Clinical Psychology Services

The field of clinical psychology has been around in various forms for over 200 years, and every year the field looks a little different. There are over 50 different areas of psychological practice and the practice of clinical psychology involves using the findings from research into human development and behavior to help people understand personal and inter-personal problems, overcome them and move forward to a more productive and happier life instead of being stuck in the past with unhelpful and maladaptive emotions, thoughts and behaviors that prevent them from developing and moving forward into better, more helpful and more adaptive thoughts, feelings and behaviors. There are a number of ways to do this by using clinical psychology and a well-trained clinical psychologist knows the ways that may be most helpful to a particular individual, family or organization.

We Provide Psychological Assessments, Clinical Behavioral Care Services and Professional Continuing Education Services to the Legal, Medical and Academic Communities and also to the Children, Adolescents and Families they serve. We focus on positive psychology and the Cognitive and Behavioral approach to diagnosis and treatment of psychological matters, with an emphasis on difficult-to-diagnose and difficult-to-treat psychological disorders. We can provide a wide range of clinical psychological services, including a variety of behavioral & psychological assessments (including School Psychology Assessments, Special Education and Neuropsychological Assessments), clinical and counseling services to children, adolescents, adults and senior citizens and consultations and continuing education services to schools and colleges and organizations. You can find more complete descriptions of these services throughout our website.

xBefore any psychological treatment or remediation can begin, it’s important to understand the nature of the problem or difficulty. A psychological assessment is the necessary first step in determining the strengths and weaknesses in an individual’s functioning when that functioning has been called into question, either by displaying actions that are unexpected or by not displaying actions that are expected, in a given circumstance or environment.

There are many types of assessments, each one focused on the different requirements of an individual, group and circumstance, but every such assessment is a variation of a psychological assessment. Psychological assessments tend to be understood as falling into two broad categories – Cognitive assessments and Behavioral assessments. ??Cognitive evaluations are psychological assessments which tend to focus more on how an individual’s brain function (that’s the ‘cognitive’ or ‘thinking’ part) interacts with that person’s behavior. Cognitive testing is often also called a Neuropsychological Assessment – and we do that. This type of testing is often called for when there are concerns about someone’s memory, ability to reason rationally or understand others.

Behavioral evaluations are psychological assessments which tend to focus more on how an individual is interacting with his or her environment and how they are functioning in the real world. The emphasis here is on the emotions, attitudes, habits and other “behaviors” that everyone exhibits. In truth, every good psychological assessment focuses on both behavior and cognition to some extent because we are all thinking, feeling and experiential human beings.

How we think, feel and experience is what comprises our psychological makeup. That is, we are all psychological beings and we interact with the world psychologically, not just physically.??There are literally thousands of psychological assessments available and all such assessments must be done by experienced, licensed and credentialed professionals to ensure that such assessments are not accidentally or deliberately misused to provide false or misleading information.

We focus on the appropriate psychological assessment of infants, toddlers, children, adolescents, adults and seniors. We can do this because we have developmental view of individuals over their lifespan.

Common uses of such assessments include “health” behaviors such as smoking, obesity, eating disorders and other maladaptive behaviors which compromise an individual’s health. In general, we are able to assist physicians and staff with evaluation and management of patients with dementia, sleep disorders, ADD, anxiety, panic, depression and the like. We can assess and treat adults as well as children, including very young children, who have serious medical issues, such as diabetes, cardiovascular issues, failure-to-thrive issues and general non-compliance about following the treatment advice from their Primary Care Providers (PCPs). We also treat more common issues such as bed-wetting, encopresis and obesity.

We also assess and treat adolescents, including those with Eating Disorders, cutting disorders and other self-injurious behaviors (SIB), and we also assess and treat adults and senior family members, including seniors, whether living at home with their families or in assisted or skilled-care facilities or rehab setting and who may have emotional or cognitive declines or competency or self-care issues.

We Take A Developmental Approach???? – A Life Span Developmental Approach

We have a Life Span Developmental focus on the functioning of children, adolescents, adults and seniors, which means that we recognize that functioning over one’s lifespan is truly developmental in nature and grows over time, building on previous experiences and bio-psycho-social functioning. A special area of focus is on the assessment of children aged 5 and under. ??Due to their young age, these children can often be misdiagnosed or their problems ignored completely due to the mistaken belief that children so young can neither have psychological problems nor be accurately diagnosed – but that’s just wrong. Conditions such as Failure To Thrive, Fetal Alcohol Syndrome, Pervasive Developmental Disorders and other conditions have psychological components that go unnoticed and untreated by health care professionals who may not be so well-trained in behavioral and developmental psychology.

