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2.
Prax Kinderpsychol Kinderpsychiatr ; 69(1): 3-21, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31918650

RESUMO

Parents' and Childcare Teachers' Agreement on Mental Health Problems, Psychosocial Ressources and Need for Action Young Children with mental health problems rarely receive professional help. Recognising a problem is one key factor for mental health care utilisation in kindergarten age. In this study psychosocial problems and ressources of 255 children (age 3,0-6,6 years) were assessed by parents and childcare teachers with the instrument "Verhaltensskalen für das Kindergartenalter" (VSK, Koglin u. Petermann, 2016). Subjective need for action was also measured. Teachers announced a need for action in 19.8 % of the children, while parents did so for 17.3 % of the children, but they agreed only for 18.9 % of these children. So agreement on need for action was low (κ = .16). Agreement was also low for psychosocial problems (Median ICC = .32), and very low with respect to the borderline/clinical range (κ = .13). No agreement was found for psychosocial ressources. Results underline the importance for Early Education and Care professionals to cooperate with institutions like social-pediatric centers to avoid blind spots in the identification of mental health problems in preschool age.


Assuntos
Transtornos do Comportamento Infantil , Saúde Mental , Professores Escolares , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Humanos , Pais
3.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31186366

RESUMO

BACKGROUND AND OBJECTIVES: In the context of protracted shortages of pediatric behavioral health (BH) specialists, BH integration in pediatric primary care can increase access to BH services. The objectives of this study were to assess the structure and process of pediatric BH integration and outcomes in patient experience (access and quality), cost, and provider satisfaction. METHODS: In 2013, we launched a multicomponent, transdiagnostic integrated BH model (Behavioral Health Integration Program [BHIP]) in a large pediatric primary care network in Massachusetts. Study participants comprised the first 13 practices to enroll in BHIP (Phase-1). Phase-1 practices are distributed across Greater Boston, with ∼105 primary care practitioners serving ∼114 000 patients. Intervention components comprised in-depth BH education, on-demand psychiatric consultation, operational support for integrated practice transformation, and on-site clinical BH service. RESULTS: Over 5 years, BHIP was associated with increased practice-level BH integration (P < .001), psychotherapy (P < .001), and medical (P = .04) BH visits and guideline-congruent medication prescriptions for anxiety and depression (P = .05) and attention-deficit/hyperactivity disorder (P = .05). Total ambulatory BH spending increased by 8% in constant dollars over 5 years, mainly attributable to task-shifting from specialty to primary care. Although an initial decline in emergency BH visits from BHIP practices was not sustained, total emergency BH spending decreased by 19%. BHIP providers reported high BH self-efficacy and professional satisfaction from BHIP participation. CONCLUSIONS: Findings from this study suggest that integrating BH in the pediatric setting can increase access to quality BH services while engendering provider confidence and satisfaction and averting substantial increases in cost.


Assuntos
Serviços de Saúde da Criança/organização & administração , Serviços de Saúde Mental/organização & administração , Atenção Primária à Saúde/organização & administração , Atitude do Pessoal de Saúde , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Educação Médica Continuada , Acesso aos Serviços de Saúde , Humanos , Massachusetts , Satisfação do Paciente , Avaliação de Programas e Projetos de Saúde , Psicoterapia , Encaminhamento e Consulta
4.
J Fam Psychol ; 33(7): 753-763, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31045402

