- Email: [email protected]
47.3 THE LAUNCHING EMERGING ADULTS PROGRAM MODEL IN A COMMUNITY CLINIC FOR MINORITY EMERGING ADULTS: CHALLENGES AND SOLUTIONS
CLINICAL PERSPECTIVES 47.1 – 47.3
Hospital (NYPH), with clinical resources at Columbia University College of Physicians and Surgeons and Weill Cornell Medical College. This center is the first of its kind to provide the necessary expertise in addressing the acute challenges faced by this population as they transition to independent adulthood while struggling with impairing anxiety conditions. Methods: The cognitive behavioral and developmental treatment model adopted by YAC, the Launching Emerging Adults Program (LEAP) developed by Dr. Anne Marie Albano, is being implemented across three different clinical settings as follows: 1) a faculty practice (the Columbia University Clinic for Anxiety and Related Disorders or CUCARD); 2) an outpatient community clinic (Washington Heights–YAC clinic at NYPH, Columbia University); and 3) a partial hospitalization program (NYPH, Weill Cornell), enhancing the lives of young adults with anxiety disorders. Results: The presentations illustrate how the LEAP treatment model adopted by YAC is meeting the needs of a specific developmental stage (young adulthood), of a specific population (minority youth, particularly of Latino background), and of those with severe and multiple problems (in partial hospitalization). Conclusions: The YAC is leading an effort to develop specialized treatment knowledge relevant to young adults with anxiety disorders and their families. Since its inception, YAC has been devoted to providing clinical care, producing original knowledge, and disseminating its model, reaching out to patients and revealing clinical problems otherwise unaddressed.
ADOL ANX EBP http://dx.doi.org/10.1016/j.jaac.2016.07.719
47.1 WHAT DO WE KNOW ABOUT EMERGING ADULTS WITH ANXIETY DISORDERS? A SUMMARY OF RECENT LITERATURE Ana Ortin Peralta, PhD, Division of Child and Adolescent Psychiatry, NYS Psychiatric Institute/Columbia University Medical Center, 1050 Riverside Dr., 5th floor, Room: 5234, New York, NY 10032; Chiaying Wei, PhD Objectives: The initial years of adult life, young or emerging adulthood, form a critical period of development during which one faces unique challenges associated with the transition from childhood to adulthood. Only rarely has existing research focused on young adults (YAs). The current presentation provides an overview of the current literature on anxiety disorders among YAs, summarizing prevalence rates of anxiety disorders, mental health service utilization, barriers to care, and availability of evidence-based treatments (EBT) relevant to this specific developmental period. Methods: Main findings from relevant studies will be reviewed and summarized. Results: Anxiety disorders are one of the most prevalent psychiatric disorders across developmental stages, with a lifetime rate of 30 percent among YAs (ages 18–29 years) and a 12-month rate of 12.5 percent among collegeage YAs (ages 19–25 years). Anxiety disorders are associated with functional impairments during this transitional period. Young adults are less likely to receive mental health services compared to adults (age <55 years). This is particularly true for those with anxiety disorders. Obstacles to mental health service use may include lack of services specialized in developmental transitions or coordination across child and adult services. Although efficacy of specific psychosocial treatments for anxiety disorders such as cognitive behavioral therapy has been established for children and adults, current literature is limited on how to effectively treat anxiety in YAs and appropriately address the specific developmental needs during this period. Conclusions: There is a lack of literature on studies focused on this age period. One solution would be to reanalyze existing data with a focus on YA. However, in light of the high prevalence of anxiety disorders and low service use, new studies need to be conducted. This new research will improve our understanding on the specific needs for YAs and develop EBT treatments. The Youth Anxiety Center aims to generate this knowledge and share our experiences implementing EBT in three clinical settings.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC)
