us/childmentalhealth.html MENTAL HEALTH CHILDREN

Transcription

MENTAL HEALTH CHILDREN
Assessment
http://www.nlm.nih.gov/medlinepl
us/childmentalhealth.html
• Screening Tools and Rating Scales
[http://www2.massgeneral.org/schoolpsychiatry/sch
oolpsychiatry_screeningtools.asp]
• The checklists in the table below can be used to help clarify which
types of mental health symptoms might be most problematic for a
child or adolescent.
• Use checklists does not produce a diagnosis. Rather, the checklists
point toward the types of mental health disorders that may be
worthwhile to consider as a cause of the child's or adolescent's
emotional or behavioral difficulties.
A particular “score” on a checklist does not mean that a child has
a particular disorder – these checklists are only one component of
an evaluation.
Diagnoses should be made only by a trained clinician after a
thorough evaluation.
Symptoms suggestive of suicidal or harmful behaviors warrant
immediate attention by a trained clinician.
Screening Tools
Table of Checklists for Preliminary Mental Health Screening
For Ages (Years)
Who Completes Checklist: Number of Items
Time to
Complete
(Minutes)
View
Free
Online
?
Child Behavior Checklists (CBCL) DETAIL
1.5- 18
Parent, Teacher: 118
Student: 112
Clinician: 96-99
15-20
Behavioral Assessment System for Children, 2nd Ed. (BASC-2) DETAIL
2-21
8-21
Parent :134-160
Teacher:100-139
Student:139-185
Parent,
Teacher: 10-20
Student: 30
Child/Adolescent Psychiatry Screen (CAPS) DETAIL
3-21
Parent: 85
15-20
Conners 3 DETAIL
3-17
Parent: 49
Teacher: 28
30
Home Situations Questionnaire (HSQ) DETAIL
4-11
Parent: 16
5
YES
School Situations Questionnaire (SSQ) DETAIL
4-11
Teacher: 12
5
YES
Pediatric Symptom Checklist (PSC) DETAIL
6-16
Parent: 35
5-10
YES
SNAP-IV-C Rating Scale-Revised DETAIL
6-18
Parent, Teacher: 90
10
YES
Beck Youth Inventories of Emotional & Social Impairment (BYI) DETAIL
7-14
Student: 5 self-reports, 20 each
5-10 per
inventory
YES
Child Behavior Checklists (CBCL)
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Behavioral Assessment System for Children, 2nd Ed. (BASC-2)
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Child Behavior Checklists (CBCL) Parent (PRF) Teacher (TRF) Youth Self-Report (YSR) Clinician (DOF)
CBCL/1½-5 (Preschool) The CBCL, used for evaluating children and adolescents ages 6-18, measures problems with
aggressive behavior, anxiety/depression, attention, rule-breaking behavior, social interaction, physical complaints,
disordered thought, and withdrawn/depressed behavior. It is used for initial assessment and can also measure changes in
behavior over time or following a treatment.
The Parent Checklist is one of the most widely used parental ratings for behavioral problems and social skills in children.
For evaluating children younger than age 6, the Child Behavior Checklist/1½-5 is used instead. The CBCL/1½-5, preschool
form, obtains parents' ratings of 99 problem items plus descriptions of problems, disabilities, major concerns about their
child, and the child's strengths. It also includes the Language Development Survey (LDS) for identifying language delays.
Versions for parents, teachers, and youth each contain approximately 120 items and take 15-20 minutes to complete. The
clinician form (DOF) contains 96 items and is for children and adolescents ages 5-14.
Achenbach System of Empirically Based Assessment at:
http://www.aseba.org/products/cbcl6-18.html Behavioral Assessment
System for Children, 2nd Ed. (BASC-2) Parent (PRS) Teacher (TRS) Student
(SRP) Different variations of each of these tools are available for evaluating
preschoolers, children, and adolescents ages 2-21. The parent version
contains 134-160 items, depending on the age of the child; the teacher
version contains 100-139 items, and each takes 10-20 minutes to complete. A
student report form for children and adolescents ages 8-21 contains 139-185
items and requires 30 minutes to complete.
