Depression is a chronic, recurring disorder that impacts children’s academic, interpersonal, and family functioning. The heritability of major depressive disorder (MDD) is likely to be in the range of 31% to 42%. This chapter begins with a brief overview of the etiology of depression. It presents a description of a cognitive behavioral therapy (CBT) intervention designed to be delivered in a group format, an individual interpersonal intervention, and an individual behavioral activation (BA) intervention that includes a great deal of parental involvement. The ACTION program is a manualized program that is based on a cognitive behavioral model of depression. There are four primary treatment components to ACTION: affective education, coping skills training (BA), problem-solving training, and cognitive restructuring. The chapter concludes with a brief discussion of universal therapeutic techniques to be incorporated into work with depressed youth regardless of the therapeutic orientation or treatment strategy.

Asthma, a pulmonary condition, is a chronic respiratory disorder typified by persistent underlying inflammation of tissues, airway obstruction, congestion, hyperresponsive airways, and the narrowing of smooth airway muscle. Asthma is one of the most common chronic medical conditions in children and is the leading cause of school absenteeism. This chapter describes childhood asthma, including its causes and triggers. It elucidates the extant research supporting treatment of the disorder and provides step-by-step empirically based interventions to ameliorate asthmatic symptomatology in children. The psychological underpinnings of asthma have been investigated in the field of psycho-neuroimmunology (PNI), which examines the interplay of the central nervous system, neuroendocrine, and immune system with psychological variables and their relation to physical health. Researchers have shown that relaxation and guided imagery (RGI), written emotional expression, yoga, and mindfulness therapy improve pulmonary lung functioning, decrease rates of absenteeism, and improve overall quality of life.

This chapter presents an overview of the key concepts discussed in the subsequent chapters of this book. The book discusses the linguistic and cultural issues to consider when assessing children and adolescents from diverse backgrounds, with a major focus on immigrants and refugees. It addresses research on the typical developmental trajectory of language and literacy of children and adolescents who must learn in a language that is not the language of their home, and the implications of that research for distinguishing whether their learning difficulties are due to inadequate proficiency in the societal language or due to a learning disability. The book describes the methods for assessing children and adolescents’ oral language proficiency (OLP) in their first and second languages. It then discusses the issues involved and methods for assessing intelligence, academic achievement, and behavioral, social, and emotional functioning.

This chapter provides an orientation to the critical issues, history, trends, policies, programs, and intervention strategies of the juvenile justice system. It reviews the types, functions, and legal responsibilities of the various juvenile justice agencies and institutions. The chapter describes the case flow within the juvenile justice system. It also discusses systems of care in juvenile justice, and specialized assessment and treatment issues with adolescents, including sexually abusive youth. It explores the foundation and groundwork for the study of juvenile delinquency and juvenile justice system while delineating the legal definitions of juvenile status offenses and juvenile delinquency, examining the nine steps in the juvenile justice case-flow process. The chapter also gives attention to systems of care, the link between trauma and delinquency, as well as the assessment and treatment considerations for forensic social workers when addressing the specialized needs of juveniles in the justice system.

Assessment of intelligence and diagnosis of intellectual disability in culturally and linguistically diverse (CLD) children and adolescents are controversial and challenging. This chapter discusses some of these controversial and challenging issues, and describes methods of assessing intelligence in CLD children and adolescents, that is, individuals whose language and cultural backgrounds are significantly different from the normative group of most standardized Intelligence quotient (IQ) tests. It addresses several issues that psychologists need to consider when evaluating intelligence, including developing rapport; fluid and crystallized intelligence; adaptive behavior; using IQ tests to establish IQ/achievement discrepancies to diagnose learning disabilities; and determining when to use formal IQ tests. The chapter then turns to a discussion of the strengths and weaknesses of assessment techniques, including several types of intelligence tests, and offers alternative approaches for evaluating intelligence that can help to overcome some of the difficulties, including modifying test administration, dynamic assessment, and ecological assessment.

This chapter presents an overview of intrapsychic theories, cognitive theories, behavioral and environmental theories, biological theories, and integrative theories. Past ideas about the nature of adolescent development serve as foundations for current adolescent developmental theories. In many ways, the adolescent years are the culmination of childhood; hence, in order to truly understand adolescence a review of what happens in the years leading up to adolescence can help clarify the nature of adolescents. Although the early biological process of puberty begins to develop several years before adolescence, in Freud’s theory puberty and adolescence are considered roughly equivalent. Adolescents experience a reawakening of and an obsession with sexuality. Studies indicate that occurrences of eating disorders, obsessive-compulsive patterns, and self-reports of same-sex attraction surface during the adolescent years as a result of the reawakening of the underlying subconscious conflicts.

