Obsessive Compulsive Disorder in Primary Care

Hands typing at a laptop.

 

Obsessive compulsive disorder is neurobiologically and phenomenologically unique from other anxiety disorders. It requires a more nuanced assessment, with special consideration in prescribing first-line medications and psychotherapies.

 

Objectives:

  • Describe the key diagnostic criteria and differential diagnosis of OCD in the primary care setting.
  • Understand the basic neurobiology of OCD and how it is different than other anxiety disorders.
  • Be able to describe the first-line psychotherapy treatment for OCD to patients and families, and how this specific type of psychotherapy may be different than other modalities.
  • Understand the psychopharmacological treatment options for OCD and how dosing strategies are different than for other pediatric psychiatric conditions.

 

Presented by: Ryan Edwards, MD

Dr. Ryan Edwards is a Board-Certified Child & Adolescent Psychiatrist. As a native Nebraskan, he earned his medical degree from the University of Nebraska Medical Center. He then completed both his residency and post-graduate fellowship training at the University of Michigan in Ann Arbor. His clinical interests include outpatient-based child & adolescent psychiatry, obsessive-compulsive disorder, complex anxiety disorders of childhood, and integrative and collaborative care across healthcare disciplines. He greatly enjoys teaching the next generation of medical professionals, and as a professional cyclist in a past life, he is also interested in the mental healthcare of young athletes.

 


 

Learn more about this series: Tele-Behavioral Health Consultation (TBHC) Primary Care Webinar Series

 


 

Published
June 24, 2022
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Language(s)
english
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Case Presentations: Anxiety and Complex ADHD

  Learning Objectives: Identify symptoms of selective mutism with comorbid generalized anxiety disorder. Describe evidenced-based treatment interventions for selective mutism in an integrated primary care practice. Report the factors that contribute to Complex ADHD. Discuss practice guidelines for interdisciplinary behavioral and medication treatments for complex ADHD in a primary care practice. Explain the nuances to diagnosis and how evidence-based treatment changes for children with comorbid PTSD and ADHD vs either disorder alone.   Presented by: Cynthia Ellis, MD, and Terri Matthews, PhD, APRN-NP, BCBA-D Dr. Cynthia Ellis is a Professor of Pediatrics and Psychiatry at the University of Nebraska Medical Center in the Department of Developmental Medicine at the Munroe-Meyer Institute for Genetics and Rehabilitation. She is board certified in Pediatrics, Developmental/Behavioral Pediatrics and Neurodevelopmental Disabilities. Dr. Ellis received her medical degree from the University of Nebraska Medical Center and completed residency training in Pediatrics and fellowship training in Child and Adolescent Psychiatry at the Medical College of Virginia/VCU. She has been practicing in the field of Developmental/Behavioral Pediatrics for over 20 years. She has extensive clinical, research, and educational experience with children with neurodevelopmental disabilities and behavioral/emotional disorders. Her clinical expertise is in the psychopharmacological management of children with developmental disabilities and other behavioral disorders. She has also published extensively in the field. Dr. Ellis is the Director of the Munroe-Meyer Institute’s MCH-funded LEND (Leadership Education in Neurodevelopmental and Related Disabilities) and ALA (Autism Leadership Academy) Interdisciplinary Training Programs. Dr. Ellis has served as the medical director for numerous public school and interdisciplinary community-based programs and as a research consultant in the field of developmental disabilities. She also participates in a number of other leadership positions on committees and boards.   Dr. Mathews is an associate professor in the College of Nursing. Dr. Mathews received her bachelor's degree in nursing from University of Nebraska Medical Center in Omaha, NE; her master’s degree in nursing from the University of Missouri-Kansas City, and her doctoral degree in Developmental and Child Psychology from the University of Kansas. Dr. Mathews clinical specialty is child and adolescent psychiatric mental health nursing. She is a Pediatric Nurse Practitioner, Psychiatric Mental Health Nurse Practitioner and a Licensed Psychologist. Dr. Mathews joined the faculty at the University of Nebraska Medical Center College of Nursing in 2008.     Learn more about this series: Tele-Behavioral Health Consultation (TBHC) Primary Care Webinar Series    

