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Professional
Services We offer
the following services with the highest degree of professionalism, care for our clients, confidentiality, and ethical standards:
* Psychotherapy and counseling for adults
* Psychotherapy and counseling for children
* Psychotherapy
and counseling for adolescents
* Neurofeedback for adults and children (EEG biofeedback and hemoencephalography)
(please visit our affiliated
website: www.neurofeedbacknewhampshire.com)
* Quantitative electroencephalography (brain mapping)
* Heart Rate Variability Training
* Parenting counseling
* Couples and family therapy
* Post-divorce mediation
* Psychological and neuropsychological testing
* Evaluations, counseling
and consultation for ADHD, learning disabilities,
Asperger's Disorder and PDD, nonverbal learning disabilities,
emotional problems and affective disorders, and intellectual
giftedness. *
Tutoring
* Special education consultation
* Consultation to physicians and attorneys
* Adoption
and infertility consultation
* Workshops and lectures on a variety of topics
* Supervision and consultation
of mental health
professionals * Neurofeedback
mentoring and consultation
Strengthening Families
Families are under a great deal of stress these days. There are
financial and employment uncertainties, behavioral and learning problems that children experience, and conflict and disagreement
between parents. Many parents and children have medical problems, learning problems, and psychological
diagnoses. Even the best of parents are frequently at a loss as to the best and most effective ways to
set rules, communicate expectations, work as a team, enforce punishments, and guide their children’s behavior and attitudes.
Helping their children establish good study habits and social skills and working with teachers and coaches can be confusing
and challenging. We help families recognize their strengths and build on them, guiding them to more effective
communication and teamwork between the parents. We help parents realistically understand their children’s
strengths and vulnerabilities, and their social skills and learning needs, and help them provide effective guidance.
We help children understand their own needs and help them communicate them to their parents. We
work with families with the goals of understanding and respecting each member’s needs and views, helping each member
develop the tools to improve him or herself, and establishing healthy relationships and a healthy parent-child hierarchy.
 NeurofeedbackWHAT IS NEUROFEEDBACK?
Neurofeedback
is a biofeedback technique that allows the brain to regulate itself in order to maintain a stable state of relaxed, focused
attention, alertness, and emotional control. It is comfortable, and involves no medication or invasive procedures. Research
has shown that, for many individuals, it can be a viable alternative or adjunct to medication.
During neurofeedback
training, the individual sits in a comfortable chair with small electronic sensors attached to his or her scalp and ears,
while looking at a computer screen. The sensors allow a computer to record the individual's brain wave patterns. The individual
is then rewarded for emitting brain wave patterns that increase his or her attention, alertness, and emotional control. The
individual receives this rewarding feedback by playing computer video games, which he or she learns to control with his brain
waves. The computer awards points when the desired brain wave patterns are emitted. The brain learns from this feedback and
adjusts accordingly, strengthening its ability to achieve and maintain this state. Over time, the brain becomes better able
to self-regulate and achieve this state on its own.
WHAT IS NEUROFEEDBACK USED FOR?
Research and clinical
studies have demonstrated the effectiveness of neurofeedback with ADD/ADHD, seizure disorders, mood regulation, depression,
anxiety, sleep disturbances, learning disabilities, Asperger's Disorder, headaches, tics, obsessive-compulsive disorder, autoimmune
disorders, pre-menstrual syndrome, chronic fatigue syndrome, chronic pain, oppositional defiant disorder, fibromyalgia, teeth
grinding, tinnitus, addictions and other conditions. All of these conditions involve difficulties with the brain's regulatory
mechanisms. Since neurofeedback helps the brain to self-regulate in ways that promote better attention, alertness and emotional
control, it could potentially help anyone who wants to improve these areas of functioning. It is already widely used in peak
performance training for athletes and executives.
WHAT IS THE TYPICAL LENGTH OF TREATMENT?
Treatment
begins with an initial evaluation in which a detailed history is taken, assessment measures are administered, and the individual
is familiarized with the equipment. This typically takes about 2 hours.
If the individual is suitable for neurofeedback,
treatment usually consists of twice weekly appointments of about ½ hour each. Treatment proceeds for a minimum of 20
sessions, but 40 or more sessions are usually advisable, depending on the initial concerns and the effect of treatment on
the individual.
