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, International Association for the Study of Pain (2013 - Present)
  • Member, American Psychological Association (2013 - Present)
  • Member, Society of Pediatric Psychology (2005 - Present)
  • Member, Society for Developmental and Behavioral Pediatrics (2006 - 2010)

Professional Education


  • Medical Education:Case Western Reserve School of Medicine (2011)
  • Fellowship:Stanford University Dept of Anesthesia Peds (2013) CA
  • 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 pediatric pain treatments.
- Understand the role of peers, parents, and systems (e.g., family, school, hospital, community) in the management of pediatric chronic 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 10-week group therapy program for teens with chronic pain, their parents/caregivers, and families. The program cultivates opportunity for youth and their families to gain support and learn from others living with chronic pediatric pain.

    Location

    Menlo Park, CA

    Collaborators

    • Rashmi Bhandari, Clinical Associate Professor, Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine
    • Austin Hilliard, Postdoctoral Research Fellow, Biology, Stanford School of Humanities and Sciences
  • 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 parental physical and behavioral health are also captured and supported when indicated. Resilience (e.g., chronic pain acceptance) 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, Clinical Associate Professor, Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine
    • Laura Simons, Associate Professor of Anesthesiology, Perioperative and Pain Medicine (Pediatric) at the Stanford University Medical Center, Stanford University School of Medicine
    • Amanda Feinstein, Postdoctoral Research Fellow, Anesthesiology, Perioperative and Pain Medicine, School of Medicine
    • Elliot Krane, Professor, Stanford University School of Medicine
    • Sean Mackey, Redlich Professor and Professor, by courtesy, of Neurology at the Stanford University Medical Center, Stanford University School of Medicine

Publications

All Publications


  • 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
  • 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