PANS and PANDAS are diagnoses that have been around for decades, supported by well-decorated scientists, researchers, and clinicians who have dedicated their careers to understanding it—teams at Stanford Medicine, Mass General, and researchers at Columbia University among them.

The idea that viruses, bacteria, and post-infectious inflammation can trigger neuropsychiatric symptoms is not new.

Rheumatic fever has long been known to cause chorea, mood changes, and OCD. PANS/PANDAS appears to function differently—not involving the heart the way rheumatic fever does, but still impacting the immune system and basal ganglia part of the brain.

Research on the immune system’s relation to the brain asks us to rethink foundational concepts of modern medicine and psychiatry, and that can be understandably challenging.

While we are beginning to understand this better, there is exciting research happening in real time to continue to develop biomarkers and medical treatments for these pediatric conditions.

These diagnoses that are incredibly complex for physicians to identify and manage, and the children who suffer from it are very ill. The resources are scattered, and families and medical providers alike are left scrambling as they try to piece together treatment. Locally and systemically, care is disjointed.

Here is what I believe: the stakes are simply too high to wait to address the needs of these families and children, and we need to act now with the resources that we do have to better support these families with the evidence-based recommendations that do exist in the medical field.

When there is a need but no safe landing place, we can’t sit back—we have to build what’s missing ourselves in this community.

Bridging the Gap for Families Navigating PANS/PANDAS

To address this need of acutely suffering children and families, I have expanded my practice to offer consulting services for PANS/PANDAS and a CE training for licensed psychologists and mental health professionals.

My goal is to serve as a credible, evidence-based resource in a landscape that has historically felt barren for families seeking assessment and guidance for OCD symptoms associated with PANS/PANDAS. I have extensively reviewed the scientific literature on this topic and work strictly within my scope as a licensed mental health counselor, rigorously trained through the International OCD Foundation’s world-renowned BTTI program. PANS/PANDAS is recognized by IOCDF as a subset of OCD caused by immune dysfunction.

A Note on Evidence-Based Care

I am a clinician who values both open-minded, creative thinking and firmly grounded in evidence-based practice.

One of the challenges in the PANS/PANDAS landscape is the presence of unlicensed providers or other professionals who operate outside their scope or recommend treatments that are unsafe or unsupported by research.

When working with children—and overwhelmed, worried parents—it is essential to stay measured. We must hold space for the possibility of complex medical or psychiatric causes without overpromising or endorsing interventions that have not been rigorously evaluated.

My goal is to serve as a steady, trustworthy guide in a landscape where families are often presented with confusing or concerning recommendations. I collaborate closely with physicians to support families as they make decisions with credible medical doctors that are guided by ethics; credible scientific research; and always weigh risks and benefits thoughtfully.

My commitment is to provide support that is responsible, ethical, and aligned with best-practice standards in today’s medicine.

Not every case will be PANS/PANDAS, and when it isn’t, I will support clients with appropriate, evidence-based care for OCD, anxiety, or other symptoms using established standards of mental health practice.

PANS/PANDAS Interdisciplinary Evaluation – Physician Referral (NYS Only)

Like many complex medical and mental health conditions, PANS/PANDAS is best understood through an interdisciplinary approach that includes both medical and mental health perspectives.

This consultation service is designed for pediatricians and other physicians who suspect PANS/PANDAS and are seeking a formal mental health evaluation to help differentiate between more traditional OCD presentations and OCD symptoms associated with PANS/PANDAS. This distinction is nuanced and requires a clinician familiar with the unique ways these conditions can present in children.

What the evaluation includes:

A 90-minute evaluation involving both the child and their caregivers

When warranted, administration of the CY-BOCS, the internationally recognized gold-standard assessment for OCD

A structured PANS/PANDAS-informed assessment guided by current research, clinical recommendations, and validated tools

A comprehensive review of the child’s psychological, social, developmental, and medical history

Following the evaluation:

A comprehensive written report is provided to the referring physician and other members of the care team

Recommendations for next steps and care coordination, as appropriate

Referrals to trusted colleagues for further evaluation (e.g., Autism or ADHD), when indicated

Connections to medical providers with experience in PANS/PANDAS, if additional medical evaluation is warranted

Important scope-of-practice note:

This assessment does not result in a formal PANS diagnosis. Mental health counselors do not diagnose PANS, as it is a clinical diagnosis of exclusion that requires medical rule-outs completed by a physician. This evaluation is intended to complement the medical assessment and help determine whether further medical intervention for PANS/PANDAS may be appropriate.

Referrals and fees:

Physicians or families may refer families directly by contacting therapy@barbshepardcounseling.com
Fee:
$450 for the diagnostic consultation and written report

Consulting for Therapists
& Clinical Teams

Clinical Consultation for Professionals

I offer clinical consultation for therapists, group practices, school-based mental health professionals, and multidisciplinary teams seeking guidance on complex cases.

This service is a good fit if you are working with a child who has suspected or confirmed PANS/PANDAS, want support with assessment, differential considerations, treatment planning, or school advocacy, or would benefit from ongoing consultation to support coordinated, evidence-informed care.

Consultation is also appropriate for clinicians looking to build confidence in evidence-based approaches for OCD, anxiety, and related symptoms within the context of PANS/PANDAS.

