When Strep Becomes Something More: A Parent's Guide to PANDAS

Child Health PANDAS Autoimmune Parenting
May 7, 2026 · 8 min read · Navesink Psychology

When Strep Becomes Something More: A Parent's Guide to PANDAS

Your child had strep throat — and then something changed. Here's what every parent needs to know about PANDAS.

HA
Hadeel Alabed
Psychology Doctoral Student Intern · Navesink Psychology
Important note

If your child has experienced a sudden, dramatic change in behavior or mood after a strep infection, speak with a specialist. Early identification leads to better outcomes.

What exactly is PANDAS?

Think of the immune system as a search-and-destroy team sent to fight strep bacteria. In children with PANDAS — Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections — that team makes a critical mistake: it accidentally attacks healthy brain tissue instead of just the bacteria.

This "friendly fire" causes the brain to become inflamed, triggering a sudden and severe onset of OCD, tics, or restrictive eating in children before puberty. It is not a behavioral problem. It is not bad parenting. It is a medical condition with biological roots.

1 in 200
children in the US have PANDAS (PANDAS Network)
Pre-puberty
typical age of onset
Group A Strep
the bacterial trigger

How can a sore throat change my child's personality?

When Group A strep bacteria enter the body, the immune system produces antibodies to fight them. In children with PANDAS, those antibodies cross-react with proteins in the brain — specifically in areas that regulate mood, movement, and behavior, like the basal ganglia.

The result: abnormal brain signaling that can look like OCD, intense anxiety, sudden mood shifts, tics, or rage. It is a cyclic pattern — symptoms flare during or after infections, then may calm, then return with the next exposure.

Common symptoms to watch for:

Sleep disturbances
Sudden OCD or anxiety
Handwriting decline
Personality changes
Tics or motor issues
Academic regression
Bedwetting (regression)
Sensory sensitivity

Did this happen "overnight"?

Often, yes — and that overnight change is one of PANDAS's most distinctive hallmarks. Parents frequently describe it as a "light switch": their child went to bed one person and woke up someone different.

That said, the initial symptoms may not appear until months after a strep infection in some children. If your child is showing signs now but had strep earlier this year, PANDAS is still worth exploring.

The "light switch" check

Keep a simple log: when did symptoms start, how suddenly, and was there any illness in the weeks before? This timeline is one of the most important pieces of evidence when speaking with a specialist.

Is this permanent?

This is the fear that keeps parents up at night — and the answer, reassuringly, is no. PANDAS is treatable. Your child is still in there. The behaviors and symptoms are a sign of a brain under physiological stress, not a permanent personality change.

With appropriate treatment — especially when caught early — many children see significant improvement and return to their baseline selves. The earlier you identify and treat it, the better the outcomes tend to be.

Is it "bad behavior" or a "medical flare"?

This is one of the most important questions a parent can ask. A child in a PANDAS flare is not being defiant — their brain is physically inflamed and sending distorted signals. Trying to discipline your way through a medical episode will not work, and it is not your child's fault.

Ask yourself: did this behavior come on suddenly, does it seem disconnected from anything that happened at school or home, and does it cycle — getting better and then worse again? Those patterns point toward something physiological, not behavioral.

Why didn't my pediatrician catch this?

PANDAS is not yet part of standard medical school curriculum, and many pediatricians simply have not been trained to recognize it. This is not a failure of your doctor — it is a gap in systemic awareness that the PANDAS community is actively working to close.

You may need to advocate strongly. Ask for a referral to a specialist familiar with PANDAS, or contact the PANDAS Network (pandasnetwork.org) for physician resources. Diagnosis typically involves:

Strep cultures
Immunological tests
Brain scans
Cunningham Panel
Medical history review
Allergy testing

How do we fix it?

Treatment addresses both the infection and the brain inflammation. Antibiotics to treat or prevent strep are often a first step. Anti-inflammatory medications, immunotherapy (like IVIG or plasmapheresis), and behavioral therapy — including ERP for OCD symptoms — are all part of the toolkit depending on severity.

Therapy alone is rarely enough during a flare. But therapy becomes very powerful once the biological component is being treated. Think of it this way: you wouldn't ask someone with a broken leg to just try harder to walk. You treat the break, then do the rehab.

5 practical tools for parents

1
Do the "light switch" check
Track how fast symptoms appeared and whether a strep infection or illness preceded them. A sudden onset after illness is a key diagnostic signal — write it down with dates.
2
Regulate yourself first
During a flare, your child's nervous system is already overwhelmed. A calm, low-stimulation response from you helps de-escalate — even when the behavior is alarming or confusing.
3
Separate the child from the symptoms
Remind yourself and your child: "This is the PANDAS talking, not you." It protects your relationship and reduces shame and confusion for your child during hard moments.
4
Create predictable structure
Routine provides neurological safety for children whose brains are under stress. Consistent schedules, low-stimulation environments, and predictable transitions reduce flare intensity.
5
Build your care team early
Assemble a team that includes a PANDAS-literate physician, a therapist familiar with OCD and childhood autoimmune conditions, and your school's support staff. No one should navigate this alone.