WHAT TYPES OF NEUROFEEDBACK ARE USED IN THIS PRACTICE?
In our practice, we tailor the
treatment to the individual and, therefore, we offer several different types of neurofeedback, and often combine different
types for an individual. The two major types of neurofeedback that we offer are brainwave
or EEG neurofeedback and HEG neurofeedback, which
is described below. Within brainwave or EEG neurofeedback we can work with amplitude training,
in which we try to regulate the functioning of a single site or multiple sites of the cortex, or we focus on the relationship
between two sites. In coherence training, we train two or more different sites
either to fire in closer synchrony with each other or to fire more independently of each other. In alpha/theta
training, we attempt to induce a deep, meditative-like state, which can be used to control anxiety and for
which there is research support for its effectiveness for individuals coping with alcohol and substance abuse.
Beta-reset training is a newer form of neurofeedback which is
being used to help people deal with the emotional components of physical disorders, such as autoimmune disorders, as
well as the effects of early emotional trauma.
HOW CAN I FIND OUT MORE?
To find out if neurofeedback
might benefit you, call Dr. Edward Jacobs. Dr. Jacobs is a trained neurofeedback practitioner, Board Certified in Neurofeedback,
and is an affiliate of EEG Spectrum International. He has taught EEG Spectrum's four day intensive training course
in different locations throughout the country. You can visit our afffiliated website: www.neurofeedbacknewhampshire.com. You can also read the book: A Symphony in the Brain, by Jim Robbins, or visit the websites of EEG Spectrum International
at www.EEGSpectrum.com, EEG Directory at www.EEGinfo.com, the International Society for Neurofeedback and Research at www.isnr.org, and Brainmaster Technologies at www.brainmaster.com. For a
comprehensive bibliography of neurofeedback research and clinical studies as applied to specific diagnoses and problems, visit
http://www.isnr.org/ComprehensiveBibliography.cfm. If you want to check with your
insurance to see if your policy covers neurofeedback, click here for the insurance codes. If you have a child who is scheduled for neurofeedback training, please click here for important guidelines for parents.
Neurofeedback for ADHD/ADD
Neurofeedback for Autism Spectrum Disorders
Neurofeedback for Learning Disabilities
Neurofeedback for Emotional Disorders
Neurofeedback for Migraine Headaches
For more information on neurofeedback procedures,
please visit: www.neurofeedbacknewhampshire.com
Heart Rate Variability Training
Chronic
stress causes wear and tear on the body. The emotional tension we experience in response to life’s
daily hassles accumulates in the body, resulting in symptoms like fatigue, headaches, gastrointestinal problems, anxiety,
physical illness, feelings of hopelessness and helplessness, and sleep problems. This undercurrent of stress
makes coping with larger problems in life more difficult. When we are chronically stressed, our heart rhythm becomes
out of sync. A healthy heart rhythm, which is associated with good mental and physical health, a well-functioning
nervous system, and a feeling of well-being, reflects a balance between sympathetic and parasympathetic activity.
The sympathetic nervous system activates us to respond to external demands by increasing our heart rate, blood pressure,
muscle tension, and other physiological processes. The parasympathetic nervous system controls those same
processes in a way that decreases activation and relaxes us. When our heart rate is healthy, both processes
are balanced and in sync, and our heart rate varies from peak sympathetic activity to peak parasympathetic activity.
This is illustrated above, in which the heart rhythm is smooth and regular, and there is maximum and consistent distance
between the peaks and the lowest points. Our bodies and minds thus are in a state of readiness for whatever demands
are made on us. When our heart rate variability is not optimum, the heart rhythm is irregular and it becomes
difficult to counter our body’s stress response with relaxation, as illustrated below.
