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Related Research Units

Psychiatry Research

Research Overview

Dr. Walter's investigations have applied the principles of community-based participatory research to a broad range of multi-year preventive and clinical interventions for youth in elementary, middle, and high schools and in pediatric primary care. These variously-funded (federal [NIH], state, intramural, philanthropic) interventions have been co-developed with the target populations to meet their self-identified needs, and have been conducted in underserved communities in New York City, Chicago, and Boston.

The school-based preventive interventions targeted pediatric risk factors for the future development of cardiovascular disease and cancer; adolescent risk factors for the contemporaneous development of sexually transmitted diseases including HIV/AIDS; and youth risk factors for the development of child and adolescent psychiatric disorders. The school-based clinical interventions focused on incorporating behavioral health services into school-based health centers to provide greater access to care in underserved communities. The findings from these innovative approaches to health care service delivery in non-traditional settings have been published in high impact medical journals; the programs have also garnered multiple national awards for exemplary innovation and have been widely disseminated.

Dr. Walter’s most recent research has focused on the development of a collaborative care intervention bringing behavioral health services to a statewide, community-based pediatric primary care network affiliated with Boston Children’s Hospital (BCH). This multi-component intervention comprises behavioral health education and psychiatric consultation for pediatric primary care practitioners, integration of behavioral health clinicians into pediatric practices, and behavioral health care coordination. The goal of this ongoing intervention is to enable the management of mild to moderate presentations of common psychiatric disorders in the primary care setting, thereby conserving the specialty behavioral health workforce for severe, complex, and treatment-refractory presentations. The outcomes of this intervention have been widely published, and locally-modified versions of the intervention have been implemented in multiple pediatric primary care networks nationwide.

Dr. Walter’s current focus is the development, dissemination, and evaluation of a new BCH website – Building Bridges of Understanding – that provides nationally accessible evidence-based behavioral health education to pediatric primary care practitioners, behavioral health clinicians working in pediatric settings, and pediatric patients and their families. This initiative is designed to create collaborative professional and lay partnerships that can help narrow the gap between youth in need of behavioral health services, and those who receive them.

Research Background

Dr. Walter was trained in preventive medicine and public health (epidemiology) at the University of California at Los Angeles schools of medicine and public health, general psychiatry at New York University Medical Center/Bellevue Hospital, and child and adolescent psychiatry at Columbia-Presbyterian Medical Center/New York State Psychiatric Institute. Dr. Walter has more than 170 print and media publications pertaining to community-based participatory research and clinical education. Her work has been recognized with the Simon Wile Leadership in Consultation and Catchers in the Rye awards from the American Academy of Child and Adolescent Psychiatry, where she has been designated a Distinguished Life Fellow.

Dr. Walter attained the rank of Professor of Psychiatry at Northwestern Feinberg and Boston University medical schools, and currently is Professor of Psychiatry at Harvard Medical School and Senior Attending Psychiatrist at Boston Children’s Hospital.

Education

Medical School

Loma Linda University
1974 Loma Linda CA

Internship

Loma Linda University Medical Center
1975 Loma Linda CA

Graduate School

School of Public Health University of California Los Angeles
1981 Los Angeles CA

Residency

Preventive Medicine University of California at Los Angeles Medical Center
1981 Los Angeles CA

Residency

General Psychiatry New York University Medical Center/Bellevue Hospital Center
1986 New York NY

Fellowship

Child and Adolescent Psychiatry Columbia-Presbyterian Medical Center/New York State Psychiatric Institute
1988 New York NY

