Abnormal Psychology

142 CHAPTER 4

Some prevention programs, such as some stress management programs, are

funded privately by health insurance companies for people they insure or by corpo-

rations for their employees. Other prevention programs, such as rape crisis centers,

are publicly funded and available to the public.

Many prevention programs focus on children, parents, or families with chil-

dren. Although most children whose parents are divorced do not develop a mental

disorder, children with divorced parents are more likely to develop a disorder than

are children whose parents are not divorced. To minimize the incidence of psycho-

logical disorders in this population, some prevention programs help parents interact

more effectively with their children (Pruett, Insabella, & Gustafson, 2005). These

programs, at least in the short run, can diminish children’s mental health problems.

Such interventions target social factors (parent-child interactions) with the goal of

improving or preserving the child’s mental health.

For instance, consider a study by Sharlene Wolchik and colleagues (2002),

which was designed to discover whether the positive effects of a prevention pro-

gram for children of divorced parents continue over time (specifi cally, 6 years after

the program) and whether having both mothers and their children involved in the

program is better than having only the mothers involved. Participants were 218

families; at the time of the prevention program, the children were 9–12 years old,

and the families were randomly assigned to one of three groups:

1. an 11-session “mother-only” group that received CBT. The intervention was
   designed to improve the mothers’ relationships with their children, teach effective
   disciplinary methods, and reduce confl ict between mothers and fathers;


2. an 11-session “mother program/child program” group that received CBT; the
   intervention for the mothers was the same as described above, and the inter-
   vention for the children was designed to improve their coping skills and their
   relationships with their mothers and to decrease their negative thoughts about
   the divorce and its aftereffects;


3. a control group of mothers and children who received books on adjusting to
   divorce.

Six years after the program, the researchers assessed psychological disorders

in the children with a comprehensive computerized questionnaire, completed by

the children and their parents. Results indicated that both the mother-only and the

mother/child interventions helped prevent psychological disorders in those chil-

dren who had more psychological problems before the intervention (more than 6

years previously); however, the fewer problems that children had at the start of the

program, the less of an impact the intervention made. This makes sense because

for these less symptomatic children, there was a smaller range within which the

intervention could have an effect. When the two types of interventions were com-

pared, they were found to be equally effective.

In conclusion, treatment can occur with varying intensity or frequency, depending,

in part, on a patient’s needs. Options include inpatient and partial hospitalization,

residential treatment, outpatient treatment, or prevention programs. All of these

community-based treatments target social factors—the patient in context. Such

treatments may also target neurological and/or psychological factors. However, for

a given patient, his or her health insurance company may not pay for or reimburse

all types of treatment, or may limit the duration of treatment. Later, we’ll examine

the fi nancial side of treatment in a bit more detail.

Targeting Social Factors in Younger

and Older Populations

Treatments for children and older adults that target social factors may need to be

modifi ed for these special populations.