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FAMILY COUNSELING FOR PARENTS OF GIRLS WITH ALIMENTARY OBESITY
Biletskaya M.,
PhD, associate Professor of the Department ofpsychosomatics and psychotherapy Saint-Petersburg State
Pediatric Medical University, St. Petersburg
Polumeeva D.,
assistant of the Department ofpsychosomatics and psychotherapy, St. Petersburg State Pediatric Medical University, St. Petersburg
Biletsky M.
assistant of the Department ofpsychosomatics and psychotherapy, St. Petersburg State Pediatric Medical University, St. Petersburg
Abstract
In the article by Biletskaya M.P. and Polumeeva D.S. the structure of family psychocorrection of adolescent girls with alimentary obesity is considered, the main mistakes that arise in the process of forming a diet are listed, the main topics that arise in the process of counseling the parents of girls suffering from alimentary obesity are considered.
Keywords: alimentary obesity, system family approach, child-parental relationship
Introduction
Currently, obesity is spreading among both adults and children [6,10]. The World Health Organization has defined obesity and overweight as "abnormal or excessive fat accumulation that can adversely affect health," and according to 2017 data, 2.8 million people die annually as a result of being overweight [1,7,9].
Most often, the cause of overweight and obesity is associated with a high-calorie diet, increased portion sizes, an increased content of fats and sugars in food, and a low content of vitamins, minerals and other trace elements [2,3,8]. However, psychogenic factors play an important role in the development of obesity. In people suffering from alimentary obesity, the emotiogenic type of eating behavior is most often found, which causes a reaction of "seizing" stress. In such cases, dietary adjustments and increased physical activity are ineffective as long as the stress response remains the same. In childhood and adolescence, the family plays a vital role. It can become, as a resource, and form a zone of chronic stress. This necessitates the involvement of the whole family in the psychocorrection of adolescents with alimentary obesity [5].
We have developed a psychocorrection program, in which adolescent girls suffering from alimentary obesity and their parents took part [4]. The structure of the psychocorrection program:
I. Organizational stage. Working with the family as a system. Purpose: Primary psychodiagnostics, psychological counseling.
II. The main stage.
Block 1: Group work with teenagers. Purpose: Psychocorrection of emotional and behavioral patterns of girls with alimentary obesity.
Block 2: Psychocorrection in the parental subsystem. Purpose: Increasing parental competence and psychocorrection of the parenting style.
Block 3 : Family psychocorrection. Purpose: Reconstruction of family relationships. Working with the family as a system.
III. Final. Working with the family as a system. Purpose: Summing Up and Disconnecting.
The preparatory stage for the psychocorrec-tional program, allowing to develop a stable motivation for psychotherapeutic work, was the conduct of family counseling for the parents of girls with alimentary obesity. During this stage of work, an analysis is made of the main difficulties and possible mistakes that most often arise in the process of forming a diet:
1) Informing parents about the possible reasons for overeating and their connection with psycho-emotional stress. These can be: conflicts in the family or with classmates, experiences associated with social interaction, complaints about the feeling of loneliness in a teenager, etc. It is necessary to talk with your child about his problems and difficulties that can lead to overweight.
2) Punishments. Dieting disorders can be spontaneous - when adolescents want to follow a diet, but in conditions of emotional stress, overeating occurs. In this case, punishments can lead to increased guilt, affect the self-esteem of a teenager, increase psycho-emotional stress, which, in turn, can lead to a repeated episode of overeating.
There are also cases when a teenager independently tries to create non-rational, rigid, restrictive diets, diets using products that are not recommended for obesity. This may be due to a lack of knowledge about the peculiarities of the functioning of the endocrine system and about the principles of building a rational diet.
Intentional non-compliance with the diet - when a teenager, being in stressful situations, independently decides not to follow a diet, despite the positive experience in correcting nutrition. If, in the described case, only scold the teenager, criticize his actions, it is easy to break contact with him and thus not achieve compliance with the diet, worsen relations with him.
In this case, criticism of the adolescent's actions and punishment can only increase tension and control in the child-parent subsystem.
The most common types of punishments in educational practice:
- Censure, condemnation.
- Deprivation (opportunities to meet friends, meals, etc.).
-The emergence of new requirements and responsibilities after a diet violation.
3) Restriction and control. These strategies are ineffective in the process of forming a diet, as they cause expressed negative emotions, protest, resistance, and, as a result, refusal to follow the rules of dietary nutrition.
4) Typical mistakes in the form of "bargaining" - when they promise to reward every time after dieting. They are rewarded with various small purchases, money.
5) Twitching, remarks related to the culture of food intake can negatively affect. For example: "do not chomp", "do not crush", "sit straight."
6) In some cases, it is not necessary to focus on the "exclusivity" and usefulness of dietary nutrition.
7) An error in the form of criticism, remarks related to the weight and appearance of a teenager.
8) Errors in the form of requirements to be constantly weighed, to track the weight.
9) Drastic changes in the diet. A gradual transition to a healthy diet is necessary.
10) Errors in the form of using food to maintain desirable or undesirable behavior are common.
