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)

This session is generally 90 minutes for the initial consultation, with the potential for periodic follow-up as needed. It may be a good fit if:

Your child has multiple diagnoses (such as ADHD, OCD, or autism) and PANS is suspected, and your team is seeking support in navigating the nuance of potential co-occurring conditions—specifically what may be related to PANS and what may reflect other underlying diagnoses.

You or your providers suspect PANS/PANDAS, but your current team is not experienced in treating it and you would like an expert lens to consult.

You already have a therapist, but want to add a PANS/PANDAS specialist to your team to consult with the therapist, family, school, and others involved in your child’s care.

Your child has a confirmed diagnosis of PANS from a medical professional, but you need guidance on addressing the mental health symptoms.

Evaluation methods include: a structured PANS/PANDAS-informed assessment guided by current research, clinical recommendations, and validated tools (such as the CY-BOCS for OCD and PANS-31); a comprehensive review of the child’s psychological, social, developmental, and medical history to screen for and assess co-occurring conditions or differential diagnoses; and a review of any records from other evaluators.

Following the evaluation: A comprehensive written report is provided to the referring physician and other members of the care team, which includes recommendations for next steps and care coordination. I also provide links to research-based interventions tailored to your child, guided by current evidence and consensus guidelines from experts in the field. When warranted, I provide referrals to trusted colleagues for further evaluation and treatment, including PANS/PANDAS medical care and/or additional psychological assessment as needed.

Important Scope of Practice Note: This assessment does not result in a formal PANS diagnosis, but it provides a very valuable piece of the puzzle from an experienced clinician on the mental health side of treatment. This evaluation is intended to complement the medical assessment and help determine whether further medical intervention for PANS/PANDAS may be appropriate. I have provided such evaluations to many families who have found this to be a critical first step in getting organized and on the right track for their child’s journey to recovery.

Referrals and Fees:

Physicians may refer families directly by contacting therapy@barbshepardcounseling.com or direct families straight to my instant booking link here.

Fee for diagnostic consultation only (one-time session):
$475 for the diagnostic consultation and written report (includes copy of 60+ page PDF Parent Guide to PANS/PANDAS)

*Please note that I am on Out-of-Network Provider and do not directly accept insurance. It is possible that your insurance company may reimburse some or all of your session if you child attends session with you. Please contact your insurance company ahead of time to ask about their reimbursement rate for your insurance plan.*

Fees for parents/child seeking ongoing care:
$475 initial session (includes diagnostic consultation, written report, and copy of PDF Parent Guide)
$200 per subsequent session

A note on cost of this session: I take your financial and time investment seriously. My rate for this assessment reflects not only the time spent in session and the additional time required to complete a comprehensive written report, but also the coordination involved in communicating findings to your referral sources and care team. It also reflects my ongoing investment in continuing education and engagement within the global PANS/PANDAS community, including participation in the IOCDF Special Interest Group, organizing annual PANS/PANDAS Awareness Day in Syracuse, developing free educational resources for clinicians and families through Instagram and my website, and supporting legislative efforts to help New York State join other states in mandating insurance coverage for PANS/PANDAS care. I understand that this may represent a significant financial commitment.

Clinical Teams & School Consultation

I provide consultation in agency settings for therapists; school-based programs; and multidisciplinary teams working with complex cases, including children with suspected or confirmed PANS/PANDAS.

School Support & Educational Consultation

I provide direct consultation to school teams via Zoom or in-person, including participation in IEP and 504 planning meetings when appropriate. This work is grounded in an understanding of the fluctuating, immune-mediated nature of symptoms and how this impacts functioning across settings. This differs from non-PANS psychiatric presentations, as PANS-related symptoms are driven by immune dysfunction and are often relapsing and remitting in course, rather than reflecting a stable or continuously present baseline.

Support may include:

Guidance for developing 504 or IEP accommodations related to neuroimmune-driven symptoms such as anxiety, OCD, sensory processing challenges, and ARFID-related school avoidance or nutritional concerns

Recommendations for academic and behavioral supports that account for symptom variability, particularly during acute flares

De-escalation strategies and crisis-response planning for use in the classroom or school setting

Education for teachers and school staff on PANS/PANDAS, including how symptoms may present behaviorally and emotionally in the school environment

Support in creating flexible, trauma-informed, and neurodevelopmentally sensitive classroom adaptations that reduce distress and promote access to learning

The goal is to help school teams better understand symptom-driven behavior, reduce misinterpretation of symptoms as purely behavioral or oppositional, and create environments that support regulation, safety, and learning—especially during periods of symptom exacerbation.

Community Mental Health Settings or Individual Therapist Consultation

I offer Zoom or in-person consultation meetings. Consultations can be tailored to the needs of your group. All consultations include practitioner-facing tools and resources, including a review of the PANS/PANDAS Assessment & Treatment Flowchart and an Intake & Referral Guide.

Fees:

$200/hr individual consultation (Zoom or in-person)

$400/hr team training (Zoom or in-person)

$150/30-minute follow-ups

On-Demand Webinar

Understanding PANS/PANDAS: A Research-Informed Clinical Overview

For those looking for a deeper dive than the PDF guide above, this 1 hour 50 minute on-demand webinar provides a comprehensive, research-informed overview of PANS/PANDAS through the lens of a Licensed Mental Health Counselor (LMHC). PANS/PANDAS are diagnoses that sit at the intersection of medical care and psychological care. This webinar focuses on understanding the literature and clinical consensus guidelines on the treatment of these diagnoses.

What We Cover:

History and evolution of PANS/PANDAS as diagnoses

Diagnostic symptoms and differential diagnosis (PANS OCD vs. non-PANS OCD)

In-depth overview of biology, immune dysfunction, and neuroinflammation

Review of medical and behavioral health literature and clinical consensus recommendations

School accommodations and classroom support

Caregiver burden and family impact

Current and ongoing research, including biomarker studies

Mental health professionals, physicians, school staff, occupational therapists, parents, caregivers, or anyone else seeking a foundational understanding of PANS/PANDAS will benefit from this training.

Includes: 119-slide PDF and on-demand access to Webinar via Zoom platform.
Cost: $99 — watch at your own pace.

FREE Resources for Therapists

I have developed a series of PDF guides designed to support licensed mental health clinicians in navigating assessment, diagnostic considerations, and referral pathways related to PANS/PANDAS. These resources are intended to bridge gaps in clinical training by offering practical, structured tools that can be integrated into everyday practice.

The first guide, PANS/PANDAS Intake, Assessment, and Referral Process for Licensed Mental Health Clinicians, provides an expanded framework for the biopsychosocial assessment. It helps clinicians screen for possible PANS/PANDAS presentations, recognize red flags, and determine appropriate next steps in treatment planning and referral.

This guide is complemented by a concise decision-tree style mental health flowchart that visually summarizes the intake and assessment process. The flowchart is designed to support clinical decision-making by clearly outlining pathways based on presenting symptoms, assessment findings, and levels of concern.

These materials are intended to be living documents. They will be continually updated as new research and clinical guidance emerge within the mental health and medical fields. I welcome collaboration with other clinicians engaged in this work, as collective knowledge and shared expertise strengthen the quality of care. These guides represent a good-faith effort to synthesize a large and complex body of information into a practical, user-friendly format that clinicians can readily apply in their work.

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.