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OHSU Doernbecher, Massachusetts General team up to help troubled youth in the Pacific Northwest

Evidence-based program helps children, their families and caregivers, better cope with the mental health, cognitive or language-based challenges underlying their everyday struggles

Oregon Health & Science University Doernbecher Children’s Hospital and Massachusetts General Hospital are partnering to disseminate and research the effectiveness of an innovative, evidenced-based program to help children struggling with significant social, emotional and behavioral challenges in Oregon and beyond.

The program, called The Collaborative Problem Solving Model (CPS), has proved successful in many settings, including outpatient mental health and education facilities; hospitals; foster care; and residential, family advocacy and juvenile justice programs.

The approach helps adult caregivers pursue expectations, reduce challenging behavior, teach skills and gather information with an empathetic rather than punitive stance.

CPS was first developed and refined at Massachusetts General. In 2008, Stuart Ablon, Ph.D. further developed the model and provided a framework for its continued growth and dissemination, nationally and internationally, creating the Think:Kids program in the Department of Psychiatry at Massachusetts General Hospital.

“The basic tenants of the model support the view that children do well if they can. If they can’t, we as caregivers need to better understand what is getting in their way so we can help,” said Stuart Ablon, Ph.D., director of Think:Kids at Massachusetts General Hospital. “Although this doesn’t seem earth-shattering, it is a significant departure from the conventional idea that ‘children do well if they want to.’

“Our primary goal is to reach a place where children with behavioral challenges are understood with the same compassion and treated with the same effective approaches as children with other learning disabilities. Thanks to the work of many great people throughout the state, Oregon is leading this change effort.”

“By seeing kids and families through a different lens, we can more accurately explain what is getting in a child’s way and shift our interactions in overt and subtle ways,” said Ajit Jetmalani, M.D., head of the Division of Child and Adolescent Psychiatry at OHSU Doernbecher Children’s Hospital. “Ultimately, restoring and building healthy relationships with loved ones and other caregivers sets the stage for resilience and success in the face of challenges.”

Children with challenging and maladaptive behavior often lack, or have difficulty in applying, crucial skills in the areas of frustration tolerance, adaptability, flexibility and problem solving. They may have a host of mental health, cognitive or language based challenges underlying their struggles. The CPS model effectively identifies what skills a child is lacking and trains/teaches these skills through a collaborative process in increments the child can developmentally handle.

Organizations that have implemented CPS have significantly decreased the need for child seclusions or restraints, reduced or eliminated the need for psychiatric medications, decreased recidivism rates, improved caregiver and client satisfaction, and improved employee retention and job satisfaction.

CPS studies have shown measurable reductions in the cost of health care, including shorter lengths of institutional stay, a reduction in the prolonged use psychotropic medication use, fewer staff injuries, and, ultimately, children who have the potential to participate as a successful, productive citizens over their lifespan.

Since 2005, Ablon and a dedicated group of Oregon clinicians and administrators have engaged more than 35 organizations around the state, while training hundreds of professionals and care providers in the model. The Collaborative Problem Solving model now is a recognized, evidenced-based practice in Oregon.

The Think:Kids/OHSU Doernbecher Division of Child and Adolescent Psychiatry agreement will support and guide systems, organizations looking to embrace the CPS philosophy and its outlined model of care.

“Fidelity to the model is highly important for its effective implementation, and we are dedicated to providing quality training, supervision and ongoing consultation to ensure its continued success,” Jetmalani said. “We believe in the potent healing and protective power of successful relationships in the lives of children, and the desire of families and other care givers to engage successfully in their lives.”

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