1. Individual & Group Counseling with Children
Susan B. Paez
Kent State University
Susan B. Paez 2002

2. Counseling the Developing Child
Designing and implementing counseling or treatment plan:
Developmental level of child
Personality strengths & weaknesses
Current style of coping
Cultural background
It is necessary to consider the following when you are designing and implementing a counseling or treatment plan for children
Cultural perspectives of the role of counseling in the family
Susan B. Paez 2002

3. Counseling the Developing Child
Cultural perspectives of role of counseling in the family
Child’s perception of the presenting problem
Child’s relationship with individuals in their life
Assess impact of these interactions on the child
In addition, you’d want to consider the following:
Strengths and weaknesses of child’s relationship with parents, siblings, peers, teachers, and significant others
Strength of child’s support systems is CRITICAL in the success of the therapy and is HELPFUL in deciding who should be involved in the counseling process.
Susan B. Paez 2002

4. Counseling the Developing Child
Involve parent(s) & other significant individuals in counseling process
Improving relationship between child and parent(s) is a central focus
Cooperation & support of teachers & other human service professionals increases probability of positive outcomes.
There are a number of individual and group approaches that involved not only the child, but the parent, siblings, peers and other significant individual's in the child's life.
Treatment should always include strategies designed to help and support parents in their efforts to help their child
Susan B. Paez 2002

5. Counseling the Developing Child
Individual & Group Techniques
Play therapy
Art therapy
Bibliotherapy
Sand tray
These are therapeutic approaches designed especially for children.
They combine the actions of talking and playing.
As we know, play is a natural activity for children.
Many activities such as playing with puppets, doll houses, games, music, drama and storytelling can help children express their thoughts and concerns in a non-threatening way.
Play therapy techniques can help resolve developmental and situational concerns or cope with traumatic events.
Role playing, playing with puppets, and unfinished stories can be used in developmental counseling groups to help children explore and clarify their values, beliefs, attitudes, and decisions.
These techniques can be used in individual and group settings.
Will explore each of these techniques individually later in the class.
Susan B. Paez 2002

6. A Bit of Background Three “traditional” theoretical viewpoints:
Psychoanalytic
Humanistic
Behavioral
The book focuses on the following, more traditional theoretical viewpoints:
Class involvement…..
Psychoanalytic-Freudian psychoanalysis, Adlerian Individual psychology & psychodynamic approaches.
Humanistic viewpoint consists of Carl Rogers’ client/person centered, existential, Gestalt approaches.
Behavioral context includes Skinner’s classical behavioral approaches, Beck’s cognitive-behavioral and Ellis’ rational emotive.
What are some other, more contemporary counseling approaches???
Susan B. Paez 2002

7. A Bit of Background Human behavior’s capacity for change
Importance of childhood experiences
Personality development is a function of a person’s needs being met
Importance of environment in shaping personality
Focus is not on counseling theories, but there are some commonalities, common themes, between all counseling approaches….
Acknowledge that human behavior has the capacity to change.
Recognize the importance of early childhood experiences.
Believe that the process of personality development is a function of a person’s needs being met.
Agree on the importance of environment in shaping personality. Most practioners take a centralist position, believing that people have rational control but are also subject to internal and external forces beyond their control.
Susan B. Paez 2002

8. A Bit of Background
Early childhood experience could lead to maladjustment/maladaptive behaviors
Goal-facilitating change in behavior
Therapeutic relationships
Necessity of a good relationship
* Acknowledge that during early childhood a person can have experiences that lead to maladjustment or maladaptive behaviors later in life.
Have the common goal of facilitating changes in behavior. These goals can be global, specific, or a combination of the two.
Involve therapeutic relationships that consist of the working alliance, real relationships, and the transference relationship, although the emphasis and importance of each will vary according to the theoretical approach of the counselor
Have at least a medium of transference and countertransference as origionally defined by Freud.
Share the belief in the necessity for a good relationship. All stress the need for the client to feel accepted and understood in the relationship; for the client to feel that the counselor is concerned and able to help; and for the counselor to be genuine and honest with the client
Susan B. Paez 2002

