Skip to main content

Advertisement

SpringerLink
Log in

Collaborative Problem Solving (CPS) as a Primary Method of Addressing Acute Pediatric Pathological Aggression Along with Other Modalities

  • Original Paper
  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

The answer for treating pathologic aggression (PA) in children on inpatient psychiatry units (based on various factors like severity of aggression and co-morbidities) is less likely to be restrictive interventions or sedating the patient. Using seclusion and restraints or medications to calm down the aggression is not free of adverse consequences. A protocol is needed to safely and effectively address aggressive and violent children and adolescents seen very commonly in psychiatry inpatient units.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Children’s Safety Network Economics and Insurance Resource Center: State Costs of Violence Perpetrated by Youth. July, 2000. http://www.csneirc.org/pubs/tables/youth-viol.htm

  2. Donohue JJ III, Siegelman P: Allocating resources among prisons and social programs in the battle against crime. Journal of Legal Studies 27:1–43, 1998

    Article  Google Scholar 

  3. Foster EM, Jones DE; The Conduct Problems Prevention Research Group: The high costs of aggression: Public expenditures resulting from conduct disorder. American Journal of Public Health 95(10):1767–1772, October, 2005

    Google Scholar 

  4. Welsh BC et al.: Costs of Juvenile Crime in Urban Areas A Longitudinal Perspective Youth Violence and Juvenile Justice, Vol. 6, No. 1, Lowell, University of Massachusetts Lowell, pp. 3–27, 2008

  5. Ryan EP, Hart VS, Messick DL, et al.: A prospective study of assault against staff by youths in a state psychiatric hospital. Psychiatric Services 55:665–670, 2004

    Article  PubMed  Google Scholar 

  6. American psychiatric Association: 2003 APA gold award: A more compassionate model for treating children with severe mental disturbances. Psychiatric Services 54:1529–1531, November 2003

    Google Scholar 

  7. Greene RW, Ablon JS, Goring JC: A transactional model of oppositional behavior: Underpinnings of the collaborative problem solving approach. Journal of Psychosomatic Research 55(1):67–75, July, 2003

    Article  PubMed  Google Scholar 

  8. Greene RW, Ablon JS, Hassuk B et al.: Innovations: Child & adolescent psychiatry: Use of collaborative problem solving to reduce seclusion and restraint in child and adolescent inpatient units. Psychiatric Services 57(5):610–612, May, 2006

    Article  PubMed  Google Scholar 

  9. dosReis S, Barnett S, Love RC et al.: A guide for managing acute aggressive behavior of youths in residential and inpatient treatment facilities. Psychiatric Services 54(10):1357–1363, October, 2003

    Article  PubMed  Google Scholar 

  10. Malone RP, Luebbert JF, Delaney MA: Nonpharmacological response in hospitalized children with conduct disorder. Journal of the American Academy of Child and Adolescent Psychiatry 36(2):242–247, February, 1997

    Article  CAS  PubMed  Google Scholar 

  11. Delaney KR: Calming an escalated psychiatric milieu. Journal of Child and Adolescent Psychiatric Nursing 7(3):5–13, July–September, 1994

    Article  CAS  PubMed  Google Scholar 

  12. Masters KJ, Bellonci C, Bernet W, et al.: Practice parameter for the prevention and management of aggressive behavior in child and adolescent psychiatric institutions, with special reference to seclusion and restraint. Journal of the American Academy of Child and Adolescent Psychiatry 41(2 suppl):4S–25S, 2002

    PubMed  Google Scholar 

  13. Finke LM: The use of seclusion is not evidence-based practice. Journal of Child and Adolescent Psychiatric Nursing 14(4):186–190, October–December, 2001

    Article  CAS  PubMed  Google Scholar 

  14. Bornman BA, Mitelman SA, Beer DA: Psychotherapeutic relaxation: How it relates to levels of aggression in a school within inpatient child psychiatry: A pilot study. The Arts in Psychotherapy 34(3):216–222, 2007

    Article  Google Scholar 

  15. Greene RW, Ablon JS: Treating Explosive Kids: The Collaborative Problem Solving approach. New York, Guilford, 2005

    Google Scholar 

  16. Greene RW, Ablon JS, Goring JC, et al.: Effectiveness of collaborative problem solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology 72:1157–1164, 2004.

