Virginias / Carolina Chapter

The Virginias/Carolinas Chapter of the Society for Adolescent Medicine is an multidisciplinary organization of professionals who work for the improvement of the health and well being of adolescents. Included in our membership are fellows, residents and students as well as primary care physicians, nurses, nurse practitioners, physician assistants, psychologists, sociologists, lawyers and advocates who specialize in Adolescent Medicine and Adolescent Health. Geographically our region includes West Virginia, Virginia, North Carolina and South Carolina.

Our chapter meetings coincide with the annual SAM meeting; our next meeting will be in St Louis, Missouri in March 2004. Chapter dues are $25, which currently gives one a “lifetime” membership in the regional chapter. Membership in the national organization is not a requirement to be a regional chapter member.

2003-2004 Officers:

President
Tamera Coyne-Beasley, MD, MPH
Department of Pediatrics
CB #7220, 130 Mason Farm Rd, 5th Floor
University of North Carolina
Chapel Hill, NC 27599-7225
Phone: 919-966-2504
Fax: (919) 966-3852
Email: tamera_coyne-beasley@med.unc.edu

Vice President
Richard Brookman, MD
Virginia Commonwealth University
Children's Pavilion
PO Box 980151
Richmond, VA 23298-0151
Phone: 804-828-9408
Fax: 804-828-5775
email: rbrookma@hsc.vcu.edu

Please feel free to contact either of us with any questions.

Exciting Events Over The Past Year Include The Following:

The opening of two new Children’s Hospitals

The Adolescent Health Service at the Virginia Commonwealth University relocated from Randolph-Minor Hall, its location for more than 30 years, to the Children's Pavilion (renovated Richmond Eye and Ear Hospital) in December 2002. The Children’s Pavilion brings together many primary care and specialty clinics that used to be spread across the MCV campus. Rich Brookman, Director of the Adolescent Health Service, continues to have an office in the clinic area. Dr. Brookman continues to have all the residents in Pediatrics and in Medicine/Pediatrics for block rotations as well as several residents a year from Internal Medicine on elective blocks. Residents from other institutions and senior medical students are welcome to inquire about an away elective with Dr. Brookman by calling 804-828-9408 or emailing rbrookma@hsc.vcu.edu.

Similarly, at the University of North Carolina, the Women and Children’s hospital has opened and consolidated all women’s, children’s and adolescent services under one roof. Dr. Carol Ford is the Director of the Adolescent Medicine Program at UNC. Her phone number and email address are (919) 966- 2504, caf@med.unc.edu .

The opening of two new eating disorder programs

Duke University

Traditional approaches to the treatment of anorexia focus entirely on the patient, as a team of therapists and other health professionals work to restore a young woman to good health. Parents have typically not been involved in the process.

However, a new therapy developed at Maudsley Hospital in London and now practiced at several clinics in the United States, takes a very different approach to treating anorexia.

Terrill Bravender, M.D., director of adolescent medicine and medical director of the Outpatient Eating Disorders Program at Duke University Medical Center, says the Maudsley technique is family-centered. "The difference from more traditional approaches is that we put a large emphasis on involving the parents in the care of their children from the very beginning," he says.

"Parents are part of the initial evaluation of patients and also participate in some of the therapy interventions that we do," explains Bravender. "We try to empower parents and help them learn how to help their children eat."

He says parents are members of a treatment team, along with the patient and health professionals.

There are three basic principles of the Maudsley technique. The first is that food is medicine: parents can learn and follow creative, positive steps to feed their sick child, just as they would to give life-saving medicine to a younger child. The second is that parents learn to re-examine their own behaviors around food, since children are heavily influenced by family attitudes. The third principle is that anorexia therapy must be collaborative, a team effort that includes a therapist, nutritionist, physician and other specialists in adolescent medicine and psychology, as well as patients and their families.

"The parents may feel like they're part of the problem," says Bravender. "We want to bring them into the therapy relationship and see them as part of the solution."

For further information contact Terrill Bravender, MD, MPH; Medical Director: (919) 620-5372

University of North Carolina

The Eating Disorders Program at the University of North Carolina at Chapel Hill offers a comprehensive specialized approach to the treatment of anorexia nervosa, bulimia nervosa, and related conditions for adolescents and adults. We offer comprehensive inpatient, daypatient, and outpatient services.

