Tag Archives: Children & Adolescents

Do preteens still play in counseling?

By Mark Loewen December 10, 2015

As a play therapist, I’m used to explaining the ins and outs of play therapy. Because play is a universal concept, most people understand that it is also a child’s “language” and can be used to address many issues in therapy. However, when it comes to preteens, play therapy takes a slight shift.

Whereas children don’t always have the ability to articulate their thoughts and feelings, preteens are becoming more able to hold conversations about important issues. They can still become very uncomfortable, however, if they have to sit across from an adult for a “serious” talk. Plus, by the time most preteens come to counseling, they’ve heard a lot of talking already.

Play is still very important to preteens, although it starts to look a little different. As children mature, activities move away from fantasy play to more structured games. Still, children of this age often feel trapped between childhood and the teen years. In play therapy, preteens often vacillate between play that is more common to younger children and activities that appeal more to teenagers.

At our counseling practice, we often use games and interactive activities to take the pressure off. Preteens enjoy both regular board and card games and also specialized therapeutic games. Games can be used to deal with anxiety, power and control issues, self-esteem, relationships and difficult behaviors. Specialized therapeutic games address topic areas such as depression, anger, anxiety, aggression, life changes, coping skills and much more. Skilled play therapists can use almost any game to address difficult issues with children and teenagers.

Preteens are also developing creative skills. They are moving into using abstract thought as life opens up to endless possibilities. Expressive arts are a great tool to address new thoughts and feelings. Using specific art materials, clients build, sculpt or draw to represent their struggles and find alternative solutions.

Preteens also enjoy using the sand tray and an array of miniatures to represent their “worlds.” Using miniatures provides a feel that is similar to setting up toys. At the same time, the child is using these

Image via Wikimedia Commons

Image via Wikimedia Commons

miniatures with a few guidelines that make the activity feel challenging. Sand tray therapy is a great way to allow kids in early adolescence to work through their issues without feeling pressured or judged.

Additionally, interactive activities can be used to teach mindfulness meditation skills. By learning to direct their breathing and use creative imagery, kids become more aware of their feelings and what’s behind them. By recognizing intense emotions, they are better able to control them and listen to what these feelings are trying to say to them.

In conclusion, preteens are balancing child’s play and teen activities. Given enough freedom, children of this age group may allow themselves to delve into pretend play, dressing up or other activities that are more typical for younger children. On the other hand, they also like the challenge of activities that are considered to be more grown-up. Maintaining this balance requires their counselors to maintain a great level of flexibility and a nonjudgmental attitude. As a result, preteens will know that counseling is a place where they can use any of their internal resources at any time to address any issue at hand.

 

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Mark Loewen is a licensed professional counselor, registered play therapist and parent coach in Richmond, Virginia. He is the owner of LaunchPad Counseling (launchpadcounseling.com), a practice that helps children, teens and parents cultivate their inner resources to overcome stressful circumstances. Contact him at mark@launchpadcounseling.com.

 

Parent-child relationship problems: Treatment tools for rectification counseling

By Monika Logan December 8, 2015

As counselors, we come in contact with clients who are angry or heartbroken and oftentimes feel defeated. This sense of pain and loss is frequently realized in the forensic setting in which I work with parents who are desperate to rebuild a parent-child relationship that is severely damaged or estranged. I also work with children who assert that they never want to see or speak with one of their parents again.

SadKidThese are not parents who have abused or neglected their children. They are parents who previously had what would be characterized as a good relationship with their children — until the time of a separation or divorce. I have worked with families in which the conflict has continued for longer than 10 years prior to therapy.

It should be noted that many people in the helping professions refer to this troubled parent-child relationship as “parental alienation.” Through the years, various nomenclatures have been applied in an attempt to give this pathological post-divorce phenomenon a name. But even as we settle on what to call it, we must help these children and the counselors who work with them.

Most counselors working with children or families have witnessed this dynamic to varying degrees. There are ample articles on child alienation, yet many counselors remain conflicted about how to effectively treat these troubled parent-child relationships.

I’ll provide a case example. “Sarah” contacted me and said she had been divorced for 15 years. She told me she had been happily remarried for five years, held a doctorate degree in mathematics and was employed as a full-time professor. But she indicated she had a damaged relationship with her 15-year-old daughter, “Julie.”

In chronicling her story in my office, Sarah vacillated between sobbing and seething with anger. She said that when Julie spent time with her biological father, “Michael,” that he undermined Sarah’s parenting boundaries, spoiled Julie and used every opportunity to denigrate Sarah. Sarah went on to say that she was worried because Julie was disregarding curfews and skipping classes, had been in trouble with the juvenile court system and had recently been caught smoking marijuana.

When I contacted Michael, he presented with a jovial disposition. He stated he was engaged to be married and was employed as a plumber. He initially appeared supportive of his daughter. Although he said he didn’t see any reason that Julie might need therapy, he indicated that he wasn’t opposed.

