The 2011 Fall Newsletter is now available under the newsletter tab or by clicking here.Read More...
As we are entering the 44th year of the American Society for Adolescent Psychiatry, our organization has proven to be a viable, stable and valued member in the world of psychiatric and mental health organizations. Despite challenges ahead, we will continue to grow our organization and, with your participation, make substantial contributions to the field of adolescent mental health and advocacy.
Our recent yearly Annual Meeting in March 2011, was an indication of the continuing success of our organization. The venue, again at Day Top Village in New York City, was professionally handled and catered. Our presenters were among the most respected members in the field of psychiatry. The William Schonfeld Memorial Award and Lecture was given to Dr. Glenn Saxe for his innovations in the study of childhood traumatic stress. Ms. Frances Roton Bell, ASAP’s Executive Director, was awarded the Herman Staples award for her incalculable dedication and contribution to our organization’s welfare. Presented topics included discussion of DSM V proposed changes, disaster psychiatry, cannabis abuse, autism research, childhood trauma and PTSD, high conflict divorce, generational psychiatry, increasing publication skills and panels on eating disorders and dialectical behavioral therapy. We have posted abstracts for some of these presentations on our website, and expect to publish original papers by some of our presenters in our journal, Adolescent Psychiatry.
Our organization has made a number of important developments that serve our goals of education, advocacy, and professional networking. Past President Dr. Joseph Kenan redesigned our website, to make a user-friendly, exciting internet interface, understanding well that our future lies in fostering and improving our web presence which has become the mainstay for contemporary communications and informational resources. In that regard, we have also developed an adolescent pscyhiatry group on LinkedIn, with plans to develop a Facebook page, and further develop our website with forums for discussion, and tabs presenting information to healthcare professionals and community members alike. These pages might serve to provide quick and easy communications between members, discussion regarding various topics, and allow the distribution of important news that affects our field to professionals and the community. Webinars too, are being considered, that will allow members throughout the country to participate in recorded presentations. Dr. Kenan already pioneered our use of videoconferencing for our periodic Board meetings, allowing us more frequent contact as a result of the practical convenience that meeting method provides.
On our publishing front, Dr. Gregory Barclay continues his editorship of our outstanding Newsletter, providing brief updates about our organization, and timely articles. Past President, Dr. Lois Flaherty has negotiated an arrangement with Bentham Science for a new journal on Adolescent Psychiatry, which will serve as the official journal of the American Society for Adolescent Psychiatry. First issue highlights included articles on borderline personality disorder in adolescents, shame in psychotherapy, and overcoming resistance in therapy. An upcoming issue will feature highlights and original papers from our Annual Meeting. Members are afforded special arrangements with the publisher for subscription. Peer reviewers, article submission, and editorial help are always welcomed.
ASAP has many plans to keep our organization up to date and competitive. Some potential ideas include financial incentives for referring new members, mentoring programs, and action groups to deal with the issues faced by teens in today’s world. We know you will not want to miss these events.
Few fields are as underserved, and in need of public education as ours. A recent news article noted a report by the Substance Abuse and Mental Health Services Administration showing that in excess of 60 percent of adolescents suffering from major depression were not receiving treatment during the study period. This is, of course, only one example of teen mental health needs within our rapidly changing society. Sociopolitical and medical model changes, global unrest, war, substance abuse, economic instability, and globalization of media and communication are just some of the factors that contribute to a unique future landscape. We are the only national academic psychiatric organization dedicated solely to the mental health and well being of adolescents. It is incumbent upon us, as clinicians and leaders in the field to light the torch, dispelling darkness around us. It is my honor to serve this organization, and follow in the footsteps of the leaders who have tread the path before me. I encourage you all to take an active role in this process and join us in these most worthy endeavors. See you on the web, and at next year’s Meeting.
Dean De Crisce, MD, FAAFS
Book Review Corner…
BY Gregory P. Barclay, M.D., Newsletter Editor
Editor’s note: In this edition, I am pleased to summarize 3 books I have recently read. They all relate to a common theme, which is how our increasing understanding of neuroscience helps us to understand and re-define the process of psychotherapy. As professionals with particular interests in adolescents, it is essential that we have a thorough and updated education in neuroscience, since what we are learning about the adolescent brain has enormous impact on how we conduct treatment and what we should expect from patients at an individual level. Moreover, as a society, our growing understanding of the adolescent brain moves us into the forefront of highly charged societal issues, including the controversies of trying adolescents who commit violent crimes as adults, invocation of the death penalty for adjudicated delinquents, and as Dr. DeCrise explains in his article, the requirement that youthful sexual offenders be placed on public monitoring.
The Behavioral Neuroscience of Adolescence, by Linda Spear, Ph.D. (2009, New York, Norton Professional Books), 368 pgs, hardcover. $40 US.
