About this blog

This blog highlights techniques that can be used in therapy with children. These videos are designed by graduate-level social work students (MSW) at the University of North Dakota and are adapted from literature and workbooks. They should be utilized by licensed mental health professionals who are trained to work with children, and used within an appropriate therapeutic context. Practitioners who would like to replicate these exercises should be informed by practice wisdom, agency guidelines, and the evidence-based literature relevant to the intervention and population. This blog is maintained by Melanie Sage, Assistant Professor of Social Work.  Please contact me with any comments or questions about this blog.  Melanie.Sage@und.edu

Bubble Breaths

by Karen

Evidence based literature supports that relaxation breathing is beneficial for the mental and physical well-being of children and adults.  Relaxation breathing techniques are incorporated in several therapy modalities utilized with children who are experiencing problems such as anxiety, depression and issues with anger management.  The relaxation technique of deep breathing is used within treatments such as trauma focused cognitive-behavioral therapy and exposure therapy.  Deep breathing relaxation is also beneficial for pain management.

Bubble Breaths is a very simple, inexpensive and portable technique; but most of all, it’s fun.   While enjoying blowing bubbles and building rapport with the clinician, children can learn about their anatomy and how their bodies and mood can be affected by their breathing.

Resources:

Hall, T. M., Kaduson, H. G., & Schaefer, C. E. (2002). Fifteen effective play therapy techniques.

Professional Psychology: Research and Practice, 33(6), 515-522.

Judith A. Cohen & Anthony P. Mannarino (2008). Trauma-focused cognitive behavioural

therapy for children and parents. Child and Adolescent Mental Health, 13(4), 158-162.

Walco, G. A., Varni, J. W., & Ilowite, N. T. (1992). Cognitive-behavioral pain management in   

            children with juvenile rheumatoid arthritis.  Pediatrics, 89(6), 1075-1080.

CMH Assignment Click It!

by Vanessa

The intervention I chose to undertake with my cinema star nephew was Click! Emotions.  This intervention is designed to assist children with developing emotional intelligence.  A practitioner and a child come up with a list of emotions together.  Then, the practitioner asks the child to express the emotion using their face, and the practitioner captures the child’s facial expression on a camera.  The child then describes to the practitioner the number of times he or she experiences that emotion. 

Center on the Social & Emotional Foundations for Early Learning. (2009). Fostering emotional literacy in young children: labeling emotions. Retrieved from http://csefel.vanderbilt.edu/kits/wwbtk21.pdf

Lowenstein, L. (2011). Creative play therapy interventions for children and families. Retrieved from http://www.lianalowenstein.com/article_journals.pdf

Lowenstein, L. (2008). Assessment and Treatment Activities for Children, Adolescents, and Families: Practitioners Share Their Most Effective Techniques. Canada: Hignell Book Printing.

Pollack, S.D. & Kistler, D.J. (2002). Early experience is associated with the development 

of categorical representations for facial expressions of emotion. Proceedings of the National Academy of Sciences of the United States of America. 99(13). 9072–9076.

Fly By Design

by Val

The intervention that I spoke about in my video assignment was a technique used in Cognitive Behavioral Therapy (CBT).  This technique demonstrates how thoughts and feelings impact actions, and that by changing thoughts, it is possible to change behavior.  This therapeutic method can be used with children as well as adults, and in groups or working with individuals.

The Fly By Design activity is part of an evidence based curriculum developed by Dr.Harvey Milkman and Dr. Kenneth Wanberg (2005).  In this activity, participants make a paper airplane and fly it.  The instructor notes how far the plane flies.  After this, participants are asked to make a second airplane and are encouraged to modify it.  The planes represent thoughts and the distance represents actions taken.  Metaphorically, one’s thoughts control one’s actions, just as the plane design controls the distance that the plane travelled.  By changing the design (or thoughts), the participant is able to control the plane (or actions).

Reference:

Milkman, D. H., & Wanberg, D. K. (2005). Pathways to Self-Discovery and Change: Criminal Conduct and Substance Abuse Treatment for Adolescents. Thousand Oaks, CA: Sage Publications.

