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Topics in International School Counseling

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Topics in International School Counseling Nick Ladany, Ph.D. Loyola Marymount University Los Angeles, California Nicholas.Ladany_at_lmu.edu Cheryl A. Brown – PowerPoint PPT presentation

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Title: Topics in International School Counseling


1
Topics in International School Counseling
  • Nick Ladany, Ph.D.
  • Loyola Marymount University
  • Los Angeles, California
  • Nicholas.Ladany_at_lmu.edu
  •  
  • Cheryl A. Brown
  • Shanghai American School (Puxi), China
  • cbrown451_at_usa.net

2
Institute Overview
  • Introductions
  • Elements of Effective and Ineffective School
    Counseling
  • Critical Mental Health Issues of Children in
    International Schools
  • Eating disorders, depression, anxiety, substance
    use and abuse, third culture kids
  • Multicultural Competence
  • Prevention Curricula
  • Effective and Ineffective Supervision
  • Model for International School Counselors
  • Job-A-Like Discussion Sessions
  • Marc Marier (American School of Dubai)
  • Jennifer Melton (Shanghai American School
    Pudong)

3
Importance of International School Counseling
  • 273,000 students enrolled in one of the 520
    overseas schools in 153 countries (2006-7).
  • Multinational student body
  • Unique challenges
  • transient and mobile family lifestyle
  • competing cultural practices
  • limited personnel resources
  • limited professional support
  • Unique demands
  • mental health needs
  • professional development
  • negotiating relationships with parents and school
    personnel

4
Needs Assessment Exercise
  • One-Two-Four-Eight Exercise
  • Identify mental health needs of students
  • Identify professional needs of counselors
  • Learn a method for intact working groups to
    identify and clarify issues of importance

5
Data Sources
  • Presentations at international school conferences
    (e.g., NESA, Tri-Association, etc.)
  • Research investigation of counselors in the
    international schools (Inman, Ngoubene, Ladany,
    2008)
  • Todays discussion

6
Student Needs
  • Family Issues
  • Parent Involvement
  • Psychiatric Disorders (e.g., Bipolar)
  • Anger Management/Relational Aggression
  • Self-esteem
  • Academic
  • Advising
  • Career Development
  • Vocational Counseling
  • Cultural shock and adjustment
  • Eating Disorders
  • Depression
  • Stress Anxiety
  • Fears over peer/social acceptance
  • Identity development
  • Substance Abuse/Addictions
  • Transition Adjustment
  • Security
  • Conflict resolution

7
Counselor Professional Needs
  • Professional Development
  • Multicultural development
  • Support from School Staff
  • Referral Resources
  • Roles Responsibilities
  • Clear Delineation
  • Administrator Teacher Understanding
  • Networking
  • Less Isolation from Collegial Support/Networking
  • Consultation Supervision
  • Academic Resources
  • Referral Resources
  • Technology
  • Financial Resources
  • Time Management Training
  • Space
  • Confidentiality/Privacy

8
Challenges with Principals, Teachers, Parents
  • Lack of Knowledge of Counselor Role
  • Lack of Trust in Counselor
  • Lack of Teamwork and Communication
  • Complexity of Counseling Process
  • Lack of Respect for Student Confidentiality
  • Parental Involvement in Students Life
  • Scheduling Conflicts
  • Lack of Empathy for Student Needs
  • Multicultural Misunderstandings
  • Dual/Multiple Relationships

9
Counselor Activities Roles
  • Premise A childs emotional needs must be met
    adequately before educational needs can be
    addressed
  • Individual counseling
  • Prevention workshops
  • Group counseling
  • Parent Family consultation/counseling
  • Teacher consultation
  • Career development
  • Administration consultation
  • Crisis intervention
  • Assessment referral
  • Minimum Recommended CounselorStudent Ratio
    1250

10
Elements of Effective Counseling(Ladany, Walker,
Pate-Carolan, Gray, 2008)
  • Empathy
  • Manage Countertransference
  • Ability to Tolerate Ambiguity
  • Working Alliance

11
Three Key Features of an Effective Counselor
  • Empathy
  • a genuine feeling of care for the clients
    situation, an ability to accurately perceive the
    clients experience (both intellectually and
    emotionally), a capacity to not only imagine the
    self as the client, but to suspend ones own
    experience and personal judgment to comfortably
    experience the clients unique inner world as
    if the counselor were the client, a capability
    to predict the clients reactions, and an ability
    to sensitively and accurately communicate this
    experience to the client (Banks, 2004).

12
Three Key Features of an Effective Counselor
  • Countertransference
  • Present in all helping relationships
  • Pantheoretical
  • An exaggerated, unrealistic, irrational, or
    distorted reaction related to a counselors work
    with a client. This reaction may include
    feelings, thoughts, and behaviors that are likely
    to be in response to the clients interpersonal
    style and presenting issues, and/or the
    counselors unresolved personal issues (e.g.,
    family of origin, life experiences, or
    environmental stressors).

13
5 Step Approach to Manage Countertransference
  • familiarize yourself with personal issues that
    may act as a trigger for countertransference
  • identify cues that alarm you when
    countertransference may be playing out in session
  • examine how countertransference influences the
    therapeutic work
  • explore the origins of the countertransference
  • use supervision and consultation to develop a
    therapeutic plan in the best interest of the
    client.

14
Three Key Features of an Effective Counselor
  • Ability to Tolerate Ambiguity

15
Defining a Counseling Relationship
  • Working Alliance (Bordin, 1979)
  • Key to positive outcomes
  • Culturally sensitive
  • Applicable across realms of helping e.g.,
    counselor-client teacher-student
    supervisor-supervisee etc.

