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Samenvatting Effective mental health interventions for youth ()
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Artikel Pameijer ‘assessment-based practice, an interventionbased model
AFI: bridge for the gap between diagnostic information and interventions
to improve a problematic situation.
Assessment:
1. Assessment process: generating and testing hypotheses, integration
of information, decision making AFI
2. Assessment methods: test, questionnaires, interviews and
observations.
For the psychologist:
1) what goals do I want to achieve by applying AFI (feed up)?
2) which elements am I already successfully implementing in my daily
work (feedback)?; and 3) where is room for improvement (feed forward)?
Seven principles of AFI:
1. Goal directed: what needs to be changed. Factors that can be
changed are:
a. Child factors (self-regulation, inhibition, executive functions
et).
b. Factors of the instructional environment
c. Parent factors that influence school achievement (intelligence
cannot be changed but way of support can).
i. Involvement
ii. Supervision
iii. Expectations
2. Transactional perspective on development (a contextual
approach, because risk factors of the child in combination with a
risky environment is related to the problematic situation). This
prevents parent, child and school blaming and stimulates reflection.
3. Focus on educational needs (to help the child achieve wanted
goals. Not the focus on what the students has (example:
ADHD/anxiety) but on what he/she needs. Goals need to be
formulated SMARTI. Solution focused instead of problem thinking.
Use supportive language.
4. What do parents and teachers need to do to help the child
achieve these goals. 20% (1/3 is school, 2/3 is teacher) of the
student’s success in school is determined by school, 80% is
environmental factors (intelligence, motivation, parental support).
5. Focus on both risk and protective factors: what are protective
factors and how can we reinforce them to make the child more
resilient. A balanced overview of protective and risk factors and the
interaction between them produces and ecologically valid case
formulation.
6. Collaborative partnership: working together with child school and
parents. They have the best insight in probabilities for change
because they are experienced with the problems of the child.
a. Student: co-investigator
, b. Teachers: educational professional
c. Parents: experts through experience
d. Psychologists: scientist practitioner and responsible for
assessment. Meta communication!
7. Systematic transparent process with 5 stages: the guidelines
are more a framework than set rules.
5 stages of AFI:
1. Intake: collect information
1. Preparation: who is taking part in the first meeting and what
are their positions and roles?
2. Reasons for assessment, questions, aims, expectations and
requests: what do those involved want to know and why? What do
they intend to accomplish (or avoid)? Which case formulations
and recommendation would be good or bad news to them? What
do they hope for and what do they fear?
3. Overview: client’s perception of the problematic (hindering)
and positive (stimulating) aspects of the child, educational and
home environment.
4. Relevant past history: anamnestic information, previous
activities and effects, e.g. what worked or did not work and why
(not)?
5. Attributions, goals and solutions: what could explain the
situation according to the child, teacher, counsellor and parents?
What do they want to accomplish and how? What are their
solutions?
6. Conclusion: questions of the clients and school-psychologist,
appointments for cooperation (who collects which information,
why, how and when?; when will we meet again to discuss our
findings?) and evaluation (have we collected relevant information
and was the cooperation constructive?).
2. Strategy: how to proceed in this case. Making hypothesis
1. What do we know already? The relevant information is
organized in four clusters (multidimensional): (1a) student, (1b)
instructional environment, (1c) parental support of learning, (1d)
history and degree of severity (1e).
2. Do we need to know more to answer the questions? Is the
stage of investigation necessary or can we move on to stage 4?
By applying the ‘if-then-rationale’, the school-psychologist checks
if extra information is required to formulate a case formulation
and suitable intervention.
3. If stage 3 is required: what information is needed? Alternate
hypotheses from a transactional frame of reference are
formulated (3a), the relevant hypotheses are selected, based on
their impact on the choice of an intervention (3b) and these
hypotheses are translated into questions for investigation (3c).
4. Conclusion of the strategy: are we moving on to stage 4 or is
the investigation- stage necessary?
, 3. Investigation: goal directed, not routine
1. Operationalize the concepts in the questions.
2. Choose the appropriate tools and instruments.
3. Formulate testing criteria: when do we accept or reject the
hypothesis?
4. Consult the clients: can they participate as co-researchers?
5. Gather the data necessary for testing the hypotheses.
6. Interpret the data and answer the questions.
4. Integration and needs assessment: answers to the question for
investigation and is the bridge to intervention.
1. Transactional case formulation: how can the situation be
understood?
2. Goals for the child, teaching strategies and parental support: what
do we need
or want to change and what can we change?
3. What does the child need to achieve these goals? What do the
teacher and
parents need to offer a fitting approach?
4. Recommendations based on the needs.
5. Estimation of the most appropriate recommendation.
5. Recommendations:
1. Preparation: what are the goals of this meeting and who should
participate?
2. Discussion of the case formulation: do clients recognise this
formulation? To what extent do they agree or perceive the situation
differently?
3. Discussion of the goals, needs and recommendations, supported
by arguments. Do clients have additional ideas, solutions or
arguments?
4. Clients choose one (or more) of the suggested recommendations.
This workable option then becomes the intervention.
5. Conclusions, evaluations and appointments.
Interventions for child, school and parents
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