Nock, M. K., & Kazdin, A. E. (2002). Examination of affective, cognitive, and behavioral factors and suicide-related outcomes in children and young adolescents. Journal of Clinical Child and Adolescent Psychology, 31 (1), 48-58. Matthew Nock and Alan Kazdin of Yale University published a study of suicide- related behaviors in 175 children and adolescents (ages 6-13). Specifically, Nock and Kazdin examined the role of affective, cognitive, and behavioral factors in suicide-related behaviors (suicidal ideation, attempts, and intent) among children and young adolescents. Participants were 122 boys and 53 girls and their mothers/maternal guardians. The children were receiving care in an inpatient facility and had to meet specific criteria for inclusion (for example, no children with neurological impairment, no children with scores on the WISC-R lower than 70, and so on). Children completed measures of depression, negative automatic thoughts, hopelessness, and suicidal ideation.
Based on further suicide assessment, each child was classified into one of three groups: non suicidal, suicide idea tors, and suicide at tempters. Nock and Kazdin were essentially trying to examine factors beyond the effects of depressed mood associated with suiciderelated behaviors. The researchers found that depressed mood, hopelessness, negative automatic thoughts, and anhedonia (loss of interest or pleasure in activities the child or adolescent typically enjoys) were all associated with suicidal ideation, intent, and current suicide attempts. After controlling for depressed mood, the researchers observed a reduction in the strength of these associations; however, three factors " anhedonia, hopelessness, and negative automatic thoughts " were all significantly associated with suicidal ideation. Also, hopelessness continued to be associated with suicidal intent, and anhedonia and negative automatic thoughts continued to be associated with a current suicide attempt.
Interestingly, children who had made a recent suicide attempt were distinguished from those who did not by a higher number of past suicide attempts and anhedonia " not by suicidal ideation. The researchers were most intrigued by the relationship between anhedonia and the presence of a current suicide attempt. Although this relationship is found among adults, it has not been studied in children. Unfortunately, the actual mechanism through which anhedonia might lead one to engage in suicidal behavior remains unknown (p. 55). The researches offered one possible explanation: It is possible that the psychological state characterized by anhedonia is more intolerable than the experience of depressed mood and negative cognitions and thus more likely to fuel the motivation to escape ones situation via suicidal behavior.
There were some interesting sex differences. In the over 11 age group, girls had more frequent negative automatic thoughts than boys and were more likely than boys to make a current suicide attempt. The researcher offered that negative cognitions may play a more significant role in suicidal behavior among girls than boys. In any case, Christian counselors will want to follow some of the researchers suggestions, that is, to include in their assessments a measure of both negative cognitions and anhedonia to help predict suicidal ideation and attempts among children. Certainly, children reporting past suicidal attempts and anhedonia should be carefully assessed and specifically asked about a plan for injurious behavior.
Breaking Confidentiality
Sullivan, J. R., Ramirez, E., Rae, W. A., Razo, N. P., & George, C. A. (2002). Factors contributing to breaking confidentiality with adolescent clients: A survey of pediatric psychologists. Professional Psychology: Research and Practice, 33 (4), 396-401. Jeremy Sullivan and his colleagues at Texas A & M reported on the common ethical dilemma faced by clinicians who work with adolescent clients. That is, whether to break confidentiality when an adolescent engages in risk-taking behaviors. The researchers sent surveys to 200 pediatric psychologists and received back 74 usable returns (37%). Respondents rated on a 5-point Likertlike scale (from 1 = extremely unimportant to 5 = extremely important) the importance of a variety of factors related to breaking confidentiality with adolescent clients. Respondents were not asked to respond to any specific risk-taking behaviors " they were just asked to rate the importance of a variety of factors as general considerations when deciding whether to break confidentiality. Factors rated as most important by respondents were protecting the adolescent, intensity of risk-taking behavior, and apparent seriousness of the risk"taking behavior.
Gender was considered the least important factor in deciding whether to break confidentiality. Sullivan and his colleagues then performed factor analysis to explore the structure of the items and determined that two factors had sufficient factor loadings. Results of the second analysis, the principal-axis-factoring analysis, supported a two-factor model, named by the researchers Negative Nature of the Behavior (Factor 1) and Maintaining the Therapeutic Process (Factor 2). (Combined, these factors accounted for 40% of the variance.) As the researchers observe, the two factors may actually be in conflict. There is a real and persisting tension for clinicians as they try to determine and weigh the risk of a specific behavior against the decision to break confidentiality and risk a threat to the therapeutic relationship. Christian counselors may see this study as a beginning point for further discussion of what does (and should) factor into a decisionmaking model when faced with difficult ethical dilemmas. It may be helpful for counselors to know which kinds of behaviors are particularly risky, as well as how to comprehensively and systematically assess the degree of potential risk to adolescent clients (and others) that results from their behaviors (p. 399).