16
3 Components of a Working Alliance
  • Agreement on Goals of Counseling
  • decrease depression, enhance study skills,
    decrease anxiety
  • Agreement on Tasks Counseling
  • explore past experiences, focus on cognitions,
    learn skills, observe classroom teaching
  • Emotional Bond Between Counselor Client
  • mutual caring, liking, trusting
  • Foundation upon which all helping is based

17
Elements of Ineffective Counseling
  • Systemic Factors
  • School culture
  • Parents
  • Contraindicated School Counselor Roles
  • Counselor Factors
  • Empathy challenged
  • Ignore Countertransference
  • Premature attempts to fix/problem solve
  • Inaccessibility to students
  • Weak Working Alliance
  • Children/students not included in goal and tasks,
    poor bond

18
Eating Disorders
  • Some Facts
  • The typical model weighs 13-19 below the normal
    expected body weight
  • The clinical criteria for anorexia nervosa is 15
    below expected weight
  • In the USA, half of adults are dieting. Children
    see and hear this and internalize the cultural
    idea that to be thin is to be successful and to
    be normal weight or fat is to fail.
  • By age 2, girls are watching TV and are starting
    to be exposed daily to messages showing that
    women who are successful are thin.
  • Before girls even go to elementary school they
    are exposed to messages (from family and/or the
    media) that certain foods are bad and that
    sugar and fat make people fat.

19
Additional Facts
  • Before girls go to elementary school they have
    heard women (their mothers, older sisters,
    caretakers) complain about their bodies and focus
    on weight loss and dieting.
  • Weight preoccupation and body dissatisfaction is
    occurring earlier and earlier.
  • 40 of girls and 25 of boys in grades 1 - 5
    reported trying to lose weight.
  • 25 of the girls reported restricting or altering
    their food intake. (This was about two times as
    many girls as boys.)
  • By fourth grade, 40 or more of girls diet at
    least occasionally.

20
In a survey of over 400 fourth grade girls
  • One third said they very often worried about
    being fat
  • Nearly half said they very often wished they
    were thinner
  • About 40 of the girls reported dieting
    sometimes to very often

21
In a study of fifth graders
  • 40 felt too fat or wanted to lose weight, even
    though 80 were not overweight.
  • The researchers found children as young as 9
    years old with severe eating disorders, including
    anorexia nervosa and bulimia.

22
Be Careful What You Wish For
  • A group of girls ages 11 17 were asked If you
    had three wishes, what would you wish for?
  • The 1 wish of nearly every girl was to lose
    weight.
  • More than two-thirds of high school girls are
    dieting and half are undernourished.
  • At the same time, one in five teenagers is
    overweight

23
Four Major Weight and Eating Problems
  • Dysfunctional Eating
  • Not regulated by hunger and satiety
  • Eating Disorders
  • Anorexia Nervosa, Bulimia Nervosa, Binge Eating
    Disorders
  • Overweight Obesity
  • Size Prejudice
  • Oppression toward obese children
  • Accepting or promoting the cultural ideal of
    thinness

24
Signs and Symptoms of Eating Disorders
  • Labeling foods as good vs. bad
  • Skipping meals
  • Dieting
  • Feeling guilty for eating
  • Counting calories and/or fat
  • Depressed mood
  • Self-critical thoughts, words, or behaviors when
    she cant exercise
  • Exercising in order to eat

25
Signs and Symptoms of Eating Disorders
  • Avoiding situations where she may be observed
    eating
  • Perfectionism
  • Hiding ones body by wearing baggy clothing or
    layers
  • Preoccupied with models, actresses, their looks,
    body, weight
  • Feeling anxious or stressed about eating
  • Accepting or verbalizing the cultural ideal of
    thinness
  • Social isolation

26
Prevention of Eating Disorders
  • Creating a school environment that promotes
    health
  • Parental involvement
  • Preschool awareness
  • Children through the 3rd grade
  • Discussion focusing on health and wellness
  • Beginning in 4th grade
  • Health and wellness
  • Discussion of eating disorders

27
Role of School Counselor
  • Identify factors in the school that hinder
    students development of positive ideas about
    body image and health
  • Offer school-wide programs targeting weight and
    eating issues
  • Educate and assist teachers and administrators
  • Educate parents
  • Work individually with students
  • Refer students when possible

28
Depression in Children and Adolescents
  • 10-15 of children and adolescents has some
    symptoms of depression (Surgeon General, 2000)
  • 20-40 adolescents report feeling sad, unhappy,
    or depressed over a 6 month period (Achenbach,
    1991)
  • 10-20 of parents report their adolescents have
    felt sad, unhappy, or depressed over a 6 month
    period (Achenbach, 1991)
  • As many as 20 of children experience a major
    depression episode before graduating from high
    school, and between 7 and 9 of children will
    experience a depressive episode by the time they
    are 14 years old (e.g., Garrison et al., 1989
    Lewinsohn, Hops, Roberts, Seeley, 1993)

29
Symptoms of Depression in Children and
Adolescents
  • Indecisiveness
  • School failure
  • Poor motivation
  • Concerns about aches and pains
  • Lack of friends
  • Feels inferior
  • Noncompliant
  • Frequently gets into fights
  • Feels unloved
  • Sadness
  • Emptiness
  • Helplessness (nothing ever works for me)
  • Diminished interest or pleasure in most
    activities (I dont care anymore)
  • Significant weight loss or gain
  • Poor appetite
  • Insomnia or hypersomnia
  • Marked restlessness or slowness

30
Symptoms of Depression in Children and
Adolescents (cont.)
  • Loss of energy/fatigue
  • Worthlessness
  • Guilt
  • Difficulty concentrating
  • Recurrent thoughts of death
  • Thoughts of suicide
  • Self-loathing (I hate myself)
  • Feeling bad
  • Irritableness or feeling crabby
  • Isolation from peers
  • Loneliness
  • Frequent crying
  • Worries that bad things will happen

31
Suicide
  • 1.6 per 100,000 for 10-14 year-olds
  • 9.5 per 100,000 for 15-19 year-olds
  • Boys four times more likely to commit
  • Girls twice as likely to attempt
  • Hispanic students most likely of all racial
    groups
  • 90 of children who commit suicide have a mental
    disorder prior to death (most common depression,
    anxiety, substance abuse)