Research has indicated that establishing and practicing certain breathing patterns can increase heart
rate variability, resulting in a balance of sympathetic and parasympathetic activity that reduces the physical and emotional
tolls of stress and provides greater relaxation and feelings of well-being. This can be accomplished by
learning to breathe slowly and steadily from the diaphragm (or “belly breathing”), inhaling for about six seconds
and exhaling for about six seconds, without holding one’s breath or straining to breathe. This is
not easy to do, given that most of us have been conditioned over a lifetime of living in stress to breathe quickly and shallowly. However,
help is available through computer technology that we use in our practice called HeartMath Heart Rate Variability Training
(HRV). First, you are coached in practicing slow and rhythmic diaphragmatic breathing. Then,
a sensor is placed on your index finger or ear lobe that monitors your heart rhythm. You then receive immediate
feedback by seeing your heart rhythm patterns in real time on a computer screen. You can see when your
heart rhythm is becoming more regular and consistent, and colored bars and tones inform you when you are in a zone of positive
and healthy heart rhythm coherence. By using this feedback in the office and practicing the breathing techniques outside
the office, you can learn to improve your heart rate variability and decrease the chronic effects of stress on your mind and
your body. HRV can be used as a stress management tool by itself or in conjunction with neurofeedback training.
Hemoencephalography (HEG)
HEG is a form of neurofeedback which trains the individual
to increase the activation of the prefrontal cortex. An infrared sensor is placed on the forehead with
a headband. The sensor acts like a camera and measures the heat output from the prefrontal lobes of the
brain, which is an indication of increased blood flow and increased activity. The prefrontal cortex is
known as the “executive” part of the brain; it is involved in regulating attention and inhibition, planning and
organization and decision making. It is important in the inhibition of pain sensations, focusing attention,
controlling impulses and sensory regulation. HEG has been used to decrease the frequency and severity of
migraine headaches and in the treatment of ADHD, anger, depression and anxiety.
Brain
Mapping
WHAT IS BRAIN MAPPING?
A brain map, also known by its scientific name, quantitative electroencephalogram,
is a way of analyzing the electrical activity of the cortex, the outermost layer of the brain. Electrical activity is recorded
over several sites, so we get a picture of how the brain is functioning in many areas. This allows us to evaluate the brain
activity that is associated with alertness, attention, emotional control, sensory processing, inhibition, motor control, learning,
and many other functions that depend on brain regulation. This recording of the brain's activity is compared to a database
of a large number of people of different ages with no known neurological abnormalities. By comparing the individual's brain
wave activity to these "normal" brains, we can see where there is abnormal activity and whether there are areas
of the brain that are not communicating in a normal fashion, which may be contributing to the individual's difficulties.
Brain mapping is used to help determine neurofeedback protocols that might be most helpful for an individual. The
mapping is done in the office and involves no invasive or uncomfortable procedures. The indivudual sits comfortably in a chair,
while a technician places electrical sensors on the scalp, which record the brain's electrical activity. The entire procedure
is usually completed within an hour.
WHY
DO WE DO BRAIN MAPS (QEEG’S)?
If you are interested
in doing neurofeedback training, we want to know as much as possible about how your brain works. We
can and do provide neurofeedback treatment without doing a qEEG. When we do, we take into account all the
clinical information that we gather about you: your symptoms, individual and family history, wakefulness, alertness and sleep
cycles, medical and medication history, mood regulation, behavior and responses to checklists and rating scales, and what
the research and our clinical experience tells us is likely to be effective. However, a qEEG provides another layer of information
that is not available through these other means. It is like looking under the hood of an automobile
to see what is happening inside and how all the parts are working together. We get information about where
in the cortex there might be atypical electrical activity that might be associated with problems in functioning, and what
parts of the brain might not be connecting well enough to make the brain function in a well regulated way. We
are able to see many factors of brain functioning that we otherwise would not have access to. This, in
turn, allows us to create training protocols that are more precisely targeted to the way your individual brain functions and
also gives us choices of possible protocols that we would not have been able to know about without the brain map. We know that the brain
map is costly and that the cost might make it hard to afford, but the information can be extremely valuable. The
reason for the cost is that several highly trained professionals besides ourselves are involved with the brain mapping and analysis. We have an experienced technician come in to the office to do the electrode
placement and brain wave EEG recording. Then the EEG is read by a Board Certified neurologist to look for
any abnormalities. In addition, a neuropsychologist interprets a very large amount of data and consults with us in order to
judge which findings are significant and which are most likely related to your difficulties, providing a basis for training.
Furthermore, there is a cost associated with gaining access to the normative database used in the analysis and, of
course, there is the cost of the equipment and software used. Of course, as with everything we do, the decision about
what to do will be based on your or your child’s individual needs after a thorough discussion between us. We
are happy to answer any and all questions and address any concerns that you might have.
HOW CAN I FIND OUT MORE?
