SSE-160 Introduction to Child and Youth Services Chapter 6 Theories, Strategies, and Techniques for Practice

After assessing the child, family, and situation, a treatment plan must be developed. After assessing the child, family, and situation, a treatment plan must be developed. Cognitive Theory Cognitive theory is based on the idea that a child’s thinking is the principle determinant of emotions and behaviors. Cognitive theory is based on the idea that a child’s thinking is the principle determinant of emotions and behaviors. The social worker directs and helps the child or adolescent to identify, challenge, and change thinking patterns that result in dysfunctional forms of emotions, behavior and problem solving. The social worker directs and helps the child or adolescent to identify, challenge, and change thinking patterns that result in dysfunctional forms of emotions, behavior and problem solving.

Cognitive Theory ABC Theory (Albert Ellis) ABC Theory (Albert Ellis) 1. A = Activate event 2. B = Belief 3. C = Consequence According to cognitive theory, most dysfunctional behavior and emotions of children and adolescents are a direct result of misconceptions that they hold about themselves or about various environmental situations. According to cognitive theory, most dysfunctional behavior and emotions of children and adolescents are a direct result of misconceptions that they hold about themselves or about various environmental situations. Correction of the emotion occurs when the misconception is changed. Correction of the emotion occurs when the misconception is changed. Many misconceptions, irrational thinking, erroneous beliefs, and cognitions are outside the young person’s conscious awareness. Many misconceptions, irrational thinking, erroneous beliefs, and cognitions are outside the young person’s conscious awareness. An exception is that some dysfunctional emotions are the result of organic physiological, neurological, or clinical problems. An exception is that some dysfunctional emotions are the result of organic physiological, neurological, or clinical problems.

Producing Change The change process occurs when the young client identifies challenges, and change misconceptions, faulty beliefs, distorted cognitions, and irrational self-talk. The change process occurs when the young client identifies challenges, and change misconceptions, faulty beliefs, distorted cognitions, and irrational self-talk. The helping process of the cognitive approach is primarily educational. The helping process of the cognitive approach is primarily educational. One unresolved concern is whether race, class, and gender experiences may have impact on the client’s beliefs and cognitions. One unresolved concern is whether race, class, and gender experiences may have impact on the client’s beliefs and cognitions. Treatment Principles Judith Beck (1995), a major proponent and theorist of this approach, identified ten (10) principles of cognitive theory. See page 127. Judith Beck (1995), a major proponent and theorist of this approach, identified ten (10) principles of cognitive theory. See page 127.

Relationship Techniques The treatment relationship is expected to help in two (2) ways: The treatment relationship is expected to help in two (2) ways: 1. First, it gives support to the young client. 2. A second contribution of the relationship is that it allows distortions of the relationship between the young client distortions of the relationship between the young client and the social worker to be examined so client and the social worker to be examined so client misperception can be corrected. misperception can be corrected. A technique(s) used by the cognitive therapist is clarifying internal communications. A technique(s) used by the cognitive therapist is clarifying internal communications. Explanation also is identified by Lantz (1996) as a treatment procedure. Explanation also is identified by Lantz (1996) as a treatment procedure. The social worker helps to explain the dysfunctions in thinking and behavior of the young client through the use of the ABC Theory, which later is used to make homework assignments. The social worker helps to explain the dysfunctions in thinking and behavior of the young client through the use of the ABC Theory, which later is used to make homework assignments. **This methodology emphasizes abstract thinking, which may not yet be available to the young child. **This methodology emphasizes abstract thinking, which may not yet be available to the young child.

Crisis Intervention ***SAMHC – uses this approach. Gilliland and James (1997) identify three (3) domains of crisis: see page 128. Gilliland and James (1997) identify three (3) domains of crisis: see page 128. Specific professional skills are required for working with children and families in crisis. Specific professional skills are required for working with children and families in crisis. 1. An important skill is poise. 2. Creativity 3. Flexibility 4. Energy

Steps in Crisis Model 1. Assessing the lethality and safety of the young client. 2. Establishing rapport and communication. 3. Defining the problem. 4. Dealing with feelings and giving support. 5. Examining alternatives. 6. Making plans. 7. Obtaining commitment. To be able to assist young clients from varying cultural groups, the social worker must examine and understand the world from the client’s view and look for alternative roles that are more appealing and adaptive to the background of the client. To be able to assist young clients from varying cultural groups, the social worker must examine and understand the world from the client’s view and look for alternative roles that are more appealing and adaptive to the background of the client. **It is also desirable to help the client make contact and elicit help from indigenous support systems. **It is also desirable to help the client make contact and elicit help from indigenous support systems.

Issues of Greatest Concern for Children and Adolescents Specific types of crisis that children and adolescents experience are abuse, potential suicide, loss, bereavement, grief, and family violence. PTSD as a problem. Specific types of crisis that children and adolescents experience are abuse, potential suicide, loss, bereavement, grief, and family violence. PTSD as a problem.