Frequently asked questions

Is PANDAS the same as OCD?
Not exactly. OCD is the symptom; PANDAS is the underlying cause in these cases. A child with PANDAS may look like they have OCD, but the root is an autoimmune response — which means treatment needs to address the immune system, not just the behavior.
Will my child have PANDAS forever?
Many children with PANDAS improve significantly — especially with early treatment. Some children fully recover. Symptoms often diminish as children age through puberty, though ongoing strep prevention may remain important.
What should I do if my child just had strep?
Complete the full course of antibiotics. Monitor closely for any sudden behavioral or emotional changes in the days and weeks after. If you notice anything sudden and out-of-character, document it and contact your physician promptly.
How is PANDAS different from normal anxiety or OCD?
The key distinction is the sudden, dramatic onset tied to infection. Standard OCD typically develops gradually. PANDAS symptoms appear like a switch was flipped — often within 24–48 hours of illness — and they may cycle with future infections.

If you're navigating PANDAS or suspect your child may be affected, we're here to help.

Anxiety Tips: Using AI To Stay Informed Without Spiraling

Using AI to Stay Informed Without Spiraling | Navesink Psychological Services
Anxiety Coping Strategies May 2026  ·  5 min read

Using AI to Stay Informed Without Spiraling

When world events feel overwhelming, the answer isn't avoidance — or a research rabbit hole. There's a better way.

MS
Matthew Strobel, Psy.D.
Navesink Psychological Services
Meet the team ↗

When something scary is happening in the world — a disease outbreak, a natural disaster, a geopolitical crisis — many of us feel the pull to do one of two things: shut it all out, or consume every piece of information we can find. Both of these instincts make complete sense. And both of them tend to make anxiety worse.

Why Avoidance Backfires

When we avoid something that makes us anxious, we get a small dose of short-term relief. The problem is that we never fully relax — we're just waiting for the anxiety to come back. And it always does. This is the anxiety cycle: feel anxious → try to ignore → feel temporary relief → encounter a reminder → feel anxious again.

World events are particularly difficult to avoid, because they show up everywhere. Imagine trying to tune out a news story by watching a sporting event. Then the announcer mentions it. A player is wearing a warmup shirt. A fan holds up a sign. Suddenly you're right back where you started — and now your avoidance strategy has failed, which can feel even more distressing.

Time Anxiety Level Avoidance cycle Staying informed Never fully resolves Returns to baseline Anxiety Over Time: Avoidance vs. Staying Informed

Avoidance provides temporary relief but keeps anxiety cycling. Processing accurate information allows anxiety to naturally resolve.

The Other Extreme: The Research Rabbit Hole

The opposite instinct — consuming every piece of information available — isn't the answer either. Most online content about scary world events is opinion-heavy, sensationalized, or simply incomplete. The more we read, the more questions we find, and the more uncertain we feel. It becomes an endless quest to find the piece of information that will finally make us feel safe. That piece doesn't exist.

Finding the Middle Ground — With AI

What we want is a happy middle ground: enough accurate information to feel grounded, without diving so deep that we destabilize. This is where tools like AI can be genuinely helpful — and they have a real advantage over a traditional internet search.

A Google search returns dozens of links: headlines designed to provoke clicks, opinion pieces, conflicting reports, comment sections. AI, when prompted thoughtfully, returns a synthesized, calm summary. You control exactly what you get.

The Strategy

Tell the AI you're anxious before you ask your question. Ask for a few facts to stay informed. Ask it to end on a positive note. Then stop — don't open links, don't search for more.

Try This Exact Prompt

Here's a real example. Copy and paste this into any AI tool:

Example Prompt
"I have significant anxiety and I am worried about the cruise ship hantavirus. Provide me a few facts about the situation so I can be informed without getting overly anxious. End on a positive note."

The response you'll get should be limited, fact-based, and give you just enough to feel oriented — without opening a door to spiraling. That's the goal.

A Word of Caution

Monitor your use of this strategy. If you find yourself asking AI for information repeatedly throughout the day — checking and re-checking — that pattern is itself a form of the anxiety cycle. Like any coping tool, this works best when used intentionally and sparingly. If it's becoming compulsive, that's worth talking through with a therapist.

Frequently Asked Questions

What if the AI gives me information that makes me more anxious?
That can happen, especially if the topic is genuinely serious. The key is to prompt carefully — specify that you want calm, factual information and a positive close. If you read the response and feel significantly worse, that's a signal to pause AI use for this topic and speak with a mental health professional instead.
Is this the same as exposure therapy?
It borrows from the same principles. Exposure therapy works by gradually confronting feared stimuli so the anxiety response naturally reduces over time. Getting accurate, contained information about a scary event is a mild, manageable form of that — you're engaging with the thing rather than avoiding it, but in a controlled way.
What if I have anxiety about things beyond just world events?
This strategy is specifically suited to informational anxiety — the kind driven by uncertainty about external events. For anxiety rooted in personal, social, or health-related concerns, or for anxiety that significantly impacts daily functioning, working with a therapist is the most effective path. Our team at Navesink Psychological Services specializes in anxiety treatment — reach out anytime.
How many times should I use this strategy in a day?
Once per topic, ideally. The goal is to get enough information to feel oriented and then redirect your attention. If you feel the urge to check again an hour later, try to notice that urge without acting on it — that pause is itself a therapeutic skill.
Anxiety Coping Strategies AI Tools News Anxiety Avoidance Mindfulness Mental Health NJ Navesink Psychology World Events Psychoeducation

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Struggling with anxiety about world events?

