About the Toolkits
Guided-self management tools are designed to teach youth with early, mild symptoms of anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), and related disorders (disruptive behavior) how to develop skills to effectively manage their symptoms at home.
The skills can be learned and practiced by children with the help of their parents, and by teens on their own or with the help of their parents as they choose. The skills can also help other family members support the symptomatic youth by engaging the entire family in accessible learning experiences that are helpful for anyone struggling from time-to-time with difficult feelings and behaviors.
Access The Videos & Handouts
Click on one of the links below to access the right Toolkit collection for you and your family.
Guided Self-Management Purpose and Intended Use
The purpose of Guided Self-Management is to support the self-management of sub-clinical to mild presentations of anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), and related disorders (disruptive behavior) in pediatric primary care by providing evidence-based tools for prevention and treatment.
The guided self-management materials are not intended to guide the care of severe, complex, or treatment-unresponsive presentations of anxiety, depression, ADHD, stress reactions, or disruptive behavior, or presentations with high medical or social complexity. The guides also do not address psychiatric disorders nearly always characterized by severity and complexity (e.g., schizophrenia, bipolar, eating, substance-related, obsessive-compulsive, trauma-related, and conduct disorders). For these types of severe and complex presentations, management in the specialty behavioral health setting generally is warranted.
The guided self-management materials should not be considered to be a statement of the standard of care. They do not account for individual variation among patients. As such, it is not possible to draw conclusions about the effects of not implementing the guides, either in general or for a specific patient. The ultimate decision regarding the use of the guides must be made by the appropriate clinician in light of the evaluation findings, other clinical data, the patient’s and family’s personal preferences and values, and the treatment options available.
Use of the guided self-management materials is voluntary. Boston Children’s Hospital provides them for teaching and educational purposes “AS IS” and makes no warranty, expressed or implied, regarding any information provided hereunder. Boston Children’s Hospital and its clinical staff assume no responsibility for any injury or damage to persons or property arising out of or related to any use of the guided self-management materials, any information provided, or for any errors or omissions.
The guided self-management materials are protected by copyright and should not be disseminated without permission from the authors.
Guided Self-Management Research
The guided self-management tools were originally created as an educational resource for the patients (and their families) of pediatric primary care practitioners (PCPs) and behavioral health clinicians (BHCs) participating in the Learning Community of the Behavioral Health Integration Program (BHIP) at the Pediatric Physicians’ Organization at Children’s (PPOC), and for PCPs participating in the Learning Collaborative of the Making Behavioral Health Visits Matter program at the Children’s Hospital Los Angeles (CHLA) Health Network. These programs have provided quality improvement support for the guided self-management tools, as follows.
The guided self-management tools were implemented in a statewide, community-based, independently-owned pediatric practice association (the PPOC) affiliated with Boston Children’s Hospital. The PPOC comprises more than 80 pediatric practices in Massachusetts with more than 500 pediatric PCPs serving over 350,000 children and adolescents. In 2019, 39 PPOC PCPs, nurses, and BHCs were trained in the use of the guides. Of the 39 participants, 84% agreed that the training “increased my understanding of how Guided Self-Management tools can help my patients and their families”; 74% agreed that the tools are “appealing in appearance and easy to read and comprehend”; 76% agreed that the tools are “feasible to use with patients and families”; 82% agreed that the tools would be “useful to patients and their families”; and 86% responded that they were “likely or very likely” to use the tools with patients and their families.
The guided self-management tools were implemented in a regional, community-based pediatric practice association (CHLA Health Network) affiliated with the Children’s Hospital Los Angeles. The CHLA Health Network comprises 64 pediatric practices in Southern California with more than 200 pediatric PCPs serving 400,000 children and adolescents. In 2019, 27 CHLA Health Network PCPs were trained in the use of the guides. Of those, 100% agreed that the tools will be “feasible to use with patients and their families”; 100% agreed that the tools would be “useful to use with patients and families”; and 94% responded that they were “likely or very likely” to use the tools with patients and their families.
