1,134 results match your criteria Child and Adolescent Psychiatric Clinics of North America[Journal]


The Science of Well-Being: Integration into Clinical Child Psychiatry.

Child Adolesc Psychiatr Clin N Am 2019 Apr 6;28(2):xiii-xiv. Epub 2019 Feb 6.

Child and Adolescent Psychiatry, MedStar Georgetown University Hospital, 2115 Wisconsin Avenue Northwest, Suite 200, Washington, DC 20007, USA. Electronic address:

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http://dx.doi.org/10.1016/j.chc.2019.01.001DOI Listing
April 2019
5 Reads

Where Do We Go from Here? Additional Opportunities to Address Well-Being in Child Psychiatry Clinical Practice and Advocacy for Children and Families.

Child Adolesc Psychiatr Clin N Am 2019 Apr 3;28(2):281-288. Epub 2019 Jan 3.

Department of Psychiatry, Medstar Georgetown University Hospital, Georgetown University Medical Center, 2115 Wisconsin Avenue Northwest, Washington, DC 20007, USA; Department of Pediatrics, Medstar Georgetown University Hospital, Georgetown University Medical Center, 3800 Reservoir Rd NW, Washington, DC 20007, USA.

Child psychiatrists should play an active role in helping parents and children to develop healthy media use habits and can introduce uses of technology including mobile applications and telepsychiatry to enhance clinical care. Strength-based approaches in clinical assessment and treatment build patient and family engagement and enhance outcomes in child psychiatry. Focusing on supporting youths' strengths and enhancing emotional and behavioral well-being are critical strategies for child psychiatrists working in consultation with schools and other community settings, and in advocating for optimal environments for children and families. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.012DOI Listing

Teaching Well-Being: From Kindergarten to Child Psychiatry Fellowship Programs.

Child Adolesc Psychiatr Clin N Am 2019 Apr 6;28(2):267-280. Epub 2019 Feb 6.

Department of Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Room 1119, Stanford, CA 94305, USA; Department of Pediatrics, Stanford University School of Medicine, 401 Quarry Road, Room 1119, Stanford, CA 94305, USA; Graduate School of Education, Stanford University School of Medicine, 401 Quarry Road, Room 1119, Stanford, CA 94305, USA.

Psychiatric training for medical students, residents, and fellows can integrate well-being principles to improve mental health. From preschool to college, principles of wellness and health promotion are increasingly prevalent and are showing promising results. Courses on happiness and well-being have been embraced at colleges and universities. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.007DOI Listing
April 2019
1 Read

The University of Vermont Wellness Environment: Feasibility and Initial Results of a College Undergraduate Health-Promoting Program.

Child Adolesc Psychiatr Clin N Am 2019 Apr 3;28(2):247-265. Epub 2019 Jan 3.

Division of Child Psychiatry, Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, USA. Electronic address:

The University of Vermont Wellness Environment program is a neuroscience-inspired, incentive-based behavioral change program designed to improve health and academic outcomes in college-age students. The program uses health promotion and illness prevention delivered in classrooms, residential halls, and via a customized App that incentivizes healthy behaviors and monitors the use of health-promoting activities. This article presents feasibility data on participation of college students in ongoing data collection about key outcomes related to health and well-being. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.011DOI Listing
April 2019
2 Reads

Health Promotion in Primary Care Pediatrics: Initial Results of a Randomized Clinical Trial of the Vermont Family Based Approach.

Child Adolesc Psychiatr Clin N Am 2019 Apr 1;28(2):237-246. Epub 2019 Feb 1.

Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, USA; Medicine, Pediatrics and Communication Sciences and Disorders, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, USA.

The Vermont Family Based Approach (VFBA) is an innovative approach to healthcare delivery that addresses challenges of the healthcare system in the United States. The authors conducted a randomized controlled trial of the VFBA at a primary care pediatric clinic. The goal of the trial was to test the feasibility of the VFBA in pediatrics and to improve healthcare engagement and health outcomes for families. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.005DOI Listing
April 2019
1 Read

Adapting Well-Being into Outpatient Child Psychiatry.

Authors:
Sean Pustilnik

Child Adolesc Psychiatr Clin N Am 2019 Apr 6;28(2):221-235. Epub 2019 Feb 6.

