Tammie Ronen, PhD - Springer Publishing

xxvi
INTRODUCTION
TREATING CHILDREN, ADOLESCENTS,
FAMILIES, COUPLES, AND GROUPS
In Part II, we address treatment across the lifespan. Nowhere is the social
part of the term social worker more essential and vital than when dealing
with clients’ problems with coping deficits. Given that we live within social
contexts, the problems of groups and families seem obvious areas for
the social work practice. The bidirectional interactions of couples and the
tri-, quad- or pentadirectional interactions that occur within groups and
families make this area of treatment far more complex than it might appear
on the surface. Children and adolescents must be treated within
their family, school, cultural, and religious systems. The systems are the
agencies that have helped create and maintain schemas and need to be addressed
if any schematic modification is to occur (or if the modification
will be maintained). One therapist speaks of how not paying necessary
homage to the powerful and controlling mother of a 16-year-old client led
to the eventual sabotage of the therapy, the withdrawal of the client from
therapy, and the return of the presenting symptoms. It is unusual for
child or adolescent clients to seek therapy. School social workers, by
virtue of their work venue, are more likely to have “walk-ins” who have
had a personal or social crisis, are experiencing overwhelming emotions,
or have recognized the need to speak with a nonjudgmental adult. Few
clinical social workers in institutional or private practice settings get these
same referrals. The work with children and adolescents is further complicated
by the need in many settings for parental approval of the treatment
beyond an initial referral screening. A key ingredient stressed
throughout this area of treatment is how one builds the client’s active
collaboration and participation in the treatment. The issue is not only
how to develop motivation for change but to maintain that motivation
through the demanding times of treatment. Ronen (Chapter 9) makes the
point that the clinician needs to identify areas and issues that the client is
willing and able to work toward changing. Further, she states, “CBT
looks for and increases clients’ support systems, strengths, and resources
and helps them to help themselves.” As DiGiuseppe states, “Children are
not so much disturbed, but are more often disturbing to others” (1992,
personal communication). Children and adolescents find themselves in
conflict with their families and in their school settings. Their difficulties
may be based on their frequent aggressiveness with peers, academic underachievement
(or failure), misuse of drugs, or impulsive or apparently
reckless behavior. We have all seen or experienced a child who is acting
out in the classroom through some externalizing behavior. A particular
teacher or educational system is motivated and trained to cope with
this child. The same behavior in another classroom or setting creates a