When Julie’s therapy sessions began, she insisted that she loathed her mother because Sarah was unreasonable. Julie stated that her mother grounded her for “trivial” reasons such as skipping school and smoking marijuana. When discussing her father’s approach to parenting, Julie described Michael as a superb parent because he did not stoop to “ruining” her life. In addition, Julie mentioned that her father was planning on buying her a car. She stated that her father would talk with her and not carry out “ridiculous, over-the-top consequences for trivial, normal teenage mishaps.”

 

Treatment tips

Step one: The first step is to ask yourself if you possess the skills and advanced training to work with families engaged in transition and ongoing conflict. If not, that is OK. This is a good time to seek referrals from colleagues who are comfortable with court-connected work.

Step two: When working with parents who are separated, divorced or are in the middle of a child-custody evaluation, counselors should request a copy of the court orders prior to starting treatment with their children. Counselors should be aware that some parents “therapist shop” and are actively looking for a counselor who will tell them what they want to hear, not necessarily what is helpful. Some potential clients are searching for a counselor to align with them and join in with them about how awful their ex-spouse is. Counselors should keep in mind that failure to contact the child’s other parent may introduce a host of issues (for example, board complaints), especially if the parent seeking treatment for the child does not have the right to do so per court order. Also make certain to obtain all necessary releases before conversing with any previous counselors who have worked with the family members.

Step three: Counselors working with parents who are irrationally rejected by their children need to be well-versed in the literature. Failing to recognize and treat alienated children and their parents prolongs emotional damage for the child and can harm the entire family system.

Step four: As a counselor, you must know who the client is. Are you working with the child, the child and the parent(s), or one/both of the parents? It is vital to understand how the client ended up in your office. Additionally, your role must be clear. Are you working as a court-appointed counselor or a court-involved counselor? Recognize that in cases of child alienation, other parties — such as other counselors, attorneys or parenting coordinators — are often involved.

Step five: Know your definitions, but do not diminish your clients by labeling them. When conversing with other professionals, it is acceptable to refer to the parent to whom the child aligns as the “favored” parent. The “rejected” parent (or “target” parent) is the parent whom the child rejects or refuses to spend time with. When working with the courts, and depending on their jurisdiction, counselors may want to use behavioral descriptions, not diagnostic labels.

Counselors should remember to focus on behaviors that can be described. Although it is acceptable to discuss the concept of triangulation, gatekeeping, pathological alignment or irrational alienation with your colleagues, it is not helpful to use these terms with clients.

Step six: Do not diagnose if you have not actually met the client or witnessed the parent-child interactions. For instance, if one parent seeks your services and reports that the other parent is alienating the child and is a narcissist and/or borderline, you cannot diagnose that other parent as borderline because you have not met with or witnessed that parent.

 

Therapeutic fallacies

Richard Warshak is a world-renowned expert on parental alienation. He has written countless peer-reviewed publications on custody disputes, divorce, alienated children and stepfamilies, and has developed educational materials. Warshak recently provided strategies that can guide counselors in working with this difficult parent-child dynamic. According to a study he published earlier this year (see http://psycnet.apa.org/psycinfo/2015-27699-001/), several fallacies can compromise the therapeutic process.

  • Children never unreasonably reject the parent with whom they spend the most time. The first fallacy counselors should recognize is that more time does not necessarily equal quality time. Using rapid clinical judgment, it is easy to conclude that a child identifies with the parent whom he or she sees the most. If counselors do not recognize this fallacy, they may determine that the parent must have done something that warranted poor treatment by the child. This line of thinking contributes to additional emotional distress. In turn, under this assumption, counselors can go on the lookout for flaws within the rejected parent to substantiate their beliefs. Counselors should be aware that when a child spends time with the nonresidential parent, that parent could be using that limited time to teach the child to disrespect and disobey the custodial parent. To offset this fallacy, counselors must stop thinking in unidimensional terms.
  • Children never unreasonably reject mothers. According to Warshak’s study, “Those who believe mothers cannot be the victims of their children’s irrational rejection are predisposed to believe that children who reject their mothers have good reason for doing so.” He advises that counselors should keep an open mind about both parents and consider that mothers may be rejected without good reason.
  • Each parent contributes equally to a child’s alienation. Counselors should not generalize that both parents are always equally at fault for a child’s alienation. Counselors would not place equal blame for intimate partner violence on the victim. Likewise, it is not helpful to equally blame both parents for a child’s unwarranted rejection when one parent may be instigating the child’s actions and attitudes.

One bias that comes into play is repetition bias. Those working in the field are permeated with the term “high conflict” and may deem that parental alienation is synonymous with that term. As described by Warshak, the term high conflict “implies joint responsibility for generating conflict.”