Psychological assessments are multi-dimensional and are useful in a wide variety of personal, academic and institutional or organizational needs.???? Psychological, neuropsychological and personality assessments can be used in a multiplicity of ways and can be loosely grouped in the following areas. Listed below are examples of how Psychological Assessments can be helpful.

Academic and School Applications

Play is the work of childhood. School is the workplace of childhood and young adulthood. How children make the transition from play to workplace is a vital part of socialization and maturity in the modern world. And it’s no doubt true that many youngsters never accommodate or assimilate very well to the needs of growing up and effectively functioning in an adult world. When teachers or parents or physicians suspect such a problem, it is appropriate to refer for a psychological evaluation to make sure no problem or difficulty exists in an area of functioning that prevents us from succeeding.

The results of a psychological evaluation in any of these or other areas could result in the legal requirement that a school needing to develop perhaps an Individualized Education Plan (IEP) to remediate academic problems for a particular child, or perhaps offer a different plan of remedial action under the law known as a Section 504 Plan to help a child or adolescent learn better. Evaluations of common problem areas include:

ADHD evaluations.
Shyness and social skills delays or disability.
Learning Disabilities and Non-Verbal Learning Disabilities.
Independent Evaluations for 504 and Chapter 766/Special Education.
Second Opinions about parent-school conflicts or behavior issues.
Independent Assessment of Developmental Disabilities, birth defects, Autism, PDD.
General academic, psychological and neuropsychological exams.
Second Opinions regarding the appropriateness of 504 plans and Individualized Education ?Plans (IEPs)
Functional Behavioral Assessments (FBAs) of classroom behavior.

Clinical and Professional Applications

Not every psychotherapist does psychological assessments. In general, every treatment plan should be based on an evaluation of the psychological functioning on the individual BEFORE treatment begins and should include follow-up evaluations should the condition worsen or change to be sure the treatment is on the right track. In addition to health assessments for medical personnel, psychological assessments can also be done to address a wide range of psychotherapeutic issues. below are some examples.

Development and attachment issues in very young children.
Memory, attention and cognitive functions in adults and seniors.
Assessment of personality.
Assessment of functional behavioral disorders.
Memory impairment due to anxiety, trauma or other issues.
Treatment Plan Reviews and Second Opinions.

Workplaces and Organizational Applications

These types of psychological evaluations are evaluations of groups. Examples of group assessments include:

Assessments of public government departments and organizations
School system and staff assessments
Government agency reviews and assessments
Non-profit agency evaluations
Nursing home and Rehabilitative Care Facility assessments
Small-medium sized family-owned private business functioning and transitional planning.

Such evaluations typically focus on how to make the group or organization function better to meet its goals in dealing with its own employees, customers, students, vendors and contractors. ??Sometimes, business and group functions are interrupted due to maladaptive behavior either within the group or work setting by members of the group itself, including management, or by events outside the group that impact the group or workplace functioning. Sometimes, such maladaptive behavior or functioning is grounds for legal action. Some examples of such events include evaluations of:

Workplace bullying.
Hostile workplace environment.
Residual workplace trauma due to catastrophe, workplace violence or natural disaster.
Managerial misconduct.

The Psychological effects and possible damage stemming from personal injuries are many and varied. The most commonly known condition arising from personal injuries is Trauma, and Post Traumatic Stress Disorder has gotten the most media coverage. But any number of psychological conditions can arise from personal injuries. Typically, psychological injury arises from street, school, or work-related accidents, but can also be caused by ballistic injuries, concussion and Mild Traumatic Brain Injury (M/TBI), and “vicarious” traumatization or “trauma by proxy.”

Even worse, such damages are also often “masked.” That is, they either aren’t readily observable or readily understandable to the naive observer and may be “masked” by other behavior that is more readily observable. Thus, psychological injury often goes unreported, is misdiagnosed, or is misattributed to other causes. Some examples of where psychological injury may have occurred include:

The effect of trauma and abuse on children – including emotional loss and ?abuse, physical ?and sexual abuse and witnessing domestic or other violence.
Psychological damage in children and adults caused by medical procedures, ?malfunctioning products or toxicity.
Psychological damage in children and adults caused by dental or? medical procedure.
Masked psychological damages and impairment due to physical injury, emotional trauma, ?chronic disabling conditions, pain, product liability/toxicity or “bystander” experiences.
Adjustment Disorders.

