Interventions in Child Clinical Psychology Flashcards
What is a clinical child psychologist?
An applied practitioner trained in the psychological assessment, treatment and management of children and young people with physical illness, disabilities, emotional, behavioural and other difficulties
Child mental health services - tier 1
Early intervention and prevention
Schools Children's centres Health visitors School nurses GPs
Child mental health services - tier 2
Early help and targeted services
Child mental health services - tier 3
Specialised CAMHS
Eating disorder specialists
Outpatient services
Child mental health services - tier 4
Inpatient provision
Can’t be helped in the community
Need round the clock support
How do we get to an intervention?
Assessment information is gathered from multiple sources
A case is formulated
Formulation
Application of psychological theory to create shared understanding of the problem
Parent-child relationship in psychological interventions
Many psychological interventions are aimed at the family level
This is build on the understanding that the parent-child interaction is key
Parents can be the most effective agents for change for the child
Why is an evidence base with children difficult to obtain?
This is a very broad area that is often under researched due to the nature of the complexity of the work and obtaining ethics
Some areas have more evidence for a particular model than others such as CBT for anxiety, but that doesn’t mean there aren’t other approaches
Main interventions for behavioural and emotional problems
Timid to Tiger
Behavioural Exposure
What does theory tell us about behavioural and emotional problems?
Children want attention from caregivers which leads them to feel loved
Real-life experiences shape children’s behaviour via positive and negative reinforcement
What does inappropriate behaviour represent?
An unmet need
What could the function of inappropriate behaviour be?
Gain attention or elicit care Avoid task demands Gain tangible reinforcement (praise) Reduce feelings of discomfort (anxiety) Provide interesting stimulation
If a child is avoiding school, why might this be and what can you do about it?
They might be gaining attention from avoiding school
An intervention could be to praise them when they do go to school
How do we come up with interventions?
Assume the behaviour is functional
Look at how it helps the child
See how their needs could be met in another way which doesn’t involve the inappropriate behaviour
Parenting programmes
Target parents
Based on principles of behaviourism
Focus on instructing the ‘how to’ of parenting
Use principles of reinforcement
Positive attention and praise for desirable behaviour
Setting clear and reasonable limits for undesirable behaviour
What is the Incredible Years programme?
Traditionally for parents of younger children (<10 years)
12-week programme
Utilises the parents as therapists - aims to raise confidence and offer support
Uses a tiered system
Incredible Years - Play (bottom tier)
10 mins a day Praise, no criticism Child led Questions are banned Teaching is banned Commentary on playing - gives attention to the child and provides learning opportunity without testing
Incredible Years - Praise
Specific, labelled and timely
Enthusiasm
Avoid ‘sting in the tail’ (see what you can do when you make the effort)
Reward systems (sticker charts) - keep them positive, one behaviour at a time and specific
Reinforcement
