Involving Parents in Child Mental Health Treatments: Survey of Clinician Practices and Variables in Decision Making.

OBJECTIVE: Child therapy outcomes research has indicated that involving parents in child mental health treatments is generally beneficial. This study aimed to explore clinicians' decisions to involve parents in treatment for childhood disorders and child-, parent-, and clinician-related variables influencing these decisions. METHODS: Data on decision making and reported use of parent involvement by 40 therapists with patients ages 6-12 were obtained from a self-report survey. Most clinicians were psychologists, White, and female and worked in community-based clinics. They reported using cognitive-behavioral and family system interventions considerably more than psychodynamic therapy. RESULTS: Clinician-reported use of parent involvement was significantly greater for children with oppositional defiant or conduct disorder than for those with attention-deficit hyperactivity disorder, depression, anxiety, or posttraumatic stress disorder or trauma. A child's age and diagnosis (100% of clinicians), parental level of stress (85%), and parent interest in working with the clinician (60%) were frequently reported as being important to clinicians' decisions. Ninety percent of clinicians reported that they believed working with parents was effective, whereas only 25% reported their own training to be influential in decision making. CONCLUSIONS: Findings regarding use of parent involvement stratified by common childhood disorder were not surprising, given the behavioral and treatment complexities of oppositional defiant or conduct disorder. Clinicians often reported parents' stress level and interest in working with the clinician as influencing decision making, reflecting the importance of lesser researched decision variables. The relatively limited influence of training on decision making suggests the need for better parent involvement education for clinicians treating children.

The therapeutic relationship in child psychotherapy: integrating the perspectives of children, parents and therapists.

This study addresses the therapeutic relationship in child psychotherapy, through an exploration of the experience of the main actors engaged in child psychotherapy.To describe and analyse the therapeutic relationship integrating the views of children, parents and therapists.This study employs a qualitative methodology, assuming a discovery-oriented approach which draws from grounded theory. Twelve psychotherapy triads participated, composed of children aged 6-10, their parents and psychotherapists. Semi-structured follow-up interviews were conducted (N=36), including a drawing in the case of the children.A positive therapeutic relationship with children and parents was viewed as a gradually constructed process, based on a positive emotional encounter between participants. It was facilitated primarily by the therapist's commitment and playful stance, the child and therapist mutual involvement, and the parent's collaboration. These aspects entailed a trustful, validating and caring relationship, that shaped children and parents' motivations towards therapy and facilitated change.From a multiple-perspective approach, therapy was conceived as a relational experience. The development of positive relationships required different and evolving dispositions from therapy main actors. Therapists' genuine feelings and engagement in therapeutic activity seem central, underlining the importance of addressing relational aspects in child therapy research and training.

[Parent-Child Treatment in Child and Adolescent Psychiatry: Models and Clinical Implementation Using the Example of a Modular Parent-Child Ward]. / Eltern-Kind-Behandlung in der Kinder- und Jugendpsychiatrie: Modelle und klinische Umsetzung am Beispiel einer bausteinorientierten Eltern-Kind-Station.

The joint treatment of mentally ill children and their parents represents a special treatment concept in child and adolescent psychiatry. A study conducted by the Working Group (BAG) "Early Childhood" shows the current situation of care and possible models of child and adolescent psychiatric parent-child treatment in Germany. Using the parent-child ward of the Child and Adolescent Psychiatry Department in Magdeburg as an example, the combined treatment of mentally ill children and their parents is presented. The treatment approach consists of a three-week diagnostic phase, after which families are discharged again to their home environment followed by a five-week therapy block, for which the families have to be readmitted to the ward. With a focus on the parent-child relationship, the treatment concept - in contrast to regular child psychiatric treatments - is dynamically adapted to the quality of the parent-child interaction and not primarily related to the disorder of the children. First studies indicate the effectiveness of the special treatment setting and illustrate the efficiency of a joint treatment of parents and child, which, however, is associated with increased economic costs. Based on these results, the chances and limitations of parent-child wards are discussed and conclusions for parent-child treatment are drawn.

