Overprescribing in Pediatric Psychopharmacology
Presented by George Kapalka, PhD, MS, ABPP
Recorded on Thursday, March 14th, 2024
Access provided upon registration on “My Courses” page
While prescribing medications to children and adolescents is sometimes necessary and beneficial, prescribers often encounter pediatric patients who have been placed on multiple medications, sometimes in excessive doses. The widespread use of medication as the first choice for a variety of concerns has led to overprescribing. Currently, about one in five youths in the US take psychotropic medications. This trend is particularly evident among specific groups, such as children and teens in the foster care system. Reasons for overutilizing medications are complex but include limited access to care, lack of appropriately trained prescribers, and inappropriate expectations from care takers as well as treating professionals.
This presentation will explore the dynamics that underlie psychological symptoms in children and adolescents, and assumptions which may lead to overprescribing. Whereas this problem is not unique to behavioral health, it is in this area of healthcare that the psychologist – especially the medical/prescribing psychologist – can apply knowledge and skills to provide the best possible care for the patient. Comprehensive mental health that addresses the complex needs of this population will be explored and recommendations will be discussed to improve judicious use of medications when warranted.
When attended in full, this program offers 1.0 APA CEs for Psychologists.
While prescribing medications to children and adolescents is sometimes necessary and beneficial, prescribers often encounter pediatric patients who have been placed on multiple medications, sometimes in excessive doses. The widespread use of medication as the first choice for a variety of concerns has led to overprescribing. Currently, about one in five youths in the US take psychotropic medications. This trend is particularly evident among specific groups, such as children and teens in the foster care system. Reasons for overutilizing medications are complex but include limited access to care, lack of appropriately trained prescribers, and inappropriate expectations from care takers as well as treating professionals.
This presentation will explore the dynamics that underlie psychological symptoms in children and adolescents, and assumptions which may lead to overprescribing. Whereas this problem is not unique to behavioral health, it is in this area of healthcare that the psychologist – especially the medical/prescribing psychologist – can apply knowledge and skills to provide the best possible care for the patient. Comprehensive mental health that addresses the complex needs of this population will be explored and recommendations will be discussed to improve judicious use of medications when warranted.
After attending this intermediate-level program, participants will be able to:
- Describe the rise in psychotropic medication use among pediatric populations in the US.
- List several reasons to deprescribe including, limiting Adverse Drug Reactions (ADRs), economic factors, and comorbid conditions.
- Explain several methodological weaknesses about psychotropic polypharmacy in pediatric populations.
This program meets APA’s continuing education STANDARD 1.1: Program content focuses on application of psychological assessment and/or intervention methods that have overall consistent and credible empirical support in the contemporary peer reviewed scientific literature beyond those publications and other types of communications devoted primarily to the promotion of the approach.
This program meets APA’s continuing education GOAL 3: Program will allow psychologists to maintain, develop, and increase competencies in order to improve services to the public and enhance contributions to the profession.
George Kapalka, PhD, MS, ABPP; Distinguished Chair, Alliant International University
Dr. George M. Kapalka, a Distinguished Professor in the California School of Professional Psychology and the Program Director of its MS in Clinical Psychopharmacology, is a prescribing and clinical psychologist based in Albuquerque, NM. He is board certified in clinical psychology (ABPP) and is a Fellow of APA Divisions 53 and 55. He has been in practice for over 30 years and primarily treats children and adolescents. His research has focused on the psychological, pharmacological and combined treatments of pediatric disorders, collaborating with primary care (particularly pediatricians), and behavior management training for parents and teachers. He is an author of six books (one of which was translated into ten foreign languages) and dozens of journal articles and other publications. (Please refer to CV submitted separately.)
Gordon, J. A. (2020). Addressing disparities: Advancing mental health care for all Americans. National Institute of Mental Health. https://www.nimh.nih.gov/about/director/messages/2020/addressing-disparities-advancing-mental-health-care-for-all-americans.shtml
Hales J, Kit BK, Gu Q, Ogden CL. Trends in prescription medication use among children and adolescents-United States, 1994-2014. JAMA. (2018) 319:2009–20. doi: 10.1001/jama20185690
Hansen, C. R., O’Mahony, D., Kearney, P. M., Sahm, L. J., Cullinan, S., Huibers, C. J. A., Thevelin, S., Rutjes, A. W. S., Knol, W., Streit, S., & Byrne, S. (2018). Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta‐analysis. British Journal of Clinical Pharmacology, 84(12), 2716–2728. https://doi.org/10.1111/bcp.13742
Reppe, L.A., Spigset, O. & Schjøtt, J. (2016). Drug Information Services Today: Current Role and Future Perspectives in Rational Drug Therapy. Clinical Therapeutics, 38(2), 414-421.
Seok, J.-W., Soltis-Vaughan, B., Lew, B. J., Ahmad, A., Blair, R. J. R., & Hwang, S. (2023). Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis. Scientific Reports, 13(1), 6921–6921. https://doi.org/10.1038/s41598-023-33979-2
Tan, C., Greiner, M. V., Nause, K., Shahabuddin, Z., & Beal, S. J. (2023). Mental Health Diagnoses, Health Care Utilization, and Placement Stability on Antipsychotic Prescribing Among Foster Care Youth. Academic Pediatrics, 23(3), 675–680. https://doi.org/10.1016/j.acap.2022.08.005
Vandana, P., & Veenstra-VanderWeele, J. (2023). Editorial: Failing in our Responsibility to Address Obesity Caused by Psychotropic Medications. Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2023.05.016
Target Audience: Psychologists.
Psychologists. This program, when attended in its entirety, is available for 1.0 continuing education credits. The Chicago School of Professional Psychology is committed to accessibility and non-discrimination in its continuing education activities. The Chicago School of Professional Psychology is also committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during discussion periods.
Non Psychologists. Most licensing boards accept Continuing Education Credits sponsored by the American Psychological Association but non-psychologists are recommended to consult with their specific state-licensing board to ensure that APA-sponsored CE is acceptable.
*Participants must attend 100% of the program in order to obtain a Certificate of Attendance.
If participants have special needs, we will attempt to accommodate them. Please address questions, concerns and any complaints to [email protected]. There is no commercial support for this program nor are there any relationships between the CE Sponsor, presenting organization, presenter, program content, research, grants, or other funding that could reasonably be construed as conflicts of interest.