Gerald Caplan s Preventive Psychiatry



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Seminar in Preventive Psychological Intervention EDS 246b Stephen E. Brock, Ph.D.,NCSP Course Description: Study and application of various primary, secondary, and tertiary psychological interventions designed to prevent school failure and/or emotional challenges. Examines techniques of identifying pupils who are experiencing mental health difficulties that interfere with school functioning, and intervention techniques designed to address these problems. 1 Gerald Caplan s Preventive Psychiatry Caplan,G. (1964). Principles of preventive psychiatry. New York: Basic Books. Primary Prevention Secondary Prevention Tertiary Prevention 2 Primary Prevention Lowering the rate of new cases of a disorder in a population over a certain period of time by counteracting harmful circumstances before they have a chance to produce problems. Examples include Child Abuse Prevention Violence Prevention Skill Building (e.g., Problem solving, conflict management, social skills instruction, bully proofing, etc.) School Safety Planning Disaster/Crisis preparedness 3 Stephen E. Brock, Ph.D., NCSP 1

Secondary Prevention Reducing the rate of disorders by shortening the duration of existing cases through early diagnosis and effective treatment. Examples include Child Abuse Intervention Violence intervention Student Success Teams School crisis response Psychological triage Crisis intervention Suicide intervention 4 Tertiary Prevention Programs designed to rehabilitate individuals with long term problems to return them to their productive capacity as quickly as possible to their highest potential Examples include Special education School referral to Mental Health 504 accommodation plans Disaster recovery Suicide postvention Psychotherapy 5 Prevention Providers While all primary, and most secondary, prevention activities are appropriate undertakings for general educators, tertiary prevention requires special expertise training and skill. This response requires long-term psychological, and psychiatric treatments that are typically beyond what most general educators can provide. Mental health professionals typically provide these services. 6 Stephen E. Brock, Ph.D., NCSP 2

Typical Seminar Agenda 1. Questions (246b & Internship) 2. Lecture 3. Break 4. General discussion & activities 7 Course Overview Required Readings To be read by the dated indicated on the seminar outline. These readings are available online or in the required texts. Required Resources While not all are required reading these documents need to be made a part of each students electronic libraries. To document that your have obtained these documents place them on a CD and turn in each no later than the date indicated on the course outline. 8 Course Overview Seminar Requirements/Activities: 1. Attendance/Class participation. 2. Field Observation/Interview. 3. Crisis Response Role-Plays/Observations. 4. Psychological Triage Activity. 5. Psychological First Aid Script. 6. Psychological First Aid Role-Plays. 7. Psychological First Aid Observation. 8. Suicide Intervention Script. 9. Final Exam. 10. Extra Credit. 9 Stephen E. Brock, Ph.D., NCSP 3

10 Child Abuse Prevention EDS 246b Preventive Psychological Intervention Stephen E. Brock, Ph.D., NCSP Adapted from Child Abuse Prevention and Intervention by Sean Surfas, Ph.D., LEP 11 Statistics In the U.S. 3+ children die in their home as the result of abuse each day. In California, between 2000 2010, 950 children died as the result of abuse. By age 18, 1/4 of girls and 1/6 of boys have been sexually assaulted. Abuse and neglect among special needs youth is 1.7 times the rate observed among other youth. 85% of sexual assaults on children are perpetrated by a familiar (usually trusted) person. A child abuse report is made every 10 seconds. 12 Stephen E. Brock, Ph.D., NCSP 4

Types of Abuse (CA statistics) Neglect 63% Physical 19% Sexual 10% Emotional 8% 13 What is Child Abuse? Is this child abuse? 1. A girl is slapped for screaming at her mother; the slap stings, but leaves no lasting mark. 2. A boy is punished in a way that requires stiches. 3. A father burns his daughter s palms with a lighted cigarette when he finds her smoking. 4. A mother is careless and spills scalding coffee on her daughter, who is seriously burned. 14 What is Child Abuse? Is this child abuse? 5. A boy s arm is broken after wrestling with his father for sport. 6. A girl is spanked so hard she is badly bruised, but the father says he did not mean to hurt her. 7. A boy is grounded for a week for a minor offense 8. A father takes away his son s drivers licensed for getting a parking ticket 15 Stephen E. Brock, Ph.D., NCSP 5