[The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders]. / Die Bedeutung von Partnerschaftsstatus und -zufriedenheit für den Outcome stationärer Mutter-Kind-Behandlungen bei postpartalen psychischen Krisen.

The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders The study examines the partnership status and satisfaction in connection with symptoms of postpartum mental disorders, mother-child attachment and outcome of inpatient mother-child treatment. Two sub-studies were carried out. In the first study, N = 126 mothers with postpartum mental disorders who went to a preliminary consultation for inpatient mother-child treatment stated their symptom burden (SCL-90), mother-child attachment (PBQ) and satisfaction with their partner relationship (PFB-K). Mothers with stressed relationships showed the highest level of symptom burden and impaired attachment. Mothers without a partner reported the least amount of impairment in mother-child attachment. In the second study, N = 41 mothers were examined over the course of inpatient treatment (within-subject design with a waiting-list). The initial relationship satisfaction was not predictive of symptom reduction or improvement in mother-child attachment. An increase in satisfaction during the treatment was though correlated with an improvement in mother-child attachment.

Mentalization and the growth of symbolic play and affect regulation in psychodynamic therapy for children with behavioral problems.

Objective: Children with behavioral problems often have problems with symbolic play organization, specifically with the regulation of negative affect and its representation. One of the aims of psychodynamic therapy with these children is enhancing their symbolic and mentalizing capacities in play. This study investigated the associations between promoting mentalization, and the growth of symbolic play and affect regulation. Method: The sample included 48 children with behavioral problems, who underwent long-term psychodynamic treatment informed with mentalization principles, with good outcome. Three hundred twenty-nine sessions were coded for children's symbolic play and affect regulation strategies, and each treatment was rated for adherence to mentalizing principles. Results: Hierarchical linear modeling showed quadratic growth of variables, wherein symbolic play initially increased followed by a deceleration in change, whereas affect regulation initially decreased followed by an increase. Adherence to mentalizing principles was associated with both symbolic play and affect regulation. A two-way interaction between time in treatment and adherence to mentalization showed that in high adherent treatments, affect regulation increased towards the end of treatment, whereas in low adherent treatments, there was no change. Conclusion: Results show support for the association between adherence to mentalization and growth of affect regulation and symbolic play in psychodynamic therapy.

[Family Psychiatry - The Attachment-Focused, Systemic-Oriented, Integrative Concept of the Family Therapy Centre (FaTC), an Acute Multi-Family Day Clinic]. / Familienpsychiatrie ­ bindungsorientiert, systemisch ausgerichtet, integrativ im akut-tagesklinischen Mehrfamiliensetting: Das FaTZ-Konzept.

Family Psychiatry - The Attachment-Focused, Systemic-Oriented, Integrative Concept of the Family Therapy Centre (FaTC), an Acute Multi-Family Day Clinic Up to three quarters of the children of mentally ill parents develop a mental disorder during their lifetime. The transmission occurs essentially through dysfunctional interaction and disturbed attachment. Parent-child interaction is characterized by a vicious circle of escalating symptoms in the child and increasing helplessness in the parents. For this family psychiatric approaches are helpful, which address the interaction in addition to the individual disorders. The Family Therapy Centre (FaTC) Neckargemünd offers family psychiatric, integrated therapy for parents and children in an acute day clinic multi-family setting. The basic therapeutic principles are attachment orientation, mentalisation and systemic perspective with a multi-family therapy approach. Typical family psychiatric case constellations are presented, for which the concept seems particularly helpful: (1) Early childhood regulatory disorders in interaction with mentally ill parents, (2) mother with PTSD and expansive-aggressive preschool child and (3) adolescents with separation anxiety and depressive-anxious mother. The previous experiences are reflected by a moderated focus group of the entire FaTC team. The FaTC concept was evaluated as very helpful. It was positively judged that the family system is visibly present on site (and not only virtually). The focus is on interaction, therefore causal therapy can be offered rather than symptomatic treatment. Limitations of the concept are therapy of severely aggressive adolescents or parents who do not want to participate. The concept of the FaTC is currently being scientifically evaluated.