What You Need to Know About Section 504 Plans

  Do you have an individual with an intellectual or developmental disability in your practice?   What is the difference between a 504 plan and an Individual Education Plan (IEP)?  How do I best support these individuals and their families?  Often providers are unaware of the benefits of 504 plans.  Please join us to learn more about what a 504 plan is and how you can be an important resource for these individuals and families. Learning Objectives: Explain what a 504 Plan is and why it is important Discuss who is eligible for a 504 Plan Identify the role of the physician, the individual and the school Recognize ways to support individuals and families when eligible for a 504 Plan   Presented by: Graciela Sharif and Kristin Flott As a Peruvian immigrant, introduced to Middle Eastern culture through marriage, and mother of a child with developmental disabilities, Graciela Sharif knows about the obstacles that individuals with disabilities and their families face in many aspects of their lives. Inspired by her oldest son who was born with Down syndrome, Graciela's purpose is to create equal access to education, health care and community services for all individuals with disabilities and their families. As a Parent Resource Coordinator, she provides education, information and support to new and existing families, so they can be active participants in the development of their children’s education and health care services.   Kristin Flott is the parent of a son with ASD and a daughter with SHCN.  She has been working in the field of disabilities for over 15 years, not including several years of non-profit, community engagement and management experience.  Since entering the field of neurodevelopmental disabilities, she has been dedicated to advocating and improving outcomes for children with disabilities and their families.  She currently serves as the LEND Director of Campus and Community Collaboration, the LEND Family Discipline Director and the LEND Pipeline Coordinator. In her role, she coordinates with campus and community partners to develop collaborative training projects and experiences as well as provide direct support to LEND trainees through networking, mentoring and participation in interdisciplinary clinics.     Learn more about this series: Tele-Behavioral Health Consultation (TBHC) Primary Care Webinar Series    

Evidence Based Psychotherapy and Medication Management for Skin Picking and Other Repetitive Behaviors

  Learning Objectives: List criteria for skin picking and other repetitive behavior disorders, and common differential diagnoses. Discuss the evidence and basis for Habit Reversal Therapy, and applications of behavioral intervention for repetitive behavior disorders. Describe evidence-based medication interventions for skin picking and repetitive behavior disorders.   Presented by: Alison DeLizza, PhD and Ryan T. Edwards, MD Dr. DeLizza is a child psychologist who has a special interest in working with children and teens with anxiety and depression. She has been working in Nebraska since 2018 when she relocated from Western Michigan. In addition to anxiety and depression, Dr. DeLizza also has experience working with children and teens with ADHD and other behavior disorders. Dr. DeLizza's therapy interests also include OCD and working with LGBTQIA+ youth. Dr. DeLizza completed her PhD in Clinical Psychology at Western Michigan University and her Clinical Internship at the Munroe-Meyer Institute at UNMC.   Dr. Ryan Edwards is a Board-Certified Child & Adolescent Psychiatrist. As a native Nebraskan, he earned his medical degree from the University of Nebraska Medical Center. He then completed both his residency and post-graduate fellowship training at the University of Michigan in Ann Arbor. His clinical interests include outpatient-based child & adolescent psychiatry, obsessive-compulsive disorder, complex anxiety disorders of childhood, and integrative and collaborative care across healthcare disciplines. He greatly enjoys teaching the next generation of medical professionals, and as a professional cyclist in a past life, he is also interested in the mental healthcare of young athletes.     Learn more about this series: Tele-Behavioral Health Consultation (TBHC) Primary Care Webinar Series      

Screening for Autism in Pediatric Primary Care

  This webinar will help the learner identify symptoms of autism in the pediatric population and identify validated and reliable screening tool that may be feasible to use in the primary care setting. The challenges of screening for autism in the primary care setting and solutions to improve screening rates will be discussed.   Learning Objectives: At the conclusion of this activity, the participants should be better able to: Recall the red flags of autism spectrum disorder in the infant and toddler age group. Review DSM-5-TR diagnostic criteria for autism spectrum disorder in the pediatric population. Identify valid and reliable autism spectrum screening tools for infants, toddlers, school age and adolescent age group. Discuss challenges, barriers, and potential strategies to incorporate autism spectrum disorder screening in the primary care setting.   Presented by: Terri Mathews, PhD, APRN-NP, BCBA-D Dr. Mathews is an associate professor in the College of Nursing. Dr. Mathews received her bachelor's degree in nursing from University of Nebraska Medical Center in Omaha, NE; her master’s degree in nursing from the University of Missouri-Kansas City, and her doctoral degree in Developmental and Child Psychology from the University of Kansas. Dr. Mathews clinical specialty is child and adolescent psychiatric mental health nursing. She is a Pediatric Nurse Practitioner, Psychiatric Mental Health Nurse Practitioner and a Licensed Psychologist. Dr. Mathews joined the faculty at the University of Nebraska Medical Center College of Nursing in 2008.     Learn more about this series: Tele-Behavioral Health Consultation (TBHC) Primary Care Webinar Series    

