By Katharina Manassis MD FRCPC
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Additional resources for Case Formulation with Children and Adolescents
1 are designed to guide clinician observations of family functioning but are not usually asked during assessment interviews. Instead, the clinician writes relevant observations in the margins while gathering other information and organizes them after the interview ends. I often leave a wide margin on one side of the page to allow room to note such observations. 1. Sometimes the questions also prompt the clinician to remember additional details of family interaction. It is important to note that the answers to the questions represent hypotheses about family interactions and how they might affect the child.
Parents, on the other hand, are more likely to disclose family financial problems or potentially embarrassing family information when their children are not present. 30 CASE FORMULATION WITH CHILDREN AND ADOLESCENTS It is also important to recognize that children’s behaviors are often quite different depending on the child’s environment. Thus, a child could be quite well mannered at school but difficult to manage at home. Conversely, some children exhibit abilities in the home environment, where they feel safe, that they do not exhibit at school, where they may be more inhibited.
Both are important sources of information, but let’s start with a discussion of interview content. To begin, the clinician is more likely to elicit relevant content if she takes the time to put the child and family at ease and make a 28 CASE FORMULATION WITH CHILDREN AND ADOLESCENTS connection with both the child and the parents (often called “establishing rapport”). Some requirements are obvious: presenting yourself as warm, relaxed, and open, cordially inviting people into the office, ensuring that everyone has a comfortable place to sit, making sure that the room is at a comfortable temperature, nobody is hungry or needs to visit the bathroom, the door is closed for privacy, and the interview is free from interruptions.
Case Formulation with Children and Adolescents by Katharina Manassis MD FRCPC