SCCAP/Miami International Child & Adolescent Mental Health (MICAMH) Conference/2020/Day 1

= Day 1 =

Promoting Resilience in the Context of Global Adversity: Refugee and Immigrant Youth, Families, and Communities
Presenter: Maryam Kia-Keating, Ph.D., Associate Professor of Clinical Psychology, University of California, Santa Barbara

Learning Objectives:

 * Increased hate and anti-immigrant sentiment today
 * Est. 2018 we are experiencing the highest levels of displacement on record globally (about 1 person every 2 secs)
 * Also displacement can be due to disaster (i.e., cyclones, forest fires, hurricanes, droughts etc...)
 * Highest numbers in China, Philippines, US, Cuba, and India
 * In 27 countries, children can be left stateless and denied several rights
 * Children make up half of the refugees worldwide
 * Phases of Migration:
 * Pre: Violence, persecution, loss, and separation
 * Migration: can be long duration- instability and unsafe living conditions esp. For children
 * Post: Not a final destination
 * Resignation Syndrome in Children
 * First diagnosed in Sweden - exists only among refugees – characterized by the loss of the will to live
 * Outcomes
 * Depression, anxiety, sleep disturbances, PTSD
 * Prevalent amongst unaccompanied minors and dependent on migration environment
 * Immigrant Paradox:
 * Foreign-born Latinx are healthier and less likely to suffer from chronic disease and/or premature death
 * High levels of resilience amongst refugees families facing trauma and adversity (related to family cohesion, belonging, autonomy)
 * Interventions: PTSD are individually based- not fully effective; school based is mixed- does not always reduce PTSD symptoms but does reduce other symptoms like depression; and family engagement in school-based interventions is promising in reducing maternal depression and increase family solving skills
 * Propose an Empathic Centered Design
 * Shift from expert-outsider perspective to solution partner practice
 * Deficit → Strength
 * Risk → Promise
 * Vulnerable → Empowered
 * Recipient → Partner
 * Focus on 5 Ss
 * Stigma
 * Somatization
 * Strengths
 * Social Needs
 * Settings

After Trauma: Understanding the Needs of Children
Presenter: Robin Gurwitch, Ph.D., Professor in Psychiatry and Behavioral Sciences, Duke University

Notes:

 * Early Ideas about Trauma and Children
 * Symptoms were mild, transient, and no intervention required until the 1980s school shooting in California
 * First time they spoke to children re: their experiences
 * One in four children will experience at least one traumatic event before the age of 16
 * 80% of abused children will face at least one mental health challenge before age 21
 * Adverse Child Experiences
 * >4 ACEs appears to be tipping point for increased risks in life
 * ¼ of children experience mental health problems but over half go untreated
 * Trauma impacts learning: impacts kindergartners the most (expulsion and suspension)
 * Increased worries/fears - guilt/shame - changes in behavior (i.e., ADHD symptoms, bullying, withdrawal) - physiological responses (i.e., sensitivity to sounds and somatic complaints)
 * Majority of children are resilient after traumatic events BUT, still need support, create a positive environment, and increase positive coping skills for the future
 * Protective Factors
 * Positive family, teacher, and peer relationships, willingness to ask for help, having pets, good social skills and self-esteem etc…
 * Interventions for Children who have Experienced Trauma
 * TF- CBT: Trauma-focused cognitive behavioral therapy
 * PCIT: Parent Child Interaction Therapy
 * CBT: Cognitive Behavioral Therapy in Schools
 * CARE: Child-Adult Relationship Enhancement: skills for engaging children with trauma exposure
 * PTSD symptoms need to present for at least a month for effective intervention

Improving Services for Kids and Families Through Implementation Science: Working on the Irrigation System
Presenter: Michael Southam-Gerow, Ph.D., Professor and Chair, Clinical Psychology, Virginia Commonwealth University

Notes:

 * New Sources of Stress for Children
 * Increased competition for schools
 * Easy accessibility to information
 * Prevalence of social pressures
 * Stressful national and global situation
 * Up to 80% of children and/or adolescents that need services do not receive them
 * Racial, income, and geographic barriers greatly impact this
 * Severe shortage of psychiatrists and other health professionals in vast majority of the US, including Florida


