Child & Adolescent Psychotherapy Services

03/15/2026

When Kids Refuse Food: Try Changing the Approach, Not the Child

Many parents feel frustrated or worried when their child refuses food. But for many kids, especially those who are sensitive to new experiences, food can feel unfamiliar, unpredictable, or overwhelming. When that happens, resistance is actually a pretty normal response.

Instead of focusing on getting kids to eat, it can help to focus on gentle exposure and predictability.

Here are 3 small shifts that can make a big difference:

1. Separate Foods on the Plate
Many kids feel more comfortable when foods don’t touch or mix together.
Try using plates with sections or simply spacing foods apart. This makes the meal feel more predictable and less overwhelming.

2. Remove the Pressure
Pressure often backfires. Instead of saying “You have to eat it,” try:
“You don’t have to eat it — we’re just learning about it.”

Remember this helpful division of responsibility:

• Your job: Provide the food
• Your child’s job: Decide whether to eat it

This approach lowers anxiety and keeps mealtimes calmer.

3. Keep Offering Calm Exposure
Research shows that many children need 8–15 exposures before accepting a new food. That means simply seeing it on the plate counts as progress.

No pressure. No battles. Just calm opportunities to explore.

Small steps really do add up.

You’ve got this.

— Suzanne Donohue, LCSW
Child & Adolescent Psychotherapy Services (CAPS)

03/10/2026

My Approach to Working with Children and Teens~~

Parents often ask what my approach to therapy is when working with children and adolescents.
My work is strongly informed by neuroscience and by leaders in the field such as Dan Siegel, Robyn Gobbel, and Stephen Porges.
This means I understand children’s behavior through the lens of the developing brain and nervous system.
Children are not “giving us a hard time.”
More often, they are having a hard time.

When a child is anxious, overwhelmed, impulsive, or emotionally reactive, it is often a signal that their nervous system is dysregulated, making it difficult for the thinking brain to stay in charge.

In therapy, I help children learn how to:
~understand their brain
~calm their nervous system
~recognize emotions
~build regulation skills
~develop confidence and resilience

For children and teens experiencing anxiety, I also integrate evidence-based Cognitive Behavioral Therapy (CBT) strategies to help them recognize anxious thoughts, challenge worry patterns, and build coping skills.

When working with children with ADHD, my approach is also informed by the work of experts such as Russell Barkley and Ross W. Greene, who emphasize understanding executive functioning challenges and helping children build the skills they need to succeed.

I also work closely with parents because co-regulation and supportive relationships are one of the most powerful ways children learn to regulate themselves.

My goal is to help children not only feel better in the moment, but to build lifelong skills for managing emotions, stress, friendships, and challenges.

Warmly,
Suzanne Donohue, LCSW
Child & Adolescent Psychotherapy Services (CAPS)
Mountain Lakes, NJ

03/02/2026

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02/28/2026

02/28/2026

Was your child diagnosed with ODD?
Hmm. Let’s slow that down for a moment.
I don’t love labels that stop the conversation.
Especially when they might prevent us from asking the more important question:
Let’s look at what’s underneath the behavior?
“Oppositional” behavior is often secondary to something else going on in the brain and nervous system.
Let’s dig a little deeper.
Sometimes what looks like defiance is actually:
**ADHD –
Impulse control difficulties.
Working memory challenges.
Frustration tolerance that runs out quickly.
A child who feels constantly corrected or overwhelmed may push back to protect themselves.
**Anxiety –
Avoidance is not manipulation — it’s safety-seeking.
When the nervous system feels overloaded, “no” can be a shield.
**Trauma –
Hypervigilance.
Control as survival.
Big reactions because the brain is wired to scan for threat.
**Depression –
Irritability.
Exhaustion.
Low motivation that gets mistaken for noncompliance.** Autism Spectrum Differences –
Sensory overload.
Transition challenges.
Rigidity that reflects neurological overwhelm — not willful defiance.
(PDA profiles can especially look oppositional when anxiety is driving control.)
Kids aren’t born defiant.
They are overwhelmed.
Misunderstood.
Or trying to cope with brains that are working overtime.
When we shift from
“Why are they acting like this?”
to
“What is their nervous system telling us?”
Everything changes.
Let’s dig deeper. 💙
— Suzanne
Child & Adolescent Psychotherapy Services (CAPS)

02/26/2026

Why Kids and Teens “Flip Their Lid” — and What Parents Can Do to Help

Have you ever watched your child go from calm to completely overwhelmed in seconds? Suddenly they’re yelling, crying, refusing, or shutting down—and logic doesn’t work.

Dr. Dan Siegel calls this “flipping your lid.” And it’s one of the most important concepts for parents to understand when supporting emotional regulation.

