Child Psychologist Helps Kids and Parents Cope in Kansas

Steven Cohen, Psy.D., a native of the Chicago area, admits that his introduction to life as a clinical psychologist at the Pawnee Mental Health Center was a little disconcerting. In the small town of Concordia, Kansas—a community where everyone knows everyone else—he was startled to be approached by some of his patients in public places. “They came up to my wife and me and started asking questions about their treatment right in the middle of the grocery store,” he recalls. “I wasn’t used to seeing patients outside of work, so it felt a little awkward at first.”

Cohen soon realized that the residents of Concordia (population 5,000) have a different viewpoint on confidentiality compared with most city dwellers. Even when he is out mowing his lawn, people who the doctor would have only expected to see in the office will drive by, honk their horns, and wave. But this is now the very thing that has helped knit him into the community.

Cohen admits that he was terrified by the prospect of starting his professional practice far from the big cities where he grew up and later received his clinical training, which included earning his doctorate at the Georgia School of Professional Psychology in Atlanta. But his wife, who had found out about an opening at the Pawnee clinic that was eligible for NHSC’s Loan Repayment Program, urged Cohen to give it a try.

“I had some other job opportunities lined up, but I came out here and really liked it,” he says.

When they unpacked their belongings in Concordia, the Cohens were determined to assimilate into their new surroundings. “We made an effort from the start to meet people,” Cohen says. “That helped a lot because it got us into the community and they made us feel welcome.”

Cohen became fascinated with psychology in college. During graduate school he performed his therapy practicum at the oncology unit of the Scottish Rite Children’s Medical Center in Atlanta. That experience helped focus Cohen on working with kids, who he discovered were his special interest. It’s also what helped him make the trek from Atlanta to Concordia after he heard about the lack of services available for kids in that area.

The Pawnee clinic, where Cohen has worked since 2000, serves five counties in rural Kansas and, along with a network of 11 other clinics, treats more than 2,000 pediatric patients each year. The clinic’s staff includes eight psychologists and one psychiatrist.

Pawnee’s clientele represents a cross-section of the local populace. “Around here, Pawnee is the only provider of mental health care,” Cohen explains, “so we really see everyone.” Most of the patients at the clinic lack health insurance and are self-paid, he notes, with most falling on the lower-income side of the clinic’s sliding fee scale.

Cohen’s caseload includes about 100 patients. He sees around 30 of them each week. Most are children, but he also sees older patients. “We’ll see multiple generations of the same family, which is really interesting,” he says, tracing manifestations of certain mental illnesses in a grandparent, parent, and child.

Among his younger patients, Cohen has found anxiety problems, many arising when adolescents face the prospect of leaving the small town environs for college or jobs in the larger world outside Concordia. Drug abuse isn’t a significant problem among teens in the area, which he credits to community prevention efforts.

One of the bigger obstacles for mental health treatment in Concordia, Cohen has found, is that extra support services are not often available. In some cases, his young patients don’t even get support from their families. This has led Cohen and several other individuals to initiate a Big Brother/Big Sister program in the town. “I was one of the founders and am still involved in that program,” he says, “which I believe is a great service for the community.” Now, when he needs to, Cohen can send his pediatric patients to the program that he helped establish for the extra attention that they need.

Another asset Cohen brought to the clinic and the community was his knowledge of the latest diagnostic testing methodologies in behavioral health. “I have a strong background in ADHD (attention deficit hyperactivity disorder), so I started up an ADHD clinic here.” It was an undertaking that turned out to be of great interest and value to local families. “I’d do an evaluation, give parents feedback, and set up a treatment plan for their child,” he notes.

Pawnee Mental Health Center also offers a monthly parent-support meeting at no cost to attendees, whether or not their children are being seen at the clinic. Cohen has spoken at those meetings several times, which give parents an opportunity to ask questions about problems they’re having with their kids. He also teaches a continuing education course at the local community college.

Despite his initial culture shock, Cohen now enjoys the slower pace and security of small town living. “It’s a friendly place,” Cohen explains. “People leave their keys in the car, and they don’t lock their doors at night. When I first came here and turned my car alarm on, people would laugh.”

The couple recently had their first child, which, Cohen explains, “was part of our plan when we moved here, because this is a great place to raise kids.” And his experience working at Pawnee has been so positive that Cohen recently renewed his contract to stay beyond the initial 2-year service commitment to NHSC.

Cohen admits it’s hard having the rest of their family live so far away—his in Chicago, his wife’s in Miami—but he says, “The people of Concordia have become our extended family in a lot of ways.”