Podcast
Pediatric Meltdown
Hosted by Lia Gaggino · EN
Tune in to Pediatric Meltdown and listen to experts provide insights and strategies on a wide variety of behavioral health and mental topics anytime and anywhere that fits your busy schedule. Guests include published researches, primary care colleagues, therapists, educators, parents and even patients. Caring for children and teens with major meltdowns, depression, suicidal ideation, anxiety, school struggles to name a few along with a myriad long list of behavioral and mental health concerns is daunting and most of us did not receive formal training in residency to prepare us to meet this need. Access to child psychiatry nationally is limited and in some regions just not available at all and as a result we must often provide what can only be called psychiatric care for our pediatric patients. In an effort to increase our understanding of behavioral and mental health assessment and treatment, we attend conferences, read articles, and participate in webinars. You can now add Pediatric Meltdown; the podcast dedicated to children's emotional well-being. Providing behavioral health care at its best is collaborative and connecting with others across disciplines enriches and enhances the care we provide. In the words of Maya Angelou "Do the best you can until you know better. Then when you know better, do better." Let's do better together!
21episodes
Episodes
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250. Hand in Hand Parenting
Jun 1101:04:42Tap to summarizeIs the true heart of pediatrics found in the connection between practitioner and family?In this powerful episode of Pediatric Meltdown, Dr. Lia Gaggino sits down with physician, educator, and hand-in-hand parenting advocate Dr. Pam Oatis, who brings decades of primary care and hospital experience to the forefront. Together, they explore how listening, humility, and authentic relationships transform patient outcomes far beyond medical treatments alone. From the challenges of working in high-need communities to navigating tense family moments and exploring ethics in end-of-life care, this episode delves into the artistry that makes pediatric medicine so uniquely soul-filling. If you’ve ever questioned whether technical skill is enough—or wondered what truly heals—this conversation will invite you to see the science of medicine through the eyes of connection and compassion. Don’t miss the life-changing insights you’ll carry into every patient encounter.Be sure to catch the special announcement in the Takeaways.[0:01 - 07:59] Leaning Into Pediatrics: Beginnings, Inspiration, and Learning From FamiliesUnderstand why primary care pediatrics is infinitely rewarding—not just for the broad medical knowledge it demands, but for the lifelong learning about people, relationships, and cultures it provides.Learn the importance of setting parents at ease through open-ended questions and authentic appreciation, establishing trust and safety from the very first visit.Explore how humility and willingness to learn from families reveal the limitations of one-size-fits-all approaches and fuel long-term, mutually respectful relationships.Hear personal stories illustrating the deep impact of simple listening skills, such as appreciating each parent and seeing profound transformation in both relationships and care outcomes.[08:00 -16:40] The Power of Listening and Cultural Humility in Pediatric CareUncover how being attuned to parents’ fears and self-doubt allows physicians to connect deeply, providing reassurance and support that transcends medical advice.Examine situations where cultural differences and past experiences inform parenting approaches, challenging providers to pause, listen, and reflect rather than judge.Appreciate how open, honest dialogue about discipline and race can lead to decades-long partnerships founded on mutual respect and understanding.Acknowledge that the wisdom and resilience of families, when honored, can lead to better outcomes than following protocols alone.[16:41 - 26:01] Human Connection: Biology, Society, and the Foundation of CareInvestigate the deep human need for connection, acknowledging our social wiring and the essential role that physical and emotional closeness play from birth through adulthood.Discover why the medical “team sport” approach leads to improved outcomes—not just for children, but for providers and families navigating medical complexity together.Identify the under-recognized burdens society places on parents and why framing parental challenges as cultural rather than personal failures empower families.Explore how respect, dignity, and honest collaboration form the backbone of effective care—and why accurate patient histories and trusting relationships matter as much as diagnostics.[26:02 - 07:59] From Touch to Teamwork: Bioethics, Palliative Care, and Listening PartnershipsLearn how physical touch is not just diagnostic, but profoundly healing, fostering trust and well-being in children and families.Understand the evolution of bioethics and palliative care as disciplines built on listening, respect, and honoring families’ definitions of meaning and quality of life.Gain insight into the development of hospital-based support systems—including listening circles—where healthcare professionals process challenging emotions confidentially and without judgment.Observe how effective palliative care programs dramatically reduce ethical conflicts by focusing on deep listening and empowering parental voice in decision-making.[54:59 - 01:04:22] Dr. G’s TakeAwaysResources Mentioned in the Episode:Hand in Hand ParentingBook recommendation: Strength to Strength by Arthur BrooksTED Talk: Abraham Verghese—A Doctor’s TouchJournal: Infant Mental HealthHarvard Center on the Developing ChildHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:“Where you struggle to be the kind of parent you want to be is not your personal failure…our culture has set up stumbling blocks for all parents.”... Dr. Pam Oatis“The listening partnership model was the key resource that allowed me to bring more of myself to my families.” ... Dr. Pam Oatis**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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249. The Pediatric Meltdown Podcast: Behind the Scenes