Many clinicians and researchers who work with adolescents classify the adolescent problems into two general categories of difficulties: externalizing problems and internalizing problems. Externalizing problems are difficulties that affect the external world of adolescents, such as drug abuse, delinquency, and engaging in risky behaviors. The adolescent who is abusing drugs is likely to also be engaged in risky sexual behaviors and delinquency. The discovery of and experimentation with drugs are common for adolescents and vary primarily from socially acceptable and legal drugs such as caffeine, cigarettes, and alcohol to socially rejected and illegal drugs, ranging from marijuana to heroin and cocaine. Unfortunately, adolescents often do not think that drug abuse is harmful, despite the fact that both alcohol consumption and marijuana use have short-term and long-term negative effects. However, sexuality during adolescence has the potential to become a serious health concern.

This chapter describes the overall health, sleep and diet and nutrition. The importance of focusing on health promotion during adolescence is apparent when considering that close to two-thirds of premature deaths in adulthood can be attributed to unhealthy lifestyle choices made in the adolescent years. The approach adolescents take to their overall physical health is driven by competing cognitive forces producing behaviors that sometimes seem contradictory. Boys tend to exercise more often than girls, and girls are more likely to engage in healthy eating habits in comparison to boys. The adolescent years are an opportunity to develop healthy eating patterns that can carry into adulthood. Family is also important in helping adolescents develop healthy eating patterns. Close to 80% of obese adolescents continue to be obese throughout their adult years, with many of them eventually having to contend with serious health issues such as heart disease, diabetes, and stroke.

This chapter describes Piaget’s formal operational stage, thinking in context, and educating adolescents. According to Piaget, during the formal operations stage adolescents advance in their ability to assess questions in scientific ways. Engaging in hypothetico-deductive reasoning does not just occur when adolescents are trying to solve complex questions about math and science. Adolescents have the ability to manipulate and talk about concepts such as love, the future, and God in very tangible ways. Adolescents develop perspective taking, which is the ability to understand the thoughts, emotions, and behaviors of others. In order for adolescents to be successful at social interactions, in which they will be engaged quite often, they need to understand other people. Adolescents value the ability to make independent decisions and consider this to be an integral part of the transition into adulthood.

Pediatric bipolar disorder (PBD) has been associated with a number of negative behavioral, academic, and interpersonal outcomes for children and adolescents. It initially received a disruptive behavior disorder diagnosis. High rates of comorbid anxiety disorders have also been found in children with PBD. Psychoeducational psychotherapy (PEP) uses a biopsychosocial model and combines family therapy, psychoeducation, and cognitive behavioral therapy (CBT) techniques with the goal of helping families to better understand and manage the symptoms of PBD and coordinate more effective treatment. This chapter focuses on a description of PEP, including three key interventions of this therapeutic approach: Psychoeducation and Motto, Building a Tool Kit, and Thinking-Feeling-Doing. PEP is a manual-based treatment designed for youth with mood disorders and their caregivers, broken down into separate youth and caregiver sessions. Sessions focus primarily on psychoeducation and skills building and are delivered in individual family (IF-PEP) and multiple family formats (MF-PEP).

The content of the obsessions and compulsions varies among individuals with obsessive-compulsive disorder (OCD); however, there are five themes that are commonly experienced across both children and adults: contamination, symmetry/ordering, forbidden or taboo thoughts, harm, and hoarding. Notably, OCD becomes more gender balanced into adolescence and adulthood. Comorbid diagnoses are common among youth with OCD. Common comorbid disorders include anxiety disorders, tic disorders, attention deficit hyperactivity disorder (ADHD), and major depressive disorder. The etiology of OCD is multidetermined with behavioral, cognitive, genetic, and biological factors being implicated. This chapter describes three successful cognitive behavioral therapy (CBT) interventions: CBT with exposure and response prevention (ERP), family-based CBT with ERP, and cognitive therapy interventions that can be used in conjunction with ERP. Treatment guidelines for pediatric OCD suggest the most efficacious treatment is CBT with ERP, either alone or in combination with pharmaco-therapy for the most severe cases.

