Overview of psychological theories related to working with obese children and adolescents. Presentation given at the In Form project interim conference, Villach Austria, 22 March 2010.

1. Working with Obese Children
and Adolescents
Psychological Background
and
Therapeutic Interventions
Vincent O’Brien
Lorenzo Gios and Sara Carbone 1

2. 2

3. Lifestyle choices, perceptions, and ways of thinking are
strong influences on health and health behaviours.
Many of these develop
during childhood and adolescence and
have a long term influence on our health.
2

4. In this presentation I want to look at how
an understanding of social cognition
and other theories can help us to understand
and work with obese children and adolescents.
2

5. Social Behaviour, Cognition and Health
3

6. Social Behaviour, Cognition and Health
Social Behaviour is a consequence of perceptions of reality.
3

7. Social Behaviour, Cognition and Health
Social Behaviour is a consequence of perceptions of reality.
Social Cognition is how we make sense of social situations.
3

8. Social Behaviour, Cognition and Health
Social Behaviour is a consequence of perceptions of reality.
Social Cognition is how we make sense of social situations.
We can divide this into:
3

9. Social Behaviour, Cognition and Health
Social Behaviour is a consequence of perceptions of reality.
Social Cognition is how we make sense of social situations.
We can divide this into:
Person Perception
3

10. Social Behaviour, Cognition and Health
Social Behaviour is a consequence of perceptions of reality.
Social Cognition is how we make sense of social situations.
We can divide this into:
Person Perception
making sense of others
3

11. Social Behaviour, Cognition and Health
Social Behaviour is a consequence of perceptions of reality.
Social Cognition is how we make sense of social situations.
We can divide this into:
Person Perception
making sense of others
Self Regulation
3

12. Social Behaviour, Cognition and Health
Social Behaviour is a consequence of perceptions of reality.
Social Cognition is how we make sense of social situations.
We can divide this into:
Person Perception
making sense of others
Self Regulation
making sense of ourselves
3

13. Health Behaviour
Why do people adopt positive health
behaviours?
4

14. 5

15. A number of theoretical models have been
suggested to explain how we make decisions
about health behaviours.
The health belief model focuses on three aspects
of decision making.
Threat perception (What is the risk to me?)
Behavioural Evaluation (What do I need to do?)
Cues to action (Why should I do this?)
5

16. Health Belief Model 6

17. Health Belief Model 6

18. Threat Behavioural
Cues to Action
Perceptions Evaluation
Benefits Internal
Susceptibility
Efficacy External
Costs Health
Severity
Barriers Motivation
Health Belief Model 6

19. Threat Behavioural
Cues to Action
Perceptions Evaluation
Benefits Internal
Susceptibility
Efficacy External
Costs Health
Severity
Barriers Motivation
Health Belief Model 6

20. Threat Behavioural
Cues to Action
Perceptions Evaluation
Benefits Internal
Susceptibility
Efficacy External
Costs Health
Severity
Barriers Motivation
Health Belief Model 6

21. 7

22. Planned Behaviour Theory suggests that factors
such as attitudes, social conformity and drivers
and opportunities for behavioural change are a at
the centre of of personal decision making
7

23. Planned Behaviour Theory 8

24. Attitudes
Planned Behaviour Theory 8

25. Attitudes = Consequences
Planned Behaviour Theory 8

26. Value
Attitudes = Consequences
Planned Behaviour Theory 8

27. Value
Attitudes = Consequences
Efficacy
Planned Behaviour Theory 8

28. Value
Attitudes = Consequences
Efficacy
Subjective Norms
Planned Behaviour Theory 8

29. Value
Attitudes = Consequences
Efficacy
Views of
Subjective Norms = Others
Planned Behaviour Theory 8

30. Value
Attitudes = Consequences
Efficacy
Views of
Subjective Norms = Others + Compliance
Planned Behaviour Theory 8

31. Value
Attitudes = Consequences
Efficacy
Views of
Subjective Norms = Others + Compliance
Behavioural Control
Planned Behaviour Theory 8

32. Value
Attitudes = Consequences
Efficacy
Views of
Subjective Norms = Others + Compliance
Behavioural Control = Resources
Planned Behaviour Theory 8

33. Value
Attitudes = Consequences
Efficacy
Views of
Subjective Norms = Others + Compliance
Behavioural Control = Resources + Opportunity
Planned Behaviour Theory 8

34. 9

35. Antonovsky has argued that when things make
sense to us we are more able to manage our lives
and are more likely to take positive actions
To enhance our well being.
He calls this our ‘sense of coherence’.
9

36. Sense of Coherence
Antonovsky, A. (1979) Health, stress, and coping. San Francisco, CA: Jossey-Bass. 10

37. Sense of Coherence
Comprehensible
Life is structured,
predictable and
explainable
Antonovsky, A. (1979) Health, stress, and coping. San Francisco, CA: Jossey-Bass. 10

38. Sense of Coherence
Comprehensible Manageable
Life is structured, Personal and
predictable and external resources
explainable are available
Antonovsky, A. (1979) Health, stress, and coping. San Francisco, CA: Jossey-Bass. 10

39. Sense of Coherence
Comprehensible Manageable
Meaningful
Life is structured, Personal and
Fits with sense of
predictable and external resources
self
explainable are available
Antonovsky, A. (1979) Health, stress, and coping. San Francisco, CA: Jossey-Bass. 10