Cognitive and Behavioral Health Care

Our Behavioral Health Care clinical services help provide restoration of function, remediation of problems and improve the quality of life in a sometimes difficult world. There are a huge variety of clinical psychological services available from different providers. We focus on specialized primary behavioral care services, which include behavioral medicine applications, cognitive-behavioral therapy, psychotherapy and play therapy for children, and other specialized treatments to help restore functioning and improve the quality of someone’s life.

We are a psychological and behavioral health services practice specializing in issues that affect children of all ages and the people and institutions with whom they interact. This includes school, colleges, Courts, governmental organizations and other health care and social service providers and agencies. We provide services to children, including very young children with medical issues; adolescents, including those with Eating Disorders and cutting disorders or other Self-Injurious Behaviors (SIB); and adults, including seniors already living in assisted facilities, rehab or other settings or who may have cognitive declines, competency or self-care issues while still living at home with their families.?? Most commonly we provide psychological assessments, clinical behavioral services and professional education to parents, school and medical personnel and other agencies interacting with children and families and by focusing on the following areas in working with children, adolescents and adults.

Adult Services

Adults need not involve other family members in their treatments, of course. But when treating adults, it is important to examine the impact of all interactions on the adult’s functioning, including the stresses and benefits of job, family, friendships, spirituality or religion, and hobbies. Our programs emphasize short-term, outcome -oriented treatment designed to improve, remediate and restore functioning.

Research regarding Behavioral Medicine indicates that many major health problems, including heart conditions, diabetes, high blood pressure, chronic pain, migraine headaches, and other problems are responsive to behavioral as well as medical intervention, In fact, it has been estimated that as much as 60-70% of visits to medical offices are for behavioral health concerns rather than medical issues.

Treatable conditions include habit disorders, stress-related disorders, coping with medical illness and recovery, work-related behavior problems, trauma recovery, anxiety, panic and other problems. ??It is not necessary to stop other treatments before using behavioral health care. Behavioral Care Providers (BCPs) frequently consult to pediatricians, internists, cardiologists, primary care providers (PCPs) and other physicians, therapists and health care providers about how to help their patients improve treatment compliance and to recover and mange their health. We are able to assist physicians and staff with evaluation and management of patients with dementia, sleep disorders, ADD, anxiety, panic, depression and many other conditions.

Child and Adolescent Services

Childhood is often not an easy time for children or parents. Even the strongest of families can experience stress, academic concerns or family problems which can combine to impact a child’s or teenager’s or adult’s ability to cope and many problems that children experience can be beyond a parent’s ability to remedy without professional help. ??Some of these problems include attention and organizational problems, separation, divorce and custody issues, disruptive behavior disorders, academic and school problems, bladder and bowel incontinence, bullying, trauma and other conditions.

When addressing child and adolescent issues, the family is often a necessary part of the treatment process. With older children, of course, the family’s involvement becomes more limited. ??Consciously raising kids while balancing the demands of life, work and family relationships is challenging, rigorous, sometimes hilarious, frequently joyful and often puzzling. Our goal is to help parents and others involved in the lives of children understand what influences and drives behavior and learn what may work to increase more positive behavior and reduce problematic behavior.

What differentiates us is that our approach to clinical, behavioral and therapeutic services takes a Life-Span Developmental approach, and is (w)holistic, family-oriented, and based on positive psychology. ??We address all the common and even some not-so-common problem behaviors and psychological issues. Some of the tools we employ in addressing issues include:

Cognitive-Behavioral Psychology & Therapy

There are many types of therapy, commonly called “counseling” or “psychotherapy.” But not all psychologically based therapy is equally effective when dealing with psychological issues – and anyone can be called a “therapist,” whether licensed or not. Be sure that any psychological therapy is done by a licensed clinician – and there are many to chose from, including Psychologists, Social Workers, Licensed Mental Health Counselors to name but a few. There are many types of therapy, commonly called “counseling” or “psychotherapy.” But not all psychologically based therapy is equally effective when dealing with psychological issues.

