We are now open for Telehealth video visits AND In-person sessions.

All recommended safety and disinfecting precautions will be added to our usual sanitary procedures for In-person sessions:

1. Appointments may only be attended if clients and staff are symptom free

2. Masks will be required of all persons over 2 years old

3. Temperature reads may be requested at each appointment

4. Clients will be asked to remain in their car until just before the appointment time

5. Clients will be asked to remain 6 feet apart in the waiting room

6. Family members may Not accompany the client to the appointment or waiting room, except for the parent/guardian of a minor

7. Clients will be required to wash hands immediately upon entering the waiting room; And wash hands and/or use hand sanitizer before and throughout the appointment as necessary

8. Staff will wash their hands before each client's appointment; And use sanitizer throughout the appointment as necessary

9. Staff will disinfect the office, waiting room, and touch points (chairs, etc) in between each client's appointment

10. Kids will be provided individual utensil packets (crayons, fidgets, etc) to leave at the office

11. Clients will be required to review and sign the Covid-19 Consent of Liability Waiver to the appointment via the Client Portal prior to your in-person appointment

Contact us with any questions or to make an appointment!

*Edited: The HPS Office is now closed to in-person or face to face therapy sessions, effective 12:00 on March 19, 2020 for the time being, due to the Shelter in Place order given by the California governor. We will open our doors and allow in-person sessions again when the order has lifted and it is safe.
Telehealth sessions are still available from the comfort and safety of your own home.

In light of current events and the contagious nature of COVID-19, the clinicians at Hilber Psychological Services request that all clients experiencing cold or flu like symptoms do not attend in-person sessions at the HPS office. We are able and happy to provide Telehealth sessions through our secure, HIPAA compliant video portal. If you have not attended a session with us using Telehealth before, your therapist can help instruct you on how to set up the connection on your computer or mobile device. Our clinicians have also been encouraged to stay home and offer video sessions if any of us experience symptoms indicative of COVID-19 or other contagious illness. The health and safety of our clients and staff are our priority.

Here are the steps we are taking to help prevent spread of germs to protect you and our staff so we can provide necessary services:

• Offering Telehealth to all clients when clinically appropriate

• Encouraging clients to reschedule or cancel 24 hours in advance if they have flu or respiratory symptoms, or to choose Telehealth instead.

• Setting up a hand washing station

• Asking all clients & families to wash hands when entering the waiting room and using hand sanitizer before and after entering office rooms

• Providing information for COVID-19 facts, hand washing, and Telehealth options. 

• Completing steps to ensure doors, furniture, toys, etc are clean

• Completing UV light disinfectant in our offices & the waiting room

• Keeping up to date with the latest information with the CDC and local services. 

Talk to your therapist about Telehealth Sessions for you and your family. Some may prefer to attend therapy in person and while the office will be available, Telehealth is very helpful and can provide the necessary support for many clients.

Please let us know if you have any questions! 

Sincerely,
Tanya Hilber, PsyD, Licensed Psychologist, PSY24479
And our Providers at Hilber Psychological Services

Singe Whitson, a child and adolescent therapist, spoke about the importance of identifying rude and mean behavior compared to bullying behaviors. It can be easy to categorize bad behavior as bullying, but it is important to not overgeneralize this term. Although a therapist never wants to minimize a client's situation, we all must learn the difference between these terms in order to not simplify the term "bullying". In reality, bullying is a very serious issue.

Whitson defines rude as, “inadvertently saying or doing something that hurts someone else". These may be seen as social errors such as, burping in someone's face, cutting in line, or kicking a ball at someone. The problem with this is that rude situations are often spontaneous. A child does not mean to burp in someone's face, but without meaning to do so, they are hurting someone else. 

Being mean involves “purposefully saying or doing something to hurt someone once (or maybe twice).” Whitson explains,  “mean behavior very much aims to hurt or depreciate someone….Very often, mean behavior in kids is motivated by angry feelings and/or the misguided goal of propping themselves up in comparison to the person they are putting down.” Although both mean and rude behavior needs to be corrected, it is important to understand how they are different from bullying. 

