How Pediatric Professionals Can Use Cognitive Behavioral Therapy to Address Anxiety

“Pediatric primary care providers can have a big impact on child mental health simply because we see children early and often,” said Dana Kornfeld, MD, REACH board member and associate clinical professor of pediatrics at George Washington School of Medicine. Dr. Kornfeld, who practices at Pediatric Care Center in Bethesda, MD, endorses the use of cognitive behavioral therapy (CBT) techniques in primary care to nip potentially crippling anxiety in the bud.

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Why Can’t This Kid Sleep?

Alana, age 17, comes in complaining that she is tired all the time and struggles to stay awake during school. Or perhaps it’s six-year-old Miko, whose mother tells you that Miko avoids going to bed and often gets up in the middle of the night. Miko says he doesn’t feel sleepy, but his teachers say he is often inattentive and sometimes quarrelsome. The most common sleep problems among young patients are these and other forms of insomnia or insufficient sleep, according to REACH faculty member Robert Kowatch, MD …

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How to Manage School Refusal

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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“Now people have a place to go”

In the absence of a single child and adolescent psychiatrist anywhere in Cape May County, New Jersey, The REACH Institute training enabled Rainbow Pediatrics to help families who had nowhere else to turn.

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