Bio

Clinical Focus


  • Pediatric Pain
  • Depression & Anxiety
  • Emotion Regulation
  • Psychology
  • Group Therapies (Teen, Sibling, Parent/Caregiver, Family)

Academic Appointments


Boards, Advisory Committees, Professional Organizations


  • Member, Academy of Integrative Pain Management (2017 - Present)
  • Ad-Hoc Reviewer, Journal of Pediatric Psychology (2017 - Present)
  • Member, Northern California Association of Pain Psychologists (2017 - Present)
  • Member, Society of Pediatric Psychology (2005 - Present)
  • Member, International Association for the Study of Pain (2013 - Present)
  • Member, American Psychological Association (2013 - Present)
  • Member, Society for Developmental and Behavioral Pediatrics (2006 - 2010)

Professional Education


  • Fellowship:Stanford University Pediatric Anesthesia Fellowship (2013) CA
  • PhD Training:Case Western Reserve School of Medicine (2011) OH
  • Fellowship:Yale Univ - SOM Yale Child Study Center (2012) CT
  • Internship:Yale Univ - SOM Yale Child Study Center (2011) CT

Research & Scholarship

Current Research and Scholarly Interests


- Employ outcomes tracking to delineate risk & resilience factors in youth with pediatric pain.
- Understand the role of peers, parents/caregivers, & systems (e.g., family, school, hospital, community) in the management of pediatric pain conditions.
- Improve functioning, behavioral health, and quality of life in youth with discomfort and their families through provision of evidence-based therapies.
- Empower families & sensitize providers to the importance of therapeutic collaborations.

Projects


  • Courage to Act with Pain: Teens Identifying Values, Acceptance, and Treatment Effects, Stanford University School of Medicine (February 18, 2014 - Present)

    CAPTIVATE is a biannual 9-week group therapy program for youth with chronic pain condition(s) and their parents/caregivers. Participants acquire coping skills while receiving support and learning from other families living with chronic pain. Youth are encouraged to engage in valued activities in the home, at school, and in the community. Caregivers are empowered to utilize behavior management strategies in the service of facilitating their child's functioning. Evidence-based treatments include Cognitive-Behavioral and Acceptance and Commitment Therapies, along with multi-family support. The program also incorporates physician guest speakers and sibling group(s) when appropriate, with past participants securing friendships that last long after the group's conclusion.

    Location

    Menlo Park, CA

    Collaborators

    • Rashmi Bhandari, Anesthesiology, Perioperative and Pain Medicine
    • Isabel Yoon, Soc Science Rsch Prof 2, Anesthesia, Anesthesia
  • Pediatric Collaborative Health Outcomes Information Registry (Peds-CHOIR) (7/9/2014 - Present)

    Peds-CHOIR is an open platform, open source, learning healthcare system that tracks patient outcomes over time. This dynamic system improves upon healthcare providers' ability to offer precision medicine and patient-centered care for both youth as well as their parents/caregivers. Specifically, pediatric patients are empowered to work on improvements in functional (e.g., mobility, pain interference), emotional (e.g., anxiety, depression), sleep (e.g., chronic fatigue), and social (e.g., peer relations; school functioning) domains, while caregiver health is also captured and supported when indicated. Resilience factors are reinforced, while risk factors such as child and parent pain catastrophizing and fear-avoidance are reduced with evidence-based treatments such as Cognitive-Behavioral Therapy. Employed by an integrated team of medical professionals including pain physicians, psychologists, nurse practitioners, and physical therapists, the platform enables a multifactorial approach to child wellness in the treatment of pediatric chronic pain conditions.