[Maternal reflective functioning as a predictor of therapeutic success of psychoanalytic short-term therapy for children aged 4 to 10 years]. / Reflexive Kompetenz der Mütter als Prädiktor des Therapieerfolgs mit Psychoanalytischer Kurzzeittherapie im Alter von 4 bis 10 Jahren.

Recent work implicates the capacity to mentalize as a predictor of therapeutic success of psychodynamically oriented psychotherapy for adults. However, little, if any, research focuses on similar associations in childhood. In the current study, we investigated the role of maternal reflective functioning (RF) in the treatment of 25 children with clinically diagnosed anxiety disorders and a high level of externalizing comorbidity in an outpatient setting. Before and after treatment of their children with short-term Psychoanalytic Child Therapy (PaCT), we assessed maternal RF using the Parent Development Interview and requested parents to report on symptoms of their 4-10-year-old children using the Child Behavior Checklist (CBCL). RF proved highly stable and showed no significant change from pre- to post-treatment over an average treatment interval of 41 weeks. While remission in internalizing symptoms was unrelated to pretreatment maternal RF, children with high-RF mothers showed significant remission of externalizing comorbidity in comparison to children with low-RF mothers both immediately after treatment as well as at six-month follow-up. These preliminary results support parental RF as a valuable prognostic criterion for successful treatment of externalizing symptoms with PaCT. These findings call for replication in large-scale follow-up studies with children diagnosed with externalizing disorders.

Traumatic experience and loss: A brief therapy with a traumatized refugee boy and his parents in exile.

In this paper, the author portrays the psychoanalytic therapy with a twelve-year-old refugee boy and his parents, prior to which the boy had been traumatised by the deaths of both his brothers in the civil war. In 2015 he had travelled with his father to Austria, where he was warmly received in a small community. The author examines how this child reacted to the traumatising experiences, as well as which resilience factors played a role in overcoming them. The psychoanalytic process is illuminated in a detailed analysis of the therapy sessions, which created a space for overcoming the helplessness, mourning the loss and furthering the integration process of the identity, disturbed after the traumatic experiences.

Psychodynamics in child psychiatry in Sweden, 1945-85: from political vision to treatment ideology.

In this article, changing treatment ideologies and policies in child psychiatric outpatient services in Sweden from 1945 to 1985 are examined. The aim is to discuss the role played by psychoanalytic and psychodynamic thinking in this process of change. When mental health services for children were introduced in the mid-1940s, psychoanalytic thinking was intertwined with the social democratic vision of the Swedish welfare state in which children symbolized the future. In practice, however, treatment ideology was initially less influenced by psychoanalytic thinking. From the early 1960s, child psychiatric services expanded and the number of units increased. By then, the political vision had disappeared, but a treatment ideology began to evolve based on psychodynamic theories, which became dominant in the 1970s.

Postpartum Depressive Disorder - Psychosomatic Aspects.

Postpartum depression (PPD) is the most common mental illness in mothers following the birth of a child. Since the symptoms of PPD are similar to the normal stress of healthy women following childbirth, it is often difficult for the attending gynaecologist or midwife to diagnose this illness in a timely manner and thus initiate adequate treatment and comprehensive support for the patient. Even if there are options for a screening using evaluated questionnaires and subsequent psychotherapy and/or drug therapy in the treatment of PPD which has proven effective, it is seen that, in most treatment approaches, little consideration is given to the affect-controlled interaction and the bonding behaviour between mother and child. This article presents diagnostic measures and current therapeutic approaches as well as their integration in practice in order to achieve awareness of this topic in everyday clinical practice and show the pathways of appropriate treatment. Specific multiprofessional treatment approaches which centre on the mother-child relationship demonstrate successes with regard to depression in the mothers and also on the development of a secure mother-child bond and are thus a protective factor in the development of the affected children. The now well-known effects of PPD on the fathers as well as the negative impacts of paternal depression on child development make it clear that the treatment should not focus solely on maternal depression, but also always on the family bond between the mother, child and father in the treatment.