Jun 400:49:09Tap to summarizeAre you curious about what really happens behind the microphones of a successful pediatric podcast—and the unconventional journeys that brought an incredible team together?In this special milestone episode of Pediatric Meltdown, host Lia brings her entire production and strategy team on-air for an unfiltered, dynamic conversation. Discover the circuitous career paths that shaped a jazz singer-turned-podcast producer, a teacher turned ADHD coach and social media strategist, and a web developer with a nomadic spirit. Uncover the highs, lows, and learning curves of building a polished show from the inside out—including struggles with self-promotion, harnessing social media, and the mounting pressures (and joys) of creative collaboration. If you've ever wondered what it takes to sustain a podcast for (close to) 250 episodes, or you’re searching for inspiration to pivot in your own career, this story of grit and reinvention will leave you rethinking what’s possible.[00:02 - 10:04] How the Team Came Together & Podcast OriginsThe show’s launch was serendipitous, sparked by a leap of faith rather than a long-held ambition to podcast.Early challenges with off-shore podcast management led to seeking more control and expertise locally.The pivotal connection to a new producer happened via networking with Adam Schaeuble of Podcast Business School.The team shares first impressions and mutual support, setting the collaborative tone for the episode.[10:05 - 15:57 ] Creative Pivots, Building Skills, and Making MediaTeam members discuss how their entertainment, teaching, and customer service backgrounds unexpectedly prepared them for podcasting and digital media.D.R.’s “Mouthy Broad Media”company name was inspired by a personal family story, blending creativity with homage.The learning curve of audio, websites, and social strategy is highlighted as an ongoing, shared challenge.The importance of curiosity, open-mindedness, and adapting to unexpected opportunities is emphasized.[15:58 - 34:30 ] The Rewards and Hurdles of Content Creation & PromotionSocial media emerges as both an essential tool for growth and the greatest challenge for the host, who dislikes self-promotion.Each team member brings different comfort levels and tactics for tackling visibility and audience engagement.Discussion of burnout, professional transitions, and how the pandemic prompted new career directions.Strategies for supporting each other (and listeners) through ADHD, workflow experimentation, and honest dialogue about what works (or doesn’t).[34:31 - 43:14 ] Leveraging Team Strengths: Services, Resources & Lessons for ListenersThe team shares their current services: web design, social media strategy, podcast production, ADHD coaching, and consulting.Emphasis on collaboration (“it’s all right here”)—listeners are encouraged to reach out for services or to get started themselves.Honest reflections on the tricky pursuit of monetization and the value of creative fulfillment.Recommendations for further learning, including Colleen Cullinan’s ADHD series and Peter Jensen’s adult ADHD episode.[43:15 - 48:49] Dr. G’s TakeAwaysResources Mentioned in the Episode:D.R. Fay - MouthyBroadMedia.comMargaret Faucella - margaretroy725@gmail.comMichael Anderson - Purple Wave Creative Agency / ThatAndersonGuy.comColleen Cullinan’s ADHD Series on Pediatric MeltdownPeter Jensen’s Adult ADHD EpisodeHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:"We sold all of our stuff. We bought an RV, and we just hit the road with, zero plans. And the whole idea was find home. You know, where is home? We just had no idea where it was." Michael Anderson on finding home by hitting the road"I'll have parents text me at 5AM. Oh, this kid didn't get up on time. Well, then just let it happen, girlfriend. Like, we will figure it out together." Margaret Faucella on Viral parenting advice"Well, my business, Mouthy Broad Media, is actually two different businesses all under one roof. I am a producer. And also a Certified Podcast consultant. So we can do everything from soup to nuts, from launching, with press releases to maintaining your podcast on a monthly basis."... D.R. Fay on the scope of her business, Mouthy Broad Media**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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248. Conversation with My Daughter: Soft Body Baddie