In my practice, I developed a nuanced view. There are times when both parents contribute to and could benefit from parenting education or family therapy. However, in the case of Sarah and Michael, Michael openly defied the court’s orders, ultimately refusing to let Sarah spend time with their daughter. He also denigrated Sarah in front of the child. I would not be practicing the concept of “non-maleficence” when working with Sarah if I were to suggest that she was at fault. Demanding more of Sarah and blaming her only adds insult to injury.

As Warshak points out, “When the rejected parent’s behavior is inaccurately assumed to be a major factor in the children’s alienation, therapy proceeds in unproductive directions.” At this point, counselors may wonder, “What am I to do?” A counselor should remain neutral and avoid making unwarranted assumptions.

  • Alienation is a child’s transient, short-lived response to the parents’ separation. This fallacy is damaging because child alienation may be deemed to be a normal byproduct of divorce that will resolve on its own. Prior to going into private practice, I co-led a support group for adults who had lost all contact with their children. These cases were not due to a background of abuse or neglect; instead, many involved a contentious divorce.

Unfortunately, some counselors espouse the notion that the child should decide when to see the rejected parent and suggest that over time, the child will come around. In some cases, the child may re-establish a relationship with the parent. However, not all children reconnect. And even if they do, parents cannot reclaim lost time.

Counselors understand that they should practice within the scope of their license. In many states, counselors are prohibited from making access or possession determinations. Counselors do not have the right to supersede a court order and tell an alienated child that he or she does not have to spend time with the rejected parent. Again, it is necessary to obtain a copy of the client’s current court orders prior to starting counseling.

Another practice tip is that counselors should encourage the parent who is the target of unwarranted rejection to remain in constant contact with his or her children. Counselors can also aid parents in knowing and understanding the stages of development and helping parents to formulate proper responses to a child’s verbal insults.

  • Rejecting a parent is a healthy short-term coping mechanism. Counselors can identify this fallacy by reflecting on common biases, many which are covered in counseling programs. Counselors must be cautious about the bias of wishful thinking because it provides a false hope to clients. As Warshak (2015) explains, “Counselors who believe that rejection of a parent is a healthy adaptation encourage parents to accept the children’s negativity until the children feel ready to discard it.” He goes on to say that “this is especially true when therapists assume that the alienation is destined to be short-lived.” Although we have specialized training as counselors, it is important to remember that we cannot predict future outcomes.

Another way to think about parental rejection is to consider whether the parents would ignore their child refusing to speak to one of the parents if the whole family still resided together. Understandably, most would find this unacceptable.

  • Alienated adolescents’ stated preferences should dominate decisions. This fallacy can be offset by using analytical thinking and a basic understanding of brain development. Many adolescents know more about adult matters than we would want them to know. Regardless, adolescents are not adults and should not make adult decisions. Adolescents are prone to peer pressure and are in the process of discovering their identity. Most adults cannot imagine asking if an adolescent would like to attend school. As Warshak writes, “Adolescents’ vulnerability to external influence is why parents are wise to worry about the company their teenagers keep.”

Counselors can help rejected parents to not personalize it when a teenager has a soccer game and prefers to forego parent-child time. Or when working with a favored parent who claims the child does not enjoy time with the target parent, counselors can point out that some adolescents do not enjoy their homework, but they are expected to do it anyway.

 

Treatment goals and tips

When working with the child:

  • Promote a healthy relationship with both parents.
  • Help the child to correct cognitive distortions.
  • Work with the child to maintain a balanced view of both parents.
  • Improve the child’s critical thinking skills.
  • Recognize when a child’s behavior is incongruent from one setting to the next.
  • Augment the child’s coping skills.

When working with the rejected parent:

  • Recognize that the parent may feel misunderstood.
  • Work with the parent not to counter-reject the child.
  • Be aware of avoidance and passivity; the parent may want to escape the poor treatment of the ex-spouse and the child by avoiding the problem altogether.

When working with the favored parent:

  • Recognize there may be a role reversal. The child may be meeting the emotional needs of the parent. Help the parent recognize his or her role as a parent and encourage the parent to engage in adult relationships to find emotional support.
  • Keep an eye open for enmeshment. What might initially appear as a healthy parent-child relationship could be extremely unhealthy. For instance, there may be a lack of community or family support.
  • Recognize that children generally benefit from the involvement of parents, absence abuse or neglect. Realize that some rejected parents may have personality disorders and continue to instigate court hearings or defy court orders.

 

The do’s and don’ts

• Do not recommend a change in custody if one parent is behaving badly. Custody reversal may be necessary in some cases, but it is not the role of the counselor to make that determination.

• Do not align with one parent over the other.

• Do cooperate with parenting coordinators and the courts.

• Do recognize that parents in litigation are likely to be working toward an adult-oriented outcome — namely to prevail in court.

• Do consider a variety of explanations when working with a child or teenager who irrationally rejects a parent.

