Child and adolescent psychiatric clinics of North America
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Child Adolesc Psychiatr Clin N Am · Apr 2004
Review Case ReportsContemporary issues in the psychiatric residential treatment of disturbed adolescents.
This article reviewed the current challenges to the provision of residential treatment for disturbed adolescents, described the Menninger Clinic's model for short-term residential treatment that has been developed over the last 10 years to meet these challenges, and provided a case example to exemplify the role of such newly developed concepts as "mentalizing" in the provision of psychiatric treatment. Stimulated by the alarm of the costs of health care in general, residential treatment is highly scrutinized by private third-party payers and public funding sources. ⋯ The essential ingredients needed to ensure that treatment is effective and that treatment gains are sustained were described. Finally, a case was used to illustrate current views of understanding some of the processes that engage patients and stimulate changes in several variables.
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This article explores the human ecology of child poverty. It focuses on the psychologic meanings of poverty in American society. Issues of shame linked to economic inequality rather than limited resource possession are at the core of clinical issues associated with poverty.
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Child Adolesc Psychiatr Clin N Am · Jul 2003
ReviewPsychological aspects of traumatic injury in children and adolescents.
Each year millions of children are exposed to some form of extreme traumatic stressor. These traumatic events include natural disasters (e.g., tornadoes, floods, hurricanes), motor vehicle accidents, life-threatening illnesses and associated painful medical procedures (e.g., severe burns, cancer, limb amputations), physical abuse, sexual assault, witnessing domestic or community violence, kidnapping, and sudden death of a parent. During times of war, violent and nonviolent trauma (e.g., lack of fuel and food) may have terrible effects on children's adjustment. ⋯ This finding has produced a fundamental change in the framework for understanding and helping children at high risk or already in trouble. This shift is evident in a changing conceptualization of the goals of prevention and intervention that currently address competence and problems. Strategies for fostering resilience described in this article should be tested in future controlled psychotherapy trials to verify their efficacy on children's protective factors.
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Child Adolesc Psychiatr Clin N Am · Apr 2003
ReviewPharmacologic treatment approaches for children and adolescents with posttraumatic stress disorder.
Posttraumatic stress disorder is a common cause of morbidity in children and adolescents. The disorder in youth is similar to that in adults, with high rates of psychiatric comorbidity. Children seem to be more sensitive to the effects of trauma, and early life trauma exposure may induce a complex sequence of events that leads to the development of multiple psychiatric disorders in adulthood. ⋯ Despite the lack of well-designed, randomized, controlled trials that support efficacy, medication can be used in a rational and safe manner. Reduction in even one disabling symptom, such as insomnia or hyperarousal, may have a positive ripple effect on a child's overall functioning. Pharmacotherapy is typically used as one component of a more comprehensive multiple modality treatment package, including psychoeducation of the parent and child, focused exposure-based psychotherapy with adjunctive family therapy when indicated, and long-term booster interventions that use an admixture of psychodynamic, cognitive-behavioral, and pharmacologic interventions.
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Child Adolesc Psychiatr Clin N Am · Apr 2006
ReviewTreatment and postrelease rehabilitative programs for juvenile offenders.
The juvenile justice system has become notably aware of the increasing use of postrelease rehabilitative treatment interventions for offenders. In many instances, juvenile justice systems are required to ensure that core treatment needs of youth are met. ⋯ It reviews cognitive-behavioral theoretical models and core postrelease treatment strategies. It presents a review of youth who have specialized needs in light of postrelease practices, describes several model postrelease rehabilitation programs, and reviews outcomes of these programs.