Читать книгу Counseling the Contemporary Woman - Suzanne Degges-White - Страница 65

Referrals for adolescent counseling are frequent and there are seldom enough practitioners who specialize in this area. According to the Department of Health and Human Services (2016), most adolescent girls struggle at some point with symptoms of depression, anxiety, attention deficit and hyperactivity disorder, or eating disorders. The National Survey on Drug Use and Health (Center for Behavioral Health Statistics and Quality, 2018) found that 13.3 percent of all youth have experienced a major depressive episode. Overall, almost 35 percent of youth at some point struggle with mood disorders, and two-thirds who do are girls. Findings from a meta-analysis of psychological treatment outcomes for depressed youth indicated that cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) were the two most efficacious treatments (David-Ferdon & Kaslow, 2008). It is imperative to note that many adolescent girls might not present with typical symptoms of depression (e.g., hopelessness, isolation, weight gain, weight loss). On the contrary, children and adolescents may have symptoms of depression that manifest with a great deal of anger, arguing, physical fighting, and outrageous behaviors. As behaviors are purposeful, adolescent behaviors can often be expressions of unmet needs closely related to adolescents’ developmental stage. See chapter 16 for additional information on counseling women with mood disorders.

To be as effective as possible in counseling adolescent girls, it is necessary to keep in mind their emotional, cognitive, and psychosocial development and the developmental tasks (e.g., competence, autonomy, intimacy, formation of identity) they are managing. These developmental tasks are linked to specific behaviors that are easily detectable. For example, arguing with and disobeying teachers and parents may stem from frustration related to an inability to succeed in school. Other young women may opt for “sensation seeking” activities in order to avoid boredom, avoid being put down, and overcome feelings of being ignored and unimportant. These behavioral functions are linked to the developmental task of achieving competency. Acting out behaviors, such as causing trouble in school, making threats, choosing outrageous clothing, or using profanity, are potentially related to an adolescent’s need to make a personal statement and to be recognized as a capable and worthy individual. In such instances, counselors should focus on validating needs and the developmental tasks at hand while helping the client to develop more appropriate and healthier alternatives. For example, allowing girls to participate in rule and decision making, exploring ways they can contribute to society, teaching them to identify and express anger and other feelings more appropriately, and teaching them negotiations skills are ways to validate and redirect their efforts at identity development and competence achievement. Lastly, clinicians should bear in mind that the expression of needs and the actions taken to fulfill them are determined to a large extent by a client’s cultural background.