Lego Therapy - Social Skills Intervention for Children with High Functioning Autism & Aspergers Syndrome

by Kalea

Lego Therapy is a social skills intervention that motivates children to work together by dividing the tasks into different roles. One child is the Engineer (describing instructions), another child is the supplier (finds the correct pieces), and another child is the builder (puts the pieces together). This intervention showed a reduction in maladaptive behavior and improvement in their socialization and communication. 

References

Owens, G., Granader, Y., Humphrey, A., & Baron-Cohen, S. (2008). LEGO ® Therapy and the Social Use of Language Programme: an evaluation of two social skills interventions for children with high functioning autism and Asperger syndrome. Journal Of Autism & Developmental Disorders, 38(10), 1944-1957. doi:10.1007/s10803-008-0590-6

Magic Key Activity

by Miranda

Sometimes when children have experienced loss, they may not be able to express their feelings. The "Magic Key" can be used to help children become more open about their feelings of loss. This technique can be used to encourage more discussion about the child's feelings of loss. This drawing can help facilitate dialogue to help the healing process. 

References:

http://www.lianalowenstein.com/e-booklet.pdf  source: David A. Crenshaw Published in Assessment & Treatment Activities for Children, Adolescents, and Families Vol. 1

Crenshaw, D.A. & J.B. Mordock. (2005). Handbook of Play Therapy with Aggressive Children. New York: Jason Aronson.

Crenshaw, D.A. & J. Garbarino. (2007). “The Hidden Dimensions: Profound Sorrow and Buried Human Potential in Violent Youth.” Journal of Humanistic Psychology, 47, 160-174.

Crenshaw, D.A. & K.V. Hardy. (2005). “Understanding and Treating the Aggression of Traumatized Children in Out-of-Home Care.” In N. Boyd-Webb, ed., Working with Traumatized Youth in Child Welfare, pp. 171-195. New York: Guilford.

All Tangled Up: Identifying Feelings and Strategies to Cope With Anxiety

by Alli

This video demonstrates an intervention that can be done with children who suffer from anxiety. According to a survey conducted by the National Institute of Mental Health, 8 percent of teenagers ages 13-18 have an anxiety disorder with the symptoms emerging around age 6. All children experience some anxiety. Treatment is only necessary if the anxiety becomes severe enough to interfere with the child’s normal activities.  Interventions can help when children are feeling overwhelmed and make their anxieties more manageable.

This intervention is called “All Tangled Up” and the idea of the intervention is to help the child externalize their worry and to show them that using one of these strategies can help calm themselves down and eliminating their anxious feelings. This intervention could be done by a social worker or the child’s parents.

References

Cavett, A. M. (2009). Playful trauma focused cognitive behavioral therapy w/maltreated children and adolescents. Play Therapy, 20-22. Retrieved from http://www.a4pt.org/ download.cfm ?ID=28212

Children’s mental health awareness: Anxiety disorders in children and adolescents fact sheet.      National Institute of Mental Health. Retrieved from http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-adolescents/anxiety-disorders-in-children-and-adolescents.pdf

Facts for families: The anxious child. American Academy of Child & Adolescents Pyschiatry. Retrieved from http://aacap.org/cs/root/facts_for_families/the_anxious_child

Lowenstein, L. (2011). Favorite Therapeutic Activities for Children, Adolscents, and Families:      Practitioners Share Their Most Effective Interventions. Toronto, Ontario: Champion Press. Retrieved from  http://www.lianalowenstein.com/e-booklet.pdf

It's My Life CD

by Kelly

Summary:  When working with adolescent clients it can sometimes be a challenge for that client to feel comfortable opening up about their feelings and emotions.  One simple intervention that can be utilized is creating an It's My Life CD.  This activity helps create a starting point for conversation and can be a tool for future discussions. 

The client will create their own CD (Title, Cover Design, Song List, etc) and can be very vague related to any part of their life, or more specific relating to treatment issues.

References:

Assessment and Treatment Activities for Children, Adolescents, and   Families: Practitioners Share Their Most Effective Techniques, ed. L. Lowenstein. Toronto: Champion Press. 

Smith, J. (2008). It’s My Life CD. In Lowenstein, L. Creative Play Therapy Interventions for Children and Families.  http://hstrial-laparicio1.homestead.com/Liana_Lowenstein_Article.pdf

You're a Star

by Lacy

The video briefly explains a simple activity for a therapist to use with a child to increase the child's awareness of people that love, care about, and help them. The activity is called "You're A Star" and can also be used as a method of coping with future emotional issues that the child may encounter.