Authors
Erica H. Lee, PhD* (Clinical Psychology)
Boston Children’s Hospital
Harvard Medical School
*Equal Author with Keneisha Sinclair-McBride, PhD
Keneisha Sinclair-McBride, PhD* (Clinical Psychology)
Boston Children’s Hospital
Harvard Medical School
*Equal Author with Erica H. Lee, PhD
Contributing Author
Heather J Walter, MD, MPH (Child & Adolescent Psychiatry)
Boston Children’s Hospital
Harvard Medical School
Designer
Zoë Judd, MS
Boston Children’s Hospital
Reviewers
Eugene D’Angelo, PhD (Clinical Psychology)
Boston Children’s Hospital
Harvard Medical School
David R DeMaso, MD (Child & Adolescent Psychiatry)
Boston Children’s Hospital
Harvard Medical School
Credentials
Dr. Lee is Assistant Professor of Psychology in the Department of Psychiatry, Harvard Medical School; and Attending Psychologist and Training Director for the Psychology Internship Program, Boston Children’s Hospital. She earned a BA in Psychology from Cornell University and her MA and PhD in Clinical Psychology from the University of California, Berkeley. She completed her internship in Clinical Psychology at Boston Children’s Hospital and post-doctoral fellowship at Harvard University. Dr. Lee has extensive training and experience in the dissemination, implementation, and testing of evidence-based interventions for youth presenting with a wide variety of behavioral health concerns. She delivers evidence-based and culturally responsive care to children, adolescents, and families within the Boston Children’s Hospital Outpatient Psychiatry Service. As a clinical educator, Dr. Lee provides supervision and teaching to trainees and staff in outpatient, primary care, and school settings, with the goal of expanding the behavioral health workforce and increasing access to mental health care. She is a national and international speaker and consultant on common youth behavioral health concerns and has won multiple awards for her teaching. In addition, Dr. Lee’s research focuses on risk and protective factors and treatment response among diverse youth. She is the author of numerous academic articles and book chapters, including contributions to the Nelson Textbook of Pediatrics. She is also a regular contributor to the popular press, where she provides practical advice on raising healthy children, navigating parenthood, and building mental wellness.
Dr. Sinclair-McBride is Assistant Professor of Psychology in the Department of Psychiatry, Harvard Medical School; Attending Psychologist, Associate Chief of Integrated Behavioral Health, Associate Training Director for the Psychology Internship Program, and Digital Wellness Lab Consultant, Boston Children’s Hospital. She received a BA in Psychology from Yale University and her MS and PhD in Clinical Psychology from Vanderbilt University. She completed her internship in Clinical Psychology at Boston Children’s Hospital and post-doctoral fellowship at Boston Medical Center and Boston Children’s Hospital. Dr. Sinclair-McBride provides evidence- based therapy to children, adolescents, and families in the Boston Children’s Hospital Primary Care Center and the Outpatient Psychiatry Service. She also engages in the supervision and teaching of trainees in these settings. Dr. Sinclair-McBride currently focuses her research and administrative efforts on the assessment and treatment of common behavioral health concerns in integrated care settings serving underserved populations. Through her work with the Digital Wellness Lab, she provides presentations and consultation to help children and adolescents be knowledgeable and empowered citizens of the digital age. She is the author of numerous academic articles and book chapters in texts such as the Handbook of Pediatric Psychological Screening and Assessment in Primary Care and the Nelson Textbook of Pediatrics. She is regularly interviewed for popular media articles and podcasts on mental health, digital wellness, and parenting.
Dr. Walter is Professor of Psychiatry, Harvard Medical School; Senior Attending Psychiatrist, Boston Children’s Hospital; former Associate Medical Director for Behavioral Health, Pediatric Physicians’ Organization at Children’s; and former Medical Co-Director, Massachusetts Child Psychiatry Access Program. Dr. Walter completed her general psychiatry training at New York University Medical Center/Bellevue Hospital and her child and adolescent psychiatry training at Columbia University Medical Center/The New York State Psychiatric Institute. She also completed training in preventive medicine at UCLA Medical Center and earned her MPH degree in epidemiology at the UCLA School of Public Health. Dr. Walter has achieved board certification in General Psychiatry, Child and Adolescent Psychiatry, General Preventive Medicine, and Public Health and has practiced child and adolescent psychiatry in New York, Chicago, and Boston for over 35 years. In addition to clinical work, Dr. Walter’s career has encompassed research, education, clinical administration, and advocacy. Dr. Walter has over 170 papers and chapters reporting the findings from her research and educational innovations, including more than 25 national clinical practice guidelines for child and adolescent psychiatry and multiple chapters on pediatric behavioral health in leading child and adolescent psychiatry and pediatric textbooks, including Dulcan’s Textbook of Child and Adolescent Psychiatry, the Nelson Textbook of Pediatrics, and Mental Health Care of Children and Adolescents – A Guide for Primary Care Clinicians. Dr. Walter has held major administrative positions at multiple academic medical centers, including Director of School Psychiatry at Columbia University Medical Center, Director of Outpatient Child and Adolescent Psychiatry at Northwestern University/Children’s Memorial Hospital, and Chief of Child and Adolescent Psychiatry at Boston Medical Center. She has held multiple leadership positions at the American Academy of Child and Adolescent Psychiatry (AACAP) and has been honored with the AACAP Simon Wile Award for Leadership in Pediatric Consultation Psychiatry, the Catchers in the Rye Award for Outstanding Work on Behalf of Children and Adolescents, and Distinguished Life Fellow. Prior to coming to Harvard Medical School, Dr. Walter achieved the rank of Professor of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine and Professor of Psychiatry and Pediatrics and Vice-Chair of Psychiatry at Boston University School of Medicine.
