Lecture 5 Flashcards
What is Intervention
Definition: Application of theories and practices with the goal of helping children and families adapt more effectively to their current and future circumstances.
Interventions today are planned by combining the most effective approaches based on what we know about child development or a particular childhood disorder.
Data is needed to show that interventions work.
Evidence focuses on interventions effect on specific behaviours- this is most effective
Cant use anecdotal evidence- needs to help broad population and be applied to different situations
Misconceptions of intervention
Only for addiction
Makes the person recognize their actions and feel guilty abt it
Forced into intervention
Calls attention to problematic behaviours
Real inervetnions- should happen with ppl- they should be involved and advocated for change
Important feaytures of interventions
Intent to help
Present and future oriented
Targets of intervention vary
Ethical
Evidence based
Child or client driven Underlying intent to help person- strive to better person/ their situation
Not about reducing symptoms in present- goal to promote future wellbeing and long term adjustement
The focus f interventions can change- individual vs family
Interventions should be ethical- should help the person, follow ethical procedures
Be evidence based- backed by data and expert consensus- fill gaps of research
Should respect child and family and work with. Them to build strengths
Often a dimension/ spectrum
Intervention spectrum
Moves from most universal to most focuses
Have child at centre and think of ecological framework- what impacts the child- family, culture
Interventions occur across ecological framework
Some aspects focues on larger groups- no defined aspect/ situation- ex focus on pre k
Move to right- get more specific- specific risks factors
Indicated prevention- elevated behavioural problems
Intervention settings- can be close to child or not- close to home to inpatient unit- differs in monitoring care
3 forms of intervention
Spectrum of intervention
Prevention- decreasing chance of undesired future outcome
Early intervention= best, sets child up for success
Treatment- undesired outcome has already occurred- want to reducer impact
Across spectrum- goal is to treat certain risk factors- reach most children possible
Prevention
Focus: Preventing problems before they occur.
Treatment
Focus: Eliminating or reducing the impact of a problem or outcome that is existing or has already occurred.
Maintenance
Focus: Increasing continued adherence to treatment over time to prevent relapse or recurrence of a problem.
Cultural considerations
Different population groups and cultures can have different:
Parenting values
Parenting beliefs
Perceptions of mental health and services
Child rearing practices Can have different values as parents and different views on disorders and health
These differences can inform how and when a family may identify a problem, willingness to seek help and treatment
Cultural compatibility hypothesis
THE CULTURAL COMPATIBILITY HYPOTHESIS
Treatments are l ikely to be more effective when they are
compatible with the cultural patter ns of the child and family.
Is some research suggesting this is ture
Better intervention outcome when clinician has same cultural background
IMPORTANT NOTE
Generalizations about cultural
practices and beliefs often fail to
capture the rich individual differences that exist within and between different cultural groups.
Caution must be taken not to
stereotype individuals of any cultural group.
Those are generalizations and patterns- not set in stone
There is variability within and across cultures
Underlying idea- emphasis on working with child and family to understand attitudes of behaviour and health to create the best treatment plan and build on cultural strengths
Cultural considerations in practice
Sprint supporting pro sociality and resilience in newcomer transitions
Goal: To promote the mental health and development of Middle Eastern refugee children and their caregivers by adapting and implementing a social–emotional intervention approach for refugee caregivers and practitioners who work with refugee families.
How to engage in research with culture in mind
SPRINT
This intervention is selective prevention- know refuges are at greater risk for trauma- warrants as a at risk group
Intervention delivered
Needs Assessment
Conducted case study interviews of refugee caregivers and service providers to better understand refugee families’ existing needs and areas of strength.
Intervention Adaptation
Thematically coded case study interviews to identify common themes of strength and needs, and directly applied the results to inform the intervention.
Identified Need
Mental Health Stigma
Intervention Adaptation
Emphasis on social– emotional development to support mental health.
Sensitivity to stigma.
Target social emotional characteristics
Identified Strength
Interpersonal Connections
Intervention Adaption
Emphasis on empathy as a critical component of social– emotional development.
Nurture social connectedness
by emphasizing the importance of healthy relationships in the
family and community.