This chapter reviews the research on expect respect, second step, and the recognize, understand, label, express, and regulate emotions (RULER) program, curricula with outcome data from US schools for step-by-step implementation by mental health professionals in the hopes of ameliorating this serious epidemic and enhancing the academic, behavioral, social, and emotional functioning of children and adolescents. School bullying and peer victimization are pervasive phenomena that affect many youth. Bullying may inflict harm or distress on the targeted youth including physical, psychological, social, or educational harm. Direct bullying is a relatively open aggressive act on the targeted youth, whereas indirect bullying is not directly communicated to the student being targeted. Moreover, physical, verbal, relational, and damage to property have been identified as specific forms or dimensions of bullying. Positive Behavioral Interventions and Supports (PBIS) is an evidence-based framework for reducing a wide variety of problem behavior in school settings.

Many children experience the death of someone close to them before the age of 18 years. This chapter reviews the effects of bereavement on children’s functioning and the risk and protective factors that exacerbate or mitigate grief-related problems. It provides step-by-step instructions for two evidence-based interventions for school-aged children and adolescents. Childhood traumatic grief refers to a condition in which children develop trauma-related symptoms that interfere with their ability to appropriately mourn a death. The Family Bereavement Program (FBP) is a theory-based intervention for parentally bereaved children and their surviving caregivers. The child component focuses on increasing self-esteem, reducing negative appraisals of stressful events, strengthening youths’ relationships with their caregivers, strengthening coping skills, and increasing adaptive emotional expression. The Grief and Trauma Intervention (GTI) is commonly implemented in schools and community-based settings after children’s exposure to a traumatic, violent, or disastrous event.

This chapter discusses methods, procedures, and interventions that have been successful in working with children and adolescents with Traumatic brain injuries (TBI) and/or concussions and for which there is empirical and clinical support. It provides empirically supported treatments that may be implemented in schools and clinics for youths with TBIs. TBIs are insults that occur from an event external to the individual. These can include open or closed head injuries and are often classified as mild, moderate, or severe. The majority of TBIs in childhood are closed head injuries and involve rapid acceleration, deceleration, and/or rotation of the head in space without impact with the skull. The level of severity depends on the physical and cognitive deficits associated with the injury. The Glasgow Coma Scale (GCS) is a commonly used scoring system used to assess the severity of acute brain injury.

Homework completion is viewed as a beneficial contributor to student learning and to the fundamental personal characteristics that underpin student academic behavior. This chapter promotes a greater understanding of the benefits of homework compliance while providing evidence-based expectations for appropriate homework loads, special education use of homework, and best practices in homework compliance management. It provides readers with empirically supported strategies for helping parents and teachers maximize the benefits of student homework completion, while reducing parental and student angst associated with compliance enforcement. The chapter offers an approach to promoting collaboration between school personnel and parents to enhance students’ academic competence using a multifaceted, school-based problem-solving model. Homework serves four primary instructional purposes: practice, preparation, extension, and integration. To augment the retention and learning of classroom material, numerous research-based interventions and strategies have been designed to enhance homework performance in children and adolescents.

Anxiety disorders are the most common mental health conditions to impact school-aged children. A particular diagnostic subtype termed “separation anxiety disorder” accounts for the majority of referrals seen within child and adolescent psychological service delivery systems including schools. The developmental connection between childhood separation anxiety disorder and adolescent/ adult panic disorder has also been well documented in the literature. Associated features of separation anxiety include parent-child dysfunction, school attendance difficulties, and challenges to social functioning. Biological and environmental factors play a role in the development of separation anxiety disorder. Evidence-based interventions for children and adolescents with separation anxiety disorder include cognitive behavioral therapy (CBT), family therapy, pharmacological treatments, or a combination of these biopsychosocial therapies. Parental behaviors and parenting style are associated with increased risk for childhood anxiety, including separation anxiety disorder.

