PEDIATRIC PSYCHOLOGY faculty of physiotherapy.pptx

1. PEDIATRIC PSYCHOLOGY
BY: SHWETA

2. INTODUCTION:
 Pediatric psychology is a multidisciplinary field of both scientific research and
clinical practice which attempts to address the psychological aspects of illness,
injury, and the promotion of health behaviors in children, adolescents, and
families in a pediatric health setting.
 Psychological issues are addressed in a developmental framework and
emphasize the dynamic relationships which exist between children, their
families, and the health delivery system as a whole.

4. Role of the pediatric psychologist:
 The field of pediatric psychology developed to address unmet needs for
psychological services in the pediatric setting and the field blends together
several distinct areas in psychology (such as behavioral medicine, health
psychology, developmental psychology, etc.)
 Pediatric psychologists work in a variety of settings and fulfill various roles such
as-
(1) Providing psychosocial services for problems related to pediatric health
conditions.

5. (2) Psychological services for mental health problems appearing in medical settings—
which involves mental issues related to medical conditions or the treatment of them,
coping related to acute and chronic illnesses, adherence, quality of life, pain, traumatic
medical stress, adjustment related issues on the psycho-social continuum, school
reintegration, and behavioral problems.
(3) Psychological services for mental health problems without concomitant health
condition.
(4) Programs for promotion of health/prevention and early intervention.
(5) Provide assistance for those with intellectual and/or developmental disabilities.
(6) Psychological training and consultation for physicians.
(7) Public health and public policy.

11. The psychological needs of pediatric patients is crucial
for providing effective care and support for their well-
being:
 Communication:
Effective communication is vital when addressing the psychological needs of pediatric patients.
Healthcare providers need to communicate in age-appropriate language, involve
parents/guardians in discussions, and create a supportive environment where children feel
comfortable expressing their concerns.
 Play and Distraction:
Play therapy and recreational activities are valuable tools in pediatric psychology. Play allows
children to express themselves, process their experiences, and cope with stress in a
developmentally appropriate way. Distraction techniques, such as music, art, or games, can also
help alleviate anxiety during medical procedures.

12.  Education and Advocacy:
Educating pediatric patients and their families about their medical condition,
treatment options, and potential psychological effects empowers them to
participate in decision-making and self-care. Advocating for resources and support
services, such as counseling, support groups, and school accommodations, can
further enhance their psychological well-being.
By addressing these psychological needs, healthcare providers can
promote resilience, coping skills, and overall mental health in
pediatric patients, fostering better outcomes and quality of life.

13. GERIATRIC PSYCHOLOGY

18. Behavior modification

19. INTRODUCTION:
 Behavior modification, also known as behavior therapy or applied behavior
analysis, is an approach within psychology that focuses on changing observable
behaviors through systematic interventions.
 Behavior modification is a treatment approach that uses respondent and operant
conditioning to change behavior. Based on methodological behaviorism, overt
behavior is modified with (antecedent) stimulus control and consequences,
including positive and negative reinforcement contingencies to increase desirable
behavior, or administering positive and negative punishment and/or extinction to
reduce problematic behavior. It also uses systematic desensitization and flooding
to combat phobias.

20. Principles of Behavior Modification:
 Operant Conditioning:
Central to behavior modification is the principle of operant conditioning, which was
developed by B.F. Skinner. According to this theory, behaviors are influenced by their
consequences. Positive reinforcement, negative reinforcement, punishment, and extinction
are techniques used to increase or decrease the frequency of a behavior.
 Classical Conditioning:
Although less commonly used in behavior modification, classical conditioning principles can
also be applied to modify behaviors. This involves pairing a neutral stimulus with a stimulus
that naturally elicits a response, eventually causing the neutral stimulus to evoke the same
response.

21.  Social Learning Theory:
This theory, proposed by Albert Bandura, emphasizes the role of
observation and imitation in learning. Behavior modification
interventions may involve modeling desired behaviors and
providing opportunities for individuals to observe and imitate
those behaviors.