• Do not discard information that is inconsistent with the counselor’s viewpoint.

 

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Monika Logan is a licensed professional counselor living in Dallas who specializes in troubled parent-child relationships and sexual behavior problems. In addition to maintaining a private practice and doing court-connected work, she recently developed a program to help youth in the criminal justice system maintain boundaries both offline and online and stay connected with their families. Contact her at mlogan@texaspcs.org.

 

Behind the Book: Solution-Focused Counseling in Schools

By Bethany Bray November 2, 2015

One of the many reasons solution-focused counseling is a good fit for school settings is because it’s a client-directed approach, says John Murphy, a longtime school psychologist and author of Solution-Focused Counseling in Schools.

School counselors often find the bulk of their time consumed with noncounseling tasks. When they Branding-Box-Solutionare able to meet with a student, using a solution-focused approach provides a customizable way to forge a therapeutic bond with the young person in a short amount of time.

“The simple and practical premise of solution-focused counseling – find what works and do more of it – is one of its most appealing features for school practitioners,” Murphy writes in the book’s conclusion. “This does not mean, however, that it is easy to do. Solution-focused work requires careful attention to language, client feedback, relationship building and other therapeutic nuances and skills. Mastery of these skills requires patience and practice. If your experience is anything like mine, however, it is well worth the effort.”

Solution-Focused Counseling in Schools was originally released in 1997; the American Counseling Association published a third edition of Murphy’s book earlier this year.

 

Q+A: John Murphy on Solution-Focused Counseling in Schools

In the book’s introduction, you write “schools are not set up to accommodate counseling.” Can you elaborate on what you mean by that?

This is not a criticism, merely an observation that the main purpose of schools is to teach reading, writing, math and other important academic skills. Unlike mental health centers and private practice settings where counseling is the main focus and the physical setting reflects that focus, school settings present some unique challenges for counselors.

These challenges include working around students’ and teachers’ busy class schedules, safeguarding client confidentiality and conducting “counseling sessions” whenever and wherever you can — in the lunchroom, on the playground, talking with a parent by phone or walking alongside a student or teacher in the hallway. This requires a lot of flexibility on the part of school practitioners.

But let’s not forget that there are advantages to school-based counseling as well. In addition to offering instant access to students and teachers, schools provide a natural and familiar setting for students and parents who might otherwise have to leave their community and travel long distances to receive services. For these reasons, and the fact that we know more than we ever have about helping people change, I ended the new edition of Solution-Focused Counseling in Schools by stating that there has never been a better time to be a school-based counselor.

 

From your perspective, what makes a solution-focused approach effective in helping elementary through high school students? How is it a “good fit”?

For starters, solution-focused counseling (SFC) is a clear and practical approach that makes sense to students, caregivers and counselors. Research tells us that people are more likely to benefit from counseling approaches that make sense to them, that respect their input and goals, and that customize counseling to them rather than requiring them to conform to the counselor’s preferred methods. SFC meets all of these criteria, which explains why it is effective with students of all ages.

Although solution-focused counselors validate problem-related experiences and struggles, they gently invite students to take action instead of spending a lot of time analyzing the problem. The “less talk, more action” nature of SFC seems to appeal to students as well as school counselors, who have very little time to do counseling in the first place.

Another reason SFC works with students is because it grabs their attention as “something different” rather than more of the same. Most students with school problems are well accustomed to problem-focused conversations with adults. These well-intentioned conversations emphasize what is wrong with students, with little or no attention to what they are doing well, which may include coping with a problem or preventing it from getting worse. In contrast, solution-focused conversations seek out students’ strengths and resources and explore how these assets could be applied toward solutions. In my experience, conversations that recognize and build on what is right and working with students engage their participation more effectively than “more of the same,” problem-saturated discussions.

The solution-focused approach fits with school counselors as well. In teaching classes and workshops throughout the U.S. and overseas, counselors often tell me that the solution-focused emphasis on “doing what works” as quickly as possible is more practical than cumbersome, time-consuming approaches that don’t fit well for schools and school problems. Building on students’ strengths also appeals to counselors’ desire to empower, energize and encourage people. The fact that solution-focused counseling accommodates a variety of cultural backgrounds and life experiences is another important feature in today’s increasingly diverse world. Most people, including myself, signed up for this business to lift people up, and SFC fits nicely with this goal.

 

What prompted you to do a third edition of this book? What’s new and different in this edition?

Though many of the basic ideas and techniques of SFC have been carried over from previous editions, several aspects of my approach to SFC have changed since the previously published second edition in 2008. Research continues to clarify specific elements of effective counseling, all of which are incorporated into the new edition of Solution-Focused Counseling in Schools. These elements include the importance of building a strong counselor-client alliance and of collecting ongoing client feedback.

