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www.bps.org.uk
Keynote Presentation: DECP Survey: Medicalization of Childhood - ADHD strand Vivian Hill and Horatio Turner
www.bps.org.uk
DECP Annual Conference 2015; Applying Creative Psychology to education, children and young people
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Medication as the main solution
!
Pressure in the child’s system
and context
Social understandings of
behaviour and medicalization
Denial of contextual factors
!
EPs’ role in current practice
EPs’ unique contribution Best practice and future directions
Conceptualising behaviour Labelling and medication Quick and easy fix Lack of alternatives
Abdicating responsibility Ignoring contextual issues
families Schools
Communication between health and education EP’s role in diagnosis Power imbalance
Raising awareness of contextual
factors
Providing tailored interventions
Child’s voice
Multi-agency pathway Psychological interventions in
context
Barriers to best practice
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• 83% of EPs felt involvement appropriate
• EP role key in managing behaviour in school
• Positive correlation (r=0.52, p<0.001) between how often EPs are consulted and use of psychological interventions
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• HCPC requirements
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• Positive correlation (r=0.6, p<0.001) between consideration of systemic factors and use of psychological interventions before medication
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reserved for those with severe symptoms and impairment or for those with moderate levels of impairment who have refused non-drug interventions, or whose symptoms have not responded sufficiently to parent-training/education programmes or group psychological treatment. (NICE, 2013)
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• NICE (2013) Managing
ADHD in pre-school children: “Drug treatment is not recommended”
• Very limited research on
drug efficacy and side effects in pre-schoolers
• Interpret with some caution – only 30 responded ‘yes’ – how many children does this translate to?
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key to treatment efficacy (Swift & Callahan, 2009).
• NICE (2013) requires
child or young person’s wishes be taken into account
• High number of “not
sure” – reflects lack of involvement?
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• What data is collected locally and nationally? Question to audience!
• Ethical implications of medicating certain groups within society?
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LAs with a protocol for diagnosis were more likely to! • Take systemic factors into
account during diagnosis (p<0.001)
• Offer psychological therapies to families before medication (p<0.05)
• Take children and young people’s views into account (p=0.05)
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