Helping Students Overcome Depression and Anxiety A Practical Guide

by Merrell, Kenneth W.

• ISBN13: 9781572306172
• ISBN10: 1572306173
• Additional ISBN(s): 9781593856489
• Edition: 1st
• Format: Paperback
• Copyright: 2001-03-31
• Publisher: Guilford Press

Summary

This unique handbook provides the school-based practitioner with clear-cut strategies for addressing depression, anxiety, and other internalizing disorders creatively and effectively with students in grades K-12. Provides a concise overview of the nature, development, and course of childhood depression and anxiety, and outlines a comprehensive assessment model.

Author Biography

Kenneth W. Merrell, PhD, is Professor and Director of School Psychology at the University of Oregon. His research and clinical interests focus on assessment and intervention of behavioral, social, and emotional problems in children and youth The author of numerous journal articles, books, and published assessment instruments, Dr. Merrell is a licensed psychologist and certified school psychologist. He is the editor of Guilford's Practical Assessment in the Schools series.

Table of Contents

Acknowledgments	xiii
About This Series	xv
About This Book	xvii
Index of Intervention Programs and General Intervention Strategies, with Descriptions of Purpose and Developmental Level	xix
List of Specific Treatment Techniques for Depression and Anxiety, Grouped by Program Component	xxiii
Understanding Depression and Anxiety in Children and Adolescents	1	(16)
Introduction and Overview	1	(1)
What Are Internalizing Disorders?	1	(2)
Definition	2	(1)
Relation to Externalizing Disorders	2	(1)
Terminology: Symptoms, Syndromes, and Disorders	2	(1)
Four Types of Internalizing Disorders	3	(8)
Depression	3	(4)
Anxiety	7	(2)
Social Withdrawal	9	(1)
Somatic Problems	10	(1)
Overlap of Internalizing Problems	11	(1)
Students with Internalizing Problems: Three Case Studies	12	(4)
Emma	12	(1)
Brandon	13	(1)
Marcus	14	(1)
The Common Thread	15	(1)
Concluding Comments	16	(1)
How Depression and Anxiety Develop and Are Maintained	17	(23)
Introduction and Overview	17	(1)
Development of Internalizing Problems	18	(4)
Biological Influences	18	(1)
Family Influences	19	(1)
Psychological Stress and Life Events	20	(1)
Cognitive Influences	20	(2)
Behavioral Influences	22	(1)
Do Specific Influences Require Specific Interventions?	22	(1)
The Course of Internalizing Problems: Stability and Persistence	23	(1)
Consequences of Internalizing Problems	24	(7)
Diminished Self-Esteem	24	(2)
Academic Problems	26	(1)
Poor Social Relationships	26	(2)
Chronic Mental Health Problems	28	(1)
Substance Abuse	28	(1)
Suicidal Thoughts, Attempts, Completions	29	(2)
Complications: Sorting Out Related Problems	31	(7)
Bipolar Disorders	31	(1)
Attention-Deficit/Hyperactivity Disorder	32	(3)
Conduct Disorders	35	(1)
Substance Abuse	36	(1)
Eating Disorders	36	(1)
Tourette's Disorder	37	(1)
Concluding Comments	38	(2)
Guidelines for Assessment and Intervention Planning	40	(24)
Introduction and Overview	40	(1)
What Are the Purposes of Assessment?	41	(1)
General Purposes of Assessment	41	(1)
Assessment as a Problem-Solving Process	41	(1)
A Model for Designing Assessments	42	(3)
Assessment Methods	43	(1)
Assessment Sources	44	(1)
Assessment Settings	44	(1)
Best Practices	44	(1)
Recommended Assessment Methods	45	(10)
Behavior Rating Scales	45	(2)
Self-Report Instruments	47	(2)
Interviews	49	(5)
Recommendations	54	(1)
Linking Assessment to Intervention	55	(5)
Progress Monitoring	56	(1)
Template Matching	57	(1)
Keystone Behavior Strategy	58	(1)
Functional Assessment	59	(1)
From Assessment to Treatment Planning	60	(1)
Concluding Comments	61	(3)
Comprehensive Intervention Programs for Depression	64	(18)
Introduction and Overview	64	(1)
Four Comprehensive Intervention Programs	65	(10)
The Adolescent Coping with Depression Course	65	(2)
The Taking Action Program	67	(2)
IFT: A Comprehensive, Family-Centered Intervention	69	(3)
Interpersonal Psychotherapy for Adolescents with Depression	72	(3)
Which Program Is Best?	75	(1)
Modifying or Designing Your Own Comprehensive Treatment Program for Depression	75	(5)
Which Components of the Program Are Most Important?	76	(1)
What Is the Best Group Composition?	77	(2)
How Many Sessions Are Enough?	79	(1)
Concluding Comments	80	(2)
Changing Thoughts and Beliefs: Cognitive Therapy Techniques for Depression	82	(20)
Introduction and Overview	82	(1)
Cognitive Therapy for Depression: An Introduction	83	(2)
Step 1: Developing Awareness of Emotional Variability	85	(1)
The Emotional Thermometer	85	(1)
The Emotional Pie	86	(1)
Step 2: Detecting Automatic Thoughts and Identifying Beliefs	86	(4)
