NURS 6630-N Week 2 Assignment: Assessing and Treating Pediatric Clients With Mood Disorders

Week 2: Therapy for Pediatric Clients With Mood Disorders

Mood disorders can impact every facet of a child’s life, making the most basic activities difficult for clients and their families. This was the case for 13-year-old Kara, who was struggling at home and at school. For more than 8 years, Kara suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. As a psychiatric mental health nurse practitioner working with pediatric clients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies.

This week, as you examine antidepressant therapies, you explore the assessment and treatment of pediatric clients with mood disorders. You also consider ethical and legal implications of these therapies.

Assessing and Treating Pediatric Clients With Mood Disorders: Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

Question description

Link for the textbook below

http://stahlonline.cambridge.org.ezp.waldenulibrar…

Apa format. 3 academic references minimum but need 7 cited references total, no more than 5 years old

Remember this is a Pharmacology class that incorporates Pharmacotherapy and not a class on diagnosing disease. I want you to tell me why you selected an option (why is it the best option) and why you did not choose the other options (I want you to defend your decision as if you were in open court). I would like 7 references cited with every assignment. I deduct 1 point per reference missing. Credible reference material only will be accepted. Sites such asWebMD and drugs.com (among others) will not be counted.

The Assignment

Examine Case Study: An African American Child Suffering From Depression from https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/02/mm/therapy_for_pediatric_clients_with_mood_disorders/index.html. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

• At each decision point stop to complete the following:
  • Decision #1
    • Which decision did you select? I chose Zoloft 25mg daily as the answer
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. (Remember, a total of 7 cited references is what I am looking for)

Assignment: Assessing and Treating Pediatric Clients With Mood Disorders

When pediatric clients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting with mood disorders.

Note: This Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.

Learning Objectives

Students will:

• Assess client factors and history to develop personalized plans of antidepressant therapy for pediatric clients
• Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy
• Evaluate efficacy of treatment plans
• Analyze ethical and legal implications related to prescribing antidepressant therapy to pediatric clients

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Reading

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

• Chapter 6, “Mood Disorders”
• Chapter 7, “Antidepressants”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Review the following medications:

• amitriptyline
• bupropion
• citalopram
• clomipramine
• desipramine
• desvenlafaxine
• doxepin
• duloxetine
• escitalopram
• fluoxetine
• fluvoxamine

• imipramine
• ketamine
• mirtazapine
• nortriptyline
• paroxetine
• selegiline
• sertraline
• trazodone
• venlafaxine
• vilazodone
• vortioxetine

Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from https://www.magellanprovider.com/media/11740/psych…

Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171
Note: Retrieved from Walden Library databases.

Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPH…

Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.
Note: Retrieved from Walden Library databases.

Required Media

Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.

Optional Resources

El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3

Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655

Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497

Cases from Stephen Stahl’s suite- Discussions

This week’s assignment is a Decision Tree

To prepare for this Assignment:

• Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy.

At each decision point stop to complete the following:

Decision #1: Assessing and Treating Pediatric Clients With Mood Disorders

• Which decision did you select?
• Why did you select this decision? Support your response with evidence and references to the Learning Resources.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
• Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

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Decision #2: Assessing and Treating Pediatric Clients With Mood Disorders

• Why did you select this decision? Support your response with evidence and references to the Learning Resources.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
• Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3: Assessing and Treating Pediatric Clients With Mood Disorders

• Why did you select this decision? Support your response with evidence and references to the Learning Resources.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
• Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
• Also include how ethical considerations might impact your treatment plan and communication with clients.

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BACKGROUND INFORMATION

The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.

• Client complained of feeling “sad”
• Mother reports that teacher said child is withdrawn from peers in class
• Mother notes decreased appetite and occasional periods of irritation
• Client reached all developmental landmarks at appropriate ages
• Physical exam unremarkable
• Laboratory studies WNL
• Child referred to psychiatry for evaluation
• Client seen by Psychiatric Nurse Practitioner

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MENTAL STATUS EXAM

Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.