47.2 THE LAUNCHING EMERGING ADULTS PROGRAM: OVERVIEW OF THE COGNITIVE BEHAVIORAL AND DEVELOPMENTAL LAUNCHING EMERGING ADULTS PROGRAM MODEL AND IMPLEMENTATION IN A FACULTY PRACTICE Elisabeth B. Zakarin, PhD, Columbia University Medical Center, 3 Columbus Circle, Suite 1425, New York, NY 10019; Anne M. Albano, PhD Objectives: Anxiety disorders are stable and impairing conditions that emerge early in childhood and severely upset normal development. Childhood anxiety predicts later onset of depression, substance abuse, and comorbid anxiety diagnoses, which further complicate functioning and lead to significant disability in young adults. Naturalistic follow-up of 288 participants of the Child/Adolescent Anxiety Multimodal Study (CAMS) revealed a sobering finding, that nearly half of treatment responders had relapsed on average 6 years after randomization. Although CAMS advanced knowledge of effective treatment for childhood anxiety in the short term, it is suggested that a developmental and contextual approach is necessary for longer-term remission and healthy transition to adulthood. Dr. Anne Albano and colleagues emphasize the role of development, which has not been a primary focus of randomized trials, as a key factor for managing anxiety and achieving high level of functioning. In this presentation, an overview of our novel model, “Launching Emerging Adults Program” (LEAP), will be provided, including the unique integration of core components of CBT, with developmentally informed interventions designed to promote healthy adolescent to young adult transitions. Methods: More than 100 young adults (ages 16–28 years) with anxiety have been enrolled in LEAP at the Columbia University Clinic for Anxiety and Related Disorders (CUCARD), a faculty practice in New York. Treatment components include individual, group, and family interventions. Results: Initial implementation of the LEAP model indicates support for a family and exposure-based treatment for adolescents and young adults (ages 16–28 years) with anxiety. Conclusions: An adapted intervention that integrates components of empirically supported cognitive-behavioral treatments for anxiety, with developmentally informed interventions, may be critical to the development of independent functioning and effective transition into adulthood for adolescents and young adults with anxiety disorders. Future research goals will be discussed.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC) http://dx.doi.org/10.1016/j.jaac.2016.07.721
47.3 THE LAUNCHING EMERGING ADULTS PROGRAM MODEL IN A COMMUNITY CLINIC FOR MINORITY EMERGING ADULTS: CHALLENGES AND SOLUTIONS Maria C. Zerrate, MD, Child and Adolescent Psychiatry, NewYorkPresbyterian Hospital, Columbia University Medical Center, Vanderbilt Clinic East 4, 622 W 168th, New York, NY 10032; Jennifer Cruz, PhD; Erica Chin, PhD Objectives: It is well known that minority populations are less likely to access mental health treatment. It is estimated that by the year 2050, more than 50 percent of the US population will be composed of minority groups, the largest of which will continue to be Latinos (according to the 2012 US Census Bureau). The implementation of The Patient Protection and Affordable Care Act has allowed millions to gain health insurance coverage, with the largest groups of newly insured being emergent adults (EA) and Latinos (according to the US Department of Health and Human Services). Anxiety disorders are vastly under-recognized and undertreated and one of the leading causes of
http://dx.doi.org/10.1016/j.jaac.2016.07.720
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www.jaacap.org
J OURNAL
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AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 55 NUMBER 10S OCTOBER 2016
CLINICAL PERSPECTIVES 47.4 – 49.0
