Playtime Therapy and Medication for ADHD, Anxiety

Support That Fits Your Child

You may be watching your child struggle with worry, impulsive behavior or emotional outbursts at home and school. Here, you will learn how playtime therapy and careful medication management address different parts of ADHD and anxiety, when combined treatment may be appropriate, and how psychiatric care can support school accommodations in North Carolina. Medication is not necessary for every child. The right plan begins with understanding your child’s symptoms, development, daily environment and strengths.

Understanding Playtime Therapy and Medical Support for Children

At Robin Trivette, PMHNP-BC, PLLC, I begin with an individualized psychiatric evaluation rather than focusing on a single symptom or diagnosis. I look at how your child is functioning at home, at school and in relationships. After the first appointment, I develop a treatment plan that may include medication and supportive therapy. I also provide play therapy and evaluations for children and adolescents.

Playtime therapy, more commonly called play therapy, gives children a developmentally accessible way to communicate and practice skills. A child who cannot easily explain anxious thoughts may express them through stories, figures, art or pretend situations. Structured activities can help a child work on naming feelings, tolerating frustration, following sequences and recovering from mistakes. Learn more about my play therapy services and developmental goals.

Medication has a different role. When clinically appropriate, it may reduce symptoms that interfere with learning, relationships or participation in therapy. A child may be better able to pause before acting, remain with an activity or use a calming skill once severe symptoms are better controlled. Therapy then provides repeated opportunities to build skills that medication cannot teach.

These treatments are complementary, but they are not automatically paired. I recommend an individualized plan based on the evaluation, symptom severity, functional impairment and response to previous care. Some children may begin with therapy and parent support. Others may benefit from medication management as one part of a broader plan.

How Play Therapy and Medication Target ADHD and Anxiety

ADHD and anxiety can both affect attention, behavior and emotional control, but treatment must be based on a full assessment rather than assumptions about a child’s behavior. Medication and play-based therapy act in different ways.

What medication may address

Stimulant ADHD medications affect dopamine and norepinephrine pathways involved in attention and impulse control. Non-stimulant options may work through related pathways. For childhood anxiety, clinicians may consider selective serotonin reuptake inhibitors, or SSRIs, which affect serotonin signaling. The choice depends on the child’s diagnosis, health history, symptoms and treatment goals.

Medication management is an ongoing process, not simply writing a prescription. The prescriber considers benefits, side effects and functioning over time. Useful observations include whether your child can start homework more easily, stay in class, sleep normally and interact with others without becoming unusually withdrawn or agitated.

What therapeutic play may build

During therapeutic play, a child may use emotion cards, drawing, clay or a feelings scale to connect physical sensations with words. Breathing and sensory grounding can be practiced in the moment. Games with rules offer low-pressure practice in waiting, shifting attention and coping when events do not go as expected.

The goal is not simply to keep a child occupied. Activities are selected or observed for clinical purposes. Progress might appear as greater frustration tolerance, more flexible problem-solving or an improved ability to ask for help. Parents can reinforce these skills in everyday situations.

A major study of 579 children with ADHD found that combined behavioral and medication treatment produced broader functional gains in areas such as anxiety, social skills and academic performance than ordinary community care, as reported by PBS. That finding does not mean every child needs medication. It shows why clinicians consider several areas of daily functioning when recommending care.

When a Combined Approach Is Clinically Indicated

Age and severity matter when choosing a starting point. For young children and children with mild to moderate distress, psychotherapy and parent-supported behavioral interventions are often considered before medication. Behavioral and play-oriented care is generally the initial approach for preschool children with ADHD symptoms or disruptive behavior.

Adding medication may be considered when symptoms remain moderate to severe, continue across settings or prevent a child from engaging in therapy and daily activities. It may also be appropriate when therapy has not sufficiently reduced substantial impairment. A careful assessment should consider sleep, medical issues, development, family observations and information from school rather than relying on one difficult week.

For an ADHD assessment, symptoms are evaluated over time and in more than one setting. The American Academy of Pediatrics states that diagnostic criteria require symptoms to persist for at least six months and cause impairment in two or more settings, such as home and school. Rating scales from parents and teachers may help show whether a pattern is consistent.

If medication becomes part of the plan, families should identify observable goals. These might include completing a morning routine with fewer prompts, remaining in the classroom or recovering more quickly from anxious distress. Follow-up should examine both symptom relief and side effects. The aim is meaningful improvement in your child’s daily life, not perfect behavior.

Bridging Clinical Care and North Carolina School Accommodations

School often provides the clearest view of how symptoms affect sustained attention, transitions, assignments and peer relationships. I help parents work through the North Carolina school system and have experience completing evaluations for IEPs, 504 plans and school accommodations.

Clinical documentation can explain a diagnosis and describe how symptoms limit school functioning. The school team then uses its own process to determine eligibility and appropriate support. An evaluation does not guarantee approval of an IEP or 504 plan, but clear information can help parents communicate their child’s needs.

Depending on the child, accommodations might include a visual schedule, sensory or movement breaks, reduced-distraction testing, written directions or positive behavioral supports.

Parents can help connect clinical and school care by keeping specific records. Note what happens before a difficult behavior, how long it lasts and what helps your child recover. Ask teachers for concrete examples rather than general descriptions such as “had a bad day.” Bring report cards, school evaluations, accommodation plans and relevant teacher feedback to the psychiatric evaluation.

As treatment continues, information from school can show whether changes are carrying over beyond home. If you are beginning that process, my guide to ADHD school accommodations in North Carolina explains practical next steps.

Getting Started: Coordinated Mental Health Care in NC

Your first contact with my practice is a free 15-minute phone screening. After you submit the online form, Brittany will contact you within 24 to 48 hours to arrange that conversation. The screening helps determine whether the practice is a suitable match for your child’s needs. If you decide to proceed, the next step is a 90-minute intake appointment.

The evaluation provides the foundation for an individualized plan. Be ready to discuss your child’s development, current symptoms, medical history, previous treatment, medications and functioning across settings. You may also bring school records and notes about patterns you have observed. I bring more than 20 years of behavioral health nursing experience to this evaluation and treatment process.

I provide medication management and supportive therapy in person in Cary and virtually for clients throughout North Carolina. The North Carolina Medical Board requires the standard of care for telemedicine to be the same as for in-person care. I do not assume that one format or treatment combination fits every family.

Self-pay fees are $300 for an initial psychiatric evaluation, $225 for a medication management and therapy follow-up, and $150 for a 25-minute medication-management and treatment-plan adjustment visit. In-network insurers include BCBS, Cigna, Aetna, Ambetter and United Healthcare. Superbills are available for out-of-network claims. More information is available on my psychiatric evaluation and medication management page.

Talk With Us About Your Child’s Next Step

To request your free 15-minute phone screening, submit the online request form, call Robin Trivette, PMHNP-BC, PLLC at (919) 297-8438 or email brittanytrivette@durhampsychiatricservices.com. In-person appointments are available at 515 Keisler Dr Suite 104, Cary, NC 27518, USA, with secure virtual care available throughout North Carolina.