This chapter presents an overview of posttraumatic stress disorder (PTSD) in childhood and adolescence, including how symptoms may present and what factors are associated with risk of developing PTSD. It provides a review of the research literature and a step-by-step guide for practice for two empirically validated treatments for youth PTSD. The symptoms of PTSD are grouped into four clusters: intrusion symptoms, avoidance symptoms, cognition and mood symptoms, and arousal and reactivity symptoms. Trauma-focused cognitive behavioral therapy (TF-CBT) was initially developed to address trauma associated with child sexual abuse and has subsequently been adapted for use with children who have experienced other trauma types. Research indicates that TF-CBT is effective in treating PTSD, depression, and related behavioral problems in children exposed to traumatic events. The chapter provides a step-by-step breakdown of TF-CBT and Prolonged Exposure for Adolescents (PE-A) interventions, including descriptions of core components and standard implementation practices.

Writing is a fundamental communication skill that is important for everyday success. Children and adolescents use written language to communicate their thoughts, ideas, and knowledge to teachers in school; send messages to friends; write papers and reports; and engage in expository writing activities. Writing is an exceptionally complex task composed of multiple processes. Theories of writing development recognize three stages of writing, including planning or prewriting, drafting or composing, and revising or editing phases. This chapter focuses on writing instruction/intervention and student motivation. Effective writing instruction relies on evidence-based instructional approaches for developing and increasing writing skills related to planning, drafting, and revising tasks. In addition, it is important to consider student motivation as a primary reason for students not demonstrating success with written-language tasks. Self-monitoring has been shown to increase students’ academic engagement during writing as well as improve the writing performance of students with learning disabilities.

Perceived quality of life is shaped by internal beliefs and social interactions. There is empirical support for the dual nature of emotions in mental health, both among adults and youth. Although many well-being studies have focused on adults, research over the past two decades has examined subjective well-being (SWB) in school-aged youth. There are empirically validated SWB promotion strategies that warrant attention. This chapter provides an overview of a number of these programs and strategies that have been used to foster youths’ positive SWB, with a particular focus on school-based practices. It describes the benefits of SWB among youth, describes specific domains that have been addressed vis-à-vis SWB promotion strategies and summarizes multicomponent programs and narrowband strategies that have been shown to promote SWB levels. The chapter concludes with a description of the factors to consider when implementing efforts to foster SWB and provides key resources to support these efforts.

Stress is a ubiquitous experience in the lives of children and adolescents, regardless of the schools they attend, their families’ income, or the neighborhood in which they live. There is clear evidence correlating low socioeconomic status (SES) with increases in exposure to violence and other traumatic and stressful experiences. Gender and age also are important factors to consider as related to the amount and type of stress experienced by youth. The three main allo-static systems involved in physiologic reactions to stress include the nervous system, the endocrine system, and the immune system. "Zippy’s Friends" is a school-based mental health promotion and intervention program for younger students in Kindergarten through first grade. The Zippy’s Friends program encourages students to understand their feelings and behavior that facilitates self-reliance and self-confidence. The three strategies of coping skill training, stress management, and mindfulness all show promise for very young children to high school students.

A consensus among professionals and the general population holds that helping children develop healthy self-concepts is a worthwhile goal. This chapter describes how healthy self-concepts are developed naturally and remediated through evidence-based interventions. Interventions for enhancing self-concept require a sound working theory, receptive and informed participants, thoughtful planning, and treatment fidelity. This chapter provides the reader with the theory and methodology to develop positive self-concepts in children and adolescents. There are a number of factors and models of self-concept that describe different factors contributing to self-concept development. The prominent models include cognitive and behavioral orientations, each with related contributing factors. People receive environmental feedback on their behavior or attributes from two feedback modes or perspectives-personal perspective and other perspective. The feedback individuals receive can be evaluated according to four standards include the absolute, comparative, ipsative, and ideal.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists two chronic tic disorder diagnoses, namely, persistent motor or vocal tic disorder (PMVTD) and Tourette’s disorder (TD). Both disorders require symptom onset before age 18 years and require the clinician to rule out alternative causes of tics, including substance abuse and other medical conditions. Tics may be categorized as either simple or complex. Children with tic disorders may be most impaired by comorbid conditions and associated features, including deficient social skills, sleep problems, anxiety and/or depression, obsessive-compulsive disorder (OCD) symptoms, and attention deficit hyperactivity disorder (ADHD) symptoms. A review conducted in 2007 found that only two approaches—habit reversal therapy (HRT) and exposure and response prevention (ERP)-have adequate evidence to treat tic disorders and TD. Tourette’s disorder and other chronic tic disorders are childhood-onset conditions characterized by sudden, involuntary movements or vocalizations.