RESUMO

This study examined the prospective associations among maternal substance use, depressive symptoms, and children's behavioral problems in a family systems therapy (ecologically based family therapy [EBFT]) condition and an individual treatment condition. Participants included 183 mothers with a substance use disorder who had at least 1 biological child in their care. Mothers were randomly assigned to the EBFT condition (n = 123) or an individual treatment condition (n = 60). Maternal substance use, depressive symptoms, and child behavioral problems were assessed at baseline and at 3, 6, and 12 months postbaseline. Autoregressive cross-lagged models were estimated to compare whether the cross-lagged paths among the 3 variables differed from zero in each treatment condition. Findings revealed that for individual treatment, strong reciprocal relationships were observed between maternal substance use and maternal depressive symptoms, and between maternal substance use and child behavioral problems. Conversely, in the EBFT group, fewer reciprocal relationships were observed, and instead, maternal depressive symptoms predicted more future child behavioral problems. These findings suggest an interruption in the dysfunctional reciprocal transmission of problem behaviors between mothers and children over time in the family therapy condition. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in interrupting the dysfunctional family dynamics that contribute to maternal substance using behaviors and child behavioral problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos do Comportamento Infantil/terapia , Transtorno Depressivo/terapia , Terapia Familiar/métodos , Relações Mãe-Filho/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Criança , Transtornos do Comportamento Infantil/complicações , Transtornos do Comportamento Infantil/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Mães/psicologia , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do Tratamento , Adulto Jovem
5.
J Consult Clin Psychol ; 87(7): 603-616, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31070387

RESUMO

OBJECTIVE: This study investigated therapeutic alliance (TA) trajectories, their demographic and symptomatic predictors, and associations with outcome in psychodynamic child psychotherapy. METHOD: The sample included 89 Turkish children (Mage = 6.87, SD = 2.11, 46% girls) with internalizing (37.11%), externalizing (21.14%), and comorbid (38.20%) problems; 12% of the children were in the nonclinical range. Independent raters coded 328 sessions from different phases of treatment using the Therapy Process Observational Coding System-Alliance Scale. Outcome measures were collected at intake and termination (Children's Behavior Checklist and Teacher Rating Form). RESULTS: Multilevel growth curve modeling indicated that TA showed a quadratic trend (high-low-high) over the course of treatment. The shape-of-change methodology indicated three subgroups following a stable pattern, a slow and an accelerated quadratic TA trajectory. Externalizing problems (teacher report) negatively predicted average TA strength. Boys and children with internalizing problems showed a declining TA trajectory, whereas children with externalizing problems (teacher report) showed an upward TA trajectory. Multivariate multiple regression analyses showed that the average TA (i.e., intercept) and the positive quadratic slope (the high-low-high pattern) positively predicted changes in internalizing and externalizing problems (teacher report). DISCUSSION: This study was the first to show the course of TA development in psychodynamic child psychotherapy, identify a number of child characteristics that facilitate and impede TA. Investigating both the strength and patterns of TA development when examining associations with outcome is important. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos do Comportamento Infantil/terapia , Psicoterapia Psicodinâmica , Aliança Terapêutica , Criança , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Feminino , Humanos , Masculino
6.
Behav Ther ; 50(3): 608-620, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31030877

RESUMO

Limited research has examined sleep-related problems (SRPs) among children and adolescents with obsessive-compulsive disorder (OCD). The present study addresses this gap by investigating preliminary associations between SRPs, demographic factors (gender and age), family variables (family accommodation and parental stress), and clinical factors (medication status, internalizing and externalizing symptoms, OCD severity, OCD-related impairment), and treatment outcomes in a sample of 103 youth (aged 7 to 17 years; 53% female) with a primary diagnosis of OCD. Clinician, parent, and child measures were used to assess demographic, family, and clinical predictors. SRPs were assessed using an 8-item measure comprising items of the Child Behaviour Checklist, Child Depression Inventory, and Multidimensional Anxiety Scale for Children as used in previous studies. Results showed that SRPs were highly prevalent among this sample and that more SRPs were associated with younger age, internalizing problems, and functional impairment. However, SRPs were not an independent predictor of OCD severity, impairment, or treatment response. Preliminary findings suggest that SRPs among youth with OCD may be more strongly associated with broader internalizing symptoms than with OCD itself. Future longitudinal research is warranted to further explore the complexity of SRPs when co-occurring with pediatric OCD.