Bullying is “intentionally aggressive behavior, repeated over time, that involves an imbalance of power….Kids who bully say or do something intentionally hurtful to others and they keep doing it, with no sense of regret or remorse -- even when targets of bullying show or express their hurt or tell the aggressors to stop.” There are many different forms of bullying including, physical, verbal, relational, and cyberbullying. The reason bullying is worse than mean or rude behavior is because of the repeated actions that leave the person being bullied feeling helpless. 

Although bullying has become a topic of greater interest, it can never be talked about enough. Bullying has many long lasting effects on children and adolescents. It is important for parents to be aware of the signs that your child is bullying someone, or being bullied. Preventing bullying will make a difference. 

 Contact us for more information on individuals who are suffering from bullying, people who may have lasting effects such as anxiety or depression, or for help with children who are struggling.

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: “A Mighty Girl.” Www.amightygirl.com, 16 Apr. 2018, www.amightygirl.com/?https=true.

According to the article, "Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds", written by Dr. David Rabiner, "although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists". The Multimodal Treatment Study of ADHD (MTA Study) tested 600 7–9-year-old children with ADHD. These children were randomly assigned into one of these four groups: 
1. Carefully monitored medication treatment
2. Intensive behavior therapy
3. Medication treatment combined with behavior therapy
4. Community care (parents obtained whatever treatment they want)

After 14 months, the study showed that those children who received carefully monitored medication treatment or medication treatment combined with behavior therapy had lower levels of overall ADHD symptoms and better overall adjustment compared to those children who received intensive behavior therapy or community care. The results stayed the same after an evaluation 10 months later. However, evaluation after 1 year and again after several groups showed no group differences based on the initial group treatment assignments. Therefore, the initial benefits of the medication had disappeared. The study continued annually through age 18 and then reduced visits to age 25. Within this group, individuals were categorized based on their medication usage:
a. Consistent, i.e,. those who had met the minimum threshold during each year;
b. Inconsistent, i.e., those meeting the minimum threshold in some but not all years; and
c. Negligible, i.e., below the minimum threshold in all years. 

At the last evaluation, age 25, participants self- and parent-reported, and doctors measured the patient's height compared to other individuals around the area that had not been diagnosed with ADHD in their childhood. Based off of the medication categorized above, only 14.3% of participants consistently used medication through age 18. After comparing the other participants, participants with ADHD maintained substantially higher ADHD symptoms over time regardless of their initial treatment. It was clear that ADHD symptoms in young adulthood are not related to patterns of medication use through adolescence. 

There was thus no indication that consistent medication treatment over a number of years had any persistent impact. However, there was a relationship found between persistent medication use and adult height. According to Dr. Rabiner, "Students in the Consistent and Inconsistent medication treatment groups had average heights — combined across these groups — that were about an inch shorter than those in the Negligible treatment group. And, participants in the Consistent Group were nearly an inch shorter on average than those in the Inconsistent group, i.e., nearly 2 inches shorter than those in the Negligible group". 

Overall, the study concluded there was substantial persistence of ADHD symptoms into adulthood and although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists. However, it is possible that some other factor that contributed to some participants taking medication more consistently, e.g., more severe symptoms, also explains the reduced height attainment in this group.

There are many take home messages:
1. Relatively few youth with ADHD use medication consistently over their development.
2. Many individuals with ADHD will continue to struggle with ADHD symptoms into adulthood. 
3. Although medication helps control symptoms in the short-term, it is not a cure.
4. It is unknown whether optimal medication treatment maintained over many years would have a greater impact.
5. Parents and clinicians need to balance the need for persistent treatment in some children with the likely consequences of reduced adult height. 

Due to the symptoms that may occur from using persistent medication, an optimal solution would be to find the lowest effective dose of medication, or combine medication treatment with other behavior therapy and/or other approaches.

If you have questions about ADHD and how it can affect you or your child or would like to schedule an appointment, please contact us. For more information on therapy, visit FAQ at Hilber Psychological Services. 

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: Rabiner, David. “Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds.” SharpBrains, SharpBrains, 28 Mar. 2018.