This column was originally featured on Newportri.com.
One year ago, Newport Mental Health joined four other Rhode Island community mental health centers in an ambitious study with Brown University Health’s Pediatric Anxiety Research Center (PARC). The five-year study is called IMPACT-RI, and it is expanding access to care for children struggling with anxiety or obsessive-compulsive disorder (OCD), while studying different treatment delivery methods.
Today, we’re beginning to see results in the lives of Newport County children.
One student entered the study after anxiety disrupted their school experience. Their anxiety became so overwhelming that the student stopped attending school altogether, choosing virtual learning at home.
Six months after entering the study, that same student was back in school.
What Does Anxiety Look Like?
At Newport Mental Health, anxiety is the most common diagnosis we see in children and teens ages 4 to 17. Anxiety can look different from one child to another. For some, it may show up as constant worry about everyday things. For others, it may involve panic attacks, obsessive-compulsive disorder, or fears connected to difficult or traumatic experiences.
“Anxiety can show up in many different ways for children,” says Stephanie Lujan Rickerman, MSN, PMHNP-BC, Division Director of Children’s Services at Newport Mental Health. “Some children may avoid school, certain foods, new experiences, or everyday activities like going to the grocery store or joining family outings. Others may become very particular about what feels safe or comfortable.”
Dawn Iacobbo, a therapist in Children’s Services who works with children in the study, says anxiety may center around school but is often more general. “It looks like school avoidance, but most of the time it’s social anxiety,” she says.
Summer break can provide relief from school-related pressures, but it does not necessarily eliminate the underlying anxiety. “Anxiety, unfortunately, doesn’t go away, but sometimes it does go on pause,” Iacobbo says. “The kids that I treat for social anxiety are still having issues with life over the summer.”
Those challenges may show up in everyday situations. “If they are asked to go into a store and order something or talk to the cashier, that would be a really difficult task for them,” Iacobbo says. “Social anxiety does extend further than school. It just looks different.”
Facing Fears, One Small Step at a Time
Several children have completed the six-month IMPACT-RI study, with 10 more currently enrolled. Each child receives the same evidence-based treatment; they are randomly assigned to receive treatment either entirely through telehealth, entirely in person, or through a flexible combination of both. Researchers are studying the effectiveness of each approach in an effort to improve access to care.
“We know that anxiety disorders are the most common mental health challenges children face, and they can have a serious impact on every area of a child’s life. This study is designed to not only identify which delivery methods work best, but also to help ensure all families—regardless of background—can access high-quality, evidence-based care,” said Jennifer Freeman, Ph.D., director of PARC at Bradley Hospital and professor of psychiatry and human behavior at Brown University. Freeman is also the principal investigator of the study.
That treatment centers on exposure therapy, a proven approach that helps children gradually face situations they fear instead of avoiding them.
For Newport Mental Health exposure coach Jenna Strout, who worked with the student experiencing challenges with attending school, that process is all about taking manageable steps. “It’s like slowly dipping your toes into cold water,” she says. “Eventually, you get comfortable.”
With the student, the first step wasn’t attending classes. It was simply returning to the school building. They initially completed virtual classes from a quiet room inside the school. Once that became manageable, they attended one class in person, then a few more.
“It was a very gradual approach, which is why I think we found success,” Strout says. “It wasn’t all at once.”
By the end of the program, the student was spending nearly the entire day at school. More importantly, the student had developed a new sense of confidence.
Iacobbo explains that exposure therapy is about helping children learn they can handle uncomfortable moments. “The more you do it, and there’s a positive outcome, the more reinforced you’ll be,” she says. “They start to build their confidence. We need to send them to school and then prove that they can get through the day using the skills that they learned. These are the skills that will get them through other uncomfortable moments.”
Although the research portion of the study has ended for this student, their care at Newport Mental Health continues, which is an option for all study participants. For the summer, the focus has shifted to spending time with friends and building independence in the community.
“We learn how to manage anxiety, not completely erase it,” Strout says. “We’re supposed to have anxiety. It has a purpose. The goal is to make sure it isn’t controlling your life.”
For Strout, watching the student’s transformation has been one of the highlights of her work. “They told me, ‘I feel a lot more sure of myself,’” she says. “And that was really the biggest success of all.”
Strengthening Care for All
In addition to the wonderful work with children, the partnership is also strengthening Newport Mental Health’s workforce. Therapists meet weekly with PARC specialists to review cases and receive consultation, while exposure coaches complete specialized training before beginning their work.
And that support continues long after the initial training. “They’re great,” Strout says of the PARC team. “You could call them at any moment, and they would answer and talk to you. They’re just so easy to work with.”
Families Can Still Participate
Newport Mental Health continues to enroll children ages 5 to 18 in the IMPACT-RI study, which continues for another four years. Each child participates in up to six months of treatment, including monthly sessions with a therapist and three sessions each month with an exposure coach.
Families interested in participating should begin with an assessment through Newport Mental Health’s Access Center. Eligible families then complete a research assessment with the PARC team. Our Access Center is open Monday through Friday, 9 a.m. to 2 p.m.
IMPACT-RI is funded by the Patient-Centered Outcomes Research Institute. Families are compensated for completing study-related surveys, while therapy is billed through insurance. Because Newport Mental Health is a Certified Community Behavioral Health Clinic (CCBHC), participation is not limited by a family’s ability to pay.
For more information, call Newport Mental Health at (401) 846-1213, option 5, or visit https://www.parcanxiety.org/.
Dayna Gladstein is President & CEO of Newport Mental Health in Middletown. Peace of Mind, which is co-written with Kristan McClintock, runs in the Newport Daily News and online at newportri.com.