Disclosure SAVING THE NEXT GENERATION: Objective 1a. Objective 1b. The Role of the Perinatal Team. Call:

Size: px
Start display at page:

Download "Disclosure SAVING THE NEXT GENERATION: Objective 1a. Objective 1b. The Role of the Perinatal Team. Call:"

Transcription

1 SAVING THE NEXT GENERATION: The Role of the Perinatal Team Terri Hargrave, MD, MPH Associate Professor Emeritus of Psychiatry SUNYUpstate October 12, 2018 Disclosure I receive grant funding from NYS OMH to consult to clinicians who see individuals under age 22 regarding mental health assessment and management issues including Obstetricians: Call: Objective 1a Recognize the importance of maternal and paternal experience to the next generation of brains Preconception Adverse Experiences and Resiliency Social Determinants of Health Objective 1b Recognize the importance of maternal and paternal experience to the next generation of brains Beginning at Conception Brain growth Number of neurons Interconnectivity Genetics and Epigenetics Social Determinants of Health

2 Objective 2 Consider how a Perinatal team can foster resiliency experiences for every new baby, recognize risk at each and every visit! Objective 3 Recognize that fathers are also at risk for perinatal mood and anxiety disorders as a consequence of becoming a father Up to 50% if mother is depressed Also correlates with risk to next generation behavior Presents somewhat differently from maternal perinatal depression Epidemic: Child Psychiatric Disorders Prevalence:16 22% (14 million) (Shaffer et al. 1996) Severe Functional Impairment: 5 9% (Costello et al.1996, 58 Fed Reg 1993) 80% receive no treatment (Burns et al.1995) Associations/Outcomes Adult Psychiatric Disorders Substance Abuse School failure/poorly qualified work force Unemployment Increased rates of incarceration Difficulty parenting/perpetration of the cycle

3 A Public Health Approach to Prevention of Childhood MHI Primary Prevention efforts applied to the whole population Secondary Prevention efforts applied to the at risk population Tertiary Prevention efforts applied to the already ill population, preventing worsening Headlines: August 2018 Parents Adverse Childhood Experiences and Their Children s Behavioral Health Problems A. Schickedanz MD,PHD, et. al. PEDIATRICS 142(2), August 2018.e The story of the child Begins in the experience of its parents during their childhoods ACES Adverse Childhood Experiences Scale (before age 18) 10 Items Yes/no answers

4 ACES, What are They? The Abuse Cluster Verbal abuse Physical abuse Sexual abuse ACES, What are They? The Neglect Cluster Emotional neglect Physical neglect ACES, What are They? The Household Dysfunction Cluster Parents separated/divorced Domestic violence ACES, What are They? The Household Dysfunction Cluster Lived with substance abuser Lived with mentally ill household member Household member in prison

5 ACE Score 4 or more: Correlations Adult Alcoholism/Liver Disease Chronic Depression/Suicide Attempts Perpetrating Domestic Violence/Being raped Difficulty Parenting ACE Score 4 or more: Correlations Smoking as an Adult/COPD Impaired Work Performance Et. Al. Difficulty Parenting Stress Science: Allostatic Load Resiliency Scale Resiliency Promoting Factors ACES 14 items 5 possible responses for each item Higher scores better Not validated as predictive, but useful in scaffolding

6 Resiliency Factors The Nuclear Family Cluster Mother loved me Father loved me We had rules and were expected to keep them My family cared how I did in school Resiliency Factors The Extended Family Cluster Other people loved me Someone enjoyed playing with me When I was upset, a relative could calm me When I felt bad, I could find someone to talk to Resiliency Factors The Community Cluster Neighbors/parents friends liked me Teachers, coaches, ministers, etc. helped me Folks around me talked about making life better Resiliency Factors Self Efficacy Cluster People noticed I was capable and could get things done I was an independent gogetter I believed life is what you make it

7 Saving the Next Generation Know and Care for their Parents Objective 1b Recognize the importance of maternal and paternal experience to the next generation of brains Beginning at Conception Brain growth Number of neurons Interconnectivity Genetics and Epigenetics Social Determinants of Health Brain growth trajectory The Brain by Dan Siegel 4Oxw A40

8 Programmed already by birth Stress Response System Autonomic Nervous System Reactivity Cortisol Response System Set Point Brain size & richness of connections Genetics and Epigenetics The Placenta as Translator of Mother s Experience 11 beta Hydroxysteroid Dehydrogenase Type II

9 Headlines August 27, 2018 Depression in Pregnancy May Alter Babies Brains Lisa Rapaport, reporter health prenatal depressionanxiety/depression in pregn... Headlines September 2018 A Meta Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development Sheri Madigan PhD, et. al. Journal of the American Academy of Child and Adolescent Psychiatry 57(9) Headlines September 2018 Parental Psychiatric Symptoms and Children s Outcomes: Toward Understanding and Responding to Intergenerational Risk in Child Psychiatry Matthew Biel, MD, MSc Journal of the American Academy of Child and Adolescent Psychiatry 57(9) Headlines 8/2/18 Perinatal Maternal Depressive Symptoms as an Issue for Population Health Michael Meaney, PhD

10 Headlines August 16, 2018 Prenatal Exposure to Violence Increases Toddlers Aggressive Behavior to their Mothers L. Miller Graff & J. Burke Lefever medical.net/news/ /prenatal exposure... Maternal Stressors leading to Epigenetic Changes Manifest at Birth Depression/anxiety/other mental illness in mom/dad Alcohol/ drug and/or other toxin exposure Domestic violence The Baby s Own (Prenatal ) ACES Maternal Stressors leading to Epigenetic Changes Manifest at Birth Poverty Poor nutrition/food Insecurity War Unsafe neighborhood Refugee/immigrant/illegal alien Et. al. The Baby s Own (Prenatal) Adverse Social Determinants of Health Stress Science: Allostatic Load Resiliency Promoting Factors ACES

