Helping parents decide on ADHD treatment for their children

In the United States, medication is often the first intervention used to treat attention-deficit/hyperactivity disorder (ADHD). Yet psychosocial interventions with both parents and teachers working together to shape the child's behavior can also be an effective approach, enabling smaller amounts of medication to be used with fewer side effects. An overview of behavioral interventions is provided with a focus on parent training in child behavior management and teacher training in classroom management. Key nursing interventions on behalf of children with ADHD include assessing parental knowledge about treatment, listening supportively to parents, and promoting partnerships among parents, teachers, and providers.     

Impact of age and symptom severity on parent-child relationships and self-perception among Chinese children with Attention Deficit Hyperactivity Disorder

Little information is available on the effect of parent-child relationships on self-perception among Chinese children with Attention Deficit Hyperactivity Disorder (ADHD) in Hong Kong. This study examined the impact of children’s age and symptom severity on the linkage of quality parent-child relationships to perceived competence/hope among children with ADHD. A clinical sample of 81 school-age children (ages 5–11, mean age = 8.38) who were diagnosed with ADHD were recruited in this study. Separate questionnaires were employed to collect data among children and their parents in the pre-treatment phase. Parent-child relationships were positively correlated with self-perception of children with ADHD, with physical competence to be father-child specific. Children’s age had moderated the correlation between mother-child relationship and children’s hope. Maternal role on children’s hope was significant for the mild symptom group; paternal role on children’s hope was significant for the severe symptom group. No moderation effect was found for symptom severity on the correlation between parent-child relationship and children’s self-perception. The study’s findings helped mental health professionals in a Chinese context to develop psychosocial interventions to foster quality parent-child relationships, which in turn will maintain children’s self-perception. Implications for social work practice are discussed.     

A Summary of Selective Experimental Research on Psychosocial Interventions for Sexually Abused Children

This study was conducted to explore current trends in psychosocial interventions for sexually abused children through a review of recent research. Our comprehensive review is limited to published (quasi) experimental studies in the English language over a period of 2000–2013. It provides a detailed analysis of the final 18 articles that met our inclusion criteria, from the 670 potentially relevant articles that were identified. Reviewers analyzed candidate articles to determine whether they met inclusion or exclusion criteria. The retrieved studies reported positive results with respect to improvements in the negative psychosocial sequelae of child sexual abuse following the use of a diverse set of treatment strategies. Of the various interventions, cognitive behavioral therapy was shown to be the most promising type of intervention for sexually abused children. In this review, we discuss some of the implications of psychosocial interventions for victims of child sexual abuse, citing both the methodological and ethical issues that should be considered.     

THE EFFECTIVENESS OF FAMILY THERAPIES FOR SELECTED BEHAVIORAL DISORDERS OF CHILDHOOD

This article reviews the scientific evidence for the effectiveness of family-based aproaches in the treatment of selected childhood behavioral disorders. Although limitations certainly exist, family interventions have consitently improved child and, in some cases, parent functioning in families with children presenting with conduct disorder (CD) and autism. Parents and other family members also directly benefit from child-focused interventions, gaining in knowledge, child management skills, and attitudinal improvements. Longh-term follow-ups indicate that CD and autistic children achieved lasting gains. Similarly, the research on attention-deficit/hyperactivity disorder (ADHD) indicates that parent training improves child noncompliance and aggression yet does not consistently affect core symptoms of ADHD. There is no evidence that adding short-term family interventions improves ADHD child functioning beyond improvements from the use of psychostimulant medications. Some tentative support for family involvement in the treatment of childhood anxieties and fears is reviewed, but clear conclusions await future investigations. Finally, several methodological limitations and needed areas of research are discussed.     

Attention Deficit Hyperactivity Disorder (ADHD) and Diverse Populations

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood. Given the high prevalence of ADHD and its significant impact on children and families, it is important for social workers to understand and know how to respond. This paper looks at Attention Deficit Hyperactivity Disorder, explores its causes, and gives special attention to its effect on diverse populations. In addition, it discusses empirically supported treatment interventions used for children with ADHD, particularly the role of parent training in the management of ADHD. Finally, it discusses the applicability of using parent-training programs with diverse populations.     

ADHD in juvenile offenders: treatment issues nurses need to know

1. When working with juvenile offenders with ADHD, advanced practice nurses should consider prescribing stimulant medication in conjunction with other psychosocial interventions to achieve maximum treatment success. 2. Nurses working with young people with ADHD in the justice system must carefully coordinate care among all health care providers and juvenile justice personnel, including attorneys, probation/parole officers, and court assessment personnel. 3. Advocating for the individual needs of clients and their families is critical; often, this includes advocating for care that is not only evidence based, but also culturally competent.     

