No parent wants to think their child has challenges, especially significant ones.  It can feel tempting to ignore the problems for awhile to see if they “go away.”  Some children probably do improve on their own as time goes by, but many children continue to struggle, and their lives are affected in more significant ways.

In general, early childhood experts recommend getting help for kids who are struggling as early as possible.  This is because children’s brain function and behavior may be more changeable at earlier ages.  And kids who catch up can then build on their skills.

If you are unsure whether your child’s behavior and skills fall within the “typical” range, seek help from professionals who are experienced in the areas of your concern.  Good initial resources are checklists of typical development milestones, our Autism Symptoms checklist, our Social Skills checklist, your child’s healthcare provider, and any professionals who already work with your child, such as your child’s speech therapist.  Teachers may also give you an informal opinion, since they see many children and may help you gauge whether your child seems different from most of the other children they teach.  I believe it is best not to rely on the opinions of friends or anyone who has not seen your child regularly and in the situations about which you are concerned.

Even if everyone you ask says everything is “fine,” as a parent you should trust your instincts.  Only you see your child every day and can observe behaviors, skills, and changes through the months and years of your child’s life.  If you suspect something may be wrong, don’t give up!  Request an evaluation by an experienced professional.  If all is well, this will ease your mind.  If your child has challenges, you will have caught them at the earliest time possible, when interventions will have the most chance of helping.

Special Note:  In particular, if you believe your child may have an Autism disorder, research is indicating that very early intervention may have the best chance of improving symptoms in some children.  I see this in my practice as well.  Age three, two, or even 18 months is not too young to begin therapy for Autism or Pervasive Developmental Disorder (PDD or PDD-NOS).  For Autism disorders especially, don’t wait!

Choosing a therapist can seem like a daunting task.  Parents must judge based on the challenges they believe their child may have, the experience, training and licensing of the therapist, location, availability, and their personal judgment about the therapist.

Because it can be difficult to sort out the issues, I offer a free 15-minute consultation to families in the Spokane, Washington State or Idaho areas.  This consultation is not therapy, but a chance to talk briefly about your needs and concerns, whether it sounds like therapy might be helpful, and let you “meet” me by phone to decide whether I may be a good fit for your child’s and family’s needs.   Call (509) 448-1506 or Click to Email, to arrange an appointment or free consultation.

Year For Change therapy emphasizes the importance of the interaction between parents and children, and gives tools and techniques to both.  At least one parent attends each therapy session.  Teachers and educators are involved too, if they desire. 

Another important difference is the strong emphasis on assessing or analyzing “what is wrong” and “what is desired.”  Instead of using a label as the basis for treatment (i.e., this child has this diagnosis, so we should do this treatment), your child is evaluated as an individual, within his or her relationships and environment.  This allows us to determine specific skill deficits, strengths, and patterns of relationships which can be brought into the therapeutic work to try to achieve more lasting and meaningful changes.

An example:  Instead of concentrating on a child’s tantrums and thinking of a generic “fix” like a consequence, I concentrate on problems the child may be having that precipitate tantrums, the child’s emotional connections to himself and others, negative patterns of interactions with peers and adults, and times when the child is successful and does not have tantrums.  These then help to determine what might help to improve or change the child’s awareness, experiences, positive emotions, and …tantrums!

How often we meet varies depending on the issues we’re working on, your goals, your travel time and schedule, and your child’s current progress.   In general, therapy appointments are once a week on the same day and time, for 50 minutes.  For some families, longer appointments and/or a different schedule such as twice a month are more suitable.  When you start therapy we will discuss an appointment schedule that works for you. 

Sessions take place at the Year For Change office in downtown Spokane.  Occasionally meetings are at school or home to support the Assessment, school meetings, or other needs.

Typically, therapy has these steps:

• Call or Click to Email, so we can discuss your concerns and needs briefly.

• Complete Year For Change forms regarding the treatment process and your rights.

• Child Assessment - including observation of child in home, school, or at our office, and treatment planning with you.

• Therapy/Treatment begins – typically weekly or bi-weekly.

• “Family Practice” - at home and/or school with child, between sessions.

• Ongoing evaluation of issues, progress, and treatment planning.

Weekly parent/child practice and follow-through with therapy plans is an essential component in the effectiveness of this treatment.

