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Friday, 10 May 2019

RISPERIDONE - THE UGLY TRUTH ABOUT HUGE PROFITS & POTENTIAL HARM TO VULNERABLE CHILDREN

RISPERIDONE - THE UGLY TRUTH ABOUT HUGE PROFITS & POTENTIAL HARM TO VULNERABLE CHILDREN





Gynecomastia = eventual lactating breasts in boys & prepubescent girls - uncommon BUT very traumatising for children on the autistic spectrum - in boys they have to be surgically removed. It starts with an average additional weight gain of 7.5 KG in a twelve month period as proven by clinical research in Australia which the DoH openly acknowledge. They also accept that the monitoring system is inadequate.

Thursday, 18 April 2019

ITALIAN TRANSLATION OF THE DECP(BPS) ENDORSED 'REFLECTIVE CHECKLIST' TO BETTER SAFEGUARD KIDS FROM TOXIC HARM - Una lista di controllo riflettente per i professionisti di salute mentale del bambino che prescrivono medicinali psicotrope approvata dal Divisione di Formazione e psicologia infantile





TRADUZIONE ITALIANA DEL DECP (BPS) ha approvato 'LISTA DI CONTROLLO RIFLETTENTE' a una migliore KIDS DI SALVAGUARDIA dai pericoli TOSSICO -



Una lista di controllo riflettente per i professionisti di salute mentale del bambino che prescrivono medicinali psicotrope approvata dal Divisione di Formazione e psicologia infantile Comitato Divisione della BPS nel mese di giugno 2016 e successivamente dal professor Peter Kinderman, l'allora presidente della British Psychological Society (vedi lettera allegata)

presidente di quest'anno del DECP, Brian Apter, come espresso nel suo 'note della presidenza sente un articolo che illustra le ragioni alla base dello sviluppo di questa Checklist Reflective dalla medicalizzazione sottocommissione della Divisione di Formazione e Psicologia del bambino è necessario, in questa fase per informare il nostro soci e tutti gli psicologi del suo sviluppo, in modo da aiutarli a sfidare efficacemente la pratica nei casi in cui hanno preoccupazioni per la salute etici e lungo termine sui bambini con cui co-lavoro.
L'idea di questa  Lista di controllo riflettente  per i professionisti della salute mentale è per i medici prescrittori di farmaci psicotropi per bambini nel Regno Unito da utilizzare come un promemoria sulle loro scrivanie per meglio salvaguardare il benessere dei bambini con cui lavorano ed è venuto dal lavoro di ispirazione e pratico di Atul Gawande su liste di controllo applicate ai campi della chirurgia e le emergenze neo-natale nel Regno Unito che hanno avuto esiti profondamente benefici sui tassi di sopravvivenza cliente. Atul Gawande è un professore di Chirurgia alla Harvard Medical School e crede che i processi incredibilmente complessi e le decisioni possono essere migliorati e resi più sicuri da semplici domande immediate e modalità pratiche di buon senso. Il suo libro seminale è stato 'The Checklist Manifesto.' 2009, che è un bestseller internazionale e ha provocato approcci radicali in molti campi.
I tassi di prescrizione in rapido aumento di psicofarmaci per i bambini da Child psichiatri e pediatri nel Regno Unito negli ultimi due decenni ha allarmato molti professionisti della salute mentale e gli organismi professionali allo stesso modo come la divisione della Formazione e Psicologia Bambino e l'Associazione degli Psicologi d'istruzione (AEP ), così come i colleghi in America dove la situazione è ancora più estrema. In alcuni Stati membri il tasso di prescrizione per metilfenidato solo è il 16% del totale della popolazione scolastica, che la maggior parte dei professionisti vorrebbe evitare nel Regno Unito
professionisti come riflettenti e di essere 'Eticamente Memore' del principio fondamentale della tutela dei bambini nella nostra cura condiviso il DECP medicalizzazione dell'infanzia sottocommissione ha cercato di produrre un contributo positivo a questa zona critica del dibattito multi-professionale e di buone pratiche. Speriamo che applicano l'approccio di cui sopra tanto celebre utilizzando semplici e ingegnose istruzioni questione potrebbe migliorare in modo significativo la Salvaguardia dei gruppi vulnerabili della società, come i bambini.
La lista di controllo ha attraversato molte fasi di generare domande adeguate e la consultazione con i colleghi circa le loro domande suitability.The sono stati poi ulteriormente affinato per migliorare la loro validità ed efficacia volto a rendere gli operatori considerano l'importanza di midfully prendere la decisione di medicare un bambino nella loro spesso molto giornata di lavoro. E 'ancora la nostra speranza che gli psichiatri infantili e pediatri, essi stessi, attraverso considerazione da parte dei loro organismi professionali potrebbero quindi essere distribuiti come un desk top promemoria che potrebbe essere situato accanto alla loro ricettario o addirittura combinato con esso come un elemento. Ciò avrebbe agito come un significativo ulteriore salvaguardia ci sentiamo.
 Ovviamente non vogliamo duplicare inutilmente le procedure, come ad esempio le ottime linee guida NICE per le condizioni specifiche per professionisti ben addestrati e informati, ma crediamo che una breve pausa in cui fare il punto con un periodo di riflessione può nel lungo termine a beneficio del cliente gruppo che tutti noi serviamo. Ci auguriamo che, come molti colleghi del settore hanno già indicato che pochi minuti ben spesi può aumentare il processo decisionale al punto di prescrizione e moderata overprescribing inutili ai bambini che può ben sulla caduta di riflessione all'interno della gamma normale dei bambini sperimentando elevati livelli di mentale angoscia per la combinazione qualunque causale di fattori ambientali, sociali e biologiche.
Il buon senso e la natura riflessiva delle domande che ci siamo posti sono, ci sentiamo, pratico e di natura etica. Purtroppo nonostante i nostri sforzi e il successo a disegno all'attenzione degli organismi professionali adeguate che inizialmente ha mostrato un sacco di promesse ad alti livelli nelle organizzazioni sembra che le considerazioni del comitato inevitabili non ha raggiunto alcuna conclusione positiva in questa fase. Questo in qualche modo rispecchia la considerazione di nuove linee guida NICE che ci sono stati anche coinvolti Ribers dal potenziale denuncia invece di meglio tutelare i bambini da quello che il presidente del Royal College of Psychiatry, Sir Simon Wessely ha refe nel nel frattempo. La tendenza preoccupante sembra essere una tendenza a tutelare prescrred come, 'eccesso di zelo prescrizione.'
Dobbiamo persistere con il tentativo di influenzare le buone pratiche in questo senso sia a livello di interazione personale con i colleghi medici con cui lavoriamo a sostegno dei bambini sui nostri casi corrispondenti e ad un livello di collaborazione professionale nella creazione di modello preferito del NICE di percorsi multi-agenzia per il comportamento del bambino .

