Counseling Children and Adolescents

Cultivating Empathic Connection

Rebekah Byrd, Chad Luke

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781351133135
• Edition: 1
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

Counseling Children and Adolescents focuses on relationship building and creating a deep level of understanding of developmental, attachment, and brain-based information.

Chapters place a clear emphasis on building strengths and developing empathy, awareness, and skills. By going beyond theory, and offering a strengths-based, attachment, neuro- and trauma-informed perspective, this text offers real-world situations and tried and true techniques for working with children and adolescents. Grounded in research and multicultural competency, the book focuses on encouragement, recognizing resiliency, and empowerment.

This book is an ideal guide for counselors looking for developmentally appropriate strategies to empower children and adolescents.

Part I
Knowledge

1
Introduction and Recognition of the Privilege of Counseling Children and Adolescents

Rebekah Byrd and Chad Luke

Objectives

• Describe and define many key terms from this chapter.
• Understand the importance of utilizing a strengths-based approach to working with children and adolescents.
• Analyze the benefits of the counseling relationship.
• Identify ways in which stress and distress manifest for you specifically.
• Examine techniques for self-care.
• Evaluate the importance of being one supportive adult.

Reflective Questions

• What brought me to the field of counseling children and adolescents? What will keep my passion for working with them (even in complex systems)?
• In what ways will I make sure my approach to working with children and adolescents is strengths-based? How will I help model this approach for others?
• What “Tenets for Relating to Children” do I need to pay more attention to?
• How can I start understanding stress, distress, burnout, and impairment while still in training?
• What are my current self-care practices?
• In what ways can I become more self-compassionate?
• How important do I believe the “power of one” can be in counseling?

The Heart and Passion for Counseling Children and Adolescents

We have seen, as we are sure many of you have, the passion that exists in many for counseling children and adolescents. While many are terrified to work with children and adolescents, there are those of us who couldn’t imagine ourselves doing anything else. Since we were young ourselves, we were drawn to children and adolescents; their wonder, their curiosities, their imaginations, their ability to explore and play for hours on end. We enter graduate school and training programs with hearts for supporting and encouraging children and adolescents however we can. We progress through our programs and do just that. Then one day, we find ourselves in a system (community, agency, school, etc.) where we feel those passions are dwindling. We are overwhelmed with unmet needs, underserved populations, ignored diversity issues, and blatant racism, paperwork, and bureaucracy. The passion for working with children and adolescents seems not enough to sustain heavy caseloads and inadequate support and resources.

Hopefully, this book will assist in preparation and skill building on the front end so that the passion reaches the end of the day and the end of the (never-ending) caseloads and ever-present needs. Don’t lose this passion! Remember why you wanted to do this work! When the days are never as long as the list of concerns, remember your love and heart for children and adolescents, and how it started in the first place.

Strengths-Based Approach

When many aspects of a child/adolescent’s life may seem deficit and competition focused, it stands out for counselors to be focused on strengths. Counseling and treatment need not focus primarily on what is broken but instead need to cultivate and encourage what is positive and good within (Seligman, 1999). Understanding that all children and adolescents have strengths, it is the counselor’s job to find these and build upon them – even when the child/adolescent cannot seem to see these strengths in themselves.

While focusing on strengths is certainly not a new concept, we need reminding. Counselors also serve as models for the other counselors around them, caseworkers, parents/caregivers, physicians, and entire treatment teams. Modeling a strengths-based approach is also an important part of advocating for that child and adolescent. You can turn most anything into a strength. Even something that may be troubling and/or annoying could have been (and most likely was) at some point a protective factor. Try to think of some more positive traits for each perceived negative trait listed in Table 1.1.

Table 1.1 Perceived Negative Trait vs. Perceived Positive Trait

Perceived Negative Trait	Perceived Positive Trait
Stubborn	Determined
Bossy	Leadership skills
Shy	Observant
Tattletale	Honest/Ethical
Pleaser	Respectful
Loud	Excited
Rowdy	Energetic
Messy	Creative
Selfish	Protective
Arrogant	Confident
Sensitive	Empathic
Slow	Careful/Thorough

We have personally observed many times when working with children and adolescents the all too popular “I dunno” shoulder shrug when we have discussed positive self-characteristics. Sometimes we think this is because we teach people in our society not to “brag” or “boast”, but more often we have found it is actually because they simply do not know. They do not know or cannot recognize one single positive characteristic within themselves. This breaks our hearts every time. It is the counselor’s job to not only recognize these within them, but to work with them in hopes that they believe them and can start to recognize these within themselves. We must believe in our children and adolescents so that they can learn to believe in themselves.

