MASSACHUSETTS CHILD PSYCHIATRY
ACCESS PROJECT
NEWSLETTER
January/February 2014
In this issue:
Triple P Positive Parenting
Program
MCPAP Helps Start Child
Psychiatry Program in Chile
WBUR Airs Show on Teens and
Stress
On the Move: Regional Sites
Change Addresses
Comings and Goings……….
MCPAP Staff Changes
About Us
About MCPAP
MCPAP Data
Frequently Asked Questions
Contact Us
Services
Services for Primary Care
Clinicians
Toolkits
Toolkits
Diagnoses
Triple P Positive Parenting
Program
MCPAP Trains Behavioral Health
Clinicians to Meet the Need in
Massachusetts
By Elaine Gottlieb
In a 2012 survey, MCPAP-enrolled physicians identified parent
training to address disruptive behavior in young children as a major
unmet need. With support from a U.S. Department of Education
“Race to the Top” grant, MCPAP is responding to this need with
comprehensive training in the Triple P Positive Parenting Program.
Triple P is a popular, evidence-based parenting and family support
system developed in Australia and implemented worldwide. Studies
have shown that Triple P can reduce problem behavior in children
and improve parenting skills.
Triple P training participants will include clinicians working on-site in
pediatric practices and clinicians from most MCPAP regional hubs.
MCPAP-enrolled physicians with integrated clinicians will have
expanded capacity to meet the needs of parents and young children
with disruptive behavior in their offices; practices without integrated
clinicians can refer to the MCPAP hubs for Triple P services (see
below for details). “We want our member physicians to have a
resource that is effective in changing behavior at an early age before
it becomes a bigger issue. When children learn to behave better,
they are more likely to learn and develop and won’t be expelled from
day care or school. Massachusetts has one of the highest rates of
day care expulsion so this training is badly needed,” says John
Straus, MD, MCPAP founding director.
MCPAP Triple P Training Program
The MCPAP Triple P training program begins in March and will take
place over three years. Each year, 20 clinicians will be trained in
Primary Care Triple P Level 3, which addresses mild to moderate
behavioral difficulties in children age 0 to 12, and is delivered either
in the primary care setting or clinician’s office in the community. In
addition, 20 clinicians will be trained each year in Standard Triple P
Level 4, which addresses more severe behavioral difficulties. This
training is geared to behavioral health clinicians who work with day
care centers and early childhood programs.
ADHD
Autism
Bipolar Disorder
Conduct Disorder
Depression
Eating Disorders
Obsessive Compulsive Disorder
Oppositional Defiance Disorder
Post-Traumatic Stress Disorder
Postpartum Depression
Schizophrenia
Substance Use
Team Bios
Tufts Medical Center/Boston
Children’s Hospital
Baystate Medical Center
UMass Medical Center
North Shore Medical Center
Massachusetts General Hospital
McLean-Brockton
Website
www.mcpap.com
All program participants will go through the Triple P accreditation
process eight weeks following training. Throughout the year, the
Triple P-trained mental health clinicians will participate in group
telephone consultations and telephonic peer support. It is anticipated
that the clinicians will treat 25-50 parents of young children with
behavioral issues annually.
About Triple P
The Triple P Positive Parenting Program is a cost-effective, practical
program based on social learning, cognitive behavioral and
developmental theory, and research on risk factors associated with
social and behavioral problems in children. Based on 30 years of
research, Triple P is ranked number one on the United Nations listing
of parenting programs. In the CDC-funded U.S. Triple P Population
Trial, researchers looked at the impact of Triple P training on child
maltreatment in 18 South Carolina counties. The trial reported
reductions in three key child welfare indicators: substantiated child
maltreatment, child out-of-home placements, and child
maltreatment injuries.
(http://www.cdc.gov/violenceprevention/pub/triple_p.html).
Triple P offers five levels of interventions and specialized versions for
dealing with issues such as divorce and for children with special
needs. MCPAP will offer training in Level 3 Primary Care Triple P,
which addresses mild to moderate behavioral difficulties, and Level 4
Standard Triple P, which addresses more severe behavioral
difficulties.
“Triple P emphasizes developing a good relationship with the child,
reinforcing desirable behavior, and encouraging independence and
problem solving as well as managing misbehavior. You need all
these components to have an effective parenting program,” says
Kathryn Hammes, PhD, a child psychologist and Triple P trainer who
will help to conduct the MCPAP training.
Triple P Level 3 aims to “catch mild disruptive behaviors at an early
age. As we know with any problem, the earlier you address it, the
easier it is to treat. Level 3 strategies address common concerns,
such as fighting and aggression,” says Dr. Hammes.
Triple P offers a variety of tools and techniques and is available in
DVDs and print. “It’s not a one-size-fits-all program. Triple P is
designed to adapt to the needs of all types of families, including
families from different cultural backgrounds,” says Dr. Hammes.
For more information on the Triple P Positive Parenting Program, go
to: www.triplep.net.
Providing Triple P Services to Families
Clinicians trained in Primary Care Triple P will offer families three to
four 15- to 30-minute consultations over a four to six week period,
depending on individual needs. During the consultations, clinicians
will work with parents to identify the child’s problems and why they
occur and develop a parenting plan to help prevent the problems and
manage them when they happen. Parents will receive a Triple P
Positive Parenting booklet and Triple P tip sheets that address
behaviors such as tantrums and disobedience.
Clinicians can begin to see parents and children once they have
completed the training in March. For those practices that do not
have on-site behavioral health, MCPAP will provide additional
information on how to refer your families to a MCPAP Hub for Triple P
services, or you can e-mail [email protected].
