"How Many More Questions?": Techniques for Clinical Interviews of Young Medically Ill Children

by Rochelle Caplan, Brenda Bursch

Overview

How Many More Questions?: Techniques for Clinical Interviews of Young Medically Ill Children provides readers with a comprehensive framework to understand how 5-10 year old children use language to formulate and communicate their thoughts. The book then guides the reader in how to effectively elicit information about sensitive and stressful topics from young children, such as their emotions, difficulties, problems, worries, and illness. Seventeen exquisitely written chapters that include twelve developmental guidelines, techniques, case examples, and illustrative dialogues provide the reader with the tools needed to address specific communication challenges involved in speaking with young children who have pain, medical trauma, terminal illness, or specific disorders like epilepsy.

How Many More Questions? is useful for pediatric professionals who strive to acquire exceptional clinical interviewing skills and who no longer wish to hear children say, "When are we done?" The wide range of medical and non-medical professionals who work with young ill children, such as pediatricians, neurologists, psychiatrists, psychologists, neuropsychologists, social workers, nurses, child life specialists, as well as interested parents will use this book as a reference guide.

Product Details

ISBN-13:	9780199843824
Publisher:	Oxford University Press
Publication date:	10/22/2012
Edition description:	New Edition
Pages:	344
Product dimensions:	9.10(w) x 6.00(h) x 0.80(d)

About the Author

Rochelle Caplan, MD, is Professor Emeritus of Psychiatry in the UCLA Department of Psychiatry and Directed the UCLA Pediatric Neuropsychiatry clinical program for twenty years. She completed her medical studies at the Jerusalem University Hadassah Medical School and her training in adult and child psychiatry at the Tel-Aviv University Sackler Medical School. Dr. Caplan is a pediatric neuropsychiatrist with clinical and research expertise in how children use language to formulate their thoughts and present them to the listener. She has devoted her clinical career to the evaluation and treatment of children with severe behavior/emotional problems due to psychiatric and neurological disorders. Her research has used psycholinguistic, behavior/emotions, and brain imaging measures to study abnormalities in the development of communication skills, behavior/emotions, and brain in children with psychiatric and neurological disorders.



Brenda Bursch, PhD, is a medical psychologist with clinical and research interests in pediatric pain, palliative care, somatization, and illness falsification. She received her PhD from Claremont Graduate School in 1990 and is a Professor in the Departments of Psychiatry & Biobehavioral Sciences and Pediatrics at the David Geffen School of Medicine at UCLA, where she has been on faculty since 1994. She is the Clinical Director of the Pediatric Psychiatry Consultation Liaison service, overseeing child psychiatry consultations for pediatric medical inpatients. She has presented lectures at professional conferences within the United States and abroad, and has published numerous scientific articles and book chapters.

Table of Contents

Introduction and overview

Part I Interview basics
1. Developmental guidelines

Part II Application of developmental guidelines: Assessment of emotions/behaviors in pediatric illness
2. Overview
3. Mood including anger and irritability
4. Fears and anxiety
5. Attention
6. Aggression
7. Insight, judgment, and reality testing
8. Somatization
9. Symptoms associated with autistic spectrum

Part III Application of the developmental guidelines: A comprehensive assessment of pediatric epilepsy
10. Overview
11. Biological aspects of pediatric epilepsy
12. Psychosocial impact of pediatric epilepsy

Part IV Application of the developmental guidelines: Specific communication challenges in young ill children
13. Overview
14. Pediatric pain
15. Pediatric iatrogenic trauma symptoms
16. Pediatric terminal illness

Part V Brief review and next steps
17. "Guess what? We are done. You are such a good talker and did such a great job!"

Editorial Reviews

Reviewer: Susan M. Wechter, PhDc, RN, PPCPNP-BC(Walsh University Nursing School)
Description: This essential book provides specific, tangible guidelines for communicating with medically fragile, school-age children. Half of the chapters are devoted to explicit child development guidelines to assist healthcare practitioners in giving children voice to their perceptions and emotions. The authors complete the guide with specific case examples of children experiencing epilepsy, pain, trauma, and terminal illness.
Purpose: The purpose is to provide professionals with the skills for conducting complex and challenging clinical interviews of these young children. Through coaching strategies, zeroing in on developmental parameters and perceptions of children 5 to 10 years of age, the authors prompt a clear vision of the world from a child's viewpoint. There are very few comprehensive, scholarly resources that provide coaching to pediatric professionals to expand their competency in communicating effectively with children, making this a valuable tool.
Audience: The book is written for a wide range of professionals and students in healthcare who desire to improve their communication skills with children. Although the authors focus on medically fragile children, the book provides a comprehensive account of the basics of child development and child perceptions that could make it useful for audiences both within healthcare and beyond. The authors present the information from a rich pediatric and neurodevelopmental framework.
Features: The book provides a clear overview of 12 developmental guidelines to use when interviewing children. These guidelines become the basis for rich interactions with medically fragile children experiencing specific emotional and behavioral alterations including mood alterations, anger, irritability, fear, anxiety, attention deficit, aggression, and somatization. Detailed information about children experiencing epilepsy, autism, pain, trauma, and terminal illness guide practitioners in empowering these most vulnerable populations. Readers come away with tangible skills they can immediately use in the clinical setting. The vignettes, sample communications, and case examples illustrate specific do's and don'ts for eliciting real and valuable information from a child's perspective. By giving a child a voice, the practitioner can better respond to and improve the validity of holistic pediatric care in a variety of healthcare settings. The one disappointment is the lack of discussion of family theory and parent and sibling influence on communication patterns of children.
Assessment: This is a wonderful tool for all professionals working with children. The authors provide one of the first written coaching guidelines with a rich developmental framework. The understanding of a child's perception of his/her feelings and thoughts about medical and behavioral care and the ability to respond accurately to a child's needs is essential. Few comprehensive resources designed to empower children through communication are available to healthcare professionals. The authors have made an outstanding contribution to improving the health of children.

