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Postpartum Mental Health Deserves More Than an Afterthought By Dr. Tara Chalakani, Chief Executive Officer, Preferred Behavioral Health Group It is no secret that the nuances of women’s health have been sorely under researched, under treated, and often dismissed. Until as recently as 2019, according to the Association of American Medical Colleges, women still did not make up even half of the participants in the medical research that affects them most: cancer, cardiovascular disease, and psychiatric disorders. With a growing awareness of mental health disorders, it seems timelier than ever to prioritize and understand the mental health needs of women. Nowhere is that need more visible, or more consistently overlooked, than in the months following childbirth. A Gap in Public Understanding Public attention has turned recently to postpartum psychosis, a diagnosis most people had never heard of, following the case of Lindsay Clancy, a former labor and delivery nurse in Massachusetts. That case is before a jury as I write this, and it is not my place to comment on it. What it has revealed is how little is commonly understood about a condition that occurs, according to Postpartum Support International, in one to two out of every thousand deliveries. Consider what that number means. The likelihood of experiencing psychosis postpartum is roughly the same as the likelihood of developing a blood clot postpartum, which published clinical reviews place at about one in every thousand women after delivery. Every new mother in this country is counseled about blood clots. She is told what to watch for, when to call, and when to go to the emergency room. Almost none are told anything at all about psychosis. That is not a failure of any one mother, or any one clinician. It is a gap in how we have chosen to define postpartum care. What Happens After Birth The hormonal fluctuations that occur postpartum are dramatically severe. Estrogen and progesterone, elevated throughout pregnancy, fall sharply within days of delivery. The mental impact of these dramatic shifts can cause what we commonly call baby blues, along with anxiety and brain fog. Clinical reviews published through the National Library of Medicine estimate that between half and three quarters of new mothers experience baby blues, which typically resolves within about two weeks. For many women, it does not resolve. The Policy Center for Maternal Mental Health reports that postpartum depression and anxiety affect roughly one in five women who give birth. And in severe instances, these shifts can contribute to psychosis, which presents as confusion, insomnia, mania, hallucinations and delusional thinking. What to Watch For Because public awareness is low, families are often the last to recognize what they are seeing. The following are worth knowing for any woman who is pregnant or recently postpartum, and for anyone who loves her. The timeline is short and the onset is sudden. Postpartum Support International reports that onset is typically within the first two weeks after delivery, though it can emerge later in the first year. A woman who seemed like herself one day can be unwell within days. Sleep is the earliest signal. Exhaustion is expected after a birth. A mother who cannot sleep even when the baby is sleeping and someone else is covering the night is a different matter. Prolonged sleep loss is both a warning sign and a contributing factor. The early signs are quieter than the ones people picture. Hallucinations are what most people associate with psychosis, but they are rarely the first symptom. Drawing on descriptions from the American Psychiatric Association and PSI, earlier indicators include: Confusion or difficulty following a conversation Paranoia, or new suspicion of trusted people Irritability or agitation that is out of character Racing thoughts, pressured speech, or unusual energy Beliefs that do not match reality Behavior that appears disorganized Symptoms fluctuate. A period of apparent clarity does not mean the episode has passed. A history of bipolar disorder carries the greatest risk. PSI and the Policy Center for Maternal Mental Health identify a personal or family history of bipolar disorder, or a previous psychotic episode, as the strongest risk factors. Risk also rises with a prior episode of postpartum psychosis and with discontinuation of psychiatric medication during pregnancy. One caveat is essential. A substantial share of women who experience postpartum psychosis have no prior psychiatric history at all. The absence of risk factors is not the absence of risk. This is a medical emergency. It is not a concern to raise at a six week checkup. PSI classifies active postpartum psychosis as an emergency requiring immediate care. Contact her obstetrician or psychiatrist, call a crisis line, or go to the emergency department. Asking directly does no harm. Families often hesitate to ask a new mother whether she is having frightening thoughts. That hesitation is understandable and it is misplaced. Asking plainly is one of the most useful things a family member can do. Postpartum psychosis is treatable. This must be said as clearly as the warnings. PSI is explicit that the majority of women who experience postpartum psychosis do not harm themselves or anyone else, and that with prompt treatment most recover fully. A woman who fears that disclosing her symptoms will cost her her children will not disclose them. Accuracy here is not reassurance. It is what makes treatment possible. What Needs to Change It is estimated that at least 20 percent of postpartum women suffer with a mental health disorder, but less than half receive treatment. This is unacceptable. Psychiatric care is not a standard component of postpartum care in this country. Screening exists in some settings and not in others. Where screening does occur, it frequently is not connected to anything. A positive result on a questionnaire is not care. These are solvable problems, and several of them have already been identified by the professionals who deliver this care. Screen more than once, and beyond six weeks. The American College of Obstetricians and Gynecologists has called for postpartum care to become an

