Interventions
Lecture 1 The what, why and which
Children in need
- 15% need additional care and help
- 5% of these children needs specialized forms of treatment care (tweede/derdelijns
zorg)
Jongeren met jeugdhulp
Jongeren met jeugdzorg
Wanneer we kijken naar het verschil tussen 2017 en 2018
zien we weinig verschil in de mate van jeugdzorg in
Nederland. De wijk en de buurtteams zijn wel veranderd,
omdat daar meer geld in werd gestoken.
Jeugdhulp naar demografische kenmerken van de jongere
1
,Expected % of youth with severe problems
Observerd % of youth with severe problems
Angstproblemen zijn het meest prevalent, maar zijn niet hinderlijk voor de omgeving. Dit
terwijl gedragsproblemen zichtbaar zijn en hinderlijk voor de omgeving.
Why is it important to intervene (early on)?
- Mental health disorders among youths 10 to 24 years of age the leading cause of
disease burden
o Interferes with social and academic functioning
- Long-term effects on adult functioning
Definitions and prevalence of young adult outcomes
In deze tabel vind je de indicatoren die van invloed zijn op de latere uitkomsten van een
persoon.
2
,Associations between adult outcomes and childhood diagnostic groups
The likelihood of having either any outcome or more than 1 outcome based on childhood
psychiatric status. Error bars indicate standard error.
Prevalence and unadjusted associations between
childhood diagnostic groups
TRAILS study
- 14 out of 19 adult outcomes were predicted by childhood and current psychiatric
disorders
- Effect of disorder depens on outcome
o Ext > health behaviors (e.g. substance abuse)
o Int > psychological functioning (e.g. loneliness, suicidality, mental health care)
- Effect size: OR’s approx.. 2
o With each disorder likelihood of negative adult outcome is doubled
Intervention spectrum
Promotion
- Target group: general population, all kids and adults
- Goal: strengthening positive factors and reducing the risk at later problems
Prevention
- Universal prevention
o (Part of) general population
- Selective prevention
o High risk groups
- Indicated prevention
o Group with elevated/subclinical levels
The selective and indicated prevention have the best effects.
Treatment
- Case identification
3
, o Based on diagnostics
- Treatment
o ‘… an array of nonmedical interventions to relieve psychological distress,
reduce maladaptive behavior, or enhance adaptive functioning through
counseling, structured or unstructured interactions, training programs, or
specific environmental changes’
How are we doing?
- ‘… our results provide little evidence for the effectiveness of traditional child
psychotherapy …’
- ‘… results provide support for the movement to revise traditional therapy techniques
or to replace and supplement them with techniques whose efficacy had been more
clearly demonstrated.’
What are interventions?
Intervention criteria:
- Goals
- Target group
- Program description
What are interventions?
- Psychotherapy with children
o Children are referred by others
o Adults provide information
o Dependent on their environment
Interventions
- … are goal directed
- … improve psychological, social and/or cognitive development of the child and/or
reduce risks and developmental problems
- … are not only directed at the wellbeing of the child
Intervention criteria
- Goal
- Target group
- Program description
o Methodology
o Support
o Executing demands
Example
Parents can’t handle the parenting of their son with behaviour problems.
What would be a good result?
- The clients are satisfied with the therapy and therapist
- The son doesn’t have behaviour problems anymore
- The parents improve discipline practices and communication skills with son
4
Lecture 1 The what, why and which
Children in need
- 15% need additional care and help
- 5% of these children needs specialized forms of treatment care (tweede/derdelijns
zorg)
Jongeren met jeugdhulp
Jongeren met jeugdzorg
Wanneer we kijken naar het verschil tussen 2017 en 2018
zien we weinig verschil in de mate van jeugdzorg in
Nederland. De wijk en de buurtteams zijn wel veranderd,
omdat daar meer geld in werd gestoken.
Jeugdhulp naar demografische kenmerken van de jongere
1
,Expected % of youth with severe problems
Observerd % of youth with severe problems
Angstproblemen zijn het meest prevalent, maar zijn niet hinderlijk voor de omgeving. Dit
terwijl gedragsproblemen zichtbaar zijn en hinderlijk voor de omgeving.
Why is it important to intervene (early on)?
- Mental health disorders among youths 10 to 24 years of age the leading cause of
disease burden
o Interferes with social and academic functioning
- Long-term effects on adult functioning
Definitions and prevalence of young adult outcomes
In deze tabel vind je de indicatoren die van invloed zijn op de latere uitkomsten van een
persoon.
2
,Associations between adult outcomes and childhood diagnostic groups
The likelihood of having either any outcome or more than 1 outcome based on childhood
psychiatric status. Error bars indicate standard error.
Prevalence and unadjusted associations between
childhood diagnostic groups
TRAILS study
- 14 out of 19 adult outcomes were predicted by childhood and current psychiatric
disorders
- Effect of disorder depens on outcome
o Ext > health behaviors (e.g. substance abuse)
o Int > psychological functioning (e.g. loneliness, suicidality, mental health care)
- Effect size: OR’s approx.. 2
o With each disorder likelihood of negative adult outcome is doubled
Intervention spectrum
Promotion
- Target group: general population, all kids and adults
- Goal: strengthening positive factors and reducing the risk at later problems
Prevention
- Universal prevention
o (Part of) general population
- Selective prevention
o High risk groups
- Indicated prevention
o Group with elevated/subclinical levels
The selective and indicated prevention have the best effects.
Treatment
- Case identification
3
, o Based on diagnostics
- Treatment
o ‘… an array of nonmedical interventions to relieve psychological distress,
reduce maladaptive behavior, or enhance adaptive functioning through
counseling, structured or unstructured interactions, training programs, or
specific environmental changes’
How are we doing?
- ‘… our results provide little evidence for the effectiveness of traditional child
psychotherapy …’
- ‘… results provide support for the movement to revise traditional therapy techniques
or to replace and supplement them with techniques whose efficacy had been more
clearly demonstrated.’
What are interventions?
Intervention criteria:
- Goals
- Target group
- Program description
What are interventions?
- Psychotherapy with children
o Children are referred by others
o Adults provide information
o Dependent on their environment
Interventions
- … are goal directed
- … improve psychological, social and/or cognitive development of the child and/or
reduce risks and developmental problems
- … are not only directed at the wellbeing of the child
Intervention criteria
- Goal
- Target group
- Program description
o Methodology
o Support
o Executing demands
Example
Parents can’t handle the parenting of their son with behaviour problems.
What would be a good result?
- The clients are satisfied with the therapy and therapist
- The son doesn’t have behaviour problems anymore
- The parents improve discipline practices and communication skills with son
4