Division of Child and Adolescent Psychiatry, Medstar Georgetown University Hospital, Georgetown University School of Medicine, 2115 Wisconsin Avenue Northwest, Suite 200, Washington, DC 20007, USA. Electronic address:

Traditional child psychiatry practices focus on children's symptoms and families' deficits. Focusing on goals and strengths can prepare patients and families for what they can do to enhance their health. The evidence-base for well-being practices supports integration into contemporary practice. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.006DOI Listing
April 2019
2 Reads

Applying Mindfulness-Based Practices in Child Psychiatry.

Child Adolesc Psychiatr Clin N Am 2019 Apr 24;28(2):209-220. Epub 2018 Dec 24.

Department of Psychiatry, Medstar Georgetown University Hospital, Georgetown University Medical Center, Georgetown University, 2115 Wisconsin Avenue Northwest, Washington, DC 20007, USA; Department of Pediatrics, Medstar Georgetown University Hospital, 2115 Wisconsin Avenue NW, Washington, DC 20007, USA. Electronic address:

Mindfulness-based interventions for adults, children, and families have grown considerably, and burgeoning evidence supports use of these approaches for a range of clinical presentations, including anxiety, depression, ADHD, and addiction. Research into the mechanisms of mindfulness suggests improvements in key brain-based functions including attentional control and emotional regulation. Mindfulness may be relevant for improving emotional and behavioral symptoms in children and families presenting for psychiatric care and also may be an important universal strategy to promote brain health. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.004DOI Listing
April 2019
1 Read

Make a Joyful Noise: Integrating Music into Child Psychiatry Evaluation and Treatment.

Child Adolesc Psychiatr Clin N Am 2019 Apr 6;28(2):195-207. Epub 2019 Feb 6.

Department of Psychiatry, University at Buffalo Jacobs School of Medicine, 462 Grider St, Buffalo NY 14215, USA.

Music is a significant part of daily life for most youth, affording clinical opportunities to cultivate positive emotions, engagement, relationships, meaning, and accomplishment. Clinical inquiry into what types of music elicit different emotions, how music fits into daily life routines, how music connects one to others, and how music anchors life events can improve the clinician-patient alliance and patient well-being practices. Music may be useful in home and school settings to help youth manage diverse moods. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.003DOI Listing
April 2019
1 Read

Promoting Mental Health and Wellness in Youth Through Physical Activity, Nutrition, and Sleep.

Child Adolesc Psychiatr Clin N Am 2019 Apr 6;28(2):171-193. Epub 2019 Feb 6.

Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Cambridge, MA 02115, USA; McLean Child and Adolescent Psychiatry Outpatient Services, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.

The medical benefits to youth conferred by physical activity, balanced nutrition, and quality sleep have been increasingly encouraged by medical and mental health providers. Emerging evidence continues to reveal benefits for youth mental health and well-being, including for youth with psychiatric disorders. This evidence seems multifactorial through both neurobiological and psychosocial systems, with common mechanisms present between physical activity, nutrition, and sleep. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.010DOI Listing
April 2019
6 Reads

The Positive Assessment: A Model for Integrating Well-Being and Strengths-Based Approaches into the Child and Adolescent Psychiatry Clinical Evaluation.

Child Adolesc Psychiatr Clin N Am 2019 Apr;28(2):157-169

Child and Adolescent Psychiatry, Georgetown University Medical Center, School of Medicine, 2115 Wisconsin Avenue Northwest, Suite 200, Washington, DC 20007, USA.

In traditional medical practice, the diagnostic interview is focused on symptom collection, diagnosis, and treatment. The psychiatric interview is based on the medical model, but mental health clinicians lack the tests found in general medicine. Rapport is the most essential tool for the psychiatrist to uncover symptoms and develop a diagnosis and treatment plan. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.009DOI Listing
April 2019
1 Read

Happiness When the Body Hurts: Achieving Well-Being in Chronic Health Conditions.

Child Adolesc Psychiatr Clin N Am 2019 Apr;28(2):147-156

University of Georgia, 125 Baldwin Street, Athens, GA 30602, USA.

This article provides a framework for understanding the application of positive psychology, in particular, Seligman's PERMA, in the context of chronic childhood illness. In particular, inflammatory bowel disease is a chronic illness that is often associated with social and emotional challenges for youth diagnosed with this lifelong condition. Specific disease factors that seemingly work against happiness are explained, and traditional notions of happiness are discussed and redefined. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.008DOI Listing
April 2019
3 Reads

The Neuroscience of Happiness and Well-Being: What Brain Findings from Optimism and Compassion Reveal.

