Siblings with Disabilities

By: Isabelle Siegel

People readily consider the struggles experienced by children with disabilities as well as by their parents, but siblings’ experiences and difficulties oftentimes go unnoticed. However, growing up with a sibling with a disability is not without consequences. Having a sibling with special needs is associated with numerous challenges, but also numerous opportunities.

Challenges

Growing up alongside a sibling with a disability can be associated with many negative emotions, some of which include anger, guilt, jealousy, embarrassment, and fear. Siblings of children with disabilities often report feeling neglected by their parents and feeling forced to hide their own problems for the sake of their family or brother/sister. They may also undergo “parentification,” meaning that they take on the role of a parent to themselves or even to their sibling. Although this parentification is associated with increased maturity, it is also associated with increased emotional vulnerability and distress. Taken together, these negative emotions and challenges render siblings of children with disabilities at higher risk for developing psychological adjustment difficulties: that is, they are more vulnerable than the average child to anxiety disorders, peer problems, academic struggles, and more.

Opportunities

People are quick to assume that having a sibling with a disability is a purely negative experience. However, growing up alongside a sibling with a disability is associated with many positive emotions and opportunities. Siblings of children with disabilities report feeling immense pride, gratitude, loyalty, and love. They tend to be more mature, responsible, empathetic, and tolerant than the average child. These positive experiences are equally as important as the negative ones, and must be acknowledged in order to fully comprehend what it is like to have a sibling with a disability.

What Parents Can Do

In order to best help the siblings of children with disabilities, parents can take several steps. These include:

  • Making sure to spend one-on-one time with each child
  • Keeping the siblings informed about their brother’s or sister’s disability and its implications
  • Understanding both the negative and positive emotions associated with being the sibling of a child with disabilities
  • Getting siblings involved in psychological services such as therapy

If you or a loved one is the sibling or parent of a child with a disability, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

Sources:
https://www.psychologytoday.com/us/blog/band-brothers-and-sisters/201406/siblings-children-disabilities
https://www.psychiatryadvisor.com/home/topics/child-adolescent-psychiatry/emotional-problems-facing-siblings-of-children-with-disabilities/
Image Source: https://raisingchildren.net.au/disability/family-life/siblings/supporting-siblings

Telehealth and Teletherapy

By: Isabelle Siegel

“Teletherapy” describes the delivery of therapy sessions via video or phone conferencing. Even before the age of COVID-19, teletherapy was quickly rising to popularity. However, COVID-19 has forced those who were on the fence about teletherapy to begin engaging in video- or phone-delivered sessions. This begs the question: Is teletherapy as effective as in-person therapy? If so, what are the benefits of teletherapy?

Is Teletherapy as Effective as In-Person Therapy?

Therapy has historically been referred to as “the talking cure,” and therefore one would presume that the therapeutic process would easily translate to talking via video or phone. Is this the case? The overall consensus of scientific research is that teletherapy is equally as effective as in-person therapy. More specifically, scientific studies support the use of teletherapy for depression, posttraumatic stress disorder, eating disorders, anxiety disorders, and other psychological disorders.

Benefits of Teletherapy

Teletherapy may even have numerous advantages over in-person therapy, as it generally makes therapy much more accessible to the average person. Some benefits of teletherapy include:

Greater Flexibility and Efficiency: Teletherapy can enable patients to easily engage in therapy sessions while simultaneously working from home, taking care of children, etc. Patients can schedule sessions during their lunch breaks, while their children nap, or whenever else is most convenient for them. With reduced wait times and travel times, teletherapy sessions almost always occupy less time than in-person sessions and, thus, afford more flexibility and efficiency for the average busy patient.

Increased Accessibility: Teletherapy allows more people access to highly-qualified therapists, regardless of where they live or their ability to travel. This can be especially helpful for people who live in rural areas, college students, and people with disabilities or lack of access to transportation.

Comfortable Environment: Teletherapy allows patients to engage in therapy sessions where they are most comfortable: in their own homes. Rather than having to travel to an unfamiliar office, patients can feel free to open up while staying within their comfort zone.

Overall, teletherapy represents a promising future direction in the field of psychology. With the potential to eliminate barriers to therapy, teletherapy may ultimately serve to render psychotherapy more accessible to the average individual.