22. Assessment and Goal Setting:
 Before implementing behavior modification techniques, it's essential to
conduct a thorough assessment to identify the target behavior(s) to be
modified, as well as the antecedents (triggers) and consequences
associated with those behaviors.
 Clear, measurable goals should be established to guide the behavior
modification process. Goals should be specific, achievable, relevant, and
time-bound (SMART).

23. Intervention Strategies:
 Positive Reinforcement:
Providing a reward or positive consequence after the occurrence of a desired
behavior increases the likelihood of that behavior being repeated. Rewards can
be tangible (e.g., stickers, tokens) or intangible (e.g., praise, social approval).
 Negative Reinforcement:
Removing an aversive stimulus after the occurrence of a desired behavior
increases the likelihood of that behavior being repeated. For example, turning off
a loud alarm after a person wakes up on time may reinforce waking up early.

24.  Punishment: Introducing an aversive consequence after the occurrence of an undesired behavior
decreases the likelihood of that behavior being repeated. However, punishment should be used
cautiously, as it can have unintended consequences and may not effectively change behavior in the
long term.
 Extinction: Withholding reinforcement for a previously reinforced behavior eventually leads to a
decrease in the frequency of that behavior. This approach is often used in conjunction with
reinforcement of alternative, more desirable behaviors.
 Prompting and Shaping: Prompting involves providing cues or instructions to guide the
performance of a desired behavior, while shaping involves gradually reinforcing successive
approximations of the target behavior until the desired behavior is achieved.

25. Monitoring and Evaluation:
 Throughout the behavior modification process, progress should be monitored regularly to
assess the effectiveness of interventions and make adjustments as needed.
 Outcome measures should be used to evaluate whether the desired behavior change has
occurred and whether it has been maintained over time.
 Behavior modification techniques can be applied in various settings, including schools,
workplaces, homes, and clinical settings, to address a wide range of behaviors, such as
academic performance, social skills, self-care behaviors, and emotional regulation. When
implemented effectively, behavior modification can empower individuals to make positive
changes in their lives and improve their overall functioning and well-being.

26. Psychological
aspects of substance
abuse

27.  Substance abuse, including smoking, alcoholism, and drug addiction, involves complex
psychological aspects that contribute to the initiation, maintenance, and recovery from
addiction.
 Smoking Addiction:
Psychological Dependence: Nicotine, the addictive substance in tobacco, affects the brain's
reward pathways, leading to psychological dependence. Smokers often associate smoking with
pleasurable activities, stress relief, socializing, or coping with negative emotions. Cue-Induced
Cravings: Environmental cues, such as seeing someone smoke or encountering situations
associated with smoking, can trigger cravings and urges to smoke. Classical conditioning
processes contribute to the strong association between these cues and the rewarding effects of
nicotine.

28.  Self-Medication:
Some individuals use smoking as a form of self-medication to alleviate symptoms of anxiety,
depression, or stress. Smoking may temporarily relieve emotional distress or provide a sense of
relaxation or stimulation. Social Influences: Social norms, peer pressure, and social networks play a
significant role in smoking behavior. Smoking may be perceived as socially acceptable or even
desirable within certain social groups, leading individuals to initiate and maintain smoking habits.
 Coping Mechanism:
Smoking may serve as a coping mechanism to deal with life stressors, trauma, or boredom. Individuals
Individuals may turn to smoking as a way to regulate mood, manage emotions, or distract themselves
from unpleasant thoughts or feelings.

29. Alcoholism:
 Reward Pathways: Alcohol consumption activates the brain's reward system, releasing neurotransmitters such as
dopamine, which produce pleasurable effects. Over time, repeated exposure to alcohol can lead to tolerance,
dependence, and addiction. Negative Reinforcement: Alcohol may be used to self-medicate symptoms of anxiety,
depression, or other mental health disorders. Individuals may drink to alleviate emotional pain, numb distressing
feelings, or escape from reality temporarily.
 Escalation of Use: Alcoholism often involves a pattern of escalating use, as individuals develop tolerance and require
increasing amounts of alcohol to achieve the desired effects. This can lead to compulsive drinking despite negative
consequences, such as health problems, relationship difficulties, or legal issues. Genetic and Environmental Factors:
Genetic predisposition, family history of alcoholism, and environmental influences contribute to the risk of developing
alcohol use disorder. Adverse childhood experiences, trauma, and exposure to parental substance abuse can increase
vulnerability to alcoholism later in life.

