Psychology Counseling Services in School Psychology
by
Tony D. Crespi, Mikayla Alicandro
  • LAST MODIFIED: 15 January 2020
  • DOI: 10.1093/obo/9780199828340-0257

Introduction

School psychologists can provide an important contribution through the provision of counseling services. While psychological assessment remains a foundation area separating school psychologists from other disciplines, counseling services offer school psychological service models an important juncture for impacting a multiplicity of psychological, familial, and school problems. Given the diversity of counseling services provided within modern schools, though, school psychologists and support professionals often lack critical information on the role school psychologists can play in providing a wide spectrum of counseling services. This article considers contemporary mental health issues impacting children, examines individual and group counseling models, considers newer research involving family counseling within the schools, and discusses legal challenges.

Overview: Challenges and Competencies

Children face a wide array of societal, familial, and personal challenges. Looking at child maltreatment alone—physical, sexual, and emotional abuse and neglect in children—Lusk, et al. 2015 notes that more than 3 million children in the United States are impacted. Still, while compelling, such areas as physical, sexual, and emotional abuse outside the schools do not represent the only avenues in which children’s emotional well-being are impacted. Looking within the schools, Spakowski and Crespi 2017 suggests that approximately 9.6 percent of children—or more than 3.5 million children—may experience inappropriate sexual contact with teachers. In fact, looking at this latter issue, US Department of Education 2004 reports that 9.6 percent of children in grades 8 to 11 report unwanted educator sexual advances. Fundamentally, school psychologists can help children cope with issues stemming from both outside as well as inside the schools. Still, these points only capture part of the spectrum of problems that have faced and continue to face children. Further, the number of children in need of counseling is significant. In fact, several million children are in need of psychological services. As an illustration, La Salle, et al. 2017 argues that school psychologists can be invaluable in identifying at-risk youth in the general population, and Miller and Eckert 2009 highlights the ethical responsibility to identify children at risk for suicide. Truly, from general psychological problems to teacher sexual contact, the need for counseling services is significant. Fortunately, school psychologists are well positioned to offer assistance. Spakowski and Crespi 2017 makes the point that school psychologists are in a key position to offer counseling. In fact, more than two decades have passed since schools were described as a perfect vehicle for the provision of counseling services (Leaf, et al. 1996, p. 620). Indeed, Roberts, et al. 2003 indicates that, given the number of children with severe psychological issues, the need for counseling services for children is notable.

  • La Salle, T. P., C. Wang, L. Parris, and J. A. Brown. 2017. Associations between school climate, suicidal thoughts, and behaviors and ethnicity among middle school students. Psychology in the Schools 54.10: 1294–1301.

    DOI: 10.1002/pits.22078Save Citation »Export Citation » Share Citation »

    A study investigating the relationship between suicidal thoughts and behaviors, school climate, and student demographics. The role of school psychologists in identifying and advocating for at-risk students and implementing appropriate interventions within school systems is considered.

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  • Leaf, P. J., M. Alegria, R. Cohen, et al. 1996. Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry 35:889–897.

    DOI: 10.1097/00004583-199607000-00014Save Citation »Export Citation » Share Citation »

    This article discusses results from the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The survey was designed to identify patterns in children and adolescents’ reported use of mental health and substance abuse services among four communities. Results varied, indicating that techniques for the increase of mental health service use among this population should be further considered.

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  • Lusk, V. L., J. Zibulsky, and K. Viezel. 2015. Child maltreatment identification and reporting behaviors of school psychologists. Psychology in the Schools 52.1: 61–76.

    DOI: 10.1002/pits.21810Save Citation »Export Citation » Share Citation »

    Due to the prevalence of child maltreatment, identifying best practices in mandatory reporting is crucial. This article addresses the unique role of school psychologists in identifying and reporting child maltreatment through methods such as consultation, evaluation, prevention, and intervention.

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  • Miller, N. D., and L. T. Eckert. 2009. Suicidal behavior: An introduction and overview. School Psychology Review 38.2: 153–167.

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    While school psychologists have an ethical and legal responsibility to prevent youth suicide, they often lack proactive strategies to deal with those at risk. This article offers an overview of youth suicidal behavior, as well as the implications regarding the practice of school psychology in relation to this issue.

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  • Roberts, M. C., A. K. Jacobs, R. W. Puddy, J. E. Nyre, and E. M. Vemberg. 2003. Treating children with serious emotional disturbances in schools and community: The Intensive Mental Health Program. Professional Psychology: Research and Practice 34:519–526.

    DOI: 10.1037/0735-7028.34.5.519Save Citation »Export Citation » Share Citation »

    Children with serious emotional disturbances are often considered by school personnel to be the most difficult students to educate and maintain. Considering that 5 percent of all children exhibit serious emotional disturbances, the implementation of effective interventions within school systems is needed. This article describes an integrated model of service and therapy—the Intensive Mental Health Program—that is designed to appropriately serve the needs of students with serious emotional disturbance (SED) in relation to their psychological functioning, behavioral management, and educational success.

