Counseling Treatment for Children and Adolescents with DSM-IV-TR Disorders - Hardcover

Robert R. Erk, Ed.D., is a past president of the Southern Association for Counselor Education and Supervision. Dr. Erk is an associate professor of counselor education and educational psychology in the College of Education and Behavioral Sciences at the University of Tennessee-Martin. His service includes over 25 years of teaching in the school and mental health counseling programs. He is licensed as a school counselor, a school psychologist, and a professional counselor and marital and family therapist. He received his doctorate in counselor education from Mississippi State University.

His professional work history includes public school teaching, serving as a high school counselor, and serving as head of a junior high school guidance office. He is a presenter of state, regional, and national workshops on Attention-Deficit/Hyperactivity Disorder (AD/HD), conducts national learning institutes on AD/HD for the American Counseling Association, and has authored articles for a number of American Counseling Association journals. Dr. Erk wrote the statement on AD/HD for the ERIC/Clearinghouse on Counseling and Student Services Digest, wrote the position statement on AD/HD adopted by the American School Counselor Association, and founded the American School Counselor Association professional interest network for children with AD/HD.

Within a counseling framework, his current research and teaching interests are centered on bringing to professional counselors a better understanding of the development of emotional and behavioral disorders in the clients and families they serve.

Counseling Treatment for Children and Adolescents Diagnosed with DSM-IV TR Disorders is designed to enable counselors to better understand the needs of children and adolescents who might be diagnosed with a DSM-IV-TR disorder. This book focuses on providing clinical information and data on behavioral disorders to people who are preparing to become counselors in mental health centers, community clinics, public schools, college counseling centers, hospital settings, government agencies, juvenile correction facilities, or private practice. Counselors from the beginning student to the more experienced counselor can learn more about the field of behavioral disorders from this book. However, it is important for readers to recognize that the broader or overarching concept of the book is to emphasize that DSM-IV-TR disorders are most often the result of a multifactorial causative process.

It is increasingly the message of clinical research that we need to redirect our thinking from a unitary or single cause model for disordered behavior to the consideration of multiple variables or factors. For example, important factors that counselors must carefully consider are developmental stages, environmental influences, biological or genetic contributions, socioeconomic influences, and culture. Each of these has an interwoven and causative part to play in every individual's life. Ultimately, the reasoning that all psychological or psychiatric diagnoses are the result of what can be described as a multifactorial causative process should become our guide. It is widely recognized, for example, that a comprehensive or holistic view of childhood disorders must involve a careful consideration of developmental factors. Researchers consider development and the timing of environmental events (e.g., positive, negative) in the lives of individuals to be inseparable and that they might have consequences across the individual's life span. Therefore, the issue of development is important to consider with respect to all the "factors" that are involved in the development of child psychopathology.

Inherent in a multifactorial causative process are three overriding propositions for counselors who recognize the importance of the developmental perspective. First is the conviction that DSM-IV-TR disorders, conditions, or problematic behaviors are connected to and best conceptualized within a "developmental" context. Accumulating knowledge tends to support this belief; however, there is much more to be known or discovered. Second, there can be no doubt about the strong "interactional and reciprocal" causes involved in both positive and maladaptive behavior. A large number of variables such as family, school, social status, and culture, often operate as profound influences and cannot be discounted. Third, and last, "empirical approaches" to the study and understanding of psychopathology in children or adolescents demand that we know more about the complexity of human behavior in the clients we serve.

It is beyond the scope of this book to cover all the disorders or conditions found in each of the respective sections of the DSM-IV-TR. Instead, the most common ones (e.g., those most often discussed in research literature and diagnosed in children or adolescents) were chosen for discussion. Still, readers will come away with a clear, concise, systematic, and up-to-date understanding of what is known about these disorders or conditions.

PURPOSE OF THIS BOOK

The interest in mental disorders or psychopathology in children and adolescents has steadily grown. New findings from the clinical literature have challenged older theoretical or conceptual models of mental disorders. We can surely say we know more today about mental disorders and psychopathology than just a decade ago. The overriding purpose of the book is to capture the interest in this rapidly evolving state, of affairs for counseling students and instructors alike. Whether mental disorders are considered individually or collectively, there is a wide and extensive audience of counseling students and practicing counselors who need more education and training in this area.