Media

Building Bridges of Understanding

Publications

  1. Selective Serotonin Reuptake Inhibitor Prescribing Within an Integrated Pediatric Primary Care Behavioral Health Program. Acad Pediatr. 2024 Oct 28; 102596. View Abstract
  2. Considerations for Behavioral Health Integration Program Implementation in Pediatric Primary Care Settings: A Qualitative Study. Acad Pediatr. 2023 Oct 27. View Abstract
  3. Pediatric Primary-Care Integrated Behavioral Health: A Framework for Reducing Inequities in Behavioral Health Care and Outcomes for Children. Pediatr Clin North Am. 2023 08; 70(4):775-789. View Abstract
  4. Virtual Collaborative Behavioral Health Model in a Community Pediatric Network: Two-Year Outcomes. Clin Pediatr (Phila). 2023 11; 62(11):1414-1425. View Abstract
  5. Impact of the Coronavirus Disease 2019 Pandemic on Mental Health Visits in Pediatric Primary Care. Pediatrics. 2022 12 01; 150(6). View Abstract
  6. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders. J Am Acad Child Adolesc Psychiatry. 2023 05; 62(5):479-502. View Abstract
  7. Utilization and Outcomes of Direct Consultation in a Child Psychiatry Access Program. Psychiatr Serv. 2023 01 01; 74(1):100-103. View Abstract
  8. Clinical Update: Collaborative Mental Health Care for Children and Adolescents in Pediatric Primary Care. J Am Acad Child Adolesc Psychiatry. 2023 02; 62(2):91-119. View Abstract
  9. Clinical Update: Child and Adolescent Behavioral Health Care in Community Systems of Care. J Am Acad Child Adolesc Psychiatry. 2023 04; 62(4):367-384. View Abstract
  10. Five-Phase Replication of Behavioral Health Integration in Pediatric Primary Care. Pediatrics. 2021 08; 148(2). View Abstract
  11. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. J Am Acad Child Adolesc Psychiatry. 2020 10; 59(10):1107-1124. View Abstract
  12. Practice Parameter for the Assessment and Treatment of Psychiatric Disorders in Children and Adolescents With Intellectual Disability (Intellectual Developmental Disorder). J Am Acad Child Adolesc Psychiatry. 2020 04; 59(4):468-496. View Abstract
  13. Five-Year Outcomes of Behavioral Health Integration in Pediatric Primary Care. Pediatrics. 2019 07; 144(1). View Abstract
  14. Three-Year Outcomes of a School-Hospital Partnership Providing Multitiered Mental Health Services in Urban Schools. J Sch Health. 2019 08; 89(8):643-652. View Abstract
  15. Factors That Predict the Use of Psychotropics Among Children and Adolescents With PTSD: Evidence From Private Insurance Claims. Psychiatr Serv. 2018 09 01; 69(9):1007-1014. View Abstract
  16. Fostering the initiation of discretionary psychotropic medication reviews by child welfare caseworkers. Child Welfare. 2018; 4(96):23-45. View Abstract
  17. Enhancing Pediatricians' Behavioral Health Competencies Through Child Psychiatry Consultation and Education. Clin Pediatr (Phila). 2018 07; 57(8):958-969. View Abstract
  18. Forward to the Future: Clinical Updates and Clinical Practice Guidelines. J Am Acad Child Adolesc Psychiatry. 2017 10; 56(10):811-812. View Abstract
  19. Clinical Update: Telepsychiatry With Children and Adolescents. J Am Acad Child Adolesc Psychiatry. 2017 Oct; 56(10):875-893. View Abstract
  20. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder. J Am Acad Child Adolesc Psychiatry. 2016 11; 55(11):990-1003. View Abstract
  21. Receipt of Evidence-Based Pharmacotherapy and Psychotherapy Among Children and Adolescents With New Diagnoses of Depression. Psychiatr Serv. 2016 Mar; 67(3):316-23. View Abstract
  22. Practice parameter for the assessment and management of youth involved with the child welfare system. J Am Acad Child Adolesc Psychiatry. 2015 Jun; 54(6):502-17. View Abstract
  23. Practice parameter for the assessment and treatment of children and adolescents with eating disorders. J Am Acad Child Adolesc Psychiatry. 2015 May; 54(5):412-25. View Abstract
