Intervening in Children's Lives: An Ecological, Family-Centered Approach to Mental Health Care

Mental health interventions for children and adolescents often flow from adult clinical models, which emphasize individual change. Yet, to accomplish long-lasting change for children and adolescents, services need to consider developmental norms, the developmental status of the child or adolescent, and the fact that mental health issues for this population are embedded in family, peer, and sibling relationships.

In Intervening in Children's Lives: An Ecological, Family-Centered Approach to Mental Health Care, Thomas J. Dishion and Elizabeth A. Stormshak describe a family-centered approach that engages children, adolescents, and their families, leveraging their motivation to change. Never before has there been a comprehensive, systematic framework for linking empirically supported interventions for this clinical population. Useful as both a preventive checkup and a more intensive intervention, this approach may be delivered in schools and other community settings to have the greatest public health impact.

The authors demonstrate how they examine psychopathology in children and adolescents in the context of their ecology (families, peer groups, communities, and schools). They present their empirically derived, assessment-driven approach; illustrate how to shape developmentally and culturally relevant interventions; and demonstrate how this ecological approach works within a health maintenance framework. Given individual variation in vulnerability to environmental stress, periodic assessments and interventions are used to prevent, treat, or reduce harm associated with problem behavior and emotional distress. The literature reveals promising findings, in that highest-risk youth are more likely to respond well to ecologically based interventions, and this approach is consistent with others showing long-lasting effects.