Gender-Affirming Practices in Primary Care

  Learning objectives: Defining terms - learning gender terminology Theoretical basis and tenants of gender affirmative model Medical interventions available to transitioning youth Learn about effective strategies and engagement of affirmative practice Increasing the clinical and cultural competence of psychologists and allied mental health professionals who will be treating transgender and gender expansive children and youth   Presented by: Andrea Garcia, MA, MS, PLMHP Andrea Garcia, MA, MS, PLMHP is a predoctoral intern in the Munroe-Meyer Institute Department of Psychology at UNMC. Andrea provides services in the Sleep and Primary Care Clinic. Andrea is a doctoral graduate student from the University of Kansas, School Psychology Program. Andrea’s dissertation research is focused on the neurocognitive outcomes of children prenatally exposed to opioids. Her research has been presented in the state capital research summit and a grant from the Children’s Miracle Network. Andrea’s clinical experience has ranged from working with children with severe emotional disturbances to children with chronic sleep problems. At the end of her clinical rotation at Munroe Meyer Institute, Andrea will pursue a post-doc in pediatric psychology focused on actively promoting the health and psychological well-being of children with complex medical conditions and their families.       Learn more about this series: Tele-Behavioral Health Consultation (TBHC) Primary Care Webinar Series    

Impact of Social Media on Youth and How to Manage Social Media Recommendations in Primary Care

  Research has shown rates of anxiety, depression, impaired sleep, and suicidal ideations have risen significantly in children over the past decade. This has correlated with the increased use of smart phones and social media. Although there are some benefits to social media use, approximately 27% of youth report negative sequelae. This presentation will provide information on strategies to help parents and youth understand the safety precautions and reduce negative implications of social media use.   Objectives: Understand the positive and negative psychological sequelae of social media on a child's mental health. Identify strategies to support parents and youth in limiting exposure to social media and developing coping responses to social media postings. Identify which youth are at most risk for negative sequelae of social media. Support community efforts and advocate for improved monitoring and filtering of social media while supporting healthy social development.   Presented by: Terri Mathews, PhD, APRN-NP, BCBA-D Dr. Mathews is an associate professor in the College of Nursing. Dr. Mathews received her bachelor's degree in nursing from University of Nebraska Medical Center in Omaha, NE; her master’s degree in nursing from the University of Missouri-Kansas City, and her doctoral degree in Developmental and Child Psychology from the University of Kansas. Dr. Mathews clinical specialty is child and adolescent psychiatric mental health nursing. She is a Pediatric Nurse Practitioner, Psychiatric Mental Health Nurse Practitioner and a Licensed Psychologist. Dr. Mathews joined the faculty at the University of Nebraska Medical Center College of Nursing in 2008.     Learn more about this series: Tele-Behavioral Health Consultation Primary Care Webinar Series     

Medication Management in Primary Care

  Objectives:  Discuss mental, behavioral, and developmental conditions for which medications are appropriate Discuss basic best practices for treatment of common behavioral health conditions Identify misconceptions about common psychotropic medications for children and adolescents Describe the process for requesting expert behavioral health consultation to manage mild to moderate behavioral health concerns in primary care  Presented by: Cynthia R. Ellis, MD Dr. Cynthia Ellis is a Professor of Pediatrics and Psychiatry at the University of Nebraska Medical Center in the Department of Developmental Medicine at the Munroe-Meyer Institute for Genetics and Rehabilitation. She is board certified in Pediatrics, Developmental/Behavioral Pediatrics and Neurodevelopmental Disabilities. Dr. Ellis received her medical degree from the University of Nebraska Medical Center and completed residency training in Pediatrics and fellowship training in Child and Adolescent Psychiatry at the Medical College of Virginia/VCU. She has been practicing in the field of Developmental/Behavioral Pediatrics for over 20 years. She has extensive clinical, research, and educational experience with children with neurodevelopmental disabilities and behavioral/emotional disorders. Her clinical expertise is in the psychopharmacological management of children with developmental disabilities and other behavioral disorders. She has also published extensively in the field. Dr. Ellis is the Director of the Munroe-Meyer Institute’s MCH-funded LEND (Leadership Education in Neurodevelopmental and Related Disabilities) and ALA (Autism Leadership Academy) Interdisciplinary Training Programs. Dr. Ellis has served as the medical director for numerous public school and interdisciplinary community-based programs and as a research consultant in the field of developmental disabilities. She also participates in a number of other leadership positions on committees and boards.     Learn more about this series: Tele-Behavioral Health Consultation (TBHC) Primary Care Webinar Series    
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