Let me get out my magic wand…wait, just kidding!  As in many other parts of life, there are no guarantees of any definite improvements when you undertake this therapy or treatment, or presumably any other.  Each child is unique, his or her potential is unknown, and it is likely that different children will respond uniquely to different types of therapies.

Some children do improve significantly with therapy; others don’t improve, improve less, or improve more slowly.  (The terms “fix” or “cure” are not really accurate).  When we work together, we will discuss progress along the way, and I may recommend another therapy if I don’t feel progress is adequate.

In regard to “who will change,” it’s important to note that parents often initially believe that only the child should change.  That could potentially be true, but this therapy strives to bring out the best in your child and you, as you both let go of habits, behaviors, thoughts and ways of interacting which are not helpful in your relationship or your current lives.  Even parents of children with known disabilities often find they change at least as much as their child, as they learn the two-way dynamics of their relationship, become more knowledgeable, and develop confidence in providing help to their child.

The length of therapy depends on many factors such as your child’s challenges, the issues you want to work on, how much time you put into practicing skills at home between therapy sessions, and how your child responds.  Sometimes a few months of therapy are sufficient to reduce some key problems or help you feel knowledgeable about handling your child’s challenges.  Children with more significant issues, for example Autism or extreme anxiety, may need help for many months, or even years. 

We plan for treatment together and monitor your child’s progress as we go along.  You always choose when to start or stop any therapy - there is no “contract” that locks you in.

Payment is usually by one or more of the following:

• Client insurance
• Client pays directly
• The Isaac Foundation (local grants for families of children in the Autism Spectrum)
• Washington State Division of Developmental Disabilities (limited funding for some families, typically for children with behavioral challenges)
• Occasionally another funding source

I accept some insurance plans.  This means I am in-network for some providers and out-of-network for others.  Feel free to call (509) 448-1506 or Click to Email and I would be happy to check your quoted insurance benefits.

Insurance policies vary widely, and can include different levels of coverage, benefits, deductibles, co-pays, co-insurance, and many other details.  My therapy services typically fall under “Outpatient Mental Health” or “Psychotherapy.”  During treatment, I will complete and submit insurance claims for you, and track claims and payments as a convenience for you. Some types of help such as consultations are usually not paid under insurance.

Your portion of payment is due by check or cash at the end of each session.  I do not take credit cards, as I have found this can contribute to families’ stressful credit card debt.

Please contact me for my standard rates.  I don’t have a formal sliding scale, but may adjust my fee occasionally; please contact me if you need to request this accommodation.

With a few exceptions, anything you disclose in therapy is confidential and can be disclosed to others only with your written authorization.  For children under age 13, the parents or legal guardians authorize any release of information about the child.  We will discuss more details about confidentiality at our first meeting, and you will have the chance to review my policies and sign your consent.  For more information, please see my Disclosure Statement and Informed Consent for Treatment and my Notice of Privacy Practices in your intake materials. 

Year For Change therapy is for children whose primary challenges relate to “people and emotions,” such as those with Autism, PDD, Asperger’s Syndrome, Oppositional Defiance, anxiety disorders, children experiencing bullying, and certain other disabilities.

It is not for treating significant trauma such as sexual, emotional or physical abuse, for children who cause (or may cause) significant harm to themselves or others; or for older, aggressive teens.  It is also not for treating the core symptoms of schizophrenia, substance abuse, eating disorders, bipolar disorder, severe depression, fetal alcohol syndrome, or similar mental health disorders.  Referrals to other qualified practitioners can be provided to you if you have these needs.

Assessment, Treatment and Therapy are currently provided at the Spokane, Washington office and nearby homes and schools.  Some clients travel from other parts of Washington State and Idaho to be seen here.  Occasionally clients arrange for my travel to their location in these states, at their expense, if this fits with my schedule and their therapy needs.

Workshops and Speeches are provided in various locations, typically for a fee including any non-local travel.

Unfortunately, online or “E-therapy” for clients outside Washington State or Idaho or who cannot be seen periodically at the office is not possible due to state licensing laws, and the ethical necessity of seeing children and families in-person for responsible therapeutic care.

Deborah Skalabrin, MSW, LICSW
701 W. 7th Avenue, Suite 15
Spokane, WA  99204
(509) 448-1506 - Phone
(509) 624-7500 - FAX