May 2800:35:40Tap to summarizeHow do we help kids and teens when social media is fueling a resurgence of body image issues and eating disorders? In this special conversation, Lia’s daughter, Julia Parzyck shares her personal and professional journey navigating the tumultuous landscape of body acceptance in a world obsessed with appearance. The episode explores the influence of social media platforms, like TikTok and Instagram, and the impact they have on pediatric mental health and body positivity. Listeners will discover practical parenting strategies rooted in empathy, compassion, and my own past mistakes. Body acceptance is an ongoing journey, not a destination. Are we ready to support the next generation in building resilience against the ever-present pressures of body image issues?[00:01 - 06:22] The Shifting Landscape of Body Image and Social MediaExplores how diet culture and body expectations have worsened for teenagers in the age of TikTok and “skinny talk,” surpassing early 2000s pressures.The proliferation of pro-eating disorder content, now openly accessible through social media, and how it’s masked as harmless tips.Contrasts curated body-positive environments with the harsher realities faced by today’s youth on unchecked platforms.Highlights the rise of the “skinny talk” hashtag/movement and its troubling normalization of disordered behaviors and comparison.[06:23 - 11:39]Owning Softness: From Childhood Stories to Social AdvocacyJulia redefines “softness” as a source of strength, both in body and emotions, coining the phrase “soft body baddie” for her community.Childhood anecdotes—ranging from fashion flair to forming the hilariously named "labia band"—remind listeners of the roots of self-expression.Explores how embracing personal quirks and struggles, like anxiety and neurodivergence, leads to greater empathy in work with children and coaching.Reflects on how family dynamics and navigating outspoken personalities shape resilience, communication, and mutual growth.[11:40 -19:47]Healing, Boundaries, and Building a Modern IdentityDiscusses the transformative impact of family therapy, learning emotional independence, and accepting that parents can’t always “fix” pain.Julia’s journey through heartbreak (a called-off wedding) reveals the non-linear, ongoing process of healing and redefining self-worth.Explores the leap of faith required to pursue a career in body-positive coaching and online content, with all its uncertainties.Highlights the value of embracing risk, letting go of the need to “do it all over,” and recognizing how adversity can fuel growth and new purpose.[19:48 - 29:22] Compassion, Societal Pressures, and Looking ForwardShares insights on how political landscapes influence fashion, body ideals, and the subtle ways women are controlled through image and expectation.Resist setting rigid future goals, focus instead on finding joy, balance, and meaning in work and life, post-trauma.Stresses that body image work is lifelong, and that society will likely never “fix” its obsessions—progress is about grace, not perfection.Leaves listeners with the message that taking up space, nurturing empathy, and living for personal fulfillment, not external approval, is an act of quiet revolution.[29:23 - 35:21] Dr. G’s TakeAwaysConnect with Julia Parzyck Instagram: Fit Fat and All That Here are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:“I see the term, soft body baddie as, I have all the softness, and I'm a baddie. And it's just this, you know, owning the space that I'm in, allowing my body to exist as it is...”...Julia Parzyck on owning the phrase “Soft Body Baddie”“I've recently started doing inclusive wardrobe styling, so a lot of my followers like to see just how I style my body without feeling like I need to make everything look, quote, unquote, flattering...”Julia Parzyck on styling for a full figure**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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247. Human Trafficking: What Pediatric Clinicians Must Know
May 2101:00:54Tap to summarizeHave you ever considered that victims of human trafficking might be walking into your clinic, hidden in plain sight, longing for someone to notice their silent signals? In this episode of Pediatric Meltdown, host Dr. Lia Gaggino sits down with Dr. Dena Nazer , a leading child abuse pediatrician, to dispel widespread myths and expose the heartbreaking realities of child trafficking. They dive deeply into what human trafficking truly looks like, why language and empathy shape outcomes, and how pediatricians can recognize and respond to red flags—even when victims don’t or can’t ask for help. If you’ve ever wondered how to protect the most vulnerable or questioned your own role in advocacy, this conversation mixes expertise and actionable strategies you can use today. Don’t miss this essential episode—sometimes the most critical intervention is simply being prepared to see what others overlook.[00:00 - 06:25] Beyond Kidnapping: The Everyday Reality of Child TraffickingMedia Myths: trafficking is not always dramatic kidnappings—many victims are exploited by someone they know, sometimes in their own homes.Defining human trafficking per US federal law: for children under 18, any commercial sexual act (anything exchanged for perceived value) is trafficking, regardless of force, fraud, or coercion.Labor trafficking in children does require proof of force, fraud, or coercion, unlike sex trafficking.Children cannot legally consent to commercial sexual acts, a fact often misunderstood by practitioners.[06:26 - 18:33] Recognizing Vulnerability: Victims, Prevalence, and Persistent MythsAll children, regardless of socioeconomic status or geography, can be victimized; not just those from impoverished or unstable backgrounds.Adolescents are particularly vulnerable due to developmental, social, and neurological factors—especially girls, though all genders are at risk.The covert nature and underreporting of trafficking, with true prevalence grossly underestimated—actual victims far exceed documented cases.Practitioners should avoid assumptions about victim profiles and recognize that trafficking does not discriminate by background or location.[18:34 -24:41] Language, Reporting, and the Power of EmpathyThere is an impact of language, advocating against terms like "prostitute" or "modern day slavery," as they distort public perception and can harm survivors.There are nuanced preferences between “victim” and “survivor,” emphasizing respect for self-identification.Addresses mandated reporting: outlines state-by-state differences, reminds clinicians to know their local laws, and suggests erring on the side of caution when in doubt.Discusses the complexities of reporting and intervention with 18+ patients, promoting support over “rescue,” and collaboration over dictating solutions.