Our team at Navesink Psychological Services works with individuals navigating anxiety in all its forms — from everyday worry to more persistent patterns. We'd love to help.

Get in touch ↗

Tips for Managing Catastrophizing

Anxiety Mental Health April 28, 2026 · 4 min read

Practical strategies from a psychologist on recognizing and moving through catastrophic thinking.

MS
Matthew Strobel, Psy.D.
Licensed Psychologist · Navesink Psychological Services
navesinkpsych.com ↗

I was recently interviewed for an article in Parade Magazine on the traits of people who often catastrophize. It's a topic that comes up constantly in my work with clients, and I wanted to expand on some practical strategies here for anyone looking to get a better handle on their own catastrophic thinking.

Catastrophizing is not a character flaw. It is a natural feature of how our brains are wired — and with the right tools, it's something you can learn to work with rather than against.
  • 1
    Start with awareness
    Ask yourself: "How big do I think this problem is compared to how a close friend or loved one would rate it?" You can even take it a step further and actually ask that friend to weigh in. If your rating is significantly higher than theirs, that's a signal you may be catastrophizing. The gap between how we perceive a problem and how others see it is often one of the clearest early indicators.
  • 2
    Don't add shame to the pile
    When you catch yourself catastrophizing, resist the urge to criticize yourself for it. This kind of thinking is a natural part of our survival system — it's hardwired into our brains and has served an important purpose throughout human history. Accepting that catastrophizing is something most people experience, and that it can even be helpful at times, keeps you from adding more fuel to an already burning fire.
  • 3
    Play it out
    Ask yourself: if what I'm afraid of actually happened, what would I do? How would I manage it? Draw on past experiences where you've navigated difficult situations and found your way through. Catastrophizing often creates tunnel vision — we see only the problem and nothing else. The solutions are usually there. We just need to shift our focus enough to find them.
  • 4
    Take action
    Think about what you can do right now. Sometimes that means giving yourself permission to step away from the problem — deciding that further thought isn't helpful in this moment and scheduling a specific time to return to it. Getting outside, moving your body (a quick walk, a short workout), or simply changing your environment can open up new ways of thinking. Bringing your full attention to one task — how does the walk feel, how many push-ups can I do — shifts focus and creates space for a clearer headspace.
  • 5
    Don't hesitate to ask for help
    Too often, people end up catastrophizing about the fact that they're catastrophizing, and then feel ashamed or embarrassed to bring it up. Reach out to a trusted friend or a mental health professional and let them help you examine your thought patterns. And who knows — with some practice, you might become the friend someone else turns to when they need that same steady perspective.

Frequently asked questions

Is catastrophizing a mental health disorder? ›
Not on its own. Catastrophizing is a cognitive pattern — a way of thinking — that most people engage in to some degree. It becomes a concern when it's frequent, intense, and significantly interferes with daily life or decision-making. It often shows up alongside anxiety and depression, and is something that responds well to therapy.
Can therapy really help with catastrophizing? ›
Yes. Cognitive Behavioral Therapy (CBT) in particular is very effective for identifying and shifting catastrophic thought patterns. At Navesink Psychological Services, our clinicians use evidence-based approaches to help clients develop more balanced, realistic thinking.
How do I know if I catastrophize more than average? ›
The friend check-in described in Tip 1 is a great starting point. If you consistently find that others rate your problems as much smaller than you do, or that you frequently imagine worst-case outcomes that don't materialize, it may be worth exploring with a professional.
What's the difference between catastrophizing and being cautious? ›
Healthy caution is proportional and action-oriented — it helps you prepare for realistic risks. Catastrophizing tends to be disproportionate, difficult to control, and often leads to paralysis rather than preparation. The key distinction is whether the thinking is helping you take useful action or keeping you stuck.

Catastrophizing is one of the most common thinking patterns I encounter in my practice, and one of the most treatable. With awareness, self-compassion, and the right strategies, it's entirely possible to change your relationship with worst-case thinking — and to feel more grounded and capable when life gets hard.

If you'd like support working through anxiety or unhelpful thought patterns, our team at Navesink Psychological Services is here to help.

Reach out at Navesink Psychology
Tags
Anxiety Catastrophizing Cognitive Behavioral Therapy Stress Management Thought Patterns Mental Health NJ Navesink Psychology Red Bank NJ
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The Therapy to Home Connection

, , ,
Child Therapy Parenting April 20, 2026 · 5 min read

Why the space between sessions matters just as much as the sessions themselves.