This is an activity that is described in more detail in Liana Lowenstein's "Favorite Therapeutic Activities for Children, Adolescents, and Families: Practitioners Share Their Most Effective Interventions" which can be accessed at:

http://www.lianalowenstein.com/e-booklet.pdf

Robinson, N.S. (1995). Evaluating the nature of perceived support and its relation to perceived self-worth in adolescents. Journal of Research in Adolescence, 5, (2), 253-280.

Colored Candy Go Around

by Allison

It can be challenging to engage children in initial therapy sessions. Colored Candy Go Around is a creative way to gather information about the client and their family and begin to open up communication as well as identify goals for therapy. This is an activity can also be used to engage children during initial group sessions. Questions can be easily modified to fit each family or group situation.

Arkell,  Katherine (2010). Published in Assessment and Treatment Activities for Children, Adolescents and Families, Vol 2. Edited by Lowenstein, L. http://www.lianalowenstein.com/e-booklet.pdf

Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of consulting and clinical psychology, 65(3), 453-463.

Butterflies in My Stomach

by Andria

Play therapy has been proven to be an effective intervention when working with children facing stressors in their life (Cochran, Cochran, Fuss, and Nordling, 2010).  Play therapy creates a non-threatening environment where a child is able to engage in self-expression (Cochran et al., 2010).  Often times, when children present themselves for therapy they are initially unwilling to share directly their thoughts and feelings (Lowenstein, 2011).  However, the use of play therapy can break down this reluctance and create an outlet for the child to express his or her feelings and emotions (Lowenstein, 2010).  Therapists who effectively use play therapy can have very productive sessions with children.  One play therapy intervention that is particularly effective is an activity named “Butterflies in My Stomach” (Lowenstein, 2011).

References

Cochran, J. L., Cochran, N. H., Fuss, A., & Nordling, W. J.  (2010).  Outcomes and stages of child-centered play therapy for a child with highly disruptive behavior driven by self-concept issues.  Journal of humanistic counseling, education and development, 49(2), 231-246.

Lowenstein, L.  (2011). Creative play therapy interventions for children and families.  Retrieved from http://www.lianalowenstein.com/article_journals.pdf

First Session Family Card Game

 by Breanna

                

Therapeutic techniques that engage all family members can be difficult to find and use in family therapy sessions. The First Session Family Card Game is designed to engage the entire family in the therapeutic process and in communicating with each other.

               

This game allows for questions that can be used to understand and observe the dynamics of the family present in therapy which can later be helpful in treatment planning. The questions are created with the purpose of family joining in mind. They also are helpful in allowing families to realize what their goals for treatment consist of. The First Session Family Card Game also includes opportunities for positive interactions between family members such as hugs and small treats further help to engage family members in the therapeutic process.

The First Session Family Card Game can be modified to fit other situations as well. For instance, the questions can be adapted so that the game could be used in a family’s last session of therapy. These questions would focus on the gains the family achieved through the therapeutic process, as well as, what they learned from their sessions and what the therapist learned from them. The game and questions can also be modified to fit specific target populations such as children for children who are experiencing loss or grief.

Chasin, R., & White, T. B. (1989). The child in family therapy: Guidelines for active engagement across the age span.

Gil, E. (1994). Play in family therapy. The Guilford Press.

Lowenstein, Liana (2006). Creative Interventions for Bereaved Children. Toronto, ON: Champions Press.

Lowenstein, Liana & Sprunk, Trudy Post (2010). Creative Family Therapy Techniques: Play and Art-Based Activities to Assess and Treat Families.

Lowenstein, Liana (Ed.) (2010). Creative Family Therapy Techniques: Play, Art and Expressive Therapies to engage children in family sessions. Toronto, ON: Champion Press. 

Using Visual Aid Interventions with ASD students

Social dysfunction or "awkwardness" is often associated with Autism Spectrum Disorders.  Early intervention has been found to be effective with children diagnosed with ASD, although it is not a curable disorder.  Early interventions can include a variety of strategies, but Visual Interventions, such as Social Stories, Social Scripts, Power Card Strategy and 5 Point scales have proven to be most effective in home, school and community setting with ASD children.  Implementation of these skills increase self and social awareness and a competence in social situations.  

