SCCAP/Miami International Child & Adolescent Mental Health (MICAMH) Conference/2020/Day 1

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Day 1[edit | edit source]

Keynotes[edit | edit source]

Promoting Resilience in the Context of Global Adversity: Refugee and Immigrant Youth, Families, and Communities[edit | edit source]

Presenter: Maryam Kia-Keating, Ph.D., Associate Professor of Clinical Psychology, University of California, Santa Barbara

Learning Objectives:[edit | edit source]

A Global Crisis of Mass Displacement
  • Increased hate and anti-immigrant sentiment today
    • Est. 2018 we are experiencing the highest levels of displacement on record globally (about 1 person every 2 secs)
    • Also displacement can be due to disaster (i.e., cyclones, forest fires, hurricanes, droughts etc...)
      • Highest numbers in China, Philippines, US, Cuba, and India
  • In 27 countries, children can be left stateless and denied several rights
    • Children make up half of the refugees worldwide
  • Phases of Migration:
    • Pre: Violence, persecution, loss, and separation
    • Migration: can be long duration- instability and unsafe living conditions esp. For children
    • Post: Not a final destination
  • Resignation Syndrome in Children
    • First diagnosed in Sweden - exists only among refugees – characterized by the loss of the will to live
  • Outcomes
    • Depression, anxiety, sleep disturbances, PTSD
      • Prevalent amongst unaccompanied minors and dependent on migration environment
      • Immigrant Paradox:
        • Foreign-born Latinx are healthier and less likely to suffer from chronic disease and/or premature death
      • High levels of resilience amongst refugees families facing trauma and adversity (related to family cohesion, belonging, autonomy)
      • Interventions: PTSD are individually based- not fully effective; school based is mixed- does not always reduce PTSD symptoms but does reduce other symptoms like depression; and family engagement in school-based interventions is promising in reducing maternal depression and increase family solving skills  
      • Propose an Empathic Centered Design
        • Shift from expert-outsider perspective to solution partner practice
        • Deficit → Strength
        • Risk → Promise
        • Vulnerable → Empowered
        • Recipient → Partner
      • Focus on 5 Ss
        • Stigma
        • Somatization
        • Strengths
        • Social Needs
        • Settings


After Trauma: Understanding the Needs of Children[edit | edit source]

Presenter: Robin Gurwitch, Ph.D., Professor in Psychiatry and Behavioral Sciences, Duke University

Notes:[edit | edit source]

Understanding and Responding to the Needs of Children after Traumatic Events
  • Early Ideas about Trauma and Children
    • Symptoms were mild, transient, and no intervention required until the 1980s school shooting in California
      • First time they spoke to children re: their experiences
  • One in four children will experience at least one traumatic event before the age of 16
  • 80% of abused children will face at least one mental health challenge before age 21
  • Adverse Child Experiences
    • >4 ACEs appears to be tipping point for increased risks in life
    • ¼ of children experience mental health problems but over half go untreated
    • Trauma impacts learning: impacts kindergartners the most (expulsion and suspension)  
    • Increased worries/fears - guilt/shame - changes in behavior (i.e., ADHD symptoms, bullying, withdrawal) - physiological responses (i.e., sensitivity to sounds and somatic complaints)  
  • Majority of children are resilient after traumatic events BUT, still need support, create a positive environment, and increase positive coping skills for the future
  • Protective Factors
    • Positive family, teacher, and peer relationships, willingness to ask for help, having pets, good social skills and self-esteem etc…
  • Interventions for Children who have Experienced Trauma
    • TF- CBT: Trauma-focused cognitive behavioral therapy
    • PCIT: Parent Child Interaction Therapy
    • CBT: Cognitive Behavioral Therapy in Schools  
    • CARE: Child-Adult Relationship Enhancement: skills for engaging children with trauma exposure
      • PTSD symptoms need to present for at least a month for effective intervention


Improving Services for Kids and Families Through Implementation Science: Working on the Irrigation System[edit | edit source]

Presenter: Michael Southam-Gerow, Ph.D., Professor and Chair, Clinical Psychology, Virginia Commonwealth University

Notes:[edit | edit source]

