Tammie Ronen, PhD - Springer Publishing

Introduction
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situation with which the system cannot cope. Similarly, the acting in or
internalizing child may not even be noticed inasmuch as they may not
cause the same level of disturbance as their externalizing classmate.
Therapy across the lifespan must be developmentally informed. For
example, expectations of generalization of learning, the use of abstractions,
or interpretations may fall flat with children, adolescents, and individuals
with cognitive loss. Treatments for children and adolescents
must take into account the need for rather concrete and focused approaches.
One such approach is the use of metaphor and metaphorical fables
to teach children and adolescents the connection between their
thoughts and their feelings and actions. Useful in teaching problem solving,
social skills, and the modification of negative thoughts, this approach
stands as an exemplar of the structured, focused, and relevant treatment
described by MacLaren and Freeman (Chapter 2). What is encouraging is
the coping skills program (CSP) developed by Allain and Lemieux (Chapter
10). The goal of this treatment program is prevention through a CBTbased
program. If youth can develop the skills to avoid problems, they
can be more successful. A prime example of this is a CBT-based program
that demonstrated that a group of freshman college students could be
“inoculated” against the problems typically found in working with undergraduates.
At the end of four years, the treated group had fewer referrals
for mental health problems, higher graduation rates, fewer dropouts from
school, and lower levels of depression.
Empowerment and advocacy have been two of the watchwords of
social work practice. Abuse, whether directed toward children, elders,
spouses, or partners appears to be a problem of increasing legal and mental
health concern. The abuse may be verbal, sexual, physical, or psychological.
It may come about as a result of acts of omission or commission.
It may be overt, leaving visible marks and scars, or more covert and subtle,
where the scars are not visible and the sequelae of the abuse only becoming
visible years later. All states have laws that mandate the clinician
to report suspected abuse. Both Mason and White (Chapters 11 and 21)
address the issue of abuse. Mason addresses abuse from the perspective of
treating children, and White focuses on adult survivors of sexual and
physical abuse. The chapters offer quite parallel points, that is, the need
to move the abused individual from victim to survivor, learning to cope
with the fear and arousal that are frequently evoked by seemingly neutral
stimuli, and the need for having and using a support network to get
through the hard times. The issue for both populations is not an emphasis
on cure, but on developing effective coping strategies. Here again,
the importance of developmental, cultural, and systemic factors must
be addressed. For children, spouses, and elders, protection and safety are
the first concerns. Treatment cannot proceed effectively in the midst of