Elimination disorders in children, including encopresis as well as nocturnal and diurnal enuresis, are common causes of concern for parents. Although these toileting problems are often grouped together when discussing child and adolescent behavioral and health interventions, their etiology, associated complications, and recommended interventions are diverse enough that for the purposes of adequately describing intervention programs for each, this chapter addresses one of the three elimination disorders. Diurnal enuresis, also referred to as “daytime enuresis” or “daytime urinary incontinence”, is characterized by typically involuntary daytime wetting. The prevalence of nocturnal enuresis in children decreases as children grow older. There are two types of nocturnal enuresis: primary and secondary. Toileting difficulties are common concerns of parents of young children. It is fortunate that there are intervention programs based largely on behavioral principles that can be implemented by parents either alone or with guidance from a clinician.

Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that is associated with significant academic and/ or social impairment over time and across settings. Children and adolescents with ADHD are more likely to repeat a grade, to be referred and identified for special education services, suspended, and drop out of school relative to students without disabilities. There is no single risk factor that fully accounts for the development of ADHD. This chapter elucidates the potential causal variables that have been identified, including neurobiological factors, hereditary influences, and environmental toxins. The neurotransmitters, dopamine and norepinephrine, which are especially prevalent in the prefrontal cortex, seem to play a pivotal role in the development of ADHD. Self-monitoring is a commonly used intervention strategy for students with ADHD that is couched within self-regulation interventions. The most effective treatments are central nervous system (CNS)-stimulant medications, behavior modification, academic interventions, and self-regulation strategies.

This chapter presents over 100 interventions using art, drama, music, writing, dance, and movement that school counselors can easily incorporate into their practices with individual students and groups, and in classroom settings. These creative interventions, based on the American School Counselor Association (ASCA) National Model framework, support the key student domains of academic, career, and personal/social development. The chapter provides a wider variety of modalities as well as easy-to-follow step-by-step instructions for each intervention. It focuses on drama-based interventions in the career domain. The career domain activity is designed to be utilized in the working phase of small school counseling groups aimed at career exploration and development with adolescents. Providing a creative atmosphere, this activity encourages adolescents to explore, develop, and articulate career goals during single or multiple group sessions.

This chapter focuses on the unique characteristics presented by three special populations that frequently receive psychotropic medications–children and adolescents, older adults, and women who are pregnant or plan to become pregnant. It is intended to sensitize social work practitioners to the unique considerations frequently encountered with these populations and to highlight the importance of combining medication therapy with counseling when addressing the mental health needs of these special populations. The chapter also provides a sampling of some Diagnostic and Statistical Manual for Mental Disorders (5th ed.; DSM-5) diagnoses frequently identified in children and highlights the medications commonly used to treat the mental disorders. Assessing and determining the medications to use to assist children and adolescents suffering from a mental disorder is never easy. Two conditions that present a particular challenge for prescribers and other members of the collaborative team are attention deficit hyperactivity disorder (ADHD) and conduct-related disorders.

This chapter describes the growing impact of internet addiction on children and adolescents. It focuses on assessment methods that practitioners working with this population can use to measure and assess the behavior. The chapter explains how practitioners can develop their own screening tools of media use for children and adolescents. It outlines comprehensive parenting guidelines based on the developmental age of the child to best integrate technology at home. Issues of screen time impact a child’s moods and feelings. Children and adolescents who suffer from anxiety, especially social anxiety, are more likely to develop an addiction to technology. The chapter describes assessment methods such as Parent–Child Internet Addiction Test (PCIAT), which assists in clinical evaluation of children suspected to suffer from addiction and Problematic and Risky Media Use in Children Checklist. The chapter describes 3–6–9–12 prevention for screen addiction outlining steps parents can take at each child’s age.

The instructions for Resource Development and Installation (RDI) with children/teens need to be adapted in developmentally appropriate language. RDI should only be used when the child/teen does not appear to have adequate tolerance to use eye movement desensitization reprocessing (EMDR) therapy. Bilateral stimulation (BLS) is used to install the resource. The BLS is stopped if the child/teen associates to negative material. The therapist may want to encourage the child/teen to set aside the negative material in an imaginal container before proceeding. In addition, the therapist may choose to use very short sets to decrease the possibility of activating negative material. During trauma-focused EMDR therapy desensitization, the therapist may use previously installed resources as interweaves to address blocked responses to treatment. The therapist should be aware that if he or she chooses to use RDI during desensitization, processing of traumatic material has stopped.