This textbook can fulfill this need because it brings the counselor pertinent clinical research information describing each disorder or condition, shows how to proceed in making an appropriate diagnosis, and demonstrates how to construct appropriate treatment regimens for clients. This book is designed to address these important considerations as fully as possible.

IMPORTANT ASSUMPTIONS IN THIS BOOK

Guiding the conceptualization and crafting of the book were certain "assumptions" that were forged into the design of the book. It makes the following assumptions about students and instructors who will use the text.

1. Readers should be reasonably familiar with the diagnostic format of the DSM-IV-TR format. Although this is not critical to have in one's educational background, it would be helpful.
2. The reader has had sufficient counseling or psychological coursework to make the material presented in this book practicable or meaningful. This will also lessen any possible misunderstanding of material that the reader might otherwise have.
3. The style or format of the book is intended primarily for individuals who are receiving education and training in counselor education or psychology programs. This book can stand alone as a source of counselor instruction. However, it can also be adapted (e.g., mated to existing coursework) for use in counseling or psychology curriculums if desired.
4. The book's comprehensiveness rests in its description of the specific disorders and therapeutic modalities that are most useful to counselors. It makes no attempt to present a complete discussion of each disorder nor all of the specific treatment techniques that might be available. For the most part, the treatment paradigms recommended assume a setting in which appropriate monitoring can be accomplished, on-site care is available, if needed, and follow-up care can be arranged.
5. The links to the DSM-IV-TR in the book are housed in the extremely simple stance that the disorder or condition discussed, in order to be treated appropriately, has to be accurately diagnosed. Furthermore, the DSM-IV-TR criteria are clinically adequate as much as clinical trials and the research literature can indicate. Also, it is vitally important to recognize that the DSM-IV-TR is not the last or only word in our understanding of serious emotional or behavioral disorders (i.e., mental disorders). Diagnosis and treatment for behavioral disorders are dynamic, multifaceted, and evolving.
6. The book represents guidelines for the practice of counseling clients who might have a DSM-IV-TR diagnosis. It should not be viewed as establishing a standard of care for any specific disorder, client, or counselor, regardless of the treatment setting. The professional counselor is expected to remain ever vigilant for new information and developments in the field.
7. The book strives to be realistic in its approach to how important appropriate diagnosis and treatment is to the concept that all clients are treatable and can make improvements in their disorders or conditions. In other words, few helping professions call for outright cures.
8. A counselor with the authority to diagnose and treat disorders must take that professional responsibility very seriously. It is the counselor who is charged in our society with recording diagnoses and prescribing treatment. This fact alone presses home the need for professional counselors who are ethical and have knowledgeable information about what they can provide.
9. Finally, children and adolescents who have serious emotional and behavioral disorders often have time as their ultimate enemy, especially if the child has not been provided with an appropriate diagnosis or treatment has remained absent. This book is intended to have as much impact in this area as it can possibly impart to practicing counselors.

FEATURES OF THIS BOOK

The organization of this book differs from that of most other texts in counseling or psychology. It integrates and presents an understandable format for the education and preparation of counselors about mental or behavioral disorders. Each chapter presents major sections on understanding how the disorder is defined, its diagnostic or clinical features, causal factors and prevention, assessment methods or procedures, comorbid conditions, implications for practice or treatment, school and family perspectives, a case illustration, summary or closing remarks, and where to go for more information.

The editor conceptualized the content and wrote three of its chapters, and 10 authors selected for their expertise in behavioral disorders wrote the remaining chapters. By having chapters in the book authored by different counselor educators or psychologists who directly teach, practice, and focus on the areas contained in this book, it means that an expert is there as a direct resource to you. Moreover, you will be able to learn what the professionals in our field are teaching students and practicing with their clients who have these disorders. The chapters were written by interested authors who follow the research literature and view it as a wonderful opportunity to assimilate and interpret the current state of understanding.

Furthermore, a sample treatment plan from the authors is included in every chapter that deals with DSM-IV-TR disorders. Whereas some chapters have similar formats for writing a treatment plan, other chapters have a different format for providing treatment. This is particularly helpful for counselors because it provides different models for viewing and constructing treatment. In summary, readers should clearly understand that there are different approaches or ways to construct or implement treatment. Currently, there are no research data to conclusively indicate that there...