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Assessment Services

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Services List:

Mental Health Evaluation
Psychological Evaluation
Psychoeducational Evaluation
Neuropsychological Evaluation
Gender Affirming Surgery/Pre-Operation Mental Health Evaluation
Extended Time Testing
Independent Educational Evaluation (IEE)
Neurocognitive Evaluation

We specialize in various evaluations from developmental, psychiatric diagnostic, psychological, psychoeducational, pre-operation, independent educational, and neurocognitive. We assess clients as young as several months old through geriatric population (ages 70+). Our evaluations are individualized to the client’s reason for referral and referral question, specific needs, and purpose for obtaining the evaluation. We take a conservative approach to testing and will add to the testing battery as needed. Our evaluations can be completed in-person or virtually.

Mental Health Evaluation

We provide comprehensive mental health evaluations and special education for a variety of symptoms, including attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, autism, and gender dysphoria. Based on the evaluation, we provide evidence-based recommendations and treatment.
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Psychological Evaluation

We provide comprehensive psychological evaluations for all ages, which include a clinical interview and cognitive testing. This evaluation may assist in obtaining disability services and special education support.  
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Psychoeducational Evaluation

We provide comprehensive evaluations consisting of cognitive and academic/achievement testing for all individuals. This evaluation may be the initial step to identifying possible learning difficulties and obtaining special services.  
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Neuropsychological Evaluation

We provide comprehensive neuropsychological evaluations, which include measuring cognitive, academic, learning, social-emotional, language, sensorimotor, visuospatial, and executive functioning. This type of evaluation aims to understand the relationship between the brain and one's behavior. Individuals looking for accommodations on standardized tests require a neuropsychological evaluation.
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Gender Affirming Surgery/Pre-Operation Mental Health Evaluation

We provide specialized evaluations for pre-operation surgery. A mental health evaluation is usually required prior to certain surgeries and/or procedures. Based on our comprehensive evaluation, we provide treatment recommendations prior to the surgery/procedure.  
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Extended Time Testing

We provide testing for accommodations (e.g., extra time) for school and/or standardized tests (e.g., LSAT, PSAT, SAT, GRE, ACT, MCAT, GMAT, Bar exam). This type of evaluation requires a neuropsychological evaluation.   
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Independent Educational Evaluation (IEE)

We conduct Independent Educational Evaluations (IEE) to provide an objective perspective of your child’s strengths and weaknesses. IEEs can also be considered a second opinion. We provide the following IEEs: psychological, psychoeducational, and neuropsychological.
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Neurocognitive Evaluation

We conduct neurocognitive evaluations to clarify and assess the severity of impairment and the likely cause(s) for the change from previous functioning.
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Check Out Our Other Services

  • Psychotherapy
  • Executive Functioning Coaching
  • Consultation
  • Emotional Support Animal
  • Parent Management Training
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We provide specialized psychotherapy and various psychological assessments to meet your individualized needs.

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Copyright 2021 © Dynamic Learning Services

Disclaimer

By accessing, viewing, and using this site, you agree to be bound by the terms and conditions of use set out below. If you do not agree to be bound by these terms of use, then please leave this website.

This site is owned and operated by Michael Appelgren. All rights are reserved. No material from the site may be copied, reproduced, republished, uploaded, posted, transmitted, or distributed in any form or otherwise without prior written permission of its owner. The information contained on this website is intended to provide general information on mental health assessments and psychotherapy regarding various mental health issues, as well as services provided by Michael Appelgren and clinical staff. The information presented on this website is believed to be reliable when posted. Michael Appelgren and clinical staff do not guarantee or warrant the quality, accuracy, completeness, timeliness, or appropriateness of this information. Michael Appelgren and clinical staff will not be responsible for any direct, indirect, incidental, consequential, special, exemplary, punitive, or any other monetary or other damages, fees, fines, penalties or liabilities whatsoever arising out of, or in connection with, this information, the website, nor liable for any errors or omissions that may be found in the information or the results obtained from the use of the information. By using this website, you assume full responsibility for the use of the information. You agree not to make any claims whatsoever against Michael Appelgren and clinical staff in connection with any of the foregoing. All information presented on this site is not a substitute for medical or other professional advice, diagnosis, or treatment of specific medical conditions. You should visit a qualified physician or health care professional for individual and personal attention related to any medical issue. Any links Michael Appelgren provides on the site to other websites are provided as reference only and do not constitute or imply endorsement by Michael Appelgren or clinical staff. Such external sites contain information posted by organizations that function independently of Michael Appelgren, and Michael Appelgren is not responsible for the accuracy, timeliness, or appropriateness of the information presented on such websites, nor does Michael Appelgren endorse, warrant, or guarantee the products, services or information described or offered at these sites.