Child Adolesc Psychiatr Clin N Am 2019 Apr 22;28(2):137-146. Epub 2018 Dec 22.

Psychiatry and Pediatrics, Vermont Center for Children, Youth and Families, University of Vermont Larner College of Medicine, 1 South Prospect Street, Burlington, VT 05401, USA. Electronic address:

Increasing behavioral data support the value of developing positive traits and attitudes to promote mental health and human flourishing. A neuroscience approach to understanding the mechanisms of the key constructs of optimism and compassion is relevant toward improving identification and measurement of relevant traits, progress and barriers to cultivating these traits, and identifying which mental health-promoting practices are most effective in promoting growth of optimism and compassion. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.002DOI Listing
April 2019
2 Reads

Better than Better: The New Focus on Well-Being in Child Psychiatry.

Authors:
David C Rettew

Child Adolesc Psychiatr Clin N Am 2019 Apr 24;28(2):127-135. Epub 2018 Dec 24.

University of Vermont Larner College of Medicine, Burlington, VT, USA; Child, Adolescent, and Family Unit, Vermont Department of Mental Health, Waterbury, VT, USA; Pediatric Psychiatry Clinic, University of Vermont Medical Center, 1 South Prospect Street, Arnold 3, Burlington, VT 05401, USA. Electronic address:

Training and practice within child psychiatry has focused predominantly on mental illness rather than mental health. A growing body of evidence, however, is demonstrating the importance for clinicians also to be able to focus directly on enhancing positive traits and emotions and increasing well-being and health promotion in their patients. This complementary aspect of mental health care has been called well-being and positive psychiatry, among other terms. Read More

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http://dx.doi.org/10.1016/j.chc.2018.11.001DOI Listing
April 2019
3 Reads

Neuromodulation: Past, Present, and Future.

Child Adolesc Psychiatr Clin N Am 2019 Jan 18;28(1):xi-xii. Epub 2018 Sep 18.

Child and Adolescent Services, Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA. Electronic address:

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http://dx.doi.org/10.1016/j.chc.2018.08.003DOI Listing
January 2019
3 Reads

Electroconvulsive Therapy and Other Neuromodulation Techniques for the Treatment of Psychosis.

Child Adolesc Psychiatr Clin N Am 2019 Jan 31;28(1):91-100. Epub 2018 Aug 31.

Department of Psychiatry, Vanderbilt University Medical Center, Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Nashville, TN 37212, USA.

Electroconvulsive therapy is an established treatment for symptoms of psychosis and is currently recommended for use in patients who are experiencing an acute exacerbation of positive symptoms or who have had catatonia. There is also evidence to suggest that electroconvulsive therapy can be a safe, effective treatment in first episode psychosis, such as schizophrenia spectrum disorders, particularly in treatment-resistant patients. Other forms of neuromodulation (transcranial magnetic stimulation, transcranial direct current stimulation, vagus nerve stimulation, deep brain stimulation) have less of an evidence base to support their use and are not formally indicated for the treatment of psychosis. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.004DOI Listing
January 2019
3 Reads

Anti-N-Methyl d-Aspartate Receptor Encephalitis and Electroconvulsive Therapy: Literature Review and Future Directions.

Child Adolesc Psychiatr Clin N Am 2019 Jan 24;28(1):79-89. Epub 2018 Aug 24.

Village at Vanderbilt, Suite 2200, 1500 21st Avenue South, Nashville, TN 37212, USA. Electronic address:

Despite the majority of patients with anti-N-methyl d-aspartate receptor (NMDAR) antibody encephalitis presenting with catatonic symptoms, the literature has not focused on well-known treatments for catatonia, such as electroconvulsive therapy (ECT). The authors review the literature identifying case reports that document the effective use of ECT for anti-NMDAR encephalitis. They also identify gaps in the literature regarding use and documentation of ECT and review possible mechanisms of action for ECT. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.005DOI Listing
January 2019
14 Reads

Transcranial Direct Current Stimulation in Child and Adolescent Psychiatric Disorders.

Child Adolesc Psychiatr Clin N Am 2019 Jan 24;28(1):61-78. Epub 2018 Sep 24.

Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address:

Research involving transcranial direct current stimulation (tDCS) in child and adolescent psychiatry is limited. Early, short-term studies have found tDCS to be safe and well-tolerated in youth with neurodevelopmental disorders (attention-deficit hyperactivity disorder, autism, learning disorders). Preliminary data suggest potential utility in symptom reduction and improving cognitive function. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.009DOI Listing
January 2019
3 Reads

Transcranial Direct Current Stimulation: Mechanisms and Psychiatric Applications.