Educational Resources for Clinicians

All clinicians who book a consultation receive access to a set of practitioner resources I have developed to support evidence-based care.

These include a PANS/PANDAS Pediatric Assessment and Treatment Process flowchart for licensed mental health providers and a PANS/PANDAS Intake, Assessment, and Referral Guide for mental health clinicians.

These materials provide step-by-step guidance on symptom assessment and safety considerations, differential diagnosis and referral pathways, crisis planning and family support, evidence-based interventions for mental health symptoms associated with PANS, and school collaboration, advocacy, and documentation.

Fees
$200/hr for individual consultation (Zoom or in-person)
$300/hr for team training (Zoom or at agency)
$150 for 30 minute follow-ups

School Consultation

School Consultation Services

Schools are often the first to notice sudden or significant changes in a student’s behavior, academic functioning, or emotional regulation. My consultation services are designed to help school teams gain clarity, confidence, and practical strategies for supporting students with suspected or diagnosed PANS/PANDAS.

How PANS/PANDAS Can Present at School

PANS/PANDAS symptoms can affect students in a variety of ways within the school setting, including sudden deterioration in handwriting, regression in math skills, severe separation anxiety or OCD symptoms, behavioral outbursts, tics or sensory changes, and rapid-onset eating restrictions.

Consultation and IEP Support

I provide consultation to school teams via Zoom or by attending meetings, including support with IEP and 504 planning when symptoms are interfering with academic, social, or emotional functioning. My role is to help teams understand symptom-driven behavior and develop appropriate, compassionate supports.

Common Questions Addressed

School teams often seek guidance around distinguishing behavioral versus medical concerns, avoiding reinforcement of compulsive behaviors during the school day, determining what information is most helpful for the school nurse, supporting separation anxiety from caregivers, and identifying appropriate accommodations for students with PANS/PANDAS or OCD.

Types of Support Provided

Support may include recommendations for IEP classification under “Other Health Impairment,” assistance with drafting individualized accommodations and supports, and strategies for managing symptom variability and regression during flares.

Commitment to Collaborative Care

I am deeply committed to supporting children and families navigating the challenges of PANS/PANDAS. This work is both personal and meaningful to me. I believe that no family should face this alone, and that effective care requires collaboration among parents, educators, clinicians, and community partners. My goal is to equip teams with the knowledge and tools needed to help students succeed.

Fees
$ 200/hour

CE Opportunities for NYS Mental Health Clinicians

Continuing Education Training

I provide a continuing education training for New York State psychologists and other licensed mental health professionals through the Hudson Valley Professional Institute. This training is scheduled for February 2026.

Training Overview

This course is designed to help clinicians develop a clear, evidence-informed understanding of PANS/PANDAS and its presentation within pediatric mental health settings. Emphasis is placed on accurate assessment, differential diagnosis, ethical scope of practice, and collaboration across systems of care.

Learning Objectives

Participants will learn to define PANS and PANDAS, including historical context, key research findings, and recent clinical updates. The training reviews distinctions between PANS and PANDAS based on known triggers and helps clinicians differentiate between typical childhood OCD and OCD presentations associated with PANS/PANDAS. Clinicians will learn to identify hallmark symptoms and clinical red flags that warrant medical referral, and understand the role of infection within current biological models of PANS/PANDAS.

The course also covers evidence-based psychological interventions, including ERP, CBT and SPACE, and how these approaches can be applied to children with PANS/PANDAS presentations. Participants will learn how to integrate family systems strategies to reduce caregiver burden and improve child outcomes, collaborate effectively with physicians, schools, and advocacy organizations, and critically evaluate current limitations, controversies, and emerging directions in PANS/PANDAS research and clinical practice.

Register here with Hudson Valley Professional Institute

Community Engagement

On October 9, 2025, I organized Syracuse’s first-ever participation in World PANS/PANDAS Awareness Day, joining more than 220 landmarks across the globe. The National Grid building lit up in support of children and families affected by PANS/PANDAS, and our community showed up—educators, pediatric and mental health providers, parents, and children gathered together for a powerful moment of visibility, connection, and advocacy.

Standing in that space, hearing families share their stories of the devastating and isolating impact of PANS, it became clear just how urgent the need is in Central New York for informed providers willing to pick up the torch for these families. The relief people expressed at simply being seen solidified this: families cannot do this alone, and our systems have a long way to go in addressing these needs.

This is why I expanded my practice to include specialized PANS/PANDAS consulting services—to meet the community’s growing need for education and collaboration that extends beyond the walls of the therapy room. To learn more about symptoms of PANS/PANDAS, click here.

Ready to get started?

Whether you’re a parent seeking guidance, a therapist navigating a complex case, or a school aiming to better support students, I’m here to help. My coaching and consulting services are designed to provide clarity, resources, and practical strategies so families and professionals can confidently navigate PANS/PANDAS. As a parent who has personally navigated the complexities of the medical system for my own family, I deeply understand the challenges families face when trying to find appropriate care for their child. I operate with a heart-forward approach and am truly here to help in any way I can.

Reach out today to schedule a session or learn more: therapy@barbshepardcounseling.com.