Clinical Psychology Interventions Flashcards
Background Info:
Emerged as a practice in the 19th Century
First psychological clinic is credited to Lightner Witmer at the University of Pennsylvania (1896)
In UK, first clinical psychology clinics emerged at the Tavistock Centre in London in 1926 and the Notre Dame Centre in Glasgow in 1931
Profession developed after World War II and with the advent of the NHS
The first ever trainees in Clinical Psychology were trained at the Maudsley Hospital in London in 1949
What is Llewelyn & Murphy (2014) 6 core competencies?
- Assessment
2.Formulation
- Intervention
- Evaluation
- Communication/ Consultation
& Service delivery - Leadership
The ‘reflective scientist-practitioner:
scientist
Evidence-based treatments and recommendations
Develop hypotheses
Conduct research and evaluate outcomes
Reflective (Schön, 1983)
Use of past experience
Use of psychological theory
think on your feet logic
What is the core purpose and philosophy of the profession of clinical psychology?
aims to reduce psychological distress and to enhance and promote psychological well-being being by the systematic application of knowledge derived from psychological theory and data.”
Developing and Evaluating Complex Interventions
- Intervention Development
Intervention should be expected to have a meaningful effect for those using it
identify the evidence-base
Interventions should be based on theory
Important to think about implementation and feasibility
- Feasibility and Piloting of the Intervention
- Evaluation of the Intervention
- Implementation of the Intervention
Why are processes relevant?
relevant for researchers and clinicians when developing and delivering interventions for mental health
Complex Interventions
those that have “several interacting components”.
Why is Child and Adolescent Mental Health Important?
A Developmental Psychopathology Perspective - how early child experiences influence later outcomes such as mental health in adulthood
Intervening could improve long-term outcomes for children and young people
Prevalence rates of emotional and behavioural problems in childhood
Ford et al., 2017
* 10% of children ) in the UK meet criteria for an emotional or behavioural disorder.
* Anxiety- 3.5%
* ADHD- 2.2%
* Disruptive behaviour disorder- 5%
50% of children conditions continue for 3 years later
Evaluating Prevalence rates
rates of co-occurring conditions are higher for children with neurodevelopmental conditions.
Challenges in Child and Adolescent Mental Health
Important that children are not over-diagnosed
Diagnosis and assessment may be complicated by the fact that some children are unable communicate how they are feeling
Should be considered in terms of what is appropriate for children for their age
If emotional and behavioural problems are impacting children, intervention may be needed
Interventions should be evidence-based, and based on theory
Externalising Behaviours in Childhood
Behaviours directed outward
Persistent pattern of inattention and/or hyperactivity/impulsivity at rates higher than would be expected for child’s developmental level
EG. ADHD
Before Age 12
Conduct Disorder
Ongoing pattern of behaviour where the rights of others or social norms are infringed
Formulation
Involves Assessment & Treatment planning such as triggers of the problem and causing the behaviour/problems to be maintained overtime?
Key Theories of Externalising Behaviours in Childhood
- Parent-Child Interactions
- Media and Peer Influences
- Executive Function Deficits
- Cognitive Factors
- Neglect
- Socio-economic factors
- Family Environment
Theory of Mind Deficits
Parenting and the Family Environment
Adverse familial environments and parenting practices commonly in families of children showing high behavioural problems
Parents more likely to engage in hostile parenting practices.
Less warmth in interactions
Socioeconomic factors
role in the development of externalising child behaviour
Children who moved out of poverty, also likely to show a reduction in behavioural problems
Related to amount of time parents spend with child
Cognitive Factors
Executive function deficits have been implicated in externalizing behaviour problems in children such as working memory
Some children with ADHD display differences in reward processing
Internalising Behaviours in Childhood
Behaviours directed inward
Related to Childhood anxiety disorders (e.g. separation anxiety)
& Childhood major depression
Childhood anxiety
‒ Generalised Anxiety Disorder
‒ Social Anxiety Disorder
‒ Some manifestations of anxiety tend to more prevalent in childhood
‒ Separation anxiety
‒ Disproportionate distress when separated from parents
‒ Distress about harm coming to parents
‒ Unable to sleep alone
Combination of inherited factors and environmental stressors
Traumatic Life Experiences
Physical Health Conditions
20% of children experience chronic physical health conditions such as asthma, epilepsy (van der Lee et al., 2007)
Children with physical health conditions experience higher levels of anxiety than children without physical health conditions (Pinquart & Shen, 2011
Learned helplessness from unpredictability of physical health conditions
Internalising problems also associated with bullying/peer victimisation
Modelling and Exposure
Children will use information from people around them to help them learn what is scary/dangerous and what is not
Model’s fearful response (US) —–àEvokes fearful response in child (CR)
Kessock-Phillip & Field (2008)
Parenting
Children whose parents have an anxiety disorder are at increased risk for having an anxiety disorder themselves (Li et al., 2008)