This book was presumably written for professionals without advanced training in neurosciences as well as those with more formal training and experience in the area. Even though I was in the latter group, I found myself challenged as I attempted to recall the basics of neuroanatomy and neurophysiology I learned 30 years ago as a medical student and later on during my residency in psychiatry. As a professional with that knowledge, I found Dr. Spear’s book to be a refreshing and comprehensive review of our current understanding of the teen brain. However, I would doubt that other professionals without advanced training in neurosciences would be able to grasp or fully comprehend the subjects as presented. For psychiatrists who work with adolescents, though, this book is one definitely to purchase and read, as the information it contains influences our expectations and approaches to adolescents in our daily work with them.
The book is divided into two sections. The first reviews overall brain structure, function, and development as influenced by evolutionary, genetic, hormonal, neural, and sociocultural factors. The interaction of these produce distinctly adolescent behaviors and thought processes that are reviewed in the book’s second section. Those later chapters include detailed reviewed of the neurodevelopmental basis of adolescent risk taking, social behavior, and cognitive capacities, as well as the basis for emergence of psychological and drug abuse disorders during adolescence.
This book is an excellent resource for any professional who works with adolescents. I found the use of bullets and italicized first sentences of paragraphs to be especially helpful for doing a quick read and review.
What Freud Didn’t Know - A Three-Step Practice for Emotional Well-Being through Neuroscience and Psychology, by Timothy B. Stokes, Ph.D. (2009, Rutgers University Press), 210 pgs., hardcover, $24.95 US
Although this book is intended for the lay person who struggles with emotional regulation problems, I found it to be a very useful book from my perspective as a treating provider. As its title suggests, Timothy Stokes reviews how Freud’s fundamental concepts of the Id, Ego, and Superego now are best understood as corresponding to brain regions of varying degrees of connectivity and maturity. He develops the concept of “Amygdala Scripts” and reviews how powerful emotional experiences are stored instantaneously in the amygdale and subsequently “hijack the neocortex”. This process is at the root of what maintains negative and distorted cognitions and compensatory maladaptive behavior, and therefore “mastering” the amygdale scripts is the core of his 3-step practice.
The 3-step practice is essentially a self-help style simplification of what is accomplished in Eye Movement Desensitization and Reprocessing (EMDR) and Dialectical Behavior Therapy. Dr. Stokes provides guidance on how to first establish an enhanced state of mindfulness so as to allow for access to deeply buried Amygdala scripts. Consequently, it is possible to develop enhanced insight to facilitate the mastering those scripts and attaining the third step, which is belief change. Throughout the book, there are examples and exercises designed for the motivated lay person to accomplish meaningful change. Dr. Stokes makes it clear, however, that many individuals with these problems require a much higher level of treatment delivered by a trained professional.
This book is useful to have on your shelf to share with a highly motivated and intelligent patient with emotional regulation problems, as it may assist them before committing to an extensive course of EMDR or DBT. It is also a good reference for patients already participating in psychotherapy.
Changing Minds in Therapy – Emotion, Attachment, Trauma, & Neurobiology, by Margaret Wilkinson (2010, New York, Norton Professional Books), 248 pgs., hardcover, $32 US.
This book is designed as a resource for therapists who conduct long term therapy with patients with trauma histories and/or disturbed early attachments. Dr. Wilkinson explores the dynamics of brain-mind change in therapy utilizing current research. She describes the neural basis of attachment, attunement, and affect regulation and how their development is influenced by our earliest attachments. Disruption of this process leads to observed changes in the orbitofrontal cortex where those experiences are initially encoded and consequently dictate how we experience emotion and relationships later in life. Dr. Wilkinson skillfully demonstrates with case examples how problems with attachment and attunement lead to clinical problems seen in the therapist’s office and how proper attunement by the therapist is central to the repair process.
Dr. Wilkinson’s book is divided into two sections. The first introduces the reader to the neurobiology of attachment, attunement, and affect regulation. In particular, she emphasizes how the right brain matures earlier than the left, and therefore how disruptions in attachment and attunement occurring at a very early age leave their residua in the right limbic structures, the Amygdala in particular. Since the ability to form memories with a verbal narrative occurs later and generally involves the left hippocampus, patients with early trauma experience right brain-mediated emotions in relationships that they neither understand nor can regulate unless therapeutic work is done to enable the left brain to neutralize the right. Dr. Wilkinson’s approach is a more traditional one in which she utilizes the therapeutic relationship itself over the course of time as the medium through which the repair process occurs. In this respect, she differs from the more contemporary therapies yet the general principles, e.g. harnessing the right limbic system with the left prefrontal cortex remains the same.
I found this to be a fascinating book because I have a particular clinical interest in adoption and attachment-related disturbances. In that respect, this is a good book for clinicians with similar interests who desire a deeper understanding of the neurobiology involved.Read More...
BY Gregory P. Barclay, M.D.
In this summer edition of our society newsletter, I am pleased to introduce a lead article written by our President-Elect, Dean DeCrise, M.D. This article relates to the implications of Megan’s Law when applied to adolescents who commit sexual offenses. This is one of several controversial issues in which ASAP is considering taking a position and for which we have reactivated our newly formed Committee for Legislative and Judicial Affairs. I asked Dean to prepare this article so that our membership have a better understanding of the Megan’s Law issue before the council takes it up at our next business meeting. For those of you who were at our 2010 annual scientific meeting in Los Angeles, Dr. DeCrise’s article summarizes his excellent presentation on the treatment of adolescent sexual offenders. And, for those of you unable to attend our meeting, please don’t despair. We have also included Dom Ferro’s summary of the outstanding keynote presentation given by Schonfeld Award Recipient Harold Koplewitz, M.D. as well as our usual photo gallery of presenters and ASAP members hard at work in Los Angeles.