  24. Collaborative care for children with ADHD symptoms: a randomized comparative effectiveness trial. Pediatrics. 2015 Apr; 135(4):e858-67. View Abstract
  25. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2014 Feb; 53(2):237-57. View Abstract
  26. Practice parameter for the assessment and treatment of children and adolescents with tic disorders. J Am Acad Child Adolesc Psychiatry. 2013 Dec; 52(12):1341-59. View Abstract
  27. Practice parameter on disaster preparedness. J Am Acad Child Adolesc Psychiatry. 2013 Nov; 52(11):1224-38. View Abstract
  28. Practice parameter for cultural competence in child and adolescent psychiatric practice. J Am Acad Child Adolesc Psychiatry. 2013 Oct; 52(10):1101-15. View Abstract
  29. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2013 Sep; 52(9):976-90. View Abstract
  30. Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2012 Sep; 51(9):957-74. View Abstract
  31. Practice Parameter for psychodynamic psychotherapy with children. J Am Acad Child Adolesc Psychiatry. 2012 May; 51(5):541-57. View Abstract
  32. Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 2012 Jan; 51(1):98-113. View Abstract
  33. Practice parameter for child and adolescent forensic evaluations. J Am Acad Child Adolesc Psychiatry. 2011 Dec; 50(12):1299-312. View Abstract
  34. A pilot demonstration of comprehensive mental health services in inner-city public schools. J Sch Health. 2011 Apr; 81(4):185-93. View Abstract
  35. Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. J Am Acad Child Adolesc Psychiatry. 2010 Apr; 49(4):414-30. View Abstract
  36. Practice parameter on the use of psychotropic medication in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2009 Sep; 48(9):961-973. View Abstract
  37. Practice parameter for the psychiatric assessment and management of physically ill children and adolescents. J Am Acad Child Adolesc Psychiatry. 2009 Feb; 48(2):213-33. View Abstract
  38. Practice parameter for telepsychiatry with children and adolescents. J Am Acad Child Adolesc Psychiatry. 2008 Dec; 47(12):1468-83. View Abstract
  39. Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry. 2007 Nov; 46(11):1503-26. View Abstract
  40. Practice parameter for the assessment of the family. J Am Acad Child Adolesc Psychiatry. 2007 Jul; 46(7):922-37. View Abstract
  41. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jul; 46(7):894-921. View Abstract
  42. Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2007 Feb; 46(2):267-83. View Abstract
  43. Practice parameter on child and adolescent mental health care in community systems of care. J Am Acad Child Adolesc Psychiatry. 2007 Feb; 46(2):284-99. View Abstract
  44. Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jan; 46(1):126-141. View Abstract
  45. Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jan; 46(1):107-125. View Abstract
  46. Teachers' beliefs about mental health needs in inner city elementary schools. J Am Acad Child Adolesc Psychiatry. 2006 Jan; 45(1):61-68. View Abstract
  47. Practice parameter for psychiatric consultation to schools. J Am Acad Child Adolesc Psychiatry. 2005 Oct; 44(10):1068-83. View Abstract
  48. School-based prevention of problem behaviors. Child Adolesc Psychiatr Clin N Am. 2001 Jan; 10(1):117-27, ix. View Abstract
  49. The development, reliability, and validity of a risk factor screening survey for urban minority junior high school students. J Adolesc Health. 1996 Sep; 19(3):171-8. View Abstract
  50. Characteristics of users and nonusers of health clinics in inner-city junior high schools. J Adolesc Health. 1996 May; 18(5):344-8. View Abstract
  51. Carrying and using weapons: A survey of minority junior high school students in New York City. Am J Public Health. 1996 Apr; 86(4):568-72. View Abstract
  52. School-based health care for urban minority junior high school students. Arch Pediatr Adolesc Med. 1995 Nov; 149(11):1221-5. View Abstract