11 Protective Maternal Experiences leading to Epigenetic Changes Manifest at Birth Father consistently present and caring Financial stability Early consistent nurturing prenatal care The Baby s own (Prenatal) Resiliency Factors Protective Maternal Experiences leading to Epigenetic Changes Manifest at Birth Extended family available Safe neighborhood Community involvement (Church, etc.) Et. al. The Baby s own (Prenatal) Resiliency Factors Objective 2 Consider how a Perinatal team can foster resiliency experiences for every new baby, recognize risk at each and every visit! Ob/Peds Primary prevention: Fostering resiliency and preventing ACES for every baby Build caring relationship with parents

12 Ob/Peds Primary prevention: Fostering resiliency and preventing ACES for every baby At every visit With every member of the Ob/Peds practice team Include fathers as much and as often as possible Ob/Peds Primary prevention: Fostering resiliency and preventing ACES for every baby Ask and address mom s and dad s concerns first before your own agenda Saving the Next Generation: Fostering resiliency and preventing ACES for every baby Identify support systems for every pregnant woman Significant other Extended family Friends Saving the Next Generation: Fostering resiliency and preventing ACES for every baby Identify support systems for every pregnant woman Community resources/services Project 62 Moms on Call peer support line: Yourself/Your Practice

13 Saving the Next Generation: Fostering resiliency and preventing ACES for every baby Stress SELF CARE: sleep nutrition exercise meditation yoga time for self Ob/Peds Saving the Next Generation: Fostering Resiliency Parents Universal screening to define the high risk babies Remember to screen mothers AND fathers ACES Less reluctance to complete scale when reported as total score rather than by individual item Other Mental Health Screening Tools Depression Anxiety Mood Disorders Psychosis

14 Objective 3 Recognize that fathers are also at risk for perinatal mood and anxiety disorders as a consequence of becoming a father Up to 50% if mother is depressed Also correlates with risk to next generation behavior Presents somewhat differently from maternal perinatal depression Remember the fathers Paternal peripartum depression is: Common: may be as common as maternal peripartum depression More likely when: Mother also depressed Low relationship satisfaction Poor social supports Remember the fathers! Paternal peripartum depression is: More likely when: Young (< 25 years old) Personal past history of depression Low Socioeconomic Status Premature baby Paternal Perinatal Depression Characteristics More likely: Irritable, cynical, angry, Self critical, Indecisive, Reclusive Avoids interaction with family

15 Paternal Perinatal Depression Characteristics Loses self in work, hobbies, exercise Risk taking behaviors Somatic symptoms Comorbid substance abuse Paternal Perinatal Depression Characteristics May present later postpartum If using Edinburgh, use lower cut off score (10 11) Usually fathers do not seek care unless prompted by someone to do so Paternal Perinatal Depression Common Themes: Perceived pressure to provide for the family with feeling unable to adequately do so Unprepared for role of infant parenting Emotional disconnect father and mother Interaction between paternal and maternal mood symptoms and psychosocial stressors Paternal Perinatal Depression? Related to decreased testosterone levels during pregnancy and postpartum

16 Why does it matter? Paternal perinatal depression correlates with: more family stress lessinfant father bonding more spanking Saving the next generation and correlates with: poor reading scores, more ADHD, ODD, conduct, anxiety and depression in offspring from early childhood When is fetal/child mental health risk present? When a parent is at risk for mental illness or is already ill, this creates risk for the fetus/child. When is fetal/child mental health risk present? ACES >4, either parent if both are involved Low resiliency score, either parent Multiple current psychosocial stressors Parental body language: Your gut feeling

17 What to do when there is risk: Build relationship Establish support system Continue screening Stress self care Empathic recognition of difficult past Psychoeducation re: Impact of ACES What to do when there is risk: Closer monitoring Care management What help does the parent want? What is available that might decrease risk? Help connecting with services When a parent is already ill Relationship Establish support system Psychoeducation Risk to fetus/baby Self care plan Care management Already ill Therapy Medication

18 For Dads: Paternal Depression Resources referral to therapist/pcp for meds Phone consult Dr. Will Courtenny: Sad Dad: An exploration of postnatal depression in men Spencer (2014) Already ill Consider Consulting Project TEACH How Project TEACH can help you For moms or dads under age 22 Phone consult: M Th 8 7; F 8 5; Help with referrals Website One time Face to face Assessment Coming October 16, 2018 Consults to you for any age mom: info@projectteachny.org

19 In Summary, Maternal and paternal experiences in childhood and in the perinatal period have tremendous impact on the brains of their children. In Summary, Paternal peripartum depression is common, presents somewhat differently in fathers, and is similarly associated with long term adverse outcomes in their children. In Summary, Using universal screening and preventive relationshipbased interventions in perinatal settings is called for to address the epidemic of childhood mental illness. Sources Objective 1: ACES and the Brain Science Van der Kolk, B The Body Keeps the Score : Brain, Mind, and Body in the Healing of Trauma (2014) Penguin Books 445pp. Burke Harris, N The Deepest Well: Healing the Long Term Effects of Childhood Adversity (2018) Houghton Mifflin Harcourt 251pp Journal of Zero to Three:National Center for Infants, Toddlers and Families (2014) Prenatal Influences on Child Development 34(4) pp6 59

20 Sources Objective 3: Paternal Depression Serrano VJ et.al. (2018) Zero to Three Focusing on Fathers: Recognizing the Role of Paternal Mental Health in Family Well Being During the Postpartum Period 38(6): Smith H et.al. (2013) Infant and Child Development Paternal Postnatal and Subsequent Mental Health Symptoms and Child Socio Emotional and Behavioral Problems at School Entry 22: Top ED et.al. (2016) Archives of Psychiatric Nursing Paternal Depression Rates in Prenatal and Postpartum Periods and Affecting Factors 30: Sources: Objective 2: Practice Evolution Raney LE (2015) Integrated Care: Working at the Interface of Primary Care and Behavioral Science American Psychiatric Publishing 276pp Langley GJ (2009) the Improvement Guide: a Practical Approach to Enhancing Organizational Performance Jossey Bass 490pp The Community Technical Assistance Center of New York Questions, Comments? Thank you

Understanding Perinatal Mood Disorders (PMD)

Understanding Perinatal Mood Disorders (PMD) Understanding Perinatal Mood Disorders (PMD) Postpartum Depression and Beyond Northwestern Medicine Central DuPage Hospital 25 North Winfield Road Winfield, Illinois 60190 630.933.1600 Northwestern Medicine

More information

Objectives. Mother-Infant Communication. Depression. Disclosures of Potential Conflicts. Why Is Perinatal Mental Health Important?

