Chapter 13 Flashcards

1
Q

Who is the client in psychological services for children and adolescents?

A
  • Adults usually seek therapy themselves and give informed consent
  • Children and teens rarely self-refer for therapy
  • Services are typically initiated by parents or other adults concerned about behaviour
  • So the question remains as to whom the psych services are for - child receiving services or parents support consent
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2
Q

Challenges in Identifying the Client

A
  • Children may not see their behaviour as problematic
  • Parents, teachers, and youth often disagree on the issue and goals (what is the problem & if that even is a problem)
  • Youth may resists therapy or feel misunderstood
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3
Q

Challenges in Identifying the Client - Parents as Gatekeepers

A
  • Parents control access: referrals, transportation, and payment
  • Their engagement affects treatment success
  • Example: Parents may disengage if the therapy does not align with their views, leading to missed sessions, cancellations and withdrawing child from therapy
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4
Q

Challenges in Identifying the Client - Legal and Ethical Complexities

A
  • Consent laws vary by age or by capacity to understand treatment
  • Psychologists must know the legal context of their practice (education on rules & child protection rules)
  • Case Example: Jorge, 14, legally refused treatment despite parental concern
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5
Q

Challenges in Identifying the Client - Consent, Engagement & Confidentiality

A
  • Legal consent does not guarantee willingness to participate
  • Confidentiality must be clearly explained at the start
  • Therapists balance youth privacy with legal obligations and parental rights
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6
Q

Importance of the Therapeutic Alliance

A
  • Parent-therapist alliance encourages better attendance and commitment
  • Youth-therapist alliance encourages better symptom and behaviour improvement
  • For best outcomes, both relationships are essential for therapy to be effective
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7
Q

Who Needs Services?

A
  • Adolescent depression is common, with rates similar to adults but it is significantly less studied, due to both parent consent being required for youth studies
  • Rates double between 13-14 and 17-18
  • Depression is chronic and recurrent, linked to struggles in peer relationships, academic decline, family conflict, and higher suicide risk
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8
Q

Burden of Child and Youth Mental Disorders - Child, his/her friends and siblings

A
  • Most directly affected by mental disorders
  • May experience feelings of isolation, low SE, or frustration, especially if they don’t understand what they’re going through
  • Friends and siblings may also be affected
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9
Q

Burden of Child and Youth Mental Disorders - Parents, caregivers

A
  • Caring for a child with MH needs can be emotionally and physically taxing
  • Parents often experience high levels of stress, guilt & helplessness
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10
Q

Burden of Child and Youth Mental Disorders - School

A

Must provide accommodations, special education support, & manage behavioural issues

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11
Q

Burden of Child and Youth Mental Disorders - Healthcare

A

Burdened with demand for pediatric MH services, which are often under-researched

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12
Q

Burden of Child and Youth Mental Disorders - Criminal Justice

A
  • Involvement may increase if MH issues go unaddressed, especially in teens with behavioural disorders
  • Conduct disorder is the most serious diagnosis in DSM (harm others, animals, etc.)
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13
Q

Issues of Premature Termination/Drop-out - Key contributing factors

A
  • Parental psychopathology (MH challenges in parents can disrupt engagement in their child’s therapy)
  • Parental isolation (lack of support can increase feelings of helplessness, burnouts, difficulty continuing transport, overwhelming parent and may reduce follow-through with treatment plans)
  • Family conflict (High stress and instability at home can interfere with consistent attendance and progress (resistance from minimum 1 parent, disagreements between parents can put teen in the middle; distressed parents (-) impact child’s recovery and it can be very difficult to manage child beliefs and parental expectations)
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14
Q

Evidence for Services for Children and Youth

A
  • Thousands of studies conducted globally
  • Wide variety of research methods and designs
  • Contradictory results make interpretation complex
  • EB for youth services lags behind adult services
  • Fewer rigorous evaluations for children & adolescents (due to additional barriers from ethical concerns)
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15
Q

Does therapy work

A

Research suggests it does work, narrowing depending on issue

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16
Q

What therapy works for this problem

A

Depends on settings, populations, difficulties, contexts, etc.