  53. Sexual, assaultive, and suicidal behaviors among urban minority junior high school students. J Am Acad Child Adolesc Psychiatry. 1995 Jan; 34(1):73-80. View Abstract
  54. Prevalence and correlates of AIDS-related behavioral intentions among urban minority high school students. AIDS Educ Prev. 1994 Aug; 6(4):339-50. View Abstract
  55. Prevalence and correlates of AIDS-risk behaviors among urban minority high school students. Prev Med. 1993 Nov; 22(6):813-24. View Abstract
  56. Comparison of three theoretical models of substance use among urban minority high school students. J Am Acad Child Adolesc Psychiatry. 1993 Sep; 32(5):975-81. View Abstract
  57. AIDS risk reduction among a multiethnic sample of urban high school students. JAMA. 1993 Aug 11; 270(6):725-30. View Abstract
  58. Factors associated with AIDS-related behavioral intentions among high school students in an AIDS epicenter. Health Educ Q. 1993; 20(3):409-20. View Abstract
  59. Factors associated with AIDS risk behaviors among high school students in an AIDS epicenter. Am J Public Health. 1992 Apr; 82(4):528-32. View Abstract
  60. Self-efficacy for AIDS preventive behaviors among tenth grade students. Health Educ Q. 1992; 19(2):187-202. View Abstract
  61. High school students' perceptions of AIDS risk: realistic appraisal or motivated denial? Health Psychol. 1992; 11(5):307-16. View Abstract
  62. Psychosocial influences on acquired immunodeficiency syndrome-risk behaviors among high school students. Pediatrics. 1991 Oct; 88(4):846-52. View Abstract
  63. Risk factors for substance use among high school students: implications for prevention. J Am Acad Child Adolesc Psychiatry. 1991 Jul; 30(4):556-62. View Abstract
  64. Steroid use among adolescents: another look. AIDS. 1991 Jan; 5(1):112-3. View Abstract
  65. The association between physical fitness and cardiovascular disease risk factors in children in a five-year follow-up study. Int J Epidemiol. 1989 Dec; 18(4):830-5. View Abstract
  66. Primary prevention of cancer among children: changes in cigarette smoking and diet after six years of intervention. J Natl Cancer Inst. 1989 Jul 05; 81(13):995-9. View Abstract
  67. Cardiovascular risk factor prevention in black schoolchildren: two-year results of the "Know Your Body" program. Am J Epidemiol. 1989 Mar; 129(3):466-82. View Abstract
  68. Primary prevention of chronic disease among children: the school-based "Know Your Body" intervention trials. Health Educ Q. 1989; 16(2):201-14. View Abstract
  69. The development, implementation, evaluation, and future directions of a chronic disease prevention program for children: the "Know Your Body" studies. Prev Med. 1989 Jan; 18(1):59-71. View Abstract
  70. Cardiovascular risk factors among black schoolchildren: comparisons among four Know Your Body studies. Prev Med. 1989 Jan; 18(1):113-32. View Abstract
  71. Modification of risk factors for coronary heart disease. Five-year results of a school-based intervention trial. N Engl J Med. 1988 Apr 28; 318(17):1093-100. View Abstract
  72. Socioeconomic status, ethnic origin, and risk factors for coronary heart disease in children. Am Heart J. 1987 Mar; 113(3):812-8. View Abstract
  73. Blood pressure and physical fitness in children. Hypertension. 1987 Feb; 9(2):188-91. View Abstract
  74. Coronary heart disease prevention in childhood: one-year results of a randomized intervention study. Am J Prev Med. 1986 Jul-Aug; 2(4):239-45. View Abstract
  75. Primary prevention of chronic disease in childhood: changes in risk factors after one year of intervention. Am J Epidemiol. 1985 Nov; 122(5):772-81. View Abstract
  76. Screening for risk factors as a component of a chronic disease prevention program for youth. J Sch Health. 1985 May; 55(5):183-8. View Abstract

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Phone: 617-355-6724
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