June is Men’s Mental Health Month, and it gives us an opportunity to say something many men rarely hear directly: you do not have to suffer in silence to prove that you are strong. Many men were raised with a narrow emotional vocabulary. From a young age, boys are often taught to be tough, stay composed, solve problems, avoid weakness, and keep going no matter what. These lessons are not always spoken out loud, but they are absorbed early. Over time, they can make it difficult for men to name sadness, fear, loneliness, shame, or exhaustion, even when those feelings are very real. This can become especially difficult in today’s world. The expectations placed on men have changed, but many men were never given a clear map for how to change with them. Older messages about being the provider, protector, and steady one still exist, while newer expectations ask men to be emotionally open, relationally skilled, and vulnerable. For many men, this can feel confusing, like the goalpost keeps moving. At the same time, many men are more isolated than they appear. Men often build friendships through shared activities, work, sports, hobbies, or helping each other with practical things. These connections matter. But when life changes, through divorce, parenting stress, job loss, retirement, grief, relocation, remote work shifts, or simply the busyness of adulthood, those connections can fade. A man may be surrounded by people and still feel deeply unknown. Digital life can add another layer. Online spaces can offer humor, support, information, and a sense of belonging. But they can also become a substitute for real connection. A man can spend hours online and still feel more alone, more frustrated, or more disconnected afterward. The question is not whether technology is good or bad. The question is whether it is helping someone feel more connected to life, or more removed from it. For many men, emotional pain does not show up as crying or asking for help. It may look like irritability, anger, withdrawal, overworking, drinking more, sleeping less, losing interest in things, spending more time online, or feeling numb. Sometimes it shows up as the belief that no one would understand anyway. But silence is not the same as wellness. Men’s mental health matters because men matter, not only as workers, fathers, partners, sons, providers, or protectors, but as whole human beings. Men deserve language for what they feel. They deserve friendships where they can be known, not just useful. They deserve care before they reach a breaking point. If you are a man who has been feeling disconnected, overwhelmed, ashamed, or quietly hopeless, please do not dismiss it. You do not need to wait until things are falling apart to reach out. Talking to someone, reconnecting with a friend, joining a group, returning to a meaningful activity, or meeting with a therapist is not weakness. It is responsible care for your health and your life. And if someone you love seems more withdrawn, angry, numb, or isolated, look beneath the surface. Many men will not start the conversation, but they may respond when someone approaches them with patience and without judgment. This month is a reminder that strength does not have to mean silence. Strength can mean honesty. Strength can mean connection. Strength can mean saying, “I’m not okay,” before the pain becomes unbearable. Preferred Behavioral Health Group is here to support individuals and families navigating stress, loneliness, depression, anxiety, substance use, and emotional crisis. Help is available, and no one has to do this alone. If you or someone you know is in immediate emotional distress or thinking about suicide, call or text 988 to reach the Suicide & Crisis Lifeline. If there is immediate danger, call 911 or go to the nearest emergency department. Adam J. Sagot, D.O. FAPA DFAACAP Chief Medical Officer

An independent recognition we have proudly maintained for nearly two decades — across our continuum of behavioral health programs. From the team at Preferred Behavioral Health Group Preferred Behavioral Health Group (PBHG) is proud to announce that we have once again been recertified by CARF International across a broad range of our service programs — a recognition we have proudly maintained for nearly two decades. CARF accreditation is an independent, international recognition that confirms our commitment to the highest standards of person-centered care, safety, and continuous improvement. For some of our programs, this isn’t a new milestone — it’s a standard we have continuously met since 2007. What Is CARF Accreditation? The Commission on Accreditation of Rehabilitation Facilities — known as CARF International — is a non-profit accrediting body widely regarded as the leading authority for quality standards in behavioral health, rehabilitation, aging services, and child and youth services. CARF accreditation is voluntary: providers choose to undergo the process to demonstrate their commitment to service quality, transparency, and measurable outcomes. To earn CARF accreditation, a program must: Meet more than 1,500 rigorous quality standards Undergo on-site surveys and audits conducted by external subject-matter experts Demonstrate measurable outcomes and person-centered practices Maintain an ongoing commitment to continuous quality improvement CARF-accredited organizations are evaluated not only on clinical practices but also on ethical conduct, financial sustainability, staff development, and the experience of the individuals and families receiving care. PBHG Programs Accredited by CARF PBHG’s CARF accreditations span nearly two decades of sustained quality measurement. Our longest-standing accredited program — Supported Employment — has been continuously CARF-accredited since 2007, with additional programs added to our accreditation portfolio over the years as our continuum of care has grown. The following PBHG programs are currently CARF-accredited: Supported Employment — CARF-accredited since 2007 Adult Outpatient Department — CARF-accredited since 2016 Preferred Center for Children & Families (PCCF) — CARF-accredited since 2016 Intensive Outpatient Treatment and Support Services (IOTSS) — CARF-accredited since 2016 — community-based, trauma-informed services including individual and group therapy, medication