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UVA Health Clinic Expands Mental Health Therapy for Children, Caregivers

A new UVA Health initiative will help to boost the number of mental health providers offering a unique and innovative form of therapy for children and their caregivers across the state.

The clinic set up by associate professor Alisa Bahl, a pediatric psychologist in the School of Medicine, will increase access to parent-child interaction therapy, a treatment for young children with behavioral difficulties, including children who have experienced trauma.

To start the clinic, Bahl received the Ashley Thompson Manning Health Innovation Award, an $80,000 grant from the Jefferson Trust.

“The therapy works by helping caregivers develop skills to manage their child’s behavioral and mental health needs,” she said. “This also lowers parenting stress, supporting both children and caregivers.”

UVA associate professor Alisa Bahl leads the effort. She started the clinic with funding from the Jefferson Trust. (Photo by Matt Riley, University Communications)

The therapy was designed for children with a wide array of disruptive behavior concerns, including those related to trauma, foster care and/or anxiety.

At UVA Health, Bahl specializes in working with children with neurodevelopmental disorders and in parenting interventions, including parent-child interaction therapy.

“It’s a two-stage approach. The first part focuses on building a warm and secure relationship between child and caregiver,” she said. “The second phase is where we coach caregivers in real time to engage with their child during challenging behavior.”

In August, the U.S. Surgeon General released an advisory that parenting stress is a public health issue. Among other actions, it called for programs to help manage parents’ stress. Other proposed measures included paid family leave, more support for child care and universal preschool.

The report found that, “over the past decade, parents have been consistently more likely to report experiencing high levels of stress compared to other adults. In 2023, 33% of parents reported high levels of stress in the past month compared to 20% of other adults.”

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The new UVA initiative started March 1. It is based out of the UVA Health Neurodevelopmental and Behavioral Health Clinic at Riverside, which opened in December through a partnership between UVA Health Children’s and Sentara Martha Jefferson Hospital.

There are rooms specifically designed for PCIT, with a one-way mirror for the therapist to stand behind while the child and caregiver are on the other side, seemingly alone.

As the child displays difficult behavior, like playing too roughly or knocking toys over, the provider will coach the parent in what to say in response to the behavior. Because the child cannot see the therapist, they learn to respond differently to their caregiver, as the caregiver learns to respond to them.

UVA associate professor Alisa Bah working with a patient at a table

Bahl and her team are based out of the UVA Health Neurodevelopmental and Behavioral Health Clinic at Riverside, in rooms designed for parent-child interaction therapy. (Photo by Matt Riley, University Communications)

The project’s goal is to increase access to the therapy across the state, Bahl said. To do this, the project will also train UVA psychologists and graduate students, increasing the pool of available providers.

The therapy requires a certification by PCIT International, which involves 40 hours of training and clinical case experience. Bahl said it’s a rigorous process that can take up to a year.

“Children and parents are in crisis right now and there aren’t enough therapists to meet the mental health needs of young children and their caregivers in Virginia,” Bahl said.

“If we train 20 therapists in two years, for example, and each one handles 10 cases per week, that would be 200 hours of PCIT therapy for children available each week,” she said. “Over the course of a year, this would vastly increase the number of children who have access.”