What Your Healthcare Organization Can do to Make Patients More Comfortable with Telepsych

Since the onset of the COVID-19 pandemic, telehealth has become a mainstay for patients across the country. The American Telemedicine Association (ATA) reports the following data:

  • 28 studies found that more than 80% of patients indicated satisfaction with telehealth
  • 75% of people expect virtual care to become a standard part of their care
  • 85.52% report that telemedicine has made getting the care they need easier

With its growing popularity, it’s clear telehealth is a long-term solution and not just a temporary fix during the pandemic. As of 2017, the American Hospital Association cited 65% of hospitals had incorporated a telehealth solution. In 2021, about one-sixth of hospitals reported using telepsychiatry with a wide variation across states.

Still, healthcare organizations have a lot to consider when implementing virtual specialty solutions like telepsychiatry, and patient comfort should be a top priority. Keep reading to learn more about common telehealth misconceptions, why virtual works so well for psychiatry, and how to set patients and providers up for success in a virtual environment.

Common telehealth misconceptions

Despite the benefits and popularity of virtual care, misconceptions about the patient experience persist, and the telepsychiatry space is no different.

Here are four of the top misconceptions we encounter on a daily basis:

  1. Patients don’t want to use telehealth: This is perhaps one of the biggest myths busted by the pandemic. Across the board, patients want to conveniently and quickly see a provider across any specialty in the most convenient way possible — and for many, that means telepsychiatry. Additionally, while some organizations might be concerned about their patients thinking telehealth is low quality, there is no current data to support this notion. As the ATA study reports, patient satisfaction is high, and patients expect telehealth to continue being a possibility for their care well into the future.
  2. Elderly patients have trouble accessing technology: According to the American Association of Retired Persons (AARP), technology usage among older adults skyrocketed during the pandemic. The AARP reports that 44% of older adults view tech more positively as a way to stay connected than they did before COVID-19. Additionally, the American Psychiatric Association (APA) reports that since the late 1990s, telepsychiatry has been an effective treatment for anxiety, dementia, and cognitive impairment within this population.
  3. Populations with specialty concerns can’t get care: Many providers or organizations may think certain patients with specific concerns, like those experiencing paranoia, wouldn’t be interested in telepsychiatry. However, psychiatrists have seen that the ability to receive care from the comfort of their own homes has a more influential benefit for this population. Additionally, for deaf or hard-of-hearing patients, sharing the call with a sign-language interpreter has proven helpful and easy to manage virtually.
  4. Reaching rural communities will be difficult: While there may be concerns about getting this population on board with telepsychiatry, patients have seen real benefits over the past few years. In rural or small-town communities where access to care is limited, stigma around getting mental health treatment still exists, and not having to go to a psychiatrist’s office is a bonus for many people who may be wary of community backlash. Additionally, according to the Pew Research Center, 93% of American adults use the internet, diluting concerns that populations in rural America can’t access virtual care. Additionally, the ability to get care from home, so they don’t have to drive long distances, is a huge plus for this population.

Why virtual works for psychiatry

The virtual environment of telepsychiatry allows providers to meet patients where they are. This virtual platform is compatible with the nature of a psychiatrist’s work, and dates back as far as the 1950’s.

Additionally, for individuals with anxiety who aren’t comfortable leaving their houses, telepsychiatry is an excellent fit. The same goes for lower income populations, or patients experiencing homelessness. For these patients, getting transportation can stand as a barrier, and it can also be more difficult for them to want to go into a busy medical office.

The vast majority of work that goes into psychiatry is talking and listening, and telepsychiatry is the perfect fit for this line of work. Educating patients, providers, and organizational leadership about the benefits of telepsychiatry can help solidify this modality as a long-term solution for your organization.

Increasing patient comfortability at healthcare organizations

While most patients will be comfortable utilizing virtual care platforms, some may be hesitant. In this case, communication is vital. Ask your patients where else they’ve used this modality in their lives. If they’ve been able to communicate and connect with their loved ones, chances are, they’ll like telepsychiatry as well.

You can also ask them what they want directly. For example, do they want to come into the clinic? Or, do they want to connect from home? Maybe there will be some patients who are interested in a hybrid option. The data you collect can help guide your organization’s decision when considering investing in a telepsychiatry solution.

Tips for providers using telepsych

While telepsychiatry is beneficial to patients, it also benefits providers. In the ATA report cited above, 94% of mental health professionals say they would like to continue offering telehealth services. That said, making sure your providers have the information they need will set them up for success as they embark on their virtual practice.

At Iris Telehealth, we ensure our providers have all the resources, tools, and support they need to do what they do best — take care of patients. We’re psychiatrist-owned and operated, and we know what providers need, like less paperwork, a supportive work/life balance, and even 24/7 tech support.

Here are five tips our providers have found useful:

  1. Ensure a nice office set-up with a neutral background that’s not too distracting or too plain, like a blank white wall
  2. To prevent headaches, encourage providers to be aware of any glare on their glasses or their computer screen
  3. Investing in a noise-canceling microphone can help providers keep communication clear and cut back on distractions
  4. To help ensure patient privacy, ask your providers to invest in a headset to ensure they’re the only ones who can hear what the patient is saying
  5. Ensuring your provider’s cameras are set to a good gaze angle can help promote connection. When a provider’s camera is pointed down and they’re looking up (or if the camera is on a different monitor than the screen they’re looking at), it can look like they’re staring off into a different direction — providers should seek to position their cameras in a way that makes it appear as though they’re looking directly at their patient

By incorporating these tips, your providers will be set up for successful patient sessions that will make patients more comfortable with any virtual communications.

Get started on your behavioral health strategy

Here at Iris, we make sure your organization has everything it needs for a successful behavioral health program.

Contact us today to see if our telepsychiatry services would be a good match for your organization. Or, if you have more questions, check out our FAQ page.

How Nurse Practitioner Authority Varies By State

Nurse practitioner practice authority varies by state. This variation defines whether or not nurse practitioners (NPs) can utilize the full extent of their education. For NPs, they follow guidelines around how they can see patients, whether or not they need a collaborative physician, and what controlled substances they can prescribe with or without the need for co-signatures. Whether your organization needs help addressing the provider shortage or decreasing wait times, an NP can help.

According to the AANP, nurse practitioners’ practice authority varies depending on what state they choose to practice in. The three types of state practice environments are:

  • Full practice (independent)
  • Reduced practice (partially independent)
  • Restricted practice (non-independent)

In restricted practice states like Texas, NPs must work under another health provider’s supervision to practice. Reduced practice states like New York allow NPs to be in a collaborative agreement with another health provider to facilitate patient care. They also have one or more limits on NP practice. Full practice states like Arizona allow NPs to practice independently, evaluate, and provide care to patients without a collaborating physician or agreement.

