Summary Advanced Child and Adolescent Psychiatry - Leiden University (Part 1)
26 views 1 purchase
Course
6464CA06Y
Institution
Universiteit Leiden (UL)
Advanced Child & Adolescent Psychiatry (Part 1)
Lectures, Literature and Case studies
Lecture 1: Introduction
Lecture 2: Autism Spectrum Disorder
Lecture 3: Anxiety and Compulsions
Lecture 4: Psychotic Disorders
Week 2:
Literature
- The peer relationships of girls with ASD at school: ...
DIFFERENCES BETWEEN SPECIALISTS(in hierarchy, education, and professional - at the same level but -)
● Psychiatrist(asamedicalspecialist):controlsandtreatssomaticsymptoms,prescribesmedication,dutiesatnightandduring
theweekend
● Clinical psychologist: specialist in (neuro-)psychological assessmentandpsychotherapy treatment
● At LUMC Curium - Psychologist-specialist vs Psychaitrist:
○ Similarities: same responsibilities as the psychiatrist
○ Difference: except for medical duties
CHILD AND ADOLESCENT DEVELOPMENT AND DISORDERS
● Normal development(cognitive, social, emotional)
● Atypical development–most common disorders:
○ Learning disabilities (such as dyslexia)
○ Speech-language disorders
○ Intellectual disabilities
○ Neurodevelopmental disorders, such as ADHD and autism
● Complex disorders– and comorbidity
○ Anxiety
○ Depression
○ Eating disorders
○ Attachment disorders/trauma
○ Stressor-related disorders
○ Personality disorders
○ Psychotic disorders
ORGANIZATION OF PSYCHOLOGICAL SERVICES INTHE NETHERLANDS
● Child Healthcare / Youth and Family Centre
○ 0-18 yrs: 0-4 child consultation clinic; 4-18 youth and family center
○ No referral of a general practitioner is needed
● Basic mental healthcare(Basic GGZ)
● Specialized mental healthcare(Specialistische GGZ):LUMC Curium
○ All ages
○ Referralof a general practitioner or Youth and family center is needed
○ Most complex cases
○ 0-18 yrs:local authorities pay(they receive funds from the central government) (16 => parents don’t need to know)
○ 18+ years:health insurance that pays
TREATMENTOUTCOME
● Factors that influence client outcomes can bedivided into four areas
○ Extra-therapeutic factors
○ Expectancy effects
○ Specific therapy techniques
○ Commonfactors:empathy,warmth,andthetherapeuticrelationshiphavebeenshowntocorrelatemorehighlywith
client outcomes than specialized treatment interventions.
● Alliance and expectancy are active ingredients of treatment.
TREATMENTRELATIONSHIP
● Interpersonal skills:
○ Verbal fluency
○ Interpersonal perception (what is happening between you and the client - knowledge on our regulation)
○ Affective modulation and expressiveness
○ Warmth and acceptance
○ Empathy
○ Focus on other
● Therapist:
, Is someone you cantrust, who can help you and understand you
○
○ Aware of the client’s age,characteristics,culturalbackground, andcontext
○ Flexible and will adjust therapy if resistance to the treatment is apparent or the client is not making adequate
progress
○ Communicateshope and optimism
○ Awareoftheirownpsychologicalprocessanddonotinjecttheirownmaterialintothetherapyprocessunlesssuch
actions are deliberate and therapeutic
L UMC CURIUM
ORGANIZATION
● LUMC – is divided into 4 divisions
● Division 3 – department Psychiatry
● Sub-department Child and Adolescent Psychiatry
● Head of Curium: Prof dr Robert Vermeiren and Manager: Willeke van den Oudenrijn
● 3 care programs - partly based on diagnostic classification
○ Neurodevelopmental disorders: Mirjam Rinne
○ Emotional disorders (anxiety, psychotic): Tes Mijnders, Eva van Well
○ Complex disorders and family problems: Lian Nijland, Lucas Korthals Altes + Janine Baartmans (De Viersprong)
AT LUMC CURIUM COMBINATION OF
● Patient care
● Research - in clinical practice, with the most complex group (severe and enduring problems)
● Education/training of professionals - all levels from MSc to specialist
● Management
PATIENT CARE
● Within a program
○ Inpatient and outpatient treatment
○ Guidelines for the diagnostic process (mainly outpatient) and treatment process
● In outpatient and inpatient teams
○ Different levels of education of professionals
○ Diagnostic process and treatment process are done by the same persons/in the same team, supervised by a specialist
○ Specific treatment programs/therapies(CBT,DBT,psychotherapy,nonverbaltherapy,farmaceuticaltreatment,family
therapy)
INDIVIDUALLY PLANNED TREATMENT PROGRAM
● As short as possible, as intensive as necessary:
○ Outpatient treatment, individually and/or family
○ Home treatment, individually and/or family
○ Day clinic (chair)
○ Clinic Inpatient (bed)
○ “Flexbed”
○ Bed on prescription (BOR)
○ Chair on prescription (SOR)
○ Consultation by telephone (TOR)
(DAY) CLINICAL TREATMENT CURIUM LUMC
1. Focused individualized treatment: concrete treatment goals
2. Treatment climate: working from competencies, skills training
3. Short inpatient treatment in strong cooperation with outpatient treatment and home training
4. Families in control
5. Empowerment of the family
6. Outpatient pre- and post-clinical treatment programs
BASIC ATTITUDE TOWARDS FAMILIES
, ● P arentsarecompetentandexpertsabouttheirchild,andthetreatmentteamareexpertsontheoreticalknowledgeaboutthe
disorder and treatment
● Parents go on together with their children, the team passes by
● Building on the competenciesof the child and the family
● Goal is not to cure but tofoster functioning and find a new balance for the child and the family
● Non-Violent Resistance (Chaim Omer) – parental (or adult) presence in the child’s mind, to reduce helplessness and gain
authority by supporting parents.
INDIVIDUAL PAPER ASSIGNMENT REFERRAL AND INTAKE AT LUMC CURIUM
● Referral:
○ First by telephone (referrer and parent) => teams
○ Referral letter
○ DAWBA (development and well-being assessment questionnaire), interview and rating
● Intake:
○ Interview with parents and child
○ Child psychiatric examination
○ Importance of the differential diagnosis for hypotheses generation
INTAKE AND TREATMENT AT LUMC CURIUM
● Diagnostic process: assessing child’s developmental history,psychologicalassessment(IQ,questionnaires),informationfrom
school
● Multidisciplinarymeetingwithaspecialist,socialworker/familytherapist,andstudent,whenindicatedwithapsychologistfor
results from psychological assessment =>descriptive diagnosis(not DSMV-classification per se)+ treatment plan
● Meeting with parents and children for advice
● Treatment => 3 monthly multidisciplinary evaluation
WORKING WITH CHILDREN AND YOUNG PEOPLE VS ADULT MENTAL HEALTH CARE
● Working with different developmental phases
● Alwaysworking with families/caretakers
● Working with schools, community, legal system, etc.
● C&A psychiatry is a relatively young specialism still in development
○ More complex, more differentiated, more co-operation => more difficult?
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller bernarditarichards. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $8.75. You're not tied to anything after your purchase.