President’s Message

President’s Message

By Andrea Chronis-Tuscano, PhD

I am thrilled to serve as  your President, during SCCAP’s 25th anniversary year! First, I want to thank Past-President Yo Jackson for her service and inspiration. When I decided to run for SCCAP President, I reflected on what I most wanted to contribute to the field of clinical child and adolescent psychology. As a first-generation college student, it is sometimes incredulous that I have had the privilege of earning a Ph.D. and becoming a Full Professor in a field which I am so passionate about—improving trajectories for at-risk youth and disseminating evidence-based practices to diverse youth and families.

Thinking back to when I first applied to graduate school, there were many ways in which I was unprepared, so many unwritten rules I was not privy to. One of my missions, as a Professor and now SCCAP President, is to expose undergraduate students to the many possibilities that a career in clinical child and adolescent psychology affords and to engage them in activities that will make them competitive for graduate programs early in their educational journey if they decide to pursue that path. I like to share that I am a first-gen student, and each time I do, several students come to share with me that they are as well, which creates a connection that can be so impactful for their professional development. I also like to share that I did not get into a doctoral program the first year I applied. Persistence, getting back on my feet, is something that has helped me throughout my career and my life more generally. By telling students my story, I hope to inspire them to do the same.

The power of shared stories has prompted me to initiate this year’s theme: “Lived Experiences of Youth and Families: What we Gain from Listening.” The field of clinical child and adolescent psychology has come a long way in identifying evidence-based assessment and treatment approaches. At the same time, many of the studies validating our diagnostic classifications, assessment tools, and interventions have not reflected the diversity of the youth and families we serve, or the real-world providers delivering care. Moreover, mental health disparities exist for a variety of reasons, including systemic disadvantages, stigma, and access barriers. As we look forward, it is a priority to learn from listening to youth and families in our research and clinical practice using qualitative methods.

I will use my own research as an example of why this is so important. For almost two decades, my lab has studied ADHD in families. Considering the strong genetic underpinnings of ADHD, many times when a child has ADHD, their parent(s) have similar characteristics, whether or not they have been formally diagnosed. As early as graduate school, when I administered parent diagnostic interviews to assess child ADHD, parents often joked that they recognized the same symptoms in themselves and/or their partners! In the spirit of the scientist-practitioner model, this clinical experience launched one of my main research foci examining how parent ADHD is related to parenting behaviors and child developmental and treatment outcomes. Evidence-based ADHD treatments rely on parents’ ability to maintain consistent routines, and to override automatic negative reactions to child misbehavior with planned use of behavioral parenting skills. Yet, when parents of children with ADHD struggle with the very same organizational and emotion regulation challenges that their children do, it makes it difficult for them to consistently implement what we behavior therapists ask them to do! We have conducted several successful studies on this topic. 

About 5 years ago, we launched an NIMH-funded hybrid effectiveness- implementation study in urban primary care clinics that treat predominantly Black/African-American families, many of whom receive public insurance (R01MH118320). As part of usual care at annual well-child visits, parents are given the option to complete a brief screener assessing their own ADHD symptoms; those that screen positive are contacted by research staff about our study. Parents who meet entry criteria receive 10 weeks of an integrated behavioral parenting intervention (BPI), with or without a parent ADHD medication trial before they begin BPI. We assembled a community partner group consisting of parents, pediatricians, embedded psychologists and office staff to inform every aspect of our research design and interventions.

What we have learned from our community partners has been the most valuable aspect of this study so far!  As is often the case, we are left with more questions than answers:  At the familial level, how can we best introduce the importance of parent mental health in a manner that is not off-putting for parents from diverse backgrounds? Who is best positioned to start these conversations? How can we do so in a way that expresses our sincere desire to support, rather than blame, parents who may be struggling with their own mental health? How do we address parental stigma around sharing diagnostic information with the school so that children with ADHD can get the educational support they need to be successful? At the practitioner level, how can we increase comfort among pediatricians, pediatric nurse practitioners, and other child health providers to inquire about parent mental health? How can we apply principles of shared decision making to determine when to begin with parent vs. child mental health services? Are our EBTs too complicated and lengthy for delivery by psychologists or other mental health professionals integrated in primary care settings? Given parental concerns about the use of psychiatric medications, what is the best way to proceed when we have concerns about a parent’s mental health?  At the broader context level, how can we continually diversify our workforce in order to increase comfort among families?  These are just a few of the questions that have arisen in our ongoing study and that members of our research team are hoping to address in our future work.

Without hearing from parents from diverse backgrounds, and the professionals working in underresourced communities who grapple with these issues on a daily basis, we will not be able to move the field forward and ultimately reduce disparities in receipt of mental health services for youth and families who need them most.