9. Therapeutic Process Mature in self-understanding & self-acceptance
Gain awareness of strengths & weaknesses
Develop realistic self-evaluation
Develop & mature in social relationships
Develop independence
Take on responsibility, make choices, & be responsible for choices
* Children have several specific needs that relate to the counseling process. Therefore, it is imperative that counselor provide an environment that will allow the child to:
Susan B. Paez 2002

10. Therapeutic Process Identify & explore their concerns
Gain a new understanding of self & others
Discover & experiment with alternative ways of thinking, feeling & behaving
Regarding of the theoretical orientation a counselor is working from, most counselors working with children are concerned with helping the child…
Susan B. Paez 2002

11. Therapeutic Process Establish a working relationship
Analyze the problem & its cause(s)
Explain the problem
Establish & implement formula for change
Terminate (important step)
The Group for the Advancement of Psychiatry has identified the following as stages in the therapeutic process:
Susan B. Paez 2002

12. Establish a Working Relationship
Relationship enable counselor to better understand child, parent(s), & needs of child
Provides basis for a “corrective emotional experience.”
Counselor builds partnership with parent(s)
Establishing working relationship enables the counselor to understand & respond to the child, the family and the child’s conscious and unconscious needs.
This phase usually takes longer in child therapy because children may need more time to accept the counselor as a person who would like to help.
What do we mean by “corrective emotional experience?” Occurs when a child reexperiences “an event or relationship in a different way and with a more positive outcome than that of the original event.”
During this stage some counselors begin to build a partnership with child’s parent (s). Parents’ intimate knowledge and insight of the child puts them in the unique position to help the counselor understand the child’s strengths and weaknesses.
Susan B. Paez 2002

13. Establish a Working Relationship
Relationship built on cooperation & respect
Input of the child is important
Basic counseling skills utilized by counselor
Understanding from a child’s point of view
In this stage, the counselor creates and maintains a relationship with the child based on cooperation and mutual respect.
The child participates fully in this relationship by helping to decide on counseling goals, choosing which activities to participate in and determinating how much to reveal/disclose about self
What are some basic counseling skills that would be helpful? By listening, attending to child’s verbal & nonverbal communication, and responding to their feelings, a warm and accepting environment is created for the child.
When the child feels understood, listened to, and the counselor has a clearer understanding of what the child is trying to communicate, he/she is encouraged and is more willing to be involved and participate in counseling
Understanding and seeing the child through their eyes, stepping into their shoes and becoming sensitive to their feelings as if they were your own. What would you call this??? EMPATHY One of Roger’s core qualities…
Susan B. Paez 2002

14. Analyze the problem and it’s cause(s)
Identify problem area(s) & select goals
Child explores thoughts, feelings, & actions related to current functioning & past behaviors
Analyzing the problem relates to the child’s life experience and involves some self-exploration by the child
The theoretical framework the counselor is working from will determine how broad or narrow, structured or unstructured the exploration of life experiences will be.
For examples, some counselors may recreate an event through play or reinterpret a past event (early recollection)
Susan B. Paez 2002

15. Analyze the problem and it’s cause(s)
Counselor will use skills to:
Listen to child
Understand child’s concerns
Communicate to the child
Showing empathy
Using open ended questions
Clarifying what child is saying
Summarizing
Counselor will use their counseling skills to listen to the child, to try to understand where the child is coming from and what is concerning them and to communicate this understanding back to the child
This will be done by: using empathy
Using open ended questions Why might that be helpful??? (helps the child put the problem in more concrete terms; encourages the child to elaborate more on their story)
Clarification is a skill used when something the child share is confusing or conflicting to you. They let the child know that you are listening to them and that you try understand what they are saying. Once again, the counselor is showing empathy to the client
Summarizing is a combo of skills including attending, listening, empathy & probing in a way that provides focus and challenge. Captures the “essence,” “the important stuff” the content and feelings expressed in the session by the child
Susan B. Paez 2002

