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Example research essay topic: American Psychiatric Association Children And Adolescents - 1,624 words

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... 995). According to Shure, ICPS can help children learn to generate or apply more than one solution for a problem, learn to create dialogues to express their feelings, and increase coping skills (Shure, 1995). Family intervention also appears to be beneficial in order to address parental self-blame. Education of the child as well as the family enhances both understanding, and compliance with treatment (Sung & Kirchner, 2000). Reynolds (1990) suggests that no one should ever engage in the treatment of a depressed child without proper training and knowledge of affective disorders, models, and treatment for several reasons. The treatment of a distressed child with a combination of symptoms, and potential suicidal ideation is a very serious task.

Reynolds (1990) suggests that if treatment fails, the child could be faced with increased feelings of helplessness, or despair. Another approach to treating children with depression is a very basic symptom-focused approach reported by Ramsey (1994). According to Ramsey (1994), it is important to begin treatment by developing an empathetic understanding of the child's attempts to reduce negative feelings of unworthiness by demanding praise and support from others. It appears that if this need exists within the student, they will be more willing to partake in treatment. Ramsey (1994), notes that the first step to effective treatment is to establish good rapport with the child rather than begin with psychological support. A good relationship with the student appears to provide enough support in the beginning of treatment.

The second step involves exploration of the student's feelings, physical health, daily activities, relationships with others, and assumptions about treatment (Ramsey, 1994). Once a good relationship has been established, Ramsey (1994) suggests that interventions should be "symptom specific", and recommends several interventions based on particular symptoms. A student's poor self concept is sometimes formed when children feel that they do not measure up favorably to other siblings or parental expectations (Ramsey, 1994). To help children develop more positive self concepts, children can benefit from being engaged in group activities or tasks at home or school that are consistent with their skills and provide a chance to feel successful (Ramsey, 1994).

Parents can also benefit from instruction, role-play, and parenting groups to help learn to understand, and communicate with children who struggle with low self-esteem (Ramsey, 1994). In order to gain a sense of how the child feels and thinks, Ramsey (1994) recommends engaging the child in play therapy, drawings, incomplete sentences, or fantasy games. By asking a child with a poor self-concept how they would like to be, a counselor can gain an idea of what is troubling the child about their status. Counselors can help the student establish a goal, identify alternative behaviors, and rehearse the new behaviors (Ramsey, 1994). Cognitive restructuring exercises can also be applied to help children increase positive thinking and rational coping skills (Ramsey, 1994). For example, messages like "I am not good at math" could be changed to "I can try to be good at math." Withdrawn children often require projective techniques such as pet therapy, art, music or diaries in order to properly engage them in therapy (Ramsey, 1994).

Active listening skills on behalf of the therapist is also beneficial when treating a withdrawn child. Ramsey (1994) also recommends involving withdrawn children in group activities with other children that they admire. Young students that are experiencing agitated anxiety can gain relief by talking to other children their age in group therapy who have similar feelings (Ramsey, 1994). In order to determine the possible causes of the child's feelings, autobiographies, drawings, puppets and play therapy can be used (Ramsey, 1994). Relaxation techniques, or imagery can be taught to help students learn to manage anxious feelings (Ramsey, 1994). Ramsey (1994) suggests that the more agitated students might respond well to token economies, in order to reward positive behavior.

When treating students for depression, it is not uncommon to encounter students that engage in self-destructive behaviors. Ramsey (1994) notes that when treating this population, it is a good idea to have the student review everything that has taken place in the child's life within the past few days in order to become aware of any threats, hints, or self-destructive intentions. If a child suggests any intentions to harm himself or herself, it should be considered as "a cry for help", and not just attention seeking behavior (Ramsey, 1994). The therapist should provide an environment that the child will view as non-judgmental (Ramsey, 1994). Some incidents that contribute to suicidal thoughts include: "losses of loved ones or pets, feelings of failure; and extreme shame or grief" (Ramsey, 1994). Of course, therapists always need to determine if the child has a plan, how well thought out it is, and if they have the means to carry out the plan.

Based on this information, a counselor or therapist should be able to determine if the child is in need of referral to crisis services. The parents need to be notified of any suicidal risk and education regarding feelings of guilt, warning signs, and panic (Ramsey, 1994). These children need special attention because often young children do not understand that death is "irreversible" (Ramsey, 1994). In a study by Fitts and Landau (1998), brief therapy is regarded as inappropriate for children with depression. Fitts and Landau (1998) suggest that these children are in need of "longer-term therapy" that provides extensive emotional guidance and support to make a lasting improvement to child's quality of life. It is also suggested, based on research, that people who are "extremely self-critical" require long-term therapy (Fitts & Landau, 1998).

