Child and Adolescent – Flashcards

-Attention spans are limited - use a variety of techniques -Use concrete techniques - concepts enhanced when they can manipulate objects or see a visual -Behavioral charts can be helpful -Back to the basics: What is the presenting problem? What can we do with that? -Typical problems: --Difficulty engaging in cooperative play --Taking things literally which can result in fear - ex. Half brother --Situational problems (divorce, abuse, parental alcoholism, etc.)

-Children have many first time experiences - school and friends -Limited ability to think logically and see possibilities -Continue to use concrete interventions - playing a board game --Engage the child in problem solving -Want to please people at this age -Typical problems: --Most commonly school-related --Also, family, appearance, health, peer relationships, self-concept, situational problems (growing up in an abusive home)

-Need to remember that formal operational thinking occurs gradually --Problem behaviors are often a result of incompetencies in thinking and reasoning -Adolescents need adult guidance for worries and problems -Often confuse cognitions and affect -Typical problems: --Overwhelmed by feelings --Worry excessively about how they look, act, and where they belong --Relationships can be difficult - struggle for independence --Change in friend groups to form identity --Overreaction by parents that creates additional problems

-Most are better able to express themselves verbally --Easier to have a verbal conversation without concrete demonstrations --Some will still be visual learners or have less maturity -Benefit from individual and group activities that address developmental issues, goal setting, visual activities for understanding relationships, role plays, imagery exercises for feeling identification, personal journaling, and reading stories about other teens. -Starting to put things into perspective

Use play therapy, role playing, self-disclosure, the counselor's comment about a probable cause, and confrontation

Used as a self-protective behavior - children protect themselves be withdrawing, acting out, regressing, etc.

-Gather information - age and grade of the child, reason for referral, date of birth and birth order, family members, parent employment, medical history, medications, developmental history, strengths and weaknesses, family and school relationships, activities, other information pertinent to the referral -Exchange expectations -Inform clients and others about counseling in developmentally appropriate language -Conceptualize the client as part of a system (family, work, environment, school, etc)

-Create child-friendly and cheerful physical setting -Define the problem through active listening (culturally sensitive) -Assess, using formal and informal procedures - needed to allow accurate client conceptualization and effective strategic planning -Build trust and rapport -Use questions appropriately --Focusing on the problem should be delayed --Listening is more important than questioning --Paraphrasing and summarizing is more effective --Reflect feelings accurately --Direct questions can be appropriate for factual information or clarification but open-ended questions generate more information and promote spontaneous expression

-Use play media - play therapy -Give clients feedback about themselves so that they can make sense of their feelings and their own and others' behavior -Affirm client unconditionally -Allow the client to change their story -Use self-disclosure judiciously -Use a one-down position -Use process questions -Use structured exercises -With adolescents: demonstrate acceptance, interest, collaboration, respect, and low reactivity...they want to know if they can trust you

-Develop interventions that are carefully planned, designed, implemented, and evaluated --Based on current goals, awareness of unsuccessful interventions, counselor skills, client ability and developmental level, client learning style, and time constraints -Use brief-counseling approaches, systemic problem-solving models, rational-emotive behavior therapy -Resist the temptation to give advice - suggestions and choices are different -Keep the session focused on the here and now --Can be effective with reluctant clients --Help client explore matters in depth and are likely to be intense, intimate, and personal --Can use there and then to diffuse the intensity of the present moment -Empower clients by affirming their resilience

-Make referrals and ensure smooth transitions -Process termination issues --May become anxious --Prepare the client ahead of time --Future counseling can happen if needed - make aware --Prepare the client for normal stumbling --Celebrate progress -Address predictions, expectations, and fears about the future -May need to phase counseling out gradually - length of time between sessions --Occasional check-ups

Art, Bibliotherapy, Games, Activity Books and Worksheets, Music, Puppets, Drama and Role Play, Storytelling, Metaphors, Therapeutic Writing, Multicultural Techniques

-Usually between the ages of 3-12 -Factors to consider: --Capacity of child to learn, have insight, and be able to form a relationship with an adult