    Location

    Menlo Park, CA

    Collaborators

    • Rashmi Bhandari, Anesthesiology, Perioperative and Pain Medicine
    • Laura Simons, Associate Professor, Stanford University School of Medicine
    • Amanda Feinstein, School of Medicine
    • Elliot Krane, Dr, Stanford University School of Medicine
    • Isabel Yoon, Soc Science Rsch Prof 2, Anesthesia, Anesthesia
    • Sean Mackey, Dr, Stanford University Medical Center
  • The Comfort Ability: A One-Day Workshop for Youth with Pain and their Parents/Caregivers, Stanford Children's Health / Lucile Packard Children's Hospital in collaboration with Boston Children's Hospital (11/12/2017)

    This supportive and interactive workshop is designed to help children with chronic or recurrent pain and their parents/caregivers learn strategies to better manage pain and improve day-to-day function. Youth are provided the opportunity to: connect with peers who also have pain; learn mind-body strategies for managing pain and pain-related stress; and develop an individual coping plan for improved pain management. Parents/caregivers acquire: parent-based strategies that promote child comfort; develop a plan to support improved youth functioning at home and school; and obtain resources for additional pain management support. Please email thecomfortability@stanford.edu for more details.

    Location

    Menlo Park, CA

    Collaborators

    • Rashmi Bhandari, Anesthesiology, Perioperative and Pain Medicine
    • Anya Griffin, Clinical Assistant Professor, Anesthesiology, Perioperative and Pain Medicine
    • Amanda Feinstein, School of Medicine
    • Rachael Coakley, Associate Director of Psychological Services and Pain Treatment Service, Boston Children's Hospital

Publications

All Publications


  • Risk and Resilience in Pediatric Pain: The Roles of Parent and Adolescent Catastrophizing and Acceptance CLINICAL JOURNAL OF PAIN Feinstein, A. B., Sturgeon, J. A., Bhandari, R. P., Yoon, I. A., Ross, A. C., Huestis, S. E., Griffin, A. T., Simons, L. E. 2018; 34 (12): 1096?1105
  • Pediatric pain and traumatic stress: Towards a neurobiological stress-health perspective Journal of Child and Adolescent Trauma Kao, G. S., Bhandari, R. P., Huestis, S. E., Golianu, B. 2017
  • Multi-Family Pediatric Pain Group Therapy: Capturing Acceptance and Cultivating Change. Children (Basel, Switzerland) Huestis, S. E., Kao, G., Dunn, A., Hilliard, A. T., Yoon, I. A., Golianu, B., Bhandari, R. P. 2017; 4 (12)

    Abstract

    Behavioral health interventions for pediatric chronic pain include cognitive-behavioral (CBT), acceptance and commitment (ACT), and family-based therapies, though literature regarding multi-family therapy (MFT) is sparse. This investigation examined the utility and outcomes of the Courage to Act with Pain: Teens Identifying Values, Acceptance, and Treatment Effects (CAPTIVATE) program, which included all three modalities (CBT, ACT, MFT) for youth with chronic pain and their parents. Program utility, engagement, and satisfaction were evaluated via quantitative and qualitative feedback. Pain-specific psychological, behavioral, and interpersonal processes were examined along with outcomes related to disability, quality of life, pain interference, fatigue, anxiety, and depressive symptoms. Participants indicated that CAPTIVATE was constructive, engaging, and helpful for social and family systems. Clinical and statistical improvements with large effect sizes were captured for pain catastrophizing, acceptance, and protective parenting but not family functioning. Similar effects were found for functional disability, pain interference, fatigue, anxiety, and depression. Given the importance of targeting multiple systems in the management of pediatric chronic pain, preliminary findings suggest a potential new group-based treatment option for youth and families. Next steps involve evaluating the differential effect of the program over treatment as usual, as well as specific CBT, ACT, and MFT components and processes that may affect outcomes.

    View details for PubMedID 29215566

  • Pediatric-Collaborative Health Outcomes Information Registry (Peds-CHOIR): a learning health system to guide pediatric pain research and treatment. Pain Bhandari, R. P., Feinstein, A. B., Huestis, S. E., Krane, E. J., Dunn, A. L., Cohen, L. L., Kao, M. C., Darnall, B. D., Mackey, S. C. 2016; 157 (9): 2033-2044

