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Similaire à John Piacentini Students Under Pressure: Helping Manage Stress and Anxiety
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John Piacentini Students Under Pressure: Helping Manage Stress and Anxiety
- 1. Anxiety in ADHD and LD John Piacentini, Ph.D., ABPP UCLA Child OCD, Anxiety, and Tic Disorders Program Help Group SUMMIT October 2, 2009
- 5. Tripartite Model of Anxiety Thoughts Behaviors Feelings
- 9. How Common are Anxiety Disorders in Children and Adolescents? Most common child psychiatric disorder - U.S. Surgeon General’s Report on Mental Health Between 12% to 20% of community youngsters suffer from anxiety severe enough to interfere with their functioning
- 21. How to Identify Problematic Anxiety in Children with ADHD and LD?
- 30. Treatment of Anxiety in Children with ADHD and LD
- 35. Cognitive Behavior Therapy From Kendall, 1992
- 39. Early Caveman Game: Ethological Perspective: Anxiety as an adaptive advantage Kiss the Mammoth and Run
- 42. Identifying Anxious Feelings Start with less threatening exercises (magazine pictures, stories about others) and then move to more personal material Hardest
- 45. Dossick & Shea, 1988 Identifying Anxious Thoughts
- 49. Charting Anxiety during Exposure
- 51. Reward Program
- 52. Cognitive Behavior Therapy FEAR PLAN F eeling Frightened E xpecting Bad Things to Happen A ttitudes & Actions that will Help R esults & Rewards From COPING CAT (Kendall et al., 1992)
- 53. CONSULTANT provide information CHEERLEADER provide encouragement COACH supervise/administer treatment components CLIENT target of specific aspects of intervention Level of Parental Involvement
- 54. Family Techniques Teach parents to: Reward child’s courageous behaviors Extinguish child’s fear behaviors Communicate, cope, and problem-solve Control their own (parent’s) anxiety
- 56. CBT for Child Anxiety (ITT Outcomes) Cochrane Report, 2006 CBT N=498 Control N=311
- 57. Impact of Comorbidity on CBT Response Kendall et al., 2001 Comorbidity does not lead to worse CBT response
- 58. Medication for Child Anxiety Fluvoxamine Placebo RUPP Anxiety Study Group. (2001). NEJM, 344 , 1279-1285.
- 59. The C hild/Adolescent A nxiety M ultimodal S tudy (CAMS) Walkup, Albano, Piacentini et al., (2008). New England Journal of Medicine
- 62. Treatment Response COMB > CBT = SRT > PBO
- 63. Pediatric Anxiety Rating Scale
Notes de l'éditeur
- Fears in childhood are very normal. In fact, developmentally appropriate fears are crucial to keep children safe from harm, and assist children to make sense of their constantly changing world. Childhood fears become a concern or a problem when the FEAR is outside of the Childs developmental stage – for example, it is normal for a child of 4 or 5 years to be Very afraid of being separated from mum or dad during the first few weeks of going to school. However, it is not developmentally appropriate for a child of 12 to be very afraid of separation from parents, and need to call mum or dada many times during a day to check that they are safe and they won’t forget to come to collect them after school. A normal fear also becomes a problem when the child experiences significant distress – out of proportion to the context, whereby it is extremely difficult to soothe them. DURATION – when the fear is not transitory (for example the first few days or even weeks of school) but rather LINGERS for at least 2 months. And when it interferes with a child’s or family’s life. Anxious kids are great to work with, they are fantastic to have in your classroom , because they do their work quietly, they are often perfectionist o they also do a great job! And they are always eager to please! However, they do cause HUGE amounts of distress to family members and cause massive disruption to family routine.