Beth Reiman, Westchester Institute for Human Development

1. Ipad
Apps
to
Enhance
TF-­‐CBT
for
Children
with
Disabili;es
BASPCAN
-­‐
The
Associa1on
of
England,
Ireland,
Northern
Ireland,
Scotland
and
Wales
for
Child
Protec1on
April
14,2015
Beth
Reiman,
Westchester
Ins1tute
for
Human
Development
Breiman@wihd.org
1
Beth
Reiman
BReiman@wihd.org
BASPCAN

2. 2
Beth
Reiman
BReiman@wihd.org
BASPCAN

3. Trauma
Beth
Reiman
BReiman@wihd.org
BASPCAN
3

4. Trauma
and
Children
with
Intellectual
Disabili;es
• Prevalence
of
trauma;c
events
• Impact
of
sexual
abuse
on
CWDs
• Lack
of
studies
regarding
this
popula;on
• Symptoms
are
similar
to
those
without
disability
but
oNen
mistaken
• Not
every
person
with
ID
needs
treatment
4
Beth
Reiman
BReiman@wihd.org
BASPCAN

5. Disconnect
from
feelings
Behavior
problems
Fear
and
anxiety
Intrusive
thoughts
Hyper-­‐
vigilance
Sleep
problems
Trauma
Symptoms
5
Beth
Reiman
BReiman@wihd.org
BASPCAN

6. Myths:
People
with
ID…
• Don’t
recognize
or
understand
a
trauma;c
event
• Don’t
experience
trauma
and
its
sequelae
• Don’t
exhibit
symptoms
of
trauma
• Don’t
have
feelings
about
trauma;c
events
• Can’t
benefit
from
therapy
6
Beth
Reiman
BReiman@wihd.org
BASPCAN

7. When
is
therapeu;c
interven;on
needed
• When
person
does
not
return
to
their
typical
state
aNer
a
couple
of
months.
• Disrupted
sense
of
safety
• Disconnec;on
from
suppor;ve
people
7
Beth
Reiman
BReiman@wihd.org
BASPCAN

8. TF-­‐CBT
• Developed
by
Deblinger,
Cohen
and
Mannerino*
• Evidenced
based,
research
• Developed
for
people
without
disabili;es
*Cohen,
K.,
Mannerino,
A.,
Deblinger,
E.,
(2012),
Trauma-­‐Focused
CBT
for
Children
and
Adolescents,
New
York:
Guilford
Press
8
Beth
Reiman
BReiman@wihd.org
BASPCAN

9. 9
Beth
Reiman
BReiman@wihd.org
BASPCAN

10. Research
project
• 3-­‐year
LEND
research
project
• Children
with
disabili;es
served
at
a
child
advocacy
center
• Focus
group
regarding
mental
health
needs
of
children
with
disabili;es
• Use
of
technology
to
make
service
more
accessible
10
Beth
Reiman
BReiman@wihd.org
BASPCAN

11. Use
of
technology
to
support
TFCBT
• Millions
of
Apps
• Use
of
Ipad
• Therapeu;c
rela;onship
• Developmental
factors
to
consider
• The
Matrix
• Tes;ng
it
out
11
Beth
Reiman
BReiman@wihd.org
BASPCAN

12. Children
with
disabili;es
and
treatment
• Challenges
due
to
verbal
and
cogni;ve
delays
• Ensuring
that
treatment
is
appropriate
• Agen;on
span
• Comfort
level
of
clinicians
• Appropriate
tools
and
resources
12
Beth
Reiman
BReiman@wihd.org
BASPCAN

13. Adapta;ons:
tradi;onal
• Adjust
pace,
session
length
• Structure
and
rou;nes
• Repe;;on
• Use
of
visuals
13
Beth
Reiman
BReiman@wihd.org
BASPCAN

14. Adapta;ons:
Current
• Assessment
• Ask
“Why
do
we
offer….”
• Use
of
technology
14
Beth
Reiman
BReiman@wihd.org
BASPCAN

15. Challenges
Psychoeduca;on
• Difficulty
generalizing
• Poor
comprehension
and
reten;on
• Limited
agen;on
span
• Fixated
on
par;cular
interest
15
Beth
Reiman
BReiman@wihd.org
BASPCAN

16. Toca
Doctor
Parts
of
the
body
Anatomical
dolls
My
Body
for
Girls
Au;smate
16
Beth
Reiman
BReiman@wihd.org
BASPCAN

17. Challenges
Relaxa;on
• Sensory
s;mula;on
• Impulsivity
• Increased
anxiety
levels
• Poten;al
for
behavioral
manifesta;ons
17
Beth
Reiman
BReiman@wihd.org
BASPCAN

18. Calm
Talk
CBT4Kids
Breathe,
Think,
Do
Breathe2Relax
Flowpaper
18
Beth
Reiman
BReiman@wihd.org
BASPCAN

19. Challenges:
Affect
Regula;on
• Difficulty
iden;fying
emo;ons
• Connec;on
of
body
responses
to
emo;on
• Verbal
and
nonverbal
responses
• Impulsivity
19
Beth
Reiman
BReiman@wihd.org
BASPCAN

20. No
More
Meltdowns
Between
the
Lines
Feeling
Electric
Emo;ons
GT
Colour
Faces
Emo;ons,
Feelings
and
Colors
20
Beth
Reiman
BReiman@wihd.org
BASPCAN

