Pediatrics - Psychiatry
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At Boston Medical Center, comprehensive mental health assessment and treatment are provided to children and adolescents in an outpatient setting. The program specializes in the assessment and treatment of children and adolescents who have problems with:
- Persistently sad or irritable mood
- Many worries and fears
- Adjusting to stressful or traumatic events
- Controlling their attention or behavior
- Understanding their thinking
- Interpersonal relationships
- Learning or development
- Involvement in high-risk behaviors
- Transition to adulthood
In addition, the program also offers consultation to pediatric practitioners for inpatient, outpatient, and emergency settings and to schools, courts, and child-serving agencies.
Yawkey Center 617.414.4561
24 Hour On-Call Service for Existing Patients: 617.638.8000 (request the Psychiatrist on call)
Conditions We Treat
A mood disorder that causes persistent sadness and loss of interest, depressive disorder is also called clinical depression. Depression can have a major negative effect on how a child or teen thinks, feels and behaves, and can take a toll on the child’s physical health, schoolwork, social relationships and family. Not merely a “case of the blues,” depression is not a weakness but a disorder that may require long-term treatment.
Once known as manic depression, bipolar disorder is characterized by extreme mood swings that fluctuate between emotional highs and lows. An individual with bipolar disorder may feel energized and euphoric, and then shift to hopelessness and depression. Most individuals with bipolar disorders feel much more like themselves with treatment plans that may include medications and counseling.
Post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) are similar mental health conditions. Children that have experienced or witnessed a traumatic event can develop PTSD, an ongoing reaction to the event where they experience uncontrollable thoughts of the event along with flashbacks, nightmares and severe anxiety lasting for months or years.
The most common of emotional disorders, anxiety disorders affect millions of people. Symptoms may include overwhelming panic and fear, obsessive thoughts, painful memories, recurring nightmares and an array of physical symptoms like feeling ill, heart palpitations, muscle tension and startling easily. Anxiety disorders include panic disorder which brings an overwhelming combination of physical and psychological distress; phobias, significant discomfort with social situations; or any other excessive or persistent fear.
A group of behavioral disorders in which a child or adolescent exhibits extreme, ongoing hostile and defiant behaviors toward any authority figure, disruptive behavior disorders (DBD) can negatively impact the life of an affected individual and those around them. There are two common disruptive behavior disorders: Conduct disorder involves repetitive behavior that violates the basic rights of others and breaking rules. Oppositional defiant disorder is characterized by hostile, defiant and disobedient behavior directed at parents, teachers and other authority figures.
Attention-deficit/hyperactivity disorder (ADHD) is a chronic mental health condition that makes it challenging for children and adults to focus on tasks, pay attention, control impulsive behavior and even to sit still. These challenges often prevent children from functioning well in school and getting along with family members at home.
Psychotic disorders, including schizophrenia and bipolar disorder, are marked by a loss of contact with reality. Children may exhibit personality changes, hallucinations, impaired thinking and generally not function well. There is no exact cause of psychotic disorders, but genetics and environmental factors are thought to play a role.
Somatoform disorders (somatic symptom disorder) is a mental disorder where the child experiences recurrent symptoms such as pain and fear with no apparent reason for their existence. The symptoms usually begin in adolescence and the condition is difficult to diagnose.
Tics are sudden, uncontrolled movements or sounds, and are often associated with Tourette’s syndrome. Simple tics involve a only a few muscle groups, like exaggerated eye blinking, while complex motor tics involve more muscle groups, like touching oneself or another person repeatedly or head banging. Tics are thought to be genetic (passed down from parents).
Impulse control disorders are a group of behaviors that cause the inability to resist an impulsive act or behavior that may be harmful to the person or those around him or her. There are six types of impulse control disorders: Trichotillomania (the uncontrollable plucking of one’s own hair); intermittent explosive disorder (an inability to control violent impulses); pathological gambling (the uncontrollable impulse to gamble); kleptomania (an inability to resist the urge to steal); pyromania (the inability to control the impulse to set fires); and not otherwise specified, including sexual addiction, repetitive self-mutilation and compulsive shopping.
An adjustment disorder is a stress-related mental illness, where someone may have a hard time adjusting to life changes, and become anxious, depressed and possibly self-destructive. Symptoms of an adjustment disorder vary but usually begin within three months of a stressful life event. Emotional symptoms may include sadness, crying spells, lack of enjoyment, trouble sleeping and feeling overwhelmed. Behavioral symptoms might include fighting, reckless driving, avoiding family or friends, and poor school performance.
Treatments & Services
- Diagnostic evaluation
- Second opinions
- Comprehensive and focused psychological and neuropsychological testing
- Evidence-based treatments, including:
o Cognitive-behavioral therapy
o Trauma-focused therapy
o Dialectical behavioral therapy
o Narrative therapy
o Social-emotional skills training
o Parenting skills training
o Family therapy
o Group therapy
o Medication evaluation and management
Evidence-based psychopharmacology, Expert second opinion
Teaching and supervision
Child Psychology, Medical Psychology
Pediatric chronic pain, concussion, coping with chronic illness, sleep, anxiety, and tics
Trauma/stressor-related, depressive, and disruptive behavior disorders; Trauma-focused and cognitive-behavioral therapies; Parenting skills training; Assessment and treatment of special populations (children and adolescents in foster care, families of Caribbean descent); Mental health education and consultation to the child welfare system
Neurodevelopmental disorders; Psychopharmacology; Assessment and treatment of special populations (children and adolescents with physical illnesses and developmental delays); Mental health education and consultation to pediatric specialty care
Children, ADHD, Mental health disparities
Trauma and Stressor-related disorders, Mood and Anxiety Disorders, Behavioral Medicine, Sexual Risk Behaviors, Special issues related to LGBT health
Helena Rocha, LISW
Michelle Prive, LICSW
Six stages of engagement in treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) have been reported by researchers at Boston Medical Center based on a diverse study, inclusive of parents of…