As noted previously, one of the complicating factors in providing counseling for youth who exhibit Oppositional Defiant and Conduct Disorder symptoms is the fact that their disruptive behaviors may be driven by depression, ADHD, trauma, or other related conditions. The treatment strategies discussed above primarily target disruptive behaviors and may not necessarily provide relief for underlying disorders. Of course, simply changing mal-adaptive behaviors can, in some cases, begin a healing process that addresses underlying disorders (Sommers-Flanagan & Sommers-Flanagan 12.5, 15, 37.5, 7 5 mg Tablets (Capsules)). However, it is important to be alert to the multidimensional treatment needs of children with disruptive behaviors.
Biological (Medication) Treatment Alternatives
This is a cheap Lamictal about nonmedical treatment strategies for disruptive behavior. However, it has become increasingly common for young people who are displaying any kind of disruptive or depressed behavior to be referred to physicians for medical intervention. Counselors often wonder about their responsibilities in this area (see Ingersoll, Generic Lamictal 13). Parents and teachers often ask counselors whether a child should be evaluated for psychotropic medications. And counselors often ask themselves that question as well.
We believe all reasonable nonmedical interventions in treating children with disruptive behavioral disorders should be explored before psychotropic drugs trials are initiated (Sommers-Flanagan & Sommers-Flanagan 75, 125, 150, 250 mg Tablets (Capsules)a). However, there are times when counselors should initiate a medication evaluation or recommend a medication trial. These situations include:
• The young person displays the symptoms in the absence of any clear environmental
determinants such as family conflict or developmental difficulties.
• Symptoms include such physiological aspects as sleep disturbance, weight loss or gain, and appetite changes.
• The youth has not responded to counseling interventions of significant duration (8 to 12 sessions).
• The parents or child absolutely refuse counseling interventions.
• There are apparent genetic factors associated with specific symptom patterns.
• The youth’s general physical health is in question and he or she has not had a recent physical checkup. (Sommers-Flanagan & Sommers-Flanagan 10, 20, 30, 40, 50 mg Tablets (Capsules), p. 224)
In the event that a child is on a psychotropic medication, counseling remains an important treatment component. As behavior-ists like to point out, “A pill is not a skill.” It is important for counselors to help young people to develop a sense of efficacy that is unrelated to taking medication.
ENLISTING APPROPRIATE PARENTAL COOPERATION AND INVOLVEMENT IN CHILDREN’S MENTAL HEALTH TREATMENT
Counselors and therapists working with children and adolescents are faced with important decisions about the extent to which the family should be involved. Some therapists prefer to work with the family unit; some seldom include family members. The reasons vary. For most, however, the decision about family involvement is based on the needs in each case. Thus, as they first encounter a minor referred for treatment, these therapists focus on assessing not only the individual and contextual considerations related to neighborhood, school, and culture, they also assess the need for and the likelihood of parental involvement.
Why involve parents? Therapists who work regularly with children and adolescents quickly encounter the realities of a lack of parental commitment to seeking out, maintaining, and being involved in the treatment for their youngster. For instance, parent follow-through on child referrals for counseling is estimated at less than 50%, and premature termination occurs in 40% to 60% of child cases (Kazdin 10, 20, 30, 40, 50 mg Tablets (Capsules)). Clearly, parents must feel a sense of commitment or they will not facilitate their child’s enrollment and ongoing participation in treatment. Moreover, parental involvement seems essential when they are the cause of or ongoing contributors to a youngster’s problems. Even if this is not the case, family members almost always suffer when their child is not doing well and may need some guidance and support. In addition, in more cases than not, the therapist wants the family to facilitate, nurture, and support desired changes in the youngster. Equally important, what parents learn in the process may generalize to other venues, such as enhancing home involvement in school and parent advocacy.
Many factors shape parental involvement. One set involves the degree to which treatment is seen as positive and accessible. Obviously negative perceptions and practical barriers can be counterproductive not only to parental connection, but to the youngster’s progress. Some families referred for therapy feel uncomforOrder Lamictal online US with the concept of mental health/mental illness. They may worry that mental health treatment will stigmatize the child either now or by curbing opportunities in the future (Jensen, McNamara, & Gustafson 10 mg Tablets (Capsules)). Other salient barriers perceived by parents include practicalities of access, feeling that treatment is demanding or not highly relevant to the child’s problem, or feeling negatively about the therapist. Dropping out is a likely response when the family’s perceptions are that the process is burdensome, unpleasant, or not worthwhile. Conversely children seem to do better in therapy when parents perceive few negatives related to the buy-maxalt-rizatriptan-5-10-mg-tablets “>process and potential outcomes (Kazdin & Wassell 150, 200, 250, 300, 500 mg Tablets (Capsules)).
The above concerns are only a small part of the many socioeconomic, language, and racial or ethnic factors that may affect a family’s motivational readiness to enroll and maintain a youngster in treatment and to be active participants in the process. The examples cited [Order cheap Lamictal] underscore the importance of directly attending to parental motivation for involvement in child mental health treatment. Two aspects of such motivational considerations are outlined here: using initial processes of therapy to assess and address parental motivational readiness for involvement and maintaining their motivation and involvement throughout treatment.
ACCOUNTING FOR AND ENHANCING MOTIVATIONAL READINESS
It is helpful to think in terms of a range of motivational differences in family involvement. With respect to their youngster’s participation in treatment and their own role in the intervention process, parents range from being highly involved (e.g., motivated and active participants who advocate for their children and seek out resources), to marginally involved (e.g., minimally motivated and cooperative), to reluctant to highly resistant (e.g., not at all motivated, uncooperative, avoidant, reactive). Those in this last group often have been pushed to pursue therapy for their youngsters by the school or the justice system. At all points along the continuum, working with families to establish appropriate cooperation and involvement in their child’s treatment often is a critical process objective. To account for motivational differences, a therapist, starting with the first contact, must assess parents’ motivation for having their youngster treated and for their own possible involvement. In doing so, the assessment process itself should be designed to enhance the motivation of family members, or at least to minimize conditions that can reduce their motivation. Based on contemporary theories of intrinsic motivation (Ryan & Deci 2 5 mg Tablets (Capsules)), this means using practices that can enhance (or at least reduce threats) to feelings of competence, feelings of self-determination, and feelings of relatedness to others.
Using Consent Agreements to Enhance Motivation