Increasing research has focused on “at-risk” youth. However, it is also important to understand that at any given point in a child/adolescent’s life, “even the most advantaged youth may be at risk for participating in or developing problematic behaviors” (Smith, 2006, p. 14). Strengths-base counseling theory is founded on multicultural counseling research and concepts and in prevention research literature (Smith, 2006). Understanding strengths can mean understanding the ways in which individuals cope with difficult situations. Further, strengths are ever evolving, changing, adapting, and growing traits rooted in the individual’s culture (Smith, 2006). Smith describes strengths that can be: culturally bound (related to or found in one’s culture), contextually based (developed or understood within a given or specific situation or context), developmental and lifespan oriented (age related, learned, and/or taught), adaptable and functional (ability to be adapted and/or applied in different situations), normed on society/culture/environment, transcendence (strengths assist in transcending life’s hardships), and polarities (develop from polarities). Let’s understand the information and research on “at-risk” youth, but let’s change our lens to understanding the children and adolescents that are, instead, “at promise”.

Empowering Children and Adolescents

It is estimated that a little over 74 million children and adolescents under the age of 18 reside in the United States and Puerto Rico (U.S. Census Bureau, 2018). In the United States, about 1 out of every 4–5 youth (ages 13–18) meets criteria for a mental health diagnosis with lasting impairment noted across their lifetime (Merikangas et al., 2010). Further, this same study noted ages of onset for major disorders such as “50% of disorders had their onset by age 6 for anxiety disorders, by age 11 for behavior disorders, and by age 13 for mood disorders and by age 15 for substance use disorders” (Merikangas et al., 2010, p. 987). A review of the literature reveals that only a minority of children and adolescents with mental health needs are able to access treatment (Reardon et al., 2017). Further, Twenge (2017) notes that even previous generations are still at substantial risk as we “are at the forefront of the worst mental health crisis in decades, with rates of teen depression and suicide skyrocketing since 2011” (p. 3).

These statistics point to the issue of children and adolescents needing help, and yet not receiving it. Counselors working in community agency settings are overloaded, and yet only see a small percentage of the child and adolescent population in need of these services. The children and adolescents who are still in need of services either seek help at school or do not receive the help they need. The National Association for College Admission Counseling (NACAC) and the American School Counselor Association (ASCA) conducted a 10-year report of national student-to-counselor ratios. This report noted that the national student-to-counselor ratio in the schools is an overwhelming 482 students to every one school counselor. It seems safe to say that children and adolescents are in need of services they are not receiving. As a note, the American School Counseling Association (2012) advocates for student-to-counselor ratios of 250:1. This is almost half of the current national average.

Counseling Children and Adolescents

It appears that most counseling programs teach classes based on adult populations. Students may have the choice of one or two classes specific to working with children and adolescents while the rest of their program of study is heavily reliant on skills, theory, techniques, and issues pertaining to an adult population. Transferring this knowledge and awareness to a child and adolescent population can be challenging without the proper tools. We hope that this book will provide you with some tools so that you feel confident and prepared to navigate this important work.

We will discuss the importance of the counseling relationship in the next section, but I ask you to keep the counseling relationship and yourself as a key component in that relationship, in mind as you read the following. Please ask yourself to what extent you believe the following – and be honest with your beliefs.

Tenets for Relating to Children

• Children are not miniature adults. The therapist does not respond to them as if they were.
• Children are people. They are capable of experiencing deep emotional pain and joy.
• Children are unique and worthy of respect. The therapist prizes the uniqueness of each child and respects the person the child is.
• Children are resilient. Children possess tremendous capacity to overcome obstacles and circumstances in their lives.
• Children have an inherent tendency toward growth and maturity. They possess an inner intuitive wisdom.
• Children are capable of positive self-direction. They are capable of dealing with their world in creative ways.
• Children’s natural language is play. This is the medium of self-expression with which they are most comfortable.
• Children have a right to remain silent. The therapist respects a child’s decision not to talk.
• Children will take the therapeutic experience to where they need to be. The therapist does not attempt to determine when or how a child should play.
• Children’s growth cannot be sped up. The therapist recognizes this and is patient with the child’s developmental process.

(Landreth, 2012, p. 46)

How did you do on that self-assessment? Can you recognize some areas in which you may be challenged? Can you recognize some areas in which you excel? You aren’t expected to have this all figured out quite yet, but keep pondering over these tenets. This list is so important and serves as such a wonderful grounding technique that you will see this list again in Chapter 15 of this volume. We also recommend putting the list on your computer or your office wall as a constant reminder and foundation for the work we do with children/adolescents.

The Benefits of the Counseling Relationship

Rapport and the therapeutic alliance are of utmost importance. Researchers have noted that independent of the many approaches to counseling, treatment, and therapeutic measures, the client-counselor relationship is a predictor of positive clinical outcomes (Ardito & Rabellino, 2011; Horvath & Bedi, 2002; Norcross, 2002). Davidson and Scott (2009) note that “a therapist who lacks the ability and skill to form a strong collaborative relationship will be ineffective, no matter how many technical interventions they can perform, as alliance is necessary for engagement” (p. 122). Having a strong client-counselor alliance is imperative for growth and c...