for those who attended the BACCH workshop
full article will appear shortly.
for those who attended the BACCH workshop
full article will appear shortly.
Registration opened today for our winter meeting.
Please go to registration page to register!
We heartily recommend this forthcoming ADHD and Allied Neurodevelopmental Services Symposium conference, organised by the ADHD Foundation. The conference will take place over two days in Liverpool on the 5th– 6th November 2015.
The presentations on the 5th November would be of interest to anyone working in a clinical capacity with adults/ young people with ADHD. The conference on the 6th November is more focused upon how we achieve outstanding educational outcomes for children and young people with ADHD.
Highlights of the conference on the 5th November include:
Highlights of the conference on the 6th November include:
See below for more information on this conference, details of the speakers, booking arrangements and information about our conference dinner on the evening of the 5th November with Rory Bremner as the after dinner speaker. If you require any more information, please contact ella.duxbury-davies
Date: 7th January 2016
Venue: Conference Room, Children’s Neurosciences Centre, St Thomas’ Hospital, First Floor, Block D, South Wing, Westminster Bridge Road, London SE1 7EH. Tel: 020 7188 7188
This training day is designed to provide information and practical advice on various diagnostic and management issues related to mental health of patients and/or their family across acute and community paediatrics. We have focussed topics around those “most wanted” by Paediatric Trainees in a recent UK-wide survey.
Programme:10:00 Registration and coffee
10:15 Medically unexplained symptoms
Dr Lee Hudson, Consultant Paediatrician, Great Ormond Street Hospital & Honorary Research Associate, Institute of Child Health
11:15 Self harm and emergency assessment
Dr Esther Sabel, Consultant Child and Adolescent Psychiatrist, Hertfordshire CAMHS
13:00 Eating disorders – what do Paediatricians need to know and do?
Dr Nasima Matine, Consultant Child and Adolescent Psychiatrist, The Phoenix Centre, Cambridge
13:45 Behavioural and emotional difficulties – workshop
Dr Nicola Herberholz, Consultant Paediatrician/Paediatric Mental Health and Dr Bo Fischer Specialist Registrar in Paediatrics/Paediatric Mental Health
15:00 Paediatric liaison
Dr Rory Conn, Specialty trainee Child and Adolescent Mental Health and Darzi Fellow in Quality Improvement and Patient Safety, Great Ormond Street Hospital
15: 45 Overview of psychological therapies and their indications
Dr Sophie Bennett, Research Associate, UCL Institute of Child Health & Honorary Clinical Psychologist, Great Ormond Street Hospital
16:30 Close and certificates
All for £50! Bargain!!
Download application below!
Contact : Bo Fischer email@example.com
Nicola Herberholz firstname.lastname@example.org
This important study adds to or understanding of the importance of family nurture(thanks to Sebastian Kraemer for the link)
This isn’t just touchy feely stuff- it actually improves core outcomes for neonatal care.
Research autism, the charity who do so much to encourage a scientific approach to ASD, are doing a conference in November which looks superb.
Good news: our brilliant colleague Jacqui Stedmon has provided all her slides and references from her brilliant somatisation workshop that she did in May
Bad (ish) news: I’ve put it in the member’s area
Feeling on the edge-, a leaflet by the Royal College of Psychiatrists, is a great leaflet to have available in Emergency departments.
Paediatrics has taken baby steps towards embracing mental health as an integral part of practice. One area where there has been progress is the incorporation of mental health into curricula. This is great, but the problem is that no-one had thought through how to achieve these time-consuming skills in the maelstrom of training.
We held a workshop last week to examine this question at the BACCH national trainee day. We had a highly engaged group who came up with a ton of suggestions. Here’s a summary with some pointers.
We put aside the curriculum document, which is a little vague in its wording, and instead talked about what would useful in practice:
1) mental state examination- how to do it, and interpret it.
Advice: this is an area where a quite common sense exercise has been made unnecessarily mysterious. The idea is simply to record the appearance, manner and pattern of communication employed by the person in front of you. In this sense, great novelists are masters of the mental state exam. There are few great novelists working in paediatrics, though, so an acronym helps you to remember some of the important aspects.
A- Appearance and Behaviour
E- Emotion [mood and affect]
P- Perception [Hallucination and illusion]
T- Thought content and process
I- Insight and Judgement
C- Cognition (how information is processed)
2) tools to assess mood problems
Low mood and especially, anxiety are extremely common in community paediatric clinic, and can generally be elicited by features of the standard history and a few selected questions, as below.
Anxiety: history of avoidant behaviors, agitation in certain situations and specifically voiced fears
Always ask: is she a worrier?
Low mood: history of loss of previous interests, lack of enthusiasm, withdrawal e.g. into computer games
Always ask: do you ever feel like you’re worthless?
There are now two questions: how do I decide which children require specialist assessment, and what do I do with those that don’t, or those that are awaiting CAMHS input?
The first question I’d probably best answered by pointing to some useful, freely available questionnaires that can be given to families to fill out. RCADS covered anxiety and depression, as does the mood and feelings questionnaire.
Managing mental health difficulties before or instead of CAMHS assessment is difficult. We have written the 5 minute tips series to help you, but essentially you need to work with the family to produce a story about why the symptoms are happening, and use that story to tease out areas of resilience and protective factors, which you can then use to improve the situation. You will also need to incorporate some standard advice, as lain out here for anxiety, and here for depression.
3) Involving local CAMHS in your training
It’s important to remember that CAMHS teams are small, and beleaguered. Also, there are increasing pressures on community paediatric teams to increase productivity. Training in mental health, across different teams/ trusts, is obviously harder to attain.
On the other hand, there are some essential experiences that ought to be possible:
Attend a CAMHS referral meeting, and learn how many referrals they get, and how many other options there are for emotional and behavioural problems other than CAMHS.
Observe a few CAMHS assessments, just to see how the approach differs from community paeds
Discuss some of your cases with a psychiatrist, not in order that they take them on, but to see another perspective.
Joint clinics can be great: my personal experience is that this works best with non-doctors who work in CAMHS- they value your medical experience while you will learn from their approach and skills. If they want you to see for a clinical reason (possible ASD, genetics) you can also ching it as a referral to your own service, so your bosses will be happy (and it’s a good model of care).
4) accessing e-learning
There is a ton of e-learning relevant to the mental health aspects of community at Mind Ed. The core curriculum is a useful introduction, the specialist CAMHS section pushes you on, and for the overlap between mental health and community, there are some Healthy Child Programme sessions that can be accessed via Mind Ed.
Finally, there is even a paediatric learning path if you log in!
5) supporting parents to deal with behavioral problems
6) a new study day
We want to do a study day on mental health for community paeds trainees. Current ideas for content include
Role of OT
Explanation of psychotherapy for children
How to give behavioural advice
Let me know what you think