Clinical Child Psychology Research Articles

A - 59 An Exploration of a Passive Decision Making Style within the Cognitive Disengagement Syndrome Population and its Contribution to Social Isolation

Abstract Objective Recent research has shown that Cognitive Disengagement Syndrome (CDS) may reduce decision-making independence. In this way, CDS may include a prognosis of social disengagement due to symptoms of the disorder such as apathy, low motivation, passivity, and low energy. This poster investigates the relationship between CDS symptoms and social disengagement and explores possible treatment focuses that could increase individuals’ connection to others and the world around them. Data Selection Information regarding this poster was obtained through a review of the literature including peer-reviewed articles from 2019–2024. Articles were gathered from the Journal of Clinical Child and Adolescent Psychology, Journal of Attention Disorders, Journal of Pediatric Psychology, Child Neuropsychology, and Research in Developmental Disabilities. Informal analyses were used to determine themes including keywords such as sluggish cognitive tempo, cognitive disengagement syndrome, decision-making, social isolation, and apathy. Data Synthesis CDS is associated with lower levels of assertiveness and higher levels of passivity than in the Attention Deficit Hyperactivity Disorder Inattentive Type (ADHD-IN) population. Current research suggests CDS is associated with social isolation influenced by difficulty initiating conversations and being more likely to engage in anxious rumination during conversations. Treatment interventions for CDS should target shyness, task-unrelated thought patterns, behavioral inhibition, hyperreactivity to social stressors, socially isolating behavioral addictions, verbal inhibition, and difficulty with divided attention. Conclusions Based on conclusions drawn in this poster, future studies should examine the impact of loneliness on social initiation frequency within the CDS population. The development of a questionnaire that aims to differentiate ADHD-IN from CDS may also be useful.

Current Landscape of Child and Adolescent Psychology Internship Programs and Implications for Workforce Development.

Doctoral psychology internships play a key role in the development of the competencies of the clinical child and adolescent psychologist workforce needed to serve the increasing behavioral and mental health needs of children. This study surveyed 50 internship training directors regarding workforce needs, the structure of experiential internship components, and the organizational infrastructure and funding of internship programs that provide focused care to children and adolescents within medical settings. Findings suggest that internships most commonly occur within academic medical settings and include clinical child psychology, integrated care, pediatric psychology, neuropsychology, and developmental disabilities tracks. On average, sites had 6 interns, 3 tracks, and 4 major rotations per track. Training directors identified program funding to be the greatest barrier to sustaining internship programs. Currently, internships are funded through clinical revenue, grants, and organizational funds covering an average intern salary of $31,020 plus benefits as well as 0.3 FTE of a training director's time to administrate the program. The number of internship tracks within a single program was associated with greater administrative time for the training director. Implications for advocacy at the federal, state, profession, and institutional level to increase funding and decrease barriers to training are discussed.

William E. Pelham Jr. (1948-2023).

William ("Bill") E. Pelham Jr. was a renowned clinical child psychologist who specialized in the assessment and treatment of children with attention-deficit/hyperactivity disorder (ADHD). Bill was born in 1948 in Atlanta, Georgia, to William E. Pelham Sr. and Kittie Copeland Kay, the eldest of four brothers. Bill is most well-known for the development, study, and advocacy of psychosocial treatments for children with ADHD. While at Florida State University in the 1980s, he developed a comprehensive summer treatment program designed to improve family and classroom functioning, strengthen peer relationships, and boost academic achievement. Bill built the case for the behavioral treatment of ADHD over nearly 50 years of programmatic research. Bill was a leader in the field of clinical child psychology. Bill passed away on October 21, 2023, after a brief illness. He is survived by his wife of 33 years Maureen, son William E. Pelham III, and daughter Caroline. His legacy will live on in their work to support children with ADHD and their families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Current training practices and training gaps in clinical child and adolescent psychology: Implications for training guidelines.

Current training practices and training gaps in clinical child and adolescent psychology: Implications for training guidelines.