This chapter discusses the modifications of using Eye Movement Desensitization and Reprocessing (EMDR) therapy with preteens and adolescents while staying true to the eight phases. The difference between employing EMDR therapy with adults versus preteens and teens lies primarily in history taking, preparation, pacing of the phases, the therapist’s attunement to the client, and the therapeutic relationship. Many of the clinical decisions and procedural considerations for working with preteens and adolescents occur within the first two phases: the History Taking, Case Conceptualization, and Treatment Planning Phase and the Preparation Phase. In order to guide the EMDR therapy process, gathering a thorough history from both the client and caregiver is necessary. Exploring the client’s positive relationships, including favorite teachers, coaches, and beloved family members, can be used as resources and cognitive interweaves (CI) during EMDR therapy. Pacing refers to the timing of when to apply the various phases of EMDR therapy.

A Cognitive Interweave (CI) is the elicitation of an adaptive perspective by the therapist that is offered when reprocessing is stuck. A therapist can use a CI when the child/teen is looping, when time is running out, or when it is necessary to expedite the session so that the client does not remain in a highly activated state. The therapist introduces new material without relying on the child/teen to provide it. It is a ‘light touch’ to elicit certain information from the child/teen’s Neuronetworks. It is important for the therapist to be familiar with the child/teen’s culture and the current genre of that child/teen’s reality. The therapist uses one or more questions to guide the client to find an answer drawn from the child/teen’s own internal wisdom. The therapist may use Socratic questioning to access the child/teen’s own logic and to resume the child/teen’s own natural processing.

Blocking beliefs questionnaire can be used by therapist to discern the Blocking Beliefs of children and adolescents. It is adapted from questions in Thought Field Therapy and the Blocking Belief Questionnaire. Frequently, therapists are not aware when children and teens are saying things that are actual Blocking Beliefs and are slowing down, looping or preventing processing. The adult statements/Blocking Beliefs are listed first in the questionnaire followed by examples of words that a child/teen might use to express his or her Blocking Beliefs. Children and teenagers often state their issues in more concrete and specific ways than adults. It is the therapist’s job to identify the child/teen’s Blocking Belief and translate it into more generalizable terms. Once therapists have identified possible Blocking Beliefs, the beliefs can be targeted directly with the Assessment Phase and then reprocessed to enable continued processing on previous targets.

With case conceptualization organized through diagnoses specific to infants through adolescents, this chapter explores the advanced application of Eye Movement Desensitization and Reprocessing (EMDR) therapy to other clinical, emotional, developmental, and behavioral issues. The chapter provides an overview of using EMDR therapy when working with children who have symptoms of specific mental health disorders, trauma, stressful life experiences, and educational issues. It also provides information on working with children with sexually reactive or trauma-reactive behaviors. Children with cognitive challenges can benefit immensely from EMDR therapy. In fact, it is one author’s assessment that EMDR therapy is the treatment of choice for children with cognitive challenges because the therapy does not require the client to have advanced verbal skills. Children with attention deficit hyperactivity disorder (ADHD) are potentially challenging in therapy, and it is important for the therapist to be aware of his or her own responses to the child.

This chapter presents simple and practical ways to employ Eye Movement Desensitization Reprocessing (EMDR) therapy scripted protocols and forms to effectively utilize the entire EMDR therapy eight-phased treatment with infants, toddlers, young children, preteens, and teens from a developmental perspective. It addresses the instructions and scripts for the Phases 3 through 8 of EMDR therapy in its entirety including Safe/Calm Place exercises. The chapter provides script for trauma reprocessing phase with children and adolescents. The reprocessing phase involves reviewing stop signal and checking Safe/Calm Place. The chapter also presents suggested procedures for closing down an incomplete session. An incomplete session is one in which a child’s material is still unresolved, that is, he or she is still obviously upset or the Subjective Units of Disturbance (SUD) is more than 1 and the Validity of Cognition (VoC) is less than 6.

