical test to diagnose ADD/ADHD. To determine if you or your child has ADD/ADHD, a professional psychologist or psychiatrist will need to conduct a comprehensive evaluation, which has been standardized by medical and psychological associations of your or your child’s symptoms. Some symptoms of ADD/ADHD such as concentration problems and hyperactivity are common to many other medical conditions and psychiatric disorders. Getting a comprehensive assessment and diagnosis is very important.

The evaluation process should include a detailed clinical interview, a computer assessment or tests based on ADD/ADHD rating scales and a medical prescreen. The interview should cover past and present ADD/ADHD symptoms, developmental history, emotional functioning, academic history, work history, and personal and family psychiatric history.

The computer assessment and standardized tests are based on the DSM-IV criteria for ADD/ADHD and assess for inattentiveness, hyperactivity, impulsivity and combined behaviors. You will also probably be asked to name someone close to you such as spouse or other family member totake part in some of the evaluation. If the client is a child, the assessor will talk with the parents about the child’s behaviors.

The assessor will provide the results once all data is gathered. Getting a diagnosis can be the first step to changing your child’s or your life. The diagnosis may explain why you or your child may have struggled with things like paying attention, following instructions, losing things, being easily distracted and being unable to organize tasks and activities. Treatment can help you or your child gain control over ADD/ADHD.


Learning Disability Assessment

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Learning disability is a disorder that’s affects individuals psychological processes involved in understanding or in using written or spoken language. Learning disability is caused by differences in how a person’s brain works and how it processes information. It may manifest itself in a defective ability to listen, speak, think, read, write, spell, or do mathematical calculations.

There is no medical treatment for learning disabilities. It is a lifelong disorder; however, children and adults with learning disabilities can be high achievers and can be taught ways to get around the learning disability and learn successfully. There are many reasons why learning disability occurs and it can happen before, during, or after birth.

Diagnosing a learning disability is a complex process as it gathers information in all areas related to the child or adult that has a suspected disability. The assessment looks at cognitive, behavioral and development factors and involves testing, medical and history taking, interview and observation by a trained specialist such as a psychologist or psychiatrist.

When the administration of tests and other assessment materials is completed, you’ll meet with your assessor or with a group of qualified professionals to discuss the results and determine whether you have a disability. A copy of the evaluation report and the documentation will be given to you. The assessment can determine whether you or your child qualifies for special education and related services. It can help you develop strategies for your learning and also provide information and approaches related to employment, education, and daily living.


Neuropsychological Testing

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Neuropsychology Testing also known as Psychological Testing is an assessment that measures and identifies cognitive, motor, behavioral and linguistic impairment and functioning in individuals. It is a way to evaluate the structure of brain function by looking at a person’s thinking skills and information processing.

You may be referred for Neuropsychological Testing because of developmental and emotional problems, illness, injury, academic achievement and poor performance at work. A typical neuropsychological evaluation covers areas such as attention and concentration, memory and learning, language, visual-spatial skills, motor and sensory skills, intellectual functioning, higher level executive skills, mood and personality.

The neuropsychological evaluation is accomplished via an interview and standardized tests that are done by a licensed clinical psychologist with specialty training. The tests are paper based and are given in the same manner to all clients. Testing can take a significant amount of time, ranging from three to four days. During testing, the psychologist is also attentive to your energy and motivation. During the interview the psychologist gather information about your background, medical history, physical status, and current concerns in order to best understand test results and make useful recommendations.

When the evaluation is completed, you will be provided with a comprehensive report that can inform you of a new or corrected diagnosis.


Test Prep

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Test Preparation assists and supports students on most standardized tests and academic work. If you want to become a successful student, you need to be prepared for tests and the more extensive practice you do the better results you achieve.

Prep tutors can help you or your children raise their grades by delivering custom designed lesson plans to address their specific needs and goals. Tutors work one-on-one with each student on content and strategies and provide students with real-life test-taking experience, by administering practice tests.

You or your children will also learn on how to relieve anxiety that occurs when taking tests and how best to prepare for a test. You or your children will get better results and will learn on how to focus on specific academic subjects.


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