Fitts and Landau (1998), clearly point out that despite these circumstances, "managed care" manages costs by endorsing brief therapy regardless of the circumstances. Thus, just because a school psychologist makes a referral outside of the school system does not necessarily mean that a child will receive the long-term therapy needed. In light of the unique challenges involved in engaging young children in therapy, Friedburg (1996) provides information regarding games and workbooks that can be utilized for this purpose. Friedburg (1996) notes that cognitive behavioral therapy can be modified in a creative way to interest young students with age-specific learning materials. For example, cognitive orientated workbooks can provide a connection between individual problems and cognitive techniques (Friedburg, 1996).

These games and workbooks are geared specifically towards internalizing issues in children, such as depression and anxiety (Friedburg, 1996). An example of one of the games is the "Depression Management Game" which requires children to seek out the irrational beliefs in various scenarios, and replace the thoughts with more positive statements (Friedburg, 1996). Friedburg reports that the workbooks benefit the school psychologist because they are familiar to the students, they require active participation, and provide direction for the therapy (Friedburg, 1996). In addition, the exercises can be retained as a document, and pages can be taken home as a homework assignment (Friedburg, 1996). Friedburg (1996) warns that the overuse of the workbooks can negatively affect the therapeutic relationship. In conclusion, there are many treatment options available to school psychologists today.

Cognitive behavior therapy appears to be the orientation most frequently endorsed by research on treatment of depressed students. Materials can be used in therapy to actively engage students who are reluctant to comply with treatment. The materials available can present as a fun activity to students, and help the therapist gather information, and establish rapport. Stimulating activities are also suggested for use with symptom specific interventions (Ramsey, 1994). It appears that the most troublesome aspect of the treatment of childhood depression is the fact that many children remain untreated, or misdiagnosed. Education and an increase in awareness of the signs of childhood depression can help reduce the amount of children that are left untreated.

Coincidentally, National Childhood Depression Day is May 4 th. This event is symbolized by a green ribbon, and is an event created by the National Mental Health Association to help spread awareness, and education regarding the seriousness of childhood depression. References American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Washington, DC, American Psychiatric Association, 2000. 345 - 346. Callahan, S. A. & Panichelli-Model, S. M. (1996).

DSM-IV and internalizing disorders: Modifications, limitations and utility. School Psychology Review, 25, 297 - 308. Clarizio, H. F. , & Payette, K. (1990). A survey of school psychologists' perspectives and practices with childhood depression. Psychology in the Schools, 27. 57 - 63.

Dixon, S. L. (1987). Working with people in crisis, (2 nd ed. ). Columbus, OH. Dubuque, S.

E. (1998). Fighting childhood depression. Education Digest, 63, 64 - 69. Fitts, S. N. , & Landau, C. (1998). Brief therapy doesn't work.

Brown University Child and Adolescent Behavior Letter, 14, 10 - 11. Friedburg, R. D. (1996). Cognitive-behavioral games and workbooks: Tips for school counselors. Elementary School Guidance & Counseling, 31, 11 - 21. Fuller, T. (1992).

Masked depression in maladaptive black adolescents. School Counselor, 20, 24 - 32. Janzen, H. L. , & Saklofske, D.

H. (1991). Children and depression. School Psychology Review, 20, 139 - 142. Ramsey, M. (1994). Depression in adolescence -- treatment: Depression in children -- treatment; Counseling. School Counselor, 41. 1 - 7.

Reynolds, W. M. (1990). Depression in children and adolescents: Nature, diagnosis, assessment, and treatment. School Psychology Review, 19, 158 - 174. Sung, E. S. & Kirchner, D.

O. (2000). Depression in children and adolescents. American Family Physician, 62, 2297 - 2308. Shure, M. B. (1995). Teach your child how, not what to think: A cognitive approach to behavior.

Brown University Child & Adolescent Behavior Letter, 11, 4 - 6 Waterman, G. S. & Ryan, N. D. (1993). Pharmacological treatment of depression and anxiety in children and adolescents.

School Psychology Review, 22, 228 - 243.


Free research essays on topics related to: american psychiatric association, young students, children and adolescents, coping skills, cognitive behavioral

Research essay sample on American Psychiatric Association Children And Adolescents

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