Alcune delle molte approvazioni  ricevute da quando ha ricevuto la copertura internazionale in articoli includono:
1) Dal sito Psychiatric Times  - luglio 2015 - professor Allen Frances, editore ex capo del DSM-IV afferma: "gli insegnanti travolto spesso consiglia che i genitori portano i loro figli a medici per la medicina quando il problema potrebbe essere più in classe di nel bambino. Dave Traxson, un bambino e psicopedagogista e dei suoi colleghi nel Regno Unito, hanno escogitato un suggerimento straordinario per contribuire a contenere l'epidemia di farmaci incurante nei bambini. hanno sviluppato una lista di domande medici dovrebbero pensare prima prescrizione di psicofarmaci ai bambini."
Prof Allen Frances Psichiatra 2018: Questa lista di controllo è il modo migliore per fermare i medici provenienti da oltre-prescrizione meds psych per kids.Forces loro di fare una valutazione più approfondita e di prendere in considerazione le molte alternative più sicure.  LINK:  
https://t.co/unJicQf5r2 (https://twitter.com/AllenFrancesMD/status/978989855655931904?s=03)
Grazie Allen.
2) “Ho visto la proposta di re lista di controllo: i farmaci bambino di psicologia in Psychiatric Times.Sembra chiaro, riflessivo e fattibile. Grazie.”  Lloyd Sederer, MD. Direttore Medico, NYS Ufficio di Salute Mentale,  Professore, Columbia / Mailman School of Public Health. Redattore Medico per la salute mentale, The Huffington Post. 
3) "Grazie per la lista di controllo. Mi chiedo quanti bambini sarebbe davvero bisogno di farmaci dopo aver lavorato attraverso questa lista di controllo? Io sono un bambino e adolescente psichiatra, e come il passare degli anni trovo sempre meno bambini davvero bisogno di farmaci, e sempre di più fare molto meglio senza le medicine che aiutano realmente quello't, in primo luogo. Ma non si parla popolare in tutto il blocco." Lisbeth Kortegaard - Consulente Bambino e Adolescenza Psichiatra a Child and Adolescent Psychiatry in Hoejbjerg, Central Region, Danimarca.  

4)  Il professor Peter Kinderman - Presidente della BPS  2016-17 ha dichiarato -

Sono felice di approvare personalmente la lista di controllo riflettente che la divisione della Formazione e Psicologia Bambino approvati per la diffusione limitata in occasione della riunione Comitato giugno, dopo la consultazione con alcuni partner interessati e ringraziare tutti voi per il vostro lavoro su questo issu e.
La lista di controllo riflettente essendo stato debitamente approvato dal DECP, così come una serie di importanti partner esterni, tra cui il  segretario generale, Kate Fallon, della  Associazione per gli psicologi educativi, significa che sono molto felice di unirmi a loro in questo senso. Sono d'accordo con la vostra speranza e quella del professor Allen Frances (redattore capo del DSM-IV) ha espresso un paio di settimane fa sul suo blog che, se la lista di controllo da utilizzare da parte dei due principali gruppi di medici per i bambini e giovani ossia bambini e adolescenti e psichiatri pediatri appositamente formati, che il numero di prescrizioni di farmaci psicotropi diventerebbero più ragionevole nel corso del tempo.
Lei ha detto che si sarebbe anche il piacere di continuare a partecipare a questa iniziativa e per mantenere i contatti con me e il Comitato DECP, se del caso e per avviare una conversazione con il presidente del Royal College of Psichiatri, Sir Simon Wesseley che è già a conoscenza di questa iniziativa , allo scopo di RCP usando come stimolo per significativa d ISCUSSIONE tra loro appartenenza del concetto. 5)  Caroline Martin, capo della ETB nella città di Dublino come feedback su questo post: " Questo riflettente Lista di controllo progettato da Dave Traxson

approvato dalla Divisione BPS di Educational & Child Psychology (tra molti altri degni di nota) è una risorsa eccellente. L'iniziativa è rivolta per l'utilizzo da parte di coloro che prescrivono farmaci psicotropi ai bambini. Tuttavia, vi suggerisco di esso può essere utilizzato anche dai professionisti educativi e psicologici che sono responsabili per la determinazione e / o attuazione di interventi per i bambini. Dobbiamo smettere di assumere la fonte del problema si trova all'interno del bambino e liste di controllo come questa sfida questa ipotesi. Certo, questo renderà per alcune conversazioni più scomode ". E ora la LISTA DI CONTROLLO - DISCUTERE suoi benefici



Una lista di controllo riflettente per i professionisti di salute mentale del bambino che prescrivono medicinali psicotrope approvata dal Divisione di Formazione e psicologia infantile Comitato Divisione della BPS nel giugno 2016.
                              PAUSE  -   REFLECT   -   RASSEGNA 