Six functional areas are assessed, including adaptability, activities of daily
living, functional communication, leadership, social skills, and study skills.
Clinical areas assessed include aggression, anxiety, attention problems,
atypicality, conduct problems, depression, hyperactivity, learning problems,
physical complaints, and withdrawal.
Home Situations Questionnaire (HSQ) Parent
This questionnaire, used with children and
adolescents ages 4-11, supplements scales
such as the Child Behavior Checklist and
Conner Parent Rating Scales-Revised. It
contains 16 items and takes 5 minutes to
complete. The HSQ lists a number of
common circumstances at home in which
behavior problems are most likely to arise.
Parents can indicate the severity of behavior
problems for each situation.
• The HSQ is available online in PDF format at:
http://www2.jabsom.hawaii.edu/dop/wpcontent/uploads/2007/12/home-situationsquestionnaire.doc
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School Situations Questionnaire (SSQ)
Teacher This companion to the HSQ helps
teachers identify the types of situations,
from a total of 12 items, in which the child's
behavioral problem is apparent at school.
Like the HSQ, the SSQ is used with children
ages 4-11 and takes 5 minutes to complete.
The scale counts the frequency of problem
occurrence as well as the severity of each
problem area.
The questionnaire is available online in PDF
format at:
http://www.drjenna.net/checklists/adhd_bx
_cl/school_sitn_quest.pdf
Child/Adolescent Psychiatry Screen
(CAPS)
• Child/Adolescent Psychiatry Screen (CAPS) Parent
• This 85-item screen is organized around symptoms of
common psychiatric disorders in children and
adolescents ages 3-21.
• It allows parents to prioritize symptoms rapidly to
discuss with their clinicians.
• This screen is useful for identifying target symptoms
or disorders, but it is not useful for monitoring the
effects of treatment. It takes 15-20 minutes to
complete.
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The Child/Adolescent Psychiatry Screen (CAPS)
http://www2.massgeneral.org/schoolpsychiatry/CAPS.htm
I. How to Use the Child/Adolescent Psychiatry Screen (CAPS) If you suspect your child has a
mental health condition and are not sure what symptoms are most troublesome, the
Child/Adolescent Psychiatry Screen can provide an initial indicator of areas for further
investigation.
This is only a preliminary screening tool. Do not assume that a particular “score” means a
child has a particular disorder; many people have symptoms like those described in this
screening tool, but do not have a “disorder.” Diagnoses should be made only by a trained
clinician after a thorough assessment. Symptoms suggestive of suicidal or harmful
behaviors warrant immediate attention by a trained clinician.
Answer all items in the checklist , using the appropriate column to indicate the frequency of
each symptom.
Examine the columns to determine if certain clusters of items have more “Moderate” or
“Severe” responses. Don’t panic: having a high (or low) number of moderate or severe
responses in any section does NOT mean that your child has this disorder. It just means that
these symptoms should be discussed with a trained clinician familiar with these disorders so
that you can make sense of these symptoms (and determine the best course of action to
address them).