Objectives. Mother-Infant Communication. Depression. Disclosures of Potential Conflicts. Why Is Perinatal Mental Health Important? The Integrated Child and Adolescent Psychiatrist: Perinatal Mental Health Care to Improve Maternal-Infant Outcomes Disclosures of Potential Conflicts Source Research Funding Advisor/ Consultant Employee

More information

What nurses need to know about Trauma-Informed Care

What nurses need to know about Trauma-Informed Care What nurses need to know about Trauma-Informed Care Define trauma-informed care Identify how to assess for trauma Tap in to resources for these patients and their families Kaiser Permanente,1995-1997

More information

Perinatal Depression For GA22

Perinatal Depression For GA22 For GA22 Who WIC Participants Why WIC Time 5-10 minutes Setup Chairs in clusters of 2 or 3. White board and pens Objectives By the end of this session, participants will: Identify the importance of attachment

More information

Parental Depression: The Elephant in the room with us

Parental Depression: The Elephant in the room with us Parental Depression: The Elephant in the room with us Ardis Olson, MD Dartmouth Medical School UPIQ Screening for Maternal Depression Learning Collaborative September 15, 2006 Ardis.Olson@dartmouth.edu

More information

Jesse Kuendig, LICSW Helen Kim, MD

Jesse Kuendig, LICSW Helen Kim, MD Jesse Kuendig, LICSW Jessica.Kuendig@hcmed.org Helen Kim, MD Agenda Mental Health and Pregnancy Impact of Historical Trauma, Racism, Implicit Bias Trauma-Informed Care Mother-Baby Program African-American

More information

TTC Evidence Brief: Evidence for Maternal Mental Health within World Vision Core Health Model Timed and Targeted Counselling (ttc)

TTC Evidence Brief: Evidence for Maternal Mental Health within World Vision Core Health Model Timed and Targeted Counselling (ttc) TTC Evidence Brief: Evidence for Maternal Mental Health within World Vision Core Health Model Timed and Targeted Counselling (ttc) Introduction Megan McGrath, World Vision Australia Polly Walker, World

More information

Silent ACEs: The Epidemic of Attachment and Developmental Trauma

Silent ACEs: The Epidemic of Attachment and Developmental Trauma Silent ACEs: The Epidemic of Attachment and Developmental Trauma Niki Gratrix, The Abundant Energy Expert http://www.nikigratrix.com/silent-aces-epidemic-attachment-developmental-trauma/ A 2004 landmark

More information

The Magnitude of the Solution. Building Self-Healing Communities

The Magnitude of the Solution. Building Self-Healing Communities The Magnitude of the Solution Building Self-Healing Communities Disclosure The content of this activity does not relate to any product of a commercial interest as defined by the ACCME; therefore, there

More information

Changing the odds for children exposed to trauma and stress

Changing the odds for children exposed to trauma and stress Changing the odds for children exposed to trauma and stress Jennifer Hays-Grudo, PhD Regents Professor Human Development and Family Science Adjunct Professor of Pediatrics OSU Center for Health Sciences

More information

handouts for women 1. Self-test for depression symptoms in pregnancy and postpartum Edinburgh postnatal depression scale (epds) 2

handouts for women 1. Self-test for depression symptoms in pregnancy and postpartum Edinburgh postnatal depression scale (epds) 2 handouts for women 1. Self-test for depression symptoms in pregnancy and postpartum Edinburgh postnatal depression scale (epds) 2 2. The Cognitive-Behaviour Therapy model of depression 4 3. Goal setting

More information

The Impact of the Opioid Crisis on Children

The Impact of the Opioid Crisis on Children The Impact of the Opioid Crisis on Children Guided Notes for Online Learning Name: Date: 1 Table of Contents Section 1: The Opioid Crisis Page 3 Section 2: Addiction Page 4 Section 3: Trauma Informed Care

More information

Trauma/ACEs 101. Tom Bradach IL Chapter, American Academy of Pediatrics

Trauma/ACEs 101. Tom Bradach IL Chapter, American Academy of Pediatrics Trauma/ACEs 101 Tom Bradach IL Chapter, American Academy of Pediatrics Providing pediatrician and interprofessional education, resources, and technical assistance Working on policy, advocacy, and systems

More information

The Magnitude of the Solution. Building Self-Healing Communities

The Magnitude of the Solution. Building Self-Healing Communities The Magnitude of the Solution Building Self-Healing Communities Beyond Resilience Flourish To Flourish: To Prosper with Sustained, Continuous, Steady, Strong Growing Well Bing & Miriam Webster Dictionaries

More information

Unique Experience of the World

Unique Experience of the World Unique Experience of the World Preparing for Anticipated World Dangerous BIOLOGY OF STRESS CHARACTERISTICS Brawn over Brains Focused: Fight, Flight or Freeze OUTCOME Individual & species survive the worst

More information

The child-parent relationship is core to a child s development

The child-parent relationship is core to a child s development M. C O N N I E A L M E I D A, P H D The child-parent relationship is core to a child s development ATTACHMENT The central theme of attachment theory is that mothers / fathers who are available and responsive

More information

Wellness Foundation Conference September 25, 2013 Nancy Frappier Wellness Center Coordinator Homeless Prenatal Program San Francisco, CA

Wellness Foundation Conference September 25, 2013 Nancy Frappier Wellness Center Coordinator Homeless Prenatal Program San Francisco, CA Caught in the Maze: Health Disparities for Homeless Women Wellness Foundation Conference September 25, 2013 Nancy Frappier Wellness Center Coordinator Homeless Prenatal Program San Francisco, CA Agenda

