Santa Clara University

Medicating Children: Solution or Problem?

COURSE CANCELED

CPSY x824

*Optional lunch will be provided by the new San Jose Chapter of A Home Within directly following the workshop.

More and more, psychoactive medications are being prescribed for children with behavior problems. This is especially true for the increasingly diagnosed Pediatric Bipolar Disorder--in recent years there has been a 4000% increase in the diagnosis of Bipolar Disorder in youth. Is there a sudden epidemic afoot or are other disorders being swept up in a diagnostic fad? Is medication always the appropriate treatment for behavior problems of all kinds? There are enormous commercial and pragmatic pressures encouraging medication. What are the clinical issues in referring our troubled young patients for medication and in not doing so? How do we think through these difficult matters, and how do we handle the inevitable counter-transference?

Join Glen Elliott, M.D., Ph.D., Chief Psychiatrist at the Children’s Health Council, Edmund Levin, M.D., psychiatric consultant to the Lincoln Child Center, and Toni Vaughn Heineman, D.M.H., Executive Director, A Home Within and Clinical Professor, UCSF, in a discussion of the clinical considerations and practical consequences of medicating these children. Is it the best treatment? When is it necessary and when is less medication better? Are there alternatives to medication? Glenn Elliot, M.D., Ph.D. will present an overview. He will explain general issues of psychiatric medications for youth, the pros and cons, as well as the phenomenon of over-enthusiastic diagnosis and pharmacological treatment of children. What larger factors influence clinical decisions? Dr. Levin will report on his recent study of the effects of selectively reducing medication in behaviorally disordered youth in residential care—sometimes less can be more. Dr. Heineman will address the complexity of interactions of internal and environmental factors in diagnosis by focusing on pediatric bipolar disorder in the context of the foster care system.

Bring your questions and your own experiences of these issues with your young patients. We will all put our heads together and try to sort out these complex matters and how they apply to the children and families we work with.

Glen R. Elliott, Ph.D., M.D. obtained his degrees at Stanford and completed training in general psychiatry at McLean Hospital/Harvard and in Child and Adolescent Psychiatry at Stanford, after which he joined the Stanford faculty. He was Director of The Children’s Center at Langley Porter at UCSF from 1989 to 2006. He is now the Chief Psychiatrist and Interim Clinical Services Director at The Children’s Health Council in Palo Alto. He also is a Professor of Clinical Psychiatry (Affiliated) in the Stanford School of Medicine. Dr. Elliott has a longstanding interest in improving the diagnosis and treatment of severe psychiatric disorders in children and adolescents. He has been involved at a national level in helping to call attention to the need for more research on these disorders. He strives to clarify the appropriate use of psychoactive medications in relieving the distress of children and adolescents with severe mental illnesses while minimizing risks to their immediate welfare and long-term development. In 2006, he authored Medicating Young Minds, a book for parents facing that difficult decision.

Edmund Levin, M.D., received his medical training at UCLA and his training in General and in Child and Adolescent Psychiatry at the Langley Porter Psychiatric Institute, UCSF. He practices in Berkeley, providing psychotherapy to individuals and consultations to individuals, families, colleagues, clinics and residential programs about issues involving diagnosis, medication and other aspects of treatment planning. He chairs the Mentoring Committee of the Northern California Regional Organization of Child and Adolescent Psychiatry and the Continuing Medical Education Committee of the Dept. of Psychiatry at Alta Bates Medical Center. He has long had an interest in trauma, early development, and concern over the influence of the health insurance and pharmaceutical industries on the teaching and practice of medicine. These issues are reflected in a paper he has written outlining the clinical consequences which resulted from successful efforts to change the institutional culture in a residential agency and the use of tapering trials of medications the children were on.

Toni Vaughn Heineman, D.M.H., is the Executive Director of A Home Within, a national non-profit based in San Francisco that aims to heal the chronic loss experienced by foster children by providing lasting and caring relationships to current and former foster youth. Toni Heineman is a clinical psychologist who has been in private practice treating children, adults, and families in the San Francisco Bay Area for 25 years. She is Clinical Professor of Psychiatry and Pediatrics at the University of California San Francisco and was selected as a fellow by Zero to Three for the 2003-2004 National Leadership Initiative. Dr. Heineman has taught and supervised interns, graduate students and psychiatric residents, and presented at numerous professional meetings. She has authored a wide range of journal articles, a book, The Abused Child: Psychodynamic Understanding and Treatment, and is co-editor of another published by Brookes in the fall of 2005, Building a Home Within: Meeting the Emotional Needs of Children and Youth in Foster Care.