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94 Cards in this Set
- Front
- Back
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The Decision-Making Process |
Begins with clinical assessment- systematic problem solving strategies to understand children with disturbances and their family and school environments -flexible ongoing hypothesis testing assesses: child’s emotional, behavioural and cognitive functioning; the role of environmental factors; nature, causes and likely outcomes of the problem |
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Idiographic Case Formulation |
Assessments focus on obtaining detailed understanding of the child or family as a unique entity |
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Nomothetic Formulation |
Emphasizes general inferences that apply to large groups of individuals |
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Developmental Considerations |
Cultural information is necessary to: -establish relationship with child and family -motivate family members to change -obtain valid information -arrive at accurate diagnosis -develop meaningful treatment recommendations |
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Developmental Considerations: Culture |
Culture-bound syndromes -recurrent patterns of maladaptive behaviours and/or troubling experiences associated with different cultures or localities -what is considered abnormal may vary between cultures |
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Developmental Considerations: Gender Patterns (Male) |
ADHD Childhood conduct disorder Intellectual disability Autism spectrum disorder Language disorder Specific learning disorder Enuresis |
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Developmental Considerations: Gender Patterns (Male) |
ADHD Childhood conduct disorder Intellectual disability Autism spectrum disorder Language disorder Specific learning disorder Enuresis |
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Developmental Considerations: Gender Patterns (female) |
Anxiety disorder Adolescent depression Eating disorders Sexual abuse |
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Developmental Considerations: Gender Patterns (Male) |
ADHD Childhood conduct disorder Intellectual disability Autism spectrum disorder Language disorder Specific learning disorder Enuresis |
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Developmental Considerations: Gender Patterns (female) |
Anxiety disorder Adolescent depression Eating disorders Sexual abuse |
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Developmental Considerations: Gender Patterns (male and female) |
Adolescent conduct disorder Childhood depression Feeding disorders Physical abuse and neglect |
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Developmental Considerations: Gender Patterns (Male) |
ADHD Childhood conduct disorder Intellectual disability Autism spectrum disorder Language disorder Specific learning disorder Enuresis |
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Developmental Considerations: Gender Patterns (female) |
Anxiety disorder Adolescent depression Eating disorders Sexual abuse |
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Developmental Considerations: Gender Patterns (male and female) |
Adolescent conduct disorder Childhood depression Feeding disorders Physical abuse and neglect |
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Developmental Considerations: Normative Information |
Basic information about child development norms is crucial in understanding why a child may be referred to professionals -isolated symptoms show little correspondence with children’s overall adjustment -age inappropriateness and symptoms typically define childhood disorders -impairment in child’s functioning is a key consideration |
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Purposes of Assessment: Description and Diagnosis |
First step: clinical description summarizes the child’s unique behaviours, thoughts and feelings that together make up the features of the child’s psychological disorder -diagnosis involves analyzing information and drawing conclusions about the nature or causes of the problem |
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Purposes of Assessment in Treatment: Prognosis and Treatment Planning |
-Prognosis: formulation of predictions about future behaviour under specified conditions -treatment planning and evaluation apply assessment information to generate a treatment plan and to evaluate its effectiveness |
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Assessing Disorders |
Clinical assessment: info is obtained from different informants, in a variety of settings, Using various methods -methods need to be reliable, valid, cost-effective and useful for treatment -clinical assessment reveals the child’s thoughts, feelings and behaviours -comprehensive assessment evaluates a child’s strengths and weaknesses across many domains |
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Clinical Interviews |
-Provide a large amount of information during a brief period -include a developmental or family history -most interviews are unstructured (May result in low reliability and biased information) -semistructured interviews are more reliable (include specific questions) |
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Assessing Disorders |
Clinical assessment: info is obtained from different informants, in a variety of settings, Using various methods -methods need to be reliable, valid, cost-effective and useful for treatment -clinical assessment reveals the child’s thoughts, feelings and behaviours -comprehensive assessment evaluates a child’s strengths and weaknesses across many domains |
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Clinical Interviews |
-Provide a large amount of information during a brief period -include a developmental or family history -most interviews are unstructured (May result in low reliability and biased information) -semistructured interviews are more reliable (include specific questions) |
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Behavioural Assessment |
-Evaluates child’s thoughts, feelings and behaviours in specific settings -target behaviours and the factors that control or influence them is primary focus -ABCs of Assessment |
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Assessing Disorders |