management, case management, and community linkages Recovery Support Services (RSS) — CARF-accredited since 2016 — Outpatient, Intensive Outpatient Program (IOP), Partial Care, and Co-Occurring treatment for individuals facing substance use and mental health challenges Adult Partial Care — CARF-accredited since 2019 — structured daytime treatment providing a higher level of support than traditional outpatient care SAIL — CARF-accredited since 2019 — adolescent partial care program serving teens ages 13–17 facing emotional and behavioral challenges Titan Group Home — CARF-accredited since 2022 — community-based residential program Hamlet Group Home — CARF-accredited since 2022 — community-based residential program 450 Group Home — CARF-accredited since 2022 — community-based residential program Maverick Group Home — CARF-accredited since 2022 — community-based residential program What This Means for the People We Serve For the individuals, children, and families who walk through our doors, CARF accreditation is more than a credential on the wall. It is a promise about what happens in every session, every treatment plan, and every residential setting. Quality you can trust. Every accredited program has been independently measured against national best practices. Person-centered care. CARF standards require services to be built around the goals, preferences, and needs of each individual. Safety and accountability. Programs are audited for safety practices, ethical conduct, and measurable outcomes. Continuous improvement. Accreditation is not a finish line — it requires ongoing evaluation, refinement, and honest self-review. For referring providers, insurers, and community partners, CARF accreditation offers additional assurance that PBHG operates at the standard expected of the nation’s leading behavioral health organizations. A Milestone — Not a Destination Earning — and maintaining — CARF accreditation is significant, but it is not the point. The point is the work it represents: thousands of conversations, treatment plans, crisis interventions, recovery milestones, and quiet moments of support that happen across our programs every week, year after year. We are grateful to our clinicians, counselors, case managers, residential staff, administrative teams, and leadership — whose sustained commitment over many years made this recognition possible. And we are grateful to the individuals and families who trust PBHG with some of the most important moments of their lives. Accreditation is not about a seal on the wall. It is about what happens — year after year — in every conversation, every treatment plan, and every hand extended to someone who needs help. Learn More About Our Programs PBHG offers a comprehensive continuum of behavioral health services for adults, children, adolescents, and families across Ocean and Monmouth counties — including outpatient care, partial care and intensive outpatient programs, recovery support services, residential group homes, and specialized services for children and families. Need Support? We’re Here to Help. If you or a loved one is looking for CARF-accredited behavioral health care, reach out today. Our team will help you find the right program and walk you through next steps. Call us today: 732-367-4700  

One simple practice can change how your child sees you — and how they see themselves. Written in collaboration with the NJ4S Monmouth & Ocean Hubs team at Preferred Behavioral Health Group. The Power of a Safe Adult Every May, Children’s Mental Health Awareness Month reminds us to check in on the kids in our lives — not just the ones who seem to be struggling, but all of them. In Monmouth and Ocean Counties, that matters. A lot of teens tell us they feel judged more than understood. Too many young people are struggling quietly, and too many parents are worried about how to help. No single program or conversation will solve everything. But years of research keep pointing to one simple truth: the biggest thing that protects a child’s mental health is having a safe, trusted adult in their life. Not a perfect one. A steady one. This month, we want to invite every parent and caregiver to try one shift. One small change that can transform how your child sees your relationship — and, over time, how they see themselves. That change is called Unconditional Positive Regard. Understanding UPR: It’s Not Earned, It’s Constant Unconditional Positive Regard (UPR) is an idea from a psychologist named Carl Rogers. The core of it is simple: you accept and value your child no matter how they behave. Your love, your warmth, your acceptance — these aren’t prizes your child wins for good grades or a clean room. They’re always there. That sounds easy. It’s not. Most of us grew up in a world where love felt tied to performance. A “good job” came after the A-plus. A frown came after the broken rule. Over time, kids pick up on a quiet pattern: I’m loved when I’m good. Which also means: when I’m not good, I’m not loved. UPR breaks that pattern. It separates what your child does from who they are. You can still set rules. You can still give consequences. You can still get frustrated. But the deeper message stays the same: you matter to me because you exist, not because of what you do. A study by Lopes, van Putten, and Moormann found that the way we parent shapes a child’s mental health well into adulthood. Kids who grow up feeling accepted no matter what carry that feeling forward — into how they see themselves, how they show up in friendships, and how they handle hard times. Building a Strong Sense of Self Here’s what UPR does on the inside of a child. When kids feel loved only when they succeed, they start to live in fear. Fear of failing. Fear of letting someone down. Fear of the moment love might be taken away. That fear shows up as anxiety, as perfectionism, as a knot in the stomach before every test and every hangout. When kids feel loved no matter what, something different happens. They learn to accept themselves. They can try, fail, and still feel okay. They can mess up — even badly — and still believe they’re worth something. This is a kind of inner shield. It doesn’t stop bad days or normal teen drama. But it keeps small setbacks from turning into big crises. A teen with that