Week 1 - Child psychopathology Flashcards
1
Q
What are the expectations of mandatory reporters for children?
A
- a mandatory reported in NSW is an individual required under Section 27 of the Children and Young Person Act 1988 to report to the Child Protection Helpline when he/she has reasonable grounds to suspect that a child, or a class of children is at risk of significant harm from abuse or neglect, and those grounds arise during the course of or from the person’s work.
2
Q
What are some general therapy adaptations for children?
A
- multiple parties in therapy (parents should ALWAYS be involved; less but still involved in adolescents)
- parents sometimes need to discuss their own mental health (if needed, refer on)
- need to have a good working relationship with all members (parents and child)
3
Q
What are some ways to manage multiple parties in the room?
A
- time
- agenda
- respect for all
- managing conflict/arguments
- if anything, side with the adolescent/child a little (they need to see you as their advocate)
- not having parents talk about little children with them in the room
4
Q
What are considerations in order to help working with children?
A
- play therapy games
- rewards to manage behaviour in the therapy session
- interactive - not just sitting and talking or going through activity sheets
- simplified language
- simplified forms or resources
- relaxed environment (e.g. sitting on the floor, kneeling at a coffee table)
- writing skills may be poor ( or non-existent)
- short concentration span
- siblings may be present a sessions
5
Q
What is the best way to encourage role play with families?
A
- parents role play new skills
- child role play new skills
- families role play new skills
6
Q
What is the purpose of role-playing new skills?
A
- allows client to build and practice skills taught
- identify positive skills
- therapist MODELS appropriate behaviour
- increases MOTIVATION and SUCCESS
7
Q
What is the parent role in adolescent treatment?
A
- adolescents primarily need a cheer squad
- assistance with brainstorming
- motivation through incentives
- facilitation of opportunities to practice skills
8
Q
How do we enhance parent-teen communication?
A
- teaching each party to listen and express empathy
- improving self-focused expression
- showing how to respect and accept while maintaining own beliefs/ parents responsibilities
- teaching parents to provide honest, constructive, specific & focused feedback (and encouraging strength recognition)
9
Q
What are the main behavioural principles related to learning?
A
- positive reinforcement (give something): a behaviour is followed by something that is rewarding (e.g. food, sticker, praise, attention)
- negative reinforcement (take something): a behaviour is followed by the removal of something (e.g. loud noise, attention)
- positive punishment (give something): a behaviour is followed by a negative consequence (e.g. 5 pushups)
- negative punishment (take something away): a behaviour is followed by the removal of something positive (e.g. taking away a toy, timeout)
- extinction: a behaviour is no longer with either positive or negative behaviour
10
Q
What are clinical implications for attention manipulation?
A
- providing attention to a particular behaviour increases it: true for negative and positive child behaviours
- need to increase parental involvement to get them to: positively reinforce good child behaviour (praise, attention, affection)
- need to increase parental involvement to get them to: negatively reinforce bad child behaviour (tantrums, whinging, attempts to gain attention by being naughty, minor injuries/pain)
11
Q
What are some factors that affect the effectiveness of conditioning?
A
- SATIATION/DEPRIVATION: the effectiveness of a positive stimulus is reduced if the individual has enough (e.g. toys, food)
- IMMEDIACY: needs to be an immediate consequence for it to be effective e.g. don’t give them a reward 5 minutes later
- CONSISTENCY: reinforcement should occur after response, and not at all at other times. Learning is slower if reinforcement is intermittent. BUT responses reinforced intermittently are slow to extinguish
- SIZE: the size of the reward has to be appropriate. Too small a reward is ineffective.
12
Q
How do we create extinction?
A
- to extinguish, the behaviour must NEVER be rewarded again - or punishment MUST always be given
- intermittent rewards or punishment maintain behaviour
- temporary escalation of the problem behaviour as the normal desired response is not working - this will always happen when a behavioural intervention is first started. It is very important to expect this, and to warn parents that this is going to happen.
13
Q
What are the clinical implications of behavioural principles?
A
- punishment or reward must be CONSISTENT
- the attention and praise must be CONSISTENT and not over the top to reduce extinction (SIZE)
- the punishment or reward must be IMMEDIATE
- number of rewards must be given to a child to comply
- no empty threats
14
Q
What are the clinical implications of rewarding children?
A
size of the reward:
- small rewards for small behaviours
- work up towards larger rewardsd
- rewards must be salient to the child (get the child to pick the rewards– over the top praise is not reinforcing)
- time with parents (positive attention) and praise ate the best rewards
- rewards can be creative – lunch orders, favourite dinners, hire dvds, extra computer time)
- eventually work towards behaviour occurring without reward
15
Q
What are the clinical implications of punishing children?
A
size and duration of the consequence:
- small, short consequence for small misdemeanours
- consequence must be important to the child
- removal of attention
- removal toy or object causing behaviour
- removal of child’s prized thing e.g. computer time, dessert