The PMHNP administers the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)

RESOURCES: Assessing and Treating Pediatric Clients With Mood Disorders

• Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

Decision Point One

Select what the PMHNP should do:

Decision Point One

Select what the PMHNP should do:

• Begin Zoloft 25 mg orally daily
• Begin Paxil 10 mg orally daily
• Begin Wellbutrin 75 mg orally BID

Client returns to clinic in four weeks

No change in depressive symptoms at all

If Zoloft 25mg orally daily is chosen as decision one

Please include the reasons why not using the two medications as my decision one

Decision Point Two

Select what the PMHNP should do next:

• Increase dose to 37.5 mg orally daily
• Increase dose to 50 mg orally daily
• Change to Prozac 10 mg orally daily

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Depressive symptoms decrease by 20%. Client reports feeling a little bit better

Please include the reasons why not using the two medications as my decision one

Decision Point Three

Select what the PMHNP should do next:

• Maintain current dose
• Increase to 50 mg orally daily
• Change to a different SSRI
• Maintain current dose

Guidance to Student

At this point, sufficient symptom reduction has not been realized. Should either increase dose or consider different SSRI. At 8 weeks post-initiation of therapy, there should have been a

significant (as defined as 50%) decrease in symptoms. This would be considered an adequate trial of antidepressant and change in dose or to a different agent would be appropriate.

Please include the reasons why not using the two medications as my decision one

Assessing and Treating Pediatric Clients With Mood Disorders Require readings

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Chapter 6, “Mood Disorders”

Chapter 7, “Antidepressants”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf

Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171

Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf

Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

Note: Retrieved from Walden Library databases.

Assessing and Treating Pediatric Clients With Mood Disorders Required Media

Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.

Assessing and Treating Pediatric Clients With Mood Disorders Optional Resources

El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3

Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655

Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497.

SAMPLE DECISION TREE TEMPLATE ASSIGNMENT

Geriatric Depression Therapy

Depression in the elderly altogether influences patients, families, and groups. Familiarity with inclining and hastening variables can help recognize patients needing screening with instruments, for example, the Geriatric Depression Scale (American Psychiatric Association, 2013). After analysis, consistent development and dynamic drug administration are essential to augment treatment and reduction. Determination of a stimulant solution ought to be founded on the best reaction profile and the most reduced danger of medication collaboration. On the off chance that abatement is not accomplished, then extra medicines, including different medications and psychotherapy, might be considered (Flint & Rifat, 2013). In instances of serious, insane, or recalcitrant depression in the elderly, electroconvulsive treatment is prescribed. This paper considers a case of a 31-year-old Hispanic man with severe depression and the treatment options available. The treatment decisions made are evaluated and the outcomes compared to facilitate greater understanding of geriatric depression therapy.

Decision Point One

Selected Decision

Begin Zoloft 25 mg orally daily

Reason for Selection

Zoloft is one of the most effective drugs for treatment of severe depression in adults. The patient had a score of 51 when the PMHNP administered MADRS, this is an indication of severe depression. Considering the available antidepressants in this case, phenelzine is recommended for use in areas where other drugs have failed (Stahl, 2014b). Effexor XL on the other hand can be used but has many potential side effects considering the patients history and lifestyle. Thus, Zoloft emerges as the best option.

Expected Results

The action of Zoloft should be evident within the first two weeks as this is the pharmaceutical expectation from the experiments completed with the drug. By the time the patient comes for checkup after two weeks, he should report ability to sleep at night. The level of concentration should also undergo a boost on administering this drug (Liu, Anderson, Mittmann, Axcell & Shear, 2015). It is also expected that the patient will be motivated to the normal activities and even relate well with people. The patient’s feeling of being an outsider due to the past treatment should start waning off.

