EBD Blog

Here’s a description of a highly touted intervention.

[Method X] is recognized worldwide as a general method to reinforce the body’s protective abilities for people of all ages who suffer from various disorders and pre-illness conditions, i.e. practically healthy people.

[Method X] involves the organized interaction between [therapy agent] and person, with optimal conditions to offer benefits to the person as well as the [therapy agent].

[Method X] can assist in the following tasks:

- Correction of psychological development for people with nervous system disorders
- Development of cognitive activity for people with psycho-neurological disorders
- Development of children’s speech
- Removal of chronic pain
- Reduction of neurological and vegetative-vascular reactions
- Relief from psychosomatic conditions
- Reduction of unintentional movements, tics and spasms
- Rehabilitation of people, victims of violence or other stressful situations
- Psycho-emotional training for specialists whose work is connected with extremely stressful situations
- Leisure and relaxation for healthy people–children and adults

The main component of [Method X] is the psychological effect from the interaction between [the client] and [the therapy assistant] in an unaccustomed environment and the physical therapy effect from [Y and Z] made by these [therapists].

Would you want to use this therapy for yourself or your child?

I would! But, that’s because I know what the therapy is.

According to Liz Ditz of I Speak of Dreams, Stephen Hinshaw gave the closing keynote speech at the Learning and the Brain conference in San Fransisco (CA , US). Professor Hinshaw, who chairs the Department of Psychology at the University of California—Berkeley and is an eminent psychologist with a list of accolades as long as my arm, spoke about his current book on the stigma associated with mental illness. Liz’s report starts as follows:

The closing keynote speech at the San Francisco Learning and the Brain conference was by Stephen P. Hinshaw on The Mark of Shame: Attitudes Toward Mental Illness (With Emphasis on Children). I thought it was excellent. You should read his memoir of his father’s life-long struggle with mental illness, The Years of Silence are Past: My Father’s Life with Bipolar Disorder. An interview is here; the Amazon link is here.

Continue reading ‘Hinshaw about mental illness’

The paper mail included a copy of Focal Point, the periodical from the Research and Training Center (RTC) on Family Support and Children’s Mental Health at Portland (OR, US) State University. As usual, it includes many worthwhile articles. It reminded me that I should reminder readers of EBD Blog about the RTC.

Continue reading ‘PDX RTC’

“Are we too quick to medicate children?” Melissa Healy asks this question in the headline of an article in the Los Angeles Times. She also weaves the related question—”Are we able to discriminate between normal and atypical behavior?”—into her article.

These are generally sensible questions. They reflect issues of real concern in the scientific community. But, when the headline asks whether we presrcibe medications too quickly, one can guess the answer pretty readily. Unless I’m way off base, would many readers expect the answer to be “no?”

Indeed, the article is nearly chockfull of critical concern about diagnoses, labeling, and treatment. Ms. Healy cites research results (without revealing some of the sources) and quotes at least a half dozen experts. Some of these experts would probably be consider advocates by some of the other experts.

As is de rigeur in contemporary journalism, Ms. Healy leads (and closes) with a case example. She tells the story of a 38-year-old mother who takes her 11-year-old daughter to a psychiatrist, because the girl’s “behavior and performance in school were exemplary, but an ill-tempered outburst had gotten the preteen kicked out of a Girl Scout troop she had joined at age 5. The girl was confused and heartbroken over her ejection.”

Katie’s maternal instincts tell her she must protect her child. But from what, she asks — a disease that threatens health, happiness and future? A bogus label applied to an admittedly challenging kid? Or drugs with potentially harmful and little-studied side effects?

And protect her exactly how — by resisting or by medicating?

In general, this is not a dispassionate examination of the question under which Ms. Healy’s article appears. I say this not because I disagree with her slant, but because the treatment is sensational and poorly informed. Had she gone more deeply into the topic, she would have learned about effective behavioral treatments that provide viable alternatives to medicaiton for many child behavior problems. Instead, she stuck with the hidden-mysteries view of Emotional and Behavioral Disorders of children.