Assuntos
Terapia Implosiva/métodos , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Transtornos do Sono-Vigília/psicologia , Transtornos do Sono-Vigília/terapia , Adolescente , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Feminino , Seguimentos , Humanos , Intenção , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Pais/psicologia , Transtornos do Sono-Vigília/diagnóstico , Resultado do Tratamento
7.
Lang Speech Hear Serv Sch ; 50(1): 1-15, 2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30950772

RESUMO

Purpose Positive behavioral interventions and supports (PBIS) provide a framework for behavioral expectations in school systems for children with and without disabilities. Speech-language pathologists who work in school settings should be familiar with this framework as part of their role in improving the outcomes for children. The purpose of this tutorial is to discuss PBIS and its use in school settings. Method The authors provide an overview of the PBIS framework and focus on its applicability in classroom-based settings. The process of implementing PBIS in classrooms and other settings such as speech-language therapy is discussed. Conclusions This tutorial provides speech-language pathologists with an overview of PBIS and may facilitate their understanding of how to implement PBIS in nonclassroom settings.


Assuntos
Terapia Comportamental/métodos , Transtornos do Comportamento Infantil/terapia , Serviços de Saúde Escolar , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil/complicações , Transtornos do Comportamento Infantil/psicologia , Transtornos da Comunicação/complicações , Transtornos da Comunicação/psicologia , Transtornos da Comunicação/terapia , Humanos , Patologia da Fala e Linguagem
8.
Behav Ther ; 50(2): 340-352, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824250

RESUMO

The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children's externalizing behaviors and parenting problems, was associated with improvements in parents' emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children's improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents' self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents' self-report of children's symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children's symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents' perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children's externalizing behaviors.


Assuntos
Comportamento Infantil/psicologia , Emoções , Terapia Familiar/métodos , Relações Pais-Filho , Pais/psicologia , Percepção , Austrália/epidemiologia , Criança , Comportamento Infantil/fisiologia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Educação Infantil/psicologia , Educação Infantil/tendências , Pré-Escolar , Emoções/fisiologia , Terapia Familiar/tendências , Feminino , Humanos , Masculino , Poder Familiar/psicologia , Poder Familiar/tendências , Percepção/fisiologia , Inquéritos e Questionários , Resultado do Tratamento
9.
Issues Ment Health Nurs ; 40(6): 486-492, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30917053

RESUMO

Over 5 million American children are estimated to be exposed to intimate partner violence (IPV) annually. The past decade has seen a surge in research, assessment, and related interventions regarding children and violence. Contemporary practice guidelines continue to expand relative to the wide range of violence that a child might be exposed to, particularly noting that children who have experienced one type of violence, such as physical abuse, are at great risk for also experiencing other forms of violence. Effects on children exposed to IPV are potentially catastrophic and can be influenced, by not only the number of exposures, but also the protective factors that are available to a child when violence is encountered. Treatment should be individualized and appropriate for the developmental level of the child. It is also essential to identify and include the child's non-abusive parent into the process to support the child and related treatment.


Assuntos
Experiências Adversas da Infância , Maus-Tratos Infantis/psicologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Violência por Parceiro Íntimo/psicologia , Pais/psicologia , Adulto , Criança , Transtornos do Comportamento Infantil/etiologia , Humanos
10.
PLoS One ; 14(2): e0212667, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30817752

RESUMO

BACKGROUND: The present study conducted secondary analyses of a randomized controlled trial to examine the transgenerational relationship between cognitive-behavioral therapy for child Separation Anxiety Disorder (SepAD) and the mental health of parents. Symptoms of anxiety and depression were compared before and after child treatment between parents of children treated for SepAD and parents of healthy children, who did not receive any treatment. METHODS: One hundred and seven children aged 4-14 years with SepAD received one of two cognitive behavioral treatment programs for SepAD (TAFF; TrennungsAngstprogramm Für Familien; English: Separation Anxiety Family Therapy or CC; Coping Cat). Their parents (N = 189; 101 mothers and 88 fathers) were assessed at baseline and post-treatment for symptoms of separation anxiety, general anxiety, and depression. A comparison group of parents (N = 74; 42 mothers and 32 fathers) of 45 children without SepAD, who did not receive any treatment, were also assessed. RESULTS: Results indicated a significant interaction effect between group and time on mothers' depression and separation anxiety, indicating that maternal symptoms of depression and separation anxiety improved in the child treatment condition in comparison to mothers of healthy children. There was no significant improvement in parental pathology levels among fathers of children treated for SepAD. CONCLUSIONS: Treatment for child SepAD may have subsequent positive effects on mothers' own levels of separation anxiety and depression, though the mechanisms are yet unknown. Future studies are needed that test the transgenerational effect of child SepAD treatment on parental mental health as the primary research question.


