The practice of pediatric behavioral healthcare has become more recognized both within your child’s primary medical home (your pediatrician) and among parents who are more aware of signs and symptoms. Ensuring a child is emotionally well is now a routine part of the pediatrician’s physical exam. At COPA, we screen all children age 12 & up at their annual well-exam for any concerns related to behavioral health.

Sondra Marshall, PHD is a licensed psychologist practicing at Central Oregon Pediatric Associates (COPA) and says that most visits to the pediatrician’s office outside of annual well exams are for behavioral health concerns. She’s currently leading a team of behavioral health specialists at COPA with plans to add a licensed clinical social worker for each COPA location this year.

COPA embraces an integrated approach to physical and mental health by embedding psychologists, like Dr. Marshall, who work in the clinic. A patient can get an immediate referral by their COPA doctor to see a psychologist, who in turn can collaborate with the doctor on a solution that’s best for the child.

“I’m here to serve our families by listening to what I call their ‘step concerns’, or behavioral or mental health challenges”, says Dr. Marshall. “After better understanding the situation I can bring in the appropriate physicians, either physical or mental, or I can counsel the family directly.”

According to Dr. Marshal, those ‘step concerns’ are things like problems with sleeping or eating, temper tantrums, stomach aches, potty training or bed wetting. The specialists on her team also help parents manage difficult emotional behaviors such as extreme defiance, stress, anxiety, and depression.

Behavioral health specialists can recognize symptoms that may be associated with bi-polar, schizophrenia, and autism spectrum disorder. Screening assessments are completed right in the primary care environment, followed by a plan for treatment or collaboration with other physicians.

Parents can also get support when helping children adhere to treatments for chronic health issues such as diabetes and obesity. The goal is to keep the child out of the emergency room and on a maintenance program that manages the illness.


Due to the greater demand for services in this region, Dr. Brian Rogers, Developmental Pediatrician from OHSU in Portland, is relocating to Bend and will start seeing patients in the COPA clinic for serious medical issues that lead to complex neurodevelopmental disorders. He spends comprehensive time with the child and recommends interventions, monitors and tracks progress, and potentially involves multiple physicians and specialists.

It’s important to keep families at home, according to Dr. Rogers, and his commitment to practicing in Bend eliminates the need for patients to travel over the mountain to Portland.

Dr. Marshall believes the expanded behavioral health team working inside the COPA alleviates parents waiting months for a referral to other medical facilities in the region. Ultimately, the progressive model of integrating pediatricians at COPA with behavioral health specialists offers better access to care at reduced costs.

“Parents know their kids best”, says Dr. Marshall, “so when a parent mentions a real concern, we know we need to listen.”


Sondra Marshall, PHD

Rebecca Scrafford, Psy.D

Mark Goodman, LCSW

Brian Rogers, MD

If you’re concerned about your child’s mental wellbeing, talk to their physician. If you worry about their immediate safety call 911 or national suicide hotline at 1-800-273-8255.

To make an appointment with a pediatrician at COPA or with the Behavioral Health Team at COPA, call 541-389-6313.