Cook Transforming Teen Behavior

Parent Teen Protocols for Psychosocial Skills Training
1. Auflage 2015
ISBN: 978-0-12-803358-6
Verlag: Elsevier Science & Techn.
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 292 Seiten

Transforming Teen Behavior: Parent-Teen Protocols for Psychosocial Skills Training is a clinician's guide for treating teens exhibiting emotional and behavioral disturbances. Unlike other protocols, the program involves both parents and teens together, is intended for use by varied provider types of differing training and experience, and is modular in nature to allow flexibility of service. This protocol is well-established, standardized, evidence-based, and interdisciplinary. There are 6 modules outlining parent training techniques and 6 parallel and complementary modules outlining psychosocial skills training techniques for teens. The program is unique in its level of parent involvement and the degree to which it is explicit, structured, and standardized. Developed at Children's Hospital Colorado (CHCO), and in use for 8+years, the book summarizes outcome data indicating significant, positive treatment effects. - Useful for teens with varied clinical presentations - Evidence-based program with efficacy data included - Explicit, user-friendly protocols, for easy implementation - Appropriate for use by varied provider types in varied settings - Includes activities, patient handouts, and identifies structured format and delivery

Mary Nord Cook, MD is an Associate Professor of Psychiatry at the Colorado School of Medicine, who served as the Medical Director of Outpatient Services for the Department of Psychiatry at the Children's Hospital Colorado (CHCO) from 2005-2014. She has been extensively involved in the training of medical students, psychology and social work graduate students, along with psychiatry residents. She recently won a resident nominated award for teaching excellence and has also been recognized by the American Academy of Child & Adolescent Psychiatry (AACAP), as an Outstanding Mentor. She specializes in working with families presenting with youngsters who've been diagnosed with Disruptive Behavior and Mood Disorders. She spearheaded the development of a series of multidisciplinary, outpatient specialty clinics, along with intensive outpatient programs at the Children's Hospital Colorado. She recently wrote a book detailing the evidence-based, standardized, skills building treatment protocols used for the school-aged patient population, in both the routine and intensive outpatient programs, titled Transforming Behavior: Training Parents & Kids Together. She also co-authored a peer reviewed journal article that described the positive clinical outcomes obtained in the intensive outpatient program for children with disruptive behavior. She has authored books, chapters, review articles and contributed to the AACAP Practice Parameters on family interventions. She frequently performs presentations in the community for school, primary care and youth outreach programs. In addition, she routinely presents at regional and national, professional conferences, often on an invited basis. Her passions are developing and applying family and strengths-based approaches, pursuant of a goal to minimize medication, while optimizing parenting and psychosocial skills. Her mantra is 'More Skills ='s Less Pills! Dr. Cook received her bachelor's degree (psychology) with honors, from the University of Michigan and her doctoral degree (medicine) from Wayne State University. She completed her general psychiatry residency at the Naval Medical Center, San Diego and her child fellowship training at the University of California, San Diego."

Autoren/Hrsg.