References:

Buron, K. D. & Mitzi, C. (2003).  The Incredible 5-Point Scale.  Shawnee Mission, Kansas: Autism Asperger Publishing Co.

Campbell, A. & Tincani, M.  (2011).  The Power Card Strategy: Strength-Based Intervention to Increase Direction Following of Children With Autism Spectrum Disorder.  Journal of Positive Behavior Interventions, 13(4), 240-249.

Gagnon, E. (2001).  Social Stories, Social Scripts and the Power Card Strategy.  Retrieved from: http://www.education.com/print/social-scripts-stories-asperger-ASD/

Feelings Hide and Seek

by Robyn

Feelings Hide and Seek – provides a safe environment for clients to verbalize and discuss their feelings; increase open communication regarding various emotional states; and strengthens family relationship through direct communication.

References

Hunter, E., Fainsilber, K., Shortt, J., Davis, B., Leve, C., Allen, N., & Sheeber, L. (2011). How do I feel about feelings? Emotion socialization in families of depressed and healthy adolescents. J Youth Adolescence, 40, 428-     441. Retrieved from http://web.ebscohost.com.ezproxy.library.und.edu

Kenney-Noziska, S. (2008). Feelings hide and seek. Techniques. Retrieved from http://lianalowenstien.com

Short, Stop, Close for ODD

This Behavior Modification strategy enables the child to know the expectations for his/her behavior and helps you to maintain consistent positive/negative reinforcement.

Short, Soft and Close: Delivering Effective Reprimands

There are three key parts of an effective reprimand; short, soft, and close.  When used correctly, reprimands can serve to alter behavior without encountering an angry confrontation.

•        Short—The reprimand should consist of the child’s name and one or two additional

         words of direction such as, “Mike, stop yelling.”

•        Soft—The reprimand should be audible only to the child.  This serves to keep the

         adults’ emotions in check and helps to lower the dynamic of the confrontation.

•        Close—The reprimand should be delivered from within a few feet of the child,

         preferably within reach of the child.  A soft touch on the arm or shoulder will prove  

         to make the reprimand much more effective than will shouting it from the next  

         room.  The child will have your full attention and will be more likely to stop the

         targeted behavior.

Finally, after the reprimand is delivered and the targeted behavior has stopped, try to catch the child doing something good within the next few minutes.  Praise him/her for positive behavior in order to reinforce desired, appropriate behavior.

Working with children produces greater effects when we build on the positives and not the negatives.  Children are eager to please, yet adults often only point out when a child has misbehaved.  Children with ODD are used to hearing about all of their negative characteristics.   By creating as many opportunities for positive reinforcement as possible, we set up ways for the child to experience the positive feelings associated with cooperation and praise.  As a general rule, each day children should hear more positive than negative comments about themselves.

https://www.msu.edu/course/cep/888/Aggression/Aggression1.htm

http://www.tourettesyndrome.net/wp-content/uploads/Hone.pdf

Arnold, D. S., O'Leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The Parenting Scale: A measure of dysfunctional parenting in discipline situations.Psychological assessment, 5(2), 137.

O'Leary, D. K., Kaufman, K. F., Kass, R. E., & Drabbman, R. S. (1970). The effects of loud and soft reprimands on the behavior of disruptive students. Exceptional Children, 2, 145-155.

Using a Problem Solving Hand

The problem solving hand is a simple technique that can be used by children to use in conflict situations. Problem solving techniques are incorporated and supported in many evidence based practices when working with children.  In the schools it addresses academic and behavioral problems by utilizing problem solving.  Schools also incorporate problem solving interventions within their social emotional curricula.   An example where problem solving is core to its evidence based intervention is the RTI (Response to Intervention) curriculum.  Click on the link below demonstrating the use of the problem solving hand.

  References

Joseph, G. E., & Strain, P. S. (2003). Comprehensive Evidence-Based Social—Emotional Curricula for Young Children An Analysis of Efficacious Adoption Potential. Topics in Early Childhood Special Education, 23(2), 62-73.