Abused Children Assess for PTSD Assess for PTSD Techniques for treating persons with PTSD include multiphasic treatment, which treats the crisis as they occur one after the other, and extinguishes intrusive images which involves going back to the original event and finding new adaptive responses. Techniques for treating persons with PTSD include multiphasic treatment, which treats the crisis as they occur one after the other, and extinguishes intrusive images which involves going back to the original event and finding new adaptive responses. Treatment of children Treatment of children Sexually abused Physically abused Ventilation of the experience. Ventilation of the experience. Find new coping and adaptive Find new coping and adaptive skills. skills. Meeting needs and overcoming some developmental lags that occur as a result of the physical abuse. Meeting needs and overcoming some developmental lags that occur as a result of the physical abuse. Learning new skills. Learning new skills. Developing more trust of adults. Developing more trust of adults.

Suicidal Children and Adolescents All children, especially adolescents, are at risk for suicide. All children, especially adolescents, are at risk for suicide. See six (6) characteristics of suicide, pages 130 – 131. See six (6) characteristics of suicide, pages 130 – 131. Loss, Bereavement, and Grief as Crisis Children of all ages are capable pf grieving. Children of all ages are capable pf grieving. Some techniques for dealing with bereavement in young children are the use of puppets, artwork, sand play, and psychodrama. Some techniques for dealing with bereavement in young children are the use of puppets, artwork, sand play, and psychodrama. For teens it is individual counseling and intervention and group grief work. For teens it is individual counseling and intervention and group grief work.

Task-Centered Social Work Developed in the 60’s and expanded on in the 70’s and 80’s. Developed in the 60’s and expanded on in the 70’s and 80’s. The focus for service is the client’s acknowledged problems, rather than the worker’s belief about the client’s problem. The focus for service is the client’s acknowledged problems, rather than the worker’s belief about the client’s problem. Help may be given by assisting the young person to solve problems; sometimes the context needs to be changed (Reid, 1996). Help may be given by assisting the young person to solve problems; sometimes the context needs to be changed (Reid, 1996). Task-centered practice is usually limited to 6-12 weeks. Task-centered practice is usually limited to 6-12 weeks. It is the client who will be the primary change agent, so his or her ideas are especially significant. It is the client who will be the primary change agent, so his or her ideas are especially significant.

Purpose and Method The purpose the task-centered practice is to help the young client resolve problems by planning and using problem-solving actions. The purpose the task-centered practice is to help the young client resolve problems by planning and using problem-solving actions. **The primary function of the session is to lay the groundwork for actions. **The primary function of the session is to lay the groundwork for actions. The number of problems for focus is also limited. The number of problems for focus is also limited. Exploring the Problem Problem explanation is a data-gathering assessment activity. Problem explanation is a data-gathering assessment activity. The practitioner and client explore the context of the problem and identify the causes that could be manipulated or the resources that could be used to alleviate the problem. The practitioner and client explore the context of the problem and identify the causes that could be manipulated or the resources that could be used to alleviate the problem.

Contracting and Planning An oral and written contract is developed that explicitly states acknowledged problems. An oral and written contract is developed that explicitly states acknowledged problems. A task identifies what the youthful client is to do to relieve the problem. A task identifies what the youthful client is to do to relieve the problem. Tasks are also planned for the practitioner to carry out before the next session. Tasks are also planned for the practitioner to carry out before the next session. A reason and a purpose for accomplishing the task must be established. A reason and a purpose for accomplishing the task must be established. Implementing the Tasks It is important to be prepared for obstacles that may prevent task accomplishment. It is important to be prepared for obstacles that may prevent task accomplishment.

Reviewing Progress As the social work practitioner meets with the young client at the beginning of each session, progress on task accomplishment and problems are reviewed. As the social work practitioner meets with the young client at the beginning of each session, progress on task accomplishment and problems are reviewed. Practitioners help remove obstacles and help client use resources. Practitioners help remove obstacles and help client use resources. Because task-centered practice is a short-term approach, termination is already determined at the 1 st session. Because task-centered practice is a short-term approach, termination is already determined at the 1 st session. See pages 135 – 136. See pages 135 – 136.

Behavior Theory Behavior therapy refers to systematic application of techniques intended to facilitate behavioral changes based principally, but not exclusively, on the conditioning theories of learning. ABC Paradigm – pages 137 – 138. ABC Paradigm – pages 137 – 138. A primary assumption made in the behavioral model is that all behavior is learned and can be defined, measured and changed. A primary assumption made in the behavioral model is that all behavior is learned and can be defined, measured and changed. Typical problems can be addressed with behavioral Tx. Typical problems can be addressed with behavioral Tx. It is especially important to be aware of the family’s culture because different behaviors may be more acceptable in one family than in another. It is especially important to be aware of the family’s culture because different behaviors may be more acceptable in one family than in another. Behavioral approaches can be used with individual groups and now communities. Behavioral approaches can be used with individual groups and now communities.

