Aaron H. Fink, M.D., P.A.

Using a developmental biopsychosocial framework, Dr. Fink does a thorough and careful assessment of new patients. In addition to interviewing the parents and child or adolescent, the evaluation process frequently includes rating scales completed by parents, teachers and /or the child. He will also review previous evaluations (e.g. psychoeducational, language or neurological reports) if they are available. If appropriate, medical tests (e.g. blood tests, MRI, sleep study), consultation with other medical specialists (e.g. neurologist, cardiologist) or psychological testing will be recommended.

In evaluating children, Dr. Fink typically first meets with the parents to gather a detailed history. He then meets with the child. The meeting with the child typically includes an interview, drawing and play. The final step of the evaluation process involves meeting with the parents to provide feedback and recommendations.

In evaluating adolescents, Dr. Fink typically first meets with the adolescent and parents together rather than first meeting with just parents. The adolescent is also given an opportunity to meet alone with Dr. Fink. This process strengthens the alliance with both the adolescent and their parents and minimizes the frequent adolescent concern that the psychiatrist is the parents’ agent to control them. Depending on the nature of the adolescent’s problems, the evaluation process will occur over one to three appointments.

Psychopharmacology can play an important role in the treatment of child and adolescent psychiatric problems. Dr. Fink views medication management as a collaborative process with patient, parents, psychotherapist and primary care physician all playing an important role. Helping parents and their child understand what medication can, and just as importantly, what medication can not do in treating psychiatric disorders is an important aspect of medication management. Potential risks, benefits and alternative treatment options are carefully considered and explained before initiating treatment. Systematic and careful follow up allow for the optimization of treatment.

Individual psychotherapy is a form of therapy in which the child or adolescent meets with a professionally trained therapist to address problems with emotions and/or behaviors. Although there are different theoretical models of psychotherapy (e.g. psychodynamic, cognitive behavioral), each relies on communication (verbal and nonverbal) as the basic tool for bringing about change in a person’s feelings and behaviors.

Through individual psychotherapy, the child or adolescent can learn more appropriate ways of expressing their wants and frustrations. They also can learn new and better coping skills. For the younger child, a combination of play and talking will be necessary to address issues, while for the older child and adolescent, there will be an increasing reliance on verbal interactions.

Family conflict is frequently seen in the families of individuals with ADHD, anxiety, and other psychiatric problems. The causes of family conflict are typically the result of a complex interaction of child characteristics, parental issues and inadequate parenting skills. It must be kept in mind that one or both parents of youngsters with a particular psychiatric disorder frequently have the disorder themselves.

Psychotherapeutic interventions for the family conflict can include traditional family therapy involving the whole family, subgroups (e.g. siblings, mother-daughter) or can involve working primarily, if not exclusively, with the parent (i.e. parenting therapy).

Behavioral techniques can be taught in parent training sessions. In the younger child, behavioral management techniques can often be used successfully to address issues of noncompliance, defiance and aggressiveness. Behavioral techniques tend to be somewhat less effective in the older child or adolescent with more ingrained behavioral problems.

About Group Therapy

Group psychotherapy is a special form of therapy in which a small group of people meet together under the guidance of a professionally trained therapist to help themselves and one another.  Group psychotherapy is widely used and has been a standard treatment option for over 50 years.
Children exist in group environments-their families, schools, and organized activities.  These are the environments in which they grow and develop as human beings.  Group psychotherapy is no different.  It provides a place where children and adolescents can come together with others to share problems or concerns, to better understand their own situation, and to learn from and with each other.
Group therapy helps children and adolescents learn about themselves and improve their interpersonal relationships.  It addresses feelings of isolation, depression and anxiety.  It helps children make significant changes so they feel better about themselves.
Group therapy works!  In studies comparing group psychotherapy to individual therapy, group therapy has been shown to be as effective and sometimes more effective. In cases of medical illness, there is substantial evidence that this form of therapy help people cope better with their illness and enhance the quality of their lives.

Commonly Asked Questions

How does group therapy work?
The group therapist selects people (usually 5 to 8) who would be helped by the group experience and who can be learning partners for one another.  In the group meetings, patients are encouraged to talk with each other in a spontaneous and honest fashion.  The therapist provides productive examination of the issues or concerns affecting the individuals and the group by guiding the discussion.

If someone is in group, do they also need individual therapy?
It depends on the individual.  Sometimes group therapy is used as the only treatment approach.  Sometimes it is used along with individual therapy and/or family therapy.  Often children and adolescents find that working simultaneously in more than one therapy stimulates growth in mutually complementary ways. 

How is group therapy different from support groups?
Under the guidance of a professional, group therapy focuses on interpersonal relationships.  Group therapy also provides children and adolescents an opportunity to work on specific problems or challenges.  The psychotherapy group is different from support in that it not only helps people cope with their problems, but also provides an opportunity for change and growth.  Support groups help people cope with difficult situations at various times, but are usually geared toward alleviating symptoms, but not growth. 

