Cognitive Behavioural Therapy with KIDS Presented by Luzanne - PowerPoint PPT Presentation

Cognitive Behavioural Therapy with KIDS Presented by Luzanne Liversage-Collins Counselling Psychologist luzanne@crs-med.co.za sayori@crs-med.co.za 073 485 9572

Welcome and Introductions Agenda Theoretical Foundations CBT with KIDS Suitability of CBT Part 1 Parental Involvement Homework in Therapy Break Luzanne Liversage-Collins | luzanne@crs-med.co.za

Case Formulation and Treatment Planning Agenda Treatment Considerations for Specific Diagnoses/ Disorders CBT with KIDS Part 2 Scope of Practice and When to Refer What CBT looks like in Practice: Specific Techniques Case Discussion Further Training Luzanne Liversage-Collins | luzanne@crs-med.co.za

Theoretical Foundations A Brief Overview Luzanne Liversage-Collins | luzanne@crs-med.co.za

CBT IS: STRUCTURED PRESENT TIME LIMITED BASED ON THE FOCUSED COGNITIVE MODEL Luzanne Liversage-Collins | luzanne@crs-med.co.za

Cognitive Model SITUATION OR BELIEF OR CONSEQUENCES TRIGGER INTERPRETATION (EMOTIONS AND BEHAVIOURS) Luzanne Liversage-Collins | luzanne@crs-med.co.za

Cognitive Model Luzanne Liversage-Collins | luzanne@crs-med.co.za

Explaining the Cognitive Model Luzanne Liversage-Collins | luzanne@crs-med.co.za

Explaining the Cognitive Model Luzanne Liversage-Collins | luzanne@crs-med.co.za

Explaining the Cognitive Model BE CREATIVE AND TAILOR THE EXPLANATIONS TO YOUR CLIENTS INTERESTS! Luzanne Liversage-Collins | luzanne@crs-med.co.za

What we know about CBT What you feel will Extremely effective in always make sense treatment of Anxiety when you know what and Affective Disorders you are thinking! Originally developed for adults Luzanne Liversage-Collins | luzanne@crs-med.co.za

Keep in mind... ● Coping Cat Manual CBT is NOT ● ACTION gender- and Workbook sensitive CBT (Kendall & Hedtke, just a collection of program for 2006) techniques. Manuals are Depressed Youth available and it is important (Stark et al. 2007) to adhere to the core ● Cat Project for components but tailor to anxious youth each child. ● FRIENDS program (Kendall) for child anxiety (Barrett, Farrell, ● Adolescent Coping Ollendick, & with Depression Dadds, 2006) Course (Clark et al., 1990) Luzanne Liversage-Collins | luzanne@crs-med.co.za

Suitability of CBT Guidelines for deciding if CBT is appropriate Luzanne Liversage-Collins | luzanne@crs-med.co.za

At what age can you use CBT with Children? 5 y 7 y Other Can be taught less Argument in literature that the sophisticated, specific and focus should be on General Consensus concrete cognitive conceptualization rather than age techniques such as positive or developmental level self talk Stallard (2004) Luzanne Liversage-Collins | luzanne@crs-med.co.za

Developmentally Appropriate Luzanne Liversage-Collins | luzanne@crs-med.co.za

Children Often find direct questions Children uncomfortable Consider delivering interventions via play- based activities e.g. children’s books, artwork, puppets, dolls, stories about a character (superhero or favourite cartoon) who used CBT skills to face and conquer all his/her fears. Age appropriate reward for participation in order to maintain motivation Luzanne Liversage-Collins | luzanne@crs-med.co.za

Individuation and autonomy more NB Adolescents Confidentiality a big concern Adolescents Open discussion with both parents and adolescents on the limits of confidentiality May need to spend more time discussing treatment goals and explaining treatment rationale Luzanne Liversage-Collins | luzanne@crs-med.co.za

Parental Involvement Support and structures needed Luzanne Liversage-Collins | luzanne@crs-med.co.za

