Stories from the Exam Room: Case Examples of Healthy Steps Interventions at Montefiore

Abstract

Healthy Steps at Montefiore follows the integrated care model in which clinically trained behavioral health professionals, with expertise in early childhood development, trauma, and attachment theory, are embedded within general pediatrics practices to meet with families in a universally accessed, non-stigmatized setting. Healthy Steps Specialists intervene at three levels to address the multiple concerns that families bring to their child’s pediatrician. First, Healthy Steps Specialists implement a universal screening program, working alongside pediatricians to identify families of infants with historical or current psychosocial stressors, and provide services intended to prevent the transmission of trauma across generations. Healthy Steps Specialists also work with families of children, aged birth to 5, who require short-term interventions related to concerns about behavior and development, including difficulties with feeding, sleep, tantrums, and aggression. Finally, Healthy Steps Specialists provide mental health interventions to parents of very young children in order to address concerns that may impede a parent’s ability to attend to their children’s developmental needs. Four vignettes included in this chapter offer examples of these levels of intervention.