30.  Social and Cultural Factors: Social factors, including peer pressure, cultural attitudes toward drinking, and
availability of alcohol, influence alcohol consumption patterns. Drinking may be normalized or encouraged
in certain social contexts, contributing to excessive or problematic drinking behavior.
 Drug Addiction:
Neurobiological Changes: Drugs of abuse, such as opioids, stimulants, and depressants,
alter brain chemistry and neural pathways, leading to addiction. These substances
hijack the brain's reward system, reinforcing drug-seeking behavior and diminishing the
the individual's ability to control their impulses.
Craving and Withdrawal: Drug addiction is characterized by intense cravings for drugs
and withdrawal symptoms when drug use is discontinued. These cravings can be
triggered by environmental cues associated with drug use and may lead to relapse
even after periods of abstinence.

31.  Psychological and Emotional Factors: Drug addiction often co-occurs with underlying psychological issues,
such as trauma, PTSD, depression, anxiety, or personality disorders. Individuals may use drugs to cope with
emotional pain, numb painful feelings, or escape from reality. Escalation of Use: Like alcoholism, drug
addiction typically involves a pattern of escalating use as tolerance develops and higher doses are required to
achieve the desired effects. This cycle of compulsive drug-seeking behavior can lead to severe consequences,
including health problems, financial difficulties, and legal issues.
 Understanding the psychological aspects of substance abuse is essential for developing effective prevention,
intervention, and treatment strategies. Comprehensive approaches that address biological, psychological,
social, and environmental factors are necessary to promote recovery and reduce the harm associated with
substance abuse. Interventions should be tailored to individual needs and incorporate evidence-based
practices from psychology, psychiatry, addiction medicine, and social work.

32. REFERENCE:
1. Aylward, B.S., Bender, J.A., Graves, M.M., & Roberts, M.C. (2011). Historical developments and trends in
pediatric psychology. In Roberts, M.C. & Steele, R.G. (Eds.) Handbook of Pediatric Psychology (3–18). New
York, NY: Guilford Press.
2. Roberts, M.C., Maddux, J., Wurtele, S.K., & Wright, L. (1982). Pediatric psychology: Health care psychology for
children In T. Millon, C.J. Green, & R.B. Meagher (Eds.), Handbook of clinical health care psychology (pp. 191–
226). New York: Plenum Press.
3. Spirito, A.; Brown, R. T.; D'Angelo, E.; Delamater, A.; Rodrigue, J.; Siegel, L. (2003). "Society of Pediatric
Psychology Task Force Report: Recommendations for the Training of Pediatric Psychologists". Journal of
Pediatric Psychology. 28 (2): 85–98. doi:10.1093/jpepsy/28.2.85. PMID 12556507.

33. 4. Mahoney, M. J., Kazdin, A. E., & Lesswing, N. J.; Franks, C. M., Wilson, G. T. (1974). "Behavior
modification: delusion or deliverance?". Annual Review of Behavior Therapy: Theory and
Practice. Vol. 2. Brunner/Mazel. pp. 11–40.
5. Mace, F. C. (1994). "The significance and future of functional analysis methodologies". Journal
of Applied Behavior Analysis. 27 (2): 385–92. doi:10.1901/jaba.1994.27-385. PMC 1297814.
PMID 16795830.
6. Pelios, L., Morren, J., Tesch, D., and Axelrod, S. (1999). "The impact of functional analysis
methodology on treatment choice for self-injurious and aggressive behavior". Journal of
Applied Behavior Analysis. 32 (2): 185–95. doi:10.1901/jaba.1999.32-185. PMC 1284177. PMID
10396771.
7. Mace, F. C., and Critchfield, T. S. (2010). "Translational research in behavior analysis: Historical
traditions and imperative for the future". J Exp Anal Behav. 93 (3): 293–312.
doi:10.1901/jeab.2010.93-293. PMC 2861871. PMID 21119847.
8. WIKIPEDIA.
9. SLIDESHARE.