MN
Michele Noesges, LCSW
Licensed Clinical Social Worker · Navesink Psychology
navesinkpsych.com ↗

The core problem

If you're a parent or caregiver of a child in therapy, you might notice that progress can feel slow at times, or that certain behaviors continue even though your child is working hard in sessions. This is a common experience, and it can be confusing.

A child may spend an hour a week in therapy — but they spend most of their time at home, making the home environment one of the biggest influences on their progress. Real, lasting change tends to happen when what's being worked on in therapy is also supported in daily life.

For example, a child might be learning how to recognize and manage anxiety. But if a caregiver responds to that anxiety with heightened energy or strong emotional reactions, it can be harder for the child to use those new skills consistently. When there's a disconnect between therapy and home, it can create confusion or reinforce old patterns.

Without some shifts in the broader environment, children can end up going in circles — trying different tools without enough consistency to see what really helps, and what doesn't.

A holistic approach

Therapy gives children tools, language, and insight. It offers a space to explore emotions and practice new ways of coping. But it's only one part of the process.

A more holistic approach to child mental health means recognizing that children are deeply influenced by their relationships and environment. When caregivers are involved, curious, and open to adjusting their responses, therapy tends to be more effective and longer lasting.

This doesn't mean being perfect. It means being open to learning, reflecting, and growing alongside your child. When children see the adults in their lives doing this too, it builds safety, trust, and supports real change.

5 practical tools for caregivers

  • 1
    Regulate yourself first
    Children often take emotional cues from adults. Before responding to your child's distress, take a moment to check in with yourself. A calmer response can help de-escalate situations more than reacting with urgency or intensity.
  • 2
    Mirror the language used in therapy
    If your child is learning specific coping skills or emotional language, try to use those same terms at home. Consistency makes it easier for your child to apply what they've practiced in sessions.
  • 3
    Validate before redirecting
    Instead of jumping straight to solutions, acknowledge your child's feelings first — "I can see you're really anxious right now." Feeling understood can help lower emotional intensity and make problem-solving easier.
  • 4
    Create predictable routines
    Structure and consistency at home can provide a sense of safety, especially for children dealing with anxiety, emotional regulation challenges, or trauma.
  • 5
    Stay curious, not critical
    If something isn't working, try to approach it with curiosity rather than frustration or judgment. Ask yourself: "What might my child need right now?" or "What's underneath this behavior?"

Frequently asked questions

Why isn't therapy alone enough? ›
Because children spend most of their time outside the therapy room. Without support in everyday moments, new skills can be hard to implement — let alone maintain. The home environment is where habits and patterns are reinforced or shifted.
Do I need to change my parenting style completely? ›
Not at all. Small, intentional shifts in how you respond can make a meaningful difference over time. The goal isn't to overhaul everything — it's to become a little more attuned and consistent.
What if I make mistakes? ›
You will, and that's part of the process. Repairing and modeling growth can be really powerful for children. It shows them that relationships can survive difficult moments — and that's a lesson that lasts.
How involved should I be in my child's therapy? ›
This depends on the therapist's approach and your child's needs. Staying informed, asking questions, and remaining open to collaboration is usually very helpful. Your child's therapist at Navesink Psychology can guide you on what involvement looks like for your specific situation.

Supporting a child in therapy isn't just about getting them to appointments — it's about shaping an environment where what they're learning can actually carry over into everyday life. When caregivers are willing to reflect and make small adjustments, therapy becomes something that extends well beyond the session.

You don't need to have all the answers. Being present, open, and willing to grow alongside your child already makes a meaningful difference.

Learn more at Navesink Psychology
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Child therapy Parenting support Anxiety in children Emotional regulation Family involvement Co-regulation School-age children Behavior support Therapeutic alliance Mental health NJ Navesink Psychology LCSW
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Practice What You Preach: The Power of "OK"

, ,

Conflict is inevitable, but how we respond makes all the difference. Discover how two simple letters, "OK," can help you pause, de-escalate, and stay true to your values in the moments that matter most.

The Rising Cost of Behavioral Health

Behavioral health conditions require consistent and focused care, and when looking at medical expenditure, the cost of quality care is evident. A recent study in JAMA Pediatrics quantified behavioral healthcare costs in 2011 and 2022, examining its effects on family financial burden. Researchers found that behavioral healthcare services have nearly doubled in the last decade, now accounting for 40% of pediatric healthcare spending. This spike in spending reflects an increased need for pediatric behavioral care. In recent years, stigma has reduced, encouraging more awareness and diagnosis. Additionally, COVID-19 may have exacerbated the need due to social isolation, school closures, uncertainty, grief, and financial stressor related triggers.  

While overall spending has increased, families are also covering more of the financial burden. Out-of-pocket costs for pediatric behavioral health care rose from $2.1 billion to $2.9 billion over the same period, increasing faster than other types of medical expenses. Families with child(ren) who need behavioral health services are more likely to experience financial strain, with some families spending more than 10% of their income on health care. 