Why is group therapy useful?
Joining a group is useful because it provides opportunities to learn with and from other people.  Children and adolescents learn to understand their own patterns of thought and behavior and those of others.   In group therapy, people learn that perhaps they are not as different as they think or that they are not alone.  Your child also has an opportunity to increase self-esteem by helping others.

Will there be people with similar problems in my child’s group?
Part of the therapist's role is to evaluate each member’s problems prior to having them join the group.  Usually there is a mix of members who can learn from each other.  While some members will have similar circumstances, it is not necessary for all to be dealing with exactly the same problem.  In fact, individuals with different strengths and difficulties are often in the best position to help one another.

What kind of commitment do we need to make?
The time commitment depends on the type of group and the nature and extent of your child’s problems.  Short-term groups devoted to specific, concrete issues may last anywhere from 6 to 20 weeks.  In open-ended groups, children and adolescents work at their own pace and leave when their particular needs or goals have been met.

What if my child is uncomfortable discussing personal problems in front of others?
It is not unusual to feel uneasy or embarrassed when first joining a group, but children and adolescents quickly begin to develop feelings of trust.  Most patients find that group therapy provides a great deal of relief because it allows them a chance to talk with others who are experiencing similar problems-in a private, safe, confidential setting.

Who Can Benefit?
Like individual therapy, group psychotherapy can benefit almost anyone.  Some of the issues typically addressed include:

• Difficulties with interpersonal relationships
• Depression and anxiety
• Coping with medical illness
• Loss
• Trauma

The Group Therapy Session
The group therapy session is a collaborative effort in which the therapist assumes clinical responsibility for the group and its members.  In a typical session, members work to express their own problems, feelings, ideas, and reactions freely and honestly as possible.  Playing , drawing, building and pretending, as well as talking are important ways of sharing feelings and resolving problems for children.   Adolescent groups rely primarily, if not exclusively, on verbal communication.  Such exploration gives the group important information needed to understand and help one another.  Members learn not only to understand themselves and their own issues, but also become “therapeutic helpers” for other members

Using a developmental biopsychosocial framework, Dr. Fink does a thorough and careful assessment of new patients. In addition to interviewing the patient and collateral sources (e.g. spouse, siblings) when appropriate, the evaluation process frequently includes rating scales completed by the patient. He will also review previous evaluations (e.g. psychoeducational, language and neurological reports) if they are available. If appropriate, medical tests (e.g. blood tests, MRI, sleep study), consultation with other medical specialists (e.g. neurologist, cardiologist) or psychological testing will be recommended.

Psychopharmacology can play an important role in the treatment of psychiatric problems. Dr. Fink views medication management as a collaborative process with patient, psychotherapist and primary care physician all playing an important role. Helping understand what medication can, and just as importantly, what medication can not do in treating psychiatric disorders is as important aspect of medication management. Potential risks, benefits and alternative treatment options are carefully considered and explained before initiating treatment. Systematic and careful follow up allow for the optimization of treatment.

Individual psychotherapy is a form of therapy in which a patient meets with a professionally trained therapist to address problems with emotions and/or behavior. Although there are different theoretical models of psychotherapy (e.g. psychodynamic, cognitive behavioral), each relies on communication as the basic tool for bringing about change in a person’s feelings and behavior.

Through individual psychotherapy, a patient can learn more appropriate ways for expressing their wants and frustrations. They also can learn new and better coping skills.

Family conflict is frequently seen in the families of individuals with ADHD, anxiety, and other psychiatric problems. The causes of family conflict are typically the result of a complex interaction of child characteristics, parental issues and inadequate parenting skills. It must be kept in mind that one or both parents of youngsters with a particular psychiatric disorder frequently have the disorder themselves.

Psychotherapeutic interventions for the family conflict can include traditional family therapy involving the whole family, subgroups (e.g. siblings, mother-daughter) or can involve working primarily, if not exclusively, with the parent (i.e. parenting therapy).

Behavioral techniques can be taught in parent training sessions. In the younger child, behavioral management techniques can often be used successfully to address issues of noncompliance, defiance and aggressiveness. Behavioral techniques tend to be somewhat less effective in the older child or adolescent with more ingrained behavioral problems.