Identifying Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD): a Public Health Concern and Opportunity.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant individual and societal negative impacts of the disorder continuing into adulthood (Danielson et al. inJournal of Clinical Child and Adolescent Psychology, in press; Landes and London in Journal of Attention Disorders 25:3-13, 2021). Genetic and environmental risk (e.g., modifiable exposures such as prenatal tobacco exposure and child maltreatment) for ADHD is likely multifactorial (Faraone et al. in Neuroscience & Biobehavioral Reviews 128:789-818, 2021). However, the evidence for potentially modifiable contextual risks is spread across studies with different methodologies and ADHD criteria limiting understanding of the relationship between early risk factors and later childhood ADHD. Using common methodology across six meta-analyses (Bitsko et al. in Prevention Science, 2022; Claussen et al. in Prevention Science 1-23,2022; Dimitrov et al. in Prevention Science, 2023; Maher et al. in Prevention Science, 2023; Robinson, Bitskoet al. in Prevention Science, 2022; So et al. in Prevention Science, 2022) examining 59 risk factors for childhood ADHD, the papers in this special issue use a public health approach to address prior gaps in the literature. This introductory paper provides examples of comprehensive public health approaches focusing on policy, systems, and environmental changes across socio-ecological contexts to improve health and wellbeing through prevention, early intervention, and support across development using findings from these meta-analyses. Together, the findings from these studies and a commentary by an author independent from the risk studies have the potential to minimize risk conditions, prioritize prevention efforts, and improve the long-term health and wellbeing of children and adults with ADHD.

Projective technique “Bird’s Nest Drawing” in child clinical psychology

IntroductionThe “Bird’s Nest Drawing” technique is one of expressive drawing projective techniques. In Russia it has been used since the 2020s. We suggest the pilot version of using this projective technique in child clinical psychology. There were investigated the cognitive and emotional components of performance by children with different types of ontogenesis.Purpose: pilot application of the technique of “Bird’s Nest Drawing” (BND) in the psychological diagnosis of children with different types of ontogenesis.Objectives69 children and adolescents 6-17 years old (28 male), examined at the Mental Health Research Center. 1. hospital patients (11-16 years old, 18 persons) diagnoses F20.8, F21.4, 2) outpatient clients with psychological diagnostics (7-16 years old, 45 persons), most of them have psychiatric diagnoses and some of them came for a consultation independently of doctors (there were family and behavior problems). 3) children conceived with the help of assisted reproductive technologies (IVF) - participants in a program for studying cognitive and emotional-personal development (5-13 years old, 8 people). Control group of normal children (14 persons).MethodsBird’s Nest Drawing (D.Kaiser, 2003, Kuftyak, 2021) - clinical expert assessment of the drawing parameters (size, location, quality, compliance with instructions) and the emotional component (color, self-assessment of the drawing).Results Table 1.Frequency of different indicators of BND in compared groups of children. Groups N Central place High Quality of drawing Nest out of tree birds /eggs Different colors Safety of nest High Assessment by participants High positive emotional expression Assessment by expertsHospital patients18 (4 m)12410410**413**5**Outpatient clients45 (22 m)38131917321025**17Children IVF8 (2 m_72436**163Normal children14(6 m)1437412**413**11**** - significance of the differences (p≤0,05 by φ criterion).Based on the data obtained, it can be noted that the most different between groups turned out to be an indicator for using different colors, subject’s assessment his picture and emotional expression assessment of picture by experts. Other parameters are similar: please of drawing,DiscussionWe have obtained our own resalts about BND method in children with different type of ontogenesis. These data are similar to D.Kaiser and E.Kuftyak in opportunity of good diagnostic practice of BND method in children and adolescents with different type of ontogenesis in scientificConclusionsBND method is a good test for child clinical psychology as a projective one. Restrictions of this investigation - small groups, simple parameters for assessment. We plan to continue this work with more clinical (diagnosis, syndrome et cetera) and sex and age characteristics.Disclosure of InterestNone Declared

Feeling the Joy of Life in the Body

The article aims to present how Bioenergetic Analysis exercises can be applied in a playful way in Child Psychotherapy. There are specificities in handling body work with children, which are: a) the understanding that patients are still in the process of ego development; b) plasticity of armor formation in this phase; c) the intention to strengthen more adaptive defense systems. As an initial theoretical review, the pioneering initiatives of body psychotherapies on child clinical psychology are discussed and a proposal for the use of bioenergetic exercises is launched, following the assumptions for the energetic mobilization of the armor rings in children, in the bottom-up sense. Finally, this article justifies the importance of training psychotherapists for specific care with children as a way of promoting health and rescuing Reich’s intention to prevent neuroses.