Among the types of therapy we specialize in is Cognitive-Behavioral Therapy (CBT). That is, the therapy focuses on what individuals think – that’s the ‘cognitive’, or intellectual part – and how individuals behave. Thinking influences behavior and vice-versa. CBT is suitable for a wide variety of issues and is easily adapted to developmental and environmental needs.

REBT

Rational-Emotive Behavior Therapy is a type of CBT that focuses on the rapid change of self-defeating or otherwise troubling and unhelpful thinking that may cause individuals to remain feeling trapped and helpless in the face of life’s difficulties. REBT is quite effective in teaching individuals to become more objective in identifying, understanding, solving and also testing solutions to problems which then can lead to improved life functioning and an improved emotional life.

Learning Disabilities (LD)

Learning Disabilities are found in people of any age, occupation or skill level. Even geniuses can have a learning disability – or even more than one. Typically, a learning disability goes undiagnosed or misdiagnosed for many years, first coming to light in high school, college or even several years into a career. It’s likely that the LD was always present in the individual, but rather was overlooked or ignored due to the individual’s ability to hide it, use other skills or abilities to compensate for it, or it was misunderstood as being something else. Behavioral or emotional reactions to LD issues typically develop – especially in school-aged children – and it is often those behavioral or emotional reactions which may draw attention while the underlying LD is missed.

This is especially true with Non-Verbal Learning Disabilities (NVLD), which are quite often misunderstood and not even evaluated during the school years, but which very often can appear as social skills deficits, failure to adapt, and inflexibility which may also bring someone with NVLD into conflict with authority figures such as school personnel, job supervisors or the police.

Social Skills Development

Social skills – including communication skills and socializing appropriately in a variety of situations – are among the most important skills needed in the modern world. Many otherwise highly skilled and competent children may be bothered by shyness, social phobia, lack of confidence or confusion when interacting with others in new or unfamiliar social settings. This may be even more true in children with verbally-based Learning Disabilities (LD), Nonverbal Learning Disabilities (NLD) or Attention Deficit Hyperactivity Disorder (ADHD), as they may have difficulty learning and adapting to the social cues and nuances that are important to making friends, holding jobs and getting along with others in modern life.

Our social skills work with children and adolescents are matched by developmental or maturational age and skill level following a curriculum designed to develop awareness and practice in self-monitoring, perceptive-other turn-taking and group behavior. We tend to focus on three areas – Self-Awareness/Shyness, Victimization/Bullying, and Making and Keeping Friends – and parents are expected to monitor the homework that each child may bring home to practice.

Anxiety Management

Test Anxiety and Performance Anxiety (Stage Fright) for young performers, musicians and public speakers are very, very common. However, these conditions, like shyness, can become very self-limiting for students as they get older if they do not receive treatment for these conditions. Children are singing, dancing, acting and playing music at increasingly younger ages. Students are routinely expected to speak up in class and failure to do so may result in a lowered grade for lack of class participation. High school and even middle school students are now called on to give oral presentations to their peers. College students – and certainly their parents – may be expected to make full multi-modal presentations, including Power Point, to enhance their college or business career.

However, the same bold and self-confident child or adult at home may be quite reluctant – or even terrified – to perform in front of strangers. Stage Fright/Fear of Observation is quite common and shouldn’t be allowed to stop a child, adolescent or adult from pursuing their goals.

EMDR

Eye Movement Desensitization and Reprocessing (EMDR) was discovered by Francine Shapiro, a psychologist in California who worked with trauma and trauma survivors. It is a so-called “power therapy” that has been especially helpful to individuals dealing with anxiety, panic and trauma issues. Our staff is proficient in the use of EMDR with children, adolescents and adults.

Play Therapy

The work of childhood is play. Quite often, the best therapeutic approach with children, especially very young children, is play therapy. Play therapy differs from standard psychotherapy procedures in that therapeutic play is the central therapeutic approach, not “talking” therapy.

Psychological and behavioral therapies and services, much like surgery or dentistry, are individualized and specialized procedures requiring specific education, training and experience to be performed appropriately. Such therapy and treatment should only be sought from properly educated, trained and credentialed behavioral and psychological practitioners.

Choosing Behavioral Health Care

Behavioral health care, also known sometimes as behavioral medicine, is a special type of health care that utilizes psychological techniques and methods to help individuals recover more quickly from, or learn how to understand and better cope with, psychological and medical conditions. The goal is to help improve patients’ health and overall quality of life.

