Clicca qui per scaricare

Applicazioni del "Cool Kids Program" di Ronald Rapee per il trattamento dei disturbi d’ansia in età evolutiva
Titolo Rivista: QUADERNI DI PSICOTERAPIA COGNITIVA 
Autori/Curatori: Alessia Incerti, Davide Nahum 
Anno di pubblicazione:  2014 Fascicolo: 34 Lingua: Italiano 
Numero pagine:  16 P. 25-40 Dimensione file:  146 KB
DOI:  10.3280/QPC2014-034003
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più:  clicca qui   qui 


Spesso nei servizi di neuropsichiatria infantile è necessario creare liste d’attesa per la presa incarico dei piccoli pazienti in psicoterapia individuale. Le risorse, infatti, non sono sempre pari al bisogno. Emerge la necessità di appoggiarsi a terapie efficaci in tempi brevi, in setting di gruppo. Tra i modelli presenti in letteratura abbiamo scelto il "Cool Kids Program" di Ronald Rapee, un trattamento evidence based la cui efficacia è basata su ricerche effettuate nell’arco di un decennio nelle seguenti strutture australiane: Macquarie University; Royal North Hosiptal e Queensland University. Si tratta di un trattamento che prevede sia una componente comportamentale (psico-educazione dell’ansia ed esposizioni) sia una componente cognitiva (critica e ristrutturazione dei pensieri). Il programma prevede un alto coinvolgimento dei genitori nel trattamento, come evidenziato da Barret et al. (1996); Mendlowitz et al. (1999); Cobham et al. (1998), i programmi cognitivo-comportamentali mirati ai bambini e con una parte del trattamento che coinvolge i genitori portano a risultati più significativi alla fine del programma e nel follow-up a tre e sei mesi. Il "Cool Kids Program" è un trattamento manualizzato, ossia comprende i manuali con i materiali specifici da usare in terapia per tutti gli attori dell’intervento (psicoterapeuta, bambino, genitori). Nel presente lavoro si descrive il protocollo di trattamento "Cool Kids", il modello teorico di riferimento, la struttura dell’intervento e le metodologie di applicazioni, realizzate dagli Autori in centro pubblico e presso studi privati.


Keywords: Psicoterapia cognitivo-comportamentale di gruppo, disturbi d’ansia, bambini, genitori

