63 Fountain Street,
Framingham, MA 01702
Tel. (508) 872-4813
Fax. (508) 626-0454
Two percent of the U.S. population is adopted, some by step parents and other relatives or by genetically unrelated adults. Adoption touches many of us, either as a member of the adoption triangle (birth parent, adoptee, adoptive parent) or as a relative or friend of one of the three. All adoptions (infant, international, older child, special needs) create a legal family with unique issues. Many of these issues are also shared by long term foster families. The formative stages of the adoptive family life cycle can be both stressful and challenging. Therapists specializing in adoption/foster care/birthparent/reunion issues can provide crucial support for patients whose lives are affected by adoption.
Alcohol and Substance Abuse
Alcohol and substance abuse is a huge problem in the United States with one in every thirteen adults abusing alcohol and several million more engaging in more risky behaviors with medication or recreational drugs. Besides the obvious behavioral disorders that occur in combination with substance abuse there are many significant and serious and potentially lethal medical problems including liver disease, immune system illnesses, increased fatal accidents and acts of violence.
Substance abusers have significant difficulty recognizing or admitting that they have an illness and it is usually the people that they love who bear the brunt of the behaviors associated with the illness and who often beg them to seek help.
Addictions and dependencies on any substance usually include loss of control, strong craving, physical dependence, and accumulated tolerance. These four symptoms create a cycle of an increasing need for substance which causes more behavioral disturbances and increases the likelihood of medical illness.
Please take the time to view the websites listed on the "" page to administer a self-test if you have any concerns about the possibility of addictive behavior.
Anxiety Disorders are the most common psychiatric disorders affecting both children and adults and may develop from a complex set of risk factors including personality, life events, genetics and brain chemistry. Over 40 million adults suffer from anxiety disorders, however, these disorders are highly treatable with psychosocial therapies, medication, or both.
There are five major types of disorders:
Generalized Anxiety Disorder - An individual experiences persistent worry and tension and an inability to relax for six months or longer. Other symptoms include fatigue, headaches, muscle tension, stomach problems, restlessness, irritability and difficulty sleeping.
Panic/Phobic Disorders - A person experiences severe attacks of panic which include symptoms such as chest pain, heart palpitations, sweating, trembling, fear of dying, or fear of losing control. Panic Disorders often occur with agoraphobia creating an avoidance of situations that could potentially cause a panic attack.
Obsessive Compulsive Disorder - Obsessions are persistent, recurring thoughts, ideas, or images that are experienced as intrusive and senseless. Compulsions are repetitive, purposeful or intentional behaviors performed as rituals or routine behaviors (such as hand washing or hoarding) to relieve anxiety caused by obsessions.
Post traumatic Stress - This disorder can develop after exposure to a terrifying event in which grave physical harm occurred or was threatened. Symptoms can include flashbacks and nightmares; avoiding places related to the trauma; emotional numbness and detachment; and difficulty sleeping, irritability or poor concentration.
Social Anxiety Disorder - An individual with this disorder experiences extreme anxiety about being judged by others and behaves in a way to avoid embarrassment or ridicule. Physical symptoms can include heart palpitations, feeling faint and profuse sweating. Persistent fear of negative evaluation by others can result in avoidance of situations causing a decrease in functioning socially and professionally.
Attention Deficit Hyperactivity Disorder
Attention Deficit Hyperactivity Disorder has become an increasing visible diagnosis for both children and adults. ADHD, which may be present with or without hyperactivity, can significantly affect the ability to perform up to one's maximum potential. This syndrome is now thought to occur in nearly 5% of the total population and therefore is a risk of significant proportion. The websites that are listed below offer an opportunity for one to fill out questionnaires and look for answers when ADHD is suspected.
ADHD in children can be diagnosed as early as three years old if there is a strong family history as well as the necessary symptomatology. Educators in the primary grades often identify students as having ADHD on the basis of behavior and performance in the classroom. The primary symptoms of ADHD are difficulties with focus or concentration, distractibility, procrastination, difficulty completing tasks and not listening well. It is possible for irritability to exist as well which will negatively affect a child in the family, with friends and in the classroom. These children usually have problems with impulse control and in these cases an evaluation is extremely important in order to determine whether or not psychopharmacological treatment should be instituted as well as the possibility of psychotherapy. If ADHD is left untreated there is often a serious deterioration in self-esteem.
ADHD is now treated by a number of different medications which are often extremely successful and are usually very safe when prescribed by a mental health professional. The medications primarily fall into the category of stimulants although there is also a non-stimulant alternative if a child has side-effects or does not respond successfully to the stimulant therapy. These medications are prescribed in collaboration with the primary care physician and are followed on a regular basis by the providers in F.P.C.A.
Adolescents and adults with ADHD show deteriorating progress as they age. The transition from high school to college and then to employment seems to be fraught with an increasing pattern of the inability to meet deadlines, consistent underachievement, excessive procrastination, and frustration either in achieving academic grades or in advancement within the workplace. The secondary problem with ADHD is that the symptoms of the disorder often create tension and conflicts within the family, with roommates, or with a spouse. Procrastination, failure to complete tasks, irresponsible or unreliable behaviors, and the higher prevalence of substance abuse are typical conflicts that are present in adult ADHD. It is highly recommended that if ADHD is diagnosed for adolescents and adults that a combination of psychotherapy and medication be instituted as the likelihood of symptom improvement is greatest within this framework of treatments.