Doody's Review Service

"The book is well structured, beginning with chapter overview and ending with summary points at the end of each section, making it concise and focused. This is an excellent text for paediatric and child-psychiatry residents in consultation liason service, and child-life specialists starting out their training. —The Psychiatrist

"With sensitivity and compassion for young children, and a focus on pragmatic and feasible solutions, the authors stress the importance of approaching clinical interviews in the contexts of the developmental stage of the child's communication skills, the impact of the specific illness on those skills, and the emotional and behavioral issues that so often arise from physical and psychological suffering." — Steven C Schachter, MD, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA

"Condensing years of clinical wisdom, the authors outline twelve essential developmental guidelines that should be considered in interviews of all children. These guidelines are accompanied by detailed, real life case vignettes that illustrate specific interviewing approaches and, equally important, which words and questions to avoid. These principles come to life in the second section of the book where they used to show how careful, developmentally-appropriate interviewing techniques form the corner stone of the diagnostic assessment." — Richard J. Shaw, MD, Professor of Psychiatry and Pediatrics, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA

"In this important and innovative book, Caplan and Bursch utilize a developmentally sensitive framework to provide professionals from a variety of disciplines with the interviewing skills necessary to conduct challenging clinical interviews with young children who have medical, psychiatric, and/or neurological illnesses. They proffer developmental guidelines for how to obtain accurate clinical information from young children. The authors also present engaging and excellent clinical vignettes throughout the volume that illustrate the principles of developmentally sensitive interviewing with a variety of high-risk youngsters. I enthusiastically recommend this book." — Dante Cicchetti, PhD, McKnight Presidential Chair, William Harris Professor, and Professor of Child Psychology and Psychiatry, Institute of Child Development, University of Minnesota, Minneapolis, MN

"Caplan and Bursch understand how to talk to, and how to listen to, children. They also understand how to talk to adults who are struggling to do the same. In this remarkably successful book they provide us with a clear understanding of the child's world view, and with example after example, they show how what we think we are saying as adults can be heard differently." — Christopher Eccleston, PhD. Centre for Pain Research, The University of Bath, UK.

"[This] is an essential, practical, developmentally sensitive guide for clinicians learning to elicit useful and accurate information from young children including those with language deficits or other mild cognitive impairments. They perceptively cover a broad range of challenging topics from talking with children who have epilepsy and its concomitant psychiatric, cognitive, linguistic and psychosocial comorbidities to talking with children who have experienced medical trauma or are dying of a terminal illness. The gentle wisdom and accumulated knowledge of Caplan and Bursch comes shining through as they take our hand and walk us through the many questions we have to ask children to understand their cognitive and emotional experiences of medical care. Just as children often ask, "Are we there yet?" Caplan and Bursch take us on a learning journey and expertly help us arrive at our destination of how to communicate clearly with children." — Maryland Pao, MD, Bethesda, Maryland

"Thanks to Caplan and Bursch for providing an excellent reference for all practitioners who interact with young children as they sort out differential diagnoses involving physical, emotional and cognitive symptoms. The book contains many sample interviews that illustrate effective techniques along with practical guidelines for clinicians to become the child's "communication assistant" or "coach" partnering with the child and family to find the best possible solutions for their presenting concerns. I particularly appreciate the section that focuses on two of the most common somatic complaints, headaches and stomach aches, providing a laundry list of potential causes. The chapter discussing terminal illness is another invaluable component. This book is like having the Child Psychiatric Consult/Liaison team in your pocket." — Beatrice Yorker, RN, MS, JD, Dean and Professor of Nursing, College of Health and Human Services, California State University, CA

"History is without question the most important diagnostic tool in the armamentarium of anyone who provides healthcare to children, and yet it is often the most challenging thing to obtain. Critical portions of the history can only be obtained from the child him or herself...That is why this wonderful book...is such a gift to any healthcare professional who needs to communicate effectively with kids, be it pediatricians, pediatric subspecialists such as neurologists or psychiatrists, nurses, psychologists or social workers. By providing clear and concise information...this book provides an essential reference for pediatric healthcare professionals." — Amy Brooks-Kayal, MD, Chief and Ponzio Family Chair in Pediatric Neurology Children's Hospital Colorado Professor of Pediatrics, Neurology and Pharmaceutical Sciences University of Colorado

"The provision of sample interviews illustrating the rights and wrongs of asking children about their symptoms and opinions are invaluable. These vignettes also illustrate how to bring the parents into the picture by obtaining the permission and establishing the readiness of the child...This book will be invaluable for trainees in a variety of mental health, counselling and medical programs, and for more advanced practitioners to enhance their skills. I will certainly be using this book in my teaching and to enrich my own practice." — Mary Lou Smith, PhD, CPsych, Department of Psychology, University of Toronto; and Neuropsychologist and Associate Senior Scientist, Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Ontario Canada

"The authors should be applauded for putting together such an important work. I enthusiastically endorse this book which I think will be an important addition to the pediatric literature for years to come." — Joseph I. Sirven, MD, Editor-in-Chief, epilepsy.com

"This is a wonderful tool for all professionals working with children. The authors provide one of the first written coaching guidelines with a rich developmental framework. The understanding of a child's perception of his/her feelings and thoughts about medical and behavioral care and the ability to respond accurately to a child's needs is essential. Few comprehensive resources designed to empower children through communication are available to healthcare professionals. The authors have made an outstanding contribution to improving the health of children." — Susan M. Wechter, PhDc, RN, PPCPNP-BC, Walsh University Nursing School, Doody's

From the Publisher