Alexandra Bobb, PhD, Brings Integrated Behavioral Health Support to the Pediatric IBD Program

Alexandra Bobb, PhD, NCSP, clinical assistant professor of Pediatrics, is a pediatric psychologist in the Behavioral Science Division at UPMC Children’s Hospital of Pittsburgh. She joined the Division of Pediatric Gastroenterology, Hepatology and Nutrition in August 2025. Dr. Bobb’s focus is on supporting children and adolescents living with inflammatory bowel disease (IBD). Dr. Bobb splits her time between the Division’s Pediatric IBD Center and the Colorectal Center for Children at UPMC Children’s (part of the Pediatric Surgery Division), working in both inpatient and outpatient settings. Her position is part of the Division’s commitment to growth and expansion of the UPMC Children’s IBD Center and in expanding embedded behavioral health care for children and families managing complex gastrointestinal conditions.

Dr. Bobb earned her undergraduate and graduate degrees, including her Doctor of Philosophy in Psychology from Texas Woman’s University. She came to Pittsburgh to complete her doctoral internship at UPMC Children’s working with the heart/lung, liver, kidney, and small intestine transplant programs, followed by a postdoctoral fellowship with the same programs and was subsequently offered a faculty position upon completion of her training. Originally from Texas, Dr. Bobb relocated with her two children and found the Pittsburgh region and UPMC Children’s to be a personal and professional fit.

“This work, this team, and this city have changed everything for us,” says Dr. Bobb. “The values here match mine, and the families I work with are incredible. I’m here for the long haul.”

Her current role was developed in coordination with Jeffrey Rudolph, MD, chief of the Division of Gastroenterology, Hepatology and Nutrition, and Whitney Sunseri, MD, director of the IBD Center, who identified behavioral health support as a strategic priority area for the IBD Center.

Dr. Bobb’s role was made possible thanks in part to seed funding provided by donors to UPMC Children’s Hospital Foundation. Through This Moment: Put a Child’s Future First, a comprehensive, five-year fundraising campaign, the Foundation is partnering with UPMC Children’s and generous community members to expand access to vital behavioral health services for children and adolescents across the region.

“There is a tremendous need for behavioral health care in the pediatric IBD setting, but also for all people living with chronic illness.” Dr. Bobb says. “Even if I can only be in clinic or at the bedside with a fraction of the patients, I want to make sure everyone in the Division is equipped to support our children and families who are living with IBD.”

Clinical Integration and Goals of Care

Dr. Bobb’s work in the IBD Center is structured to support patients across the entire care continuum, with an emphasis on early diagnosis, family adjustment, educational access, and long-term mental health. Many of her encounters begin with newly diagnosed patients, but she also is consulted in established care relationships when families or provider colleagues identify emotional or functional concerns.

In these types of early interactions, the goals are to help families come to terms with a new diagnosis and adapt to the realities of living with a chronic illness.

“A lot of these patients are going through medical tests and don’t really know why they’re in so much pain, why they can’t eat, why they are not going to school. Their whole world gets flipped upside down, sometimes overnight,” Dr. Bobb says. “My role early on is to help them begin to cope with the fact that they now have a chronic illness. It’s a lot to deal with for anyone and perhaps more so for children.”

As a nationally certified school psychologist, Dr. Bobb brings expertise in helping families navigate educational accommodations, such as 504 plans and individualized education programs (IEPs). A 504 plan provides classroom and testing accommodations under federal disability law, while an IEP outlines special education services for students with more significant learning or functional needs. Many of the families facing a new IBD diagnosis have never previously interacted with these kinds of systems, but they are central to preserving identity, development, and social connection.

“I want our kids back in school doing the things they care about and should be doing as children,” Dr. Bobb says. “They need normalcy, peer support, structure, and the ability to build a life outside of their diagnosis.”

Behavioral Health Risks and Mental Health Screening

Children and adolescents living with IBD face well-documented psychosocial risks. Pain, fatigue, symptom unpredictability, dietary restrictions, medication effects, and immune modulation all may contribute to the development of anxiety and depression, especially in adolescence. The developmental complexity of this age group can make it difficult to differentiate behavioral symptoms from underlying medical distress.

“What I hear from many kids is, ‘This is just my life. I’ve always felt like this,’” Dr. Bobb says. “But when we start talking more, it becomes clear that many are carrying anxiety, fear, and exhaustion with them all the time. They have adapted to this mode of existence, but that does not mean it is sustainable or conducive to long-term mental health.”