Dysfunctional Career Thoughts and Perceived Quality of Parental Relationships in Adolescents With Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is known to cause significant difficulties in interpersonal relationships. Empirical research in career development has demonstrated that close, supportive relationships are associated with positive vocational behaviors (Kenny et al., 2018). We examined dysfunctional career thoughts and perceived quality of parental relationships in high school students with ADHD. One hundred two adolescents (76 boys, 26 girls) with ADHD responded to measures of career thoughts and interpersonal relationship quality. Preliminary exploratory analysis, using multiple linear regression, showed that male participants' dysfunctional career thoughts were statistically significantly related to their relationships with their mothers. For female participants, relationships with fathers represented an area for further exploration. Results suggest that career professionals can enhance positive outcomes of decision-making and problem-solving issues in adolescence with additional focus on relational interventions. Future research should incorporate the influence of gender and race/ethnicity on crucial relationships and focus on paternal relationships using cognitive information processing–based interventions with this population.     

Medication for Children with Attention-Deficit Hyperactivity Disorder

When making assessments and planning interventions, social workers adopt a biopsychosocial perspective. One important area where biologically based treatments influence psychosocial functioning is the area of psychopharmacology. However, even though many clients take medications, social workers often feel poorly prepared to address a subject that could be very important to their clients; that subject is the meaning of the medication to the client. The meanings that clients ascribe to medication can have a significant impact on medication adherence. Using attention-deficit/hyperactivity disorder (ADHD) to illustrate, I provide an overview of ADHD and common forms of treatment, discuss the possible meanings and acceptability of stimulant treatment for ADHD, provide practice guidelines for helping families reduce ambivalence about medication, present two clinical vignettes, and suggest resources for social workers and families.     

Current issues in HIV disease and AIDS: Implications for health and rehabilitation professionals

HIV disease and AIDS are being redefined as chronic, long-term conditions that are suitable for vocational rehabilitation interventions. With the advent of more effective medical interventions, many individuals with these diseases are living longer and are interested in pursuing employment options. In this article, physiological and neurological symptoms, psychological and mental health issues, psychosocial issues affecting women, and employment-related issues and interventions are discussed as they apply to the health and rehabilitation practitioner working with individuals with HIV disease and AIDS.     

Bipolar disorder in children

This article presents an overview of bipolar disorder (BPD) in children, a condition that only recently has been recognized as a legitimate diagnosis. Bipolar disorder in children is underrecognized for many reasons including lack of awareness, diagnostic confusion, and the different clinical picture in children. Available data strongly suggest that prepubertal childhood BPD is a non-episodic, chronic, rapid cycling, mixed manic state. It may be comorbid with attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) or it may demonstrate features of ADHD and CD, further complicating recognition and subsequent treatment. Treatment issues are discussed, and some reasons for the urgency of early recognition and treatment are explained.     

Pediatrics: The emerging psychosocial challenges of the AIDS epidemic

HIV has a pervasive and profound effect on the psychological, social and neuropsychological functioning of infected infants, children and their families. This article discusses direct and indirect psychological manifestations of HIV in children. Direct effects are the outcome of the virus acting on the central nervous system and can result in compromised cognitive, language, motor, socio-emotional and motivational functioning. Indirect effects involve psychological responses to the stress of living with a life threatening illness, the social ostracism, disruption in life goals and undergoing frequent invasive and protracted medical procedures. A major focus of this article is to outline and describe a model comprehensive psychosocial support system developed within the Pediatric Branch of the National Cancer Institute. This includes early intervention issues and strategies for working with families during the introductory phase of the treatment program that also provides the framework for a care management approach, salient mental health problems that frequently occur in this group, and appropriate interventions for individuals and families. Attention is also given to dealing with anticipatory loss and bereavement, implementing traditional innovative intervention techniques, and for providing advocacy services concerning possible legal, financial, housing, and educational issues.     

Implications of the Literature on Equine-Assisted Activities for Use as a Complementary Intervention in Social Work Practice with Children and Adolescents

This article reviews the literature investigating psychosocial benefits of equine-assisted activities (EAA) for children and adolescents with physical, mental, and family challenges. It further analyzes implications for clinical social work practice in the use of EAA as complementary or adjunct interventions with these populations, thus addressing a gap in the literature on population-specific outcomes of EAA. As a contribution to methodology in future research, the conceptual analysis suggests that concurrent examination of complementary interventions across categories of special needs could add to the knowledge base concerning these children’s psychosocial status. Cross-domain investigations could also assess the contribution of each challenge to the status of children with multiple conditions.     

Treatment Outcome Research: How Effective Are Treatments for Abused Children?

The effectiveness of treatments with abused children is supported by only a limited number of studies. Yet despite the lack of an empirical base, many interventions remain popular in clinical practice. This paper introduces social work clinicians to the primary issues involved in the evaluation of psychotherapy with children and adolescents in general, and applies these issues to an understanding of interventions with abused children. Toward this end, current findings on child abuse treatments are synthesized and critically analyzed. This paper speaks to the continuing gap between empirically-based outcome research and clinical practice.     