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  • Spakowski, A. M., and T. D. Crespi. 2017. Sexual abuse with children: Educator infractions and counseling considerations. Online Journal of Counseling and Education 6.1: 30–40.

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    Teacher sexual misconduct toward students is a critical problem within schools, but it often goes unreported and unresolved. Therefore, understanding the prevalence and profound impact that such abuse has on students and school systems is crucial. This article examines these issues and considers preventative interventions that school psychologists can utilize to ensure safe school environments for students.

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  • US Department of Education. 2004. The condition of education 2004. Washington, DC: National Center for Education Statistics.

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    The National Center for Education Statistics serves as a federal entity for the collection, analysis, and reporting of educational data relative to the Department of Education in the United States and Territories. Statistics regarding US school systems’ conditions and students’ progress can be considered via this online source.

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The Primacy of the Therapeutic Relationship

One consistent finding that has emerged from psychotherapy outcome research is that while psychotherapy is found to be generally effective, outcomes tend to be similar across widely divergent therapeutic approaches, as noted in Lambert and Ogles 2004. These results have stimulated examination of the factors that are common across all counseling and psychotherapy approaches. One of the common factors research has pointed to is the critical role that the therapeutic relationship plays in therapy effectiveness. In fact, Asay and Lambert 1999 estimates that the therapeutic relationship accounts for 30 percent of the variance in psychotherapy outcomes, or twice what is accounted for by technique or therapeutic orientation. The importance of the therapeutic relationship is hypothesized by Murphy 1999 as possibly more critical to success in work with children and adolescents. Shirk and Karver 2003 is a meta-analysis of the research linking the therapeutic relationship with outcomes in child and adolescent therapy, and finds that relationship variables are modestly but consistently correlated with outcome across diverse types and modes of therapy for children and adolescents. Based on this work, we know that a simple but powerful therapeutic tool that school psychologists can use to effect favorable counseling outcomes is the development of warm, positive therapeutic relationships, as well as a shared sense of goals and active collaborations, often referred to as the therapeutic alliance—as emphasized by Lambert and Ogles 2004. Simply stated, when children feel respected, heard, and understood by someone they feel they can trust, they will be more open, self-disclosing, and motivated to change, and more receptive and responsive to interventions. The techniques and strategies used to foster positive therapeutic relationships are based on the humanistic orientation of client-centered psychotherapy, and hinge on the foundational techniques of active listening and reflection taught in most introductory counseling courses. Broken down into its most basic elements, Ivey and Ivey 2006 identifies the microskills involved in listening and empathic understanding, including attending behavior; use of open questions; observation skills; encouraging, paraphrasing, and summarizing; and noting and reflecting feelings. All told, then, Auger 2005 advocates the use of a broadly humanistic approach, which emphasizes a warm caring relationship and exploration of client feelings and experiences; this may be sufficient to provide substantial improvement in some cases seen by school psychologists.

  • Auger, R. W. 2005. School-based interventions for students with depressive disorders. Professional School Counseling 8.4: 344–352.

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    This article considers the role of school counselors in assisting students with depressive disorders through the use of appropriate interventions. Both individual and group interventions are discussed, along with guidelines and strategies to effectively consult with other school personnel in order to alleviate students’ depressive symptoms.

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  • Asay, T. P., and M. J. Lambert. 1999. The empirical case for common factors in therapy: Quantitative findings. In The heart and soul of change: What works in therapy. Edited by M. A. Hubble, B. L. Duncan, and S. D. Miller, 23–55. Washington, DC: American Psychological Association.

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    This chapter considers the debate surrounding the use and effectiveness of psychotherapeutic treatment. Specifically, multiple research studies supporting the general effectiveness of psychotherapy and common factors relative to such treatment are examined. One common factor considered to be of much influence in the effectiveness of psychotherapy is that of the therapeutic relationship.

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  • Ivey, A. E., and M. B. Ivey. 2006. Intentional interviewing and counseling: Facilitating client development in a multicultural society. 6th ed. Pacific Grove, CA: Brooks/Cole.

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    This book provides a step-by-step approach to intentional interviewing and counseling with children and adolescents. Specifically, a hierarchy of microskills is described in order for the development of a positive therapeutic relationship to be established.

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  • Lambert, M. J., and B. M. Ogles. 2004. Efficacy and effectiveness of psychotherapy. In Bergin and Garfield’s handbook of psychotherapy and behavior change. 5th ed. Edited by M. J. Lambert, 139–193. New York: John Wiley & Sons.

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    This book provides a critical examination on the efficacy and effectiveness of counseling and psychotherapy. Too often practitioners are unaware of differences between and among modalities. This text serves a vital role and as a key reference in this regard.