Knoff, H. M. (2009).  Implementing Response-to-Intervention at the School, District, and State Levels. Little Rock, AR: Project ACHIEVE Press.

A brief summary of how to administer the SASSI-A2.

by Todd

The SASSI-A2 was developed by Dr. Glenn A. Miller.  The original adult version of the SASSI was published in 1988 and quickly became one of the most widely used substance abuse screening instruments.  The SASSI-A2 was published in 1994 and became just as popular for screening clients twelve to eighteen years of age.  The SASSI-A2 boasts a 94% instrument accuracy.  However, it is not intended to prove a substance disorder diagnosis, but to be single component of a comprehensive screening process.  The self-report questionnaire takes approximately fifteen minutes to complete, and can be administered by any human service worker trained in proper administration procedures.

Coll, K.M., Juhnke, G.A., Thobro, P., Haas, R. (2003). A preliminary study using the substance    abuse subtle screening inventory: Adolescent form as an outcome measure with adolescent offenders. Journal of Addictions & Offender Counseling, 24, 11-22.

Feldstein, S.W., Miller, W.R. (2007). Does subtle screening for substance abuse work? A review of the substance abuse subtle screening inventory (SASSI). Addiction, 102, 41-50.

Juhnke, G.A., Kelly, V.A. (2005). Addictions counseling with adolescents. In Kelly, Virginia A. (Ed); Juhnke, Gerald A. (Ed). (2005). Critical incidents in addictions counseling. (p 107-112). Alexandria, VA: American Counseling Association.

Lazowski, L.E., Miller, G.A. (2007)  SASSI: A reply to the critique of Feldstein & Miller.. Addiction, 102, 1001-1002.

Miller, F.G., Lazowski, L.E. (2005). Substance abuse subtle screening inventory for adolescents: Second version. In Grisso, Thomas (Ed); Vincent, Gina (Ed); Seagrave, Daniel (Ed).

Miller, W.R., Feldstein, S.W. (2007). SASSI: A response to Lazowski & Miller (2007). Addiction, 102, 1002-1004.

Sweet, R.I. Saules, Karen K. (2003). Validity of the substance abuse subtle screening inventory-  adolescent version (SASSI-A). Journal of Substance Abuse Treatment, 24, 331-340.

Intervention to begin discussion for CBT with adolescents

This in an intervention I use with my clients to help them open up (a lot of them are anxious and won't talk), particularly in groups to facilitate discussion. Because about 99% of my clients have some type of anxiety disorder, we normally use CBT to treat it, and this intervention allows them to feel comfortable opening up and talking about their feelings. It also helps gather information about the client that they may not have normally told you (without the game).

References:

Masia-Warner C, Klein RG, Dent HC, et al. (2005). School-based intervention for adolescents with social anxiety disorder: results of a controlled study. J Abnorm Child Psychology, 33(6):707-722.

Verhulst F. (2001) Community and epidemiological aspects of anxiety disorders in children. In: Silverman WK, Treffers PDA, eds. Anxiety Disorders in Children and Adolescents: Research, Assessment and Intervention. Cambridge, MA: Cambridge University Press; 273-292.

Anorexia Nervosa and the Maudsley Approach to re-feeding your starving child

The Maudsley Approach is applied to adolescents 18 and under who are living with their families.  It is designed to intervene aggressively in the first stages of illness and is a short term model as short as 20 sessions or six months in duration.

The Maudsley Approach builds on evidence that family therapy approaches are superior to individual therapy approaches with younger patients.  This approach involves the family from the outset of treatment and relies heavily on patient involvement in the re-feeding of the child with an eating disorder.

Parents are empowered to help their adolescent recover from this life threatening illness, rather than having them watch passively from the sidelines.  This treatment involves compassion, yet persistent and firm expectations that your adolescent eat an amount of food that can reverse the state of starvation his or her body is in and help them to gain weight.

In the first stage of treatment, the therapist plays an active and key role in helping parents separate their child from the child’s illness.  Parents are given the task of re-feeding and removing the illness from the child.   

Re-feeding the patient begins as the patient usually has just been hospitalized and is medically compromised.  This phase focuses exclusively on the re-feeding of the patient and other psychological issues are not explored.  Parents are encouraged to set their own goals regarding their child’s weight and health, with the emphasis on physical appearance and menstruation in girls as an indicator rather than precise weight goals.

