References
Bittner, A., Goodwin, R.D., Wittche, H.U. Beesdo, K., Hoffer, M., & Lieb. R. (2004). What
Characteristics of Primary Anxiety Disorders Predict Subsequent Major Depressive
Disorder? The Journal of Clinical Psychiatry, 65(5), 618-26.
Bosgraaf, L., Spreen, M., Pattiselanno, K., & Van Hooren, S. (2020). Art Therapy for
Psychosocial Problems in Children and Adolescents: A Systematic Narrative Review on
Art Therapeutic Means and Forms of Expression, Therapist Behavior, and Supposed
Mechanisms of Change. Frontiers in Psychology, NA. https://link.gale.com/apps/
docA637807418/AONE?u=s4556763&sid=AONE&xid=e68aee94
Child Mind Institute. (2015). Children's Mental Health Report. Retrieved December 05, 2020, from https://childmind.org/2015-childrens-mental-health-report/
Gale, C. K., & Millichamp, J. (2016). Generalised anxiety disorder in children and
adolescents. BMJ clinical evidence, 2016, 1002.
Hancock, K. M., Swain, J., Hainsworth, C. J., Dixon, A. L., Koo, S., & Munro, K. (2018).
Acceptance and Commitment Therapy versus Cognitive Behavior Therapy for Children
With Anxiety: Outcomes of a Randomized Controlled Trial. Journal of Clinical Child &
Adolescent Psychology, 47(2), 296–311. https://doi-org.westernseminary.idm.oclc.org/
10.1080/15374416.2015.1110822
James, D., and Glaze, L. (2006). Bureau of Justice Statistics Special Report: Mental Health
Problems of Prison and Jail Inmates. Retrieved from: http://www.bjs.gov/content/pub/
pdf/mhppji.pdf
Merikangas, K. R., He, J., Burstein, M. E., Swendsen, J., Avenevoli, S., Case, B., … Olfson, M.
(2011). Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of
the National Comorbidity Survey Adolescent Supplement (NCS-A). Journal of the
American Academy of Child and Adolescent Psychiatry, 50(1), 32–45. doi:10.1016/
j.jaac.2010.10.006
Riley S. (2001). Art therapy with adolescents. The Western journal of medicine, 175(1), 54–57.
https://doi.org/10.1136/ewjm.175.1.54
Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T.,
Kendall, P. C. (2008). Cognitive Behavioral Therapy, Sertraline, or a Combination in
Childhood Anxiety. The New England Journal of Medicine, 359(26), 2753–2766.
doi:10.1056/NEJMoa080463
Audio TranscriptAuto-generated
Hi, everyone.
I know I'm a little bit late to the game
posting my presentation, so thank you.
If you're watching and thank you in advance for any
feedback, you have to give, um, from my research project,
I decided to do a summit tive program evaluation for
a counseling group that I designed called anxiety coping Skills
for teens.
Uh, tiny overview of this group.
It's a six week closed group for teenagers on dhe.
It's based on act acceptance and commitment therapy, but it
also weaves together some art interventions, so it's very hands
on and experiential.
But it's based on the principles of act like, um,
mindfulness present moment awareness, diffusion from thoughts and feelings of
the ability to cope with painful thoughts and feelings and
identifying more factors about your identity.
Identifying your values, the things that make life worth living
and then committing to acting on those principles so that,
um, you feel more confident in who you are.
So that's a little bit about act, and then I'll
talk a little bit more later on about why I
would be weaving in art principles as well.
So this is a group that I designed and the
purpose of this program evaluation would be to see actually
what the impact a group like this would have and
what the outcomes would be.
The goal of the group is to help teens decrease
their anxiety symptoms.
Andan also increase their ability to cope with anxiety and
stress. So the program evaluation the goal of that is,
um is to see, you know, we're going for this
goal. But is that the impact that the group is
having? And are those outcomes?
So for the literature review, the main question we should
ask. It's probably why do we need an anxiety group
for teens?
Um, I don't think I need to convince anybody.