Clinical assessment: info is obtained from different informants, in a variety of settings, Using various methods -methods need to be reliable, valid, cost-effective and useful for treatment -clinical assessment reveals the child’s thoughts, feelings and behaviours -comprehensive assessment evaluates a child’s strengths and weaknesses across many domains |
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Clinical Interviews |
-Provide a large amount of information during a brief period -include a developmental or family history -most interviews are unstructured (May result in low reliability and biased information) -semistructured interviews are more reliable (include specific questions) |
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Behavioural Assessment |
-Evaluates child’s thoughts, feelings and behaviours in specific settings -target behaviours and the factors that control or influence them is primary focus -ABCs of Assessment |
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ABCs of Assessment |
To observe: Antecedents Behaviours Consequences of the behaviours |
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Behaviour Analysis |
General approach to organizing and using assessment information in terms of the ABCs -identify a wide range of antecedents and consequences -develop hypotheses about which are most important and/or most easily changed |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Psychological Testing |
-purpose is to assess some aspect of child’s knowledge, skill or personality -scores compared with those of a norm group (norm group may have limitations in terms of race, ethnicity, culture. SES, etc) |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Psychological Testing |
-purpose is to assess some aspect of child’s knowledge, skill or personality -scores compared with those of a norm group (norm group may have limitations in terms of race, ethnicity, culture. SES, etc) |
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Intelligence Testing |
-WISC-IV: emphasizes fluid reasoning abilities, higher order reasoning, information processing speed |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Psychological Testing |
-purpose is to assess some aspect of child’s knowledge, skill or personality -scores compared with those of a norm group (norm group may have limitations in terms of race, ethnicity, culture. SES, etc) |
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Intelligence Testing |
-Wechsler Intelligence Scale for Children (WISC-IV) : emphasizes fluid reasoning abilities, higher order reasoning, information processing speed -Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) -Stanford-Binet-5 (SB5) -Kaufman Assessment Battery for Children (K-ABC-III) |
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Personality Testing |
-Central dimensions of personality (the Big 5 factors): timid or bold; dependable or undependable; agreeable or disagreeable; tense or relaxed; Reflective or unreflective
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Psychological Testing |
-purpose is to assess some aspect of child’s knowledge, skill or personality -scores compared with those of a norm group (norm group may have limitations in terms of race, ethnicity, culture. SES, etc) |
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Intelligence Testing |
-Wechsler Intelligence Scale for Children (WISC-IV) : emphasizes fluid reasoning abilities, higher order reasoning, information processing speed -Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) -Stanford-Binet-5 (SB5) -Kaufman Assessment Battery for Children (K-ABC-III) |
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Personality Testing |
-Central dimensions of personality (the Big 5 factors): timid or bold; dependable or undependable; agreeable or disagreeable; tense or relaxed; Reflective or unreflective
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Neuropsychological Assessment |
-Attempt to link brain functioning with objective measures of behaviour known to depend on an intact central nervous system -use of comprehensive batteries |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Psychological Testing |
-purpose is to assess some aspect of child’s knowledge, skill or personality -scores compared with those of a norm group (norm group may have limitations in terms of race, ethnicity, culture. SES, etc) |
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Intelligence Testing |
-Wechsler Intelligence Scale for Children (WISC-IV) : emphasizes fluid reasoning abilities, higher order reasoning, information processing speed -Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) -Stanford-Binet-5 (SB5) -Kaufman Assessment Battery for Children (K-ABC-III) |
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Personality Testing |
-Central dimensions of personality (the Big 5 factors): timid or bold; dependable or undependable; agreeable or disagreeable; tense or relaxed; Reflective or unreflective
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Neuropsychological Assessment |
-Attempt to link brain functioning with objective measures of behaviour known to depend on an intact central nervous system -use of comprehensive batteries |
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Classification and Diagnosis |
Classification: system for representing major categories or dimensions of child psychopathology -strategies for determining best plan for a given individual: ... ideographic and nomothetic strategies |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Psychological Testing |
-purpose is to assess some aspect of child’s knowledge, skill or personality -scores compared with those of a norm group (norm group may have limitations in terms of race, ethnicity, culture. SES, etc) |
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Intelligence Testing |
-Wechsler Intelligence Scale for Children (WISC-IV) : emphasizes fluid reasoning abilities, higher order reasoning, information processing speed -Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) -Stanford-Binet-5 (SB5) -Kaufman Assessment Battery for Children (K-ABC-III) |
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Personality Testing |
-Central dimensions of personality (the Big 5 factors): timid or bold; dependable or undependable; agreeable or disagreeable; tense or relaxed; Reflective or unreflective
