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An Invitation

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There once was an old man who lived near the ocean. One morning, the man went for a walk on the beach and found the shore covered with starfish, stretching in both directions. A storm had passed the night before, stranding the starfish on the sand.

In the distance, the man noticed a little boy walking along the shoreline. As the boy approached, he paused every so often, bent down to pick up a starfish, and threw it into the sea. When the boy came close enough, the man shouted, “Good morning! May I ask what you are doing?”

The boy stopped, looked up, and replied, “I’m throwing the starfish into the ocean. The storm washed them onto the beach, and they can’t return to the sea by themselves. They need my help” (Image 0.1).

The old man replied, “But there must be thousands of starfish on this beach. I’m afraid you really won’t be able to make much of a difference.”

The boy bent down, picked up another starfish, and threw it into the water as far as he could. Then, he turned to the man, smiled, and said, “I made a difference to that one!”

Like the starfish in the story, many children and adolescents are in need of help. Roughly 20% of all youths experience at least one psychological disorder prior to adulthood. This percentage means that nearly 15,000,000 youths in the United States alone will encounter problems with their behavioral, cognitive, or social–emotional functioning. These problems include developmental disabilities like Down syndrome or autism spectrum disorder, externalizing problems like attention-deficit/hyperactivity disorder or aggressive behavior, internalizing problems like anxiety and depression, and health-related problems such as eating disorders and insomnia. Problems like these are serious; they can adversely affect children’s ability to care for themselves and communicate with others, perform well in school, foster relationships with family and friends, and achieve happiness and satisfaction in life.

Equally worrisome is the fact that most children and adolescents who need help receive substandard care or no professional treatment whatsoever. Barriers to effective treatment include poor recognition of children’s psychological problems; limited access to high-quality, mental health services, especially among children from socioeconomically disadvantaged families; and an overall shortage of mental health professionals who are trained in evidence-based treatment. The sheer number and severity of children’s problems can cause us to become pessimistic, like the old man in the story.

On the other hand, recent scientific advances can cause us to be hopeful and motivate us to help children and families in need. The past 30 years have witnessed a remarkable increase in the scientific study of child psychopathology. New research has advanced the field, enabling us to more fully understand the causes of these conditions. Research depends on teams of professionals, working together to discover the causes of these disorders across multiple levels of analysis: genetic, biological, psychological, familial, and social–cultural.

Similarly, we have made great strides in developing evidence-based treatments for children with mental health problems. These treatments include new medications, psychotherapies, and prevention strategies that can be delivered in clinics, hospitals, schools, and the community. There is also increased effort to tailor these interventions to meet the needs of children and families from diverse cultural, ethnic, linguistic, and socioeconomic backgrounds.

The recent global pandemic has also required children and families to cope with enormous stress. Children must adjust to education at home, separation from friends at school, and the suspension of many activities they used to enjoy. Parents must juggle the demands of work with the responsibilities associated with caring for their children and other relatives. Families must tolerate the sadness that arises from the loss of loved ones and the anxiety that stems from uncertainty in nearly all domains of life. The recent health crisis challenges us to face these stressors with resilience, courage, and compassion.


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Now, more than ever, the world desperately needs caring professionals who are willing to dedicate their professional lives to serving children and families in need. Even if you do not intend to become a mental health professional, it is likely that you will play a significant role in the life of a child (if you haven’t already). Not all of us are called to be researchers or therapists, but everyone has the opportunity to promote the welfare of children in some capacity: as a caregiver, parent, teacher, coach, or mentor. This book is intended to introduce you to this intellectually exciting and personally rewarding field. Welcome!

Introduction to Abnormal Child and Adolescent Psychology

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