The Handbook of Child and Adolescent Clinical Psychology A Contextual Approach

1004 Pages·1999·13.26 MB·English

by  Alan Carr

The Handbook of Child and Adolescent Clinical
Psychology
The Handbook of Child and Adolescent Clinical Psychology is a comprehensive, thorough and
practical guide to modern child and adolescent clinical psychology. It covers all central
concerns for practitioners in a single manual, including: conduct problems, emotional
problems, learning disabilities, child protection, somatic illness, major depression, suicide,
drug abuse, schizophrenia, divorce, foster care and bereavement.
The book is divided into six sections, the first of which sets out developmental and
diagnostic frameworks. In Sections II, III and IV, problems that commonly occur in early
childhood, middle childhood and adolescence respectively are described and guidelines for
assessment and management are given. Section V deals with child abuse and neglect, and
Section VI deals with clinical problems associated with major life transitions including foster
care, parental divorce and bereavement. Each chapter opens with a broad chapter plan and
case study, followed by sections on classification, epidemiology and clinical features.
Biological, psychodynamic, cognitive-behavioural and family systems explanations are then
considered, and guidelines for multisystemic intervention, based on evidence and best
practice, are given for each clinical problem.
Written with practice in mind, including a section on report writing, The Handbook of
Child and Adolescent Clinical Psychology will be essential reading for child and adolescent
clinical psychologists, and valuable to many professionals in training, including educational
psychologists, counselling psychologists, health psychologists, child psychotherapists, family
therapists, psychiatrists, psychiatric nurses, counsellors and child-care workers.
Alan Carr is Director of the Doctoral Programme in Clinical Psychology at University
College Dublin, Ireland. His previous publications include Positive Practice: A Step by Step
Guide to Family Therapy (1995) and Family Therapy and Systemic Practice (1997). He is on
the editorial board of the Journal of Family Therapy and the Journal of Child Centred Practice,
has published over 50 papers in the fields of clinical psychology and family therapy and has
practised in the UK, Ireland and Canada.
The Handbook of Child and
Adolescent Clinical Psychology
A Contextual Approach
Alan Carr
First published 1999 by Routledge
11 New Fetter Lane, London EC4P 4EE
Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001
This edition published in the Taylor & Francis e-Library, 2005.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks
please go to www.eBookstore.tandf.co.uk.”
Brunner-Routledge is an imprint of the Taylor & Francis Group
© 1999 Alan Carr
All rights reserved. No part of this book may be
reprinted or reproduced or utilized in any form or by
any electronic, mechanical, or other means, now known
or hereafter invented, including photocopying and
recording, or in any information storage or retrieval
system, without permission in writing from
the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Carr, Alan, Dr.
The handbook of child and adolescent clinical psychology: a
contextual approach/Alan Carr.
p. cm.
Includes bibliographical references and index.
ISBN 0-415-19491-1 (hardcover). —ISBN 0-415-19492-X (pbk.)
1. Child psychology—Handbooks, manuals, etc. 2. Adolescent
psychology—Handbooks, manuals, etc. I. Title.
RJ503.3.C37 1999
618.92′89–dc21 98–25289
CIP
ISBN 0-203-36082-6 Master e-book ISBN
ISBN 0-203-37338-3 (Adobe eReader Format)
ISBN 0-415-19491-1 (hbk)
ISBN 0-415-19492-X (pbk)
When a dog barks late at night and then retires again to bed he punctuates and gives majesty
to the serial enigma of the dark, laying it more evenly and heavily upon the fabric of the mind.
King Sweeney in the trees hears the sad baying as he sits listening on a branch, a huddle
between earth and heaven; and he hears also the answering mastiff that is counting the
watches in the next parish. Bark answers bark till the call spreads like fire through all Erin.
Soon the moon comes forth from behind her curtains riding full tilt across the sky, lightsome
and unperturbed in her immemorial calm. The eyes of the mad king upon the branch are
upturned, whiter eyeballs in a white face, upturned in fear and supplication. Was he mad?
The more one studies the problem the more fascinated one becomes.