 * Future Directions
 * Use evidence-based treatment design and service system and workforce development
 * Treatment design:
 * Managing and Adapting Practice (MAP)
 * Similarities and differences to modular and transdiagnostic approach
 * Multiple Evidence Bases
 * Think about individual cases and progress using local knowledge
 * Outcomes
 * MAP showed decreases in symptoms from pre to post (ie. anxiety, depression, PTSD)
 * Service system:
 * Medicaid and state funding will pay more for evidence base services depending on the state
 * R-MAP will match clients to relevant evidence base services based on age, gender, problem, race/ethnicity but it does not capture every case
 * Conclusions:
 * Standard Evidence-Based Treatments (EBT) alone may not be sufficient to create high-performance systems (about ⅓ don’t benefit)
 * Hybrid models help:
 * EBT
 * PLUS approaches
 * Know what is readily available
 * Workforce:
 * Multiple approaches are needed
 * 3 Rs: Routes, Regulations (i.e., receiving mental health or healthcare training in military), Rates (increase salaries for providers)
 * Pipeline: Grad Training (Masters Social Work- MSW)
 * MAP class v. standard curriculum
 * Increase of strategies from Pre-Study to Post-Study in MAP group

Addressing Psychological Well-being Among Refugee and Immigrant Youth and Families
Presenter: Maryam Kia-Keating, Ph.D., Associate Professor of Clinical Psychology, University of California, Santa Barbara

Child-Adult Relationship Enhancement (CARE): Strengthening relationships with children/teens who have experienced trauma
Presenter: Robin Gurwitch, Ph.D., Professor in Psychiatry and Behavioral Sciences, Duke University

Clinical Strategies for Developing Socioemotional Competence in Youth
Presenter: Michael Southam-Gerow, Ph.D., Professor and Chair, Clinical Psychology, Virginia Commonwealth University

Learning Objectives:

 * Emotional Competence
 * Awareness and labeling
 * Emotion vocabulary
 * Clear emotional displays
 * Interventions involve intensity ratings + identification of emotions
 * Understanding
 * Causes and consequences of emotion experiences
 * Involves recursive thinking and social cognition
 * Multiple emotions
 * Opposite feelings can occur at the same time
 * Emotion regulation: regulator and regulated
 * You cannot control emotions but can gain awareness and do something about it
 * Development from less conscious to planful
 * Emotions usually point towards what’s important to us
 * Interventions involve cognitive component (specifically on anger, worry sadness, and fear)
 * Focus is on changing at least some of the thoughts
 * Expression: advanced
 * Expression of feelings makes it easier to deal with them (e.g., through expressive writing)
 * Emotion socialization


 * Culture and Emotion
 * Individualistic
 * Less likely to suppress emotions
 * Collectivism
 * Increased likelihood of suppressed emotions
 * Emotion regulation is not universal
 * Active engagement (i.e., problem solving, reframing) can help with coping strategies for those undergoing chronic stress
 * Those in poverty, need an individualistic/unique treatment plan


 * Conclusion:
 * Emotion is central to human experience
 * Help children/adolescents develop emotional competence
 * Can be promoted via context of family therapy

Tech Parenting: How to Support Parents in Managing Children’s Screen Time
Presenter: Justin Parent Ph.D., Assistant Professor, Florida International University

Conducting Semi-Structured Assessment of Suicide Risk in Youth in Clinical Settings: Balancing Standardization with Clinical Utility
Presenter: Ashley M. Shaw, Ph.D., Clinic Director, Licensed Clinical Psychologist, & Postdoctoral Associate, Mental Health Interventions and Technology (MINT) Anxiety Program, Florida International University

Other 2020 Days

 * SCCAP/Miami International Child & Adolescent Mental Health (MICAMH) Conference/2020/Day 2
 * SCCAP/Miami International Child & Adolescent Mental Health (MICAMH) Conference/2020/Day 3