[24:42 - 47:58] Identification, Patient Support, and Multi-Agency CollaborationRed flags in clinical settings: domineering non-parental adults accompanying children, delayed care-seeking, lack of address knowledge, repeated STIs, or signs of fear and withdrawal.Ways to build trust and elicit disclosures: prioritize safety, establish boundaries about reporting, and use risk-factor-based screening questions.Trauma-informed care—responding with empathy, validation, and minimal dramatization—to avoid re-traumatizing patients.Connect with local Child Advocacy Centers and understanding local resources and procedures before a crisis arises.[47:59 - 59:59] Dr. G’s TakeAwaysAdditional Resources Mentionedhttps://mychildrenschildren.com/my-childrens-children-name/https://mychildrenschildren.com/better-is-good-incremental-steps-forward/Human Trafficking Hot Line: 888-373-7888 https://humantraffickinghotline.org/en/contact Child Advocacy Center map: https://www.nationalchildrensalliance.org/cac-coverage-maps/National Child Traumatic Stress Network https://www.nctsn.org/what-child-trauma/traumatypes/sex-trafficking/about-child-sex-traffickingHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:"Most of the victims share this exploitation that it's one person exploiting another person, for the purpose of sex, labor, or even both. And they all share the loss of freedom."... Dr. Dena Nazer on the loss of freedom "It's more about empowering them, supporting them, collaborating with them, helping them be involved in their healthcare… versus just throwing things at them and dictating how you want them to be helped."...Dr. Dena Nazer on how pediatricians can help **TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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246. Pediatric Psychopharmacology: Tips for Prescribers
May 15, 202501:01:15Tap to summarizeCan medication truly transform the landscape of pediatric mental health, or are we oversimplifying the complexities of growing minds? In this episode of Pediatric Meltdown, Dr. Lia Gaggino welcomes Dr. Jess Pierce, a hospital-based child psychiatrist whose expertise bridges the worlds of pediatrics and mental health, especially for children in rural areas. Unraveling the fascinating history of psychopharmacology and delving into the mechanisms of action for the antidepressants, this episode offers a roadmap for pediatricians navigating the maze of SSRIs, SNRIs, risks like serotonin syndrome, and difficult conversations about side effects. The nuances matter and Dr. Pierce guides us skillfully.Discover why family history, patient buy-in, and transparent communications are pivotal to successful treatment—and why prescribing for young people demands a delicate blend of science, art, and empathy. This conversation will change the way you see—and approach—medication and the treatment of kids' mental health.[00:08:51] Exploring Pediatric Psychopharmacology’s RootsTracing the unexpected origins of antidepressants, including how tuberculosis and hypertension treatments led to modern psychopharmacologyThe monoamine hypothesis: understanding the neurotransmitter focus in early depression treatmentsThe move beyond serotonin, dopamine, and norepinephrine: new research on neurobiology, neurogenesis, and stress responseProzac’s arrival and its impact in reshaping the treatment landscape for pediatric mental health[08:52- 18:06 ] SSRIs in Practice: Similarities, Differences, and SelectionAll SSRIs share rapid absorption, high protein binding, and similar side effect profiles—but key differences can matterImportant reasons to avoid Paxil and to use Lexapro over Celexa, particularly due to side effect burdensNuanced considerations: matching specific SSRIs to individual patient needs, such as Prozac’s activating profile for low-energy depressionPractical dosing strategies: the art of balancing “start low and go slow” with the urgency to help suffering children[18:07- 27:59] Navigating Risks, Side Effects, and Patient MonitoringThe truth behind the Black Box Warning: clarifying risks of suicidal ideation vs. the dangers of untreated depressionWhy regular, open conversations with families about medication side effects—especially sexual side effects in teens—build trust and adherenceRecognizing and managing serotonin syndrome: how to spot symptoms and when emergency intervention is neededIdentifying high-risk drug interactions, including situations with migraine or neurology medications[28:00-45:19 ] From SNRIs to the Five-Step Prescribing Approach and BeyondHow SNRIs differ from SSRIs in action, side effects, and indication—especially in pain syndromes or where activating effects are desiredThe use of Wellbutrin as an alternative with fewer sexual side effects, and cautions for seizure-prone populationsStrategic guidelines: the five-step approach to medication choice, considering patient history, family response, symptoms, buy-in, and comorbiditiesCritical cautions with genetic testing and the limitations of using these results to guide first-line medication choices[45:20-1:00:00] Dr Lia’s TakeAwaysResources Mentioned:Dr. Pierce’s PPT on Pediatric Psychopharmacology Hello! Here's the link to the slides: Psychopharm PPTAACAP Facts for Families – Medication guides, anxiety and depression info sheetsNational Alliance on Mental Illness (NAMI) – Patient and family educational resources and peer supportMC3 Psychopharmacology Reference Card – Quick reference for prescribersHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:“So I myself always dose Zoloft at bedtime because if my patients are gonna have an effect on sleepiness or alertness, it tends to be the former and so I dose it at bedtime.".. Dr. Jess Pierce on why doctors dose zoloft at bedtime"Having those conversations really open openly at the beginning, I think can make a big difference in terms of how they hang in there for the treatment."... Dr. Jess Pierce on breaking medication stigma in child mental health**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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245. When Sadness Looks Like Anger: Rethinking Pediatric Depression and Behavioral Activation
