Bryan Carter - Academia.edu (original) (raw)
Papers by Bryan Carter
Children's Health and Illness Recovery Program (CHIRP)
During the remaining Sessions 10–12 of the Children’s Health and Illness Recovery Program (CHIRP)... more During the remaining Sessions 10–12 of the Children’s Health and Illness Recovery Program (CHIRP) no new skills or strategies are introduced. Rather these sessions focus on continuing to practice and consolidate the skills introduced in Sessions 1–9 and problem solve those areas where the teen and parent(s) continue to struggle.
Children's Health and Illness Recovery Program (CHIRP)
This chapter provides an explanation as to how having a chronic illness can start a cascading eff... more This chapter provides an explanation as to how having a chronic illness can start a cascading effect that results in the teen becoming more inactive and less involved in important life events experienced by healthy teens, and how this can actually worsen some of their symptoms and lead to more disability. The CHIRP interventions are introduced as a program specifically designed to provide teens, and their parents, with skills that can disrupt this process and allow the teen to more actively participate in life. A “Weekly Activity and Exercise Action Plan” Worksheet is provided to begin the process of gradually becoming more active at a level that is sensitive to the teen’s medical and health issues.
Children's Health and Illness Recovery Program (CHIRP)
Session 4 builds on “Managing the Impact” coping skills by helping you learn to apply “Challengin... more Session 4 builds on “Managing the Impact” coping skills by helping you learn to apply “Challenging Your Thoughts” skills to the stressful situations identified earlier and recorded on the “Thought-Changing Skills” Worksheet from the previous session. The goal of this session is to assist you in more accurately identifying those distortions in your assumptions, beliefs and thinking that underly distressful and uncomfortable emotions/feelings, which in turn can amplify unpleasant symptoms such as energy level and pain intensity. Common thinking errors such as hopelessness, catastrophic thinking, and mind reading are introduced and applied to your own identified automatic thoughts. This is followed by introducing strategies for challenging those often unsubstantiated and disabling thoughts that serve as barriers to setting goals, expectations, and motivation, which make it difficult to get your coping and lifestyle back on track.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 9 involves a review with you and your parent(s) of the individual skills you have acquire... more Session 9 involves a review with you and your parent(s) of the individual skills you have acquired in Children’s Health and Illness Recovery Program (CHIRP) and providing guidance aimed at avoiding a relapse in your improvement. Key components of CHIRP are emphasized as they apply to your “Working Toward a Normal Daily Schedule.” The benefits of improved sleep and activity level, increased social contacts with peers, and increased comfort in assertively communicating with others are reinforced as critical for continued progress. Your parents are encouraged to support and trust your efforts in becoming more independent in managing various aspects of your medical condition, as well as in your decision making in setting a personal schedule and making lifestyle choices. Family members are strongly encouraged to continue to follow family rules for communicating about symptoms and resolving conflicts as discussed in the CHIRP sessions.