shield can fail a math test and feel disappointed. A teen without it can fail the same test and feel, for a moment, like they are a failure as a person. “I don’t like this behavior, but I always love and value YOU.” The consistency mantra of Unconditional Positive Regard Softening the Inner Voice We want to say this part plainly, because it matters. A lot of kids — especially those who’ve been through hard things — carry a harsh voice inside their head. It sounds like “nobody really likes me.” Or “I’m too much.” Or “I’m not enough.” When that voice runs on a loop, it shapes how kids see the world, how they handle setbacks, and whether they feel safe reaching out when things get hard. UPR pushes back against that voice. When a child has spent years hearing, in small everyday ways, that they are loved even at their worst, that message slowly becomes part of how they talk to themselves. It doesn’t cure depression. It doesn’t erase trauma. But it builds a foundation, one day at a time, that says: you belong here. You are loved, exactly as you are. That’s what trauma-informed care looks like at the kitchen table. Practical Application: Be the Trusted Adult This Summer Parents often ask us: “Okay, this sounds nice, but what does it actually look like at 5:30 PM when my kid is slamming doors?” Here’s where to start. Curiosity Over Discipline. When a child acts out, they’re almost always trying to meet a real need with the only tools they have. A toddler who’s hitting is usually overwhelmed. A teen who’s shutting down is usually stressed and doesn’t have the words for it yet. The most powerful thing you can do is change the question. Instead of “How do I win this fight?” try “What is my child trying to tell me with this behavior?” You can still hold the limit. You don’t have to be okay with the behavior. But leading with curiosity changes the whole room. Structure as Safety. For little kids, knowing what happens next is calming. Meals, naps, bedtime, transitions — a predictable rhythm lowers anxiety and stops meltdowns before they start. For teens, strict rules often backfire. What works better is teamwork. Sit down and ask: “What do you need to feel supported this summer? What do I need to feel okay about it?” Make agreements about phones, curfews, and time with friends — together. You’re still the parent. But you’re also teaching them how to think about their own well-being — a skill they’ll need long after they leave home. The Consistency Mantra. When you’re frustrated or angry, try saying this out loud: “I don’t like this behavior,

  If someone has suggested that your child might benefit from psychiatric medication — a teacher, a pediatrician, a school counselor — and your first reaction was hesitation, you are not alone. That hesitation does not make you a bad parent. It makes you a thoughtful one. At Preferred Behavioral Health Group (PBHG), we hear this every day from families across Toms River, Brick, Lakewood, and throughout Ocean and Monmouth Counties. Parents come to us carrying real fears and real questions. This guide is designed to meet you where you are — with honesty, clinical clarity, and no pressure. Why Parents Hesitate — And Why That’s OK The Most Common Fears (Named) Research on parental attitudes toward pediatric psychotropic medication identifies the same core concerns. They deserve to be named, not dismissed: “Will my child be on this forever?” The fear that medication becomes a life sentence is one of the most common barriers. In reality, many children use medication as a short-to-medium-term support while building coping skills through therapy and behavioral intervention. “Will it change who they are?” Parents worry about personality changes or emotional blunting. When properly managed, medication should help a child be more themselves — not less. “They’ll grow out of it.” For some conditions, symptoms do evolve. But waiting without support can mean years of preventable academic and social difficulty. The question is whether support right now could change your child’s trajectory. What the Research Actually Says Studies consistently show that parental beliefs are among the top factors influencing whether children receive appropriate treatment. Extended family opinions, past personal experiences, and cultural attitudes all shape a parent’s decision. A 2022 study by Hoagwood and Acri in the Journal of the American Academy of Child & Adolescent Psychiatry underscores the importance of making evidence-based knowledge accessible to parents as a key lever for improving child mental health care engagement. PBHG’s approach starts with listening — understanding your specific fears before recommending anything. What Medication Management Looks Like in Practice The Assessment: Measurement-Based, Not Guesswork At PBHG, we do not write prescriptions based on a single appointment. Our child and adolescent psychiatry team uses measurement-based diagnostics — tools like the Vanderbilt Assessment Scales — to build a complete picture. We gather input from you, your child’s teachers, and other caregivers. Titration: Finding the Right Fit Titration is the process of starting at the lowest effective dose and adjusting gradually based on response and side effects. This is a partnership: your observations at home and your child’s teacher’s feedback at school are essential data. You will become an expert in what your child needs. When medication is properly managed, it should help your child be more themselves — not less. Non-Stimulant Options For parents concerned about stimulant medications, there are non-stimulant alternatives. Options such as atomoxetine, guanfacine, and clonidine work through different mechanisms. Our team will walk you through each option based on your child’s specific presentation and your family’s concerns. The School-Clinical Bridge: How Medication Supports IEP and 504 Success This is where PBHG makes a meaningful difference. Many families come to us after months of frustration trying to get their child an IEP or 504 Plan. Schools require documentation — evidence that a disability substantially impacts a major life activity. Without clinical documentation, parents are often told their child “doesn’t qualify.” Why Schools Need Clinical Documentation In New Jersey, a 504 Plan requires