Skip to main content

Advertisement

SpringerLink
Log in

Training Pediatric Residents and Pediatricians About Adolescent Mental Health Problems: A Proof-of-Concept Pilot for a Proposed National Curriculum

  • Original Article
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Objective

This article presents a DVD-based educational program intended to help pediatric residents and practicing pediatricians recognize and respond to adolescent depression in busy primary care settings.

Methods

Representatives from pediatrics and adolescent medicine, child and adolescent psychiatry and psychology, and experts in the creation of educational mental health programs met to design a multimedia approach to improving the mental health diagnostic skills among pediatric residents. The authors chose depression as the initial topic because of its relatively high prevalence among children and adolescents, and evidence suggesting that pediatricians may have difficulty diagnosing this disorder in the primary care setting. The authors created a 30-minute DVD program featuring depressed adolescents and experts in child psychiatry and adolescent medicine. After viewing the DVD, residents in the training program, as well as practicing pediatricians, completed a standardized survey to assess the usefulness and attractiveness of this approach to pediatric education.

Results

The survey results support the potential value of this type of material and the feasibility of similar programs in addressing an array of mental health concerns in pediatric residencies. Participants found the program useful and indicated interest in receiving more educational programs in this format.

Conclusion

The authors suggest that the relative ease with which initiatives such as this media-based approach can be implemented make this educational technique appropriate and feasible on a large scale for programs throughout the nation and for a variety of mental health concerns.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Shaffer D, Fisher P, Dulcan MK, et al: The NIMH diagnostic interview schedule for children version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA study: methods for the epidemiology of child and adolescent mental disorders study. J Am Acad Child Adolesc Psychiatry 1996; 35: 865–877

    Article  CAS  PubMed  Google Scholar 

  2. Kessler RC, Berglund P, Demler O, et al: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005; 62: 593–602

    Article  PubMed  Google Scholar 

  3. Weissman MM, Wolk S, Goldstein RB, et al: Depressed adolescents grown up. JAMA 1999; 281: 1707–1713

    Article  CAS  PubMed  Google Scholar 

  4. Eaton DK, Kann L, Kinchen S, et al: Youth Risk Behavior Surveillance—United States, 2005. MMWR Surveill Summ 2006; 55: 1–108

    PubMed  Google Scholar 

  5. Jellinek MS, Murphy JM, Little M, et al: Use of the pediatric symptom checklist to screen for psychosocial problems in pediatric primary care. Arch Pediatr Adolesc Med 1999; 153: 254–260

    Article  CAS  PubMed  Google Scholar 

  6. Zuckerbrot RA, Jensen PS: Improving recognition of adolescent depression in primary care. Arch Pediatr Adolesc Med 2006; 160: 694–704

    Article  PubMed  Google Scholar 

  7. March J, Silva S, Petrycki S, et al, Treatment for Adolescents with Depression Study (TADS) Team: Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. JAMA 2004; 292: 807–820

    Article  CAS  PubMed  Google Scholar 

  8. Kataoka SH, Zhang L, Wells KB: Unmet need for mental health care among U.S. children by ethnicity and insurance status. Am J Psychiatry 2002; 159: 1548–1555

    Article  PubMed  Google Scholar 

  9. Wu LT, Ringwalt CL: Use of alcohol treatment and mental health services among adolescents with alcohol use disorders. Psychiatr Serv 2006; 57: 84–92

    Article  PubMed Central  PubMed  Google Scholar 

  10. Chen H, Cohen P, Kasen S, et al: Impact of adolescent mental disorders and physical illnesses on quality of life 17 years later. Arch Pediatr Adoles Med 2006; 160: 93–99

    Article  Google Scholar 

  11. Thomas CR, Holzer CE III: The continuing shortage of child and adolescent psychiatrists. J Am Acad Child Adolesc Psychiatry 2006; 45: 1023–1031

    Article  PubMed  Google Scholar 

  12. Koppelman J: The Provider System for Children’s Mental Health: Workforce Capacity and Effective Treatment. National Health Policy Forum Issue Brief Number 801. Washington DC, The George Washington University, 2004

    Google Scholar 

  13. ACGME: Number of Accredited Programs by Academic Year (7/1/2008-6/30/2009). Available at www.acgme.org/adspublic/reports/accredited_programs.asp

  14. Althouse LA, Stockman JA: Pediatric workforce: a look at adolescent medicine data from the American Board of Pediatrics. J Pediatr 2007; 150: 311–312, 100-102

    Article  PubMed  Google Scholar 

  15. Shugerman R, Shipman S, et al: Too many, too few or just right? A national survey of practicing pediatricians. Assessing the pediatric subspecialty supply. Presented at the 2008 Pediatric Academic Societies Annual Meeting.

  16. Wells KB, Sherbourne C, Schoenbaum M, et al: Quality improvement programs for depression in managed primary care: a randomized controlled trial. JAMA 2000; 283: 212–220

    Article  CAS  PubMed  Google Scholar 

  17. Williams J, Palmes G, Klinepeter K, et al: Referral by pediatricians of children with behavioral health disorders. Clin Pediatr 2005; 44: 343–349

    Article  Google Scholar 

  18. Cooper S, Valleley RJ, Polaha J, et al: Running out of time: physician management of behavioral health concerns in rural pediatric primary care. Pediatrics 2006; 118: e132–e138

    Article  PubMed  Google Scholar 

  19. Shipman SA, Lurie JD, Goodman DC: The general pediatrician: projecting future workforce supply and requirements. Pediatrics 2004; 113: 435–442

    Article  PubMed  Google Scholar 

  20. Stein REK, Zitner LE, Jensen PS: Interventions for adolescent depression in primary care. Pediatrics 2006; 118: 669–682