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Neuropsychological Assessment |
-Attempt to link brain functioning with objective measures of behaviour known to depend on an intact central nervous system -use of comprehensive batteries |
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Classification and Diagnosis |
Classification: system for representing major categories or dimensions of child psychopathology -strategies for determining best plan for a given individual: ... ideographic and nomothetic strategies |
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Ideographic vs. Nomothetic Strategies |
Ideographic: highlight child’s unique situation Nomothetic strategies employed to: -benefit from all the information accumulated on a given problem or disorder -determines the general category to which the problem belongs |
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Functional Analysis |
-allows for a child’s behaviour to be compared with a known reference group -economical to administer and score -lack of agreement between informants is relatively common as is highly informative -CBCL gives clinicians a useful profile of the variety and degree of the child’s problems |
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Behavioural Observation |
-Parents or other observers record baseline data to provide information about behaviours in real-life settings -recordings may be done by parents or others (may be difficult to ensure accuracy) -clinicians may set up role-play simulation to observe children and their families |
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Psychological Testing |
-purpose is to assess some aspect of child’s knowledge, skill or personality -scores compared with those of a norm group (norm group may have limitations in terms of race, ethnicity, culture. SES, etc) |
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Intelligence Testing |
-Wechsler Intelligence Scale for Children (WISC-IV) : emphasizes fluid reasoning abilities, higher order reasoning, information processing speed -Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) -Stanford-Binet-5 (SB5) -Kaufman Assessment Battery for Children (K-ABC-III) |
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Personality Testing |
-Central dimensions of personality (the Big 5 factors): timid or bold; dependable or undependable; agreeable or disagreeable; tense or relaxed; Reflective or unreflective
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Neuropsychological Assessment |
-Attempt to link brain functioning with objective measures of behaviour known to depend on an intact central nervous system -use of comprehensive batteries |
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Classification and Diagnosis |
Classification: system for representing major categories or dimensions of child psychopathology -strategies for determining best plan for a given individual: ... ideographic and nomothetic strategies |
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Ideographic vs. Nomothetic Strategies |
Ideographic: highlight child’s unique situation Nomothetic strategies employed to: -benefit from all the information accumulated on a given problem or disorder -determines the general category to which the problem belongs |
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DSM Criticisms |
-fails to capture complex adaptations, transactions, and setting influences crucial to understanding and treating child psychopathology -gives less attention to disorders of infancy/childhood -fails to capture the interrelationships and overlap known to exist among many childhood disorders |
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DSM: pros and cons |
Pros: -help clinicians summarize and order observations -facilitate communication among professionals -aid parents by providing recognition and understanding of their child’s problem Cons: -disagreement about effectiveness of labels to achieve their purpose -negative effects and stigmatization -can negatively influence children’s views of themselves and their behaviour |
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Treatment |
-interventions today are planned by combining the most effective approaches to a particular problem -most useful treatments based on what we already know about a particular childhood disorder -data is needed to show that interventions work -multiple problems require multiple solutions -problem -solving strategies are a part of a spectrum of activities for treatment, maintenance and prevention -interventions are part of an ongoing decision-making approach |
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Treatment |
-interventions today are planned by combining the most effective approaches to a particular problem -most useful treatments based on what we already know about a particular childhood disorder -data is needed to show that interventions work -multiple problems require multiple solutions -problem -solving strategies are a part of a spectrum of activities for treatment, maintenance and prevention -interventions are part of an ongoing decision-making approach |
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Cultural Compatibility Hypothesis |
Treatment is likely to be more effective when compatible with the cultural patterns of the child and family |
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Treatment |
-interventions today are planned by combining the most effective approaches to a particular problem -most useful treatments based on what we already know about a particular childhood disorder -data is needed to show that interventions work -multiple problems require multiple solutions -problem -solving strategies are a part of a spectrum of activities for treatment, maintenance and prevention -interventions are part of an ongoing decision-making approach |
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Cultural Compatibility Hypothesis |
Treatment is likely to be more effective when compatible with the cultural patterns of the child and family |
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Treatment services for children must... |
-attend to presenting problem -consider specific cultural practices of the family *must me careful not to stereotype individuals of any cultural group |
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Treatment Goals |