Animal-assisted dyadic therapy: A therapy model promoting development of the reflective function in the parent-child bond.

Animal-assisted psychotherapy (AAP) inherently incorporates standpoints, interventions, and ways of action promoting the development of the reflective function and mentalization, and thus has special value for parent-child psychotherapy. Two central tools in AAP contribute to this process. The first is the ethical stance of the therapist, who sees the animals as full partners in the therapy situation, respecting them as subjects with needs, desires, and thoughts of their own. The second tool combines nonverbal communication with animals together with the relating, in the here and now, to the understanding and decoding of body language of everyone in the setting. Nonverbal communication in AAP enables access to implicit communication patterns occurring between parent and child. This article provides a survey of theoretical development and research constituting a basis for the development of therapeutic approaches for the improvement of parent-children dynamics, followed by a description of a dyadic therapy model of a mentalization-based treatment originating from a psychoanalytic-relational orientation. Clinical examples are provided to illustrate AAP processes in parent-child psychotherapy (consent was received for examples that were not aggregated).

Ericksonian hypnotherapy for selective mutism: A single-case study.

BACKGROUND AND AIM OF THE WORK: Children affected by selective mutism don't speak in contexts that are unfamiliar to them or in which speaking is expected or required (e.g. school, kindergarten…). Such disorder interferes with the child's normal activities, may have invalidating consequences in the long run if left untreated, is associated to anxious conditions and is considered hard to treat. Contemporary research is still in need of methodologically rigorous outcome studies and the results described in the small number of published randomized controlled trials and retrospective studies indicate cognitive-behavioral interventions lasting 20-24 sessions as the best therapeutic option. This case study, involving a 7-year-old girl, aims at providing preliminary evidence on the effectiveness of Ericksonian hypnosis in the treatment of this condition. A brief review of current evidence is provided. METHODS: The case was treated by a licensed hypnotherapist, specialized in family therapy, in 5 sessions during the course of 3 months. RESULTS: After 3 months the symptoms of the client were resolved and the diagnosis was no longer applicable. Other improvements regarded her mood, social skills and school performance.  Conclusions: Ericksonian Hypnotherapy lead to the remission of the disorder and to the improvement of the general well being of the client in 5 sessions, a much briefer time span compared to what is reported in current literature. This paper represents the first step in the elaboration of replicable and reliable intervention principles.

Where is the Child in Family Therapy Service After Family Violence? A Study from the Norwegian Family Protection Service.

Extensive documentation on consequences of family violence laid the ground for a politically decided mandate for the Norwegian Family Protection Service (FPS) to prioritize families with children and violence. This study explores the practice of one of the country's larger FPS offices following this mandate and its kick-off start. Data from all cases in 1 year with families with children and violence were gathered (106) as to what were cases referred, services provided, main cross-points, dilemmas, and challenges. Descriptive statistical analyses were utilized and qualitative analysis conducted. The study shows success in supplying a direct, much used route both for private persons and main collaborative agencies, although all abusers need others as promoters for change. The service succeeds to pioneer brief treatment combined with taking a stand against violence. However, while services are provided fairly quickly when violence is reported, several changes are called for: A more violence-sensitive intake procedure, stronger cooperation with specialty mental health service and primary health service, extended use of assessment tools and outcome measures. Given the nature of violence, particularly follow up measures are required. However, first and foremost, the study calls for a better inclusion of the child. Despite mandated priority, a major neglect of children takes place. In line with the UN Convention on the Rights of the Child, the Norwegian Family Protection Services in a country complying with this Convention is obliged to take the child more successfully into account in its own right. Future efforts are required to safeguard child-focused services.