The third edition has new chapters on topics such as the restrictive influence of problems and practical strategies for developing “goals that matter,” as well as additional practice exercises at the end of each chapter and a widely expanded chapter on innovative ways to use solution-focused strategies in group counseling, classroom teaching, peer helping programs, parent education, consultation with parents and teachers, systems-level change and referral forms. I also included new appendices with examples of solution-focused checklists and referral forms, therapeutic letters to students of all ages, scripts for introducing client feedback tools and handy crib sheets for conducting SFC sessions.

 

What is a main takeaway you want counselors of all types, including nonschool counselors, to know about the importance of solution-focused counseling in school settings?

The main takeaway is that the ideas and techniques in this book are “value added.” A value-added technique adds value and impact to whatever it is combined with, making everything else you do with clients more effective. Examples of value-added techniques include obtaining client feedback, giving compliments, validating students’ experiences and exploring exceptions to the problem.

The beauty of these techniques is that there are no risks or downsides to using them. The worst thing that can happen is that the person does not respond and nothing changes, at which point you simply move on to something else. Even then, value-added techniques can enhance the alliance by conveying respect for people’s input, wisdom and capability. The bottom line is this: You can use the techniques in this book regardless of your theoretical orientation and regardless of whether or not you consider yourself a solution-focused practitioner.

 

You were a public school teacher and school psychologist for many years. How have you seen the role of school counselor/psychologist change since then?

I haven’t seen much of a change in the roles of most school counselors or school psychologists, especially when it comes to the small amount of time they spend in intervention-related activities such as individual and group counseling, parent/teacher consultation and schoolwide prevention/intervention programs. I am not criticizing the professionals who fill these roles, many of whom would like to spend more time on such activities. School counselors and psychologists often tell me that they are pulled in so many different directions and saddled with certain responsibilities that leave little time for counseling and other intervention-related services. Unfortunately, the situation will not change in a big way if schools continue to rely exclusively on outside professionals and agencies to provide the bulk of school-based counseling and intervention services.

 

What advice would you give to a new professional who is starting a career as a school counselor?

Find ways to stay active, involved and hopeful about your profession and the people you serve. Effective practitioners are continually engaged in professional learning and development. They also find ways to sustain their hope in the midst of the ongoing problems and challenges they face on a daily basis. I would also advise them to make sure that their job description and role includes sufficient time for counseling and intervention activities.

 

Besides your book, what resources would you recommend for school counselors who would like to learn more about solution-focused counseling?

There are many more resources on solution-focused counseling with young people and schools than there were when I wrote the book’s first edition almost 25 years ago. An Internet search of “solution-focused counseling in schools” will yield various articles and chapters. The Solution-Focused Brief Therapy Association’s website (sfbta.org) contains general information about SFBT. I also maintain a website on solution-focused and strengths-based practices in schools that has a variety of links and additional information about solution-focused practice in schools, workshop offerings on the topic and other related topics (drjohnmurphy.com).

 

 

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Solution-Focused Counseling in Schools is available from the American Counseling Association bookstore at counseling.org/publications/bookstore or by calling 800-422-2648 x 222

 

For more insights from Murphy, see these downloadable VISTAS articles from ACA:

Solution-Focused Counseling in Schools

Building School Solutions From Students Natural Resources

Student-Driven Interviewing Practical Strategies for Involving Students in School Solutions

 

Also, see ACA’s podcast with Murphy on solution-focused school counseling: bit.ly/1OSO26v

 

 

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About the author

John J. Murphy is a licensed psychologist and professor of psychology and counseling at the University of Central Arkansas. Previously, he was a public school teacher and school psychologist.

 

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday

 

 

Stuck in the middle

By Ann M. Ordway and Ruth O. Moore October 21, 2015

Licensed professional counselors are increasingly becoming involved in court proceedings relative to their work with families involved in high-conflict divorce, separation and custody litigation. Counseling professionals can serve in a variety of roles when working with families embroiled in divorce litigation. For example, a counselor might develop a therapeutic relationship with an individual family member, a couple or the entire family unit. These roles are typically kept distinctly separate. However, when working with high-conflict families, such roles can become easily blurred. Thus, Child-Custody_brandingcounselors can be unexpectedly swept into litigation because of misinformation, hidden agendas, the expansion of what started as a fairly simple role or even a lack of knowledge about court terminology and procedures (such as not recognizing when counselors are required to release information to the court and when they are not).

Counselors must be proactive and engage in cautious practice when interacting with high-conflict families and with court professionals. We offer counselors 10 simple guidelines to follow.

1) Be aware of ulterior motives. There is no question that individuals going through separation or divorce appropriately turn to counselors for support and guidance to get through one of life’s most challenging psychosocial events. But the possibility also exists that attorneys will refer clients to counseling for other reasons. For example, if a couple is involved in custody litigation, an attorney might refer a client to a counselor to document the client’s version of events or to set the stage for later seeking an opinion from the counselor about the client’s mental health status or ability to function as a parent. There may also be times when attorneys direct clients to bring their children to counseling in hopes of later soliciting a supporting opinion from the counselor regarding the individual’s abilities as a parent.