Attia, E., & Walsh, B. T. (2009). Behavioral management for anorexia nervosa.New England Journal of Medicine, 360(5), 500-506.

Couturier, J., Isserlin, L., & Lock, J. (2010). Family-based treatment for adolescents with anorexia nervosa: a dissemination study. Eating disorders,18(3), 199-209.

Wallis, A., Rhodes, P., Kohn, M., & Madden, S. (2007). Five-years of family based treatment for anorexia nervosa: The Maudsley Model at the Children's Hospital at Westmead. International journal of adolescent medicine and health,19(3), 277-284.

Stop, Watch, and Copy: A modeling technique

Stop, Watch, and Copy is a modeling technique that can be used with any child, but is particularly useful with children who have a diagnosis of autism or asperger’s syndrome.  Children with autism or asperger’s often tend to miss social cues which result in them not being able to exhibit appropriate behaviors in social situations.  Not being able to act appropriately in social situations creates added stress in the life of a child who already is dealing with the symptoms related to the autism or Aspergers syndrome.

To implement Stop, Watch, and Copy, you can use visual cue cards (like the one’s below) or verbally talk with the child about stopping when they enter a social situation, watching what is going on around them, and then copy the behaviors (positive) that they see other people doing.  It is important that the child can identify the difference between positive and negative behaviors so that they do not copy the negative behaviors that may be occurring. 

Bellini, S., & Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Children, 73(3), 264-287.

Charlop-Christy, M. H., Le, L., & Freeman, K. A. (2000). A comparison of video modeling with in vivo modeling for teaching children with autism. Journal of autism and developmental disorders, 30(6), 537-552.

Nikopoulos, C. K., & Keenan, M. (2004). Effects of video modeling on social initiations by children with autism. Journal of Applied Behavior Analysis, 37(1), 93-96.

Shipley-Benamou, R., Lutzker, J. R., & Taubman, M. (2002). Teaching daily living skills to children with autism through instructional video modeling. Journal of Positive Behavior Interventions, 4(3), 166-177.

The Stop Light Model: Cognitive Behavioral Therapy

by Jessica

Depression will affect between 3-8 percent of the population by mid-adolescence.  Research supports CBT to be used with significant success with mild to moderate depression.  The National Institute of Mental Health has found that when treating major depression in adolescents with medication, CBT not only aids in a faster recovery, but also provides additional safeguards for those vulnerable to suicide.

CBT gives the adolescent a way of better understanding how their negative thoughts affect how they respond to different situations, and in turn, how they feel.  With the use of specific tools to change negative thoughts, youth are able to work their way out of depression.  One of the goals of CBT is cognitive restructuring which asks the client to identify his or her negative, unrealistic or unhelpful thoughts, evaluate evidence for and against these, and generate a more positive, realistic or helpful thought based on this evidence”

 This video gives one example of a CBT tool that can be used to aid in cognitive restructuring.

Cognitive Behavior Therapy and Medication. (n.d.). Retrieved July 15, 2012, from Worry Wise Kids:www.worrywisekids.org/treatments/med_thrpy.html

Friedburg, R. D. (2009). Self-Instructional and Cognitive Restructuring Methods. In Cognitive Behavioral Therapy Techniques for Children and Adolescents (pp. 121-128). New York: The Guilford Press .

Gledhill, J., & Hodes, M. (2011). The Treatment of Adolescents with Depression. Current Medical Literature - Psychiatry 22(1) , 1-7.

Labbe, C. (2007). Depressed Adolescents Respond Best to Combination Treatment. Retrieved July 15, 2012, from National Institutie of Mental Health: www.nih.gov/news/pr/oct2007/nimh-01.htm

Rapport Building Developmental Assessment

The video demonstrates the use of drawing "Face Circles" and "Family Circles" in order to conduct a developmental assessment of a child while also building rapport.  Completing a developmental assessment allows an interviewer to later tailor questions to a particular child's competence and overall functioning, including motor skills, language, and cognitive skills.  This will aide in collecting the most reliable information from the child during later interviews.