As of right now, there are 29 NP full practice authority states, 16 reduced practice states, and 11 restricted practice states.

Finding the right fit

While NPs are essential to addressing the provider shortage and improving patient experience, they’re also indispensable when it comes to mental health treatment. The type of NP working in the mental health field is called a psychiatric mental health nurse practitioner or a PMHNP. These providers work in correctional settings, residential treatment centers, inpatient hospitals, health systems, and private practices. However, the majority of PMHNPs are practicing in underserved and rural areas.

PMHNPs can be a major benefit to your organization, especially if your organization serves patients from vulnerable populations, like Community Mental Health Centers (CMHCs), Certified Community Behavioral Health Clinic (CCBHCs) and Federally Qualified Health Centers (FQHCs). PMHNPs are skilled at caring for patients, and their quality level is similar or equal to a psychiatrists. Not only can they provide a similar quality of care as a psychiatrist, but they are also skilled at facilitating holistic care, which overall contributes to the level of quality care and treatment they can provide.

PMHNPs receive specific training in various types of treatment they provide like:

  • Extensive training in psychotherapy and behavioral health conditions
  • Crisis intervention and directing patient care planning
  • Collaborative care
  • Effective communication with patient families

If your organization is looking to provide these skills and treatments, PMHNPs might be a valuable asset for your organization.

Challenges and opportunities you might face

Across the country, healthcare organizations are facing a provider shortage. According to USAFacts, as of March 2021, 37% of the U.S. population lived in 5,833 mental health professional shortage areas. Providing cost-effective but high-quality care can be difficult in these regions, but in full authority NP states, the providers can serve as a primary care provider.

In restricted and reduced practice states, PMHNPs cannot practice without a collaborating physician. During the provider shortage, it is especially challenging to find a collaborating physician. These agreements have to be renewed annually, and they have to meet with the physician they are collaborating with on a monthly basis. This specific agreement can cause issues for rural areas where there may not be a physician locally available, or there may be a shortage of physicians who would be able to work collaboratively with a nurse practitioner. In some extenuating circumstances, if the collaborating physician becomes ill or retires, patients cannot be seen, and you might have to cancel the appointment.

By utilizing telepsychiatry, you can find the best-qualified PMHNP for your organization’s needs, especially during a provider shortage when you cannot find a PMHNP locally. Telehealth can extend healthcare delivery to underserved populations and rural areas. With the help of a PMHNP, it can be easier to meet that need by partnering with telehealth organizations like Iris Telehealth. Telepsychiatry solutions can help healthcare organizations overcome access issues and help alleviate the pressure of finding a qualified provider locally. For example, a PMHNP living in Texas can meet the licensure requirements in Utah, making it possible to extend healthcare delivery through telepsychiatry.

Telepsychiatry that meets you where you are

Regardless of where nurse practitioners practice, they can utilize telehealth to connect their patients with specialty care while working in their scope of practice. Telepsychiatry can open up your search by hiring a PMHNP from across the country instead of searching locally, especially since there is a high saturation of providers on the East Coast and a higher need on the West Coast.

If you decide to hire a PMHNP for your organization, you can ease some of the administrative burdens, like licensing, credentialing, and obtaining a collaborative agreement.

How Iris Telehealth can help

Iris Telehealth serves as a resource for providers who need support and can help your organization source and vet potential PMNHPs. If you’re looking to develop a formal telepsychiatry program to provide high-quality care for your patients, Iris can help you through the process.

If you would like to learn more about how telepsychiatry can help supplement your behavioral health team, contact us today.

The Long-Term Effects of COVID-19 on Mental Health

The COVID-19 pandemic has left a seismic impact on the hearts and minds of people across the world — whether through job loss, the grief of losing a loved one, difficulty paying bills, or trouble finding quality healthcare.

In tandem with these experiences, the state of mental health has plummeted. According to data published by The Lancet, 76 million people have reported pandemic-related anxiety, a number that increased by 26 percent between 2019 and 2020.

As the pandemic continues, we’re pausing to look back at the unique experiences of different populations across the country, the long-term effects on mental health, and how to help decrease the impact of COVID-19.

Long-term effects on families, rural Americans, and underserved populations

The COVID-19 pandemic has affected everyone differently and has been particularly challenging for families, Americans in rural parts of the country, and underserved populations.

Families and children

For families, the pandemic transformed daily life. Social determinants of health have been exacerbated, and paying bills has gotten harder. In fact, The Commonwealth Fund reported that 7.7 million workers lost their employer-sponsored health insurance (ESI) jobs due to the pandemic-induced recession. This loss also affected 6.9 million dependents across the country.

Additionally, nearly 93% of school-aged children were engaged in distance learning, creating changes and new dynamics in the home. Today, as kids transition from a more controlled, virtual environment to one that’s in-person with more people, noise, and different expectations, it may trigger separation anxiety or underlying fears that could potentially impact their development.

The compounding stress has been so significant that the American Academy of Pediatrics, alongside the Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association, recently declared a national state of emergency in children’s mental health.

Rural America

During the pandemic, 30% of rural Americans reported suffering from anxiety or depression. While finding care can prove challenging, many rural Americans turned to telehealth. In fact, 43% say they have used telehealth for mental health and/or substance use treatment services once a month or more over the past year.

Telepsychiatry works to reach people to get them the right care when and where they need it. For healthcare organizations located in rural areas looking to impact their communities and improve their services in the wake of COVID-19, telepsychiatry can make a real difference in the short and long term.

Underserved Populations

The impact COVID-19 had on underserved populations was especially hard. A survey by The Commonwealth Fund found that Latino and Black people, women, and people with low income are most at risk of mental health concerns because of the pandemic.

The COVID-19 pandemic has underscored the need for health equity. By making mental healthcare more accessible and equipping communities with the right mental health resources, these populations will have the care they need throughout and after the pandemic.

Provider shortages and increased need

Healthcare organizations were hit hard throughout the pandemic, further exacerbating the pre-existing psychiatrist shortage and causing people to delay mental and medical care. At the height of the pandemic, 1 in 5 adults in the U.S. reported they could not get care or delayed care for serious problems, and 57% reported negative consequences. Additionally, a report by the Kaiser Family Foundation (KFF) found that the pandemic and the economic recession created new barriers for those experiencing mental health conditions. In a July 2020 poll, KFF reported specific negative impacts on adults:

  • 36% had difficulty sleeping
  • 32% had difficulty eating
  • 12% experienced an increase in alcohol consumption or substance use
  • 12% experienced worsening chronic conditions due to worry and stress

While there’s mounting pressure on healthcare organizations, there are steps they can take to help relieve shortages and empower patients and providers.

