Table of Contents

Introduction to the child's world...........................................................................................................1

Indicators of well being:..................................................................................................................1
Developmental and Cultural Considerations........................................................................................1
The Counseling Process.......................................................................................................................3
Corsini's 9 factors of change............................................................................................................3
Lazarus's BASIC ID model:............................................................................................................4
Formula for outcome evaluations:..............................................................................................4
Things to consider during the first interview:..................................................................................4
Steps to overcoming children's resistance:..................................................................................5
A general model for counseling:......................................................................................................5
Legal and ethical considerations for counselors...................................................................................5
Steps of decision making:...............................................................................................................5
Strom-Gottfried (2008) - decision-making framework :.............................................................5
Rights of children in counseling:................................................................................................6
Psychoanalytic Counseling...................................................................................................................6
Primary defenses..............................................................................................................................6
Higher order defenses......................................................................................................................6
Person-Centered Counseling................................................................................................................7
The counseling process....................................................................................................................7
Basic principles................................................................................................................................7
Messages:....................................................................................................................................7
Gestalt Therapy.....................................................................................................................................8

Introduction to the child's world

Indicators of well being:

Continuing, nurturing relationships

A community that is stable, supportive, and consistent
Adults who set limits, provide structure, and guide by having appropriate expectations
Developmentally appropriate opportunities as building blocks for cognitive, motor,
language, emotional, and social skills
Experiences tailored to individual differences for each childs optimal development
Physical protection and safety with regulations to safeguard those needs

Resilience = the dynamic process of people who do better than expected in adverse circumstances;
they beat the odds

Developmental and Cultural Considerations

Developmental Tasks and Interventions for the Eight Stages of Human Development

Stage 1: Birth to age 1 1/2 - Basic Trust versus Basic Mistrust

Task:
develop trust in their parents and environment
learn the world is safe, consistent, predictable, interesting
Interventions:
Children need responsive, affectionate, consistent caregivers who meet their
basic needs in order to bond with others.
Stage 2: 1 1/2 to 3 - Autonomy versus Shame and Doubt
Task:
Gain a sense of self-control as well as control over their environment.
Interventions:
Children have gained trust, need to experience success in doing things for
themselves
Overly restrained or overly punished children develop a sense of shame and
doubt
Stage 3: 3 to 6 - Initiative versus Guilt
Task:
Develop a sense of initiative as opposed to feelings of guilt about never doing
anything right
Interventions:
Children begin to set goals and take leadership roles in carrying out projects.
Parents should empower children by giving them choices and allowing them to
participate in family activities.
Unacceptable behavior is corrected in a loving, caring manner
Discipline is based on logical consequences
Expectations are realistic in order to prevent guilt and anxiety
Stage 4: 6-12 - Industry versus Inferiority
Task:
Learn range of academic, social, physical and practical skills needed in an adult
world.
Interventions:
Encouragement and praise will help children achieve competence and be
productive
Nurturing can help children develop special talents and abilities
Stage 5: 12 to 18 - Identity versus Role Confusion
Task:
Develop a self-image, know who they are and how their roles will fit into their
future
Interventions:
Adults should make teens feel accepted as they develop their identity through
group activities, work or play
Key questions are: "Who am I?" and "Where am I going?"
Period of exploration for further education, training, jobs, career and marriage.
Stages 6, 7 and 8 - Adult Stages
Task:
Achieve intimacy through sharing a close friendship or love relationship in
young adulthood

Middle adulthood tasks are proper care of children and productive work life
Older adults are concerned with ego integrity - acceptance of past life, a search
for meaning in the present and continued growth and learning in the future
Interventions:
Must match young adult's counseling to his or her learning style
Adults may use concrete or abstract thinking in problem solving
Issues in counseling often center on relationships, careers and the search for
meaning and purpose in life
CHILDRENS MENTAL HEALTH

