Developmental factors in the treatment on adolescents.

Abstract

Most empirically supported interventions for adolescent mental health problems are either downward adaptations of adult treatments or upward adaptations of child treatments. Although these treatments show respectable effects with teens, a review of the outcome research reveals significant gaps, both in coverage of adolescent conditions and problems (e.g., eating disorders, suicidality) and in attention to the biological, psychological, and social dimensions of adolescent development. The authors critique the field, propose a biopsychosocial framework for the development of dysfunction and intervention, and discuss ways the developmental literature can and cannot inform intervention and research. A long-term goal is an array of developmentally tailored treatments that are effective with clinically referred teens and an enriched understanding of when, how, and why the treatments work. Has Research Produced Treatments That Work With Adolescents? Considerable evidence indicates that treatments emerging from the research process to date do produce substantial benefit for adolescents (see,

A Theoretical Model of Common Process Factors in Youth and Family Therapy

“…However, as important as this probably is, a literature search revealed that very little work has examined the impact of client characteristics on therapist behavior in youth mental health treatment research. In fact, the clinical literature emphasizes the importance of therapists varying their behavior based on the developmental characteristics that youth clients bring to treatment, however, there has been extremely little research done that has examined children's social, emotional, peer, biological, and cognitive development and how these characteristics affect therapist behavior toward the child client and their parents (Kendall & Choudhury, 2003;Shirk, 1999;Weisz & Hawley, 2002). Furthermore, there have been several studies that have measured parental characteristics such as parental mental health (e.g., Hutchings, Appleton, Smith, Lane, & Nash, 2002;Luk, Staiger, Mathai, Field, & Adler, 1998), but there are no studies that examine therapist responses to these parental characteristics.…”

Crianças e adolescentes com problemas emocionais e comportamentais têm necessidade de políticas de inclusão escolar?

“…Por perturbarem o ambiente da sala de aula, tendem a ser mais rapidamente identificados pelos outros alunos e professores e constituem o foco do maior número de programas de intervenção citados na literatura. (CHRISTENSON;HAVSY, 2004;VAN ARCKER, 2007;WEBSTER-STRATTON;REID, 2003;HAWLEY, 2002). Aqui se incluem os transtornos de conduta e déficit de atenção/hiperatividade.…”

“…Aproximadamente 21% dos adolescentes deprimidos evoluem para transtorno bipolar, que leva a flutuações de humor que podem variar de euforia/irritabilidade a depressão. (FU I;CURATOLO;FRIEDRICH, 2000;HAWLEY, 2002 Os transtornos alimentares em escolares são associados à ingestão persistente de substâncias que não são nutritivas, nem adequadas para alimentação, como ingestão de cabelo ou de terra (pica); a repetida regurgitação e remastigação do alimento, sem causa médica (ruminação); ou a própria alimentação, com restrição alimentar pela preocupação excessiva com o peso (anorexia/bulimia). Enquanto ingestão de substâncias impróprias é comum em crianças pequenas ou com retardo mental, sobretudo se há histórico na família, a anorexia e a bulimia já são mais comuns no início da adolescência.…”

Modèle de l’engagement et de l’abandon de traitement de l’adolescent avec trouble de personnalité limite

“…Leurs résultats suggèrent que la motivation à changer et la perception de l'efficacité du traitement constituent des enjeux associés à l'engagement. Finalement, une vaste étude réalisée à partir de données épidémiologiques recueillies aux États-Unis et au Canada met en évidence l'association entre l'abandon et les perceptions à l'égard du traitement (Weisz & Hawley, 2002). Comptant près de 20 % de répondants âgés de 15-24 ans, cette étude a montré que des dispositions négatives à rencontrer des professionnels de la santé mentale de même que des attentes pessimistes à l'égard du traitement accroissent le risque d'abandon.…”

“…Les patients qui reçoivent une médication et de la psychothérapie seraient toutefois moins susceptibles d'abandonner que ceux qui bénéficient d'une seule modalité thérapeutique (Weisz & Hawley, 2002). Par ailleurs, l'approche thérapeutique pourrait faire une différence chez les adolescents.…”