That anxiety is a prevalent issues for teenagers.
The data that I have is from 2015, but I'm
sure this year you can imagine it's and so skyrocketed
with Cove it and whatnot.
Um, so 49% of youth have a mental disorder mental
health disorder, and 31% of those disorders can be accounted
for by anxiety disorders.
And we also know that anxiety during your youth can
lead to an onslaught of issues later on, things like
conduct disorder, depression, suicide ality, increased incarceration and, ah, lot
of other things.
So early intervention is really important.
Um and so this next fact is especially, um surprising
and sad.
80% of youth with an anxiety disorder do not receive
treatment. This was in a study by Done by Child
Mind Institute.
And, um they found that number 80% of youth not
receiving treatment for anxiety and, um did more study on
it and attributed it largely thio ah, shortage and mental
health professionals.
And so the idea behind running mawr groups for teenagers
with anxiety is that if a mental health professional can
reach six or eight teenagers at once instead of just
one, you're helping to close that gap.
And, um And then I also included the question, Why
use Why this kind of a group?
So why use act and art therapy?
So, in a really big study done on what the
most effective treatment for teens with anxiety is, they found
that it's a combination of medication typically SSR eyes and
CBT so.
But more recent studies have found that act is as
effective with teens as CBT, which isn't surprising it is
born out of it.
So a lot of evaluating thoughts and kind of separating
thoughts from feelings from facts from yourself.
All of, um, that kind of cognitive stuff is really
wound up in it.
Uh, but it has been shown now to be as
effective and the point behind adding art therapy to it.
I wanted the group to be really experiential, and our
therapy has been shown to improve psychosocial problems with teens.
Um, and there was an article, I think, in the
Western Journal of Medicine.
Um, where a psychologist was explaining why art therapy is
effective with teens and, um stated that it's probably due
to, you know, when you're doing something with your hands
and doing art therapy intervention, it takes a lot of
the pressure off that they might feel with traditional talk
therapy. Especially, I would say, like if they're surrounded with
their peers and their feeling that peer pressure, Um, so
it's less.
It's a less intimidating and less, um, it's a lower
risk way off, discovering your thoughts and feelings, and especially
with teens, they're starting to develop that abstract reasoning, and
but it can be intimidating to start expressing that.
So using art therapy as an intervention e discovered as
seen legitimate for working with teens.
So for the methodology, um, I decided to run three
different groups with separate leaders and separate sets of members
and then collecting data along the way.
So, um, I believe I will.
I'll be searching for both qualitative and quantitative findings, um,
using a screening interview just to identify the members of
the group, an entrance interview and exit interview and then
a follow up probably three months later.
So for the quantitative findings, I would be using the
God seven, the generalized anxiety disorder assessment that's widely used
and reputable on Get Something I already used with clients
and find really helpful.
So would identify pinpoints specific symptoms that clients have experienced
in the past couple of weeks and you know, things
like body tension and shaking and trouble sleeping.
Um, worry.
That is difficult to control, so it it pinpoints precise
symptoms. And I'd like Thio have this assessment incorporated at
each point of contact with with the group members and,
um, and as part of the screening process, I would
like Thio identify Onley used only group members that score
at least a 10.
It's a scale of 0 to 21 10 marks.
Moderate anxiety.
Um, and so at least narrowing down the group Thio,
um, teenagers who are experiencing moderate to severe anxiety.
Um, and so this this quantitative findings portion of the
study would use a pre test post test and follow
up design and then, for the qualitative findings, which would
be the primary purpose of the study, would use the
interview questions And, um, yeah, I just to discover what
the impact really is.
And I think an interview format would allow for more
exploration of that.
And then those would be coated later with things that
were identified.
And the responses, um, themes like particular interventions that were
used like particular art interventions.
Um, things like self efficacy and confidence in one's ability
to cope with anxiety.
You m Yeah, stuff like that.