Symptoms are arranged in sections/clusters to help
identify areas for discussion with a trained clinician:
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Items 1-7 Anxiety
Item 8 Panic Disorder
Item 9 Phobia
Item 10-11 Obsessive-Compulsive Disorder (OCD)
Item 12 Post-Traumatic Stress (PTSD)
Item 13 Generalized Anxiety Disorder
Item 14 Enuresis (bed-wetting) / Encopresis (fecal soiling)
Items 15-16 Tics (vocal and/or motor)
Items 17-31 Attention Deficit/Hyperactivity Disorder
(ADD/ADHD)
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Items 32-38 Mania/Bipolar Disorder
Items 39-46 Depression
Items 47-49 Substance Abuse / Dependence
Items 50-53 Anorexia / Bulimia
Items 54-64 Antisocial Disorder
Items 65-70 Oppositional Defiant (ODD) Disorder
Items 71-72 Hallucinations or Delusions
Items 73-74 Learning Disability
Items 75-85 Autistic Spectrum (including Asperger’s)
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Use the results for a focused conversation with your child’s primary care clinician, mental health
clinician, or with school staff about options to improve your child’s mental health. If particular sections
receive mostly moderate and severe answers, show and describe these to your clinician. At that time, it
may be useful to show and describe the “Past” column, since some symptoms tend to predict certain
other symptoms or clarify other factors to consider.
Consider obtaining additional screening tools and rating scales for more detailed assessment. Many of
these are described and/or accessible from www.schoolpsychiatry.org.
II. Child/Adolescent Psychiatry Screen (CAPS) Child’s
Name:______________________________________
Date of Birth :_________________
Male _____ Female _____
Form Completed By:_________________________________
Relationship to Child:________________________________
For each item below, check the one category that best describes your child during the past 6 months.
None = the child never or very rarely exhibits this behavior.
Mild = the child exhibits this behavior approximately once per week, and few others notice or complain
about this behavior.
Moderate = the child exhibits this behavior at least three times per week, and others notice or comment
on this behavior.
Severe = the child exhibits this behavior almost daily, and multiple others complain about this behavior.
Past = the child used to have significant problems with this behavior, but not during the past 6 months.
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1. Has difficulty separating from parents* (* = or major caregiver/guardian)
_____None _____None _____Mild _____Moderate _____Severe
____Past
2. Worries excessively about losing or harm occurring to parents*
____Past
3. Worries about being separated from parent* (getting lost or kidnapped)
____Past
4. Resists going to school or elsewhere because of fears of separation
____Past
5. Resists being alone or without parents*
____Past
6. Has difficulty going to sleep without parent nearby
____Past
7. Physical complaints (headache, stomach ache, nausea) when anticipating separation
____Past
8. Has discrete periods of intense fear that peak within 10 minutes
____Past
9. Has excessive, unreasonable fear of a specific object or situation
____Past
10. Has recurrent thoughts that cause marked distress (e.g., fears germs)
____Past
11. Driven to perform repetitive behaviors (e.g., handwashing, doing things 3 times)
____Past
12. Has recurrent, distressing recollections of past difficult or painful events
____Past
13. Worries excessively about multiple things (e.g., school, family, health, etc.)
____Past
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14. Goes to the bathroom at inappropriate times or places
15. Makes noises, and is often unaware of them
16. Makes repetitive, sudden, nonrhythmic movements
17. Fails to pay close attention to details or makes careless mistakes
18. Has difficulty sustaining attention during play or school activities
19. Does not seem to listen when spoken to directly
20. Does not follow through on instructions; fails to finish schoolwork/chores
21. Has difficulty organizing tasks and activities
____Past
____Past
____Past
____Past
____Past
____Past
____Past
____Past
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22. Loses things necessary for tasks are activities (toys, pencils, etc.)
