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

SSE-160SSE-160Introduction to Child and Introduction to Child and

Youth ServicesYouth Services

Chapter 6Chapter 6

Theories, Strategies, and Theories, Strategies, and Techniques for PracticeTechniques for Practice

Theories, Strategies, and Theories, Strategies, and Techniques for PracticeTechniques for Practice

• After assessing the child, family, and situation, a After assessing the child, family, and situation, a treatment plan must be developed.treatment plan must be developed.

Cognitive TheoryCognitive Theory• Cognitive theory is based on the idea that a child’s Cognitive theory is based on the idea that a child’s

thinking is the principle determinant of emotions and thinking is the principle determinant of emotions and behaviors.behaviors.

• The social worker directs and helps the child or The social worker directs and helps the child or adolescent to identify, challenge, and change thinking adolescent to identify, challenge, and change thinking patterns that result in dysfunctional forms of emotions, patterns that result in dysfunctional forms of emotions, behavior and problem solving.behavior and problem solving.

Cognitive TheoryCognitive Theory• ABC Theory (Albert Ellis)ABC Theory (Albert Ellis)

1. A = Activate event1. A = Activate event

2. B = Belief2. B = Belief

3. C = Consequence3. C = Consequence

• According to cognitive theory, most dysfunctional behavior and According to cognitive theory, most dysfunctional behavior and emotions of children and adolescents are a direct result of emotions of children and adolescents are a direct result of misconceptions that they hold about themselves or about misconceptions that they hold about themselves or about various environmental situations.various environmental situations.

• Correction of the emotion occurs when the misconception is Correction of the emotion occurs when the misconception is changed.changed.

• Many misconceptions, irrational thinking, erroneous beliefs, Many misconceptions, irrational thinking, erroneous beliefs, and cognitions are outside the young person’s conscious and cognitions are outside the young person’s conscious awareness.awareness.

• An exception is that some dysfunctional emotions are the An exception is that some dysfunctional emotions are the result of organic physiological, neurological, or clinical result of organic physiological, neurological, or clinical problems.problems.

Producing ChangeProducing Change• The change process occurs when the young client The change process occurs when the young client

identifies challenges, and change misconceptions, faulty identifies challenges, and change misconceptions, faulty beliefs, distorted cognitions, and irrational self-talk.beliefs, distorted cognitions, and irrational self-talk.

• The helping process of the cognitive approach is primarily The helping process of the cognitive approach is primarily educational.educational.

• One unresolved concern is whether race, class, and One unresolved concern is whether race, class, and gender experiences may have impact on the client’s gender experiences may have impact on the client’s beliefs and cognitions.beliefs and cognitions.

Treatment PrinciplesTreatment Principles• Judith Beck (1995), a major proponent and theorist of this Judith Beck (1995), a major proponent and theorist of this

approach, identified ten (10) principles of cognitive approach, identified ten (10) principles of cognitive theory. See page 127.theory. See page 127.

Relationship TechniquesRelationship 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.1. First, it gives support to the young client.

2. A second contribution of the relationship is that it allows2. A second contribution of the relationship is that it allows

distortions of the relationship between the young clientdistortions of the relationship between the young client

and the social worker to be examined so clientand the social worker to be examined so client

misperception can be corrected.misperception can be corrected.

• A A technique(s)technique(s) used by the cognitive therapist is clarifying used by the cognitive therapist is clarifying internal communications.internal communications.

• Explanation also is identified by Lantz (1996) as a treatment Explanation also is identified by Lantz (1996) as a treatment procedure.procedure.

• The social worker helps to explain the dysfunctions in thinking The social worker helps to explain the dysfunctions in thinking and behavior of the young client through the use of the ABC and behavior of the young client through the use of the ABC Theory, which later is used to make homework assignments.Theory, which later is used to make homework assignments.

• **This methodology emphasizes abstract thinking, which may not **This methodology emphasizes abstract thinking, which may not yet be available to the young child. yet be available to the young child.

Crisis InterventionCrisis Intervention

***SAMHC – uses this approach.***SAMHC – uses this approach.

• Gilliland and James (1997) identify three (3) domains Gilliland and James (1997) identify three (3) domains of crisis: see page 128.of crisis: see page 128.

