1. By Josh and Megan

2. Relevant Issues
Bullying
Social Anxiety
School
Academic
Stressors
Stigma

3. Video Clip

5. Bullying
 1 in 7 Students in Grades K-12 is either a bully or a victim of bullying.
 It is estimated that 160,000 children miss school every day due to fear
of attack or intimidation by other students. Source: National Education
Association.
 According to bullying statistics, 1 out of every 10 students who drops
out of school does so because of repeated bullying.
 Many kinds of bullying from National Centre Against Bullying (NCAB)
1. Physical bullying
2. Verbal bullying
3. Indirect bullying
4. Cyberbullying
http://www.makebeatsnotbeatdowns.org/facts_new.html

6. Example of Bullying

7. Social Anxiety
 SAD is quite common among adolescents, with lifetime prevalence rates of between 5 to
15 % of adolescents in the United States. (Kashdan, T. B., & Herbert, J. D. 2001)
 Cognitive Behavior Therapy is one of the most popular interventions for adolescents
anxiety. (Sauter, F. M., Heyne, D., & Michiel Westenberg, P. 2009)
 Anxiety disorders affect one in eight children. Research shows that untreated children
with anxiety disorders are at higher risk to perform poorly in school, miss out on
important social experiences, and engage in substance abuse.
(http://www.adaa.org/living-with-anxiety/children).
 Characterized by: (Kashdan, T. B., & Herbert, J. D. 2001)
 intense fear of embarrassment
 Humiliation
 Negative evaluation by others social situations
 Tendency to avoid situations
Kashdan, T. B., & Herbert, J. D. (2001). Social anxiety disorder in childhood and adolescence: Current status and future directions. Clinical Child and Family
Psychology Review, 4(1), 37-61.
Sauter, F. M., Heyne, D., & Michiel Westenberg, P. (2009). Cognitive behavior therapy for anxious adolescents: Developmental influences on treatment design
and delivery. Clinical Child and Family Psychology Review, 12(4), 310-35.

8. Example of Social Anxiety

9. Case Example: Steffan
15 years old
Diagnosed: Asperger's Syndrome
Bullied at School
Working on coping skills dealing with anxiety, anger or frustration
States he is gay
Lives with mother and step father

10. Cognitive Theory Practice:
 Individuals with High functioning Autism/ Asperger Syndrome
also exhibit deficits in the cognitive and self-regulatory processes
known as executive functioning. (Grattan and Eslinger 1992)
 this study challenges thinking patterns and includes the use of
metacognitive strategies, self-monitoring and self-regulation,
and exposure and response situations (Solomon et al. 2004;
Webb et al. 2004).
 Significant gains also were noted in participants’ demonstrated
abilities to make inferences about the cause of problems and
their abilities to identify potential problem solutions.

Stichter, J. P., Herzog, M. J., Visovsky, K., Schmidt, C., Randolph, J., Schultz, T., & Gage, N. (2010). Social competence
intervention for youth with Asperger syndrome and high-functioning autism: An initial investigation. Journal of
Autism and Developmental Disorders, 40(9), 1067-79.

11. Beck’s Model of Cognitive Theory
Situation Emotion (S) Automatic Thought (s) Rational Response Outcome

12. Psychodynamic Practice
 “All of the brilliantly understood knowledge in the
world will not make a clinician effective with
adolescent clients unless he or she is able to form a
good relationship with those clients (Roaten, G. K.,
2011)”
 “Through empathy we can tap into areas of the
personality to which the child’s verbalization may not
give us access (Palombo, 2001)”

13. Academic Stressors
 Stress associated with school
attendance, academic achievement,
social rejection, and humiliation
may have serious consequences on
students who have other risk
factors for suicide (Medina,C., &
Luna, G. 2006)
 Students with learning and
behavioral disabilities are more
likely to experience school stress
(Medina,C., & Luna, G. 2006)
 Medina, C., & Luna, G. (2006). SUICIDE ATTEMPTS
AMONG ADOLESCENT MEXICAN AMERICAN
STUDENTS ENROLLED IN SPECIAL EDUCATION
CLASSES. Adolescence, 41(162), 299-312.

14. Stigma
 Teens without adult and
peer support have an
increased tendency
toward suicide. Many of
them feel marginalized
and unaccepted
(Medina,C., & Luna, G.
2006)

15. Case Example: Meghan
14 years old
Father is a
severe
alcoholic
Parentified,
never was
taken “care of”
by mom
Shame &
Stigma over
being the
daughter of an
“alcoholic”
Anxiety &
stress with
school work
(high
academic
achievement
with effort)

16. EBP
 Bond with caregiver & the needs of the self- “Failure to
accommodate this position leaves the individual
feeling isolated and depressed, with no self object
support for ones true self. “
 “The child (and later, the adult) is on a continual
search for self object experiences that will provide
what is lacking”
 “As the self becomes strengthened through self object
responsiveness (most notably in the therapeutic
relationship), it becomes less shameful of these self
object needs…” (Cooper & Lesser, 2011)

17. In Session
 Building the therapeutic alliance
 Use of empathy, warmth and acceptance
 Provide a holding environment- intense and often
“unacceptable” feelings
 Validating and mirroring Meghan’s feelings
 Giving Meghan some control, ownership and responsibility
within session (partner vs. authority)
 Transference and counter transference
Roaten, G. K. (2011). Innovative and Brain-Friendly Strategies for Building a Therapeutic
Alliance With Adolescents. Journal Of Creativity In Mental Health, 6(4), 298-314.
Palombo, J. (2001). The Therapeutic Process with Children with Learning Disorders.
Psychoanalytic Social Work, 8(3/4), 143-168.

18. Additional Helpful Techniques
 Young people may find therapeutic benefit from
experiential approaches using art or some other form
of metaphoric communication (Roaten, G.K., 2011)
 Sandbox , music, interactive games

19. CBT
Psychodynamic
Theory Overlap