Children's Health and Illness Recovery Program (CHIRP), 2020
In Session 7 the teen is introduced to the concept of avoidant coping and the pernicious impact t... more In Session 7 the teen is introduced to the concept of avoidant coping and the pernicious impact this has on creating increased functional disability in multiple areas of one’s life physically, academically, and socially. Behavioral strategies to disrupt this cycle inevitably involve improving engagement behaviors such as increasing social contacts and improving school attendance, all of which call for improved interpersonal communication skills and assertive behaviors; that is, the behavioral antithesis of avoidance. The clinician will employ several worksheets in the Workbook in the process of increasing teen skills and comfort at communicating and asserting their wants and needs with others.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 6 is intended to be a family-focused session, with the teen and parent(s) seen conjointly... more Session 6 is intended to be a family-focused session, with the teen and parent(s) seen conjointly for all or at least a major portion of the session. This format allows the clinician to observe the ways in which the teen and parent(s) approach such issues as problem solving and decision making and to coach and provide feedback and guidance in developing family dynamics that increase teen confidence and skills in becoming more confident and independent. The mechanism for stimulating these discussions is generated from the Workbook exercises and Worksheets addressing the activity schedule of a healthy teen versus the teen with a chronic illness and together generating strategies for increasing teen independence that they will approach between sessions.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 8 is again focused primarily on family communication and dynamics for the purposes of ide... more Session 8 is again focused primarily on family communication and dynamics for the purposes of identifying and addressing parenting behaviors and parent–teen dynamics that may unwittingly undermining teen confidence in becoming more independent in managing their illness and lifestyle. The clinician engages the family in a discussion of parental and teen roles within the family system and an examination of the impact of the teen’s illness on family members’ roles. Behavioral family systems concepts of “misguided support” and “strong beliefs” that family members hold, but that inadvertently may be serving to maintain a dependent or even overprotective/enmeshed family dynamic, are introduced and applied to the family situation, along with strategies for moving these dynamics in a more independence-engendering direction.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 2 of the Children’s Health and Illness Recovery Program (CHIRP) builds on the topic of st... more Session 2 of the Children’s Health and Illness Recovery Program (CHIRP) builds on the topic of stress and stress management by introducing the concept of reducing the impact of stressors via developing more effective coping strategies. In CHIRP, two specific forms of coping are emphasized: “Solving the Problem” coping and “Managing the Impact” coping. This session focuses on teaching the teen about these two forms of coping and learning the when and how of applying each, with the main emphasis being on developing active problem-solving skills in order to reduce stress by addressing and altering the situation.
Clinical Practice in Pediatric Psychology, 2017
Clinical Practice in Pediatric Psychology, 2015
Journal of Clinical Psychology in Medical Settings, 2013
Health Psychology, 1998
This study examined marital role strain in 33 couples caring for a child with cystic fibrosis (CF... more This study examined marital role strain in 33 couples caring for a child with cystic fibrosis (CF) and 33 couples with a healthy child. The relationship between role strain, marital satisfaction, and psychological distress was tested. Couples completed a structured interview, questionnaires, a card sort procedure, and 4 daily diaries assessing activities and mood. Couples in the CF versus comparison group reported greater role strain on measures of role conflict, child-care tasks, and exchanges of affection. They also spent less time in recreational activities, but no reliable group differences were found in marital satisfaction or depression. Regression analyses indicated that role strain was related to marital satisfaction and depression and that recreation time accounted for additional variance. Path analysis suggested that recreation mediated the negative relationship between role strain and distress. The importance of using a contextual, process-oriented approach is discussed.
Journal of Pediatric Health Care, 1998
Being a teenager with a chronic illness can be challenging. The symptoms of an illness, particula... more Being a teenager with a chronic illness can be challenging. The symptoms of an illness, particularly pain and fatigue, can interfere with just being a normal teen. The Children’s Health and Illness Recovery Program, or CHIRP, was developed to teach teens and their family strategies to help them live as normal a life as possible while coping with the effects of their chronic illness. The skills acquired in the CHIRP intervention are life skills almost every teen can use, and these skills can be especially valuable for those working to overcome the negative effects of chronic illness. The CHIRP Teen and Family Workbook provides evidence-based activities shown to improve coping skills, stress management, communication skills, and functioning in teens with chronic medical conditions. In addition, family-based activities included in CHIRP assist teens and parents in developing more effective ways to communicate about their illness and increase teen confidence and independence in both man...
Children's Health and Illness Recovery Program (CHIRP)
When, for various reasons, the teen cannot alter the stressfulness of a challenging situation via... more When, for various reasons, the teen cannot alter the stressfulness of a challenging situation via active problem solving (“Solving the Problem”), such circumstances call for employing strategies to “Manage the Impact” of the stressor on their physical and emotional functioning. In Session 3 of the Children’s Health and Illness Recovery Program (CHIRP), the clinician instructs the teen in effective relaxation skills including diaphragmatic breathing and progressive muscle relaxation. These are introduced and practiced in the session, with homework practice assigned for skill development. Cognitive behavioral therapy skills are introduced to help the teen understand the bidirectional relationships between thoughts, emotional responses, and behavioral responses. Finally, thought-changing skills and activities are introduced from the CHIRP Workbook with the assignment of recoding stressful situations and their associated thoughts and feelings on a Thought Record sheet.