disability among EA. Evidence-based treatments (EBT) for anxiety disorders are well established, and core principles for cultural competent treatments have been developed, yet there is a paucity of information on the treatment of minority young adults with anxiety disorders. This presentation will illustrate the development of the Washington Heights Youth Anxiety Center (WHYAC), a clinical program within the NewYork-Presbyterian Hospital Youth Anxiety Center, created with the goal of providing minority EA with state-ofthe-art treatment by integrating EBT and cultural competence in a community setting. Methods: Key points from relevant studies highlighting the need to treat common mental health disorders such as anxiety disorders among underserved EA in the United States will be presented. An overview of the development, challenges, and future directions of the WH-YAC will be provided by the program’s medical director. Results: This talk will showcase the effort at the WH-YAC to better prepare practitioners and create programs specifically equipped to address the needs of Latino EA by adapting treatment strategies and implementing and disseminating a new standard of care for minority young adults with anxiety disorders. Conclusions: There is a clear gap in mental health treatment of minority populations. Development and dissemination of programs focused on providing evidence-based and culturally competent mental health services for Latino EA are a necessity and of particular relevance in this era of healthcare reform. This presentation will illustrate a response to this need and an effort to help close the disparity gap.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC) http://dx.doi.org/10.1016/j.jaac.2016.07.722
47.4 FLEXIBLE IMPLEMENTATION OF LAUNCHING EMERGING ADULTS PROGRAM IN A PARTIAL HOSPITALIZATION PROGRAM FOR YOUNG ADULTS Angela Chiu, PhD, Weill Cornell Medical Center, 525 East 68th Street, 11th floor, New York, NY 10065; Michelle Pelcovitz, PhD; Avital Falk, PhD; Elaina Zendegui, PsyD; Shannon M. Bennett, PhD Objectives: Anxiety disorders are more frequent in adolescence and early adulthood than any other time in life and are associated with concerning functional impairments during this transitional period into adulthood. Among the young adult patients who present for short-term psychiatric services in New York-Presbyterian’s Partial Hospitalization Programs (PHP), anxiety disorders represent the second most common principal diagnosis. In light of high prevalence rates, it is important to make EBP for anxiety available at this level of care. However, little is known about the best methods for disseminating EBP for anxiety into short-term psychiatric partial settings. The Youth Anxiety Center (YAC) aimed to augment partial hospital programming with cognitive behavioral interventions from the Launching Emerging Adulthood Program (LEAP), a developmentally informed treatment for reducing anxiety symptoms and improving independent functioning among emerging adults. Methods: YAC took a multicomponent implementation strategy that involved direct services, consultation, and training. YAC staff worked collaboratively as part of multidisciplinary teams and adopted a division of labor approach as a tactic to manage patients presenting with multiple problems. In addition to consulting on comprehensive treatment plans, YAC completed assessments to provide diagnostic clarity, conducted co-therapy services with hospital staff, and led anxiety-specific groups as well as groups targeting young adult issues using the LEAP model. YAC also offered trainings on exposure and introduced a weekly didactic to support psychiatry fellows in the implementation of EBP. Results: This presentation will highlight the multicomponent strategy taken to infuse the partial programming with EBP for emerging adults with anxiety. The collaborative approach contributed to positive attitudes about EBP implementation. Challenges and strengths of the implementation process will be discussed. Conclusions: Identifying effective methods of augmenting existing services in short-term psychiatric programs with EBP for anxiety may have important
J OURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 55 NUMBER 10S OCTOBER 2016
implications for young adult patients for whom anxiety may have been overlooked or unsuccessfully treated.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC) http://dx.doi.org/10.1016/j.jaac.2016.07.723
