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Paeds Casesmental-behavioural-and-psychosomatic

Paeds Cases · mental-behavioural-and-psychosomatic

Family assessment and family interventions — OSCE

OSCE communication-and-counselling station assessing a single mother whose 8-year-old son with ADHD has escalating aggression despite an optimised stimulant — testing systematic family assessment, the coercive-cycle mechanism, intensity-matched intervention selection (parent training first-line), the parent-blaming trap, and a safeguarding conversion when ongoing family violence is disclosed.

osce communication and counselling3 min readVerification in progress

Target exams

RACP DWERACP DCEMRCPCH ClinicalMRCPCH TheoryRCPSC Pediatrics
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Study tools

Target exams

RACP DWERACP DCEMRCPCH ClinicalMRCPCH TheoryRCPSC Pediatrics
Prompt
Aisha is the single mother of Tariq, aged 8, who has ADHD on an optimised stimulant. Tariq's aggression at home has been escalating for four months since Aisha separated from her partner: he hits, screams, and refuses to comply, and nothing Aisha tries works for more than a few days. She is exhausted, in tears, and asks the GP to "increase his medication or admit him because I cannot parent him." A neighbour has told her the behaviour is "her fault for the breakup." During the assessment Aisha confides that her ex-partner, who has weekly contact with Tariq, has been verbally abusive toward her during handovers and last week shoved her against a wall while Tariq watched.

Candidate information (2 minutes reading, 12 minutes station)

You are the general paediatric registrar in an outpatient clinic. Tariq, aged 8, with ADHD on an optimised stimulant, is brought by his mother Aisha, who is raising him alone after a recent separation. His aggression at home has been escalating for four months. Read the presentation, then conduct the assessment and counselling. The examiner will role-play Aisha. [6] [12]

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References7ShowHide
  1. [1]Henggeler SW, Melton GB, Brondino MJ, Scherer DG, Hanley JH Multisystemic therapy with violent and chronic juvenile offenders and their families: the role of treatment fidelity in successful dissemination. J Consult Clin Psychol, 1997.PMID 9337501
  2. [4]Sanders MR, Kirby JN, Tellegen CL, Day JJ The Triple P-Positive Parenting Program: a systematic review and meta-analysis of a multi-level system of parenting support. Clin Psychol Rev, 2014.PMID 24842549
  3. [6]Kazdin AE Parent management training for conduct problems in children: Enhancing treatment effectiveness. Int J Clin Health Psychol, 2018.PMID 30487914
  4. [7]Thomas R, Abell B, Webb HJ, Avdagic E, Zimmer-Gembeck MJ Parent-Child Interaction Therapy: A Meta-analysis. Pediatrics, 2017.PMID 28860132
  5. [9]Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry, 2010.PMID 20921118
  6. [10]Miller IW, Kabacoff RI, Epstein NB, Bishop DS, Keitner GI, Baldwin LM, van der Spuy HI The development of a clinical rating scale for the McMaster model of family functioning. Fam Process, 1994.PMID 8039568
  7. [12]Mingebach T, Kamp-Becker I, Christiansen H, et al. Meta-meta-analysis on the effectiveness of parent-based interventions for the treatment of child externalizing behavior problems. PLoS One, 2018.PMID 30256794
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