Report of the Psychotherapy Task Force of the American Academy of Child and Adolescent Psychiatry. (1/61)

In this task force report, the authors define the field of child and adolescent psychotherapy; review the state of the field with respect to advocacy, training, research, and clinical practice; and recommend steps to ensure that psychotherapy remains a core competence of child and adolescent psychiatrists.  (+info)

Family ward: a new therapeutic approach. (2/61)

This article describes a new integrated child psychiatric family ward treatment model at the Tampere University Hospital. Theoretically, the treatment is based on an integration of systems and psychoanalytical theories as well as behavioral approach. A centerpiece of the model is a 3-week treatment period for the whole family at the family day ward. The work of the multidisciplinary team on the ward focuses on family relationships, on representational level, and on the interactional behavior of the family. Interaction and relationships are also used as tools, including a reflective working model and sharing concrete interaction with the family. So far, the family ward has offered 165 family treatment periods for 113 different families. Altogether in 63% of the total treatment periods one or both parents have had mental illness and in 15% of the total treatment periods there have been serious custody disputes with accusations of sexual abuse of the child. Helping these multi-problem families is a special challenge for our treatment model and at the moment we are developing new methods for assessment and support of parenthood.  (+info)

Morbidity in reflex sympathetic dystrophy. (3/61)

Reflex sympathetic dystrophy (RSD), an unusual diagnosis in general paediatrics, is well recognised by paediatric rheumatologists. This study reports the presentation and the clinical course of 46 patients (35 female, age range 8-15.2) with RSD. The patients saw professionals from an average of 2.3 specialties (range 1-5). Twenty five (54%) had a history of trauma. Median time to diagnosis was 12 weeks (range 1-130). Many children had multiple investigations and treatments. Once diagnosis was made, treatment followed with physiotherapy and analgesics. Median time to recovery was seven weeks (range 1-140), with 27.5% relapsing. Nine children required assessment by the child and adolescent psychiatry team. This disease, though rare, has significant morbidity and it is therefore important to raise clinicians' awareness of RSD in childhood. Children with the condition may then be recognised and referred for appropriate management earlier, and spared unnecessary investigations and treatments which may exacerbate the condition.  (+info)

Treatment interventions and findings from research: bridging the chasm in child psychiatry. (4/61)

BACKGROUND: Along with all other branches of medicine, child and adolescent psychiatry is faced with the need to consider its evidence base and justify its activities accordingly. AIMS: To consider critically the use of the term 'evidence', to suggest limits to the value of conventionally defined evidence and to point to possible ways forward to bridge the gap between research findings and clinical practice. METHOD: A review of the literature relating to the use of evidence-based methods. RESULTS: The term 'evidence' needs to be used more widely than is conventionally the case. Substantial evidence exists from controlled trials, but there are barriers to its use. CONCLUSIONS: A move away from nonvalidated methods of intervention is both desirable and feasible. The use of qualitative methods of enquiry, both in situations where controlled trials are unlikely to be feasible and as adjuncts to quantitative methods, should be considered more seriously.  (+info)

Comprehensive mental health care in a pediatric dialysis-transplantation program. (5/61)

The dialysis-transplantation (D-T) program at The Hospital for Sick Children, Toronto has a mental health component directed by a psychiatrist and a social worker. As of Jan. 1, 1975, 53 kidney transplants had been carried out on 44 children. Patients and their families are counselled continuously by the psychiatrist and the social worker before, during and after transplantation. Members of the multidisciplinary team meet regularly to plan treatment for the children. Mental health issues are an integral part of team discussions and help determine D-T program policy. Psychological preparation, mental health consultation, therapeutic intervention and continuous counselling prevent many of the mental health problems that plague a D-T program.  (+info)

Empirically supported treatments in pediatric psychology: where is the diversity? (6/61)

OBJECTIVE: To examine the extent to which studies used to support empirically supported treatments for asthma, cancer, diabetes, and obesity address issues of cultural diversity. METHOD: We chose original articles (71) of treatments used to support empirically supported treatments (ESTs) published as part of a special series on ESTs in the Journal of Pediatric Psychology. Trained coders reviewed each study to determine if the following were reported: race/ethnicity and socioeconomic status (SES) of the sample, moderating cultural variables, cultural assumptions or biases of the treatment, larger cultural issues, and measurement or procedure bias. RESULTS: Results revealed that few studies addressed cultural variables in any way. Only 27% of the studies reported the race or ethnicity and 18% reported the SES of research participants. Additionally, 6% discussed potential moderating cultural variables. The remaining variables were addressed in 7% or less of the studies. CONCLUSIONS: These data support the criticism that ESTs fail to address important issues of culture and call into question the external validity of ESTs to diverse populations. Future research should explicitly address cultural issues according to the nine recommendations described here.  (+info)

PAROXYSMAL SNEEZING. (7/61)

Although sneezing is a particularly common symptom, there are surprisingly few references to this subject in the medical literature. Many of these references are shrouded in superstition and unscientific theory. Preparation of this report was stimulated by an interesting example of severe uncontrollable non-allergic paroxysmal sneezing which was carefully investigated with regard to both physical and psychological factors. A further example of paroxysms of sneezing occurring in a patient with temporal lobe seizures is also discussed with particular reference to the control of the sneezing episodes in association with anticonvulsant medication and control of the epileptic attacks. In addition, the neurophysiological mechanisms of sneezing are reviewed and the specific neurological references to the subject are discussed in relation to physiological and clinical data. At times the symptom of sneezing would appear to reflect some unknown disorder which may have central and possibly cortical affiliations.  (+info)

THE DEVELOPMENT AND ORGANIZATION OF A CHILDREN'S PSYCHIATRIC HOSPITAL. (8/61)

Thistletown Hospital is a children's psychiatric hospital which was established by the Department of Health of the Province of Ontario. Special legislation permitting control of the admissions procedures was enacted. The administrative organization consists of a series of committees made up of the heads of hospital departments. An advisory board of distinguished psychiatrists and psychologists advises the Minister of Health directly on major policy changes or innovations envisaged for the hospital. Clinical organization is related to four functions: (1) service (treatment and assessment), (2) research, (3) training of staff, and (4) community education.The basic units of the hospital are related to the treatment or research design necessary in special diagnostic categories. A children's psychiatric hospital should not be restricted to in-patient facilities but should consist of a totally community-oriented service.  (+info)