An Bulkens, LMFT

Psychoanalytic Psychotherapy and Psychoanalysis for Children, Teens & Adults

(530)321-2970

Chico therapist An Bulkens, LMFT is psychotherapist and counselor in Chico, California.  An Bulkens specializes in psychotherapy and counseling for young children  (toddlers, preschoolers, adolescents) and support for parents, with a special emphasis on  early childhood psychotherapy, and counseling  for preschoolers and Kindergarten aged child.  She also offers parenting skills support. She offers psychoanalytic psychotherapy for adults.  Her approach is grounded in  Lacanian Psychoanalysis. She was also trained as a clinical psychologist in Europe, Belgium.  Her education emphasized developmental psychology and psychoanalytic therapy. 

Filtering by Tag: ADHD

Early Behavioral Therapy help children with ADHD

A new study, published in the Journal of Clinical Child and Adolescent Psychology, found that typical stimulant medication like Ritalin,  prescribed for children diagnosed with ADHD as a first-line of treatment, was actually most effective as a supplemental, second-line treatment for those who needed it.  Often at doses that are lower than what is typically prescribed. The study showed that children who started with behavioral treatment before being prescribed medication did better.

The study was unique in the fact that it is the first study that evaluates the effects of altering the treatment in midcourse. For example, adding a drug treatment to a behavioral treatment, or the other way around.  The results show that the sequence in which you give treatments makes a big difference in outcomes. It is important to note that this study tracked behavior, and not abilities like academic performance or attention. 

The study enrolled 146 children with ADHD diagnosis between the ages of 5 and 12, and assigned half of them randomly on a low dose of generic Ritalin.  The other half received no medication, but their parents began attending group meetings to learn some techniques that could help them modify and respond to their children's difficult behaviors. 

These techniques were based on a simple system of rewards and consequences. Parents reward positive behavior, ignore irritating but harmless behavior like doing baby talk. 

If a child had not improved after 2 months, the child was randomly assigned to eiter a more intense version of the same treatment, or an added supplement, like adding meds to the behavioral treatment. 

About two-thirds of the kids that started with the behavior therapy needed a 'booster.' About 45% of those who started on medication did. However, the behavior first group had on average four fewer rule violations an hour at school, than the medication first group.

According to the authors it could be that the parents of the children who started on the medication were less motivated to follow up with the behavioral classes. It was a lot of work, and the parents might have thought that it will not make that much of a difference. 

In a different study it was determined that starting with the behavioral treatment before following it with medication, costs on average $700 annually lest per child than treatment as usual. 

To schedule an appointment call An or Jamie at (530) 321-2970.

 

DSM-V: new diagnostic manual coming out: What are its implications for psychotherapy in Chico?

May 2013: the DSM-V, the new Diagnostic Manual for Psychiatric disorders is a fact. This new manual has been highly controversial as its scientific basis is quite problematic and as the APA has refused to an independent review of this new manual. The field testing step that was needed for quality control was skipped. This is not an acceptable approach to prepare and approve a diagnostic system.  Allen Frances, MD, chairman of the DSM-IV task force and professor emeritus at Duke states: 

'Psychiatric diagnosis has become too important in selecting treatments, determining eligibility for benefits and services, allocating resources, guiding legal judgments, creating stigma, and influencing personal expectations to be left in the hands of an APA that has proven itself incapable of producing a safe, sound, and widely accepted manual.' He also states that new diagnoses in psychiatry are more dangerous than new drugs because they influence whether or not millions of people are placed on drugs - often after short visits with primary care doctors.' 

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An Bulkens    |    Licensed Marriage and Family Therapist    |   MFC 52746

Tel. (530) 321- 2970    |   186 E 12th ST,  Chico, CA 95928