About Group Therapy

Group psychotherapy is a special form of therapy in which a small group of people meet together under the guidance of a professionally trained therapist to help themselves and one another.  Group psychotherapy is widely used and has been a standard treatment option for over 50 years.
Each of us exists in group environments-our families, schools, organized activities or work.  These are the environments in which we grow and develop as human beings.  Group psychotherapy is no different.  It provides a place where you come together with others to share problems or concerns, to better understand your own situation, and to learn from and with each other.
Group therapy helps people learn about themselves and improve their interpersonal relationships.  It addresses feelings of isolation, depression and anxiety.  It helps people make significant changes so they feel better about the quality of their lives.
Group therapy works!  In studies comparing group psychotherapy to individual therapy, group therapy has been shown to be as effective and sometimes more effective,  In cases of medical illness, there is substantial evidence that this form of therapy help people cope better with their illness, enhance the quality of their lives and , in some cases, such as breast cancer, has even been shown to help people live longer.

Commonly Asked Questions

How does group therapy work?
The group therapist selects people (usually 5 to 8) who would be helped by the group experience and who can be learning partners for one another.  In the group meetings, patients are encouraged to talk with each other in a spontaneous and honest fashion.  The therapist provides productive examination of the issues or concerns affecting the individuals and the group by guiding the discussion.

If someone is in group, do they also need individual therapy?
It depends on the individual.  Sometimes group therapy is used as the only treatment approach.  Sometimes it is used along with individual therapy.  Often people find that working simultaneously in both individual and group therapy stimulates growth in mutually complementary ways. 

How is group therapy different from support groups and self-help groups?
Under the guidance of a professional, group therapy focuses on interpersonal relationships.  Group therapy also provides individuals an opportunity to work on specific problems or challenges.  The psychotherapy group is different from support and self-help in that it not only helps people cope with their problems, but also provides an opportunity for change and growth.  Support groups, which are generally led by professionals, help people cope with difficult situations at various times, but are usually geared toward alleviating symptoms, but not growth.  Self-help groups usually focus on a particular shared symptom or situation and are usually not led by a trained therapist.

Why is group therapy useful?
Joining a group is useful because it provides opportunities to learn with and from other people.  You learn to understand your own patterns of thought and behavior and those of others.   In group therapy, you learn that perhaps you are not as different as you think or that you are not alone.  You also have an opportunity to increase self-esteem by helping others.

Will there be people with similar problems in my group?
Part of the therapist's role is to evaluate each member’s problems prior to having them join the group.  Usually there is a mix of members who can learn from each other.  While some members will have similar circumstances, it is not necessary for all to be dealing with exactly the same problem.  In fact, people with different strengths and difficulties are often in the best position to help one another.

What kind of commitment do I need to make?
The time commitment depends on the type of group and the nature and extent of your problems.  Short-term groups devoted to specific, concrete issues may last anywhere from 6 to 20 weeks.  In open-ended groups, individuals work at their own pace and leave when their particular needs or goals have been met.

What if I am uncomfortable discussing my personal problems in front of others?
It is not unusual to feel uneasy or embarrassed when first joining a group, but soon you begin to develop feelings of trust.  Most patients find that group therapy provides a great deal of relief because it allows them a chance to talk with others who are experiencing similar problems-in a private, safe, confidential setting.

Who Can Benefit?
Like individual therapy, group psychotherapy can benefit almost anyone.  Some of the issues typically addressed include:

• Difficulties with interpersonal relationships
• Depression and anxiety
• Medical illness
• Loss
• Trauma
• Personality Disorders
• Addictive Disorders

The Group Therapy Session
The group therapy session is a collaborative effort in which the therapist assumes clinical responsibility for the group and its members.  In a typical session, members work to express their own problems, feelings, ideas, and reactions freely and honestly as possible.  Such exploration gives the group important information needed to understand and help one another.  Members learn not only to understand themselves and their own issues, but also become “therapeutic helpers” for other members.

Using a developmental biopsychosocial framework, Dr. Fink does a thorough and careful assessment of the athlete. In addition to interviewing the athlete and collateral sources (e.g. coaches, trainers) when appropriate, the evaluation process frequently includes questionnaires and rating scales completed by the athlete. He will also review previous evaluations (e.g. psychoeducational, language and neurological reports) if they are available. If appropriate, Dr. Fink will recommend medical tests (e.g. blood tests, MRI, sleep studies), consultation with other medical specialists (e.g. neurologist, cardiologist) or psychological testing.

Psychopharmacology can play an important role in the treatment of athletes with psychiatric problems, but requires special considerations (e.g. impact on performance, banned substance). Potential risks, benefits and alternative treatment options are carefully considered and explained before initiating treatment. Systematic and careful follow up allow for the optimization of treatment.

Through individual psychotherapy, athletes can learn to be more self-aware and able to better express themselves. They can also learn new and better coping skills.

Psychotherapy can address problems including choking, slumps and dealing with injuries and performance disappointments. Psychotherapy can also be valuable in improving interpersonal problems with teammates and/or coaches.

Using psychological insights and techniques, athletes can improve their performance. Athletes can learn to improve their focus, maintain motivation and channel their competitiveness. They can develop greater mental toughness and improve confidence.