Programs That Work

Children and adolescents in the general population and in clinical populations reveal surprisingly high rates of playing with fire or actual firesetting behavior. A single fire has the potential to cause a cascade of serious consequences to the child, family, and the community, some of which may continue forever. Yet, there is limited practical information and advice based on available empirical evidence to help programs or practitioners work effectively with children or adolescents who misuse fire, and their families. This book provides practical guidelines designed to facilitate the clinical assessment and treatment of youthful firesetting behavior based on nearly four decades of research and intervention experience with this population. The topics covered in this book address several important content areas. Initial chapters provide an overview of the significance of the problem, and some lessons learned based on case control, clinical trial, and real-world implementation projects. Recommendations for using screening and assessment measures that evaluate firesetting and general psychosocial issues are included. Several intervention methods are outlined for use with children, caregivers, and families. These methods encompass fire safety education materials and several cognitive-behavioral treatment skills-training procedures that focus on understanding of the fire, affect regulation and self-control, parenting practices, and home-based management programs. The book also includes suggestions to promote professional and program development which reflect on various educational, ethical, legal, collaborative, and community safety considerations. The book’s content is intended to help a diverse array of practitioners understand and target the context in which the misuse of fire occurs.Less

Cognitive-Behavioral Therapy (CBT) has shown to be effective in the treatment of childhood OCD. This online Therapist Guide outlines a 12-session CBT-based treatment for OCD that benefits not only children and adolescents, but their families as well. Each session incorporates a family therapy component in addition to individual treatment for the child. It is a combined approach program that educates the child and family about OCD in order to reduce negative feelings of guilt and blame and to normalise family functioning. It also provides guidelines for conducting both imaginal and in vivo exposures, which are techniques at the core of helping children reduce their anxiety. For use with children ages 8 to 17, this online resource is an indispensable tool for clinicians helping children and their families cope with OCD.Less

The experience of childhood trauma can lead to a broad spectrum of long-term psychological consequences, including depression, anxiety, and posttraumatic stress disorder. The severity and longevity of these results are a function of a complex individual and universal equation that includes biological and environmental variables. In recognition of the growing need for a manualized treatment that aims to increase youth insight into how an individual’s history of exposure to trauma may relate to current emotional experiences and how these, in turn, may be linked to maladaptive behaviors, cue-centered therapy (CCT), was developed. CCT is a structured, multimodal intervention designed to reduce posttraumatic stress, depression, and anxiety in children exposed chronically to interpersonal violence. By incorporating diverse psychoeducational approaches with evidence-based treatments for childhood trauma, CCT empowers children to become their own agents of change. By addressing the impact of allostatic load; educating youth and caregivers about the conditioning process that occurs through repeated exposure to trauma; using insight-oriented strategies and visual icons, and a physiological approach; CCT is a unique protocol that builds on the greatest strengths of its predecessors. This manual includes an introduction by the author, Dr. Victor Carrion, that details the history of CCT and discusses posttraumatic stress disorder. Instructions are provided for therapists on how to use this manual, including an outline of the complete course of CCT, individual session outlines, summaries, forms, and take-home assignments.Less

Evidence-based Child Forensic Interviewing addresses the issues regarding the inherent mismatch between the needs of the legal system and the capabilities of young children. This is especially problematic when legal decisions with potentially serious consequences depend on the results of the interview, such as in cases involving eyewitness memory, divorce, and allegations of abuse and neglect. Without accommodations to a child's developmental level, interviews can result in false reports, miscommunication, and misinterpretation, despite an interviewer's best intentions. This online guide presents an innovative approach to close the gap by providing the scaffolding, structure, and guidance children need to perform optimally. It covers the Developmental Narrative Elaboration (DNE) Interview, an evidence-based step-by-step process and set of techniques for forensic contexts designed to help children ages 3-12 accurately tell as much as they can about their experiences and perceptions. The DNE is comprised of a developmentally sensitive core template and optional techniques that can be embedded at the interviewer's discretion as cases unfold. This online resource reviews the relevant research and then, with sample language, transcripts, and suggested activities, details a three-phased interview with examples.Less

Family-based Interpersonal Psychotherapy (FB-IPT) for Depressed Preadolescents presents the rationale and basic principles for interpersonal psychotherapy (IPT) and for interpersonal psychotherapy for depressed adolescents (IPT-A), a developmental adaptation that is designed to treat adolescents, ages 12 to 18 years, with depression. The heart of this book introduces family-based interpersonal psychotherapy for depressed preadolescents (FB-IPT), a psychosocial treatment for preadolescent depression for children between 7 and 12 years. FB-IPT is conceptually rooted in an interpersonal model of depression and in developmental research on the antecedents of depression in youth. FB-IPT focuses on improving two domains of interpersonal impairment in depressed preadolescents—parent–child conflict and peer impairment—as a means to decrease preadolescents’ depressive symptoms. Stronger interpersonal skills and relationships buffer depressed preadolescents from stressors that arise during this important developmental period. Research shows that preadolescent depression is an important public health concern because it is often a gateway condition that increases the risk for recurrent depression in adolescence. Preteen depression not only interferes with normative social development at a formative period but also results in residual impairments in interpersonal functioning, which may increase risk for recurrent depression into adolescence and adulthood. Effective interventions for depression in the preadolescent period that target family and interpersonal risk factors may reduce risk for depression recurrence in adolescence. Chapters 5 through 17 of this Therapist Guide describe in detail the steps for conducting FB-IPT with depressed preadolescents and their parents.Less