The mission of the program is to provide the most current and evidence-based treatments to help individuals suffering from eating disorders to achieve a lasting recovery.

Our philosophy is based on the belief that eating disorders are caused by both biological and psychological factors and that full recovery requires a supportive and respectful multidisciplinary approach that addresses all aspects of the individual.

The core goals of the program include:

• Achieving a healthy and sustainable body weight.
• Developing healthy (nondieting) eating habits
• Learning how to reintegrate healthy activity into one’s lifestyle
• Treating any physical complications that may have arisen as a result of unhealthy eating or weight control practices
• Treating additional problems such as anxiety or depression
• Providing tools to replace unhealthy thoughts with healthier ones
• Challenging the irrational thinking that maintains eating disorders
• Empowering parents to help their child recover and remain well
• Providing a step-down approach that gradually introduces more autonomy and helps reintegrate individuals back into a healthy lifestyle
• Achieving a balanced and healthy lifestyle

Inpatient program

The inpatient facility is on the 5^th floor of the Neurosciences Hospital at UNC. This new facility includes 10 beds that are dedicated to the treatment of eating disorders. The inpatient program is highly structured and follows the principles of cognitive-behavioral therapy. All patients participate in the structured group program and receive individualized treatment as well. All meals and snacks are supervised in a supportive environment by experienced members of our treatment team. Post-meal observations are designed to be anxiety-reducing.

Components of the inpatient treatment program include:

• Daily consultation with the psychiatrist
• Group cognitive-behavioral therapy
• Individual nutritional counseling and meal planning
• Instruction in healthy nutrition
• Family therapy
• Occupational therapy
• Recreational therapy
• Relaxation training, gentle stretching, and reintegration of exercise
• In-house school
• Community meetings
• Spirituality groups
• Media awareness groups
• Computer-based psychoeducation and homework

Day treatment

The UNC Day Treatment Program provides active structured programming including three meals and two snacks per day. Day treatment is recommended for individuals who have successfully completed the inpatient program or whose treatment needs could best be met with a less structured environment. Day treatment programming includes many of the same features as inpatient treatment, but allows the patient greater autonomy and helps with facing challenges of the outside world.

Outpatient treatment

The UNC Outpatient Eating Disorders clinic is the third component of stepped care. Outpatient treatment includes medication consultation, individual psychotherapy, family therapy, nutrition counseling, and group psychotherapy. In addition, our staff can provide consultation with outpatient providers from other locales to assist with discharge planning and ongoing outpatient care.

Involvement of the family

Eating disorders can devastate families and our philosophy is to integrate family into treatment whenever possible. This includes regular family meetings as well as invitations to attend weekly multifamily groups in order to learn more about our approach to treating eating disorders and to help empower families to assist in recovery.

For further information, contact Eliana Perrin, MD, MPH; Pediatric Medical Director, (919) 966-2504

NOAPPP Conference – November 10-13, 2003, Arlington, VA

The annual conference of NOAPPP (National Organization on Adolescent Pregnancy, Parenting, and Prevention) will be held at the Hyatt Regency Crystal City, Arlington, VA on November 10-13. Pre-conference workshops are on November 10 and the main conference all day November 11 and 12 and morning of November 13. The theme is “Blueprint for Success: Emerging Programs, Themes, and Policies.” Plenary speakers, panels, and numerous workshops will address these focus areas:

            Promoting Sexual Health in Young Adults

            Inspiring Responsibility in Young Men

            Increasing Teen Parents’ Potentials for Success

            Engaging Parents, Families, and Communities

            Maximizing Potential for the Children of Teen Parents

            Exploring and Reducing the Impact of Interpersonal Violence

            Developing and Sustaining Successful State and Local Coalitions

Virginias-Carolinas Chapter Vice-President, Rich Brookman will be co-presenting a 2-part workshop on recent developments in adolescent sexuality and sexual health care. This conference would be of interest to any professional in health, education, social services, or related fields who works with pregnant, parenting, or sexually active at-risk young people. Detailed information may be found on the NOAPPP website at www.noappp.org.

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