May 7, 202501:14:56Tap to summarizeAre you struggling to support young patients—and maybe even yourself—with the emotional aftermath of our “new normal”? In this compelling episode of Pediatric Meltdown, Dr. Colleen Cullinan returns to unpack the reality of pediatric depression in a world rocked by uncertainty. Discover why traditional approaches, like focusing solely on symptoms, may actually miss the bigger picture when kids are faced with unprecedented stress. Learn how changing the narrative, adopting techniques such as Acceptance and Commitment Therapy (ACT), and making small, values-driven changes can help children—and parents—find hope, function, and connection again. This episode isn’t just about treating depression; it’s about transforming how we relate to struggle and building resilience against the tide of ongoing adversity. Tune in for real stories, actionable tools, and a refreshing reminder: even the heaviest feelings can be given a name, a shape, and ultimately, a little less power.[00:00 - 08:40] The Impact: Symptom Overload, and Functional ImpairmentThe pandemic has significantly amplified youth mental health issues, leading to increased rates and severity of pediatric depression and anxiety.Symptom checklists like the PHQ-9 now reveal almost universal distress—so much so that a "normal" score is rare.Chronic uncertainty and prolonged stress (for both kids and adults) exacerbate feelings of hopelessness, helplessness, and irritability.The primary care challenge: shifting from symptom identification to understanding the real-life impact on activities, relationships, and overall well-being.[08:41 - 28:29] Rethinking Depression in Pediatrics: Connection, and Therapy ApproachesConnection—not just checking PHQ-9 scores—is a critical protective factor for youth mental health and should be the heart of clinical encounters.Traditional Cognitive Behavioral Therapy (CBT) and newer Acceptance and Commitment Therapy (ACT) are compared — with ACT focusing on accepting thoughts and changing relationships with them, not just “fixing” or disputing them.Dr. Cullinan explains how ACT techniques, including physicalizing and naming despair, help kids distance from and better manage their feelings.The “beach ball” metaphor illustrates how fighting negative thoughts can cause you to miss life’s joys—and how letting them coexist with living can restore function and hope.[28:30 -58:59] Strategies: Playful Experiments, Values-Based Goals, Motivational ToolsPractical examples include using humor, metaphor, and even quick physical challenges (like the “lemon” exercise) to help kids gain distance from distressing thoughts.Naming depressive feelings or thoughts (e.g., “pathetic,” “Bob”) can help externalize and reduce their influence, making them easier to talk about and manage.Motivational Interviewing is highlighted as a powerful tool—but only if it genuinely centers each child’s unique values and interests, not the provider’s agenda.Avoidance, not just the presence of sadness or fear, is flagged as the true engine of suffering; the focus shifts to acceptance and gentle behavioral activation.[59:00-1:06:47] Building Resilience: Safety, Nurture, New Frames, and Practical PearlsChildren’s beliefs and “frames” about themselves and the world are shaped by repeated messages—caregivers can help reframe these with new, nurturing narratives.Safe, stable, nurturing relationships offer the strongest protection and resilience against depression and trauma, as explored through frameworks like toxic stress and child transformation health.Providers can make meaningful impact in just minutes with new language, metaphors, and reframing exercises—even in a busy primary care setting.[1:06:48 - 1:14:36] Dr. G’s TakeAwaysAdditional Resources MentionedThe Thriving AdolescentStop Avoiding StuffThe Mindful Self-Compassion WorkbookThriving AdolescentAssociation for Contextual Behavioral SciencePraxis - ACT TrainingCaring for Children in Foster and Kinship Care: Keeping a Trauma-Informed focus with Moira SzilagyiThe Art of Conscious Parenting with Dr. Robert SaulToxic Stress: Safe, Stable, Nurturing Relationships are the AntidoteHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:“This uncertainty piece is the worst. We as humans are creatures that crave certainty. We'll invent certainty where we can. Like, that's what the human brain has evolved to do is to make uncertain things certain.”... Dr. Colleen Cullinan on how your brain operates.“We know that there are these things that are in play all the time. We also know that the way the human body and brain works, it's impossible or it just has never been successful for people to just snap on and off their feelings.”... Dr. Colleen Cullinan on emotional conflict**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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244. Taming Pediatric Anxiety with Brain-Body-Behavior Strategies
