Counseling children and adolescents
Children and adolescents often face difficulties while in their developmental stages. This is more so, because growth and development brings about unfamiliar changes which they cannot completely comprehend. As such it becomes inevitable that they will find themselves in many psychological crises which require the intervention and implementation of psychiatric therapy. This paper will focus on the most effective play and non play therapy techniques for children and adolescents. In regard to this, the techniques will be employed in individual, family and group therapy case studies. In addition, an analysis of both legal and ethical requirements of these counseling strategies will be incorporated in the study. Ultimately, the goal is to determine which of these two therapy techniques is more effective in the counseling of children and adolescents.
Counseling of children and adults draws from a vast range of psychology theories. Among these theories includes cognitive theory, behaviorist theory, humanist theory and psychoanalytic theory. In their application in counseling the therapy draws from particular principles related to the specific theories. The cognitive theory involves the manipulation of mental schema in the learning of behaviors. It is a vital theory for the teaching of new and therapeutic skills in children and adolescents. They are involved in developing vital skills necessary in taking control of their emotions which then impact greatly on their behaviors. On the other hand, the behaviorist theory is applied in counseling for the learning of desired behaviors through the use of modeling, reinforcement and conditioning. It is rather common for the incorporation of both the cognitive and behaviorist theories in counseling therapy. Their integration has been known to effect significant change and cultivation of positive skills in both children and adolescents. With reference to these theories and their application, the paper will discuss the use of Drama play therapy technique and cognitive behavioral therapy technique in the counseling of children and adolescents.
Regardless of the application of adult based theories in the psychiatric treatment of children and adolescents, these individual entities use completely different approaches. Brown and Prout (2007, p.1) contend that children and adolescents have different developmental phases, interact in unique environments and have other aspects which definitely necessitate unique therapy approaches. Drama therapy is a play therapy technique which has been consistently used for the treatment of adolescents' and children's mental and developmental problems. Play holds a special place in the growth of both children and adolescents. A majority of the problems and anxieties experienced by children emanate from conflicts between their drives, ego and superego. For instance, in the case where a child feels enraged by the behavior of a sibling, the conflict emerges between their drive to be aggressive and towards the unacceptable initiative instigated by the child's ego and superego. Thus, children are only able to overcome these problems through play. Chethik (2005, p.49) argues that play allows children to interact with their fantasy worlds and by exercising their imaginations are able to calm their inner drives which allows them to relate to reality in a more effective manner.
In the illustration of the drama technique, the discussion will focus on therapy for adolescents facing anger management problems and are projecting on others. In addition, the cultivation of self esteem, self identity and emotional stability in children will also be analyzed. Adolescents are at a time in their lives when experimentation is an enormous part of their learning experiences. Geldard and Geldard (2006, p.34) assert that adolescents are highly influence by their environment and its occupants and at times, there emerges conflicts which lead to adolescents engaging in inner struggles. In this case study, a teenage girl Mercy who has not previously engaged in any deviant behavior starts to do so after the parents go through a divorce. Angry at her father for leaving them, she becomes rowdy and keeps blaming herself for the divorce. However, she does not voice her anger towards the father and is gradually receding into a depression.
In the individual therapy of Mercy, drama therapy technique can be applied through role play. With ample time Mercy can be encouraged to play the roles of the people in her life. The therapist takes on the role of Mercy and engages with Mercy who eventually plays the roles of both her mother and father. While confronting the father, Mercy is bound to talk about her pain and anger over his leaving. With the use of enhanced costumes and props, Mercy settles into her role as a therapist and gradually, her anger can be observed to decline. At the end of the sessions as Gallo-Lopez and Schaefer (2006, p. 88) de-roling is performed as Mercy is resettled back to her real self. This is effective when done in a clam and reflective manner and the therapist provides feedback. Family therapy can also be incorporated in Mercy's therapy especially by having her mother attend therapy sessions. This can allow Mercy to confront her mother and seek her mother's reassurance which will help her to stop blaming herself.