Flann O’Brien (1939). At Swim-Two-Birds (pp. 216–217)
London: Penguin
Contents
List of illustrations vii
Foreword xiv
Preface xv
Acknowledgements x viii
SECTION I Frameworks for practice 1
1 Normal development 2
2 Influences on problem development 33
3 Classification, epidemiology and treatment effectiveness 64
4 The consultation process and intake interviews 87
5 Report writing 1 41
SECTION II Problems of infancy and early childhood 1 70
6 Sleep problems 1 71
7 Toileting problems 2 00
8 Learning and communication difficulties 2 29
9 Autism and pervasive developmental disorders 2 88
SECTION III Problems of middle childhood 3 12
10 Conduct problems 3 13
11 Attention and overactivity problems 3 66
12 Fear and anxiety problems 4 01
13 Repetition problems 4 66
14 Somatic problems 4 98
SECTION IV Problems in adolescence 5 70
15 Drug abuse 5 71
vi
16 Mood problems 6 14
17 Anorexia and bulimia nervosa 6 68
18 Schizophrenia 6 99
SECTION V Child abuse 7 42
19 Physical abuse 7 43
20 Emotional abuse and neglect 7 73
21 Sexual abuse 7 97
SECTION VI Adjustment to major life transitions 8 47
22 Foster care 8 48
23 Separation and divorce 8 69
24 Grief and bereavement 9 00
Bibliography 9 31
Index 9 77
Illustrations
Figures
1.1 Well-being and strains across the family lifecycle 6
2.1 Predisposing, precipitating, maintaining and protective factors to consider in 36
psychological problems of children and adolescents
2.2 Patterns of parenting 45
2.3 Modifying effect of parental support on the psychological distress of children who 46
receive regular, occasional and no corporal punishment
2.4 Marital satisfaction across the lifespan 48
4.1 Stages of the consultation process 88
4.2 Intake information form 92
4.3 Genogram symbols 99
4.4 The Boyle genogram completed in 1994 105
4.5 Child-centred assessment: example of a genogram, lifeline and indicators of 107
emotional climate used in a child-centred assessment
4.6 Process of recursive reformulation 113
4.7 Karpman’s triangle 117
5.1 Example of progress notes from an assessment session 143
5.2 Example of progress notes from a treatment session 144
5.3 Example of a comprehensive assessment report 147
5.4 Example of an end-of-episode case summary 151
5.5 Example of a letter to a referring agent 154
5.6 Example of a letter to a client 155
5.7 Relationships between various types of report arising out of psychological 161
consultations
5.8 Clinic audit form 164
5.9 Client audit form 165
5.10 Referrer audit form 166
6.1 Typical sleep requirements in childhood 174
6.2 Classification of sleep disorders in DSM IV 175
6.3 Classification of sleep disorders in ICD-10 176
6.4 Factors to consider in childhood sleep problems 184
6.5 Sleep diary 186
6.6 Child’s start chart for sleep problems 193
7.1 Prevalence of wetting and soiling from birth to adolescence 207
7.2 Parent recording chart for monitoring changes in soiling and/or wetting 211
viii
7.3 Parent recording chart for monitoring diet, fluids, exercise and laxative use 212
7.4 Factors to consider in enuresis 214
7.5 Factors to consider in encopresis 216
7.6 Child’s star chart for enuresis and encopresis 221
8.1 Classification of disorders of learning and communication in DSM IV 231
8.2 Classification of disorders of learning and communication in ICD-10 232
8.3 Example of a report on a case of specific reading disorder (or dyslexia) 254
8.4 Abilities assessed by subtests of the WISC-III 267
8.5 Factors to consider in adjustment problems in cases of traumatic brain injury 274
9.1 Classification of pervasive developmental disorders in DSM IV 291
9.2 Classification of pervasive developmental disorders in ICD-10 292
10.1 Classification of disruptive behaviour disorders in DSM IV 318
10.2 Classification of disruptive behaviour disorders in ICD-10 318
10.3 Factors to consider in childhood conduct problems 336
10.4 Three-column chart for monitoring antecedents and consequences of positive and 349
negative target behaviours
10.5 Child’s star chart for conduct problems 350
10.6 Monitoring chart for time out 351
10.7 Points chart for an adolescent 352
10.8 Adolescents’ privileges and fines 353
