Development of adaptable and flexible treatment manuals for externalizing and internalizing disorders in children and adolescents

Abstract

Development of adaptable and flexible treatment manuals for externalizing and internalizing disorders in children and adolescents Desenvolvimento de manuais adaptáveis e flexíveis para transtornos de externalização e internalização em crianças e adolescentes A b s t r a c t In this paper we describe the process used to develop treatment manuals for internalizing and externalizing disorders in children and adolescents. These manuals were developed to offer health care providers and others working in child mental health a flexible intervention that could be adapted to different countries and localities based on: 1) the amount of health care and school resources that are available; 2) the nature and severity of the types of problems children have; and 3) the preferences and cultural factors that are important within these communities. We also discuss the experiences and cultural issues faced by sites in Egypt, Lebanon, Israel, and Brazil who volunteered to implement the manualized treatment programs. The feedback received from these sites indicates that the manuals can be implemented to help children with internalizing and externalizing problems Keywords: Evidence-based medicine; Behavior therapy; Therapy; Affective symptoms; Disruptive behavior disorders ResumoNeste artigo, descrevemos o processo utilizado para elaborar manuais de tratamento para transtornos de externalização e intrnalização em crianças e adolescentes. Esses manuais foram elaborados para oferecer uma intervenção flexível para provedores de atenção à saúde e demais profissionais que trabalham com a saúde mental da criança, podendo ser adaptados a diferentes países e localidades, com base: 1) no nível de atenção médica e de recursos educacionais disponíveis; 2) na natureza e na gravidade dos tipos de problemas que as crianças apresentam; e 3) nas preferências e fatores culturais que são importantes nessas comunidades. Discutimos, também, as experiências e os problemas culturais enfrentados pelas localidades no Egito, Líbano, Israel e Brasil que foram voluntárias em implementar os programas de tratamento especificados nos manuais. O retorno recebido dessas localidades indica que os manuais podem ser implementados para auxiliar as crianças com problemas de externalização e internalização.

Prevalence of behavior problems and associated factors in preschool children from the city of Salvador, state of Bahia, Brazil

“…[1][2][3] Although conceptualization is challenging, most authors agree that behavior problems include deviation from social behavior [1][2][3] and manifestation of signs and symptoms that do not meet criteria for mental health disorders, but suggest a future risk to the child's development. 4 According to Achenbach & Edelbrock, behavior problems can be grouped into two major categories: internalizing and externalizing behaviors.…”

Family Focused Treatment for Patients with Bipolar Disorder in Turkey: A Case Series

“…Thus, reducing the number of written assignments in favor of oral practice within and between sessions may make FFT more accessible in societies in which oral communication is emphasized. The cultural adaptation issues which are highlighted in this paper have been previously reported elsewhere (Bauermeister et al, 2006).…”

An examination of cross-cultural systems implementing evidence-based assessment and intervention approaches

“…As described in other papers in this edition, [11][12][13][14] the Integrated Services Program (ISP) Task Force of the World Psychiatric Association's Presidential Global Program on Child Mental Health sought to implement a feasible yet comprehensive clinical service delivery program for children with internalizing and externalizing disorders, applicable across different countries and cultures. Specific therapies were chosen due to the evidence base for their reducing youth symptomatology, 15 and were adapted for this project.…”

“…Specific therapies were chosen due to the evidence base for their reducing youth symptomatology, 15 and were adapted for this project. 13 Four international sites were chosen to participate based on their willingness to pilot the treatments and help investigate the implementation process. These sites include Brazil, Egypt, Israel, and Lebanon, each distinct in culture, population, setting, and staffing.…”