SOLUTION: Empower Primary Care Physicians to address mental health concerns in children and adolescents by increasing their knowledge and confidence in diagnosing and treating common behavioral health disorders.

The program’s intent is to provide the necessary training so that primary care physicians can evaluate common mental health disorders, prescribe appropriate treatment if indicated, and monitor patients progress. It is not designed to manage complex and complicated mental health disorders but the milder forms of common pediatric mental health conditions such as ADHD, anxiety, and depression.

The curriculum covers a wide variety of mental health conditions commonly seen in primary care offices. The program consists of a series of virtual learning sessions (in both a traditional didactic format as well as small group vignette sessions) spanning a total of 12 hours. 

Learning Objectives:
Upon completion of this CME activity, participants should be able to:
1) Demonstrate an increased percentage of patients seen in their primary care practice with common behavioral health disorders who otherwise would be referred out to subspecialty (i.e., child and adolescent psychiatry) waitlists.
2) Adopt regular use of diagnostic/screening rating-scales f or common psychiatric disorders.
3) Increase the appropriate use of common psychiatric medications when indicated.

Residents - $250

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*Limited number of slots available. Register today!

Faculty:
The program will be run by James Mackenzie, DO. Dr MacKenzie is a fellowship trained Board Certified (ABPN) Child and Adolescent Psychiatrist practicing in the Chicagoland area for the past 15 years. He has spent the entirety of his career working closely with primary care physicians to create strategies for treating patients collectively. He has served most of his career as the Medical Director of the Pediatric Psychiatry Consultation and Emergency Services at Ann & Robert H Lurie Children’s Hospital of Chicago and more recently as the Director of Pediatric Collaborative
Care at Rush University Medical Center and now Advocate Children’s Hospital. After serving as President of the Illinois Psychiatric Society, he proudly helped pass legislation making Illinois the first State in the US to require both private and public insurance to reimburse primary care physicians for collaborating with psychiatrists--a step forward to improve patient access to care.

Session Learning Objectives:

Introduction to the Collaborative Care Model (CoCM) 
● Provide an overview of the Collaborative Care Model providing an understanding
of the concept, development, purpose, and implementation.

Demystification of Psychiatry
● Discuss how psychiatrists use the American Psychiatric Association’s Diagnostic Statistical Manual (DSM) and highlight the basics of categorical decision making and biopsychosocial factors when considering a psychiatric diagnosis. Describe key differences between DSM-IV-TR and DSM-5 (2013) (i.e., removal of the axes I → I V, removal of disorders such as Pervasive Developmental Disorder (PDD), Asperger’s Disorder. and childhood disintegrative disorder). Review the potentially confusing nomenclature format of psychotropic medications (and why weight-based dosing of medication i s rarely used). Discuss basic transference and countertransference and why simple awareness of these normal emotions and reactions is helpful i n everyday practice.

● Understanding the Role of a Therapist: Review the basic tenets of evidence-based psychotherapies (such as cognitive-behavioral vs supportive vs applied behavioral analysis). Understand the potential benefits and l imitations of talk therapy and the potential range of providers (school-based psychologists, councilors, or therapists) who may also be involved i n the treatment of our patients.

Crisis Management in the Outpatient Setting 
● Discuss the practical approach to safely responding to crises such as agitation and other emotional-behavioral i issues. Discuss utility of flexible thinking (“picking the battles”) and use of desensitization techniques f or kids who become acutely anxious/dysregulated. Brief discussion of the “5-B’s” of acute agitation.

● Emergency safety issues: (situations such as suicidal patients or others presenting with acute risk of harm to self/others → ED environment f or 24 hr. secure environment). Discuss wanting to avoid the well-intended temptation to treat mental health emergencies differently than we might medical emergencies...i.e., grandma would not be routinely expected to drive a child having an asthma attack or seizure to the ER.

Practical Approach of Pediatric Anxiety Disorders 
● Diagnosis: Review the diagnostic criteria and clinical highlights of anxiety disorders (including separation, social, generalized, and panic disorders, as well post-traumatic stress disorder) i including relevant rating scales and other
diagnostic t tools. Discuss the challenging clinical presentation of anxious children still developing the metacognitive skills to describe/understand their symptoms.

● Treatment: Review the evidence-based pharmacologic treatment of pediatric patients suffering from anxiety disorders. Review evidence-based research suggesting choice of medication and the superior benefit of combined medication with t therapy versus either modality alone. Highlight significant differences in choice of medication f or children vs adults experiencing acute and/or severe anxiety.

Practical Approach of Pediatric Mood Disorders
● Diagnosis: Review the diagnostic criteria and clinical highlights of mood disorders (depressive and bipolar disorders) i including relevant rating scales and other diagnostic t tools. Discuss the key differences i n pediatric and adult mood disorders. Discuss suicide screening i instrument (Columbia).

● Treatment: Review the evidence-based pharmacologic treatment of patients suffering from pediatric mood disorders. Review evidence-based research suggesting choice of medication and the superior benefit of combined medication with t therapy versus either modality alone. Discussion of the FDA black-box warning on antidepressants with children, adolescents, and young adults—and examples of how to discuss the warning label with parents/legal guardians and related documentation. Discuss the stepwise levels of traditional psychiatric care
based on increased acuity.

Practical Approach of Early Childhood Disorders
● Diagnosis: Review the diagnostic criteria and clinical highlights of a group of disorders typically diagnosed i n early childhood (attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD)). Brief review on Autism Spectrum Disorder (ASD) and how i t may clinically “masquerade” as ADHD with components of anxiety/irritability. Include applicable rating scales.

● Treatment: Review the evidence-based treatments of the early childhood disorders including stimulant and non-stimulant medication. Briefly review basic target symptom medication management of ASD.

Psychosis, illusions, and imaginary friends
● Review the categorical approach when considering etiology of acute psychosis, starting with organic possibilities (metabolic, endocrine, neurologic, infectious, neoplastic/autoimmune, vascular, pharmacologic) or other emotional causes (PTSD or parasomnias); cultural experiences; differentiating imaginative play from classic psychosis.

Small Group clinical vignette discussions 
Small group 1 Attention Deficit Hyperactivity Disorders (ADHD)
Small group 2 Depressive Disorders & Anxiety Disorders

● Two high-yield small group case-based discussions on the topics of Attention Deficit Hyperactivity Disorders ADHD), Depressive Disorders, and Anxiety Disorders. These vignette-based small group discussions will cover specific treatment strategies on a more detailed level than the general didactic classes.

Accreditation
The Illinois Academy of Family Physicians (IAFP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA PRA Category 1 - The Illinois Academy of Family Physicians designates this live activity for a maximum of 15 AMA PRA Category 1 credit™.

Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.

Questions?  Contact Kate Valentine at [email protected]