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Counseling Children

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Ethics Presentation

on 25 September 2015

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Transcript of Counseling Children

content and origins
Noteworthy
Behavioral
Emotional
Important Findings:
Important Findings:
Diagnostic:
Exploration:
Theories
The 3-Step Principal
Significance:
Significance:
Significance:
Significance:
Counseling Children
By: Matthew, Kevin, Christina and Hannah
Who Counsels Children and How Do They Do It?
Problems
Legal & Ethical
Challenges
Hot-Button Issues
Relevant Readings
Limited to the use of
basic
principals only:
Psychotherapy
Cognitive Behavioral Therapy (CPT)
Significance:
Gestalt Therapy
General Systems Theory
Free form tasks require that a counselor assess content for patterns, themes, and discuss the child’s integration of their own work to learn about a child’s emotions and coping effectiveness.
Art Therapy
Family Therapy
warm and friendly relationship
acceptance
atmosphere of permissiveness
reflections of the child’s feelings
respect for autonomy
allow the child to lead
do not hurry
*
Spontaneity, openness
!
Warning:
Children often attribute their distress to external factors rather than internal ones.
Because children are dependent upon their parents, this interferes with the most critical aspect of psychoanalyst, transference.
*
Reeducation and Relearning
Reinforces adaptive behaviors
Extinguishes maladaptive behaviors
Offers new learning experiences
include gaining coping skills, communication skills, and breaking habits. Counseling Children often uses shaping as a way to master complex behaviors though a series of mastering successive approximations. Reading skills are an example.
Goals
*
Encourages "Safe Risk" taking
Translates easily to play therapy
Insight-oriented change, therefore takes place at an age appropriate level which is best derived from indirect interpretation, through stories and metaphors. The child then learns to symbolically represent their experiences.
GOALS
include the child gaining an awareness of their thoughts, feelings, and physical self.
A
B
*
General systems theory believes that patterns within a system are circular rather than linear. A linear assumption would be that a child’s maladjustment is being caused by something WITHIN the child. Circular causality implies the understanding that influence is not only internal, but mutual as well. This is easily explained in the example: A causes B and B caused A.
Emphasizes the importance of environment
Stresses the understanding of familial roles
Goals
include family therapy in which positive change for a child client relies heavily upon changes in how the family interacts.
Child-centered counseling
*
Self-Esteem Building
Goals
include bolstering areas of belonging, connected to family and peers; advocacy, having a trusted person during crisis; risk management, mastering tasks and taking risks; empowerment, opportunities to makes choice and have a sense of power over their lives
Step 1:
All people are special and valuable because they are unique
Step 2:
Because people are special and unique they have a responsibility to help and and NOT hurt themselves
Step 3:
People are responsible for “watching” their own actions to see if they are treating themselves as an important person
To detect distortions or possible developmental issues a counselor may ask a child to copy another picture, picture completion, or instructions to draw a particular thing.
Similar to parent management training, Behavioral Family Therapy aids in reducing family factors which contribute to child behavioral problems and the breakdown of communication within the family. Parental education is a huge part of this.
*
A 10-year review of family therapy finds it to be helpful in treating conduct disorders and substance abuse, as well as being helpful for ADHD, anxiety, and depression.
Play Therapy
*
Play therapy is especially appropriate for children ages 3 through 12 years old. Play therapy has proven equally effective across age, gender, and presenting problem.
Meta-analytic reviews of over 100 play therapy outcome studies have found that the over-all treatment effect of play therapy ranges from moderate to high positive effects.
Research suggests that it takes an average of 20 play therapy sessions to resolve the problems of the typical child referred for treatment.
Keys:
Relationship with therapist
Expression of emotions
Safe risks
Cultivate empathy and respect for others
Learn new social skills
Develop self-efficacy
Develop responsibility for behavior
&
Strategies
X
Y
Z
a
B
C
Confidentiality
Counselors may be torn between their ethical obligation of privacy to minor clients, and a legal obligation to the parents or legal guardians
Maintaining confidentiality is an essential component to maintaining a therapeutic relationship; thereby, leaving the child more comfortable to reveal intimate details during the therapy process
Risk - If the child is at clear risk for harm to self or others then parents should be notified. However, if the child is engaging in self-harming behaviors (e.g., cutting) but not in any immediate danger than painting confidentiality may be better as to not damage the therapeutic relationship
Contracts
Legally - Minors are not allowed to enter into a legal contract which would be required to begin therapy; therefore, minors cannot enter into counseling without the consent of a parent or caregiver
School Counseling - Because counselors are an optional service provided by the school at the time of enrollment counselors are not required to seek parental consent; However, parents have the right to object to counseling on legal grounds.