• Specific professional skills are required for working Specific professional skills are required for working with children and families in crisis.with children and families in crisis.

1. An important skill is poise.1. An important skill is poise.

2. Creativity2. Creativity

3. Flexibility3. Flexibility

4. Energy4. Energy

Steps in Crisis ModelSteps in Crisis Model1. Assessing the lethality and safety of the young client.1. Assessing the lethality and safety of the young client.

2. Establishing rapport and communication.2. Establishing rapport and communication.

3. Defining the problem.3. Defining the problem.

4. Dealing with feelings and giving support.4. Dealing with feelings and giving support.

5. Examining alternatives.5. Examining alternatives.

6. Making plans.6. Making plans.

7. Obtaining commitment.7. Obtaining commitment.

• To be able to assist young clients from varying cultural groups, To be able to assist young clients from varying cultural groups, the social worker must examine and understand the world from the social worker must examine and understand the world from the client’s view and look for alternative roles that are more the client’s view and look for alternative roles that are more appealing and adaptive to the background of the client.appealing and adaptive to the background of the client.

• **It is also desirable to help the client make contact and elicit **It is also desirable to help the client make contact and elicit help from indigenous support systems.help from indigenous support systems.

Issues of Greatest Concern for Issues of Greatest Concern for Children and AdolescentsChildren and Adolescents

• Specific types of crisis that children and adolescents Specific types of crisis that children and adolescents experience are abuse, potential suicide, loss, experience are abuse, potential suicide, loss, bereavement, grief, and family violence. PTSD as a bereavement, grief, and family violence. PTSD as a problem. problem.

Abused ChildrenAbused Children• Assess for PTSDAssess for PTSD

• Techniques for treating persons with PTSD include Techniques for treating persons with PTSD include multiphasic treatment, which treats the crisis as they occur multiphasic treatment, which treats the crisis as they occur one after the other, and extinguishes intrusive images one after the other, and extinguishes intrusive images which involves going back to the original event and finding which involves going back to the original event and finding new adaptive responses.new adaptive responses.

• Treatment of childrenTreatment of childrenSexually abusedSexually abused Physically abusedPhysically abused

•Ventilation of the experience.Ventilation of the experience.

•Find new coping and adaptiveFind new coping and adaptive

skills.skills.

•Meeting needs and Meeting needs and overcoming some overcoming some developmental lags that occur developmental lags that occur as a result of the physical as a result of the physical abuse.abuse.

•Learning new skills.Learning new skills.

•Developing more trust of Developing more trust of adults.adults.

Suicidal Children and Suicidal Children and AdolescentsAdolescents

• All children, especially adolescents, are at risk for All children, especially adolescents, are at risk for suicide.suicide.

• See six (6) characteristics of suicide, pages 130 – 131.See six (6) characteristics of suicide, pages 130 – 131.

Loss, Bereavement, and Grief as CrisisLoss, 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 Some techniques for dealing with bereavement in young children are the use of puppets, artwork, sand young children are the use of puppets, artwork, sand play, and psychodrama.play, and psychodrama.

• For teens it is individual counseling and intervention For teens it is individual counseling and intervention and group grief work.and group grief work.

Task-Centered Social WorkTask-Centered Social Work

• Developed in the 60’s and expanded on in the 70’s and Developed in the 60’s and expanded on in the 70’s and 80’s.80’s.

• The focus for service is the client’s acknowledged The focus for service is the client’s acknowledged problems, rather than the worker’s belief about the problems, rather than the worker’s belief about the client’s problem.client’s problem.

• Help may be given by assisting the young person to Help may be given by assisting the young person to solve problems; sometimes the context needs to be solve problems; sometimes the context needs to be changed (Reid, 1996).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 It is the client who will be the primary change agent, so his or her ideas are especially significant.his or her ideas are especially significant.

Purpose and MethodPurpose and Method

• The purpose the task-centered practice is to help the The purpose the task-centered practice is to help the young client resolve problems by planning and using young client resolve problems by planning and using problem-solving actions.problem-solving actions.