Peer Victimization
Grills, A. E., & Ollendick, T. H. (2002). Peer victimization, global self-worth, and anxiety in middle school children. Journal of Clinical and Adolescent Psychology, 31 (1), 59-68. Peer victimization refers to discomfort intentionally and repeatedly inflicted by ones peers. In a study of peer victimization, Amie Grills and Thomas Ollendick of the Child Study Center at the Virginia Polytechnic Institute and State University reported on 279 sixth-grade, middle school children. Children completed the Self-Perception Profile for Children (with a Global Self-Worth subscale that was used for the study), the Peer Victimization Scale, and the Multidimensional Anxiety Scale for Children. In response to previous studies on peer victimization, Grills and Ollendick tested the mediator model for girls and the moderator model for boys. In the mediator model it was proposed that victimization would negatively affect self-worth in victimized girls that, in turn, would lead to greater levels of anxiety (p. 61). It was also proposed that self-worth might play a moderating role for boys as it pertains to the relationship between peer victimization and anxiety: whether degree of self-worth differentially influenced boys anxiety responses to being victimized by their peers (p. 61). The findings supported both models. Consistent with prior research, 27% of the participants reported elevated levels of victimization. The researchers found that boys reported more victimization than did girls, though girls reported more anxiety than boys. For girls, global self-worth mediated the anxiety that can attend peer victimization, which suggested to the researchers that when girls are victimized by their peers, the experience negatively affects their self-worth. Global self-worth for boys moderated the peer victimization-anxiety relation, that is, victimized boys high on measures of self-worth reported fewer symptoms of anxiety than victimized boys low on measures of self-worth. According to the researchers these findings support the need for interventions that enhance childrens sense of self-worth. This is a potentially valuable area for prevention, and one that Christian counselors can certainly support.
Involving Fathers
in Counseling Duhig, A. M., Phares, V., & Birkeland, R. W. (2002). Involvement of fathers in therapy: A survey of clinicians. Professional Psychology: Research and Practice, 33 (4), 389-395. If you have worked with children or families for any length of time, you have been asked, Who would you like present for the first appointment? Amy Duhig, Vicky Phares and Robyn Birkeland of the University of South Florida asked this and many other questions of 219 clinicians who specialize in child psychology and family therapy. Historically, mothers have tended to be overrepresented in therapy with children, and the researchers were examining paternal and maternal involvement in treatment. Surveys were sent to 500 members of organizations of divisions of organizations specializing with children or families (for example, the American Association for Marriage and Family Therapy).
Respondents ranged in age from 23-74 years (mean age = 45 years), and 64% were women. The vast majority (95%) of respondents were Caucasian. Clinicians reported that when they asked mothers or fathers to participate, mothers were more likely (91%) to participate than fathers (63%) a greater percentage of time. Perhaps not surprisingly, fathers were more likely to be involved in counseling when they were part of an intact family (rather than a single-parent family of children or adolescents). Overall, mothers are included more frequently than fathers in treatment of both children and adolescents in both intact and single-mother households (p. 392). Duhig and her colleagues also found a positive correlation between years of clinical experience and involving fathers in counseling. The same was true for years working with children and adolescents: the longer clinicians work with this population the more likely they are to include fathers. Christian counselors will certainly want to support maternal and paternal involvement in counseling with children and adolescents. Consistent with this, counselors can offer parents, and especially fathers (who are underrepresented in therapy), a rationale for the benefits they and their children may gain from their involvement in the counseling process.
Neighborhood Safety
Hill, N. E., & Herman-Stahl, M. A. (2002). Neighborhood safety and social involvement: Associations with parenting behaviors and depressive symptoms among African American and Euro-American Mothers. Journal of Family Psychology, 16 (2), 209- 219. Nancy Hill and Mindy Herman- Stahl reported on their study of neighborhood characteristics given that unsafe and under-resourced neighborhoods can undermine parenting behaviors and have a deleterious effect on children. Specifically, Hill and Herman-Stahl investigated the mediating role of maternal depression on reports of neighborhood safety and discipline consistency. Hill and Herman-Stahl interviewed 103 African-American and Euro-American mothers of kindergarten-age children.
Christian counselors will certainly want to support maternal and paternal involvement in counseling with children and adolescents. Consistent with this, counselors can offer parents, and especially fathers, a rationale for the benefits they and their children may gain from their involvement in the counseling process. The sample was drawn from a semiurban city (population = 206,000; 60% Euro-American, 37% African- American). The sample was similar with respect to childrens and mothers age, number of children in the home, mothers and fathers education level, employment status, and family income. African-American children were more likely to have been in Head Start than were Euro-American children, and African-American mothers were more likely to be single parents (though there were no differences between one- and two-parent families on measures of maternal depression). Single mothers tended to be less involved in their neighborhoods. Hill and Hermann reported no significant difference across ethnicity on measures of parenting behavior. Mothers tended to report high levels of acceptance, low levels of inconsistent discipline, hostile control, and withdrawal of relations. Euro-American mothers tended to rate their neighborhoods as safer than African-American mothers (though inter- viewers rated the neighborhoods as having similar levels of safety, p. 213).
Online counseling is always available to help you out.
Mothers perceptions of neighborhood safety were negatively related to hostile control strategies, inconsistent discipline, and withdrawal of relations. Mothers social involvement was not related to parenting; however, there was a difference between African-American and Euro-American mothers on social involvement and withdrawal of relations: When social involvement is low, African American mothers are more likely to withdraw from their child (p. 214), but this was not the case for Euro-American mothers. The subjective self-report of neighborhood safety was negatively correlated to maternal depression. Also, being involved in ones neighborhood was not related to depressive symptoms. The researchers checked whether elevated symptoms of depression lead people to reside in at-risk neighborhoods and whether depression significantly clouds ones views of ones neighborhood. Neither of these alternative hypotheses was supported. The researchers concluded that interventions designed for families in unsafe neighborhoods should focus on promoting parents mental health, well-being, and disciplinary strategies (p. 217). Christian counselors could certainly support and participate in interventions would address social support versus social isolation, as well as community-wide support to facilitate neighborhood safety and cohesion.
Author RSS Views:
Print this article
Ask about this article