Counseling Adolescents Competently

Lee A. Underwood, Frances L.L. Dailey

• Publisher: SAGE Publications, Inc
• Year: 2016
• Print ISBN: 9781483358857
• eBook ISBN: 9781483358864
• Edition: 1
• Topic: Social Sciences
• Subtopic: Education Counseling
• Index: Social Sciences

"This is a text that is long overdue, I am excited to see such talented and experienced counselors come together to write such an informative updated text on counseling today's adolescents."

–Jennifer Jordan, Winthrop University

Counseling Adolescents Competently is a comprehensive text for students and professionals compiling foundational and emerging skills in the counseling field. Authors Lee Underwood and Frances Dailey review extensive interventions ranging from assessment to diagnosis as well as fresh perspectives on working with this often challenging group. Employing clinical case scenarios and profiles that demonstrate key issues, this book helps the counselor-in-training to understand the relevant theories and research around adolescents to better engage in culturally relevant interventions and treatment planning.

1 Introduction

Background

Before embarking on the journey of counseling adolescents, one must first understand what characterizes adolescents’ core issues developmentally, the external and internal factors that contribute to adolescents in need of counseling services, the history of the counseling field, and the role of providers in working with adolescents. Questions to ask throughout the chapter include “What characteristics may affect counseling adolescents?” “What characterizes an adolescent?” “What adolescent factors are pertinent to counseling interventions?” “What would be the interaction between the provider and the adolescent?”

Specifically, at the end of this chapter, you will be able to do the following:

• Reason out why adolescents present in counseling services
• Provide characteristics and prevalence information on adolescents
• Know the challenges faced by adolescents
• Describe the role of providers in counseling adolescents
• Distinguish the areas in which providers may be of service to adolescents
• Identify and describe various vulnerabilities of the adolescent that would lead him or her to become involved in the counseling arena
• Use case illustrations to demonstrate one’s understandings of the keystones learned in each chapter

The Adolescent

Which Adolescents Present for Counseling: Who Are They?

Throughout media, there seems to be an often repeated set of questions pertaining to adolescents today. What are they doing? How do we interact with them to help steer them? And if the adolescents are experiencing challenges, whose responsibility are they? How can we best support them? In what ways can counseling be beneficial to their presenting problem? However, before broaching these questions with credibility, insight, and guidance toward effect lasting, positive change for adolescents, the interventionist must first understand in essence—who are today’s adolescents? Of course, these questions are not limited to persons within the media. They are asked within our homes, personal circles, places of worship, and community organizations, and they highlight that today’s adolescents are among the most challenged generation yet. There seems to be a resounding clarion call that many of today’s adolescents need help. There seems to be a nebulous cloud of challenges, concerns, and implications associated with their newfound abilities to make decisions that not only affect their present life but also their future health, careers, and relationships (Table 1.1). When the questions are asked within our offices, during case consultations, milieu meetings, school offices, program planning meetings, we answer them from a strong knowledge base, insight, and aim to be not only problem identifiers and statistic collectors but also professional providers at all levels of experience who are called to wield impactful interventions with “an attitude and philosophy (in which) excellence is a fundamental goal” (Council for Accreditation of Counseling and Related Educational Programs [CACREP], 2014b). Accordingly, for community and school counselors, burgeoning behavioral health providers, and seasoned professional providers, having a sense of mastery in working with any population takes many years (Freeman, Hayes, Kuch, & Taub, 2007).

Table 1.1

Note. CACREP, Council for Accreditation of Counseling and Related Educational Programs; LGBT, lesbian, gay, bisexual, and transgender.

Let us start our understanding of today’s adolescents by first becoming acquainted with some alarming facts that pertain to their overall well-being. The U.S. Department of Health and Human Services (DHHS) has established a national survey to identify key indices influencing today’s adolescents that lead to their death, disability, and social problems. This relevant information helps to better identify the realities facing adolescents. The Youth Risk Behavior Surveillance System is conducted every 2 years and represents data of adolescents from 9th- to 12th-grade public and private school students. Among the 2011 findings, Youth Risk Behavior Surveillance System (2012) identified key concerns facing today’s adolescents. These concerns are discussed in Table 1.2.

Table 1.2

Source. Statistics are from Youth Risk Behavior Surveillance System (2012, June).