MCPAP Helps Start Child Psychiatry
Consultation Program in Chile
By Elaine Gottlieb
Just over a year ago, Chile became the first overseas country to
implement a child psychiatry consultation program. Like the U.S.
and other countries worldwide, Chile has a shortage of child and
adolescent psychiatrists – just 180 for a population of 17.4 million –
to treat pressing mental health issues such as the world’s second
highest adolescent suicide rate and a high rate of child
maltreatment.
In December 2012, child psychiatrist Beatriz Ortega started API
(Apoyo Psiquiatria Infantil), a child psychiatry consultation program
modeled on MCPAP, at the child and adolescent outpatient unit at
Salvador Hospital in Valparaiso, Chile’s third largest city. Dr. Ortega
learned about MCPAP from Hector Parada, a native of Chile who was
an MGH child psychiatry fellow and worked with the MCPAP MGH
team.
Dr. Ortega turned to MCPAP for assistance in starting the program.
In September 2012, she traveled to Boston and visited the MGH and
North Shore Medical Center MCPAP team sites and met with MCPAP
Statewide Medical Director Barry Sarvet. “Everyone was very helpful
and I was able to sit in on evaluations and observe how MCPAP
works,” says Dr. Ortega.
“At MCPAP, we are always happy to
share our experience. The MCPAP
model is brilliant in its simplicity and
can easily be adapted to work in
different places,” says Jeffrey Q.
Bostic, MD, EdD, child and adolescent
psychiatrist and Medical Director of
the MCPAP MGH hub.
Dr. Jeff Bostic and Dr. Beatriz Ortega
In the Chilean public health system, primary care centers are staffed
by primary care physicians and psychologists who see both adults
and children. Dr. Ortega and Carolina Garces, a child psychiatry
fellow, provide telephone consultations to physicians, psychologists,
and social workers. They also visit Valparaiso’s seven primary care
centers once a month to discuss patients, conduct onsite
evaluations, and provide training on mental health conditions.
“Primary care physicians feel more confident in treating patients.
Patients no longer have to come to the hospital for a first evaluation
and can often be treated at the primary care center. We get fewer
referrals and patients are more accurately diagnosed,” says Dr.
Ortega.
API has gained the attention of the Chilean child psychiatry
community, including Alicia Espinoza, recent president of SOPNIA
(the Society for Child and Adolescent Psychiatry and Neurology) who
is planning to establish a child psychiatry program in Santiago,
Chile’s capital. SOPNIA invited Dr. Bostic and Dr. Paula Rauch,
director of the MGH Child and Adolescent Psychiatry Consultation
Service, to its annual meeting in October 2013. During his stay, Dr.
Bostic visited Salvador Hospital and observed API and provided
guidance to the staff. “I’ve been inspired by the Chilean child
psychiatrists and their ability to work in a difficult, complex system
and deal with limited resources. We now have 28 U.S. states and
Chile with child psychiatry consultation programs, all learning from
one another and dealing with similar issues,” says Dr. Bostic.
Dr. Espinoza visited Boston again in December 2013 and met with
Dr. Bostic and MCPAP founding director John Straus to discuss her
plans for a child psychiatry consultation program at the child and
adolescent outpatient unit at the Santiago hospital where she works
and supervises. “We are very grateful to Dr. Bostic, Dr. Straus, and
Dr. Rauch for their interest in Chile and for helping us to provide
better mental health services to our children and adolescents,” she
says.
Troubling New Findings: Teens and Stress
On February 13, WBUR’s “On Point” aired a show on teenage stress
– an issue of increasing concern locally in light of the third teen
suicide this school year in Newton.
http://onpoint.wbur.org/2014/02/13/stress-teens-ama-parenting
On the Move: Regional Sites Change Addresses
Southeast:
The MCPAP McLean Southeast hub has moved to:
23 Isaac St.
Middleborough, MA 02346
New Phone #: (774) 419-1184
Central:
Therapists Dannette Mucaria and Deanna Pedro
and Care Coordinator Kelly Chabot
have moved to: UMass Memorial Outpatient offices
328 Shrewsbury St, Worcester.
The prescribers remain at the UMass Memorial Child Outpatient
Department.
MCPAP Comings and Goings….
John Straus, MD, has led MCPAP from its beginning and continues to
oversee the strategic direction of MCPAP as its founding director. We
are also grateful to Dr. Barry Sarvet for his ongoing leadership as
Medical Director for MCPAP. With the regional hubs now running at
full capacity and new programs on the horizon we are pleased to
have hired two additional staff members:
Marcy Ravech, MSW, arrived in early December as the first full-time
Director of MCPAP. This new position was created to focus on
MCPAP’s utilization, growth, and sustainability. Marcy’s professional
career includes working in community-based behavioral health and
federally qualified community health centers. She also worked as
Associate Director of Policy and Research focusing on children’s
behavioral health at the Blue Cross Blue Shield of Massachusetts
Foundation.
Afeisha Henry stepped into the new role of MCPAP Administrative
Assistant in mid-January. In addition to working with MCPAP,
Afeisha is pursuing her BA at Cambridge College majoring in
psychology and focusing on juvenile justice.
Irene Tanzman has left MCPAP, and we thank her for her significant
contributions to the development and continued success of the
program. Although she started as a data analyst, Irene took on
much more during her tenure here, from the newsletter to the
website to coordinating meetings, site visits, and supporting the
excellent work of our six regional hubs. We will miss Irene and are
grateful for all she has done for MCPAP.
©MBHP February 2014