Child and Adolescent Psychiatry

Stanford Early Life Stress Research Program

The ELS Clinic, under the direction of Dr. Victor G. Carrion, emphasizes early intervention for children and families who have experienced an acute or chronic stressor or traumatic event. Examples of types of stressors include natural disasters (flooding, fires, earthquakes, etc.) and also those that are man-made (assaults, motor-vehicle accidents, physical and sexual abuse, witnessing violence, etc.) There may be other type of stressors such as experiencing parents' divorce, intrusive medical interventions, etc. Even though some adults may not consider an event to be traumatic, it may qualify as such if the child experienced it as threatening or frightening.

The stressor should be identified during the Intake. Some examples of questions that can assist the Intake coordinator assess if a child is an appropriate referral to this clinic include:

  1. Has there been any particular event in the past that the child experienced with overwhelming fear?
  2. Has the child experienced any major life-changing event?
  3. Has the family experienced a traumatic event where some member was in danger?
  4. Have the behaviors described begun after a major event in the child's life?

Although our assessments will go through the typical diagnostic considerations, it is important for the family to understand that the treatment intervention will concentrate on addressing these stressors. Although diagnostically-sensitive, this is not a diagnosis-focused clinic, rather it is driven by the understanding that stressors and biological correlates of stress vulnerability interact to initiate or maintain neurobehavioral disorders.

The ELS Clinic Intake (2-hour Assessment + 1-hour Psychotherapy hour)

  • CODE Intake form
  • Protocol Intake Questions
  • Selected Questionnaires
  • Psychoeducation component
  • Clinical Picture
  • Treatment
  • Identification of Target Problems

The ELS Treatment Approach

  • Structured – blocks of 20 sessions
  • Multi-modal – combines different therapeutic elements
  • Dyadic – caretakers active participants of treatment
  • Research – family may be presented with one or two Human Subjects Consents for participation in research. One evaluates children between 10-16 with history of sexual abuse, physical abuse or witnessing violence. The other evaluates treatment outcome.

List of Clinics

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