In the course of the family counseling, basic recommendations were given to help in organizing the adolescent's nutritional diary, as well as on the main aspects of family interactions related to the topics of food and overweight.
The most important were the following topics:
1) Introduction of a food diary. This diary is necessary in order to give individual recommendations for changing the style of eating and eating patterns. In the diary, you should indicate all meals during all 7 days, with the allocation of the volume of food (in pieces, sizes of plates, forks, glasses, etc.). The time of the meal and the reason for the meal (hunger, anxiety, for the company, after seeing an advertisement, etc.) should be indicated.
2) Recommendations should be given on the structure of the diet, the selection of the required foods
and avoidance of certain high-calorie types of food at home.
3) Recommendations for adherence to a certain physical activity, taking into account the individual characteristics of a teenager. These physical activities, exercises can be effective if they are jointly observed by family members with whom the teenager maintains positive contact.
4) Recommendations for changing the environment around the teenager. It is necessary to introduce a new diet gradually and consistently, gradually introduce new ways of family pastime associated with a more active lifestyle.
5) Recommendations for the provision of psychological support to a teenager, for cooperation with a teenager in organizing a new daily routine. You should talk with a teenager, honestly answer his questions related to overweight, expressing a desire to help him, suggest working together on the result.
6) Recommendations for spending time together. Jointly organize the choice of meals, arrange cooking evenings, it is especially important at the stage of expanding the adolescent's diet.
7) Organize outdoor walks, use pedometers on your smartphone. Record your results on the pedometers by gradually increasing the number of steps per day. Arrange joint exercises, exercise at home. During self-isolation, instead of walking, take part and diversify your leisure time with new physical exercises, buy video games, where you should dance, run, "fight" in front of the TV.
8) Physical activity, exercise and walks - they should be made interesting, exciting, they should evoke positive emotions. Rigorous training plans should be avoided.
9) Do not deny your teenager all favorite dishes. You can allow on certain days (for example, birthday, new year), most importantly, to arouse and maintain interest in healthy food.
10) Recommendations - for joint family support for diet and exercise. It is necessary to develop new attitudes towards healthy eating for the whole family.
Conclusion
Thus, when conducting family counseling for parents of girls with alimentary obesity, an important stage of work is to inform and discuss in detail the most common mistakes in educational practice when forming a diet in adolescent girls and to consider in detail the recommendations for interaction in the child-parent subsystem with adolescents with alimentary obesity. This practical experience can be included in a comprehensive approach to the treatment of alimentary obesity in adolescents and can be recommended to specialists working with this contingent.
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SPECIFICITY OF AFFECTIVE DEVELOPMENT IN CHILDREN WITH ASD
Savina T.
Candidate of pedagogical sciences, Associate Professor, Russian State University for the Humanities. Institute of Psychology L.S. Vygotsky
Abstract
The article presents the specifics of the development of children with ASD, considered from the standpoint of the level organization of their affective development. The qualitative and quantitative characteristics of the violations identified in the process of research at the levels of: environmental impacts; affective expansion; affective communication; affective stereotypes; symbolic regulation. The presented results indicate violations of all levels of regulation of the emotional sphere in children with ASD.
Keywords: hypersensitivity, eye contact, tactile contact, emotional regulation, affective development.
Investigating the problem of affective development of children with autism spectrum disorders (ASD), first, I would like to clarify what is meant by ASD.
Autism spectrum disorders include a wide range of disorders, ranging from psychological disorders to mental disorders. It is a lifelong complex of impairments that entails changes in the development of communication and social interaction. Children with ASD hear and understand the world in their own way, which is manifested in the specifics of their behavior, play and communication [3]. The picture of these manifestations is very diverse, but the main signs are: impaired communication, the presence of fears and increased anxiety, a high level of stereotypes and autostimulation [4]. A distinctive feature of children with ASD is the specificity in the development of their perception [2, 4].
Due to the wide range of behavioral manifestations in children with ASD, a problem arises related to making an accurate diagnosis at the early stages of development in order to successfully integrate them into society. In general, the prognosis for children with ASD is unfavorable and largely depends on the timeliness of intervention and diagnosis [2, 3]. In our work, an attempt was made to study disorders of emotional regulation in preschool children.
The research was carried out according to the author's method of V.V. Lebedinsky and M.K. Bardyshevskaya, in the version adapted by Yu.A. Mi-khailova "Assessment of affective development at an early age" [1]. V.V. Lebedinsky and M.K. Bardyshevskaya base this technique on the concept of development of level emotional regulation. The authors distinguish five levels included in the organization of the structure of emotional regulation - these are: the level of assessment of environmental influences; the level of affective stereotypes; the level of affective expansion; the level of affective communication; the level of symbolic regulations [1].
In the diagnosis, a quantitative and qualitative assessment of the disorder was used. The study involved 6 boys aged 5-6 years. Diagnostics taken together lasted about three months in total and included observation of the child in different situations (i.e., with parents, with strangers, with children, indoors, during a single game, etc.). To conduct a quantitative analysis, a scoring was introduced: 0 points - no violations are noted; 1 point - mild / moderate disorders; 2 points -marked violations are noted [1].
During the study, the following results were obtained (see tables 1-6). Results are presented as group averages.