Privacy

Information provided in the contact forms will be kept confidential and will not be sold to entities outside of Dynamic Learning Services. Providing confidential information in the contact form will allow Michael Appelgren and/or clinical staff to contact you to follow up regarding your request(s). It is important to note there are risks whenever you use electronic devices or submit confidential information electronically or through the internet. To the extent possible, your information will be kept confidential. By providing contact and other relevant information will constitute your agreement despite the known risks aforementioned. You agree not to hold Michael Appelgren or clinical staff responsible for a breach of confidential information resulting from the use of third-party services.

Equal Care

Your culture is of great importance to us and how we provide treatment. Equal care is provided to all clients regardless of race, color, religion, creed, age, gender, gender expression, national origin, disability, marital status, sexual orientation, or military status.

Disclaimer

Mental Health Evaluation

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Assessing with Confidence

What Could I Expect?

Our clinicians have a range of experiences working with diverse populations and assessing different mental health symptoms. We provide thorough and comprehensive mental evaluations for individuals of all ages (children, adolescents, and adults) based on symptomology and provide appropriate recommendations for intervention.

What is the Intake Process?

There will be an initial interview prior to testing, which occurs over the phone. You will consult with a clinician and determine the next steps forward and how we can meet your needs. During this time, our clinicians will provide information about the evaluation process and answer any questions you may have. We share the different services we offer, explain our accepted forms of payment, and schedule an appointment.

Considerations for Mental Health Conditions Include:

  • Duration of symptoms (e.g., How long have symptoms been present?)
  • Frequency of symptoms (e.g., how often are symptoms occurring or present?)
  • Age of Onset of symptoms
  • Level of Distress (e.g., mild, moderate, severe)
  • Level of Impairment (e.g., lack of employment, academic failure)
  • Due to medical reasons or substance abuse

Feeling overwhelmed by life events? Struggling to maintain meaningful relationships with others? Feeling sad? Constantly worrying about the future or about your career? If you can relate, you might be one of many individuals who are struggling with mental health. We specialize in the assessment of a variety of symptoms, several including depression, autism, anxiety, depression, gender dysphoria, and attention-deficient/hyperactivity disorder.

What are the next steps? Don’t worry, our easy process is described below.

Clinical Interview

You will meet with a clinician to begin the evaluation. We start by building rapport and making you feel comfortable as we know this can be an overwhelming process. The clinical interview includes a discussion about your current unique challenges, early childhood and development, school and/or work, medical, and family histories.  Additional questions are asked about past and present mental health symptoms. There is no simple “test” that can identify a mental health condition, that is why we use multiple evidence-based assessments and best practices to come up with our conceptualization and understanding of the issues.

After the clinical interview, you and/or your child will be asked to complete several scientifically validated rating scales on the computer. These scales may be completed independently or with the assistance of your clinician. Afterward, we generate scores that are compared nationally with thousands of other individuals, with symptoms or without symptoms, to statistically calculate the severity and impairment of your current symptoms.

A brief break is provided to you so your clinician can formulate their thoughts based on the clinical interview, standardized measurements administered, and years of clinical experience working with diverse populations. Your clinician will analyze the information gathered and rule out disorders that may be similar to the current presenting symptoms.

Conclusions

Your clinician will meet to share and discuss the findings with you based on the information gathered and our expertise. Receiving a confirmation of a mental health condition can be confusing or overwhelming. For these reasons, we take the time to answer your questions and provide you with a holistic approach to treatment. Your clinician will provide you with the most appropriate recommendations and interventions, which include psycho-education. Your clinician will discuss various services provided at Dynamic Learning Services should you decide to pursue treatment or provide you with appropriate referrals for additional interventions.

