Partnership With Rite Aid Healthy Futures Benefits McLean’s Youngest Patients

“We are impressed and inspired by what McLean is doing to support children and teens—its child and family curriculum, resources, support groups, diagnostic tools, and treatment options,” said DeCamara.

“McLean deploys not just clinical expertise and leadership in the field, but compassionate care, too. We are honored to support McLean and its groundbreaking work in mental health.”

Foundational Parent Group

Recognizing that families frequently face a waiting period before treatment, this six-week virtual group is meant to ground parents in knowledge, skills, and strategies to help set their children up for greater success at MAMP.

“Over the past decade, there has been a lot of research showing that targeting parents can impact meaningful change in families of youth with anxiety disorders,” said R. Meredith Elkins, PhD, co-program director of MAMP.

“Our hope is that by delivering the curriculum, parents and children can come into MAMP and hit the ground running. When parents understand the rationale behind our approach, they can be more empowered partners in their kids’ treatment.”

If the group proves to be effective, Elkins would like to roll it out to parents of youngsters currently treated in other hospital programs, as well as parents from the broader community.

Exposure Informed by DBT (Dialectical Behavior Therapy)

MAMP has been seeing increasing numbers of children and teens with histories of suicidality, self-harm, and emotional dysregulation.

The program’s primary treatment modality is exposure and response prevention therapy, the gold standard treatment for anxiety disorders and obsessive compulsive disorder, but these young people need more.

“Some children and teens are feeling really big emotions in addition to anxiety—guilt, shame, and loneliness, to name a few. They may have challenges with maintaining close relationships, such as difficulties with friends and family,” said Abigail Stark, PhD, a staff psychologist with MAMP.

“We hope that by augmenting treatment with DBT, we’ll be able to address these additional symptoms some of our patients are experiencing.”

DBT, an evidence-based treatment, is used with people who have difficulty regulating and managing their feelings, including those who engage in self-harm.

Every week, patients will attend a 45-minute DBT-informed session focused on increasing emotional awareness and handling the strong emotions that get in the way of their progress.

They will also fill out “DBT diary cards,” tracking their emotions and behaviors, including those related to avoidance, self-harm, and suicidality.

Finally, DBT principles will be incorporated into family meetings, teaching parents how to “validate their children while also pushing them to face some of the intense emotions they experience via exposure,” according to Stark.

As with the foundational parent group, exposure informed by DBT, if proven effective, may eventually be offered in the broader community.

“We’re so grateful to Rite Aid Healthy Futures for this partnership,” said Elkins.

“These are pressing clinical needs and this support is enabling us to create programs to help more kids and families.”

CARE (Child and Adolescent Routine Evaluation)

The third initiative supported by Rite Aid Healthy Futures is CARE, a comprehensive patient assessment approach that McLean has rolled out in all of its programs treating children and adolescents.

Its purpose is to ensure that clinicians get a full picture of every patient’s mental health status for better diagnosis and treatment.

“Kids aren’t just one note, they’re a symphony. They might have anxiety, but also may have depression, ADHD, autism, or family issues,” explained Daniel P. Dickstein, MD, FAAP, chief of the Nancy and Richard Simches Division of Child and Adolescent Psychiatry and creator of CARE.

“CARE strives to ensure that we have a comprehensive understanding of every child in every program, using standardized measures to augment clinical judgment and ensure we don’t miss anything.”

CARE has three components:

• A comprehensive set of questionnaires—21 in all—asking children and parents about mood, anxiety, sleep, irritability, suicidality, activity, autism, substance use, ADD/ADHD, discrimination and bias, and more
• An interview about thoughts and behaviors related to suicidality and self-harm
• A follow-up assessment, three months after the questionnaires, looking at functional outcomes. How are symptoms affecting the patient’s day-to-day functioning? Has school performance been affected? Friendships? Family relationships?

CARE is not intended to replace clinical judgment and skill—what Dickstein refers to as the “art of medicine”—but rather to add the “science of measurement”—synergistically combined for better diagnoses and treatments.

CARE data should also lead to program improvements and provide fertile material for research, according to Dickstein.

“We think this will potentially transform childhood mental health care at McLean and beyond. We’re grateful to Rite Aid Healthy Futures for catalyzing this innovation, the first-ever effort of its type in the country,” he said.