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Understanding Treatment

HEALTHY PEOPLE SEEK HELP
OHEL provides comprehensive mental health services to those facing acute mental illness and everyday individuals and families confronted by everyday emotional challenges.

Today our generation faces mounting pressure from everyday life stresses and being proactive is the smartest thing you can do. With over 43 years’ experience in strengthening the emotional well-being of individuals and families, OHEL provides a depth of highly experienced professionals, fluent in English, Hebrew and Yiddish and who are sensitive to the different cultural sensitive of diverse communities.

Below you will find an informative overview to understanding mental health treatment services.

WHAT IS PSYCHOLOGICAL EVALUATION?

A psychological evaluation is a series of tests provided by a licensed psychologist or by a certified school psychologist  (in a school setting) in order to determine a child’s cognitive, academic, social/emotional, behavioral and personality functioning.  Tests included in a psychological evaluation may include IQ tests, neuro-psychological tests, social/emotional checklists, behavioral questionnaires, tests of visual perception, attention and concentration, academic functioning and personality functioning.  When testing children, a clinical interview of the parents, which may inquire about medical, academic, social/emotional, psychiatric and developmental history is crucial.  A clinical interview with the child as well as behavioral observations of the child during the testing process is also an essential part of the evaluation.  

A Psychological evaluation may be indicated for an adult in cases of competency evaluations, child custody situations, or in the application for certain positions.  The same tests or adult versions of the tests listed above are administered.

Once all tests are administered and scored, a profile can be developed which will indicate the person’s cognitive strengths and weaknesses, the possibility of learning disabilities,  neurological impairment, interpersonal functioning and emotional disturbance, to name a few of the themes addressed in an evaluation.  It is important to note that one test alone should not be used to formulate a profile or diagnosis. The psychologist will look for similar themes or functional levels that are exhibited across the spectrum of the administered tests.  A comprehensive report is written which indicates how the person is functioning in all areas.  Recommendations are made based on test findings.  Usually, the actual scores for each test are provided as well.  The report should be reviewed with the person or with the parents receiving the report so that results and recommendations can be properly understood.  

WHAT IS PSYCHIATRIC EVALUATION?
A psychiatric evaluation is a comprehensive interview conducted by a licensed adult or child psychiatrist. During the interview, information is gathered about the patient’s presenting symptoms; what brings them for evaluation at this time; historical information, such as information on family of origin, psychiatric history of patient or their family, developmental history, and medical history; current functioning in a variety of areas including interpersonal relationships and behavior at home, school, or job; and drug or alcohol history.  In addition, the psychiatrist will conduct a mental status exam, which determines the current psychiatric status of the patient at the present time.  During the mental status exam, the psychiatrist can evaluate whether the patient is harmful to self or others, psychotic, depressed, highly anxious etc.

Depending on the results of the evaluation, the psychiatrist may recommend medication.  If medication is prescribed, the psychiatrist will ask to see the patient within a short period of time to determine whether the medication is working properly, possible side effects, and dosage titration.  Once a patient is stabilized on medication, psychiatric monitoring via a medication evaluation may only be necessary once every few months.  If the patient’s condition improves, the patient can be weaned off the medication.  Contrary to what many people believe, a person may not have to be on psychiatric medication forever. However, it should be noted that psychiatric medication should only be prescribed by a licensed psychiatrist.  In addition, going on or off medication needs to be done under the supervision of the psychiatrist and not on one’s own.  

WHAT IS PLAY THERAPY FOR CHILDREN?
Play is an essential component of healthy child development.  It helps children develop a sense of mastery, increase communication skills, and promote interpersonal skills.

Play Therapy is a popular form of counseling or psychotherapy that uses play, verbal and non-verbal, to explore psychological dynamics within the child and to help the child communicate their thoughts and feelings.  The goal of Play Therapy is to help the child understand and resolve their psychological issues, which may manifest in problems such as parent/child relations, social/emotional issues, and behavior at school. Play therapy can help the child achieve better social integration, and in general help the child emotionally grow and develop in a richer and more positive manner.  Play therapy is one form of child therapy. Some therapists who work with young children will often work with the parents, either with the child present or via parenting sessions in addition to the individual child sessions.

Play Therapy can also be used as a tool of diagnosis. A play therapist can observes a child playing with toys (play-houses, pets, dolls, etc.) to determine the cause of the disturbed behavior. The objects and patterns of play, as well as the willingness to interact with the therapist, can be used to understand the underlying rationale for behavior both inside and outside the session. 

Play therapy can be divided into two basic types: nondirective and directive. Nondirective play therapy is a non-intrusive method in which children are encouraged to work toward their own solutions to problems through play. It is typically classified as a psychodynamic therapy. In contrast, directive play therapy is a method that includes more structure and guidance by the therapist as children work through emotional and behavioral difficulties through play. It often contains a behavioral component and the process includes more prompting by the therapist. Directive play therapy is more likely to be classified as a type of cognitive behavioral therapy.

Licensed therapists, such as psychologists, social workers, mental health counselors can all provide play therapy provided that they have been trained to work with children and have been trained in play therapy techniques.

WHAT IS PSYCHOTHERAPY- FOR INDIVIDUALS, COUPLES OR FAMILIES?
Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client, patient, family, couple, or group. If a person is having a psychological problem, like depression or anxiety, that is affecting his individual functioning and/or interpersonal relationships (home, work, or marriage), psychotherapy may be indicated. Individual psychotherapy is usually done by a licensed and trained mental health professional, who is a highly knowledgeable in the area of the presenting problem.

Psychotherapy aims to increase the individual's sense of his/her own well-being, coping mechanisms and overall functioning. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

 Psychotherapy may  be performed by practitioners with a number of different qualifications, including psychiatry, clinical psychology, counseling psychology, clinical or psychiatric social work, mental health counseling, marriage and family therapy, rehabilitation counseling, school counseling, play therapy, music therapy, art therapy, drama therapy, dance/movement therapy, occupational therapy, psychiatric nursing, psychoanalysis and those from other psychotherapies. It may be legally regulated, voluntarily regulated or unregulated, depending on the jurisdiction. Requirements of these professions vary, but often require graduate school and supervised clinical experience. Most forms of psychotherapy use spoken conversation. Some also use various other forms of communication such as the written word, artwork, drama, narrative story or music. Psychotherapy with children and their parents often involves play, dramatization (i.e. role-play), and drawing, with a co-constructed narrative from these non-verbal and displaced modes of interacting

Therapy is generally used in response to a variety of specific or non-specific manifestations of clinically diagnosable and/or existential crises. Treatment of everyday problems is more often referred to as counseling. However, the term counseling is sometimes used interchangeably with "psychotherapy".

There are several main broad systems of psychotherapy, including but not limited to psychodynamic, cognitive behavioral, systemic (often used in family treatment) and humanistic.  Psychotherapy can be performed individually, with couples, or with groups such as a family or specialized group (parenting group, socialization groups, etc).

While some psychotherapeutic interventions are designed to treat the patient using the medical model, many psychotherapeutic approaches do not adhere to the symptom-based model of "illness/cure". Some practitioners, such as humanistic therapists, see themselves more in a facilitative/helper role. 

As sensitive and deeply personal topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect strict confidentiality.  A therapist may not speak with anyone other than the patient without written consent by the patient.  In the case of children, parents or legal guardians must sign release in order for the therapist to speak with anyone other than the parents or the child, such as grandparents, teachers, medical doctors, etc.

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