-Build up a sense of self-efficacy and competence -Help child learn about self and others -Increase ability to make self-enhancing decisions -Practice self-control and self-responsibility -Increase problem-solving and decision-making skills -Develop relationship-building skills -Practice self-control and self-responsibility -Explore and express feelings - expand feeling vocabulary -Children are comfortable with playing because it feels natural to them -It builds self-efficacy and competence because they're making decisions

-Tracking -Restating Content -Reflecting Feelings -Returning Responsibility to the Child -Using the Child's Metaphor -Limiting

-Describing the child's behavior to the child to convey that what the child is doing is important -Avoid labeling objects -Allow the child to project his or her own meaning onto toys and actions -Build a relationship with the child

-Paraphrasing the child's verbalizations -Use the child's language and words -Build a relationship with the child

-Helping the child express and understand his or her emotions and expand emotional vocabulary -Deepens the counselor-client relationship -Surface and underlying deeper feelings

-Increasing the child's self-reliance, self-confidence, and self-responsibility -Help them practice decision making, give them a sense of accomplishment, and heighten their feelings of mastery and control

-Metaphor - child expresses feelings, thoughts, and attitudes and indirectly tells the story of his or her situation and relationships -Tracking, restating, reflecting feelings, and returning responsibility without imposing the counselor's own interpretation -Avoid breaking the metaphor by going outside of the story into the real world

-Protecting the child and the counselor from harm -Increasing the child's sense of self-control and responsibility -Enhances his or her self of social responsibility -Most counselors wait to set a limit until children are about to break one of the playroom rules -Limits are intended to keep the child from -Physically harming oneself, other children, or the counselor -Deliberately damaging the play facility or materials -Removing toys or materials from the facility -Leaving the session early -Staying in the session late

-Axline developed this therapy in 1969 based on Rogerian Client-Centered Therapy -Counselor provides three core conditions: --Empathy --Genuineness --Unconditional Positive Regard -Five distinct phases --Children use play to express diffuse negative feelings --Children use play to express ambivalent feelings, usually anxiety or hostility --Children again express mostly negative feelings, but the focus has shifted to specific targets --Ambivalent feelings (positive and negative) resurface but now are focused on specific people --Positive feelings predominant, but the child expresses realistic negative attitudes in appropriate situations -Active role without directing -Genuinely interest in the child's feelings, actions, and decisions -Follow along a be a part of the play with them -Activate the child's innate capacity for solving problems and moving towards optimal living

-Developed by Kottman in 1993 -Combines principles and strategies of individual psychology with basics of play therapy -Conceptualize children through Adlerian constructs and communicate through toys and materials -Four phases --Build an egalitarian relationship with the child using basic play therapy skills --Gain an understanding of the child's lifestyle and how the child sees themselves, others, and the world through art, metaphors, and play --Help the child gain insight into their lifestyle using metaphors, stories, art, roleplaying, etc based on hypotheses --Provide reorientation and reeducation for the child, which may involve helping them learn and practice new skills and attitudes -Non-directive and directive elements -Strength-based - thank you for letting me play with you...I'm really glad you shared your toys with me

-Developed by Knell (1993) -CBPT combines CBT strategies within a play therapy delivery system -Integrate play activities with verbal and nonverbal communication -Four stages --Assessment - formal and informal instruments for baseline data --Introduction/orientation to play therapy - gives parent initial evaluation --Middle stage - combines play activities and interactions with specific CBT techniques (modeling, role playing, behavioral contingency) to teach children more adaptive behaviors for dealing with specific issues...generalize skills to real world --Termination - help the child develop plans for coping with various situations after counseling ends, use behavioral techniques to reinforce changes in thinking, feeling, and behaving and encouraging the child to practice strategies for generalizing the progress made in the playroom -Non-directive and directive elements -Helping them connect their behaviors to their thought process

-Developed by Jernberg (1979) -Modeled after healthier interaction between parents and their children -Use of parents as observers and co-therapists -Use of two counselors in the session -Dimensions of structure, challenge, intrusion/engagement, and nurture -Intensive (hands-on), brief, active, and directive -Created to help parents interact with their children --Remedy problems in the attachment process -Challenge the child by using age-appropriate risks -Intrusion and engagement by using spontaneous interactions to show that the world is fun -Initiates interactions to soothe, calm, quiet, and reassure the child -Demonstrate structure by setting limits -More in the community than the school setting