16. Explain the problem Explanation & interpretation of problem
Involve child’s family
Utilize play, stories &/or art activities
Child’s self-understanding/insight is important
Once again, this will depend of the counselor’s theoretical orientation
Often times the child’s family is involved so that parents and siblings can make changes in the way they interact with the child
In order to enhance interpretation, counselors could utilize play, art activities, stories…
Insight can be experienced as self-understanding. Can be arrived at either directly or symbolically or can be conveyed through the therapist’s interpretation to the child.
Susan B. Paez 2002

17. Explain the problem “As if” scenarios Understanding hidden meanings
Insight
Impact of child’s behavior on the world around them
Sometimes labeling the child’s feelings directly would be too threatening, so the counselor could present an “as if” scenario.
Instead of requiring the child to own a feeling or need, the therapist may make a general statement about the feeling or need for children.
For example, counselor may say, “well some children might feel really sad and confused if something like that happened to them”
Counselor could also say, “when I saw your age, I used to worry whether or not my classmates like me. Do you think kids today worry about that?”
Counselor trying to help child understand the hidden meaning behind their messages
This can be accomplished by identifying and exploring themes or patterns in their communication
Themes could include: child’s mood or affect, needs, desires, or behaviors expressed directly or indirectly through words or symbols
Recognition of these themes are every important and helps the child to develop insight into their world
Insight could be described as “understanding that is translated into constructive action.”
Counselor is helping the child better understand the reasons for his/her feelings or behaviors
Offering clarifying response, using “as-if” scenarios, and by exploring themes in the child’s expressions may help the child identify, label & understand their feelings…
Once the connections are made, the counselor can start to point out and children can begin to understand how their behaviors impact the people in his/her world
Once the child understand his/her role in the situation, then they can gain control over the problem instead of the problem having all the power over the child
Susan B. Paez 2002

18. Establish & Implement the formula for change
Changes are made in this stage
Work to achieve change & translate insight into action
Experiment
Involve parent(s) & family
This could also be referred to as the “action stage.”
To help the child, the counselor should provide experiences, either in reality or fantasy, the allow the client to sense the value of making choices and instituting change.
If at all possible, counselor should also provide those experiences that allow the child to experiment with new behaviors in the relationship with the counselor.
Through this process, the child modifies his/her behavior in harmony and in a safe place. He/she gains insight and has a new view on the relationship.
Susan B. Paez 2002

19. Establish & Implement the formula for change
Internalization
Form a self-appraisal
Enhance self-esteem
Define values
Strengthen coping skills
Encouragement
As I just mentioned, during this phase, the child is translating new understanding and learning into action through the process called internalization
The process enables a child to use the strength of the therapeutic alliance to form a realistic self-evaluation, to enhance or boost self esteem, define values and what is important to them, and strength their coping skills
Encouragement is important throughout the entire counseling process. However, it is particularly important as the child begins to experience the power of their own inner resources. The child needs encouragement and support as they are trying out these new behaviors and making changes in their life. The child begins to feel powerful, worthy and in control.
Susan B. Paez 2002

20. Termination
Determined by mastery, adjustment and/or acceptance of concerns
Based upon changes in thoughts, feelings & behaviors
Goal: child to integrate changes into his/her daily life
Throughout the therapeutic process the child will gain new skills and technique…
Refer back to the treatment plan…have the goals been met???
Ultimate goal is for the child to integrate the healthy changes that were made during counseling into his/her everyday life
Susan B. Paez 2002