More information

Postpartum Depression Screening

Postpartum Depression Screening Postpartum Depression Screening October 13, 2018 Deborah CowleyMD Psychiatrist Perinatal Consultant University of Washington Disclosures Perinatal Psychiatry Consultation Line/PAL for Moms UW Perinatal

More information

ADVERSE CHILDHOOD EXPERIENCES AND BEHAVIORAL HEALTH

ADVERSE CHILDHOOD EXPERIENCES AND BEHAVIORAL HEALTH 1 ADVERSE CHILDHOOD EXPERIENCES AND BEHAVIORAL HEALTH Presentation to the State Epidemiological Outcomes Workgroup By Aileen Fink, Ph.D. aileen.fink@state.de.us December 16, 2016 2 ACKNOWLEDGEMENTS The

More information

Perinatal depression and anxiety Women s Mental Health Symposium UCT Department of Psychiatry and Mental Health Simone Honikman

Perinatal depression and anxiety Women s Mental Health Symposium UCT Department of Psychiatry and Mental Health Simone Honikman Perinatal depression and anxiety Women s Mental Health Symposium UCT Department of Psychiatry and Mental Health Simone Honikman www.pmhp.za.org Outline Common perinatal mental disorders (depression & anxiety)

More information

Brain Research: Early Experiences Matter. Opening Minds, 2016

Brain Research: Early Experiences Matter. Opening Minds, 2016 Brain Research: Early Experiences Matter Opening Minds, 2016 Disclosure I declare that neither I, or my immediate family, have a financial interest or other relationship with any manufacturer/s of a commercial

More information

Depression During and After Pregnancy

Depression During and After Pregnancy A Resource for Women, Their Families, and Friends I have trouble eating and sleeping. I feel lonely, sad, and don t have the energy to get things done. Sometimes I don t even want to hold my baby. If this

More information

Class #2: ACTIVITIES AND MY MOOD

Class #2: ACTIVITIES AND MY MOOD Class # Class #: ACTIVITIES AND MY MOOD CLASS OUTLINE I. Announcements & Agenda II. III. IV. General Review Personal Project Review Relaxation Exercise V. New Material VI. Personal Project I. Any Announcements?

More information

COMMUNITY MATERNITY RESOURCE GUIDE

COMMUNITY MATERNITY RESOURCE GUIDE COMMUNITY RESOURCE GUIDE At MetroPlus Health Plan, we want to make sure that you and your baby are as healthy as possible. Here is a list of community resources that are available to you through MetroPlus.

More information

The Perinatal Mental Health Project (PMHP)

The Perinatal Mental Health Project (PMHP) Overview of the Hanover Park maternal mental health screening study The Perinatal Mental Health Project (PMHP) The PMHP is an independent initiative based at the University of Cape Town. It is located

More information

Uncovering Resilience & Nurturing Innate Health Northland Prevention Conference

Uncovering Resilience & Nurturing Innate Health Northland Prevention Conference Uncovering Resilience & Nurturing Innate Health 2017 Northland Prevention Conference Adverse Childhood Experiences orecent research focuses on Adverse Childhood Experiences (ACEs), which include abuse

More information

Kripalu Yoga in the Schools Evidence-Based Curriculum

Kripalu Yoga in the Schools Evidence-Based Curriculum Kripalu Yoga in the Schools Evidence-Based Curriculum KYIS Definition of Yoga Breathing exercises, postures and relaxation techniques for self-care KYIS Curriculum Overview Three Modules 24 Lessons 35

More information

Perinatal Substance Use: Evidence for Current Practice. Karen Clemmer, MCAH Coordinator, Sonoma County

Perinatal Substance Use: Evidence for Current Practice. Karen Clemmer, MCAH Coordinator, Sonoma County Perinatal Substance Use: Evidence for Current Practice Karen Clemmer, MCAH Coordinator, Sonoma County The impact of perinatal marijuana use on pregnancy outcomes & lactation Learning Objectives Influence

More information

Perinatal Mood Disorders: An Interdisciplinary Training Video. Facilitator s Guide, Pre-test and Post-test

Perinatal Mood Disorders: An Interdisciplinary Training Video. Facilitator s Guide, Pre-test and Post-test Perinatal Mood Disorders: An Interdisciplinary Training Video Facilitator s Guide, Pre-test and Post-test 2013 INTRODUCTION Perinatal mood disorders (PMD) have been described as one of the most common

More information

Infant Parent Relationships: Strength-based Early Intervention Approaches

Infant Parent Relationships: Strength-based Early Intervention Approaches Infant Parent Relationships: Strength-based Early Intervention Approaches Foundations of Infant Mental Health Central California Children s Institute December 6, 2012 Deborrah Bremond, Ph.D., MPH Defining

More information

Prenatal and Post Partum Depression is Not Just a Mood. This is Serious Stuff.

Prenatal and Post Partum Depression is Not Just a Mood. This is Serious Stuff. Prenatal and Post Partum Depression is Not Just a Mood. This is Serious Stuff. Deborah McMahan, MD Health Commissioner Prenatal and Infant Care Network November 28, 2016 Agenda Prevalence of mental illness

More information

JOURNAL OF INTERNATIONAL ACADEMIC RESEARCH FOR MULTIDISCIPLINARY Impact Factor 3.114, ISSN: , Volume 5, Issue 3, April 2017

JOURNAL OF INTERNATIONAL ACADEMIC RESEARCH FOR MULTIDISCIPLINARY Impact Factor 3.114, ISSN: , Volume 5, Issue 3, April 2017 PREVALENCE OF POSTPARTUM DEPRESSION AMONG WOMEN-A CROSS SECTIONAL STUDY MRS.RAJESWARI.H* *Professor & HOD, Dept. of Mental Health Nursing, Narayana College of Nursing, Chinthareddypalem, Nellore, Andhrapradesh,

More information

ACEs and Homelessness. Trauma-Informed Care awareness training Erica Smith, MA, MPH October 2018

ACEs and Homelessness. Trauma-Informed Care awareness training Erica Smith, MA, MPH October 2018 ACEs and Homelessness Trauma-Informed Care awareness training Erica Smith, MA, MPH October 2018 What is trauma? Trauma is an event (or a series of events) that are experienced by an individual. The event

More information

What Can MIHP Providers Do?