• **The primary function of the session is to lay the **The primary function of the session is to lay the groundwork for actions.groundwork for actions.

• The number of problems for focus is also limited.The number of problems for focus is also limited.

Exploring the ProblemExploring the Problem• Problem explanation is a data-gathering assessment Problem explanation is a data-gathering assessment

activity.activity.

• The practitioner and client explore the context of the The practitioner and client explore the context of the problem and identify the causes that could be problem and identify the causes that could be manipulated or the resources that could be used to manipulated or the resources that could be used to alleviate the problem.alleviate the problem.

Contracting and PlanningContracting and Planning

• An oral and written contract is developed that An oral and written contract is developed that explicitly states acknowledged problems.explicitly states acknowledged problems.

• A task identifies what the youthful client is to do to A task identifies what the youthful client is to do to relieve the problem.relieve the problem.

• Tasks are also planned for the practitioner to carry out Tasks are also planned for the practitioner to carry out before the next session.before the next session.

• A reason and a purpose for accomplishing the task A reason and a purpose for accomplishing the task must be established.must be established.

Implementing the TasksImplementing the Tasks• It is important to be prepared for obstacles that may It is important to be prepared for obstacles that may

prevent task accomplishment.prevent task accomplishment.

Reviewing ProgressReviewing Progress

• As the social work practitioner meets with the young As the social work practitioner meets with the young client at the beginning of each session, progress on client at the beginning of each session, progress on task accomplishment and problems are reviewed.task accomplishment and problems are reviewed.

• Practitioners help remove obstacles and help client Practitioners help remove obstacles and help client use resources.use resources.

• Because task-centered practice is a short-term Because task-centered practice is a short-term approach, termination is already determined at the 1approach, termination is already determined at the 1stst session.session.

• See pages 135 – 136. See pages 135 – 136.

Behavior TheoryBehavior Theory

Behavior therapy refers to systematic application of techniquesBehavior therapy refers to systematic application of techniques

intended to facilitate behavioral changes based principally, butintended to facilitate behavioral changes based principally, but

not exclusively, on the conditioning theories of learning.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 A primary assumption made in the behavioral model is that all behavior is learned and can be defined, measured and all behavior is learned and can be defined, measured and changed.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 It is especially important to be aware of the family’s culture because different behaviors may be more acceptable in one because different behaviors may be more acceptable in one family than in another.family than in another.

• Behavioral approaches can be used with individual groups Behavioral approaches can be used with individual groups and now communities.and now communities.

Person-Centered TherapyPerson-Centered Therapy

• The person-centered model (sometimes called the client-The person-centered model (sometimes called the client-centered model) was developed by Carl Rogers in the centered model) was developed by Carl Rogers in the 1940’s.1940’s.

• This theory is aimed at the incongruence between the This theory is aimed at the incongruence between the young person’s experience and his or her self-concept.young person’s experience and his or her self-concept.

• Rogers believed that there is an inherent tendency in Rogers believed that there is an inherent tendency in each person to grow toward self-actualization.each person to grow toward self-actualization.

• The approach exposes that the human organism is The approach exposes that the human organism is innately good and naturally wants to behave in healthy innately good and naturally wants to behave in healthy ways.ways.

• The therapist’s task is to create the conditions that allow The therapist’s task is to create the conditions that allow and encourage growth.and encourage growth.

Person-Centered TherapyPerson-Centered Therapy• Rogers noted that three (3) conditions, namely Rogers noted that three (3) conditions, namely

genuineness, unconditional positive regard, and empathy genuineness, unconditional positive regard, and empathy help to free the actualization process.help to free the actualization process.

• The role of the social worker is to become the companion The role of the social worker is to become the companion to the child in the journey toward self-discovery.to the child in the journey toward self-discovery.

• **Client-centered play therapy more than any other play **Client-centered play therapy more than any other play therapy, grants the child the freedom to be him or herself therapy, grants the child the freedom to be him or herself without facing evaluation or pressure to change.without facing evaluation or pressure to change.

