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Gepubliceerd in:

01-06-2014

Developmentally Sensitive Cognitive Behavioral Therapy for Adolescent School Refusal: Rationale and Case Illustration

Auteurs: David Heyne, Floor M. Sauter, Thomas H. Ollendick, Brigit M. Van Widenfelt, P. Michiel Westenberg

Gepubliceerd in: Clinical Child and Family Psychology Review | Uitgave 2/2014

Abstract

School refusal can be difficult to treat and the poorest treatment response is observed among older school refusers. This poor response may be explained, in part, by the impact of developmental transitions and tasks upon the young person, their family, and the treatment process. This paper describes and illustrates the @school program, a cognitive behavioral therapy (CBT) designed to promote developmental sensitivity when planning and delivering treatment for adolescent school refusal. Treatment is modularized and it incorporates progress reviews, fostering a planned yet flexible approach to CBT. The treatment is illustrated in the case of Allison, a 16-year-old female presenting with major depressive disorder and generalized anxiety disorder. A case formulation guided the selection, sequencing, and pacing of modules targeting predisposing, precipitating, perpetuating, and protective factors. Treatment comprised 16 sessions with Allison (interventions addressing depression, anxiety, and school attendance) and 15 concurrent sessions with her mother (strategies to facilitate an adolescent’s school attendance), including two sessions with Allison and mother together (family communication and problem solving to reduce parent–adolescent conflict). Two treatment-related consultations were also conducted with Allison’s homeroom teacher. Allison’s school attendance improved during the course of treatment. By post-treatment, there was a decrease in internalizing behavior, an increase in self-efficacy, and remission of depressive disorder and anxiety disorder. Clinically significant treatment gains were maintained at 2-month follow-up. Factors influencing outcome may include those inherent to the @school program together with less specific factors. Special consideration is given to parents’ use of both authoritative and autonomy-granting approaches when helping an adolescent to attend school.

vorige artikel Developmentally Adapted Cognitive Processing Therapy for Adolescents Suffering from Posttraumatic Stress Disorder after Childhood Sexual or Physical Abuse: A Pilot Study

The CBT evaluated in this study was based on the treatment reported in Last et al. (1998 ).

These two treatment-focused visits are in addition to an initial school visit during the assessment phase.

The student welfare coordinator has a role in providing student counseling and liaising with other helping professionals.

Families attend two assessment sessions across 2 weeks. This permits a comprehensive assessment, including a visit to the school in between the two assessment sessions with the family, as well as contact with other professionals who have been involved.

In the Netherlands, MA-level psychologists receive 4.5 years specialized training in psychology. Dutch practicing psychologists rarely have doctoral-level training.

Session numbers 7 and 10 with mother.

In the Netherlands, adult education programs are commonly accessed by high school students who are not permitted to re-enroll in their current school. Students can achieve their high school diploma through a year-long educational track in an adult education program. The class schedule is similar to that in high school (i.e., 5 days a week), but students do not have to participate in non-academic classes (e.g., gym).

The first booster session took place 5 weeks after the final treatment session and the second booster session took place 2 weeks thereafter.

Prior to referral, Allison had undergone medical examinations which failed to find a somatic cause for her complaints.

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Titel: Developmentally Sensitive Cognitive Behavioral Therapy for Adolescent School Refusal: Rationale and Case Illustration
Auteurs: David Heyne
Floor M. Sauter
Thomas H. Ollendick
Brigit M. Van Widenfelt
P. Michiel Westenberg
Publicatiedatum: 01-06-2014
Uitgeverij: Springer US
Gepubliceerd in: Clinical Child and Family Psychology Review / Uitgave 2/2014
Print ISSN: 1096-4037
Elektronisch ISSN: 1573-2827
DOI: https://doi.org/10.1007/s10567-013-0160-0

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Developmentally Adapted Cognitive Processing Therapy for Adolescents Suffering from Posttraumatic Stress Disorder after Childhood Sexual or Physical Abuse: A Pilot Study

Co-occurring Aggressive and Depressive Symptoms as Related to Overestimations of Competence in Children with Attention-Deficit/Hyperactivity Disorder

Antisocial Behavior, Psychopathic Features and Abnormalities in Reward and Punishment Processing in Youth

Focusing on the Positive: A Review of the Role of Child Positive Affect in Developmental Psychopathology