Chapter Seventeen

Chapter Seventeen INTERVENTION AND PREVENTION Developmental Psychopathology: From Infancy through Adolescence, 5th edition By Charles Wenar and Patricia Kerig

INTERVENTION AND PREVENTION • In this chapter we discuss ways in which childhood psychopathologies can be ameliorated or prevented • Developmental psychopathology moves away from uniformity myth and toward finding “best fit” for particular child given his/her developmental stage, psychopathology, personal qualities, and family characteristics

There is preference for using integrated models for understanding and treating psychopathology so that we can determine “which therapy might be most effective for whom” at a particular time in life • Movement toward using evidence-based approaches for intervention and prevention highlights need for ongoing research in field of child and adolescent care • Empirical Validation: methods, challenges, and outcomes

Ethnic Diversity and Intervention • cultural differences in pathology • cultural differences in treatment • cultural competency for therapists • culturally compatible interventions

Revising various models of psychopathology studied earlier, we now apply them to intervention strategies: • Psychoanalytic Approach • Humanistic Approach • Behavioral Therapies • Cognitive Therapies • Family Systemic Approach

Some prefer to distinguish psychotherapy, which is intervention directed at changing internal factors that mediate between environment and child’s behaviors, from interventions directed toward changing the environment, such as behavior therapies or family systemic therapies

1. Psychoanalytic Approach • Classical Psychoanalysis • Conceptual Model • Therapeutic Process • transference • interpretations • insight • working through • Ego Psychology • Conceptual Model • Therapeutic Process

Object Relations Theory • Conceptual Model • Therapeutic Process • Family Context • Psychodynamic Developmental Therapy for Children (PDTC) • Conceptual Model • Therapeutic Process • Empirical Support

2. Humanistic Approach • Humanistic (Client-Centered) Therapy • Conceptual Model • unconditional positive regard • conditions of worth • Therapeutic Process • Play Therapy • Empirical Support

3. Behavior Therapies • Conceptual Model • A-B and A-B-A-B designs • Developmental Dimension • Therapeutic Process • classical conditioning • operant conditioning • observational learning • Family Context • Empirical Support

“ABAB Design”

4. Cognitive Therapies • Conceptual Model • Therapeutic Process • cognitive treatment for Anxiety Disorder • cognitive treatment for Obsessive-Compulsive Disorder • Interpersonal Problem-Solving Skills Training (IPS) • Empirical Support

5. Family Systemic Approach • Conceptual Model • Therapeutic Process • restructuring techniques • Empirical Support

Integrative Developmental Psychopathology Model of Intervention (Shirk and Russell) • This model promotes consideration of multiple theoretical orientations to most accurately link intervention planning to pathogenic processes • 3 major domains of development are addressed: • cognitive • emotional • interpersonal

PREVENTION • Prevention is important but too often neglected approach to alleviating devastating effects that risk factors may have on children’s development • Addressing potential problems before they occur or become entrenched greatly reduces the cumulative effort, costs, and suffering incurred if action is taken only after psychopathology develops

The earlier we address developmental trajectory’s deviation from healthy track, the less effort needed to nudge it back and the more promising the long-term outcome • 3 types of prevention • primary • secondary • tertiary “The Continuum of Prevention and Intervention” Onset of Problem Problem Entrenched ←-----------------------------------→ primary secondary tertiary intervention

CONCLUSION Developmental Psychopathology’s understanding of risk and protective factors, sensitivity to the dimension of time, and focus on process by which psychopathology occurs provides ideal framework for developing and researching prevention program

Chapter Seventeen