So for the screening interview, I would be narrowing it
down to group members who are between the ages of
14 to 17, experiencing moderate to severe anxiety and for
ethical reasons, I would want to make sure that they're
not currently suicidal, and if they are, refer them to
some one on one help I am, and another.
Another elimination would be that they're not currently working with
one of my mental health professional, because that would pose
a limitation if we weren't able to tell if the
group was impacting them or if they're other counseling list.
Um, and then during the entrance interview, it would include
the gods seven, um, and then also some questions like
What skills do you have to cope with anxiety and
stress? Because we want to tell later on what skills
do you have now and we want to see if
that's increased.
And we want to assess the level of self efficacy
with questions like, Do you feel capable of coping with
anxiety? I also would like to assess the level of
hopefulness regarding mental health.
So do you feel confident that you can decrease your
anxiety over time?
Do you feel capable of improving this?
And then I would really like Thio assess the level
of functioning.
So have you questions like have you skipped any school
or extracurricular or work obligations or events because of anxiety?
Like, how is it?
How is it impacting your life?
And then what else are you using?
So are you using substances?
Are you using sex?
Are you using alcohol?
Um, gaming, television.
You know, what are they already using To cope with
anxiety so that later we can go on, we can
measure. All right.
Now, are they using healthier coping mechanisms?
And then the exit survey questions would include a lot
of the same just to kind of see what differences
were achieved.
Um, but also questions about what was specifically helpful about
the group and what they attribute or if the group
was helpful for them in their coping skills.
What about it?
Was it hearing from other group members and that normalizing
experience that you receive?
Realizing that a lot of other teams have anxiety?
Was it the relationship you had with the group leader?
Was it the coping skills that were being explained by
the leader?
Was it the art interventions?
And then I also want to include some other questions
in there like that would hopefully minimize limitations to the
study. Like during the during the group.
Did you experience any major life changes that started or
relieved? A lot of stress.
So did you graduate from high school and suddenly felt
like all your stress was gone.
Um, did your parents get a divorce, which made your
life way more stressful stuff like that?
And then what coping skills did you take away and,
um, kind of reassess those questions about they feel that
they're coping skills have improved.
And then the follow up survey would include a lot
of the same questions.
Um, but a few months down the road to see
kind of how much was retained.
And if you know, if they're especially like with the
God seven.
I think that'll be interesting seeing if they did increase.
I mean, if they did decrease their anxiety symptoms by
50% during the group, did it just go back up
a few months later?
Are they still using coping skills that they learned in
group stuff like that?
Eso for the group design?
I'm I think I won't go into detail with that
for this presentation.
I have the entire curriculum in in my, um, paper,
but I gave a little bit of a description of
the beginning of that.
Um, yeah.
One moment.
So for the presentation and discussion of results, I will
partly be using the logic model.
It's something we learned about in our textbook, and it
uses, um, kind of an input, output and outcomes.
Um, organization of things.
So input would be kind of things that have to
be invested like the counselors, time planning and then meeting
with the group.
Any materials or event space that was used for the
group and outcomes outputs would be things from the clients,
like what they had to put into the group.
In order for this study to be effective, they had
to show up for that hour.
They had to complete homework assignments, that type of thing.
And then the outcomes would be what did we discover
during the study?
What were the themes that arose and what was the
data that we found?
Um, and that answered our question.
What is the impact and outcome of a group like
this? I'm another.
A big part of the presentation results would be to
see if a group like this has the potential to
be published on Dhe and also just in terms of
lending to the ethics of the counseling profession.
I think having more groups that are evidence based on
dhe. I think I was surprised that you can just,
um, that there are so many groups that you that
counselors just have the ability to be, you know, creative
and to run.
And I don't have any doubt that there that they
have the potential to be potential to be helpful, especially
if the leader, um, establishes good relationships with the clients
and helps them establish this of each other.
But having a group where you can say we've tested
this and we know that it's effective so that you
feel really ethical in the way that you advertise the
group, I think, lends to the professionalism of counseling.
So, um, that is my overview of my paper.
Thanks for any feedback you have to give, and I'll