To find out if neurofeedback or brain mapping might benefit you, call Dr. Edward Jacobs, or go to www.q-metrx.com.
If you want to check with your insurance to see if your policy covers
brain mapping, click here for the insurance codes.
Psychological Testing Psychological testing is a way of evaluating a person's functioning in one or
several areas by obtaining a large amount of information in a relatively short period of time. Information is gathered
from interviews with the client and significant others, such as parents or spouses, and by the administration of tests, many
of which are objectively developed in order to compare the individual with others his or her age. We provide testing,
for children and adults, to help evaluate ADHD, learning disabilities, nonverbal learning disabilities, Asperger's Disorder,
Pervasive Developmental Disorder, intellectual abilities, personality functioning, social and emotional functioning, depression,
severe psychological impairment, and parenting skills. Our evaluations are often used to determine an individual's eligibility
to obtain accommodations or modifications for special education, academic support, and community services, from preschool
through college. We are often asked to differentiate between different areas of difficulty when there has been uncertainty
about an individual's diagnosis. We provide evaluations for individuals throughout the lifespan.
ADHD EVALUATIONS FOR ADULTS
AND CHILDREN
Attention-Deficit/Hyperactivity
Disorder is often difficult to diagnose. It is often difficult to tell the difference between normal variations
in attention and a problem that is clinically significant. Furthermore, there are many problems and conditions
that can cause attention problems or in which attention problems can be just a part of a larger picture, like depression,
anxiety, mood disorders, Asperger’s Disorder and learning disabilities. When we evaluate for ADHD,
we conduct a comprehensive clinical interview in which we review your individual and family history to see if your problems
fit the pattern of ADHD or if they may be indicative of other concerns. We then get information from the
client and, when possible and useful, parents, teachers and other significant individuals to get a more complete understanding
of how the individual functions in his or her various roles in life. We often do some psychological testing
that gives us additional, objective information about intelligence, attention, organization and information processing.
Once we have all the information, we meet with the client, or the parents if the client is a child, and review all
the information and let you know whether a clear diagnosis can be made. We then write a report making recommendations
for the client, his or her parents, and the school (in the case of a child) to follow up on.
LEARNING DISABILITIES
EVALUATIONS
The evaluation of learning disabilities begins with a comprehensive interview in which
the client’s problems and history are reviewed in order to learn as much as possible about how the he or she is functioning,
how he or she functioned in the past, and how the problem developed over time. Information is taken about
home and school functioning and, in the case of an adult, occupational functioning when appropriate. We
then provide psychological testing specifically geared to the problems the individual is experiencing. We
typically assess the individual’s intelligence, attention and organizational skills and compare these to a person’s
abilities in the academic areas of concern, such as reading, math and written language. Often an individual
will have learning or processing problems that transcend specific subjects, such as a language-based learning disability or
a nonverbal learning disability. Individuals with these types of learning disabilities might struggle academically
in more than one area. Our evaluation assesses these areas as well. We then have a meeting
in which we provide feedback and write a report giving providing recommendations.
ASPERGER’S DISORDER
AND PDD EVALUATIONS
Asperger’s Disorder and Pervasive
Developmental Disorder (PDD) describe individuals who are on the high functioning end of the Autism spectrum.
These conditions are often difficult to diagnose, even with the best evaluation, because children and adults who have
these conditions often function well in many areas and can do well at home and at school. Children with
Asperger’s and PDD often have attention problems and are often misdiagnosed with ADHD. They can meet
the criteria for a diagnosis of ADHD, but the Asperger’s or PDD is often overlooked, resulting in these serious conditions
going unrecognized and not being attended to properly. Asperger’s and PDD can also look like other
types of learning or processing problems, and these have to be sorted out in order to arrive at an accurate diagnosis.
We do our best to gather a comprehensive history and a description of how the individual is functioning at home and
at school and, in the case of an adult, at work. We often give questionnaires and rating scales to the
client, parent and teacher to complete, which help clarify the symptom picture. Often, additional psychological
testing is recommended. We also evaluate Asperger’s and PDD in adults and provide consultation to
the individual and his or her spouse, when appropriate. A feedback meeting is held to provide information
and a diagnosis, when warranted, as well as recommendations to help the client and family deal with the condition productively.