Child Abuse Defined The physical or mental injury, sexual abuse or exploitation, negligent treatment, or maltreatment of a child under the age of 18 by a person who is responsible for the child s welfare under circumstances which indicate that the child s health or welfare is harmed or threatened. Child Welfare Act 16 Neglect Failure of parents or caretakers to provide needed, age appropriate care including food, clothing, shelter, protection from harm, and supervision appropriate to the child s development, hygiene, and medical care. 17 Physical Abuse Any non-accidental injury to a child under the age of 18 by a parent or caretaker. These injuries may include beatings, shaking, burns, human bites, strangulation, or immersion in scaling water or other, with resulting bruises and welts, fractures, scars, burns, internal injuries or any other injury 18 Stephen E. Brock, Ph.D., NCSP 6

Sexual Abuse Any inappropriate sexual exposure or touch by an adult to a child or an older child to a younger child. This includes, but is not limited to fondling, sexual intercourse, sexual assault, rape, incest, child prostitution, exposure, and pornography. It does not matter whether the victim was forced or tricked to any of the above. Regardless it is considered sexual abuse. 19 Sexual Offenses that are Child Abuse 1. Sexual Assault 2. Sexual Molestation 3. Sexual Exploitation 4. Sexual Grooming 20 Emotional Abuse Parental behavior, such as rejecting, terrorizing, berating, ignoring, or isolating a child, that causes or is likely to cause, serious impairment of the physical, social, mental, or emotional capacities of the child. 21 Stephen E. Brock, Ph.D., NCSP 7

Reporting Child Abuse A mandated reporter is required to report child abuse if she or he in their professional capacity, or within the scope of his or her employment has knowledge of, or observes a child whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect (P.C. 1166[a]) 22 Reporting Child Abuse Contact Child Protective Services and/or local law enforcement. Suspected Child Abuse Report form http://ag.ca.gov/childabuse/pdf/ss_8572.pdf Guidance for mandated reporters http://www.dominican.edu/about/forfaculty/file/childa buselaw.pdf http://www.ctc-capc.org/wp- content/uploads/2010/06/ca-child-abuse-neglect- Law-Condensed_2007.pdf 23 Reporting Child Abuse Sacramento County CPS http://www.dhhs.saccounty.net/cps/pages /CPS-Home.aspx 24 Hour Child Abuse Hotline: (916) 875-5437 (875-KIDS) In an emergency always call 911 for law enforcement. 24 Stephen E. Brock, Ph.D., NCSP 8

Disclosure of Reporter Identity The identity of the reporter shall be confidential, and shall be disclosed only To agencies investigating the report When the person waives confidentiality By court order 25 Informing Family Members Mandated reporters are typically not required to inform parents of family members that a report has been made In some cases it might be a good idea In other instances doing so might place the child in harms way 26 Investigation Either law enforcement or CPS will investigate all reports and make one of the following determinations: Unfounded (no evidence to suggest abuse) Inconclusive (not enough evidence) Substantiated (enough evidence to suggest abuse) All inconclusive and substantiated reports go into the Child Abuse Central Index (CACI) http://oag.ca.gov/childabuse 27 Stephen E. Brock, Ph.D., NCSP 9

Failure to Report A misdemeanor punishable by up to 6 months in county jail, a fine up to $1,000.00, or both May be subject to civil damages May lose your credential 28 Immunity from Liability Immune from civil or criminal liability as a result of making a required report 29 Required Resources Child Welfare Information Gateway. (2013). What is child abuse and neglect? Washington, DC: U.S. Department of Health and Human Services. Retrieved from http://www.childwelfare.gov/pubs/factsheets/whatiscan.pdf Crime and Violence Prevention Center. (2007). California child abuse & neglect reporting law: Condensed version. Sacramento, CA: California Attorney General s Office. Retrieved from http://www.ctc-capc.org/wp- content/uploads/2010/06/ca-child-abuse-neglect-law- Condensed_2007.pdf U.S. Department of Health and Human Services. (2011). Child maltreatment 2010. Washington, DC: Author. Retrieved from http://www.acf.hhs.gov/programs/cb/pubs/cm10/cm10.pdf 30 Stephen E. Brock, Ph.D., NCSP 10

Activity Develop a suspected child abuse scenario Complete a child abuse report form Discuss your understanding of the possible outcomes of the hypothetical report you would file. 31 Final Exam Develop possible questions 32 Next Meeting Violence Prevention Read Child Welfare Information Gateway (2013) Obtain U.S. Department of Health &Human Services (2011) Activity Making a CPS report. 33 Stephen E. Brock, Ph.D., NCSP 11