Irina Ivanovna Mamaichuk. Her scientific contributions in child clinical psychology and psychology of developmental disorders

The article is dedicated to the memory of Professor of the Department of Medical Psychology and Psychophysiology of the Saint Petersburg State University, a leading specialist in the field of child clinical psychology Irina Ivanovna Mamaychuk. An attempt to analyze and generalize its great scientific and practical contribution to child clinical psychology is made. The stages of her professional path are singled out and described: (1) the study of the mechanisms and types of disturbed development in children with cerebral palsy; (2) study of the psychology of children with various disorders of the musculoskeletal system; (3) empirical substantiation of strategies and technologies for psychological assistance to children with various variants of disturbed development; (4) development of methodological and applied problems of child clinical psychology. The results and conclusions of Irina Ivanovna’s key studies are revealed, which have made a great contribution to understanding the causes and mechanisms of mental disorders in children and adolescents, and embodying the principles of ontogenetic and system-structural approaches developed at the Leningrad — St. Petersburg school of psychology. In particular, the study of the role of motility in perceptogenesis in various variants of dysontogenesis; specifics of violations of interfunctional relationships in children with motor and mental disorders; subspecies of mental retardation of cerebral-organic origin; psychological characteristics of children and adolescents with somatic pathology. Based on the analysis of scientific works, a list of the main problems and prospects of modern child clinical psychology is highlighted. An approach to psychological assistance and psychological correction of disorders in children and adolescents is described, taking into account the role of the family and the immediate environment. It is emphasized that the empirical work of Irina Ivanovna has become the “gold standard” in the study of the problems of children with mental dysontogenesis, and her theoretical generalizations and methodological developments are very important а for the further development of child clinical psychology and understanding the problem of mental development in general.

Future Directions in Child Maltreatment Research

ABSTRACT Child maltreatment (or child abuse and neglect) is a common area of interest in clinical child psychology. Research has examined the causes and consequences as well as the myriad risk factors and interventions that are effective in supporting child maltreatment victims and families. Child maltreatment is unique, however, from the study of disorders and even other kinds of adversity in that the scientific interest is shared across many disciplines including but not limited to, social welfare, medicine, law, and biology. As a result, the current state of the field although robust, is limited by a lack of shared definitions, common approaches to research and inclusion of widely differing sample types making the results often nonreproducible and of limited generalizability. The goal of the current paper is to provide clinical child and adolescent psychologists a guide to the complexity of child maltreatment research and to suggest possible solutions to navigate the challenges associated with research on child maltreatment. The manuscript provides suggestions that researchers could follow to ensure that mistakes from the past are not repeated and so that clinical psychology can contribute to the field with the most robust research for this significantly important public health issue.

‘Please Don’t Do This to Us’: TV Show Illustrates Importance of Families in SUD Care of Youth

‘Please Don’t Do This to Us’: TV Show Illustrates Importance of Families in SUD Care of Youth

Introduction to the Special Issue: Advancing Racial Justice in Clinical Child and Adolescent Psychology

ABSTRACT Relative to White youth, racially and ethnically marginalized youth in the U.S. are less likely to initiate treatment, stay in treatment, and receive adequate care. This special issue attends to racial injustice in clinical child and adolescent psychology. While numerous factors drive these racial disparities, this special issue focuses specifically on opportunities and responsibilities we have as mental health providers, teachers, mentors, researchers, and gatekeepers to make our field more racially just. In this introduction to the special issue, we review barriers and solutions across multiple contexts including structural, institutional, and practice-based. We also discuss challenges and opportunities to diversify our field and increase the representation of racially and ethnically marginalized practitioners and scholars in clinical child and adolescent psychology. We then briefly review the special issue articles and make final recommendations for how to move the field forward.

Dismantling Structural Racism in Child and Adolescent Psychology: A Call to Action to Transform Healthcare, Education, Child Welfare, and the Psychology Workforce to Effectively Promote BIPOC Youth Health and Development

ABSTRACT The field of clinical child and adolescent psychology is in critical need of transformation to effectively meet the mental health needs of marginalized and minoritized youth. As a field, we must acknowledge and grapple with the racist and colonial structures that support the scientific foundation, education and training of psychologists, and the service systems currently in place to support youth mental health in this country. We argue that to effectuate change toward a discipline that centers inclusivity, intersectionality, anti-racism, and social justice, there are four interrelated systems, structures, or processes that currently support racial inequity and would need to be thoroughly examined, dismantled, and re-imagined: (1) the experience of mental health problems and corresponding access to quality care; (2) the school-to-mental healthcare pathway; (3) the child welfare and carceral systems; and (4) the psychology workforce. A “call to action” is issued to address structural racism in these systems and recommendations are provided to guide clinicians, health care systems, educators, welfare and carceral systems, and those involved in training and retaining psychologists in the field in actions they can take to contribute to transformation. We assert that change will only occur when we individually and collectively take responsibility for the roles we have as agents for radical change within the personal and professional contexts in which we live and work. Only then will the field of clinical child and adolescent psychology be able to address the youth mental health crisis and effectively promote the health and well-being of all children.