____Past
23. Is easily distracted easily by irrelevant stimuli
____Past
24. Is forgetful in daily activities
____Past
25. Is fidgety or squirms in seat
____Past
26. Has difficulty remaining seated
____Past
27. Runs or climbs excessively; is restless
____Past
28. Talks excessively
____Past
29. Blurts out answers before questions have been completed
____Past
30. Has difficulty waiting turn
____Past
31. Interrupts or intrude on others
____Past
32. Episodes of unusually elevated or irritable mood
____Past
33. During this episode, grandiosity or markedly inflated self-esteem (Superhero )
____Past
34. During this episode, is more talkative than usual/seems pressured to keep talking
____Past
_____Moderate _____Severe
____Past
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35. During this episode, races from thought to thought
____Past
36. During this episode, is very distractible
____Past
37. During this episode, excessively involved in things (too religious, hypersexual)
____Past
38. During this episode, dangerous involvement in pleasurable activity (spending, sex)
____Past
39. Depressed or irritable mood most of the day, most days for at least 1 week
____Past
40. Loss of interest in previously enjoyable activities
____Past
41. Notable change in appetite (not when dieting or trying to gain weight)
_____None _____None _____Mild
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42. Difficulty falling or staying asleep, or sleeping excessively through the day
____Past
43. Others notice child is sluggish or agitated most of the time
____Past
44. Loss of energy nearly every day
____Past
45. Feelings of worthlessness or inappropriate guilt nearly every day
____Past
46. Thinks about dying or wouldn’t care if died
____Past
47. Smokes cigarettes, drinks alcohol, OR abuses drugs (Circle all that apply)
____Past
48. Has bad things happen when under the influence of substances
____Past
49. Has made unsuccessful efforts to stop using a substance
____Past
50. Is excessively worried about gaining weight, even though underweight
____Past
51. If female, has stopped having menstrual cycles (after regularly having)
____Past
52. Thinks he/she is fat, even though not overweight (pulls skin and claims is fat, etc.)
____Past
53. Engages in binging and purging (eats excessively, then vomits or uses laxatives)
____Past
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54. Bullies, threatens, or intimidates others
_____None _____None _____Mild _____Moderate
55. Initiates physical fights
56. Uses weapons that could harm others
57. Has been physically cruel to animals
58. Has shoplifted or stolen items
59. Has deliberately set fires
60. Has deliberately destroyed others’ property
61. Lies to obtain goods or to avoid obligations
_____Severe
____Past
_____Severe
____Past
_____Severe
____Past
_____Severe
____Past
_____Severe
____Past
_____Severe
____Past
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62. Stays out at night despite parental prohibitions
63. Has run away from home overnight on at least two occasions
64. Is truant from school
65. Loses temper
66. Actively defies or refuses to comply with adult rules
67. Deliberately annoys others
68. Blames others for his/her mistakes or misbehavior
69. Easily annoyed by others
70. Is spiteful or vindictive
_____Mild _____Moderate _____Severe
____Past
____Past
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____Past
____Past
____Past
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____Past
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71. Has unusual thoughts that others cannot understand or believe
____Past
72. Hears voices speaking to him/her that others don’t hear
____Past
73. Does poorly at sports or games requiring physical coordination skills
____Past
74. Has difficulty at school with: reading, writing, math, spelling (Circle all that apply)
____Past
75. Had delayed speech or has limited language now
____Past
76. Avoids eye contact during conversations
____Past
77. Does not follow when others point to objects
____Past
78. Shows little interest in others; emotionally out of sync with others
____Past
79. Difficulty starting, stopping conversation; continues talking after others lose interest
____Past
80. Uses unusual phrases, possibly over and over (speaks Disney or movie lines)
____Past
81. Does not engage in make-believe play; plays more alone than with others
_____None _____None
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82. Unusual preoccupations with objects or unusual routines (lines up 100’s of cars, etc.)
_____None _____Mild _____Moderate _____Severe
____Past
83. Difficulty with transitions; may be inflexible about adhering to routines or rules
____Past
84. Shows unusual physical mannerisms (hand-flapping, shrieks, objects in mouth, etc.)
____Past
85. Unusual preoccupations (schedules, own alphabet, weather reports, etc.)
____Past
Thank you for answering each of these items. Please list any other symptoms that concern you:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
© Copyright 2004 Jeff Q. Bostic: This screen may be freely used by individuals, clinicians, or schools,
but may not be used for profit or for proprietary purposes
• Pediatric Symptom Checklist (PSC) Parent The PSC can be
completed by parents and contains 35 items for children and
adolescents ages 6-16. It is available free in English and
Spanish. Translations into Creole, Mandarin Chinese, and
Swahili also exist. The PSC is designed to alert clinicians early
to difficulties in functioning that may indicate current or
potential psychosocial problems, so that early intervention
might be provided. It is used only as a screening tool and not
to make a formal diagnosis or measure treatment
interventions. The PSC takes 5-10 minutes to complete.