This chapter assists the therapist in conceptualizing how to use the eight phases of eye movement desensitization and reprocessing (EMDR) therapy with each age group of children; infants through adolescents. It addresses the developmental stages of each age group and how to apply the phases of EMDR therapy. Then, where appropriate, assessment forms, instructions, and/or scripts are included for children 0 to 6 years of age and preteens and teenagers. Therapists may guide parent involvement by teaching basic parenting skills. As part of the initial phases of EMDR therapy, the therapist integrates standardized infant/toddler assessment processes as recommended by Early Headstart programs. Alternating bilateral stimulation can be taught in many ways using toys. Trauma reprocessing phases with infants through 14 months will most likely need parents as assistants in expressing what may be the child’s traumatic event, emotions, and body sensations.

Children come to psychotherapy for a variety of stressful or traumatic situations that are unique to children. This chapter is designed to help the clinician conceptualize these child-specific situations through all eight phases of Eye Movement Desensitization and Reprocessing (EMDR) therapy. It addresses how to use EMDR therapy with child/teen-specific situations. There are many issues infants, toddlers, children, and adolescents face when their parents divorce. Once the child learns resourcing and containment skills, the therapist can then have the child focus on any anticipatory anxiety about testifying. EMDR therapy works well with infants, toddlers, children, and adolescents in dealing with their sense of loss, safety, power, and control in a divorce situation. An EMDR therapy child/adolescent therapist is encouraged to use and weave together other clinical modalities and techniques within the eight phases of treatment to treat the many common issues that children/teens bring to psychotherapy.

This chapter overviews how to get started with Eye Movement Desensitization and Reprocessing (EMDR) therapy with infants to adolescents. EMDR therapy is an integrative and comprehensive phased treatment. The chapter is organized using the eight phases, such as Preparation Phase, Assessment Phase, Desensitization Phase, Installation Phase, Body Scan Phase, Closure Phase, and Reevaluation Phase, of EMDR therapy as headings. Adaptive Information Processing (AIP) model and the phases of EMDR therapy are the foundation for case conceptualization in treatment. Therapists’ case conceptualization in treating children with EMDR therapy includes integrating information collected from both the parent and child. The therapist’s primary goals are to assess the child’s skills, affect management, and resources. One of the hallmarks of EMDR therapy is learning to use bilateral stimulation (BLS). Children process and communicate through play, so integrating play therapy tools and techniques within EMDR therapy is helpful in conceptualizing the treatment of children.

This chapter presents a case study of a 9-year-old girl whom the author met for weekly counseling sessions over a 4-month period in her private practice. Synthesizing developmental, relational, and systemic perspectives, the author describes her initial presenting concerns related to gender nonconformity, as well as how she conceptualized the patient and her needs within her familial, school, community, and cultural contexts. Additionally, the author describes the creative arts and expressive treatment approach she utilized within a relational-cultural framework, and the outcomes related to the patient’s developing gender identity. The patient’s struggles began with the school’s expectations that students begin changing into gender-specific uniforms for physical education (PE) classes. As a lesbian, gay, bisexual, and transgender (LGBT) affirming counselor with a specialty in working with children and adolescents, the author’s informed consent communicates her validation and affirmation of the full range of gender identities.

Everyone has needs and struggles. Awareness is a key step in assuring that the counselor’s needs and struggles do not negatively impact the children and adolescents with whom they work. A counselor should begin by knowing and acknowledging his or her own personal issues, strengths, and vulnerabilities and how these issues might be presenting in their work as a professional counselor. Self-awareness, support, supervision, boundaries, and self-care are the foundations of a sustainable counseling practice. It is not a sign of strength or quality of character to be able to individually suffer through or manage the stressors inherent in counseling work. In fact, independent or isolated management of stress is a liability. The counselors, who experience both effectiveness and well-being, acknowledge stress and the compassion fatigue that is inherent to this work. They show willingness to look at themselves and get the help they need.

This chapter presents the elements of counseling that can influence self-awareness and growth among children and adolescents. It builds on the basics and offers guidance to enhance counseling effectiveness. Children and adolescents thrive within the context of responsive relationships and these relationships are central to emotional growth. A good counselor balances the child or adolescent’s need for support and the necessity of independence in self-reflection. The fields of motivational interviewing (MI), self-determination theory, and counseling with children and adolescents are filled with specific techniques to encourage growth and change. Accordingly, the chapter highlights key elements of counselor action. Of equal importance, there will be instances in which being present, in absence of action, will create space for the child or adolescent to experience and consequently increase awareness of his or her own self—a critical foundation for growth and change.