Drawings can assist in building rapport with a child because drawing, typically, is an engaging activity and is an appropriate tool of communication with all ages of children.

The video also demonstrates the skill of inviting narrative from the child while both are engaged in drawing.  This allows the child to practice answering in narrative form while discussing neutral or positive topics.

References:

Anderson, J., Ellefson, J., Lashley, J., Lukas Miller,  A., Olinger, S., Russell, A., Stauffer, J., & Weigman, J. (2010). The CornerHouse Forensic Interview Protocol: RATAC®. The Thomas M. Cooley Journal of Practical and Clinical Law, 12(2). 193-331.  Available at: www.ncjrs.gov/App/Publications/abstract.aspx?ID=258656

Hiltz, B. & Bauer, G. (2003). Drawings in forensic interviews of children. American Prosecutor's Research Institute, 16(3). Available at: www.ndaa.org/pdf/update_vol16_no3.pdf

Using an ADHD rating scale

          As many as 3-9% of school aged children in the United States suffer from ADHD.  The use of an ADHD rating scale can help practitioners with the diagnosis for ADHD.  An ADHD rating scale can be filled out by any two different people who see the child on a regular basis in two different settings.  Most popular choices are parents and teachers.  There are a number of ADHD rating scales available; this is an example of one of them.

by Kristin Petersen

References:

Supporting the use of an ADHD rating scale are the following resources:

http://www.guideline.gov/content.aspx?id=33564&search=adhd+rating+scale

http://www.chadd.org/Content/CHADD/Understanding/Evaluation/EvaluationandAssessmentTools/default.htm

http://www.aafp.org/afp/2001/0901/p817.html

Anxiety Body Signals in Children

Children seen in a mental health setting have an estimated occurrence of anxiety between 12-20% (Carter, 2010).  Often feelings of anxiety and its concurrent physical discomfort  can cause feelings of fear and confusion which may cause children to have avoidant or distracting responses. 

The therapeutic treatment in relation to anxiety in children and having primary efficacy is Cognitive Behavioral Therapy (CBT).  In the preliminary phase of CBT treatment, psycho-education, the clinician can assist the child to identify their body’s signals when anxious.  By being able to focus on their body’s responses to anxiety (e.g., which signals are the strongest and most noticeable) they become more self-aware and able to promptly use calming or relaxation techniques. 

The below-referenced articles provide more research regarding up-to-date information about anxiety and  children, Cognitive Behavioral Therapy (CBT) approaches, intervention techniques and applicable worksheets. 

Click here for a worksheet for discussing anxiety body signals with children.  This worksheet appears in the book called Anxiety by Stallard, referenced below.

by Tara Shirek

References:

1.  Carter, S. Managing anxiety in children. (2010). Retrieved on April 14, 2012 from: http://www.lianalowenstein.com/articles.html.
2. Jongsma, A. E., Peterson, L. M., & McInnis, W. P. (2006). Eating disorder. In T.J.Bruce (Ed.), The adolescent psychotherapy treatment planner (4th ed., pp. 109-117). Hoboken, New Jersey: John Wiley & Sons.
3. Beidas, R.S. , Benjamin, C.L., Edmunds, J.M., Kendall, P.C., Puleo, C.M. (2010) Flexible Applications of the coping cat program for anxious youth. Cognitive Behavioral Practice 17(2): 142–153. doi:10.1016/j.cbpra.2009.11.002.
4. Stallard, P. (2009). Anxiety: Cognitive behavior therapy with children and young people.  Routledge, London.

Reducing Pica Behavior

   Studies have found that some children may engage in Pica behaviors, because they receive an oral stimulation from the texture of the inedible item.  The use of a Pica Box follows this theory and attempts to replace inedible items with items that are edible, but have the same texture as the inedible item.  The video will demonstrate how to use a Pica Box to help reduce Pica behavior in children.  It will give examples of edible items that can be exchanged for inedible items and it will also give examples of verbal cues that can be used when intervening with the Pica behavior.

The linked articles below provide more information and research on the concept of exchanging edible items for inedible items to help reduce Pica behavior.

by Cassandra Dale

1. The Use of a Pica Box in Reducing Pica Behavior in a Student with Autism
2. Reducing Pica Behavior by Teaching Children to Exchange Inedible items for Edibles