Differences between Expected Results and Actual Results

When the patient revisited after four weeks and reported a decrease of 25% in the symptoms. This is in the direction of the expectations. However, another outcome was not anticipated, the patient was experiencing erectile dysfunction (Gaboda, Lucas, Siegel, Kalay & Crystal, 2014). This is a side effect of the drug that was not expected when the treatment plan was made. Zoloft has a number of potential side effects and erectile dysfunction is one of them though not very common. The rest of the outcomes reflected the expected trend even though the rate was a bit lower than anticipated.

Decision Point Two

Selected Decision

Add augmenting agent such as Wellbutrin IR 150 mg in morning

Reason for Selection

The client was experiencing a decrease in the depression symptoms because of administering Zoloft but the same drug had led to erectile dysfunction. It is a good idea to maintain Zoloft for reducing depression and combine it with another antidepressant with abilities to abate erectile dysfunction. Wellbutrin is such an antidepressant that can be used to help the patient’s erection function normally while on depression therapy (Flint & Rifat, 2013). In this case, the focus is not to treat the side effect of Zoloft as this is not advisable, but it is to introduce an antidepressant and slowly withdraw Zoloft and thereby correcting erectile dysfunction.

Expected Results

When Wellbutrin is introduced as augmenting agent, the patient should experience much reduced symptoms. This is because both Zoloft and Wellbutrin will be working to reduce depression and thus the combined effect should be bigger (Flint & Rifat, 2013). In addition, the patient should start having normal erection as a result of the working of Wellbutrin. This should even make the patient better and more motivated.

Differences between Expected Results and Actual Results

The patient visited again after four weeks and he stated that the depressive symptoms had even reduced further. He also informed that the erection dysfunction had been abated. These two outcomes were expected as the therapy was being administered. Nevertheless, different other outcomes from the ones anticipated arose (Gaboda, Lucas, Siegel, Kalay & Crystal, 2014). The patient was feeling jittery and nervous. Either of the two drugs could influence this; Zoloft and Wellbutrin as both are known to cause feelings of anxiety in some cases. Sometimes the feeling of jittery is caused by the kind of dosage of the two drugs.

Decision Point Three

Selected Decision

Change Wellbutrin to XL 150 mg orally in AM

Reason for Selection

The patient is experiencing jitteriness as the only problem with the current therapy. The effect of medication is as intended and so it is not proper to change just because of the side effect. Jitteriness may be caused by the immediate release of Wellbutrin. Trying to change the administration of Wellbutrin may be the solution to jitteriness. Administering Wellbutrin in its extended release form can help to reduce depression and remove jitteriness. It is not proper to introduce a new drug to treat the side effects of another before trying to modify the dosage of the original drug.

Expected Results

Administration Wellbutrin in its extended release form is anticipated to treat jitteriness if in fact the problem is the immediate release of Wellbutrin. It is also expected that the patient will continue experiencing an improved rate of depression reduction (Liu, Anderson, Mittmann, Axcell & Shear, 2015). The ceasing of jitteriness should allow the patient to have confidence in the therapy and are motivated to continue using the medication. The concentration ability of the patient should increase tremendously. The patient should also not have problems with sleeping at night.

Differences between Expected Results and Actual Results

The decision seems to be in agreement with the standard way of dealing with side effects of therapy administered to a patient (Laureate Education, 2016g). It was recommended that a drug can be modified in the way it is administered in an attempt to handle the side effects rather than introduce another drug to treat the side effect (Liu, Anderson, Mittmann, Axcell & Shear, 2015). This is because every drug has side effects and so treating one may be just as good as introducing another.

Impact of Ethical Considerations on Treatment Plan

Ant-depression therapy in adults has many complications that accompany any medication plan adopted. It involves taking risks, as there are many side effects of the drugs used in this therapy. Some drugs cause patients to have suicidal tendencies (Flint, 2012). Based on the doctor’s evaluation of the patient, some drugs may not be included in the therapy of certain patients. In this case, some drugs may not be used especially those that induce suicidal tendencies as this patient is not interacting with people and that make is risky.