Child Adolesc Psychiatr Clin N Am 2019 Jan 28;28(1):53-60. Epub 2018 Aug 28.

Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address:

Transcranial direct current stimulation (tDCS) involves the application of weak electric current to the scalp. tDCS may influence brain functioning through effects on cortical excitability, neural plasticity, and learning. Evidence in adults suggests promising therapeutic applications for depression, and the adverse effect profile is generally mild. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.008DOI Listing
January 2019
3 Reads

Transcranial Magnetic Stimulation in Conditions Other than Major Depressive Disorder.

Child Adolesc Psychiatr Clin N Am 2019 Jan 20;28(1):45-52. Epub 2018 Sep 20.

Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA.

Transcranial magnetic stimulation (TMS) is a treatment approved by the Food and Drug Administration for major depressive disorder (MDD). TMS is a neuromodulation technique that works by creating a focal magnetic field that induces a small electric current. Compared with other neuromodulation techniques, TMS is a noninvasive treatment modality that is generally well-tolerated. Read More

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http://dx.doi.org/10.1016/j.chc.2018.08.001DOI Listing
January 2019
4 Reads

Pediatric Electroconvulsive Therapy: An Anesthesiologist's Perspective.

Child Adolesc Psychiatr Clin N Am 2019 Jan 11;28(1):21-32. Epub 2018 Sep 11.

Department of Anesthesiology and Perioperative Medicine, Nemours/Alfred I. DuPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA.

Proper planning and communication between psychiatry and anesthesiology teams is vital to conferring the greatest therapeutic benefit to children presenting for electroconvulsive therapy while minimizing risk. Anesthesia for the child undergoing electroconvulsive therapy should ideally provide deep hypnosis, ensure muscle relaxation to reduce injury, have minimal effect on seizure dynamics, and allow for rapid recovery to baseline neurologic and cardiopulmonary status. Unique factors for pediatric electroconvulsive therapy include the potential need for preoperative anxiolytic and inhalational induction of anesthesia, which must be weighed against the detrimental effects of anesthetic agents on the evoked seizure quality required for a successful treatment. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.002DOI Listing
January 2019
3 Reads

Electroconvulsive Therapy as a Safe, Effective Treatment for Catatonia in an Adolescent with a Nasogastric Tube: A Case Report.

Child Adolesc Psychiatr Clin N Am 2019 Jan 18;28(1):121-125. Epub 2018 Sep 18.

Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA.

This case provides support for electroconvulsive therapy as a safe treatment in adolescents with a feeding tube. The patient presented to our hospital with symptoms of catatonia with minimal oral intake. She had stopped eating, had minimal interaction with her environment, and spent weeks with a nasogastric tube for nutritional support. Read More

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http://dx.doi.org/10.1016/j.chc.2018.08.002DOI Listing
January 2019
3 Reads

Electroconvulsive Therapy for Catatonia in Children and Adolescents.

Child Adolesc Psychiatr Clin N Am 2019 Jan 29;28(1):111-120. Epub 2018 Aug 29.

Department of Psychiatry, Institute of Living/Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06114, USA.

Catatonia may be more common in children and adolescents than previously thought. A boost for the recognition of pediatric catatonia comes from changes in Diagnostic and Statistical Manual of Mental Disorders, 5th edition, facilitating the diagnosis in a wide range of pediatric and adult patients with associated developmental and autistic spectrum disorders; and schizophrenic, affective, and medical disorders. The current status, assessment, and treatment of pediatric catatonia are described. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.007DOI Listing
January 2019
3 Reads

Electroconvulsive Treatment for Catatonia in Autism Spectrum Disorders.

Child Adolesc Psychiatr Clin N Am 2019 Jan 28;28(1):101-110. Epub 2018 Aug 28.

Department of Psychiatry, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. Electronic address:

Catatonia has been increasingly recognized in people with autism spectrum disorders (ASD). Assessment, diagnosis, and treatments are reviewed and illustrated with 2 new case vignettes. The use of electroconvulsive treatment (ECT) is recommended in patients who fail to respond to medical treatments, including a trial of lorazepam or another benzodiazepine. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.006DOI Listing
January 2019
3 Reads

Pathway to Electroconvulsive Treatment for Minors.