Receiving an accurate diagnosis is the beginning step to welcoming change. Understanding the diagnosis (i.e., what it is and what it is not) may help explain why it is challenging for you to start a task, finish a task, keep yourself organized, or why you might feel sad or anxious. Seeking treatment can help you manage your symptoms.

Pyschological Evaluation

What is a psychological evaluation?

A psychological evaluation consists of a series of formal and structured psychological tests, as well as clinical interviews to help identify one’s emotional, behavioral, and cognitive profile. Psychological evaluations may be administered in writing or verbally, or conducted in-person or via the computer. Psychological evaluations can be used in the identification of intellectual differences and personality disorders.

What is included in the psychological evaluation?

A psychological evaluation can include multiple components such as:

    • Structured and Unstructured Clinical Interviews
    • Review of Records (e.g., educational, family, medical, psychiatric)
    • Mental Status Exam
    • Clinical Observations
    • Administration of Cognitive Measures (e.g., WISC-V or WAIS-IV)
    • Formal Rating Scales/Survey

What does the cognitive test measure?

There are different types of cognitive measures (e.g., verbal and nonverbal). Cognitive measures assess one’s potential and examines the following areas:

  • Verbal Reasoning
  • Nonverbal Reasoning
  • Visual Processing
  • Cognitive Proficiency (i.e., working memory and processing speed)

What is the psychological evaluation process?

Similar to the Mental Health Evaluation, the process begins with an initial consultation. Afterward, an evaluation appointment is scheduled with our staff. On the day of the evaluation, a clinical interview will be completed to clarify any information in the intake paperwork, and gain insight into the client’s symptoms (e.g., mood, anxiety, executive functioning) and impairment in functioning. Norm-reference psychological tests will be administered. Once all of the information is gathered, your clinician will conceptualize the underlying symptoms based on extensive professional knowledge, prior experience, and up-to-date research. The results will then be communicated to you outlining the most appropriate next steps and interventions.

Psychoeducational Evaluation

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What is a psychoeducational evaluation?

A psychoeducational evaluation consists of a series of formal and structured psychological and academic/achievement tests, as well as clinical interviews to help identify one’s emotional, behavioral, learning, and cognitive profile. Psychoeducational assessments may be administered in writing or verbally, or conducted in-person or via the computer. This evaluation can be used to determine eligibility for special education services, 504 accommodations plan, or accommodations on standardized tests (e.g., SAT, ACT, Bar Exam).

 

What is included in the psychoeducational evaluation?

A psychoeducational evaluation can include multiple components such as:

  • Structured and Unstructured Clinical Interviews
  • Review of Records (e.g., educational, family, medical, psychiatric)
  • Mental Status Exam
  • Clinical Observations
  • Administration of Cognitive Measures (e.g., WISC-V and WAIS-IV)
  • Administration of Academic/Achievement Measures (e.g., WIAT-IV and KTEA-3)
  • Formal Rating Scales/Survey

What does the cognitive test measure?

There are different types of cognitive measures (e.g., verbal and nonverbal). Cognitive measures assess one’s potential and examine the following areas:

  • Verbal Reasoning
  • Nonverbal Reasoning
  • Visual Processing
  • Cognitive Proficiency (i.e., working memory and processing speed)

What does the academic and achievement test measure?

Just the same as cognitive measures, there are various academic and achievement tests. Academic and achievement tests are designed to measure one’s level of skills and proficiency of knowledge in different domains such as:

  • Language Processing
  • Writing (e.g., spelling skills and essay composition)
  • Reading (e.g., basic reading skills and reading comprehension)
  • Mathematics (e.g., basic calculation and word problem-solving)

What is the psychoeducational evaluation process?

Similar to the Mental Health Evaluation and Psychological Evaluation, the process begins with an initial consultation. Afterward, an evaluation appointment is scheduled with our staff. On the day of the evaluation, a clinical interview will be completed to clarify any information in the intake paperwork, and gain insight into the client’s symptoms (e.g., mood, anxiety, executive functioning) and impairment in functioning. Norm-reference psychological and academic tests will be administered. Once all of the information is gathered, your clinician will conceptualize the underlying symptoms based on extensive professional knowledge, prior experience, and up-to-date research. The results will then be communicated to you outlining the most appropriate next steps and interventions.