What Can MIHP Providers Do? MIHP Webcast MATERNAL DEPRESSION / STRESS December 1, 2009 What Can MIHP Providers Do? Catherine Kothari Maternal-Child Research, MSU/KCMS (269) 501-4149 (cell) kothari@kcms.msu.edu Mary Ludtke Mental

More information

The Aboriginal Mental Health & Wellbeing Workforce Forum 2017 HOW CAN WE REDUCE THE RATES OF SUICIDE IN THE ABORIGINAL COMMUMITIES?

The Aboriginal Mental Health & Wellbeing Workforce Forum 2017 HOW CAN WE REDUCE THE RATES OF SUICIDE IN THE ABORIGINAL COMMUMITIES? The Aboriginal Mental Health & Wellbeing Workforce Forum 2017 HOW CAN WE REDUCE THE RATES OF SUICIDE IN THE ABORIGINAL COMMUMITIES? The rate of suicide among young Indigenous men is the highest in the

More information

Other significant mental health complaints

Other significant mental health complaints Other significant mental health complaints 2 Session outline Introduction to other significant mental health complaints Assessment of other significant mental health complaints Management of other significant

More information

The Effects of Trauma. And How to Facilitate Recovery!

The Effects of Trauma. And How to Facilitate Recovery! The Effects of Trauma And How to Facilitate Recovery! Adverse Childhood Experiences (ACEs). 17,000 Surveyed 63% experienced at least 1 of the following categories: 11% experienced emotional abuse. 28%

More information

Mental Health Screening in Primary Care Pediatrics

Mental Health Screening in Primary Care Pediatrics Mental Health Screening in Primary Care Pediatrics Nathalie Bernabe Quion MD MPH FAAP Assistant Professor in Pediatrics George Washington University School of Medicine and Health Sciences Medical Director

More information

Workshop ACEs. Adverse Childhood Experiences and how knowing about them can inform our (clinical) practice

Workshop ACEs. Adverse Childhood Experiences and how knowing about them can inform our (clinical) practice Workshop ACEs Adverse Childhood Experiences and how knowing about them can inform our (clinical) practice! Dr Sara Ketteley Consultant Psychiatrist at Great Chapel Street Adverse Childhood Experiences

More information

Safe Babies Foster Parent Training Program

Safe Babies Foster Parent Training Program Safe Babies Foster Parent Training Program Module 1: Introduction to the Safe Babies Program 1 Begin the process of group participation Learning outcomes Understand the purpose and origins of the Safe

More information

Safety Individual Choice - Empowerment

Safety Individual Choice - Empowerment Safety Individual Choice - Empowerment Diane M. Gruen-Kidd, LCSW Department for Behavioral Health, Developmental and Intellectual Disabilities Diane.Gruen-Kidd@ky.gov Please Be Aware There are parts of

More information

Overcoming Avoidance in Trauma-Focused Cognitive Behavioral Therapy

Overcoming Avoidance in Trauma-Focused Cognitive Behavioral Therapy Overcoming Avoidance in Trauma-Focused Cognitive Behavioral Therapy Alison Hendricks, LCSW Hendricks Consulting Learning Objectives Participants will: 1. Cite strategies for identifying and understanding

More information

From Risk to Protection: Engaging Caregivers Affected by Interpersonal Trauma in Child and Family Focused Trauma Treatment

From Risk to Protection: Engaging Caregivers Affected by Interpersonal Trauma in Child and Family Focused Trauma Treatment From Risk to Protection: Engaging Caregivers Affected by Interpersonal Trauma in Child and Family Focused Trauma Treatment Sarah Gardner, LCSW-C 4 th BIENNIAL TRAUMA CONFERENCE Addressing Trauma across

More information

Adverse Childhood Experience

Adverse Childhood Experience Adverse Childhood Experience Why we need to look after our own wellbeing when working with children and young people who have experienced adversity Dr Sarah Temple MRCGP sarah@ehcap.co.uk www.mindfulemotioncoaching.co.uk

More information

Gender Sensitive Factors in Girls Delinquency

Gender Sensitive Factors in Girls Delinquency Gender Sensitive Factors in Girls Delinquency Diana Fishbein, Ph.D. Research Triangle Institute Transdisciplinary Behavioral Science Program Shari Miller-Johnson, Ph.D. Duke University Center for Child

More information

PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS

PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS Abbey Kruper, Psy.D. Assistant Professor Department of Obstetrics & Gynecology Medical College of Wisconsin OBJECTIVES 1. Overview of perinatal anxiety

More information

4/3/2017 WHAT IS ANXIETY & WHY DOES IT MATTER? PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS OBJECTIVES. 1. Overview of perinatal anxiety

4/3/2017 WHAT IS ANXIETY & WHY DOES IT MATTER? PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS OBJECTIVES. 1. Overview of perinatal anxiety PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS Abbey Kruper, Psy.D. Assistant Professor Department of Obstetrics & Gynecology Medical College of Wisconsin OBJECTIVES 1. Overview of perinatal anxiety

More information

THE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (P. I. C. S.

THE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (P. I. C. S. A Child s Name or ID: Date: 2013 THE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (P. I. C. S. - 6) Revised for DSM-III - R (1989) and DSM-IV (1995, 2008) GENERAL

More information

James F. Paulson, Ph.D. Associate Professor of Psychology, Old Dominion University Pediatric Psychologist, Children s Hospital of The King s

James F. Paulson, Ph.D. Associate Professor of Psychology, Old Dominion University Pediatric Psychologist, Children s Hospital of The King s James F. Paulson, Ph.D. Associate Professor of Psychology, Old Dominion University Pediatric Psychologist, Children s Hospital of The King s Daughters Common terms Antenatal Postnatal Postpartum Perinatal

More information

Promoting Maternal Mental Health During and After Pregnancy

Promoting Maternal Mental Health During and After Pregnancy Promoting Maternal Mental Health During and After Pregnancy Nancy Byatt, DO, MS, MBA, FAPM Medical Director, MCPAP for Moms Marcy Ravech, MSW Program Director, MCPAP for Moms 4 MCPAP For Moms 1 in 7 women