Apr 30, 202500:53:53Tap to summarizeHave you ever wondered why anxiety in children can look and feel so physical—and what we as pediatricians, parents, or caregivers can do about it? We’re visiting a fan favorite from Episode #26 of Pediatric Meltdown, Dr. Lia Gaggino sits down with Dr. Colleen Cullinan, a leading pediatric psychologist, to dissect the powerful 3 B’s approach: Brain, Body, and Behavior. Together, they reveal eye-opening truths about integrated behavioral health, the ways anxiety manifests in kids, and practical, actionable strategies for managing emotional meltdowns in real-time. This is not just about recognizing anxiety—it's about transforming how we support kids inside and outside the exam room. If you want to empower families, level up your clinical skills, and make a tangible difference, don’t miss this conversation. This episode could change the way you think about pediatric care—forever.[00:00 - 11:35] Integrated Care Foundations: Building Partnerships in Pediatric PracticeIntegrated behavioral health bridges the gap between physical and mental health, creating seamless care experiences for families.Primary care is often the first—and sometimes only—entry point for children facing emotional or behavioral challenges.Partnerships between pediatricians and behavioral health providers increase accessibility, reduce stigma, and foster earlier intervention.The synergy and trust between pediatricians and psychology professionals leads to holistic, effective patient care.[11:36 - 15:49] The Role of Primary Care in Managing Anxiety and Emotional HealthPrimary care providers serve as trusted anchors, introducing mental health as an essential component of overall health.Familiarity with a child's history allows pediatricians to recognize subtle behavior changes and collaborate meaningfully with behavioral specialists.Normalizing physical symptoms of anxiety (like stomachaches and headaches) helps bridge conversations from medical to emotional concerns.Educating families on the inseparability of physical and emotional health empowers them to seek support without shame.[15:50 - 28:55] Anxiety Explained: The 3 B’s and Practical Strategies for KidsThe "3 B’s": Brain, Body, and Behavior, are interlinked—anxiety in the brain triggers body sensations, which guide behavior, often leading to avoidance.Psychoeducation is key: Emphasizing to families and youth that everyone experiences anxiety validates their feelings and reduces shame.Simple, actionable distress tolerance tools—breathing exercises, grounding techniques (like the “five senses” method), and focusing attention—can be taught in minutes during a regular visit.Providers can help children recognize “worry thoughts” and redirect their response before anxiety spirals into withdrawal or meltdown.[28:56 - 49:20] When to Escalate: Distress Tolerance, Prevention, and Team-Based SolutionsDistress tolerance techniques can bridge the gap until a child can access specialized behavioral care—or be sufficient for milder cases.Functional impairment is the marker for when anxiety moves from “manageable” to requiring traditional CBT or higher-level intervention.Exposure therapy explained: At its core, CBT for anxiety involves identifying fears and encouraging gradual, manageable exposure to them, with improvement through repetition.Advocacy for integrated behavioral health, resource sharing, and ongoing partnerships with community therapists are essential for sustainable, high-impact child mental health care.[49:21- 53:34] Dr. Lia’s TakeAwaysAdditional Resources MentionedNemours Kids Health – Comprehensive resources for parents, youth, and clinicians on a range of medical and behavioral health issues.AACAP Facts for Families – Accessible mental health information from the American Academy of Child and Adolescent Psychiatry.Book Recommendation: Raising an Emotionally Intelligent Child by John Gottman – A guide for families on emotional communication and resilience.Here are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:“The role of the primary care person is to usher in this idea that mental health care is physical health care, that those things are the same."...Dr. Colleen Cullinan on the role of the primary care physician"We have a brain, we have a body, we have behaviors, and all of those things are working together all of the time. And sometimes when one kind of gets activated, the others follow suit."...Dr. Colleen Cullinan on how Anxiety manifests.**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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243. The Child Mental Health Podcast: Expert Insights from Child Psychiatry
Apr 23, 202500:46:33Tap to summarizeAre pediatricians prepared for the mental health crisis that’s impacting so many of our children today?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino sits down with nationally recognized child psychiatrist and podcast host Dr. Elise Fallucco to uncover the urgent realities facing pediatric practice. From understanding why a simple podcast name change can transform the reach of critical mental health education, to exploring the real-world, stepwise journey pediatricians navigate when facing complex child anxiety and medication management, this episode is a masterclass in practical empowerment. Listeners will discover actionable strategies for burnout, the evolving landscape of pediatric mental health treatment, and authentic stories of resilience, support, and resourcefulness. The stakes have never been higher—and the need to equip pediatric clinicians with the right knowledge and mindset is more critical than ever. Don’t miss this invigorating roadmap for providing exceptional care in panicked times.