Commentary: Goldilocks Revisited: Do We Need More Practice Competencies in Pediatric Psychology?

The publication of the Thompson et al. competencies framework for pediatric palliative care marks a third set of practice guidelines published. There is essential tension between specialist training in clinical child psychology (our "home" discipline) leading to further subspecialty training in pediatric psychology, the desired balance between the two, and impact on teaching, training, and patient care. A purpose of this invited commentary is to stimulate further awareness and subsequent discussion of the integration of more narrow practice skills in a growing and developing field, as the tendency toward greater specialization and siloed practice increases.

Diversifying Clinical Child and Adolescent Psychology: A Change Gonna Come

ABSTRACT Objectives Workforce diversity is an ongoing challenge in the field of clinical child and adolescent psychology. This article discusses individual, institutional, and nonspecific factors that contribute to a lack of diversity among clinical child and adolescent psychologists and offers suggestions to diversify and advance the field of clinical child and adolescent mental health. Method Seventeen professors, licensed psychologists, faculty, and clinicians in the field of clinical child and adolescent psychology answered questions about workforce diversity and who is permitted access to the field. No formal research was conducted. Results Individual factors included: racial discrimination and microaggressions, feelings of isolation, otherness, and not belonging. Institutional factors included: racism in academia, racial underrepresentation, ethnocentric and culturally-biased training, biased admissions selection processes, financial barriers, and lack of institutional commitment. Nonspecific factors were: values misalignment, hidden expectations, suboptimal mentoring, and limited research opportunities. Conclusions Drawing on recent scholarship and the Contexts, Actions, and Outcomes (CAO) Model, we recommend institutional changes in programs, policies, practices, resources, climate, partnerships, and inquiry to improve diversity in the field of clinical child and adolescent psychology.

Seven Tales from the Clinical Child Psychologist

The article presents seven archetypical fairy tales composed to reflect the inner dynamics of some of the most common clinical cases in the practice of child and adolescent psychiatry. These seven stories provide seven collective archetypal images of child suffering. When clothed in a story, the pain is more bearable to live with and to deal with even in the most difficult environment.

Introduction to the Special Issue. A Dozen Years of Demonstrating That Informant Discrepancies are More Than Measurement Error: Toward Guidelines for Integrating Data from Multi-Informant Assessments of Youth Mental Health

ABSTRACT Validly characterizing youth mental health phenomena requires evidence-based approaches to assessment. An evidence-based assessment cannot rely on a “gold standard” instrument but rather, batteries of instruments. These batteries include multiple modalities of instrumentation (e.g., surveys, interviews, performance-based tasks, physiological readings, structured clinical observations). Among these instruments are those that require soliciting reports from multiple informants: People who provide psychometrically sound data about youth mental health (e.g., parents, teachers, youth themselves). The January 2011 issue of the Journal of Clinical Child and Adolescent Psychology (JCCAP) included a Special Section devoted to the most common outcome of multi-informant assessments of youth mental health, namely discrepancies across informants’ reports (i.e., informant discrepancies). The 2011 JCCAP Special Section revolved around a critical question: Might informant discrepancies contain data relevant to understanding youth mental health (i.e., domain-relevant information)? This Special Issue is a “sequel” to the 2011 Special Section. Since 2011, an accumulating body of work indicates that informant discrepancies often contain domain-relevant information. Ultimately, we designed this Special Issue to lay the conceptual, methodological, and empirical foundations of guidelines for integrating multi-informant data when informant discrepancies contain domain-relevant information. In this introduction to the Special Issue, we briefly review the last 12 years of research and theory on informant discrepancies. This review highlights limitations inherent to the most commonly used strategies for integrating multi-informant data in youth mental health. We also describe contributions to the Special Issue, including articles about informant discrepancies that traverse multiple content areas (e.g., autism, implementation science, measurement validation, suicide).

What works in the psychological treatment of child conduct problems? An umbrella review of meta-analytic studies