More information

EI Leadership April 24, 2018

EI Leadership April 24, 2018 Early Childhood Community Partnerships to Support Families Struggling with SUD EI Leadership April 24, 2018 Setting the Stage The issue of young children impacted by substance use disorders in families

More information

Something Has To Change

Something Has To Change Something Has To Change A Three-Strand Approach 1.Looking In 2. Looking Out 3. Looking At Theory Stress, burnout, depression, anxiety, compassion fatigue, secondary PTSD... It is important to safeguard

More information

Psychiatric Case Formulation. Assessing Pediatric Mental Health in the Medical Home

Psychiatric Case Formulation. Assessing Pediatric Mental Health in the Medical Home Psychiatric Case Formulation Assessing Pediatric Mental Health in the Medical Home August 15, 2016 Rebecca Marshall, MD, MPH A 7 Year-old Boy with Hyperactive Behavior Steven is a 7 year old boy brought

More information

Pathway to wellness. What is perinatal anxiety and depression? Post & Ante Natal Depression Support & Information Inc.

Pathway to wellness.   What is perinatal anxiety and depression? Post & Ante Natal Depression Support & Information Inc. Post & Ante Natal Depression Support & Information Inc. What is perinatal anxiety and depression? Pathway to wellness 9am 4pm Monday to Friday (02) 6288 1936 services@pandsi.org www.pandsi.org Address

More information

TRAUMA-INFORMED CARE. Mary Mueller, LMSW Michigan Department of Health and Human Services

TRAUMA-INFORMED CARE. Mary Mueller, LMSW Michigan Department of Health and Human Services TRAUMA-INFORMED CARE Mary Mueller, LMSW Michigan Department of Health and Human Services Agenda Describe trauma, its impact and prevalence Discuss trauma-informed approaches in family planning services

More information

Depression During and After Pregnancy

Depression During and After Pregnancy Depression During and After Pregnancy Q: What is depression? A: Depression is more than just feeling blue or down in the dumps for a few days. It s a serious illness that involves the brain. With depression,

More information

SCREENING FOR ANXIETY IN BC: IS THE EPDS ENOUGH?

SCREENING FOR ANXIETY IN BC: IS THE EPDS ENOUGH? SCREENING FOR ANXIETY IN BC: IS THE EPDS ENOUGH? NICHOLE FAIRBROTHER, PH.D. R.PSYCH. ASSISTANT PROFESSOR UBC DEPARTMENT OF PSYCHIATRY ISLAND MEDICAL PROGRAM TEAM & FUNDING TEAM FUNDING Nichole Fairbrother

More information

Perinatal Depression: Current Management Issues

Perinatal Depression: Current Management Issues Perinatal Depression: Current Management Issues Cindy-Lee Dennis, PhD Professor in Nursing and Psychiatry, University of Toronto Canada Research Chair in Perinatal Community Health Shirley Brown Chair

More information

Module 2 Understanding the Science of Brain Development

Module 2 Understanding the Science of Brain Development September 2013 Module 2 Understanding the Science of Brain Development Participants will: Module 2 Learning Objectives Understand the impact of the prenatal period on the developing brain including the

More information

Learning objectives: 2/21/18. Children s Research Triangle Wendy Kovacs Cortes, Ph.D., LMFT

Learning objectives: 2/21/18. Children s Research Triangle Wendy Kovacs Cortes, Ph.D., LMFT Wendy Kovacs Cortes, Ph.D., LMFT Learning objectives: Biological and relational components of intergenerational trauma. Epigenetics and ACES. How relational trauma is transmitted intergenerationally. How

More information

Maternal Emotional Wellness Resource Guide

Maternal Emotional Wellness Resource Guide 2017 Maternal Emotional Wellness Resource Guide Page 0 Service Providers 2-1-1 is a collaborative effort and we need your partnership. Your agency is responsible to get your information to 2-1-1 and provide

More information

Pediatric Primary Care Mental Health Specialist Certification Exam. Detailed Content Outline

Pediatric Primary Care Mental Health Specialist Certification Exam. Detailed Content Outline Pediatric Primary Care Mental Health Specialist Certification Exam Detailed Content Outline Description of the Specialty The Pediatric Primary Care Mental Health Specialist (PMHS) builds upon the Advanced

More information

An introduction to providing trauma informed services

An introduction to providing trauma informed services An introduction to providing trauma informed services TIC - for volunteers 1. Why this presentation 2. Trauma, neglect and attachment 3. Working in a trauma informed way as a volunteer 4. Looking after

More information

Center for Child Counseling

Center for Child Counseling Center for Child Counseling Every day in Palm Beach County, babies, toddlers, and children are the victims of abuse and neglect. Their stories would break your heart. At the Center for Child Counseling,

More information

UW MEDICINE PATIENT EDUCATION. Baby Blues and More DRAFT. Knowing About This in Advance Can Help

UW MEDICINE PATIENT EDUCATION. Baby Blues and More DRAFT. Knowing About This in Advance Can Help UW MEDICINE PATIENT EDUCATION Baby Blues and More Recognizing and coping with postpartum mood disorders Some women have baby blues or more serious postpartum mood disorders. It helps to know about these

More information

Like a footprint in wet cement Understanding Adverse Childhood Experience Research. The agenda 1/13/2015

Like a footprint in wet cement Understanding Adverse Childhood Experience Research. The agenda 1/13/2015 Like a footprint in wet cement Understanding Adverse Childhood Experience Research Victor I. Vieth Senior Director & Founder National Child Protection Training System Gundersen Health System The agenda

More information

Outcomes of Infants with Neonatal Abstinence Syndrome

Outcomes of Infants with Neonatal Abstinence Syndrome Outcomes of Infants with Neonatal Abstinence Syndrome Caroline O. Chua, MD, FAAP Medical Director, Division of Neonatology Director, Neonatal Follow Up Clinic Nemours Children s Hospital Orlando, Florida