Person-Centered Therapy The person-centered model (sometimes called the client- centered model) was developed by Carl Rogers in the 1940’s. The person-centered model (sometimes called the client- centered model) was developed by Carl Rogers in the 1940’s. This theory is aimed at the incongruence between the young person’s experience and his or her self-concept. This theory is aimed at the incongruence between the young person’s experience and his or her self-concept. Rogers believed that there is an inherent tendency in each person to grow toward self-actualization. Rogers believed that there is an inherent tendency in each person to grow toward self-actualization. The approach exposes that the human organism is innately good and naturally wants to behave in healthy ways. The approach exposes that the human organism is innately good and naturally wants to behave in healthy ways. The therapist’s task is to create the conditions that allow and encourage growth. The therapist’s task is to create the conditions that allow and encourage growth.

Person-Centered Therapy Rogers noted that three (3) conditions, namely genuineness, unconditional positive regard, and empathy help to free the actualization process. Rogers noted that three (3) conditions, namely genuineness, unconditional positive regard, and empathy help to free the actualization process. The role of the social worker is to become the companion to the child in the journey toward self-discovery. The role of the social worker is to become the companion to the child in the journey toward self-discovery. **Client-centered play therapy more than any other play therapy, grants the child the freedom to be him or herself without facing evaluation or pressure to change. **Client-centered play therapy more than any other play therapy, grants the child the freedom to be him or herself without facing evaluation or pressure to change. Principles and Practice in Client-Centered Play Therapy A primary method of client-centered play therapy involves the participation of the therapist in play, as directed by the child. A primary method of client-centered play therapy involves the participation of the therapist in play, as directed by the child.

Communication Theory The presenting problem in this approach is concern with identifying the redundant communication patterns that serve as the rules that govern interactions. The presenting problem in this approach is concern with identifying the redundant communication patterns that serve as the rules that govern interactions. A primary assumption of this approach is that communication affects behavior, and all behavior, including but not limited to speech, is communication. A primary assumption of this approach is that communication affects behavior, and all behavior, including but not limited to speech, is communication.

Strategies for Change 1. Reframing – offering plausible alternative meaning to some aspects of the young client’s problem. aspects of the young client’s problem. 2. Restraint from change – go slow to make change. 3. Positioning – see example, page Behavior Prescription – see page 142.

Problem-Solving Approach developed primarily by Helen Harris Perlman (1957), “4 P’s”. Approach developed primarily by Helen Harris Perlman (1957), “4 P’s”. 1. Person 2. Problem 3. Place 4. Problem Steps in the Problem-Solving Process 1. Request for services 2. Identifying the problem 3. Contracting 4. Implementation of the plan 5. Termination 6. Evaluation

Assumptions and Thinking Underlying the Approach Learning is problem-solving. Learning is problem-solving. Problem-solving is a here and now, reality based way of helping young people who need assistance. Problem-solving is a here and now, reality based way of helping young people who need assistance. Work must begin “where the client is”. Work must begin “where the client is”. Use the power of the helping relationship to motivate the client. Use the power of the helping relationship to motivate the client.Limitations Not suitable for all clients. Not suitable for all clients. Not suitable for all ethnic groups. Not suitable for all ethnic groups.

Existential Social Work For the existentialist, young people discover their own uniqueness in the way they relate to the objective experience of life. For the existentialist, young people discover their own uniqueness in the way they relate to the objective experience of life. Krill (1996) identified five (5) organizing principles of existentialist philosophy. Krill (1996) identified five (5) organizing principles of existentialist philosophy. 1. Disillusionment 2. Freedom of choice 3. Meaning in suffering 4. The necessity of dialogue 5. The stance of responsible commitment Change can occur by relinquishing defensive beliefs, judgments and symptoms that interfere with the natural growth process. Change can occur by relinquishing defensive beliefs, judgments and symptoms that interfere with the natural growth process. A therapeutic task is to help the young client experience disillusionment with security efforts that block growth. A therapeutic task is to help the young client experience disillusionment with security efforts that block growth.

Components of Change Two (2) components, rational and experiential, are required for change to occur. Two (2) components, rational and experiential, are required for change to occur. See page 146 (Krill, 1996). See page 146 (Krill, 1996). Role Theory Emphasis on the person-situation configuration. Emphasis on the person-situation configuration. Positions are classifications of persons such as teacher – father – women – children – social workers. Positions are classifications of persons such as teacher – father – women – children – social workers. Ascribed positions are attained through skill or effort (social worker, doctor, politician). Ascribed positions are attained through skill or effort (social worker, doctor, politician). Rule expectation is a set of expectations from generalized others. Rule expectation is a set of expectations from generalized others. **Use of role plays. **Use of role plays.

Techniques 1. On the spot interviews 2. Mirroring 3. Sharing Using Multiple Bodies of Theory