·  Sono differenze comportamentali del bambino pervasiva, che si verificano in una vasta gamma di contesti sociali e osservato da una serie di diversi individui nella comunità?
·  Sono difficoltà del bambino grave, duraturo, e significativamente compromettere?
·  Ci sono stati sforzi nelle relazioni del bambino, il contesto sociale, e la storia recente che potrebbero spiegare questo modello di comportamenti?
·  Il bambino ha comportamenti che presentano che strettamente conformi a un uso approvato per il farmaco particolare essere considerato in questo momento?
·  Esistono prove ricerca sulla efficacia e la sicurezza di questo farmaco specifico con i bambini della stessa età, il sesso e gruppo sociale?
·  Sono comportamenti che presentano del bambino in modo significativo che compromettono in una serie di impostazioni per bilanciare in modo accettabile il possibile impatto sullo sviluppo del cervello e il corpo del bambino dalle prove basate effetti collaterali dei farmaci specifici che sono considerati?
·  Fare i genitori del bambino e professionisti coinvolti vedere le differenze del bambino come abbastanza significativo da richiedere questo farmaco?
·  Ha un intervento psicologico, come ad esempio una terapia di parlare (CBT, ecc); un intervento sociale, come 'Circle of Friends' / 'Buddy System' o un intervento fisico come la partecipazione nello sport stato provato prima di prescrivere questo farmaco particolare psicotropi essere considerato?
·  Ci sono stati significativi effetti collaterali avversi riportati da questo farmaco specifico con bambini della stessa età, sesso e gruppo sociale?
·  Avete accuratamente soppesato i rischi a breve e lungo termine e li equilibrato contro i possibili benefici?

·  Avete ricevuto un valido consenso dal genitore e il bambino?

E forse il più domanda di ricerca:

·  Se un bambino nella vostra famiglia o cerchia di amici aveva gli stessi comportamenti che presenta i che sono di fronte a voi ora, sarebbe ancora essere pronti a prescrivere questo farmaco?


ENGLISH TEXT -
A Reflective Checklist for Child Mental Health Professionals who Prescribe Psychotropic Medicines Endorsed by the Division of Educational and Child Psychology Division Committee of the BPS  in June 2016 and subsequently by Professor Peter Kinderman, the then President of the British Psychological Society (See enclosed letter)

This year’s chairperson of the DECP, Brian Apter, as expressed in his ‘Chair’s Notes feels an article outlining the rationale underpinning the development of this Reflective Checklist by the Medicalisation Subcommittee of the Division of Educational and Child Psychology is needed at this stage to inform our members and all psychologists of its development so as to help them effectively challenge practice in cases where they have ethical and long term health concerns about the children with whom they co-work.
The idea for this Reflective Checklist for Mental Health practitioners is for prescribers of psychotropic medications to children in the U.K. to use as an aide-memoire on their desks to better safeguard the wellbeing of children they work with and came from Atul Gawande’s inspirational and practical work on checklists applied to the fields of surgery and neo-natal emergencies in the U.K. which have had profoundly beneficial outcomes on client survival rates. Atul Gawande is a Professor of Surgery at Harvard Medical School and believes that incredibly complex processes and decisions can be improved and made safer by simple prompt questions and common sense practical procedures. His seminal book was 'The Checklist Manifesto.' 2009 which is an international bestseller and has provoked radical approaches in many fields.
The rapidly increasing prescription rates of psychotropic drugs for children by Child Psychiatrists and Paediatricians in the U.K. over the last two decades  has alarmed many mental health practitioners and professional bodies alike such as the Division of Educational and Child Psychology and the Association of Educational Psychologists (AEP) as well as colleagues in America where the situation is even more extreme. In some States the prescription rate for Methylphenidate alone is 16% of the total school population which most professionals would want to avoid in the U.K.
As reflective practitioners and being ‘Ethically Mindful’ of the paramount principle of the Safeguarding Children in our shared care the DECP Medicalisation of Childhood Subcommittee has endeavoured to produce a positive contribution to this critical area of multi-professional debate and good practice. We hope that applying the much celebrated above approach of using simple and thought provoking question prompts could significantly improve the Safeguarding of vulnerable groups in society such as children.
The checklist went through many stages of generating suitable questions and consultation with colleagues about their suitability.The questions were then further refined to improve their face validity and effectiveness at making practitioners consider the importance of midfully making the decision to medicate a child in their often very busy working day. It is still our hope that child psychiatrists and paediatricians, themselves, through consideration by their professional bodies could then be distributed as a desk top aide-memoire which could be situated next to their prescription pad or indeed combined with it as one item. This would act as a significant additional safeguard we feel.
 Obviously we do not want to unnecessarily duplicate procedures, such as the excellent NICE Guidelines for specific conditions for well trained and informed professionals but we do believe that a brief pause where they take stock with a period of reflection may in the long term benefit the client group we all serve.  We hope as many colleagues in the field have already indicated that a few minutes well spent may enhance the decision making at the point of prescription and moderate unnecessary overprescribing to children who may well on reflection fall within the normal range of children experiencing higher levels of mental distress for whatever causal combination of environmental, social and biological factors.
The common-sense and reflective nature of the questions we have posed are, we feel, both practical and ethical in nature .  Sadly despite our best efforts and success at drawing it to the attention of the appropriate professional bodies which initially showed a lot of promise at  high levels within the organisations it seems that the inevitable committee considerations has not reached any positive conclusion at this stage. This in some way mirrors the consideration of new NICE Guidelines that we have also been involvedribers from potential complaint rather than  better Safeguarding Children from what the President of the Royal College of Psychiatry, Sir Simon Wessely has refe in in the intervening period. The worrying trend seems to be a tendancy to protect prescrred to as, ‘over-zealous prescribing.’
We must persist with trying to influence good practice in this regard at both a personal interaction level with the medical colleagues we work with supporting children on our caseloads and at a professional collaboration level in setting up NICE’s preferred model of multi-agency pathways for child behaviour.

