Questions for the PCA Psychologists...
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Many urgent situations are not really emergencies. "Urgent" means something you think shouldn't wait until morning or until our next office hours to be seen, or something you need advice about right away, but which does not seem immediately threatening to life or limb. Urgent situations are far more common than emergencies in childhood.

One of our providers is always available - 24 hours a day, 7 days a week (YES-EVEN SUNDAY and HOLIDAYS) - to give advice or make arrangements for your child to be seen, either by us at the office or by an appropriate pediatric specialist at Children's Hospital OR MGHfC, if needed.

We also encourage you to use our 
"The Purple Book" to help determine the urgency in which your child needs to be seen.
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Upcoming Pill Swallowing Class with Dr Bronson
April 2016
Dear Patients, Families and Friends,
Many of you are aware that we have two wonderful psychologists from Psychological Care Associates located right at Children's Medical Office.  Dr Bronson and Dr Graham have been a tremendous asset to our team and we enjoy working with them daily to provide integrated care to our patients.  Drs. Amanda Bronson and Donna Graham, provide consultation, evaluation, education, brief treatment and referral guidance for children and families, together and in coordination with your primary care provider at CMO.  In addition to the previously listed services, PCA at CMO also offers daily call-in to the psychologists to all of our patients.  This call-in is intended for Q&A, mild guidance and introductions. Call 781.645.7228 11:30am-Noon Monday-Friday to speak with Dr Bronson or Dr Graham.  This newsletter offers insight to some of the frequently asked questions during call-in.

Children's Medical Office

Going forward, we at PCA thought it would be fun & helpful to share examples of parent questions posed to our psychologists during Call-In Time, & our responses.  Don't worry, nothing will be shared that is personal, unique, or identifiable. Rather, the questions will be notable for the common chords they strike in many of us, along with our effort to share practical feedback.

Q: " It's testing time & my son is having stomach aches, headaches, & other ailments. I suspect this may be stress, but what should I do?"

A:  First, talk to your pediatrician so that medical causes are ruled out.  Your doctor will also ask questions to ensure that your son is hydrated, sleeping enough, eating normally-- the basic functions that can also cause ailments you describe, but which can go awry during test prep times. Once a medical diagnosis is ruled out, then it's fairly safe to assume that these symptoms are stress related. Did you know that requests for mental health services peak during MCAS prep times? So your child's reactions to the pressure, anxiety, fear of failure, & fear of not comparing well to peers are quite common. There's also the contagion aspect of MCAS stress: peers & teachers alike are experiencing collective anxiety, & this rubs off on parents & family members too.  Given the contagion, think of this as needing a family-wide intervention, the goal being to increase everyone's tolerance for dealing with stress and to maintain perspective. MCAS' become exaggerated in importance and so it's vital for you as a parent to communicate that they are not the final or only word in your estimation of your child's worth or abilities. Continue to communicate this balanced view, while also introducing your son to the notion of relaxation strategies. Start by helping your son identify what works to calm and soothe himself. Make a family game of identifying & broadening everyone's stress-reduction repertoire. Reinforce using these strategies, even for a few minutes a day. You are teaching your son the lifelong art of self-soothing and this will follow him wherever he goes. There are future MCAS' & stressors aplenty to come!  Unintended consequences:  you'll be tackling not just your child's stress-induced reactions, but yours & the rest of your family's as well!  Stress management self-help books & CDs abound, or call for a Consultation from one of our Primary Care Psychologists. 




Q: "How can I get my 12 year old daughter off social media every moment she's home? It's interfering with schoolwork, family time, & her doing other things. Plus her mood seems all over the place & I'm worried."


A: You are voicing 3 potentially overlapping concerns: excessive social media use, difficulty knowing how to set limits on gadget time, & your daughter's moods.  

The Biggest Concern: WHY are limits on excessive social media time so necessary? Interference with homework, activities, & family time is just one, important aspect. What is rarely talked about yet can be hugely concerning (& may be a culprit in your daughter's fluctuating moods) &  a significantly under-recognized phenomena - is social media's impact on kids' developing resiliency.  Gone are the days when the social pressures of the school day could be eased by the calm & quiet of returning home, a natural break time to distract, reflect, be soothed, learn to self-soothe, & refuel.  Instead, social media bombards & burdens our kids unrelentingly with social pressures, inclusion-exclusion fears, dramas, & sometimes cyberbullying.  Lacking this respite at home can interfere with kids learning critical coping skills to manage their strong emotions & build their identity. Without respite, their stress mounts, moods run wild, & behavior becomes more dysregulated. Explaining this phenomena to your daughter is key. She will not like the limits & will still resist them, but she is likely to have greater appreciation if she is given a rationale which goes far beyond the mundane parent & child struggle, & is in fact validating of her inner experience. Talking about this together can open the door to further discussions about how she is doing navigating her worries & social world.


The Reality: Social media is pervasive & there are many challenges to limiting its use. We all know that a big, complicating factor is that gadgets are now necessary, not just for normal socializing, but also for homework tasks, reaching out to peers to clarify homework assignments & receiving help, & communicating with teachers. Cellphones are now smartphones, with access to the internet & all kinds of popular sites, some of which blatantly promote social drama, provocation & meanness. Many teens know full well how to bypass parental phone & computer blocks. So what's a parent to do? 


Limits: Your daughter truly needs her gadgets, but finding the appropriate places, times, & duration of use are within the parental realm. A pre-teen needs to know that some appropriate parental monitoring will happen. Avoid putting a computer in her bedroom; instead, homework & computer time should occur in the family's public areas where you can help her stay on homework task with built-in breaks. Ideally, a child's first phone comes with the caveat that phones will never be allowed in bedrooms past bedtime. It's key for parents to model moderation & prioritization of family time with rules of no family phone use during mealtimes & establishing additional unplugged times.  Expect your daughter's resistance to these limits. Be prepared to discuss her fears about not being plugged in to her peers' every social media interaction. Nonetheless, she will hear your concern & rules very differently if the central, organizing focus is about helping her build resilience in the face of very real & potentially extreme day-to-day pressures.