Assuntos
Ansiedade de Separação/terapia , Transtornos do Comportamento Infantil/terapia , Terapia Cognitivo-Comportamental , Depressão/diagnóstico , Pai/psicologia , Mães/psicologia , Adolescente , Adulto , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/psicologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Depressão/psicologia , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Índice de Gravidade de Doença , Fatores Sexuais , Resultado do Tratamento
11.
BMC Psychol ; 7(1): 3, 2019 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-30635046

RESUMO

Children develop in the context of the family. Family functioning prominently shapes the psychosocial adaptation and mental health of the child. Several family psychosocial risk factors have been shown to increase the risk of behavioral problems in children. Early identification of families with psychosocial profiles associated with a higher risk of having children with behavioral problems may be valuable for targeting these children for prevention and early intervention services. METHODS: We developed the Family Health Questionnaire (FHQ) for the purpose of evaluating families' psychosocial risk profiles in the primary care setting. The questionnaire included 10 formative indicators that have been shown to influence children's behavioral health. We aimed to establish a correlation between the family risk factors on the FHQ and child behavioral health. In addition, we examined the properties of the questionnaire as a screening tool for use in primary care. Families of 313 of children 4-6 years of age presenting for well child examinations at two primary care clinics completed both the FHQ and the Pediatric Symptom Checklist 17 (PSC-17), a validated screening instrument for pediatric behavioral problems. RESULTS: We found that the FHQ was positively and significantly correlated with the PSC score (r = .50, p < .05). CONCLUSIONS: The FHQ may be a valuable screening tool for identifying families with psychosocial risk profiles associated with increased risk of childhood behavioral problems.


Assuntos
Transtornos do Comportamento Infantil/prevenção & controle , Transtornos do Comportamento Infantil/psicologia , Relações Familiares/psicologia , Atenção Primária à Saúde/métodos , Criança , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Feminino , Humanos , Masculino , Nebraska , Fatores de Risco , Inquéritos e Questionários
12.
J Bodyw Mov Ther ; 23(1): 11-15, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30691737

RESUMO

Child development and wellness are strictly dependent on several factors among them physical activity, a proper nutrition and, of critical importance, a healthy mind. Psychopathologies like attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) have a direct negative impact on social, academic or occupational functioning of the affected children. If left untreated, these pathologies may progress to adulthood, thus requiring research strategies on conventional and nonconventional modalities of treatment. In this pilot study, conducted during the academic year 2015/2016, a combination of exercises of TaijiQuan (TJQ) and Qi Gong (QG) were taught to four selected children, three males and one female, aged between 6 and 10, suffering from the above mentioned behavioural disorders. The main goal was to understand if it is possible to achieve any kind of improvement in their condition, by evaluating the scores of the Achenbach Teacher's Report Form (TRF) in the beginning and ending of the experimental period. Results showed very interesting improvements in symptoms of CD, ODD and ADHD-HI (hyperactive-impulsive), while ADHD-PI (predominantly inattentive) showed only minor improvements. The overall symptom improvement was 43% across pathologies, which demonstrates that TJQ and QG may be a promising treatment of symptoms for children with behavioural disorders. More research is needed with controlled experimental designs and statistically representative samples in order to fully comprehend the versatility of these modalities.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Transtornos do Comportamento Infantil/terapia , Qigong/métodos , Tai Ji/métodos , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Feminino , Humanos , Masculino , Projetos Piloto
13.
Eur Psychiatry ; 57: 1-9, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30658274