32
Suicidal Risk Factors
  • what would prevent
  • past attempts
  • social support/interpersonal isolation
  • impulsivity
  • substance use
  • family member
  • depressed mood
  • thoughts/feelings of hopelessness or helplessness
  • thoughts of hurting yourself
  • plan
  • means
  • time
  • place
  • Contract

33
Anxiety in Children and Adolescents
  • 1 year prevalence in children 9-13 years old is
    13
  • Separation Anxiety Disorder
  • Anxiety about being apart from parent(s)
  • Fear parent may become ill or have an accident
  • May develop after a move or trauma
  • Generalized Anxiety Disorder
  • Excessive worry about most things
  • Social Phobia
  • Persistent fear of being embarrassed in social
    situations
  • Young children tend to exhibit symptoms more
    behaviorally (e.g., cry, tantrums, timid)
  • Anxiety and depression often coexist

34
Symptoms of Anxiety in Children and Adolescents
  • Anxiousness
  • Fear
  • Worry
  • Panic
  • Nightmares
  • Avoidance
  • Thoughts of monsters
  • Thoughts of being hurt
  • Thoughts of danger
  • Increased heart rate
  • Difficulty concentrating
  • Thoughts of contamination
  • Depersonalization
  • Stuttering
  • Swallowing
  • Avoid eye contact
  • Trembling voice
  • Nausea
  • Muscle tension

35
Role of School Counselor with Depressed and
Anxious Students
  • Availability and approachability
  • Identify depressed or anxious mood
  • Work with parents
  • Work individually with students
  • Receive consultation/supervision
  • Refer students when possible
  • Individual counseling/psychotherapy
  • Family counseling/psychotherapy

36
Substance Use Abuse
  • Often increased accessibility and availability
    in Overseas Schools
  • Middle school children 12-15
  • 50 have tried alcohol at least once
  • Average age of first drink10.4 years old
  • 23 have been drunk

37
Substance Use Abuse
  • U.S. High School Senior Lifetime Use
  • Alcohol 81
  • Tobacco 64
  • Marijuana 42
  • Inhalants 17
  • Hallucinogens 13
  • Cocaine 6
  • Often coexist with another mental health disorder

38
Substance Abuse Dependence
  • Factors associated with SA D
  • Stress
  • Family turmoil
  • Another mental health disorder
  • Physiological predisposition
  • Family member use and abuse
  • Peer use and abuse
  • Academic difficulties
  • Poor self-esteem
  • Poor coping resources
  • Family therapy most effective treatment for
    children and adolescents
  • True for most childhood mental health issues

39
Eating Disorders
  • Some Facts
  • The typical model weighs 13-19 below the normal
    expected body weight
  • The clinical criteria for anorexia nervosa is 15
    below expected weight
  • In the USA, half of adults are dieting. Children
    see and hear this and internalize the cultural
    idea that to be thin is to be successful and to
    be normal weight or fat is to fail.
  • By age 2, girls are watching TV and are starting
    to be exposed daily to messages showing that
    women who are successful are thin.
  • Before girls even go to elementary school they
    are exposed to messages (from family and/or the
    media) that certain foods are bad and that
    sugar and fat make people fat.

40
Additional Facts
  • Before girls go to elementary school they have
    heard women (their mothers, older sisters,
    caretakers) complain about their bodies and focus
    on weight loss and dieting.
  • Weight preoccupation and body dissatisfaction is
    occurring earlier and earlier.
  • 40 of girls and 25 of boys in grades 1 - 5
    reported trying to lose weight.
  • 25 of the girls reported restricting or altering
    their food intake. (This was about two times as
    many girls as boys.)
  • By fourth grade, 40 or more of girls diet at
    least occasionally.

41
In a survey of over 400 fourth grade girls
  • One third said they very often worried about
    being fat
  • Nearly half said they very often wished they
    were thinner
  • About 40 of the girls reported dieting
    sometimes to very often

42
In a study of fifth graders
  • 40 felt too fat or wanted to lose weight, even
    though 80 were not overweight.
  • The researchers found children as young as 9
    years old with severe eating disorders, including
    anorexia nervosa and bulimia.

43
Be Careful What You Wish For
  • A group of girls ages 11 17 were asked If you
    had three wishes, what would you wish for?
  • The 1 wish of nearly every girl was to lose
    weight.
  • More than two-thirds of high school girls are
    dieting and half are undernourished.
  • At the same time, one in five teenagers is
    overweight

44
Four Major Weight and Eating Problems
  • Dysfunctional Eating
  • Not regulated by hunger and satiety
  • Eating Disorders
  • Anorexia Nervosa, Bulimia Nervosa, Binge Eating
    Disorders
  • Overweight Obesity
  • Size Prejudice
  • Oppression toward obese children
  • Accepting or promoting the cultural ideal of
    thinness

45
Signs and Symptoms of Eating Disorders
  • Labeling foods as good vs. bad
  • Skipping meals
  • Dieting
  • Feeling guilty for eating
  • Counting calories and/or fat
  • Depressed mood
  • Self-critical thoughts, words, or behaviors when
    she cant exercise
  • Exercising in order to eat

46
Signs and Symptoms of Eating Disorders
  • Avoiding situations where she may be observed
    eating
  • Perfectionism
  • Hiding ones body by wearing baggy clothing or
    layers
  • Preoccupied with models, actresses, their looks,
    body, weight
  • Feeling anxious or stressed about eating
  • Accepting or verbalizing the cultural ideal of
    thinness
  • Social isolation

47
Prevention of Eating Disorders
  • Creating a school environment that promotes
    health
  • Parental involvement
  • Preschool awareness
  • Children through the 3rd grade
  • Discussion focusing on health and wellness
  • Beginning in 4th grade
  • Health and wellness
  • Discussion of eating disorders

48
Eating Disorder Prevention Program
  • Psychoeducation
  • Media literacy
  • fat talk
  • Size acceptance
  • Emotional eating
  • Stress management
  • Self-esteem
  • Promoting healthy body image
  • Social Norms
  • What are social norms?
  • What influences social norms?
  • What misperceptions exits within your school?
  • What are the consequences of these
    misperceptions?
  • Actual social norm data
  • E.g., in reality, diets dont work