Facilitating children's views of therapy: an analysis of the use of play-based techniques to evaluate clinical practice.

This article reports on a follow-up study exploring the use of play-based evaluation methods to facilitate children's views of therapy. The development and piloting of these techniques, with 12 children in the author's own practice, was previously reported in this journal. It was argued that play-based evaluation methods reduce the power imbalance inherent in adult researcher/interviewer-child relationships and provide children with meaningful ways to share their views. In this article, follow-up research into play-based evaluations with 20 children and 7 different play therapists is drawn upon to explore in greater depth the strengths and weaknesses of these techniques. The study shows that play-based evaluation techniques are important and flexible methods for facilitating children's views of child therapy. It is argued that those play therapists who incorporate their therapeutic skills effectively, maintain flexibility and sensitively attune to the child during the evaluation session, enable the child to explore their views most fully.

Animal-assisted therapy in early childhood schools in São Paulo, Brazil / Terapia assistida por animais em escolas de educação infantil de São Paulo

Since ancient times, humans and animals have interacted for different purposes. Animal Assisted Therapy (AAT) is used for the assistance and treatment in humans and educational projects where animals are used as co-therapists or co-educators. The use of animals facilitates the process of teaching and learning, and stimulates physical and therapeutic activities. So that knowledge on AAT could be expanded, current study analyzes the opinion of people directly involved in education on AAT implementation as an educational model in early childhood schools in São Paulo, Brazil. Questionnaires were handed out to 10 pedagogical coordinators, 32 teachers, 23 parents and 26 children aged 3-6 years. Results revealed that AAT is not well-known for most interviewees, including pedagogical coordinators, teachers and parents. However, interviewees believe in the benefits of child-pet interactions and are favorable to the implementation of AATs in schools. Projects should be interdisciplinary and must involve professionals from other areas, such as psychologists and veterinarians. Regarding the educational model, interviewees believe in the innovation capacity of AAT and in the possibilities of interdisciplinarity among teachers in the use of animals. Research also demonstrated that children like and support the use of animals in the school.(AU)

Desde a pré-história já existia a interação dos humanos com os animais com diferentes finalidades. A terapia assistida por animais (TAA) é utilizada para assistências e tratamentos em humanos e projetos pedagógicos, na qual os animais são utilizados como co-terapeutas ou co-educadores. O emprego de animais facilita o processo de ensino-aprendizagem e estimula atividades físicas e terapêuticas. Para contribuir com o conhecimento da TAA, o presente trabalho objetivou abordar a opinião de pessoas diretamente relacionadas à escola, a respeito da implantação da TAA, como modelo educacional nas escolas de educação infantil da cidade de São Paulo. Foram aplicados questionários em 10 coordenadores pedagógicos, 32 professores, 23 pais e 26 crianças de 3 a 6 anos de idade. Os resultados encontrados demonstraram que a TAA ainda não é bem conhecida por uma parcela dos entrevistados, incluindo coordenadores pedagógicos, professores e pais de alunos. No entanto, os entrevistados acreditam nos benefícios da interação criança-animal e defendem projetos voltados a implantação da TAA nas escolas, embora estes projetos devam ser interdisciplinares e envolver profissionais de outras áreas, tais como, pedagogos, psicólogos e médicos veterinários. Em relação ao modelo educacional, nossos entrevistados acreditam na capacidade inovadora da TAA, assim como, nas possibilidades de interdisciplinaridade entre os professores no uso dos animais. Também ficou demonstrado que as crianças gostam e apoiam o uso de animais na escola.(AU)

Quem é o cliente: criando o cenário para a terapia colaborativa com crianças e suas famílias / Who is the client: setting the stage for collaborative therapy with children and their families