Some of the many endorsements received since it has received international coverage in articles include:
1)From the Psychiatric Times website - July 2015 - Professor Allen Frances, ex- editor in chief of DSM-IV states, "Overwhelmed teachers often recommend that parents take their kids to doctors for medicine when the problem may be more in the classroom than in the kid. Dave Traxson, a child and educational psychologist and his colleagues in the United Kingdom, have come up with a terrific suggestion to help contain the epidemic of careless medication in kids. They have developed a checklist of questions doctors should think about before prescribing psychoactive drugs to children."
Prof Allen Frances Psychiatrist 2018:This checklist is the best way to stop doctors from over-prescribing psych meds for kids.Forces them to do more thorough evaluation & to consider the many safer alternatives. LINK: 
https://t.co/unJicQf5r2 (https://twitter.com/AllenFrancesMD/status/978989855655931904?s=03)
Thanks Allen.
2)“ I saw the proposed checklist re: child psych medications in Psychiatric Times. It seems clear, thoughtful and feasible. Thank you.” Lloyd Sederer, MD. Medical Director, NYS Office of Mental Health, Adjunct Professor, Columbia/Mailman School of Public Health. Medical Editor for Mental Health, The Huffington Post.
3)"Thanks for the check list. I wonder how many children would really need medications after working through this check list? I am a child and adolescent psychiatrist , and as the years go by I find fewer and fewer children really need medications, and more and more do so much better without the meds that didn´t really help in the first place. But it is not popular talk around the block."   Lisbeth Kortegaard - Consultant Child and Adolescent Psychiatrist at Child and Adolescent Psychiatry in Hoejbjerg, Central Region, Denmark.  

4) Professor Peter Kinderman - President of the BPS 2016-17 stated -

I am happy personally to endorse the Reflective Checklist that the Division of Educational and Child Psychology approved for limited dissemination at their June Committee meeting, following their consultation with some interested partners and to thank you all for your work on this issue.
The Reflective Checklist having been duly endorsed by the DECP, as well as a range of significant external partners, including the General Secretary, Kate Fallon, of the Association for Educational Psychologists, means I am very happy to join with them in this regard. I agree with your hope and that of Professor Allen Frances (Editor in Chief of DSM-IV) expressed a couple of weeks ago on his blog that, were the Checklist to be used by the two main groups of prescribers for children and young people i.e. child and adolescent psychiatrists and specifically trained paediatricians, that the number of prescriptions of psychotropic medication would become more reasonable over time.
You mentioned that you would also be pleased to remain involved in this initiative and to liaise with me and the DECP Committee where appropriate and to start a conversation with the President of the Royal College of Psychiatrists, Sir Simon Wesseley who is already aware of this initiative, with a view to the RCP using it as a stimulus for meaningful discussion amongst their membership of the concept.

5) Caroline Martin, Chief of the ETB in the City of Dublin as feedback on this post: "This Reflective Checklist designed by Dave Traxson endorsed by the BPS Division of Educational & Child Psychology (amongst several notable others) is an excellent resource. It is targeted for use by those who prescribe psychotropic meds to children. However, I suggest it can also be used by educational & psychological professionals who are responsible for determining and/or implementing interventions for children. We need to stop assuming the source of the problem lies within the child and checklists like this challenge this assumption. Granted, this will make for some more uncomfortable conversations."

AND NOW THE CHECKLIST - DISCUSS ITS BENEFITS



A Reflective Checklist for Child Mental Health Professionals who Prescribe Psychotropic Medicines Endorsed by the Division of Educational and Child Psychology Division Committee of the BPS  in June 2016.
                              PAUSE -  REFLECT  -  REVIEW 

· Are the child’s behavioural differences pervasive, occurring in a wide range of social settings and observed by a range of different individuals in the community?
· Are the child’s difficulties severe, enduring, and significantly impairing?
· Have there been any stresses in the child’s relationships, social context, and recent history which might explain this pattern of behaviours?
· Does the child have presenting behaviours that closely conform to an approved usage for the particular medication being considered at this time?
· Is there research evidence on the efficacy and safety of this specific medication with children of the same age, gender, and social grouping?
· Are the child’s presenting behaviours significantly impairing in a range of settings to acceptably balance the possible impact on the child’s developing brain and body from the evidence based side effects of the specific medications being considered?
· Do the child’s parents and involved professionals see the child’s differences as significant enough to require this medication?
· Has a psychological intervention, such as a talking therapy (CBT etc.); a social intervention such as ‘Circle of Friends’ / ‘Buddy System’ or a physical intervention such as participation in sport been tried prior to prescribing this particular psychotropic medication being considered?
· Have there been any reported significant adverse side effects from this specific medication with children of the same age, gender and social grouping?
· Have you carefully weighed up the short and long-term risks and balanced them against possible benefits?

· Have you received valid consent from the parent and the child?

And perhaps the most searching question:


· If a child in your immediate family or circle of friends had the same presenting behaviours that are in front of you now, would you still be prepared to prescribe this drug?

WATCH THE BEST 11 MINUTES ON OUR DIVIDED BRITISH EDUCATION SYSTEM FROM SIR KEN ROBINSON & AN EXCELLENT CLIP ON ADHD - COURTESY OF TEDTALKS ON YOUTUBE.



LINK:https://www.youtube.com/watch?v=zDZFcDGpL4U&feature=share

PICK OUT THE EXCELLENT CLIP ON ADHD RATES ACROSS AMERICA AND WHAT IT MEANS.

