Mental Health Care of Children and Adolescents: A Guide for Primary Care Clinicians 894 Table A7-1. Common Elements Indicationsa EPB Sourcesb Common Elements of EBPs Amenable to Primary Care Chapters Symptoms of emo- tional distress in young children (eg, dysregulation, aggression, extreme tantrums, irritability, unhappy mood, ex- treme anxiety, lack of social reciprocity with caregiver, poor attachment) Parenting ed- ucation (See examples in the “Parenting Educa- tion” cell earlier in this table.) Promoting First Relationships Parents as Teachers Child-Parent Psychotherapy Cognitive behav- ioral therapy Reframe child’s per- ceived bad behavior. Reinforce strengths and protective factors. Teach… Prevention of unnec- essary or extreme triggers Attention and praise for positive behavior Clear, simple com- mands and limit setting Relaxation and anxi- ety management Consistent, safe responses to negative behavior Special time (“time in”) with parents 17 Abbreviations: EBP, evidence-based practice PCIT, Parent-Child Interaction Therapy PTSD, post- traumatic stress disorder. a Use of common elements approaches for these indications should not delay full diagnostic evaluation or definitive therapy if the patient’s symptoms suggest a psychiatric emergency, severe impairment, or marked distress. Common elements approaches are well suited to the care of patients whose symptoms do not reach a diagnostic threshold, the care of patients who are resistant or otherwise not yet ready to pursue further diagnostic assessment or treatment, and the care of patients who are awaiting further diagnostic assessment and treatment. b See Appendix 6, PracticeWise: Evidence-Based Child and Adolescent Psychosocial Interventions, for more information about these evidence-based practices. (continued) 39-MHCC_appendix-07.indd 894 4/6/18 11:53 AM
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