49
Role of School Counselor
  • Identify factors in the school that hinder
    students development of positive ideas about
    body image and health
  • Offer school-wide programs targeting weight and
    eating issues
  • Educate and assist teachers and administrators
  • Educate parents
  • Work individually with students
  • Refer students when possible

50
Depression in Children and Adolescents
  • 10-15 of children and adolescents has some
    symptoms of depression (Surgeon General, 2000)
  • 20-40 adolescents report feeling sad, unhappy,
    or depressed over a 6 month period (Achenbach,
    1991)
  • 10-20 of parents report their adolescents have
    felt sad, unhappy, or depressed over a 6 month
    period (Achenbach, 1991)
  • As many as 20 of children experience a major
    depression episode before graduating from high
    school, and between 7 and 9 of children will
    experience a depressive episode by the time they
    are 14 years old (e.g., Garrison et al., 1989
    Lewinsohn, Hops, Roberts, Seeley, 1993)

51
Symptoms of Depression in Children and
Adolescents
  • Indecisiveness
  • School failure
  • Poor motivation
  • Concerns about aches and pains
  • Lack of friends
  • Feels inferior
  • Noncompliant
  • Frequently gets into fights
  • Feels unloved
  • Sadness
  • Emptiness
  • Helplessness (nothing ever works for me)
  • Diminished interest or pleasure in most
    activities (I dont care anymore)
  • Significant weight loss or gain
  • Poor appetite
  • Insomnia or hypersomnia
  • Marked restlessness or slowness

52
Symptoms of Depression in Children and
Adolescents (cont.)
  • Loss of energy/fatigue
  • Worthlessness
  • Guilt
  • Difficulty concentrating
  • Recurrent thoughts of death
  • Thoughts of suicide
  • Self-loathing (I hate myself)
  • Feeling bad
  • Irritableness or feeling crabby
  • Isolation from peers
  • Loneliness
  • Frequent crying
  • Worries that bad things will happen

53
Suicide
  • 1.6 per 100,000 for 10-14 year-olds
  • 9.5 per 100,000 for 15-19 year-olds
  • Boys four times more likely to commit
  • Girls twice as likely to attempt
  • Hispanic students most likely of all racial
    groups
  • 90 of children who commit suicide have a mental
    disorder prior to death (most common depression,
    anxiety, substance abuse)

54
Suicidal Risk Factors
  • what would prevent
  • past attempts
  • social support/interpersonal isolation
  • impulsivity
  • substance use
  • family member
  • depressed mood
  • thoughts/feelings of hopelessness or helplessness
  • thoughts of hurting yourself
  • plan
  • means
  • time
  • place
  • Contract

55
Anxiety in Children and Adolescents
  • 1 year prevalence in children 9-13 years old is
    13
  • Separation Anxiety Disorder
  • Anxiety about being apart from parent(s)
  • Fear parent may become ill or have an accident
  • May develop after a move or trauma
  • Generalized Anxiety Disorder
  • Excessive worry about most things
  • Social Phobia
  • Persistent fear of being embarrassed in social
    situations
  • Young children tend to exhibit symptoms more
    behaviorally (e.g., cry, tantrums, timid)
  • Anxiety and depression often coexist

56
Symptoms of Anxiety in Children and Adolescents
  • Anxiousness
  • Fear
  • Worry
  • Panic
  • Nightmares
  • Avoidance
  • Thoughts of monsters
  • Thoughts of being hurt
  • Thoughts of danger
  • Increased heart rate
  • Difficulty concentrating
  • Thoughts of contamination
  • Depersonalization
  • Stuttering
  • Swallowing
  • Avoid eye contact
  • Trembling voice
  • Nausea
  • Muscle tension

57
Role of School Counselor with Depressed and
Anxious Students
  • Availability and approachability
  • Identify depressed or anxious mood
  • Work with parents
  • Work individually with students
  • Receive consultation/supervision
  • Refer students when possible
  • Individual counseling/psychotherapy
  • Family counseling/psychotherapy

58
Substance Use Abuse
  • Often increased accessibility and availability
    in Overseas Schools
  • Middle school children 12-15
  • 50 have tried alcohol at least once
  • Average age of first drink10.4 years old
  • 23 have been drunk

59
Substance Use Abuse
  • U.S. High School Senior Lifetime Use
  • Alcohol 81
  • Tobacco 64
  • Marijuana 42
  • Inhalants 17
  • Hallucinogens 13
  • Cocaine 6
  • Often coexist with another mental health disorder

60
Substance Abuse Dependence
  • Factors associated with SA D
  • Stress
  • Family turmoil
  • Another mental health disorder
  • Physiological predisposition
  • Family member use and abuse
  • Peer use and abuse
  • Academic difficulties
  • Poor self-esteem
  • Poor coping resources
  • Family therapy most effective treatment for
    children and adolescents
  • True for most childhood mental health issues

61
  • Preventive Interventions with School-Age Youth
  • Vera Reese (2004)

62
Tripartite Concept of Prevention
  • Primary Prevention
  • Target children and adolescents who are currently
    unaffected by a particular problem for the
    purposes of helping them continue to function in
    healthy ways
  • E.g., anti-drug programs that are school-wide
  • Secondary Prevention
  • Targets children and adolescents exhibiting early
    stage problems to forestall the development of
    more serious difficulties
  • E.g., working with aggressive kindergartners to
    curb later violent episodes
  • Tertiary Prevention
  • Targets children and adolescents with established
    problems or disorders in order to reduce the
    dureation or consequences of the problematic
    behavior
  • Similar to direct counseling
  • E.g., family planning programs designed for
    pregnant teenagers

63
Risk and Protective Factors
  • Characteristics of children and adolescents and
    their environment that influence their chance of
    developing mental health problems
  • Biological predispositions, personality traits,
    problematic behaviors, faulty beliefs, family
    processes peer influences, school experiences,
    and community variables
  • Risk factors
  • Negative aspects of the self or environment
  • Protective factors
  • Foster resilience to risk and promote competence
    and adaptive outcomes

