This Month in Psychopharmacology

Child and Adolescent Psychiatry Academy

Highlights from 2024 NEI Congress: Child and Adolescent Psychiatry Academy
Wednesday, November 6, 2024

Every year NEI Fall Congress kicks off with multiple pre-conference programs, including the Child & Adolescent Psychiatry Academy. In 2024, the NEI Child & Adolescent Psychiatry Academy included a series of insightful presentations and a lively panel discussion with expert faculty Adelaide Robb, MD, Jeffrey Strawn, MD, Timothy Wilens, MD, and Katherine Dahlsgaard, PhD.


Don’t Trip! Making an Accurate Diagnosis in Pediatric Psychiatry Is Always the First Step
Adelaide Robb, MD highlighted the importance of accurate diagnosis and timely treatment initiation for pediatric patients with psychiatric symptoms. She identified common "tripping hazards" that can get in the way of achieving this outcome and offered practical tools for overcoming obstacles that may arise across a variety of psychiatric conditions.


How, When, and Why...or Why Not? Antidepressants in Pediatric Mental Health Care
Jeffrey Strawn, MD explored the use of antidepressants in pediatric mental health. Beginning with an assessment of the benefits and risks of using these medications in pediatric mood and anxiety disorders, he then discussed the need for a collaborative approach in deciding whether and when to incorporate these medications into the treatment of an individual patient. Finally, he provided practical guidance on how to actually do so, including what constitutes an adequate trial, when/how to augment with other treatments, and when/how to switch.


A.D.H.D., Easy as 1-2-3? Practical Tips for Managing ADHD in Pediatric Patients
Timothy Wilens, MD focused on managing pediatric ADHD, stressing the importance of communication and collaboration with caregivers and care teams. He presented best practices for prescribing both stimulant and non-stimulant medications, exploring the nuances of different formulation options and strategies to tailor treatment plans to each individual patient.


Panic On the Playground! Managing Anxiety in Pediatric Patients
Katherine Dahlsgaard, PhD, a clinical psychologist, and Jeffrey Strawn, MD, a child and adolescent psychiatrist, delved into the interplay between exposure-based psychotherapy and pharmacotherapy in treating anxiety disorders in children and adolescents. Among the many practical takeaways from this presentation was guidance on how to integrate exposure experiences into the ‘med check.’

Using Exposure in the Med Check: Some Basics
You are qualified to do this Exposures can be quick and they don’t have to move the needle much It’s okay for the child to get anxious during the exposure (that’s the point)
Exposures are life lessons—you are coaching a life lesson
You do it first OR alongside the patient—so they know what is expected of them
Avoidance begets anxiety—go after the avoidance!
You are modeling the Exposure Lifestyle for the patient and their parents
Call it “an exposure” or “a bravery challenge” or “an experiment”—they need to know the name so they can report it to their therapist later
You are modeling that there is nothing dangerous about feeling anxiety
You are modeling for the parents that the child’s anxiety does not make YOU anxious
© Katherine Dahlsgaard, PhD

Using Exposure in the Med Check: Some Examples
Fear of vomiting Inconveniencing others Interoception
“(whisper voice) vomit (whisper voice)” Let’s order and then cancel our order” (mini-exposure for social anxiety about “inconveniencing others” or “appearing stupid”) “Let’s do jumping jacks together while we are talking” - a mini-interoceptive exposure for panic
© Katherine Dahlsgaard, PhD

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Jeffrey R. Strawn, MD; Katherine K. Dahlsgaard, PhD, ABPP; Timothy E. Wilens, MD; Adelaide S. Robb, MD (left to right)

The recording of each of these presentations, as well as all of the presentations from 2024 NEI Fall Congress, will be made available on the NEI website as Encore Presentations for NEI Members.


Source:
Adelaide S. Robb, MD. Don’t Trip! Making an Accurate Diagnosis in Pediatric Psychiatry Is Always the First Step. Presented November 6 at Child and Adolescent Psychiatry Academy, 2024 NEI Congress, Colorado Springs, CO.


Jeffrey R. Strawn, MD. How, When, and Why...or Why Not? Antidepressants in Pediatric Mental Health Care. Presented November 6 at Child and Adolescent Psychiatry Academy, 2024 NEI Congress, Colorado Springs, CO.


Timothy E. Wilens, MD. A.D.H.D., Easy as 1-2-3? Practical Tips for Managing ADHD in Pediatric Patients. Presented November 6 at Child and Adolescent Psychiatry Academy, 2024 NEI Congress, Colorado Springs, CO.


Jeffrey R. Strawn, MD and Katherine K. Dahlsgaard, PhD, ABPP. Panic On the Playground! Managing Social Anxiety in Pediatric Patients. Presented November 6 at Child and Adolescent Psychiatry Academy, 2024 NEI Congress, Colorado Springs, CO.

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