Ms. Judd is the Graphic Designer for the Behavioral Health Education in Pediatric Primary Care program in the Department of Psychiatry at Boston Children’s Hospital. Ms. Judd has a background in early childhood education with degrees from the University of Massachusetts Amherst in Communication Disorders and Psychology, with a concentration in Education. She studied graphic design at the University of Massachusetts Lowell, and received her MS in Experience Design from Northeastern University. Ms. Judd has a special interest in designing health and wellness educational materials for pediatric patients and their families.
Dr. D’Angelo is Professor of Clinical Psychology at Harvard Medical School and the Chief of the Division of Psychology, Director of Training in Psychology, and Linda and Timothy O’Neill Chair in Psychology at Boston Children’s Hospital. He was the Director of the Outpatient Psychiatry Service at BCH for approximately 20 years. He earned his PhD from the Joint Program in Social Work and Clinical Psychology at the University of Michigan in 1980. He completed his internship in Clinical Psychology at Boston Children’s Hospital and a post-doctoral fellowship at the Boston Children’s Hospital/Judge Baker Children’s Center. He is board certified in Clinical Psychology by the American Board of Professional Psychology. Dr. D’Angelo has received the Karl Heiser Presidential Award from the American Psychological Association, the Career Contribution Award from the Massachusetts Psychological Association, and the Connie Hersey Distinguished Service Award for Contributions to Education and Training from the Association of Psychology Postdoctoral and Internship Centers. He is the past President of the American Academy of Clinical Psychology and also of the Massachusetts Psychological Association. He is also Past Chair of the Association of Psychology Postdoctoral and Internship Centers. He is a Fellow and a Commissioner in the Commission on Accreditation, American Psychological Association. He holds numerous appointments to both state and federal advocacy committees where he focuses on prevention, access to care, and education and training in mental health. He has published numerous papers and book chapters on education and training in psychology, adaptations of evidence-based interventions for youth from diverse backgrounds, suicide risk, and investigations of both clinical high risk and first episode psychosis.
Dr. DeMaso is George P. Gardner – Olga E. Monks Professor of Child Psychiatry and Professor of Pediatrics, Harvard Medical School; and former Psychiatrist-in-Chief, Boston Children’s Hospital. Dr. DeMaso completed his pediatric internship at Massachusetts General Hospital, his general psychiatry training at Duke University Medical Center and his child and adolescent psychiatry training at Boston Children’s Hospital/Judge Baker Guidance Center. He also completed training in pediatric consultation liaison psychiatry at Boston Children’s Hospital. Dr. DeMaso has board certification in General Psychiatry and Child and Adolescent Psychiatry and has practiced child and adolescent psychiatry in Boston for over 40 years. In addition to clinical work, Dr. DeMaso’s career has encompassed research, administration, and advocacy. Dr. DeMaso has over 240 published works reporting the findings from his clinical and research innovations, including multiple chapters on pediatric behavioral health in the Nelson Textbook of Pediatrics and Mental Health Care of Children and Adolescents – A Guide for Primary Care Clinicians. He also co-edited the genre-leading Textbook on Pediatric Psychosomatic Medicine and co-authored the genre-leading Clinical Manual of Pediatric Psychosomatic Medicine (now re- titled the Clinical Manual of Pediatric Consultation-Liaison Psychiatry). Dr. DeMaso has held top leadership positions at the American Academy of Child and Adolescent Psychiatry, and has earned multiple awards from AACAP, including the Simon Wile Award for Leadership in Pediatric Consultation Psychiatry, the Klingenstein Third Generation Foundation Award for Research in Depression or Suicide, the Catchers in the Rye Advocacy Award, the Outstanding Mentor Award, and Distinguished Life Fellow.