64
Types of Interventions
  • Person-centered
  • Offer services directly to the target population
  • E.g., communication skills training, self-esteem
    enhancement
  • Environment-centered interventions
  • Seek to modify the childs social context
  • E.g., parental child rearing techniques,
    teachers classroom management techniques
  • Need to understand developmental differences
    among youth
  • Need to understand multicultural differences
    among youth
  • Outcome Evaluation
  • Obtain multiple perspectives
  • Need to consider both proximal and distal goals
    and outcomes

65
Best Practices
  • Programs that attempt to affect multiple risk and
    protective factors at both person-centered and
    environment-centered levels

66
Substance Abuse Prevention
  • Contextual risk factors
  • Norms regarding drug use
  • Accessibility
  • Physiological predisoposition
  • Low bonding to family
  • Early persistent problem behaviors
  • Academic failure
  • Low degree of commitment to school
  • Peer rejection in elementary grades
  • Alientation and rebelliousness
  • Early onset of drug use
  • Family use of drug and alcohol
  • High levels of family conflict
  • Protective factors
  • Membership in structured, goal-directed peer
    groups
  • Strong attachment with parents
  • Parental involvement

67
Substance Abuse Prevention
  • Early person-centered prevention efforts failed
  • Just say no
  • Increased knowledge and awareness but rarely
    changed drug use
  • Oversimplified the complexity of drug use and
    abuse
  • Contemporary programs more effective
  • Combine person-centered and environmental-centered
    levels of intervention
  • Assertiveness skills
  • Enhanced coping
  • Interpersonal self-efficacy
  • Alter norms in families and peer-groups regarding
    drugs

68
  • Multicultural Issues

69
  • "Travel is fatal to prejudice, bigotry, and
    narrow-mindedness, and many of our people need it
    solely on these accounts. Broad, wholesome,
    charitable views of men and things cannot be
    acquired by vegetating in one corner of the earth
    all one's lifetime." -- Mark Twain

70
Third Culture Kid (TCK)
  • Defined as
  • "a young person who has spent a sufficient period
    of time in a culture other than his/her own,
    resulting in the integration and blending of
    elements from both the host culture and his/her
    own culture into a third culture."

71
Culture - Blend
  • intensity of exposure to a second or third
    culture,
  • age at which child comes into contact with a
    culture other than that of the parents,
  • amount of time a young person spends within a
    second or third culture.

72
TCK
  • A TCK's roots are not embedded in a place, but in
    people,
  • No two children/individuals are alike.

73
TCK Strengths
  • Independent
  • exercise leadership
  • cross cultural skills
  • increased maturity
  • broader world view

74
TCK Challenges
  • Isolation
  • Trust issues
  • Can never go back home again
  • Repatriation
  • Unresolved grief or sadness
  • Feel cheated and angry. . .
  • Delayed adolescence

75
Issues specific to different age groups
  • Preschoolers
  • threatened by moving personnel packing their bed,
    toys and personal belongings
  • Grade School Children
  • worry about details -- finding their way home,
    finding a room in their new school

76
Issues specific to different age groups
  • Teenagers
  • biggest fear is acceptance by their peers
  • College Students and Young Adults
  • distance can create sense of loss
  • instructors and schedule in overseas schools will
    contrast

77
Adjustment issues manifest
  • Drug use
  • Eating disorders
  • Involvement in solitary pursuits
  • Depression acute sense of isolation
  • Anxiety
  • Identity Issues

78
What can you do?
  •  Maintaining continuity
  • Watch for signs of adjustment problems
  • Listen carefully to childs concerns
  • Approach teacher/counselor about concerns
  • Assign a few manageable chores
  • Work to develop a caring, nurturing environment
    overseas
  • Recognize positive aspects of their life
  • Recognize and talk about losses
  • Value keeping in touch with life in the home
    country

79
Repatriation
  • When returning to the home country, parents may
    need to help teachers and administrators in the
    new school understand the transition the children
    will be going through in the first few months.
  • If possible, money should be budgeted for school
    clothing so that the student will ''fit in."
  • Returning children should be encouraged to keep
    in touch with friends they made while overseas.

80
Parenting/Teaching In A Stressful World
  • Shifts in Socio-Political Climate
  • How do TCKs experience world changes?
  • How are these experiences reassessed?
  • How do TCks reassess the nation when it is now
    the enemy?
  • How do TCKs evaluate shifts in home land
    differently from Americans reared all their lives
    within the U.S.?
  • How is the threat of terrorism handled?

81
Multicultural Counseling
82
Counselor Multicultural Competence (Ancis
Ladany, 2010)
  • Multicultural
  • Issues related to multiple cultures that include
    gender, race, sexual orientation, ethnicity,
    disability, socioeconomic status, nationality,
    age, religion, etc.
  • Counselor Multicultural Competence
  • Knowledge
  • Self-Awareness
  • Skills

83
Counselor/Psychologist Multicultural Competence
  • Consists of three interrelated subconstructs
  • 1. Multicultural Knowledge- general knowledge
    about multicultural issues such as an academic or
    intellectual understanding of how factors such as
    gender, race, sexual orientation, disability,
    nationality, religion, and so forth, may
    influence a clients life and multicultural
    knowledge unique to the specific clients.
  • 2. Multicultural Self-Awareness- ability to
    reflect upon and understand ones own multiple
    multicultural identities, and how these
    identities are expressed in a counseling
    relationship.
  • 3. Multicultural Skills- reflected in
    multicultural counseling self-efficacy (i.e.,
    confidence to perform particular multicultural
    skills) along with the adeptness to carry out
    these multicultural skills.

