Family Matters: Are we there yet guys? Conflict, Process, Resolution(?) in training Psychologists to work with families

Child and Family Psychology Programme, University of CanterburyKaryn France, Helen Butler, Michael Tarren-Sweeney

The Child and Family Psychology Programme is contributed to by the Health Sciences Centre, the School of Educational Studies and Human Development and the Psychology Department.

Structure

From 2010:

MA or MSc in Child and Family Psychology (fixed curriculum)- 4th and 5th years

Limited entry PGDipChFamPsyc (27 months) starts concurrent with 5th year

Includes 5th year placements and 6th year 1500 hour internship

Final exam: External academic and professional examiners

The beginning of our journey:

Number 8 wire and a search for identity?

Our name:

“Child and Family Psychology”

chosen under the 1981 Act

vexatious issue in the literature

La Greca & Hughes (1999): “clinical-child, pediatric, school, family and counselling psychologists….(need) to work collaboratively … for the training of all psychologists who specialise in... children, youth and families.”

Roberts et al (1998; 1999) in the same discussion

clinical-child name merely semantics to fit APA categories

and this is where we place ourselves now

Vision

To prepare psychologists to work with children and families across settings

“Multilingual psychologist” able to work within

Mental Health*, Paediatrics *, Group Special Education*, School Psychology* NGOs*, Private settings*

* new internships or positions established in response to the programme

Children often pop up in more than one setting concurrently, or over time

Whanau approach

Guiding principles

Jericho Principle: Service

Culbertson (1993), Melton (1989)

child and family services are most likely to be effective when “walls (between disciplines and services) come tumbling down”

training has exacerbated the separation between services by preparing students to work in particular settings (Power, Shapiro & DuPaul, 2003)

Jericho Principle: Training Black (1991), La Greca & Hughes (1999), Roberts et al (1998; 1999)

need for clinical child, pediatric, educational/school, and developmental training to merge … to meet the needs of children and families

not a grafting-on of child components to an adult clinical programme

Not narrow or over-specialist

competence in clinical child psychology requires a broader perspective and facility to interact in interdisciplinary ways than does competence in traditional clinical psychology (Roberts, 2006)

Our curriculum

Much of our curriculum is difficult to distinguish from any other psychologist training

our graduates need to deal with presentations across the spectrum moderate presentations within relatively intact families distressing severe and unusual psychopathology of our most vulnerable

children in care, and their families

so we do psychometrics and DSM diagnoses, write reports and do formulations practice interviewing think about the scientist-practitioner and Vail models learn the theory and practice of CBT. do the Treaty Workshops and reflect on the meaning of being bicultural

Curriculum: Distinctive aspects

We also have some more distinctive (but not necessary unique) aspects to our students’ socialisation and skills building

Models

Ecological Systems Theory

Inclusion

Positive Behaviour Support (Functional Analysis)

Positive Psychology

Overarching question ”what is a child and family psychologist?”

Curriculum: Skills

Skills

assessment and therapeutic interviewing of adults, families, children and other professionals

Child Study Video

Behavioural Family Interventions training

working with relationships

shadow Family Court assessment

Curriculum: Teaching structures

Problem-Based Learning

skills for assessing and conceptualising complex and ambiguous human problems

unique features i.e. 'context' dependent,

regular didactic learning is ill-equipped to describe

Systems Analysis

psychologists should be able to analyse and influence, in positive ways, the environment in which they are working

includes everything; atmosphere, colleagues, processes and procedures, ‘culture’, aims and goals

Teaching structures cont.

