chapter  13
23 Pages


The conclusions drawn in this chapter are based on the results of over 150 controlled studies containing more than 5,000 cases who received wellspecified psychological interventions. For each of the eleven main problem areas listed below six or more studies containing more than 200 cases were reviewed. Each group of studies contained the most methodologically robust investigations that could be located through computer and manual literature search methods of English language journals for the period 1977 to 1997. The areas covered were:

• Child abuse and neglect • Enuresis and encopresis • Attention deficit hyperactivity disorder • Oppositional defiant disorder • Conduct problems in adolescence • Drug abuse in adolescence • Anorexia and bulimia • Anxiety • Depression • Paediatric pain problems • Adjustment to divorce

What works for child abuse and neglect? The evidence reviewed in Chapter 2 showed that abused children and their families can benefit from psychological interventions which focus on the child, the parents or the social system within which the abuse occurs. For physical abuse and neglect, three child-focused interventions were particularly effective. These were residential treatment, therapeutic day care and resilient peer therapy. Residential treatment in which the child was placed at a special unit and visited daily by parents provided a protective, supportive and intellectually stimulating context within which positive parent-child interaction was fostered. Therapeutic day care where intellectual stimulation was provided within the context of supportive child-teacher relationships

Conclusions 301

and high staffing levels promoted cognitive and social-emotional development. Resilient peer therapy, where at-risk children were given structured opportunities to be befriended by socially skilled peers enhanced social development.