40. Sense of Coherence
Comprehensible Manageable
Meaningful
Life is structured, Personal and
Fits with sense of
predictable and external resources
self
explainable are available
It makes
sense to me
Antonovsky, A. (1979) Health, stress, and coping. San Francisco, CA: Jossey-Bass. 10

41. Sense of Coherence
Comprehensible Manageable
Meaningful
Life is structured, Personal and
Fits with sense of
predictable and external resources
self
explainable are available
I have
It makes
what it takes
sense to me
to do this
Antonovsky, A. (1979) Health, stress, and coping. San Francisco, CA: Jossey-Bass. 10

42. Sense of Coherence
Comprehensible Manageable
Meaningful
Life is structured, Personal and
Fits with sense of
predictable and external resources
self
explainable are available
I have
It makes
what it takes It’s worth it!
sense to me
to do this
Antonovsky, A. (1979) Health, stress, and coping. San Francisco, CA: Jossey-Bass. 10

43. Sense of Coherence
It makes sense
Resources
It makesworth it! me
It’s sense to
Meaningful
Manageable
Comprehensible
11

44. 12

45. According to Personal Construct Theory, we
divide the world and our lived experiences of it,
into similar and dissimilar constructs. We form our
impressions, make our decisions based on these,
largely pre constructed, general impressions.
12

46. According to Personal Construct Theory, we
divide the world and our lived experiences of it,
into similar and dissimilar constructs. We form our
impressions, make our decisions based on these,
largely pre constructed, general impressions.
George Kelly (1955) developed the Repertory Grid
interview technique to help therapists understand
how their
12

47. According to Personal Construct Theory, we
divide the world and our lived experiences of it,
into similar and dissimilar constructs. We form our
impressions, make our decisions based on these,
largely pre constructed, general impressions.
George Kelly (1955) developed the Repertory Grid
interview technique to help therapists understand
how their
Clients understand and make sense of their
world.
12

48. Personal Constructs
Me as
Ideal
Me me
others
see me
Kelly, G (1955) The psychology of personal constructs (vols. 1 and 2). N.Y.: Norton 13

49. Personal Constructs
Open Reserved
Me as
Ideal
Me me
others
see me
Kelly, G (1955) The psychology of personal constructs (vols. 1 and 2). N.Y.: Norton 13

50. Personal Constructs
Me
Open Reserved
Me as
Ideal others
me see me
Kelly, G (1955) The psychology of personal constructs (vols. 1 and 2). N.Y.: Norton 13

51. Personal Constructs
Me as
Me others
see me
Open Reserved
Ideal
me
Kelly, G (1955) The psychology of personal constructs (vols. 1 and 2). N.Y.: Norton 13

52. Personal Constructs
Ideal Me as
me Me others
see me
Open Reserved
Kelly, G (1955) The psychology of personal constructs (vols. 1 and 2). N.Y.: Norton 13

53. Personal Constructs
Make our Lives Predictable
Grow and Change
Influence Perceptions and Expectations
Represents ‘Personal Truths’
Not always internally consistent
Understanding another person’s construct is a measure of
empathy
Kelly, G (1955) The psychology of personal constructs (vols. 1 and 2). N.Y.: Norton 14

54. 15

55. Our recent work with 9 and 10 year old
children gave us an interesting insight
into how children think.
15

56. Our recent work with 9 and 10 year old
children gave us an interesting insight
into how children think.
We found they were strongly influenced
by parents and peers.
15

57. Our recent work with 9 and 10 year old
children gave us an interesting insight
into how children think.
We found they were strongly influenced
by parents and peers.
Even if they new some of the ‘technical’
information about healthy living, they
didn’t always understand how to fit it in
to their own lives.
15

58. 16

59. Young children are often very concerned that they fit
16

60. Young children are often very concerned that they fit
in with others.
16

61. Young children are often very concerned that they fit
in with others.
Family and friends, are important influences.
16

62. Young children are often very concerned that they fit
in with others.
Family and friends, are important influences.
But children are constantly looking to see what is normal
16

63. Young children are often very concerned that they fit
in with others.
Family and friends, are important influences.
But children are constantly looking to see what is normal
how to fit in.
16

64. Young children are often very concerned that they fit
in with others.
Family and friends, are important influences.
But children are constantly looking to see what is normal
how to fit in.
And this can distort and disrupt ‘rational’ thinking.
16

65. How children think
17

66. How children think
What kinds of food are least healthy?
“Pasta isn’t very
healthy because it’s got
calories.....
17

67. How children think
What kinds of food are least healthy?
But we need
“Pasta isn’t very calories don’t we?
healthy because it’s got So it must be healthy.”
calories.....
17

68. How children think
What kinds of foods are least healthy?
18

69. How children think
What kinds of foods are least healthy?
“My mum says...”
18

70. How children think
What kinds of foods are least healthy?
“Chinese
“My mum says...” food isn’t very
healthy.... because you
always get too much
to eat.”
18

71. What’s important?
19

72. What’s important?
Listening to children- (Understanding how they think)
19

73. What’s important?
Listening to children- (Understanding how they think)
Working with them not on them
19

74. What’s important?
Listening to children- (Understanding how they think)
Working with them not on them
Working with families, groups, communities.
19

75. What’s important?
Listening to children- (Understanding how they think)
Working with them not on them
Working with families, groups, communities.
Take into account social and environmental factors that inform and
support health behaviours.
19