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Dbp and CBT – a Professionally Rewarding "Blend" - the Impact of Professional Collaboration on a Vulnerable Underserved Group : Children with Disabilities, Including Those with Autism Spectrum Disorders, Mental Health Challenges, and Their Caregivers
Objectives: To develop, audit and systematically improve a collaborative and integrated model of service delivery between a volunteer mental health clinician (Cognitive Behavioural Psychotherapist) and a physician (Developmental Behavioural Paediatrician). To provide Specialist Paediatric care, Sub-specialty Developmental Behavioral consultation/support, Paediatric Psychopharmacotherapy (medication management), and Psychotherapeutic support for both child and caregiver as well as care coordination are offered by this, despite an overwhelming, persistent lack of time; and professional and material resources.
Methods: Case selection occurs from the socioeconomically, ethnically and geographically diverse clientele of a public health sector, sub-specialty paediatric ambulatory service. Clinical evaluation, case-conferencing and existing clinical evidence informs management plans, to the limit of material and human resources. Where necessary, cross-referrals are made to other disciplines e.g. Psychiatry, Occupational Therapy and to other governmental agencies, e.g. Ministry of Education.
Results: This professional synergy, despite its occurrence in a resource-poor environment, includes improvements in the insight of the child/teen and/or their caregiver(s) to their own challenges, self-monitoring (where applicable), coordinated medical, pharmacologic and mental health management; as well as application of well-known evidence-based strategies to enhance positive behaviours, to augment coping skills; personal and family resilience in chronic conditions.
Conclusions: Multidisciplinary, integrated models of care, have proven synergistic and more efficacious in the management of comorbid developmental disabilities, medical and psychiatric problems. There is potential to expand this type of service, to include other related disciplines to provide more effective service to this vulnerable niche of our paediatric population nationwide.