If you or a loved one is interested in teletherapy, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

Sources:
https://positivepsychology.com/teletherapy/
https://www.apa.org/monitor/2017/02/online-therapy
https://www.psychologytoday.com/us/blog/millennial-media/201901/14-benefits-teletherapy-clients
Image Source:
http://www.brownedhi.org/the-cultural-revolution-of-teletherapy/

Anger Management during COVID-19

By: Elyse Ganss

According to the New York Times, domestic violence rates have surged during the era of the coronavirus pandemic. Domestic and family violence rates typically increase when families have more time to spend with one another, a time that is usually reserved for holidays. However, with stay-at-home orders occurring nationally, families have been spending more time together and consequently, violence rates have increased worldwide.

Violence occurs as a result of out of control anger. Anger is an emotion that occurs on a spectrum from irritation to rage. Aggressive, out-of-control responses due to anger lead to abusive actions. Dealing with angry feelings in a positive way is crucial to maintaining healthy relationships. Expressing anger in a calm manner such as having a controlled conversation with whoever you may be angry with is a constructive way to address anger. However, if anger is not dealt with it can lead to passive-aggressive behavior or having a hostile personality.

The Mayo Clinic recommends various tips for keeping anger under control. These tips include thinking before you speak, expressing anger in a calm way, getting exercise to reduce stress, practicing relaxation techniques and receiving help from mental health professionals.

If your anger levels are out of control, feel unavoidable, or if you are often enraged, seeking help for anger management may be the best course of action.

A mental health professional, whether it be a licensed psychologist, psychotherapist, clinical social worker, psychiatric nurse practitioner, or psychiatrist, will work with the patient to develop a new way of thinking and behaving when faced with situations that induce anger. Although anger may currently feel overwhelming, a professional can help work with you to reduce your anger and to help heal and restore your relationships.

If you or someone you know is looking for support, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://www.nytimes.com/2020/04/06/world/coronavirus-domestic-violence

https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/anger-management/art-20045434

https://www.apa.org/topics/anger/control

Image Source: https://www.mindful.org/feeling-angry-try-this/

COVID-19: How to Cope with Stress During COVID-19

COVID-19: How to Cope with Stress During COVID-19

By: Alexa Greenbaum

In crisis situations, it is normal to feel overwhelmed with emotions. The COVID-19 pandemic can feel threatening, as there are many unknowns. For example, published information from reputable sources, such as in the media, news, articles, journals, government officials, and specialists in relevant fields of work often contradict one another. It is important to note that everyone deals with stress differently, nonetheless, focusing on being resilient in response to COVID-19 will help minimize stressors and allow growth from traumatic experiences.

In this time of many uncertainties and conflicting information, it can be difficult to be calm. Feeling a lack of control, fears, and ruminating on stressors can escalate undesirable emotions. These stressors can feel or be traumatic and as a result, especially in isolation, cause people to consciously think about how COVID-19 is stressful.

It is difficult to stay calm but to subside unwanted stress, taking a step back and identifying your fears and putting emotions into perspective is a great way to start the process of becoming resilient to chaotic situations. It is important to understand and accept that there are a number of things that are out of control in life and emotions cannot prevent stressful situations. As a result, growth is associated with reflection and cognitive processing.

In effort to overcome stress about COVID-19, some pathways to resilience include focusing on positive relationships, positive emotions, and hardiness. Connecting and not isolating yourself by supporting loved-ones, focusing on what is in your control, and connecting with larger social networks such as your communities can provide emotional and instrumental support. Communicating with others can also elicit positive emotions such as laughter and optimism and can influence the belief that one can grow from negative events.

Taking care of yourself during a time of crisis is of upmost importance. To do so, take time to unwind and give yourself a break from looking at the news, create a routine, and take care of your body and mental health.

If you or someone you know is experiencing uncontrollable stress from COVID-19 or another crisis, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Sources:

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

https://yalehealth.yale.edu/covid-19-managing-stress

https://www.forbes.com/sites/amymorin/2017/05/13/6-ways-to-stop-stressing-about-things-you-cant-control/#7529342630db

Image Source:

https://www.nysut.org/news/2020/april/stress-management

Co-Parenting During COVID-19

Co-Parenting During COVID-19

By: Alexa Greenbaum

Co-parenting is challenging even during normal times. The crisis of COVID-19 can add to the stress of co-parenting. There are many aspects that make co-parenting even more difficult now than before. Some parents may have to work longer hours during the pandemic, whereas others may have reduced hours and are therefore struggling with finances; these are just a few extra stressors that parents are facing during this pandemic. Adding to the difficulty, different states handle custody arrangements differently, which adds confusion to the process.

