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Evidence-Based Assessment for Child and Adolescent Psychiatry: Better Tools for Better Decisions and Outcomes
INSTITUTES 5.5 – 6.1
5.5 THE POSITIVE APPROACH TO THE DIAGNOSTIC INTERVIEW: IS TALKING ABOUT WHAT’S WRONG NECESSARILY RIGHT? Alan Schlechter, MD, New York University School of Medicine, 60 E 8th St Apt 10K, New York, NY 10003-6516 Objectives: The goal of this session is to describe how using positive emotions, novelty, and mindfulness may be a more useful and evidenced-based way to begin the diagnostic interview. In Martin Seligman’s 1998 inaugural address to the annual meeting of the American Psychological Association, he called for a major investment into the study of well-being. Since that time, the study of positive emotions, novelty, and mindfulness are no longer just the domain of self-help gurus. The growing scientific literature highlights how the use of talking about what is “right” may be the optimal way to engage a patient in the diagnostic interview. Methods: Considerable research has focused on the benefits of positive emotions, novelty, and mindfulness that includes increased attention, desire to learn, and desire to connect with other people, a significant advantage for both the patient and the clinician conducting an assessment. Results: The field of positive psychology has developed several theories surrounding the benefits of positive emotions, novelty, and mindfulness for the development of relationships and goal setting that may enhance the rapport and development of a positive therapeutic alliance. We will review the literature and offer some practical techniques to support clinicians conducting a positive strength-based interview. Conclusions: This presentation will provide a review of positive psychology and how its growing knowledge of positive emotions, novelty, and mindfulness may support the development of a diagnostic interview and increase the quality of the doctor-patient relationship.
RF http://dx.doi.org/10.1016/j.jaac.2016.07.044
5.6 PRACTICE AND POLICY TOOLS TO SUPPORT SCHOOLS IN CREATING SAFE AND SUPPORTIVE LEARNING ENVIRONMENTS Sharon H. Stephan, PhD, Psychiatry, University of Maryland, 737 West Lombard Street, 426, Baltimore, MD 21201 Objectives: Components of comprehensive school mental health systems, including policies and practices designed to promote school safety and reduce student risk, will be reviewed, with recommendations for consulting mental health clinicians to support schools in creating safe and supportive learning environments. Methods: A comprehensive school mental health approach, including universal, selected, and targeted approaches, is required to promote student safety and well-being. Dr. Sharon Hoover Stephan, Co-Director of the National Center for School Mental Health at the University of Maryland School of Medicine (Baltimore, MD, USA), will discuss national, state, and local policies and practices related to comprehensive school mental health programming. Empirically supported, school-based interventions designed to promote safety, reduce risk, and respond to threat and trauma will be reviewed, including universal approaches (e.g., Kognito AtRisk for Educators, Psychological First Aid for Schools), selected interventions (e.g., Support for Students Exposed to Trauma), and targeted interventions (e.g., Cognitive Behavioral Intervention for Trauma in Schools). Successful school district and building practices and policies related to threat assessment and the promotion of safety and well-being (e.g., the Virginia Model for Student Threat Assessment) will be shared to support clinicians who consult with schools on how to foster safe and supportive learning environments. Participants also will receive information on measures used to assess school climate and student risk and practices for successful implementation of universal or selective screening practices in schools. Results: Participants will gain knowledge of evidence-based prevention and intervention programs and specific policies that promote a safe and supportive school environment for all students.
S94
www.jaacap.org
Conclusions: A comprehensive mental health approach is a necessary component of the national agenda to promote safe and supportive schools, and child psychiatrists are well positioned to partner with schools to establish effective policies and implement support empirically to that end.