In addition to mood symptoms, patients with IBD can be affected by body image concerns, trauma associated with repeated procedures, and social withdrawal, which is commonly observed during the first year after diagnosis. Dr. Bobb collaborates with the Division’s Child Life team to improve procedural preparation and normalize emotional reactions to care. She also works closely with families to evaluate functional impact over time and determine whether additional interventions, such as psychiatric consultation or community therapy may offer help.

“I don’t want to wait until a child is failing out of school or self-isolating in their room before we try to intervene,” Dr. Bobb says. “We need to be thinking about function, risk, and regulation early on, so we have the knowledge and data to act before a crisis occurs or patterns form into habits.”

Supporting the Transition to Adult IBD Care

In partnership with Whitney Gray, CRNP, who leads the IBD Center’s care transition efforts, Dr. Bobb provides mental health and developmental support to adolescents preparing for the eventual transfer to adult care. This work typically begins in early adolescence and continues through the latter teenage years. In this work, there is an emphasis on care and medication adherence, medical literacy, and self-advocacy.

“Adolescents are natural risk-takers, and with a chronic illness, that can mean skipping medications or ignoring symptoms,” Dr. Bobb says. “We want to teach what is at stake and build healthy habits while our patients are young. Establishing good habits early makes it a lot easier down the road when you’re an adult and taking care of yourself.”

In parallel, Dr. Bobb also works with parents and caregivers to help them let go of full medical responsibility for their child while still maintaining a trusted and supportive role. For families who have managed a child’s IBD for years, this shift can be difficult and emotional.

“You have kept your child healthy, and now we are asking you to give up control,” Dr. Bobb says. “My job is to help everyone gain confidence in the process, so kids grow into independence and parents see that it’s working.”

Expanding Access, Continuity, and Peer Support

In addition to her clinical patient care responsibilities, Dr. Bobb is interested in developing systems to improve behavioral health continuity across the IBD Center’s inpatient and outpatient services. When patients are diagnosed in the hospital, the goal is to provide early contact and a structured follow-up plan. Part of this is working to create more formal care workflows to ensure that transitions in attending coverage or clinic scheduling do not disrupt psychological care.

“We’re a large hospital and a large IBD program, and care can feel fragmented sometimes when patients are moving between inpatient and outpatient settings or between different providers,” Dr. Bobb says. “Behavioral health can help create a sense of continuity, because I can be a consistent point of contact across those transitions.”

One of her long-term goals for the IBD Center is the development of structured peer and family support groups. The idea builds on her past experience working in the pediatric transplant program at UPMC Children’s, where camp-style gatherings and social activities created space for patients to connect with others living with similar conditions. There is the same opportunity in IBD care for building community and reducing isolation.

“I cannot tell a child what it is like to go to school with a colostomy bag – what that experience feels like,” Dr. Bobb says. “But another kid can. We want to create those relationships, both in person and virtually, so geography, income, or school schedules are not barriers.”

A Social Scientist’s Perspective on Regulation and Resilience

Although her current role is clinically focused on patients with GI conditions, Dr. Bobb’s work is grounded in social science. Her early training focused on gendered language, praise and punishment, and the ways in which parental behavior shapes identity formation in children.

Her doctoral dissertation explored attachment and self-regulation in the context of technology use, examining how parental distraction affects children’s behavioral development and emotional resilience. That foundation continues to inform how she approaches patients and families managing chronic illness.

“I’ve always seen myself as a social scientist,” Dr. Bobb says. “I notice a pattern, something that’s not working, and I want to understand why. Then I want to figure out how to fix it.”

This perspective shapes the long-term vision Dr. Bobb has for pediatric behavioral health in the IBD and Colorectal Centers. The goal is to position both programs as hubs for studying medical coping and emotional regulation in children and adolescents living with gastrointestinal disease, not just to treat behavior health issues and psychological distress as it emerges, but to more fully understand how early regulatory skills influence long-term health outcomes — and to create systems of care that help patients and their families lean and develop those skills at the beginning of their journey living with IBD.

“What determines whether anxiety derails your life or whether you’re able to keep going has a lot to do with how you regulate in the face of distress,” Dr. Bobb says. “We all experience fear and pain, and the uncertainty that comes from living one’s life in the circumstances that exist. The difference is whether you’ve been taught how to sit with it, move through it, understand it, and keep functioning.”

As her work progresses at UPMC Children’s, Dr. Bobb has plans to explore how self-regulation and coping strategies can be taught more explicitly in pediatric subspecialty care, and how early interventions might shape developmental trajectories in children facing long-term illness.

“I love the clinical work. I love talking with families. But I also want to step back and study what is working and how to make it better,” Dr. Bobb says.

Learn more about the IBD Center at UPMC Children’s Hospital of Pittsburgh.