Clinical Child Psychology

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Clinical Child Psychology
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Clinical Child Psychology vs.Pediatric
Psychology

• Considerable overlap, but
• Clinical Child Psychologists typically work
  with children and adolescents once psychological
  systems have developed
• Usually in private practice settings or
  outpatient clinics
• Diverse in orientation
• Traditional training (assessment, developmental
  processes, family therapy)

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Pediatric Psychology

• AKA child health psychology
• Usually practiced in medical settings
• Frequently intervene before psychopathology
  develops
• More likely to adopt a cognitive-behavioral
  orientation
• More short-term interventions
• Tend to emphasize medical and biological issues
  in training, research and service delivery

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History

• Remember Clinical Psychology has its roots in
  the assessment and treatment of childhood
  disorders Witmer, Binet
• However, through the 20th century, study of
  childhood psychopathology was largely ignored
  adultmorphism
• Neither Psychoanalysis or Behaviorism recognized
  the unique nature of childhood disorders

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DSM-III

• The first version of the DSM to make specific
  recommendations concerning developmental
  considerations in the diagnostic criteria for
  childhood disorders

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Nowadays

• DSM-IV Over 2 dozen Axis I disorders specific to
  children
• Several major journals concerned with children
  Journal of Abnormal Child Psychology, Journal of
  Clinical Child Psychology
• Division 53 Clinical Child and Adolescent
  Psychology
• Division 54 Pediatric Psychology
• New field of study Developmental Psychopathology
  the study of childhood disorders from a
  developmental perspective

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Why the recent attention?

• Psychopathology relatively common in childhood (8
  22 of children diagnosed with a behavioral,
  emotional or learning disorder)
• Many childhood disorders have lifelong
  consequences
• Most adult disorders have their roots in
  childhood disorders
• By studying childhood disorders, may be better
  able to develop effective early interventions
• Media attention to high-profile, child-related
  problems (school violence, misuse/over-use of
  meds, child abuse, etc.)

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Issues Unique to Clinical Child Psychology

• 1. Referral Issues
• 2. Developmental Considerations
• Rapid physical, social, cognitive and behavioral
  changes
• 3. Infant Temperament (Thomas, Chess, etc.)
• 4. Early Attachment (Object Relations theory,
  Bowlby, Ainsworth)

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Childhood Stressors

• Maladaptive parenting
• Birth of a sibling
• Exposure to poverty
• Starting school
• Parental conflict and divorce
• Child abuse

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Classification Issues

• Greater emphasis on empirically derived
  classification
• Based more on research and use of clinical rating
  scales

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Assessment Issues

• As with adults, continued concern with
  psychometric properties of the instruments
• Many of same techniques used
• However
• More information supplied by adult referral
  services
• Cognitive maturation limits usefulness of
  self-report data
• Majority of referrals from schools, having to do
  with school-based problems
• Almost always include concerns with behavior
  within the family setting
• Issues of confidentiality

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Treatment

• Talk therapy not really an option for younger
  children verbal skills, insight
• Play therapy
• Behavior therapy especially operant procedures
• Cognitive-Behavioral Interventions
• Biological Interventions medication, dietary
  modifications