Solutions for healthcare organizations

This lack of access to care for both mental and physical health throughout the pandemic decreased overall wellness. So, what can healthcare organizations and providers do to help set their patients up for success? There are three solutions every organization should consider.

1. Incorporate an integrated care program

Conditions like generalized anxiety disorder, social anxiety, agoraphobia, and more have been exacerbated. When mental health goes untreated, certain medical conditions can worsen over time. The Centers for Disease Control and Prevention (CDC) calls mental and physical health equal components of overall health.

That’s where integrated care programs come in. These programs can play a significant role in helping hospitals, health systems, Federally Qualified Health Centers, and Community Health Centers recover from the pandemic. This convergence of medical and behavioral health facilitates true collaboration between providers, offers patients the best possible care, and mitigates downstream medical costs.

2. Invest in telepsychiatry

As the demand for care increases due to unmet needs, staffing up healthcare organizations with telepsychiatry solutions can help hospitals keep up with demand, support providers, and provide high-quality care to patients. This solution is beneficial for patients in need of specialty care who may not have time to sit on a waiting list or in an emergency room.

By incorporating this solution, hospitals will have a specialist on call 24/7 in the emergency department to consult with inpatient services or support outpatient services to drive better outcomes. Telepsychiatry makes it possible for people to get the care they need when they need it.

3. Ask questions

When providers take the time to ask people how they are and how COVID has affected their lives, it can open up critical communication channels that can ultimately help your organization better serve your patients. For example, if a patient is experiencing food insecurity, providers can point them toward a food bank. Or, if they need to get tested for COVID but don’t know where to go, your organization can help them find a testing location. Asking the right questions can reveal core issues, reduce stress, and encourage connection.

Healing long-term effects through self-care and awareness

Stress can take a toll on us all. For providers who are already dealing with high rates of burnout, it’s imperative to set aside time for self-care. Incorporating lifestyle medicine principles into your life can help heal long-term physical and mental effects. The pillars of this solution include staying hydrated, eating nutritious foods, exercising, getting adequate sleep, limiting substance use, and emphasizing social connectedness.

Taking care of your mental health and turning your awareness towards self-care can make a big difference in helping heal the long-term effects of the COVID-19 pandemic.

Where Iris Telehealth fits in

If you’re looking to incorporate telepsychiatry into your organization but don’t know where to start, Iris Telehealth is here to help. Together, we can help your organization combat the long-term effects of the COVID-19 pandemic. Contact us today!

How Telepsychiatry Can Serve as a Long-Term Solution for Shortage Areas

In many rural areas across the U.S., and even in a lot of urban areas, there’s a huge lack of access to psychiatry or behavioral health services in general. Partially due to the ongoing (and worsening) psychiatry shortage, many healthcare organizations find it difficult to locate high-quality, local behavioral health providers to serve their communities.

And, those challenges compound when an organization needs more specialized care — like bilingual providers or providers who specialize in working with children or older populations. Fortunately, telepsychiatry can go a long way toward filling those care gaps.

In this piece, we’ll break down how telepsychiatry can specifically benefit shortage areas across the country, what challenges your healthcare organization might face in implementing a telepsychiatry program, and best practices that will set you up for success.

What is a shortage area?

Health Professional Shortage Area (HPSA) is a federal designation that identifies an area as having a geographic shortage, which means there’s a shortage of providers for everyone in a defined geographic area. There are also population-based shortages areas — Medically Underserved Areas (MUAs) or Medically Underserved Populations (MUPs), which signify a shortage of providers for a specific group of people — for example, migrant farmworkers or low-income patients. Organizations that qualify as facility HPSAs include public hospitals or nonprofit outpatient centers, correctional facilities, state mental health hospitals, and FQHCs.

Telepsychiatry can provide critical behavioral health support to shortage areas

Shortage areas or HPSAs may be a particularly good fit for telepsychiatry programs because they are disproportionately affected by the national psychiatrist shortage. Healthcare organizations in HSPAs are often unable to have an in-person provider on staff for their care setting, , but through telepsychiatry, they can access quality providers from across the country. Without utilizing telepsychiatry services, organizations will often find themselves with long wait times — or without care entirely.

Having access to providers all over the country who can provide excellent care quickly and conveniently is a huge benefit for these organizations.

Telepsychiatry can also open up access to providers with specific specialties that would otherwise be nearly impossible for healthcare organizations in HPSAs to staff. For example, in communities where the prominent language spoken isn’t English, having access to a telepsychiatry provider who speaks that language is a huge benefit to patients as it enables them to see someone who they feel they can connect with. Additionally, some providers specialize in mental healthcare for LGBTQ patients or other specific patient populations. It can be hugely beneficial to have access to someone who is an expert in that area.

Through telepsychiatry, your organization can access those specialties and fill gaps you can’t fill through your local provider network.

Challenges and considerations for implementing telepsychiatry programs in HPSAs

Whenever your organization begins the process of searching for a telepsychiatry provider, it might be difficult to find the right fit for your community. It’s important to make sure any potential providers understand the culture of your area and can work effectively with your specific patient populations. Working with a telepsychiatry vendor, like Iris Telehealth, can be beneficial through that process as they have in-depth knowledge and experience with identifying, interviewing, and matching providers who would be a good fit for your community and your organization.

Initially, your organization may also face challenges in locating adequate funding for your telepsychiatry program. However, there is no shortage of federal grants available to help bring any necessary resources or technology to your community — you just need to make sure you consider the time it could take to apply for and receive that grant funding.

Some good grant resources to keep an eye on include:

  • Rural Health Information Hub: RHIhub keeps an active list of all funding opportunities for all U.S. states and territories. If your organization is located in a rural area, this will be a great resource for current and future grants.
  • SAMHSA: SAMHSA keeps a comprehensive list of grants for the improvement of quality and availability of substance use and mental health treatment services.
  • Grants.gov: Grants.gov is the largest repository of federal grants for healthcare organizations across the country.