SC http://dx.doi.org/10.1016/j.jaac.2016.07.045
INSTITUTE 6 EVIDENCE-BASED ASSESSMENT FOR CHILD AND ADOLESCENT PSYCHIATRY: BETTER TOOLS FOR BETTER DECISIONS AND OUTCOMES Cathryn A. Galanter, MD, Psychiatry, State Univeristy of New York Downstate/KCHC, 451 Clarkson Ave Rm A1217, Brooklyn, NY 11203-2054; Eric Youngstrom, PhD, Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB 3270, Chapel Hill, NC 27599; Peter S. Jensen, MD Objectives: Participants will learn about evidence-based assessment (EBA) to support diagnostic and treatment decision-making and improve patient care. Methods: Field-leading experts will review the extant literature, including recent scientific updates and clinically relevant take-home literature, to help child and adolescent psychiatrists and other mental health care professionals gain knowledge on methods of delivery of EBA to deliver improved patient care. Using proven high-structure didactic methods (e.g., “Think-Pair-Share”) and multiple question and answer sessions, participants also will develop plans to use EBA in their practice. Presenters will emphasize free and validated options whenever available. Results: Cathryn Galanter, MD, and Eric Youngstrom, PhD, will introduce the Institute and provide a framework for incorporating EBA into practice. Dr. Youngstrom then will review how to best use rating scales for assessment and monitoring. Prudence Fisher, PhD, will review research diagnostic instruments. Dr. Galanter will review research updates and clinical impact of science of diagnostic decision-making. Kelly Posner, PhD, will review how to use EBA to improve assessment of suicide risk, ideation, and behavior. Graham Emslie, MD, will review how EBA can improve psychopharmacological treatment outcomes. Jon McClellan, MD, will review monitoring of medication adverse effects. Peter Jensen, MD, will synthesize the lectures and leads exercises in which participants identify several changes that they intend to make in their practices based on the course content. Conclusions: The combination of concepts and tools bundled in this Institute provide a practical, low-cost way of improving consistency and accuracy of diagnostic and treatment decision-making. The tracking and monitoring strategies also boost the effectiveness of interventions and provide a safety net for more rapid detection and management of adverse events. Using free options in the AACAP Toolbox and other online resources, these methods have the potential to add to practitioners’ toolkits and provide better outcomes for more youths.
EBP RI SII http://dx.doi.org/10.1016/j.jaac.2016.07.047
6.1 THERE’S AN APP FOR THAT: EVIDENCE-BASED ASSESSMENT AND RATING SCALES Eric Youngstrom, PhD, Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB 3270, Chapel Hill, NC 27599 Objectives: The goal of this session is to provide a brief overview of evidence-based assessment, emphasizing the following: 1) three major phases of assessment over the course of treatment; 2) an overview of several rating scales and methods for identifying which to use in your practice; and 3) new ways that rating scales can add to prediction, prescription of treatment, and process measurement. Methods: Evidence-based assessment can inform treatment by helping to predict probable issues and diagnoses, prescribe different treatments, and monitor the process of treatment progress and outcome. After a brief overview, we will focus on rating scales. These can help scout out potential
J OURNAL
OF THE
AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 55 NUMBER 10S OCTOBER 2016
5.5 THE POSITIVE APPROACH TO THE DIAGNOSTIC INTERVIEW: IS TALKING ABOUT WHAT’S WRONG NECESSARILY RIGHT? Alan Schlechter, MD, New York University School of Medicine, 60 E 8th St Apt 10K, New York, NY 10003-6516 Objectives: The goal of this session is to describe how using positive emotions, novelty, and mindfulness may be a more useful and evidenced-based way to begin the diagnostic interview. In Martin Seligman’s 1998 inaugural address to the annual meeting of the American Psychological Association, he called for a major investment into the study of well-being. Since that time, the study of positive emotions, novelty, and mindfulness are no longer just the domain of self-help gurus. The growing scientific literature highlights how the use of talking about what is “right” may be the optimal way to engage a patient in the diagnostic interview. Methods: Considerable research has focused on the benefits of positive emotions, novelty, and mindfulness that includes increased attention, desire to learn, and desire to connect with other people, a significant advantage for both the patient and the clinician conducting an assessment. Results: The field of positive psychology has developed several theories surrounding the benefits of positive emotions, novelty, and mindfulness for the development of relationships and goal setting that may enhance the rapport and development of a positive therapeutic alliance. We will review the literature and offer some practical techniques to support clinicians conducting a positive strength-based interview. Conclusions: This presentation will provide a review of positive psychology and how its growing knowledge of positive emotions, novelty, and mindfulness may support the development of a diagnostic interview and increase the quality of the doctor-patient relationship.
