Evidence-based behavioral intervention trainings for parents are one of the many techniques that, when effectively implemented, can be associated with sustained behavioral improvements among children with oppositional and disruptive behaviors. (Kazdin, 2017) Use of these interventions can strengthen positive bonds between children and their parents and may also reduce the need for referrals for higher […]
Author Archive: Shirley Fett
Medication Management for Adolescent Anxiety 11/20/2020
For a more than a decade there has been evidence in the literature that Selective Serotonin Reuptake inhibiters (SSRI) can help teenagers with anxiety disorder feel and function better (Ipser et al., 2009). While these medications are not FDA approved for anxiety in adolescents, it appears clear that medications, in particular in combination with therapy […]
Challenges Adapting to Acute and Ongoing Stressors: Revisiting the Adjustment Disorder Diagnoses 11/13/2020
Social distancing and other pandemic related changes to our lives appear to be correlated with an increase in adult substance abuse, and to an overall increase in mental health symptomatology with onset or exacerbation of mood symptoms, sleep difficulties, irritability, increased worry and cognitive strain. Stress does that; isolation magnifies the hurt; and uncertainty keeps […]
Psychotropic Polypharmacy with Children and Adolescents 11/6/2020
The challenges of addressing behavioral health problems in children and adolescents remain an ongoing dilemma because of the high incidence of youth with significant problems, coupled with the ongoing difficulties for families and providers in accessing and optimizing care in a coordinated and comprehensive manner. Particularly in the arena of prescribing psychotropic medications, there are […]
Adolescent Substance Abuse in the Time of Covid-19 10/29/2020
While our understanding of the psychosocial impacts of the pandemic remains limited as would be expected of an externality that is constantly changing, there is clear evidence that the rates of substance use among adults in the time of the coronavirus pandemic are increasing (Spagnolo et al, 2020). Increased use of alcohol has been reported […]
Autism Meltdowns & Aggression 8/10/23
With autism currently affecting nearly 1 in 36 children, most healthcare providers will be treating individuals with Autism Spectrum Disorder (ASD) at some point in time. Particularly for those more significantly affected, the issue of agitated and aggressive outbursts is often a major concern, though even in those with less significant symptom profiles, affectively charged […]
Perchance to Sleep: Cognitive Behavioral Therapy for Insomnia 10/15/2020
One of the primary presenting complaints in the primary care setting is insomnia. It can be a solitary presenting symptom or it can be part of a constellation of symptoms related to a medical cause or mood or anxiety disorder. A good assessment of onset, extent, duration, onset, severity, triggers of the sleep problem, in […]
Ways to Say “No” Nicely 10/1/2020
Telling patients “no” is not always easy. Primary care physicians (PCPs) especially know this all too well. In addition to “keeping the peace” with patients and avoiding conflict, providers may feel pressure to obtain better patient satisfaction scores, knowing that their status and/or compensation, in part, may be linked to higher scores. How do you […]
Understanding Different Mental Health Therapies 9/25/2020
Psychotherapy is a mainstay treatment for many mental health conditions. In the primary care setting, it is helpful to have a basic understanding of the common therapies that might be recommended to help guide patients as they are accessing treatment. Cognitive Behavioral Therapy (CBT): This is one of the most common types of psychotherapy and […]
Substance Abuse in the time of the Coronavirus Pandemic 9/18/2020
The far-reaching effects of the coronavirus pandemic continues to present challenges to primary care and mental health providers. Depression and anxiety have been predictably impacted by isolation and perceived health risks that our patients are experiencing. It has become more evident as time has passed, that people struggling with substance abuse are at higher risk […]