CHILD AND ADOLESCENT PSYCHIATRY PORTAL |
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CAPP Line: 1-800-253-2103 | capp.ucsf.edu | Connecting for Care
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Spring flowers are blooming, and the number of practices enrolled in CAPP continues to grow, especially in the Central Valley and northern CA counties. We are deepening relationships with our PCP network through more frequent consultation and interactive training events, and we are planning to offer in-person regional trainings and networking opportunities in the months ahead.
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School-Based Consultation & Collaboration
As youth are entering the home stretch of the school year, CAPP has engaged with McClymond High School's leadership, teachers and Restorative Justice Team to pilot timely school-based consultation. CAPP has also provided trainings and consultation to school-based health center clinicians and staff at La Clinica's and Castlemont's school-based health centers. We look forward to strengthening these partnerships and expanding our programming in the upcoming school year.
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Fresno Madera Medical Society (FMMS) and CAPP partner in Educational events in 2022
On March 31, Dr. Petra Steinbuchel led a webinar case-based consultation discussion, including pearls on trauma-informed care, aggressive behavior etiologies, and discussing SSRIs with families.
On April 8, Dr. Anne Glowinski led discussion of anxiety and depression at the annual FMMS retreat in Yosemite.
In September, CAPP and FMMS will offer in-person CME accredited “Mental Health Bootcamp for Primary Care” in Fresno (more details to follow).
If you are interested in having CAPP present an in-person training in your area, please let us know by emailing CAPP@UCSF.edu.
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How To Consult With a CAPP Psychiatrist
1. Request consult by calling 1-800-253-2103 or via the online consult request form on our CAPP website
2. Receive a prompt call-back & real-time phone consultation on diagnostic and treatment recommendations that are securely faxed/emailed back to you.
During consultation, services recommended to families may include:
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Reach Out & Connect (ROC) Psychologist Consultation: An opportunity for caregivers to collaborate with a therapist on how to best meet the needs of their child during a one-time consultation session
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Bridge Care Coordination, for families who need extra assistance in navigating recommended resources & referrals due to motivational, language and/or other barriers.
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CAPP ECHO: All teach, all learn |
Project ECHO is a worldwide tele-mentoring program in which learning communities of generalists and specialists follow an “all teach, all learn” approach to increasing local expertise and reducing health disparities, especially in rural and underserved areas.
In March 2021, CAPP launched its own Project ECHO designed to improve pediatricians’ knowledge, skills, and confidence in diagnosing and managing commonly occurring mental health conditions in children. This year over 100 primary care providers from Fresno through Humboldt county have enrolled in our Phase 2 CAPP ECHO.
A tremendous thanks to Joan Jeung MD MPH and CAPP Senior Associate Director for spearheading our educational efforts and leading CAPP ECHO.
I feel more comfortable with medication management of anxiety -
I can better address parent-child interaction and guide when there is a breakdown -
ECHO Participants
We are continuing to develop topics for future Project ECHO meetings, and would love to hear your suggestions and feedback: CAPP@ucsf.edu
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CAPP EDUCATIONAL EVENTS
Upcoming CAPP Webinars (with CME)
Gender Dysphoria
Diane Ehrensaft, PhD, Kristin Avicolli, LCSW
& Andrea Pedersen NP
May 12, 2022 @ 12:00-1pm
Eating Disorders
Amanda Downey, MD, Erin Accurso, PhD
June 9, 2022 @ 12:00 - 1 pm
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Case Example: 8-year old boy with ADHD and trauma
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An 8-year-old child, the youngest of three in a newcomer Latinx family, is brought to a school-based health clinic by their mother after a school conference. The child's teacher had complained about their refusal to do schoolwork and inability to stay in their seat and recommended that the child be evaluated for ADHD. The child's mother states that the child is easily frustrated when doing homework sheets, often refuses to do age-appropriate chores at home, and is unable to sit through the family dinner. The mother states that a cousin was recently diagnosed with ADHD and did not react well to medication, so she is not sure about giving medication to her child if diagnosed with ADHD. The child has no allergies, no history of cardiovascular problems, no physical chronic conditions.
The provider collects rating scales from the child’s mother and teacher, including the Vanderbilt (link) which indicate a combination of impulsive and inattentive ADHD symptoms and some anxious, irritable and defiant behaviors, but no bullying, lying or cruelty. The PEARLS (link) reveals a history of adverse-experiences and trauma during the family’s migration to the U.S.
Next, the provider gives the family psychoeducation about potential school accommodations and behavioral services which their child may qualify for (see IEP/504 and evaluation links) and assists with a formal evaluation request letter (see template), which the parent submits to the school. After the evaluation, the provider helps the family advocate for a reduced workload and daily report card in which the child earns points and privileges for on-task behavior and work completion (FUI link & ADDitude link). The provider also shares psychoeducation about the overlap in presentation between ADHD and trauma reactions (link); the teacher appreciated hearing that some of the child’s behaviors may be reflective of his trauma history and was open to learning about trauma-informed approaches to help promote his success (ACES aware link).
Finally, the provider reviews behavioral parenting treatments options, which are effective in improving difficulties related to ADHD and trauma. They discuss key strategies from these treatments, such as establishing and implementing routines, giving clear and specific instructions, as well as providing consistent positive rewards and effective discipline (CDC link & CLS link). The provider also shares that behavioral parent and classroom management services are often most effective when used with medication (AAP guidelines); the provider uses motivational interviewing strategies (link) to respectfully explore the family’s willingness to try medication in combination with behavioral strategies.
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CAPP Line: 1-800-253-2103| capp.ucsf.edu |
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