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PSYC3018 Abnormal Psychology > Child: Treatment > Flashcards

Flashcards in Child: Treatment Deck (19)
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What are the principles for effective treatment of conduct disorders?

1. Target the ecology of the child - the context in which they are developing (change the parents/environment)
2. Take a developmental perspective - sensitive to the age and development of the child
3. Be formulation/hypothesis-drive - if I change this, what will happen?
4. Form a strong therapeutic team - make a connection


Ecology of the child

Less likely to produce lasting chages


Developmentaly minded

Problems begins very early
> core treatment early is the parent
> core treatment later is the parent and the child
> most powerful in the early childhood parenting changes


When is the most optimal period for intervention?

Early childhood interventions


Parent training interventions

> Started in the 70's and 80's
> core theory is based of coercive family process


What are the problems we need to treat

> Parents pay less and less time with the child and gives them less attention
> The time spent with the child is no longer positive involvement
> Amount of time and emotion when the child is misbehaving is going up and up
> Change the pattern of differential attention


What does parent training aim to do?

1. Increasing the TIME and ATTENTION spent with the child when they are behaving nicely
2. Developing discipline strategies to REDUCE the amount of EMOTIONAL ENGAGEMENT when the child is MISBEHAVING

Reverse the coercive cycle - positive behaviour is ignored and negative behaviour is rewarded with time and attention.


What are procedures to encourage positive behaviour?

What would you like your child to do more of?
> play nicely
> speak in a nice voice
> play independently
Parent now goes home and tries to catch the child performing these 'positive behaviours'
> reward them with your time - "Sam, I just saw you do something I asked you to do, I am now yours for 10 minutes. Let's go!"


What type of reward schedule should be used to be the most powerful?

> Intermittent, unpredictable, varying rewards - don't use behaviour charts!
> Based on love and attachment, not just descriptors and artificial rewards


What is effective discipline? How to you go about getting it?

Develop a set routine:
> Child misbehaves; get the child attention in a simple way; don't keep responding and escalate the situation.
> If the child does not comply (and tries to escalate), go into calm predictable consequence eg time out (age sweet spot 2-8) or a logical consequence
> If the child complies, go straight back into attention rich engagement


What are the main points of effective Time Out

> Make it fast, emotionless - don't escolate the coercion model
> For time out to work, time in must be FUN, LOVING and full of PRAISE etc - make a differential contrast.


Effective treatment for adolescents?

> Need to know where they are
> Have to engage the adolescent
> Need to consider hormones and individualisation - rewarding and engaging with a teenager is difficult


Hierarchical structure

> Parents 'executive' parental system

> Parents no longer work together and the child


How does (Harlow's) attachment theory help develop treatment for conduct disorders?

> Attachment theory states that we are driven to form a bond with caregiver: touching, feeding, eye contact etc
> Use these attachment processes as rewards for positive behaviour instead of descriptive praise and star charts etc


What is the success rate of parent training?



What are predictors of poor outcomes with parent training?

> severe parental psychopathology (depression, anxiety etc) (very high)
> marital (low predictable)
> low SES (medium predictable)
> poor response and engagement with program


What are the different treatment outcomes with cold (high callous-unemotional traits) and hot (low callous-unemotional traits) kids?

> Both types improve
> Cold kids are less responsive to parenting interventions


Why might cold (high callous-unemotional traits) kids be less responsive to parenting interventions?

> The genetic loading is much higher and the environmental loading is much lower.
> They are much less emotionally responsive - eg time out didn't phase them as much: "Yeah, I'll do the time. I'll be back."


Play therapy (just treating the kids out of context) has no evidence for externailsing disorders. Does it have any evidence for other disorders?

> No effect with anxiety or depression
> Minor evidence for kids with trauma
> Can only work if changing some terrible beliefs. Then it ends up acting more like CBT - only works when the child has metacognition, which begins at age 8 and above