RF http://dx.doi.org/10.1016/j.jaac.2016.07.044
5.6 PRACTICE AND POLICY TOOLS TO SUPPORT SCHOOLS IN CREATING SAFE AND SUPPORTIVE LEARNING ENVIRONMENTS Sharon H. Stephan, PhD, Psychiatry, University of Maryland, 737 West Lombard Street, 426, Baltimore, MD 21201 Objectives: Components of comprehensive school mental health systems, including policies and practices designed to promote school safety and reduce student risk, will be reviewed, with recommendations for consulting mental health clinicians to support schools in creating safe and supportive learning environments. Methods: A comprehensive school mental health approach, including universal, selected, and targeted approaches, is required to promote student safety and well-being. Dr. Sharon Hoover Stephan, Co-Director of the National Center for School Mental Health at the University of Maryland School of Medicine (Baltimore, MD, USA), will discuss national, state, and local policies and practices related to comprehensive school mental health programming. Empirically supported, school-based interventions designed to promote safety, reduce risk, and respond to threat and trauma will be reviewed, including universal approaches (e.g., Kognito AtRisk for Educators, Psychological First Aid for Schools), selected interventions (e.g., Support for Students Exposed to Trauma), and targeted interventions (e.g., Cognitive Behavioral Intervention for Trauma in Schools). Successful school district and building practices and policies related to threat assessment and the promotion of safety and well-being (e.g., the Virginia Model for Student Threat Assessment) will be shared to support clinicians who consult with schools on how to foster safe and supportive learning environments. Participants also will receive information on measures used to assess school climate and student risk and practices for successful implementation of universal or selective screening practices in schools. Results: Participants will gain knowledge of evidence-based prevention and intervention programs and specific policies that promote a safe and supportive school environment for all students.
S94
www.jaacap.org
Conclusions: A comprehensive mental health approach is a necessary component of the national agenda to promote safe and supportive schools, and child psychiatrists are well positioned to partner with schools to establish effective policies and implement support empirically to that end.
SC http://dx.doi.org/10.1016/j.jaac.2016.07.045
INSTITUTE 6 EVIDENCE-BASED ASSESSMENT FOR CHILD AND ADOLESCENT PSYCHIATRY: BETTER TOOLS FOR BETTER DECISIONS AND OUTCOMES Cathryn A. Galanter, MD, Psychiatry, State Univeristy of New York Downstate/KCHC, 451 Clarkson Ave Rm A1217, Brooklyn, NY 11203-2054; Eric Youngstrom, PhD, Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB 3270, Chapel Hill, NC 27599; Peter S. Jensen, MD Objectives: Participants will learn about evidence-based assessment (EBA) to support diagnostic and treatment decision-making and improve patient care. Methods: Field-leading experts will review the extant literature, including recent scientific updates and clinically relevant take-home literature, to help child and adolescent psychiatrists and other mental health care professionals gain knowledge on methods of delivery of EBA to deliver improved patient care. Using proven high-structure didactic methods (e.g., “Think-Pair-Share”) and multiple question and answer sessions, participants also will develop plans to use EBA in their practice. Presenters will emphasize free and validated options whenever available. Results: Cathryn Galanter, MD, and Eric Youngstrom, PhD, will introduce the Institute and provide a framework for incorporating EBA into practice. Dr. Youngstrom then will review how to best use rating scales for assessment and monitoring. Prudence Fisher, PhD, will review research diagnostic instruments. Dr. Galanter will review research updates and clinical impact of science of diagnostic decision-making. Kelly Posner, PhD, will review how to use EBA to improve assessment of suicide risk, ideation, and behavior. Graham Emslie, MD, will review how EBA can improve psychopharmacological treatment outcomes. Jon McClellan, MD, will review monitoring of medication adverse effects. Peter Jensen, MD, will synthesize the lectures and leads exercises in which participants identify several changes that they intend to make in their practices based on the course content. Conclusions: The combination of concepts and tools bundled in this Institute provide a practical, low-cost way of improving consistency and accuracy of diagnostic and treatment decision-making. The tracking and monitoring strategies also boost the effectiveness of interventions and provide a safety net for more rapid detection and management of adverse events. Using free options in the AACAP Toolbox and other online resources, these methods have the potential to add to practitioners’ toolkits and provide better outcomes for more youths.
EBP RI SII http://dx.doi.org/10.1016/j.jaac.2016.07.047
6.1 THERE’S AN APP FOR THAT: EVIDENCE-BASED ASSESSMENT AND RATING SCALES Eric Youngstrom, PhD, Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB 3270, Chapel Hill, NC 27599 Objectives: The goal of this session is to provide a brief overview of evidence-based assessment, emphasizing the following: 1) three major phases of assessment over the course of treatment; 2) an overview of several rating scales and methods for identifying which to use in your practice; and 3) new ways that rating scales can add to prediction, prescription of treatment, and process measurement. Methods: Evidence-based assessment can inform treatment by helping to predict probable issues and diagnoses, prescribe different treatments, and monitor the process of treatment progress and outcome. After a brief overview, we will focus on rating scales. These can help scout out potential
J OURNAL
OF THE
AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 55 NUMBER 10S OCTOBER 2016