Authors:
Bradley Freeman

Child Adolesc Psychiatr Clin N Am 2019 Jan 17;28(1):1-19. Epub 2018 Sep 17.

Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Suite 3023, Nashville, TN 37212, USA. Electronic address:

The decision-making process of prescribing electroconvulsive treatment (ECT) to minors often extends outside of medicine. The legal arena is commonly involved in many jurisdictions, and some states have legislation governing the administration of this treatment in addition to hospital policies and regulations. Treatment failures, additional opinions, explicit consent, and legal tribunals are sometimes needed to deliver ECT to a minor in need. Read More

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http://dx.doi.org/10.1016/j.chc.2018.07.001DOI Listing
January 2019
1 Read

Making Meaning After the Death of a Child.

Child Adolesc Psychiatr Clin N Am 2018 10 29;27(4):xv-xxiv. Epub 2018 Jul 29.

Courageous Parents Network, 21 Rochester Road, Newton, MA 02458, USA.

Two bereaved mothers recount how they made meaning after the deaths of their children, recounting how opportunities to tell their stories in medical settings enabled them to construct narratives that promoted resilience and a sense of control. Pediatric palliative care can be conceived as opening space for patients and guardians to tell their stories outside of the specifics of illness, so medical teams can work to accommodate families' values and goals, thereby initiating the process of meaning making. Viewing videos of parent stories enables medical trainees to enhance their communications skills, empathy, and compassion. Read More

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http://dx.doi.org/10.1016/j.chc.2018.05.011DOI Listing
October 2018
2 Reads

Dealing with Death and Dying.

Child Adolesc Psychiatr Clin N Am 2018 10;27(4):xi-xiii

Psychiatric Consultation Liaison Service, Department of Child Psychiatry and Behavioral Health Advanced Illness Management Team/ Palliative Care, Nationwide Children's Hospital, 190 South High Street #295, Columbus, OH 43215, USA. Electronic address:

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http://dx.doi.org/10.1016/j.chc.2018.07.010DOI Listing
October 2018
1 Read

Social Media Consequences of Pediatric Death.

Child Adolesc Psychiatr Clin N Am 2018 10 25;27(4):599-605. Epub 2018 Jul 25.

Virginia Commonwealth University, Richmond, VA, USA.

Social media is an important access point for engagement of children and adolescents. For individuals with a life-limiting illness or serving as the caregiver for an ill child, social media can be a helpful outlet for support and information gathering. It has democratized the process of being remembered through providing an ongoing account of thoughts, pictures, and videos that theoretically live on forever via a digital legacy. Read More

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http://dx.doi.org/10.1016/j.chc.2018.05.008DOI Listing
October 2018
1 Read

The "Liaison" in Consultation-Liaison Psychiatry: Helping Medical Staff Cope with Pediatric Death.

Child Adolesc Psychiatr Clin N Am 2018 10 4;27(4):591-598. Epub 2018 Jul 4.

Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston Children's Hospital and Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.

Pediatric consultation-liaison clinicians are well positioned to provide support, guidance, and systemic recommendations about how to help medical clinicians cope with the stresses of working with dying children. Interventions to support sustainability in this work need to occur at the institutional and team-based levels as well as in individual practice. Shared clinical work around challenging cases provides opportunities to engage with medical clinicians about their difficult experiences and provide reflection and support. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10564993183064
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http://dx.doi.org/10.1016/j.chc.2018.05.005DOI Listing
October 2018
12 Reads

Bereavement After a Child's Death.

Child Adolesc Psychiatr Clin N Am 2018 10 27;27(4):579-590. Epub 2018 Jun 27.

Pediatric Advance Care Team, Boston Children's Hospital, Dana Farber Cancer Institute, Boston, MA, USA.

The death of a child is a heart-wrenching experience that can have a significant impact on parents, siblings, and families while also often having ripple effects throughout the child's community. Pediatric loss has an impact on family structure and dynamics, individual identity formation, and conceptualization as well as professional practice. This article explores bereavement after a child's death through the lens of the family, the parent, the sibling, the forgotten grievers, and the provider. Read More

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http://dx.doi.org/10.1016/j.chc.2018.05.010DOI Listing
October 2018
1 Read

Parenting with a Life-Limiting Illness.

Child Adolesc Psychiatr Clin N Am 2018 10 25;27(4):567-578. Epub 2018 Jul 25.

Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, YAW 6900, Boston, MA 02114, USA.