84
Models of Multicultural Identity Development
  • Knowledge of simple demographic or nominal
    variables (e.g., race) insufficient to predict
    behavior.
  • More Explanatory Models
  • Racial Identity (e.g., Cross, 1971, 1995 Helms,
    1990, 1995 Helms Cook, 1999)
  • Gender Identity (e.g., Downing Roush, 1985
    McNamara Rickard, 1989 Ossana, Helms,
    Leonard, 1992)
  • Sexual Orientation Identity (e.g., Cass, 1979
    Chan, 1989 Rust, 1993 Troiden, 1988)
  • Ethnic Identity (e.g., Phinney, 1989, 1992
    Sodowsky, et al., 1995)
  • Needed
  • Scheme to help organize and manage multiple
    models
  • Apply across multiple demographic variables
  • gender, race, sexual orientation, ethnicity,
    disability, socioeconomic status

85
Heuristic Model of Non-Oppressive Interpersonal
Development (Ancis Ladany, 2001, 2010)
  • Socially Oppressed Groups (SOG)
  • Female
  • Person of color
  • Gay/Lesbian/Bisexual/Transgendered
  • Non-European American
  • Person with a Disability
  • Working Class
  • Socially Privileged Groups (SPG)
  • Male
  • White
  • Heterosexual
  • European American
  • Physically Abled
  • Middle to Upper Class

86
Means of Interpersonal Functioning (MIF)
  • For each demographic variable, people progress
    through similar phases
  • thoughts and feelings about oneself, as well as
    behaviors based on ones identification with a
    particular demographic variable
  • Common Features Between SOG SPG
  • e.g., ., both women and men will exhibit
    complacency regarding societal change in the less
    advanced stages of MIF
  • Unique Features Within Socially Oppressed and
    Socially Privileged Groups
  • e.g., generally, women feel less empowered and
    men will perceive greater entitlement
  • People can be more advanced in terms of their MIF
    for one demographic variable (e.g., sex) than
    their MIF for another variable (e.g., race).
  • e.g., a White woman may have an understanding of
    the limiting effects of sex role socialization
    but lack an awareness of White privilege
  • Social Context Initial model restrictively
    applied to people who live in the United States,
    however, expanded and emic applications
    currenltly under development

87
4 General Stages of Means of Interpersonal
Functioning
  • (1) Adaptation
  • Features apathy regarding the socially
    oppressive environment, superficial understanding
    of differences among people, endorsement of
    oppressive contingencies, active participation in
    oppressive acts
  • (2) Incongruence
  • Features previous beliefs about oppression and
    privilege seem incongruent conflict confusion
    dissonance some awareness no real commitment to
    advocacy
  • (3) Exploration
  • Features anger may be a prominent emotion, some
    of which is founded on current recognition of
    oppressive situations but also fueled by guilt or
    shame for not having recognized the oppressive
    state of affairs previously hypervigilance,
    hyperawareness, seek encounter-like events.
  • (4) Integration
  • Features proficiency in associating with
    multiple SOGs SPGs, insight into oppressive
    interactions, committed pursuit of non-oppression
    in the environment

88
Stages of Means of Interpersonal Functioning
(Gender Female)
  • (1) Adaptation
  • Believes equality exists and oppression doesnt
  • (2) Incongruence
  • Event occurs such as reading about salary
    discrepancies between men and women
  • (3) Exploration
  • Engages in reflection and seeks out information
    about feminism and womens roles
  • (4) Integration
  • Able to make realistic appraisals of types of
    gender oppression and sorts through possible
    advocacy stances

89
Stages of Means of Interpersonal Functioning
(Gender Male)
  • (1) Adaptation
  • Over-attributes gender differences to genetics,
    Im not privileged
  • (2) Incongruence
  • Okay with having women around at work but less
    inclined to have partner work outside the home
  • (3) Exploration
  • Engages in exploring how being a man has
    advantages in our culture
  • (4) Integration
  • Is able to function interpersonally with men and
    women who are at various stages of interpersonal
    functioning

90
Stages of Means of Interpersonal Functioning
(Race Person of Color)
  • (1) Adaptation
  • Identification with White people, denigration of
    People of Color
  • (2) Incongruence
  • A White friend tells an African American person
    that she never thought of her as African American
  • (3) Exploration
  • Associate with groups or organizations that
    strongly identify with people who are Hispanic
  • (4) Integration
  • Engages in multiple forms of advocacy for people
    who are Asian

91
Stages of Means of Interpersonal Functioning
(Race White)
  • (1) Adaptation
  • Colorblind perspective, we all belong to the
    human race
  • (2) Incongruence
  • Intellectual understanding of racism but no real
    advocacy to change matters or White privilege
  • (3) Exploration
  • Actively considers what it means to be White
  • (4) Integration
  • Adept at interacting with People of Color at
    various stages of interpersonal functioning

92
Stages of Means of Interpersonal Functioning
(Sexual Orientation Gay, Lesbian, Bisexual,
Transgendered)
  • (1) Adaptation
  • Identifies with heterosexual norms in the US
    culture
  • (2) Incongruence
  • Recognition that sexual feelings cannot easily be
    ignored Tension between being out versus
    closeted becomes difficult to maintain
  • (3) Exploration
  • Joins GLBT organizations or reads about others
    who proudly proclaim their sexual orientation as
    GLBT
  • (4) Integration
  • Adept at living in multiple worlds of people with
    a variety of sexual orientations

93
Stages of Means of Interpersonal Functioning
(Sexual Orientation Heterosexual)
  • (1) Adaptation
  • Gay-bashing Homosexuality is a sin
  • (2) Incongruence
  • Questions unhealthy heterosexist stance based on
    contact experiences
  • (3) Exploration
  • Actively examines the privileges associated with
    being heterosexual
  • (4) Integration
  • Able to advocate for and associate with people
    who have diverse sexual orientations

94
4 Stages of Means of Interpersonal Functioning
  • (1) Adaptation
  • Features apathy regarding the socially
    oppressive environment, superficial understanding
    of differences among people, endorsement of
    oppressive contingencies, active participation in
    oppressive acts
  • Client unlikely to be aware of multicultural
    dynamics between the counselor and client
  • Counselor unlikely to attend to multicultural
    issues in conceptualizing clients