The results of this study highlights a detrimental gap between the demand for behavioral care and its accessibility. With in-network providers disappearing, many families are unable to afford necessary behavioral care for their children. Financial strain can cause families to delay or forgo care, often leading to reliance on acute care and increased long-term costs. Additionally, high out-of-pocket spending is associated with reductions in care and poor overall health outcomes. As demand continues to grow, expanding access to behavioral health professionals and strengthening insurance coverage will be key to reducing both the financial burden on families and barriers to care for children.

At Navesink Psychological Services, we focus on one simple idea: “People Over Profits.” We want to offer the highest level of evidence-based care to as many individuals and families as possible. Although we are an out-of-network provider, every clinician and evaluator offers sliding scale appointments and pro bono services to meet the needs of our community. Since our first day in business, we have never turned someone away because they could not afford an out-of-network service; instead, we work with them to figure out how to get them the care they need and deserve.

Foster, A., Cushing, A., Hoffman, J., Nash, K., Lee, C., & Michelson, K. (2026). Expenditures for pediatric behavioral health care over time and estimated family financial burden. Jama Pediatrics, 180(2), 194-201. doi:10.1001/jamapediatrics.2025.5181

Building a Winning Home: How to Create a Family Culture of Accountability and Love

As a licensed psychologist who works with whole family systems, Dr. Tom Gambino has found that families often struggle to establish rules and boundaries at home. Parents report that loving and supporting a child while also holding them accountable can be a difficult balance to strike. But by borrowing from the world of sport psychology, families can take a page from a championship playbook. Winning teams consistently describe how a strong team culture carries them through adversity, keeps them united, and holds every member accountable — regardless of their role.

One strategy for building that same warm, "winning" culture at home is the weekly family meeting. During these meetings, every family member shares their thoughts on what the rules, expectations, and norms at home should look like. Children are encouraged to offer their own ideas, while parents share what matters most to them. Together, the family agrees on 5 to 7 rules, which are written on poster board, signed by every member, and displayed in multiple places around the house. From that point on, everyone is responsible for holding each other accountable, and any concerns are saved for the next weekly meeting. Over time, parents can introduce incentives to reinforce the rules, and the list itself can only be changed with the full agreement of the entire family. This work can also be completed in a family therapy session with the help of the licensed professionals at Navesink Psychological Services.


Cannabis Use and Mental Health

Cannabis and Mental Health

​​Clients and their families often ask about cannabis use to treat mental health concerns when working with our providers at Navesink Psychological Services in Red Bank, NJ. George Halliwell, LPC often works with clients looking to reduce cannabis use.

Kansagara, Terry, Ayers, et al. recently published Cannabis and Mental Health A Review describing the current research on cannabis use for mental health conditions as well as the effects of cannabis use. While clients will often report anecdotal evidence that cannabis use improves their mental health conditions, studies have not shown positive effects. Currently, there is no mental health condition for which cannabis is currently supported as a treatment, yet there are substantial documented harms. 

Mental Health Diagnoses

For PTSD, Kansagara describe two clinical trials, the largest of which found no difference in PTSD symptom severity between cannabis and placebo. Of note, the sample was 80 veterans so overall the study was small and with a select group of individuals. One small study found nabilone (synthetic THC) reduced nightmares but not sleep quality overall. Evidence is low-certainty and insufficient to recommend cannabis for PTSD. 

For Anxiety, THC has unpredictable effects: a low dose (7.5 mg) reduced anxiety in some people, while a higher dose (12.5 mg) induced it. CBD at 150–300 mg/day shows some early promise for generalized and social anxiety disorder, but evidence is still low-certainty and more trials are needed.

For Depression, almost no clinical trials exist. Cannabis does not appear to improve depression, and heavier use is associated with increased suicidality and self-harm. 

For Bipolar Disorder, seven observational studies consistently show cannabis worsens mania, reduces recovery, and leads to worse social and employment outcomes. Patients with bipolar disorder should be clearly advised against cannabis use, especially high-THC products.

The area of clearest and most alarming risk is Psychosis. Up to 50% of people who experience cannabis-induced psychosis go on to develop schizophrenia or other chronic psychotic disorders. One 2024 longitudinal study found an 11-fold increased risk of psychotic disorders associated with adolescent cannabis use. Daily use (vs. no use) roughly doubles the risk of psychosis. People with a family history of psychotic disorders are at even greater risk.

Cannabis is frequently self-used for ADHD, but the one small clinical trial found no benefit on attention, memory, or cognition. Acute intoxication actually mimics ADHD symptoms.

About 30% of people who used cannabis in the past year meet criteria for Cannabis Use Disorder (CUD). There are no FDA-approved medications to treat it. Cognitive Behavioral Therapy (CBT), motivational enhancement therapy, and contingency management have some evidence. At Navesink Psychological Services, our team has expertise in CBT, motivational interviewing, and behavioral management, strategies that help clients reduce cannabis use and empower them to make different choices.