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  • Murphy, J. J. 1999. Common factors of school-based change. In The heart and soul of change: What works in therapy. Edited by M. A. Hubble, B. L. Duncan, and S. D. Miller, 361–386. Washington, DC: American Psychological Association.

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    This chapter examines the effectiveness of psychotherapeutic treatment within school systems to bring about school-based change across a variety of contexts. Specifically, a collaborative common factors approach, known as the 5-E method, is considered in relation to such change. In this method, the therapeutic relationship is considered to be an important factor in children and adolescents’ treatment success.

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  • Shirk, S. R., and M. Karver. 2003. Prediction of treatment outcome from relationship variables in child and adolescent therapy: A meta-analytic review. Journal of Consulting and Clinical Psychology 71.3: 452–464.

    DOI: 10.1037/0022-006X.71.3.452Save Citation »Export Citation » Share Citation »

    This article examines the results of twenty-three studies in which the associations between variables relative to children and adolescents’ therapeutic relationships and outcomes of treatment were considered. Specifically, the importance of the therapeutic relationship for treatment success was found to be moderately but consistently related across all developmental levels and types of therapeutic techniques assessed.

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Counseling and Psychological Maltreatment

Lusk, et al. 2015 (cited under Overview: Challenges and Competencies) reports that child maltreatment alone is a prevalent problem, with some 800,000 cases reported in one recent year. Given that educators are mandated reporters, the work of school psychologists in helping teachers understand the issues is also a notable challenge. Looking wider, Duchnowski, et al. 2002 reports that since the beginning of this century, approximately 10 percent of adolescents have moderate to severe mental health problems necessitating intervention, and 20 percent have mental health problems creating at least mild problems. Root and Resnick 2003, meanwhile, estimates that 3 to 7 percent of children have attention-deficit/hyperactivity disorder (ADHD). Looking at the most prevalent disorders, Lee, et al. 2016 notes that anxiety disorders are among the most prevalent psychiatric disorders in children, with prevalence rates from 6 to 20 percent, and that this condition places a child at risk for additional psychopathology. In many ways, given that school-based mental health services are often the only services available to students (see Auger 2005, cited under Primacy of the Therapeutic Relationship), school psychologists are in an unparalleled position.

  • Duchnowski, A. J., J. Kutash, and R. M. Friedman. 2002. Community-based interventions in a system of care and outcomes framework. In Community treatment for youth: Evidenced-based interventions for severe emotional and behavioral disorders. Edited by B. Burns and K. Hoagwood, 16–37. New York: Oxford Univ. Press.

    DOI: 10.1093/acprof:oso/9780195134575.003.0002Save Citation »Export Citation » Share Citation »

    Considering the prevalence and impact of moderate to severe mental health problems among the adolescent population, identifying appropriate interventions within school systems is important. Through consideration of changes related to the effectiveness of treatment interventions and the delivery of mental health services throughout history, school personnel can gain a better understanding of the effectiveness of specific interventions to treat this population.

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  • Lee, S. S., A. M. Victor, M. G. James, L. E. Roach, and G. A. Bernstein. 2016. School-based interventions for anxious children: Long-term follow-up. Child Psychiatry and Human Development 47:183–193.

    DOI: 10.1007/s10578-015-0555-xSave Citation »Export Citation » Share Citation »

    Anxiety disorders are among the most prevalent psychiatric disorders among children and adolescents. Consequently, such high prevalence rates place this population at risk for additional psychopathology and psychiatric diagnoses. Therefore, understanding best practices in treatment interventions for anxiety disorders among youth is critical. This study considers the long-term outcomes of cognitive-behavioral therapy and parent training on youth’s anxiety symptoms three years post-treatment.

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  • Root, R. W., and R. J. Resnick. 2003. An update on the diagnosis and treatment of attention-deficit/hyperactivity disorder in children. Professional Psychology: Research and Practice 34:34–41.

    DOI: 10.1037/0735-7028.34.1.34Save Citation »Export Citation » Share Citation »

    Gaining a comprehensive understanding of attention-deficit/hyperactivity disorder (ADD/ADHD) is crucial for the effective delivery of empirically based treatments to take place within school systems. This article provides an important look at multiple components related to the disorder, including DSM-V criteria for diagnosis, prevalence and progression, comorbidity, influential factors, assessment, and legislature pertaining to diagnosis.