Cook, Mary Nord

Leseproben

Foreword
Douglas A. Kramer, MD, MS, Middleton, Wisconsin “I wish I had thought of that!” That was my first thought as I read Transforming Teen Behavior, by Mary Nord Cook, MD. My second thought was, “I am learning things here.” That’s a nice experience for someone who will begin his eighth decade before Transforming is published. Dr. Cook is a physician specializing in child and adolescent psychiatry with special expertise in treating families. To my mind, her work is not in family therapy, but in family psychiatry. She brings to her work and to this book the medical background of a physician, beginning with dissecting a human cadaver as a first year medical student, later seeing patients in the emergency room, the operating room, and the delivery room. In the latter, she goes into the procedure with one patient and emerges with two, the mother and infant, and ideally the father and perhaps older siblings. This represents the essence of child psychiatry, the true patient being the relationship between the parent(s) and child, the life-giving, nurturing, and loving relationship that results ultimately in a healthy independent adult. As a child and adolescent psychiatrist, Dr. Cook brings to this project her knowledge of child and adolescent development, including physiological, psychological, and relational development; her knowledge and experience with child and adolescent psychiatric disorders, including the developmental processes that underlie these disorders; and her knowledge of child and adolescent counseling, individual psychotherapy, group psychotherapy, family psychotherapy, and pharmacotherapy. Bringing all of these areas of expertise and experience together creates a family psychiatrist. Notice that the last area of expertise listed is pharmacotherapy, because with most disorders affecting adolescents this is the least important and ideally the last utilized modality. Child and adolescent psychiatry began in Chicago in 1909 in what is known today as the Institute for Juvenile Research (Levy, 1968; Richmond, 1960; Truitt, 1926). It was the first of hundreds of child guidance clinics. From the first day in this first clinic, the child guidance model involved both the child or adolescent and his or her parents. Typically, the child or adolescent would be interviewed and counseled by a child psychiatrist or child psychologist, and the parents would be interviewed and counseled by a psychiatric social worker. This model persisted into the 1940s, increasingly informed by the prevalent theory of the time—psychoanalytic theory—with an associated decrease in parent involvement. The child’s intrapsychic conflicts became the target of treatment efforts. In the early 1950s, a group of child psychiatrists, along with clinicians and theorists from other disciplines, began exploring the idea of treating whole families. The initial advocates were Nathan Ackerman, MD (Ackerman, 1972; Ackerman & Sobel, 1950), Gregory Bateson, MA (Bateson, 1972, 1978, 1979; Lipset, 1980; Ruesch & Bateson, 1951), and Carl Whitaker, MD (Whitaker, 1946, 1966, 1975, 1976, 1989; Whitaker & Malone 1953), the two physicians having trained in child psychiatry, and Mr. Bateson in anthropology (Bateson, 1958). In the meantime, child and adolescent psychiatry continued with a psychoanalytic and psychodynamic approach until the mid-1970s (McDermott & Char, 1974), when an initially gradual, but rapidly accelerating, emphasis on medication treatment emerged. The child’s synapses and neurotransmitters were the new target of treatment efforts. Thus, child psychiatry began in the child guidance clinics with parent and child treatment, moved into university centers and private practice settings with a primary focus on the individual child, and finally to an even more reductionistic worldview when the medication era became paramount. The treatment of families, with a number of theoretical orientations, remained multidisciplinary as the field matured over the second half of the twentieth century. In addition to Drs. Ackerman and Whitaker, two other child psychiatrists were instrumental in the foundation of family psychiatry, John Bowlby, MD (Bowlby, 1969, 1988; Bowlby & Robertson, 1953), and Salvador Minuchin, MD (Minuchin, 1965; Minuchin, Auerswald, King, & Rabinowitz, 1964). Of all of the early advocates of treating whole families from all of the various disciplines, including general psychiatry, the contributions of the four founding child psychiatrists have been the most lasting (Kramer, in press). Three subsequent generations of child psychiatrists have contributed to both keeping family psychiatry a healthy presence within general and child psychiatry, but have made and continue to make additional contributions and refinements in theory and technique. Dr. Cook is an important member of this fourth generation of child psychiatrists who practice family psychiatry. She and her colleagues at Children’s Hospital Colorado have brought children, parents, and families back into treatment, drawing on the lessons of the founders of both child psychiatry and family psychiatry, in a context that emphasizes developmental, psychodynamic, and family systems principles, and based on the emerging sciences of interaction (Josephson & Kramer, 2014; Kramer, 2012, 2014). Hence, my initial thought, “I wish I had thought of that!” But that’s how it should work in healthy systems. It’s exciting to observe. Based on the scientific advances of the past 30 years, I have often wondered—in terms of what is known as a thought experiment—what psychiatry would look like if we were tasked to invent it today—if somehow all of the rest of medicine had evolved as it has but without the invention of psychiatry? The last 15 years of the twentieth century and the first 15 of the twenty-first have seen the conception, intrauterine development, and birth of the sciences of interaction. At a minimum, these include gene×environment interaction (G×E) (Caspi et al., 2002; Caspi et al., 2003; Suomi, 2004), epigenetics (Champagne & Meaney, 2001; Kramer, 2005a; Weaver, Cervoni, Champagne, D’Alessio, Meaney 2004), and nonlinear brain dynamics (Asano & Freeman, 2012; Freeman, 1991, 1995, 2003; Pincus, Freeman, & Modell, 2007), the latter possibly being thought of as brain×environment interaction (B×E) (Kramer, 2005b). The most important result of sequencing the human genome has been the discovery that variation among humans is more a function of G×E at the organismic level, and epigenetics at the chromosomal level, than strictly a gene driven result. Psychiatry’s love affair with pharmacological treatments, although certainly helpful (and harmful) to many patients, rested on the belief that allelic differences contribute to synaptic and receptor variations and lead to psychiatric disorders. Interestingly, my answer to our proposed thought experiment is that psychiatry, and more importantly child psychiatry, would look more like it did at the origin than it has during the psychoanalytic and psychopharmacologic eras. The one difference from those early years is that it would be understood, based on the sciences of interaction, that the patient would not be the child or adolescent (or the adult), nor would the patient be the parents. The patient would be the whole family—however constituted. For both trait and state differences, this is the unit where G×E and B×E interactions occur. These processes influence normal developmental, as well as facilitate possible corrections with respect to developing traits that may lead to or already constitute a psychiatric disorder (Kramer, in press). In the introductory section of the adolescent portion of Transforming Teen Behavior, Dr. Cook describes her overall perspective: “An interactive, experiential, and psycho-educational style workshop is facilitated, each session covering specific topics of skill sets, as outlined by the syllabus. The clinicians use a method of psycho-educational and Socratic teaching in conjunction with empathic and reflective listening, to inspire adolescents to ponder and brainstorm, about themselves, their families, and peers.” A similar parent-oriented statement occurs in their section. In what context is this “interactive, experiential, and psycho-educational style” implemented? Although a number of reasonable modifications to the standard treatment format are suggested, especially as a function of staffing differences, the default condition is three Intensive Outpatient Program (IOP) sessions per week for 6 weeks. The first of the three IOPs involves two, concurrently run, parent and teen workshops of 90 minutes duration each. The second IOP might occur the following afternoon, and includes concurrent parent and teen workshops for 60 min, and either a 60-min multi-family group therapy session including all families in the current track, or individual family psychotherapy sessions for the (no more than) six current families. The last of the IOP sessions would logically occur on Thursday afternoon. This IOP uses a creative arts therapy approach—either art or music—to utilize a nonverbal modality to practice psychosocial skills learned in the first two sessions of the week. This IOP is multi-family, but also includes siblings 6 years...