RESUMO

BACKGROUND: Severe behavioural problems (SBPs1) in childhood are highly prevalent, impair functioning, and predict negative outcomes later in life. Over the last decade, clinical practice guidelines for SBPs have been developed across Europe to facilitate the translation of scientific evidence into clinical practice. This study outlines the results of an investigation into academic experts' perspectives on the current prevalence, implementation, and utility of clinical guidelines for SBPs in children aged 6-12 across Europe. METHODS: An online semi-structured questionnaire was completed by 28 psychiatry and psychology experts from 23 countries. RESULTS: Experts indicated that approximately two thirds of the included European countries use at least an unofficial clinical document such as textbooks, while nearly half possess official guidelines for SBPs. Experts believed that, although useful for practice, guidelines' benefits would be maximised if they included more specific recommendations and were implemented more conscientiously. Similarly, experts suggested that unofficial clinical documents offer a wide range of treatment options to individualise treatment from. However, they stressed the need for more consistent, evidence-based clinical practices, by means of developing national and European clinical guidelines for SBPs. CONCLUSIONS: This study offers a preliminary insight into the current successes and challenges perceived by experts around Europe associated with guidelines and documents for SBPs, acting as a stepping stone for future systematic, in-depth investigations of guidelines. Additionally, it establishes experts' consensus for the need to develop official guidelines better tailored to clinical practice, creating a momentum for a transition towards European clinical guidelines for this population.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Psiquiatria Infantil/organização & administração , Pediatria/organização & administração , Comportamento Problema , Conscientização , Criança , Comportamento Infantil/fisiologia , Europa (Continente) , Humanos , Guias de Prática Clínica como Assunto , Prevalência
14.
Trials ; 20(1): 29, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621787

RESUMO

BACKGROUND: School absenteeism (SA) is associated with anxiety, depression, and disruptive behavior. It is a risk factor for academic difficulties and school dropout, which predict problems in adulthood such as social, work-related, and health problems. The main goal of this study is to examine the initial effectiveness of a modular transdiagnostic cognitive behavioral therapy (CBT) intervention (Back2School) for increasing school attendance and decreasing psychological problems, relative to a comparator control arm (treatment as usual [TAU]). METHODS/DESIGN: One hundred sixty children, aged 7 to 16 years, will be randomly assigned to either Back2School or TAU. The design is a two (Back2School and TAU) by four (preassessment [T1], postassessment [T2], and 3-month [T3] and 1-year [T4] assessments) mixed between-within design. The primary outcome is school attendance based on daily registration. Secondary outcomes pertain to youth psychosocial functioning, quality of life, bullying, self-efficacy, and teacher-parent collaboration. These secondary outcomes are measured via youth, parent, and teacher reports. DISCUSSION: This study will provide critically needed empirical evidence on the initial effectiveness of a manualized treatment program for youth with SA. If the intervention is found to be effective, the program can be further implemented and tested in a larger school health effectiveness trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03459677 . Retrospectively registered on 9 March 2018.


Assuntos
Absenteísmo , Transtornos do Comportamento Infantil/terapia , Terapia Cognitivo-Comportamental/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Adolescente , Criança , Humanos , Qualidade de Vida , Projetos de Pesquisa
15.
Trials ; 20(1): 16, 2019 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-30616662

RESUMO

BACKGROUND: Norwegian health, care, and welfare services are experiencing increased demands to deliver services that are safe, effective, of high quality, and that ensure user involvement. Yet, evidence-based treatment for common disorders such as depression, anxiety, trauma, and behavioral problems in children are not regularly used in clinical practice in Norway. Possible explanations for this are that many standard, evidence-based treatments may have difficulty addressing the complexity and comorbidity of referred children and the fact that children's treatment needs often shift during treatment. The Modular Approach to Therapy for children with Anxiety, Depression, Trauma and Conduct problems (MATCH-ADTC) was designed to address these challenges and reduce some of the barriers to therapists' use of evidence-based treatment in their practice. METHODS/DESIGN: Participants will include 280 children (aged 6-14.5 years at intake) who receive treatment in child and adolescent mental health outpatient clinics in Norway, and their families. Families are randomly assigned to either the experimental group receiving treatment from therapists trained in MATCH, or to the comparison group receiving treatment from therapists delivering treatment as usual (TAU). Data on children's symptomology, child and family functioning, demographics, background information, and mental health outcomes are collected as well as frequent feedback on treatment response, plus video-recordings of treatment sessions and implementation quality scores from each participating clinic. Questionnaires are administered in six waves. DISCUSSION: MATCH has been tested in the US with promising results, but we do not know whether this treatment approach will produce similar results in Norway. The implications of this study are 1. Possibly better treatment outcomes and/or more efficient improvements for children and families treated in mental health outpatient clinics in Norway 2. Clinicians learning to use more evidence-based practices in their treatment 3. Implementation of standard procedures for obtaining feedback from children and families and sharing the feedback with clinicians 4. Increased understanding, at the end of the trial, of whether introducing MATCH improves outcomes for children and families treated in mental health outpatient clinics TRIAL REGISTRATION: ISRCTN, registration number: ISRCTN24029895 . Registered on 8 August 2016.