Wednesday, 17 April 2019

GERMAN TRANSLATION OF THE DECP(BPS) ENDORSED 'REFLECTIVE CHECKLIST.' TO BETTER SAFEGUARD KIDS -Ein reflektierendes Checkliste für Kinder Mental Health Professionals, die von der Abteilung für Bildungs- und Kinderpsychologie Abteilung Ausschuss des BPS im Juni 2016

DEUTSCHE traslation DER DECP ‚REFLEKTIERENDES PRÜFLISTE.‘

Ein reflektierendes Checkliste für Kinder Mental Health Professionals, die von der Abteilung für Bildungs- und Kinderpsychologie Abteilung Ausschuss des BPS im Juni 2016 und anschließend von Professor Peter Kinderman, der damaligen Präsident der British Psychological Society (siehe beiliegenden Brief) Befürworteten psychotrope Arzneimittel verschreiben

Dieses Vorsitzende Jahr des DECP, Brian Apter, ausgedrückt in seinem ‚Vorsitzenden Hinweise fühlen einen Artikel umreißt die Gründe, die Entwicklung dieser Reflective Checkliste durch die Medikalisierung Subcommittee der Abteilung für Bildungs- und Kinderpsychologie untermauert wird in dieser Phase notwendig, um unsere zu informieren Mitglieder und alle Psychologen ihrer Entwicklung, um sie effektiv in Fällen der Praxis zu helfen, herauszufordern, wo sie ethische und langfristigen gesundheitlichen Bedenken über die Kinder haben, mit denen sie gemeinsam arbeiten.
Die Idee für diese  Reflective Prüfliste  für Praktiker Mental Health ist für Verordner von Psychopharmaka an Kinder im Vereinigten Königreich als Aide-mémoire auf ihren Schreibtischen nutzen , um besser das Wohlbefinden der Kinder zu schützen , mit denen sie arbeiten und kam von Atul Gawande inspirational und praktische Arbeit auf Checklisten zu den Bereichen Chirurgie und neonatalen Notfälle im Vereinigten Königreich angewandt , die zutiefst positive Ergebnisse auf demClient - Überlebensraten hatten. Atul Gawande ist Professor für Chirurgie an der Harvard Medical School und glaubt, dass unglaublich komplexe Prozesse und Entscheidungen können durch einfache schnelle Fragen und gesunden Menschenverstand praktisches Verfahren sicherer verbessert und durchgeführt werden. Sein bahnbrechendes Buch war ‚Die Checkliste Manifest.‘ 2009, die ein internationaler Bestseller und hat in vielen Bereichen radikale Ansätze provoziert.
Die rasch zunehmende Verschreibungsraten von Psychopharmaka für Kinder durch Kinder Psychiater und Kinderärzte in Großbritannien in den letzten zwei Jahrzehnten hat sich viele psychische Gesundheit Praktiker und Berufsverbänden gleichermaßen wie die Abteilung für Ausbildung und Kinderpsychologie und der Association of Educational Psychologen (AEP alarmiert ) sowie Kollegen in Amerika, wo die Situation ist noch extremer. In einigen Staaten allein die Verschreibung Rate für Methylphenidat ist 16% der Gesamtschülerzahl, die meisten Profis wollen würden in Großbritannien vermeiden
Als reflektierende Praktiker und ‚Ethisch Aufmerksam‘ des obersten Prinzips der Sicherung der Kinder sind die DECP Medikalisierung von Kindheit Subcommittee in unserer gemeinsamen Versorgung hat einen positiven Beitrag zu diesem kritischen Bereich von multiprofessionellen Debatte und guter Praxis zu produzieren bemüht. Wir hoffen, dass der viel gefeierten oben Ansatz der Verwendung von einfacher Anwendung und zum nachdenken anregenden Frage Aufforderungen erheblich den Schutz der gefährdeten Gruppen in der Gesellschaft wie Kinder verbessern könnten.
Die Checkliste ging durch viele Stufen der Erzeugung geeignete Fragen und Beratung mit Kollegen über ihre suitability.The Fragen wurden dann weiter verfeinerte ihr Gesicht Gültigkeit und Wirksamkeit zu verbessern, zu machen Praktiker die Bedeutung der midfully die Entscheidung betrachten, ein Kind zu behandeln in ihrem oft sehr anstrengender Arbeitstag. Es ist immer noch unsere Hoffnung, dass Kinderpsychiater und Kinderärzten, sich, durch die Betrachtung durch ihre Berufsverbände dann als Tischplatte Memorandum verteilt werden könnten, die neben ihrem Rezeptblock entfernt werden könnte oder in der Tat mit ihm als einem Posten zusammengefasst. Dies würde als eine erhebliche zusätzliche Sicherheit fühlen wir uns.
 Natürlich wollen wir nicht unnötig Verfahren zu vervielfältigen, wie die ausgezeichneten NICE-Leitlinien für spezifische Bedingungen für gut ausgebildete und informierte Profis, aber wir glauben, dass eine kurze Pause, in dem sie eine Bestandsaufnahme mit einer Zeit der Reflexion auf lange Sicht den Client profitieren Gruppe wir alle dienen. Wir hoffen, dass so viele Kollegen im Bereich angegeben haben, bereits, dass ein paar Minuten gut angelegten kann die Entscheidung an der Stelle von verschreibungspflichtigen und moderaten unnötigen overprescribing Kindern machen verbessern, die können auch auf Reflexion fällt in dem normalen Bereich von Kindern höhere geistigen erleben Not auch immer kausale Verbindung von ökologischen, sozialen und biologischen Faktoren.
Die gesunden Menschenverstand und reflektierende Natur der Fragen , die wir gestellt haben , sind, fühlen wir uns, sowohl praktisch als auch ethischer Natur. Leider trotz unserer Bemühungen und Erfolg an die Aufmerksamkeit der entsprechenden Berufsverbänden bei Zeichnung , die zunächst viel versprechend zeigte auf einem hohen Niveau innerhalb der Organisationen scheint es , dass die unvermeidlichen Ausschuss Überlegungen keine positiven Abschluss in diesem Stadium erreicht hat.Diese in gewisser Weise spiegelt die Berücksichtigung der neuen NICE - Richtlinien , die wir auch beteiligt Ribers vor möglicher Beschwerde statt besser Schutz der Kinder von dem, was der Präsident des Royal College of Psychiatry, Sir Simon Wessely hat Refe  in in der Zwischenzeit. Der beunruhigende Trend scheint eine Tendenz zu sein prescrred als ‚übereifrige Verschreibungs.‘ Zu schützen
Wir müssen mit dem Versuch bestehen beide in dieser Hinsicht gute Praxis zu beeinflussen auf persönliche Interaktion Ebene mit den medizinischen Kollegen arbeiten wir mit Kindern auf unseren Fallzahl und bei einer professionellen Zusammenarbeit Ebene bei der Einrichtung von NICE bevorzugtem Modell der Multi-Agentur Wegen für Kinder Verhalten unterstützt .

