Clinical Psychology Interventions in Child and Adolescents Mental Health

Question 1

What are psychological interventions in clinical psychology?

Answer 1

• Clinical psych emerged as parctice in the 19th century

Question 2

What was the first psychological clinic?

Answer 2

Lightner Witmer

Question 3

What does a clinical psychologist do? - llewelyn & murphy 2014

Answer 3

There are 6 core competencies

Question 4

What are the 6 core competencies - llewelyn & murphy

Answer 4

1. assesment
2. formulation
3. intervention
4. evaluation
5. communication / consultation and service delivery
6. leadership

Question 5

The ‘reflective scientist practitioner

Answer 5

a combination of a scientist & reflective practitioner

= Core purpose & philosophy of clinical psych (BPS 2010)

Question 6

What does a scientist do?

Answer 6

Evidenced based treatments & recommendations
Develop hypotheses (almost like a research question)
Conduct research & evaluate outcomes

Question 7

What does one who is reflective do - Schon 1983)

Answer 7

‘Thinking on your feet’
‘use of past exp’
‘use of psych theory’

Question 8

What does clinical psych aim to do - BPS 2010

Answer 8

redue psychological distress and enhance and promote psychological well being by the systematic application of knowledge derived from psychological theory and data

Question 9

What are complex initerventions?

Answer 9

Those that have several interacting components

Question 10

Who issued guidance on how interventions should be developed and evaluated?

Answer 10

Medical Research Council (MRC)

Question 11

What did the MRC say about dev interv?

Answer 11

There = 4 main staged for developing, evaluating & implementing complex interventions

Question 12

What are the 4 main stages according to MRC?

Answer 12

1. Intervention Development
2. Feasibility & Piloting of the intervention
3. Evaluation of the intervention
4. Implementation of the intervention

Question 13

What is intervention development?

Answer 13

Interv = should be expected to have a meaningful effect for patients/service users

Question 14

How does one develop an intervention? - three stages

Answer 14

1. identify the evidence base = look at what research has been done
2. interventions shoould be based on theory = have an early understanding of the process of change
3. important to think about implementation & feasibility

processes are relevant for researchers & clinicians when developing & delivering interv for mental health

Question 15

Why is child & adolescent mental health important according to a developmental psychopathology perspective?

Answer 15

How early child exp influence later outcomes such as mental health & adulthood

Question 16

Approx how many children in the UK meet criteria for emotional / behavioural disorder?

Answer 16

10% (5-16 yrs)

Question 17

Approx how many children in the UK meet criteria for anxiety?

Answer 17

3.5%

Question 18

Approx how many children in the UK meet criteria for adhd?

Answer 18

2.2%

Question 19

Approx how many children in the UK meet criteria for disruptiive beh?

Answer 19

5%

Question 20

What does ford et al say about the duration of conditions in children?

Answer 20

For about 50% they persist for 3 years

Question 21

When a child has neurodevelopmental conditions (autism, intellectual disability) prevelence rates of co-occuring conditons =

Answer 21

higher

Question 22

Challenges in child & adolescents mental health?

Answer 22

It is important children = not over diagnosed = behaviours are needed to be clinically relevant

Question 23

Behaviours should be considereed interms of what is….

Answer 23

Appropriate for their age (e.g temper outbursts at 3 vs 14 yrs)

Question 24

What may diagnosis and assesments be complicated by?

Answer 24

the fact that some children = unable to communicate how they = feel

Question 25

What should interventions be based on always?

Answer 25

evidence & theory

Question 26

Where were the first clinical psych trainees trained?

Answer 26

Maudley hospital in London 1949

Question 27

Externalising behaviouirs in childhood?

Answer 27

behaviours directed putward e.g aggression, non-compliance, impulsivity

Question 28

What is ADHD ?

Answer 28

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

Question 29

What is ODD?

Answer 29

Oppositional defiant disorder Pattern of angry / irritable mood and argumentative / defiant behaviour - exhibited w at least one person who = not a sibling

Question 30

What is conduct disorder?

Answer 30

Ongoing pattern of behaviour where teh rights of other or social norms = ignored = shows at least 3 beh over a 12 month period

Question 31

What is formulation?

Answer 31

Putting together a diagnosis

Question 32

What are the processes of formulation/

Answer 32

1. Presentation at clinical seervices 2. Assesmnet 3. Treatment planning 4. Treatment implemation and moitoring overtime

Question 33

Key Theories in externalsing beh in childhood: - env

Answer 33

Parent child interactions Media and peer influences Executive function deficits Cog fcators Theory of Mind deficits Neglect Socio economic factors Family env

Question 34

Key Theories in externalsing beh in childhood: - gen

Answer 34

Genetics Structural braindiff Maternal smokoing during oreg Low birth weight Neurotransmitters

Question 35

Parenting & the family env - johnston & Mash 2001)

Answer 35

Adverse faimalial env & parenting practices = commonly observed in families of children who show high levels of externalising beh prob

Question 36

Duncombe et al 2012 = Child emotion regulation = Externalising child behavious = Inconsistent Discipline & Corporal punishment

Answer 36

Child emotion regulation may mediate the r/s between parenting practices and child disruptive beh

Question 37

Socioeconomic factors in dev of externalsing child beh

Answer 37

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

Question 38

Cog factors in dev of externalising child beh

Answer 38

Executive function deficits = been i,plicated in ex beh prob in children ---> impulsivity, wwm and cog flex

Question 39

Cog factors in dev of externalising child beh - Seidman 2006

Answer 39

Some children w adhd display diff in reward processing - preference for smaller, immediate rewards over larger later rewards & dispkay greater sensittiity to social rewards

Question 40

Internalising behav in childhood

Answer 40

Beh directed inward = withdrawl & low mood = childhood anxiety disorders e.g sep anx = childhood major dep

Question 41

Childhood anxiety

Answer 41

Anxiety in children = will over lap w adult anciety (GAD & SAD) Some manifestations of anx = more preveleant in childhood

Question 42

What is Sep Anx?

Answer 42

= Disproportiante distress when sep form parents = Distress ab harm coming to parents = Unable to sleep alone Comb of inherited factors & env stressors

Question 43

Traumatic Life Exp & Physical Health Cond - how many % of children exp

Answer 43

20% children exp chronic physical health cond e.g. asthma, epilepsy - van der lee et al

Question 44

Anxiety = higher level in those w or w out physical health cond?

Answer 44

with

Question 45

Unpredictability of physical health conds e.g epileptic fits can lead to?

Answer 45

Learned helplessness

Question 46

Ferro & Boyle example of their theory of indirect effect of physical health cond by impacting the family env

Answer 46

P.H.C = Maternal Depression = Family Dysfun = Anxiety & Depression in children

Question 47

Understanding potentional env mechanismis for mental health will help us to develop...

Answer 47

targeted interventions - that target those mechanisms

Question 48

Clinical psychologists might consider....

Answer 48

a range of factors and ofter work as a part of multi disciplinary teams (p.h services)