Working with Children and Adolescents Flashcards
1
Q
According to Theodore (2017) what 6 broad themes does contact between children/adolescents and psychologists centre around?
A
- 6 broad themes:
- Crises (suicidal behaviour, school violence, grief)
- Educational concerns and learning disabilities
- Psychopathology
- Psychosocial Adjustment (social skills, stress, coping, divorce)
- Physiological health conditions (obesity, asthma, diabetes, Tourettes)
- Neuropsychological conditions (Austism Spectrum, traumatic brain injury)
- Common issues;
- Anxiety and depression; often expressed through outbursts, anxiety focus on future, depression on past
2
Q
Outline the Developmental Perspective of childhood development according to Sattler
A
- The interplay of genetic disposition and environment follow a non-random form and direction.
- Rate and timing of particular development show intra-individual differences (language vs physical development) and inter-individual differences (compared to peers)
- Change is both qualitative (appearance of new processes) and quantitative (changes in magnitude of capacity)
- By 2 years, most begin to develop expressive language
- By 7 years thought processes become more systematic
- Emphasises Bio-Psycho-Social factors which interact
- Maladaptive behaviours result from mismatch between needs and environment
3
Q
Outline the Normative-Developmental Perspective of childhood development according to Sattler
A
- The Normative-Developmental Perspective is an extension of the developmental perspective where changes in cognitions, affect and behaviour are considered relative to peers.
- Cognition = Mental processes incl perception, reasoning, memory
- Affect = experience of emotion
- Consider the influence of:
- Demographic variables; age, gender SES
- Developmental Variables; language, motor, social skills
- Influence of Prior Development
- Normative Data is used to establish reasonable treatment goals, guide in selecing target behaviours, compare information across sources, identify abnormal levels of functioning
4
Q
Outline the Cognitive Behavioural Perspective of childhood development according to Sattler
A
- Focusses on the importance of cognitions and the environment as major determinents of emotion and behaviour (ABC perspective)
- Cognition = Thoughts and processing of information. Inc values and beliefs, negative self statements, hypersensitivity to others, low self concept
- Environmental Contingencies = setting/context (eg temp, noise), natural reinforcers (food, contact), distractors (crowds, cold)
- Empirical Validation is emphasised throughout assessment and treatment
- Functional behavioural assessment = Target antecedents and consequences
5
Q
Outline the Family Systems Perspective of childhood development according to Sattler
A
- Focus on the structure and dynamics of a family as determinents of a child’s behaviour. 8 Elements:
- Structure; characteristics of the members
- Function; tasks the family performs for its members
- Assigned and shared roles; responsibilites of each member
- Modes of Interaction; style of interaction
- Resources; health, finance, skills
- Family History; stressors and outlook
- Life Cycle; stage of family unit (age of children, parents)
- Individual members history
- Parts of a family are interrelated and cannot be understood in isolation. Sum is greater than the parts, and the total function shapes behaviour of the individual and vice versa.
6
Q
What is the eclectic approach to assessment of childhood development according to Sattler?
A
- The eclectic approach offers a framework rather than a perspective
- Emphasises four main factors
- Indivual, familial and environmental factors are critical in childhood development
- Children are shaped by the environment and genetic constitution
- Observed behaviour may not always reflect childrens potentials
- Children also shape their environment
7
Q
What 10 Factors can be utilised to increase engagement with children?
A
- Setting: Make the space child friendly (toys, books, furniture), including waiting room
- Environment: Consider that children can be noisy, how this might affect other clients
- Language: Use age appropriate language suited to the child’s level
- Tone: Don’t talk down or patronise
- Timing: Avoid times when the child may be tired or miss out on favourite activities
- Length: Be conscious of the attention span, take breaks
- Flexibility; Adapt to the child, work on the floor, follow their lead
- Demeanour: Be relaxed, curious, open to their ideas
- Characteristics; Patience, Warmth, Respect, Understanding, Assertiveness, Adaptability, Creativity
- Pop Culture: Knowledge of age appropriate culture (careful not to be daggy)
8
Q
What are some considerations during the first session with a child and how can you address them?
A
- Client Autonomy: It is unlikely the child was involved in the decision to go to therapy.
- They may believe themselves to be defective
- They may be frightened
- They may not understand what is happening
- Techniques
- Do not include the adult in the first session
- Prepare two client consent forms; the formal one for the adult, and a simple one for the child.
