Transcript Developmental Considerations

Developmental Considerations
• Most Common Adjustment Problems
– Attachment problems or developmental delays
in
Motivation Issues
• Children and adolescents are more likely to
blame others for their difficulties, such as
teachers, peers, or family members.
• Adolescents in particular often resist others’
explanations of their problems and refuse to
take their medication or participate in
psychotherapy.
Communicating through Play
• Therapists who work with children must first win
the child’s trust through appropriate and
interesting activities
• Young children communicate more freely in play
than in formal verbal interviews
• Guided play activities are a common type of
intervention for children
• However, dolls can be misused as assessment tools
by untrained examiners
Cultural Diversity
• There are few published research studies
comparing the effects of particular types of
therapy with children from different ethnic groups.
• Ideally, therapists should share the child’s
ethnicity and cultural background
• Practitioners are advised to conduct culturally
appropriate assessments of child clients, using
language that is familiar to the child. Major
Approaches to Psychological Treatment
Major Approaches to Psychological
Treatment
– Psychodynamic Therapy
– Nondirective Play Therapy
– Behavioral Therapy
– Cognitive-Behavioral Therapy
– Evaluation of Cognitive-Behavioral
and Behavioral Therapies
Psychodynamic Therapy
• Little research has been done on
psychodynamic therapy, so its effectiveness
is unknown
Nondirective Play Therapy
• Probably more effective than no therapy,
nondirective play therapy has limited
effectiveness in clinic settings
Behavioral Therapy
• Behavioral therapy can teach specific skills,
but careful treatment design is needed to
produce durable, general effects
Cognitive-Behavioral Therapy
• Treats many of a child’s problems at the
same time using different techniques.
This is effective in controlled laboratory
settings, but its utility in actual treatment
clinics and in the long term is not
established
Family Therapies
• Systems-oriented family therapy
• Behavioral family therapy
• Functional family therapy
Systems-oriented Family Therapy
• Systems-oriented family therapy views the
source of the child’s problems as
dysfunctional family interactions, not
individual psychopathology
Behavioral Family Therapy
• Behavioral family therapy views the child’s
problems as coming from inappropriate
reinforcement contingencies and lack of
social skills
Functional Family Therapy
• Functional Family Therapy sees both faulty
family communications and inappropriate
contingencies as creating children’s
problems
Foster Care
• More appropriate to place teens in
foster care rather than young children
• Teens should be placed in foster care
only when unmanageable, refuse to
obey their parents, are delinquent,
and/or abuse drugs
• Or when their friends are antisocial or
gang members
Drug Treatments for Childhood
Disorders
• Medications prescribed to
– Suppress dangerous behaviors
– Suppress intrusive behaviors that interfere
with child’s functioning and learning
– Enhance positive behavior
Stimulants
• Stimulants are used mainly for
attention-deficit/hyperactivity disorder.
• They are effective in treating symptoms,
• but don’t improve social relationships or
school achievement in the long term
Antidepressant drugs
• Tricyclic antidepressants are ineffective
with children
• SSRI’s hold promise of being safe and
effective to treat depression and anxiety
Antipsychotic
• Used to control psychotic behavior in
adults
• Used re used to reduce assaultiveness,
restlessness, and self-injury in severely
ill children, but have serious side effects
Guidelines for use with Children
• Should not be the first or only treatment
tried. Use less restrictive treatments
first
• The child should receive a component
medical and psychological exam to
establish a diagnosis
• The child as well as the parents should
consent to the use of drugs. No one
should be coerced into taking
medications, if at all possible
• Drug
administration
should
be
conservative, with the smallest dosage
possible and for the briefest possible
time
Prevention and Early Intervention
• Emotional and cognitive problems have
been reduced by comprehensive
programs for high-risk, disadvantaged
infants and preschool children and their
parents
• Conduct disorder and seriously
antisocial behavior have been reduced
in aggressive kindergarten children by
the Fast Track program
• Depressive symptoms have been
reduced in children and adolescents by
the Penn Optimism Program
• Prejudice and discrimination have been
reduced in school-age children by the
Jigsaw Classroom program