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WRNMMC Offers Adolescent Intensive Outpatient Program


By: Kalila Fleming

WRNMMC Command Communications Staff Writer

In 1949, Mental Health Month was established to increase awareness of the importance of mental health and wellness in Americans lives, and to celebrate recovery from mental illness.

Teens of active-duty service members face unique challenges that make their mental health and well-being more vulnerable.
Walter Reed National Military Medical Center (WRNMMC) has made efforts in combating the realities of mental health issues that adolescent military dependents face.
“Military children are faced with unique challenges when compared to civilian children. Military children are more likely to move every few years, and constantly have to adjust to a new community (region, school, peers). In addition, a service member parent may have deployments from home, and these separations from their parent(s) may be stressful for the child and family system,” Dr. Uchenwa Okoli, Child and Adolescent Psychiatrist and Director of the Adolescent Intensive Outpatient Program and WRNMMC said.
Public Health Service Lt. Cmdr. (Dr.) Micah Sickel, Deputy Service Chief of the Child and Adolescent Psychiatry Service (CAPS) noted the clinic recently launched the Adolescent Intensive Outpatient Program (A-IOP) for high risk teenagers, ages 13-18 years old.
“This program is for teens who are experiencing increased difficulties due to a number of psychiatric disorders, including mood disorders, disruptive behavior disorders and anxiety disorders. A-IOP is designed to help adolescents who are transitioning from inpatient or partial hospitalization, and require more intensive outpatient services to prevent repeat inpatient or partial hospitalizations, and/or need crisis stabilization and could benefit from more intensive outpatient care,” Sickel said.
Traditionally, referrals made to the clinic consist of teenagers struggling with depression, self-injurious behavior, anxiety, impulsive and aggressive behaviors, anger issues, distorted or inaccurate thinking and/or school difficulties, Okoli explained.
Additionally Okoli mentioned, “[In addition to the A-IOP] The program(s) [we] have in the Child Adolescent Psychiatry Service (CAPS) include individual  therapy, family therapy, parent guidance, medication management and neuropsychological testing.”
Okoli also noted the learning opportunities that are provided for health care providers in training, “[Our clinic] is also a primary teaching site for the child psychiatry fellowship program, and there is academic activities occurring on-site daily.”
In Fall 2015, Army Lt. Col. David Miller, Deputy Chief for Clinical Operations in CAPS and Clinical Psychologist, led the development team for establishing the A-IOP at WRNMMC.
Miller stated, “The program fills a treatment need, saves money, and early outcome data suggests the program is working.” He added, “…as far as I know the A-IOP at Walter Reed is the only one of its kind in the DoD and recent comparison of teen completed pre-treatment symptom scores to final session symptom scores revealed statistically significant reductions in depression, anxiety, and anger.”
The A-IOP development team was integral with determining the A-IOP mission, curriculum, Standard Operating Procedures (SOP), symptoms screening measures and staff/patient safety.
Additionally Miller stated that ongoing assessment of program efficacy is required, he is hoping the department will share the A-IOP model with other military treatment facilities nationwide.
Both Sickel and Okoli explained what parents should look for if they have a child that is suffering from a mental or behavioral disorder.
“It is important for parents to observe for any changes from their teenagers baseline that may be impairing their functioning at home and school. For example, if your teenager seems more withdrawn, isolated, and sad, or if you teen has severe mood swings and is engaging in high risk behaviors… families can contact CAPS, and request evaluation by a behavioral health provider,” the doctors said.
“Adolescence is a time of identity exploration and autonomy. During this time while adolescents are trying to figure out, ‘Who am I?’ their executive functioning centers in their brains are still actively developing, placing teenagers at a higher risk for impulsive, poor judgment behaviors,” Okoli said.
She added, “Teenagers may also be navigating psychosocial stressors specific to this developmental phase at school, and among peer groups and family.”
Additionally both doctors included that the program meets after school from 4:30 p.m. to 7:30 p.m. on Tuesdays, Wednesdays, and Thursdays for three consecutive weeks for a total of nine sessions. The program curriculum also includes a variety of psychoeducational groups such as Suicide Prevention, Resiliency Development, Anger Management, Stress Management and Pet Therapy. Group-focused interventions, team building to improve emotional regulation, as well as coping and problem solving-skills are also included in the program sessions.
Okoli expressed that parent involvement is essential in the program, as parents are required to remain on base during program hours and participate in select groups.
For more information, the Child and Adolescent Behavioral Health Clinic is located in the America Zone (Building 19) on the 4th floor or contact the clinic at 301-295-0576.