More information

Women s Mental Health

Women s Mental Health Women s Mental Health Linda S. Mullen, MD Director, Women s Mental Health Assistant Professor of Clinical Psychiatry in OB/GYN Columbia University & NewYork Presbyterian Hospital Departments of Psychiatry

More information

ADVERSE CHILDHOOD EXPERIENCES

ADVERSE CHILDHOOD EXPERIENCES ADVERSE CHILDHOOD EXPERIENCES Steven Kairys MD MPH The ACE Study Adverse Childhood Experiences Lead Authors: Dr.s Vincent Felitti and Robert Anda. Initial publication May 1998 in AJPM Ongoing study examining

More information

SECTION 1. Children and Adolescents with Depressive Disorder: Summary of Findings. from the Literature and Clinical Consultation in Ontario

SECTION 1. Children and Adolescents with Depressive Disorder: Summary of Findings. from the Literature and Clinical Consultation in Ontario SECTION 1 Children and Adolescents with Depressive Disorder: Summary of Findings from the Literature and Clinical Consultation in Ontario Children's Mental Health Ontario Children and Adolescents with

More information

Helen Bader School of Social Welfare

Helen Bader School of Social Welfare Helen Bader School of Social Welfare Improving lives and strengthening communities through research, education and community partnerships Criminal Justice Social Work Childhood Trauma & Effective Trauma

More information

Understanding Adverse Childhood Experiences. Building Self-Healing Communities

Understanding Adverse Childhood Experiences. Building Self-Healing Communities Understanding Adverse Childhood Experiences Building Self-Healing Communities Robert Anda, MD, MS Co-Founder ACE Interface 2013 www.aceinterface.com Building Self-Healing Communities Health Care Child

More information

Emergent Issues Affecting Early Intervention/ Early Childhood. Workforce Development for Inclusion in Early Childhood November 4, 2017 Washington, DC

Emergent Issues Affecting Early Intervention/ Early Childhood. Workforce Development for Inclusion in Early Childhood November 4, 2017 Washington, DC Emergent Issues Affecting Early Intervention/ Early Childhood Workforce Development for Inclusion in Early Childhood November 4, 2017 Washington, DC Conversation Points Changing Demographics Emergent Trends

More information

The Blues Prior, During and After Labor: Es Dificil ser Mujer? The Health Education Action for Latinas (HEAL) Model

The Blues Prior, During and After Labor: Es Dificil ser Mujer? The Health Education Action for Latinas (HEAL) Model The Blues Prior, During and After Labor: Es Dificil ser Mujer? The Health Education Action for Latinas (HEAL) Model Maria Lourdes F. Reyes, MD, MPH Director of California programs, PCI National Healthy

More information

Helping Children Cope After A Disaster

Helping Children Cope After A Disaster Helping Children Cope After A Disaster Penn State Milton S. Hershey Medical Center 2001 This booklet may be reproduced for educational purposes. Penn State Children s Hospital Pediatric Trauma Program

More information

What is a Perinatal mental illness Depression Anxiety Risk Factors What PANDAS does

What is a Perinatal mental illness Depression Anxiety Risk Factors What PANDAS does Mental Health What is a Perinatal mental illness Depression Anxiety Risk Factors What PANDAS does Perinatal Mental Illnesses occur during pregnancy, or after the birth of a child. PANDAS supports those

More information

ACES: Adverse Childhood Experiences

ACES: Adverse Childhood Experiences ACES: Adverse Childhood Experiences Melissa L. Hoffmann, Ph.D UT Division of Child & Adolescent Psychiatry UT Center of Excellence for Children in State Custody University of Tennessee Health Sciences

More information

Primary Care Tool for Assessment of Depression during Pregnancy and Postpartum

Primary Care Tool for Assessment of Depression during Pregnancy and Postpartum HRSA-UIC Assessment of Depression Perinatal during Pregnancy Project: and Postpartum Primary Care Tool for Assessment of Depression during Pregnancy and Postpartum te to health care provider: This tool

More information

The Cornell Peripartum Psychosis Management Tool

The Cornell Peripartum Psychosis Management Tool The Cornell Peripartum Psychosis Management Tool Benjamin Brody, MD Assistant Professor of Clinical Psychiatry Weill Cornell Medical College Chief, Division of Inpatient Psychiatry Weill Cornell Medical

More information

MCPAP Clinical Conversations:

MCPAP Clinical Conversations: MCPAP Clinical Conversations: After the screen: A Practical Approach to Mental Health Assessment in the Pediatric Primary Care Setting Barry Sarvet, MD Professor and Chair of Psychiatry, UMMS-Baystate

More information

TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT:

TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT: TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT: How to Appreciate, Assess and Address Heather C. Forkey, M.D. Foster Children Evaluation Service (FaCES) UMass Children s Medical Center Worcester MA Disclosure

More information

Social Determinants of Child Mental Health

Social Determinants of Child Mental Health Social Determinants of Child Mental Health October 13 th, 2018 Douglas Russell, MD Adolescent and Child Psychiatrist PAL Consultant Seattle Children's Hospital Disclosures No financial disclosures We will

More information

Improving Social Emotional Assessment and Intervention in Early Intervention

Improving Social Emotional Assessment and Intervention in Early Intervention Improving Social Emotional Assessment and Intervention in Early Intervention Evelyn J. Blanck Mary McHugh Presentation to the Early Childhood Advisory Council Council September 26, 2013 Presentation Objectives

More information

Integrative Medicine (Formerly known as CAM)

Integrative Medicine (Formerly known as CAM) Integrative Medicine (Formerly known as CAM) Larry Bergstrom MD Integrative Medicine Division of Consultative Medicine (CMED) bergstrom.larry@mayo.edu Goals and Declarations 1) To define Integrative Medicine

More information

Trauma and Stress- Related Disorders. Adjustment Disorder Post Traumatic Stress Disorder Reactive Attachment Disorder

Trauma and Stress- Related Disorders. Adjustment Disorder Post Traumatic Stress Disorder Reactive Attachment Disorder Trauma and Stress- Related Disorders Adjustment Disorder Post Traumatic Stress Disorder Reactive Attachment Disorder What is psychological trauma? Psychological trauma is an emotional response to a terrible