Good Faith
If “the counselors sincerely believes that child abuse or neglect may have occurred or is occurring, they will be protected from lawsuits that might be filed” (p. 235)
That is to say, if the counselors believe that the child has been harmed or is being harmed, reports the concern, and the accused is found innocent, the counselor is less likely to face persecution because they are acting in the benefit of the child
Counseling Children and Adolescents, 4th Ed.- Ann Vernon
Counseling Children, 8th Ed.- Donna Henderson, Charles Thompson
Counseling Adolescents and Children: Developing Your Clinical Style- Deanna Pledge
Child Temperament: New Thinking About the Boundary Between Traits and Illness- David Rettew
Counseling Children through the World of Play- Daniel Sweeney

Identifying a "Phase" as Opposed to a "Disorder"
To Medicate or Not to Medicate
Conversion Therapy
Attachment Therapy
1. Children in time --> viewed as servants. no such thing as "childhood"
2. The Renaissance- the printing press--> schools
3. 18th century- mental health in children thought to be possessions
4. 1924- the American Orthopsychiatric Association of psychologists, social workers, and psychiatrists was formed.
5. 1960s- children were considered individuals in their own right
6. Counseling can prevent problems that can result in: delinquency
school failutre
emotional disturbance.

7. Mental health professionals counsel children, counselors do so by creating a safe environment.
Child Abuse and Neglect
Every state requires counselors to report the abuse and neglect of a child.
However, some counselors do not report abuse or neglect due to a myriad of reasons...
retaliation from persecutor,
improper handling by the system
betraying child’s trust
believing the child can be better helped by maintaining the work relationship
Confidentiality Exceptions
Inpatient Confidentiality - Clients are typically deemed not qualified to make crucial decisions about their own well being, therefore the burden falls on the parent or guardian to do so on their behalf
Harm - If the child is seen as being in immediate danger to the self or others, or engaging in potentially dangerous behavior they are the contact the child's parents or guardians
Release of Records - Parents generally do not have the right to access a child’s notes and records unless subpoenaed by a court, at which point it is assessed if the parent is acting in the child’s best interest
Planning
A child's mind and emotions are fluid and highly influential. A counselor may plan to work on a particular area but may find that other presenting problems have manifested that make the initial plan obsolete
Parental Involvement
Counselors do not work with the client alone, they all work with the child's parents who may seek to have a promiannt role and influence on their child's development. Parents may require more information about their child's progress or be frustrated at the speed of progress
In cases of divorce both parties may not agree with regard to treatment procedure or if the child be receiving treatment at all, which can make therapy difficult
Coping
Counselors deal with a myriad of presenting problems, from issues at school, dealing with depression and suicide, familial issues, to problems with friends. Being regularly bombarded with struggles of others can be psychologically and emotionally taxing on a counselor.
Client Resilience
Ideally every client would be motivated and cooperative during the therapuetic process to ensure the most benefit
Unfortunately not every client is as open to change as a counselor would like, thereby making the therapy process more difficult
Following Instructions
Due to their limited cognitive capacity limits some children in appropriately responding to a counselor's question or requirements
During play therapy, some children may not be familiar with the game or have trouble understanding the guidelines
Diagnosis
No parent or child wants to hear about the a negative diagnosis, particularly more significant and debilitating ones
The challenge comes in identifying the problems, making the diagnosis, informing relevant parties, and them helping them cope and providing hope
Common
grieving a death
parent's divorce
a parent's new marriage
academic failure
depressed
peer problems
abuse

long periods of sadness
outbursts of anger
excessive worry and anxiety
aggressive and or destructive
withdrawn
regression
temper tantrums
In more extreme cases, emotional and behavioral disturbances in children almost always leads to academic failure. More than 50% drop out of high school, and only 20 to 25% earn a diploma or certificate of completion.
*
education needed: bachelors degree
masters degree & then some enter into a doctorate or PhD program
Full transcript