Intervention strategies for children and adolescent with disorders: from intrapsychic to transactional perspective

A large amount of studies and clinical evidence document the importance of infancy and early childhood influences on long term developmental trajectories toward mental health or psychopathology (Sameroff, 2000, 2010). Without healthy, productive adults no culture could continue to be successful. This concern is the main motivation for society to support child development research. Although the academic interests of contemporary developmental researchers range widely in cognitive and socialemotional domains, the political justification for supporting such studies is that they will lead to the understanding and ultimate prevention of behavioural problems that are costly to society. With these motivations and support, there have been major advances in our understanding of the intellectual, emotional, and social behaviour of children, adolescents and adults. This progress has forced conceptual reorientations from a unidirectionalunderstanding of development (e.g., parents affect children and not vice versa) toward a bidirectional conceptualization of development. Childrenare now assumed to affect and even select their environments as much as their environments affect their behaviour. Indeed, key among many of the most influential developmental theories in the past several decades is the assumption that children have bidirectional, or reciprocal, relationships with their environments (Bandura, 1977; Bronfenbrenner, 1979). To date, it is widely accepted that children’s healthy development is shaped by complex transactional processes among a variety of risk and protective factors, with cumulative risk factors increasing the prediction of emotional and behavioural problems (Anda et al., 2007; Rutter & Sroufe, 2000; Sameroff, 2000). Risk and protective factors include individual child characteristics such as genetic and constitutional propensities and cognitive strengths and vulnerabilities; parent characteristics such as mental health, education level, sense of efficacy, and resourcefulness; family factors such as quality of the parent-child relationship, emotional climate, and marital quality; community connectedness factors such as parental social support, social resources, and children’s peer relationships; and neighbourhood factors such as availability of resources, adequacy of housing, and levels of crime and violence (Sameroff & Fiese, 2000). The predictive value of these factors across many studies led to the development of transactional-bioecological models that attempt to conceptualize the relative contributions of proximal and distal risk and protective factors to children’s developmental outcome (Bronfenbrenner & Morris, 2006). In 1975, Sameroff and Chandler proposed the transactional model. This theoretical framework has become central to understanding the interplay between nature and nurture in explaining the development of positive and negative outcomes for children. The transactional model is a model of qualitative change. Sameroff asserted that the transactional model concerned qualitative rather than incremental change and that the underlying process was dialectical rather mechanistic in nature. The aim of this chapter is to explore this theoretical framework and its intervention strategies. In the first part, the transactional model will be described after a brief summary that will illustrate the transition from intrapsychic to transactional perspective. In the second part, intervention strategies for children and adolescent will be described. The attention of research on environmental risk and protective factors has fostered a more comprehensive understanding of what is necessary to improve the cognitive and social-emotional welfare of children and adolescents.