Assuntos
Ansiedade/terapia , Transtornos do Comportamento Infantil/terapia , Depressão/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Ferimentos e Lesões/terapia , Adolescente , Criança , Feminino , Humanos , Masculino , Noruega , Pacientes Ambulatoriais , Garantia da Qualidade dos Cuidados de Saúde , Projetos de Pesquisa
16.
Child Psychiatry Hum Dev ; 50(1): 1-12, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29855819

RESUMO

Research shows that parenting interventions are plagued with the problem of early treatment termination. A brief 6-week intervention, parent-child care (PC-CARE) was developed to minimize the time investment for parents while maximizing the probability of improving behavioral problems of their 1-10 year old children. The purpose of this study was to determine the feasibility of PC-CARE and examine preliminary outcomes. The data were collected as part of an open trial in a community mental health clinic and included pre- and post-treatment performance outcomes, weekly measures of treatment progress, and assessments of treatment fidelity. Participants were 64 children and their primary caregivers, referred by physicians, social workers, or self-referred for help with their children's difficult behaviors. The retention rate was 94%. Results of analyses pre- to post-intervention scores showed significant improvements in child behavioral problems as well as improvements in parenting stress and positive parenting skills. The findings suggest that PC-CARE may be a beneficial treatment for children with disruptive behaviors, encourage future research into the efficacy of this brief parenting intervention, and its effectiveness in other populations and contexts.


Assuntos
Transtornos do Comportamento Infantil , Comportamento Infantil/psicologia , Educação não Profissionalizante/métodos , Relações Pais-Filho , Poder Familiar/psicologia , Pais , Adulto , Criança , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Cuidado da Criança , Pré-Escolar , Centros Comunitários de Saúde Mental/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Pais/educação , Pais/psicologia , Comportamento Problema/psicologia , Técnicas Psicológicas
17.
Psychol Serv ; 16(2): 260-265, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30407054

RESUMO

Researchers propose that technology has the capacity to promote therapeutic alliance; however, clinicians worry the opposite is true. Behavioral parent training (BPT), an approach that is reliant on the parent as the mechanism of change, is the standard of care for early-onset (3-8 years old) behavior disorders. Importantly, behavior disorders are among the most common reasons parents seek mental health services for their children; therefore, BPT affords an ideal context within which to better understand the potential interrelationship between technology and therapeutic alliance. To this end, this study examined the link between smartphone-enhancements to 1 BPT program and parent-therapist alliance in 9 families of children with early-onset behavior disorders. Findings suggest relative differences in patterns of alliance and use of the smartphone-enhancements within the technology-enhanced group, patterns that have implications for better understanding the impact of technology on the therapeutic process, the deployment of existing technology-enhanced services, and the development of future technology-enhanced services. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Terapia Comportamental , Transtornos do Comportamento Infantil/terapia , Aplicativos Móveis , Pais , Aliança Terapêutica , Adulto , Terapia Comportamental/educação , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pais/educação
18.
J Autism Dev Disord ; 49(3): 924-934, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30368628