Einige der vielen Vermerke ,  da sie erhalten hat , internationale Berichterstattung in Artikel erhalten sind:
1) Von der Psychiatrischen Zeiten Website  - Juli 2015 - Professor Allen Frances, Ex - Chefredakteur der DSM-IV heißt es: „überwältigen Lehrer oft empfehlen , dass Eltern nehmen ihre Kinder an Ärzte für dieMedizin , wenn das Problem im Unterricht sein kann als in dem Kind. Dave Traxson, ein Kind und Schulpsychologen und seine Kollegen in Großbritannien, haben mit einem tollen Vorschlag kommen ,um die Epidemie von unvorsichtigen Medikamenten bei Kindern zu enthalten. Sie haben eine Checkliste von Fragen entwickelt , die Ärzte über , bevor denken sollen Verschreibung vonPsychopharmaka an Kinder.“
Prof. Alles Frances Psychiater 2018: Diese Checkliste ist der beste Weg , Ärzte zu stoppen über Verschreibung psych meds für kids.Forces sich gründlichere Bewertung tun & viele sichereren Alternativen zu prüfen.  LINK:  
https://t.co/unJicQf5r2 (https://twitter.com/AllenFrancesMD/status/978989855655931904?s=03)
Dank Allen.
2) „Ich sah die vorgeschlagene Checkliste re: Kind Psych Medikamente in Psychiatric Times. Es scheint klar, nachdenklich und machbar. Danke.“  Lloyd Sederer, MD. Ärztlicher Direktor, NYS Office of Mental Health,  Adjunct Professor, Columbia / Mailman School of Public Health. Medical Editor for Mental Health, The Huffington Post. 
3) "Danke für die Checkliste. Ich frage mich , wie viele Kinder wirklich Medikamente benötigen würde ,nachdem er durch diese Checkliste zu arbeiten? Ich bin ein Kind und Jugendpsychiater, und nach einigen Jahren gehe ich finden immer weniger Kinder wirklich brauchen Medikamente und mehr und mehr tun , so viel besser ohne die Medikamente , die wirklich in erster Linie helfen Artikel nicht. Aber es ist nicht populär reden um den Block.“ Lisbeth Kortegaard - Berater Kinder- und Jugendpsychiater an Kinder- und Jugendpsychiatrie in Hoejbjerg, Central Region, Dänemark.  

4)  Professor Peter Kinderman - Präsident der BPS  2016-17 angegeben -

Ich persönlich bin glücklich , die Reflective - Checkliste , die die Abteilung für Ausbildung und Kinderpsychologie für eine begrenzte Verbreitung in ihrer Juni Ausschusssitzung, nach ihrer Konsultation mit einigen interessierten Partnern genehmigt zu unterstützen und Sie alle für Ihre Arbeit an diesem issue zu danken e.
Die Reflective Prüfliste ordnungsgemäß von der DECP, sowie eine Reihe von bedeutenden externen Partnern unterstützt wurden, einschließlich der  Generalsekretär, Kate Fallon, der  Vereinigung für Bildungs- Psychologen, bedeutet , dass ich bin sehr zufrieden mit ihnen in dieser Hinsicht zu verbinden. Ich stimme mit Ihrer Hoffnung und die von Professor Allen Frances (Chefredakteur von DSM-IV) ausgedrückt, die ein paar Wochen auf seinem Blog die Checkliste von den beiden Hauptgruppen von Verordner für Kinder und Jugendliche verwendet werden sollten , dh Kinder- und Jugendpsychiater und speziell Pädiater trainiert, dass die Zahl der Verschreibungen von Psychopharmaka wären vernünftige , im Laufe der Zeit.
Sie erwähnten , dass Sie auch an dieser Initiative beteiligt bleiben gerne und mit mir in Verbindung stehen und dem DECP Ausschuss gegebenenfalls und ein Gespräch mit dem Präsident der Royal College of Psychiater, Sir Simon Wessely , die bereits Kenntnis von dieser Initiative zu starten mit Blick auf den RCP es als Anregung für eine sinnvolle d mit ISKUSSION unter ihrer Mitgliedschaft des Konzepts. 5)  Caroline Martin, Leiter der ETB in der Stadt Dublin als Feedback zu diesem Beitrag: " Diese Reflective Prüfliste entworfen von Dave Traxson

von der BPS Division of Educational & Child Psychology unterstützt (unter mehreren bemerkenswerten andere) ist eine hervorragende Ressource. Es ist für die Verwendung von denen , die psychotrope Medikamente zu verschreiben Kindern ausgerichtet. Allerdings schlage ich kann es auch durch pädagogische und psychologische Fachkräfte eingesetzt werden , die verantwortlich sind für die Bestimmung und / oder Durchführungsmaßnahmen für Kinder. Wir müssen aufhören , die Quelle des Problems angenommen innerhalb des Kindes liegt und Checklisten , wie diese Herausforderung dieser Annahme. Zugegeben, wird dies für einige unbequemen Gespräche machen „. UND PRÜFLISTE NOW - DISKUTIERT seine Vorteile


