ch10.ppt

CHAPTER 10 – PREVENTION COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION - OVERVIEW Prevention programs: Designed to decrease the risk of serious problems including physical and mental health disorders Community Psychology: Branch of psychology concerned with...

CHAPTER 10 – PREVENTION COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION - OVERVIEW Prevention programs: Designed to decrease the risk of serious problems including physical and mental health disorders Community Psychology: Branch of psychology concerned with the reciprocal relationship between the community and the individual COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.  POVERTY UNICEF (2003) – Estimates 1 Billion children worldwide do not have adequate food, shelter, education etc Approximately 17% of American children live at or below the poverty line Many risk factors for poverty: increased violence, environmental pollutants, physical and mental health disorders Prevention programs designed to decrease poverty COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS APPROACHES TO PREVENTION Primary Prevention: Intervention before a disorder has developed (to prevent its occurrence) Secondary Prevention: Intervention after the onset of the disorder (usually called treatment) Tertiary Prevention: With chronic disorders – focus is on rehabilitation and long-term adaptation COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL  APPROACHES TO PREVENTION Universal Preventive Interventions: Applied to the general population (e.g., vaccines, etc) Selective Preventive Interventions: Targeted to individuals at high risk of developing a disorder Indicative Preventive Interventions: Targeted to individuals at high risk and are showing subclinical signs of the disorder COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.  PREVENTION – CENTRAL CONCEPTS Risk reduction model: Identifying high risk groups and, using research, develops intervention programs Risk factors: Characteristics of the person or environment that increases chance of developing a disorder Protective factors: Characteristics of a high-risk person or environment that decreases risk of developing the disorder COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS  COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION – CENTRAL CONCEPTS Importance of determining the outcome of a program  Incidence rates: Number of new cases in a given year (requires a very large sample)(4.789 new cases for tomorrow)  Number needed to treat: the number of people needed to treat to save one person from getting the disorder (e.g., aspirin=130)(56.965 covid19 cases )  Meta-analysis: Comparing the outcome on several studies of a prevention program  Efficacy & effectiveness  PROMOTING EVIDENCE-BASED PARENTING Home Visiting Programs: At-risk (low-income teenage single mothers) given several interventions on pregnancy, health care, parenting, etc. Triple P Positive Parenting: multi-level system designed to target different at-risk parents  Enhancing knowledge, skills, confidence  Promoting safe environments for children  Promoting children’s competence COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. THE TRİPLE P The Triple P – Positive Parenting Program is one of the most effective evidence-based parenting programs in the world, backed up by more than 30 years of ongoing research. Triple P gives parents simple and practical strategies to help them confidently manage their children’s behavior, prevent problems developing and build strong, healthy relationships. Triple P is currently used in 25 countries and has been shown to work across cultures, socio-economic groups and in many different kinds of family structures. http://www.triplep.net/glo-en/home/ COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. THE TRİPLE P The Triple P – Positive Parenting Program ® is a parenting and family support system designed to prevent – as well as treat – behavioral and emotional problems in children and teenagers. It aims to prevent problems in the family, school and community before they arise and to create family environments that encourage children to realize their potential. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. THE TRİPLE P Triple P draws on social learning, cognitive behavioral and developmental theory as well as research into risk factors associated with the development of social and behavioral problems in children. It aims to equip parents with the skills and confidence they need to be self-sufficient and to be able to manage family issues without ongoing support. And while it is almost universally successful in improving behavioural problems, more than half of Triple P's 17 parenting strategies focus on developing positive relationships, attitudes and conduct. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. THE TRIPLE P Triple P is delivered to parents of children up to 12 years, with Teen Triple P for parents of 12 to 16 year olds. There are also specialist programs – for parents of children with a disability (Stepping Stones), for parents going through separation or divorce (Family Transitions), for parents of children who are overweight (Lifestyle) and for Indigenous parents (Indigenous). http://www.triplep.net/glo-en/find-out-about-triple-p/triple-p-in-a-nutshell/ COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PROMOTING EVIDENCE-BASED PARENTING Incredible Years: Designed for kids (3-8) with conduct problems – now a broader age group. Group discussion, videotape examples, behavioral rehearsal  Trains parents to praise positive behaviors, play effectively with kids, and set limits appropriately COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. SHARED PARENTING As shared parenting has been recognized by the research community, as well as by legal and mental health practitioners, as a viable post-separation parenting arrangement that is optimal to child development and well-being, there is consensus that both the legal and psycho-social implementation of shared parenting as a presumption should proceed without delay, with the full sanction and support of professional bodies and associations. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. SHARED PARENTING Shared parenting is when children are brought up with the love and guidance of both parents following a separation. ‘Shared parenting’, 'equal parenting’, ‘involved parenting’, 'co-operative parenting’, ‘parallel parenting’ and other terms are used. Generally the term 'shared parenting' is preferred. Shared parenting goes wider than the time each parent spends with their children. It must involve the child spending a significant proportion of their time with each parent. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. SHARED PARENTING But it does not imply a stated or fixed proportion of parenting time being allocated to each parent, much less that the child’s time be divided equally between the two parents in every case. http://www.familylives.org.uk/advice/divorce-and-separation/shared-parenting-and- contact/what-is-shared-parenting/ COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION OF VIOLENCE Physical Abuse of Children: Meta-analysis indicates that home visit programs, behavioral parent training and multimodal (i.e., multi-faceted) programs are effective in reducing abuse Bullying and delinquency: Triple P and Incredible Years are effective in treating these problems. School-based programs on anger management and conflict resolution have mixed success http://www.who.int/violence_injury_prevention/violence/en/ COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION OF VIOLENCE Each year an estimated 200 000 young people aged 10–29 years are murdered, making homicide the fourth leading cause of death for this age group. Millions more sustain violence-related injuries that require emergency medical treatment, and countless others go on to develop mental health problems and adopt high-risk behaviors such as smoking and alcohol and drug abuse as a result of the violence they experience. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION OF VIOLENCE Preventing youth violence: an overview of the evidence aims to help policy- makers and planners – particularly in settings with limited human and financial resources – to address youth violence using an evidence-informed approach. Jointly published by WHO, the United Nations Development Programme, and the United Nations Office on Drugs and Crime, the Global status report on violence prevention 2014 reflects data from 133 countries and is the first report of its kind to assess national efforts to address interpersonal violence, namely child maltreatment, youth violence, intimate partner and sexual violence, and elder abuse. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION OF VIOLENCE Violence prevention topics Child maltreatment, Intimate partner and sexual violence, Elder maltreatment, Collective violence, Youth violence, Self-directed violence http://www.who.int/violence_injury_prevention/violence/en/ COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION OF VIOLENCE Bullying and delinquency: Triple P and Incredible Years are effective in treating these problems. School-based programs on anger management and conflict resolution have mixed success  Olweus Bullying Prevention Program: focus on changes in school and classroom, produced effective outcomes  Fast Track Program: focus on engaging the community with a high risk population – also noted success in terms of preventing conduct problems  Meta-analysis confirms the success of these programs in decreasing bullying and victimization COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.  PREVENTION OF INTERNALIZING DISORDERS Anxiety: Coping Koala effective program – identification of at- risk children and treating in group format for children and small number of session for parents Coping Cat is a CBT manualized and comprehensive treatment program for children from 7 to 13 years old with separation anxiety disorder, related anxiety disorders, and/or social phobia. It was designed by Philip Kendall and colleagues at the Child and Adolescent Anxiety Disorders Clinic at Temple University. A related program called C.A.T. is aimed at adolescents, while the focus of Coping Cat is usually on older children. A group version of Coping Cat has also been designed to work with 4 to 5 children together. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.  PREVENTION OF INTERNALIZING DISORDERS The goals of the treatment are three-fold:  the child learns to recognize, experience, and cope with anxiety  the child learns to reduce his/her level of anxiety  the child learns to master developmentally appropriate, challenging, and difficult task. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.  PREVENTION OF INTERNALIZING DISORDERS Depression: Universal programs not particularly effective. Small effects for selective and indicated programs COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION OF SUBSTANCE ABUSE Two types of Universal Programs:  Interactive: work on the development of interpersonal skills (more effective)  Non-interactive: More information based Key features of efficacious programs  Universal programs more effective with active parent involvement  Develop 1) identification of social pressures, 2) work on life skills, 3) involve several levels of school, home, community, 4) very systematic COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.  PREVENTION OF PROBLEMS FROM TRAUMA OR LOSS Critical Incident Stress Debriefing: Immediately following a traumatic event with counselors trained to help people process & discuss the experience (in groups)  Outcome indicates not helpful and can be harmful (as different people process information differently)  Similar findings for bereavement interventions COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PREVENTION OF PROBLEMS FROM TRAUMA OR LOSS Risk of lifetime exposure to a potentially traumatic event (PTE) increases exponentially across the lifespan until non-exposed individuals are rare. Although a minority of individuals in the general population develop trauma-related emotional and behavioral problems, this is not true of multiply traumatized or poly-victimized individuals. These experiences can start to accumulate very early in life with potential to disrupt normal development of stress-related biological systems and trigger the emergence of pervasive emotional and behavioral problems. http://www.sidran.org/resources/for-survivors-and-loved-ones/what-is-psychological-trauma/ COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.