    Article  PubMed  Google Scholar 

  21. Owens PL, Hoagwood K, Horwitz SM, et al: Barriers to children’s mental health services. J Am Acad Child Adolesc Psychiatry 2002; 41: 731–338

    Article  PubMed  Google Scholar 

  22. Davis M: Addressing the needs of youth in transition to adulthood. Adm Policy Ment Health 2003; 30: 495–509

    Article  PubMed  Google Scholar 

  23. Coyle JT, Pine DS, Charney DS, et al, Depression and Bipolar Support Alliance Consensus Development Panel: Depression and Bipolar Support Alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in children and adolescents. J Am Acad Child Adolesc Psychiatry 2003; 42: 1494–1503

    Article  PubMed  Google Scholar 

  24. Gardner W, Kelleher KJ, Pajer KA, et al: Primary care clinicians’ use of standardized tools to assess child psychosocial problems. Ambul Pediatr 2003; 3: 191–195

    Article  PubMed  Google Scholar 

  25. Leaf PJ, Owens PL, Leventhal JM, et al: Pediatricians’ training and identification and management of psychosocial problems. Clin Pediatr 2004; 43: 355–365

    Article  Google Scholar 

  26. Wells KB, Kataoka SH, Asarnow JR: Affective disorders in children and adolescents: addressing unmet need in primary care settings. Biol Psychiatry 2001; 49: 1111–1120

    Article  CAS  PubMed  Google Scholar 

  27. American Academy of Pediatrics: Periodic Survey #59: Identification, management and referral for patient mental health problems and maternal depression, 2004. Available at www.aap.org/research/periodicsurvey/ps59exs.htm

  28. Gardner W, Kelleher KJ, Pajer KA, et al: Primary care clinicians’ use of standardized psychiatric diagnoses. Child Care Health Dev 2004; 30: 401–412

    Article  CAS  PubMed  Google Scholar 

  29. Combs-Orme T, Hetlinger CA, Simpkins CG: Comorbidity of mental health problems and chronic health conditions in children. J Emotional and Behavioral Disorders 2002; 10: 116–125

    Article  Google Scholar 

  30. Wegner LM: Pediatricians and antidepressant medications: black box or black hole? Pediatrics 2005; 116: 233–235

    Article  PubMed  Google Scholar 

  31. Frazer C, Emans J, Goodman E, et al: Teaching residents about development and behavior. Arch Pediatr Adolesc Med 1999; 153: 1190–1194

    Article  CAS  PubMed  Google Scholar 

  32. Brennan TA, Rothman DJ, Blank L, et al: Health industry practices that create conflicts of interest: a policy proposal for academic medicine. JAMA 2006; 295: 429–433

    Article  CAS  PubMed  Google Scholar 

  33. Briggs-Gowan MJ, Horwitz SM, et al: Mental health in pediatric settings: distribution of disorders and factors related to service use. J Am Acad Child Adolesc Psychiatry 2000; 39: 841–849

    Article  CAS  PubMed  Google Scholar 

  34. Casebeer L, Kristofco RE, Strasser S, et al: Standardizing evaluation of on-line continuing medical education: physician knowledge, attitudes, and reflection on practice. J Contin Educ Health Prof 2004; 24: 68–75

    Article  PubMed  Google Scholar 

  35. Fordis M, King JE, Ballantyne CM, et al: Comparison of the instructional efficacy of internet-based CME with live interactive CMD workshops: a randomized controlled trial. JAMA 2005; 294: 1043–1051

    Article  PubMed  Google Scholar 

  36. Cook DA: The research we still are not doing: an agenda for the study of computer-based learning. Acad Med 2005; 80: 541–548

    Article  PubMed  Google Scholar 

  37. Fox G: Teaching normal development using stimulus videotapes in psychiatric education. Acad Psychiatry 2003; 27: 283–288

    Article  PubMed  Google Scholar 

  38. Cook DA: Learning and cognitive styles in web-based learning: theory, evidence and application. Acad Med 2005; 80: 266–278

    Article  PubMed  Google Scholar 

  39. Brigham and Women’s Hospital: Depression: a guide to diagnosis and treatment, 2001. National Guideline Clearinghouse. Available at www.guidelines.gov/summary/summary.aspx?doc_id=3432

  40. D’Alessandro DM, Kreiter CD, Kinzer SL, et al: A randomized controlled trial of an information prescription for pediatric patient education on the internet. Arch Pediatr Adolesc Med 2004; 158: 857–862

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychiatry, Massachusetts General Hospital, Wang 812, Parkman St., Boston, MA, 02114, USA

    Lawrence Kutner Ph.D., Cheryl K. Olson Sc.D., Steven Schlozman M.D., Mark Goldstein M.D., Dorothy Warner Ph.D. & Eugene V. Beresin M.D.

Authors
  1. Lawrence Kutner Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cheryl K. Olson Sc.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steven Schlozman M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark Goldstein M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dorothy Warner Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eugene V. Beresin M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eugene V. Beresin M.D..

Additional information

We thank Richard L. Falzone, M.D., for assistance with media production; Michael S. Jellinek, M.D., Mark H. Mandell, M.D., and Emmett Schmidt, M.D., for assistance with data collection; and Danielle DeLuca for administrative support. This research was supported by a staff grant from the Josiah Macy Jr. Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kutner, L., Olson, C.K., Schlozman, S. et al. Training Pediatric Residents and Pediatricians About Adolescent Mental Health Problems: A Proof-of-Concept Pilot for a Proposed National Curriculum. Acad Psychiatry 32, 429–437 (2008). https://doi.org/10.1176/appi.ap.32.5.429

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1176/appi.ap.32.5.429

Keywords

Search

Navigation