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 […]
Beyond the ACE Score: “As the twig is bent…” 4/16/2021
Spoiler Alert: Traumatic exposures, coupled with impaired parent-child relationships, experienced during early infancy and early childhood years are associated with great risk to children’s cognitive, emotional and social development. The seminal Adverse Childhood Experiences study demonstrated the strong correlation between the number of adverse events experienced in childhood and the risks for negative health and […]
Alternative Treatments for Depression 4/11/2021
Depression is a common, often undertreated mental health for children and adolescents across the country. Front line treatments are well known, and include: various forms and types of psychotherapies (individual and/or family, DBT, IPT, etc.), medications such as the selective serotonin re-uptake inhibitors (SSRIs), selective norepinephrine uptake inhibitors (SNRIs), and others, and various supportive interventions, […]