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Child & Youth Mental Health Algorithm - GPSC

Child & Youth Mental Health Algorithm - GPSC

Child

Child and Youth Mental HealthPSP Modulerationale for using medicine. Answer any and all questions about fears orconcerns.Talk to the child in developmentally appropriate language about sideeffects, such as upset stomach or constipation, and encourage them totalk to their caregiver should they experience any difficulties. Encouragecaregivers to have a regular dialogue regarding side effects with theirchildren, especially when beginning a new medication.Encourage parents to bring you information that is anti‐medicine to bediscussed with you so that misinformation or disinformation can becorrected.Remember to discuss the issue of addiction. Bring it up yourself if thecaretaker or child does not do so.Medications for ADHD are: Among the most effective treatment in all medicine Usually helpful to most children with ADHD Usually able to be used without significant side effectsMedications for ADHD are not: Addictive Destructive of the child’s personality A crutchBeRealisticBeResponsiveDiscuss with parents reasonable parenting expectations and the needs forongoing support.Discuss expectations and potential obstacles in the treatment course.ADHD symptoms have the best chance of improving when child and familyare both aware of ADHD and there is agreement with the treatment plan.The goal with treatment of ADHD is to achieve remission (i.e., reducesymptoms and improve functioning).Be available for urgent matters within office hours (this depends onindividual practitioners’ preference and can include phone, email or textmessaging).Schedule frequent, brief face‐to‐face visits at times that do not conflictwith school (15‐20 minutes).Monitor and support child’s wellness activities (exercise, sleep, healthydiet, etc.).Resources - Psychotherapeutic Support for Children Caregivers (PSC)_2011_07_04 4 of 4

Psychotherapeutic Support for Teens (PST)Practical Pointers for Primary Care Health Providers Treating AdolescentDepression – Supportive RapportThis tool provides clinicians with guidelines/suggestions that they can use to direct their clinical interactions with the teen.Checklist Type of Support Guidelines/Suggestions Approach • Be friendly but not a friend• Create a supportive space• Establish confidentiality and limits of confidentiality (self-harm, danger toothers, etc) and be very CLEAR about these Be Present-Focused • Help identify the most important problems occurring now Be Problem-Oriented • Help develop and apply practical solutions to ongoing problems Provide Education • Provide education about depression and education about the treatment(complete KADS, TeFA) Be Responsive • Be available for urgent matters by phone, email or text messaging withinoffice hours.• Schedule frequent brief face to face visits at times that do not conflictwith school (15-20 minutes)• Monitor and support teen wellness activities (exercise, sleep, healthydiet, etc.)• Ensure access to professional care during the off hours for emergenciesFurther guidelines to create a supportive environmentRemember to embed these guidelines/suggestions within a supportive, active listening environment. Thisincludes the following: Compassionate and non-judgmental attitude, but be real Active listening: eye contact, verbal (“ah hum”, “go on”), and non-verbal (head nod) clues tolistening engagement Clarification (“help me understand”, “could you explain what you were thinking about that”, etc.) Emotional identification (“seems as if you are feeling frustrated”, etc.) Do not understand the young person too quickly – you are likely to be wrong If you do not know what they are talking about – ask If you do not know an answer to a question – admit it and tell them how you will find out.Remember that parental or c aretaker involvement is often necessary during the assessment and treatment ofdepression in an adolescent. W henever possible information about the young person’s emotional state andfunction should be obtained from the parent or caretaker. It is not uncommon for teens and parents/caretakers tohave different opinions about the me ntal state a nd activities of th e young person. When this occurs, jointdiscussion of the issue will be nec essary for clarification and o ptimal intervention planning. However, it isessential to ensure that appropriate confidentiality is being maintained during this process.Confidentiality is important but it has its limits. Abuse, suici de intent, harm of others ne ed to be identified asissues that can not be kept confidential. Drug use must be discussed with the youth and an ap propriatedecision pertaining to the degree of drug involvement must be clarified in terms of at what point does drug usebecome drug misuse/ abuse that requires informing others.© Stan Kutcher 2008

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