In a more general sense, cannabis use impacts Cognition. THC acutely impairs memory, executive function, and processing speed. Adolescents who use regularly may experience lasting IQ declines. In adults, cognitive effects likely improve with sustained abstinence, but the timelines are unclear.

High Risk Groups

While we know that cannabis use does not currently show evidence to treat mental health concerns, it is especially important to consider high risk groups that should be strongly discouraged from cannabis use. These groups include:

  • Adolescents and young adults (developing brains)

  • People with bipolar disorder

  • People with psychotic or psychosis-risk conditions (including those with a first-degree relative with psychosis)

  • Pregnant individuals (moderate-certainty evidence of preterm birth and low birth weight)

  • Those with a history of substance use disorder

Summary of Mental Health Effects of Cannabis and Cannabinoids

Opportunity For Connection

Being a mental health practice leader includes understanding what others need beyond the basic levels of a comfy chair and a well-stocked snack cabinet. Isolation can lead to burnout and a reduction in quality of care for clients, issues that can be corrected through connection. To support connection, we host events for not only our staff but the mental health community at large, because when we all feel better, we all do better, which helps as many clients as possible.

More Snow?!?! An Opportunity for Acceptance

Well, it looks like we are in for another snowstorm Sunday night, with totals reaching multiple inches in the Red Bank area, and chances of snow are high for all of New Jersey.

As I checked the weather, my initial thoughts were “Oh no, not again! We were just starting to see the green signs of spring as the snow from our last storm melted off. This is going to mess up the Monday morning commute and delay schools. I wish it wouldn’t snow again!”

Then it hit me! What a great time to practice some acceptance using skills taught in Acceptance and Commitment Therapy (ACT). While I can not control the storm, I can control my thoughts and feelings about it and make space for the uncomfortable. I can see the joy in changing weather patterns and the excitement of school-aged children, hopeful for a snow day. I can set an intention to get some more exercise shoveling and helping neighbors dig out their cars. If work is cancelled, I can spend the time connecting with my family and friends and live the values that are most important to me.

So, whether we get a light dusting or a full-on blizzard, I am mentally prepared to accept the outcome and find peace in not fighting what I can not control.

Enjoy the rest of winter!

Technology Time Outs For Connection

Parents and families are often looking for guidance about technology use, and I have been working to find the research to help navigate these waters. 

Parental Technology Use in a Child’s Presence and Health Development in the Early Years, a systematic review and meta-analysis published in JAMA Pediatrics, examined how parents’ use of technology around young children affects early development. The study found that technoference (the frequent parental use of technology) was associated with negative psychosocial and cognitive outcomes. 

The findings do not suggest that technology use is inherently harmful or that parents should avoid using their devices completely. They demonstrate that we should be mindful about how and when technology is used around children. This is especially important during routine moments and daily interactions that could lead to communication, connection, and learning, if there is not a screen standing in the way. Early childhood requires responsiveness and reciprocal actions. If parents engage in frequent technology use around their children, connection decreases. Our team at Navesink Psychological Services suggests scheduled Tech Time Outs where everyone puts away devices and focuses on meaningful connections. For example, we saw many families enjoying time outside in Red Bank watching the ice boats on the Navesink River. Find the moments to put tech away and reconnect with what matters.

Social Media For Teens, The Goldilocks Theory of Too Little, Just Right, and Too Much

We often have families ask about social media use, and until recently, there has not been a lot of great research. As we help families in the Red Bank area navigate concerns with social media we are always looking for resources to share.

A recent article published in JAMA, Social Media Use and Well-Being Across Adolescent Development, compared the amount of time teens spend on social media to their well-being. In short, "moderate after-school social media use was linked to the highest well-being outcome," while teens that did not use social media at all "were more likely to experience decreased well-being in later adolescence."

The goal is to find the right amount or just enough time on social media for all teens. In my experience, families that are proactive and involve their teens in the social media decision-making process often have the best outcomes. Proactive work involves educating teens on being safe on social media, setting clear guidelines and limits for how long/when social media is allowed, and transparency that parents will have access or be able to see what their child is posting on social media. As teens become older, parents can become more lenient and flexible. 

An analogy that comes to mind is a teen learning how to drive a car. Even though there are inherent risks to driving, we wouldn't want to prevent them from driving a car or give them keys to a car the minute they turn 16. The general course of action for teens learning how to drive is taking a driving class, practicing driving with a driving instructor, driving with an adult in the car, then a probationary license with restrictions, with the goal being to receive their full license a few years later. Having these graduated steps in driving is a good framework for teens as they learn about social media and how to use it. 

Guest feature by Dr. Gambino, https://gambinopsych.com/

Be Your Best Self, Even When Sick!

Between colds, flu, stomach bugs, and more, this time of year can be especially challenging in our the Red Bank area as colder weather sets in and germs circulate more easily, leaving many individuals and families feeling run down. When the inevitable happens and you find yourself sick, how you respond to that experience matters.

Illness can be an opportunity to practice self-compassion and psychological flexibility. Rather than criticizing yourself for getting sick or becoming frustrated that you cannot function at your usual level, take a step back and acknowledge the reality of the moment: your body is unwell. Acceptance does not mean giving up, it means recognizing what is true so that you can respond more effectively.