New Sources of Stress for Children
  • New Sources of Stress for Children
    • Increased competition for schools
    • Easy accessibility to information
    • Prevalence of social pressures
    • Stressful national and global situation
  • Up to 80% of children and/or adolescents that need services do not receive them
    • Racial, income, and geographic barriers greatly impact this
    • Severe shortage of psychiatrists and other health professionals in vast majority of the US, including Florida


Future Directions, Outcomes & Workforce
  • Future Directions
    • Use evidence-based treatment design and service system and workforce development
    • Treatment design:
      • Managing and Adapting Practice (MAP)
      • Similarities and differences to modular and transdiagnostic approach
      • Multiple Evidence Bases
      • Think about individual cases and progress using local knowledge
    • Outcomes
      • MAP showed decreases in symptoms from pre to post (ie. anxiety, depression, PTSD)
    • Service system:
      • Medicaid and state funding will pay more for evidence base services depending on the state
      • R-MAP will match clients to relevant evidence base services based on age , gender, problem, race/ethnicity but it does not capture every case
      • Conclusions:
        • Standard Evidence-Based Treatments (EBT) alone may not be sufficient to create high-performance systems (about ⅓ don’t benefit)
      • Hybrid models help:
        • EBT
        • PLUS approaches
        • Know what is readily available
    • Workforce:
      • Multiple approaches are needed
      • 3 Rs: Routes, Regulations (i.e., receiving mental health or healthcare training in military), Rates (increase salaries for providers)
      • Pipeline: Grad Training (Masters Social Work- MSW)
        • MAP class v. standard curriculum
        • Increase of strategies from Pre-Study to Post-Study in MAP group  


Workshops[edit | edit source]

Addressing Psychological Well-being Among Refugee and Immigrant Youth and Families[edit | edit source]

Presenter: Maryam Kia-Keating, Ph.D., Associate Professor of Clinical Psychology, University of California, Santa Barbara

Child-Adult Relationship Enhancement (CARE): Strengthening relationships with children/teens who have experienced trauma[edit | edit source]

Presenter: Robin Gurwitch, Ph.D., Professor in Psychiatry and Behavioral Sciences, Duke University

Clinical Strategies for Developing Socioemotional Competence in Youth[edit | edit source]

Presenter: Michael Southam-Gerow, Ph.D., Professor and Chair, Clinical Psychology, Virginia Commonwealth University

Learning Objectives:[edit | edit source]

Emotional Competence
  • Emotional Competence
    • Awareness and labeling
      • Emotion vocabulary
      • Clear emotional displays
      • Interventions involve intensity ratings + identification of emotions
    • Understanding
      • Causes and consequences of emotion experiences
        • Involves recursive thinking and social cognition
    • Multiple emotions
      • Opposite feelings can occur at the same time
    • Emotion regulation: regulator and regulated
      • You cannot control emotions but can gain awareness and do something about it
      • Development from less conscious to planful
      • Emotions usually point towards what’s important to us
      • Interventions involve cognitive component (specifically on anger, worry sadness, and fear)
        • Focus is on changing at least some of the thoughts
        • Expression: advanced
          • Expression of feelings makes it easier to deal with them (e.g., through expressive writing)
    • Emotion socialization


Culture and Emotion
  • Culture and Emotion
    • Individualistic
      • Less likely to suppress emotions
    • Collectivism
      • Increased likelihood of suppressed emotions
    • Emotion regulation is not universal
  • Active engagement (i.e., problem solving, reframing) can help with coping strategies for those undergoing chronic stress
  • Those in poverty, need an individualistic/unique treatment plan


Conclusion
  • Conclusion:
    • Emotion is central to human experience
    • Help children/adolescents develop emotional competence
      • Can be promoted via context of family therapy


Tech Parenting: How to Support Parents in Managing Children’s Screen Time[edit | edit source]

Presenter: Justin Parent Ph.D., Assistant Professor, Florida International University

Conducting Semi-Structured Assessment of Suicide Risk in Youth in Clinical Settings: Balancing Standardization with Clinical Utility[edit | edit source]

Presenter: Ashley M. Shaw, Ph.D., Clinic Director, Licensed Clinical Psychologist, & Postdoctoral Associate, Mental Health Interventions and Technology (MINT) Anxiety Program, Florida International University

Other 2020 Days[edit | edit source]

References[edit | edit source]