CLINICAL PERSPECTIVES 48 CULTURAL AND LINGUISTIC CONSIDERATIONS IN PSYCHIATRIC TREATMENT OF YOUTH WITH HEALTH CARE DISPARITIES: INTERPLAY OF MULTIPLE MINORITY IDENTITIES, INCLUDING ETHNICALLY DIVERSE DEAF AND HARD OF HEARING YOUTH Karen A. Goldberg, MD, University of South Florida, 3515 E Fletcher Ave, USF Department of Psychiatry, Tampa, FL 336134702; Dorrie L. DeGutis, MD; Jana K. Dreyzehner, MD; Lisa M. Cullins, MD; Barbara Robles-Ramamurthy, MD Objectives: The purpose of this Clinical Perspectives program is to educate the child and adolescent psychiatrist about culturally and linguistically based healthcare disparities in psychiatric assessment and treatment of youth and the special considerations affecting a minority within a minority, such as minority deaf and hard-of-hearing (HH) youth. Methods: This program will consist of three designated segments over the course of the 3-hour allotted time period. In the first segment, the speakers will explore healthcare disparities common in various minority populations based on cultural and linguistic differences and introduce the National Culturally and Linguistically Appropriate Services (CLAS) standards and blueprint for ensuring availability of services that are respectful of and responsive to the cultural and linguistic needs of all individuals. In the second segment, the speaker will present the cultural aspects of deafness, including the difference between “deaf” versus “Deaf,” special considerations in the assessment and treatment of deaf/HH youth, and the challenges in accessing culturally competent comprehensive care. In the third segment, the interplay of multiple minority identities that may exist in deaf and HH youth will be explored. Various perspectives, special considerations, and best practices and approaches to improving mental health services for minority Deaf and HH youth will be illustrated and discussed through clinical cases. Results: By attending this program, the participants will have a better understanding of the healthcare disparities common in various minority populations and of the National CLAS standards and their application in the mental health treatment of children and adolescents. Participants will also develop awareness of the clinical issues affecting psychiatric treatment of deaf/HH youth and the challenges in accessing culturally competent comprehensive care. Conclusions: Child and adolescent psychiatrists attending this program will be in a better position to provide optimal psychiatric services to culturally and linguistically diverse youth and “minorities within minorities,” including ethnically diverse Deaf and HH youth as a result of increased awareness of the various cultural perspectives and linguistic considerations.
COMD ETHN SP Sponsored by AACAP's Diversity and Culture Committee and Deaf and Hard of Hearing Committee http://dx.doi.org/10.1016/j.jaac.2016.07.725
CLINICAL PERSPECTIVES 49 EVALUATING AND IMPLEMENTING COMPLEX PSYCHOSOCIAL INTERVENTIONS FOR CHILDREN AND YOUTH Amy Cheung, MD, MS, Psychiatry, University of Toronto, 2075 Bayview Ave, Toronto, ON, Canada; Gregory K. Fritz, MD
www.jaacap.org
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Hospital (NYPH), with clinical resources at Columbia University College of Physicians and Surgeons and Weill Cornell Medical College. This center is the first of its kind to provide the necessary expertise in addressing the acute challenges faced by this population as they transition to independent adulthood while struggling with impairing anxiety conditions. Methods: The cognitive behavioral and developmental treatment model adopted by YAC, the Launching Emerging Adults Program (LEAP) developed by Dr. Anne Marie Albano, is being implemented across three different clinical settings as follows: 1) a faculty practice (the Columbia University Clinic for Anxiety and Related Disorders or CUCARD); 2) an outpatient community clinic (Washington Heights–YAC clinic at NYPH, Columbia University); and 3) a partial hospitalization program (NYPH, Weill Cornell), enhancing the lives of young adults with anxiety disorders. Results: The presentations illustrate how the LEAP treatment model adopted by YAC is meeting the needs of a specific developmental stage (young adulthood), of a specific population (minority youth, particularly of Latino background), and of those with severe and multiple problems (in partial hospitalization). Conclusions: The YAC is leading an effort to develop specialized treatment knowledge relevant to young adults with anxiety disorders and their families. Since its inception, YAC has been devoted to providing clinical care, producing original knowledge, and disseminating its model, reaching out to patients and revealing clinical problems otherwise unaddressed.