Behavioral health care techniques can be used as additional or supplemental treatments to regular medical treatments. These techniques are often also successfully used as the sole treatments for many conditions, such as anxiety, depression, trauma recovery, “bad habit” reversals and other problems.

Behavioral care can also help people heal by teaching how illnesses, attitudes, behaviors and emotional states interact to affect medical conditions and also influence responses to treatment, recovery and well-being. Behavioral care shows patients how to utilize behavioral and psychological techniques and procedures to change, remediate and improve their level of functioning and alleviate distress.

Be sure to inquire about the credentials and experience of anyone from whom you seek psychological services. Surprisingly, not everyone who is called a “therapist” or “counselor” needs to be trained or licensed in order to offer their “therapy” to the public. It is our belief that consumers are best protected and best served by seeking psychological and behavioral services only from experienced and licensed health care practitioners.

Of all licensed practitioners, only licensed clinical psychologists typically spend from 5-7 years in intensive psychology education, training and research before they may be licensed to practice independently. Other practitioners’ training, such as that of licensed counselors or social workers, is usually shorter and emphasizes other areas of specialty prior to licensing.

Psychiatrists, for example, typically focus on biological interventions and are licensed as physicians and to prescribe medications, while psychologists are not.??For more information on how to choose a licensed professional who’s right for you and your family, consider asking friends who have received behavioral or psychological treatment and also consider contacting the licensing board for psychologists, social workers, licensed mental health counselors or licensed marriage and family therapists in the state where you live. You can also refer to national associations such as the American Psychological Association.

Before any psychological treatment or remediation can begin, it’s important to understand the nature of the problem or difficulty. A psychological assessment is the necessary first step in determining the strengths and weaknesses in an individual’s functioning when that functioning has been called into question, either by displaying actions that are unexpected or by not displaying actions that are expected, in a given circumstance or environment.

We Take A Developmental Approach???? – A Life Span Developmental Approach

Academic and School Applications

ADHD evaluations.
Shyness and social skills delays or disability.
Learning Disabilities and Non-Verbal Learning Disabilities.
Independent Evaluations for 504 and Chapter 766/Special Education.
Second Opinions about parent-school conflicts or behavior issues.
Independent Assessment of Developmental Disabilities, birth defects, Autism, PDD.
General academic, psychological and neuropsychological exams.
Second Opinions regarding the appropriateness of 504 plans and Individualized Education ?Plans (IEPs)
Functional Behavioral Assessments (FBAs) of classroom behavior.

Clinical and Professional Applications

Development and attachment issues in very young children.
Memory, attention and cognitive functions in adults and seniors.
Assessment of personality.
Assessment of functional behavioral disorders.
Memory impairment due to anxiety, trauma or other issues.
Treatment Plan Reviews and Second Opinions.

Workplaces and Organizational Applications

These types of psychological evaluations are evaluations of groups. Examples of group assessments include:

Assessments of public government departments and organizations
School system and staff assessments
Government agency reviews and assessments
Non-profit agency evaluations
Nursing home and Rehabilitative Care Facility assessments
Small-medium sized family-owned private business functioning and transitional planning.

Workplace bullying.
Hostile workplace environment.
Residual workplace trauma due to catastrophe, workplace violence or natural disaster.
Managerial misconduct.

The effect of trauma and abuse on children – including emotional loss and ?abuse, physical ?and sexual abuse and witnessing domestic or other violence.
Psychological damage in children and adults caused by medical procedures, ?malfunctioning products or toxicity.
Psychological damage in children and adults caused by dental or? medical procedure.
Masked psychological damages and impairment due to physical injury, emotional trauma, ?chronic disabling conditions, pain, product liability/toxicity or “bystander” experiences.
Adjustment Disorders.

Contacting Us About Services

All clinical services are under the direct supervision or provision of Michael Abruzzese, Ph.D., HSPP. Dr. Abruzzese is a licensed clinical psychologist and also a licensed school psychologist. He is also a Clinical Instructor at the Tufts University School of Medicine and formerly a Clinical Instructor at Harvard Medical School . Dr. Abruzzese may be contacted directly for consultations and clinical inquiries at 508-775-6767. But if you are experiencing any kind of emergency or crisis, call 911 immediately for assistance.

Disclaimer of Clinical Advice and Therapeutic Relationship:

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