Setting your telepsychiatry program up for success

Regardless of where your organization is located, there are certain steps you can take to help ensure the long-term success of your telepsychiatry program:

  1. Train and educate your staff: Training your staff on specific systems or processes you may need to implement for your telepsych program can seem daunting at first, but it’s an important step to ensure you have the buy-in from your team to launch a successful program. As you walk them through any changes that might come with your new program, remember there are many resources available to help train your staff on how to work with specific technologies. Start by reaching out to your local telehealth resource center to learn more.
  2. Work with a dedicated telepsychiatry partner: If the prospect of launching your program and staffing it with telepsychiatry providers seems overwhelming, it may be a good idea for your organization to reach out to a company like Iris, who can help you set up your program from the ground up.
  3. Educate yourself and your staff on how federal and state policies apply to you: It’s important to make sure your organization is aware of how billing and reimbursement policies affect your telepsychiatry program. And remember, there’s no shortage of evidence that patients like having access to telepsychiatry and telemental health services.

No matter what stage you’re in with your telepsych program, support is out there to help you build a program that provides life-saving access to behavioral health services for your community. If you’re looking for highly qualified, compassionate psychiatrists and psychiatric mental health nurse practitioners with experience working in shortage areas, Iris Telehealth can help. Contact us for more information about building an effective telepsychiatry program.

A Psychiatrist’s Guide to Job Hunting

Job hunting can be a stressful process, and there’s a lot to consider when navigating your next career move. As a psychiatrist, finding a job that prioritizes your well-being is essential. After all, being a mental health professional is tough, and provider burnout is a serious issue affecting 78% of psychiatrists. While the psychiatry field is full of opportunities, it’s crucial to pick the right one to ensure you avoid burnout and love your work.

So, how can you find a fulfilling, flexible job that gives you ample time with family and friends? Read on to learn how you can find that perfect fit.

Know what you want

Psychiatrists spend an average of 48 hours at work per week, and 60% of that time is spent with patients. Additionally, psychiatrists report above-average stress related to their work environment and the complexities of their jobs. That means ensuring your work environment encompasses what you want is essential whether you’re onsite seeing patients or conducting telepsychiatry appointments from home.

As you search for the right fit, consider the following:

  • Time zone difference (telepsychiatry)
  • Patient population
  • Patient volume
  • Work/life balance
  • Amount of paperwork
  • Flexibility

Most importantly, be honest with yourself and realistic about what you want. Whether that’s your desired schedule, patient volume, or team culture — you shouldn’t have to settle. Creating a list can help identify what you need from a position and help you stay true to what’s negotiable and non-negotiable for you. These boundaries can help create longevity and happiness over time.

Questions for a potential employer

The job market for psychiatrists is rife with opportunity, and it’s projected to grow by 13% in the next decade, significantly outpacing other healthcare professions like pediatricians, surgeons, and anesthesiologists. Simultaneously, the U.S. is also experiencing a provider shortage, and the need for psychiatrists is great. That surplus of opportunity makes it all the more important to find the perfect fit that will help you thrive.

The following questions can help you narrow in on the right position.

Compensation

  • What’s their pay structure?
  • What’s their no-show rate?
  • Will you be paid fee-for-service?
  • Who is responsible for taxes?

Administrative

  • What type of electronic medical record do they use?
  • Who is responsible for their licensing? Credentialing? Malpractice insurance?

Growth

  • How many partners do they work with?
  • How long has the company been in business? How have they grown?

Culture

  • What does their company value?
  • Is the organization mission-driven?

At Iris Telehealth, we make our values clear from the beginning. From creating a culture that promotes a positive work-life balance to ensuring less administrative paperwork and excellent benefits — we prioritize people over all else.

Telepsychiatry companies and the importance of job matching

If you’ve ever worked for a medical group, telepsychiatry company, or staffing agency, you’ve probably witnessed good and bad job matching. How an organization approaches job matching can make a big difference in quality.

For telepsychiatry companies, a provider might be matched at random — or they might be matched thoughtfully based on experience and need. If you’ve only worked for healthcare organizations directly, you’ve most likely not dealt with job matching, but if you’re considering working with a telepsychiatry company to expand your options, it’s something you should be aware of.

Acknowledging red flags

As a mental health professional, chances are there have been times when you’ve felt undervalued. Or, maybe you’ve worked in a healthcare system that didn’t prioritize quality care. Whether you’ve dealt with long commutes, troublesome work politics, or disorganization, you know a job can quickly turn stressful.

Being able to identify and acknowledge red flags is an integral part of the job search. Below are three common red flags you should take note of during your job hunt.

  1. They’re not getting to know you: The company you’re talking to should try to get to know you as a person, understand what you like about a job, and understand your personality. When companies take this extra step, it shows they care about making sure their providers are placed somewhere that aligns with the work they want to do and the values they hold.
  2. They’re not giving you information about your placement: If the company isn’t giving you information about your placement, chances are they might take a “plug and play” approach. This approach makes matches based on age and licenses, without regard to a provider’s preference towards things like desired schedule or population. That said, it’s also important to make sure you have the specialization to serve the population they’re asking you to see. All of this can make a big difference in whether or not the company can provide longevity.
  3. They have a high turnover rate: Does the company have a swinging door or providers coming and going? If so, this can be indicative that the telehealth company or staffing agency isn’t making suitable matches. If you suspect their retention is low, it could be helpful to ask how often their clinicians switch jobs or change sites. Additionally, it’s always best practice to check out a company’s Glassdoor page. Company review websites like Glassdoor can provide insights into turnover rates, culture, and whether they live up to their mission and values.

Transparency is key. That’s why at Iris, we get to know our providers first to ensure we can find the right job or clinic placement for them. We pride ourselves on being upfront with all of the necessary details that will affect your day-to-day and job satisfaction. From the clinical setting to the scheduling details to our prescribing philosophy, we are committed to ensuring the role is the right match for you.

Finding the perfect fit

The perfect fit means that you’ll be able to do great, meaningful work and have time for the important stuff. The right job should also include excellent benefits, have a great culture, and allow you to enjoy the work-life balance you’ve always dreamed of. At Iris, we surveyed our providers to determine why they saw Iris as the perfect fit, and four reasons stood out among the rest.

  1. Communication and organization
  2. Staff connection
  3. Iris’ match commitment
  4. Unparalleled clinical support

The benefits of working somewhere that aligns with your goals and values is indispensable. Where you spend your time matters, and for providers at the frontlines of the country’s behavioral health challenges, making sure you have the work/life balance you need to make time for yourself and your family and friends is of the utmost importance. As a mental health professional, you should be respected, valued, and applauded for your work, and finding an employer who aligns with that mission is essential.

Love your work and save the world

At Iris Telehealth, we prioritize the wellbeing of our providers over everything else. Work-life balance is a top priority, and we create a flexible, fulfilling culture that helps you spend more time caring for patients and less time on paperwork — we take care of that for you.

Through our telepsychiatry services, Iris providers deliver care to the patient populations who need it most and help healthcare organizations achieve their goals through clinically sound and financially sustainable psychiatry programs. If you want to learn more about working for us, contact us today.