• It is available free at:
http://psc.partners.org/psc_order.htm
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(Adapted from Jellinek, M. "Approach to the Behavior Problems of Children and Adolescents." In T.A.
Stern, J.B. Herman, P.L. Slavin (Eds.) The MGH Guide to Psychiatry in Primary Care. 1998.
New York: McGraw-Hill: 437-443).
Why screen for psychosocial problems?
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Studies indicate that less than 30 percent of children with substantial dysfunction are recognized by primary care
clinicians. Nationally, referral rates of children seen by pediatricians to mental health services range from 1 to 4
percent. Often recognition depends on parental complaint or school report of overt behavioral problems; early
recognition, prevention, and less overt dysfunction (such as secondary and childhood depression, or family factors
such as divorce) are much less likely to be addressed.
Children with chronic disease are about twice as likely to have a psychosocial disorder (those suffering from
epilepsy are at highest risk). Psychosocial functioning also has an impact on medical compliance and is associated
with higher utilization of primary care services.
Children who have major difficulties in one area of functioning often demonstrate symptoms and difficulties in
other areas of daily functioning. For example, if they are having school difficulties secondary to attentiondeficit/hyperactivity disorder (ADHD), symptoms such as motoric activity or impulsivity will be evident at home and
may interfere with other activities. Even less overt disorders such as learning disabilities or difficulties in peer
relationships will often manifest as depressed mood at home, tension with siblings, or low self-esteem.
Accidents, a leading cause of death in children and adolescents, are often secondary consequences of psychosocial
stressors. Fires, falls from windows, drowning, and motor vehicle accidents are all more likely in the context of
psychosocial dysfunction.
http://psc.partners.org/psc_order.htm
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How can screening for psychosocial problems help children?
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Screening enables clinicians to recognize problems – quickly – and to provide help, preferably at an
early and effective point. Screening tests are not designed to yield diagnoses or label children. For
example, rather than review symptoms of diabetes in every child, a urine screening test helps the
primary care clinician determine which children need further evaluation. Similarly, psychosocial
screening is a starting point for further questions and assessment.
A key component for determining appropriate treatment, as prescribed by the DSM-IV (Diagnostic
and Statistical Manual of Mental Disorder. Fourth Edition) and the DSM-IV-PC (Diagnostic and
Statistical Manual of Mental Disorder. Fourth Edition. Primary Care Version), is the extent of
impairment or severity. Some presentations, such as psychosis or a serious suicide attempt, are
clearly severe and will need to be referred for possible hospitalization. Other conditions, however,
such as depression or ADHD, can vary widely in severity and in milder cases will be managed in
primary care settings, some with support or changes in school program; others with psychotropic
medications and more comprehensive treatment programs. Early recognition, at a point before
damage to self-esteem, is both prognostically better for the child and economically better for the
child’s family and for those funding services.
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Psychosocial Problems and Screening
Childhood psychosocial dysfunction, considered a "new morbidity" twenty-five years ago, has
become widelyacknowledged as the most common, chronic condition of children and
adolescents.1, 2 Epidemiologic studies report that 12-25% of all American school-age children
and 13% of preschoolers have an emotional and/or behavioral disorder.3-8 The rates of
psychosocial impairment are higher in risk groups such as low income and/or single parent
households.
