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  #1  
Old January 21st, 2007, 04:27 PM
Maureen Metcalfe Maureen Metcalfe is offline
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Default CBT and Children/Families

Dr. Pretzer and all:

I am looking for tapes of good examples of cognitive behavioral therapy with children and families to share with staff.

While we are all professionals, our group is struggling with initiation of treatment, for example, who do we work with first the child or the adult(s), and once we figure this out, we know how to set an agenda, but it's the next step we are getting stuck on ... maybe it the transition we are having difficulty with . . . or maybe we are just struggling in all aspects and are having difficulty generalizing past reading cbt texts?

Please help!
Thank you.
Maureen
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Old January 29th, 2007, 10:55 PM
James Pretzer James Pretzer is offline
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Default Re: CBT and Children/Families

Unfortunately, I'm not aware of many good videos of CBT with children and families (and I've been looking for some time). If anyone knows of any good videos other than the ones I list, please post whatever info you have.

The University of Manchester (England) has a number of videos available at http://www.medicine.manchester.ac.uk...eos/catalogue/. I have "CBT for depressed adolescents" by Professor Richard Harrington & Chrissie Verduyn. It focuses primarily on individual therapy with adolescents but includes some vignettes with parent and child. They also have a two-part video on CBT for anxiety in adolescents which I haven't seen yet. The other videos I can think of focus just on individual and /or group therapy with kids or just on parent training.

In terms of deciding whether to work with the child or the adults first, I generally recommend by including as many of the relevant individuals as possible in the initial evaluation. Including the child and both parents is a minimum. Siblings, grandparents, teachers, etc. may have a lot to contribute. It generally is useful to meet with parents and child (or with the entire family) and also to meet privately with the child as well as meeting privately with the parents. Once the initial evaluation is done, one can come up with an initial treatment plan and decide who to include in treatment.

There are a number of factors to consider in deciding who to work with:
  • Who plays an active role in the problem?
  • Who can provide the necessary information?
  • Who has the power to make the necessary changes?
  • Who's consent do we need?
If we're trying to change family interactions, consider including the family. If we're trying to increase autonomy, consider individual therapy. If we're trying to increase the parents' effectiveness, consider meeting with just the parents.


It is important to remember that the family has quite an impact on children and adolescents. Often family intervention is the most promising approach (I'm going to have to be awfully brilliant in my hour a week to match the impact that the family can have the rest of the week). If individual therapy with the child is called for, some family involvement is usually necessary as well. Individual therapy without any family involvement sometimes makes sense with older adolescents but it usually is a good idea to combine family intervention with individual therapy or to focus primarily on family intervention.
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