As the introduction to the Clinician’s Handbook of Pediatric Psychological Consultation in Medica... more As the introduction to the Clinician’s Handbook of Pediatric Psychological Consultation in Medical Settings, this chapter sets the stage for the book by defining consultation-liaison (CL) and differentiating it from other forms of pediatric psychology practice. Competencies for the practitioner of CL pediatric psychology, including the necessary training experiences, are addressed along with strategies for becoming an effective CL psychologist. A brief historical overview is provided to help the reader develop the context and evolution of current CL practice. Finally, the authors introduce the framework for the handbook to guide the reader through the book.
Chapter 11 provides supplemental material for teens whose chronic illness challenges involve majo... more Chapter 11 provides supplemental material for teens whose chronic illness challenges involve major problems with chronic pain. While pain is a necessary protective mechanism of the body, chronic pain involves complex interactions between the nervous system, the brain, our emotions, and various situational factors that can actually make our experience of pain worse. The activities in this session are intended to help teens better understand these interactions and apply pain management strategies. Many of the coping strategies in the Children’s Health and Illness Recovery Program (CHIRP) have been shown to be effective in helping teens manage chronic pain more effectively so that they are able to more actively participate in the multiple areas so important to development.
Ever since the establishment of the subspecialty of pediatric psychology, psychologists have been... more Ever since the establishment of the subspecialty of pediatric psychology, psychologists have been called upon to provide consultation to their pediatrician colleagues in ever-expanding roles and in a variety of medical settings. In response, a number of models have been created to address how psychologists fit into the overall health-care system in order to address those psychosocial factors that can have a major impact on prevention/early intervention in pediatric illness and injury and overall adjustment and quality of life. This chapter addresses both theoretical and pragmatic issues in establishing and maintaining a viable consultation-liaison service while avoiding personal and professional burnout.
Children's Health and Illness Recovery Program (CHIRP)
During the remaining Sessions 10–12 of the Children’s Health and Illness Recovery Program (CHIRP)... more During the remaining Sessions 10–12 of the Children’s Health and Illness Recovery Program (CHIRP) no new skills or strategies are introduced. Rather these sessions focus on continuing to practice and consolidate the skills introduced in Sessions 1–9 and problem solve those areas where the teen and parent(s) continue to struggle.
Children's Health and Illness Recovery Program (CHIRP)
This chapter provides an explanation as to how having a chronic illness can start a cascading eff... more This chapter provides an explanation as to how having a chronic illness can start a cascading effect that results in the teen becoming more inactive and less involved in important life events experienced by healthy teens, and how this can actually worsen some of their symptoms and lead to more disability. The CHIRP interventions are introduced as a program specifically designed to provide teens, and their parents, with skills that can disrupt this process and allow the teen to more actively participate in life. A “Weekly Activity and Exercise Action Plan” Worksheet is provided to begin the process of gradually becoming more active at a level that is sensitive to the teen’s medical and health issues.
Children's Health and Illness Recovery Program (CHIRP)
Session 4 builds on “Managing the Impact” coping skills by helping you learn to apply “Challengin... more Session 4 builds on “Managing the Impact” coping skills by helping you learn to apply “Challenging Your Thoughts” skills to the stressful situations identified earlier and recorded on the “Thought-Changing Skills” Worksheet from the previous session. The goal of this session is to assist you in more accurately identifying those distortions in your assumptions, beliefs and thinking that underly distressful and uncomfortable emotions/feelings, which in turn can amplify unpleasant symptoms such as energy level and pain intensity. Common thinking errors such as hopelessness, catastrophic thinking, and mind reading are introduced and applied to your own identified automatic thoughts. This is followed by introducing strategies for challenging those often unsubstantiated and disabling thoughts that serve as barriers to setting goals, expectations, and motivation, which make it difficult to get your coping and lifestyle back on track.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 9 involves a review with you and your parent(s) of the individual skills you have acquire... more Session 9 involves a review with you and your parent(s) of the individual skills you have acquired in Children’s Health and Illness Recovery Program (CHIRP) and providing guidance aimed at avoiding a relapse in your improvement. Key components of CHIRP are emphasized as they apply to your “Working Toward a Normal Daily Schedule.” The benefits of improved sleep and activity level, increased social contacts with peers, and increased comfort in assertively communicating with others are reinforced as critical for continued progress. Your parents are encouraged to support and trust your efforts in becoming more independent in managing various aspects of your medical condition, as well as in your decision making in setting a personal schedule and making lifestyle choices. Family members are strongly encouraged to continue to follow family rules for communicating about symptoms and resolving conflicts as discussed in the CHIRP sessions.