Conclusion

Depression in the elderly is a noteworthy, normal, and developing issue that requires treatment. It has genuine ramifications for the patient, family, and group. Recognizable proof took after by a careful evaluation can help manage the determination of a proper upper prescription. There are a few variables to consider when choosing, altering, and changing antidepressants in the elderly. Together, these techniques can help advance the sheltered utilization of antidepressants in the elderly (Flint & Rifat, 2013). Other than medicines, different treatments for wretchedness that may be considered incorporate different types of psychotherapy and neurostimulation, with electroconvulsive treatment as yet being the highest quality level for extreme or crazy discouragement

NB: The below is not a sample assignment- they are notes on how one can treat mood disorders in children and adolescents.

Assessment and Treatment of Mood Disorders in Children and Adolescents

Assessment and Treatment of Mood Disorders in Children and Adolescents” was presented at the Minnesota Psychological Association Friday Forum series on November 6, 2015.  Dr. Leffler focused on the following three areas: enhancing diagnostic skills related to mood disorders in youth, utilizing assessment strategies for identifying mood disorders in youth, and applying treatment techniques for youth with mood disorders.

Pediatric mood disorders, which include depression and bipolar spectrum disorder, are among the more severe childhood disorders. These disorders have been found to result in significant impairments in numerous areas including interpersonal interactions, communication patterns, academic and employment functioning, family engagement, and suicide.

Enhancing diagnostic skills related to mood disorders in youth.  Accurate diagnosis of mood disorders in children and adolescents is crucial to aiding in directing the most effective treatment interventions.  Accurate diagnosis can be hindered by comorbidity in diagnosing mental illness in children (Caron & Rutter, 1991). Mood disorders in children and adolescents can be particularly complex due to variations and overlap in symptom presentation and development (Mash & Barkley, 2007). It is crucial that the assessment process includes evaluating functioning and symptom presentation throughout the development of the individual, from a nomothetic and ideographic approach in all the systems the individual is a part of (Leffler, Riebel, & Hughes, 2014).

Utilizing assessment strategies for identifying mood disorders in youth.  Structured and semi-structured clinical interviews can be integrated into diagnostic assessments within the time allotted for these initial appointments (Leffler et al., 2014).  Information from these interviews along with narrow or broad-band measures can assist in diagnostic clarity.  Results from these techniques can be integrated with a biopsychosocial history to facilitate conceptualization of the client.  For example regarding bipolar disorder, knowing the base rate of the illness in your practice setting, the client’s family history of bipolar disorder and scores on a parent checklist provides a considerable amount of information about the degree of risk of bipolar disorder in a specific case (Youngstrom & Youngstrom, 2005). Regarding informants and scores on rating scales, parent report should always be included in the differential diagnosis of mania in children and adolescents. Teacher report on the Achenbach Child Behavior Checklist (CBCL) was found not to add incremental information about bipolar diagnoses, and low scores on the CBCL can be decisive in most settings in ruling out bipolar (Youngstrom & Youngstrom, 2005).  However, high scores on the CBCL Externalizing scale should trigger more thorough assessment.

Examples of narrow band measures for depression that were reviewed include the Children’s Depression Inventory (ages 7-17), the Reynolds Child Depression Scale (ages 8-12), the Reynolds Adolescent Depression Scale (ages 13-18), the Center for Epidemiological Studies Depression Scale for Children (ages 12-18), the Center for Epidemiological Studies Depression Scale (ages 14 and older), and the PHQ-9M (ages 11-17).  Narrow band measures of mania included the General Behavior Inventory (ages 11-17), the Parent General Behavior Inventory (ages 5-17), the Parent Young Mania Rating Scale (ages 11-17), and the Mood Disorder Questionnaire (ages 12-17).  Non-proprietary measures are also available and include those listed on the American Psychiatric Association Diagnostic and Statistical Manual fifth edition (DSM 5) assessment webpage (http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-measures).  These include the PROMIS Emotional Distress—Depression—Parent Item Bank,

The Affective Reactivity Index (ARI) and adaptations of the Altman Self-Rating Mania Scale (ASRM). Versions for youth and parents are available.  Broad-band measures that were reviewed include the Behavior Assessment System for Children (BASC-2), the Child Behavior Checklist (CBCL), the Conner’s Comprehensive Rating Scales (CBRS), the Conner’s Rating Scales –Revised (CRS-R), and the Devereux Scales of Mental Disorders.