21. Challenges
Cogni;ve
Coping
• Abstract
thinking
• Sequences
of
events
• Priori;zing
• Task
breakdown
• Ambiguity
21
Beth
Reiman
BReiman@wihd.org
BASPCAN

22. ICBT
CBT4Kids
Popplet
22
Beth
Reiman
BReiman@wihd.org
BASPCAN

23. Challenges
Trauma
Narra;ve
• Organiza;onal
problems
• Cri;cal
thinking
• Academic
skills
for
wri;ng
23
Beth
Reiman
BReiman@wihd.org
BASPCAN

24. Story
Maker
Notability
Puppet
Pals
Popplet
Anatomical
dolls
24
Beth
Reiman
BReiman@wihd.org
BASPCAN

25. Children
with
disabili;es
Opportunity
for
Healing
25
Beth
Reiman
BReiman@wihd.org
BASPCAN

26. Apps
Links
• Au;sMate:
:
hgp://au;smate.com/Au;sMate-­‐Comprehensive-­‐App-­‐For-­‐Au;sm
• Anatomical
Dolls:
hgps://itunes.apple.com/us/app/anatomical-­‐dolls/id591616357?mt=8
• Toca
Doctor:
hgps://itunes.apple.com/us/app/toca-­‐doctor/id424209938?mt=8
• My
Body:
hgps://www.appannie.com/apps/ios/app/my-­‐body-­‐for-­‐girls-­‐ad-­‐free/
• Calm
Talks:
hgps://itunes.apple.com/us/app/calm-­‐talk/id668393731?mt=8
• Emo;ons,
Feelings
and
Colors:
hgps://itunes.apple.com/us/app/emo;ons-­‐feelings-­‐colors-­‐!/id581936735?mt=8
• Parts
of
the
Body:
hgps://itunes.apple.com/us/app/parts-­‐of-­‐the-­‐body/id578592791?mt=8
• CBT4kids:
hgps://itunes.apple.com/us/app/cbt4kids-­‐toolbox/id605222992?mt=8
• Breathe,
Think,Do:
hgps://itunes.apple.com/us/app/breathe-­‐think-­‐do-­‐with-­‐sesame/id721853597?
mt=8
• Breathe2Relax:
hgps://itunes.apple.com/us/app/breathe2relax/id425720246?mt=8
Beth
Reiman
BReiman@wihd.org
BASPCAN
26

27. App
Links
(con;nued)
• Flowpaper
hgps://itunes.apple.com/us/app/flowpaper/id424499611?mt=8
• iCBT:
hgps://itunes.apple.com/us/app/icbt/id355021834?mt=8
• No
More
Meltdowns:
hgps://itunes.apple.com/us/app/no-­‐more-­‐meltdowns/id407341438?mt=8
• Between
the
Lines
1:
hgps://itunes.apple.com/us/app/between-­‐the-­‐lines-­‐level-­‐1-­‐hd/id574405272?
mt=8
• Feel
Electric:
hgps://itunes.apple.com/us/app/feel-­‐electric!/id463493101?mt=8
• GT
Colour
Faces:
hgps://itunes.apple.com/us/app/gt-­‐colour-­‐faces/id682209555?mt=8
• Popplet:
hgp://popplet.com/app/
• StoryMaker:
hgps://itunes.apple.com/us/app/storymaker-­‐for-­‐social-­‐stories/id570007786?mt=8
• Notability:
hgps://itunes.apple.com/us/app/notability/id360593530?mt=8
• Puppet
Pals:
hgps://itunes.apple.com/us/app/puppet-­‐pals-­‐hd/id342076546?mt=8
• Emo;ons:
hgp://bridgingapps.org/app/?id=525637590
Beth
Reiman
BReiman@wihd.org
BASPCAN
27

28. Resources
• Trauma-­‐Focused
CBT
for
Children
and
Adolescents:
hgp://www.amazon.com/Trauma-­‐Focused-­‐CBT-­‐Children-­‐Adolescents-­‐Applica;ons/
dp/1462504825
• Focht-­‐New,
G.,
Clements,
P.,
Barol,
B.,
Faulkner,
M.,
Services,
K.,
(2008),
Persons
with
developmental
disabili;es
exposed
to
interpersonal
violence
and
crime,
Perspec'ves
in
Psychiatric
Care,
44(1).
• Haddock,
K.,
Jones,
R.,
(2006),
Prac;;oner
consensus
in
the
use
of
cogni;ve
behaviour
therapy
for
individuals
with
a
learning
disability,
Journal
of
Intellectual
Disabili'es,
10(3)
221-­‐230.
• Mevissen,
L.,
de
Jongh,
A.,
(2010),
PTSD
and
its
treatment
in
people
with
intellectual
disabili;es,
Clinical
Psychology
Review,
30
308-­‐316.
• Sturmey,
P.,
(2004),
Cogni;ve
therapy
with
people
with
intellectual
disabili;es,
Clinical
Psychology
and
Psychotherapy,
11(4),
222-­‐232
• Na;onal
Child
Trauma;c
Stress
Network:
hgp://www.nctsn.org/
• Child
Trauma
Academy:
hgp://childtrauma.org/
Beth
Reiman
BReiman@wihd.org
BASPCAN
28