Who needs to be involved? Can be under or over involved! Need to support child in at least attempting tasks Cheerleaders Currently Seeing Child Time, Cost, Transportation Reinforce/ support child specifically if behaviour interfering with treatment Psych= Coach Time at School Support or reinforce tasks as needed Social Worker(s) Siblings School Grandparents Psychologist(s) Anyone living at home Friends Luzanne Liversage-Collins | luzanne@crs-med.co.za

Homework in Therapy Luzanne Liversage-Collins | luzanne@crs-med.co.za

Very important component of CBT! Encourage opportunities to practice skills learnt in session Give psych a chance to see if youth understands skill Allow youth to generalize skills to real life situations Luzanne Liversage-Collins | luzanne@crs-med.co.za

Very important component of CBT! REWARD RENAME BE SPECIFIC Positive Self Talk When, Where, ● ● Show that I can ● Reward How often, ● tasks Attempts How to remember Take home ● Check for ● projects obstacles Action Plan ● Luzanne Liversage-Collins | luzanne@crs-med.co.za

BREAK Luzanne Liversage-Collins | luzanne@crs-med.co.za

Case Formulation and Treatment Planning Luzanne Liversage-Collins | luzanne@crs-med.co.za

Case Formulation and Treatment Planning ● Guides Treatment Planning ● Needs to be consistently reviewed and updated throughout the process ● Psych’s understanding of the problem and highlights possible obstacles ● Various models exist for conceptualization ● Beck ( https://stories.psychwire.com/beck/CBT- CCT/?fbclid=IwAR1yVh0laHbzdNH4Y05f65Wbc0I_PgXUMn3xxsdoNWi7F1eLrep LjjvpZE0 ), Hudson and Rapee (2004) Luzanne Liversage-Collins | luzanne@crs-med.co.za

● Target assessment for the typical cognitions, behaviours and emotions that relate to the presenting problem ● Do so by eliciting detailed descriptions of 1 or 2 recent events that highlight presenting concerns ● Enquire Re: Cognitions and behavioural choices Luzanne Liversage-Collins | luzanne@crs-med.co.za

Case Formulation and Treatment Planning ● Convert Case Formulation into a treatment plan ● Amount of emphasis given to a particular skill within a treatment plan varies ● Treatment plan must SELECT , specific CBT techniques that will best address the problem ● SEQUENCE techniques to progress to a goal – what skills does youth need before an NB experience and after e.g. exposure ● Implement each technique at appropriate DOSE ● NB to ensure thorough understanding of each specific CBT technique so you can adapt it Luzanne Liversage-Collins | luzanne@crs-med.co.za

Specific Diagnoses Treatment Considerations Luzanne Liversage-Collins | luzanne@crs-med.co.za

Treatment Considerations GAD May suggest clients Tend to be makes mistakes on perfectionists with purpose (spelling, H/W so consider smudging etc) putting a time limit and ask parents to assist Generally have more abstract worries so be May require rewards creative! E.g. for efforts thunderstorm Luzanne Liversage-Collins | luzanne@crs-med.co.za

Treatment Considerations H/W may need to be completed daily Separation Anxiety Disorder NB to involve the parents (and school) and a lot of work focused on parental involvement e.g. out of session exposures such as leaving child with baby-sitter and not answering calls/ texts when child seeks reassurance. Family members often participate in rituals and routines, they may need to change their behaviour Luzanne Liversage-Collins | luzanne@crs-med.co.za

Treatment Considerations School Refusal PTSD Depression Luzanne Liversage-Collins | luzanne@crs-med.co.za

Scope of Practice And when to refer Luzanne Liversage-Collins | luzanne@crs-med.co.za

What CBT looks like Specific Techniques Luzanne Liversage-Collins | luzanne@crs-med.co.za

Case Discussion Luzanne Liversage-Collins | luzanne@crs-med.co.za

Further Training Luzanne Liversage-Collins | luzanne@crs-med.co.za

Join our Mailing List for more Course Information on upcoming courses! www.crs-med.co.za/workshops Please feel free to contact me should you have any questions/ queries! Luzanne@crs-med.co.za Luzanne Liversage-Collins | luzanne@crs-med.co.za