Re-Visioning Attention Deficit Hyperactivity Disorder (ADHD)

Constructionist notions have become commonplace in theoretical discussions of the self, but are seldom translated into consideration of specific social work practice concerns such as ADHD. Explorations of ADHD, on the other hand, typically emphasize a narrow, medically-oriented symptom picture that is devoid of the psychosocial context in which the so-called symptoms emerge. A transactional approach to the understanding of ADHD is advanced. This article promotes a link between constructionism and social work's psychosocial or person-in-environment perspective. Such a perspective supports approaches to the assessment of ADHD that illuminate larger cultural messages and their constraining influence on individual meaning-making. Intervention, conducted at multiple levels, must be geared to the establishment of more hopeful and affirming narratives.     

Learned Mothering: Raising a Child with ADHD

This is a report of the findings of an exploratory research study, using the qualitative method of Grounded Theory, of the experience of 25 mothers of children with Attention-deficit Hyperactivity Disorder (ADHD). These mothers have been encumbered with great responsibilities caring for and managing their ADHD children, but little has been written that addresses their experience and their need for understanding and support. Because their children experience the world in highly idiosyncratic ways, the mothers need to learn to parent their children accordingly and not depend on the empathic responsiveness that comes intuitively with normal children. Discussion of theoretical and clinical issues should prove helpful to social workers and other clinicians.     

The evidence base for social support interventions in child and family practice: Emerging issues for research and practice

This paper examines the evidence base for interventions which seek to enhance social support resources for families with children at risk of adverse developmental outcomes. Substantive and methodological issues related to the implementation of social support interventions are discussed and a research agenda for the development, testing and evaluation of such interventions is presented.     

Medicalization as professional process: postwar trends in pediatrics

In the late 1950s American pediatricians began to place increased emphasis on psychosocial and behavioral issues in medical training and research. An intraprofessional movement for psychosocial pediatrics led to alterations in the specialty's stated jurisdiction. One explanation for the movement's origins is that demand for treating sick children was eroding; primary-care providers took up the delivery of behavioral services to avoid extinction. This paper shows that routinization of work, not market decline, preceded psychosocial pediatrics. Academicians rather than community practitioners spearheaded boundary expansion. The movement's major consequence appears to be a new division of labor between pediatricians and other health care professionals rather than increased pediatric treatment of children's psychosocial disorders.     

Re-Framing and de-Pathologizing Behavior in Therapy for Children Diagnosed with Psychosocial Disorders

The increasing number of children diagnosed with psychosocial disorders reflects a trend toward pathologizing behavior that is unusual, challenging or extreme. Although these behaviors may match items on the symptom lists for various disorders, a therapist must first consider the origin and context of those behaviors for an individual child through a non-pathological lens. This paper proposes a framework for understanding the behavior of difficult children based on core issues rather than diagnostic symptoms: arousal/excitability, range of focus, perfectionism, intensity, interpersonal sensitivity, sensory sensitivity, cognitive/perceptual style, perception of time, reaction style, and affiliation/integrity. Each trait is examined from two perspectives: how it can lead to or be interpreted as a problem, and how a therapist can re-frame the trait and build on it to identify effective interventions. This approach affirms children’s strengths and upholds social work values.Barbara Probst, Adjunct Professor is affiliated with Graduate School of Social Service, Fordham University, NY, USA.Address correspondence to Barbara Probst, MSW, LCSW, Graduate School of Social Service, Fordham University, Neperan Road, Tarrytown, NY 10591, USA; e-mail: barbprobst@aol.com     

A Systematic Review of Psychosocial Interventions in Treatment of Opioid Addiction

Opioid addiction has become a U.S. epidemic. It is important to determine whether psychosocial interventions help prevent relapse. A total of 14 studies were included in this systematic review. Most studies compared psychosocial interventions in conjunction with pharmacological maintenance. Only 2 studies found that psychosocial interventions led to statistically significant benefits for outcomes related to opioid abuse when compared to maintenance and less or no psychosocial intervention. Psychosocial interventions were not found to be additive to pharmacological treatments during induction or maintenance stages. Further research is needed to determine effectiveness of psychosocial interventions during dose reduction and long-term relapse prevention.     

Counseling Gay Males with AIDS:

As the incidence of acquired immune deficiency syndrome (AIDS) increases, persona with AIDS will present themselves for counseling in both the private and public sector. Counselors will therefore need to be aware of psychical issues affecting gay men who have the virus. This article highlights some of these critical issues. Specifically, the author discusses informational needs, management of distressing feelings, hope and denial, physical intimacy, and psychosocial interventions