evidence that a disability substantially limits a major life activity. An IEP requires the Child Study Team to determine the child needs specially designed instruction — a process that involves testing by licensed school psychologists or neuropsychologists. PBHG’s role in this process: For 504 Plans, our clinical team has direct and regular input — providing psychiatric assessments and treatment records that establish your child’s needs. For IEP evaluations, we serve as advocates and guides: helping you understand the process, communicate with the school, and ensure the clinical picture is clearly represented — even though the formal testing determination rests with the Child Study Team. From Diagnosis to Accommodation: A Real Pathway Here is what the path can look like for families in Toms River, Brick, Lakewood, Middletown, and across Ocean and Monmouth Counties: Clinical evaluation and measurement-based assessment at PBHG. Diagnosis and medication discussion (if appropriate). Clinical documentation prepared and shared with your child’s school. PBHG advocates for your family throughout the IEP/504 process, providing guidance and clinical context. Ongoing monitoring — medication, treatment progress, and accommodations reviewed together. What PBHG Does Differently in Ocean and Monmouth County A Team-Based Approach PBHG’s clinical team works to coordinate care across your child’s world — with your pediatrician, with school staff, and with your family. While every patient’s care looks different, our goal is always the same: no one should be navigating this alone. When collaboration is possible and appropriate, we pursue it. From Preschool to Adolescence Treatment approaches differ by age, and so does our guidance: Age Group Our Approach Preschool (3–5) Behavioral parent training is the first line of intervention. Medication is considered only when other approaches have been insufficient. School-Age (6–12) Medication may be recommended alongside school-based support and therapy, depending on the child’s needs. Adolescents (13+) Treatment planning incorporates the young person’s own voice, input, and assent. Your Next Step If you are considering medication for your child — or struggling to get the school support your child needs — Preferred Behavioral Health Group is here. Our child and adolescent psychiatry team in Ocean and Monmouth County specializes in helping families move from hesitation to clarity. Schedule a Psychiatric Evaluation or call 732-323-3660. Reviewed by Adam J. Sagot, D.O., FAPA — Board-Certified in Psychiatry, Child & Adolescent Psychiatry, and Forensic Psychiatry. Chief Medical Officer, Preferred Behavioral Health Group.

Adam J. Sagot, D.O., FAPAChief Medical OfficerPreferred Behavioral Health Group February is National Teen Dating Violence Awareness and Prevention Month. To avoid treating this month as simply a symbolic observance, we must use it as a reminder that relationship violence often begins early, frequently goes unrecognized, and carries lasting mental health consequences.  Data highlighted by the American Academy of Pediatrics show that approximately one in three adolescents in the United States experiences physical, emotional, or sexual abuse in a dating relationship. The American Academy of Child and Adolescent Psychiatry further emphasizes what we see each day in our work, that teen dating violence is associated with depression, anxiety, substance use, academic decline, and increased risk of future victimization. These are not isolated behavioral issues, but they are developmental and public health concerns.  If we are serious about prevention, we must adopt a trauma-informed approach. That begins with a mindset shift. Instead of asking what is wrong with a teen, we ask what may have happened to them. Irritability, secrecy, declining grades, social withdrawal, or risk-taking behaviors may represent coping responses to coercion, fear, or shame.  At PBHG, we approach every case with a trauma-informed lens.    A trauma-informed response prioritizes safety, trust, and empowerment.  Current data recommends creating private, nonjudgmental space for adolescents to talk. Teens are unlikely to share about abuse if they anticipate punishment, disbelief, judgment or loss of autonomy. Simple statements such as, “I am glad you told me,” or “You do not deserve that,” reduce isolation, provide validation of emotional experience and reinforce dignity. Listening without immediately taking over the situation helps restore a sense of control that abuse often strips away.  Education is equally critical. We encourage direct conversations about consent, boundaries, respect, and digital behavior. Many teens normalize jealousy, constant texting to monitor whereabouts, password sharing, or pressure for sexual activity. These behaviors are often mislabeled as signs of closeness. They are not. They are warning signs.  The National Alliance on Mental Illness and Mental Health America both stress that emotional abuse is real abuse. Humiliation, threats of self-harm used as manipulation, isolation from friends, and persistent monitoring can be profoundly destabilizing. As adults, we must learn to recognize subtle shifts in mood, unexplained injuries, sudden loss of friendships, or a partner who insists on constant contact.  For parents, educators, and community members, prevention begins with modeling healthy relationships. Teens cannot do this alone; they need guidance and for their “village” to step-up and show-up.  Demonstrate conflict resolution without intimidation. Ask open ended questions, such as, “How do you handle disagreements?” Make sure teens know where to seek help, whether through school counselors, pediatricians, or crisis resources.  Connection is the strongest protective factor. Surveillance and control are not substitutes for trust. When adolescents feel respected, heard, and supported, they are more likely to identify unhealthy dynamics and seek help early.  Remember, the strongest predictor of happiness later in life is the quality of relationships in their life.  We must protect our teens and educate them on the risks of unhealthy or unsafe relationships.    Teen dating violence is preventable. Awareness is the first step. Informed, trauma sensitive engagement must follow. 

