Clinical Psychology, School Counseling


Health Care to Children & Adolescents with Psychosocial Disorders

According to the recent estimates, 17% to 22 % of the children under age of 18 years meet the diagnostic criteria for one or more mental disorders. Of these, 11 to 14 million children, that is, at least, half of them may be severely handicapped by this order, and half may have trouble coping with the demands of community, family and school.

The most commonly known developmental problem faced by the children is LD (Learning Disability), Attention Deficit Hyperactivity Disorder (ADHD), Anxiety Disorder (AD), Disorders such as Enuresis, Encopresis, Sleep Walking, Tics, Autism, etc

To participate in the management of these disorders, psychologists have developed a broad range of treatments

Primary prevention addresses risk and protective factors that may influence the onset of a disease. The goals of primary prevention are to prevent specific disorders and diseases and to foster general health enhancement through education

Secondary prevention is aimed at reducing the prevalence or severity of a disorder through early identification and treatment

Tertiary prevention refers to efforts to minimize the sequelae of established disorders or diseases through rehabilitation

Interdisciplinary Collaborative Activities in School Settings

collaboration between paediatric psychologists, health care providers, teachers, and other school personnel

Relevant factors that can affect collaboration include the goal or content of collaboration.

Pediatric psychologists and at times pediatric health care providers will work with school staff and parents concerning planning for the educational and classroom support needs of an individual child.

School counselors and health care providers may have information concerning the needs of children with various health conditions, medication management, and/or neuropsychological status of individual children who have been seen for medical and/or psychological evaluation and/or treatment, all of which may be very useful to teachers

Teachers also have valuable information about how the child is responding to the social and educational demands of the school setting that can help to inform the psychologist’s or pediatrician’s recommendations and to develop an effective educational and psychological management plan for the child.

  • characteristics of collaborators,
  • outcomes of collaboration,
  • relationship characteristics,
  • stages of collaborative relationships.

Models of Collaboration/Consultation

Pediatric psychologists have described a range of collaborative models that have focused on clinical consultation in patient care or teaching and that are applicable to school settings.

Four basic models of psychological consultation in pediatric settings are:-

(1) Independent functions

In this model, the psychologist or behaviouralpaediatrician functions as a specialist who provides diagnostic information and, in some instances, recommendations for management in the classroom setting of a patient referred by a teacher or paediatrician.

(2) Indirect consultation

An alternative approach is the indirect psychological consultation or process-educative model. The hallmark of this model is that the psychologist or paediatrician assumes the role of informed colleague who provides advice, teaching, or protocols for ongoing management.

(3) Collaborative team models

A third general model of consultation, the collaborative team model, is characterized by shared responsibility and joint decision making among the paediatric psychologist and teacher concerning the child’s management

(4) Systems-based approach

The models of consultation described thus far emphasize interactions and relationships among the individual pediatric psychologist, paediatrician, teacher, and/or educator.

Systems-based approach, is characterized by a proactive approach that may also develop a novel service designed to address the ongoing problem in systems of care

Collaborative Challenges

teachers spend a considerable amount of time with children and are often skeptical about taking suggestions from a consultant.

Moreover, teachers may believe that the test data the neuropsychological consultant provides will not result in meaningful, concrete intervention techniques that can be employed in the classroom

In fact, these are difficult to accomplish, and they require a high level of expertise and the time to develop and implement specific recommendations based on classroom observation on the part of the psychologist consultant.

Another challenge faced is that the effective consultation and collaboration with school staff concerning the complex, highly individual needs of children with Autism is inevitably time consuming as it requires observation of the child in a classroom context, phone and face-to-face contact with teachers, and ongoing reviews of the child’s progress.

Another challenge posed by this work involves the need to coordinate neuropsychological consultation with input from pediatric neurologists and pediatricians concerning medication management

Psychosocial Challenges and Clinical Interventions for Children and Adolescents

Children with chronic illnesses are faced with a number of ongoing stressors that affect many dimensions of their lives. They often encounter changes in their physical, social, and emotional functioning, and must cope with the added burden of clinic visits and daily medical treatments

Parents also experience increased demands on their time, energy, and resources, as well as shifts in the enactment of their primary social roles (e.g., parental, marital)

Non-identification of psychosocial problems of school children.

It is a serious concern when children and adolescents go without needed mental health services

There are a number of factors that causes such problems

  • 1Training programs that do not provide school counselors with specific education, knowledge, training, and skills to address psychosocial disturbances in their patients.
  • School counselors may be undertrained in recognizing the complex problems associated with mental health issues and also may lack the necessary expertise to care for children who evidence psychopathology
  • Even in the case where a child is identified by the primary care school counselor families may be reluctant for a number of reasons to follow through with recommended services.
  • Reasons may include the stigma associated with labeling and receiving psychological services at a school.
  •  A general unfamiliarity with the nature and benefits of psychological services by children and their caregivers and health care providers hinders use of services.
  • So do environmental barriers like limited office space and lack of cooperation from teaching faculties.
  • Beliefs of parents and teachers about the inability of school counselors to manage psychosocial problems of students

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