95
4 Stages of Means of Interpersonal Functioning
  • (2) Incongruence
  • Features previous beliefs about oppression and
    privilege seem incongruent conflict confusion
    dissonance some awareness no real commitment to
    advocacy
  • Client present with some conflict related to a
    recent multicultural event
  • Counselor may include demographic information in
    case conceptualizations, however, the information
    is not well differentiated or integrated

96
4 Stages of Means of Interpersonal Functioning
  • (3) Exploration
  • Features anger may be a prominent emotion, some
    of which is founded on current recognition of
    oppressive situations but also fueled by guilt or
    shame for not having recognized the oppressive
    state of affairs previously hypervigilance,
    hyperawareness, seek encounter-like events.
  • Client heightened awareness of multicultural
    issues for self or between the counselor and
    client
  • Counselor eager to cause insight

97
4 Stages of Means of Interpersonal Functioning
  • (4) Integration
  • Features proficiency in associating with
    multiple SOGs SPGs, insight into oppressive
    interactions, committed pursuit of non-oppression
    in the environment
  • Client seek counselors who are advanced in their
    MIF
  • Counselor accurate empathy with clients that are
    from multiple SOG SPG groups,
    conceptualizations cognitively and integratively
    complex with respect to multicultural issues

98
4 Types of Client-Counselor Interpersonal
Interaction Dynamics
  • Similar to Racial Identity Interactions (Cook,
    1994 Helms, 1990 Helms Cook, 1999)
  • Progressive
  • the counselor is at a more advanced stage than
    the client (e.g., counselor-integration,
    client-adaptation)
  • Parallel-Advanced
  • the counselor and client are at comparable
    advanced MIF stages (e.g., integration,
    exploration)
  • Parallel-Delayed
  • the counselor and client are at comparable
    delayed MIF stages (e.g., adaptation,
    incongruence)
  • Regressive
  • client is at a more advanced stage than the
    counselor (e.g., client-integration,
    counselor-adaptation)

99
Implications for Client Outcome
  • Counseling Process
  • Counseling Outcome
  • Best to Worst Outcomes
  • Parallel-Advanced or Progressive
  • Parallel-Delayed
  • Regressive

100
Implications for Societies and Cultures
  • Social structures can be classified as operating
    within a dominant stage of functioning

101
Sexual Abuse Prevention
102
General Session
  • Nick Ladany, Ph.D. Roger Douglas, Ed.D.
  • Clare Burgess, Shana Flicker, Lauren Kulp

103
Most Common Social-Emotional-Behavioral Issues in
the International Schools
  • Cultural Adjustment
  • Eating Problems
  • Depression Suicidality
  • Stress Anxiety
  • Substance Abuse
  • Transition Adjustment
  • Diversity
  • Crisis Management and Response
  • Family Issues Parent Involvement
  • Learning Disabilities
  • Anger Management
  • Mental Health Disorders (e.g., Bipolar)
  • Self-esteem
  • Career Development
  • Sexual Safety, Sexual Assault, and Sexual
    Awareness

104
Program Philosophy
  • The Sexual Safety and Sexual Awareness Program is
    designed for teaching professionals, counselors,
    staff, administrators, and parents to
  • (1) create a sexually safe environment for
    children and adolescents
  • (2) prevent incidents of sexual abuse and
    violence
  • (3) offer resources in the event that abuse or
    violence occurs

105
Sexual Abuse and Assault
  • Child Sexual Abuse is the exploitation or
    coercion of a child by an older person (adult or
    adolescent) for the sexual gratification of the
    older person. Child sexual abuse involves a
    continuum of behavior ranging from verbal,
    nonphysical abuse to forcible touching offenses.
    It can take the form of a single encounter with
    an exhibitionist, occasional fondling by a casual
    acquaintance, years of ongoing abuse by a family
    member, rape, or exploitation through pornography
    and/or prostitution.
  • Sexual Assault occurs when one of the following
    conditions exist
  • Force, even if there is no bruise or injury
  • Fear, even if the victim didnt fight back
  • A person is disabled and cannot give consent
  • A person is severely intoxicated or unconscious
    as a result of drugs or alcohol
  • The victim is under the age of 18

106
Sexual Abuse and Assault Occurs
  • 20 of women and 5-10 of men have experienced
    some form of sexual abuse as children and
    adolescents
  • Peak ages 7-13 years old
  • Up to one half of victims under the age of 7
  • 70-90 of the time the perpetrator is known
  • Kept secret through bribes and threats

107
The Scope of Sexual Victimization in Germany
(Kury, Chouaf, Obergfell-Fuchs, Woessner, 2004)
  • Sample of 309 women university students
  • 27 reported at least one experience with
    unwanted sexual intercourse because it was
    hopeless to stop the man
  • 40 reported unwanted touching of breasts or
    genitals
  • 58 reported at least one experience of stalking
  • Alcohol and drug use increases risk (Krahe,
    Scheinberger, Waizenhoter, 1999)

108
United States vs. Germany
  • Teen Pregnancy Rates
  • U.S. 5 times higher than in Germany
  • Sexually Transmitted Infection Rates (HIV,
    Syphilis, Gonorrhea, Chlamydia)
  • U.S. 5-66 times higher than in Germany
  • Reasons
  • Unwritten Social Contract Well respect your
    right to act responsibly, giving you the tools
    you need to avoid unintended pregnancy and
    sexually transmitted infections, including HIV.
  • Societal openness and comfort with sexuality and
    pragmatic governmental policies.

109
Prevention Programs
  • Best Practices involves programs that attempt to
    affect multiple risk (self-esteem) and protective
    factors (resilience) at both person-centered
    (skills training) and environment-centered
    (school, family) levels
  • Most effective when learning takes place over
    time with practice.
  • Child abuse prevention programs lead to greater
    knowledge and skills regarding sexual safety.