With the advent of managed and especially capitated health care systems,10 primary care
providers assume an even greater "gatekeeping" responsibility to identify, manage and refer
children with emotional and/or behavioral disorders.11 Yet, recent studies estimate that only
about 50% of these children are identified by their primary care physicians and that once
identified, only a fraction of these children receive appropriate mental health treatment.9, 12-15
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A number of studies16-19 have documented an increasing prevalence of behavioral and emotional
problems in the U.S. and other countries in children and adults. Despite the growing burden of
psychosocial morbidity, pediatricians still do not receive adequate training concerning psychosocial
problems,20 are hesitant to attach potentially deleterious labels to children,13 do not have time
during office visits to address psychosocial needs, and may have limited access to mental health
referral networks.15 Recent efforts such as the American Board of Pediatrics increasing ambulatory
and behavioral training requirements, publications such as Bright Futures,21 and the Diagnostic and
Statistical Manual for Primary Care22 may help to increase awareness of psychosocial morbidity
over the long-term, but as of now primary care pediatricians still struggle to provide psychosocial
services.2, 21-22 The move to managed care approaches in medicine and the increasing focus on
productivity and profitability has created an additional pressure for pediatric clinicians to limit
attention on psychosocial problems.
One way to counterbalance this pressure is to use a parent-completed screening questionnaire as
part of routine primary care visits23 to facilitate recognition and referral of psychosocial problems.
The Pediatric Symptom Checklist (PSC) was developed for this purpose. The PSC is a one-page
questionnaire listing a broad range of children's emotional and behavioral problems that reflects
parents' impressions of their children's psychosocial functioning. Cutoff scores for pre-school and
school-age children indicating clinical levels of dysfunction have been empirically derived using
Receiver Operator Characteristic analyses in studies comparing the performance of the PSC to other
validated questionnaires and clinicians' assessments of children's overall functioning. 24-25
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In a number of validity studies, PSC case classifications agreed with case classifications on the
Children's Behavior Checklist (CBCL), clinicians' Global Assessment Scale (CGAS) ratings of
impairment, and the presence of psychiatric disorder in a variety of pediatric and subspecialty
settings representing diverse socioeconomic backgrounds.26-30 When compared to Children's Global
Assessment Scale scores (CGAS) in both middle and lower income samples, the PSC has shown high
rates of overall agreement (79%;92%), sensitivity (95%;88%) and specificity (68%;100%).24-27 Studies
using the PSC have found prevalence rates of psychosocial impairment in middle class or general
settings (~12%) that are quite comparable to national estimates of psychosocial problems. 25-30
More recently, efforts to develop specific subscales of the PSC for use in identification of
attentional, internalizing (depression/anxiety), and behavior problems31 and to develop both child32 and teacher-report versions of the PSC are well along.
Previous studies using a variety of measures have consistently shown that the prevalence of
psychosocial impairment varies considerably based on a number of sociodemographic risk factors,
and research with the PSC has paralleled many of these findings. For example, low socioeconomic
status,33 living with a single parent,34 parental mental illness,35-36 family discord ,37 the child's
temperamental characteristics, and male sex 37-38 have all been shown to increase the probability of
psychosocial dysfunction. Consistent with these findings, studies using the PSC have shown the
prevalence of child psychosocial dysfunction to be two to three times higher in children from low
income,27,39 single-parent,27 and/or mentally ill parents.28
• Research currently in progress suggests that
routine psychosocial screening with the PSC is
associated with increased mental health
referrals, decreasing child symptom scores,
and increased parental satisfaction. Other
studies are looking at the costs of screening
and possible cost offsets in pediatric medical
costs after children are screened and treated.
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The following information relates to the psychometric properties of the PSC:
Instructions for Scoring: The PSC consists of 35-items that are rated as never, sometimes, or often present and scored 0, 1,
and 2, respectively. Item scores are summed and the total score is recoded into a dichotomous variable indicating psychosocial
impairment. For children aged six through sixteen, the cut-off score is 28 or higher. For four and five year-old children, the PSC
cut-off is 24 or higher (Little et al, 1994; Pagano et al, 1996). Items that are left blank by parents are simply ignored (score = 0).
