Lecture 12: Treatment for CD Flashcards
Guiding principles for effective treatment
- target ecology of child
- take a developmental perspective
- be hypothesis-driven
- form strong therapeutic team
target ecology of child
relationship processes: with parents, peers, adults, siblings
behaviour settings: home, school, public park, neighbourhood, school activities
common, established treatment for young and adolescents?
active involvement of parents– behavioural parent training
good treatment for early to middle childhood?
parent training
- social learning based parent training
- parent management training
- fam interventions
good treatment for late childhood/ adolescence
parent training + youth-focused components
- multisystematic therapy
- focus on child themselves
- help them regulate emotions
what does developmental perspective say
- when its optimal time for intervention
- which fam env. variables should be targeted
- how to best involve child
whens the sweet spot
- early childhood– 2-8 yrs old
contemporary theory
attachment theory–> structural systems
with coercive family processes– coercive cycles– reinforcement traps
how does coercive family process work
pre-treatment:
+ behaviour–> tend to ignore
- behaviour–> give attention, attachment RICH discipline= parent gives so much attention
BUT its better if…
post-treatment: operant based
+ behaviour–> give attention, attachment RICH
- behaviour–> ignore, calm attachment neutral discipline
Behavioural family intervention– for parent training you need…
- social support
- child interventions
- anger management
- high risk settings
- brief marital interventions– need to consider parent depression
reward behaviour when child being good?
- descriptive praise
- physical contact (hugs)
- parent time (give them YOUR time)
reward behaviour– should it be consistent type?
no, it should be unpredictable, varying rewards– becomes resistant to extinction
attachment rich rewards
- when good= RLY praise them– RICH attachment
touching, eye-contact, expressions
attachment neutral discipline
- when being bad= no attachment– ignore them, don’t give them attention
effective discipline
child misbehaves–> gain child’s attention (in quiet voice: don’t do A, pls do B)–> if child complies= praise–> if child doesn’t, then repeat clear instructions quietly, don’t be emotional–> child escalates–> time out
time out
- should be brief– don’t lock them in there forever
- quiet time in a chair
- time out in separate room (safe, neutral, boring place)
- as soon as they have cooled down= can get them out
- time in needs to be fun, loving
- needs to be attachment neutral
problems with time out
- parent waits too long
- gets stressed, destroys stuff in room
- get more angry once out of room
- multiple children= hectic
developmental perspective: late childhood/ adolescents
monitoring and supervision= super important
what happens when theres fam adversity (unemployment), parent problems, disrupted parenting practices
= conduct problems
so, you need model of engaging
even if your treatment is good, need actual engagement model– need everyone to work together
Minuchin: hierarchical structure of healthy family
- parents need to be a TEAM
- need clear hierarchical system between kids and parents
- if system disrupts= won’t work