-Created by John Littrell -Based on the brief counseling model developed by the Mental Research Institute --Problem definition in concrete terms --Investigation of solutions attempted so far --Definition of change to be achieved --Formation and implementation of a plan for change -Focused on children's strengths and the future -May preclude counselor burn out -Effective tool for creating new pattern

-Time Limited -Solution-Focused -Action-based -Socially interactive -Detail oriented -Humor eliciting -Developmentally attentive -Relationship-based

-Developed by Albert Ellis (1955) -Combines cognitive, emotive, and behavioral techniques in an active-directive therapeutic process -Emotional distress results from dysfunctional cognitions, and there is a strong interconnectedness between thoughts, feelings, and behaviors -Primary goal is to help people develop a rational philosophy of life that enables them to think and feel better and begin to act in self-enhancing ways that will aid them in attaining personal goals -Cognition is the most important determinant of emotion - thoughts lead emotions -Beliefs about activating events influence people's emotions and behaviors -Irrational beliefs need to be disputed and replaced with rational beliefs -Designed as a self-help and educative therapy that emphasizes the acquisition of skills -Spitting in someone's soup - challenging someone's beliefs, confrontation -A comprehensive therapy because it deals with irrational beliefs that perpetuate the problem so that lasting change can be achieved -Help clients maintain change through homework assignments, bibliotherapy, and various self-help materials -Putting yourself out of a job by helping children identify irrational beliefs on their own -Helps clients get better not just feel better

A - As people fulfill their goals they encounter an activating event B & C - The beliefs about that event creates emotional and behavioral consequences D, E, & F - The irrational beliefs contributing to these emotions and behaviors must be disputed to help clients develop effective new beliefs and effective new feelings

-Emphasis on prevention -Goal - help children understand and apply principles of emotional health, teach the principles of rational thinking and to apply the concepts to common concerns and issues that children encounter in the course of normal development -Implemented through structured emotional education lessons - feelings, beliefs and behaviors, self-acceptance, problem solving -Sessions begin with stimulus activity (bibliotherapy, art, worksheet, etc) and are followed by a discussion --Content questions - emphasize the cognitive learnings from the activity --Personalization questions - help the students apply the learnings to their own experiences -Emotional education lessons should be regularly scheduled -Present topics sequentially with core ideas introduced and reinforced in developmentally appropriate ways -Can be extended with a follow-up activity --Be fact detectives at home and at school --Find facts and assumptions --Share them with the class the next day

-Open-ended, whatever problems members are facing at that time -Emphasis is on here-and-now experiences of individual group members -Members present current concerns -Learn REBT principles for problem resolution -Select a topic that all members are struggling with -The leader assumes a more active role in keeping with the age and level of participation of the group members -Objectives: --Modeling rational attitudes --Helping members apply basic REBT ideas

-6-10 members -Focus on children's normal developmental difficulties -Sessions structured around an activity with a specific objective -The assumption is that the participants do not have a serious problem but are instead learning skills

-help meet everyday challenges of growing up -oriented towards growth, not remediation

-help clients deal with situations that are causing negative feelings and stress -give opportunity for students to understand issue in more depth -explore feelings -coping strategies

-Healthy family -Interacts with the Environment -Capable of adaptation and flexibility -Able to maintain the stability needed to allow the development of its members -Makes accommodations to environmental changes

-Isolated from and does not adapt to the environment -Does not accommodate the changing developmental needs of its members

-Permissiveness-restrictiveness: control and power in the parents' behaviors -Hostility-warmth: levels of support and affection given to children -Anxious/emotional involvement-calm detachment: parents' emotional engagement or connectedness

-Reflects the degree to which children and adolescents are at risk for serious behaviors such as substance abuse, risky sexual activity, depression, violence, gang involvement, and conduct disorders. Minimal Risk --Students who enjoy favorable demographics such as high SES, etc. --Positive family, social, and school interactions --Limited exposure to stressors Remote Risk --Less favorable demographic characteristics such as lower SES --May be members of a family under stress --Interactions less positive High Risk --Negative interactions, numerous stressors, and individual characteristics such as negative attitudes, poor self-regulation, and academic and social skill deficiencies Imminent Risk --In addition to preceding characteristics, have developed gateway behaviors Highest Risk --Engaged in serious problem behaviors such as violence, risky sexual behavior, and drug use, as well as depression or suicidal ideation

