Lecture 12 CP Treatment

Question 1

guiding principles for effective treatment

Answer 1

1. Target the ecology of the child
2. Take a developmental perspective
3. Be formulation/hypothesis-driven
4. Form a strong therapeutic team

Question 2

Active involvement of parents

Answer 2

common to the most established treatments for both young children and adolescents

Early-to Middle-Childhood:
-Parent training (aka: Parent Management Training; Social learning based parent training; BehaviouralFamily Intervention, etc)

Late-Childhood/Adolescence:
-Parent training + youth-focused components (e.g., Multisystemic Therapy)

Question 3

A developmental perspective informs

Answer 3

• when is the optimal time for intervention
• which family environment variables should be targeted
• how to best involve the child

early-to-middle childhood: key -parenting targets -> coercive cycles

Late childhood/adolescence:

• Key parenting targets-> monitoring and supervision (skills for regulating child activities outside home)
• children as active participant

Question 4

Parenting Targets for working with early onset CD

Answer 4

Positive Involvement, rewards for prosocial behaviour, secure attachment

Effective Discipline Strategies, modeling of non-aggressiveinter-personal style

Monitoring of child’s activities, Positive social engagement

Question 5

Coercive Family Process

Answer 5

positive behaviour: from ignore & attachment-neutral to attention & attachment-rich

negative behaviour: from attention & attachment-rich discipline to ignore/calm & attachment-neutral discipline

Question 6

Levels of behavioural family intervention

Answer 6

Mass media education

Targeted provision of information

Clinical interventions
–provision of information
–brief parent training
–intensive family intervention

Question 7

Problems with Time out

Answer 7

Parent waits too long before using time out

Parent uses it emotionally

Child gets very distressed -gets sick, destroys room

Fight starts again as soon as time out ends

Multiple children

Question 8

reasons for children as participant in late childhood

Answer 8

1. With physical development, child increasingly capable of resisting the limit-setting strategies
2. The unique developmental tasks of adolescence, problem-solving and communication, best targeted with parents-children jointly.
3. Emerging cognitive resources (abstract reasoning, perspective taking, meta-cognition) to engage in self-regulatory skills training not possible at younger ages

Question 9

Minuchin: Hierarchical structure of a healthy family

Answer 9

Executive parental subsystem + Child subsystem

Question 10

effectiveness of parent training

Answer 10

Parent training success rates: ~60%

Predictors of poor outcomes: SE disadvantage, minority group, younger maternal age, parental psychopathology