Abnormal Psychology

Foundations of Treatment 143

Targeting Social Factors in Younger Patients

As discussed in Chapter 2, all of us are influenced by factors in our social

environment—and in some ways, this is particularly true of children, who are not

yet able to function independently in the world and must rely heavily on the people

around them. In targeting social factors, family therapy is a frequent form of treat-

ment for children with psychological disorders. In some cases, family therapy may

focus on parental guidance, instructing parents how to interact more effectively with

their children; the children may not necessarily be present for all—or even any—of

these discussions (Dishion & Stormshak, 2007).

Social factors may also be targeted in group therapy for children and adoles-

cents, for instance, to help them develop appropriate social skills with peers. Other

groups are for parents, to help them further develop parenting skills and make

them feel less isolated. Mental health clinicians may also advise school personnel or

specifi c teachers, to help them better understand a given child or to develop more

effective ways of interacting with the child or resolving peer confl icts (Dishion &

Stormshak, 2007).

Targeting Social Factors in Older Patients

Elderly patients can have psychological disorders that leave them unable to care

for themselves, such as the cognitive disorder dementia, which involves signifi cant

memory problems (to be discussed in more detail in Chapter 15). In such cases,

treatment may involve family therapy to help the patient and family members plan

long-term care. The family may decide to have the elderly patient move in with a

family member or into an assisted living facility. Given the medical problems that

often develop or become worse with age, family therapy sessions may include mem-

bers of an elder’s healthcare team (Tisher & Dean, 2000).

Treating a Multicultural Population

One social factor that may not be targeted directly by a treatment may nevertheless

serve as a potential backdrop to treatment, namely the demographic characteristics

of the patient—ethnic background, race, or sexual orientation. The United States

has an increasingly multicultural population, as shown in Figure 4.6. By the year

2025, approximately 40% of adults and almost half of

all children in the United States will be from a racial

or ethnic minority group (U.S. Census Bureau, 2000).

Individual members of each ethnic or racial group,

however, may have many different reasons for having

immigrated to the United States, may have different

values and traditions, and may vary in other ways that

can infl uence treatment.

How Ethnicity Can Infl uence Treatment

Information about a patient’s ethnic background, race,

or sexual orientation can influence the type of treat-

ment used or lead a clinician to modify the treatment.

Moreover, if patient and therapist have different back-

grounds, this may lead to misunderstandings about

treatment goals, methods, and expectations. For

instance, experiences with discrimination and prejudice

can lead someone to have negative automatic thoughts

about the futility of continuing to look for a better job

(“What’s the point, they won’t hire me anyway”); the

patient sees the problem (depression about feeling stuck

in a dead-end, low-paying job) as having an external

Figure 4.6

4.6 • The Multicultural Population of the United States

Source: Adpated from U.S. Dept. of Health & Human Services, 2001, p. 6.

k 46 Th M lti lt lP l ti fth U itdStt

0

50

100

150

200

250

300

350

U.S. population (millions)

White Hispanic/

Latino

(can be of

any race)

Black/

African

American

Total

population

American

Indian/

Alaska

Native

Asian and

Pacific

Islander

2000 census

2025 projection