A counselor needs to be clear at the onset of the therapeutic relationship about why the client is there, what the client expects, what the counselor can and cannot do and whether the referral is from the client’s attorney for a specific reason. It is critical for the counselor to also know who the identified client is.

Counselors can certainly work with clients to enhance their coping skills and to effect change. If a client has a history of substance abuse, for example, proactive and voluntary involvement in counseling can demonstrate that client’s interest in and willingness to tackle a problem before being ordered to do so by a judge. Participation in counseling can also indicate effort and bolster a court’s impression that the client’s problem is under control.

However, it is important that counselors not be used to perpetuate a false impression for court purposes. Counselors cannot control the sincerity of a client’s motive, but we do not want to be complacent in a ruse to gain an advantage in court.

2) Know your role and avoid dual relationships/multiple roles. A counselor in a therapeutic role provides support for clients and empowers them to build on their existing strengths and make positive changes. In contrast, an evaluator gathers information from multiple angles and sources for the express purpose of rendering a report and recommendations to the court.

Counselors can certainly opine about the condition and progress of the client. However, counselors should not opine about the condition, progress or functionality of individuals they have not met or for whom they have limited information.

Sometimes the client, or an attorney, will ask the treating counselor to offer an opinion about specific issues such as parental fitness, abuse or domestic violence. The counselor must offer recommendations and opinions that are consistent with the counselor’s role and competency. For example, it might be fine to say that the client presents with symptoms consistent with someone who has been a victim of domestic violence. But if the counselor’s information is limited only to what the client has told the counselor, it would not be prudent to comment on the propensity of the client’s partner toward violence. Similarly, it would not be prudent to repeat the client’s statements as fact if the counselor was not present for the described events.

3) Be familiar with ethical codes, legal statutes and best practices. The 2014 ACA Code of Ethics specifically addresses issues such as informed consent and confidentiality, dual relationships, multiple roles and identifying the client. When in doubt about a situation, counselors need to always consult the ACA Code of Ethics and avail themselves of the ethical consultations made available through the American Counseling Association (call 800.347.6647 ext. 314 or email ethics@counseling.org).

It is also in the best interest of counselors to be familiar with their state laws and regulations. Some state laws include nuances that more clearly define when confidentiality must be broken, such as in cases of child abuse and neglect.

Counselors must also refrain from offering legal advice to clients, while at the same time remaining aware of laws in their jurisdictions so they can avoid guiding clients down the wrong path. Counselors should refer clients to attorneys when legal advice is needed and in the client’s best interest. One counselor encountered serious legal problems and a licensing board complaint when she suggested that a client, whom the counselor believed to be a victim of domestic violence, take the children and relocate to another country where the client’s family lived. States have specific laws regarding the removal of children from the jurisdiction. Removal of children without the permission of the court or consent from the other parent can result in criminal charges against the removing parent and a loss of custody.

4) Obtain consent and document all contact. Counselors should obtain copies of any documentation regarding custody and visitation when a separation or divorce is involved. Counselors need to ask for the most current copy of the court order and document that the copy is represented to be the most current copy. A counselor’s informed consent document should outline the expectation that all modified and updated court orders will be provided as they occur.

When there is no official documentation, counselors must keep detailed records about what they were told and by whom. Counselors working with children in divorce situations should seek consent and input from both parents whenever possible. When this is not possible, the reasons should be documented. Sometimes a court order will grant one parent sole custody of the children or sole decision-making authority. Other times one parent may state that the other parent isn’t involved because of estrangement or death. Client records need to reflect what the presenting parent has told the counselor so that the counselor will have a reasonable basis for proceeding if another parent surfaces and objects.

5) Offer support, not re-entrenchment. From a humanistic perspective, the therapeutic alliance is built upon support and unconditional positive regard for the client. However, in cases of high-conflict separation or divorce, there can be a fine line between the position that the client is 100 percent right and the estranged spouse is 100 percent wrong.

It can be difficult for two people to settle the economic and custody-based differences in their legal case when one person is cemented into a faulty belief system of entitlement or stuck in a position rooted in principle. Settlements result from the art of compromise, and positions based on principles can be expensive. In other words, clients are sometimes so concerned with winning a point that they lose sight of the big picture and end up jeopardizing more important elements of the case. Counselors sometimes do their clients a disservice by being so supportive of the client’s position that the client cannot move forward realistically through a legal system that is often more concrete in the application of the law.

6) Maintain neutrality where appropriate. This guideline pertains mostly to counselors working with children. It is easy to become invested in the parent whom the counselor sees or talks to most frequently. Hearing only one side of the story can absolutely affect the counselor’s view of the child’s experience, especially when the child has limited verbal or cognitive abilities, is not emotionally insightful or is not detail oriented.