Here’s what it means.

The Brain Has Two Main Parts Working Together:

The Thinking Brain🧠 (Upstairs Brain)
This is the prefrontal cortex. It helps with:
• Reasoning
• Problem-solving
• Impulse control
• Perspective-taking
• Emotional regulation

This part develops slowly—and isn’t fully mature until the mid-20s.

The Emotional Brain🧠 (Downstairs Brain)
This includes the amygdala and limbic system. It is responsible for:
• Big emotions
• Threat detection
• Fight, flight, or freeze responses

This system is fast, automatic, and very strong—especially in children and teens.

When kids are calm, these two parts work together.
When kids are overwhelmed, the “lid flips.”

The thinking brain goes offline.
The emotional brain takes over.

This is why your child literally cannot “just calm down” or “use their words” in that moment.

They aren’t choosing to be difficult.
Their brain is in survival mode.

This is especially true for kids with:
• ADHD
• Anxiety
• Emotional sensitivity
• Executive functioning delays
• Social stress or sensory overload

Their lids flip faster—and come back down more slowly.

What Helps Bring the Lid Back Down:

First: Connection, not correction.

When a child is dysregulated, they need co-regulation before self-regulation.

Helpful responses include:
• Speaking calmly
• Reducing demands temporarily
• Validating feelings (“That was really frustrating.”)
• Offering physical or emotional presence
• Giving the nervous system time to settle

Only after the brain is calm can learning, reflection, and problem-solving happen.

The long-term goal is not to prevent all lid-flipping.
It’s to help kids learn how to bring their lid back down.

This is how emotional regulation develops.

And the most powerful regulator of a child’s nervous system…
is a calm, regulated adult.

—
Child & Adolescent Psychotherapy Services (CAPS)
Supporting emotional development, self-regulation, and resilient kids.

02/25/2026

Did you know February is International Boost Self-Esteem Month?

Self-esteem isn’t something children are born with—it’s something that develops over time through experiences, relationships, and how adults respond to them.

Research shows that self-esteem grows when children:

• feel accepted and valued for who they are
• experience success after effort—not perfection
• learn that mistakes are part of learning
• develop competence through practice
• feel emotionally safe, understood, and supported

Self-esteem is not built through constant praise.
It is built through confidence earned through experience.

Children develop lasting self-esteem when they learn:

“I can try hard things.”
“I can handle mistakes.”
“I can recover when things don’t go my way.”
“I am valued, even when I struggle.”

As parents, one of the most powerful things you can do is help your child focus on effort, persistence, and growth—not just outcomes.

Instead of saying:
“Good job, you’re so smart.”

Try saying:
“I noticed how hard you worked on that.”
“You didn’t give up—that builds confidence.”
“You handled that challenge really well.”

Self-esteem is deeply connected to emotional resilience, mental health, and long-term success.

And the good news is—it can be strengthened at any age.

— Suzanne Donohue, LCSW
Child & Adolescent Psychotherapy Services (CAPS)
Mountain Lakes, NJ
Follow: https://www.facebook.com/CAPS.NJ/

02/25/2026

When Your Young Child Doesn’t Listen, Says “No,” or Melts Down Over Small Things — It’s Not What You Think

Many parents of bright, capable young children tell me:

“He understands. He just refuses.”
“She hears me, but ignores me.”
“He melts down over the smallest transitions.”

Here’s the truth:

For many young children—especially those with attentional, sensory, or neurodevelopmental differences—this is not willful defiance.

It is a nervous system challenge.

Their thinking brain knows the rule.
But in the moment, their emotional brain and sensory system take over.

They may struggle with:
• shifting from one activity to another
• stopping something their brain has “locked" onto
• tolerating disappointment
• delaying gratification
• regulating strong emotional reactions

This is not a character issue.
This is a developmental skill-building process.

Research in child development and neuroscience shows that self-regulation, flexibility, and impulse control develop gradually through co-regulation, structure, and repetition—not punishment or lectures.

What helps most?

1. Clear expectations ahead of time
Their brain does better with predictability.

2. Calm, confident limits
Not harsh. Not negotiable. Calm and steady.

3. Validation without changing the boundary
“I know that’s hard. I’m here.”

4. Consistency
The brain learns safety through predictability.

5. Your calm nervous system
Your regulation helps regulate theirs.

Over time, with the right support, their brain builds the pathways needed for flexibility, emotional regulation, and resilience.

These children often grow into deeply thoughtful, creative, and capable individuals.

They are not giving you a hard time.
They are having a hard time.

And with the right support, they thrive.

