Clinical Psychology Interventions in Child and Adolescents Mental Health Flashcards
What are psychological interventions in clinical psychology?
- Clinical psych emerged as parctice in the 19th century
What was the first psychological clinic?
Lightner Witmer
What does a clinical psychologist do? - llewelyn & murphy 2014
There are 6 core competencies
What are the 6 core competencies - llewelyn & murphy
- assesment
- formulation
- intervention
- evaluation
- communication / consultation and service delivery
- leadership
The ‘reflective scientist practitioner
a combination of a scientist & reflective practitioner
= Core purpose & philosophy of clinical psych (BPS 2010)
What does a scientist do?
Evidenced based treatments & recommendations
Develop hypotheses (almost like a research question)
Conduct research & evaluate outcomes
What does one who is reflective do - Schon 1983)
‘Thinking on your feet’
‘use of past exp’
‘use of psych theory’
What does clinical psych aim to do - BPS 2010
redue psychological distress and enhance and promote psychological well being by the systematic application of knowledge derived from psychological theory and data
What are complex initerventions?
Those that have several interacting components
Who issued guidance on how interventions should be developed and evaluated?
Medical Research Council (MRC)
What did the MRC say about dev interv?
There = 4 main staged for developing, evaluating & implementing complex interventions
What are the 4 main stages according to MRC?
- Intervention Development
- Feasibility & Piloting of the intervention
- Evaluation of the intervention
- Implementation of the intervention
What is intervention development?
Interv = should be expected to have a meaningful effect for patients/service users
How does one develop an intervention? - three stages
- identify the evidence base = look at what research has been done
- interventions shoould be based on theory = have an early understanding of the process of change
- important to think about implementation & feasibility
processes are relevant for researchers & clinicians when developing & delivering interv for mental health
Why is child & adolescent mental health important according to a developmental psychopathology perspective?
How early child exp influence later outcomes such as mental health & adulthood
Approx how many children in the UK meet criteria for emotional / behavioural disorder?
10% (5-16 yrs)
Approx how many children in the UK meet criteria for anxiety?
3.5%
Approx how many children in the UK meet criteria for adhd?
2.2%
Approx how many children in the UK meet criteria for disruptiive beh?
5%
What does ford et al say about the duration of conditions in children?
For about 50% they persist for 3 years
When a child has neurodevelopmental conditions (autism, intellectual disability) prevelence rates of co-occuring conditons =
higher
Challenges in child & adolescents mental health?
It is important children = not over diagnosed = behaviours are needed to be clinically relevant
Behaviours should be considereed interms of what is….
Appropriate for their age (e.g temper outbursts at 3 vs 14 yrs)
What may diagnosis and assesments be complicated by?
the fact that some children = unable to communicate how they = feel
What should interventions be based on always?
evidence & theory
Where were the first clinical psych trainees trained?
Maudley hospital in London 1949
Externalising behaviouirs in childhood?
behaviours directed putward e.g aggression, non-compliance, impulsivity
What is ADHD ?
Attention Defiant Hyperactivity Disorder
Persistent pattern of inattention and/or hyperactivity/ impulsivity at rates higher than expected for child’s developmental level
- occurs before 12
- pervasive across settings
What is ODD?
Oppositional defiant disorder
Pattern of angry / irritable mood and argumentative / defiant behaviour
- exhibited w at least one person who = not a sibling
What is conduct disorder?
Ongoing pattern of behaviour where teh rights of other or social norms = ignored
= shows at least 3 beh over a 12 month period
What is formulation?
Putting together a diagnosis
What are the processes of formulation/
- Presentation at clinical seervices
- Assesmnet
- Treatment planning
- Treatment implemation and moitoring overtime
Key Theories in externalsing beh in childhood: - env
Parent child interactions
Media and peer influences
Executive function deficits
Cog fcators
Theory of Mind deficits
Neglect
Socio economic factors
Family env
Key Theories in externalsing beh in childhood: - gen
Genetics
Structural braindiff
Maternal smokoing during oreg
Low birth weight
Neurotransmitters
Parenting & the family env - johnston & Mash 2001)
Adverse faimalial env & parenting practices = commonly observed in families of children who show high levels of externalising beh prob
Duncombe et al 2012 = Child emotion regulation = Externalising child behavious = Inconsistent Discipline &
Corporal punishment
Child emotion regulation may mediate the r/s between parenting practices and child disruptive beh
Socioeconomic factors in dev of externalsing child beh
Children moving out of property = likely tp show a reduction in beh prob (not emotional)
= related to amount of yime parents = spend w their child
Cog factors in dev of externalising child beh
Executive function deficits = been i,plicated in ex beh prob in children —> impulsivity, wwm and cog flex
Cog factors in dev of externalising child beh - Seidman 2006
Some children w adhd display diff in reward processing - preference for smaller, immediate rewards over larger later rewards & dispkay greater sensittiity to social rewards
Internalising behav in childhood
Beh directed inward = withdrawl & low mood
= childhood anxiety disorders e.g sep anx
= childhood major dep
Childhood anxiety
Anxiety in children = will over lap w adult anciety (GAD & SAD)
Some manifestations of anx = more preveleant in childhood
What is Sep Anx?
= Disproportiante distress when sep form parents
= Distress ab harm coming to parents
= Unable to sleep alone
Comb of inherited factors & env stressors
Traumatic Life Exp & Physical Health Cond - how many % of children exp
20% children exp chronic physical health cond e.g. asthma, epilepsy - van der lee et al
Anxiety = higher level in those w or w out physical health cond?
with
Unpredictability of physical health conds e.g epileptic fits can lead to?
Learned helplessness
Ferro & Boyle example of their theory of indirect effect of physical health cond by impacting the family env
P.H.C = Maternal Depression = Family Dysfun = Anxiety & Depression in children
Understanding potentional env mechanismis for mental health will help us to develop…
targeted interventions - that target those mechanisms
Clinical psychologists might consider….
a range of factors and ofter work as a part of multi disciplinary teams (p.h services)