Parents with life-threatening illness face unique challenges in their dual roles as patients and parents. They are at risk for depression, parenting stress, and impaired family functioning, and their children are at risk for adjustment difficulties. In addition to treatment of depression and other mental health issues, patients may also benefit from evidence-informed guidance addressing the challenges of parenting while ill. Read More

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http://dx.doi.org/10.1016/j.chc.2018.05.002DOI Listing
October 2018
1 Read

Children's Artwork: Its Value in Psychotherapy in Pediatric Palliative Care.

Child Adolesc Psychiatr Clin N Am 2018 10 25;27(4):551-565. Epub 2018 Jul 25.

Stanford University School of Medicine, Division of Pediatric Critical Care Medicine, 770 Welch Road, Suite 435, Palo Alto, CA 94304-5876, USA. Electronic address:

Pediatric palliative care is a comprehensive treatment approach (physical, psychological, social, spiritual) for children living with life-threatening conditions. These patients and siblings, as well as children of ill parents, face extraordinary psychological challenges. Structured art techniques incorporated into psychotherapy can be powerful for children dealing with life-and-death realities. Read More

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http://dx.doi.org/10.1016/j.chc.2018.05.004DOI Listing
October 2018
20 Reads

Ethical Issues Around Pediatric Death: Navigating Consent, Assent, and Disagreement Regarding Life-Sustaining Medical Treatment.

Child Adolesc Psychiatr Clin N Am 2018 10 25;27(4):539-550. Epub 2018 Jul 25.

Division of Pediatric Hematology/Oncology, The Herman and Walter Samuelson Children's Hospital at Sinai, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA; Johns Hopkins University Berman Institute of Bioethics, 1809 Ashland Avenue, Baltimore, MD 21205, USA. Electronic address:

Decisions regarding whether or not to pursue experimental therapies or life-sustaining medical treatment of children with life-limiting illness can be a significant source of distress and conflict for both families and health care providers. This article reviews the concepts of parental permission (consent), assent, and emerging capacity and how they relate to decision-making for minors with serious illness. Decision-making capacity for adolescents is discussed generally and in the context of emotionally charged situations pertaining to the end of life. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10564993183064
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http://dx.doi.org/10.1016/j.chc.2018.05.009DOI Listing
October 2018
4 Reads

Supporting Children and Families at a Child's End of Life: Pediatric Palliative Care Pearls of Anticipatory Guidance for Families.

Child Adolesc Psychiatr Clin N Am 2018 10;27(4):527-537

Hospice and Palliative Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, A1055, Columbus, OH 43205, USA.

Mental health professionals can play a key role in helping pediatric patients and their families prepare for and endure the death of a child. Impactful interventions include assisting a family's transition toward acceptance of a child's pending death, using prognostication as a tool in emotional preparedness, and education on expectant symptoms to optimize management and sense of caregiver efficacy. Read More

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http://dx.doi.org/10.1016/j.chc.2018.05.003DOI Listing
October 2018
1 Read

"Will You Remember Me?": Talking with Adolescents About Death and Dying.

Child Adolesc Psychiatr Clin N Am 2018 10 31;27(4):511-526. Epub 2018 Jul 31.

Office of the Clinical Director, National Institute of Mental Health, 10 Center Drive MSC 1276, NIH Building 10 CRC 6-5360, Bethesda, MD 20892-1276, USA.

This article describes the preparation, rationale, and benefits of talking with adolescents who have life-threatening or life-limiting illness about advance care planning (ACP) and end-of-life concerns in a developmentally sensitive manner. The first step is to ensure that a health care provider is ready to work with adolescents in ACP discussions by taking a self-inventory, learning communication skills, and understanding individual barriers. The authors then outline how to assess patient and family readiness, including developmental, cultural, personal, and psychosocial considerations. Read More

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http://dx.doi.org/10.1016/j.chc.2018.05.001DOI Listing
October 2018
11 Reads

Emergency Child and Adolescent Psychiatry: Updates on Evidence Base and Innovations to Improve Care.

Authors:
Vera Feuer

Child Adolesc Psychiatr Clin N Am 2018 07;27(3):xiii-xiv

Division of Emergency Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 75-59 263rd Street, Glen Oaks, NY 11004, USA. Electronic address:

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http://dx.doi.org/10.1016/j.chc.2018.04.001DOI Listing
July 2018
5 Reads

Training, Education, and Curriculum Development for the Pediatric Psychiatry Emergency Service.