Regarding custody, parents have to work together to ensure the safety of their children. Unlike before the pandemic, if they do not see eye to eye, they now have limited means of settling the matter in the justice system. State Supreme Courts such as in California, Maryland, and Texas, have issued that parents should follow their court-ordered processioning schedule during COVID-19. However, there are some exceptions including the event of a “lockdown” or a “shelter in place.” In other states, such as New York, the administrative judge has ordered to “act reasonably.” This uncertainty can spark conflict between co-parents as well.

To accommodate in this challenging time, the American Academy of Matrimonial Lawyers and The Association of Family and Conciliation Courts released a joint statement of guidelines on March 19 to help separated parents create a plan during the health crisis. The statement says, “Family law judges expect reasonable accommodations when they can be made and will take serious concerns raised in later filings about parents who are inflexible in highly unusual circumstances.” Nonetheless, the major issue that co-parents are facing, concerning their children, is that many parents are losing the ability to have daily or normal interactions with their kids.

Healthy co-parenting through COVID-19 requires parents to put aside their differences and put their children first. Parents need to know that although this time is confusing for children, kids are generally resilient. Both parents should talk to their kids, whether it be in-person, from 6-feet apart, or virtually about the pandemic. Communication during this time is the best way for a child to have a sense of normality. Thus, this is a time for parents to embrace technology and do their best to work together as co-parents.

Kids are feeling overwhelmed too. Therefore, as a co-parent, focus on doing everything they can do to emotionally support their kids. Reassuring their child that we will get through this, that some changes are only temporary, and most importantly, they are loved is the best way to be there for their child during this time.

If you or someone you know is looking for support, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Sources:

https://www.usnews.com/news/best-states/articles/2020-04-27/americans-struggle-with-co-parenting-during-covid-19

https://www.paleyrothman.com/legal-blog/co-parenting-during-covid-a-practical-guide

https://www.healthychildren.org/English/healthy-living/emotional-wellness/Building-Resilience/Pages/Co-Parenting-through-COVID-19.aspx

https://www.thecenterforfamilylaw.com/afcc-aaml

Image Source:

https://nyulangone.org/news/divorce-co-parenting-covid-19-challenges-opportunities

The Less Talked-About Side of OCD: Obsessive Compulsive Disorder

By: Isabelle Siegel

When thinking about OCD (Obsessive Compulsive Disorder), most people instinctively think of those who care about cleanliness and tidiness. In fact, it is not uncommon to use the phrase “I’m so OCD” to imply that one agonizes over neatness and order. This perception of OCD is not without reason, as many people with OCD do obsess over germs, contamination, and order and engage in excessive hand washing, cleaning, and ordering.

However, it is important to note that this is not the reality for many other sufferers of OCD. OCD is a wide-ranging disorder involving the presence of obsessions—“repeated thoughts, urges, or mental images that cause anxiety”—and compulsions—repetitive behaviors performed to relieve the anxiety. These obsessions can take nearly any form, with contamination and order being only two of them. Some other common obsessions include thoughts about: losing control or going insane, harming oneself or others, unwanted sexual ideas or images, and/or religion. For example, it is well-documented that people with OCD may experience intrusive thoughts about homosexuality, pedophilia, violence and aggression, and/or suicide.

Many people with these less talked-about OCD “themes” take longer to realize that they have OCD because their symptoms are not in line with the stereotypical hand washing and tidying. These individuals often engage in different compulsive behaviors to alleviate anxiety. These behaviors may include mental compulsions such as repeated checking and rumination (that is, repetitively reviewing and evaluating one’s thoughts and their meanings). For example, the individual who obsesses about violence and aggression may repeatedly check that he/she has not unintentionally harmed those around him/her.

It is ultimately important to acknowledge this less talked-about side of OCD in order to encourage sufferers to acknowledge their symptoms and to guide them to get the treatment and help that they need. 