Applying treatment techniques for youth with mood disorders. Treatment interventions that are well-established and probably efficacious were reviewed for depression and bipolar disorder.  Well–established therapies for depression in children include cognitive behavioral therapy (CBT) provided in individual or group settings along with parent involvement.  Treatments for adolescents with depression include CBT offered in a group therapy format, and interpersonal psychotherapy (IPT) provided in an individual format.  Additionally, CBT with adolescents and parents and IPT- adolescents (IPT-A) are probably efficacious interventions (David-Ferndon, & Kaslow, 2008).  Probably efficacious treatments for child and adolescents with bipolar disorder include Family psychoeducation plus skill building (i.e., Multi-Family Psychoeducational Psychotherapy, Family-Focused Treatment) and cognitive-behavioral therapy (CBT; Fristad, MacPherson, 2014). Overall treatment approaches for depression and bipolar include cognitive behavioral therapy, interpersonal psychotherapy, and family based strategies.   Additionally, mindfulness and health and wellness techniques were reviewed.  A two-week integrated partial hospitalization program (PHP) for youth with mood disorders and their families was discussed.  Mayo Clinic’s Child and Adolescent Integrated Mood Program (CAIMP) integrates a family-based approach to treating complex mood disorders in a PHP setting.  Preliminary results of CAIMP suggest decreased inpatient psychiatric readmission for patients, decreased levels of youth depression, and improved functioning.

Jarrod M. Leffler, Ph.D., L.P., ABPP, is a diplomate of the American Board of Professional Psychology in the specialty of Clinical Child and Adolescent Psychology (ABCCAP).  He is the director of the Child and Adolescent Integrated Mood Program (CAIMP), the co-director of the Pediatric Mood Disorder Program, and director of the Pediatric Transitions Program (PTP). He is an Associate Professor, and faculty member of the Mayo Clinic Clinical Child Psychology Fellowship (Department of Psychiatry and Psychology) and Mayo Clinic Graduate School (Rochester, MN).  His research program focuses on the assessment and treatment of mood disorders in children and adolescents; clinical program development, implementation and evaluation; biological mechanisms of identifying mood disorders; and training of mental health professionals.  Dr. Leffler received his Doctorate in Psychology from Saint Louis University and completed his internship at Harvard Medical School and Children’s Hospital Boston before completing his Post-Doctoral Fellowship at The Ohio State University in Child and Adolescent Mood Disorders.

References

Caron C., & Rutter, M. (1991). Comorbidity in child psychopathology: concepts, issues and research strategies. Journal of Child Psychology and Psychiatry, 32(7): 1063-80.

David-Ferndon, C., & Kaslow, N.J., (2008).  Evidence-based psychosocial treatments for child and adolescent depression. Journal of Clinical Child Adolescent Psychology, 37(1): 62-104.

Fristad, M.A., & MacPherson, H.A. (2014). Evidence-based psychosocial treatments for child and adolescent bipolar spectrum disorders. Journal of Clinical Child and Adolescent Psychology, 43(3): 339-55.

Leffler, J.M., Riebel, J., & Hughes, H.M. (2014). A Review of Child and Adolescent Diagnostic Interviews for Clinical Practitioners. Assessment, 22(6): 690-703.

Mash, E.J., & Barkley, R. (2007).  Assessment of Childhood Disorders, Fourth Edition Eric J. Mash, Russell Barkley Editors. The Guilford Press: New York, NY.

Youngstrom, E.A., & Youngstrom, J.K. (2005). Evidence-based assessment of pediatric bipolar disorder, Part II: Incorporating information from behavior checklists. Journal of the American Academy Child Adolescent Psychiatry, 44(8): 823-8.