3. Working with Children & Families Flashcards

1
Q

What are some sociocultural factors you must take into consideration when formulating the case?

A

1) identity: race, culture, gender

2) relationships: family, friends

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2
Q

Describe systemic theory. (6)

A
  • Relational problem, NOT the individual’s problem. Sees the problem in the contexts of the individual’s relationships.
  • identify recurring themes (eg. mistrust, blaming)
  • circular (rather than linear) assumptions about associations
  • systems embedded within systems
  • circumstances of the family
  • cultural context: social GRAAACCEESS
  • therapist is now part of the system
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3
Q

In systemic theory, what does systems embedded within systems imply?

A
  • Implies that no one system should be priviledged over the other.
  • microsystem, mesosystem, exosystem, macrosystem, chronosystem
  • Must consider whole spectrum and all components of the family. Even the perspectives of those who are not present in the room. (absent family members, friends, professionals)
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4
Q

What are some circumstances of the family we must consider?

A

1) SES
2) Migration
3) Parental separation
4) Blended families
5) Family life cycle (every TRANISITION of a stage has potential for more stress and problems)
6) Family culture (beliefs and traditions)

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5
Q

What are social GRAAACCEESS of the individual?

A

Gender, race, age, ability, appearance, class, culture, education, employment, sexuality, spirituality

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6
Q

What does it mean for systemic formulation when the therapist is not part of the system?

A

Therapist will bring their own beliefs and biases into the problem. Importance of reflective practice

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7
Q

How do you conceptualise the problem in a systemic way?

A

1) look for differences in perspectives
2) look for long term patterns of responding to these differences
3) current problems are solutions to past problems
(the current behavior may be ineffective and dangerous but it served a positive adaptive function in the past. it’s their coping mechanism)

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8
Q

What did John Bowlby propose about Attachment Theory?

A

Life is best organised as a series of daring ventures from a secure base

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9
Q

What are the 4 different kinds of attachment styles proposed in attachment theory?

A

1) Secure attachment
2) Anxious attachment
3) Avoidant attachment
4) Disorganised attachment

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10
Q

Describe secure attachment. (3)

A
  • The child has a secure base, so it feels safe to explore.
  • The child will move back to the secure base when it feels under threat.
  • The child has positive expectations about the function of relationships for security and emotional soothing when distressed.
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11
Q

Describe anxious attachment. (4)

A
  • caregiver is inconsistent and child is unsure of caregiver’s availability and when he/she would leave.
  • constantly seeks comfort from caregiver in the form of clingy behavior
  • sometimes appear more distressed than they feel in order to get the caregiver’s attention (“attention needing”)
  • difficult to soothe as calming down might mean parent will leave
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12
Q

Describe avoidant attachment. (3)

A
  • caregiver is rejecting
  • minimize attachment behaviors in order not to get rejected
  • act tough: ignore own emotions and not appear distressed or needing much attention from caregiver
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13
Q

Describe disorganised attachment.

A
  • Caregiver is FRIGHTENING to the child (abusive, or mum is frightened from being abused by dad etc.)
  • Triggers attachment system in the child. Child is hardwired to cling onto parent for security, but the more they cling the more frightening it becomes. Attachment relationship becomes disorganised.
  • First example of a relationship is already a negative one. No idea what to do in other relationships.
  • Child develop ways of coping: being controlling and demanding towards their parent as it is their only way of being close and safe.
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14
Q

What are the 2 ways the child learns to cope with disorganized attachment when he/she grows up?

A

1) Anxious approach to relationships
- coercive interactions (aggressive and controlling behaviors)
2) Avoidant approach
- self-reliant
- compliant

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15
Q

What kind of negative “internal working model” of the self and others can develop from disorganized attachment?

A

Core beliefs - “I am unloveable”, “others are frightening”

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16
Q

When a child brings their internal working model into relationships in the future, what concept is related to this?

A

Transference - indiviidual behaves in a way that put partner in am abusive role (counter transference)

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17
Q

How to encourage adaptive behaviors across home, school, and community settings?

A

Behavioral reinforcement systems

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18
Q

What are some possible systemic interventions?

A

1) psychoeducation for parents (eg. help them understand how attachment can result in current behaviors)
2) Collaboration with other professionals

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19
Q

What are the 2 kinds of parenting interventions?

A

1) Behavior-focused practices

2) Emotion-Focused practices

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20
Q

Describe behavior-focused practices as a parenting intervention method.

A

Managing child’s behavior: key idea is to increase good behavior, reduce bad behavior

1) increasing desired behaviors
- attend to child without agenda 10-15min a day
- using rewards
2) decreasing undesired behaviors
- ignoring bad behavior
- distraction
- empathy
- consequences (punishment)

21
Q

What does it mean to attend to the child without agenda?

A

Joint play without instructions or demands. Follow the child’s lead. Just give a running commentary of the activity rather than instructive commands. This is not an educational session. It’s just about being with the child and giving them attention.

22
Q

What is the purpose of attending to your child without agenda?

A

Improves child’s attention and receptivity to parent and parent’s sensitivity to child

23
Q

How do we use rewards to increase desired behaviors? What types of rewards are there?

A
  • Give clear instructions and reward must immediately follow behavior.
  • Types of rewards: attention, physical contact, verbal, material
  • Reward charts: agree on a behavior and how it should be done. Reward them when they do it.
  • Note that younger children cannot wait too long, so need less stars to get the reward.
24
Q

What are some key things to note when ignoring bad behaviors to decrease undesired behaviors? (4)

A

1) make sure child will be safe
2) make sure it is COMPLETE. don’t give in halfway. No verbal or non-verbal communication. Don’t show irritation or physical contact. Because those are forms of attention. Return attention only when appropriate behavior is demonstrated.
3) Expect behavior to get worse before it gets better. They will up the ante to make you comply.
4) Don’t use on kids with trauma as it can be perceived as a form of neglect.