Application of EST to case formulation

Bronfenbrenner (1979) via Belsky (1980) and Cicchetti et al (2000)

separation of the ontological system from the microsystem

inclusion of the mesosystem within the exosystem

chronosystem implied, not directly addressed

no sense of psychologist as part of the systems

useful grid with levels of systems on one side and risk/resilience factors on the other.

useful as a basis for a formulation exercise

Advantages

Herbert (2001) formulation is like a funnel containing a series of filters an ecological analysis widens the mouth of the funnel

Gives a framework to the conceptualisation of complexity multiple systems across multiple individuals.

e.g. mother’s depression resides within her ontogenic system but influences the child within the microsystem

Allows a close explication of proximal process in the microsystem. everything must percolate down through the microsystem in order to affect

ontogeny e.g. beliefs about beauty and eating disorders

Cont

Takes the focus off the individual and onto the context (Annan, 2005) interpersonal problems are considered as imbalances, not deficits

Allows a perspective of the social construction of the problem

Allows some perspective on our own place in the systems and in socio-cultural history e.g.inclusion policies

Solicited comments from ChFamPsyc graduates

“Usefulness or otherwise of this grounding now you are out there as practitioners?”

general positive comments and specific examples

military family

“having some insight into this world view and the impact on parenting and extended family expectations …led to new literature”

behaviour problems?

Sarah had two friends who led her around and told her what to do next…Sarah's friends' behaviour had meant that her difficulties were not exposed at school. Led to the diagnosis of a Specific Learning Disability

changed the intervention

Cont: Reflection exercise

Baird (2005) intern intensive weeks (2 hours)

case presentation to 5th and 6th years with discussion to follow

next day interns only, class conducted in the following manner:

i) presentation of 3 strengths and 3 challenges, class silent

ii) class responds with active listening skills

iii) class gives positive feedback, student responds

iv) class poses questions, student writes and clarifies only

v) 15 minute student preparation time

vi) student returns and responds to questions, class is silent

vii) open discussion

Benefits

Allows discussion of the intricacies of very complex situations

Allows reflection on personal impact of cases involving children

And impact of working in multiple systems.

Practice in active listening and emotion-labelling skills

Slows down the pace

Removes competitive jostling

Provides often challenging feedback in a manner which is warm and positive throughout

Knitting of personal and professional growth in these sessions is palpable.

Are we there yet?

We have covered an incredible distance

children and families have access to 34 more psychologists

we have psychologists working where there were no psychologists before

Challenges on list has changed

lack of “conflict”

university, professional and employment challenges resolving

References

Annan, J. (2005). Situational analysis: A framework for evidence-based practice. School Psychology International, 26(2), 131-146.

Baird, B. N. (2005). The internship, practicum and field placement handbook: A guide for the helping professions (4th ed). Prentice Hall.

Belsky, J. (1980). Child maltreatment: An ecological integration American Psychologist 35, 320-335.

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, Massachusetts: Harvard University Press.

Cicchetti, D. Toth, S. L., & Maughan, A. (2000). An ecological-transactional model of child maltreatment. In A. J. Sameroff, M. Lewis, & S. Miller (Eds). Handbook of developmental psychopathology (2nd ed., pp. 689-722)

Herbert, M. (2001). Clinical formulation. Chapter 2 in T. Ollendick, A. S. Bellack, & M. Herbert (Eds), Children and adolescents: Clinical formulation and treatment.

La Greca, A., & Hughes, J. (1999). United we stand, divided we fall: The education and training needs of clinical child psychologists. Journal of Clinical Child Psychology, 28, 435-447.

Power, T., Shapiro, E. S., & DuPaul, G. J. (2003). Preparing psychologists to link systems of care in managing and preventing children’s health problems. Journal of Pediatric Psychology, 28(2), 147-155.

Roberts, M.C. (1998). Innovations in specialty training: The clinical child psychology program at the University of Kansas. Professional Psychology: Research and Practice, 29, 394-397.

Roberts, M. C., Carlson, C. I., Erickson, M. T., Friedman, R. M., La Greca, A. M., Lemanek, K. L., Russ, S. W., Schroder, C. S., Vargas, L. A. & Wohlford, P. F. (1998). A model for training psychologists to provide services for children and adolescents. Professional Psychology: Research and Practice, 29, 293-299.

Roberts, M. C. & Sobel, A. B. (1999). Training in clinical child psychology: Doing it right. Journal of Clinical Child Psychology, 28, 482-489.