- “I understand that I can say no at any time”
- “I understand that X may tell other adults what I say if something needs to be done”
9
Q
What are some tips for explaining the need for parents to not stay in the therapy room?
A
- Remember that although the parents may be paying, the child is also a client
- When necessary to calm a younger child, minimise verbal and non verbal involvement.
- Children and adolescents tend to speak more freely away from parents
- When parents insist;
- reassure them that concern is natural,
- explain method and treatment plan
- arrange check in sessions,
- reassure that in case of risk you will communicate
- Most of all, assure them that their child is in a safe environment
10
Q
According to Taylor and Adelman, what are some considerations when enlisting a parent’s support in children’s mental health treatment?
A
-
Barriers to Parental Motivation:
- negative perceptions of mental illness,
- negative feelings about the therapist,
- practicality of access,
- demands of treatment
-
Use consent agreements to manage motivation:
- Involve parents in decisions (whether to bring the child on 1st consult, which therapist, time frame),
- Share assessment info to agree upon a definition of the problem
-
Maintaining Involvement
- Ensure parents feel related to the therapist
- Enhance value of involvement by inclusion of ongoing participation
- Provide continuing support for learning and growth
-
Always;
- Help all parties appreciate the value of alliances,
- Listen to all persepectives
- Validate feelings
11
Q
What changes occur to the brain during adolesence?
A
- The brain continues to develop into the 20s
- Pre-Frontal Cortex; peak grey matter is puberty onset, significant synaptic pruning occurs during adolescence
-
Social Cognition: Medial pre-frontal cortex activity reduces in adolecence (different cognitive strategy)
- Perspective taking task: adolescent problem solving intact but perspective tacting is still developing
- Limbic System: Reward for risk taking is hypersensitive during adolescence (while decision making in Prefrontal Cortex is still developing)
12
Q
According to Sekelman (2015) what 6 things should be done when working with adolescents?
A
- Avoid diagnostic labels where possible. Seek to understand the adolescent’s perspective.
- Avoid repeating unsuccessful encounters with other therapists: Ask what worked and didn’t and what was upsetting
- Remember that adolescents feel misunderstood and dismissed; remain open-minded and ask how they feel things are going
- Be flexible and willing to improvise.
- Consider autonomy invite adolescents to take the lead in defining treatment goals.
- Your role is guide not expert: Respect that adolescents have the strengths and resources to initiate healthy change.
13
Q
According to Orygon, what are some important considerations when encountering barriers to engagement with adolescents?
A
- Why is the behaviour occuring?
- Development may not have caught up with demands (difficulty expressing themselves)
- Negative interpersonal experiences and traumas
- Stressors and medication
- Belief therapy will not support them or that you are there to help others
- Practical barriers (language, culture, cost)
- What if you can’t engage despite best efforts?
- Don’t force the issue
- Consider onward referral or alternative treatment plans
- Leave the door open
14
Q
According to Orygen what are the 10 core principles for dealing with challenging behaviours?
A
- Adopt a non-blaming stance and try to understand their perspective
- Don’t take the behaviour personally
- Reassure them that you are here to support them
- Always work from a recovery oriented approach and explore their strengths
- Check in regularly to make sure you are on track
- Ask if there are practical things you can help with (ie centrelink)
- Consider transference and counter-transference
- Involving parents and peers may help if the young person is open to it
- Always try to conduct a risk assessment
- Practice self care, use supervision, avoid burnout
15
Q
What are some techniques for dealing with specific types of challenging behaviours?
A
-
Reluctant/Resistent Behaviour
- Acknowledge and normalise the difficulty
- Try to explore why they are resistent
- Consider practical, cognitive, language, and culture barriers
- Empathise if the young person feels coerced
- Ask if there is any way you can make them more comfortable (pet?)
-
Self-Harm
- Explore the function of the self harm (open and curious)
- Reassure them you won’t remove their coping mechanism
- Balance confidentiality and risk
-
Aggression
- Protect yourself and others from harm
- Be clear, respectful and agree as much as possible
- Give choices and be clear about consequences
-
Intoxication
- Treat as health not moral issue
- Always assess mental state and risk (if low risk, reschedule)
- Be mindful that drugs are often seen as a solution not problem
-
Chaotic Behaviour
- Be clear and concise
- Conduct an MSE
- Be practical and obtain collateral info