How Your Healthcare Organization Can Effectively Reduce the Usage of Benzodiazepines

Across the country, healthcare organizations are working to decrease the amount of benzodiazepines they are prescribing to patients — and are considering whether they should go ahead and adopt a “no benzo” policy altogether.

In this piece, we’ll discuss the pros and cons of using benzodiazepines, best practices for prescribing policies, and benzo alternatives your organization can utilize.

What are benzodiazepines, and how are they used?

Benzodiazepines are a class of sedatives or hypnotics, and they are most commonly used for insomnia, panic disorders, situational anxiety (like fear of flying), or other sleep disorders.

The three most commonly prescribed benzos are:

  • Diazepam (Valium)
  • Clonazepam (Klonopin)
  • Alprazolam (Xanax)

However, you can generally identify less common benzos from their generic name — which will often end in “pam.”

What are the pros and cons of using benzodiazepines?

The pros to using benzos are that they’re effective and fast-acting, making them a common medication for panic disorders and situational anxiety. A benzodiazepine will work a lot faster than an SSRI, which would take several weeks to start working. If someone is going on an airplane and they have a fear of flying, they might take a medication just for that one time during that day, or if they have panic disorder, but only have panic attacks once or twice a year, they might have the medication available as needed.

There are also specific cases where someone may experience involuntary movements as a side effect of an antipsychotic medication, and benzos can help treat those side effects. In these cases, providers and patients might find that the benefits of using benzos outweigh the risks.

However, there are certainly some significant risks to using benzos — with the most common being that people become physically dependent on them with regular use. Then, if they were to rapidly stop the medicine, a patient could have seizures as part of that withdrawal. People can also become psychologically dependent on the medication. These two dependencies mean that benzos are fairly common drugs of abuse.

If someone takes a benzodiazepine in combination with alcohol, an opiate, or another sedating medication, they can have a fatal overdose. So, that’s a risk your organization and your providers have to consider whenever you’re prescribing benzos.

Additionally, chronic long-term use of benzos can increase a patient’s risk of early-onset dementia.

More and more organizations are finding that, despite their efficacy, the potential downsides to prescribing a high volume of benzos are too serious to ignore.

How to identify whether your organization needs to change your benzo policy

Generally speaking, it’s a good idea when possible to reduce your organization’s use of benzodiazepines.

One of the first steps to doing that is to take an inventory of your current prescription volume. It’s not uncommon that we’ll start working with a health center whose previous provider had as many as 30% of their patients on a benzodiazepine. Often, providers can be surprised themselves when they see just how many of their patients are using them.

If you find that your organization is prescribing a high volume of benzos, it’s important to take that seriously because that’s a lot of medication getting out into the public. You hope that all of it’s being used appropriately, but there could be dangerous outcomes if it’s not.

Across the board, clinics with low benzodiazepine, or no benzodiazepine, policies notice fewer issues with patients needing immediate refills or demanding their medication be filled.

Best practices for reducing benzo usage with your patients

For organizations that previously had a high volume of their patients using benzos, it can be difficult to switch to a low benzo, or no benzo, policy. That’s because once someone is on a benzodiazepine, it can be a challenge to get them tapered off.

In an ideal world, having as few patients as possible using a benzo is the best option. But, there are effective alternatives when that’s not the case:

  • For patients experiencing anxiety, starting an SSRI, which is the gold standard first-line treatment for anxiety, is a good alternative.
  • Prescribing a low-dose mood stabilizer can help reduce the risk of withdrawal seizures.
  • The most effective long-term solution for tapering someone off the medication is long-term cognitive-behavioral therapy (CBT), which is more effective and safer than starting somebody on a controlled substance.

The first step to decreasing the number of benzos your organization prescribes is education. It can be an uncomfortable change for some providers, but providing education as to why it’s so important and the risks associated with benzos is critical. The next thing you want to do is start tracking your prescription trends to know whether your organization is making progress. Having a monthly or weekly report on how many benzodiazepine prescriptions you’re writing can make a big difference.

How Iris Telehealth approaches benzodiazepines

At Iris Telehealth, we try to find providers who share our prescribing philosophy, which means being very cautious with all controlled substances. We think it’s important to understand there is a time and a place for each of these medications, and we don’t want providers who are inflexible or don’t see the shades of gray that inherently come with medicine. But, at the end of the day, we want providers who are educated on the alternatives and make an effort to not default to medications like benzodiazepines.

For your organization, it’s important to ask any prospective provider about their prescriber philosophies before you onboard them so you can ensure they will fit well with your organization’s goals. And remember, even if you or your providers don’t ever want to prescribe benzos, you need to be skilled and willing to help safely taper somebody off them because stopping them cold can be dangerous.

If you’re interested in working with Iris to identify high-quality psychiatrists and PMHNPs who can help your organization achieve its goals and serve your patient populations, contact us today, and we can get that conversation started.

Virtual Psychiatric Care vs. On-Site Psychiatric Care

Telepsychiatry has evened the playing field for people in need of mental health help by providing psychiatric services, most often through video conferencing. This allows patients, no matter their location, to receive high-quality psychiatric care. The great thing about telepsych is that conducting an appointment virtually does not impact the quality of care received. There are very few differences between getting psychiatric care virtually and psychiatric care on-site.

With the COVID-19 pandemic and the U.S.’s ongoing shortage of psychiatrists, offering telepsychiatry services just isn’t going to be optional anymore. It’s now necessary that organizations and providers be able to treat patients virtually when on-site care isn’t possible.

Fortunately, the nationwide shift to telemedicine early in the pandemic has proven that there’s little to no difference between the quality of virtual psychiatric care and on-site psychiatric care. Telepsychiatry has made psychiatric services more accessible, affordable, and convenient than ever — for patients, providers, and healthcare organizations alike.

For organizations still debating whether to invest in virtual psychiatric care vs. on-site psychiatric care for their long-term care strategies, this piece will address four common questions you may have:

1. Is the length of treatment different for a virtual appointment?

There’s a huge misconception that there’s a difference in the level of care between a virtual psychiatric appointment and an on-site appointment. The truth is, a virtual appointment runs much the same way an on-site appointment does. There’s no difference in the length of treatment, the type of care, or how the provider conducts the appointment.

Just like in an on-site appointment, the patient will be connected directly with their provider (either in a healthcare organization or in their own home) for a private, confidential session. The provider will then conduct an in-depth evaluation and work with the patient towards a diagnosis and treatment plan that is specific to their needs. If patients require medication, a virtual psychiatrist can prescribe that as well — often through your organization’s existing system. Additionally, follow-up care will be set up as needed.