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Individual Counseling

One-on-one counseling represents the most commonly practiced psychological intervention, and Prout, et al. 1993 finds that these approaches are used by school psychologists more than other interventions. Although counseling is more time-intensive than other modalities, it offers advantages. In particular, individual interventions allow for a treatment approach tailored to each student’s particular issues, needs, and goals. In addition, one-on-one counseling affords the opportunity to develop a strong therapeutic relationship between the school psychologist and student. Individual counseling also presents challenges for schools. The constraints of the school day necessitate briefer sessions and shorter treatment than in clinical environments, for example. Prout, et al. 1993 finds that school psychologists report individual counseling sessions last typically 30–40 minutes, and individual cases last ten sessions. Another challenge to the school practitioner is the ambiguous nature of the client. Although the identified client is ostensibly the student, school psychologists are also meeting needs of teachers, parents, and administrators, and may work with any of these people. Students are rarely self-referred and are commonly referred to school psychologists by teachers, administrators, or parents. As such, Shirk and Karver 2003 (cited under Primacy of the Therapeutic Relationship) notes that students may not recognize or acknowledge problems, may feel misunderstood, may feel blamed, or may feel stigmatized by a referral. In fact, the nature of the referral may result in poor motivation or defiance. Lambie 2004 (cited under Motivation Enhancement Approaches) notes this stance may be common among adolescents. How effective is individual counseling? Outcome studies of psychotherapy interventions with children indicate that there is sound empirical support for the effectiveness of counseling with youth. Meta-analytic studies find that children and adolescents who receive counseling or psychotherapy fare better than those who do not receive services: the interventions are moderately successful and the benefits are lasting. Given the benefits of school-based counseling, the question becomes not whether school psychology practices should include individual counseling, but rather what methods to adopt to optimize outcomes. School psychologists have described themselves as “eclectic pragmatists” (Sandoval 1993), and have traditionally adopted a wide range of approaches. As an illustration, Prout, et al. 1993 finds that school psychologists tend to report cognitive-behavioral orientations as most useful, but also endorse a variety of orientations, including multimodal therapy, reality therapy, family systems, social learning, and client-centered approaches. Consideration of the outcome literature from the past twenty years, and the parameters of school counseling interventions, suggests several principles and approaches for school psychologists in their individual work with students.

  • Prout, H. T., S. P. Alexander, C. E. M. Fletcher, J. P. Memis, and D. M. Miller. 1993. Counseling and psychotherapy services provided by school psychologists: An analysis of patterns in practice. Journal of School Psychology 31:309–316.

    DOI: 10.1016/0022-4405(93)90013-9Save Citation »Export Citation » Share Citation »

    This article examines the results from a survey regarding patterns of practice within the field of school psychology. Specifically, topics related to the role of school psychologists and the delivery of their services are discussed in detail. The importance of school psychologists in the provision of counseling and psychotherapy and the implications of individual counseling within schools are also considered.

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  • Sandoval, J. 1993. The history of interventions in school psychology. Journal of School Psychology 31:195–217.

    DOI: 10.1016/0022-4405(93)90028-HSave Citation »Export Citation » Share Citation »

    Understanding which interventions are best for students and how to properly implement them within the school system are important aspects of a school psychologist’s role. This article considers the different aims and classifications of recommended interventions, such as those involving the modification of behavior, self-perception, and the environment within the classroom and general school setting.

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Cognitive-Behavioral Approaches

Among school psychologists, Prout, et al. 1993 and Sandoval 1993 (both cited under Individual Counseling) find behavioral and cognitive-behavioral approaches have been popular and viewed as useful. These approaches seem appealing for counseling in schools, as they tend to be oriented toward work on specific, concrete problems, symptoms, and disorders. In addition, they are present-focused, structured, and geared toward short-term treatment. Indeed, their efficacy in these contexts is supported empirically. While Prout and DeMartino 1986, a meta-analysis of school-based psychotherapy, finds that all therapy orientations are effective generally, the largest effect sizes were found for behavioral and cognitive approaches. These authors also found that the problems treated most successfully were observable behaviors and problem-solving skills. Roberts, et al. 2003 (cited under Overview: Challenges and Competencies) is a review of the evidence-based support for therapeutic approaches across specific problem domains. The review determined that cognitive-behavioral therapy (CBT) approaches were unequivocally the most effective treatments for anxiety disorders, including obsessive-compulsive disorder and post-traumatic stress disorder. These findings replicate strong empirical support for CBT approaches with youth in traditional clinical settings (Braswell and Kendall 2001), and in general they mirror the treatment outcome literature for adults, which consistently finds CBT to be highly effective for treating anxiety disorders. While studies like Roberts, et al. 2003 (cited under Overview: Challenges and Competencies) and Auger 2005 (under Primacy of the Therapeutic Relationship) find CBT is not as robust for depressive disorders, the data finds that CBT and behavioral interventions continue to be a viable and effective treatment approach. Given the strong evidence supporting CBT for anxiety in children and adolescents, and the high prevalence of anxiety disorders among children and adolescents (see McLoone, et al. 2006), all school psychologists who provide individual counseling should have some acquaintance with the basic arsenal of cognitive-behavioral techniques and strategies. Fortunately, McLoone, et al. 2006 and Roberts, et al. 2003 (under Overview: Challenges and Competencies) provide a useful sense that CBT techniques are relatively straightforward to learn, since they are based on a very structured approach for which a number of step-by-step manuals are available. Roberts and colleagues advise that school psychologists invest in a number of CBT treatment programs, such as Philip Kendall’s “Coping Cat” program, a manualized individual treatment for anxiety in 9- to 13-year-olds.