25
Q

What is emotion-focused practices about? (parenting intervention)

A

Reflective parenting that is attachment focused.

  • meaning of child’s behavior
  • what the parent brings to the relationship (transference, countertransference)
26
Q

Which is more effective - behavior-focused or emotion-focused parental interventions?

A

Behavioral management is more useful if the relationship base is strong. If not strong, must work with child’s inner needs first.

27
Q

What are 2 emotion-focused practices that parents can do?

A

1) The Parent Map - What parents bring to the relationship

2) The Parent APP - The meaning of child’s behavior

28
Q

What is the Parent Map?

A
  • Exploring what parent brings to the relationship.
  • Identify parent’s sources of stress:
    1) personal history
    2) current life situation (eg. relationships, responsibilities like work and finance)
    3) current level of emotion (too “hot” or too “cold”; consider why you are disconnected)
29
Q

What is the Parent APP?

A

1) Attention
2) Perspective taking
3) Provide empathy

30
Q

What does it mean to show attention to your child?

A
  • be curious and interested in your child’s thoughts and feelings
  • consider the meaning of the bad behaviors. how are their thoughts and feelings creating the bad behaviors.
  • focus is on building relationship and trust, which will increase compliance.
31
Q

What does it mean to engage in perspective taking to understand the meaning of his/her behavior?

A
  • Wonder what it is like to see the situation from your child’s perspective. Step out of your perspective first and model this to your child. Your child will learn to step out of his/her own perspective and empathise with you too.
    Can build their social competence as well.
32
Q

What does it mean to provide empathy to your child?

A
  • Let the child know that your understand what he/she is going through.
  • Even when the consequence needs to administered, it can be done with empathy.
  • Verbalise what you are thinking and let him verbalise what he is thinking
33
Q

What are some things to note while working with children?

A

1) use the words they use rather than adult-determined words
2) children have less developed abstract thinking. therapy must be made concrete by grounding them in their own life experience
3) sessions are more lighthearted and contain more humour
4) psychologist must be creative to engage the child (eg. art, movies, websites, videos)

34
Q

What therapies are important for anorexia nervosa?

A
  • CBT
  • cognitive analytic theory - brief therapy with roots in psychodynamic and cognitive theory
  • maudsley model (family therapy: parents are coached to enforce eating and weight gain in their child
  • must come along side interventions ensuring weight gain, as severe weight loss can be fatal
35
Q

What kinds of interventions are appropriate for children with ADHD?

A

1) group-based parent education programmes
- help parents manage child’s behavior
2) group or individual CBT & social skills training for school aged children

36
Q

What are the key aims of interventions for ADHD children?

A
  • To minimise and adapt to difficulties with inattentiveness, hyperactivity, and impulsiveness.
  • To reduce their impact on relationships and educational achievement.
37
Q

How does the ‘coping cat’ programme help children with anxiety disorders?

A
  • help them to recognise, cope with, and reduce their anxiety in real life situations
  • CBT based intervention
  • individuals or small groups
  • add 2 sessions of family intervention
38
Q

What are the types of therapy available for children with conduct disorder?

A

1) skills-based group interventions for parents and older children
- parents: help them be more effective in preventing and managing child’s behavior
- older children: social and and cognitive problem-solving programmes
2) family therapy
- for more complex and severe cases
- coordinated approach with schools, social services, and other professionals

39
Q

What are some benefits to giving a diagnosis to a child?

A

+ offer access to educational benefits and social services

+ gives family a way of uniting against the difficulty rather than blaming the problem on the child

40
Q

What are some disadvantages of giving a diagnosis to a child?

A
  • label remains with them for life even as they grow and change over the years
  • may become self-fulfilling prophecy
  • prejudice and stigma
  • take away attention from social and environmental factors that may have contributed to development and maintenance of the problem.
41
Q

Give an example of how peers interaction can create a vicious cycle of impaired social development?

A

perceive yourself as less socially competent than others -> don’t take up opportunities for healthy experimentation -> more isolated -> emotional distress

42
Q

What does Erik Erikson’s Psychosocial model suggest about how psychological difficulties develop?

A

Series of developmental stages to be negotiated to increase psychosocial competence and avoid self-doubt and anxiety. If stages are not successfully negotiated, children tend to become isolated and less able to manage new relationships and challenging situations.

43
Q

Why is it important to provide early intervention for children with psychological difficulties?

A

Successful intervention in early life can prevent a whole lifetime of further psychological difficulties.

44
Q

Why are family relationships especially important for children?

A

Because they are almost entirely dependent on these relationships. Source of psychological distress in children are often found within families.

45
Q

What are the kinds of relationships in families we can focus on? (4)

A

1) relationship with siblings
2) relationship with parents
3) couple’s in relation to each other
4) family’s rs with wider family - grandparents, uncles, aunts, nieces, nephews

46
Q

What are some examples of transition and change for families?

A
  • entry and exit from family
  • new school
  • new parent
47
Q

How do difficulties emerge during family transitions?

A

Difficulties emerge when family cannot make the necessary changes needed to meet the new expectations and new roles in the family relationship

48
Q

What are some interventions carried out during family therapy?

A
  • build mutual trust and understanding

- discuss the impact of specific events the family gone through (eg. divorce, death of someone)

49
Q

What are an important issue to take note when working with families?

A

Cultural sensitivity
- if family has beliefs that oppose therapist’s own beliefs, they need to be mutually respectful. can risk therapist being overly passive and anxious about what to do or say. Or therapist may also appear disrespectful