However, while the approach to care can be similar, the biggest advantage of using a telepsychiatry provider is expanding access to quality psychiatric treatment for people in rural and underserved areas.

2. Can a patient’s mental health condition impact the level of care they receive?

In almost all cases, patients can receive care virtually just as they would be on-site. However, sometimes the decision comes down to personal preference and availability. In some rare cases, a virtual appointment would not be ideal for patients who are in mechanical restraints, not willing to consent to receive mental health treatment virtually, or not able to conduct an appointment in a safe, private environment wherever they are located. In these scenarios, on-site treatment (if possible) is recommended.

Other than these few exceptions, a patient’s particular mental health condition does not impact their ability to receive adequate care virtually. At Iris Telehealth, we work with providers to ensure patients are safe, comfortable, and experience the highest level of care possible.

3. Do virtual and on-site psychiatric appointments have the same level of effectiveness for children and adults?

There is no major difference in patient outcomes or patient satisfaction for virtual care vs. on-site care. In a study published by The American Journal of Managed Care, 62.6% of patients and 59% of clinicians cited they did not see a difference in quality in a virtual visit compared to an on-site visit with most patients preferring virtual psychiatric visits. With the onset of the pandemic, adults and children have both been struggling to maintain their mental health while being isolated and dealing with day-to-day life. When an on-site appointment is not feasible, children and adults can seek psychiatric help virtually to get their mental health back on track.

4. What are the top concerns providers have with virtual appointments vs. on-site appointments?

Some providers have to overcome patient concerns around telepsychiatry because they’re worried about being recorded during their sessions. During the session, the provider will never record patients without telling them, and they must ensure they receive patient consent before conducting any appointments. Just like at an on-site appointment, providers will review everything patients need to know before the appointment and ensure they understand how everything will flow.

Providers also have to work through using technology to speak with their patients who may not be tech-savvy. When providers partner with Iris Telehealth or another telehealth vendor, they will be properly trained, educated, and given adequate support to address patient concerns and work through any technology fears patients may have.

Another concern providers have is whether they will have the same connection with their patients virtually as they would on-site. Most providers and patients find this answer to be a resounding yes! According to a study performed by APA, 82 percent of people tried virtual care due to the pandemic, and about half had a positive response to it. Fifty-nine percent say they would use it for a mental health concern in the future — and most patients who take advantage of virtual care report positive experiences and satisfaction.

How Iris Telehealth can help

Whether your organization chooses to implement virtual psychiatric care or on-site care, you can rest assured patients will receive the same level of care and treatment with both options. One is not inherently better than the other. However, telehealth makes mental health help available to more people across the U.S. and breaks down barriers to receiving help.

If you would like more information on how to implement telepsychiatry into your organization — or how it can help you meet the mental health needs of your community — contact us today.

Understanding and Treating Eating Disorders in Children

Thank you for following along the journey through common pediatric care disorders and treatments! This is our fourth and final post in our series on pediatric behavioral health conditions. For more, visit our posts on pediatric stress and trauma, pediatric depression, and pediatric anxiety.

In this post, we’ll discuss the prevalence and risk factors surrounding pediatric eating disorders, screening challenges, and treatment for eating disorders in primary care — while considering additional challenges that have popped up during the COVID-19 pandemic. Because you’ll probably see Anorexia Nervosa and Bulimia Nervosa most often in pediatric care, we’ll spend more time on those two.

We hope this guide will empower you to understand and treat this increasingly prevalent pediatric health condition.

Anorexia Nervosa is a battle against body and mind

Anorexia Nervosa (AN) is a tricky disorder that’s not just physical, but a combination of psychological characteristics leading to physical changes. Common characteristics associated with Anorexia Nervosa include:

  • Lower body weights than minimally expected (less than 85% of expected BMI)
  • Intense fear of gaining weight
  • Persistent behavior that interferes with weight gain
  • Undue influence by body weight or shape
  • Failure to recognize low body weight
  • Secret exercising and/or compulsion to stand or move
  • Baggy clothes and complaints of being cold

Look out for AN in children who participate in activities where weight or appearance plays a role and picky eaters or children significantly affected by societal pressure.

As always, keep an eye out for comorbidities as AN is comorbid with at least one other psychiatric disorder in 55.2% of cases.

Restricting type and binge eating/purging type are the two subtypes of Anorexia Nervosa, though binging and purging is less likely in children than adults:

  • The restricting type is defined by restricted food consumption, and you’ll see symptoms such as fasting or avoiding “risk” foods.
  • The binge/purging type includes children who demonstrate both binging and purging symptoms and are severely underweight.

The good news is that prognosis for teens with Anorexia Nervosa is more promising than the same diagnosis for adults. If you can catch and treat Anorexia Nervosa in a patient’s childhood years, you can take the necessary steps to improve their development.

Screening and treating Anorexia Nervosa is a family affair

Screening for AN is tough. Children may keep their eating disorder a secret by including attempting to pad weight by putting objects in their pockets during weight checks, drinking excessive water prior to appointments, or explaining weight loss through a medical illness. And they may deny the psychological characteristics of AN.

For this reason, an honest parent/child rapport is essential for diagnosing children with AN. You’ll need to advise parents about symptoms to watch throughout the screening process, especially if they note any unexpected weight loss or failure to gain expected weight. Also, be sure to require a medical workup to understand the physical symptoms children may be experiencing and schedule frequent follow-up visits.

Remember that family relationships can be essential to effective treatment. One of the most commonly used treatment models, the Maudsley Model, includes intensive family therapy to educate and empower parents. It’s an outpatient model and includes programs that meet regularly for 6-12 weeks. It has proven successful in weight restoring children, who in turn learn increased autonomy over time.

For children who don’t have access to family therapy, we’d recommend a model focused on individual therapy to restore autonomy over eating.

Bulimia Nervosa is another secret battle

Anorexia Nervosa goes hand in hand with Bulimia Nervosa (BN). Approximately 60% of patients diagnosed with AN develop BN, and BN often develops at 14-22 years of age. As with AN, Bulimia Nervosa (BN) can be a secret battle, and patients can have BN symptoms for up to five years before seeking treatment. The good news is that 50% of patients are symptom-free 5-10 years after receiving treatment.

BN patients are often within the normal expected weight range, making it more challenging to see the physical characteristics of the condition. However, teens with BN may be secretive and note difficulty with interpersonal relationships, and males with BN may overexercise or use steroids.

Keep on the lookout for BN as it’s relatively prevalent — 1-2% of adolescent females and 0.5% of males meet DSM-5 criteria for BN.