  • Braswell, L., and P. C. Kendall. 2001. Cognitive-behavioral therapy with youth. In Handbook of cognitive-behavioral therapies. 2d ed. Edited by K. S. Dobson, 246–294. New York: Guilford Press.

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    Cognitive-behavioral therapy is a highly effective treatment in transforming thoughts, feelings, and behaviors. Therapies based in cognitive-behavioral theory allow for individuals to transform their current worldview and enhances problem-solving abilities. It is important to consider the value of age-appropriate modes of delivery, the client’s level of development, the roles and expectations of the therapist, and the recognition of the social context of treatment. This chapter provides an important look at the similarities and differences in facilitating cognitive-behavioral therapies.

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  • McLoone, J., J. L. Hudson, and R. M. Rapee. 2006. Treating anxiety disorders in a school setting. Education and Treatment of Children 29.2: 219–242.

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    Considering anxiety disorders are the most prevalent psychiatric diagnoses among youth, it is not a surprise that their implication and impact on this population is detrimental. Specifically, it has been noted that anxiety disorders have a significant impact on children and adolescent’s school functioning, especially when left untreated. This article offers a review of three school-based programs for the treatment of anxiety, and discusses practical issues regarding implementation.

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  • Prout, H. T., and R. A. DeMartino. 1986. A meta-analysis of school-based studies of psychotherapy. Journal of School Psychology 24:285–292.

    DOI: 10.1016/0022-4405(86)90061-0Save Citation »Export Citation » Share Citation »

    This article provides a meta-analytic review of thirty-three studies examining the effectiveness of school-based psychotherapy. Overall, results from the studies indicated that all school-based therapy orientations are found to be generally effective in treating students. More specifically, it was found that while psychotherapy was considered moderately effective when utilized within school systems, both cognitive and behavioral interventions are considered to be the most effective among this population, especially when targeting both observed behaviors and problem-solving abilities.

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Solution-Focused Brief Therapy

A relatively new addition to therapy approaches is solution-focused brief therapy (SFBT). Mostert, et al. 1997 notes that this approach seems suited to school-based counseling: it is briefer than cognitive-behavioral approaches, fits well into the time frames afforded individual interventions; is present- and future-oriented; and is limited in scope to addressing a specific problem. SFBT has the unique and appealing perspective of a strengths-based approach. Clients’ positive behavior is emphasized, and clients are seen as capable of solving their problems through their strengths. Through this positive lens, the focus of treatment is not on decreasing or eliminating negative behavior, but on increasing positive behavior. According to Newsome 2005, this positive focus engenders hope and enhances self-efficacy and self-esteem in students. Franklin, et al. 2008 and Newsome 2005 show that although support is not yet as extensive as for CBT, solution-focused brief therapy is promising and is accumulating a body of evidence supporting its efficacy. Murphy 1994 provides a useful overview of the approach, emphasizing the SFBT principle to increase successful behaviors and strategies rather than to eliminate negative behaviors or problems. Murphy also offers a detailed discussion of the “5-E” method utilized in SFBT: Task One, Eliciting: Allow client to describe his or her concerns and problems while being alert to possible exceptions to the problem pattern. Task Two, Elaborating: Instances of times of exception to the problem or symptoms are explored through questions about client experiences and circumstances. Task Three, Expanding: The task of treatment focuses on increasing instances of exception, times when the problem is not present or less severe and increasing the frequency of exceptions. Clients are encouraged to “do more of” what’s working. Task Four, Evaluating: Effectiveness of the efforts is evaluated based on predetermined goals. Scaled questions (ratings on a scale of 1 to 10, for instance) are frequently used. Task Five, Empowering: Encourage the client to take ownership of changes to increase self-efficacy. This includes strategies such as asking questions like, “How were you able to make that change?” In sum, individual counseling offers options for helping students and offers advantages in its ability to allow treatment tailored to needs and goals, and fosters an intensive, positive relationship between student and school. The development of this therapeutic bond forms the foundation to intervention, and the person-centered approach, which has as its centerpiece the therapeutic relationship to support and encourage students toward successful outcomes. In challenging cases, treatment approaches such as motivational enhancement, cognitive-behavioral strategies, and solution-focused brief therapy offer proven strategies for success.

  • Franklin, C., K. Moore, and L. Hopson. 2008. Effectiveness of solution-focused brief therapy in a school setting. Children and Schools 30.1: 15–26.

    DOI: 10.1093/cs/30.1.15Save Citation »Export Citation » Share Citation »

    The use of solution-focused brief therapy within schools has been considered efficacious in increasing the self-esteem and positive outcomes of students with behavioral problems in multiple studies. Due to the collaborative approach of SFBT between students, parents, teachers, and involved others, it is considered to be extremely effective within the school setting. Results from a follow-up study on previous research regarding the effectiveness of SFBT with sixty-seven middle school students identified with school-related behavioral problems are discussed within the article.

