Chapter 20: Pediatric and Clinical Child Psychology :Chapter 20: Pediatric and Clinical Child Psychology http://www.youtube.com/watch?v=4uQVsB53npY


Overview :Overview Definitions, History, and Perspectives Major Activities: - General Issues - Assessment - Interventions - Are Psychological Interventions for Children and Adolescents Efficacious? - Pharmacological Treatment - Prevention - Consultation Training


Developmental Considerations :Developmental Considerations Psychologist, Dr. Geoffrey Putt http://www.youtube.com/watch?v=2DkW49-rbj8


Developmental Perspective :Developmental Perspective Developmental Perspective – Pathology - results from some deviation in one or more areas of devt. compared with same age peers. (a) Active, dynamic process that is best assessed over time; (b) similar devt. problems may lead to different outcomes (c) different developmental problems may lead to the same outcome; (d) developmental processes and failures may interact; and (e) developmental processes and the environment are interdependent-each influences the other such that they cannot be viewed separately.


Developmental Considerations :Developmental Considerations Psychiatrist Dr. Jim Sorrell http://www.youtube.com/watch?v=6Z7K9gU2teA&feature=channel


Definitions: Clinical Child Psychology :Definitions: Clinical Child Psychology Clinical child psychology (CCP)– Assessment/Treatment of pathology in children and adolescents. Setting – Usually private practice settings or in outpatient clinics. Subspecialties – much overlap between the subspecialties CCP are often more diverse in their theoretical orientations than pediatric folks. CCP place a greater emphasis on training in assessment, developmental processes, and family therapy.


When do Children Need Therapy? :When do Children Need Therapy? Clinical Psychologist Dr. Cynthia Arnold http://www.youtube.com/watch?v=LWtOukSr_yI


Definitions: Pediatric Psychology :Definitions: Pediatric Psychology Pediatric psychology (PP)– Assessment/treatment – younger children and adolescents prior to or early in development of psychopathology. Setting – Usually Medical setting with referrals from pediatricians. Compared to clinical child psychology – PP use short-term, immediate intervention strategies Tend to place a greater emphasis on medical and biological issues.


Pediatric Interventions :Pediatric Interventions Psychologist Dr. Brett Kuhnhttp://www.youtube.com/watch?v=hpjG_JQCnVc


General Issues :General Issues Who is the client? In many instances, the most effective treatment is directed at the parents because they are largely in control of the child. Internalizing/Externalizing Disorders


Assessment :Assessment Children and adolescents: Rarely seek out treatment on their own. Know less about roles of mental health professionals May/May not why they are asked to see you. Interview differently Pay attention to beh observations (naturalistic, analog, participant, or self-observational strategies) Seek information from other people besides the child (collateral). Intelligence Tests (WISC, WPPSI), Objective/Projective Personality Tests Questionnaires and Rating Scales (CARS, PIC, CBCL)


Interventions :Interventions Play Therapy – an eclectic set of techniques that uses expressive play as a substitute/supplement to verbalizations. Behavior Therapy Behavioral Pediatrics Cognitive-Behavioral Therapy Psychoanalytically Oriented Group and Family Therapy


Interventions :Interventions Behavioral Pediatrics – the application of cognitive and/or behavioral techniques to problems encountered by children in medical settings. Cognitive-Behavioral Therapy – therapy framework - that emphasizes the role of thinking in the etiology and maintenance of problems. - By teaching children to alter their cognitions through internal assessments and self-statements, the therapy aims to improve the child’s problem solving and planning, help him or her to delay gratification, and bring any problematic behaviors under rational control. Group and Family Therapy


Are Psychological Interventions for Children and Adolescents Efficacious? :Are Psychological Interventions for Children and Adolescents Efficacious? In general, psychological interventions for children and adolescents are efficacious. Recent reviews have identified specific interventions for specific child and adolescent problems that have empirical support.


Pharmacological Treatment :Pharmacological Treatment Medications may be used by themselves or as adjuncts to psychotherapy in the treatment of children and youth. The medications most frequently used are those that treat AD/HD.


Prevention :Prevention Prevention – the principle that, in the long run, preventive activities will be more efficient and effective than individual treatment administered after the onset of disease or problems. Both pediatric and clinical child psychology focus on the prevention of childhood problems.


Consultation :Consultation Consultation – the act by which a person who provides services to others enlists the help of an expert for the purpose of improving these services. Various health, social, and legal service agencies consult with clinical child psychologists and pediatric psychologists about psychiatric, developmental, psychosomatic, or other illness-related difficulties.


Psychoeducation about Autism :Psychoeducation about Autism Clinical Psychologist, Dr. Stacy Carmichael http://www.youtube.com/watch?v=SE8O_ed9Ons


Example of Consultation :Example of Consultation Clinical Psychologist, Dr. Rochelle Harris http://www.youtube.com/watch?v=icZI-i-usyc


Consultation :Consultation Independent Functions Model – psychologist functions as a specialist and independently carries out diagnostic and treatment activities on patients Indirect Consultation Model – the pediatrician retains chief responsibility for patient management. The psychologist has, at best, limited contact with the actual patient and makes a contribution through analysis of information provided by the pediatrician. Collaborative Team Model – pediatrician, psychologist, nurse, and others work together and share the responsibility and decision making.


Training :Training Roberts et al. (1998) presented the following training model: Life span development psychology Life span developmental psychopathology Child, adolescent, and family assessment methods Intervention strategies Research methods and systems evaluations Professional, ethical, and legal issues Issues of diversity Multiple disciplines and service delivery systems Prevention, family support, and health promotion Social issues affecting children, adolescents, and families Specialized experience in assessment, intervention, and consolation


Future :Future Issues related to ethnicity, race, or culture Research Innovative treatment models Increased focus on injury prevention and prevention of child abuse/neglect.