Of course, differential diagnoses also exist, so be wary as you diagnose patients with BN. What may appear as Bulimia Nervosa could be the Anorexia Nervosa binge/purge subtype, Binge Eating Disorder (BED), or other conditions.

Family and social factors are risk factors for Bulimia Nervosa

Family factors such as PTSD or perfectionistic temperaments are major risk factors for Bulimia Nervosa. These risk factors are compounded with dieting and social pressures to be thin, and when combined, they can create the feelings of guilt and shame we associate with BN.

Remember comorbidities as you’re investigating factors. One study showed lifetime psychiatric comorbidity of 88%, and most teens had at least one comorbid psychiatric illness with BN.

As a provider screening for Bulimia Nervosa, you must stay vigilant

As with Anorexia Nervosa, you’ll face significant challenges screening for Bulimia Nervosa. Adolescents with BN will often want to keep their eating disorder a secret and be ashamed of binging and purging symptoms. Because weight is often within the normal range, physical characteristics are less obvious than AN. Children with AN may not be aware of their feelings or able to verbalize shame, and they may not even understand their behavior is abnormal.
As with AN, patients will often deny the psychological aspects of BN, and you’ll have to stay suspicious throughout screening to understand the full picture.

Treating Bulimia Nervosa is a family affair

Research on both therapy and medication for Bulimia Nervosa is still ongoing. The two therapy types for BN include Family-Based Treatment (FBT) and Dialectical Behavioral Therapy (DBT). As with AN, family-based Maudsley therapy is the most effective. Educating the entire family system also alleviates behaviors that will encourage binging and purging. DBT should also be integrated into any therapy for eating disorders to help cope with stress symptoms.

COVID-19 is making eating disorders worse

During the first lockdown period in spring 2020, grocery shopping, doctor visits, and social support systems were interrupted, exacerbating eating disorders.

In some cases, children who liked the sense of control that came with a scheduled routine turned to controlled, disordered eating to cope with the uncertainty. Social distancing made hiding restrictive behaviors and weight loss easier for children who wanted to keep their behaviors secret. On top of this, virtual appointments have made it more difficult to assess vital signs, weights, and labs, causing eating disorder screenings to be less accurate.

While telehealth, virtual nutrition coaching, and more have led to some creative solutions to address eating disorders, the reality is that COVID-19 is making eating disorders more prevalent and more difficult to treat as a whole.

Keep up the great work!

We understand eating disorders are challenging to diagnose and treat, and the societal pressure on appearances makes your job as a provider even tougher. Know that as you’re supporting children and families, you give them the best chance to overcome their eating disorders and live fulfilling lives.

Research on eating disorders is ongoing, so be sure to follow the most updated guidance. For now, here are a few resources we recommend:

As always, Iris Telehealth is here as a resource for providers who need support. If your organization feels the pressure of increased numbers of patients experiencing pediatric eating disorders, contact us today.

Breaking Down the American Rescue Plan’s Emergency Rural Health Care Grant Program

The American Rescue Plan Act opened up two new categories of Emergency Rural Health Care Grants, which will provide up to $500 million to community-based nonprofit healthcare organizations and federally recognized tribes. The purpose of these grants is to help rural organizations increase access to much-needed healthcare services — including telehealth. If your organization has been impacted by COVID-19 and seeks to expand or improve services, these grants may be a good fit for you.

The two grant tracks: Recovery Grants and Impact Grants

The Emergency Rural Health Grant program is awarding grants in two main tracks: Recovery Grants and Impact Grants.

Track one: Recovery Grants

Recovery Grants must be used in connection with the COVID-19 pandemic to support health care needs in your community. In your application, you can request grant funding to address one or more of the following categories:

  • Vaccine distribution
  • Medical supplies and equipment for medical surge
  • Reimbursement for healthcare-related revenue loss during the pandemic
  • Telehealth expansion
  • Construction or renovation of healthcare facilities
  • Staffing for testing or vaccine administration

Track two: Impact Grants

Impact Grants must be used in connection with the COVID-19 pandemic and to support long-term, sustainable healthcare services — including the development of holistic healthcare programs (that blend behavioral care and other medical services), the expansion of telehealth services, and more. In your application, you can request funding for:

  • Establishing a regional partnership to implement a model that supports the long-term sustainability of rural healthcare
  • Establishing an evidence-based model that organizations in your community can replicate
  • Identifying a health-related problem within your community and developing a solution
  • Establishing a methodology to calculate impact measures
  • Covering the cost of technical assistance necessary for project implementation
  • Paying professional service fees associated with the grant request

Key program dates and details

Here are some of the key details of the Emergency Rural Health Care Grant program:

  • Applications for grant awards are due October 12, 2021
  • Recovery Grant awardees will receive between $25,000 and $1 million
  • Impact Grant awardees will receive between $5 million and $10 million
  • The Recovery Grant period is expected to begin around November 1, 2021, and last approximately 36 months
  • The Impact Grant period is expected to begin around January 1, 2022, and last approximately 36 months

What Recovery Grant applicants need to submit in their application

Each Recovery Grant application must include the following:

  • A summary page including the intended funding track, applicant name, amount of grant request, and project description
  • A detailed table of contents
  • A completed “Application for Federal Assistance” form (SF-424)
  • A completed “Budget Information — Non-Construction Programs” form (SF-424A) or “Budget Information — Construction Programs” form (SF-424C)
  • Organizational documents demonstrating eligibility
  • Additional evidence of eligibility that demonstrates that your healthcare organization primarily serves rural areas
  • A complete budget narrative

What Impact Grant applicants need to submit in their application

Each Impact Grant application must include the following:

  • A summary page including the intended funding track, applicant name, amount of grant request, and project description
  • A detailed table of contents
  • A completed “Application for Federal Assistance” form (SF-424)
  • A completed “Budget Information — Non-Construction Programs” form (SF-424A) or “Budget Information — Construction Programs” form (SF-424C)
  • Organizational documents demonstrating eligibility
  • Additional evidence of eligibility that demonstrates that your healthcare organization primarily serves rural areas
  • A complete budget narrative

How your organization can apply to this grant program

Before your organization officially submits your application, make sure you’ve read the Notice of Funds Availability (NOFA) and reviewed the materials on the program webpage.

Contact your state’s Rural Development office and submit the materials outlined above when you’re ready to submit your application.

For more detailed information about the materials you’ll need to submit, please refer to the Recovery Grant application checklist and the Impact Grant application checklist.