-Reflects the types of prevention and intervention approaches that are most appropriate for different levels of risk Universal Approaches --Correspond to minimal risk --Appropriate for all children, not just those presumed to be at risk Selected Approaches --Aimed at people who share some circumstance or experience that increases the likelihood of developing a problem in the future Booster Sessions --Review and reinforce components of universal and selected approaches Indicated Treatment Approaches --Used with children who are at imminent risk for serious problems or have just started to engage in serious problem behaviors Second-Chance Programs --For people who have engaged in severe problem behavior already

-Reflects the manner in which the three contexts are involved in early, broad-based prevention efforts that coordinate support and training activities, and treatment approaches that incorporate a variety of efforts. Family Context --Prevention may involve providing culturally appropriate family-strengthening opportunities that increase interaction and communication School-Based Prevention --Early compensatory programs such as Head Start and before- or after-school programs that provide safe, nurturing environments for children whose parents are not available at those times Society/community Context --Prevention involves improving economic conditions, increasing the availability of low-cost housing and affordable, quality child care, increasing job opportunities, providing an umbrella of community-based support services, and promoting prosocial norms and values

-Awareness of personal bias and values -Awareness of the client's worldviews -Knowledge about culturally appropriate interventions and strategies

How individuals blend their cultural beliefs and practices with dominant beliefs and practices of a society -Integration -Assimilation -Separation -Marginalization

blending of cultures

replacing culture of origin with dominant culture

rejecting dominant culture and retaining culture of origin

rejecting and separating from both cultures

-Children develop ethnic self-identity - classified into group -Ethnic constancy occurs as children recognize that it remains consistent over time -Children engage in cultural practices known as ethnic role behavior -Children exhibit ethnic knowledge characterized by the recognition that many of their behaviors are important components of ethnic heritage -Children develop ethnic feelings and preferences by expressing emotions and feelings related to their ethnic group

-Identity Diffusion or Foreclosure -Moratorium -Ethnic Identity Achievement

yet to explore ethnic identity

explore their ethnic heritage, practices, and customs

commit to an ethnic identity

-cornerstone of many family therapy theories -allows counselors to gain perspectives on the patterns of interaction among family members, the family's structure/organization, the family's belief structure -family is viewed as whole unit -linearity examines immediate events and possible consequences (A-->B) --used in individual counseling -circular causality helps one examine all of the possible related events through multiple interrelationships and dynamics --Family problems are seen as the result of mistaken interactional patterns -don't assign blame, but examine more effective ways of interacting with one another

-Virginia Satir -root of family problems is emotional suppression -existential family counseling works from the inside out by helping individuals express their honest feelings and developing more genuine interactions -emphasis is on emotional expression is alternative to reductionism emphasis on behavior

-Salvador Minuchin -concerned with boundaries and the hierarchy among family members -boundaries provide balance between privacy and openness within a family --clear and consistent boundaries are essential to healthy families -parental subsystem is relationship between parents and children -sibling subsystem -spousal subsystem -3 solutions might be maintaining family's problem --solution family has chosen to deny problem exists --solution is an effort to solve problem that isn't really a problem --solution is an ineffective effort to solve a problem

-reality is co-created by the counselor and the family -reality of the situation is redefined by the counselor -emphasizes process of decision making -emphasizes orientation to the future and to change with quick, concrete, and working solutions -counselor's role is to validate the family's experience, guide family members as they shift their behavior/perceptions of their problem, build on the family's existing strengths, resources, and success

-time-sensitive and oriented to the present -views family system as needing homeostasis (the mechanism by which families go back to equilibrium in the face of a disruption) -families are goal-directed and rule-governed systems -emphasizes the problem and how it relates to the family's interactional sequence -families are stuck...get them moving again

-concerned with how clients understand the word around them and what meanings they create to explain the world, and how these meanings are constructed -individuals are active in shaping their perceptions when constructing their view of the world

-allows counselor to be a collaborator with the family -co-construct healthy narratives to replace the problem-saturated ones