Tutoring and Study Skills Coaching
ACADEMIC TUTORING
Academic tutoring services can be provided on a weekly basis. During the first session your child's skills will
be informally assessed and a plan will be developed. You will receive an email of your child's plan within a week of the
first session.
After the first session and based upon the assessment of your child's skills, you can consider
the need for additional tutoring sessions to address the skills that your child needs to learn. The number of sessions will
be a mutual agreement between the parent and tutor.
Tutoring can be tailored to meet your child's individual
needs in the areas of:
* Reading comprehension using Project Read strategies
* Math calculation and/or problem
solving strategies
* Written language skills and strategies using Project Read-Written Expression strand
* Critical
thinking skills related to academics
You, the parent, will need to be available during the session so that strategies
may be shared. Other children (siblings and/or friends) cannot be present or need to be otherwise occupied during the tutoring
sessions due to distractibility.
Either individual or small group sessions may be arranged based on the age level
and skills needed by your child.
Children may receive a combination of study skills and academic skills within
one session, based on their individual needs.
ORGANIZATIONAL/STUDY SKILLS COACHING
Direct services will
assess and teach your child skills in the following four areas:
Organization at School -- A place for notes and
handouts, a system for transporting material between home and school, storage for materials not being used (binder/file, backpack
and locker);
Organization at Home -- A place to do homework, a location for tools to complete work, and storage
for work in progress or completed;
Time Management -- Strategies to learn how to plan, prioritize, and manage time
for homework completion and long term assignments;
Study Skills for Test Taking -- Strategies for matching the
type of information to learn to a certain study format and alternatives to practice information to aid in retention.
The focus of coaching will be to allow your child to locate what he/she needs quickly, so that more time can be spent on
learning new academic information. Organizational systems are set up to meet individual children's needs and help to improve
school success, so each organizational system may look different for each child.
Essential organizational/study
skills coaching services begin with a one-hour meeting. The meetings are scheduled at two-week intervals, with an email communication
between week one and week two. You, the parent, and your child must attend all sessions so that a consistent message is communicated
and skills can be continued between sessions. Other children (siblings and/or friends) cannot be present during the consultation
session due to distractibility.
The first session will focus on determining the organizational and study skills
that your child currently has and what he/she needs to learn. The current notebook, folder or file system that your child
uses needs to be available for review. A current report card and/or teacher's comments is also helpful to determine areas
of strengths and weaknesses. Finally, your child will create a skills contract to address one goal for developing organizational
skills during the following sessions.
After the first session and based upon the assessment of your child's
skills, you can consider the need for additional coaching services to address the skills that your child needs to learn. The
number of sessions will be a mutual agreement between the parent and coach.
ABOUT THE TUTOR: MARGARET BENTLEY,
M.ED.
Margaret (Meg) Bentley is a Specialist in the Assessment of Intellectual Functioning (S.A.I.F.) and Learning
Disabilities Specialist, certified in New Hampshire. She is also certified in General Special Education and Elementary Education.
Meg earned her Bachelor of Arts degree in Elementary and Special Education at Boston College and her Master of Education
degree in Learning Disabilities at Rivier College in 1988. In addition to her Master's Degree, advanced coursework for
certification as a Specialist in the Assessment of Intellectual Functioning was completed at Rivier College in 1990.
Meg has extensive experience working with children, teachers and parents in the field of special education. She was an S.A.I.F.
and Learning Specialist for the Hudson, NH School District for nine years. Meg worked for the Litchfield School District as
the Special Education Coordinator, working with families and students from preschool through high school. She has also taught
children in both general education classrooms and in a resource room setting.
As a college instructor, Meg Bentley
taught undergraduate and graduate courses at Rivier College in Nashua, NH and at Notre Dame College in Manchester, NH. In
addition, Meg has shared her wealth of knowledge and educational techniques by presenting teacher training seminars in Hudson,
Derry, Pembroke, Manchester, NH and Plymouth, MA.
Meg has specialized training in the Orton-Gillingham based reading
instructional techniques of Project Read and Wilson Reading. Intensive study of learning strategies developed by Howard Gardner
and Mel Levine are incorporated into Meg's instruction.
Meg provides tutoring and coaching to children and
adolescents, as well as consultation to their families. She is experienced in working with students with Attention Deficit
Disorder, Asperger's Disorder, Nonverbal Learning Disability as well as other learning differences.
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