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Additional Reference – Lecture 2, Risk & Resilience. Schaffer, H.R. (2000). The early experience assumption: Past, present, and future, International Journal of Behavioral Development , 24, 1, pp5-14. Additional Reference, Lecture 2, Risk & Resilience.

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Additional Reference – Lecture 2, Risk & Resilience

  • Schaffer, H.R. (2000). The early experience assumption: Past, present, and future, International Journal of Behavioral Development, 24, 1, pp5-14

Rosaleen McElvaney, Phd

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Additional Reference, Lecture 2, Risk & Resilience

  • Preview Ravens Siberer, U., Erhart, M., Gosch, A., Wille, N., The European KIDSCREEN Group (2008), Mental health of children and adolescents in 12 European countries: Results from the European KIDSCREEN study, Clinical Psychology and Psychotherapy, 15, 3, pp. 154-163

Rosaleen McElvaney, Phd

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Additional Reference – Lecture 3, Behavioural Model & ASD

  • Eikeseth, S., Smith, T., Jahr, E and Eldevik, S. (2002). Intensive behavioural treatments at school for 4-to-7 year-old children with autism. Behaviour Modification, 26, 49-68

Rosaleen McElvaney, Phd

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Models of Development and Mental Health

Lecture 4:

Cognitive Model: Anxiety

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Changing focus of children’s fears

  • (Koplewicz, 1996, in Dadds & Barrett, 2001, JCPP,Weems & Costa, 2005)

Rosaleen McElvaney, Phd

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Anxiety Disorders

  • Separation anxiety disorder

  • Specific phobias

  • Selective mutism

  • Obsessive compulsive disorder

  • Generalised anxiety disorder

  • Panic attacks

  • Post Traumatic Stress Disorder/Acute Stress Disorder

Rosaleen McElvaney, Phd

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Obsessive Compulsive Disorder & Generalized Anxiety Disorders

1% for adolescents

2-4% for GAD

Adolescents> children

Girls>boys for GAD

No diff for OCD

Prevalence of Anxiety Disorders

  • Anxiety Disorders

  • 7.3% of population?

  • Females>males

  • Continuity into adulthood

  • High co-morbidity

  • 44 adults per 1,000 (Office of National Statistics, 2000, cited in NICE Guidelines, 2004)

  • Separation Anxiety Disorder & Phobias

  • 4% and 2-3%

  • Children > Adolescents

  • Girls > Boys

Rosaleen McElvaney, Phd

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Additional Reference, Lecture 4, Cognitive Model & Anxiety Disorders

  • Gosch, E.A., Flannery-Schroeder, E., Mauro, C.F., Compton, S.N. (2006). Principles of cognitive-behavioral therapy for anxiety disorders in children, Journal of Cognitive Psychotherapy, Vol. 20 Issue 3, pp.247-262,

Rosaleen McElvaney, Phd

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Social Learning Theory Perspective Disorders

  • Bandura (1977)

  • Learning through direct observation as well as experience – modelling

  • Children may learn anxious responses through observing this behaviour being modelled by significant others – role models doubting their own ability or overestimate the likelihood of threat

  • Perceived self-efficacy to cope with and control anxiety-provoking stimuli

Rosaleen McElvaney, Phd

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Information Processing Perspective Disorders

  • Cognitive bias at level of perception, encoding, interpretation and retrieval of information

  • Anxious children more attentive to potential dangers, more likely to interpret situations as dangerous and more likely to remember fear-relevant cues (Beck, Emery & Greenberg, cited in Gosch et al., 2006)

Rosaleen McElvaney, Phd

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Triple vulnerability model DisordersBarlow, 2000

  • Genetic vulnerability

  • General psychological vulnerability concerning a sense of impending uncontrollable and unpredicatble threat

  • Specifc psychological vulnerability resulting from early learning experiences that lead a child to experience anxiety in certain situations

  • Barlow, D. (2000). Unravelling the mysteries of anxiety and its disorders from the persepctive of emotion theory, American Psychologist, 55, pp1245-1263.

Rosaleen McElvaney, Phd

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Additional Reference, Lecture 4, Anxiety & Cognitive Model Disorders

  • Kendall, P.C., Hudson, J.L., Gosch, E., Flannery-Schroeder, E., Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomised clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, Vol 76, 2, pp. 282-297

Rosaleen McElvaney, Phd

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Kendall et al. study Disorders

  • Increasing parent involvement?

  • Reciprocal relationships between parents & children

  • Anxious children are more likely to have anxious parents whose behaviour may maintain anxiety and avoidance – parents may facilitate anxiety through reinforcement and modeling

  • Familial variables – high levels of parental anxiety predict pororere outcomes

Rosaleen McElvaney, Phd

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Kendall et al. study contd. Disorders

  • Effectiveness of child-focussed cbt supported by randomized control trials for anxiety disorders when compared to randomised controls ( Branmish & Kendall, 2005; Comptom et al., 2004, cited in Kendall et al., 2008)

  • 56% of anxious youth no longer met criteria for diagnosis following cbt; 63% at 6-12 months follow up (Cartwright-Hatton et al., 2004, cited in Kendall et al., 2008)

Rosaleen McElvaney, Phd

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Therapeutic Intervention DisordersGosch et al., 2006

  • Assessment

  • Psychoeducation

  • Affective education

  • Self-instruction training

  • Cognitive restructuring

  • Problem-solving

  • Relaxation training

  • Modelling

  • Contingency management

  • Exposure

Rosaleen McElvaney, Phd

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Cognitive Model - critique Disorders

  • Development of anxiety: Significant differences between those who suffer from anxiety and those who don’t, supports theory BUT Thinking causes disorder or is a result of disorder?

  • Manualised therapeutic interventions

    • Rigid procedures, need to take account of individuality

  • Extensive support for short term effects

  • Randomized controlled trials – ‘probably effective’

Rosaleen McElvaney, Phd

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Carr (2007) Disorders

  • 4 meta analyses of CBT for children with various difficulties (350 studies)

  • Average child fared better than 76% to 81% of children in control groups, 2 studies showed improvements maintained at 6 month follow up

  • ‘dose effect’ – 20-45 sessions acccounting for 50-75% of clients’ recovery

Rosaleen McElvaney, Phd

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Caution in interpreting research Disorders

  • Just because there is a abundance of empirical research conducted on CBT does not mean there is more evidence for effectiveness of CBT

  • More amenable to traditional quantitative methodologies

  • More focussed on easily measurable symptom change

  • Does not take account of intrapersonal dynamics & relationships

Rosaleen McElvaney, Phd

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Addditional References, Lecture 4, Anxiety & Cogntive Model Disorders

  • Butler, A., Chapman, J., Forman, E., & Beck, A. (2006). The empirical status of cognitive-behavioural therapy: A review of meta-analyses. Clinical Psychology Review.

  • Carr, A. (2007). The effectiveness of psychotherapy: A review of research. Dublin: Irish Council of Psychotherapy.

Rosaleen McElvaney, Phd