Thought Charts	88	(1)
The Cognitive Replay Technique	88	(1)
Thought Forecasting	89	(1)
Hypothesizing/Guessing	89	(1)
The Down-Arrow Technique	90	(1)
Step 3: Evaluating Automatic Thoughts and Beliefs	90	(6)
Identifying Cognitive Distortions or Thinking Errors	91	(2)
Examining the Evidence: Three Questions	93	(1)
Evaluating Positives and Negatives	94	(2)
Step 4: Changing Negative Automatic Thoughts and Maladaptive Beliefs	96	(5)
Daily Record of Thoughts	96	(1)
Triple-Column Technique	97	(1)
Reframing and Relabeling	97	(2)
Cognitive Rehearsal	99	(1)
Increasing Positive Self-Statements	100	(1)
Concluding Comments	101	(1)
Changing Thoughts and Beliefs: Rational-Emotive Therapy, Attribution Retraining, Learned Optimism, and Journal-Writing Strategies for Depression	102	(15)
Introduction and Overview	102	(1)
Disputing Irrational Thoughts: The RET Approach	103	(3)
Self-Monitoring and Self-Control Training	106	(1)
Attribution Retraining and Learning to Be Optimistic	107	(5)
Attribution Retraining	107	(3)
Learned Optimism Training	110	(2)
Writing It Down: Journal Writing as an Intervention Tool	112	(3)
How Often? Where?	114	(1)
Structure and Format for Journal Entries	114	(1)
Some Practical Considerations	115	(1)
Concluding Comments	115	(2)
Behavior Change, Emotional Education, Interpersonal Problem Solving, and Conflict Resolution Strategies for Depression	117	(22)
Introduction and Overview	117	(1)
Behavioral Interventions for Depression	118	(6)
Specific Uses and Advantages	118	(1)
Activity Scheduling	119	(2)
Operant Conditioning Techniques	121	(3)
Emotional Education	124	(8)
Identifying Comfortable and Uncomfortable Feelings	125	(2)
Learning to Express Feelings: The Incomplete Sentence Technique	127	(1)
Identifying and Expressing Feelings: ``How Do You Feel?''	128	(1)
The Reacting to Emotional Situations Technique	128	(2)
Expressing Feelings: A Self-Rating Inventory for Communicating Feelings	130	(2)
Interpersonal Problem Solving and Conflict Resolution Training	132	(5)
Why Teach Conflict Resolution?	132	(1)
Step 1: Learning about Maladaptive Styles of Problem Solving	133	(2)
Step 2: Training in Conflict Resolution	135	(2)
Social Skills Training	137	(1)
Concluding Comments	138	(1)
Behavioral Treatments for Anxiety: Systematic Desensitization	139	(18)
Introduction and Overview	139	(1)
Overview of Systematic Desensitization	140	(11)
Step 1: Relaxation Training	142	(4)
Step 2: Development of an Anxiety Hierarchy	146	(2)
Step 3: Desensitization (Graded Exposure)	148	(3)
Other Behavioral Interventions	151	(4)
Modeling	151	(1)
Differential Positive Reinforcement	152	(2)
Variations on Reinforcement: Shaping and Extinction	154	(1)
Concluding Comments	155	(2)
Social Skills Training and Other Cognitive-Behavioral Treatments for Anxiety	157	(14)
Introduction and Overview	157	(1)
Self-Control Training for Anxiety	158	(1)
Self-Instructional Training	159	(1)
The ``Coping Cat'' Program for Anxious Youth: An Innovative, Comprehensive Treatment Approach	160	(2)
The Transfer of Control Approach	162	(2)
Social Skills Training	164	(6)
Skills Deficit or Performance Deficit?	164	(1)
Basic Steps in Social Skills Training	165	(3)
Training Suggestions for Socially Withdrawn and Anxious Students	168	(2)
Concluding Comments	170	(1)
Finding More Help: Referral Guidelines for Mental Health Counseling, Psychiatric Medications, and Alternative Treatments	171	(22)
Introduction and Overview	171	(1)
Making Referrals for Mental Health Counseling and Psychiatric Medications	172	(5)
When Should I Make a Referral?	172	(2)
Who Provides Services?	174	(1)
Medical Generalist or a Specialist?	174	(1)
How Do I Find a Good Referral Source?	175	(1)
What Can I Do to Facilitate the Referral?	175	(1)
Whose Financial Responsibility Is It?	175	(2)
Using Medications to Treat Children's Social-Emotional Problems: Some Basic Issues and Concerns	177	(3)
Excessive and Unnecessary Use of Medication	178	(1)
Adverse Reactions and Effects	179	(1)
Labeling and Stigmatization	179	(1)
What If the Parents Are Opposed to Using Medications?	179	(1)
Medications for Treatment of Depression	180	(4)
Tricyclic Antidepressants	180	(1)
Selective Serotonin Reuptake Inhibitors	181	(1)
Other Medications for Treating Depression	182	(2)
Medications for Anxiety-Related Problems	184	(2)
Benzodiazepines	184	(1)
Antihistamines	185	(1)
Selective Serotonin Reuptake Inhibitors	185	(1)
Tricylic Antidepressants	186	(1)
Buspar	186	(1)
Alternative Interventions	186	(4)
St. John's Wort: Nature's Mood Enhancer?	187	(1)
Using Light Therapy to Treat Seasonal Depression	188	(2)
Concluding Comments	190	(3)
Appendix: Reproducible Worksheets	193	(30)
References	223	(4)
Index	227