Spotting OCD in Pediatric Patients

Distressed child with hands on head.

“Even among skilled clinicians, misconceptions about obsessive-compulsive disorder or OCD can delay diagnosis and treatment,” explains Carla E. Marin, Ph.D., a licensed psychologist and Assistant Professor at Yale School of Medicine. With common sayings like “we’re all a little OCD” and representations of OCD that center on germs and handwashing, getting a clear picture of…

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Why Clinicians Should Consider Coding by Time for Mental Health Care

Clinician comforts patient.

“Many primary care providers are still coding by medical decision-making for mental health care,” explains Eugene Hershorin, MD, a REACH faculty member and medical coding expert. “However, time-based coding is both easier and often results in higher coding levels and therefore higher payment rates, especially for pediatric patients who require ongoing care for mental health…

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Sleep Smart: Back-to-School Edition

REACH faculty, Dr Kowatch, emphasizes that it’s essential for caregivers to recognize the challenges that can arise when transitioning from summer to a more structured school routine. “Parents have got to anticipate there may be an adjustment period for the first week or two.”

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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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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 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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Working with challenging families

You’re in the consultation room with Anita, who first brought her 15-year-old son Vic to you two weeks ago. Vic has been suspended from school several times for increasingly dangerous behavior. Anita uses a wheelchair because she has multiple sclerosis. Today she is distraught. Last night, she forbade Vic to leave the house, but he went anyway. He didn’t come home last night or go to school this morning. Anita has called everyone she can think of, but no one knows where he is. The police won’t help until he has been missing at least 24 hours. Anita has come to you as a last resort. When you saw Vic, you were troubled by his history of uncontrolled behavior and his uncooperative stance. You were hoping to get him to open up in a follow-up visit. But now Anita is here alone, frantic because she doesn’t know where Vic is. What do you do?

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