Interventies
Content course
Evidence-based treatments
- Cognitive-behavioral therapy
- Psychodynamic informed therapies
- Systems therapy
- Parent counselling/parent management skills
- The next generation
College 1
Children in need
Why is it important to intervene (early on)?
- Mental health disorders among youth 10 to 24 years of age the leading cause of disease
burden. (Harhay & King, 2012)
- Long-term effects on adult functioning (great smoky mountains study, 2018)
TRAILS study
- 14 out of 19 adult outcomes were predicted by childhood and current psychiatric disorders
- Effect of disorder depends on outcome
o Ext > health behaviors (e.g. substance abuse)
o Int > psychological functioning (e.g. loneliness, suicidality, mental health care)
- Effect size: OR’s approx.. 2
o With each disorder likelihood of negative adult outcome is doubled
So in fact, there is good reason to intervene early on!
Intervention spectrum
Goes from promotion to maintenance. In this course focussed mostly on the treatment peace
Promotion target group: general population
Goal: strengthening positive factors and reducing the risk at later problems. (VB. Schijf van 5)
Universal prevention: (part of) general population
- Op volle kracht in school curriculum (Tak et al.)
Selective prevention: high risk groups
- Op volle kracht in high-risk neighborhoods (Kindt et al.)
Indicated prevention
- Group with elevated/subclinical levels. You select kids who already show signs of the
disorder. It becomes similar to the actual treatment or intervention but they don’t meet the
criteria for a full blown disorder yet.
Treatment
Case identification: based on diagnostics
How are we doing with our treatments at the moment?
Not so great. Our results provide little evidence for the effectiveness of traditional child
psychotherapy.
,What are interventions?
- Goal directed
- Improve psychological, social and/or cognitive development of the child and/or reduce risks
and developmental problems (Ince & Van den Ber, 2010).
- They are not only directed at the wellbeing of the child (Yirmiya, 2010).
Intervention criteria
- Goal
- Target group
- Program description
o Methodology
o Support
o Executing demands
Goal
Formulating goals
- What’s wrong with…?
o Support the child
o Stimulate language development
o Cope with trauma
Deze doelen zijn niet smart geformuleerd
S specific, significant, simple, sustainable
M measurable, meaningful, manageable
A achievable, agreed, attainable
R realistic, result-based, reasonable
T time-bound, timed, time-specific
So rather than:
Support the child after a 3-month intervention the child should be able to cope with his anxieties.
Stimulate language development after a 3-month intervention language development is on a level
that is adequate for admission to primary school.
Target group
What’s wrong with?
Children that are behind in their language development children aged 2 to 6 years old which are
behind 2 or more years in their language development (passive and/or active).
Program description
Methodology
,Non-specific factors
- Good relationship between client and therapist
- Client’s motivation
- Structure of intervention
- Good fit between question for help (presenting problem) and provided service
- Treatment integrity
- Education of therapist
- Organization/work conditions (workload, caseload, supervision)
Specific factors
- Program that works for a specific target group
o How does it work?
Mediators
o For whom does it work?
moderators
Support
- Etiology and maintaining factors
- Conceptual analysis of risk factors and protective factors
- What are changeable factors = goal?
- Specific and nonspecific factors?
Executing demands
- Applicable and executable in clinical practice
- Transferable
- Limiting conditions are clear
, College 2
Evidence-based treatments
Usual care is not effective. EBT’s work more effective than usual care. There are many treatments
available.
You need basic science in order to design interventions. You need knowledge on etiology: the
precipitating factors, maintaining factors and risk factors.
PMTO – Parent Management Training Oregon Model
Family based interventions: PMTO, Family check-up
Coercion Theory
Deviancy Training (Dishion et al.)
Deviant peers influence and train each other to become even more deviant, that’s where it becomes
harmful and a bad idea to put all these deviant and aggressive children together in a group context.
Intervention criteria
Clear description of goal, target group, program description.
