When working with an agency it is important to know the services they provide and the population that will be worked with. Learning and understanding how one might approach a population is important and can lead to better outcomes for those clients. Understanding how a therapist will approach a population theoretically and in a counseling setting is significant and will give insight on how to provide the best services for those clients. In this paper, the author will describe Child and Adolescent Behavioral Health and the services provided at this agency along with theoretical approaches for working with this population. I completed my clinical 2 and internship 1 with this agency and loved my time their.
Child and Adolescent Behavioral Health
Child and Adolescent Behavioral Health (C&A) is a non-profit mental health organization working with children, adolescents, young adults, and their families with a variety of emotional and behavioral needs. This agency started as Child and Adolescents Service Center (CASC) in 1976 and has been meeting the needs of its clients for 44 years through many developments and changes. Child and Adolescent Service Center changed its name to Child and Adolescent Behavioral Health in 2008 to better reflect the mission of the agency. Specifically, the mission of C&A is “working together to be the premier resource for emotional and behavioral health services and products that help children, youth, and families successfully meet life’s challenges” and their vision is “health, hope, happiness, and opportunity for all children, youth, and families” (C&A, 2019).
C&A currently has four locations and the Alliance office was the first to open in 1977. The second building to open was the Shipley School where they provide a Day Treatment program. In 1997, the Belden office opened after a record year of growth for the agency and in 2018 the fourth location opened the Plain Community office which is located in a school. While C&A provides office-based services and day treatment, they also collaborate with city and county school districts to offer school-based consultation services as well as working with the Early Childhood Resource Center (ECRC) who provides classes for parents and support groups.
Services
While C&A collaborates with others, they also provide many programs and services for early childhood (birth-6), middle childhood (7-13), and transitional youth (14-24). All programs include trauma-informed day treatment, trauma therapy, school-based consultation, dialectical behavior therapy, sexually inappropriate behavior remediation (SIBR), alcohol and other drug services (AOD), multi-systemic therapy, multi-systemic therapy with problem sexual behavior, A+ groups, and services offered with all programs like consultation, assessments, case management, psychiatric evaluations, and medication management. The A+ groups include parenting groups to help the parent-child relationships and promote communication, adventure therapy groups to build on skills and summer workshops to provide opportunities during summer to create positive interactions with peers and adults.
Currently, C&A does not have any art therapy programs but does have some employees with art therapy backgrounds that use arts under expressive activities within therapy. C&A makes use of art activities and play activities especially when working with youth and clients that need something different than a normal talk therapy session.
Children and Adolescents
Working with children and adolescent is much different than working with adults. When working with young clients, therapists might approach counseling differently using play and creative activities to communicate (Sharry, 2004). Some creative activities that can be implemented are artwork, worksheets, storytelling, or puppets that engage the child in a more development pleasing way (Sharry, 2004). At C&A therapist work with the client and caregiver to create goals and treatment plans together in the first session. Approaching the therapeutic relationship in a collaborative way provides the client and therapist with open meaning, understanding, and communication (Sharry, 2004). This client-centered view helps therapists understand the needs of the client while also being aware of their families or caregiver. Being client-centered also includes understanding the strengths of the client and incorporating them within the treatment. Another way to be a client-centered organization is by providing mental health services in places children and adolescents can attend.
Providing mental health services to children and adolescents is needed and an estimated 20% of youth have chronic social and emotional problems that often go untreated (Joyce-Beaulieu & Sulkowski, 2015). By simply working with the population in a client-centered approach we know providing services is important and having those services in a place they can access them can be a solution. Schools are frequently a place where children and adolescents will find important mental health services and often times the most affordable as well. C&A is one community-based organization that provides not only office-based counseling but school-based counseling and social workers that go into the surrounding schools and work with kids in need. School is a great place to provide these services to best acquire, practice, and attain social and emotional skills and behaviors (Joyce-Beaulieu & Sulkowski, 2015). School-based therapy is not only beneficial because of the environment but also because it reduces other barriers to service. Having therapists within the school removes transportation challenges, helps caregivers not miss work, and helps reduce the financial strain on the families (Joyce-Beaulieu & Sulkowski, 2015).
Theoretical Approach
Understanding the needs and issues children and adolescents deal with is only one part of working with this population. Counselors also need to be aware of what theoretical approach they will use within the youth’s treatment.
One theoretical approach to working with children and adolescents is through cognitive behavioral therapy (CBT). CBT is a model of counseling that focuses on the thoughts of the person and how the emotions and behavioral responses will affect both long- and short-term issues in the individual (Joyce-Beaulieu & Sulkowski, 2015). The main idea is when thoughts are positive, better choices are made and reinforced which will lead to repeated behavior and when negative thoughts are present, maladaptive behaviors are reinforced and those become repeated habits (Joyce-Beaulieu & Sulkowski, 2015). The goal is to help children and adolescents recognize emotions, thoughts, and behavior and work toward more positive outcomes. To help the client reframe to more positive outlooks, a therapist might use many techniques. Some tools CBT therapists use include psychoeducation, social skills training, relaxation training, and the use of art therapy (Joyce-Beaulieu & Sulkowski, 2015).
Another therapeutic approach is trauma-focused cognitive behavioral therapy (TF-CBT) which is another tool used at C&A. This approach works with children and adolescents specifically those who have dealt with significant trauma. The trauma a client might experience can be from sexual or physical violence and often leads to symptoms of reduced confidence in the individual and trust in others (Kirsch, Keller, Tutus, & Goldbeck, 2018). TF-CBT treatment approach may include similar tools as CBT but focused on enhancing safety, the youth’s development, and healing. The session might include psychoeducation, relaxation, parenting skills, affect modulation, cognitive processing, gradual exposure, and a child-caregiver session (Kirsch, Keller, Tutus, & Goldbeck, 2018). Working with parents throughout treatment is an important aspect when working with children and adolescents and can help the client reach goals when behavior is reinforced at home.
Conclusion
While completing practicum hours at Child and Adolescent Behavioral Health the author has learned a lot about working with children and adolescents and working in an agency that provides many other services and programs. Going into this agency, I had a basic understanding of working with a young population and this research has helped me understand why some theoretical approaches are used and successful as well as gain insight on how I might implement them. Learning and researching how I might approach counseling has helped me feel more comfortable to work with clients and aid them throughout the therapy experience. By researching and practicing I will continue to become more aware of what theoretical approach I will work from and how I will approach clients overall.
References
Child & Adolescent Behavioral Health. (2019, October 21). Retrieved from http://www.childandadolescent.org/.
Joyce-Beaulieu, D., & Sulkowski, M. L. (2015). Cognitive Behavioral Therapy in K-12 School Settings: A Practitioner’s Toolkit. New York, NY: Springer Publishing Company. Retrieved from http://search.ebscohost.com.uc.opal-libraries.org/login.aspx?direct=true&db=e000xna&AN=969949&site=ehost-liv
Kirsch, V., Keller, F., Tutus, D., & Goldbeck, L. (2018). Treatment expectancy, working alliance, and outcome of Trauma‑Focused Cognitive Behavioral Therapy with children and adolescents. Child and Adolescent Psychiatry and Mental Health, 12. Doi:10.1186/s13034-018-0223-6
Sharry, J. (2004). Counselling Children, Adolescents and Families: A Strengths-Based Approach. London: SAGE Publications Ltd. Retrieved from http://search.ebscohost.com.uc.opal-libraries.org/login.aspx?direct=true&db=e000xna&AN=251760&site=ehost-live
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