Counselors should start with the understanding that children generally fare much better in divorce situations when they are not caught in the middle. Counselors serve the child well by supporting his or her relationship with both parents, unless there is a clear risk of harm to the child. Counselors can refer family members in need of support to other professionals to avoid conflicts of interest.

7) Do not offer an opinion of someone you have never met. It isn’t uncommon for a lawyer to ask a child’s counselor to render an opinion and recommendations regarding custody of the child or for a client’s counselor to opine regarding parental fitness and ability. However, the counselor should stick exclusively to what the counselor knows.

It is OK to speak about the counselor’s own client — with the client’s permission — to include what that client has reported, the consistency of words and affect, and impressions regarding that client. It is not wise, however, to offer comment on a parent whom the counselor has never met. Such comments would be based exclusively on what the parent who is a client has reported to the counselor. It is acceptable to state, “The client reported that her husband hit her,” but it is not advisable for the counselor to state, “Mr. Jones is an abusive man who is violent in his relationships. He should not be trusted to have custody of his son.”

8) Do not assume you can avoid court involvement. Some counselors think they can avoid court involvement by adding one or two phrases to their informed consent documents stating that they refuse to participate in court proceedings. Although there might be an argument that the client agreed to waive any right to call the counselor as a witness, a subpoena can trump that agreement. In other words, if an attorney subpoenas a counselor, the counselor will likely have to appear for a deposition or for a hearing.

The counselor can seek to have the subpoena quashed and should not release any clinical information until it is determined that the subpoena is valid and will be upheld. Best practices suggest that the counselor obtain consent from the counselor’s own client or an authorization to release information. However, even without that consent or waiver, the counselor may have to provide records or even testify.

Avoiding court begins the moment the client walks in the door. Informed consent and documentation are essential. Counselors should be trained in courtroom dynamics, testimony and legal and ethical issues even when it is the counselor’s preference to not go to court. Such measures, including ongoing communication with the client, can decrease the likelihood of having to participate in court proceedings.

9) Consult with your state licensing board, malpractice insurance carrier or attorney when necessary. If subpoenaed, consulting with an attorney before releasing records or providing testimony is wise. It is helpful for any counselor whose practice involves working with high-conflict families to have an attorney available for prompt consultation if necessary.

An attorney can review documents and guide the counselor regarding the process for balancing ethical responsibility and court involvement. Sometimes subpoenas can be quashed or suppressed. Some counselors make the mistake of responding to a threatening letter from legal counsel suggesting that the counselor must immediately make all records available. An attorney will know if the request or demand is valid in the counselor’s jurisdiction and can guide the counselor away from any ethical pitfalls associated with an incorrect response or the premature release of confidential records. Under no circumstance, however, should a subpoena simply be ignored.

10) Choose your words carefully. Wording can be everything. When asked for a report or an opinion, the counselor should confine his or her response to that which the counselor knows. Counselors should avoid supposition and assumption. It is acceptable to say, “My client stated …,” but it is not acceptable to respond as if the counselor was present or witnessed the event unless that is the case.

Simple wording can make a difference in how the counselor’s opinions or recommendations are received. When asked a question by an attorney, the counselor should listen to the question, think about it and then offer an answer that is responsive without providing more information than was requested.

Credibility is critical, and it is the counselor’s reputation (as well as the best interests of the client) on the line when the counselor renders an opinion or makes recommendations. The counselor must be able to support recommendations and opinions with facts, best practices and empirical evidence.

Conclusion

Counseling high-conflict families going through separation or divorce can present a slippery slope. The work is extremely important for the family unit and its individual members because they are dealing with an extremely challenging life event. However, cases involving the courts are stressful in even the simplest of cases. Many counselors prefer to maintain a supportive role and do not wish to do forensic (court-related) work. However, they can easily be maneuvered into the role of witness regardless of their efforts to avoid that position.

The guidelines provided in this article do not represent an exhaustive list of the professional and ethical responsibilities of counselors involved with high-conflict divorce cases. However, following these guidelines can help counselors maintain credibility, be more mindful of potential legal and ethical obligations and provide the client or family with needed emotional support. The guidelines should also remind counselors of the importance of receiving training for work with this population.

 

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Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Ann M. Ordway has been an attorney for 25 years and practiced in family court for many years before entering the counseling profession. She is completing her doctorate in counselor education and supervision through Walden University. She is a distance clinical professor in the Department of Counseling and Special Populations at Lamar University in Beaumont, Texas. Contact her at aordway@lamar.edu.

Ruth O. Moore is a licensed professional counselor and national certified counselor who is a distance clinical professor at Lamar University. She has extensive experience in expert witness testimony and has published and presented widely on court process in child abuse and child custody cases. Contact her at rmoore@lamar.edu.