Evaluation criteria
1. Underpinning
a. Theoretically well supported
i. Plausible that intervention leads to desired effect?
b. Intervention criteria
Content course
Evidence-based treatments
- Cognitive-behavioral therapy
- Psychodynamic informed therapies
- Systems therapy
- Parent counselling/parent management skills
- The next generation
College 1
Children in need
Why is it important to intervene (early on)?
- Mental health disorders among youth 10 to 24 years of age the leading cause of disease
burden. (Harhay & King, 2012)
- Long-term effects on adult functioning (great smoky mountains study, 2018)
TRAILS study
- 14 out of 19 adult outcomes were predicted by childhood and current psychiatric disorders
- Effect of disorder depends on outcome
o Ext > health behaviors (e.g. substance abuse)
o Int > psychological functioning (e.g. loneliness, suicidality, mental health care)
- Effect size: OR’s approx.. 2
o With each disorder likelihood of negative adult outcome is doubled
So in fact, there is good reason to intervene early on!
Intervention spectrum
Goes from promotion to maintenance. In this course focussed mostly on the treatment peace
Promotion target group: general population
Goal: strengthening positive factors and reducing the risk at later problems. (VB. Schijf van 5)
Universal prevention: (part of) general population
- Op volle kracht in school curriculum (Tak et al.)
Selective prevention: high risk groups
- Op volle kracht in high-risk neighborhoods (Kindt et al.)
Indicated prevention
- Group with elevated/subclinical levels. You select kids who already show signs of the
disorder. It becomes similar to the actual treatment or intervention but they don’t meet the
criteria for a full blown disorder yet.
Treatment
Case identification: based on diagnostics
How are we doing with our treatments at the moment?
Not so great. Our results provide little evidence for the effectiveness of traditional child
psychotherapy.
,What are interventions?
- Goal directed
- Improve psychological, social and/or cognitive development of the child and/or reduce risks
and developmental problems (Ince & Van den Ber, 2010).
- They are not only directed at the wellbeing of the child (Yirmiya, 2010).
Intervention criteria
- Goal
- Target group
- Program description
o Methodology
o Support
o Executing demands
Goal
Formulating goals
- What’s wrong with…?
o Support the child
o Stimulate language development
o Cope with trauma
Deze doelen zijn niet smart geformuleerd
S specific, significant, simple, sustainable
M measurable, meaningful, manageable
A achievable, agreed, attainable
R realistic, result-based, reasonable
T time-bound, timed, time-specific
So rather than:
Support the child after a 3-month intervention the child should be able to cope with his anxieties.
Stimulate language development after a 3-month intervention language development is on a level
that is adequate for admission to primary school.
Target group
What’s wrong with?
Children that are behind in their language development children aged 2 to 6 years old which are
behind 2 or more years in their language development (passive and/or active).
Program description
Methodology
,Non-specific factors
- Good relationship between client and therapist
- Client’s motivation
- Structure of intervention
- Good fit between question for help (presenting problem) and provided service
- Treatment integrity
- Education of therapist
- Organization/work conditions (workload, caseload, supervision)
Specific factors
- Program that works for a specific target group
o How does it work?
Mediators
o For whom does it work?
moderators
Support
- Etiology and maintaining factors
- Conceptual analysis of risk factors and protective factors
- What are changeable factors = goal?
- Specific and nonspecific factors?
Executing demands
- Applicable and executable in clinical practice
- Transferable
- Limiting conditions are clear
, College 2
Evidence-based treatments
Usual care is not effective. EBT’s work more effective than usual care. There are many treatments
available.
You need basic science in order to design interventions. You need knowledge on etiology: the
precipitating factors, maintaining factors and risk factors.
PMTO – Parent Management Training Oregon Model
Family based interventions: PMTO, Family check-up
Coercion Theory
Deviancy Training (Dishion et al.)
Deviant peers influence and train each other to become even more deviant, that’s where it becomes
harmful and a bad idea to put all these deviant and aggressive children together in a group context.
Intervention criteria
Clear description of goal, target group, program description.
Evaluation criteria
1. Underpinning
a. Theoretically well supported
i. Plausible that intervention leads to desired effect?
b. Intervention criteria