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  • Mostert, D. L., R. Johnson, and M. P. Mostert. 1997. The utility of solution-focused brief counseling in schools: Potential from an initial study. Professional School Counseling 1.1: 21–24.

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    School counselors have often expressed that the internal and external demands of the school system (e.g., heavy caseloads, time constraints, lack of resources, and nonpractical training) make adequate progress and success with students a difficult endeavor. SFBC has been considered a possible solution for school counselors due to its practical, effective, and flexible delivery. This article considers results from a study in which the efficacy of SFBC in the treatment of students by twenty trained school counselors was assessed.

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  • Murphy, J. J. 1994. Working with what works: A solution-focused approach to school behavior problems. School Counselor 42.1: 59–65.

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    This article discusses an alternative approach to traditional counseling in which the utilization of “exceptions” is focused on as opposed to “problems” inherent to the client. This circumstantial focus, considered unique to SFBC, is thought to be effective when working with students experiencing school-based behavioral difficulties due to the greater control gained over their behaviors. Further, the author offers a detailed discussion of the “5-E” method utilized in SFBT, which involves five major steps: Eliciting, Elaborating, Expanding, Evaluating, and Empowering (see paragraph above).

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  • Newsome, W. S. 2005. The impact of solution-focused brief therapy with at-risk junior high school students. Children and Schools 27.2: 83–90.

    DOI: 10.1093/cs/27.2.83Save Citation »Export Citation » Share Citation »

    Students considered to be “at risk” are increasingly more likely than those who are not at risk to have multiple school absences, higher drop-out rates, behavioral problems, below average achievement, and low expectations of themselves. Due to these negative outcomes, identifying appropriate interventions for these students is crucial. SFBC has been considered an effective treatment for these students due to its collaborative and future-oriented approach and its focus on student’s strengths and positive qualities. This article considers the outcomes of SFBT on twenty-six junior-high students identified as at risk within their school.

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Motivation Enhancement Approaches

As noted, students referred for counseling or psychotherapy in schools often present with denying problems, or lacking motivation for treatment. Fortunately, clinicians have available empirically supported strategies for enhancing insight and increasing motivation for change. Miller and Rollnick 2002 notes that motivational interviewing involves a set of techniques and strategies originally developed for use with substance abusers, another population often considered resistant to treatment or unmotivated for change, However, Lambie 2004 says the approach uses many of the principles from client-centered and cognitive orientations, and can be used successfully in school-based individual counseling. These strategies are primarily intended as very brief interventions (one to three sessions, typically) to facilitate greater problem recognition and motivation for change at the beginning stages of counseling, after which work can shift to change-focused approaches. Lambie reviews the basic principles and strategies of motivational enhancement approaches as applied to school settings. First, ambivalence and resistance to change is viewed as a normal response. It is understood that when pushed for change from outside, individuals often feel as though their autonomy and personal control are being challenged, and they react with a “push back” response. Therefore, motivational enhancement approaches seek to use active listening and gentle feedback approaches, instead of confrontation strategies, in order to encourage problem recognition by the student. These strategies allow students to explore all aspects of the problem issue, focusing on the perceived positives as well as negatives of their behavior or problem, and what they have to gain or lose by changing. A “decisional balance sheet” technique can be used, in which the student lists the pros and cons of changing, as well as the pros and cons of staying the same. Throughout the process, the clinician emphasizes the student’s control and personal choice in the issue. However, the clinician listens for and emphasizes “change talk,” or insight and acknowledgement that a problem may exist, and that change may be beneficial. Further, the clinician emphasizes the student’s ability to confront the problem and successfully negotiate change, as individuals will only move toward change when they believe there is a viable pathway and a reasonable chance for success.

  • Lambie, G. W. 2004. Motivational enhancement therapy: A tool for professional school counselors working with adolescents. Professional School Counseling 7.4: 268–276

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    It has been noted that, at times, adolescent clients may show defiance, resistance, and hostility to the provision of counseling services, especially within the school system. This article provides an important look at the challenges and complexities of working with adolescent clients with such an attitude. Motivational enhancement therapy (MET) is considered to be an effective treatment for adversarial adolescents. An introduction to the theoretical basis of MET and strategies for its use are also examined.

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  • Miller, W. R., and S. Rollnick. 2002. Motivational interviewing: Preparing people to change addictive behavior. 2d ed. New York: Guilford Press.

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    “Motivation interviewing” is an empirically based intervention aimed at increasing clients’ motivation for change. Originally directed toward individuals with substance abuse disorders, this treatment has been adapted and empirically supported to increase adherence and participation in noncompliant and unmotivated populations, including adolescents. This book can be used by practitioners as a guide for the proper implementation of the principles and skills that comprise motivational interviewing.