110
Curriculum Overview
  • Kindergarten
  • Giving and getting safe touches
  • Dealing with unsafe touches
  • Learning the touching rule
  • Learning the safety steps
  • Grade 1
  • Identifying touches safe touches/unsafe touches
  • Safety Physical abuse-Telling an Adult
  • Learning the touching rule
  • The always ask first rule (this is stranger
    danger basically)
  • Grade 2
  • The touching rule
  • The always ask first rule
  • Secrets about touching-telling a grown-up
  • Identifying touches safe touch/unsafe touch

111
Curriculum Overview
  • Grade 3
  • The touching rule and safety steps
  • The always ask first rule
  • Identifying touches safe / unsafe / unwanted
    touch
  • Cyber safety Go Places Safely
  • Grade 4
  • Harassment-knowing what to do
  • Cyber safety - What's Private?
  • Defining and Understanding Sexual Safety
  • Grade 5
  • Safety with cyber pals
  • Keeping Out of Danger
  • Defining and Understanding Sexual Safety

112
Curriculum Overview
  • Grade 6
  • Safe talking in cyberspace
  • Knowing Who You Can Ask and Tell
  • Defining and Understanding Sexual Safety
  • Grade 7
  • Cyber safety Personal information and meeting up
  • Refusal Skills
  • Defining and Understanding Sexual Assault
  • Grade 8
  • Cyber safety Online chat/messaging
  • Signals of Intent to Have Sex
  • Defining and Understanding Sexual Assault
  • Grade 9
  • Cyber safety Grooming and luring
  • Dating violence
  • Reducing Risk of Sexual Assault

113
Curriculum Overview
  • Grade 10
  • Cyber safety Cyber stalking
  • Date rape
  • What is sexuality?
  • Decision Making
  • Defining and Understanding Sexual Assault
  • Grade 11
  • Sexual harassment
  • Gender roles/stereotypes
  • Assertive Communication
  • Defining and Understanding Sexual Assault
  • Grade 12
  • Sexual orientation
  • Setting Sexual Limits
  • Defining and Understanding Sexual Assault
  • Date rape drugs

114
Instructional Considerations
  • Create a Support Team
  • Staff support important
  • Teachers are in best position to implement
    program and make a difference
  • Student access
  • Consistency of information
  • Knowledge of individual students
  • Best position to assess learning

115
Classroom Guidelines
  • Setting up the classroom
  • Circles and horseshoes
  • Can use a station
  • Establishing ground rules
  • Behavioral conduct rules
  • Encourage students to participate in making the
    rules
  • Frame rules in the positive
  • Instead of Dont talk out of turn say Raise
    your hand and wait until youre called on.

116
Classroom Guidelines
  • Setting the pace
  • Encouraging participation from all
  • Wait time (5-10 second rule)
  • Attend to nonparticipators
  • Handling disruptive behavior
  • Follow-up later as may be a sign of abuse

117
Lesson Highlights
  • Grade Level
  • Content Areas
  • Materials
  • Procedures (teaching steps)
  • Reflection
  • Resources

118
Sample Lesson Plan
  • Grade Level Elementary School Grade K
  • Content Area Getting and Giving Safe Touches
  • Objectives
  • Students will be able to identify safe, caring
    touches
  • Materials
  • Precut magazine photos of safe touches
  • Construction paper for each student
  • Paste
  • Doll

119
Procedure (Teaching Steps)
  • 1. Warm-up / Review
  • Review some of the rules that the children have
    learned that keep them safe. For example Always
    ask you parents / guardian if someone wants you
    to go with him or her. Always ask your parents /
    guardian if someone wants to give you a gift.
  • 2. Story and Discussion (Safety rules for
    touching)
  • Explain that there are many different types of
    touch. There are safe touches and there are
    unsafe touches. Safe touches are good for your
    body. They make you feel cared for, loved, and
    important.
  • 3. Show and Explain photograph A (or use a
    picture of a parent and child hugging)
  • Photograph A is on the back of card 8,
    Preschool/Kindergarten, unit II Touching Safety.
  • Explain who / what is in the picture. For
    example, This is a picture of Chris and his
    dad. Discuss the following questions with the
    class
  • a) Does this look like a safe or an unsafe touch?
    (Safe touch) How can you tell? (By the faces of
    the two people. They look happy.)
  • b) Why do you think the parent is hugging the
    child? (He loves Chris. He is happy. They
    havent seen each other in a while.)

120
Procedure (Teaching Steps)
  • 4. Introduce a doll or puppet and ask the
    students to give the doll or puppet safe touches
    (pats on the head, holding hands, shaking hands.)
  • a) Ask the class who gives safe touches likes the
    safe touches they gave the doll or puppet.
  • b) Demonstrate a safe touch with the students by
    shaking their hands.
  • 5. Activity Safe Touch Collage
  • Have each student choose several pictures of safe
    touch that he or she likes and glue them onto a
    piece of construction paper. In a sharing
    circle, ask the children to say why they like the
    touches theyve chosen and from whom they like to
    receive such touches.
  • 6. Summarize the lesson
  • Remind the students that they have learned about
    different kinds of touch and that safe touches
    are good for your body and make you feel cared
    for, loved, and important.

121
Reflection
  • Students will be able to recognize safe touches
  • Resources
  • Video Joey Learns the Touching Rule
  • Book Sams Story. A Committee for Children
    Publication

122
Questions and Reactions
123
Teacher Training
124
Guidelines for Appropriate Touching of Students
  • Evaluate
  • What is your preferred style of touching?
  • Appropriate Touch
  • Children need appropriate touching
  • Should originate from student needs
  • Give options
  • Talk
  • Establish appropriate boundaries that are
    sensitive to culture, beliefs, and person history

125
Recognizing Disclosures of Child Abuse
  • Teachers are in a unique position to recognize
    and help abused children
  • Signs of Abuse
  • Sudden changes in behavior
  • Inappropriate sexualized behavior
  • Excessive play with private body parts
  • Disclosure

126
Types of Disclosure
  • Direct Disclosure
  • Indirect Hints
  • My brother wouldnt let me sleep last night.
    Mr. Jones we
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