•outcomes related to child functioning -reduce or eliminate symptoms -enhance social competence -improve academic performance • outcomes related to family functioning -reduce level of family dysfunction -reduce stress -enhance family support •outcomes of social importance -improve child’s participation in school-related activities -decrease involvement in juvenile justice system -reduce need for special services -reduce accidental injuries or substance abuse -enhance physical and mental health |
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Ethical and Legal Considerations |
-APA ethical code provides min. ethical standards •select treatment goals and procedures that are in the best interest of client •ensure participation is active and voluntary •keep records to document treatment effectiveness •protect confidentiality •ensure therapists qualifications and competencies -determine when minor is competent to make decisions -be cautious about ineffective or potentially harmful treatment -comply with federal, state and local laws |
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Ethical and Legal Considerations |
-APA ethical code provides min. ethical standards •select treatment goals and procedures that are in the best interest of client •ensure participation is active and voluntary •keep records to document treatment effectiveness •protect confidentiality •ensure therapists qualifications and competencies -determine when minor is competent to make decisions -be cautious about ineffective or potentially harmful treatment -comply with federal, state and local laws |
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Ethical Issues in Clinical Work with Children and Family |
1. children inherently more vulnerable 2. Children’s abilities more variable and change over time 3. Children are more reliant upon others and their environment 4. Ethical principle and practice in treatment of adults must be modified in response to child’s current development abilities and legal status 5. Boundary and role issues are often more prevalent and complex 6. Adult practice and knowledge base does not transfer reliably to the care of children 7. Practitioners must develop skills to work with families, agencies and systems 8. Key to monitor ones own actions and motivations 9. Seeking consultation advice is helpful in difficult situations 10. Essential to maintain an absolute commitment to safety and well-being of patient |
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Genre Approaches to Treatment |
•more than 70% of clinicians use an eclectic approach •psychodynamic treatments -view child psychopathology as determined by underlying unconscious and conscious conflicts -focus is on helping child develop an awareness of unconscious factors contributing to problems |
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Behavioural Treatments |
-assume behaviours are learned -focus is on re-educating child -procedures include: •Positive reinforcement or time-out • modelling •systematic desensitization •changes in child’s environment |
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Genre Approaches to Treatment |
•more than 70% of clinicians use an eclectic approach •psychodynamic treatments -view child psychopathology as determined by underlying unconscious and conscious conflicts -focus is on helping child develop an awareness of unconscious factors contributing to problems |
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Behavioural Treatments |
-assume behaviours are learned -focus is on re-educating child -procedures include: •Positive reinforcement or time-out • modelling •systematic desensitization •changes in child’s environment |
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Cognitive Treatments |
-view abnormal behaviour as result of deficits and/or distortions in child’s thinking -focus is on changing faulty cognitions |
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Cognitive Behavioural Treatments |
-view psychological disturbances as a result of faulty thought patterns and/or faulty learning/environmental experiences -focus on identifying and changing maladaptive cognitions; teaching child to use cognitive and behavioural coping strategies; helping child learn self-regulation |
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Client-Centered and Family Treatments |
Client-Centered: focus on creating a therapeutic setting that provides unconditional acceptance of child Family Treatments: view individual disorders as manifestations in disturbances in family relations -focus on family issues underlying children’s problematic behaviour |
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Biological Treatments |
-view child psychopathology as resulting from psychobiological impairment or dysfunction -rely primarily on pharmacological and other biological approaches to treatment co |
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Combined Treatments |
-use of 2+ interventions, each of which can stand on its own as a treatment strategy -more communities implementing comprehensive mental health programs from children -recent efforts used evidence-based intervention within framework or 5 core principles of therapeutic change 1.feeling calm 2. Increasing Motivation 3. Repairing Thoughts Treatment Effectiveness 4. Solving Problems 5. Trying the opposite |
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Treatment Effectiveness |
-best practice guidelines: systematically developed statements to assist practitioners and patients -two main approaches in developing best practice guidelines •scientific approach derived guidelines from a review of current research findings •expert-consensus approach uses experts’ opinions to fill gaps in scientific literature |
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Positive and Negative Findings |
Positive: •changes achieved through therapy are greater than changes in those not receiving therapy •Children receiving therapy are better off after therapy •Treatments equally effective for internalizing and externalizing disorders •treatment effects tend to be long-lasting Negative: •fewer than 20% of Treatments demonstrate evidence for reducing impairment in life functioning •community-based therapy is far less effective than structured research therapy •conventional services for children may have limited effectiveness |
