Evidence-based Practices for Children & Adolescents

1. Evidence-based Practices for Children & Adolescents Rev. Torin T. Sanders, Ph.D., LCSW-BACS

2. WHO IS TORIN SANDERS?

3. OBJECTIVES • By the end of the workshop, participants will: 1) Be able to articulate the fundamentals and importance of evidence-based practice to social work 2) Be able to apply EBP to a variety of disorders including anxiety, disruptive behaviors, trauma and depression.

4. WAITING ROOM SIGN • ***WARNING*** • Notice to all Clients • Therapists at this facility are: • Not knowledgeable, Not Trained and Not skilled in the use of proven treatment approaches for children and adolescents (Ben Saunders, MUSC)

5. WHAT IS EVIDENCE-BASED PRACTICE? • PROCESS IN WHICH THE PRACTITIONER COMBINES RESEARCH, CLINICAL EXPERTISE, AND CLIENT CHARACTERISTICS TO GUIDE DELIVERY OF SERVICES • (SACKETT)

6. PRACTICE SHOULD NOT BE BASED UPON

7. WHAT IS THE PROCESS?

8. BEGINNINGS OF EBP • 1999 – EILEEN GAMBRILL • 2003 – LEONARD GIBBS, ROSEN & PROCTOR • 2007 – NIMH SYMPOSIUM “Partnerships to integrate Evidence-based mental health practice into social work education and research”

9. IMPORTANCE OF EBP

10. IMPORTANCE OF EBP

11. APPLICATION OF EBP

12. ANXIETY DISORDERS • Prevalence rates in children/adolescents is 10-20% • Separation anxiety, generalized anxiety, social anxiety disorder • Coping Cat program (Temple U) , 16 weeks (also a brief model) • 7-13 year olds • Treatment manual and youth workbook

13. Coping Cat

14. COPING CAT • VIEW HANDOUT

15. DISRUPTIVE BEHAVIOR DISORDERS • Prevalence rate among preschoolers – 13% • Includes diagnoses such as Conduct Disorder and Oppositional Defiant Disorder • DBDs are highly predictive of later delinquency, substance use, property destruction

16. DBD INFO • Prevalence rate among preschoolers – 13% • Includes diagnoses such as Conduct Disorder and Oppositional Defiant Disorder • DBDs are highly predictive of later delinquency, substance use, property destruction

17. PARENT-CHILD INTERACTION THERAPY • Baumrind’s parenting theory • Permissive (indulgent) • Authoritarian (coercive) • Authoritative (responsive and demanding) -Nurturing, Clear Communication, Consistent Enforcement of behavioral standards

18. PARENT-CHILD INTERACTION THERAPY

19. PCIT HANDOUT • PCIT.ORG • FOR MORE INFORMATION

20. TRAUMA • POST TRAUMATIC STRESS DISORDER/ACUTE STRESS DISORDER • KEY COMPONENTS • EXPOSURE • INTRUSIVE IMAGERY • AVOIDANCE • AROUSAL • ALTERATIONS IN COGNITION & MOOD

21. TRAUMA

22. TRAUMA FOCUSED - CBT • APPLICABLE FOR CHILDREN AGES 3-18 YEARS OLD • OCCURS OVER 8-20 SESSIONS; MORE FOR KIDS WITH COMPLEX TRAUMA • PARALLEL AND JOINT SESSIONS • WWW.MUSC.EDU/TFCBT WWW.TFCBT.ORG

23. TRAUMA FOCUSED - CBT • USE OF PRACTICE • PSYCHOEDUCATION & PARENTING TRAINING/WORK • RELAXATION (music, exercise, dance, bubbles, drawing,reading) • AFFECTIVE EXPRESSION • COGNITIVE COPING

24. TRAUMA FOCUSED - CBT • TRAUMA NARRATIVE • IN VIVO MASTERY OF REMINDERS (GRADUAL EXPOSURE) -naming, tone, direct facing, expectation CONJOINT CHILD-PARENT WORK (30/30) ENHANCE SAFETY

25. DEPRESSION • TYPICAL SYMPTOMS INCLUDE: -IRRITABLE MOOD -LOSS OF INTEREST (ANHEDONIA) -BOREDOM -CHANGES IN SLEEP/APPETITE -SELF INJURY/SUICIDE IDEATION

26. DEPRESSION

27. INTERPERSONAL THERAPY • COUNTERINDICATED FOR: - BIPOLAR - INTELLECTUAL DEV. D/O - SUBSTANCE USE D/O

28. INTERPERSONAL THERAPY • THREE COMPONENTS • EDUCATION (RATING SCALE, ASSIGN SICK ROLE, IDENTIFY PROBLEM AREA) • AFFECT IDENTIFICATION (LABEL/EXPRESS FEELINGS) • INTERPERSONAL SKILLS BUILDING (PROB-SOLVING, COMMUNICATION, EMPATHY)

29. INTERPERSONAL THERAPY THE CLOSENESS CIRCLE & PROBLEM AREAS SEE HANDOUT

30. SPECIFIC INTERVENTIONS FOR ETHNIC MINORITIES HANDOUT

31. RESOURCES • NATIONAL REGISTRY OF EVIDENCE BASED PRACTICES (NREPP) • DR. LEONARD GIBBS’ EVIDENCE-BASED PRACTICES FOR THE HELPING PROFESSION • CAMPBELL COLLABORATIVE • CALIFORNIA EVIDENCE-BASED CLEARINGHOUSE FOR CHILD WELFARE

32. Q & A • CONTACT INFO • DRTSANDERS@TORINSANDERS.COM • 504-579-4499