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The Challenges of Adolescent and Pediatric Mental Health

The Challenges of Adolescent and Pediatric Mental Health. Dr. David Prescott. What You Should Learn:. 1. One Helpful and One Non-Helpful Interview Technique 2. The Most Common Mental Health Problems in Children and Adolescents 3. At least one new intervention approach or strategy.

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The Challenges of Adolescent and Pediatric Mental Health

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  1. The Challenges of Adolescent and Pediatric Mental Health Dr. David Prescott

  2. What You Should Learn: • 1. One Helpful and One Non-Helpful Interview Technique • 2. The Most Common Mental Health Problems in Children and Adolescents • 3. At least one new intervention approach or strategy

  3. Technique #1: Anything that will Help Your Patient Come Back

  4. Psychotherapy Dropout Quiz • The percentage of psychotherapy clients who attend only one session: _______ • Of those clients who return for a second session, ________ percent drop out after the second session.

  5. Answers • One Session Only: 20-57% • Drop Out After Second Session: 37-45%

  6. Technique #2: Listen and Don’t (Immediately) React

  7. No Barking……………No WahwaWah

  8. Some of My Favorite Questions • What is that like for you. • What makes that hard? • What goes through your mind? • What happened right before (after) that? • What have you tried so far? • How confident are you that you will actually do what we talked about?

  9. Case Example • Jim J(Middle School) • -School Refusal • -Anxiety • -Oppositional

  10. Diagnosis and Prevalence Facts • One in Four (25%) of Primary Care Visits for Teens involve a Mental Health Issue • One in Five (21.4%) adolescents will experience a mental health disorder between the ages of 13-18.

  11. Most Prevalent Child and Adolescent Mental Health Diagnoses • ADHD – 6.8% • Illicit Drug Use – 4.7% • Illicit Alcohol Use – 4.2% • Behavior and Conduct Problems – 3.5% • Anxiety – 3.0% • Depression – 2.1%

  12. Treatment and Intervention • Technique #3: • Find Out What has been tried already

  13. ADHD and Anxiety – Case Example • Therapy Focus on Behavior vs. Attention • Planning (Increasingly Self-Directed) • Medication Timing

  14. Cutting and Self-Harm • PREVALENCE DATA • 15% of College Students Engage in Some Type of Self-Harm • 17% of Adolescents Engage in Some Type of Self-Harm • RISK FACTORS • Feel Rejected by Peers • Being Bullied • Identifies as Gay or Bisexual

  15. Case Example: Self-Harm and Depression • High School Student • High Achievement Striving • “Broken” Relationship with Peer • Highly Reactive and Emotionally Stoic Family

  16. Disruptive Behavior Problems • Behavioral Treatment Rather than Insight Oriented Treatment • Engage Parents • Short-Term Extinction Bursts

  17. Medical Protocol Adherence • Small Goals (What Can You Accomplish by The Day After Tomorrow) • Immediate vs. Long-Term Benefit • Progress Not Perfection • Measurement

  18. Substance Use Problems • MOTIVATIONAL INTERVIEWING • What is Off The Table? (Precontemplative) • Listen for the Ambivalence (Contemplative) • Accurate Information • Improvement vs. Abstinence

  19. David Prescott, Ph.D. prescottd@husson.edu 207-561-0104 (cell)

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