Child adol treatment

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  • 1.Treatment of Child/Adolescent Disorders

2. Autism Spectrum Disorders (ASDs) ASDs include Autistic disorder, Asperger syndrome,and Pervasive Developmental Disorder not otherwisespecified. Based on research, behavioral therapies that helpchildren with ASDs provide structure, direction, andorganization for the child. Family participation intherapy is also necessary for success. Behavioral therapies for ASDs should start as earlyas possible. 3. Behavioral therapies for ASDs Behavioral therapies help children with ASDs buildlanguage, social and play skills. Applied behavioral analysis (ABA) is frequently used forchildren with ASDs and research shows that it can bevery effective in helping children with ASDs. ABA involves identifying the behaviors that need to bereduced and the ones that need to be built. In ABA the child practices skills repeatedly and thetherapist constantly provides positive reinforcements forthe child. The program is highly individualized based onthe childs interests, abilities and behavior. 4. Applied Behavioral Analysis (ABA) ABA is a general intervention approach that can beadapted to different circumstances and settings. ABAcan be used in combination with other psycho-educational and behavioral strategies. In ABA, the skills and behavior of each child areassessed, and appropriate functional skills to betaught are chosen with respect to the childs ability. The teaching environment is is set up to emphasizeclassroom structure, to adapt instructional activities,and to develop meaningful curriculum. 5. Early Intensive Behavioral Intervention (EIBI) Early intensive behavioral intervention (EIBI) in contrast to ABA, isa much more prescriptive, manualized program that integratescomponents of ABA. Children in an EIBI program have therapy approximately 40 hoursper week over the course of up to two years. It is recommended that the child start therapy before the age ofthree. Two manualized EIBI programs are the University of California, LosAngeles (UCLA)/Lovaas model and the Early Start Denver Model(ESDM). Both programs involve high intensity instruction usingABA techniques but have several differences. The UCLA/Lovaas method uses one-on-one therapy sessions anddiscrete trial teaching. The ESDM uses ABA principles with developmental andrelationship-based approaches for young children. 6. Other interventions for ASDs Cognitive behavioral therapy- CBT is used to teach children with ASD tomonitor and manage their own behaviors through changing theirperceptions, self-understanding and beliefs. Change is more likely to takeplace when a child is actively involved in their own behavior management.CBT is only appropriate for children with some degree of self-understanding and self- awareness and are therefore mostly used withschool-age children and adolescents with High Functioning Autism andAspergers Disorder. Social Skills Interventions Peer-mediated intervention is used toencourage specific social skills and to also encourage broader interactionsand relationships (Rogers, 2000; McConnell, 2002). In this type ofintervention, children without ASD are taught how to initiate, elicit,prompt and reinforce social behaviors of children with ASD (Odom,Chandler, Ostrosky, McConnell, & Reaney, 1992). Parents can also betaught to train siblings to use peer-mediated approaches at home toimprove child-sibling interactions (Strain, Kohler, Storey & Danko, 1994). 7. Childhood Schizophrenia Treatment should include family education and ongoingfamily intervention so that the family is in the best position toprovide support to the child. Individual treatment with the adolescent must take intoaccount the childs developmental level. Due to likely social skills deficits, social skills training shouldbe an integral part of the treatment.These sessions teach kids the coping mechanisms andcommunication skills that will help them go to school andsocialize with their peers.Cognitive behavioral therapy is also commonly recommendedto help children manage their symptoms; its been shown toreduce both severity of symptoms and the risk of relapse. 8. Psychoeducational Family Therapy A psychoeducational approach helps families learnskills and gain resiliency to handle chronicproblems/illnesses that affect a member of thefamily. Traditional family therapy techniques are used:joining, establishing an alliance with familymembers, maintaining neutrality, and assessing howto gain positive outcomes. 9. Combining medication management and a familypsychoeducational intervention offers families a therapeuticpackage aimed at reducing family stress and preventingsymptomatic relapse in the schizophrenic member. When family members are not being blamed for thedevelopment of the disorder in one of their members it iseasier to engage and retain them into treatment programs,thus increasing the likelihood of improved treatmentcompliance. Their willingness to work with the therapist is also increased ifthey understand that efforts will help them reduce the familyslevel of emotional intensity so that relapse in theschizophrenic might be delayed or reduced in severity. 