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Group Counseling

Littrell and Peterson 2002 observes that groups can positively impact schools. Fleming 1999 finds that fundamentally short-term counseling can be effective in helping children develop adaptive processes for coping. Still, what groups are generally involved? What “stages” characterize group process? What issues need to be considered in initiating group counseling services? Shechtman 2002 outlines major group types: (1) Educational Groups: typically, these groups target the normal population and may address social skills issues including classroom behavior, school performance, and peer relations. (2) Counseling Groups: typically, these groups target children with developmental challenges, with the groups often addressing self-esteem and social challenges. (3) Therapy Groups: these groups are targeted at adjustment and behavioral difficulties ranging from aggressive and violent behavior to eating disorders, depression, and suicide.

  • Fleming, V. M. 1999. Group counseling in the schools: A case for basic training. Professional School Counseling 2:409–414.

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    Group counseling within school systems can be beneficial to students by providing them with opportunities to develop social skills, explore sensitive and personal issues, and engage with peers exploring similar experiences. These opportunities, though, are only beneficial when provided by those with appropriate training and education in such work. This article considers the importance of the level of competence and training of those facilitating group counseling with students to ensure beneficial outcomes.

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  • Littrell, J. M., and J. S. Peterson. 2002. Establishing a comprehensive group work program in an elementary school: An in-depth case study. Journal for Specialists in Group Work 27:161–172.

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    Understanding how to create and maintain comprehensive group counseling within school systems is a challenging yet beneficial endeavor. This article discusses the results from an in-depth case study examining the influential factors related to the establishment of successive school-wide group counseling programs. Specifically, the importance of a counselor’s knowledge and skill set in facilitating positive and effective group work within the schools is considered in detail.

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  • Shechtman, Z. 2002. Child group psychotherapy in the school at the threshold of a new millennium. Journal of Counseling and Development 80:293–299.

    DOI: 10.1002/j.1556-6678.2002.tb00194.xSave Citation »Export Citation » Share Citation »

    Recognizing and understanding the varying approaches to group therapy with children (such as educational, counseling, and psychotherapeutic interventions) is critical in identifying the most effective practices for this population. This article examines the different types of groups practiced with children and the implications of each. More specifically, in order to increase practitioner understanding and competence in implementing group therapy with children, the varying stages that serve as a theoretical basis for the comprehension of group development (the Forming Stage, the Storming Stage, the Norming Stage, the Performing Stage, and the Adjourning Stage) are discussed in greater detail.

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Legal Issues in School Practice

This section overviews key legal issues impacting counseling; namely, consent, notification confidentiality dangerous behavior, and disclosure. Consent, or informed consent, involves a patient or legal guardian’s consent to treatment, or for release of treatment information. As an example, Jacob and Powers 2009 notes the importance of confidentiality issues in school psychology practice, and Rosenburg 1981 reports on a critical case where a student was not placed appropriately, highlighting important consequences when school psychologists neglect meeting key standard. In a basic way, all minors must have parental permission to participate in counseling. Further, school psychologists might consider securing consent from participants as well as legal guardians. Notification is generally a lower standard for practice than the acquisition of informed consent. Unfortunately, many students do not read student handbooks, student handouts, or mailings provided in the course of a school year. Because many students do not read such materials, written notification alone may not be adequate. Signed consents are preferable. Confidentiality involves the legal obligation not to disclose information surrounding treatment. While adults in counseling own “privilege,” and thus confidentiality, parents, not minors, actually own privilege. As such, participants should be informed about limits of confidentiality and disclosure issues. Appropriate safeguards should be implemented to maximize confidentiality through careful selection of setting and through participant and parent contracts. Regarding dangerous behavior, the question arises of how one should proceed if a concern arises regarding danger to self or others. Schools should develop policies and procedures in order to protect both counseling participants as well as practitioners. While there may be situations where suicidal risk, for example, may seem so imminent that an emergency room visit may be required, or a risk to safety so evident that police must be contacted immediately, more commonly a student may simply make a comment worthy of concern but not evidenced by behavior necessarily supportive of a concurrent threat? An immediate consultation and interview by another school mental health professional is one viable option, with a consensus guiding decision-making. In terms of disclosure, how should a practitioner proceed if a parent or teacher requests details from counseling? Must a practitioner disclose confidential information? Unfortunately, while disclosure may compromise therapeutic progress and basic trust, parents “own” privilege related to minor confidentiality. While it makes sense to explain to a parent that breaking confidentiality may compromise a child’s trust and progress, it is also true that a school psychologist must share counseling content details if requested, as the parent, not the child, owns privilege and confidentiality. In contrast, a practitioner must protect a child’s privilege and confidentiality with a teacher, and therefore cannot disclose or discuss a child’s involvement or progress.

  • Jacob, S., and K. E. Powers. 2009. Privileged communication in the school psychologist–client relationship. Psychology in the Schools 46.4: 307–318.

