Chapter 17 -- Clinical Child and Adolescent Psychology

I. Definitions and History
A. Clinical child psychology is work with children and adolescents after psychological symptoms have developed
B. Pediatric psychology is clinical child psychology in medical settings
C. Clinical child psychology dates back to 1896 and the first psychological clinic with the focus on learning problems
D. In 1967, the specialty of pediatric psychology began with a formal organization

II. Risk Factors for Child Disorders
A. Environmental factors – Poverty, toxic environments, neighborhood crime, poor schools, and lack of jobs
B. Parental factors – Low socioeconomic status, parental physical and mental illnesses, and abusive and neglectful parenting
C. Child factors – Medical and psychological problems, social skills deficits, and low cognitive ability

III. Characteristics of Resilient Children
A. Individual characteristics
1. Good intellectual functioning
2. Sociable
3. High self-esteem
4. Recognized talents
5. Religious faith
B. Family characteristics
1. Close relationships with parents
2. Authoritative parenting (high on support and structure)
3. Socioeconomic resources
4. Connections to extended family
C. Outside family characteristics
1. Connected to pro-social adults
2. Connected to pro-social organizations
3. Attending effective schools

IV. Multimethod Assessment of Children
A. Combine multiple sources of information (children, parents, teachers, peers)
B. Use multiple techniques (interviews, behavioral observations, intelligence tests, achievement tests, questionnaires, neuropsychological assessment)
C. Gather information about multiple settings to check for consistency

V. Interviewing Children
A. Start with the whole family to watch interactions
B. Ask about favorite activities
C. Ask about school
D. Ask about parental discipline
E. Play games as rewards or to encourage self-disclosure
F. Praise the child for effort not for achievement

VI. Child Therapy
A. Most effective are cognitive-behavioral therapies aimed at improving parenting and child self-control, improvement about 75% of the time
1. Include modeling, behavioral contingencies, and contracts for reinforcing desired behavior
2. Withdrawal of privileges and timeout as punishment rather than spanking
3. Include cognitive strategies of disputing, reframing, mindfulness, and problem-solving
B. Self-Instructional Training – Children are taught to talk through problems in steps to consider choices and consequences
C. Parent-child interaction therapy
1. Combines behavioral and interpersonal techniques
2. Teach parents how to interact with their children
3. With play, parents should describe and mirror child's behavior rather than ask questions
D. Psychodynamic play therapy: encourage child to play with objects to represent family situations and then interpret the play
E. Humanistic play therapy: encourage child to play, reflect child’s feelings, empathize, and express compassion to facilitate self-actualization