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Child Mental Health

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jessica davis

on 21 November 2014

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Transcript of Child Mental Health

Child Mental Health
Subtopics
PTSD
Bullying
Autism
Family Environment
Introduction
These subtopics correlate with one another and can greatly affect a child’s mental health. These four subtopics are risk factors that can negatively impact mental health. We chose these subtopics because they are prevalent issues that are seen in the behavioral field and are often underlying causes of symptoms. These subtopics are also seen grouped together with one another and can lead to disorders such as PTSD, depression and anxiety.

Autism, bullying, abuse and unhealthy environments effect all people regardless of race, ethnicity culture, socioeconomic status or gender. These subtopics affect all different types of children and unfortunately will have consequences that negatively affect a child’s mental health.

PTSD
Evidence Based Practice Resources:

• Meta-Analysis and Systematic Reviews
• Evidence Summaries and Abstracts
• Research Articles
• Study Protocols

Bullying
Is a bully prevention program that focuses on a team building model more or less effective in adolescents than an approach which focuses on increased levels of staff intervention?

Summary of research:

•Team-building vs increased supervision including disciplinary action

•Increased education on bullying

•Perceived effective aspects of intervention
Autism (ASD)
-According to the CDC, 1 in every 68 children are diagnosed with ASD.

-ASD is five times more prevalent in males than females. Approximately 1 in 42 boys will be diagnosed with ASD verses 1 in 189 girls who are affected.

-83 % of children diagnosed with ASD have co-occurring neurologic, developmental, chromosomal, psychiatric and genetic diagnosis.

-46% of children with ASD have average or above average intellect.

-ASD can be diagnosed in children as early as two years old. Parents typically become aware of developmental delays before their child turns one.

www.cdc.gov/ncbddd/autism/data.html
Family Environment
Conclusion: Risk Factors of Mental Health for Children
Post-traumatic stress disorder

Bullying

Autism spectrum disorder

Family Environment

Amanda Wolfe, Denae Biegel, Melanie Fuentes, & Jessica Davis
Why should we
(social workers) care?
-ASD does not discriminate

-Some social workers will have their career working with ASD clients and their families

-ASD affects not only the client but their whole family

-Social workers should be educated on empirically supported interventions

Evidence Based Practice Resources for Interventions
-Evidence based articles

-Meta-analysis

-Southwest Autism Research and Resource Center (SARRC)

-EIBI increases IQ scores and adaptive behavior skills

-Clinician views success as “seeing a change in a child’s behavior” with emphasis on socialization.

Question: How reliable are IQ scores for a 2-3 year old child?

Synthesis
-Most empirical evidence

-Supported by most practitioners

-Implemented by most practitioners

-Can be implemented by clinicians or parents

-Collaborative joint effort to determine goals (desired behaviors)

-EIBI that is implemented in the home environment is more beneficial to families that do not have transportation.

-Focus on expanding language and communication skills which makes it culturally sensitive because the parent can implement the intervention in their own language.

Diversity of Intervention
-Not all children with ASD show improvement after interventions have been implemented, including Early Intensive Behavioral Intervention. More research is required to analyze different factors, such as child characteristics, that might contribute to these findings.

-Research is needed to analyze the long term effectiveness of EIBI.

Unknown
Benefits of programs:

•Reduction in bullying
•Positive attitudes in students and faculty
•Education on what, when, how, and what to do.

Downfall of programs:

•Increase in reports of bullying
•Peer Mediation issues
Benefits and Downfalls
•Preventive and reactive approach

•Peer Mediation

•Rachel’s Challenge
Clinical expertise
Overall findings
•Combo of high authority involvement and team building

•Increased supervision on campus

•Peer Mediation and human development

•Spread awareness of bullying

• Scales that were used to measure progress included:
-Children’s Depression Inventory (CDI)
-Child Depression Rating Scale (CDRS-R)
-Clinical Global Impression-Severity (CGI-S)
-Cognitive Therapy Rating Scale
-Clinician Administered PTSD Scale (CAPS)

• Interventions: therapy
-Individual and group
-Exposure therapy
-Developmentally adapted cognitive processing therapy (D-CPT)
-EMDR
-Trauma focused CBT
Synthesis
Therapy in combination with medication:

• Comorbidity and PTSD can be a risk factor for antisocial and aggressive behavior. The research suggested that the issue of comorbidity needs further study.