  1. Abbott M.J., Gaston J., Rapee R.M. (2002). Bibliotherapy in the treatment of children with anxiety disorders. Paper presented at the 5rd International Child and Adolescent Mental HealthConference, Brisbane, June 11-15.
  2. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington DC: American Psychiatric Association.
  3. Andrews G., Stewart G.W., Alien R., Henderson A.S. (1990). The genetics of six neuroticdisorders: a twin study. British Journal of Psychiatry, 157: 6-12.
  4. Barrett P.M., Dadds M.R., Rapee R.M. (1996a). Family treatment of childhood anxiety: acontrolled trial. Journal of Consulting and Clinical Psychology, 64: 333-342., 10.1037/0022-006X.64.2.33DOI: 10.1037/0022-006X.64.2.33
  5. Barrett P.M., Rapee R.M., Dadds M.R., Ryan S.M. (1996b). Family enhancement ofcognitive style in anxious and aggressive children. Journal of Abnormal Child Psychology, 24: 187-203., 10.1007/BF0144148DOI: 10.1007/BF0144148
  6. Barrett P.M., Duffy A.L., Dadds M.R., Rapee R.M. (2001). Cognitive-behavioural treatment of anxiety disorders in children: long-term (6 year) follow-up. Journal of Consulting and Clinical Psychology, 69: 135-141., 10.1037/0022-006X.69.1.13DOI: 10.1037/0022-006X.69.1.13
  7. Chorpita B.F., Barlow D.H. (1998). The development of anxiety: the role of control in theearly environment. Psychological Bulletin, 124: 3-21., 10.1037/0033-2909.124.1.DOI: 10.1037/0033-2909.124.1.
  8. Cobham V.E., Dadds M.R., Spence S.H. (1998). The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting and Clinical Psychology, 66: 893-905., 10.1037/0022-006X.66.6.89DOI: 10.1037/0022-006X.66.6.89
  9. Dadds M.R., Heard P.M., Rapee R.M (1992). The role of family intervention in the treatment of child anxiety disorders: some preliminary findings. Behaviour Change, 9: 171-177 Dadds M.R., Barrett P.M., Rapee R.M., Ryan S. (1996). Family process and child anxiety and aggression: an observational analysis. Journal of Abnormal Child Psychology, 24: 715-734., 10.1007/BF0166473DOI: 10.1007/BF0166473
  10. Dadds M.R., Spence S.H., Holland D.E., Barrett P.M., Laurens K.R. (1997). Preventionand early intervention for anxiety disorders: a controlled trial. Journal of Consulting and Clinical Psychology, 65: 627-635., 10.1037/0022-006X.65.4.62DOI: 10.1037/0022-006X.65.4.62
  11. Eley T.C., Stevenson J. (2000). Specific life events and chronic experiences differentially associated with depression and anxiety in young twins. Journal of Abnormal Child Psychology, 28: 383-394., 10.1023/A:100517312711DOI: 10.1023/A:100517312711
  12. Flannery-Schroeder E.C., Kendall P.C. (2000). Group and individual cognitive-behavioraltreatments for youth with anxiety disorders: A Randomized Clinical Trial. Cognitive Therapy and Research, 24: 251-278., 10.1023/A:100550021928DOI: 10.1023/A:100550021928
  13. Foa E.B., McNally R.J. (1996). Mechanisms of change in exposure therapy. In: Rapee R.M., editor, Current Controversies in the Anxiety Disorders. New York: Guilford Press, pp. 329-343.
  14. Goodyer I.M., Altham P.M.E. (1991). Lifetime exit events and recent social and family adversities in anxious and depressed school-age children and adolescents II. Journal of Affective Disorders, 21: 229-238., 10.1016/0165-0327(91)90002-AGrahamP.,editor(2005).Cognitive-BehaviourTherapyforChildrenandFamilies–SecondEdition.Cambridge:UniversityPress(trad.it.:Manualediterapiacognitivo-comportamentaleconibambiniegliadolescenti.Roma:FieraeLiuzzo,2010)DOI: 10.1016/0165-0327(91)90002-AGrahamP.,editor(2005).Cognitive-BehaviourTherapyforChildrenandFamilies–SecondEdition.Cambridge:UniversityPress(trad.it.:Manualediterapiacognitivo-comportamentaleconibambiniegliadolescenti.Roma:FieraeLiuzzo,2010)
  15. Hudson J.L., Rapee R.M. (2004). From anxious temperament to disorder: an etiologicalmodel of generalized anxiety disorder. In: Heimberg R.G., Turk C.L., Mennin D.S., editors, Generalized anxiety disorders: Advances in research and practice. New York: Guilford Press, pp. 51-74.
  16. Kendall P.C. (1994). Treating anxiety disorders in children: results of a randomised clinical trial. Journal of Consulting and Clinical Psychology, 65: 724-730., 10.1037/0022-006X.62.1.10DOI: 10.1037/0022-006X.62.1.10
  17. Kendall P.C., Southam-Gerow M.A. (1996). Long-term follow-up of a cognitive-behavioraltherapy for anxiety-disordered youth. Journal of Consulting and Clinical Psychology. 62: 100-110., 10.1037/0022-006X.64.4.72DOI: 10.1037/0022-006X.64.4.72
  18. Kendall P.C., Flannery-Schroeder E.C., Panichell-Mindel S.M., Southam-Gerow M., Henin
  19. A., Warman M.J. (1997). Therapy for youths with anxiety disorders: a second randomized clinical trial. Journal of Consulting and Clinical Psycholoy, 65: 366-380., 10.1037/0022-006X.65.3.366DOI: 10.1037/0022-006X.65.3.366
  20. Lyneham H.J., Rapee R.M. (2002). Evaluation of Tele- psychology treatment approaches for children with anxiety disorders. Paper presented at the 5rd International Conference on Childand Adolescent Mental Health, Brisbane, Australia.