Emphasize empathy
Socialization in different contexts
Race socialization- messages that parents give to child about race
Ethnic socialization- regards other races then black races
Preperation for bias- families understand discrimination and racism- prepare child to deal with it
Cultural socialization- expose child to positive traditions and cultural aspects
Preperation of mistrust- detrimental- taught to mistrust other groups- they are a threat
white Parants communicate egalitarianism- all ppl are equal- not successful teach a fallacy and to ignore the problem
Having in group members do intervention- match culture
Realistically demonstrate child’s different experiences and beliefs about race
Growing area in research
Expanding into cultures beyond black and white
Looks into how cultures interpret experiences and emotions
Black parents teach child top avoid feelings more- becomes a maladaptive strategy
Helpful to think of to support families learning
What is most helpful in context of enviroment and experiences
Treatment goals
Over time, treatment goals have moved beyond eliminating problem behaviors to also focus on building children’s adaptation and coping skills to facilitate long-term adjustment, and to affect change at multiple levels.
3 levels of treatment
- SUPPORT CHILD FUNCTIONING
Goals: Improve child symptoms and functioning; enhance social competence; improve academic performance - SUPPORT FAMILY FUNCTIONING
Goals: Improve family functioning; improve marital and sibling relationships; reduce family stress; improve quality of life; enhance family support - SUPPORT SOCIETY
Goals: Improve school-related participation; reduce justice system and special services involvement and mental health care costs; improve community health
Ethical and legal considerations
The American Academy of Child & Adolescent Psychiatry (AACAP) and American Psychological Association (APA) provide minimum ethical standards for practice:
Select treatment goals and procedures that are in the best interests of the child.- intent to help, psychologists must do no harm
Make sure that client participation is active and voluntary.- child participation is active
Keep records that document the effectiveness of treatment in achieving its objectives.keep track of if treatment is working, helps services later on, support research
Protect the confidentiality of the therapeutic relationship.-keep info confidential when can
Ensure qualifications and competencies of the therapist.
There are increasing calls to Involve children as active partners in decision making regarding their own psychological or medical treatment.- client focused approach
Standards of care- when engaging in treatment and intervention
Children are inherently more vulnerable than adults.
Children’s abilities are more variable and change over time.
Children are more reliant upon others and upon their environment.
Ethical principles and practices in treatment must be modified to children’s developmental abilities and legal status.
Seeking consultation and advice is helpful in difficult situations.
It is essential to maintain a commitment to the safety and wellbeing of the patient.
Boundary and role issues are often more prevalent and more complex when caring for children than for adults.
Within same developmental period- see variablity in children
Maintain professional boundary
Differences in treatment for children vs adult
Child is referred- often receiving different treatment- collaboration o the care and caregiver
7 general approaches to treatment
Psychodynamic
Behavioural
Cognitive
CBT
client entered
Family
Neurobiological
70 of physicians use ecclectic approach- variety of approaches
Psychodynamic
View child psychopathology as determined by underlying unconscious and conscious conflicts., freud-psychoanalytic
Focus on helping the child develop an awareness of the unconscious factors that contribute to their problems. Often focus on impacts of early memories and experiences.
EXAMPLES: Identifying conflicts through play therapy or verbal interactions with a therapist; Helping the child resolve conflicts and develop adaptive ways of coping
1- therapy is based on Freud’s evolved theory- concious and unconscious mind
2- problems shaped by childhood experienes
3- explores variety of thoughts and feelings
4- therapeutic relationship helps other relationships
5- gives insight to inner life- gives insight to unconscious thoughts and feelings
Identify unconscious thoughts and feelings
Behavioural
View behaviors as learned.- little Albert, social learning theory, applied behaviour analysis, John Watson- behaviourism
Focus is on “re-educating” the child using procedures derived from learning theory. Often focus on changing children’s environments by working with parents and teachers.
EXAMPLES: Positive reinforcement; Modeling
Child diagnosed with ADHD- change problematic behaviours- lack of focus, cant sit still
Need parents and teachers to modify behaviour
Teacher- help to teach child to monitor own behaviour and not interrupt
Neg behaviour can be shaped and modified
Parents- come up with individual behavioural plan
Goal- change challenging behaviour