Childhood obsessive compulsive disorder (OCD) is a complex condition that is often accompanied by high levels of family stress and strain. Families of youth with OCD face a unique set of difficulties in that they often are intimately involved in their children’s symptoms. This pattern of responding to OCD, frequently referred to as accommodation, comes in many forms, and for most families, it occurs daily. Research suggests that accommodation is accompanied by increased levels of family distress, anxiety, and conflict, which, when high enough, can undermine successful OCD treatment. Although evidence-based treatments exist for childhood OCD, few protocols offer strategies for treating these more complex family presentations. This program offers an empirically supported approach for managing childhood OCD complicated by poor family functioning. It identifies specific family features that may contribute to treatment nonresponse in childhood OCD, and provides clinicians with an innovative set of strategies for addressing them. By focusing on emotion-regulation strategies and family-problem-solving exercises, families learn to troubleshoot difficult OCD episodes in an effective and supportive manner.Less

It's Only a False Alarm is a workbook for children and adolescents ages 8–17 who are undergoing treatment for Obsessive-Compulsive Disorder (OCD). Designed to be used in conjunction with the program outlined in the corresponding Therapist Guide, this online workbook contains easy-to-read psychoeducational material to help children understand their disorder and how to overcome it. It is filled with interactive worksheets and forms, as well as at-home exercises designed to help children relieve their anxiety and manage their OCD-related symptoms. Whether they are fearful of contamination or obsessed with symmetry, children will benefit from the exposure exercises found in this workbook, and that not performing their rituals and habits cannot result in catastrophe. It also includes graphs and an “OCD Thermometer” to provide children with a visual reminder of their progress over time.Less

This online therapist guide is specifically designed for working with adolescents with panic disorder and agoraphobia. It features the program developed at the Center for Anxiety and Related Disorders at Boston University and targets patients aged 12-17. It is comprised of 12 sessions to be delivered over an 11-week period. Adolescents learn about the nature of panic and anxiety and how to challenge their panic thoughts. Exposure sessions help them face their fears and stop avoiding situations that cause heightened anxiety. An adaptation chapter addresses how to modify the program for intensive (8 day) treatment, as well as how to tailor the treatment to different ages. Each session includes an optional parent component and an appendix provides handouts for parents. A corresponding online workbook is specifically designed for adolescent use, with easy to understand explanations and teen-friendly formsLess

The RUBI Autism Network has developed and tested a structured parent training manual for children with autism spectrum disorder (ASD) and disruptive behaviors. The manual is based on principles of applied behavior analysis and is designed for therapists to use with parents of children with ASD and co-occurring challenging behaviors, such as tantrums, noncompliance, difficulties with transitions, and aggression. A trained therapist utilizes the manual and parent workbook to guide the parent in applying techniques and tools to help manage the child’s challenging behaviors. The treatment includes 11 Core sessions, 7 Supplemental sessions, a home visit, and follow-up telephone booster sessions. Each of the sessions contains a therapist script, activity sheets, a parent handout, and treatment fidelity checklists. Additionally, accompanying each core session are video vignettes that the therapist uses to demonstrate concepts taught in the session. The videos include 30- to 60-second vignettes demonstrating common parenting mistakes as well as implementation (to varying degrees of success) of the strategies being taught. The treatment is designed to be delivered individually to parents in weekly outpatient visits. Parents are given homework assignments between sessions that focus on applying techniques to specific behaviors.Less

The RUBI Autism Network has developed and tested a structured parent training manual for children with autism spectrum disorder and disruptive behaviors. The manual is based on principles of applied behavior analysis and is designed for therapists to use with parents of children with autism spectrum disorder and co-occurring challenging behaviors, such as tantrums, noncompliance, difficulties with transitions, and aggression. A trained therapist utilizes the manual to guide the parent in applying techniques and tools to help manage the child’s challenging behaviors. The treatment includes 11 Core sessions, 7 Supplemental sessions, a home visit, and follow-up telephone booster sessions. Each of the sessions contains a therapist script, activity sheets, a parent handout, and treatment fidelity checklists. Additionally, accompanying each core session are video vignettes that the therapist uses to demonstrate concepts taught in the session. The videos include 30- to 60-second vignettes demonstrating common parenting mistakes as well as implementation (to varying degrees of success) of the strategies being taught. The treatment manual is designed to be delivered individually to parents in weekly outpatient visits. Parents are given homework assignments between sessions that focus on applying techniques to specific behaviors.Less