    Article  PubMed  Google Scholar 

  17. Greene RW, Ablon SA, Goring JC etal.: Treatment of oppositional defiant disorder in children and adolescents. In: Barrett P, Ollendick TH (Eds) Handbook of Interventions that Work with Children and Adolescents: Prevention and Treatment. West Sussex, England, Wiley, pp. 369–393, 2003

    Google Scholar 

  18. Vitiello B, Hill JL, Elia J et al.: P.r.n. medications in child psychiatric patients: A pilot placebo-controlled study. Journal of Clinical Psychiatry 52(12):499–501, December, 1991

    CAS  PubMed  Google Scholar 

  19. Khan SS, Mican LM: A naturalistic evaluation of intramuscular ziprasidone versus intramuscular olanzapine for the management of acute agitation and aggression in children and adolescents. Journal of Child and Adolescent Psychopharmacology 16(6):671–677, December, 2006

    Article  PubMed  Google Scholar 

  20. Staller JA: Intramuscular ziprasidone in youth: A retrospective chart review. Journal of Child and Adolescent Psychopharmacology 14(4):590–592, Winter, 2004

    Article  PubMed  Google Scholar 

  21. Barzman DH et al.: A retrospective chart review of intramuscular ziprasidone for agitation in children and adolescents on psychiatric units: Prospective studies are needed. Journal of Child and Adolescent Psychopharmacology 17(4):503–509, August, 2007

    PubMed  Google Scholar 

  22. Hazaray E, Ehret J, Posey DJ et al.: Intramuscular ziprasidone for acute agitation in adolescents. Journal of Child and Adolescent Psychopharmacology 14(3):464–470, Fall, 2004

    Article  PubMed  Google Scholar 

  23. Jangro WC, Preval H, Southard R et al.: Conventional intramuscular sedatives versus ziprasidone for severe agitation in adolescents: Case-control study. Child and Adolescent Psychiatry and Mental Health 3:9, 2009.

    Google Scholar 

  24. Barzman DH, Findling RL: Pharmacological treatment of pathologic aggression in children. International Review of Psychiatry 20(2):151–157, April, 2008

    Article  PubMed  Google Scholar 

  25. Buitelaar JK, van der Gaag RJ, Cohen-Kettenis P, Melman CT: A randomized controlled trial of risperidone in the treatment of aggression in hospitalized adolescents with subaverage cognitive abilities. Journal of Clinical Psychiatry. 62(4):239–248, April, 2001

    CAS  PubMed  Google Scholar 

  26. Campbell M, Small AM, Green WH et al.: Behavioral efficacy of haloperidol and lithium carbonate: A comparison in hospitalized aggressive children with conduct disorder. Archives of General Psychiatry 41:650–656, 1984

    CAS  PubMed  Google Scholar 

  27. Malone RP, Delaney MA, Luebbert JF et al.: A double-blind placebo-controlled study of lithium in hospitalized aggressive children and adolescents with conduct disorder. Archives of General Psychiatry 57(7):649–654, July, 2000

    Article  CAS  PubMed  Google Scholar 

  28. Masi G, Milone A, Canepa G et al.: Olanzapine treatment in adolescents with severe conduct disorder. European Psychiatry 21(1):51–57, January, 2006

    Article  PubMed  Google Scholar 

  29. Krishnamoorthy J, King BH: Open-label olanzapine treatment in five preadolescent children. Journal of Child and Adolescent Psychopharmacology 8(2):107–113, 1998

    Article  CAS  PubMed  Google Scholar 

  30. Connor DF, Glatt SJ, Lopez ID et al.: Psychopharmacology and aggression. I: A meta-analysis of stimulant effects on overt/covert aggression-related behaviors in ADHD. Journal of the American Academy of Child and Adolescent Psychiatry 41(3):253–261, 2002

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

Core Library, Case Western Reserve University, Cleveland, Ohio Pratt Library, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio. Cartoon source: Parenting press (1) Redirecting a Child Who Throws Things When Angry by Shari Steelsmith (2) Practice At Taking “No” for an Answer by Shari Steelsmith.

Author information

Authors and Affiliations

  1. Cincinnati Children’s Hospital Medical Center, D4/37, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA

    Gaurav Kulkarni

  2. W.O. Walker Center, 10524 Euclid Avenue, 8th Floor, Cleveland, OH, 44106, USA

    Parikshit Deshmukh

  3. Cincinnati Children’s Hospital Medical Center, MLC 3041, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA

    Drew Barzman

Authors
  1. Gaurav Kulkarni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Parikshit Deshmukh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Drew Barzman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gaurav Kulkarni.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kulkarni, G., Deshmukh, P. & Barzman, D. Collaborative Problem Solving (CPS) as a Primary Method of Addressing Acute Pediatric Pathological Aggression Along with Other Modalities. Psychiatr Q 81, 167–175 (2010). https://doi.org/10.1007/s11126-010-9126-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11126-010-9126-2

Keywords

Search

Navigation