Contemporary Approaches to Infant and Child Mental Health

This book provides a clinical approach to assessment and intervention with infants and children (0-12-years-old) and their families who present to mental-health practitioners with emotional, behavioural, and/or developmental difficulties, including psychiatric disorders.

A wide range of common and not so common presentations is covered. Specialist chapter authors integrate evidence from research with their own clinical experience. Principles of assessment and intervention are outlined. De-identified case material is used to explore the complex interplay of developmental, environmental, socio-cultural, psychological, biological, and political factors in mental-health presentations, to outline how an experienced clinician can assess the contribution of these factors to the infant’s or child’s presentation, and to demonstrate how this impacts on decision making about diagnosis, treatment planning, and intervention. Cases are also used to examine controversial issues in the field, and the ethical dilemmas that confront practitioners. These include the relative weight given to biological and genetic risk factors in the aetiology of disorder, the marked increase in the diagnosis of ADHD and bipolar disorder in children, the complex impact of child abuse and neglect on symptomatic presentations, the inadequacy of current diagnostic classification systems, the role of medication in treatment, and the impact of systemic and resource factors on clinicians and families. Formulation and difficulties of diagnosis and differential diagnosis in developing children are emphasised. The importance of communication and collaboration with colleagues in various disciplines is stressed.

Drawing on developments in developmental psychology, neurobiology, and social science that have led to a new understanding of the importance of the early years, the book provides a broad developmental, relational, and psycho-social corrective to dominant biological models and approaches.

This authoritative, engaging, and readable book will prove of value to students and to experienced practitioners in a wide range of disciplines.

Table of Contents

Preface

Acknowledgments

Contributors

PART A: INFANCY

1. Infant development and developmental risk - Louise Newman
• Development in infancy
• Early parenting disturbances
• References
2. The infant with special meaning - Bryanne Barnett and Valsamma Eapen
• Introduction
• Perinatal loss and grief
• The unexpected infant
• Conclusion
• References
3. Working with the very sick infant in hospital - Campbell Paul
• Historical perspectives on young children in hospital
• Case reports and follow-up studies
• Dimensions of the baby’s experience
• Approaches to intervention
• Direct psychotherapy with the child and family
• Cognitive behavioural approaches
• Family and group approaches
• Conclusion
• References
4. Infants in alternative care - Prue McEvoy and Patricia O’Rourke
• Introduction
• Case: Anthony: early assessment and intervention in fostering infants
• Case: Lucy: falling through the cracks: systemic splitting
• Case: Nathan: colliding systems: invisible infant
• Case: Thomas and Christopher: learned hopefulness: systemic denial
• Conclusions
• References
5. Infants in cultural transition - Rosalind Powrie
• Introduction
• Migration and parenting
• Culture and parenting
• Assessment of infants and families in cultural transition
• Service provision
• Conclusion
• References
6. The unsettled infant - Beulah Warren
• Theoretical framework
• What interferes with this natural process?
• Principles of assessment
• Principles of intervention
• Sleeping and settling over the first year
• Intervention based on developmental needs
• Developmental guidance and supportive counselling
• Conclusion
• References
7. Interventions for vulnerable parents and infants - Louise Newman
• Introduction
• Early intervention and prevention
• Clinical approaches
• Building parental reflective capacity
• Parenting after trauma
• Working with mothers with BPD and their infants
• References

PART B: CHILDHOOD

8. The school-age child - Sarah Mares
• Introduction
• The era of competence
• Attachment
• The transition to school and peer relationships
• Assessment, diagnosis, formulation, and intervention
• Conclusion
• References
9. Pervasive developmental disorders - Kerry J Bull, Avril V Brereton, and Bruce J Tonge
• Autism Spectrum Disorders
• Autistic Disorder (Autism)
• Asperger’s Disorder
• Pervasive Developmental Disorder – Not Otherwise Specified
• Rett’s Disorder
• Childhood Disintegrative Disorder (Heller’s Syndrome)
• Co-morbidities
• Diagnostic assessment
• Epidemiology
• Aetiology
• Early signs
• Screening
• Outcome
• Treatment
• Summary
• References
10. Anxiety in children - Nick Kowalenko
• Development
• Risk and protective factors
• References
11. Disruptive behaviour and aggression - Sarah Mares
• Introduction
• Symptoms, diagnosis, course, and comorbidity
• Aetiology and models of risk
• Approaches to intervention
• Conclusion
• References
12. The child with chronic illness - Michael R Bowden
• Introduction
• Issues for the child
• Issues for the family
• Approach to assessment and formulation
• Treatment planning
• Team issues
• Conclusion
• References
13. Children exposed to family conflict - Raphael T W Chan
• Introduction
• Impact of parental separation
• Family conflict and children’s mental health
• Challenges for the practitioner
• Assessment and intervention
• Therapy agreement
• Interventions for parents
• Interventions for children
• Setting realistic goals
• References
14. Treating the child in out-of-home care - Megan Chambers
• Who are the children in out-of-home care?
• What is ‘care’?
• Children in care as a special-needs group
• Issues in treatment
• When a child presents with a problem
• Issues in assessment
• The crisis presentation
• Diagnosis
• Treatment
• Developing a treatment plan
• Individual interventions
• Conclusions
• References
15. Interventions with school-aged children and their families - Graham Martin
• A tiered behavioural approach
• An intergenerational family approach
• Working with the wider system
• Conclusion
• References

Index