If you or a loved one appears to be suffering from OCD, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

Sources:
https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml
https://iocdf.org/about-ocd/
https://www.psychologytoday.com/us/blog/overcoming-self-sabotage/201002/rumination-problem-solving-gone-wrong
Image Source:
https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm

Anxiety and Bullying

Image result for anxiety and bullying

 

Anxiety and Bullying

By: Vanessa Munera

Being bullied is not an easy thing to handle. It can be a traumatic experience for teens that are being targeted. Those who are bullied experience impacts in their lives such as feeling lonely, anxious, isolated, and vulnerable. Unfortunately, when a bully moves on to the next target, these consequences of bullying linger longer for the victim. After prolonged exposure, victims of bullying can develop adverse effects. These victims will experience depression, eating disorders, and thoughts of suicide. In addition, victims of bullying can develop some sort of anxiety disorder. The top four major anxiety disorders victims of bullying can experience are Post-Traumatic Stress Disorder (PTSD), generalized anxiety disorder (GAD), panic attacks and social anxiety disorder.

  1. Post-Traumatic Stress Disorder (PTSD): this occurs after a traumatic or life-threatening event. PTSD can develop due to events such as a car accidents or losing a close relative. This disorder can also show up after repeated abuse or even bullying. Children who are bullied may experience nightmares, flashbacks, withdraw from others, or are easily startled. Kids, who undergo long term and abusive bullying, have increased chances of developing PTSD.

2. Generalized Anxiety Disorder (GAD): Kids with GAD are often tormented with worries and fear that distract them for their daily life activities. Those with generalized anxiety have a constant feeling that something bad is going to happen. This is not uncommon with victims of bullying. With GAD, physical symptoms may appear such as insomnia, stomachaches, fatigue, and restlessness.

3. Panic Attacks: Those who suffer from panic disorders must deal with unpredictable and repeated attacks. When suffering from a panic attack, the attack is usually with no warning and can cause physically symptoms. These symptoms include sweating, chest pain, and rapid or irregular heartbeats. In fact, a part of the brain called the amygdala plays a pivotal role in panic attacks. When left untreated, the sufferer will begin to avoid going out or things they once enjoyed, in order to prevent another panic attack.

4. Social Anxiety Disorder: People who suffer from social anxiety fear being humiliated or seen negatively by others. Those with this disorder often worry that the way they look or act cause others to mock them. This can cause sufferers to avoid social gatherings to avoid being humiliated. In fact victims of bullying often develop social anxiety due to the repeated shame and public humiliation they experienced.

If you or a loved one appears to be suffering from an Anxiety Disorder, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

 

References:

https://www.verywellfamily.com/bullying-and-anxiety-connection-460631

https://www.stopbullying.gov/blog

 

 

Bipolar One Vs. Bipolar Two

By: Yael Berger

Bipolar, also known as manic depression, is a mood disorder characterized by extreme highs and extreme lows. Extreme highs are called mania while the extreme lows are called depression. It is seen in both adults and children and tends to run in the family. If you have a close relative with Bipolar disorder, you have an increased chance of developing the disorder. According to the national institute of mental health, “an estimated 4.4% of U.S adults experience bipolar disorder at some time in their lives.” There are two different types of Bipolar that are often difficult to distinguish between.

Bipolar I patients commonly present with these symptoms:

  • An episode of extreme mania lasting at least one week and usually an episode of severe depression lasting at least two weeks
    • Mania is characterized by irritability, mood swings, and possibly excessive spending, drinking, excessive sexual behavior etc.
  • Less need for sleep
  • Increased self-esteem, speech, thoughts, distractibility
  • Rapid mood swings
  • Can have a break with reality
    • Hallucinations, delusional or paranoid thoughts
  • Usual onset: around 18 years old

Bipolar II patients commonly present with these symptoms:

  • An episode of hypomania lasting at least four days and always accompanied by an episode of extreme depression lasting at least two weeks
  • Hypomania is a milder form of mania but it is still noticeable to others
  • Typically are prescribed antidepressants with mood stabilizers
  • Usual onset: around mid-20s

There are a few key differences between bipolar I and bipolar II. The main difference is that Bipolar I often begins with mania while Bipolar II often begins as a depressive episode that is later diagnosed when an episode of hypomania occurs. Bipolar II is sometimes wrongly diagnosed as depression at first because it often starts as a depressive episode. Bipolar I is usually obvious and severely disrupts a patient’s life while Bipolar II can be less noticeable. However, once a hypomanic episode in Bipolar II patient causes severe impairment it would then be categorized as Bipolar I. Bipolar I can lead to hospitalization more often than Bipolar II because of the extreme mania that occurs. A combination of medication and therapy can help both Bipolar I and II.

