The integrative approach, “Sequentially Planned Integrative Counselling for Children” (SPICC Model) outlines a way to working with children and adolescents who are suffering from emotional, cognitive and behavioural disturbances. Judy’s feeling of sadness and general social disinterest can well be solved using this approach. This model integrates a range of theoretical concepts and approaches to reach desired outcomes in the client/counselling environment (Geldard, Geldard, and Yin Foo, 2013). SPICC is a well-structured kind of integration and the theory is used in a sequence that provides a plan when working. The sequential plan is used deliberately so that the theory can be applied appropriately.
Therapeutic change requires the client to go for several or a single SPICC cycle depending on how many issues the child has and need to be solved with a clear start, middle and end of the cycle. The main goal of taking the child through these cycles is to help them acquire adaptive functioning skills e.g. in their relationship with others, at school or with their parents. Processes in the spiral are part of the counselling procedure, that is, as the kid tells their story deeply, there is the occurrence of experiential piece that has strong transference. Emotions and a lot of resistance are also involved as the kid tells their part of experience.
As the child continues to explore how they view themselves and confronting their beliefs that are self-destructive, there is occurrence of a cognitive shift. The child finally starts to implement the newly acquired skills of behaviour in their real life. According to Geldard, Geldard, and Yin Foo (2013), the child has got a whole tool box of new experiences that brings to completion the therapy cycle or opens up another cycle. Timely switch or transition between the phases of SPICC is important in therapeutic change in order for the therapy to be effective. Geldard et al (2013) argues that a counsellor can use the collaborative style that entails both directive and client-led interventions. The style is inspired by luminaries who include client led self-discovery and client led counsellor interpreted. This is however done without a bias towards any particular one in the name of pluralism. It is crucial to develop an individual’s style.
There are several interventions that are important to have an effective therapeutic process. They include the use of an appropriate media, creating a trusting relationship, using appropriate skills and interventions for dealing with transference and resistance and lastly, providing opportunities or facilities for play that are meaningful. These conditions would emphasize on provision of safe space for the Judy’s story to unravel in the room of therapy throughout all the phases of SPICC. According to Robson (2010), the first impression of the client in the first one or two sessions are important in furthering the next stages and the case is the same in adults. The counsellor should understand that children, just like adults will be able to know whether the therapist is inattentive, attuned or lacking attention to detail. It is therefore important that I learn how close the Judy’s frame of reference is for initial communication. Greater attention to detail may be required in children as when compared to adults.
Moreover, kids cooperate better when it comes to bodywork or exercises that require movements of the body. It would be a good idea to acknowledge how good the child is at performing the activities compared to the therapist. This is where it is advisable to apply behavioural and cognitive pieces of SPICC as different ages greatly differ (Clifford, 2013). It is important to maintain a therapeutic relationship with a child for them to have trust on a therapist. In this case, Judy had been opening up to the therapist in the few sessions they had shared together. It is important for the therapist to make sure that Judy does not lose trust in her.
As her therapist, I would continue giving early evidence of being helpful in assisting Judy overcome the impact of her parents’ divorce. According to Clifford (2013), clients usually consider their therapists as helpful if from the beginning, the therapist helps the client see their situation in a manner that no one is to be blamed. Judy can then start to thinking positively about the divorce of her parents and start being interested in learning again. Since I am Judy’s therapist I am supposed to be in a position to understand how confusing, stressful and sad divorce can be to any kid. I should therefore work closely with Judy’s mum to help her provide stability at their home. The stability at Judy’s home should be with reassurance in a positive attitude
However, I am supposed to be cautious not to share sensitive issues or ask sensitive questions about the cause of the divorce. This is because there are ethical and legal obligations that apply when counseling minors. Confidentiality is essential not to cause more harm than good. Another specific intervention I would use on Judy would be to show her that I am capable of keeping every session emotionally safe. Clients are able to notice early enough whether the therapist is likely to be judgmental. This is what the therapist must avoid.