More information

5/2/2017. By Pamela Pepper PMH, CNS, BC. DSM-5 Growth and Development

5/2/2017. By Pamela Pepper PMH, CNS, BC. DSM-5 Growth and Development By Pamela Pepper PMH, CNS, BC DSM-5 Growth and Development The idea that diagnosis is based on subjective criteria and that those criteria should fall neatly into a set of categories is not sustainable,

More information

Depression: what you should know

Depression: what you should know Depression: what you should know If you think you, or someone you know, might be suffering from depression, read on. What is depression? Depression is an illness characterized by persistent sadness and

More information

Policy Statement January 2009

Policy Statement January 2009 Policy Statement January 2009 Access to Quality Care for Maternal Depression: Meeting the Challenge Maternal depression (also known as perinatal depression) is a significant public health concern affecting

More information

PROMOTING A TRAUMA INFORMED SYSTEM OF CARE: PSYCHOEDUCATIONAL ACTIVITIES FOR SCHOOL-AGED CHILDREN. Megan Plagman, LMSW, MPH & Meghan Graham, LMSW

PROMOTING A TRAUMA INFORMED SYSTEM OF CARE: PSYCHOEDUCATIONAL ACTIVITIES FOR SCHOOL-AGED CHILDREN. Megan Plagman, LMSW, MPH & Meghan Graham, LMSW PROMOTING A TRAUMA INFORMED SYSTEM OF CARE: PSYCHOEDUCATIONAL ACTIVITIES FOR SCHOOL-AGED CHILDREN. Megan Plagman, LMSW, MPH & Meghan Graham, LMSW WHAT IS TRAUMA? Severe neglect, loss, and/or witnessing

More information

Specialist Perinatal Mental Health Service (SPMHS)

Specialist Perinatal Mental Health Service (SPMHS) Specialist Perinatal Mental Health Service (SPMHS) INFORMATION FOR FAMILIES AND CARERS 2 Specialist Perinatal Mental Health Service (SPMHS) WELCOME The Specialist Perinatal Mental Health Service (SPMHS)

More information

Surviving and Thriving: Trauma and Resilience

Surviving and Thriving: Trauma and Resilience Guiding our community s children through life s critical moments with trauma-informed mental health and child development services. Surviving and Thriving: Trauma and Resilience John Richardson-Lauve,

More information

Criminalization of Substance Use Among Pregnant Women in Tribal Communities. March 22, 2018

Criminalization of Substance Use Among Pregnant Women in Tribal Communities. March 22, 2018 Criminalization of Substance Use Among Pregnant Women in Tribal Communities March 22, 2018 Welcome and agenda Welcoming Remarks Expert Presentation Q/A and Discussion Dawn Levinson, Division of Healthy

More information

Adverse Childhood Experiences: How Faith Based & Community Organizations Can Promote Resiliency

Adverse Childhood Experiences: How Faith Based & Community Organizations Can Promote Resiliency Early Adverse Experiences : How Faith Based & Community Organizations Can Promote Resiliency are the pipeline to a multitude of societal problems. Dr. Mimi Graham, Director FSU Center for Prevention &

More information

MCPAP Clinical Conversations: Screening for Developmental and Behavioral Problems in Young Children

MCPAP Clinical Conversations: Screening for Developmental and Behavioral Problems in Young Children MCPAP Clinical Conversations: Screening for Developmental and Behavioral Problems in Young Children Michael Tang, MD Ellen C. Perrin, MD R. Christopher Sheldrick, PhD April 25, 2017 What is screening?

More information

5/12/11. Educational Objectives. Goals

5/12/11. Educational Objectives. Goals Educational Objectives Learn: steps for initial depression screening and management in primary care when to refer to mental health providers tools for providers and patients principles of collaborative

More information

23/06/2015. Absolutely none!!

23/06/2015. Absolutely none!! Absolutely none!! Child and adolescent Mental Health can we help? Dr Tina Nicholson CCFP Family Practitioner and Medical Lead, Cochrane Clinical Lecturer Dept Family Med. U of C. Member of CanReach Faculty

More information

Warning Signs of Mental Illness in Children/Adolescents. Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center

Warning Signs of Mental Illness in Children/Adolescents. Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center Warning Signs of Mental Illness in Children/Adolescents Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center Identify At least 5 warning signs of mental illness in children

More information

TRAUMA INFORMED CARE: THE IMPORTANCE OF THE WORKING ALLIANCE

TRAUMA INFORMED CARE: THE IMPORTANCE OF THE WORKING ALLIANCE TRAUMA INFORMED CARE: THE IMPORTANCE OF THE WORKING ALLIANCE Justin Watts PhD. NCC, CRC Assistant Professor, Rehabilitation Health Services The University of North Texas Objectives Upon completion of this

More information

UW MEDICINE PATIENT EDUCATION. Baby Blues and More. Postpartum mood disorders DRAFT. Emotional Changes After Giving Birth

UW MEDICINE PATIENT EDUCATION. Baby Blues and More. Postpartum mood disorders DRAFT. Emotional Changes After Giving Birth UW MEDICINE PATIENT EDUCATION Baby Blues and More Postpartum mood disorders Some new mothers have baby blues or more serious postpartum mood disorders. This chapter gives ideas for things you can do to

More information

1/26/2018 PREVENTING THE RETRAUMITIZATION OF CHILDREN FROM ADDICTED FAMILIES THE PROBLEM RISK FACTORS FOR ENDANGERMENT

1/26/2018 PREVENTING THE RETRAUMITIZATION OF CHILDREN FROM ADDICTED FAMILIES THE PROBLEM RISK FACTORS FOR ENDANGERMENT PREVENTING THE RETRAUMITIZATION OF CHILDREN FROM ADDICTED FAMILIES Susan Kilman LCSW, AADC THE PROBLEM ABOUT 1 IN 8 (8.7 MILLION) AGED 17 OR YOUNGER LIVE IN HOUSEHOLDS WITH AT LEAST ONE PARENT WHO HAD

More information