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October 24, 2022
As you’ve heard, the US Preventative Service Task Force (USPSTF) recently issued draft guidelines recommending that primary care providers (PCPs) screen all adults aged 19 to 64 for anxiety disorders. Guidelines recommending anxiety screening for children aged 8 to 18 were finalized last week. The question is, if the screener indicates that anxiety is an issue, then what do you do? Patty Gibson, MD, a psychiatrist on the REACH Adult Behavioral Health faculty, shared some basics from the course to answer the question.
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May 23, 2022
Asked the top three things a pediatric primary care provider (PCP) needs to know about child trauma, Brooks Keeshin, MD, said, “Trauma happens. That’s numbers 1, 2, and 3.” In fact, up to 80% of children experience trauma by the time they are 18. A large body of evidence indicates that childhood trauma affects physical and mental health, both short term and long term. Dr. Keeshin, a child abuse pediatrician and child psychiatrist, is developing a new REACH Institute course to teach PCPs to assess and treat child trauma. “Trauma reactions can look like other mental health conditions,” said Dr. Keeshin. “Traumatic stress can present with symptoms of ADHD, depression, or anxiety. If the pediatrician knows a child has been exposed to trauma, that changes what they do. But first they need to know.”
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April 14, 2022
Eating disorders are life-threatening mental health conditions—and they are not limited to affluent white girls! Eating disorders affect people of lower socioeconomic status, members of non-white ethnic groups, preteen children, and boys. LGBTQIA young people are at particular risk. DSM-5 defines four main categories of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder, along with several atypical disorders.
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May 19, 2020
A medical appointment can be intimidating and scary for a child with a history of trauma. Still, this visit might be the first time a patient shares that they have been sexually or physically abused or that they are terrified to live with their fighting parents during COVID-19. Your role as a primary care provider (PCP) is critical. Your interactions with your patient need to feel safe. As constrained as your time is, you must make every minute count toward establishing a connection.
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November 15, 2018
The new edition of Guidelines for Adolescent Depression in Primary Care (GLAD-PC) is now available on The REACH Institute website. This practical toolkit offers dozens of resources to help pediatric primary care providers diagnose and treat depression.
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October 29, 2018
Ryan, age 12, has missed almost three weeks of school so far. He complains of nausea and headache most school days and has to be cajoled into getting out of bed, but his mother says he is fine on weekends. The mother, who is eight months pregnant, is frantic; she can’t afford to take any more time off work before she delivers. School refusal can have serious consequences. On the short term, the child falls behind academically, both the child and the family experience disruption and distress, and there can be legal and financial ramifications. Long-term consequences for school refusers include violent behavior, school dropout, early marriage, and unemployment. “The main goal of treatment is to get the child back to school as soon as possible,” says Lisa Hunter Romanelli, PhD, REACH Institute CEO and clinical psychologist. “Being absent from school is highly reinforcing.” Like many school refusers, Ryan presents somatic complaints. After you rule out physiological causes– not only for these complaints but also for any underlying conditions that can produce depression or anxiety–what’s next?
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September 21, 2018
As you’ve dealt with back-to-school (and back-to-sports) visits, you probably have been challenged by the gap between what’s needed and what’s practical. This visit may be the only time you see this child this year. You know that emotional and mental health is as important as physical health. But you have only so much time for each check-up. Screening tools are a big help…
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September is National Suicide Prevention Month. The 988 Suicide & Crisis Lifeline provides free, confidential support 24/7. Individuals can call, text, or chat 988 to connect with trained crisis counselors. This month, we’ll be sharing resources…
Last week to register! Join REACH on September 18 for Collaborating with Schools in Pediatric Care, a one-day training designed to help clinicians more confidently address school-related behavioral health concerns. Participants will learn practical strategies for…
Nearly half of pediatric outpatient visits involve a behavioral health concern, yet many pediatricians report feeling unprepared to diagnose and treat mental health conditions. While new residency requirements represent an important step forward, there remains a…
Time is running out for primary care clinicians to join a CBT training in 2026 ⏰ The REACH Institute is offering two trainings for clinicians to learn practical, evidence-based cognitive behavioral therapy (CBT) techniques they can…
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