Clinical Psychology Interventions

Question 1

Background Info:

Answer 1

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

Question 2

What is Llewelyn & Murphy (2014) 6 core competencies?

Answer 2

1. Assessment

2.Formulation

3. Intervention
4. Evaluation
5. Communication/ Consultation
   & Service delivery
6. Leadership

Question 3

The ‘reflective scientist-practitioner:

Answer 3

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

Question 4

What is the core purpose and philosophy of the profession of clinical psychology?

Answer 4

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.”

Question 5

Developing and Evaluating Complex Interventions

Answer 5

1. 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

2. Feasibility and Piloting of the Intervention
3. Evaluation of the Intervention
4. Implementation of the Intervention

Question 6

Why are processes relevant?

Answer 6

relevant for researchers and clinicians when developing and delivering interventions for mental health

Question 7

Complex Interventions

Answer 7

those that have “several interacting components”.

Question 8

Why is Child and Adolescent Mental Health Important?

Answer 8

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

Question 9

Prevalence rates of emotional and behavioural problems in childhood

Answer 9

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

Question 10

Evaluating Prevalence rates

Answer 10

rates of co-occurring conditions are higher for children with neurodevelopmental conditions.

Question 11

Challenges in Child and Adolescent Mental Health

Answer 11

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

Question 12

Externalising Behaviours in Childhood

Answer 12

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

Question 13

Conduct Disorder

Answer 13

Ongoing pattern of behaviour where the rights of others or social norms are infringed

Question 14

Formulation

Answer 14

Involves Assessment & Treatment planning such as triggers of the problem and causing the behaviour/problems to be maintained overtime?

Question 15

Key Theories of Externalising Behaviours in Childhood

Answer 15

• Parent-Child Interactions
• Media and Peer Influences
• Executive Function Deficits
• Cognitive Factors
• Neglect
• Socio-economic factors
• Family Environment
  Theory of Mind Deficits

Question 16

Parenting and the Family Environment

Answer 16

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

Question 17

Socioeconomic factors

Answer 17

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

Question 18

Cognitive Factors

Answer 18

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

Question 19

Internalising Behaviours in Childhood

Answer 19

Behaviours directed inward
Related to Childhood anxiety disorders (e.g. separation anxiety)
& Childhood major depression

Question 20

Childhood anxiety

Answer 20

‒ 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

Question 21

Traumatic Life Experiences

Answer 21

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

Question 22

Modelling and Exposure

Answer 22

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)

Question 22

Parenting

Answer 22

Children whose parents have an anxiety disorder are at increased risk for having an anxiety disorder themselves (Li et al., 2008)