Link to Ms. Healy’s article.

Altough I’ve only recently skimmed it, Erica Westly has a blog that appears to have some relevant content. Readers might wish to take a peek at Adolescent Psych. I saw content on many topics that overlap with those we cover here at EBD Blog.

Under the headline “Schools hope mental health screenings will help end stigma,” Heather Parker reported that Carlsbad (NM, US) High School will conduct screenings for mental illness among students. The school will use grant funds to help identify students who might be at risk for depression, suicide, or other problems and, therefore, in need of further evaluation.

With parent permission, 475 ninth grade students will be screened for signs of depression and suicidal tendencies.

“This effort is part of the Garrett Lee Smith Memorial Suicide Prevention Grant the school district received,” said Janey Lynn, wellness and prevention coordinator at CHS.

I have to guess this effort will raise some of the same concerns as educators have see with Teen Screen (see here for an EBD Blog post and related comments).

Link to Ms. Parker’s article.

Is the frequency of bi-polar disorder increasing among youth and young adults? In an article circulated by Reuters International, the answer appears to be “yes,” among younger individuals the chances of coming away from an office visit with the diagnosis of bi-polar disorder increased dramatically in the decade from 1994 to 2003.

Dr. Mark Olfson, from Columbia University, New York and New York State Psychiatric Institute, and colleagues compared increases between 1994-1995 and 2002-2003 in office visits that culminated in a diagnosis of bipolar disorder among individuals aged 19 and younger to that among adults aged 30 and older.

They found that outpatient visits with a diagnosis of bipolar disorder in the younger age group increased approximately 40-fold, from 25 per 100,000 in 1994-1995 to 1,003 per 100,000 population in 2002-2003. During the same time, the diagnosis of bipolar disorder in adults increased nearly 2-fold, from 905 to 1,679 per 100,000.

This finding, coupled with others about the incidence of bi-polar disorder, will spur questions about diagnostic criteria and ascertainment bias in assessment. Just as the question about “true” and “identified” incidence of Autism have been raised, there will be similar questions about bi-polar disorder.

The Reuters report is based on a study in the Archives of General Psychiatry, but the Web site for the journal does not yet show the September table of contents. However, one can get the Reuters story from many sites (e.g., Yahoo! news).

The annual meeting of Teacher Educators for Children with Behavioral Disorders (TECBD), now named after Rob Rutherford who founded it, will be held 15-17 November 2007 in Tempe (AZ, US). Steve Forness, Cheryl George, and John Maag are among the people who’ll be speaking this year.

Every year, EBDBlog has announced the call for papers, so this is nothing new. There is still time to propose a presentation for this year’s meeting. Potential presenters may submit proposals for sessions using the TECBD site.

Link to the Web site for TECBD. Link for proposing presentations.

NARSAD: The Mental Health Research Association announced its grants for 2007, including 23 Distinguished Investigators and 222 Young Investigators. The awards represent more than $15 million in grants, and many of them are relevant to Emotional and Behavioral Disorders among children and youths.
Continue reading ‘NARSAD 2007′

If one surfs about looking for sites providing comments about pediatricians and about ADHD, Autism, and other childhood disorders, it’s easy to find dozens (scores? hundreds?) of recommendations for vitamins, herbs, exercises, chiropracty, martial arts, and such. It’s a lot harder to identify sources of sensible, scientific information. Here are a few. Please feel free to contribute others by commenting.
Continue reading ‘Some pediatricians’

For students with Emotional and Behavioral Disorders who make the transition to post-secondary education and for their families, the challenges are substantial, according to a story entitled “Off to College on Their Own, Shadowed by Mental Illness” by Lynette Clemetson of the New York Times. Ms. Clemetson uses two separate cases to illustrate her observations.

Her mother called it a negotiable proposition. But to Jean Lynch-Thomason, a 17-year-old with bipolar disorder who started college this fall, her mom’s notion to fly from their home in Nashville to her campus in Olympia, Wash., every few weeks to monitor Jean’s illness felt needlessly intrusive.

