Matt Swenson, MD Child and Adolescent Psychiatry Fellow matthew.swenson@hsc.utah.

edu

TECH SAVVY TREATMENT

Using technology to improve delivery of mental healthcare in a medical setting

Autism Apps An App to keep track of all the apps!

Big Companies with a growing Evidence Base

A 9 year old girl

Brought to you by her parents because she has been Refusing to go to school for the past three days. No triggering event She is described as always having been a little slow to warm up. She is otherwise a delightful and social girl. History of intermittent stomach aches but is otherwise healthy. No bribe seems to work. Her parents have even tried to force her to go and they share a long, seemingly traumatic story: Parents carry her to the car in her pajamas, Drive to school Sit in the parking lot listening to her weep uncontrollably before deciding to bring her to your office. They feel bad for her but are also increasingly angered by this behavior. They are at a loss as to what they can do and ask whether they should think about home-schooling.

QUICK REVIEW: TREATMENT OF CHILDHOOD ANXIETY

1. Therapy 2. Therapy
CBT
1.Education 2.Emotional awareness and Relaxation Training 3.Assessing avoidance and desensitization/exposure 4.Cognitive restructuring

3. Therapy

4. Medication (SSRI)

MoodyMe

Covers most anxiety disorders (OCD, GAD, Social Phobia, Panic) with solid CBT educational format and skill-building

Target age group is 6-12

Great website and additional resources for parents. Allows them to take control and know how to start the discussion with their kids www.myanxiouschild.com

Demo

Ages 7 to 13 No formal training in CBT required 12 Sessions for the price/time/effort of 6 Child-paced activities including problem solving, changing self-talk, and identifying somatic signs of anxiety Downloadable MP3 relaxation script Selection of videos of other children engaging in exposure tasks and using coping strategies

Includes a built in reward system Comes with printable Coachs Manual and Go-ToGadget (child workbook)

A 15 year old boy

Parents complain that he has seemed not himself Isolating himself from friends and family. His parents explain that he has gone through a lot lower than expected grades a break-up with a girlfriend seeing less of his friends since school ended. Attributed his isolative behavior to teenager moodiness Tried to be supportive Alarmed when he recently blew up at home when his parents asked him to turn of the T.V. He stormed off yelling, I wish I were dead! This is very uncharacteristic behavior and his parents are very worried, but dont know what to do. In meeting with Hunter alone you notice a blunted affect and that he is minimally engaged but cooperative. He is clearly holding back tears when you ask about recent stressors. You ask whether he meant what he said about wanting to be dead to which he hesitantly replies, I dont know. No, I dont think so. He denies ever having a specific plan to hurt himself.

SCREENING INSTRUMENTS

Operation Reach Out is Designed To:

Encourage people to reach out for help when they are having suicidal thoughts Help those who are concerned about family members or friends who may be suicidal

Provide a personal contact help center

Provide activities to help people who are depressed stay connected to others

 DBT emphasizes skill building in 4 key domains Patients typically use a DBT Diary Card to track
progress

DBT (Dialectical Behavioral Therapy)

Try recommending the app so that they can show you their progress and teach you what they are learning.

A 4 year old girl

Brought to you by her mother who expresses concern about her daughters behavior.

Mother explains that she and her husband divorced three months ago, and although they have tried repeatedly to talk to her about things, her daughter doesnt seem to get it. She continues to ask why we cant all just sleep in the same house?
She also seems to be much more emotional. Mom asks you about the best way to explain this complicated topic, and also wonders whether professional counseling is necessary.

Divorce demo

Discussion
matthew.swenson@hsc.uta h.edu