Ch 13: Intervention: Children and Adolescents Flashcards
(38 cards)
1
Q
Who is the client in psychological services for children and adolescents?
A
- rarely refer themselves and there is poor agreement between parents and youth about therapy goals
- parents serve as gatekeepers to enable or disable services
2
Q
How many adolescents requiring services receive them?
A
- only 1/3
3
Q
What do alliances predict?
A
- parent-therapist alliance predicts child/youth participation in therapy
- youth-therapist alliance predicts symptom improvement
4
Q
What are the legal issues around consent in BC?
A
- youth is capable of consent at 12 years old
- only one parent needs to consent (divorced or separated)
- legal consent is necessary but not sufficient because the youth has to agree to participate
5
Q
What is typical of risk factors for youth?
A
- often don’t have control over these conditions
- treatment must still address these contexts
6
Q
What did Levitt find about child psychotherapy?
A
- found no evidence for the efficacy of child psychotherapy
7
Q
What are the four large scale meta analyses in the 80s and 90s?
A
- Casey and Berman found effect sizes comparable to Smith and Glass
- Weisz found d=.79 (larger for behavioural approaches)
- Kazdin found large effect sizes and that studies often used volunteer school treatment groups (recommended a research focus on characteristics that influence outcome)
- Weisz used weighted least squares to calculate d=.54 (studies with more error variance assigned less weight)
8
Q
What is publication bias?
A
- unpublished dissertations were stronger methodologically but obtained lower effect sizes than published studies
- more evident in child studies rather then adult studies
9
Q
What are well-established treatments?
A
- well-established treatments produce effects superior to a placebo or another treatment in at least 2 different/independent trials meeting strict methodological criteria
10
Q
What are probably-efficacious treatments?
A
- these meet the same criteria but evidence does not come from different/independent researchers
11
Q
What did Huey and Polo find?
A
- a number of treatments are probably efficacious for minority youth
12
Q
What does exhibit 13.1 in the textbook tell us?
A
- most treatments are behavioural, cognitive-behavioural and interpersonal
- many involve parents learning strategies to respond to children’s behaviours
- parental psychopathology may make it difficult for parents to engage in and complete services for children
13
Q
What are disruptive behaviour disorders?
A
- disruptive behaviour is the most common reason for child referrals
- ODD -> CD: oppositional defiant disorder often leads to conduct disorder
14
Q
What are effective treatments for disruptive behaviour disorders?
A
- parenting programs
- multisystematic therapy (MST)
15
Q
What is an evidence-based treatment for adolescent depression?
A
- coping with depression in adolescence (CBT)
16
Q
What are coercive exchanges?
A
- parents unintentionally reward the child for whining or aggression, child rewards the parents for giving in to his or her complaints
17
Q
What are five parenting practices?
A
- skill encouragement
- discipline
- parental monitoring
- problem-solving
- positive involvement
18
Q
What is multisystemic therapy (MST) for?
A
- designed to trat serious delinquency in adolescents by intervening in an integrated way in the multiple systems in which they are involved
19
Q
What theories does MST come from?
A
- grounded in ecological theory and behavioural approach
- behaviour is multiply determined
20
Q
How does MST work?
A
- caregiver plays a key role in youth’s short and long-term adjustment
- MST therapists work in teams of 2-5 with small caseloads and are available 24/7
21
Q
What do the MST therapists do?
A
- faciliate collaboration between school and family
- target any caregiver barriers to parenting capacity
- services offered in homes, schools and neighbourhoods
- emphasis on developing supportive network for family
22
Q
Do EBTs work?
A
- standard community care for child and adolescent disorders are less effective than evidence-based psychotherapy
- better outcome than 60% of youth receiving usual care
23
Q
What did a review by Lee, Harvath and Hunsley find?
A
- > 75% of clients followed the course of services to completion with strong improvement rates for internalizing problems an greater variability in outcomes for parenting interventions to treat disruptive behaviours
24
Q
What is the use of treatment manuals associated with?
A
- early alliance
- use of treatment manuals does not undermine therapeutic alliance
25
What are modular treatment options?
- modular approach allows for tailoring of services to meet the needs of youth for whom there is no single evidence-based program
26
What did Chorpita and Daleiden do in relation to modular treatment options?
- reviewed 322 randomized controlled trials of treatments for youth
- identified clusters of treatment strategies shown to be efficacious
- advocated for individualizing treatments by selecting and integrating treatment modules that correspond to client's presenting problems
27
What did Weisz do in relation to modular treatment?
- developed modular treatment options for depression, anxiety and conduct problems in children aged 7 to 13
- modular treatment outperformed treatment as usual and specific EBTs
28
What is RAD?
- reducing anxiety and depression
- weekly (12 sessions) or bootcamp (5-6 sessions)
- 8-10 adolecents age 13-18
- recruited from waitlist or offered group as supplement to individual treatment
- manualized CBT
29
Why does RAD have multiple facilitators?
- in case a participant gets triggered and needs to leave
30
What measures are used in RAD?
- screen for child anxiety related disorders (SCARED)
| - patient health questionnaire (PHQ-9)
31
What are the core skills developed in RAD?
- behavioural activation
- exposure (principle of desensitization)
- identifying and challenging unhelpful thoughts
- improving communication and conflict resolution
- stress coping
- social connection among group members
32
What is Child-parent relationship therapy?
- based on play therapy work of Gary Landreth
- 10 week manualized parenting course
- teaches parents how to use play therapy skills to help young children experiencing social, emotional or behavioural problems
33
What is CPRT also called?
- filial play therapy
34
How many people are there per group for CPRT?
- 2-3 facilitators and 6-8 parents
35
What are the pre-screening measures for CPRT?
- interview
- parental acceptance scale
- measurement of empathy in adult-child interaction (MEACI)
36
What are the learning goals for CPRT?
- regain control as a parent
- help child develop self-control
- effectively discipline and limit inappropriate behaviour
- understand child's emotional needs
- communicate more effectively with child
37
Why play therapy?
- helps children communicate their inner experiences
- nonpathologizing approach based on the belief that children have the internal drive to achieve
- based on respect for child and confidence in their ability to direct their own process
- work through deeper emotional fears, wounds and experiences
- range of toys: real-life, acting-out aggression and creative/expressive
38
What are the core skills from CPRT?
- positive involvement with child
- improved communication with child
- encouragement of skill and confidence development in child
- limit setting and discipline