Adam J. Sagot, D.O., FAPAChief Medical OfficerPreferred Behavioral Health Group A teenager skips dinner and says they already ate. A college student trains for hours after consuming very little. A parent notices shrinking portions, oversized clothing, increasing irritability, and mounting anxiety around meals. These moments often appear subtle, but do not let them go unaddressed as they may represent the early stages of a psychiatric illness.  National Eating Disorders Awareness Week, observed in late February, calls attention to a group of serious mental health conditions that affect both adolescents and adults. The American Psychiatric Association, the American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatry all recognize that these illnesses are common, complex, and potentially life threatening. NAMI and Mental Health America continue to emphasize that eating disorders carry among the highest mortality rates of any psychiatric condition, driven by both medical complications and suicide.  The term “eating disorder” does not describe one single problem. It encompasses a range of unhealthy relationships with food and body image. For some individuals, disordered eating often centers on severe restrictions and fear of weight gain. For others, it involves recurrent episodes of consuming large amounts of food followed by attempts to compensate, sometimes by forcing them to vomit. Some struggle primarily with binge eating without purging. Others avoid large categories of food because of fear, anxiety, or sensory sensitivity. Increasingly, we are also seeing unhealthy reliance on weight loss medications, including off label use of GLP 1 agonists, in ways that mask or reinforce disordered eating patterns.  These behaviors do not arise in a vacuum. Eating disorders often serve a psychological function. For some, controlling food intake becomes a way to exert control when other areas of life feel chaotic. For others, disordered eating may develop in the aftermath of trauma. In some cases, it is intertwined with depression, anxiety, obsessive thinking, or other medical and psychiatric conditions. Body image dissatisfaction, social comparison, and cultural pressures frequently amplify vulnerability. There is rarely a single cause. Biological predisposition, environmental stressors, and psychological coping patterns intersect.  Physical signs still matter. Rapid weight loss, failure to grow as expected, dizziness, cold intolerance, menstrual changes, and fatigue signal physiologic strain. In individuals who induce vomiting, clinicians may observe Russell’s sign, redness or callusing over the knuckles from repeated contact with the teeth. Dental enamel erosion, electrolyte disturbances, bradycardia, and cardiac rhythm abnormalities can develop silently. These are not cosmetic issues. They reflect systemic compromise.  Treatment works best when it is coordinated. Current recommendations support multidisciplinary care that integrates medical monitoring, psychiatric oversight, psychotherapy, and nutritional rehabilitation. For adolescents, family-based treatment has strong evidence and actively engages caregivers in restoring nutrition. Registered dietitians with eating disorder expertise are essential. Communication among providers is not optional, it is critical.  Nutritional restoration requires vigilance. Refeeding syndrome is a well-documented risk in malnourished patients. Rapid shifts in insulin and electrolytes, particularly phosphate, can precipitate cardiac and neurologic complications. Careful reintroduction, or titration, of caloric intake, frequent laboratory monitoring, and close clinical observation reduce risk. In medically unstable patients, inpatient or residential treatment may be necessary before outpatient therapy is safe.  Families should resist the urge to wait for clarity. Significant weight change, behavioral rigidity around food, or medical symptoms more than justify asking the question or seeking out a medical consultation. Early intervention improves outcomes and reduces chronicity.  Awareness week should sharpen our clinical lens and our sense of urgency. Eating disorders are complex, biologically influenced, and treatable illnesses. They demand coordinated care, sustained follow-through, and informed advocacy from the families and communities who recognize the warning signs first. 

