clinical practice with children and families session 5 notes
clinical practice with children and families session 5 notes SCWK885505
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This 3 page Class Notes was uploaded by Amber Notetaker on Thursday February 18, 2016. The Class Notes belongs to SCWK885505 at Boston College taught by Sarah Ryan in Fall 2016. Since its upload, it has received 21 views. For similar materials see clinical practice: children and families in Social Work at Boston College.
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Date Created: 02/18/16
Clinical- child & Fam: 2/18 Depressive Disorders Persistent Depressive Disorder - previously dysthymic disorder - 1 year in children 2 years in adults - depressive episodes with two or more depressive symptoms - pay attention to rule outs - medical conditions - bipolar disorder - needs to be happening in 2 more settings - if not we are going to focus on PTSD Disruptive mood Dysregulation Disorder - severe temper outbursts with underlying persistent angry or irritable mood - Frequency: 3 or more times a week - Duration: temper outbursts and the persistently irritable mood between outbursts - lasts at least 12 months - Severity: present in 2 settings and severe in at least one - Onset: not before 6 and not after 18 - Common rule outs: bipolar, IDD, depressive disorder, ADHD, autism, separation anxiety disorder - substance, medication or medical condition - if ODD present, do not also diagnose this - meant to replace juvenile bipolar disorder - it was being over diagnosed - very similar to IED (intermittent explosive disorder) - treatment implications - no empirically supported treatments - avoid bipolar medications - consider CBT treatments used for depression in children - coping skills for thoughts, feeling and behavior - parent training - parent support group Depression Treatment: Individual Psychotherapy Approaches - CBT (Cognitive behavioral therapy) - Goals: improving coping, emotion regulation, problem solving, social skills - Treatment: psychoeducation, coping skills, emotion regulation, cognitive restructuring, self-monitoring changes, activity scheduling, diary tracking - if the problem can be changed we want to use a problem solving strategy - if the problem cannot be changed we want to use coping strategies - IPT-A (Interpersonal therapy for adolescents) - Goals: decrease depressive symptoms and improve interpersonal functioning - Focuses on patterns of interpersonal relationships - Follows problem area model: - interpersonal role disputes - greif - role transition - interpersonal deficits - single parent home (for adult model) - Other treatments - solution focused therapy - narrative therapy - art therapy - play therapy with younger children - Psychopharmacology - SSRIs- lower side effects, but can increase suicidiality Fluxetine-Prozac - Alternative anti-depressants Buproprion-Wellbutrin Nefazodone-Serzone Venlafaxine-Effexor Mirtaxapine-Remeron - TCAs- older, risk of pediatric death Bipolar Disorder: Developmental Differences Child vs Adults - youth with BPD I spend more times symptomatic than adults with more polarity switches than adults - youth lack affect regulation - rapid fluctuations in mood symptoms: youths have more difficulty verbilizing emotions - in youth there is this irritable mood all the time where in adults the default is the upswing - intervals between episodes decrease decrease as illness becomes worse - rapid cycling: youth can cycle between 30 times a day - less substance abuse in children -> prompt treatment before substance abuse becomes a problem - longer remissions -> less likely to relapse - children who begin illness earlier in life-become poor responders to treatment as adults Differential diagnosis fo Bipolar Disorder - look for a thyroid condition - can be a cause for some symptoms - need to differentiate between DMDD, IED, depression, PTSD, ODD/CD, ADHD, schizophrenia, schizoaffective, organic, disruptive, borderline personality disorder - look for signs of burnout in parents - co-morbid diagnosis - use differential checklists Brain Development - frontal lobe doesn’t develop until late adolescents - chemical imbalance of bipolar disorder accentuates the absence of the developed frontal lobe Bipolar Disorder Treatment: Multimodal treatment - managing mood: individual therapy psychopharmacology family treatment
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