During recent decades, ethnic and racial variability has increased greatly in classic immigration countries such as Australia, Aotearoa-New Zealand, Canada, and the United States. In Western Europe as well, immigration from North Africa, Asia, and neighboring European countries has accompanied the economic rise and decrease in birthrates characterizing that part of the world. In all these countries, minority and immigrant groups may include a disproportionate percentage of young people who need to find a place in society while developing complex and evolving forms of identity. This chapter introduces a variety of culturally informed models of identity development that may be useful to social workers, clinical and counseling psychologists, and educators. They may be in a position to support adolescents from a broad range of ethnic, religious, and bicultural groups as well as youth differing in their sexual orientation and gender identity.

Tweens and teens are not overgrown children or immature adults: their brains are distinctly different from both, making them more sensitive to emotional and social factors. This chapter synthesizes information about how these neurobiological changes affect adolescents’ experiences of loss. Loss in adolescence creates the potential for double jeopardy, being both more vulnerable and less willing to indicate a need for help—when faced with grief and loss. This loss can be from a death, a changed relationship, or an experience of social marginalization. The critical task of identity development begins and romantic and other social relationships with peers become the focus. Gender and sexuality orientations become clearer and may lead to marginalization. Adverse childhood events, socioeconomic influences, schooling, and anxiety all affect teens’ ability to cope with losses. Interventions including Learn to BREATHE and Grief-Help are described as helpful for adolescent grief as they incorporate peers and creative outlets.

It is not uncommon for children, adolescents, and families to seek counselors’ services when they are in crisis. Despite a growing literature base in school crisis prevention, intervention, and preparedness, there is a relatively scant literature base addressing mental health crisis intervention for professional counselors. This chapter addresses elements pertinent to crisis intervention, including mandated reporting, and associated trauma or grief. Children understand and process grief and trauma differently based on developmental and cognitive ability levels. Unfortunately, it is not uncommon for children to experience traumatic events before reaching adulthood. As an example, international studies document that child sexual abuse, physical abuse, or domestic violence affects approximately 25% of children. War, natural disasters, motor vehicle accidents, violence, terrorist acts, and refugee experiences can all contribute to trauma reactions. Regrettably, if left untreated, complications associated with unresolved trauma or grief can last well into adulthood.

This chapter details the elements of counseling with children and adolescents that are essential to setting a solid stage for deeper work. It covers the techniques addressing the initial contact and important contextual issues, such as setting up a child- and adolescent-friendly office space. Initial contact sets the stage for the therapeutic alliance. Research has shown that educating clients about counseling improves treatment progress and outcome, attendance, and helps to prevent premature termination. Counseling provides a safe, nonjudgmental space in which clients can self-reflect; identify strengths; experiment with new ideas of self and ways of being; and learn effective emotional regulation, relationship, and life skills. Beginning counseling can be quite stressful for some children and their caregivers, and breaking down barriers is essential. Once relationships are established and counseling is flowing naturally, both the counselor and the client feel more relaxed.

The use of distance counseling (DC) and telemental health (TMH) counseling expanded exponentially during the COVID-19 crisis. On March 13, 2020, President Trump declared a national emergency in the United States due to the COVID-19 pandemic, and by March 30, 256 million Americans were required to stay home. More recently, online learning for K-12 students has emerged to support students who are home-schooled or home-bound. DC has been successfully utilized with children, adolescents, and young adults in a variety of clinical studies and practical applications. They must review a detailed informed consent document with clients/students/parents outlining technology risks and benefits that includes a detailed safety plan or emergency contact plan. As always, counselors must be competent to use technology for DC/TMH interventions, and must assess the competence, preference, access, and ability of the client or student before using distance interventions.

This chapter provides practitioners with a basic outline of considerations and techniques for conducting family therapy. This modality is not individual therapy with a witness, wherein the therapist is central and interacting with one family member at a time. Instead, family therapy is an interactive, active, and provocative experience for both clinician and family members. The chapter outlines reasons for and against using a family modality, followed by basic principles underlying family therapy. It discusses how to get started in family therapy and highlights core intervention strategies that are common across most contemporary approaches. Family therapy is the appropriate choice of treatment for a number of presenting problems, including conflict among family members; difficulties associated with divorce; remarriage of parents; adjustment to illness or death of a family member; and psychological and behavioral problems of children and adolescents.