Child Adolesc Psychiatr Clin N Am 2018 07 12;27(3):501-509. Epub 2018 Apr 12.

Lifespan Pediatric Behavioral Health Emergency Services, Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Rhode Island Hospital, Main Building, Room #038, 593 Eddy Street, Providence, RI 02903, USA. Electronic address:

Pediatric psychiatric emergency care is delivered in different settings with vastly different resources around the country. Training programs lack guidance on developing optimal curricula for this highly variable but crucial setting. A model curriculum for child and adolescent psychiatry trainees may be helpful to provide such guidance; its components include recommendations for assessing baseline knowledge, identifying and teaching core subject content, encouraging development of essential skills, and building in supervision for learners. Read More

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http://dx.doi.org/10.1016/j.chc.2018.02.006DOI Listing
July 2018
3 Reads

Multidisciplinary Approach to Enhancing Safety and Care for Pediatric Behavioral Health Patients in Acute Medical Settings.

Child Adolesc Psychiatr Clin N Am 2018 07 24;27(3):491-500. Epub 2018 Apr 24.

Division of Emergency Medicine, Emergency Mental Health Services, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA.

Emergency department visits by pediatric behavioral health patients are increasing, increasing the complexity of care. This article describes initiatives at 3 academic medical centers using multidisciplinary teams, including medical, child life, and security staff, to help decrease anxiety and increase patient comfort. Training in Dialectical Behavior Therapy and agitation management simulations increase staff preparedness for working with agitated and emotionally dysregulated patients. Read More

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http://dx.doi.org/10.1016/j.chc.2018.03.004DOI Listing
July 2018
11 Reads

Psychiatric Community Crisis Services for Youth.

Child Adolesc Psychiatr Clin N Am 2018 07;27(3):479-490

Child Health and Development Institute of Connecticut, Inc, 270 Farmington Avenue, Suite 367, Farmington, CT 06032, USA.

Each year, increasing numbers of children and families seek care for psychiatric crises; unfortunately, most communities offer limited services to meet these needs. Youth in crisis often present to emergency departments, but may not need or benefit from that level of care. Instead, data reflect improved clinical and financial outcomes when communities offer a continuum of crisis services. Read More

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http://dx.doi.org/10.1016/j.chc.2018.03.002DOI Listing
July 2018
32 Reads

Telepsychiatric Evaluation and Consultation in Emergency Care Settings.

Child Adolesc Psychiatr Clin N Am 2018 07;27(3):467-478

Department of Psychiatry, School of Medicine, University of Colorado, 13001 East 17th Place, Box F546, Aurora, CO 80045, USA. Electronic address:

Telepsychiatric care in the emergency setting is a viable and accessible modality that helps address the needs of patients, families, and communities. An expanding literature base for telepsychiatry in multiple clinical settings has shown benefits, including increased access to care, equal efficacy to face-to-face encounters, cost efficiency, decreased wait-times, decreased unnecessary psychiatric hospitalizations, and high levels of patient satisfaction. The evidence base for emergency telepsychiatry is growing for pediatric populations. Read More

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http://dx.doi.org/10.1016/j.chc.2018.03.001DOI Listing
July 2018
2 Reads

Social Services and Behavioral Emergencies: Trauma-Informed Evaluation, Diagnosis, and Disposition.

Child Adolesc Psychiatr Clin N Am 2018 07 13;27(3):455-465. Epub 2018 Apr 13.

Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital, NYU Langone, New York, NY, USA; Psychiatry and Behavioral Health, NYC Administration for Children's Services, 150 William Street, 11th Floor, New York, NY 10038, USA.

The emergency department's role in a psychiatric crisis is to assess for safety, provide crisis interventions, reach a diagnosis, make decisions about disposition and treatment, and provide linkage to the next level of care within the hospital or in the community. The evaluation of children and adolescents involved in the child welfare system brings numerous additional challenges to this already-complex environment, including familial and systemic issues and an almost ubiquitous history of trauma. This article endeavors to increase understanding of child welfare-related issues and provides insight toward using a more trauma-informed and comprehensive approach that incorporates all these factors. Read More

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http://dx.doi.org/10.1016/j.chc.2018.02.007DOI Listing
July 2018
3 Reads

Current Pediatric Emergency Department Innovative Programs to Improve the Care of Psychiatric Patients.

Child Adolesc Psychiatr Clin N Am 2018 07 17;27(3):441-454. Epub 2018 Apr 17.

University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.