Age 0-2: Normal achievements are eating, sleeping, attachment. Common behavior
problems are stubborness, temper, toileting difficulties. Clinical difficulties are mental
retardation, feeding disorders, autistic spectrum disorder.
Age 2-5: Normal achievements are language, toileting, self-care skills, self-control, peer
relationships. Common behavior problems are arguing, demanding attention, disobedience,
fears, overactivity, resisting bedtime. Clinical disorders are speech and language disorders,
problems stemming from child abuse and neglect, some anxiety disorders, such as phobias.
Age 6-11: Normal achievements are academic skills and rules, rule-governed games, simple
responsibilities. Common behavior problems are arguing, inability to concentrate, selfconsciousness, showing off. Clinical disorders are ADHD, learning disorders, school refusal
behavior, conduct problems.
Age 12-20: Normal achievements are relations with the opposite sex, personal identity,
separation from family, increased responsibilities. Common behavior problems are arguing
and bragging. Clinical disorders are anorexia, bulimia, delinquency, suicide attempts, drug
and alcohol abuse, schizophrenia, depression.

The Counseling Process

Corsini's 9 factors of change

Cognitive:
Universalization: people get better when they understand they are not alone, that
other people have similar problems, suffering is universal.
Insight: people understand themselves and gain new perspectives
Modeling: people profit from watching other people.
Affective:
Acceptance: receiving unconditional positive regard from a significant person, such
as the counselor, builds a person's acceptance of self.
Altruism: change can happen when a person recognizes the gift of care from the
counselor or others or from the sense of giving love, care and help to others.
Transference: it implies the emotional bond created between the counselor and the
client.
Behavioral:
Reality testing: people can change when they can experiment with new behavior and
receive support and feedback.

 Ventilation: Having a place to express anger, fear or sadness and still be accepted
promotes change.
Interaction: people improve when they can admit something is wrong.

Lazarus's BASIC ID model:

B: behavior - habits, responses and reactions that can be observed. -> fighting, crying, inappropriate
talking, stealing, procrastination
A: affect - a variety of emotions and moods. -> anger, anxiety, phobias, depression, loneliness,
helplessness.
S: sensation/ school - basic senses of seeing, hearing, touching, tasting and smelling. -> headaches,
backaches, dizziness, stomachaches, school failure, non-achievement
I: imagery - fantasies, mental pictures, dreams, images from auditory and other senses ->
nightmares, low self-esteem, negative body image, fear of rejection, daydreaming
C: cognition - thoughts, ideas, values, opinions. -> irrational thinking, not setting goals, decision
making problems, problem solving difficulties, worthlessness.
I: Interpersonal relationships - interaction with family, friends, peers, teachers -> withdrawing
(shyness), conflicts with adults, conflict with peers, family problems etc
D: drugs/diet/biology - health -> hyperactivity, weight-control problems, drug abuse, addictions

Formula for outcome evaluations:

B: less withdrawn, less compulsive, more honest
A: more feelings of joy, less hostile, less depressed
S: enjoys more, less anxious, more relaxed
I: fewer nightmares, better self-image
C: less criticism, more positive self-statements
I: more or deeper friendships, states wishes and preferences
D: has reduced bad habits, sleeps well, active

Things to consider during the first interview:

Children's resistance to counseling - Questions:

What is counseling and why do I have to go there?

Did I do something wrong? Am I being punished?
Is something wrong with me?
Do Mom and Dad thing something is wrong with me? Do they love me?
Will my friends think something is wrong with me? Will they make fun of me if they find
out?
Will it hurt? Is it like going to the doctor?
How long does it take? When will I get to go home or back to class?
If I don't like it, will I have to come back?
What am I supposed to say and do? What if I say something wrong?

Should I tell bad things about my family?

Will the counselor tell anybody what I say?

Steps to overcoming children's resistance:

development of a good counseling relationship

healthy balance between adult-adult and parent-child activities
offer children as many choices as possible to restore to them some control.
the counselor's office should seem friendly, comfortable, relaxed, safe
children need to understand what counseling is and what they can expect from it.