— Suzanne Donohue, LCSW
Child & Adolescent Psychotherapy Services (CAPS)
Mountain Lakes, NJ
Follow: https://www.facebook.com/CAPS.NJ/

02/23/2026

OK, let’s jump into anxiety~~~~

Not the definition. Not the textbook version.

But what anxiety actually looks like in real life — in kids, teens, and young adults.

Because anxiety doesn’t announce itself. It shows up in disguise.

In kids, anxiety can look like:
• School avoidance/refusal
• Stomachaches or headaches
• Meltdowns or anger
• Constant reassurance seeking
• Trouble sleeping
• Avoiding new things

Not defiance~~A nervous system that doesn’t feel safe.

In teens, anxiety often looks like:
• Irritability
• Procrastination
• Perfectionism
• Social withdrawal
• Shutting down
• “Lack of motivation”

Not laziness~~Overwhelm.

In young adults, anxiety can look like:
• Overthinking everything
• Avoiding opportunities
• Difficulty making decisions
• Sleep struggles
• High self-criticism

Not weakness~~Protection mode.

Anxiety is a brain trying to protect — not hurt.

And when kids understand what’s happening inside their brain,
they can learn how to calm it, strengthen it, and take back control.

Anxiety is treatable.
And change is absolutely possible.

Child & Adolescent Psychotherapy Services (CAPS)

02/23/2026

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02/23/2026

When Your ADHD Child or Teen Struggles with Emotional Dysregulation: What to Ask Your Medical Provider

As a therapist, I focus heavily on teaching emotional regulation, executive functioning, and coping skills. These strategies are essential and often life-changing.

However, for some children and teens with ADHD, emotional dysregulation remains intense despite strong therapeutic support and parenting strategies.

While I am not a medical doctor and cannot make medication recommendations, I do encourage parents to have informed conversations with their child’s prescribing medical provider.

One important discussion may include asking about both stimulant and non-stimulant medication options—and understanding why each may help.

Here is the evidence-based reasoning:

ADHD Is Not Just About Attention — It Is Also About Regulation

Research shows ADHD affects the brain’s executive functioning system, particularly in areas responsible for:

• Impulse control
• Emotional regulation
• Frustration tolerance
• Response inhibition
• Cognitive flexibility

This involves differences in dopamine and norepinephrine activity in the prefrontal cortex—the part of the brain responsible for regulation and self-control (Barkley, 2015; Arnsten, 2009).

This is why emotional reactions can feel immediate, intense, and difficult to control.

This is neurological—not willful.

Why Stimulant Medications May Help Emotional Regulation

Stimulant medications (such as methylphenidate or amphetamine-based medications) are considered first-line treatment for ADHD and are supported by decades of research.

They work by increasing dopamine and norepinephrine availability in the brain, which improves:

• Impulse control
• Frustration tolerance
• Emotional regulation
• Ability to pause before reacting
• Executive functioning overall

Research shows stimulants improve emotional regulation in approximately 70–80% of children with ADHD (American Academy of Pediatrics, 2019).

Many parents notice their child is:

• Less reactive
• More flexible
• Better able to tolerate frustration
• More socially successful

—not just more attentive.

Why Some Children Also Benefit from Non-Stimulant Medications

Non-stimulant medications (such as atomoxetine, guanfacine, or clonidine) work differently. They support regulation of the nervous system and emotional reactivity.

These medications may help with:

• Emotional intensity
• Impulsivity
• Irritability
• Anxiety
• Aggression or explosive reactions
• Nervous system over-activation

Some non-stimulants, particularly guanfacine and clonidine, act on the brain’s regulation centers and can help calm emotional reactivity and improve frustration tolerance (Connor et al., 2010).

Why Some Children Benefit from a Combined Approach

For some children, stimulant medication improves focus and impulse control, while a non-stimulant helps regulate emotional intensity and nervous system reactivity.

This combination can be particularly helpful for children who have:

• Severe emotional dysregulation
• Frequent meltdowns
• Impulsive verbal or emotional reactions
• Co-occurring anxiety
• Difficulty “settling” emotionally

Medication does not replace therapy. It creates a neurological state where therapy and skill-building can be more effective.

Medication helps create access to regulation.

Skills help build long-term independence.

Both matter.

The Most Important Message

Medication is not about changing your child’s personality.

It is about helping their brain access the regulation and control they already want—but may not yet be able to consistently achieve on their own.

If your child continues to struggle with emotional dysregulation despite strong therapeutic and parenting support, it may be helpful to ask their medical provider:

“What medication options might help with both attention and emotional regulation?”

Your child’s medical provider can guide you through safe, individualized options.

With the right support—therapeutic, environmental, and when appropriate, medical—children with ADHD can develop strong emotional regulation, confidence, and long-term success.

— Child & Adolescent Psychotherapy Services (CAPS-NJ)