Preferred Behavioral Health Group (PBHG) is proud to welcome Karen Campi to its Board of Trustees in 2026. Karen brings more than two decades of leadership in healthcare operations, community engagement, and mental health advocacy, along with a deep commitment to advancing whole-person care across New Jersey. For 25 years, Karen has been a driving force behind Campi Dental, a family-founded practice established in 1933. Her leadership has guided the practice’s continued growth through innovative digital marketing, strategic communications, event planning, and operational oversight. Equally important, she has prioritized team development and meaningful community partnerships, helping position Campi Dental as both a trusted healthcare provider and a respected community resource. Karen offers a uniquely valuable perspective to PBHG’s mission through her work at the intersection of oral health and mental health. She is a passionate advocate for equipping dental professionals to recognize early indicators of mental health challenges in adolescents, elevating dental practices as critical and often overlooked partners in youth suicide prevention. Her advocacy has helped expand the role of non-traditional healthcare settings in identifying and responding to emerging behavioral health needs. As a community leader, Karen spearheads Campi Dental’s Campi Cares initiatives, including the Sponsor a Student back-to-school supply drive, the Annual Candy Buy-Back Program benefiting the Tunnel to Towers Foundation, and Operation Sleigh Bells, which provides holiday gifts to children and teens in need. She also leads the practice’s internship and scholarship programs in partnership with organizations such as Monmouth County Habitat for Humanity, the Boys & Girls Clubs of Monmouth County, Mary’s Place By the Sea, and Preferred Behavioral Health Group. These efforts earned Campi Dental the 2021 Jersey Shore Chamber Golden Osprey Award. Karen’s leadership and impact have been widely recognized. She is a recipient of the NJBIZ Leading Women in Business Award, the MODC Silver Gull Award, and the 2025 Preferred Impact Award, presented by PBHG in recognition of her compassion, advocacy, and commitment to addressing mental health challenges in real time. Through grassroots outreach, philanthropic leadership, and community mobilization, Karen exemplifies how healthcare organizations can serve as pillars of community wellness—an approach that closely aligns with PBHG’s values and strategic vision. Beyond Campi Dental, Karen serves as a Board Member, Executive Committee Secretary, and Vice Chair of Marketing for the Monmouth-Ocean Development Council; Director of Strategic Development on the Executive Board of WEforum; and Sponsorship Chair for SPTS’s Women of Wellness and Wonder Luncheon. A New Jersey native, she began her career in public relations at AT&T Wireless. Karen’s appointment to the PBHG Board of Trustees reinforces the organization’s commitment to innovative, community-centered approaches to behavioral health. PBHG looks forward to the insight, leadership, and strategic perspective she brings as the organization continues to expand access to equitable, high-quality behavioral health services across New Jersey.

Adam J. Sagot, D.O. FAPAChief Medical Officer As we settle into February, many of us find ourselves reflecting on the resolutions we set just one month ago. Whether your goal was to drink less, eat better, manage stress, or simply take better care of yourself, sustaining momentum can feel harder than starting. From a mental health perspective, consistency is less about perfection and more about building sustainable habits that support both body and mind. Set reasonable goals. Staying active is not just about hitting a number on a fitness tracker. It is about moving in ways that fit your life, reduce stress, and contribute to long-term health. Some of our worlds most successful athletes and entrepreneurs aim to improve just 1% per day. A great reminder that minor changes really do matter. A recent study in The Lancet suggests that “small and realistic increases in [physical activity] of 5 min/day might prevent up to 6 % of all deaths.”  This insight is so powerful because it reframes physical activity as something accessible, not intimidating. If five extra minutes of moderate effort can make a measurable difference in population health, imagine what happens when those minutes become habits that build week after week. Ask yourself, how can you make yourself 1% better today? The benefits of staying active extend well beyond mortality statistics. Regular movement supports cardiovascular health, helps regulate mood and anxiety, improves sleep quality, and strengthens metabolic function. It can be a low-cost, high-impact strategy for managing chronic conditions like hypertension or type 2 diabetes. Activity also plays a key role in cognitive health across the lifespan. Exercise stimulates the release of positive endorphins, reinforcing a sense of agency over your well-being. These changes can even enhance be a vehicle for social connection when done in group settings or with friends. It is important to acknowledge that maintaining a physical activity routine is not always easy. Common barriers include time constraints, competing responsibilities, physical discomfort or injury, lack of motivation, or simply not knowing where to begin. The strategy that works best is to start with what you can do. Perhaps that means an extra five-minute walk after lunch, a brief stretch break between meetings, or choosing stairs instead of elevators. Remember that small steps that add up and build confidence. If your February resolution feels like it is slipping, be kind to yourself and remember that consistency grows from tiny actions repeated over time. You don’t have to run marathons to reap the benefits of being active. Start where you are, honor the small gains, and let those early wins fuel your forward progress. With that mindset, staying active becomes a sustainable part of your life, not just a New Year’s goal. PBHG is available to every individual looking to improve their overall wellbeing, particularly their psychological and behavioral health.

