One consequence of the evidence-based practice movement is the proliferation of manualized interventions. Clinicians voice a number of concerns about the use of treatment manuals. These include concerns that manuals impede the therapeutic relationship and discourage flexibility in addressing the individual needs of clients. One manualized intervention called parent-child interaction therapy (PCIT) has shown exceptional promise in the treatment of child behavioral problems. PCIT is a parent-mediated behavioral intervention aimed at reducing externalizing behaviors in children by changing parenting practices. The manual includes session scripts for clinicians, a proscribed sequence of intervention activities, and checklists for clinicians and parents to document that intervention is completed in the prescribed manner. Three cases are presented in which clients vary by personal characteristics and individual needs. Case descriptions reveal how this manualized intervention was adapted successfully to address the needs of a variety of families. Implications for therapeutic relationship are also discussed.
This study evaluated a novel intervention designed to teach middle and high school girls to inform adults of the early signs of an eating disorder. Students completed measures assessing the likelihood of talking to a peer about her eating behavior, encouraging a peer to talk to an adult, sharing concerns about a peer with an adult, or talking to an adult about concerns related to herself. Participants demonstrated increased likelihood of talking to an adult about a friend's eating following intervention. Results indicate it may be possible to significantly increase girls' willingness to address or share concerns about a friend's eating.
Play assessment can tell us a great deal about a child's cognitive and emotional functioning. Pretend play is often a part of a clinical assessment, because play is such a natural form of expression for young children (age 4–10 years). Clinicians often infer much about a child's functioning from their observations of pretend play. Standardized play tasks and measures are being developed that can be used in a formal assessment battery. Play assessment can contribute to treatment planning and outcome evaluation.
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