Overcoming anxiety about the news

In the wake of the Texas school shooting tragedy, your young patients–and their families–may be experiencing anxiety that can affect normal functioning. That anxiety can manifest in many ways, from reluctance to go to school to increased aggressive tendencies. 

In fact, pediatric primary care providers (PCPs) have been observing the effects of news consumption on their young patients for years now. The spike in anxiety at the beginning of the Covid pandemic is another example. Families may be experiencing trauma as they watch scenes of devastation and displacement in Ukraine. Every act of terrorism or mass violence inspires more fear. The examples go on.

As your families’ trusted PCP, you can influence how patients and families deal with anxiety over recent events and the continuous barrage of bad news that characterizes today’s media culture.

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ADHD medication “holidays”?

As summer rolls around, families may ask whether their children can have a “holiday” from their psychoactive medication, especially for attention-deficit hyperactivity disorder (ADHD). We asked Lawrence Amsel, MD, MPH, a REACH faculty member and associate professor of psychiatry at Columbia University, to lay out the pros and cons.

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8 Tips for Working with Mental Health Therapists

Many patients who have mental health conditions need talk therapy in addition to the treatment you provide as the pediatric primary care provider (PCP). If you practice in an area where therapists are available, we hope you have developed referral relationships, as you learned in your REACH training. You may also see patients who are already working with a therapist.

In either case, the communication between you and the therapist makes a huge difference in the quality of care the two of you provide.

To learn how PCPs and therapists can collaborate to improve the mental health of children and adolescents, we talked with clinical psychologist Kevin Stark, PhD, a founder of The REACH Institute’s CATIE program, and pediatrician Hilary Bowers, MD, director of behavioral and mental health services at Children’s Primary Care Medical Group, a large pediatric practice in San Diego and Riverside counties in California.

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Getting through to difficult patients and families

It’s 10:30 Monday morning, and you’re 45 minutes behind. Earlier, you had to confront a receptionist about coming in late again. You have to get out today by 4:30 so you can get to your daughter’s softball game. Beating under all this stress is worry about your mom, who has been diagnosed with stage 2B breast cancer.

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New treatments for ADHD

Newer treatments approved by the Food and Drug Administration (FDA) for pediatric patients with attention-deficit/hyperactivity disorder (ADHD) include two medications that address some of the common issues families have with standard stimulant treatments. Another development is use of devices to manage ADHD symptoms.

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Helping AAPI patients cope with racism

Discrimination and hate crimes against people of Asian American and Pacific Islander (AAPI) descent have risen during the COVID-19 pandemic. You may be wondering how you can help your AAPI patients cope with feelings that arise from experiences of racism.

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New coding guidelines for 2021

2021 brings big changes to coding for mental health visits in pediatric primary care! The new coding guidelines issued by the Centers for Medicare and Medicaid Services (CMS) reduce the documentation burden and increase the levels of payment (work relative value units or wRVUs).

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Cross-titrating psychiatric medications

If you struggle with titrating psychiatric medications for your pediatric patients, you are not alone. Even for some alumni of the REACH program Patient-Centered Mental Health in Pediatric Primary Care, lack of comfort with psychiatric medications can hamper effective treatment.

What does it take to dose and cross-titrate effectively? We asked two REACH faculty members: Peter S. Jensen, MD, REACH founder, and Amy Kryder, MD, education lead of the statewide REACH program in Virginia.

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Helping families deal with holiday stress

“In some ways the holidays this year will be harder than last year for many people,” said Deborah Buccino, MD, pediatrician and REACH board member. “Earlier, we had pretty clear-cut rules about what you could and could not do safely. This year, we have a lot more gray areas.”

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7 ways to support LGBTQIA+ youth

In a recent national survey, 46% of young LGBTQIA+ respondents said that they wanted counseling for psychological or emotional health issues and couldn’t get it. As a pediatric primary care provider (PCP), you may be well aware of the challenges your LBGTQIA+ patients face. To help you help them, we gathered suggestions from two experts, both of whom were panelists in our May webinar on supporting LGBTQIA+ youth: • Andersen Guske, nonbinary 22-year-old LGBTQIA+ advocate • Amy Dryer, MD, pediatrician and REACH faculty member Together, they offered 7 suggestions.

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