Eatontown — Preferred Behavioral Health Group (PBHG), a leading nonprofit provider of mental health, recovery, and prevention services, today announced a slate of new leadership appointed to its Board of Trustees: Michael Kokes, who will serve as Board Chairman; Jennifer Godoski, who will serve as Board Vice Chair; and Board of Trustee members Catherine M. Cunningham, MD and Pamela A. Major.  Together, these trustees bring exceptional expertise in business leadership, behavioral health, community empowerment, and systemwide innovation to PBHG’s mission of improving the lives of individuals and families throughout New Jersey. “We are thrilled to welcome this new leadership team to our Board of Trustees,” said Dr. Tara Chalakani, CEO of Preferred Behavioral Health Group. “Each brings extraordinary talent, passion, and leadership that will help us advance our mission of delivering high-quality, compassionate behavioral health services. Their collective expertise will guide PBHG through its next chapter of growth and innovation.” Michael Kokes, Board Chairman A third-generation real estate developer, Michael Kokes is the founder and President of Kokes Properties, where he oversees strategic planning and daily operations. Prior to launching Kokes Properties, he served as Vice President of The Kokes Organization, managing multiple construction projects and leading the successful divestiture of the family assets. Mr. Kokes brings deep industry knowledge, operational acumen, and a long-standing commitment to community development. A current member of the Board of Trustees, Michael is replacing outgoing Chairman Randy Minniear. “PBHG plays a vital role in strengthening the mental health and well-being of our communities,” said Kokes. “I am honored to serve as Board Chairman and work alongside such dedicated professionals to support and expand the organization’s mission.” Jennifer Godoski, Board Vice Chair Jennifer Godoski currently serves as Director of Policy and Government Affairs for New Jersey Resources.  A respected leader in state government and public policy, Godoski previously served as Chief of Staff to the New Jersey Department of Transportation and worked for several Governors, members of Congress, and state legislators. A graduate of the College of New Jersey, Godoski’s service to the public and her community is extensive.  She serves as the Governance Chair of Crossroads of the American Revolution, as a trustee of NJSEED, and Co-Chair of the Monmouth County Chapter of Alliance for Action.  Jennifer is also a Board member of the Jersey Shore Partnership and serves as the Government Relations Committee Chair of the Monmouth Ocean Development Council. “I’m excited to serve as Vice Chair of Preferred Behavioral Health Group, an organization that is dedicated to improving the lives of so many New Jerseyans,” said Jennifer Godoski. “I look forward to working with PBHG as they continue to set the gold standard for behavioral services in Central Jersey and beyond.” Catherine M. Cunningham, MD, Board of Trustees Member Dr. Catherine M. Cunningham is the Vice President & Chief Medical Officer at Hackensack Meridian Health Carrier Clinic. A board-certified psychiatrist with specialized training in perinatal mental health, she completed her residency at Rutgers Robert Wood Johnson Medical School and serves as an Assistant Professor at the Hackensack Meridian School of Medicine. “I am proud to join the PBHG Board during such a pivotal time for behavioral health,” said Dr. Cunningham. “PBHG’s commitment to accessible, patient-centered care aligns closely with my own values, and I look forward to helping advance innovative solutions that meet the needs of individuals and families across New Jersey.” Pamela A. Major, Board of Trustees Member A coach, author, vision strategist, and playwright, Pamela A. Major has dedicated her career to building community capacity and empowering individuals. While working within the Monmouth County Human Services Division, through the Behavioral Health Division, she founded the Monmouth County Stigma Free Coalition and led efforts to increase awareness of mental health, domestic violence, and sexual assault. Ms. Major is a trained ACE Interface speaker and the author of I Am a Diamond and The Comfort for the Body and Soul. She holds master’s degrees in teaching and in human services counseling/life coaching. “PBHG’s work is transformative, and I am grateful for the opportunity to contribute to an organization that uplifts, educates, and empowers,” said Major. “Together, I believe we can build stronger, more resilient communities and help individuals realize their full potential.” ABOUT PBHG Preferred Behavioral Health Group (PBHG) is at the forefront of behavioral healthcare in New Jersey, offering comprehensive services since 1978. Committed to fostering healing and hope, PBHG provides top-tier mental health, substance use, and prevention services with a focus on trauma-informed care and inclusivity. With a dedication to innovation and personalized care, PBHG empowers individuals, families, and communities to embrace well-being and attain optimal mental wellness. Explore PBHG’s transformative programs and services, grounded in trauma-informed care practices, at preferredbehavioral.org.