Este artigo discute o processo de criação de um cenário para o trabalho colaborativo com crianças e suas famílias e aborda a seguinte questão: Quem é o cliente? Trata-se de uma apresentação teórica dos princípios básicos da clínica colaborativa seguida de um exemplo com comentários e reflexões que visam ilustrar como estas ideias são colocadas em prática.(AU)

This article talks about the process of setting the stage in working collaboratively with children and their families and addresses the question: Who is the client? A theoretical presentation of the main principles of collaborative practices is followed by a case vignette with comments and reflections as an example of how these ideas are put into practice. The article addresses the dilemmas practitioners face when working with children and families.(AU)

Atendimento a uma criança que relatava ver o espírito da avó / Therapy for a child who reported having seen her grandmother's ghost

Descreve-se o atendimento de criança do sexo feminino, com queixa inicial, trazida pela mãe, de que a filha "via a avó", falecida há alguns meses. A mãe relatou também que a criança se recusava a entrar sozinha nos ambientes da casa, pois temia a presença da avó e falava sobre o assunto frequentemente. Foram realizadas duas sessões na sala de atendimento e quatro na residência da criança com participação de suas amigas, utilizando-se procedimentos de dessensibilização, modelagem, modelação e instrução, associados a atividades lúdicas, além de orientação aos familiares. Os resultados mostraram decréscimo e supressão de verbalizações sobre o espírito da avó, uso de espaços da casa antes evitados, melhora no rendimento escolar e recuperação de contatos com colegas. Um follow-up, com visita à família e entrevista com professores, evidenciou a manutenção das aquisições. São discutidas questões sobre esse tipo de queixa em nossa cultura.

This paper presents the therapy provided to a young girl brought in by her mother for initially reporting "seeing her grandmother" who had died some months before. The mother claimed that the child refused to enter rooms in the home alone as she feared her grandmother's presence and that the child frequently mentioned the subject. Two sessions were held at the school and four at the child's home in the company of some of her friends. Procedures involving desensitisation, modelling, shaping and instruction were incorporated into play activities, and support was offered to the child's family members. The results showed a decrease and suppression of utterances concerning the grandmother's ghost, the use of formerly-avoided spaces in the house, an improvement in school performance and the recovery of contact with friends. Follow-up carried out through a visit made to the family and the child's teachers confirmed the maintenance of the acquisitions above. We discuss issues related to such kinds of sightings in our culture.

Atendimento a uma criança que relatava ver o espírito da avó / Therapy for a child who reported having seen her grandmother's ghost

Descreve-se o atendimento de criança do sexo feminino, com queixa inicial, trazida pela mãe, de que a filha "via a avó", falecida há alguns meses. A mãe relatou também que a criança se recusava a entrar sozinha nos ambientes da casa, pois temia a presença da avó e falava sobre o assunto frequentemente. Foram realizadas duas sessões na sala de atendimento e quatro na residência da criança com participação de suas amigas, utilizando-se procedimentos de dessensibilização, modelagem, modelação e instrução, associados a atividades lúdicas, além de orientação aos familiares. Os resultados mostraram decréscimo e supressão de verbalizações sobre o espírito da avó, uso de espaços da casa antes evitados, melhora no rendimento escolar e recuperação de contatos com colegas. Um follow-up, com visita à família e entrevista com professores, evidenciou a manutenção das aquisições. São discutidas questões sobre esse tipo de queixa em nossa cultura.(AU)

This paper presents the therapy provided to a young girl brought in by her mother for initially reporting "seeing her grandmother" who had died some months before. The mother claimed that the child refused to enter rooms in the home alone as she feared her grandmother's presence and that the child frequently mentioned the subject. Two sessions were held at the school and four at the child's home in the company of some of her friends. Procedures involving desensitisation, modelling, shaping and instruction were incorporated into play activities, and support was offered to the child's family members. The results showed a decrease and suppression of utterances concerning the grandmother's ghost, the use of formerly-avoided spaces in the house, an improvement in school performance and the recovery of contact with friends. Follow-up carried out through a visit made to the family and the child's teachers confirmed the maintenance of the acquisitions above. We discuss issues related to such kinds of sightings in our culture.(AU)