Letters to the editorct@counseling.org

 

Where’s Waldo? A creative tool to introduce CBT skills

By Brandon Ballantyne October 13, 2015

Regardless of how old I get, there are certain childhood activities, toys and outlets that continue to bring me positive memories and feelings. One of my fondest activities from childhood involved Where’s Waldo?

The Where’s Waldo? series was created by Martin Handford. In the books, the reader is invited to scramble and search through pages and pages of chaos and busy illustration in attempt to locate and find the main character, Waldo. Waldo is typically dressed in a red-and-white-striped hat and

"Where's Waldo" image via Flickr creative commons http://bit.ly/1NBXHy9

“Where’s Waldo” image via Flickr creative commons http://bit.ly/1NBXHy9

shirt. However, there are many lookalikes on each page, so attention to detail is very important for the reader.

As a licensed professional counselor who works with adolescents, I find it important to incorporate a certain level of creativity into the process of helping clients build coping skills. I have been strongly trained in the area of cognitive behavior therapy (CBT), so I commonly introduce interventions and skills associated with thought logs and coping thoughts.

With adolescents, I find that providing a basic understanding of CBT is effective in most cases. I typically introduce the theory of CBT as a relationship between thoughts and feelings. I provide education on the way in which thoughts directly influence feelings and establish a foundation of awareness that we can achieve more desirable feelings if we can find ways to change thoughts.

With this basic description of CBT in mind, the intervention of a thought log can be very effective in helping adolescents to practice “catching” negative thoughts, identifying the immediate emotions and then “inserting” coping thoughts to challenge the negative self-talk, thus leading to more desirable emotions and more effective problem-solving of the situation at hand.

I introduce a thought log to my adolescent clients as a type of journal. They can use it to sit down for a given period of time or while in the presence of an external event to actively practice recording negative self-talk/thoughts and any associated emotions that arise as a result of those thoughts. Next the client will identify and record an associated coping thought/positive affirmation to counter the negative self-talk and associated emotions.

It is important to ask clients to rank the intensity of their thoughts and emotions because some coping thoughts may create new emotions, while others may simply decrease the intensity of the negative self-talk. This helps clients form a personal conceptualization and understanding of which coping thoughts are more effective on the basis of the emotions that they want to achieve or decrease the intensity of.

 

The Where’s Waldo? connection

At this point, you may find yourself wondering how this CBT intervention relates to Where’s Waldo? In my professional opinion, the chaos and busy illustration featured on each page of Where’s Waldo? simulates the day-to-day chaos and conflict that clients may experience within their system of stressors: school, family, relationships, peers, jobs, etc.

In the Where’s Waldo? activity, finding Waldo is the goal. For many adolescents, personal goals and ambitions are often discouraged or lost among the chaos and conflict of their day-to-day stressors. This is because that ongoing chaos and conflict can create a stream of negative thought that adolescents often find too difficult to challenge.

In my work with clients, I ask them to practice completing a thought log while engaged in the Where’s Waldo? activity. I invite them to sit with a piece of paper while they search for Waldo and record any negative thoughts that they experience. Examples of negative thoughts while trying to locate Waldo: “I can’t do this”; “This is too hard”; “I want to give up”; “I do not succeed at anything.”

I also ask my clients to record emotions created by these thoughts — for example, frustration, anger, hopelessness and anxiety. It is important to sit with clients as they engage in this activity because the thought log is an active, ever-changing intervention and skill. The counselor not only educates clients on how to perform the thought log but also serves as a support, encouraging clients to counter their negative thoughts with coping thoughts that will help them resist the urge to give up on finding Waldo.

This activity provides clients with an outlet to practice emotional distress tolerance and implement CBT skills in the context of a simulated activity. It also offers them encouragement to apply those same skills to actual day-to-day stressors. To conclude the activity, counselors can invite clients to compare and contrast the negative thoughts and emotions they experienced during the activity with what arises when they encounter the presence of the day-to-day chaos of real life.

Processing the activity creates an opportunity for clients to access personal growth and insight. It also provides them with the confidence to take the thought log home and implement it with some of the specific stressors that may have brought them into treatment. I believe that change occurs when clients are able to apply what is learned in therapy to real-life dilemmas.

By simulating chaos and conflict through creative, nonintimidating outlets such as this Where’s Waldo? activity, we can help clients to acquire the tools and confidence to effectively apply those coping skills to the personal dilemmas that initially led them to treatment.

Remember, as overwhelming as the chaos may seem on each page of Where’s Waldo?, the truth is that Waldo really does appear on every page. This can help to reinforce the idea to clients that at times in real life, it is necessary to tolerate the distress that is present. Because for every moment that distress is tolerated, the opportunity to reach the goal increases.

 

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Brandon S. Ballantyne is a licensed professional counselor, national certified counselor and certified clinical mental health counselor with Reading Health System in Reading, Pennsylvania. Contact him at ballantynebrandon@yahoo.com.