10.9 Daily report card 354
11.1 Factors to consider in attention deficit hyperactivity disorder (ADHD) 384
12.1 Classification of disorders where anxiety is a major feature in DMS IV 404
12.2 Classification of disorders where anxiety is a major feature in ICD-10 405
12.3 Factors to consider in childhood anxiety problems 435
12.4 Form for tracking fear 442
12.5 Relaxation exercises handout for parents and youngsters 444
12.6 Factors to consider in school refusal (SR) 451
13.1 Classification of disorders where repetition is a central feature in DSM IV 467
13.2 Classification of disorders where repetition is a central feature in ICD-10 467
13.3 Self-monitoring form for obsessive-compulsive disorder (OCD) 477
13.4 Factors to consider in obsessive-compulsive disorder 479
13.5 Form for assessing antecedents and consequences of tics throughout the day 492
13.6 Form for assessing the number of tics in a single time slot over a week 493
14.1 Classification of psychological conditions with predominantly physiological 501
symptoms in DSM IV
14.2 Classification of psychological conditions with predominantly physiological 502
symptoms in ICD-10
14.3 Psychological and physiological dimensions along which the aetiology and 503
symptomatology of typical paediatric presentations fall
14.4 Factors to consider in somatic complaints 515
14.5 Diary for recording pain 524
14.6 Self-monitoring system for physical illnesses 525
14.7 Child’s star chart for somatic complaints 527
14.8 Factors to consider in headaches 538
ix
15.1 The 12 steps of AA 589
15.2 Factors to consider in adolescent drug abuse 600
16.1 Classification of disorders where mood is a major feature in DSM IV 621
16.2 Classification of disorders where mood is a major feature in ICD-10 622
16.3 Factors to consider in depression 639
16.4 A model of depression for psychoeducation 646
16.5 Self-monitoring form for depression 649
16.6 Factors to consider in suicide risk 659
17.1 Factors to consider in eating disorders 685
18.1 Classification of schizophrenia and other psychotic disorders in DSM IV 704
18.2 Classification of schizophrenia and other psychotic disorders in ICD-10 705
18.3 A diathesis-stress model of schizophrenia 718
18.4 Factors to consider in schizophrenia 723
18.5 Psychoeducational notes where a family member has a diagnosis of schizophrenia 730
19.1 A model of the sequence of events leading to an abusive act 750
19.2 Factors to consider in physical child abuse 752
19.3 Checklist of four conditions that predict positive treatment response in families 761
where child abuse has occurred
20.1 Four feeding patterns associated with non-organic failure to thrive (NOFT) 780
20.2 Factors to consider in neglect, emotional abuse and related problems 785
21.1 A model of patterns of interaction in which repeated sexual abuse may be embedded 802
21.2 Factors to consider in child sexual abuse 805
21.3 A flow chart for taking action following an allegation of child sexual abuse 814
22.1 A co-operative foster-care system 860
22.2 A conflictual foster-care system 861
23.1 Factors to consider in parental post-separation adjustment and parenting abilities 876
23.2 Factors to consider in children’s adjustment following separation or divorce 879
24.1 Factors to consider in children’s grief reactions 916
Tables
1.1 Stages of the family lifecycle 5
1.2 Development of motor and sensory skills 9
1.3 Newman’s revision of Erikson’s psychosocial stage model 25
2.1 Defence mechanisms at different levels of maturity 40
2.2 Functional and dysfunctional, problem- and emotion-focused coping strategies 42
3.1 Multiaxial classification systems DSM IV and ICD-10 67
3.2 Reliability of diagnoses of four childhood psychological disorders 69
3.3 Co-morbidity in community populations for four major DSM diagnostic categories 70
3.4 Co-morbidity in community and clinic populations for four major syndromes on 72
child- and parent-completed versions of Achenbach’s Behaviour Checklist
3.5 Internalising, externalising and mixed syndromes assessed by the Child Behaviour 74
Checklist and related instruments
3.6 Broad problem areas in clinical child psychology 78