If four or more items are left blank, the questionnaire is considered invalid.
How to Interpret the PSC: A positive score on the PSC suggests the need for further evaluation by a qualified health (M.D.,
R.N.) or mental health (Ph.D, LICSW) professional. Both false positives and false negatives occur, and only an experienced
clinician should interpret a positive PSC score as anything other than a suggestion that further evaluation may be helpful. Data
from past studies using the PSC indicate that 2 out of 3 children who screen positive on the PSC will be correctly identified as
having moderate to serious impairment in psychosocial functioning. The one child "incorrectly" identified usually has at least
mild impairment, although a small percentage of children turn out to have very little actually wrong with them (e.g., an
adequately functioning child of an overly anxious parent). Data on PSC-negative screens indicate 95% accuracy, which,
although statistically adequate, still means that 1 out of 20 children rated as functioning adequately may actually be impaired.
The inevitability of both false-positive and false-negative screens underscores the importance of experienced clinical judgment
in interpreting PSC scores. Therefore, it is especially important for parents or other lay people who administer the form to
consult with a licensed professional if their child receives a PSC-positive score.
Validity: Using a Receiver Operating Characteristic Curve, Jellinek, Murphy, Robinson, et al (1988) found that a PSC cutoff score
of 28 has a specificity of 0.68 and a sensitivity of 0.95 when compared to clinicians’ ratings of children’s psychosocial
dysfunction. In other words, 68% of the children identified as PSC-positive will also be identified as impaired by an experienced
clinician, and, conversely, 95% of the children identified as PSC-negative will be identified as unimpaired.
Reliability: Test-re-test reliability of the PSC ranges from r = .84 - .91. Over time, case/not case classification ranges from 83% 87%. (Jellinek & Murphy, 1988; Murphy et al, 1992).
Inter-item Analysis: Our studies (Murphy & Jellinek, 1985; Murphy, Ichinose, Hicks, et al, 1996) also indicate strong (Cronbach
alpha = .91) internal consistency of the PSC items and highly significant (p < 0.0001) correlations between individual PSC items
and positive PSC screening scores.
Qualifications for Use of the PSC: The training required may differ according to the ways in which the data are to be used.
Professional school (e.g., medicine or nursing) or graduate training in psychology of at least the Master’s degree level would
ordinarily be expected. However, no amount of prior training can substitute for professional maturity, a thorough knowledge of
clinical research methodology, and supervised training in working with parents and children. There are no special qualifications
for scoring.
SNAP-IV-C Rating Scale-Revised
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Parent Teacher Although devised (by Swanson, Nolan and Pelham)
primarily for ADHD, the SNAP contains 90 items that can be completed
by parents, teachers, or other caregivers for use by a healthcare
provider in a more general assessment. The SNAP-IV-R takes 10
minutes to complete and is used with children and adolescents ages 618. Criteria for ADHD and Oppositional Defiant Disorder are included. In
addition, the SNAP-IV-C contains 10 items about classroom symptoms
of inattention, hyperactivity, and impulsivity. Additional items assess
Conduct Disorder, Intermittent Explosive Disorder, Tourette's Disorder,
Stereotypic Movement Disorder, Obsessive-Compulsive Disorder,
Generalized Anxiety Disorder, Narcolepsy, Manic Episode, Major
Depressive Episode, and Dysthymic Disorder.
• Available free online at:
www.ADHD.net or at http://www.add-pediatrics.com/add/snapiv.html.
• Beck Youth Inventories of Emotional & Social Impairment
(BYI) Beck Youth Inventories of Emotional and Social
Impairment (BYI) Student These five self-report
assessments for children and adolescents 7-14 years old
can be used separately or in any combination to assess a
youth's experiences of depression, anxiety, anger,
disruptive behavior, and self-concept. Each inventory
contains 20 statements that take approximately 5-10
minutes to complete.
• Available for purchase at:
http://harcourtassessment.com/haiweb/Cultures/enUS/default.htm.