Neuropyschological Evaluation

Are you or your child struggling academically? Do you suspect an intellectual disorder, learning disorder, ADHD, or Autism? A comprehensive neuropsychological evaluation can help clarify one’s functioning and guide appropriate treatments and interventions.

What is a neuropsychological evaluation?

A neuropsychological evaluation consists of a series of formal and structured psychological and academic/achievement tests, as well as clinical interviews to help identify one’s emotional, behavioral, learning, and cognitive profile. Neuropsychological assessments may be administered in writing or verbally, or conducted in-person or via the computer. A neuropsychological evaluation is used to assess brain-based disorders by examining cognitive and academic skills on brain function.

Benefits of receiving a neuropsychological evaluation

  • Receiving a comprehensive neuropsychological evaluation will provide an in-depth and holistic examination of one’s strengths and weaknesses.
  • A neuropsychological evaluation provides additional information that might not be assessed if a psychoeducational evaluation was previously administered.
  • Neuropsychological evaluations can provide answers to why an individual continues to struggle or does not make adequate progress despite receiving specialized and intensive supports.
  • Individuals who are seeking accommodations for standardized testing (e.g., SAT, GRE) are required to undergo a neuropsychological evaluation.

What is included in the neuropsychological evaluation?

A neuropsychological evaluation can include multiple components such as:

  • Structured and Unstructured Clinical Interviews
  • Review of Records (e.g., educational, family, medical, psychiatric)
  • Mental Status Exam
  • Clinical Observations
  • Administration of Various Measures
    • Cognitive Measures (e.g., WISC-V and WAIS-IV)
    • Academic/Achievement Measures (e.g., WIAT-IV and KTEA-3)
    • Language Measures
    • Direct Measure of Executive Functioning (e.g., D-KEFS)
    • Learning and Memory Measures (e.g., WRAML-3)
    • Sensorimotor and Visuospatial Measures
  • Formal Rating Scales/Survey (e.g., BASC-3)
Learn About Extended Time Testing

What is the neuropsychological evaluation process?

Similar to the Mental Health Evaluation, Psychological Evaluation, and Psychoeducational Evaluation the process begins with an initial consultation. Afterward, an evaluation appointment is scheduled with our staff. On the day of the evaluation, a clinical interview will be completed to clarify any information in the intake paperwork, and gain insight into the client’s symptoms (e.g., mood, anxiety, executive functioning) and impairment in functioning. Norm-reference psychological, academic, language, memory, and executive functioning tests will be administered. Once all of the information is gathered, your clinician will conceptualize the underlying symptoms based on extensive professional knowledge, prior experience, and up-to-date research. The results will then be communicated to you outlining the most appropriate next steps and interventions.

Gender Affirming Surgery / Pre-Operation

Are you or a loved one undergoing surgery or procedure requiring a mental health evaluation? We provide specialized evaluations to assist in pre-operation procedures. As with most evaluations, it begins with a clinical interview to obtain background information. The evaluation includes a review of records and collateral information. The clinical interview focuses on behavior, psychiatric symptoms, and understanding of the surgery. The information discussed in the clinical interview is critical to assess the appropriateness of surgery and to enhance the client’s success during the post-surgery adjustment. The evaluation may require multiple sessions.

Components of the Evaluation

  • Reasons for Seeking Surgery
  • Informed Consent
  • Understanding of the Surgery and its Associated Lifestyle Changes
  • Social Supports
  • Psychiatric Symptoms (current and past)

Receive your 15-minute free consultation with a knowledgeable clinician.

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Extended Time Testing

How do I find out if I require accommodations for standardized tests?

A comprehensive evaluation, usually neuropsychological testing, can help identify required accommodations for standardized tests needed to meet criteria for testing boards. If you have a confirmed or suspected diagnosis of anxiety, depression, Autism, ADHD, or learning disorder and demonstrate significant difficulty causing a disability, the testing board should provide accommodations. The initial step to seek accommodations is to receive comprehensive testing.

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We have shown to be successful in helping individuals obtain the required accommodations for standardized tests. We understand what the testing boards require as documentation for accommodations. We offer testing on weekends and can have a report within 2 weeks. We offer expedited services if needed.

What are accommodations at school?