Terapia infantil e treino de pais em um caso de agressividade / Child therapy and parent training in a case of aggressiveness

A Análise do Comportamento na Clínica explica o desenvolvimento e manutenção do comportamento em função de fatores ambientais históricos e atuais. No caso dos atendimentos infantis, a participação dos pais é indispensável, pois eles fazem parte do contexto e oferecem consequências para os comportamentos da criança. O presente estudo teve como objetivo avaliar o efeito do treino de pais e de uma intervenção comportamental em padrões comportamentais agressivos de uma criança. Participaram da terapia um garoto de 9 anos e seus pais. A queixa principal estava relacionada a comportamentos agressivos da criança e seus pais receberam orientações para a solução dos comportamentos-problema. Foi observada mudança no contexto familiar e, consequentemente, nos comportamentos do cliente. A emissão dos comportamentos inadequados diminuiu de frequência e o garoto passou a emitir novos comportamentos adequados. Tais resultados indicaram a importância do manejo ambiental no qual a criança estava inserida para que seus comportamentos se modificassem.

Clinical Behavior Analysis explains the development and maintenance of behavior through historical and actual environmental variables. With regard to children’s care, the participation of parents is extremely important because they are part of the frame of reference and present congruity for children’s behavior. This case study aimed to evaluate the effect of parental training and behavior intervention in the child’s aggressive behavioral patterns. A nine-year-old boy and his parents underwent treatment. The major complaint was the child’s aggressive behavior and therefore his parents were trained to solve the child’s behavior problems. Changes in the family context, and consequently the client’s behavior, were observed. The frequency of inappropriate behavior decreased and the boy started showing new, appropriate behavior. Such results indicate the importance of changing the child’s environment in order to achieve the desired modification in behavior.

Terapia infantil e treino de pais em um caso de agressividade / Child therapy and parent training in a case of aggressiveness

A Análise do Comportamento na Clínica explica o desenvolvimento e manutenção do comportamento em função de fatores ambientais históricos e atuais. No caso dos atendimentos infantis, a participação dos pais é indispensável, pois eles fazem parte do contexto e oferecem consequências para os comportamentos da criança. O presente estudo teve como objetivo avaliar o efeito do treino de pais e de uma intervenção comportamental em padrões comportamentais agressivos de uma criança. Participaram da terapia um garoto de 9 anos e seus pais. A queixa principal estava relacionada a comportamentos agressivos da criança e seus pais receberam orientações para a solução dos comportamentos-problema. Foi observada mudança no contexto familiar e, consequentemente, nos comportamentos do cliente. A emissão dos comportamentos inadequados diminuiu de frequência e o garoto passou a emitir novos comportamentos adequados. Tais resultados indicaram a importância do manejo ambiental no qual a criança estava inserida para que seus comportamentos se modificassem(AU)

Clinical Behavior Analysis explains the development and maintenance of behavior through historical and actual environmental variables. With regard to children’s care, the participation of parents is extremely important because they are part of the frame of reference and present congruity for children’s behavior. This case study aimed to evaluate the effect of parental training and behavior intervention in the child’s aggressive behavioral patterns. A nine-year-old boy and his parents underwent treatment. The major complaint was the child’s aggressive behavior and therefore his parents were trained to solve the child’s behavior problems. Changes in the family context, and consequently the client’s behavior, were observed. The frequency of inappropriate behavior decreased and the boy started showing new, appropriate behavior. Such results indicate the importance of changing the child’s environment in order to achieve the desired modification in behavior(AU)