ABSTRACT
The main aim of this article is to describe the development of a new day treatment program for older children (8-11 years) with behavioural problems. The article outlines the content of the program and it also sets out the rationale behind the development of the new day service. The day program involves therapeutic and educational input and children attend the program two days a week for one academic term (10-13 weeks). Therapeutic input focuses on improving functioning in relation to a number of developmental processes that are known to be linked to the development of problem behaviour. These include improving emotional competence, dealing with peer relationship problems and interpersonal difficulties, and changing negative patterns of thinking about the self and others. The GoZone team also attempt to work collaboratively with the children's families and schools. A preliminary investigation of the effectiveness of the program is also reported. Parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ) pre- and posttreatment. Findings showed that over the course of treatment parents reported a significant decrease in overall levels of emotional and behavioural problems and also reported a significant decrease in levels of emotional symptoms and peer problems. However, no significant changes in emotional and behavioural functioning were reported by teachers at school over the course of treatment. Potential ways of boosting the magnitude of positive change achieved by the new day treatment program are discussed.
Subject(s)
Ambulatory Care , Child Behavior Disorders/therapy , Program Development , Affect , Child , Family/psychology , Female , Humans , Interpersonal Relations , Male , Peer Group , Surveys and Questionnaires , Treatment OutcomeABSTRACT
CONTEXT: Approximately 3% of the US population receives psychotherapy each year from psychiatrists, psychologists, or social workers. A modest number of psychotherapies are evidence-based therapy (EBT) in that they have been defined in manuals and found efficacious in at least 2 controlled clinical trials with random assignment that include a control condition of psychotherapy, placebo, pill, or other treatment and samples of sufficient power with well-characterized patients. Few practitioners use EBT. OBJECTIVE: To determine the amount of EBT taught in accredited training programs in psychiatry, psychology (PhD and PsyD), and social work and to note whether the training was elective or required and presented as a didactic (coursework) or clinical supervision. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional survey of a probability sample of all accredited training programs in psychiatry, psychology, and social work in the United States. Responders included training directors (or their designates) from 221 programs (73 in psychiatry, 63 in PhD clinical psychology, 21 in PsyD psychology, and 64 in master's-level social work). The overall response rate was 73.7%. Main Outcome Measure Requiring both a didactic and clinical supervision in an EBT. RESULTS: Although programs offered electives in EBT and non-EBT, few required both a didactic and clinical supervision in EBT, and most required training was non-EBT. Psychiatry required coursework and clinical supervision in the largest percentage of EBT (28.1%). Cognitive behavioral therapy was the EBT most frequently offered and required as a didactic in all 3 disciplines. More than 90% of the psychiatry training programs were complying with the new cognitive behavior therapy requirement. The 2 disciplines with the largest number of students and emphasis on clinical training-professional clinical psychology (PsyD) and social work-had the largest percentage of programs (67.3% and 61.7%, respectively) not requiring a didactic and clinical supervision in any EBT. CONCLUSION: There is a considerable gap between research evidence for psychotherapy and clinical training. Until the training programs in the major disciplines providing psychotherapy increase training in EBT, the gap between research evidence and clinical practice will remain.