Rules for a Healthier & Happier Family 7/19/2021

SmartCare is a San Diego County-funded program that works with families of all sorts: single-parent, divorced, married, unmarried, remarried, casually coupled, multigenerational, you name it. Parents call us for various reasons centered on their children’s needs, but they often share their concerns about their own and their family’s situation. SmartCare sees value in discussing family […]

SmartCare & the National Pediatric Mental Health Care Access Program 7/8/2021

As an early adopter and provider of child psychiatric consultation to the pediatric community, SmartCare Behavioral Healthcare Consultation Services (SmartCare BHCS) has worked with the local pediatric community for more than one decade.  In 2020, the program has served nearly 1600 children and families and provided 550 consultations to 298 distinct primary care pediatric providers.   […]

Prescribing for Foster Children:  PCPs & the JV-220 process 7/2/2021

Today’s e-Weekly provides an overview of the JV-220 process as it applies to a general pediatric primary care practice and provides references to relevant forms and protocols to assist in compliance with informed consent regulations for youth in foster care in San Diego County. Prescribing psychotropic medications to children and adolescents who are in foster […]

Elevated or Irritable Mood States: Mania & Hypomania 6/24/2021

A unique element in behavioral health care — that of assessing a patient’s abnormal mood states — may on occasion be a special concern in the primary care setting. Comfort with assessing mood states and making appropriate psycho-social and medical interventions can be important skills. This eWeekly discusses the issues of mania and hypomania, as […]

Mental Health Psychotherapies – A World of Options 6/10/2021

While “therapy” of one sort or another is a mainstay treatment for many, if not most, mental health conditions, there is such a plethora of models and methods of psychotherapy that it can be a significant challenge for referring primary care providers to determine where to direct their patients to seek care most suited to […]

The Latest on Prazosin for Trauma Associated Nightmares 5/27/2021

Adverse Child Experiences (ACEs), or traumatic experiences, have significant medical and psychological sequelae.  ACES may or may not lead to post traumatic stress disorder, and regardless of the presence of a formal diagnosis, exposure to ACEs increase the risk for poor sleep and traumatic nightmares.  There are many psychotherapeutic and resiliency enhancing ways to support […]

The Family APGAR:  Dimensions of Family Functionality 5/21/21

We are all familiar with the APGAR score as a critical tool in neonatal assessment.  Not so, the Family APGAR, which is a tool that measures important elements of a family system that can be helpful in assessing a family’s resources and functionality in responding to the vicissitudes and challenges in their lives.   As with […]

Extra-Pyramidal Symptoms (EPS) 5/13/2021

Antipsychotic medications have a variety of indications, and at times are used off-label for treatment of a variety of behavioral problems. The primary mechanism of action of antipsychotic is antagonism (or partial agonism) of centrally located D2 receptors, though most agents have additional targets (including serotonin and histamine pathways). Adults will commonly take these medications […]

Stimulants, Psychosis, and Stressors 5/7/2021

ADHD is a common neurobiological condition among school-age children (Wolraich et al., 2019). The American Academy of Pediatrics recommends primary care providers treat ADHD in school age youth 1) with referrals to evidence supported psychosocial treatment (such as Parent Training In Behavior Management) or other outpatient individual, family and group educational and treatment interventions, and […]

Autism and Repetitive and Restricted Behaviors 4/22/2021

In this discussion of Autism Spectrum Disorder (ASD), we will review the latest evidence in treatment for repetitive behaviors.  Individuals and families impacted by ASD can present with a range of challenges and needs, it is important for providers to be familiar with a range of interventions and supports.  Most particularly, youth with ASD can […]