10. Because schizophrenia can be considered a chronic disorder, amedical family therapy can also be utilized as an intervention. Medical family therapy consists of a coordinated effort by aninterdisciplinary team to treat a disorder. The focus is helpingfamilies to cope better with a chronic illness, manage medication,communicate better with providers, and accept that the illness maynot be cured. This model for family therapy replaces the traditional medicalmodel that focuses exclusively on a sick individual receiving care toone in which the family becomes a key component to the caregivingsystem. It seeks to draw out the familys strengths so as to enhance coping. Therefore, both psychosocial factors and biological interventionsplay an important role in improving outcomes for the familymember with schizophrenia and the family. 11. Childhood Eating Disorders- Anorexia and Bulimia Treatment includes: Adequate nutrition, reducing excessive exercise, andstop-ping purging behaviors. For less severe eating disorder cases individual therapy and medication areeffective for many eating disorders. However, in more chronic cases,specific treatments have not yet been identified. Treatment plans often are tailored to individual needs and may include oneor more of the following: 1. Individual, group, and/or familypsychotherapy, 2. Medical care and monitoring, 3. Nutritional counseling,4. Medications. Individual therapy should focus on resolution of distorted cognitions, bodyimage and self-image issues, and treatment of mood and anxiety disorders. Family therapy should focus on education, addressing communication,family relationships, and individuation issues. Some patients may also need to be hospitalized to treat problems caused bymal-nutrition or to ensure they eat enough if they are very underweight. 12. Anorexia Nervosa Treating anorexia nervosa involves three components:Restoring the person to a healthy weight, treating thepsychological issues related to the eating disorder,reducing or eliminating behaviors or thoughts that leadto insufficient eating and preventing relapse. Different forms of psychotherapy, including individual,group, and family-based, can help address thepsychological reasons for the illness. In a therapy called the Maudsley approach, parents ofadolescents with anorexia nervosa assume responsibilityfor feeding their child. This approach appears to be veryeffective in helping people gain weight and improveeating habits and moods. 13. Bulimia Nervosa To reduce or eliminate binge-eating and purgingbehaviors, nutritional counseling and CBT can beeffective. CBT helps a patient focus on his or her current problemsand how to solve them. The therapist helps the patientlearn how to identify distorted or unhelpful thinkingpatterns, recognize, and change inaccurate beliefs, relateto others in more positive ways, and change behaviorsaccordingly. CBT that is tailored to treat bulimia nervosa is effectivein changing binge-eating and purging behaviors andeating attitudes. CBT can be individual or group-based. 14. Behavioral Disorders- ADHD, Conduct Disorderand Oppositional Defiant Disorder Evidence-based Psychosocial Treatment forADHD - Treatment for ADHD should include apsychosocial component. Research on the treatment of ADHD supports thatthere are two treatments that have scientificevidence for short-term effectiveness: behavioralpsychosocial treatmentsalso called behaviortherapy or behavior modificationand stimulantmedication. Behavior modification is the onlynonmedical treatment for ADHD with a largescientific evidence base. 15. Children with ADHD have problems in daily life functioningin many areas including academic performance and behaviorat school, relationships with peers and siblings, disobediencewith adults, and relationships with their parents. How a child with ADHD will do in adulthood is best predictedby three things(1) whether his or her parents use effectiveparenting skills, (2) how he or she gets along with otherchildren, and (3) his or her success in school. Behavioral treatments must focus on these things and teachskills to parents, teachers, and children with ADHD. ADHD is a chronic condition, therefore teaching skills thatwill be valuable to the child as they get older is really critical. 16. Behavior Modification for ADHD Behavior modification is a form of therapy in which parents, teachers, andchildren are taught skills by a therapist. Parents and teachers use those skills in their daily interactions with thechild with ADHD to improve the childrens functioning, the child withADHD uses the skills they learn in their interactions with other children. Behavior modification can be thought of as the ABCsAntecedents (thingsthat happen before behaviors that influence them), Behaviors (things thechild does that parents and teachers want to change),