32 Disruptive Behaviors: Insights and Strategies from a Child Psychiatrist

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Children that exhibit aggressive and disruptive behaviors can be hard to manage and treat especially if the root causes are not clearly understood. Paresh Patel, M.D., PhD, joins us in this episode to talk about exploring what may be behind difficult behaviors and offers management and treatment strategies.

Dr. Patel emphasized that behaviors are often symptoms of deeper problems. Pediatric clinicians can begin to peel back the layers, and with the support of mental health professionals, find strategies that address what is really going on with kids. He also believes that medication should only be administered with the intent to stop the medication. Take a listen to his thoughts about the role of psychotropic medications and aggressive and disruptive behaviors and when we can lean on our colleagues in psychiatry.

Although the first stop for many parents whose kids are struggling with difficult behaviors is the pediatric office, it is really about a team approach that includes our friends in psychiatry and mental health.

Tune in for a thoughtful discussion about aggression and disruptive behaviors in kids with Dr. Patel!

[00:01 - 07:23] Opening Segment

• Let’s welcome, Paresh Patel, M.D., PhD
• His path to child psychiatry 

[07:24 - 21:57] Disruptive Behaviors 

• What Paresh learned under the MC3 Program
• Medication is only a smart part of treatment 
• Handling children with disruptive behaviors 
• Paresh shares his experience 
• Behaviors are symptoms
• Non-verbal vs. verbal communication
• Some key insights from Paresh 

[21:58 - 36:13] Free Will Among Children 

• Paresh’s message for parents on how to be “super parents”
• He talks about the notion of free will among children
• Here’s a true story from Paresh you should not miss 

[36:14 - 51:29] Longitudinal Relationships and Trust

• Building relationships and trust among pediatricians
• When to resort to antipsychotic medication for children 
• We break down the different therapies available to children

[51:30 - 58:21] Closing Segment

• Paresh’s message for his resident self
• Finals takeaways
• Children do well if they can
• Behavior is a symptom 
• Turning parents into “super parents”
• No bad kid or bad parent
• Start medication to stop medication 
• Involve the therapist in the therapy 
• Jump with both feet and pay attention

Tweetable Quotes:

“The behavior is just a symptom of a deeper problem, and a deeper problem can be along the child continuum.” - Paresh Patel, M.D., PhD

“Start medication with the intention to stop it.” - Paresh Patel, M.D., PhD

Resources Mentioned:

• Michigan Child Collaborative Care Program
• Pediatric Meltdown previous episode: Autism Spectrum Disorders in Primary Care: Recognizing Early Signs and Initiating Treatment‬
• Book: The Explosive Child

Email pdpatel@med.umich.edu to connect with Paresh and check out Michigan Medicine to learn more about his work. 

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