Allow yourself to slow down and do the best you can within your current limits. Pushing yourself to maintain the same pace you would have while healthy often prolongs recovery and increases both physical and emotional strain. Choosing rest and care is not avoidance. It is a values-consistent act of respecting your health.

Mindful awareness of emotional reactions can be tremendously helpful while not feeling well. Notice what comes up for you when illness interferes with productivity. You might find yourself thinking, “Why am I so angry that I can’t complete this task?” Approaching these thoughts with curiosity rather than judgment can reveal how harsh or unfair your expectations may be. This awareness creates space to respond with greater kindness toward yourself.

As we move through cold and flu season, remember to care for yourself both physically and emotionally. Practicing acceptance, self-compassion, and flexibility during times of illness supports not only recovery, but long-term well-being as well.

Finding Presence, Meaning, and Connection During the Holiday Season

As the year comes to a close, I would like to wish you a happy and healthy holiday season. This time of year often invites reflection on the meaningful moments of the past year and on the hopes and intentions we carry forward into 2026.

For many, the holidays are full and fast-paced. While we cannot always control the demands placed on us, we can choose how we relate to them. Even brief moments of intentional presence can help anchor us during busy or emotionally charged times. Presence does not require silence or stillness; it can be found in ordinary moments such as preparing a warm cup of cocoa, watching snow fall, wrapping gifts, or even during a routine task such as washing your hands. Gently noticing what you can see, feel, or hear in these moments allows you to step out of “autopilot” and reconnect with the here and now.

The holidays can also bring automatic thoughts and expectations about how we should feel, what the season should look like, or how others should behave. When these expectations go unexamined, they can contribute to stress, disappointment, or guilt. Taking time to notice these thoughts, and asking whether they are helpful or accurate, can create space for more balanced and compassionate perspectives. This is also a great opportunity to step away from social media where the shoulds can be strengthened as we view everyone’s ideal pictures and memories, which is far from the reality we all live.
We also recognize that the holidays can be especially difficult for those who have experienced loss, loneliness, or significant change over the past year. If joy feels hard to access, you are not doing anything wrong. Making room for difficult emotions, rather than pushing them away, can be an important part of healing. At the same time we can utilize the power of connection and small, values-based actions. Reaching out to a trusted friend, family member, or support person can be a meaningful step toward connection, even if it feels challenging at first.

As you move toward the new year, we invite you to reflect on what truly matters to you and to consider small, intentional choices that align with those values. Growth does not require perfection, only willingness and compassion toward yourself!

Here’s to a reflective, connected, and meaningful holiday season, and to a supportive and intentional 2026.

-The NPS Team

Consultation for Clinicians Building Private Practices

Dr. Drapkin and I are launching Practice Together, a monthly consultation group for clinicians building private practices.

We’ve both been in the trenches of practice ownership, learned a lot the hard way, and wanted to create a space to share what we’ve learned with others doing this work.

Small group. 75 minutes. Virtual. Thoughtful, practical, and supportive.

Details here: https://tinyurl.com/PracticeConsult

The Missing Link in Autism Support? Outpatient Care That Connects All Settings

At a recent conference focused on advancing care for individuals with autism through scientific research, Thomas Frazier II, Ph.D., a respected researcher and current Chairman of the Board of Directors at Autism Speaks, responded to a participant’s question about how to justify needed outpatient services for children who also attend school full-time. This concern is familiar to many of the families we serve at Navesink Psychological Services, who are often juggling full-time schooling alongside essential therapeutic supports.

Dr. Frazier emphasized that outpatient services remain crucial for children, as they frequently target skills and areas of functioning that fall outside the scope of school-based supports. For example, children may require community-based interventions to help them successfully participate in extracurricular activities, or families may encounter behavioral challenges at home that school providers cannot directly address.

In his response, Dr. Frazier expressed hope for more integrated, coordinated, and collaborative models of care, with outpatient providers taking the lead in supporting children across environments, including sharing information back into school settings. His comments immediately resonated with the model of care used at NPS, in which we aim not only to deliver effective interventions to families, but also to connect these interventions to the broader contexts in which children live and learn. Providers who do this work effectively need both a solid understanding of school systems and strong consultation skills. While only one small part of this workshop, it was encouraging to hear our model of practice at NPS, highlighted in a positive way!

-Dr. Johanna Strobel, BCBA

Pediatrician vs. Psychologist for an ADHD Evaluation: Which Is Best for Your Child?

When families begin exploring whether their child may have ADHD, one of the first questions that comes up is who should do the evaluation. Two common options are a pediatrician or a psychologist, and while both can diagnose ADHD, the type of evaluation and the level of detail you receive can be very different. Understanding the strengths and limitations of each can help you choose the right fit for your family.

When a Pediatrician May Be the Right Choice

For many families, the pediatrician is the first stop and sometimes that’s all that’s needed.

