Location: Children's Nutrition Research CenterTitle: Application of empirically supported treatments to clinical settings. In: Jelalian, E., Steele, R.G., editors. Handbook of Childhood and Adolescent Obesity) Author
Submitted to: Springer Verlag
Publication Type: Book / Chapter
Publication Acceptance Date: 9/10/2008
Publication Date: 9/10/2008
Citation: Johnston, C.A., Dalton, W.T. 2008. Application of empirically supported treatments to clinical settings. In: Jelalian, E., Steele, R.G., editors. Handbook of Childhood and Adolescent Obesity. New York, NY: Springer Verlag. p. 437-462. Interpretive Summary:
Technical Abstract: This book chapter identifies treatments for pediatric obesity that have been shown to be effective in research settings and discusses how these treatments can be implemented in an applied clinical setting. Behavior-based treatments have demonstrated the best outcomes. Commonly used behavioral strategies include self-monitoring, goal-setting, contingency management, and stimulus control. Self-monitoring is defined as having individuals observe and record their own behaviors with tools such as food diaries, habit books, and weight charts. Contingency management refers to strategies that change behavior by modifying its consequences. Examples of contingency management are positive reinforcement and the use of rewards. Stimulus control refers to changes made to an environment to increase the likelihood of behavior change. Examples include removing the television from a child’s bedroom and increasing the visibility of fruits and vegetables around the home. There is strong evidence for using the above approaches in combination. Additionally, most effective treatments take a multidisciplinary approach and include individuals such as pediatricians, psychologists, nutritionists, and other health professionals. Evidence also supports focusing treatment on the entire family and not just the child. The authors note that treatments may need to be tailored for various groups such as ethnic minorities, severely overweight children, and those with physiological or psychological comorbidites. For example, pharmacotherapy may be a consideration for severely overweight children. In conclusion, there is firm support for the behavioral treatment of pediatric overweight. Clinicians should use these evidence-based approaches to provide informed treatments for overweight children.