Principles and Practice in Client-Centered Play TherapyPrinciples and Practice in Client-Centered Play Therapy• A primary method of client-centered play therapy involves A primary method of client-centered play therapy involves

the participation of the therapist in play, as directed by the the participation of the therapist in play, as directed by the child.child.

Communication TheoryCommunication Theory

• The presenting problem in this approach is concern The presenting problem in this approach is concern with identifying the redundant communication with identifying the redundant communication patterns that serve as the rules that govern patterns that serve as the rules that govern interactions.interactions.

• A primary assumption of this approach is that A primary assumption of this approach is that communication affects behavior, and all behavior, communication affects behavior, and all behavior, including but not limited to speech, is communication.including but not limited to speech, is communication.

Strategies for ChangeStrategies for Change

1. Reframing – offering plausible alternative meaning 1. Reframing – offering plausible alternative meaning to someto some

aspects of the young client’s problem.aspects of the young client’s problem.

2. Restraint from change – go slow to make change.2. Restraint from change – go slow to make change.

3. Positioning – see example, page 142.3. Positioning – see example, page 142.

4. Behavior Prescription – see page 142.4. Behavior Prescription – see page 142.

Problem-SolvingProblem-Solving• Approach developed primarily by Helen Harris Perlman (1957), Approach developed primarily by Helen Harris Perlman (1957),

“4 P’s”.“4 P’s”.

1. Person1. Person

2. Problem2. Problem

3. Place3. Place

4. Problem4. Problem

Steps in the Problem-Solving ProcessSteps in the Problem-Solving Process1. Request for services1. Request for services

2. Identifying the problem2. Identifying the problem

3. Contracting3. Contracting

4. Implementation of the plan4. Implementation of the plan

5. Termination5. Termination

6. Evaluation6. Evaluation

Assumptions and Thinking Assumptions and Thinking Underlying the ApproachUnderlying the Approach

• Learning is problem-solving.Learning is problem-solving.

• Problem-solving is a here and now, reality based way Problem-solving is a here and now, reality based way of helping young people who need assistance.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 Use the power of the helping relationship to motivate the client.the client.

LimitationsLimitations• Not suitable for all clients.Not suitable for all clients.

• Not suitable for all ethnic groups.Not suitable for all ethnic groups.

Existential Social WorkExistential Social Work• For the existentialist, young people discover their own For the existentialist, young people discover their own

uniqueness in the way they relate to the objective experience uniqueness in the way they relate to the objective experience of life.of life.

• Krill (1996) identified five (5) organizing principles of Krill (1996) identified five (5) organizing principles of existentialist philosophy.existentialist philosophy.

1. Disillusionment1. Disillusionment

2. Freedom of choice2. Freedom of choice

3. Meaning in suffering3. Meaning in suffering

4. The necessity of dialogue4. The necessity of dialogue

5. The stance of responsible commitment5. The stance of responsible commitment

• Change can occur by relinquishing defensive beliefs, judgments Change can occur by relinquishing defensive beliefs, judgments and symptoms that interfere with the natural growth process.and symptoms that interfere with the natural growth process.

• A therapeutic task is to help the young client experience A therapeutic task is to help the young client experience disillusionment with security efforts that block growth.disillusionment with security efforts that block growth.

Components of ChangeComponents of Change

• Two (2) components, rational and experiential, are required Two (2) components, rational and experiential, are required for change to occur.for change to occur.

• See page 146 (Krill, 1996).See page 146 (Krill, 1996).

Role TheoryRole Theory• Emphasis on the person-situation configuration.Emphasis on the person-situation configuration.

• PositionsPositions are classifications of persons such as teacher – are classifications of persons such as teacher – father – women – children – social workers.father – women – children – social workers.

• Ascribed positionsAscribed positions are attained through skill or effort (social are attained through skill or effort (social worker, doctor, politician).worker, doctor, politician).

• Rule expectationRule expectation is a set of expectations from generalized is a set of expectations from generalized others.others.

• **Use of role plays.**Use of role plays.

TechniquesTechniques

1. On the spot interviews1. On the spot interviews

2. Mirroring2. Mirroring

3. Sharing3. Sharing

Using Multiple Bodies of TheoryUsing Multiple Bodies of Theory