[00:02 - 05:46] Branding, Access, and Reaching Pediatric CliniciansPediatric mental health education is increasingly being disseminated beyond in-person local trainings, leveraging digital platforms like podcasts to amplify access and reach.Clear, descriptive branding ensures the right clinicians can find mental health resources at the exact moment they need support in practice.The main driver in choosing content is what pediatricians most urgently seek: practical, actionable advice about managing medications for anxiety and ADHD.Making specialized knowledge accessible via on-demand, digestible podcast episodes empowers clinicians to feel less isolated and more competent.[05:47 - 13:30] The Ongoing Challenge of Anxiety, Burnout, and Self-CareAnxiety has emerged as the most common and burdensome mental health concern for children, exacerbated by societal stress and recent global events.Differentiating normal anxiety from clinical anxiety is crucial: functional impairment and life disruption are key markers for escalated intervention.Coping strategies for clinicians are vital; the “three pillars” are staying busy with purposeful activity, reaffirming personal/professional mission, and prioritizing self-care.Peer connection, exercise, and carving out time for meaningful relationships are highlighted as essential personal de-stressors.[13:31 - 25:00] Building Skill, Facing Complexity, and the Realities of CarePediatricians experience a four-stage progression from fear and avoidance to high-confidence care in managing pediatric mental health—each with unique challenges and rewards.Access limitations to child psychiatry have forced primary care clinicians to expand their skillsets and comfort zones, often out of necessity.Collaborative consultation programs, like psychiatric access hotlines, accelerate learning, build confidence, and foster an environment where sharing expertise is normalized.Developing fluency with diagnoses and medication management leads to more effective and streamlined care; “herd immunity” and practice culture shifts increase collective capacity.[25:01 - 36:05] Pain Points, Solutions, and Sustaining Progress in Pediatric Mental HealthBarriers to therapy—including logistics, family skepticism, and stigma—limit effective care, even as access improves; motivational interviewing is a partial solution but not a panacea.Integrated behavioral health models and school-based clinics offer promising solutions by reducing friction and meeting children and families where they are.Time constraints and misaligned incentives remain top frustrations; procedures are often reimbursed more than complex mental health care, despite the latter’s intensity and impact.Empathy, accessibility, and moral support from psychiatric colleagues are critical; recognizing mental health care as “full contact”—and requiring strong boundaries—is essential for sustainability.[36:06 - 46:13] Dr. Lia’s TakeAwaysConnecting with Dr. FalluccoSocial Media/Web site:Web site: https://psyched4peds.comLI: https://www.linkedin.com/in/elise-fallucco-9b402485?original_referer=https%3A%2F%2Fwww.google.com%2FIG: https://www.instagram.com/psyched4peds/Podcast:Resources & Links MentionedChild Mental Health for Pediatric Clinicians PodcastMC3 Michigan Child Collaborative Care ProgramNational Network of Child Psychiatry Access Programs – NNCPAPBessel van der Kolk, MD - Trauma & RecoveryDr. Jessi Gold – Burnout BookAmerican Academy of PediatricsChild Mental Health Podcast: Apple https://podcasts.apple.com/us/podcast/child-mental-health-for-pediatric-clinicians/id1696529206Spotify https://open.spotify.com/show/6V3ru0mRZd8Phj2DAHtO9AWebsite: https://psyched4peds.comTweetable Quote: "The number one issue that kids and, and and pediatricians are struggling with in their practice is anxiety. It's so common. It's become more frequent and prevalent over the past couple years, and it's not a surprise why.".. Elise Fallucco on The rising tide of pediatric anxiety"Pediatricians are left kind of holding the hot potato, of the child that has a problem in their office who they care about and they wanna be able to take care of."...— Elise Fallucco on The Pediatrician's Mental Health Challenge:Here are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine **TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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242. Making Sense of a Mess: My Giant To-Do List
Apr 16, 202500:21:21Tap to summarizeCan one person truly make a difference in the complex world of pediatric healthcare?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino explores how primary care pediatricians can step up amidst the chaos in Washington DC and stand as the trusted advocates children need. While Lia prepares for the pediatric academic society PAS in Honolulu, she is wrestling with the disastrous current health policy challenges and calls for local action. Lia pleads with her peers to organize and cause “good trouble”. This episode underscores that our most vulnerable population — children — deserves the unwavering dedication of empowered and informed advocates. In pursuit of crafting a brighter future for children's health, will you rise to meet the challenge?[00:00:04 - 00:01:21] Preparing for Change and ConnectionPediatric Meltdown is dedicated to children's mental health and emotional well-being.Dr. Lia Gaggino shares her passion for facilitating thoughtful conversations with experts.New and creative medical approaches are thriving and contributing to community upliftment.Enjoying family time and Hawaii's scenic beauty is part of Lia’s plan to recharge.[00:01:21 - 00:04:19] The Chaos in D.C. - A Call to ActionThe state of national politics is concerning, described as a "dumpster fire."Staying informed plays a crucial role despite the overwhelming current events.Balancing leisure with staying critically aware of policy changes affecting pediatrics.Connecting with pediatric colleagues to brainstorm actionable steps.