• Medications, such as selective serotonin reuptake inhibitors (SSRIs), are sometimes used to treat PTSD or trauma related symptoms and in some cases are effective when combined with therapy. From the research collected, combined pharmacotherapy and psychological therapies to treat PTSD in adolescents did not prove to be more effective than medication or therapy alone. In one study, children and adolescents who had experienced abuse showed less improvement in symptoms compared to those who had no history of abuse during combination treatment.

• Parent involvement is necessary and common in PTSD treatment. This was also greatly emphasized by the clinician that I interviewed.
Synthesis Cont.
• Prior to doing research, I assumed that therapy alone was most effective for treating trauma related symptoms; however, I wanted to compare therapeutic interventions to combination treatment consisting of both therapy and medication.

• After doing research and interviewing a clinician who works specifically with children and adolescents who have experienced trauma, I believe that therapies such as EMDR and the counting method are most effective when treating trauma as a result of abuse in adolescents.

• The clinician that I interviewed, often implements psychoeducation with parents when working with adolescents who have experienced abuse, teaching that it is imperative that the client feels safe in his or her environment before beginning trauma work.

• In some cases, further trauma work is unnecessary as the psychoeducation piece is effective with decreasing symptoms related to PTSD.

Intervention
• Gender
• Race
• Socioeconomic Status
• Culture
• Language

Diversity
• Comorbidity
• Differences in children and adolescents
• Scales and forms of measurement
• Dropout rates
• Need for a more thorough assessment of trauma

Unknown
Early Intensive Behavioral Intervention
Evidenced Based Practice Resources

Studies:
Children's behaviors
Relationship between parents and children
Domestic violence between parents
Synthesis
When used as an intervention for children who are adopted and have attachment issues, child parent relationship therapy had a moderate to large effect on children's behavior problems
Triple P-Positive Parenting Program is a training that educates parents on ADHD which in return has reduced external behaviors and controls the disruptive behaviors of school aged children with ADHD
It is important to recognize that children and adolescents exposed to family violence can be a traumatic experience. Treatment that targets PTSD symptoms show a decrease in behavior.
Parental conflict affected the child's internalizing behavior, externalizing behavior, and trouble with peers.
Intervention
Child parent relational therapy

Results showed significant reduction in child's problem behaviors

Includes child and parents

Parent-child relationship is critical for the long-term welfare of children

Builds bonding, trust, and communication
Diversity
Triple P-Positive Program study was done with Iranian children and mothers. Results could be different with American families or if the study included fathers instead of mothers

Common concerns in Arizona such as children who were adopted, children with ADHD and PTSD.
Unknown
Research was lacking direct correlation of conflict in the home and negative behaviors of children

Able to address different aspects and draw conclusions

Not enough research done on my subtopic
Conclusion: EBP Interventions
Post-traumatic stress disorder- Successful with parental involvement. EMDR has been proven to be successful and also the counting method.

Bullying- Preventive and reactive interventions. Increased supervision on campus, peer mediation, and team building activities.

Autism spectrum disorder- Early intensive behavioral interventions implemented by clinicians and parents in the home and in the community.

Family Environment- Parent child relationship therapy to build bonding, trust and communication.

Conclusion: Needs for Future
Post-traumatic stress disorder- Research to differentiate between child vs adolescents in treating Post-traumatic stress disorder. An assessment, scale and a form of measurement specific to this disorder.

Bullying- Evidence based intervention that is both preventive and reactive to bullying.

Autism spectrum disorder- Research that look at the long term effects of early intensive behavioral interventions.

Family Environment- Future research should include fathers. Research that focuses on correlation of conflict in home & negative behaviors in children.
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