Group therapy for the treatment of Mercy can be utilized through a theatre group. It is crucial to select a theatre group of individuals whom Mercy can relate and where she can seek help. Shechtman (2007, p.16) insists that for effective group counseling, the groups should be intimate and a place where both children and adolescents can voice their frustrations and develop a sense of well being. Through role play group members enact various characters which they feel portray most aspects of their lives. As Halerin & Kymissis (2005, p.200) explain, through the dramatization of various roles, individuals are able to model new roles and behaviors which they can use in their lives as a positive influence. This way Mercy will release her anger over the crises at home and at the same become strong and discover her ultimate potentials as an individual.
Children experiencing low self esteem can be put through the same drama therapy in order to bring out their confidence and enhance emotional stability. In this sort of therapy, be it individual, family or group oriented children can use superhero figures in the role play. Rubin (p.24) claims that the use of superheroes allows children to resolve their inner feelings of strength or weakness and as they compare the qualities of superheroes, they find a place of identity. Most superheroes are depicted as characters that have overcome major barriers and emerged strong and victorious. While a child plays the role of superhero, they are able to overcome their feelings of helplessness and inadequacy. Also, when in family therapy parents who play these superheroes provide the child with a role model for self identity and self confidence. Furthermore, role play in family therapy can enhance interaction within the family and as Sori (2005, p.38) argues provide an environment which encourages families to be cooperative and work towards getting solutions to their conflicts.
Cognitive behavioral therapy is also an effective non play therapy technique for treating low self esteem in children and adults. Low self esteem in children and adolescents is normally contributed to the distortion of their inner schemas. One such distortion is the application of unrealistic self standards where children and adolescents aim at being perfectionists or become rather overly dependent on others in the society. Another dysfunction also emerges when children and adolescents are unable to accurately evaluate themselves. This can be attributed to external influences like peers and parents who are constantly putting them down. By demeaning the children's being it becomes difficult for them to develop confidence. Depicting the source of such dysfunctional attitudes is the initial stage in formulating appropriate cognitive behavioral therapy.
The case study for the analysis of this therapy technique involves John, a thirteen year old student who needs therapy after expressing his will to commit suicide. Regardless of John's outstanding academic performance, he is constantly withdrawn and often engages in self depreciating thinking. Following an initial evaluation with John, his parents and the therapist it is evident that John is constantly under pressure to perform and be the very best. His achievements are met with high excitement by the parents but he claims that when he makes mistakes or achieves less than expected, he is faces reprimand. Furthermore, John has set such high and unrealistic standards for himself that he feels the need to punish himself when he falls short of them. Clearly, John's self esteem has become quite vulnerable. Moreover, this unrealistic self criticism emerges from John's desire for acceptance. As Dattilio et al (2006, p.195) argues, such dysfunctional attitudes call for cognitive restructuring.
Therapy for John will involve particular activities which aim at distancing his desire for perfectionism from acceptance. At first John is encouraged to follow realistic goals which are set by the therapist. In doing so, John is presented with evidence of how his perfectionism is unreal. Family and group therapy can be incorporated by having the parents visit professionals who can thus direct John on the right requirements especially with regard to academic performance. This will also show him that his hard work pays even without the aspect of self criticism or perfectionism. He can also observe other group members and reflect on his self treatment by comparing it to that of his friends or parents. Through such interactive session, John will eventually develop adequate skills for altering his schema and being less critical and overly demanding to himself.
Both play and cognitive behavioral therapies are bound by legal and ethical constraints. Of great importance is the aspect of confidentiality. Therapists must be keen to maintain confidentiality with their patients and especially in group therapies where there are many individuals who do not want their information disclosed to others. Basically Landreth (2005, p.66) argues that the therapist has an ethical and legal responsibility to their patients by protecting their information through confidentiality. Moreover, in the counseling of children and adolescents, legal authorization is required from the parents or guardians.
In conclusion, a comparison of the two modes of therapy indicates almost similar conclusions but the play therapy emerges rather more effective than the cognitive behavioral therapy. Play therapy has the advantage of treating children and adolescents within their own comfort zone. It brings out realistic and individual based skills which are far more effective in reaching to their inner feelings which eventually results to behavior change Christner et al (2007). However, therapy techniques are determined by unique circumstances being experienced by the children and adolescents.
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