Overall, statistics suggest that adolescents are likely experiencing some problems at home and/or at school that interfere with his or her overall functioning. Nationally, about a quarter of youth (26.1%) reported feeling sad or hopeless almost every day for 2 weeks or more in a row in 2009 (National Fact Sheet: http://www.cdc.gov/healthyyouth/data/yrbs/data.htm). Having a sense of national trends helps guide professional providers in the ethical practice of “reflecting current knowledge and projected needs concerning counseling practice in a multicultural and pluralistic society” (CACREP, 2014b, p. 9) and demonstrates our understanding of the context in which our clients live.

Specific Factors Relevant to Counseling Adolescents

Adolescents’ involvement in counseling can range from those receiving services in private practice behavioral health settings, university counseling centers, guidance and school counseling programs, child welfare systems, and community-based programs. Additionally, providers across the country are encountering a significant increase in the number of adolescents who are involved in gangs, are alienated from school, are described as emotionally unstable and disproportionately rageful, have poor parental monitoring and attachments, and reside in neighborhoods where drugs and violence have become a normative feature of everyday life (Underwood, Warren, Talbott, Dailey, & Jackson, 2013).

Many of the adolescents involved in counseling are a heterogeneous group of young people between the ages of 10 and 20 (Gentry & Campbell, 2002; Ozer, Park, Paul, Brindis, & Irwin, 2003). Estimated at more than 40 million, the adolescent population in the United States is “more racially/ethnically diverse than the overall population” (National Adolescent Health Information Center, 2008; Ozer et al., 2003). According to Ozer et al. (2003), adolescents tend to live in suburban areas as opposed to rural or city areas. However, the differentiation of mental health concerns of adolescents residing in urban and rural areas appears somewhat minimal.

Developmental Characteristics.

Adolescence is a period that includes a host of physical and mental transitions. Identity and social skills formation, vocational interest, and cognitive development dominate this period (Tucker, Smith-Adcock, & Trepal, 2011). Learning to navigate these developmental tasks strengthen their intra- and interpersonal skills and cultivates both individuation and a sense of belonging within relationships (Tucker et al., 2011). This is particularly important for adolescents who are ethnic minorities who specifically benefit from developing protective traits that allow them to decrease or avoid risks of experiencing negative effects of discrimination and prejudice (Romero, Edwards, Fryberg, & Orduña, 2014). Likewise, for all adolescents, the more they feel encouraged to explore their identity and neutralize stressors, the more resilient they are to the challenges that they face during this critical life period (Romero et al., 2014). Additional information on developmental and social concerns is included in Chapter 2.

Substance Use and Mental Illness.

The Substance Abuse and Mental Health Services Administration (SAMHSA, 2013) reports that in 2012, approximately 12% of adolescents aged 12 to 17 received counseling in an inpatient or outpatient setting due to emotional or behavioral problems within the past year. Half of these adolescents received services due to depressive symptoms (SAMHSA, 2013). Almost 30% received services due to problems at home (or with family), followed by 24% due to being oppositional or defiant, and 23% due to suicidal ideation or attempts (SAMHSA, 2013). Suicide is the third leading cause of death in adolescents and young adults (SAMHSA, 2013) and is considered a crosscutting feature in many of the representative disorders of this group. Additionally, 22% of adolescents received services for anxiety, which was followed by having problems at school (19.7%) and having trouble controlling anger (18.9%). Another 12% of adolescents received mental health services in an educational setting (SAMHSA, 2013). Depressive symptoms seem to be the impetus for receiving mental health services for at least half ...

Table of contents

• Cover
• Half Title
• Publisher Note
• Title Page
• Copyright Page
• Brief Contents
• Detailed Contents
• Preface
• Acknowledgments
• Section I Foundational Issues
• 1 Introduction
• Section II Theoretical Perspectives
• 2 Adapting Counseling Theory to Adolescents
• 3 Trauma-Focused Care
• 4 Multicultural Family Systems
• 5 Juvenile Justice–Involved Adolescents
• 6 Strengths-Based and Resilience Perspectives
• Section III Evidence-Informed Interventions
• 7 Play Therapy
• 8 Screening and Assessment in Adolescent Counseling
• 9 Treatment Planning Issues
• 10 Counseling Interventions
• 11 School Counseling Interventions
• 12 Relational and Career Issues
• 13 Chemical and Behavioral Addictions
• 14 Divorce Impact
• 15 Gender-Specific and LGBTQ Issues
• 16 Sexually Maladaptive Behaviors
• Section IV Legal and Ethical Considerations
• 17 Who Is the Client? Key Ethical and Legal Issues
• 18 Supervision and Consultation
• 19 Use of Technology With Adolescents: Telemental Health Treatment
• 20 Conclusion and Future Direction
• Index
• About the Author