Advertisement

Ethical Issues Applying CBT in Pediatric Medical Settings

  • Gerald P. Koocher
  • Jeanne S. Hoffman
Chapter
Part of the Autism and Child Psychopathology Series book series (ACPS)

Abstract

Events related to chronic or acute illness, pain, and chronic distressing symptoms in children and adolescents can trigger a range of psychological problems that have the potential to disrupt the lives of families and impede optimal medical care. Cognitive behavioral therapies include a range of approaches that can effectively address the anxiety, depression, and other emotional and behavioral problems while promoting adherence to treatment frequently encountered in pediatric medical care contexts. Developmental differences create particular ethical challenges related to adapting consent processes, treatment goals, and the application of particular techniques. This chapter provides examples of ethical challenges that can arise in applying CBT with pediatric patients along with strategies for providing optimal ethical care.

Keywords

CBT Children Ethics Health-care ethics Medical ethics Pediatrics 

References

  1. Allen, T. M., Wren, A. A., Anderson, L. M., Sabholk, A., & Mauro, C. F. (2018). A group CBT-yoga protocol targeting pain-related and internalizing symptoms in youth. Clinical Practice in Pediatric Psychology, 6(1), 7–18.  https://doi.org/10.1037/cpp0000206.CrossRefGoogle Scholar
  2. Birnie, K. A., Noel, M., Chambers, C. T., Uman, L. S., & Parker, J. A. (2018). Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database of Systematic Reviews.  https://doi.org/10.1002/14651858.CD005179.pub4.
  3. Caporino, N. E., Read, K. L., Shiffrin, N., Settipani, C., Kendall, P. C., Compton, N., & Albano, A. M. (2017). Sleep-related problems and the effects of anxiety treatment in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 46(5), 675–685.  https://doi.org/10.1080/15374416.2015.1063429.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Ernst, M. M., O’Brien, H. L., & Powers, S. W. (2015). Cognitive-behavioral therapy: How medical providers can increase patient and family openness and access to evidence-based multimodal therapy for pediatric migraine. Headache: The Journal of Head and Face Pain, 55(10), 1382–1396.  https://doi.org/10.1111/head.12605.CrossRefGoogle Scholar
  5. Gola, J. A., Beyda’s, R. S., Antonio-Burke, D., Kratz, H. E., & Fingerhut, R. (2016). Ethical considerations in exposure therapy with children. Cognitive and Behavioral Practice, 23(2), 184–193.  https://doi.org/10.1016/j.cbpra.2015.04.003.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Haman, K. L., & Hollon, S. D. (2009). Ethical considerations for cognitive-behavioral therapists in psychotherapy research trials. Cognitive and Behavioral Practice, 16(2), 153–163.  https://doi.org/10.1016/j.cbpra.2008.08.005.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Hoffman, J. S., & Koocher, G. P. (2018). Strategies for ethical practice in medical settings. Practice Innovations, 3(1), 43–55.  https://doi.org/10.1037/pri0000062.CrossRefGoogle Scholar
  8. Isaia, A. R., Weinstein, S. M., Shankman, S. A., & West, A. E. (2018). Predictors of dropout in family-based psychosocial treatment for pediatric bipolar disorder: An exploratory study. Journal of Child and Family Studies, 27, 1–17.  https://doi.org/10.1007/s10826-018-1126-0.CrossRefGoogle Scholar
  9. Koocher, G. P. (2005). Behavioral research with children: The Fenfluramine challenge. In E. Kodesh (Ed.), Learning from cases: Ethics and research with children (pp. 179–193). New York: Oxford University Press.Google Scholar
  10. Koocher, G. P., & Keith-Spiegel, P. C. (2016). Ethics in psychology and the mental health professions: Standards and cases (4th ed.). New York: Oxford University Press.Google Scholar
  11. Law, E. F., Beals-Erickson, S. E., Fisher, E., Lang, E. A., & Palermo, T. M. (2017). Components of effective cognitive-behavioral therapy for pediatric headache: A mixed methods approach. Clinical Practice in Pediatric Psychology, 5(4), 376–391.  https://doi.org/10.1037/cpp0000216.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Levis, D. J., & Castelda, B. A. (2005). Stampfl’s therapist-directed implosive (flooding) therapy. In M. Hersen, J. Rosqvist, A. M. Gross, R. S. Drabman, G. Sugai, & R. Horner (Eds.), Encyclopedia of behavior modification and cognitive behavior therapy. Sage Online.  https://doi.org/10.4135/9781412950534.n153.
  13. Loades, M. (2015). The cognitive behavioral treatment of depression and low self-esteem in the context of pediatric chronic fatigue syndrome (CFS/ME): A case study. Journal of Child and Adolescent Psychiatric Nursing, 28(4), 165–174.  https://doi.org/10.1111/jcap.12125.CrossRefPubMedPubMedCentralGoogle Scholar
  14. McGuire, J. F., Wu, M. S., Choy, C., & Piacentini, J. (2018). Editorial perspective: Exposures in cognitive behavior therapy for pediatric obsessive-compulsive disorder: Addressing common clinician concerns. Journal of Child Psychology and Psychiatry, 59(6), 714–716.  https://doi.org/10.1111/jcpp.12818.CrossRefPubMedPubMedCentralGoogle Scholar
  15. McMurtry, C. M., Tomlinson, R. M., & Genik, L. M. (2017). Cognitive behavioral therapy for anxiety and fear in pediatric pain contexts. Journal of Cognitive Psychotherapy, 31(1), 41–56.  https://doi.org/10.1891/0889-8391.31.1.41.CrossRefGoogle Scholar
  16. Norcross, J. C., Hogan, T., Koocher, G. P., & Maggio, L. A. (2017). Clinician’s guide to evidence-based practices: Mental health and the addictions (2nd ed.). New York: Oxford University Press.CrossRefGoogle Scholar
  17. Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cognitive and Behavioral Practice, 16(2), 172–180.  https://doi.org/10.1016/j.cbpra.2008.07.003.CrossRefGoogle Scholar
  18. Reigada, L. C., Polokowski, A. R., Walder, D., Sigethy, E. M., Benkov, K. J., Bruzzese, J., & Masia Warner, C. (2015). Treatment for comorbid pediatric gastrointestinal and anxiety disorders: A pilot study of a flexible health sensitive cognitive-behavioral therapy program. Clinical Practice in Pediatric Psychology, 3(4), 314–326.  https://doi.org/10.1037/cpp0000116.CrossRefGoogle Scholar
  19. Sookman, D. (2015). Ethical practice of cognitive behavioral therapy. In The Oxford handbook of psychiatric ethics. New York: Oxford University Press.  https://doi.org/10.1093/oxfordhb/9780198732372.013.35.CrossRefGoogle Scholar
  20. Turner, C., O’Gorman, B., Nair, A., & O’Kearney, R. (2018). Moderators and predictors of response to cognitive behavior therapy for pediatric obsessive-compulsive disorder: A systematic review. Psychiatry Research, 261, 50–60.  https://doi.org/10.1016/j.psychres.2017.12.034.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gerald P. Koocher
    • 1
  • Jeanne S. Hoffman
    • 2
  1. 1.Quincy CollegeQuincyUSA
  2. 2.Tripler Army Medical CenterHonoluluUSA

Personalised recommendations