There is increasing demand for physicians in pediatric settings to address not only the physical but also the psychosocial health of their child and adolescent patients. Brief interventions (BIs), and in particular Motivational interviewing (MI), offer an efficient means of targeting behavioral, developmental, and social problems within the context of pediatric practice. This review addresses the patient-centered care foundation of and empirical support for brief pediatric interventions, including educational and media-based interventions, MI-based prevention and intervention with health risk behaviors, procedural pain control, and adherence to treatment recommendations. In addition, developmental considerations and future directions for BI research in pediatric practice are summarized.Physicians in pediatric health care settings address complex challenges in providing comprehensive care to children, adolescents, and their parents. Toward this end, BIs have been used in pediatric settings to aid in the prevention, early detection, and brief treatment of behavioral, developmental, and social problems associated with health care concerns to serve children and their families more effectively. Brief interventions encompass a diverse range of theoretically based approaches, intervention targets, and delivery methods to address such issues as educational and media-based interventions, MIbased prevention and intervention with health risk behaviors, procedural pain control, and adherence to health care recommendations. One particularly efficacious form of BI used extensively with health risk behaviors is MI.
The HSQ appears to be a psychometrically sound and clinically useful measure to assess humor dimensions in adolescents.
Background: Among adolescents, substance abuse often occurs in conjunction with risk-taking behaviors.Aims: This review explores the nature and etiology of concomitant risk-taking behaviors, addressing behavioral, genetic, temperamental, and family factors that accompany adolescent substance use. Method: A literature review was conducted to determine the breadth of factors that contribute to adolescent substance abuse and correlated risk-taking behaviors, and to identify relevant evidencebased treatments. Results: The literature review revealed that among adolescents, substance abuse occurs as part of a cluster of problems and risk-taking behaviors. Predisposing factors include temperament, genetics, neurobehavioral disinhibition, social competencies, parenting, abuse/neglect, and peer behaviors. Various interventions, including individual therapies, parent training, and family therapies comprise the empirically-supported treatments for these co-occurring behaviors. Conclusions: The literature indicates that adolescents being seen for substance-related problems should be evaluated for engagement in other risk-taking behaviors, and school, peer, and social functioning. In addition, the data support that family, versus individual, interventions should be the norm for substance-abusing adolescents. Declaration of interest: The authors neither received financial support, nor are involved in financial relationships that pose a conflict of interest for this work.
Empirically supported interventions (ESIs) for treating substance problems have seldom been made available to or tested with minority populations. Dissemination of ESIs may help reduce the disproportionate health disparities that exist. However, ESIs may require some adaptation to be effective with minority populations. One ESI, motivational interviewing (MI), appears to be particularly culturally congruent for Native American communities. We worked with Native American community members and treatment providers to adapt MI for Native communities. Reflecting their feedback and suggested amendments, we created and disseminated an intervention manual to improve the accessibility of MI within Native communities. To help guide practitioners working with Native American clients, we used focus-group methodology to explore communication patterns for negotiating change. Native American treatment providers expressed comfort with and enthusiasm for integrating MI into their current practices. Recommendations for adaptations ranged from simple to complex changes. The unique value and challenges of collaboration between academic and community members are presented from each author's perspective. This culturally adapted MI manual will likely improve the accessibility and adoption of MI practices as well as encourage controlled, clinical trials with Native communities.
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