[00:04:19 - 00:08:39] Advocacy for Children’s NeedsEmphasizing the trust placed in pediatricians and the responsibility that comes with it.Safe health practices are under threat from misinformation spreading rapidly.Vital programs and advisory committees crucial for child safety are being dismantled.Highlighting the unnecessary and detrimental effects of defunding health initiatives.[00:08:39 - 00:12:39] Empower Your Voice and CommunityHighlighting real stories as powerful tools for advocacy.Breaking down scientific data into relatable family narratives aids understanding.Demystifying Medicaid's role as crucial support for countless families.Urging listeners to take definitive action, whether through social media or community forums.Resources Mentioned:AAP Advocacy Guide Member log-in required to accessOn Tyranny Timothy SnyderAAP MMR Vaccine InformationAAP Medicaid State Fact SheetsHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:"We've witnessed chaos, unprecedented and relentless. The landscape of Washington DC is reflective of a larger societal unrest, a crucible that now must forge strength and unity”.... Dr. Lia Gaggino on the state of our leadership“We hold immense power—the collective, albeit often silent, force of pediatricians everywhere. Yet, it's up to us to raise our voices, louder if need be, to wake the world up to preventable illnesses like measles”....Dr. Lia Gaggino on the power of numbers when you raise your voice**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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241. Fighting Untruths and Chaos: The Power of the Pen and A Little Therapy
Apr 9, 202500:46:14Tap to summarizeAre you feeling overwhelmed by the world's chaos and seeking hope amidst uncertainty? In this moving episode of Pediatric Meltdown, host Dr. Lia welcomes Dr. Robert Saul to discuss the powerful principles guiding his commitment to advocacy and change. Dr. Saul introduces the transformative 12 words that have anchored his life's work and how these principles can propel communities forward. Together, they examine the impact of truth, trust, and the little-known role of the communal aspect in tackling societal issues. As Dr. Saul passionately delves into historical and modern-day examples of lying within power structures and challenges us to confront uncomfortable truths. Discover where the true power of change lies and how understanding our roles can lead to actionable advocacy. This episode isn't just a conversation—it's a call to action for those yearning to make a difference.[00:00 - 05:09] The Art of Medicine and the Value of ListeningDiscussing the importance of comprehensive clinical encounters beyond quick checkupsStressing that empathy and genuine presence build deeper connections in healthcareHighlighting the responsibility to offer hope and guidance, not merely prescriptionsSuggesting that professionals and caregivers must pause to recalibrate when stress levels rise[05:10 - 12:31] Accepting Responsibility: “I Am the Problem, I Am the Solution”Exploring the idea that acknowledging our collective part in societal problems is the first stepUnderlining the distinction between culpability and willingness to engage in solutionsDiscussing how seeing oneself as part of the issue spurs commitment to meaningful actionReminding listeners that we are interconnected in every community concern[12:32 -31:06] Truth, Trust, and Social FabricDefining trust as the “currency” of relationships and community lifeArguing that telling the truth consistently is essential for building and preserving trustNoting that children thrive when caregivers, professionals, and policymakers work together with integritySuggesting that widespread misinformation undermines the health and wellbeing of communities[31:07 - 42:06] Looking Ahead: Ongoing Work and HopeEncouraging continued involvement in committees, local boards, and mentorship rolesHighlighting the drive to create community programs focused on healing and trauma-informed carePlanning future projects that address truth, trust, science, diversity, and civilityEnding with an affirmation that sustained efforts at all levels can foster a more promising future[42:07 - 55:46] Dr. G’s TakeAwaysAdditional Resources Mentionedhttps://mychildrenschildren.com/my-childrens-children-name/https://mychildrenschildren.com/better-is-good-incremental-steps-forward/Power S. The Education of an Idealist: A Memoir. Dey St. 2019; 580 pp. (p. 282)Snyder T. On Freedom. Crown, New York; 2024. 345 pp.https://mychildrenschildren.com/infant-mental-health-part-i/https://mychildrenschildren.com/with-malice-toward-none-with-charity-for-all-2/Keenan JF. The Works of Mercy. Lanham, MD: Rowman & Littlefield; 2007.Saul R. Mercy. GHS Proc May 2016; 1(1):70https://mychildrenschildren.com/trust-is-the-currency-of-social-interaction-2/https://mychildrenschildren.com/caste-inaction-is-action-part-ii/https://mychildrenschildren.com/the-cost-of-lies-2/https://mychildrenschildren.com/areas-of-moral-clarity/https://mychildrenschildren.com/our-better-angels/ Episodes of PM with Bob:Ep #7 The Art of Conscious Parenting#100 The Art of Medicine#231 Raising Good Citizens Through Conscious Parenting (a repeat of #7)Here are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:"We are the problem. We are the solution. We are the resource.".. Dr. Robert Saul on Words to live by“We may not be seeing kids in an exam room, but there's so much that we can do in so many different spaces to make the world a better place for children."... Dr. Robert Saul on what we can do to further the cause**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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