21. Key Factors in the Therapeutic Process
Self-protective behaviors
Symbolic forms of communication
Transference- the needs, feelings, & desires derived from past experiences that are reflected in the therapeutic relationship. The key issue of transference is the distortion that prior relationships impose on the therapeutic relationship.
For example-B/c of past experience with an abusive parent, a child may have difficulty placing his/her trust in the therapist.
Transference relationship also contains elements of the child’s present day reality. For example: a child who is angry at his/her parent may transfer hostility on to the counselor.
Countertransference-the counselor contributes characteristics that may hinder the child’s expression of his/her feelings, wishes, fantasies, and behavior.
An example- Counselor who has unresolved anger about being placed in a foster home and who transfers those feelings to a child who is about to be removed from his/her abusive parent.
IMPORTANT: Counselors should be alert to their own unresolved issues and take steps to resolve them before undertaking work with children who are experiencing similar conflict.
Generally, resistance refers to the child’s attempt at self-protection through the use of defensive behavior. It is a natural part of the therapeutic relationship and can aide as well as interfere with therapeutic process.
Resistance can take many forms: withdrawing, acting out, regressing
Counselor wants to explore the reasons behind the resistance instead of challenging/pushing the child
Children may also try to divert attention/avoid from what has been disclosed by either rambling on or closing up/shutting down
When this happens the counselor is left somewhat guessing about what is going on for the child
While silence could be view as resistance, it could also mean that the child is “working through/thinking through” what is going on for them…
Important for the counselor to give the child some time. This show respect for the child. By showing respect, the child begins the trust the process and the counselor. He/she may also use that relationship as a way of reducing anxiety.
Often times children have not developed sophisticated language that is need for the more traditional “talk therapy”
As a result, they often use a more indirect form of communication, known as a methaphor.
Metaphors are forms of symbolic communication; patterns of images, symbols, words, emotions & actions which synthesize, conserve, and represent experiences.”
Some examples may include: stories, myths, parables, fairy tales to convey meaning
It is common to have very young children “play” out their concerns instead of “talk” about them.
Susan B. Paez 2002

22. Counseling Children in Groups
Group counseling advantages
Cost and time saving
Share problems & benefit from peer feedback
Children learn they are not alone
Encourage & support one another
Increasing popularity in many settings
Chat a bit about Michael’s House experience
Encourage and support one another as they practice solutions to problems and learn new coping skills
Group counseling is becoming more popular in a variety of settings such as school, child guidance clinics, hospitals, residential treatment centers, and other human service agency settings.
Susan B. Paez 2002

23. Developmental Group Counseling
“Dynamic, interpersonal process that
focuses on conscious thoughts,
feelings, and behaviors.”
(Corey, 2000)
Groups create and nurture a climate of mutual trust, caring, understanding, acceptance, and support that enables children to share their personal concerns with their peers and group counselor
Susan B. Paez 2002

24. Stages of Group Process
Transition
Working
Ending
Forming
Exploring
Susan B. Paez 2002

25. Formation Preplanning for a successful group
What are the needs of the children?
Who will be in the group?
How many should be in the group?
When does the group begin & end?
Susan B. Paez 2002

26. Exploration
Individuals become more aware of & start to understand their feelings & behaviors as well as those of other group members
Susan B. Paez 2002

27. Transition
Dealing with anxiety and conflict in the beginning as group members start to work on their issues and concerns
Susan B. Paez 2002

28. Working Experiment with alternative behaviors
Learn new problem-solving skills
Susan B. Paez 2002

29. Working Group Leader Skills Reinforce desired group behaviors
Look for common themes
Model appropriate behaviors
Support members
Interpret the meaning of behavior patterns
Focus on translating insight into actions
Reinforce desired group behaviors that foster cohesion & productive work
Look for common themes, thread, connections
Model appropriate behaviors, especially caring confrontation
Support members especially in their willingness to take risks and assist them in carrying this behavior into their daily living, generalizing these new skills into their life
Interpret the meaning of behavior patterns so that children can reach deeper levels of self-exploration and consider alternative behaviors
Finally, focus on translating insight into action; this can be done by encouraging members to practice new skills
Susan B. Paez 2002

30. Ending Put learning into practice Self evaluation Susan B. Paez 2002
Book talks a bit about self-evaluation. Could have the child write down two strengths and two weaknesses.
Any other suggestions of how a child could evaluate themselves?
Susan B. Paez 2002

31. The End
Thank you!!!
Susan B. Paez 2002