Cognitive Therapy of Depression

Children for a variety of reasons often are reluctant to talk about their feelings and concerns in therapy whether individual, group, or family therapy. Therapists sometimes need to be resourceful to help children who are anxious to participate in a meaningful way in the therapy process. It is important for children to feel included in the process. Some children may not feel they can express themselves because they may be too young, others may be silent due to anxiety, anger, fear, resentment, and a few may not be able to talk due to trauma events.

Therapists need to have various strategies that do not rely on language such as symbolic play either directive or non-directive, drawing, storytelling, or therapeutic work with symbols. Many therapists, irrespective of the therapeutic modality (e.g. CBT, Interpersonal, Psychodynamic), have integrated play techniques in their work with children.

Most children do not choose to come to therapy, rather they are “brought” or “sent” by parents, teachers or other professionals who in turn are sometimes pressured to do so by extended family, social services, or courts.  The child’s experience upon arrival at the therapist’s office is often like being punished and sent to the principal’s office.

Creative methods of engagement are dictated by necessity because good therapy doesn’t usually take place in a context of fear and punishment. The therapist must think out-of-the box for ways to transform the experience for the child and make the context a safe, comfortable, and playful context that gradually allows for trust to build and for the child to be able to use the therapeutic space in a helpful way.

for more information go to: http://cognitivetherapyforchildren.net

When we think of children at risk what comes to mind is drug abuse. Children can be at risk for emotional problems, depression, anxiety, learning disabilities, social problems, school drop-out, sexual acting out and high risk behaviors. How do we know? Children often lack the verbal skills to tell us how they feel. They keep their emotions hidden and seem introverted, shy or withdrawn. On the other hand, they act out, become hyperactive, impulsive and angry.

Children experiencing academic difficulties at school are at risk. Their self-esteem is affected; they are constantly challenged and cannot keep up with the demands of the school. These problems can be caused by a learning disability, a metabolic problem, ADD/ADHD, processing issues or emotional problems such as depression and anxiety. Depending on the child’s temperament they might persevere in school and keep trying to succeed or they may abandon the effort and simply quit. Either way, finding out the underlying causes through a consultation with a professional will help avoid future issues. A professional child psychologist that is able to provide therapy, diagnosis and treatment. This psychologist should specialize in children and understands how depression, anxiety and learning problems are different in children and adults.

Children are at risk when there is a sudden change in their behavior. If your child was an outspoken, self-secured and confident child who all of a sudden becomes angry, withdrawn and insecure, you should be concerned. He might be experiencing problems in school, be the victim of bullying, social ridicule, bad company, or changes in the home. Have there been any recent loses, changes, divorces or upsets in the child’s life? Talking to them about the change, their worries and providing reassurance might be enough. Sometimes they will resist parental intervention. Again, seeking professional help is recommended.

Finally, there’s the risk for sex and drug abuse. Teenagers experiment and many times they are too young to realize the consequences of their behavior. Talking to them about sex and drugs, keeping open communication with them, knowing where your children are and who they are spending time with is crucial. This is when they will request privacy and “trust.” The privacy and the trust must only go so far.

In short, our children can be at risk academically, emotionally or behaviorally. They can show red flags early on and we can deny their existence. This can increase their chances of depression or anxiety, decrease their academic performance and increase the risk of teenage pregnancy, drugs or diseases. When in doubt, contact a professional. Intervention early on may prevent the problem for snowballing out of control.

Play Levels Of Social Interaction In Speech And Language Therapy There are different levels of play used in the assessment of children’s speech and language. These levels are used to measure children’s play skills. However, there are also play levels of social interaction that can give a general overview of the child’s play skills. In general, there are six play levels of social interaction that children go through respectively. Each level becomes more complex than the previous one, and requires more communication and language skills than the other. Unoccupied Play The first level of play is unoccupied play. In this kind of play, the child may seem like he is simply sitting quietly in one corner but actually is finding simple things that he sees around him to be rather amusing. A typical adult may not notice that what the child is doing is already considered to be play, unless they observe meticulously. The child may just be standing and fidgeting at times, but this could already be unoccupied play at work. Onlooker Play The second level is onlooker play. In this level, the child watches other children play but doesn’t engage in play himself. This is when children learn to observe others. Such play level can show a child’s attention and awareness skills. Solitary Play The third level is solitary play where the child plays by himself and doesn’t intend to play with anyone else. This level shows an outright manifestation that the child do have play skills, only that it is still at a level that no interaction is required. A child can be at this level when he is already able to play functionally with an object, can play by himself up to fifteen minutes, and is able to follow simple play routines. Parallel Play The fourth one is parallel play. This level characterizes children who play side by side but don’t communicate with each other. Neither do they share toys. It is said to serve as a transition from solitary play to group play and is at its peak around the age of four years. A child is said to be in this stage when he is able to play alone, but the activity he is doing is similar with the play activity that other children beside him are engaging in. The child also doesn’t try to modify or influence the play of other children around him. Here, the child is playing ‘beside’ rather than ‘with’ the other kids in the area. Associative Play Next is the associative play. This is where the children still don’t play with each other but are already sharing the toys that they are playing with. This level shows the child’s awareness of other children, although there is no direct communication between them, other than the sharing of toys and the occasional asking of questions. Their play session doesn’t involve role taking and has no organizational structure yet. The child still carries on the way he wants to play, regardless of what the other children around him are doing. Cooperative Play The last level is cooperative play. This is the final stage wherein the children are already playing together, sharing toys and communicating with each other. This level usually happens at about the age of five or six, where children engage into group games and other highly structured play activities. These levels can be utilized by the therapist as a guide when it comes to the interactions that he wishes to have with the child through play activities.