A general model for counseling:

Step 1: defining the problem through active listening: "In other words, you are feeling ___
because___, and you want ____."
Step 2: clarifying the child's expectations:
Step 3: exploring what has been done to solve the problem
Step 4: exploring what new things could be done to solve the problem
Step 5: obtaining a commitment to try one of the problem-solving ideas
Step 6: closing the counseling interview

Legal and ethical considerations for counselors

Steps of decision making:
1. Develop ethical sensitivity to the moral dimensions of counseling.
2. Identify and define the problem. Clarify facts, who has a stake in the situation,
and the sociocultural context of the case.
3. Think about your own emotional reactions to the situation.
4. Apply fundamental ethical principles and theories to the situation (autonomy,
nonmaleficence, beneficence, justice, fidelity, veracity). Define the central issues
in the dilemma and possible options.
5. Refer to professional standards, relevant laws and regulations, and current
ethics literature.
6. Consult with colleagues or experts.
7. Involve the client in the decision-making process.
8. Identify desired outcomes and action to achieve those outcomes.
9. Consider different courses of action.
10. Choose and act.
11. Reflect on the actions taken

Strom-Gottfried (2008) - decision-making framework :

A Assess the options
B Be mindful of the process
C Consult
D Document
E Evaluate

Rights of children in counseling:

To be respected and told the truth

To know about the evaluation process, rationale, and results in understandable terms
To be told about the interventions and reasons for them in clear language
To receive information about confidentiality and its limits
To be involved with the counselor and/or parents in decision making and goal setting
To control the release of their personal information
To be released from treatment if unsuccessful
Not to be the scapegoat in a dysfunctional family

Remley and Herlihy (2007) ways to cope with requests:

1. Discuss the request with the child and ask if the minor is willing to talk to the adult.
2. Try to convince the adult that the nature of the counseling relationship and the importance of
confidentiality work for the best interests of the child.
3. Hold a session with the child and the adult and act as a mediator.
4. Inform the child beforehand, and then tell the content to the adult.
5. Refuse to disclose the information after having informed your supervisor.

Psychoanalytic Counseling
Primary defenses

Identification - the development of role models that people identify with or imitate. It often
occurs with the same-sex parent and may be borne out of love or power.
Projection - attributing ones own unacceptable characteristics to others or to things in the
external world.
Rationalization - an attempt to prove that ones behavior is justified and rational and is thus
worthy of approval by oneself and others.
Denial - a refusal to face unpleasant aspects of reality or to perceive anxiety-provoking
stimuli.
Fantasy - seeking gratification of needs and frustrated desires through the imagination.
Withdrawal - becoming passive or learning to avoid being hurt.
Fixation deciding to remain at the present level of development rather than move to the
next stage.
Undoing - engaging in some form of atonement for immoral or bad behavior or for the
desire to participate in such behavior.
Acting Out - reducing the anxiety aroused by forbidden desires by expressing them.
Compensation - covering up a weakness by emphasizing some desirable trait or reducing
frustration in one area of life by over-gratification in another area.

Higher order defenses

Displacement - redirecting energy from a primary object to a substitute when an instinct is

blocked.
Repression - forces a dangerous memory, conflict, idea, or perception out of the conscious
into the unconscious and places a lid on it to prevent the repressed material from
resurfacing.

Suppression - conscious effort to do the same thing.

Reaction Formation - the development of attitudes or character traits exactly opposite to
ones that have been repressed.
Intellectualization - the act of separating the normal affect, or feeling, from an unpleasant or
hurtful situation.
Regression - a retreat to earlier developmental stages that are less demanding than those of
the present level.
Sublimation - redirect the libidinal desires and energy into productive and acceptable
activities and outlets.