Children's Health and Illness Recovery Program (CHIRP), 2020
In Session 7 the teen is introduced to the concept of avoidant coping and the pernicious impact t... more In Session 7 the teen is introduced to the concept of avoidant coping and the pernicious impact this has on creating increased functional disability in multiple areas of one’s life physically, academically, and socially. Behavioral strategies to disrupt this cycle inevitably involve improving engagement behaviors such as increasing social contacts and improving school attendance, all of which call for improved interpersonal communication skills and assertive behaviors; that is, the behavioral antithesis of avoidance. The clinician will employ several worksheets in the Workbook in the process of increasing teen skills and comfort at communicating and asserting their wants and needs with others.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 6 is intended to be a family-focused session, with the teen and parent(s) seen conjointly... more Session 6 is intended to be a family-focused session, with the teen and parent(s) seen conjointly for all or at least a major portion of the session. This format allows the clinician to observe the ways in which the teen and parent(s) approach such issues as problem solving and decision making and to coach and provide feedback and guidance in developing family dynamics that increase teen confidence and skills in becoming more confident and independent. The mechanism for stimulating these discussions is generated from the Workbook exercises and Worksheets addressing the activity schedule of a healthy teen versus the teen with a chronic illness and together generating strategies for increasing teen independence that they will approach between sessions.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 8 is again focused primarily on family communication and dynamics for the purposes of ide... more Session 8 is again focused primarily on family communication and dynamics for the purposes of identifying and addressing parenting behaviors and parent–teen dynamics that may unwittingly undermining teen confidence in becoming more independent in managing their illness and lifestyle. The clinician engages the family in a discussion of parental and teen roles within the family system and an examination of the impact of the teen’s illness on family members’ roles. Behavioral family systems concepts of “misguided support” and “strong beliefs” that family members hold, but that inadvertently may be serving to maintain a dependent or even overprotective/enmeshed family dynamic, are introduced and applied to the family situation, along with strategies for moving these dynamics in a more independence-engendering direction.
Children's Health and Illness Recovery Program (CHIRP), 2020
Session 2 of the Children’s Health and Illness Recovery Program (CHIRP) builds on the topic of st... more Session 2 of the Children’s Health and Illness Recovery Program (CHIRP) builds on the topic of stress and stress management by introducing the concept of reducing the impact of stressors via developing more effective coping strategies. In CHIRP, two specific forms of coping are emphasized: “Solving the Problem” coping and “Managing the Impact” coping. This session focuses on teaching the teen about these two forms of coping and learning the when and how of applying each, with the main emphasis being on developing active problem-solving skills in order to reduce stress by addressing and altering the situation.
Clinical Practice in Pediatric Psychology, 2017
Clinical Practice in Pediatric Psychology, 2015
Journal of Clinical Psychology in Medical Settings, 2013
Health Psychology, 1998
This study examined marital role strain in 33 couples caring for a child with cystic fibrosis (CF... more This study examined marital role strain in 33 couples caring for a child with cystic fibrosis (CF) and 33 couples with a healthy child. The relationship between role strain, marital satisfaction, and psychological distress was tested. Couples completed a structured interview, questionnaires, a card sort procedure, and 4 daily diaries assessing activities and mood. Couples in the CF versus comparison group reported greater role strain on measures of role conflict, child-care tasks, and exchanges of affection. They also spent less time in recreational activities, but no reliable group differences were found in marital satisfaction or depression. Regression analyses indicated that role strain was related to marital satisfaction and depression and that recreation time accounted for additional variance. Path analysis suggested that recreation mediated the negative relationship between role strain and distress. The importance of using a contextual, process-oriented approach is discussed.