Ein reflektierendes Checkliste für Kinder Mental Health Professionals, die von der Abteilung für Bildungs- und Kinderpsychologie Abteilung Ausschuss des BPS im Juni 2016 Befürwortet psychotrope Arzneimittel verschreiben.
                              PAUSE  -   REFLECT   -   REVIEW 

·  Ist die kindliche Verhaltensunterschiede allgegenwärtig, in einem breiten Spektrum von sozialen Einstellungen auftritt und durch eine Reihe von verschiedenen Personen in der Gemeinschaft zu beobachten?
·  Sind das Kind Schwierigkeiten schwere, dauerhafte und beeinträchtigen erheblich?
·  Gibt es in dem Kind Beziehungen, sozialer Kontext keine Spannungen gewesen, und die jüngste Geschichte , die dieses Muster von Verhaltensweisen erklären könnte?
·  Hat das Kind Verhaltensweise vor , die in engen Zusammenhang mit einer genehmigten Nutzung für die bestimmten Medikamente entsprechen zu diesem Zeitpunkt in Betracht gezogen werden?
·  Gibt es Forschungsergebnisse über die Wirksamkeit und Sicherheit dieses spezifischen Medikaments mit Kindern im gleichen Alter, Geschlecht und sozialen Gruppierung?
·  Des Kindes präsentieren Verhalten deutlich in einer Reihe von Einstellungen zu beeinträchtigen , die möglichen Auswirkungen auf die kindliche Entwicklung des Gehirns und des Körpers von den evidenzbasierten Nebenwirkungen der spezifischen Medikamente akzeptabler Ausgleich berücksichtigt?
·  Die Eltern des Kindes tun und die beteiligten Fachleute des Kindes Unterschiede als signifikant genug sehen , dieses Medikament zu verlangen?
·  Hat eine psychologische Intervention, wie zum Beispiel eine Gesprächstherapie (CBT etc.); eine soziale Intervention wie ‚Circle of Friends‘ / ‚Buddy System‘ oder ein körperlicher Eingriff wie dieTeilnahme am Sport vor versucht worden , diese besondere psychotrope Medikamente verschreiben berücksichtigt?
·  Gibt es aus diesem speziellen Medikament mit Kindern im gleichen Alter, Geschlecht und soziale Gruppierung alle berichteten signifikanten unerwünschten Nebenwirkungen gewesen?
·  Haben Sie sorgfältig die kurz- und langfristigen Risiken und ausgewogen sie gegen mögliche Vorteile abgewogen?

·  Haben Sie eine gültige Einwilligung der Eltern und das Kind empfangen?

Und vielleicht Frage der Suche:


·  Wenn ein Kind in Ihrer unmittelbaren Familie oder Freundeskreis das gleiche präsentierenden Verhalten hat , die nun vor Ihnen sind, werden Sie noch dieses Medikament verschreiben , hergestellt werden?

A Reflective Checklist for Child Mental Health Professionals who Prescribe Psychotropic Medicines Endorsed by the Division of Educational and Child Psychology Division Committee of the BPS  in June 2016 and subsequently by Professor Peter Kinderman, the then President of the British Psychological Society (See enclosed letter)

This year’s chairperson of the DECP, Brian Apter, as expressed in his ‘Chair’s Notes feels an article outlining the rationale underpinning the development of this Reflective Checklist by the Medicalisation Subcommittee of the Division of Educational and Child Psychology is needed at this stage to inform our members and all psychologists of its development so as to help them effectively challenge practice in cases where they have ethical and long term health concerns about the children with whom they co-work.
The idea for this Reflective Checklist for Mental Health practitioners is for prescribers of psychotropic medications to children in the U.K. to use as an aide-memoire on their desks to better safeguard the wellbeing of children they work with and came from Atul Gawande’s inspirational and practical work on checklists applied to the fields of surgery and neo-natal emergencies in the U.K. which have had profoundly beneficial outcomes on client survival rates. Atul Gawande is a Professor of Surgery at Harvard Medical School and believes that incredibly complex processes and decisions can be improved and made safer by simple prompt questions and common sense practical procedures. His seminal book was 'The Checklist Manifesto.' 2009 which is an international bestseller and has provoked radical approaches in many fields.
The rapidly increasing prescription rates of psychotropic drugs for children by Child Psychiatrists and Paediatricians in the U.K. over the last two decades  has alarmed many mental health practitioners and professional bodies alike such as the Division of Educational and Child Psychology and the Association of Educational Psychologists (AEP) as well as colleagues in America where the situation is even more extreme. In some States the prescription rate for Methylphenidate alone is 16% of the total school population which most professionals would want to avoid in the U.K.
As reflective practitioners and being ‘Ethically Mindful’ of the paramount principle of the Safeguarding Children in our shared care the DECP Medicalisation of Childhood Subcommittee has endeavoured to produce a positive contribution to this critical area of multi-professional debate and good practice. We hope that applying the much celebrated above approach of using simple and thought provoking question prompts could significantly improve the Safeguarding of vulnerable groups in society such as children.
The checklist went through many stages of generating suitable questions and consultation with colleagues about their suitability.The questions were then further refined to improve their face validity and effectiveness at making practitioners consider the importance of midfully making the decision to medicate a child in their often very busy working day. It is still our hope that child psychiatrists and paediatricians, themselves, through consideration by their professional bodies could then be distributed as a desk top aide-memoire which could be situated next to their prescription pad or indeed combined with it as one item. This would act as a significant additional safeguard we feel.
 Obviously we do not want to unnecessarily duplicate procedures, such as the excellent NICE Guidelines for specific conditions for well trained and informed professionals but we do believe that a brief pause where they take stock with a period of reflection may in the long term benefit the client group we all serve.  We hope as many colleagues in the field have already indicated that a few minutes well spent may enhance the decision making at the point of prescription and moderate unnecessary overprescribing to children who may well on reflection fall within the normal range of children experiencing higher levels of mental distress for whatever causal combination of environmental, social and biological factors.
The common-sense and reflective nature of the questions we have posed are, we feel, both practical and ethical in nature .  Sadly despite our best efforts and success at drawing it to the attention of the appropriate professional bodies which initially showed a lot of promise at  high levels within the organisations it seems that the inevitable committee considerations has not reached any positive conclusion at this stage. This in some way mirrors the consideration of new NICE Guidelines that we have also been involvedribers from potential complaint rather than  better Safeguarding Children from what the President of the Royal College of Psychiatry, Sir Simon Wessely has refe in in the intervening period. The worrying trend seems to be a tendancy to protect prescrred to as, ‘over-zealous prescribing.’
We must persist with trying to influence good practice in this regard at both a personal interaction level with the medical colleagues we work with supporting children on our caseloads and at a professional collaboration level in setting up NICE’s preferred model of multi-agency pathways for child behaviour.

