ABSTRACT
Anxiety disorders in children and adolescents commonly appear in primary care, and many clinicians will need to guide families on treatment. Our purpose in this article is to give a brief overview of assessment and treatment principles for clinicians who intend to work in primary care. Anxiety and its expression are heavily influenced by children's developmental progression and capabilities. Anxiety disorders have multiple underlying etiologies including temperament and environmental exposure to stressors and trauma. All anxiety disorders are strengthened by an operant process known as escape conditioning. The most effective treatments for child and adolescent anxiety begin with behavioral based interventions including exposure with response prevention (ERP) and cognitive behavioral therapy (CBT). Medication can be effective in combination with CBT and ERP, or as a standalone treatment when behavioral interventions are NOT available. Selective Serotonin Reuptake Inhibitors and Serotonin Norepinephrine Reuptake Inhibitors have been evaluated via randomized clinical trials for treatment of childhood anxiety, but most are not approved by the Food and Drug Administration. When anxiety is severe and functional impairment is high, referral for psychiatric consultation and multimodal treatment reduces the likelihood of poor outcomes.
ABSTRACT
Introduction: Personal financial wellness is a milestone in graduate medical education. Prior surveys addressing financial wellness have not included family medicine (FM) residents and to date, no literature has explored the relationship between perceived financial well-being and personal finance curriculum in residency. Our study aimed to measure the financial well-being of residents and its association with the delivery of financial curricula in residency and other demographics. Methods: Our survey was included in the Council of Academic Family Medicine Educational Research Alliance (CERA) omnibus survey sent to 5,000 FM residents. We use the Consumer Financial Protection Bureau (CFPB) financial well-being guide and scale to measure financial well-being and categorize into low, medium, and high ranges. Results: Two hundred sixty-six residents (response rate of 5.32%) responded with a mean financial well-being score of 55.7 (SD 12.1), in the medium score range. Financial well-being was positively associated with any form of personal financial curricula in residency, year in residency, income and citizenship. Most residents 204 (79.1%) agreed/strongly agreed that personal financial curricula are important to their education, and 53 (20.7%) never received personal financial curricula. Conclusions: Personal financial well-being scores of family medicine residents are considered medium per the CFPB ranges we assigned. We find a positive and significant association with the presence of personal financial curricula in residency. Future studies should evaluate the effectiveness of different formats of personal finance curriculum in residency on financial well-being.