This is not an exhaustive list, but provides examples of accommodations:

    • Shorter assignments
    • Additional time to complete assignments
    • Seating close to instruction
    • Use of visual schedules
    • Advanced copy of class notes
    • Use of assistive technology
    • Redirection and prompting

Need extra time in school or on standardized tests?

Do you or a loved one need accommodations on standardized tests? Would extra time or multiple breaks help you demonstrate all your knowledge? Standardized tests are our way of life now and are present in elementary schools through high school and even in post-secondary education. Standardized testing can be nerve-racking and intimidating. We can see if you require accommodations through the Americans with Disabilities Act (ADA).

What are accommodations for standardized testing (e.g., SAT, GRE, LSAT, MCAT, GMAT)?

Examples of accommodations include:

  • Extra time (50% or 100%)
  • Use of assistive technology
  • Extra or extended breaks
  • Changes in the testing environment (e.g., testing in a separate room)
  • Changes in the timing of testing (e.g., stop time during breaks)

What are accommodations?

Accommodations are a change in teaching or testing procedures to provide an individual with an equal opportunity to demonstrate their knowledge and skills.

Consider the following as an example of an accommodation. Two individuals are required to copy notes from the classroom board, one individual has 20/20 vision (good eyesight); however the second individual cannot see far objects and, therefore, has difficulty copying objects from the board. The person with poor vision would be accommodated with the use of prescription eyeglasses. That is, the individual requires an accommodation (e.g., use of eyeglasses) because they would not be able to accomplish the task  (e.g., copying from the board). Accommodations are not meant to provide an advantage for an individual, but they are meant to allow the individual the same opportunity to be successful as their peers.

Documentation Needed for Accommodations

It will be important to maintain school records, such as report cards, Individualized Education Program (IEP), accommodations plan, previous evaluations (e.g., psychoeducational), and teacher reports about what they observe in the classroom and the need for more time in the classroom to complete tests and/or tasks. These are essential to include in the evaluation to demonstrate a history of challenges. Additionally, it will be important to provide any medical reports or letters from a primary physician, neurologist, or psychiatrist indicating a diagnosis, including ADHD, learning disorder, Autism, anxiety, depression, communication disorder, or intellectual disorder. Providing documentation of accommodations provided in the past (formal or informally) on standardized tests will demonstrate the challenges with working quickly are long-standing and unremitting.

It will be important for you to understand and be able to explain how your disorder and/or symptoms lead you to not being able to complete a task, causing a disability, which leads to the need for accommodations (e.g., extra time). This, in turn, will help you advocate for yourself, and understand your strengths and weaknesses.

Important Links

Click on the name of the test you are taking/planning on taking for more information on how to apply for accommodations on standardized tests:

INDEPENDENT EDUCATIONAL EVALUATION (IEE)

What is an IEE?

An independent educational evaluation a.k.a. an IEE is an evaluation conducted by a qualified person who is not employed by the school district the student attends at the public’s expense. This request can be made by a child’s parent. Families may seek an IEE to have an objective perspective of the child’s needs. The testing procedures for the IEE are the same as those followed by the school district.

Possible reasons for requesting an IEE

  • There is no qualified person to perform the evaluation
  • You believe the school/evaluator is using insufficient or outdated information to make individualized education program (IEP) decisions
  • If the evaluator did not assess all areas of suspected disability
  • Disagreement between the results and actual performance day-to-day
  • Evaluation not done in child’s home language and/or was not culturally appropriate

How do I request an IEE?

Submit a written letter to the special education coordinator,
case manager, or principal at your child’s school. You can also send the letter
by email or certified mail (dependents on the district’s policies). Include the
following:

  • Child’s name, school, date of birth, and identification (ID) number
  • State you are requesting an IEE at the Department of Education’s (DOE) expense
  • Briefly state the reasons why you are requesting an IEE
  • Ask that the school respond about the next steps to get the IEE
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Important Links

NEUROCOGNITIVE EVALUATION

What is a neurocognitive evaluation?

Concern for cognitive change (commonly called a chief complaint of memory loss) usually triggers the need for a neurocognitive evaluation. This usually happens in older individuals (age 65+) but can be present in younger adults. We use a systematic approach to evaluating an older adult client presenting with cognitive impairment or decline from previous functioning. The goal of this diagnostic evaluation is to determine the severity of impairment and the likely cause(s). This evaluation can help clarify traumatic brain injury (TBI), dementia, Alzheimer’s disease, and motor disorders (e.g., Parkinson’s), as well as differentiate cognitive impairments due to mood disorders and anxiety.

