Welcome to the start of the new school year! Everything seems to be in place – new school, fresh start, seemingly nice kids, great teachers – this is going to be the best year yet – the year when your child can get out of bed, get dressed, get out the door, get to school, go to classes, sing in the chorus, play on the soccer team, come home happy – yes, this is the year! But then that same old problem, school refusal, rears its ugly head once again…

School refusal refers to a pattern of school avoidance or frequently leaving school early.  This is not an issue of truancy, but often rather a symptom of anxiety, depression, or some other concern.  Attending school or the thought of attending school creates such significant distress for some children and teens that they experience somatic concerns including stomachaches, headaches, nausea, an increased heart rate and other uncomfortable physical sensations, such as tantrums and meltdowns.  Such students appear “stuck” – unable to take action towards getting back into school.  School refusal affects approximately 2 to 5% of school-age children.  In addition to school refusal often leading to students falling behind academically, it is often also associated with a decline in social opportunities and an inability to attend extracurricular activities that often center around school, subsequently leading to greater isolation.

Not all is lost, for school refusal can be addressed gradually, compassionately and effectively. Mountain Valley Treatment Center specializes in working with teens, young adults, and their families to address the underlying anxieties and challenges related to school refusal and avoidance by first completing a functional analysis and achieving a better understanding of the school refusal behaviors.  That is, for example, to determine if school refusal is related to bullying; fears of transitioning from middle school to high school or high school to college; social judgment concerns; problems stemming from perfectionism; problems related to engagement in compulsions as related to OCD – and the list could go on.  Mountain Valley works with residents and families to identify the overarching problem, and then breaks it into more workable parts.  Mountain Valley teaches residents and families how to utilize cognitive behavioral therapy techniques to identify unhelpful thoughts and subsequent unpleasant feelings that fuel the avoidance and maintain the anxiety.  Families learn to identify ways that they may have been accommodating some of the school refusal behaviors and inadvertently maintaining the avoidance.  Residents learn about anxiety maintenance and how avoiding school may alleviate distress in the short-term but create greater distress in the long-term.  They identify their reasons for engaging in this challenging work and then engage in exposure with response prevention (ERP) as a way of creating opportunities to change their experiences with unpleasant school situations, thereby reducing their distress and increasing their ability to attend school and function while there.

But the work doesn’t stop there!  In addition to the work being done on the Mountain Valley campus, our residents and families take their exposures on the road.  That is, they take the skills learned and experiences obtained at Mountain Valley and engage in school refusal work at home with their schools and with their school staff.  In preparation for this, our residents participate in small group academics and have the opportunity to complete a parallel work exchange and one-on-one academic tutoring.  They also have the opportunity to be communicating with teachers, friends from school, coaches and mentors, and begin preparing for a transition back into school during their time with us here in New Hampshire.

Dr. Timothy DiGiacomo, Mountain Valley’s Clinical Director, is a licensed clinical psychologist with comprehensive experience treating children, adolescents and adults with individual, group and family therapy, including utilizing CBT-based modalities for anxiety, depression and trauma. Tim has treated individuals with anxiety, depressed mood, motivational difficulties, stress-related problems, learning difficulties, and trauma.  Tim has completed the International OCD Foundation’s Advanced Behavior Therapy Training Institute (BTTI) and is trained in Trauma Focused Cognitive Behavioral Therapy, Child Parent Psychotherapy, and other evidence-based treatments.  He has a particular interest in family therapy.  Tim enjoys meeting clients where they are at and helping them to learn the tools that they need to resolve their difficulties.  Tim takes a strengths-based and supportive approach to empower families to make positive changes that work for their family’s needs.
Dr. DiGiacomo oversees, leads and guides the clinical program and strategic development of our clinical services.  This includes, but is not limited to, ensuring the incorporation of the latest in Evidence Based Practices (EBP) for the treatment of OCD and Anxiety Disorders, overseeing Performance Measures systems including Outcomes Monitoring, research, and screening approval for prospective clients.  He also serves as the “Clinical Face” of Mountain Valley externally.  This includes, but is not limited to, developing and delivering local, regional and national conference presentations, supporting clinical outreach activities, liaison with external organizations and entities to the benefit of Mountain Valley and in the overall treatment of OCD and Anxiety Disorders.
Dr. DiGiacomo provides on-site clinical supervision of staff and systems including directly supervising the Senior Clinician and at least one therapist for both administrative/performance and clinical supervision and providing clinical supervision for the Associate Clinical Director.  He actively engages in and supports the marketing communications initiatives and branding to include, but not be limited to, identifying national accreditation for the Residential Exposure Specialist training, supporting the digital marketing program, and publication of the work we do.
During his time at West Central Behavioral Health in Lebanon, NH, Dr. DiGiacomo worked as a clinician, psychological assessment coordinator, Team Leader, and Acting Director of the Child Team.  He served as a Clinical/Adjunct Assistant Professor of Psychiatry for the Geisel School of Medicine at Dartmouth College, providing therapy and assessment supervision, and teaching seminars for psychology interns and post-doctoral fellows.  He has taught courses on co-parenting and alternative dispute resolution for the State of New Hampshire for families going through divorce.  He has also served as adjunct faculty for New England College and Franklin Pierce University, teaching at both the undergraduate and graduate levels.  He served as a psychologist and consultant for the Plainfield, NH and Lebanon, NH school districts.  Tim has worked in research at Yale University, in clinical roles at VA Medical Centers, and in various mental health facilities.
Dr. DiGiacomo graduated from the Virginia Consortium Program in Clinical Psychology and completed his internship and post-doctoral fellowship at Dartmouth Medical School.  He earned his Master of Arts in Community and Clinical Psychology at Norfolk State University.  He completed his B.A. in psychology at Fairfield University.