In recent years parents, teachers, coaches, pediatricians, behavioral health providers and others have increasingly faced the challenge of teens who announce that they have a self-diagnosed mental health disorder. This can be a problem as over reliance of a youth’s self-diagnosis can short-circuit the process of more fully understanding what’s really going on behind the label […]

In the first two parts of this newsletter series, we reviewed the prevalence, screening and assessment of substance use disorders in Native American youth. In Part 3, we will review treatment for substance use disorders in Native American youth. Keeping in mind the population we are discussing, effective treatment for substance use disorders should ideally include […]

In Part 1 we reviewed the prevalence and screening for substance use disorders in Native American youth. In Part 2, we will review more about assessment for substance use and co-occurring mental health disorders in Native American youth. Early intervention can dramatically reduce morbidity and mortality. As healthcare providers, we know about the potential harmful […]

Part 1: Prevalence and Screening As healthcare providers, we know that Native American populations, for a multitude of historical and social reasons, have a problematic history with substance use disorders. The goal of this newsletter series is to describe the prevalence and patterns of substance use among Native American youth, as well and identify methods […]

Case Presentation: The parents of your 4-year-old patient with Autism level 2 with verbal impairment comes in to ask about leucovorin and whether it will help their child speak. Leucovorin, also known as folinic acid, is the active form of folate (vitamin B9). It is used in cancers that require specific types of chemotherapies and […]

Case example You’re treating a 15-year-old girl with Major Depressive Disorder. She has moderate benefit from a combination of weekly therapy and sertraline. The sertraline dose has had to be titrated slowly because of nausea as a side effect. When the dose was recently increased to 200mg she complained of such severe nausea that she […]

Case example A 16-year-old comes in for a well child check. She has a history of anxiety and depression and is on 20mg of escitalopram daily. She goes to therapy weekly and finds it helpful. The medication has helped her depression but she is still pretty anxious at school most days. The anxiety distracts her […]

A 17-year-old high school senior with a history of attention deficit hyperactivity disorder presents to the office. He shares that he was recently accepted to college but is worried about keeping up with the coursework. How do you advise him? The transition from high school to college can be daunting, especially for individuals with disabilities […]

Case Presentation: You are seeing a 9-year-old male with preexisting ADHD, predominantly Inattentive Presentation who was recently removed from his biological mother and placed in a foster home. He has been stable on Concerta 27mg every morning for the last year with improvement in his symptoms in the school setting. His foster mother reports he […]

Dialectical Behavior Therapy (DBT) is an evidence-based psychotherapy effective for both youth and adults. It was originally developed in the 1970s by American psychologist Dr. Marsha Linehan, who sought to create a treatment that could help individuals with borderline personality disorder and chronic suicidality. DBT is particularly helpful for individuals struggling with emotional dysregulation, relationship […]