Inside Pediatrics Spring 2015

Care for Children in Alabama

Inpatient care The unit is under the direction of

Outpatient care Children’s Behavioral Health (CBH), the outpatient component of The Ireland Center, sees patients at The Ireland Center and also in offices in Homewood, a suburb of Birmingham. “We know the likelihood of recidivism after inpatient treatment increases when children and their families do not receive the follow- up therapy they need in an outpatient setting,” said Stacy White, MBA, MSHA, program administrator for outpatient and psychiatry physician services. “We want to reach children and families to arm them with the coping skills they need to succeed. We’re striving to be a center of excellence so our patients benefit from the continuum of care, from hospitalization to outpatient treatment to advocacy and education in their homes, schools and communities.” Like the inpatient service, CBH employs a multidisciplinary team approach in caring for children and adolescents with psychiatric and behavioral health problems. Diagnoses include ADD, ADHD, anxiety, mood disorder, depressive disorder, bipolar disorder, conduct disorder, schizophrenia, Asperger’s syndrome, autism and others described in the Diagnostic and Statistical Manual of Mental Disorders. Services provided include individual therapy, medication management, support groups and behavioral therapy. CBH also provides recommendations to schools, communicating with educators to advocate on behalf of the patient. “We are here to offer hope and partnership to parents so our patients can grow to become happy, healthy and confident individuals,” said Laura Barefield, M.D., who serves as medical director for outpatient services. “Each child and family has treatment needs that must be tailored to him or her. We value innovative approaches to treatment, but understand that there are no shortcuts to

a good assessment and individualized treatment plans. Evidence shows that treatment combining therapy and medication administration is superior to medication alone. We focus on providing our patients and families with tools to navigate life’s storms and to maximize their opportunities for success.” Unfortunately, the demand for outpatient services also exceeds supply. “Our outpatient wait time for a new appointment can be anywhere from four to six months,” White said. To fill the void, The Ireland Center offers a new evidence-based program called Parent- Child Interaction Therapy. “It’s a 20-week program through which parents are coached in appropriate parenting skills and behaviors management,” White explained. “The parent interacts with the child while a psychologist behind an observation window transmits suggestions for behavior management through an earpiece.” According to White, very few of the patients seen under the umbrella of The Ireland Center have true psychiatric diagnoses. For most, the problems are behavioral in nature. “To make an impact, we must provide services that support the entire family. Our goals are pretty straightforward,” she said. “We will continue to recruit psychiatrists and psychologists, and to work for grant funding to provide mental health services. Our goal is to decrease recidivism by working to help not just our patients — but our families.” More information is available at www.childrensal.org/the-ireland-center- inpatient-and-outpatient-psychotherapy .

attending psychiatrists who are also the leaders of a multidisciplinary team that includes primary therapists, licensed clinical social workers, registered nurses, behavioral interventionists, psychiatric clinical assistants and occupational therapists. Clinical psychologists are available for consultation and testing. Each child has an individualized plan of care that, according to Brown, guides her staff each day. Census on the inpatient psychiatric unit stays at about 97 to 99 percent, and most of the patients are covered by Medicaid. The average length of stay is 10.8 days, but Brown said they have had patients who needed their care for as long as 18 months. A variety of support services supplements the treatment provided within The Ireland Center. The hospital’s Sunshine School, which employs certified teachers, offers educational support and assistance with school assignments. The child life team provides age-appropriate group and individual programs and activities. Occupational therapists teach life skills and provide learning through play, while pastoral care lends spiritual support as needed. To ease the transition from inpatient to outpatient status, the inpatient staff has created the Family Education Empowerment Team, or FEET. “This group is open to parents and guardians to help prepare for their child’s return home after hospitalization,” Brown said. “They meet weekly to share issues and to hear about the techniques our experts use to help children maintain control and manage their behaviors in a positive way. We tell them, ‘This is the group you and your family need to assist in keeping your child out of the hospital and to keep you in control.’”

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