The Emergency Rural Health Care Grant program is a perfect fit for healthcare organizations located in rural, underserved areas looking to impact their communities and improve their services in the wake of COVID-19. It also offers some excellent opportunities for organizations to incorporate or expand telepsychiatry services into their behavioral health programs. If your organization is interested in learning more about how telepsychiatry can supplement and improve your services, contact Iris Telehealth today — we’re always here to help.

What You Can Do to Support Children Experiencing Stress and Trauma

This is our third post in our series on pediatric behavioral health conditions. For more, visit our posts on pediatric depression and pediatric anxiety.

Children experience trauma differently than adults. As a pediatric care provider, it’s important to understand these differences, how you can spot them, and best practices for treating them.
Keep reading for a discussion of the types of trauma and their prevalence, risk factors and protective factors for child and adolescent PTSD, review screening and assessment for PTSD in primary care, and the algorithm for treatment.

Almost half of children in the U.S. have experienced trauma

The survey on adverse childhood experiences by the National Institute for Children’s Health Equality indicated that nearly 50% of children in the United States have experienced one or more types of serious childhood trauma. Most children are resilient after traumatic exposure, but a minority of children develop significant mental health problems as a result.

Traumatic experiences can impact a child’s neurological development, trust, emotional regulation, and social skills. These essential skills help children function, and your ability to help treat children for these PTSD-related conditions will aid their growth.

Also, remember that research has shown complex trauma impacts both the mental and physical health of children. Both short-term somatic effects and long-term effects on childhood development can result from complex trauma.

COVID-19 has been a mass, traumatic event for children

Children who had their lives interrupted during COVID-19 will be experiencing the repercussions for years and may respond to COVID-19 as a traumatic event. Anxiety and fears related to contracting the virus, economic challenges, and deaths of family members are all traumatic events in addition to the fallout from schedule changes and social isolation.

In the short and medium-term, children may experience symptoms similar to anxiety, depression, PTSD, dissociation, depersonalization, and emotional dysregulation. In the long term, these traumas can cause physical, social, and intellectual development problems. You may see violent and risky behaviors in children resulting from COVID-19 trauma.

Remember, these factors will all contribute to PTSD symptoms in children, and multiple traumas can interact together to form more complex experiences. Your care plan should take these events into account as you build a picture of how a child’s trauma may have affected them.

PTSD can develop after one year of age

Navigating the different types of pediatric stress and trauma disorders can be confusing, so be sure to review the definitions of unique DSM-5 stress and trauma disorders to support your patients adequately. Also, remember that children can develop PTSD after only one year of age and that a PTSD diagnosis can be surprising for families who don’t realize that PTSD can develop this early.

Even when children aren’t old enough to talk and verbalize symptoms, you may notice PTSD through unusual behaviors in play, such as new aggression. Remember that adults who re-experience childhood PTSD symptoms may face additional mental health challenges as they age, so diagnosing and treating PTSD in children will help a patient throughout their entire life cycle.

There are a range of risk factors for PTSD development

You’ll see children respond to trauma differently, but factors including gender, exposure to trauma, and pre-existing anxiety disorders can make it more likely that a traumatic event will result in PTSD development. Disasters are high-stress situations, and the specific experiences a child has during a disaster can affect risk factors for PTSD; for example, feeling one’s life is in danger or delayed evacuation may act as higher risk factors.

Fortunately, there are ways to help! Protective factors can decrease the risk of children developing PTSD after traumatic exposure. These include parental support, lack of parental PTSD, and resolution of parental trauma-related symptoms. It’s important to support parents throughout the aftermath of traumatic exposure, as they can significantly affect a child’s likelihood of developing PTSD.

And remember, PTSD isn’t the only condition that can result from traumatic exposure. Other disorders and medication side effects can also create symptoms that present similarly to PTSD. You’ll act as a detective to screen for PTSD if needed, but stay open-minded and wary of differential diagnoses too.

Evaluating and screening for PTSD

I recommend screening annually for PTSD with all primary care patients using the question “has anything really scary or upsetting ever happened to you or your family” for both children and parents or guardians. This question can elicit productive responses that may suggest you formally screen for PTSD.

Many other more formal tools exist for screening for PTSD. The CATS (Child and Adolescent Trauma Screen) test is an effective tool for primary care screening. You can either provide a caregiver report or youth report for patients and families to complete depending on the child’s age. This test differentiates normal, moderate, and probable by age.

Normal scores will encourage support, empathy, and productive habits for children. For moderate CAT scores, you should monitor children and assess for co-occurring depression or anxiety and schedule follow-up visits. With a probable PTSD score, you should assess for co-occurring depression and anxiety, refer for trauma-focused, evidence-based therapy, and closely monitor for suicidal ideation or self-injurious behavior with a scheduled follow-up visit.

Treating PTSD

Psychotherapy is the first line of treatment for PTSD, and your plan for treating PTSD should help the child progress developmentally and learn positive coping strategies to regulate emotions.

While you may see many acronyms and terms for evidence-based therapy, any psychotherapy plan involves:

  • Caregiver involvement
  • Developing skills for coping/relaxation
  • Challenging negative cognitive distortions related to the trauma
  • Building a trauma narrative

Treatment will allow children to integrate the traumatic event into their experience to the extent that they can retell the event without increasing distressing feelings.

Make sure you educate children and families that PTSD symptoms can reoccur following future traumatic experiences, and ensure the family understands that they may benefit from additional mental health treatment if this occurs.

At this time, no medications are FDA approved for PTSD in children and teens. However, you may consider medication if children are diagnosed with comorbid conditions or symptoms that are causing significant distress or functional impairment despite evidence-based psychotherapy.

If you are suggesting medication for children, you should target the symptom causing the most distress or functional impairment and remember that medications are supported by published evidence but are not FDA-approved.

Your goal is to safely withdraw treatment and monitor for symptom recurrence

PTSD treatment generally consists of three phases: an 8-12 week acute treatment phase, a 6-12 month maintenance phase, and a 3-6 month treatment discontinuation phase. In the third phase, you will aim to safely withdraw treatment and monitor for symptom recurrence.

Make sure you communicate regularly with the family during this phase and ensure they understand the benefits and risks of withdrawing treatment. If symptoms reoccur, you’ll have to make sure the family understands that this is not a failure of treatment but instead will require a slowing of the discontinuation pace.

Your role as a communicator in this phase is key!

Resources for you

PTSD is a complex condition to treat and may involve steps forward and backward in treatment. Stay patient, as your role is essential to helping children interact in the world as they work through their PTSD. More resources we recommend include:

As always, Iris Telehealth is here as a resource for providers who need support. If your organization is feeling the weight of increased numbers of patients experiencing pediatric stress disorders, contact us today. We’d love to talk to you about the difference telepsychiatry can make in your practice!