Person-Centered Counseling
The counseling process
outlined by Rogers (1942) includes 12 steps.
1. The individual comes for help.
2. The helping situation is characterized as a chance to grow.
3. The counselor promotes free expression of feelings about the concerns.
4. The counselor accepts, recognizes, and clarifies these feelings.
5. The persons negative feelings are followed by positive drives toward growth.
6. The counselor accepts and recognizes the positive feelings, which gives the person a chance
to understand himself as he is. Insight and self-understanding emerge.
7. This insight provides a foundation from which the person can move to a new level.
8. Mingled with it is an awakening to clarification of possible decisions and courses of action.
9. Then the beginning of small but significant positive actions begin.
10. Further insight occurs.
11. More integrated positive action, less fear, and more confidence follow.
12. The person feels less need for help and recognizes the relationship is near an end.

Basic principles
of the child-centered relationship are as follows (Virginia Axline):
1. The counselor has a genuine interest in the child and builds a warm, caring relationship.
2. The counselor accepts the child unconditionally, not wishing the child were different.
3. The counselor institutes a feeling of safety and permissiveness in the relationship, allowing
the child freedom to explore and express him- or herself.
4. The counselor maintains sensitivity to the childs feelings and reflects them in a way that
increases the childs self-understanding.
5. The counselor strongly believes in the childs capacity to act responsibly and solve personal
problems, and allows the child to do so.
6. The counselor trusts the inner direction of the child, allowing the child to lead the
relationship and refusing to override the childs direction.
7. The counselor does not hurry the therapeutic process.
8. The counselor uses only the limits necessary for helping the child accept personal and
appropriate responsibility.

Messages:
I am here (nothing will distract me).

I hear you (I am listening carefully).

I understand you.
I care about you.
Play therapy
1.
2.
3.
4.

Phases of child-centered play therapy.

Children use play to express a range of negative feelings.
Children use play to express ambivalent feelings, usually fear or anger.
Children use play to express negative feelings, but the focus has shifted to specific targets
like parents or teachers or the counselor.
5. Ambivalent feelings, both positive and negative, come back but now are directed toward
parents, siblings, or others.
6. Positive feelings prevail with the child expressing negative emotions appropriately.

Gestalt Therapy
Core concepts
AWARENESS = emotional health, the hallmark of wellness as well as the goal of counseling. Selfregulation requires awareness of ones inner self and of the external environment. People with high
levels of awareness of their needs and their environment know which problems and conflicts are
resolvable and which are not.
CONTACT = the interaction of the person with the environment, recognizing what is occuring here
and now, moment to moment, knowing about a need and trying to fulfill that need by engaging with
the environment.
SELF = is in the process of becoming. A nurturing environment is necessary for the child to
develop this sense of self. Rejection or lack of support lead to a diminished ability to self-regulate
and interact with the environment. In a healthy person, self is always changing, transforming by
taking in what nourishes and rejecting what obstructs growth.
INTEGRATION = all parts of the person work in a well-coordinated, wholesome manner.
Neuroticism comes from:
1. Lacking contact with the environment: People may become so rigid that they cut themselves
off from others or from resources in the environment.
2. Confluence: People may incorporate too much of themselves into others or incorporate so
much of the environment into themselves that they lose touch with who and where they are.
Then the environment takes control.
3. Unfinished business: People may have unfulfilled needs, unexpressed feelings, or unfinished
situations that clamor for their attention. (This situation may manifest itself in dreams.)
4. Fragmentation: People may try to discover or deny a need such as to show aggression. The
inability to find and obtain what one needs may be the result of fragmenting ones life.
5. Top dog/underdog: People may experience a split in their personalities between what they
think they should do (top dog) and what they want to do (underdog).
6. Polarities (dichotomies): People tend to flounder at times between existing, natural
dichotomies in their lives, such as body-mind, self-external world, fantasy-reality, infantilemature, biological-cultural, poetry-prose, spontaneous- deliberate, personal-social, thinkfeeling, and unconscious-conscious. Much of everyday living seems to be involved in
resolving conflicts posed by these competing polarities.