Asperger's/Autism Sepectrum Disorders
Autism Spectrum Disorders include autism, Asperger's Syndrome and Pervasive Developmental Disorder. All of the Autism Spectrum Disorders are brain disorders in which a child shows varying degrees of deficiency in social interactions, verbal and non-verbal communication, psychological development, academic development and repetitive behavioral symptoms. Poor eye contact, delayed language, impaired speech and a mounting number of peculiar behaviors are symptoms that point to the possibility of Autism Spectrum Disorder being present. There is no cure for these disorders, but early diagnosis, intervention, and multiple therapeutic programs can significantly improve the problems that may exist at home or at school for children with this disorder.
If there are any concerns that you have about your child and Autism Spectrum Disorder, please refer to the list of links on our page. They will give you more complete and thorough information.
Child psychiatry focuses on trying to analyze the behavioral problems and to find out why they are occurring.
The psychiatric treatment of children with emotional disorders is a field that continues to grow and where demands for services are ever-increasing. With children we see many of the same disorders that are present in adults, e.g. anxiety, depression, Attention Deficit Hyperactivity Disorder, etc. The presentation of symptoms, however, is usually quite different. The manifestation of emotional difficulties in children is most often displayed by behavioral changes. Most children are not able to articulate their feelings easily and often find behavioral outlets to deal with their personal discomfort.
Adolescents are more apt to talk about their feelings but it is not unusual to find that the same issues exist during the teen years and that school problems, social problems, or dangerous or inappropriate behaviors are presenting symptoms at a time of crisis.
Currently we have many modalities to treat children which include individual therapy, family therapy and medication management. The most successful intervention is a combination of two or three of the above. There have never been more choices in terms of medication treatments for children who have emotional illnesses, but these treatments come with considerable controversy. The prescribing clinicians at F.P.C.A. will, if so, meet with parents and decide the appropriate course of action.
Depression has become an increasing medical and psychiatric problem in our world today. When is depression a problem for someone in contrast to the normal emotional ups and downs which some describe as "the blues" or "feeling down"? Generally speaking, if these feelings last for more than two weeks and begin to interfere with your daily functioning then depression must be suspected. Depression comes in a mild version called dysthymia but also can appear in a major and significant form called major-depressive disorder. In yet another instance, depression may be a component of a cycling mood disorder known as bipolar disorder.
With depression, a number of symptoms emerge that can include a lack of energy, difficulty sleeping, difficulty concentrating at school or at work and the feeling that one is just not able to participate or succeed in tasks that they could previously accomplish. In children, the added behaviors that may be present include increased agitation or acting out, as well as social withdrawal.
The websites provided on our page below will give you an opportunity to administer a self test that may help you determine whether or not you are experiencing depression. Many times depression also presents with a series of medical symptoms including headaches, gastro-intestinal symptoms, increasing sleep disruption, loss of appetite, migraines and sexual dysfunction.
Depression may come from a number of different sources including psychological stressors, certain medical illnesses, a family history of depression, drugs and alcohol abuse, or medication side-effects. These issues need to be considered as sources of depression when evaluating the symptoms listed above.
After having a complete psychiatric evaluation, the best treatment for clinical depression is to have a combination of both psychotherapy and medication. Antidepressant medication should be taken for at least six consecutive months, with no abrupt discontinuation for the most successful outcome and to avoid the recurrence of symptoms. Psychotherapy can always be helpful, with or without medication, to help you cope with feelings and change negative patterns in your life.
There are two major eating disorders: anorexia nervosa and bulimia nervosa.
Anorexia is defined by a person's refusal to maintain a minimally normal body weight, a fear of gaining weight, and a disturbed perception of his or her own body shape or size. For females, anorexia is also typified by being underweight which leads to the loss of periods for at least three months. Some people with anorexia manage their weight by restricting their intake, starving themselves, while others go through periods of binge eating and vomiting or using laxatives. Exercising for long periods is also common. Over restricting food intake, fear of weight gain, and preoccupation with body size and food also can be problems that benefit from therapy even if a person does not meet all the clinical diagnostic criteria for anorexia nervosa.
Bulimia is defined by a person binge eating, feeling that he or she cannot stop or control it, and then using vomiting, laxatives, enemas, fasting, or excessive exercise to try to get rid of the food or the calories they have eaten. Typically, the binge eating is secretive, fast, and often is planned. It is often triggered by sad or angry feelings, interpersonal stresses, being extremely hungry from fasting or by feeling very bad about one's body or weight. Binge eating or frequent overeating that leads to obesity also can be a problem that affects a person's emotional health.
We have provided counseling for almost three decades to couples undergoing distress in marital relationships, having difficulties with emotional and physical intimacy, experiencing conflicts with communication or struggling with life transitions. We offer help for couples in dealing with decisions about separation, divorce, and the emotional aftermath that inevitably occurs. Single parenting, blended families, and visitation issues also put stress on relationships and often result in feelings or behaviors that create conflict and cause personal turmoil. These sorts of difficulties are often improved with a therapy plan that may be either conflict-specific or more of an ongoing treatment.
Parenting is the toughest job you'll ever have, and kids don't come with an "owner's manual"! Are your children's arguments getting you down? Do you feel worn out and angry or frustrated at your child's unruly behavior? Does your child tune out or need to be told directions over and over? Is your child tantruming or using other inappropriate behavior to get attention or "get their way"? You may be ready for some parent guidance education.
At F.P.C.A. we offer parent guidance therapy from psychiatric social workers, psychologists, and psychiatrists. When interest is high we run parenting groups based upon behavior modification techniques and group support. Talking, sharing your parenting frustrations with others and picking up some concrete "Parenting 101" tips will increase your skills, and you'll be on your way to a more rewarding relationship with your child.