All of this edition’s articles and book reviews have a common connection – the developing adolescent brain. With the advent of functional MRI and other imaging procedures, there is now undeniable proof of what we who work with adolescents know from clinical experience: The adolescent brain is in a state of massive change and uneven development, the result of pruning with increased white matter and diminishing gray matter through to age 24 or later. Hence, their impulsivity, emotional over-reactivity, and cognitive immaturity have clearly established origins in brain development and are only influenced to a degree by hormones and sociocultural variables. This fact alone is of enormous significance to us as an organization established to advocate for adolescents, especially with the current trends to try adolescents who commit crimes as adults, invoking the death penalty for adolescent criminals, and, as Dr. DeCrise states in his summary, applying Megan’s Law to youthful sexual offenders.
In his president’s column, Dr. Joe Kenan describes the changes in ASAP’s membership and finances over the past decade. We are also sad to note the passing of some ASAP giants, Mike Kalogerakis, James Masterson, and Everett Dulit. The challenge before us at this time is how we can grow and adapt, as a society to advocate for adolescents with mental health and substance abuse problems, to meet current reality vs. the alternative of atrophying into irrelevance. It is key for our membership to become engaged and involved. ASAP membership is now open to non-psychiatric physicians and non-physician licensed mental health professionals, as well as continuing to offer reduced-cost membership to trainees. If we each recruited one member, our society would increase to 400 members! That alone might allow us some semblance of a return to those “hey days” conferences Dr. Kenan speaks of in his president’s column and grant us more legitimacy as an advocacy organization. It might also allow us to print and mail our newsletter once again! We all know colleagues with a passion for working with teens, so what is holding us back? Do consider asking a colleague to join, plan to attend our annual meeting in New York March 26-27, 2011, pay your dues on time, and join a committee or council (we have openings on the Governing Board and the Committee for Legislative and Judicial Affairs).
Finally, I continue to welcome any contributions to our newsletter. Please ask any residents or students interested in getting something published to contact me. Or, if you have something of your own (including poetry) to submit, or have a passion for reading and writing book reviews, drop me a line at firstname.lastname@example.org.Read More...
by Gregory Barclay
…That the ASAP Council on Topical Studies has been reactivated?
Joe Kenan, M.D is the Chair
This council addresses controversial issues in the field of adolescent psychiatry with the intention of assisting the governing board in making a position statement. Among the issues currently being considered is:
- The Graham & Sullivan vs. Florida Supreme Court case relating to adolescent competency to stand trial as an adult
- The psychological impact on children when adopted by LGBT couples
Are you interested in contributing to ASAP in a meaningful way? Have you ever wanted to be a part of big policy decisions? Please consider volunteering to participate in this council. Councils typically meet annually at the March ASAP Scientific Meeting. Accordingly,next year’s new council will convene during our annual meeting in Los Angeles, March 6-7, 2010. If you are interested, please contact Frances Bell at (972) 613-0985 or via email: email@example.com.
Gregory P. Barclay, M.D.
Gregory P. Barclay, M.D., Editor
On August 1, 2009, The American Board of Adolescent Psychiatry (ABAP) ceased to exist as an independent organization, the result of a planned merger with The American Society of Adolescent Psychiatry (ASAP). ASAP has assumed full responsibility for the re-certification process for all of the current ABAP Diplomates. In addition, the day to day administrative procedures, staff and offices remain unchanged since heretofore they were handled by Francis Bell, ASAP’s Executive Director. In particular, records and certification will continue to be maintained with the same integrity as in the past.
A new Council on Certification in Adolescent Psychiatry has been developed, and the former ABAP functions will be assumed by this new council. Accordingly, Richard Ratner, M.D. has assumed the duties of Chair of the Council on Certification in Adolescent Psychiatry.
In addition to maintaining the certification status for existing Diplomates, the Council on Certification in Adolescent Psychiatry is committed to developing a new certification exam. The Council will be working on this task in the months ahead and is seeking input from ASAP members and ABAP Diplomates in its development. If you are interested in assisting us with this process, please contact Frances Bell.
We are happy to see this merger finally come to pass, as it allows for the process of Certification in Adolescent Psychiatry to continue under the sponsorship of the only national organization devoted exclusively to Adolescent Psychiatry. We invite all ABAP Diplomates who currently are not members of ASAP to join at this time. In addition to the many individual benefits of membership, a strong ASAP will help strengthen our identities and the value of our certifications as adolescent psychiatrists in difficult times. Prospective members may check our websitewww.adolpsych.org, or contact Frances Bell at (972) 613-0985 for a copy of the most recent Newsletter and a membership application.Read More...