Conduct problems (CP) constitute a major field for child clinical psychology, in terms of not only prevalence, but also developmental, social, and clinical relevance. This study carried out an umbrella review of meta-analyses on the efficacy of treatment/indicated prevention of child CP (mean age range up to 12 years). Following a registered protocol, several databases (i.e., Web of Science, PsycINFO, PROSPERO, and The Cochrane Library) were searched for meta-analyses published from January 2002 to March 2022. Nine meta-analytic publications met the required criteria, and the main characteristics and findings of the studies were systematically described. Weighted effect sizes (ESs) were calculated through RStudio program. Analyses of heterogeneity, publication bias, quality (AMSTAR-2), and credibility were also conducted. Results indicate that parent training has been the most studied intervention, with a weighted ES of d = -0.49 (95% CI -.67 to -.32). The reviewed studies identified several moderators for the efficacy of parent training, including individual (severity of CP), family (financial disadvantage), and intervention (delivery format) characteristics. Results from child-centered play therapy were also analyzed, d = -.34 (95% CI -.40 to -.28), but the reduced number of meta-analyses and the weakness detected by quality assessment suggest the need of cautiously considering the pooled effects. In general, evidence seems to be suggestive of the efficacy of treatment of CP, particularly for parent training. Nevertheless, efficacy seems to be moderate, heterogeneity indexes are high, and quality assessments of meta-analyses are often suboptimal. This study suggests several avenues to strengthen knowledge in this field

Evidence Base Update of Psychosocial Treatments for Adolescents with Disruptive Behavior

ABSTRACT Objective This article expands the review of psychosocial treatments for adolescents with disruptive behavior (DB), published previously by this journal. That earlier review focused on DB treatment studies published 1966–2014; the current paper updates the evidence base by incorporating DB treatment studies published 2014–2021. Method A literature search and screening process identified 63 new studies for inclusion in this updated review. The 63 new studies were combined with 86 studies from the prior review and evaluated using Journal of Clinical Child and Adolescent Psychology level of support criteria, which classify studies as well established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy based on the evidence. Results In total, 3 well-established, 7 probably efficacious, and 10 possibly efficacious treatments for adolescents with DB were identified. Further, 52 treatments were classified as experimental and 22 treatments were determined to have questionable efficacy. Conclusions There continues to be a large body of literature building the evidence base for treatments of adolescent DB. With a few exceptions, treatments falling into the top three evidence levels utilized more than one theoretical approach, enhancing each treatment’s ability to target DB from multiple angles. Key advances include broad representation of various demographic groups, countries of origin, treatment settings, and provider types in this body of research. Despite these advances, more research is needed to address key gaps in the field, including the need for more studies on treatments tailored to adolescents with DB who are not yet involved with the juvenile justice system.

Translating Liberation Psychology for Children and Adolescents from Historically Marginalized Racial and Ethnic Backgrounds: A Synthesis of the Literature.

Youth from historically marginalized racial and/or ethnic backgrounds often face discrimination, oppression, prejudice, racism, and segregation (DOPRS). These experiences, in turn, impact well-being and psychological functioning. Though the field of clinical child psychology is on the path to address DOPRS in clinical practice, there is sparce guidance for clinicians. Liberation psychology aims to address oppression through understanding history, acknowledging and naming DOPRS, community solidarity, and healing. Liberation psychology may be a vehicle for clinical child psychologists to address the impacts of DOPRS and empower children and adolescents to promote joy and healing within clinical settings. The literature is reviewed and synthesized to provide practical guidance so clinical child psychologists may translate liberation psychology into clinical practice. Several conceptual frameworks are presented that may help in implementing liberation psychology. Suggestions are provided for how clinical child psychologists may move beyond notions of cultural competence to a psychologist-activist model. Specific methods to create a foundation of liberation psychology in mental health treatment are discussed, such as utilizing empowerment, community, critical consciousness, and ethnic-racial socialization. Finally, specific practice considerations are provided for clinical child psychologists when applying liberation psychology in treatment.

Bayes factor benefits for clinical psychology: review of child and adolescent evidence base.

Background: Statistical methods are a cornerstone of research in clinical psychology and are used in clinical trials and reviews to determine the best available evidence. The most widespread statistical framework, frequentist statistics, is often misunderstood and misused. Even when properly applied, this framework can lead to erroneous conclusions and unnecessarily prolonged trials. The implications for clinical psychology are difficulties in interpreting best available evidence and unnecessarily costly and burdensome research. An alternative framework, Bayesian statistics, is proposed as a solution to several issues with current practice. Methods: Statistical tests of primary outcome measures were extracted from 272 studies, which were cited in 11 recent reviews in the Evidence-based updates series in the Journal of Clinical Child and Adolescent Psychology. The extracted tests were examined regarding relevant features and re-analyzed using Bayes Factors. Results: When statistical tests were significant, the majority (98%) of re-analyzed tests agreed with such claims. When statistical tests were nonsignificant almost half (43%) of re-analyzed tests disagreed with such claims. Equally important for clinical research, an average of 13% fewer participants per study would have been required if the studies had used Bayes Factors. Conclusions: Bayes Factors offer benefits for research in clinical psychology through intuitive interpretations, and less costly trials.