199. PANDAS and PANS: Non-pharmacologic Treatment

Imagine a world where children with OCD and Tourette’s can manage their symptoms without relying solely on medications. In this episode of Pediatric Meltdown, we explore innovative interventions like Habit Reversal Training and ERP Therapy that offer new hope for young patients. Dr. Lia’s guest is a listener’s favorite, Dr. Colleen Cullinan. She has a gift for taking you inside the child’s mind and telling you exactly what they’re thinking.  She’ll talk about the profound impact of intentional, compassionate care and the crucial role of family support in the treatment process. Tune in to discover effective strategies for tackling the emotional and psychological struggles these children face and how these methods pave the way for lasting improvements.

     

[03:13 -17:21]  Understanding Isolation and Negative Reinforcement in Mental Health

Concept of breaking the cycle of negative reinforcement and the importance of compassionate interventions.Connection between emotional regulation in various scenarios and therapies like cognitive behavioral therapy and acceptance and commitment therapy.Discussion on how the brain’s problem-solving nature struggles with internal experiences, leading to anxiety.Therapies offer solutions that counter the brain's intuitive problem-solving approach.

[17:22 - 29:42]  Exposure and Response Prevention (ERP) for OCD  

Emphasis on intentionally facing fears without engaging in compulsive behaviors.Insights into how ERP can be rewarding for families affected by OCD.Challenges and solutions in treating internal obsessions and related mental compulsions.Significance of ERP in helping individuals understand their fears are not dangerous.

[29:43 - 41:52]  Nonpharmacologic Therapies for OCD, Tics, and Tourette's

Overview of therapies like exposure and response prevention, habit reversal training, and comprehensive behavioral intervention for tics.Discussion of the non-logical and visceral nature of these behaviors and breaking the cycle of negative reinforcement.Strategies for managing compulsive skin picking, including competing responses and awareness.Practice and gradual exposure to triggers as critical parts of treatment.

[41:53 - 55:12] Resources and Tools for Comprehensive Behavioral Intervention for Tics

Introduction to CBIT as a detailed treatment involving awareness building and breaking down tics.Challenges in finding CBIT-trained therapists and resources to locate such providers.Mention of the Tourette Association of America and the TLC Foundation for Body Focused Repetitive Behaviors.University training programs in clinical psychology as potential access points for therapists trained in habit reversal training.

[55:13 - 59:58]  Closing segment Takeaways

Links to resources mentioned on the show

International OCD Foundation:  https://iocdf.org 

Tourette’s Association of America: https://tourette.org

TLC Foundation for Body-Focused Repetitive Behaviors https://www.bfrb.org

AACAP Facts for Families OCD: 

Imagine a world where children with OCD and Tourette’s can manage their symptoms without relying solely on medications. In this episode of Pediatric Meltdown, we explore innovative interventions like Habit Reversal Training and ERP Therapy that offer new hope for young patients. Dr. Lia’s guest is a listener’s favorite, Dr. Colleen Cullinan. She has a gift for taking you inside the child’s mind and telling you exactly what they’re thinking.  She’ll talk about the profound impact of intentional, compassionate care and the crucial role of family support in the treatment process. Tune in to discover effective strategies for tackling the emotional and psychological struggles these children face and how these methods pave the way for lasting improvements.

     

[03:13 -17:21]  Understanding Isolation and Negative Reinforcement in Mental Health

Concept of breaking the cycle of negative reinforcement and the importance of compassionate interventions.Connection between emotional regulation in various scenarios and therapies like cognitive behavioral therapy and acceptance and commitment therapy.Discussion on how the brain’s problem-solving nature struggles with internal experiences, leading to anxiety.Therapies offer solutions that counter the brain's intuitive problem-solving approach.

[17:22 - 29:42]  Exposure and Response Prevention (ERP) for OCD  

Emphasis on intentionally facing fears without engaging in compulsive behaviors.Insights into how ERP can be rewarding for families affected by OCD.Challenges and solutions in treating internal obsessions and related mental compulsions.Significance of ERP in helping individuals understand their fears are not dangerous.

[29:43 - 41:52]  Nonpharmacologic Therapies for OCD, Tics, and Tourette's

Overview of therapies like exposure and response prevention, habit reversal training, and comprehensive behavioral intervention for tics.Discussion of the non-logical and visceral nature of these behaviors and breaking the cycle of negative reinforcement.Strategies for managing compulsive skin picking, including competing responses and awareness.Practice and gradual exposure to triggers as critical parts of treatment.

[41:53 - 55:12] Resources and Tools for Comprehensive Behavioral Intervention for Tics

Introduction to CBIT as a detailed treatment involving awareness building and breaking down tics.Challenges in finding CBIT-trained therapists and resources to locate such providers.Mention of the Tourette Association of America and the TLC Foundation for Body Focused Repetitive Behaviors.University training programs in clinical psychology as potential access points for therapists trained in habit reversal training.

[55:13 - 59:58]  Closing segment Takeaways

Links to resources mentioned on the show

International OCD Foundation:  https://iocdf.org 

Tourette’s Association of America: https://tourette.org

TLC Foundation for Body-Focused Repetitive Behaviors https://www.bfrb.org

AACAP Facts for Families OCD:  https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Obsessive-Compulsive-Disorder-In-Children-And-Adolescents-060.aspx 

Other episodes with Dr. Cullinan you may like:

https://pediatricmeltdown.com/episodes

120 ADHD: Part 4 Executive Function  (pt4)

119 ADHD Part 3: Executive Function  (pt3)

109 ADHD Symptoms: Executive Functions Part II

088 ADHD: Strategies for Boosting Executive Function

Building Better Workflows Podcast

Building Better Workflows 

Key quotes for Twitter:

“Tics and Tourette's are very difficult. Of all of these disorders that we're talking about, which I think are all sort of habit-ish disorders, we're going to pick a label, which is not perfect, but it's the one I've selected at this moment."...Dr. Colleen Cullinan on the difficulty of treating these type of disorders

"A body focused; repetitive behavior can take up to 40 weeks to break. It requires a tremendous amount of practice, and I don't know if you've ever tried to teach a child anything. But if they're not motivated, they're not going to be into it.".. Dr. Colleen Cullinan on breaking long-term habits in children

**Transcript of Episode Available upon email request - [email protected] **

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