RESUMO

Publicly funded mental health services play an important role in serving children with autism spectrum disorder (ASD). Previous research indicates a high likelihood of adaptations when therapists deliver evidence based practices to non-ASD populations, though less is known about therapists' use of adaptations for children with ASD receiving mental health services. The current study uses a mixed quantitative and qualitative approach to characterize the types and reasons therapists adapted a clinical intervention [An Individualized Mental Health Intervention for Children with ASD (AIM HI)] for delivery with clinically complex children with ASD served in publicly funded mental health settings and identify therapist characteristics that predict use of adaptations. The most common adaptations were characterized as augmenting AIM HI and were done to individualize the intervention to fit with therapeutic style, increase caregiver participation, and address clients' and caregivers' needs and functioning. No therapist characteristics emerged as significant predictors of adaptations. Results suggest that therapists' adaptations were largely consistent with the AIM HI protocol while individualizing the model to address the complex needs of youth with ASD.


Assuntos
Transtorno do Espectro Autista/terapia , Transtornos do Comportamento Infantil/terapia , Prática Clínica Baseada em Evidências/métodos , Financiamento Governamental , Pessoal de Saúde , Serviços de Saúde Mental , Adolescente , Adulto , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Cuidadores/psicologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Feminino , Financiamento Governamental/métodos , Pessoal de Saúde/psicologia , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Adulto Jovem
19.
J Pediatr Hematol Oncol ; 41(3): 218-221, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30543579

RESUMO

INTRODUCTION: Children with chronic disorders like ß thalassemia major (TM) and their care givers are known to face various psychosocial problems. This study used screening tests to detect these psychosocial issues so that prompt referral for counseling is possible. METHODS: A semistructured demographic questionnaire, Pediatric Symptom Checklist (PSC-17) and the Strengths and Difficulties Questionnaire (SDQ) were administered to 30 children with TM, on regular treatment at a tertiary care hospital. The same questionnaires were administered to age-matched and sex-matched controls. Parents were administered the General Health Questionnaire (GHQ). Children with TM scored higher on both PSC-17 (9.93 vs. 4.87; P<0.001) and SDQ (14.9 vs. 10.9; P=0.008). The parents of children with TM scored higher on the GHQ (10.3 vs. 8.0; P=0.027). RESULTS: Psychosocial morbidity was higher in children with TM and their care-givers. Screening tools help detect children and care givers in need of formal counseling. CONCLUSIONS: The study makes a case for management of these issues by the pediatrician in tandem with mental health professionals. Some strategies that can be used in managing these children and their families are presented. In addition, issues in management with particular focus on a developing country context are highlighted and discussed.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Gerenciamento Clínico , Talassemia beta/psicologia , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/terapia , Aconselhamento , Países em Desenvolvimento , Feminino , Humanos , Masculino , Programas de Rastreamento , Inquéritos e Questionários
20.
Psychiatry Res ; 271: 454-458, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30537668

RESUMO

Children with severe aggressive behavioral problems are one of the groups most frequently referred to mental health clinics, and they engage in behaviors that put them at risk for substance use problems and a host of other negative outcomes. The present study aimed to assess the long-term outcome (six-year follow up) of the Coping Power Program delivered in a mental health hospital for children with behavioral disorders. We recruited one hundred and twenty children (mean age = 9.9, SD = 0.85), twenty-three patients were lost during the follow-ups. The sample of the current study included sixty-seven youths with Oppositional Defiant Disorder, and thirty with Conduct Disorder. We used Child Behavior Check List, Inventory of Callous Unemotional traits and a youth survey to evaluate substance use. After the baseline evaluation they were allocated to Coping Power or to a generic multi-component treatment. Coping Power produced significant reduction in Callous Unemotional traits, relative to the control condition; Coping Power seems to be effective also in reducing the rate of substance use. However, no differences have been found in externalizing behavior reduction in the two groups. This study contributes to the successful dissemination of best-practice treatments in public mental health services for children.


Assuntos
Adaptação Psicológica , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Transtornos do Comportamento Infantil/terapia , Psicoterapia de Grupo/métodos , Adaptação Psicológica/fisiologia , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Transtorno da Conduta/fisiopatologia , Transtorno da Conduta/terapia , Feminino , Seguimentos , Humanos , Masculino
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