Emergency departments (EDs) across North America have become a safety net for patients seeking mental health (MH) services. The prevalence of families seeking treatment of children in MH crisis has become a national emergency. To address MH access and improve quality and efficient management of children with MH conditions, the authors describe ED projects targeting this vulnerable population. Read More

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http://dx.doi.org/10.1016/j.chc.2018.02.004DOI Listing
July 2018
36 Reads

Maintaining Safety and Improving the Care of Pediatric Behavioral Health Patients in the Emergency Department.

Child Adolesc Psychiatr Clin N Am 2018 07 19;27(3):427-439. Epub 2018 Apr 19.

Division of Emergency Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 75-59 263rd street, Glen Oaks, NY 11004, USA. Electronic address:

Pediatric emergency visits for behavioral health complaints have been increasing for more than a decade. There are currently no best practices or ideal models of care. However, the evidence base for existing emergency department operational concepts can be used to implement modifications to workflow, care model, staffing, and physical environment to address patient needs. Read More

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http://dx.doi.org/10.1016/j.chc.2018.03.005DOI Listing
July 2018
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An Emergency Department Clinical Pathway for Children and Youth with Mental Health Conditions.

Child Adolesc Psychiatr Clin N Am 2018 07;27(3):413-425

Mental Health, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada.

Children and youth presenting to the emergency department with mental health concerns present a challenge for clinicians and system capacity. Addressing a significant system gap and sparse strategies in the literature, representative leaders from hospital and community agencies developed a novel pathway to guide efficient and doable risk assessment and ensure timely transition to appropriate community mental health services. This article describes and reflects on our innovative Emergency Department Clinical Pathway for Children and Youth with Mental Health Conditions that bridges traditional barriers between hospital and community settings to address mental health needs for this population. Read More

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http://dx.doi.org/10.1016/j.chc.2018.02.005DOI Listing
July 2018
25 Reads

Focused Medical Assessment of Pediatric Behavioral Emergencies.

Child Adolesc Psychiatr Clin N Am 2018 07 17;27(3):399-411. Epub 2018 Apr 17.

Division of Pediatric Emergency Medicine, Cohen Children's Medical Center of New York, Northwell Health, 269-01 76th Avenue, New Hyde Park, NY 11040, USA.

There is no uniformly accepted standard of care for medical clearance of pediatric patients with psychiatric complaints. Emerging data argue for a thorough history and physical examination and against routine laboratory testing. The differential diagnosis of patients presenting with psychiatric health complaints is extensive and includes both medical and psychiatric disorders. Read More

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http://dx.doi.org/10.1016/j.chc.2018.02.003DOI Listing
July 2018
12 Reads

Crisis in the Emergency Department: The Evaluation and Management of Acute Agitation in Children and Adolescents.

Child Adolesc Psychiatr Clin N Am 2018 07;27(3):367-386

Department of Psychiatry, Columbia University Medical Center, 3959 Broadway CHONY 6N, New York, NY 10032, USA.

Acute agitation in children and adolescents in the emergency department carries significant risks to patients and staff and requires skillful management, using both nonpharmacologic and pharmacologic strategies. Effective management of agitation requires understanding and addressing the multifactorial cause of the agitation. Careful observation and multidisciplinary collaboration is important. Read More

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http://dx.doi.org/10.1016/j.chc.2018.02.002DOI Listing
July 2018
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The State of Emergency Child and Adolescent Psychiatry: Raising the Bar.

Child Adolesc Psychiatr Clin N Am 2018 07 12;27(3):357-365. Epub 2018 Apr 12.

Department of Child and Adolescent Psychiatry, NYU Langone Health, One Park Avenue, 7th Floor, New York, NY 10016, USA; Department of Child and Adolescent Psychiatry, Bellevue Hospital Center, 562 First Avenue, 21st Floor, New York, NY 10016, USA.

The current state of emergency child and adolescent psychiatry includes common historical challenges to safe and effective care as well as recent innovations in multiple settings that increase the quality of that care. These include (1) enhancements within pediatric emergency departments (EDs), (2) specialized and dedicated child psychiatry emergency programs that are hospital based, (3) telepsychiatry programs that spread access to child psychiatric evaluation and treatment planning, and (4) community-based mobile programs diverting youth from EDs. Together, these highlight the work in North America over the past 5 years to improve the care of youth in psychiatric crisis. Read More

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http://dx.doi.org/10.1016/j.chc.2018.02.001DOI Listing
July 2018
2 Reads