ADOL ANX EBP http://dx.doi.org/10.1016/j.jaac.2016.07.719
47.1 WHAT DO WE KNOW ABOUT EMERGING ADULTS WITH ANXIETY DISORDERS? A SUMMARY OF RECENT LITERATURE Ana Ortin Peralta, PhD, Division of Child and Adolescent Psychiatry, NYS Psychiatric Institute/Columbia University Medical Center, 1050 Riverside Dr., 5th floor, Room: 5234, New York, NY 10032; Chiaying Wei, PhD Objectives: The initial years of adult life, young or emerging adulthood, form a critical period of development during which one faces unique challenges associated with the transition from childhood to adulthood. Only rarely has existing research focused on young adults (YAs). The current presentation provides an overview of the current literature on anxiety disorders among YAs, summarizing prevalence rates of anxiety disorders, mental health service utilization, barriers to care, and availability of evidence-based treatments (EBT) relevant to this specific developmental period. Methods: Main findings from relevant studies will be reviewed and summarized. Results: Anxiety disorders are one of the most prevalent psychiatric disorders across developmental stages, with a lifetime rate of 30 percent among YAs (ages 18–29 years) and a 12-month rate of 12.5 percent among collegeage YAs (ages 19–25 years). Anxiety disorders are associated with functional impairments during this transitional period. Young adults are less likely to receive mental health services compared to adults (age <55 years). This is particularly true for those with anxiety disorders. Obstacles to mental health service use may include lack of services specialized in developmental transitions or coordination across child and adult services. Although efficacy of specific psychosocial treatments for anxiety disorders such as cognitive behavioral therapy has been established for children and adults, current literature is limited on how to effectively treat anxiety in YAs and appropriately address the specific developmental needs during this period. Conclusions: There is a lack of literature on studies focused on this age period. One solution would be to reanalyze existing data with a focus on YA. However, in light of the high prevalence of anxiety disorders and low service use, new studies need to be conducted. This new research will improve our understanding on the specific needs for YAs and develop EBT treatments. The Youth Anxiety Center aims to generate this knowledge and share our experiences implementing EBT in three clinical settings.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC)
47.2 THE LAUNCHING EMERGING ADULTS PROGRAM: OVERVIEW OF THE COGNITIVE BEHAVIORAL AND DEVELOPMENTAL LAUNCHING EMERGING ADULTS PROGRAM MODEL AND IMPLEMENTATION IN A FACULTY PRACTICE Elisabeth B. Zakarin, PhD, Columbia University Medical Center, 3 Columbus Circle, Suite 1425, New York, NY 10019; Anne M. Albano, PhD Objectives: Anxiety disorders are stable and impairing conditions that emerge early in childhood and severely upset normal development. Childhood anxiety predicts later onset of depression, substance abuse, and comorbid anxiety diagnoses, which further complicate functioning and lead to significant disability in young adults. Naturalistic follow-up of 288 participants of the Child/Adolescent Anxiety Multimodal Study (CAMS) revealed a sobering finding, that nearly half of treatment responders had relapsed on average 6 years after randomization. Although CAMS advanced knowledge of effective treatment for childhood anxiety in the short term, it is suggested that a developmental and contextual approach is necessary for longer-term remission and healthy transition to adulthood. Dr. Anne Albano and colleagues emphasize the role of development, which has not been a primary focus of randomized trials, as a key factor for managing anxiety and achieving high level of functioning. In this presentation, an overview of our novel model, “Launching Emerging Adults Program” (LEAP), will be provided, including the unique integration of core components of CBT, with developmentally informed interventions designed to promote healthy adolescent to young adult transitions. Methods: More than 100 young adults (ages 16–28 years) with anxiety have been enrolled in LEAP at the Columbia University Clinic for Anxiety and Related Disorders (CUCARD), a faculty practice in New York. Treatment components include individual, group, and family interventions. Results: Initial implementation of the LEAP model indicates support for a family and exposure-based treatment for adolescents and young adults (ages 16–28 years) with anxiety. Conclusions: An adapted intervention that integrates components of empirically supported cognitive-behavioral treatments for anxiety, with developmentally informed interventions, may be critical to the development of independent functioning and effective transition into adulthood for adolescents and young adults with anxiety disorders. Future research goals will be discussed.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC) http://dx.doi.org/10.1016/j.jaac.2016.07.721