If you or someone you know has any type of Bipolar Disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit https://www.counselingpsychotherapynjny.com/

Sources:

https://www.healthline.com/health/bipolar-disorder/bipolar-1-vs-bipolar-2#symptoms

https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml

https://www.psychologytoday.com/us/blog/two-takes-depression/201901/10-things-know-about-bipolar-disorder

Image:

https://www.medicalnewstoday.com/articles/319280.php

Low Self Esteem: Imposter Syndrome

Low Self Esteem: Imposter Syndrome

Low Self Esteem: Imposter Syndrome

By: Julia Keys

        Do you ever feel like no matter how much you accomplish, you still are inadequate compared to others around you? Feeling fraudulent about one’s achievements is so common that psychologists have given it a name: Impostor Syndrome.  People with Impostor syndrome doubt their own accomplishments and have a fear of being exposed as a fraud among their colleagues.  Despite the fact that people with Impostor Syndrome have great external evidence for their accolades, they still cannot be convinced that they deserve what they have accomplished.Those with Impostor Syndrome often attribute their success to external factors such as luck or good timing.

Impostor Syndrome can be caused by perfectionism and fear of failure. However, if you are afraid you won’t be perfect or that you will fail, then you will be discouraged from going after new goals! The constant pressure found in those with Impostor Syndrome can cause feelings of guilt, shame, embarrassment, and at its worst, depression and anxiety.

One group of people that are especially prone to Impostor Syndrome are highly successful women.  The discrepancy between external achievement and internalization of achievement within successful women may be caused by our society’s standards. Gender roles have greatly shaped what it looks like to be a successful man versus what it looks like to be a successful woman. Successful men are stereotypically in positions of power while successful women are stereotypically in caretaker’s positions.  The type of achievements that constitute success in our culture, such as obtaining a high degree, being financially successful, or being promoted to a leadership position are more aligned with the stereotypes of male achievement, which may explain why when women achieve such goals, they feel like frauds.

No one should have to feel like a fraud, especially if they prove to be very high achieving. If you or someone you know can relate to the information above, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Sources:

https://www.psychologytoday.com/us/blog/the-scientific-fundamentalist/200912/why-do-so-many-women-experience-the-imposter-syndrome?collection=59879

https://www.psychologytoday.com/us/blog/the-scientific-fundamentalist/200912/why-do-so-many-women-experience-the-imposter-syndrome?collection=59879

Photo Source:

https://www.google.com/search?rlz=1C1OPRB_enUS649US649&biw=703&bih=687&tbm=isch&sa=1&ei=wdreXOyjA7CMggfj_7OACg&q=imposter+&oq=imposter+&gs_l=img.3..0i67j0l9.23457.23457..23925…0.0..0.65.65.1……1….1..gws-wiz-img.A4lE_uMxDas#imgdii=jwWSPXuWpL7DEM:&imgrc=rNl-1Zw95v2pzM:

Childhood Trauma: Effects on Adult Wellbeing

Childhood Trauma: Effects on Adult Wellbeing

Childhood Trauma: Effects on Adult Wellbeing

By: Julia Keys

The child brain grows and makes connections at a rapid rate and is extremely emotionally sensitive. Unfortunately, children that experience some sort of major trauma such as emotional, physical, or sexual abuse, neglect, war, poverty, or unsafe living conditions can be greatly negatively impacted later on in life.

Children who have parents that are for some reason unwilling or unable to provide the love and care they need oftentimes blame themselves for the lack of parental attention. In response to this lack of care, children may start to act in ways in which they feel would help the parents love them more. As the child grows up, they can become detached from their own needs because they are so focused on the love they receive from others.

Another effect of childhood trauma is victimhood thinking. Although a child may have been helpless when they were raised, self-victimization does not help an adult in the long run because it robs them of the self-empowerment they need to change their lives in the ways they desire.

Children growing up in environments where anger is expressed violently may begin to learn that anger is dangerous and therefore should be avoided. However, suppressing emotional expression is unhealthy and can cause individuals to be passive aggressive, which is an ineffective way to communicate. The most damaging effect of childhood trauma can have on an adult is the development of psychological disorders such as depression, anxiety, or post-traumatic stress disorder.

If you or someone you love is struggling with the effects of childhood trauma, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling and Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/.