1. The Challenges of Adolescent and Pediatric Mental Health
Dr. David Prescott

2. What You Should Learn:
1. One Helpful and One Non- Helpful Interview Technique
2. The Most Common Mental Health Problems in Children and Adolescents
3. At least one new intervention approach or strategy

3. Technique #1: Anything that will Help Your Patient Come Back

4. Psychotherapy Dropout Quiz
The percentage of psychotherapy clients who attend only one session: _______
Of those clients who return for a second session, ________ percent drop out after the second session.

5. Answers One Session Only: 20- 57%
Drop Out After Second Session: %

6. Technique #2: Listen and Don’t (Immediately) React

7. No Barking……………No Wah wa Wah

8. Some of My Favorite Questions
What is that like for you.
What makes that hard?
What goes through your mind?
What happened right before (after) that?
What have you tried so far?
How confident are you that you will actually do what we talked about?

9. Case Example Jim J (Middle School) -School Refusal -Anxiety
-Oppositional

10. Diagnosis and Prevalence Facts
One in Four (25%) of Primary Care Visits for Teens involve a Mental Health Issue
One in Five (21.4%) adolescents will experience a mental health disorder between the ages of

11. Most Prevalent Child and Adolescent Mental Health Diagnoses
ADHD – 6.8%
Illicit Drug Use – 4.7%
Illicit Alcohol Use – 4.2%
Behavior and Conduct Problems – 3.5%
Anxiety – 3.0%
Depression – 2.1%

12. Treatment and Intervention
Technique #3:
Find Out What has been tried already

13. ADHD and Anxiety – Case Example
Therapy Focus on Behavior vs. Attention
Planning (Increasingly Self- Directed)
Medication Timing

14. Cutting and Self-Harm PREVALENCE DATA
15% of College Students Engage in Some Type of Self-Harm
17% of Adolescents Engage in Some Type of Self-Harm
RISK FACTORS
Feel Rejected by Peers
Being Bullied
Identifies as Gay or Bisexual

15. Case Example: Self-Harm and Depression
High School Student
High Achievement Striving
“Broken” Relationship with Peer
Highly Reactive and Emotionally Stoic Family

16. Disruptive Behavior Problems
Behavioral Treatment Rather than Insight Oriented Treatment
Engage Parents
Short-Term Extinction Bursts

17. Medical Protocol Adherence
Small Goals (What Can You Accomplish by The Day After Tomorrow)
Immediate vs. Long-Term Benefit
Progress Not Perfection
Measurement

18. Substance Use Problems
MOTIVATIONAL INTERVIEWING
What is Off The Table? (Precontemplative)
Listen for the Ambivalence (Contemplative)
Accurate Information
Improvement vs. Abstinence

19. prescottd@husson.edu 207-561-0104 (cell)
David Prescott, Ph.D.
(cell)