47.3 THE LAUNCHING EMERGING ADULTS PROGRAM MODEL IN A COMMUNITY CLINIC FOR MINORITY EMERGING ADULTS: CHALLENGES AND SOLUTIONS Maria C. Zerrate, MD, Child and Adolescent Psychiatry, NewYorkPresbyterian Hospital, Columbia University Medical Center, Vanderbilt Clinic East 4, 622 W 168th, New York, NY 10032; Jennifer Cruz, PhD; Erica Chin, PhD Objectives: It is well known that minority populations are less likely to access mental health treatment. It is estimated that by the year 2050, more than 50 percent of the US population will be composed of minority groups, the largest of which will continue to be Latinos (according to the 2012 US Census Bureau). The implementation of The Patient Protection and Affordable Care Act has allowed millions to gain health insurance coverage, with the largest groups of newly insured being emergent adults (EA) and Latinos (according to the US Department of Health and Human Services). Anxiety disorders are vastly under-recognized and undertreated and one of the leading causes of
http://dx.doi.org/10.1016/j.jaac.2016.07.720
S72
www.jaacap.org
J OURNAL
OF THE
AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 55 NUMBER 10S OCTOBER 2016
CLINICAL PERSPECTIVES 47.4 – 49.0
disability among EA. Evidence-based treatments (EBT) for anxiety disorders are well established, and core principles for cultural competent treatments have been developed, yet there is a paucity of information on the treatment of minority young adults with anxiety disorders. This presentation will illustrate the development of the Washington Heights Youth Anxiety Center (WHYAC), a clinical program within the NewYork-Presbyterian Hospital Youth Anxiety Center, created with the goal of providing minority EA with state-ofthe-art treatment by integrating EBT and cultural competence in a community setting. Methods: Key points from relevant studies highlighting the need to treat common mental health disorders such as anxiety disorders among underserved EA in the United States will be presented. An overview of the development, challenges, and future directions of the WH-YAC will be provided by the program’s medical director. Results: This talk will showcase the effort at the WH-YAC to better prepare practitioners and create programs specifically equipped to address the needs of Latino EA by adapting treatment strategies and implementing and disseminating a new standard of care for minority young adults with anxiety disorders. Conclusions: There is a clear gap in mental health treatment of minority populations. Development and dissemination of programs focused on providing evidence-based and culturally competent mental health services for Latino EA are a necessity and of particular relevance in this era of healthcare reform. This presentation will illustrate a response to this need and an effort to help close the disparity gap.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC) http://dx.doi.org/10.1016/j.jaac.2016.07.722
47.4 FLEXIBLE IMPLEMENTATION OF LAUNCHING EMERGING ADULTS PROGRAM IN A PARTIAL HOSPITALIZATION PROGRAM FOR YOUNG ADULTS Angela Chiu, PhD, Weill Cornell Medical Center, 525 East 68th Street, 11th floor, New York, NY 10065; Michelle Pelcovitz, PhD; Avital Falk, PhD; Elaina Zendegui, PsyD; Shannon M. Bennett, PhD Objectives: Anxiety disorders are more frequent in adolescence and early adulthood than any other time in life and are associated with concerning functional impairments during this transitional period into adulthood. Among the young adult patients who present for short-term psychiatric services in New York-Presbyterian’s Partial Hospitalization Programs (PHP), anxiety disorders represent the second most common principal diagnosis. In light of high prevalence rates, it is important to make EBP for anxiety available at this level of care. However, little is known about the best methods for disseminating EBP for anxiety into short-term psychiatric partial settings. The Youth Anxiety Center (YAC) aimed to augment partial hospital programming with cognitive behavioral interventions from the Launching Emerging Adulthood Program (LEAP), a developmentally informed treatment for reducing anxiety symptoms and improving independent functioning among emerging adults. Methods: YAC took a multicomponent implementation strategy that involved direct services, consultation, and training. YAC staff worked collaboratively as part of multidisciplinary teams and adopted a division of labor approach as a tactic to manage patients presenting with multiple problems. In addition to consulting on comprehensive treatment plans, YAC completed assessments to provide diagnostic clarity, conducted co-therapy services with hospital staff, and led anxiety-specific groups as well as groups targeting young adult issues using the LEAP model. YAC also offered trainings on exposure and introduced a weekly didactic to support psychiatry fellows in the implementation of EBP. Results: This presentation will highlight the multicomponent strategy taken to infuse the partial programming with EBP for emerging adults with anxiety. The collaborative approach contributed to positive attitudes about EBP implementation. Challenges and strengths of the implementation process will be discussed. Conclusions: Identifying effective methods of augmenting existing services in short-term psychiatric programs with EBP for anxiety may have important
J OURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 55 NUMBER 10S OCTOBER 2016
implications for young adult patients for whom anxiety may have been overlooked or unsuccessfully treated.