Some of the many endorsements received since it has received international coverage in articles include:
1)From the Psychiatric Times website - July 2015 - Professor Allen Frances, ex- editor in chief of DSM-IV states, "Overwhelmed teachers often recommend that parents take their kids to doctors for medicine when the problem may be more in the classroom than in the kid. Dave Traxson, a child and educational psychologist and his colleagues in the United Kingdom, have come up with a terrific suggestion to help contain the epidemic of careless medication in kids. They have developed a checklist of questions doctors should think about before prescribing psychoactive drugs to children."
Prof Allen Frances Psychiatrist 2018:This checklist is the best way to stop doctors from over-prescribing psych meds for kids.Forces them to do more thorough evaluation & to consider the many safer alternatives. LINK: 
https://t.co/unJicQf5r2 (https://twitter.com/AllenFrancesMD/status/978989855655931904?s=03)
Thanks Allen.
2)“ I saw the proposed checklist re: child psych medications in Psychiatric Times. It seems clear, thoughtful and feasible. Thank you.” Lloyd Sederer, MD. Medical Director, NYS Office of Mental Health, Adjunct Professor, Columbia/Mailman School of Public Health. Medical Editor for Mental Health, The Huffington Post.
3)"Thanks for the check list. I wonder how many children would really need medications after working through this check list? I am a child and adolescent psychiatrist , and as the years go by I find fewer and fewer children really need medications, and more and more do so much better without the meds that didn´t really help in the first place. But it is not popular talk around the block."   Lisbeth Kortegaard - Consultant Child and Adolescent Psychiatrist at Child and Adolescent Psychiatry in Hoejbjerg, Central Region, Denmark.  

4) Professor Peter Kinderman - President of the BPS 2016-17 stated -

I am happy personally to endorse the Reflective Checklist that the Division of Educational and Child Psychology approved for limited dissemination at their June Committee meeting, following their consultation with some interested partners and to thank you all for your work on this issue.
The Reflective Checklist having been duly endorsed by the DECP, as well as a range of significant external partners, including the General Secretary, Kate Fallon, of the Association for Educational Psychologists, means I am very happy to join with them in this regard. I agree with your hope and that of Professor Allen Frances (Editor in Chief of DSM-IV) expressed a couple of weeks ago on his blog that, were the Checklist to be used by the two main groups of prescribers for children and young people i.e. child and adolescent psychiatrists and specifically trained paediatricians, that the number of prescriptions of psychotropic medication would become more reasonable over time.
You mentioned that you would also be pleased to remain involved in this initiative and to liaise with me and the DECP Committee where appropriate and to start a conversation with the President of the Royal College of Psychiatrists, Sir Simon Wesseley who is already aware of this initiative, with a view to the RCP using it as a stimulus for meaningful discussion amongst their membership of the concept.

5) Caroline Martin, Chief of the ETB in the City of Dublin as feedback on this post: "This Reflective Checklist designed by Dave Traxson endorsed by the BPS Division of Educational & Child Psychology (amongst several notable others) is an excellent resource. It is targeted for use by those who prescribe psychotropic meds to children. However, I suggest it can also be used by educational & psychological professionals who are responsible for determining and/or implementing interventions for children. We need to stop assuming the source of the problem lies within the child and checklists like this challenge this assumption. Granted, this will make for some more uncomfortable conversations."

AND NOW THE CHECKLIST - DISCUSS ITS BENEFITS



A Reflective Checklist for Child Mental Health Professionals who Prescribe Psychotropic Medicines Endorsed by the Division of Educational and Child Psychology Division Committee of the BPS  in June 2016.
                              PAUSE -  REFLECT  -  REVIEW 

· Are the child’s behavioural differences pervasive, occurring in a wide range of social settings and observed by a range of different individuals in the community?
· Are the child’s difficulties severe, enduring, and significantly impairing?
· Have there been any stresses in the child’s relationships, social context, and recent history which might explain this pattern of behaviours?
· Does the child have presenting behaviours that closely conform to an approved usage for the particular medication being considered at this time?
· Is there research evidence on the efficacy and safety of this specific medication with children of the same age, gender, and social grouping?
· Are the child’s presenting behaviours significantly impairing in a range of settings to acceptably balance the possible impact on the child’s developing brain and body from the evidence based side effects of the specific medications being considered?
· Do the child’s parents and involved professionals see the child’s differences as significant enough to require this medication?
· Has a psychological intervention, such as a talking therapy (CBT etc.); a social intervention such as ‘Circle of Friends’ / ‘Buddy System’ or a physical intervention such as participation in sport been tried prior to prescribing this particular psychotropic medication being considered?
· Have there been any reported significant adverse side effects from this specific medication with children of the same age, gender and social grouping?
· Have you carefully weighed up the short and long-term risks and balanced them against possible benefits?

· Have you received valid consent from the parent and the child?

And perhaps the most searching question:


· If a child in your immediate family or circle of friends had the same presenting behaviours that are in front of you now, would you still be prepared to prescribe this drug?