In this case, I would avoid making judgment on what Judy is doing with drugs that she is abusing and her lack of interest in learning. Duff and Bedi (2010) explains how clients generally need to have enough feedback that they can be able to grow or come out of their challenges or problems. In the same way, clients feel they want feedback that is informative compared to critical information. This helps the client to feel safe rather than hurt by a situation. In the same way, I should not make Judy feel worse hurt by her situation of using marijuana or lack of interest her studies.
The other intervention to creating and maintaining an effective therapeutic relationship would be conveying perspectives that enhance Judy’s self-esteem along with provision of constructive coaching and feedback. When the counselor shares positive appreciation, comments, enjoyment and so forth, the self-esteem of the client tend to grow (Clifford, 2013). Genuine admiration, appreciation and acknowledgement of clients’ progress after every session are critical in boosting the esteem of the client. In the same way, focusing on client’s strengths help relaxing them and assists them to learn more.
As a therapist I would in the same way make positive comments and appreciate Judy for efforts she makes in class. Focusing on her strengths on what she can best do would also greatly help her not to have self-pity on looking at her divorced parents. Appreciation should also be made when Judy makes it through her withdrawal periods from marijuana (Geldard, Geldard, and Yin Foo, 2013). There is importance in asking nice questions because it enables clients to get insights and helps the clients to know that their therapists are interested in them. The therapist can give a summary of sympathy of how they got to where they are and this can create a bond between them. Coaching of clients using new skills and guiding clients from their problems to resolutions of issues that trouble the clients leads to client-therapist bond. This is because the clients feel a sense of progressing from feeling and doing better.
Adolescent and child psychiatrists deal with issues of ethics and questions in their professional activities. Whether in hospital settings or in private practice, ethical issues affect the relations of patients, organizations, families and agencies or colleagues. Ethical issues in most cases lead to legal concerns which can lead to complicating the decision making of the therapist. The most common issues involved in therapeutic practice with children and adolescents are issues of confidence and those of dissent/consent/assent. Confidentiality is a usual concern when working with kids. This is because guardians are the one who initiate care for the youngsters. The parents legitimately expect that the child’s therapist would give them the feedback to attempt improves care for their children (Robson, 2010). Another ethical issue that is involved in counselling children is the competence of the therapist. The therapist ought to be true and competent through having knowledge and skills. By doing this, the therapist can be able to deal with the young and understand human development.
As mentioned earlier, confidentiality is one of the most difficult areas to deal with and the most common ethical issue. Parents have legal right to knowing the examination, evaluation, records and treatment of their children. However, breaking confidentiality may lead to lack of trust and communication of the child to the therapist (Robson, 2010). The result of this is the child may not take treatment early enough. By informing the parents, the counselor is obeying the law. Confidentiality occurs in four types which are; complete, limited, informed forced or no guarantee. The psychiatry should understand that youngsters are undergoing fast developmental changes in cognitive, physical, communicative, affective and interpersonal spheres. Although there has been attention to ethical issues in adult therapy, there is less emphasis in dealing with children and adolescents. Despite the considerable overlap, working with adolescents has brought new factors that lead to need for separate ethical considerations. There should be balance between the rights of guardians and parents and those of adolescent patients.
Clifford, R. (2013). Children of Rogernomics: a neoliberal generation leaves school. British Journal Of Guidance & Counselling, 41(4), 463-465.
Duff, C. & Bedi, R. (2010). Counselor behaviors that predict therapeutic alliance: From the client's perspective. Counselling Psychology Quarterly, 23(1), 91-110.
Geldard K, Geldard D, Yin Foo R. (2013). Counselling Children: A Practical Introduction.4th ed. London: Sage.
Robson, M. (2010). Therapeutic work with children: a contextual overview. British Journal Of Guidance & Counselling, 38(3), 247-261.