Journal of Pediatric Health Care, 1998
Being a teenager with a chronic illness can be challenging. The symptoms of an illness, particula... more Being a teenager with a chronic illness can be challenging. The symptoms of an illness, particularly pain and fatigue, can interfere with just being a normal teen. The Children’s Health and Illness Recovery Program, or CHIRP, was developed to teach teens and their family strategies to help them live as normal a life as possible while coping with the effects of their chronic illness. The skills acquired in the CHIRP intervention are life skills almost every teen can use, and these skills can be especially valuable for those working to overcome the negative effects of chronic illness. The CHIRP Teen and Family Workbook provides evidence-based activities shown to improve coping skills, stress management, communication skills, and functioning in teens with chronic medical conditions. In addition, family-based activities included in CHIRP assist teens and parents in developing more effective ways to communicate about their illness and increase teen confidence and independence in both man...
Children's Health and Illness Recovery Program (CHIRP)
When, for various reasons, the teen cannot alter the stressfulness of a challenging situation via... more When, for various reasons, the teen cannot alter the stressfulness of a challenging situation via active problem solving (“Solving the Problem”), such circumstances call for employing strategies to “Manage the Impact” of the stressor on their physical and emotional functioning. In Session 3 of the Children’s Health and Illness Recovery Program (CHIRP), the clinician instructs the teen in effective relaxation skills including diaphragmatic breathing and progressive muscle relaxation. These are introduced and practiced in the session, with homework practice assigned for skill development. Cognitive behavioral therapy skills are introduced to help the teen understand the bidirectional relationships between thoughts, emotional responses, and behavioral responses. Finally, thought-changing skills and activities are introduced from the CHIRP Workbook with the assignment of recoding stressful situations and their associated thoughts and feelings on a Thought Record sheet.
As the introduction to the Clinician’s Handbook of Pediatric Psychological Consultation in Medica... more As the introduction to the Clinician’s Handbook of Pediatric Psychological Consultation in Medical Settings, this chapter sets the stage for the book by defining consultation-liaison (CL) and differentiating it from other forms of pediatric psychology practice. Competencies for the practitioner of CL pediatric psychology, including the necessary training experiences, are addressed along with strategies for becoming an effective CL psychologist. A brief historical overview is provided to help the reader develop the context and evolution of current CL practice. Finally, the authors introduce the framework for the handbook to guide the reader through the book.
Chapter 11 provides supplemental material for teens whose chronic illness challenges involve majo... more Chapter 11 provides supplemental material for teens whose chronic illness challenges involve major problems with chronic pain. While pain is a necessary protective mechanism of the body, chronic pain involves complex interactions between the nervous system, the brain, our emotions, and various situational factors that can actually make our experience of pain worse. The activities in this session are intended to help teens better understand these interactions and apply pain management strategies. Many of the coping strategies in the Children’s Health and Illness Recovery Program (CHIRP) have been shown to be effective in helping teens manage chronic pain more effectively so that they are able to more actively participate in the multiple areas so important to development.
Ever since the establishment of the subspecialty of pediatric psychology, psychologists have been... more Ever since the establishment of the subspecialty of pediatric psychology, psychologists have been called upon to provide consultation to their pediatrician colleagues in ever-expanding roles and in a variety of medical settings. In response, a number of models have been created to address how psychologists fit into the overall health-care system in order to address those psychosocial factors that can have a major impact on prevention/early intervention in pediatric illness and injury and overall adjustment and quality of life. This chapter addresses both theoretical and pragmatic issues in establishing and maintaining a viable consultation-liaison service while avoiding personal and professional burnout.