DIAGNOSTIC CLINIC SI

INTERVENTII LA COPII
Anca Dobrean
ancadobrean@psychology.ro

Cristina Costescu

TEMATICA

Specific al evalurii i interveniei la copii.

Aspecte ale dezvoltarii relevante pentru interventii clinice la copii.
Sisteme de diagnostic si interventie la copii.
Deficitul de atenie i hiperactivitate: modele teoretice.
ADHD: evaluare i intervenii validate stiintific.
Tulburarea de conduit: evaluare i intervenii validate stiintific.
Opoziionismul provocator: evaluare i intervenie.
Tulburari pervazive de dezvoltare
Depresia la copii: evaluare i intervenii validate stiintific.
Anxietatea la copii: evaluare i intervenii validate stiintific.
Tulburarile alimentare la copii: evaluare i intervenii validate stiintific.
Practicile parentale i relaia cu dezvoltarea i psihopatologia copilului.
Programe de preventie a problemelor de sntate mental la copii.

Notare:

Evaluarea cunostintelor din cadrul tematicii - 6 puncte

Activitate de seminar 3 p

1 p oficiu

Practici validate tiinific

Evidence based practice
Evaluare

validata stiintific

Evidence based assessment

Interventii

validate stiintific

Evidence based treatment

Evidence-Based Practice

http://www.newsweek.com/id/216506/outp
ut/print

Ignoring the Evidence

Why do psychologists reject science?
BY SHARON BEGLEY | NEWSWEEK
PUBLISHED OCT 2, 2009
From the magazine issue dated Oct 12, 2009

Evidence-Based Practice

Many clinicians fail to "use the

interventions for which there is the
strongest evidence of efficacy"
and
"give more weight to their personal
experiences than to science."
As a result, patients have no
assurance that their "treatment will
be informed by science."

Evidence-Based Practice

Clinical psychologists are "deeply

ambivalent about the role of science" and
"lack solid science training"a result of
science-lite curricula, especially in Psy.D.
programs.
Also, one third of patients get better no
matter what therapy (if any) they have,
"and psychologists remember these
successes, attributing them, wrongly, to
the treatment. It's very threatening to
think our profession is a charade."

Evidence-Based Practice

A 2008 survey of 591 psychologists in

private practice found that they rely more
on their own and colleagues' experience
than on science when deciding how to
treat a patient.
If they keep on this path as insurers
demand evidence-based medicine, warns
Mischel, psychology will "discredit and
marginalize itself."

Evidence-Based Practice

A new generation of therapists who

apply science
Division 53 - Society of Clinical
Child and Adolescent Psychology
http://www.apa.org/about/division/
div53.html
http://www.nice.org.uk/guidance/in
dex.jsp?action=byType&type=2&sta
tus=3

APA -2005

Evidence-based practice in psychology is the

integration of the best available research with
clinical expertise in the context of patient
characteristics, culture, and preferences.
-IOM, 2001 & Sackett, 2000

Best available
research evidence

Clinical Decision-Making

Patients values,
characteristics, and
circumstances

Clinical
Expertise

Evaluare validata tiinific - concepte

Diagnostic
gr. diagnostikos - capacitate de a distinge; de
la dia - ntre; gnosis - cunoatere) denot o
activitatea de cunoatere
restrns - termenul medical pentru
clasificare (Guze, 1978);
larg - o formulare sau o concluzie privind
natura unui fenomen (Woolf, 1977)
Psihodiagnostic
cunoaterea factorilor psihologici cu relevan
pentru diverse activiti. Psihodiagnosticul
clinic vizeaz cunoaterea factorilor psihologici
cu relevan pentru sntate i boal.

Evaluare validata tiinific - concepte

Evaluarea psihologica

procesul de colectare de date despre

un caz;
pentru gruparea acelorai cazuri pe
baza trsturilor lor distinctive a fost
propus termenul de taxonomie, iar
pentru conceptualizare a fost propus
termenul de formulare a cazului

Testarea psihologica

Procesul de diagnostic

Continuu
Un diagnostic nu se pune pe baza unei
singure descrieri a simptomelor,
Informaia se colecteaz n timp

pentru a nelege aspectele multiple ale

prezentrii problemelor,
precum i variaiile n adaptare i dezvoltare
care se fac vzute cu diverse ocazii i n
diferite contexte.

De ce avem nevoie de diagnostic?

Consens
Comunicare
Cercetare

Tratament si monitorizare

Cum sunt operationalizate bolile

mentale?

Diagnostic and Statistical Manual of Mental

Disorders, Fourth Edition, Text Revision
(DSM-IV-TR)

Publicat de American Psychiatric Association

SUA
Include doar informatii despre bolile mentale

International Classification of Diseases (ICD)

World Health Organization

Utilizat in intreaga lume
Include informatii despre toate tulburarile (mentale, fizice, etc.)

Tipuri de diagnostic

Diagnostic nosologic (gr. Nosos

rau, boala) incadrarea
tabloului clinic intr-o categorie

Sanatate sau boala (DSM-IV sau ICD)

Diagnostic etiopatogenetic

Sanatate Optimism vs. pesimism,

speranta, response expectancy
Boala vulnerabilitate, predispozitii

Instrumente & Proceduri de evaluare

clinica

Interviuri
Observatii
Chestionare
Teste sau probe
Constrangeri: vrsta copilului,
probleme, disponibilitate, timp

Procesul de diagnostic

Clasificarea tulburrilor vs. clasificarea

indivizilor.
Sistemele de diagnostic clasific tulburri,
nu indivizi.
Clasificm simptomele n primul rnd
pentru ca profesionitii s poat comunica
clar despre sindroamele descriptive.
Utiliznd limbajul comun al unui sistem de
diagnostic, se faciliteaz conexiunea
indivizilor cu serviciile existente

Diagnostic vs. clasificare

www.dsm5.org
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