Services Offered
Many treatment plans will include assessment, therapy, and parent support. However, there are times when you may only need or be seeking one component.
Prior to jumping into intervention, an assessment is needed to help understand the core symptom presentation and confirm you are in the right place. Oftentimes, this will look like identifying a clinical diagnosis, such as OCD, Specific Phobia, or another anxiety disorder. Diagnosis and understanding symptoms helps us determine where to start in treatment.
At Freely Living, the assessment phase incorporates written responses from parents, symptom check-lists, parent and child interviews, and administration of OCD-specific measures as indicated.
The assessment phase does not include full rule-outs of neurodivergent diagnoses (autism, ADHD) or PANS/PANDAS; however, includes initial screening that may lead to discussion and referrals if indicated. Assessment is often ongoing as, over time, we are all able to learn more about your child.
If you are already established with a provider and are wondering about an OCD diagnosis, Dr. Hoffman is able to assist in assessing for symptoms of OCD to help rule-in or rule-out this diagnosis.
Dr. Hoffman does not offer comprehensive psychological evaluations.
Assessment
Following assessment, many individuals begin with weekly therapy. At this pace, we can often build momentum to set your child up for progress.
Therapy typically starts with psycho-education, so everyone can understand the patterns that are occurring, what maintains them, and how the brain and body are all involved.
With that understanding, we can move into more active stages of intervention.
Exposure and Response Prevention is commonly the first line approach for youth with an OCD diagnosis, and Exposure Therapy, for those with a phobia. These treatments involve understanding obsessions, compulsions, safety behaviors, avoidance, and accommodations and carefully designing a plan to change the patterns, one step at a time. At Freely Living, your child is in the driver’s seat to set the pace and level of difficulty, with guidance and support from Dr. Hoffman. As often as possible, parents are involved in this process.
When ERP and exposure based treatments are not the right fit, or perhaps your child is struggling with another form of anxiety, there are other options for treatment.
Dr. Hoffman routinely integrates Acceptance and Commitment Therapy (ACT) into treatment plans to help assist in accepting and welcoming challenging emotions and experiences while taking steps that are in line with an individual’s values. She is also experienced in Inference-Based Cognitive Behavior Therapy (I-CBT), a cognitive approach to OCD treatment that helps individuals better understand how they have come to their doubt, whether that’s a reliable process, and learn how to trust themselves and their senses. Of note, I-CBT has research support for adults and has yet to be studied with kids.
Therapy
Professional Consultation
For mental health clinicians, Dr. Hoffman offers individual consultation sessions to help explore interventions and care for your complex clients. OCD treatment, including ERP, can look simple on the surface. However, at an individual level there are times when applying what you have learned requires creativity and adaptation. Diagnosing OCD can be complex as well, and you may have questions about how to guide your process to help better identify and support those who are experiencing it.
If you do not need full supervision, but would like to talk through some ideas to help support your work, please reach out about as needed or ongoing consultation.
For many youth with OCD and anxiety, parent support is a critical component of care. Parents are often pulled into patterns of reassurance, avoidance, and accommodation to help manage distress in the moment. This can look like helping the child avoid challenging situations by doing them for them, removing expectations, or pulling them out early. Parents may find themselves answering repetitive questions, being a listening ear for confessions, or offering logic and explanation to try and convince their child it is okay to do something. Further, they may make subtle or large changes in how they conduct their own behavior to avoid triggering OCD or anxiety.
When OCD, phobias, or anxiety are the root cause of these behaviors, well-timed, planned, and supportive changes are often incredibly helpful. They give your child a chance to gain confidence and experience that helps them step further out of these patterns. At times, there are other reasons for these behaviors (PANS/PANDAS flare, autistic/ADHD/sensory need), which is why understanding the driver is incredibly important for well-matched treatment. Parenting in general is not an easy task, and when there is added complexity, particularly when helpful responses feel counter-intuitive, having guidance along the way can make a difference.
For younger youth, parents are nearly always in session, learning alongside us and identifying ways they can change their own patterns and behaviors to support the child. For teenagers, parents may be less involved in session. Depending on the presenting concerns, doing their own learning can be a great support and Dr. Hoffman can help suggest resources.
Now you may be wondering, what if my child won’t attend therapy? What if I only want parent support? or What if my child doesn’t want me working with their therapist but I need to learn all of this too? That’s where parent-only work can come in. There is evidence that progress can be made for some youth by parent changes alone. And there are times when that is the best suited intervention for a given family. Dr. Hoffman is glad to work with parents when the primary goal is to understand OCD, phobia, or anxiety patterns (and help tease them apart from other needs when relevant), and help parents make changes to their own behaviors in support of the child.
Dr. Hoffman is well-versed in accommodation reduction models, such as that promoted in Supportive Parenting of Anxious Childhood Emotions (SPACE).