Components of Neurocognitive Evaluations

  • Review of Records (e.g., medical records, previous evaluations)
  • Cognitive Measures (e.g., WISC, K-BIT)
  • Memory (e.g., WMS-IV, CVLT-3)
  • Language Processing (e.g., Boston Naming Test, EVT-3, PPVT-5)
  • Executive Functioning (e.g., WCST, D-KEFS, CTMT2)
  • Motor Skills (e.g., grooved pegboard, finger tapping)
  • Academic Measures (e.g., WRAT-5, Test of Premorbid Functioning, WIAT-4)
  • Mental Status Exam
  • Test of Malingering (e.g., TOMM)
  • Rating Scales and Adaptive Functioning
    • Dementia Rating Scale (DRS-2)
    • Independent Living Scales (ILS)
    • Anxiety (e.g., BAI), Depression (e.g., BDI-II, GDS), Trauma, Substance Use Scales
    • Personality (e.g., MCMI-IV, MMPI-3)

What is the neurocognitive evaluation process?

The evaluation begins with a thorough background history with the client and collateral informant (e.g., spouse, partner, parent, sibling) and a mental status examination of the client. The clinician will review medical records such as brain imaging (e.g., MRI or CT scan) and lab tests. The client will be administered a series of standardized measures as listed above. At the end of the evaluation process, a feedback session is conducted to go over the results and discuss recommendations and treatment planning.

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Important Links

Psychotherapy Services

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Therapy at Dynamic Learning Services

At Dynamic Learning Services, we offer individual, couple, and family therapy. We provide non-judgmental, holistic, collaborative, using primarily evidence-based cognitive-behavioral therapy (CBT) and trauma-focused cognitive-behavioral therapy (TF-CBT) when working with a diverse population. We use gender-affirming language when working with individuals who identify as LGBTQIA+.

Our experience includes treating a variety of symptoms, including anxiety, depression and mood, attention-deficit/hyperactivity disorder (ADHD), specific learning disorder, autism, executive functioning, and posttraumatic stress disorder (PTSD).  Additional therapy modalities include solution-focused therapy, motivational interviewing, and communication/interaction family therapy.

What is Cognitive-Behavioral Therapy (CBT)?

The premise of CBT is that how we perceive situations (i.e., cognitions) affects our feelings and our behaviors.  CBT tries to identify the underlying assumptions and beliefs that are causing impairment or dysfunction and challenge automatic thoughts through cognitive restructuring. CBT is evidence-based and is considered a brief psychotherapy approach.

Step 1: Reflect

The first step in initiating therapy is to reflect on whether you are ready to make changes in your life. Therapy can be challenging and frustrating and can feel like a waste of time if you are not receptive to making different decisions to allow yourself to grow.

Step 2: Evaluation

If you choose to pursue treatment with us, you or you and your child will meet with a clinician so they may learn more about the current symptoms. During this time, the clinician will ask about challenges faced at home and in school.  After the evaluation, the clinician will provide initial diagnostic impressions and recommendations.

Step 3: Treatment Planning

Your clinician and you will collaborate and develop a personalized treatment plan based on the current symptoms and the severity of symptoms. The treatment plan will incorporate the goals you identify for treatment.

Step 4: Reevaluate Your Progress

Periodically, you and your clinician will meet to review what is working in sessions and make adjustments to treatment as needed.

Step 5: Termination

Termination in therapy is typically referred to as the period in which the psychotherapy relationship comes to an end. There are several reasons for termination, which includes achieving therapeutic progress (i.e., decrease in symptomology and intact functioning), the client’s lack of commitment to therapy, or symptoms are beyond the scope of available care. Termination can be a stressful time for clients; therefore, your clincian will assist you in processing your thoughts and feelings toward termination, discuss the next steps, and provide appropriate referrals if needed.

Executive Functioning Coaching

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What is Executive Functioning?

