Filling a NICH

Michael Harris, Ph.D.

There is an exciting new program at OHSU Doernbecher Children’s Hospital for children and adolescents with complex medical conditions who struggle to properly manage their health and are repeatedly hospitalized.

In collaboration with CareOregon and other insurance providers, we have developed NICH, or Novel Interventions in Children’s Healthcare, to provide intensive behavioral health care for young people living with diabetes, cancer, cystic fibrosis, kidney disease and chronic pain.

Patients and families connect with our team over the phone, via telehealth technology, during clinic visits and through in-person home visits, thus preventing unnecessary hospitalizations, reducing overall costs and ensuring better disease management.

Through care coordination, case management and family-based problem-solving therapy, NICH provides a number of benefits, including help in returning to school and assistance in finding more supportive living arrangements.

Kim Spiro, Ph.D.

One NICH success story involves a young teenager who had been hospitalized nine times in eight months for poorly controlled Type 1 diabetes. Since this teen enrolled in NICH, he has successfully stayed out of the hospital, regularly checks his blood sugars, returned to school after missing six months, and now lives with a relative who provides more structure and oversight.

All of these measures result in better diabetes care.

NICH is grounded in an intensive behavioral health model known as Behavioral Family Systems Therapy (BFST) — skills-based intervention focused on family-based problems associated with properly managing a complex medical condition — and our NICH staff are uniquely trained to deliver this innovative program.

Matthew Heywood, M.P.H.

As both a clinician and a researcher, I have 25 years experience with BFST. Kim Spiro, Ph.D., NICH coordinator, previously worked for the Oregon Social Learning Center, where she oversaw a nationally and internationally recognized intensive home-based intervention for adjudicated youth in the foster care system. Our interventionist, Matthew Heywood, M.P.H, also comes from the Oregon Social Learning Center, where he was an interventionist working under the direction of Spiro.

We believe the coordination of care between the family and the health care team is important to provide patients and their families with enhanced coping skills. For more information about NICH, contact Kim Spiro at

Michael A. Harris, Ph.D.
Chief, Division of Pediatric Psychology
Associate Professor of Pediatrics
OHSU Doernbecher Children’s Hospital, Child Development and Rehabilitation Center