Pros of a Pediatrician Evaluation

✔ Quick and accessible
Pediatricians can usually provide an ADHD evaluation within a short timeframe. If you need documentation quickly, for school, accommodations, or medication management, this can be very helpful.

✔ Familiar with your child
Most pediatricians know their patients well and already have a long-term medical history, which can support their clinical decision-making.

✔ Adequate for straightforward ADHD cases
When the primary goal is simply to confirm ADHD and begin medication, pediatricians often use brief rating scales completed by parents (and sometimes teachers), along with a brief interview and in-office observation.

Cons of a Pediatrician Evaluation

✘ Typically brief and limited in scope
Pediatricians usually do not conduct comprehensive assessments. Their evaluations often rely on checklists rather than deeper testing.

✘ May miss learning or emotional comorbidities
ADHD commonly occurs alongside anxiety, learning differences, or executive functioning challenges. These are difficult to identify without a more detailed psychological evaluation.

✘ Treatment support outside of medication may be limited
While pediatricians are essential for medication management, they often cannot provide detailed recommendations for behavioral, academic, or therapeutic interventions.

When a Psychologist Is the Better Choice

If you want a deeper understanding of your child, not just a yes/no diagnosis, a psychologist can provide a far more comprehensive evaluation.

Pros of a Psychological Evaluation

✔ Thorough and comprehensive
Psychologists use multiple data sources: clinical interviews, rating scales, standardized tests, direct observation, and cognitive or academic assessments. This leads to a fuller picture of your child’s profile.

✔ Identifies comorbidities
Psychologists can assess for anxiety, depression, autism, learning disorders, executive functioning issues, and more. This matters because the majority of children with ADHD have at least one additional challenge that affects treatment.

✔ Personalized treatment recommendations
You don’t just walk away with a diagnosis; you get a roadmap. Psychologists provide individualized strategies for home and school, behavioral recommendations, and guidance for therapy, accommodations, and skill-building.

✔ Ongoing support beyond medication
Families often find that psychologists provide an additional layer of support for understanding behaviors, advocating at school, and navigating long-term needs.

Cons of a Psychological Evaluation

✘ Takes longer
Comprehensive testing can take several hours, and reports may take time to complete.

✘ Higher upfront cost
Psychological evaluations tend to be more expensive, though the depth of information can offer substantial long-term value.

✘ Availability may be limited
It can take time to find a psychologist with openings who specializes in ADHD and child assessment.

Which Should You Choose?

A pediatrician may be sufficient if:

  • You need quick documentation of ADHD

  • The case seems straightforward

  • Your primary goal is to access for medication

A psychologist is the better choice if:

  • You want a deep understanding of your child’s strengths and challenges

  • You suspect learning issues or other emotional/behavioral concerns

  • You want detailed, individualized treatment and school recommendations

  • You want support beyond medication management

Bottom Line

Both pediatricians and psychologists play important roles in supporting children with ADHD. The right choice depends on what you’re hoping to learn, the complexity of your child’s needs, and how comprehensive you want the evaluation to be.

If your goal is simply to document ADHD quickly, a pediatrician can usually meet that need. But if you want a full picture of your child’s functioning, learning style, and any co-occurring conditions, along with a tailored plan for moving forward, a psychologist is typically the best option.

“What’s the best planner for a student with ADHD?”

Unfortunately, there isn’t a single right answer. The truth is, the best planner is the one your student will actually use, and one that fits within the systems they already rely on. A beautifully designed planner doesn’t do much good if it sits unopened at the bottom of a backpack!

Start with the Ecosystem

Before buying anything new, look at what the college or school already has in place. Many universities now use online learning management systems (like Canvas or Blackboard) that include calendars, task lists, and notification features. Building out from those existing tools, rather than trying to create a completely separate system, helps reduce friction and increases the odds that your student will stick with it.

Structure Over Stationery

Even more important than the planner itself is the structure and routine around how it’s used. For example:

  • Set a weekly planning time: Every Sunday night, review upcoming assignments, exams, and commitments, and map out the week ahead.

  • Create a start-of-semester ritual: When new classes begin, add all major due dates and exam days into the planner or app.

  • Check in regularly: Early on, it can help to have frequent check-ins — either with a parent, coach, or counselor — to make sure systems are working. Over time, these can fade as the student gains independence and confidence.

Without these habits, even the most perfect planner won’t make much difference.

Don’t Forget Campus Resources

If your student doesn’t already have academic supports in place, reach out to the disability services office (sometimes called accessibility services or student support services). They can offer accommodations, coaching, and tools that make organization and time management more manageable.

Bottom Line

The best planner for an ADHD student isn’t a product; it’s a process.  Find something that integrates with their existing tools, build consistent routines, and reinforce those habits until they stick. That’s where real progress happens.

 
Highly Recommended by Alignable

Navesink Psychological Services
55 Route 35
Red Bank, NJ 07701
732.784.7793
mstrobel@navesinkpsych.com

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Copyright © 2016-2026 Matthew G. Strobel, Psy.D.

Autism New Jersey Public Policy Partner