There are multiple definitions, explanations, and theories of executive functioning and there is no consensus of a single definition. From our experience and an easy way to think about executive functioning is imagining an orchestra conductor of all other orchestra conductors in the brain. It is the part of the brain that cues and directs how the brain works and processes information. 

Executive functioning is located in the frontal lobe of the brain (the area right behind the forehead), and it takes about 20-something years to develop and fully mature. Our executive functioning helps not only with the organization but also assists in the managing of our emotions and our behaviors.

How do I know if I have difficulty with executive functioning?

If you struggle with daily functioning such as keeping up with assignments and projects, decision-making, difficulty staying focused when required, then you might have vulnerability in your executive functioning. If you think or suspect you have an attentional disorder, such as attention-deficit/hyperactivity disorder (ADHD) then testing can help clarify your skills. Testing for executive functioning weaknesses should be completed as part of a full evaluation that looks at how you learn and think. Licensed psychologists and/or neuropsychologists can conduct the necessary evaluation to assess executive functioning.

How does executive functioning affect my life?

Here are some signs and issues individuals struggle with when executive functioning is impaired:

  • Trouble starting and/or completing tasks
  • Adjusting processing speed (e.g., difficulty completing timed tasks)
  • Prioritizing a task
  • Completing a task but not handing it in
  • Estimating how long a task will take
  • Difficulty following multistep directions
  • Becoming easily frustrated
  • Interrupting others
  • Forgetting appointments

Services Offered

We provide individualized and prescriptive organizational skills training to address an individual’s executive functioning. We start with an initial assessment (e.g., clinical interview and rating scales) to obtain a baseline and pinpoint the areas of need.

Each session consists of direct instruction on the identified executive functioning skill. Individuals will be tasked to practice the skills taught, discussed, and reviewed in sessions from week to week. Reflection and metacognition (awareness and understanding of one’s own thought processes) are important components of the training.

How do you assess executive functioning?

There are measures and tests that look at a wide range of executive skills.

Measures used to assess executive functioning:

  • Intelligence
  • Trail Making
  • Rating Scales (broadband and narrow)
  • Informal (observations, background/developmental history)

Executive skills include:

  • Attention
  • Inhibition
  • Processing Speed
  • Word Retrieval
  • Set Shifting/Cognitive Flexibility
  • Working Memory

Consultation Services

Pre-Evaluation

Have you received previous evaluations and/or have Individualized Education Programs (IEP) and are not sure what should come next? Do not worry, our team will thoroughly review all the past reports and documentation. With permission, we will also contact current and past treatment providers and/or teachers. Once the information has been reviewed, we can discuss the next steps including a personalized evaluation and intervention plan. It is important to obtain an accurate diagnosis to be able to identify the most effective treatment.

Check Out Our Assessment Services

Special Education and Individualized Education Program (IEP)

Special Education and the IEP Process can be overwhelming and confusing. You recognize your child is struggling academically or socially and want the best possible plan to ensure academic success. You might ask yourself, “what is the difference between a 504 plan or an IEP?” We have years of experience working in NYC and NJ school systems so we understand the process. We can explain special education law and the IEP process in detail. Initially, we will review background information such as previous evaluations and IEPs. At times an updated evaluation or additional testing may be warranted after a review of records. Afterward, we will work with you to create a meeting strategy to prioritize the most effective classroom placement, supportive services, and accommodations for your child.

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Independent Evaluations

Has your child been referred for an evaluation to determine eligibility for special education but you are not in agreement? We offer independent (second opinion) educational evaluations (IEE) when necessary. The initial step is for our dedicated and experienced staff to review background information and previous evaluations. Then we create an individualized testing plan that addresses your concerns. Once testing is complete, we will create a plan to discuss educational placement, supportive services, and accommodations for your child. We also consult with other professionals such as occupational therapists, physical therapists, speech-language pathologists, psychiatrists, and neurologists.

Check Out Our Assessment Services

LGBTQIA+

Does your workplace need training on LGBTQIA+ related topics? Are you in need of a trainer/presenter at your school to discuss how staff can support LGBTQIA+ youth? We have expertise in providing training to different audiences on LGBTQIA+ topics. We have experience providing consulting services to school districts (e.g., administrators and teachers) and mental health practitioners (e.g., social workers). We believe it is important to provide supports in school and in the workplace for LGBTQIA+ individuals.

Read Dr. Michael Appelgren’s dissertation titled:

Descriptions of Psycho-Social and Academic Support Systems in Schools for Gay, Lesbian, Bisexual, Transgender, Queer, and Questioning Middle School and High School Students

Emotional Support Animal (ESA)

Young Woman Embracing Dog

Emotional Support Animal vs. Service Animals

Although the terms are frequently used interchangeably, they are different. A service animal (e.g., dog) is trained to assist and guide a person with an identified disability that impairs one’s physical, intellectual, sensory, or mental functioning. Service animals help an individual with a disability perform everyday tasks, such as pressing the elevator button, altering the person to anger, picking up dropped items, and pulling a wheelchair.

An emotional support animal (ESA) provides relief to its owner as a result of having an emotional or mental disability and provides companionship and relieves loneliness. Under the Americans with Disabilities Act (ADA), an ESA encompasses animals from all species. It is important to note that over the years there has been an increase in emotional support animals (ESAs) on airplanes, in community settings, and in homes/apartments. Airlines and landlords beginning to tighten up the way they are coping with the increase of ESAs.

Qualifying Conditions For An ESA

These are some of the common mental health disabilities that qualify an individual for an ESA:

  • Anxiety
  • Depression
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Chronic Stress
  • Post-Traumatic Stress Disorder (PTSD)

Benefits/Risks of ESA

The following are examples of some of the benefits of ESAs:

  • Helps reduce mental health symptoms (e.g., anxiety, depression)
  • Provides unconditional love
  • Works in conjunction with other forms of treatment
  • Provides social support
  • Helps stabilize intense emotions

Possible risk of being granted an ESA would require a letter indicating the presence of a disability that becomes part of the individual’s clinical record. Questions about mental health disability can be asked about as qualifications in certain employment. In some states, the mental health evaluator is required by law to inform the state of a person’s mental health disability. Mental health disabilities can come up when seeking government security clearance and life and disability insurance. A finding of a mental health disability and not reporting it on certain applications may have serious consequences for the individual. Documentation of a mental health disability can become a factor in child custody cases.

Considerations For ESA Evaluation

First and foremost, legal and ethical considerations must be taken when providing an evaluation for ESAs. Regarding this point, mental health professionals must avoid entering into multiple relationships. If a client is already in therapy with a provider, then the clinician must consider their dual role of therapy provider and evaluator. A clinician must be able to identify any biases or other factors that might possibly interfere with the therapeutic relationship.

Second, the individual seeking the accommodation of an ESA must meet the criteria for a psychiatric disorder (e.g., anxiety, PTSD, depression) consistent with the Diagnostic and Statistical Manual- 5th Edition (DSM-5) and be assigned the disorder by a mental health professional. The individual must qualify as disabled based on a mental health condition and the presence of the animal must provide some relief of symptoms to the individual. A disability describes a psychological condition that substantially interferes with the individual’s ability to perform major life activities. It means the person requires the presence of the animal to function or remain psychologically stable, which is more than having a pet.

One of the limitations of the evaluation is the fact the assessment of the animal is beyond the scope of the evaluator’s skill set. Clients may consider assessing the animal’s temperament by obtaining documentation such as the Canine Good Citizen (CGC) test.

Check out ESA Assessment Checklist

Emotional Support Animal Evaluation Process

The evaluation process for an ESA may require multiple sessions.

Clinical Interview- A thorough and comprehensive interview will be conducted with one of our trained professionals in-person or virtually. The interview would include background history and mental health symptoms. Information will be gathered through direct interviews, as well as the use of multiple tools (e.g., surveys and rating scales). A review of previous records and collateral information is also part of this process. The evaluation also assesses the presence of malingering using objective measures (e.g. MCMI-IV, MMPI-2), how does the animal alleviate their owner’s symptoms, and how the animal responds in public settings and with others. The evaluation also includes observing the client and animal interact.

Click On The Following Links To Find Information about ESA laws in NJ, NY & PA.

NJ ESA Housing Law | NY ESA Housing Law | PA ESA Housing Law

Click on the following link to access information from the US federal government on the use ESAs on airplanes. It is recommended that you contact the individual airlines to get specific information about ESAs.

Air Carries Access Act (ACAA)