    DOI: 10.1002/pits.20377Save Citation »Export Citation » Share Citation »

    While the ethical obligation of client confidentiality is a crucial component within school psychology practice, understanding the legal boundaries of privileged communication with clients is equally important. This article provides an important look at the differences between the duty of school psychologists to confidentiality and privileged communication, on the one hand, and the implications each has for practice within the field, on the other.

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  • Rosenburg, R. E. 1981. Hoffman v. Board of Education. Hofstra Law Review 10.1: 279–309.

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    This United States Supreme Court ruling highlights the need for school-based teams to reevaluate those placed in special education to determine eligibility. Hoffman v. Board of Education involved the negligent misplacement of a student with average intelligence into classes for the “mentally retarded.” This decision established that failure to reevaluate students is negligent and school districts will be held legally accountable.

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Summary and Conclusions

Behavioral and psychological problems have increased in children. Issues involving family discord, parental neglect, abuse, attention disorders, and violence in the home all impact children’s adjustment. Unfortunately, large numbers of children exhibit multiple disorders. Riddle and Bergin 1997 notes, for instance, that 28.6 million children live within an alcoholic family; Pope and Hudson 1992 estimates that as many as 67 percent of children may experience sexual abuse; and, more globally there are more than eight million children in need of psychological services. Indeed, approximately one in seven children have been punched, kicked, or choked by a parent, and Crespi and Howe 2002 remarks that children from violent homes demonstrate violent behavior at school. With the knowledge that school professionals can socialize children to different behaviors to decrease the chances of emulating aggressive and violent behavior learned at home, counseling programs are of increasing importance. It makes sense, then, to offer counseling in schools. Crespi and Rigazio-DiGilio 1996 observes that school-based early intervention programs can decrease delinquent behaviors in youth, and it has been noted that schools function as a vital resource for psychological services. Looking to the future, coursework guided by evidence-based practice will likely become more commonplace. One difficult area in school practice involves legal issues. Changes in legal standards for consent and disclosure could ultimately address this highly complex issue. Key questions follow: (1) Should practitioners advocate for the elimination of parental consent for participation in counseling? Since it is reasonable to assume that not all students wish to have parental figures know their interest in counseling, parental consents can reduce participation. Future directions could modify these requirements. (2) Should school psychologists be required to disclose counseling content to parents? Since parents own “privilege,” disclosure is required. At the same time, this can reduce trust. Future initiatives might massage this issue to more effectively encourage candid participation by clients. This article has been constructed to serve as a resource. In a broad way, while children are coping with an array of problems, school psychologists have the opportunity to offer students an array of positive interventions. Individual and group counseling can be a useful intervention model. The challenge, from this point forward, is helping practitioners and schools begin to implement the model.

  • Crespi, T. D., and E. A. Howe. 2002. Families in crisis: Considerations for special service providers in the schools. Special Services in the Schools 18:43–54.

    DOI: 10.1300/J008v18n01_03Save Citation »Export Citation » Share Citation »

    Due to the pressures of today’s society, children and their families are increasingly facing a multitude of issues. Understanding the influence that these experiences have on students’ school-related behavioral is crucial, and school personnel should therefore be trained in recognizing and dealing with such issues through appropriate interventions. This article considers these issues, appropriate school-based interventions to combat them, and the influence of the home-school relationship.

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  • Crespi, T. D., and S. A. Rigazio-DiGilio. 1996. Adolescent homicide and family pathology: Implications for research and treatment with adolescents. Adolescence 31:353–367.

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    Adolescent violence and aggression are pertinent issues that, when left untreated, have unfortunately led to felony-murder and homicide in multiple cases. Understanding the variables that perpetuate these behaviors is crucial in order for appropriate interventions to occur and such outcomes avoided. Specifically, this article considers the influence of family variables in understanding adolescent homicide, as well the role that school psychologists have in effectively intervening with students at risk for such behavior.

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  • Pope, H. G., and J. I. Hudson. 1992. Is childhood sexual abuse a risk factor for bulimia nervosa? American Journal of Psychiatry 4:455–463.

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    Understanding the effects of childhood sexual abuse is critical in effectively treating those who have been abused. One implication to be considered is the possible influence of sexual abuse as a risk factor for the development of bulimia nervosa. The authors discuss the prevalence of childhood sexual abuse and, more specifically, examine results from a study considering the influential relationship between these two factors.

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  • Riddle, J., and J. J. Bergin. 1997. Effects of group counseling on the self-concept of children of alcoholics. Elementary School Guidance and Counseling 3:192–204.

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    This article considers the prevalence and impact of children with alcoholic parents. Specifically, although most children of alcoholics do not develop such tendencies themselves, they are considered to be at a much greater risk compared to children who do not have alcoholism in their families. Given this finding, school systems should be considered important settings to combat such risks and aid students through these experiences. More specifically, the use of group counseling in schools can be utilized to help students with alcoholic parents cope with their experiences together.

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