  21. Manassis K., Bradley S.J. (1994). The development of childhood anxiety disorders: towards anintegrated model. Journal of Applied Developmental Psychology, 15: 345-366., 10.1016/0193-3973(94)90037-DOI: 10.1016/0193-3973(94)90037-
  22. Manassis K., Mendlowitz S.L., Scapolato D. et al. (2002). Group and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial. American Academy of Child and Adolescent Psychiatry, 41: 1423-1430., 10.1007/s10608-005-3168-DOI: 10.1007/s10608-005-3168-
  23. Meichenbaum D. (1977). Cognitive- behaviour modification: An Integrative Approach. New York: Plenum.
  24. Mendlowitz S.L., Manassis K., Bradley S., Scapillato D., Mietzitis S., Shaw B.F. (1999).
  25. Cognitive-behavioral group treatments in childhood anxiety disorders: the role of parentalinvolvement. Journal of the American Academy of Child and Adolescent Psychiatry, 38: 1223-1229., 10.1097/00004583-199910000-00010PriorM.,SansonA.,SmartD.,OverklaidF.(2000).Path-waysfromInfancytoAdolescence:AustralianTemperamentProject1983-2000.Melbourne:AustralianInstituteofFamilyStudiesDOI: 10.1097/00004583-199910000-00010PriorM.,SansonA.,SmartD.,OverklaidF.(2000).Path-waysfromInfancytoAdolescence:AustralianTemperamentProject1983-2000.Melbourne:AustralianInstituteofFamilyStudies
  26. Rapee R.M. (1997). Potential role of childrearing practices in the development of anxiety anddepression. Clinical Psychology Review, 17: 47-67., 10.1016/S0272-7358(96)00040-DOI: 10.1016/S0272-7358(96)00040-
  27. Rapee R.M. (2000). Group treatment of children with anxiety disorders: outcome and predictors of treatment response. Australian Journal of Psychology, 52: 125-130., 10.1080/0004953000825537DOI: 10.1080/0004953000825537
  28. Rapee R.M. (2001). The development of generalized anxiety. In: Vasey M.W., Dadds M.R., editors, The Developmental Psychopathology of Anxiety. Oxford: Oxford University Press, pp. 481-503.
  29. Rapee R.M. (2003). The influence of comorbidity on treatment outcome for children and adolescents with anxiety disorders. Behaviour Research and Therapy, 41: 105-112.
  30. Rapee R.M., Wignall A.M., Hudson J.L., Schniering C.A. (2000). Treating Anxious Children and Adolescents: An Evidence-Based Approach. Oakland, CA: New Harbinger
  31. Publications.
  32. Rapee R., Wignall A., Psych D., Spence S., Lyneham H. (2008). Helping Your Anxious Child: A Step-by-Step Guide for Parents, Oakland, CA: New Harbinger Publications. Ronald M., Rapee H.J. Lyneham J.L. Hudson M., Kangas V.M., Wuthrich, C.A. Schniering
  33. (2009). A Selective Intervention Program for Inhibited Preschool-Aged Children of Parents With an Anxiety Disorder: Effects on Current Anxiety Disorders and Temperament. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 6: 602-60., 10.1097/CHI.0b013e31819f6faDOI: 10.1097/CHI.0b013e31819f6fa
  34. Sburlati E.S., Lyneham H.J., Schniering C.A., Rapee R.M. (2014). Evidence-Based CBT for Anxiety and Depression in Children and Adolescents: A Competencies Based Approach, Chichester, UK: John Wiley & Sons, Ltd.
  35. Schniering C.A., Hudson J.L., Rapee R.M. (2000). Issues in the diagnosis and assessmentof anxiety disorders in children and adolescents. Clinical Psychology Review, 20: 453-478., 10.1016/S0272-7358(99)00037-DOI: 10.1016/S0272-7358(99)00037-
  36. Silverman W.K., Field A.P. (2011). Anxiety Disorders in Children and Adolescents. Cambridge Child and Adolescent Psychiatry, New York, NY: Cambridge University Press.
  37. Spence S., Cobham V., Wignall A., Rapee R.M. (2000). Helping Your Anxious Child: A Step-By-Step Guide for Parents, Oakland, CA: New Harbinger Publications.
  38. Topolski T.D., Hewitt I.K., Eaves L.I. et al. (1997). Genetic and environment influences onchild reports of manifest anxiety and symptoms of separation anxiety and overanxious disorders: a community-based twin study. Behaviour Genetics, 27: 15-28., 10.1023/A:102560710756DOI: 10.1023/A:102560710756
  39. Toren P., Wolmer L., Rosental B. et al. (2000). Case series: brief parent-child group therapy for childhood anxiety disorders using a manual-based cognitive-behavioural technique. Journal of the American Academy of Child and Adolescent Psychiatry, 39: 1309-1312., 10.1097/00004583-200010000-0001DOI: 10.1097/00004583-200010000-0001
  40. Williams S.L. (1996). Therapeutic changes in phobic behavior are mediated by changes in perceived self-efficacy. In: Rapee R.M., editor, Current Controversies in the Anxiety Disorders. New York: Guildford Press, pp. 344-368.
  41. Wuthrich V.M., Rapee R.M., Cunningham M.J., Lyneham H.J., Huson J.L., Schniering C.A.
  42. (2012). A Randomized Controlled Trial of the Cool Teens CD-ROM Computerized Program for Adolescent Anxiety. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 3: 261-270., 10.1016/j.jaac.2011.12.00DOI: 10.1016/j.jaac.2011.12.00

Alessia Incerti, Davide Nahum, in "QUADERNI DI PSICOTERAPIA COGNITIVA" 34/2014, pp. 25-40, DOI:10.3280/QPC2014-034003

   

FrancoAngeli è membro della Publishers International Linking Association associazione indipendente e no profit per facilitare l'accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche