Behavioral Health Services with High-Risk Infants and Families Meeting the Needs of Patients, Families, and Providers in Fetal, Neonatal Intensive Care Unit, and Neonatal Follow-Up Settings

There are relatively high rates of complications in the fetal and neonatal periods (1 in 33 fetuses born with birth defects and 1 in 10 preterm births in the US). With advances in maternal-fetal care and growing services and life-extending medical innovations in the neonatal period, more families are presenting to Neonatal Intensive Care Units (NICUs) and often for longer lengths of time. The growing recognition of mental health needs of families and providers in fetal care centers, NICUs, and neonatal follow-up programs has led to a quickly increasing presence of behavioral health providers in these settings.

Behavioral Health Services with High-Risk Infants & Families is a practical guide for mental health clinicians working in fetal care, NICU, and neonatal follow-up care. The book provides a broad overview of common medical conditions in fetal and NICU settings (e.g., congenital anomalies, premature birth, hypoxic injury in the perinatal period), prevalence, and symptoms of behavioral health challenges, specific considerations for assessment and intervention, and cross-cutting issues to assist the clinician with optimizing behavioral health care integration with mothers, partners, babies, and families. Additionally, information about the provision of psychosocial support and education to staff is also included. The text represents a comprehensive, practical resource for behavioral health clinicians working with pregnant women, partners, infants, families, and providers in perinatal and neonatal intensive care settings. The book features de-identified case examples, trauma-informed care prompts/scripts, specific questions for assessment and intakes, key medical terms, resource guides, and reference lists.

Allison G. Dempsey, PhD is a licensed psychologist and Associate Professor of Psychiatry at University of Colorado School of Medicine. She is the Director of the Connections Program for High-Risk Infants and Families and the Perinatal Behavioral Health Pathways Program. She has worked with high-risk
infants and families for over a decade across fetal care, neonatal intensive care, and neonatal follow-up settings. She is the elected co-chair of the executive committee of the National Network of NICU Psychologists. Her clinical work focuses on the development and psychological and behavioral
functioning of high-risk infants and their families across the continuum of medical settings from pregnancy through early childhood. Her research focuses on models of care for behavioral health service delivery with high-risk infants and families.

Joanna C.M. Cole, PhD, PMH-C is a licensed clinical psychologist and Associate Professor of Clinical Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania. She is the manager of psychosocial programs within the Center for Fetal Diagnosis and Treatment at the
Children's Hospital of Philadelphia, caring for expectant parents diagnosed with a fetal birth defect. Dr. Cole provides psychotherapy with individuals and couples on effective coping strategies and emotional preparation for different stages in the medical experience, from pregnancy diagnosis and
prenatal care, through the birth process and the neonatal intensive care stay. She also provides options counseling and grief support to help families plan for and cope with the intrauterine and/or neonatal death of their baby. She is the Associate Clinical Chair for the Family StEPS Program, a new
initiative across CHOP's fetal and early childhood programs to provide resources, clinical care, and partnerships to help nurture parental-child attachment and development. Dr. Cole is also an active member in Postpartum Support International, where she acts as an international trainer and
Curriculum Manager for the Perinatal Mood Disorders Components of Care 2-Day Training Course and Advanced Psychotherapy Course.

Sage N. Saxton, PsyD is a licensed psychologist whose work focuses on children and families from birth through early childhood. Dr. Saxton is a Professor of Pediatrics with the Oregon Health & Science University's (OHSU) Institute on Development and Disability (IDD). She is the Director of the NICU
Follow Up Program and has worked with high-risk infants and their families for over 13 years. Dr. Saxton is an active member of both the National Perinatal Association (NPA) and Postpartum Support International and serves on the Board of Directors for the NPA. She is the elected co-chair of the
executive committee of the National Network of NICU Psychologists. Dr. Saxton's research interests include developmental and educational outcomes for children born prematurely, children's adjustment to traumatic loss, and the provision of hospital-based parental support. She is actively involved in
programmatic development efforts nationally to improve family and patient centered NICU care.

SECTION I: ROLES AND PRACTICE ISSUES

1. History of Psychological Services in Neonatal Intensive Care
Michael T. Hynan

2.Roles, Activities, and Opportunities of Behavioral Health Clinicians in Delivering Continuity of Care
Tiffany Willis, LaTrice L. Dowtin, Dailyn Acosta, and Kara Hansen

3.Quality Improvement and Research Across Fetal and Neonatal Care Settings
Pamela A. Geller, Ariana Albanese, Victoria A. Grunberg, John Chuo, and Chavis A. Patterson

4.Systems Interventions and Program Development
Susanne Klawetter, Jill A. Hoffman, Kristi Roybal, and Sunah S. Hwang

5. Interdisciplinary Behavioral Health Teams
Chavis A. Patterson, Mona Elgohail, Alison Hartman, Vincent C. Smith, and Pamela A. Geller

6. Teaching and Training Developing Professionals in Perinatal and Neonatal Settings
LaTrice L. Dowtin, Tiffany Willis, Soudabeh Givrad, and Melissa Scala

7.Operations and Ethical Considerations
Elizabeth Fischer, KristiLynn Cedars, Abbey Kruper, and Steven R. Leuthner


SECTION II: CROSS-CUTTING MENTAL HEALTH ISSUES AND APPROACHES

8. Infant Mental Health for High-Risk Infants Across the Continuum of Care
Miller Shivers, Annelise Cunningham, Natalia Henner, and Kerri Machut

9.Perinatal Mood and Anxiety Disorders Among Parents of High-Risk Fetuses and Infants
Birdie Meyer, Brenda Papierniak, and Christena Raines

10. Screening for Perinatal Mood and Anxiety Disorders Across Settings
Amy E. Baughcum, Olivia E. Clark, Shannon L. Gillespie, and Jeanne Decker

11. Psychotherapy and Medication Interventions for Perinatal Mood and Anxiety Disorders Across Settings
Teni Davoudian, Jacquelyn Knapp, Lana Weber, and Nicole Cirino

12. Trauma and Trauma Informed Care
Mary Coughlin

13. Addressing Perinatal Substance Use Across the Continuum of Care
Jennifer J. Paul, Jessalyn Kelleher, Susanne Klawetter, and Sarah Nagle-Yang

14. Human Milk and Breastfeeding
Diane L. Spatz and Elizabeth D. Morris

15. Shared Decision-Making Across Settings
Jeannie Zuk, Kristin Carter, Beth McManus, and Brooke Dorsey Holliman

16. Perinatal Crisis and Traumatic Bereavement
Mara Tesler Stein and Deborah L. Davis

17. The Value of Peer Support for High-Risk Pregnant Women and Their NICU Infants
Sue L. Hall, Jenny Landry, and Erin Thatcher


SECTION III: FETAL CARE SETTINGS

18. Specialty Care Settings: Perinatal Management, Fetal Therapy and the Fetal Therapy Center
Christina Paidas Teefey, Sarah Robinson, and Julie S. Moldenhauer

19. Role of Behavioral Health Clinicians in Fetal Care Settings
Lacy Chavis, Sakina Butt, and Elizabeth Vaught

20. Uncertainty and Coping in the NICU: Relationships Matter
Zina Steinberg and Susan Kraemer

SECTION IV: NEONATAL INTENSIVE CARE SETTINGS

21. Neonatal Intensive Care Settings
Sara C. Handley and David Munson

22. Role of Behavioral Health Clinicians in the NICU Setting
Rochelle Steinwurtzel, Sandhya Brachio, Sheau-Yan Ho, Solimar Santiago-Warner

23. Regulation, Relationships, and Reflection: Developmental Care in the NICU
Ayelet Talmi and Joy V. Browne

24. Mental Health and Coping Challenges Among Families in the NICU
Jennifer Harned Adams, Stacey R. Bromberg, and Anna Zimmerman


SECTION V: NEONATAL FOLLOW-UP SETTINGS

25. A Brief History of Neonatal Follow Up and Why It's Done
Howard Needelman, Beatrice Egboh, Whitney Strong-Bak, and Grace Winningham

26. Common Neurodevelopmental and Behavioral Challenges in Neonatal Follow-Up
Kathryn E. Gustafson and Mollie G. Warren

27. Role of Behavioral Health Clinicians in Neonatal Follow-Up Settings
Casey Hoffman and Annie Markovits

28. After the NICU: Primary Care Behavioral Health Services
Verenea J Serrano, Jonna von Schulz, Melissa Buchholz, Kristina Malik, Amy Wrenn, and Ayelet Talmi