    Abstract

    The pediatric adaptation of the Collaborative Health Outcomes Information Registry (Peds-CHOIR) is a free, open-source, flexible learning health care system (LHS) that meets the call by the Institute of Medicine for the development of national registries to guide research and precision pain medicine. This report is a technical account of the first application of Peds-CHOIR with 3 aims: (1) to describe the design and implementation process of the LHS; (2) to highlight how the clinical system concurrently cultivates a research platform rich in breadth (eg, clinic characteristics) and depth (eg, unique patient- and caregiver-reporting patterns); and (3) to demonstrate the utility of capturing patient-caregiver dyad data in real time, with dynamic outcomes tracking that informs clinical decisions and delivery of treatments. Technical, financial, and systems-based considerations of Peds-CHOIR are discussed. Cross-sectional retrospective data from patients with chronic pain (N = 352; range, 8-17 years; mean, 13.9 years) and their caregivers are reported, including National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) domains (mobility, pain interference, fatigue, peer relations, anxiety, and depression) and the Pain Catastrophizing Scale. Consistent with the literature, analyses of initial visits revealed impairments across physical, psychological, and social domains. Patients and caregivers evidenced agreement in observable variables (mobility); however, caregivers consistently endorsed greater impairment regarding internal experiences (pain interference, fatigue, peer relations, anxiety, and depression) than patients' self-report. A platform like Peds-CHOIR highlights predictors of chronic pain outcomes on a group level and facilitates individually tailored treatment(s). Challenges of implementation and future directions are discussed.

    View details for DOI 10.1097/j.pain.0000000000000609

    View details for PubMedID 27280328

  • Potential Chemotherapy Side Effects: What Do Oncologists Tell Parents? PEDIATRIC BLOOD & CANCER Ramirez, L. Y., Huestis, S. E., Yap, T. Y., Zyzanski, S., Drotar, D., Kodish, E. 2009; 52 (4): 497-502

    Abstract

    In order to determine the number of short-term side effects and late effects discussed during an informed consent conference (ICC) after the diagnosis of acute leukemia, we observed the occurrence(s) and the ratio between short-term side effects versus late effects during an ICC.ICC(s) of childhood leukemia trials were audio-taped at six different study sites. The side effects mentioned during each of these ICC(s) were coded and analyzed.One hundred forty cases were reviewed, from which we coded a total of 3,173 acute side effects and 242 late effects. The mean total side effects mentioned during each ICC was 24 (range 5-47). The number of late effects coded were significantly less than acute side effects. We also found that the duration of ICC(s) was positively correlated with the number of side effects mentioned. In addition, the frequency of total side effects mentioned was independent of patient or parent demographic factors.Our results show that acute side effects are often mentioned but the discussion of late effects is much less frequent in the initial ICC(s). Careful consideration regarding the ratio of acute and late effects that are communicated to parents in the context of the ICC may facilitate parental understanding of clinically relevant side effects.

    View details for DOI 10.1002/pbc.21835

    View details for Web of Science ID 000263532500014

    View details for PubMedID 19101994

  • A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia PEDIATRIC BLOOD & CANCER Peterson, C. C., Johnson, C. E., Ramirez, L. Y., Huestis, S., Pai, A. L., Demaree, H. A., Drotar, D. 2008; 51 (1): 99-104

    Abstract

    Mixed findings on the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia (ALL), without radiation, indicate the need for a comprehensive meta-analytic review. The purpose of the current study was to conduct a meta-analysis assessing neuropsychological and academic functioning differences between children with ALL treated solely with chemotherapy and comparison groups.Thirteen articles met inclusion criteria for the meta-analysis and were analyzed using a random effects model, weighted least squares methods.Mean effect sizes were significantly different from zero for multiple domains of intelligence and academic achievement; processing speed; verbal memory; and some aspects of executive functioning and fine motor skills, indicating worse functioning in ALL survivors. Effect sizes for visual-motor skills and visual memory were not significantly different from zero.Results support the presence of neuropsychological and academic sequelae for ALL survivors treated solely with chemotherapy and highlight the need for ongoing follow-up of children with ALL using a standardized neuropsychological test battery and research methodology.

    View details for DOI 10.1002/pbc.21544

    View details for Web of Science ID 000255816800020

    View details for PubMedID 18322925

  • Depressive Symptoms in Children and Adolescents with Type 1 Diabetes Diabetes Care Hood, K. K., Huestis, S. E., Maher, A., Butler, D., Volkening, L., Laffel, L. M. 2006; 29 (6)

    View details for DOI 10.2337/dc06-0087

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