Psychotherapies Children And
Adolescents
• http://www.aacap.org/cs/root/facts_for_families/psychothera
pies_for_children_and_adolescents
Psychotherapy is a form of psychiatric treatment that involves
therapeutic conversations and interactions between a
therapist and a child or family. It can help children and families
understand and resolve problems, modify behavior, and make
positive changes in their lives. There are several types of
psychotherapy that involve different approaches, techniques
and interventions. At times, a combination of different
psychotherapy approaches may be helpful. In some cases a
combination of medication with psychotherapy may be
more effective.
Different types of psychotherapy:
• Cognitive Behavior Therapy (CBT)
helps improve a child's moods,
anxiety and behavior by
examining confused or distorted
patterns of thinking. CBT
therapists teach children that
thoughts cause feelings and
moods which can influence
behavior. During CBT, a child
learns to identify harmful thought
patterns. The therapist then helps
the child replace this thinking
with thoughts that result in more
appropriate feelings and
behaviors. Research shows that
CBT can be effective in treating a
variety fo conditions, including
depression and anxiety.
• Dialectical Behavior
Therapy (DBT) can be used to
treat older adolescents who have
chronic suicidal
feelings/thoughts, engage in
intentionally self-harmful
beaviors or have Borderline
Personality Disorder. DBT
emphasizes taking responsibility
for one's problems and helps the
person examine how they deal
with conflict and intense negative
emotions. This often involves a
combination of group and
individual sessions.
• Family Therapy focuses on
helping the family function in
more positive and constructive
ways by exploring patterns of
communication and providing
support and education. Family
therapy sessions can include
the child or adolescent along
with parents, siblings, and
grandparents. Couples
therapy is a specific type of
family therapy that focuses on
a couple's communication and
interactions (e.g. parents
having marital problems).
• Group Therapy is a form of
psychotherapy where there
are multiple patients led by
one or more therapists. It uses
the power of group dynamics
and peer interactions to
increase understanding of
mental illness and/or improve
social skills. There are many
different types of group
therapy (e.g. psychodynamic,
social skills, substance abuse,
multi-family, parent support,
etc.).
• Interpersonal Therapy (IPT) is
a brief treatment specifically
developed and tested for
depression, but also used to
treat a variety of other clinical
conditions. IPT therapists
focus on how interpersonal
events affect an individual's
emotional state. Individual
difficulties are framed in
interpersonal terms, and then
problematic relationships are
addressed
• Play Therapy involves the use
of toys, blocks, dolls, puppets,
drawings and games to help
the child recognize, identify,
and verbalize feelings. The
psychotherapist observes how
the child uses play materials
and identifies themes or
patterns to understand the
child's problems. Through a
combination of talk and play
the child has an opportunity to
better understand and
manage their conflicts,
feelings, and behavior.
• Psychodynamic Psychotherapy emphasizes understanding the issues that
motivate and influence a child's behavior, thoughts, and feelings. It can
help identify a child's typical behavior patterns, defenses, and responses to
inner conflicts and struggles. Psychoanalysis is a specialized, more
intensive form of psychodynamic psychotherapy which usually involved
several sessions per week. Psychodynamic psychotherapies are based on
the assumption that a child's behavior and feelings will improve once the
inner struggles are brought to light.
• Psychotherapy is not a quick fix or an easy answer. It is a complex and rich
process that, over time, can reduce symptoms, provide insight, and
improve a child or adolescent's functioning and quality of life.
• At times, a combination of different psychotherapy approaches may be
helpful. In some cases a combination of medication with psychotherapy
may be more effective. Child and adolescent psychiatrists are trained in
different forms of psychotherapy and, if indicated, are able to combine
these forms of treatment with medications to alleviate the child or
adolescent's emotional and/or behavioral problems.

us/childmentalhealth.html MENTAL HEALTH CHILDREN

Transcription

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