Cognitive Behavioural Therapy with KIDS Presented by Luzanne - - PowerPoint PPT Presentation

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Cognitive Behavioural Therapy with KIDS Presented by Luzanne - - PowerPoint PPT Presentation

Apr 10, 2023 223 likes •594 views

Cognitive Behavioural Therapy with KIDS Presented by Luzanne Liversage-Collins Counselling Psychologist luzanne@crs-med.co.za sayori@crs-med.co.za 073 485 9572 Welcome and Introductions Agenda Theoretical Foundations CBT with KIDS

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Cognitive Behavioural Therapy with KIDS

Presented by Luzanne Liversage-Collins

Counselling Psychologist

luzanne@crs-med.co.za sayori@crs-med.co.za 073 485 9572

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Agenda

CBT with KIDS Part 1

Welcome and Introductions Theoretical Foundations Suitability of CBT Parental Involvement Homework in Therapy Break

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Agenda

CBT with KIDS Part 2

Case Formulation and Treatment Planning Treatment Considerations for Specific Diagnoses/ Disorders Scope of Practice and When to Refer What CBT looks like in Practice: Specific Techniques Case Discussion Further Training

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Theoretical Foundations

A Brief Overview

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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CBT IS:

PRESENT FOCUSED TIME LIMITED STRUCTURED BASED ON THE COGNITIVE MODEL

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Cognitive Model

SITUATION OR TRIGGER BELIEF OR INTERPRETATION CONSEQUENCES (EMOTIONS AND BEHAVIOURS)

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Cognitive Model

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Explaining the Cognitive Model

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Explaining the Cognitive Model

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Explaining the Cognitive Model

BE CREATIVE AND TAILOR THE EXPLANATIONS TO YOUR CLIENTS INTERESTS!

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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What we know about CBT

What you feel will always make sense when you know what you are thinking!

Originally developed for adults

Extremely effective in treatment of Anxiety and Affective Disorders

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Keep in mind...

just a collection of

  • techniques. Manuals are

available and it is important to adhere to the core components but tailor to each child.

CBT is NOT

  • ACTION gender-

sensitive CBT program for Depressed Youth (Stark et al. 2007)

  • FRIENDS program

for child anxiety (Barrett, Farrell, Ollendick, & Dadds, 2006)

  • Coping Cat Manual

and Workbook (Kendall & Hedtke, 2006)

  • Cat Project for

anxious youth (Kendall)

  • Adolescent Coping

with Depression Course (Clark et al., 1990)

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Suitability of CBT

Guidelines for deciding if CBT is appropriate

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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At what age can you use CBT with Children?

Argument in literature that the focus should be on conceptualization rather than age

  • r developmental level

General Consensus

Stallard (2004)

Can be taught less sophisticated, specific and concrete cognitive techniques such as positive self talk

Luzanne Liversage-Collins | luzanne@crs-med.co.za

7 y 5 y

Other

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Developmentally Appropriate

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Children

Often find direct questions uncomfortable Age appropriate reward for participation in order to maintain motivation

Consider delivering interventions via play-based activities e.g. children’s books, artwork, puppets, dolls, stories about a character (superhero or favourite cartoon) who used CBT skills to face and conquer all his/her fears.

Luzanne Liversage-Collins | luzanne@crs-med.co.za

Children

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Adolescents

Individuation and autonomy more NB Confidentiality a big concern May need to spend more time discussing treatment goals and explaining treatment rationale Open discussion with both parents and adolescents on the limits of confidentiality

Luzanne Liversage-Collins | luzanne@crs-med.co.za

Adolescents

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Parental Involvement

Support and structures needed

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Who needs to be involved?

Social Worker(s) School Psychologist(s) Friends Currently Seeing Child Reinforce/ support child specifically if behaviour interfering with treatment Psych= Coach Need to support child in at least attempting tasks Cheerleaders Time, Cost, Transportation

Can be under or over involved!

Support or reinforce tasks as needed

Time at School

Siblings Grandparents Anyone living at home

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Homework in Therapy

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Very important component of CBT!

Encourage opportunities to practice skills learnt in session Give psych a chance to see if youth understands skill Allow youth to generalize skills to real life situations

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Very important component of CBT!

  • Show that I can

tasks

  • Take home

projects

  • Action Plan

RENAME

  • When, Where,

How often, How to remember

  • Check for
  • bstacles

BE SPECIFIC

  • Positive Self Talk
  • Reward

Attempts

REWARD

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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BREAK

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Case Formulation and Treatment Planning

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Case Formulation and Treatment Planning

  • Guides Treatment Planning
  • Needs to be consistently reviewed and updated throughout the process
  • Psych’s understanding of the problem and highlights possible obstacles
  • Various models exist for conceptualization
  • Beck (https://stories.psychwire.com/beck/CBT-

CCT/?fbclid=IwAR1yVh0laHbzdNH4Y05f65Wbc0I_PgXUMn3xxsdoNWi7F1eLrep LjjvpZE0), Hudson and Rapee (2004)

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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  • Target assessment for the typical

cognitions, behaviours and emotions that relate to the presenting problem

  • Do so by eliciting detailed

descriptions of 1 or 2 recent events that highlight presenting concerns

  • Enquire Re: Cognitions and

behavioural choices

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Case Formulation and Treatment Planning

  • Convert Case Formulation into a treatment plan
  • Amount of emphasis given to a particular skill within a treatment plan

varies

  • Treatment plan must SELECT, specific CBT techniques that will best

address the problem

  • SEQUENCE techniques to progress to a goal – what skills does youth

need before an NB experience and after e.g. exposure

  • Implement each technique at appropriate DOSE
  • NB to ensure thorough understanding of each specific CBT technique

so you can adapt it

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Specific Diagnoses

Treatment Considerations

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Tend to be perfectionists with H/W so consider putting a time limit and ask parents to assist May require rewards for efforts

Treatment Considerations

GAD

May suggest clients makes mistakes on purpose (spelling, smudging etc) Generally have more abstract worries so be creative! E.g. thunderstorm

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Treatment Considerations

H/W may need to be completed daily

Luzanne Liversage-Collins | luzanne@crs-med.co.za

Separation Anxiety Disorder NB to involve the parents (and school) and a lot of work focused on parental involvement e.g. out of session exposures such as leaving child with baby-sitter and not answering calls/ texts when child seeks reassurance. Family members often participate in rituals and routines, they may need to change their behaviour

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Treatment Considerations

School Refusal PTSD Depression

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Scope of Practice

And when to refer

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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What CBT looks like

Specific Techniques

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Case Discussion

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Further Training

Luzanne Liversage-Collins | luzanne@crs-med.co.za

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Join our Mailing List for more Course Information on upcoming courses! Please feel free to contact me should you have any questions/ queries! Luzanne@crs-med.co.za

www.crs-med.co.za/workshops

Luzanne Liversage-Collins | luzanne@crs-med.co.za