“I am so totally aware of the control you have over me right now,” Jean said, sitting in her parents’ living room one evening last June, before coolly reminding her mother of her upcoming 18th birthday. “In a few months the power dynamic is going to be different.”

For Chris Ference, 19, who is also bipolar, the fast-approaching autonomy of his freshman year held somewhat less appeal. His parents had always directed every aspect of his mental health care. Last summer, over Friday night pizza at his home in Cranberry Township, Pa., he told them that assuming control felt more daunting than liberating.

“If it was up to me, I would just have it so you could make those decisions for me up until I was like, 22,” he said. “I mean, you’ve raised me well up to now. You know me better than anyone.”

This is an important topic, so I’m glad that Ms. Clemetson brought it to the fore. Follow this link (free subscription required) to read Ms. Clemetson’s story. Fortunately, there are resources on which college students with EBD can depend; learn more about some of them at these sites:

• Active Minds on Campus is a national (US) organization that Ms. Clemetson mentioned; Active Minds encourages student-managed groups on college and university campuses to promote awareness of mental health issues, advocate for mental health and mental illness resources, encourage fellow students to seek help when it is needed, and establish relationships with the mental health community. (I’m glad to note that there’s a chapter at U.Va., the institution where I am employed.)
• The American Psychological Association provides a special section of its outreach Web site devoted to college mental health.
• APA’s college mental health section.
• Cope.Care.Deal, which is funded by the Annenberg Foundation Trust a Sunnylands, provides resources for adolescents.
• Colleges and universities that receive US federal funds are required to provide services for individuals with disabilities, and this requirement goes beyond ensuring that campuses have wheelchair-accessible facilities; search for “disability” at any school’s Web site.

Technorati tags: mental health, bi-polar, depression

10 December 2006 Update: On Psych Central, John Grohol covered this story, too. Here’s a link to his entry.

Children receive diverse psychiatric diagnoses of Emotional and Behavioral Disorders that leave parents and the children bewildered, according to a story entitled “What’s Wrong With a Child? Psychiatrists Often Disagree” by Benedict Carey, in the New York (NY, US) Times. Mr. Carey recounts multiple examples of children who have been characterized as having bipolar disorder, attention deficit disorder, oppositional-defiant disorder, pervasive developmental disorder, depression and anxiety.

At a time when increasing numbers of children are being treated for psychiatric problems, naming those problems remains more an art than a science. Doctors often disagree about what is wrong.

A child’s problems are now routinely given two or more diagnoses at the same time, like attention deficit and bipolar disorders. And parents of disruptive children in particular — those who once might have been called delinquents, or simply “problem children” — say they hear an alphabet soup of labels that seem to change as often as a child’s shoe size.

In my opinion, this is a pretty predictable consequence of approaching these problems as something that should be handled by medical practices, when many of them would be better managed by environmental manipulations. We need to identify the specific needs of the children and design methods for teaching them how to do things. If the problem is “argues with adults,” we should analyze the conditions under which the behavior occurs—the antecedents and the consequences of arguing—and either modify those events or teach the child a self-management strategy (or both). If the problem is fidgeting (is that really a problem?), we need to determine what fidgeting does for the child and address that function; I suspect that most children can learn non-fidgets activities and, when we make them more rewarding than fidgeting, the salience of the problem will be reduced greatly.

What happens too often, in my view, is that we go through a checklist of “symptoms” looking for a secret, hidden pattern that represents an underlying disorder. We’re still trying to do Freud here. What we actually get, of course, is a cluster problems. Evidence may show that these problems do, in fact, cluster together, but such clustering doesn’t necessarily indicate that they reflect an underlying organic base for the individual problems.

I also recognize that providers of mental health care for children must use a diagnostic system so that costs of providing services can be charged to insurance companies. Just because someone has to pay for therapy doesn’t mean that therapy has to be medications nor that we should ignore simple and practical means of addressing problems.

Link to Mr. Carey’s article (free subscription may be required).