Importance Of Play In Speech TherapyPlay has a very important role in speech therapy. It is actually one way that speech therapy can be conveyed, especially if the one undergoing therapy is a child.What’s Play Got To Do With It?Play isn’t just used during the therapy proper. In fact, play is already used during the initial phases of assessment. Kids can be very choosy with people that they interact with, so seeing a therapist for the first time doesn’t promise an instant click. Rapport has to be established first, and this is usually done through play.Benefits Of PlayOther than using it as a tool to establish rapport, play also gives a lot of benefits. First off, it gives an over view of the child’s skills, whether it be their abilities or limitations. Then, therapy wise, play can be used to make a child cooperate with whatever exercises a therapist has lined up for him/her. Since play doesn’t put much pressure on a child, he/she would likely cooperate to do the exercises and not know that what he/she is doing is already called therapy.When the child is more relaxed, he can be at a more natural state. If a child is at his more natural state, then his skills could show more naturally. Thus, this would be a benefit on the therapist’s part, since the therapist could get a more comprehensive assessment of the child’s skills. Play could also make therapy more fun and less scary. Since play is an activity to be enjoyed, the child would not get bored with monotonous therapy activities that seem like chores, rather than activities. Play As A SkillIn fact, play is considered to be a skill itself, because it is a natural activity that children do. If a child doesn’t play, then there must be something wrong with him, most probably with his Inner Language skills. This is because; play is a representation of a child’s inner language. This is just one of the many reasons why play is important. It actually has a domino effect, if you look at the bigger picture. Play is needed to have Inner language, which is in turn needed to have Receptive language that is a prerequisite of Expressive language. Thus, if a child has no play abilities, then his whole language system may be affected.Play And CognitionPlay is also a basis of a child’s cognition skills. The more developed a child’s play skills are, the higher the probability that his cognition skills would be at a fair state. However, play and condition are not the same. Play is more likely a prerequisite or a co-requisite of cognition.What Parents Have To SayUnfortunately, most parents may have a negative impression when they see the therapist playing with their child. Initially, parents get surprised and shocked that they paid a very valuable amount for therapy, only to find out that their child would only be playing.That’s why it is very important for therapists to explain the procedures that they are going to do with the child to the parents. To make the session more interesting, the therapist could also include the parent/s in the play session with the child. In this way, the child would definitely think that it is a play session. Additionally, the parent can also do the play activity at home with the child. Doing this, could serve to be practice of the targeted skill of the play activity.

Steve Cownley

http://www.health.comyr.comhttp://www.allsortsofbits.comoj.com

In recent years, cognitive behavioral psychotherapy with children and adolescents is receiving an increasing amount of attention. While cognitive behavior therapy with children and adolescents considered as an effective and widely used therapeutic approach, most cognitive behavioral therapists lack skills when it comes to working with parents and other family members. Research shows that most childhood disorders are associated with family problems. Children?s difficulties occur in a familial context and family members play a role in the initiation, maintenance, as well as exacerbation of children?s problems. However, there are few cognitive behavioral approaches to family therapy. This is regrettable for at least two reasons. First, children and adolescents infrequently refer themselves to therapy and typically are brought to therapy by powerful others such as peers, teachers, and institutions. Second, cognitive therapists working with individual youngsters rarely hold enough reinforcers and create a consistent environment to effect generalizable and enduring changes in the family context.

Since the beginning, family therapy has been interested in how interactions between family members can create and maintain problem behavior.  Family therapists are also interested in the circular nature of causality (A influences B influences C influences A). This approach allows therapists to gain an understanding of how the child?s context can create, maintain and change the presenting problem.

Family therapy techniques would be complementary to cognitive behavioral therapies with children, adolescents and their families.