ADOL ANX EBP Supported by the Youth Anxiety Center (YAC) http://dx.doi.org/10.1016/j.jaac.2016.07.723
CLINICAL PERSPECTIVES 48 CULTURAL AND LINGUISTIC CONSIDERATIONS IN PSYCHIATRIC TREATMENT OF YOUTH WITH HEALTH CARE DISPARITIES: INTERPLAY OF MULTIPLE MINORITY IDENTITIES, INCLUDING ETHNICALLY DIVERSE DEAF AND HARD OF HEARING YOUTH Karen A. Goldberg, MD, University of South Florida, 3515 E Fletcher Ave, USF Department of Psychiatry, Tampa, FL 336134702; Dorrie L. DeGutis, MD; Jana K. Dreyzehner, MD; Lisa M. Cullins, MD; Barbara Robles-Ramamurthy, MD Objectives: The purpose of this Clinical Perspectives program is to educate the child and adolescent psychiatrist about culturally and linguistically based healthcare disparities in psychiatric assessment and treatment of youth and the special considerations affecting a minority within a minority, such as minority deaf and hard-of-hearing (HH) youth. Methods: This program will consist of three designated segments over the course of the 3-hour allotted time period. In the first segment, the speakers will explore healthcare disparities common in various minority populations based on cultural and linguistic differences and introduce the National Culturally and Linguistically Appropriate Services (CLAS) standards and blueprint for ensuring availability of services that are respectful of and responsive to the cultural and linguistic needs of all individuals. In the second segment, the speaker will present the cultural aspects of deafness, including the difference between “deaf” versus “Deaf,” special considerations in the assessment and treatment of deaf/HH youth, and the challenges in accessing culturally competent comprehensive care. In the third segment, the interplay of multiple minority identities that may exist in deaf and HH youth will be explored. Various perspectives, special considerations, and best practices and approaches to improving mental health services for minority Deaf and HH youth will be illustrated and discussed through clinical cases. Results: By attending this program, the participants will have a better understanding of the healthcare disparities common in various minority populations and of the National CLAS standards and their application in the mental health treatment of children and adolescents. Participants will also develop awareness of the clinical issues affecting psychiatric treatment of deaf/HH youth and the challenges in accessing culturally competent comprehensive care. Conclusions: Child and adolescent psychiatrists attending this program will be in a better position to provide optimal psychiatric services to culturally and linguistically diverse youth and “minorities within minorities,” including ethnically diverse Deaf and HH youth as a result of increased awareness of the various cultural perspectives and linguistic considerations.
COMD ETHN SP Sponsored by AACAP's Diversity and Culture Committee and Deaf and Hard of Hearing Committee http://dx.doi.org/10.1016/j.jaac.2016.07.725
CLINICAL PERSPECTIVES 49 EVALUATING AND IMPLEMENTING COMPLEX PSYCHOSOCIAL INTERVENTIONS FOR CHILDREN AND YOUTH Amy Cheung, MD, MS, Psychiatry, University of Toronto, 2075 Bayview Ave, Toronto, ON, Canada; Gregory K. Fritz, MD
www.jaacap.org
S73