Promoting Mental Health and Well-Being in Children and Adolescents: The Intersection of Positive Psychology and Counseling Psychology

Abstract

This chapter describes the Strengths-Based Inclusive Theory of Psychotherapy (S-BIT of Psychotherapy), a novel counseling theory/orientation that emphasizes evidenced-based positive psychological approaches and cultural considerations. The S-BIT of Psychotherapy is appropriate for individuals across the lifespan but was designed with children and adolescents specifically in mind. In this chapter, the S-BIT of Psychotherapy will be discussed, including its core assumptions and theoretical propositions. In addition, the therapeutic process, assessment approach, and prevention and intervention strategies that align with the S-BIT of Psychotherapy will be described. Lastly, a case example will be provided to highlight the S-BIT of Psychotherapy in practice.

Appendices

Appendix A: Comprehensive Model of Positive Psychological Assessment Intake–Child/Adolescent Form

Thank you for choosing to participate in psychological services at (agency name). To provide you with the best services possible, we are requesting your completion of the following paperwork. The information requested includes questions about your current and past functioning, family and social relationships, educational and work history, and more. Please note that we are interested in understanding areas of weakness or struggle as well as areas of strength and well-being, as treatment of any problem areas identified will be informed by the strengths that you possess and the resources available in your environment.

Name: ____________________________________________________________

Date Form Completed: _________ Date of Birth: _________

Parent/Stepparent/Guardian’s Name: _______________________________

Address (City, State, and Zip): ____________________________________

Marital Status: __________________________________

Phone: (Home) ____________ (Work) ____________ (Cell) _____________

(Duplicate parent contact information as needed. Not included here due to space.)

Emergency Contact Name: _______________________________________

Relationship: _________________________ Phone: ___________________

Who referred you? _____________________________________________

Referral’s relation? _____________________________________________

(Parent’s/Guardian's) Employment Status: ___________ Occupation: ____________

Employer’s Name and Address: ___________________________________

Highest level of education: __________________________ Grade: ______

School: _____________________________________________________

Disability Status (developmental; for example, Down syndrome, intellectual disability): ___________________________________________

Disability Status (acquired; for example, spinal cord injury, traumatic brain injury): ______________________________________________________

Religion and Spiritual Orientation:__________________________________

Race and Ethnicity: __________________________________________________

Sexual Orientation:______________________________________________

Socioeconomic Status/Income:____________________________________

Indigenous Heritage: Native _____ Nonnative _____ (check which applies)

National Origin: Please indicate where you were born: __________________

Gender: ______________________________________________________

Other identities: _______________________________________________

What is your primary concern? ____________________________________

What are your weaknesses? ______________________________________

What are your strengths? _________________________________________

(Consider having a list or providing a list of strengths and corresponding definitions for clients who may struggle to identify or to find language that represents their strengths.)

What people or things in your environment are helpful/supportive? _____________________________________________________________

What people or things bring happiness and well-being to your life? _____________________________________________________________

Have you been in counseling in the past? If so, please indicate with whom, where, and when._______________________________________________

Have you had an evaluation/testing in the past? If so, please indicate with whom, where, and when._________________________________________

Physician: ____________________________________________________

Medical diagnoses: _____________________________________________

Medications: __________________________________________________

What do you do to maintain a healthy lifestyle? _____________________________________________________________

What do you hope to achieve from this evaluation/therapy? _____________________________________________________________

Appendix A slightly modified from Owens, R. L., Magyar-Moe, J. L., & Lopez, S. J. (2015). Finding balance via positive psychological assessment and conceptualization: Recommendations for practice. The Counseling Psychologist, 43(5), 634–670. https://doi.org/10.1177/0011000015584956

Appendix B: Comprehensive Model of Positive Psychological Assessment Semi-Structured Clinical Interview

Background Information

• What brings you in? (Assess duration, frequency, intensity, triggers, etc.)

• What are particular areas of struggle for you/your child?

• What have/has you/your child tried to do to cope with the difficulties you’ve described? What worked? What was less successful? (The therapist can ask about each area specifically.)

• What barriers have/has you/your child faced or currently face in your environment?

• How would you describe your/your child’s identity? For example, some clients reference their cultural background or gender. However, there are a number of variables that can describe people. How would you describe yourself/your child? How do others describe you/your child? (Reference the ADDRESSING and RESPECTFUL models for additional examples, if needed, or for follow-up. Also be prepared to provide specific questions to the client if they are unable to generate this information with further prompts, such as “How would you describe your financial situation?” “What is your sexual orientation?”)

• You mentioned (insert client’s strengths from the intake paperwork) are your/your child’s strengths. Please describe these and how you/your child use(s) them.

Medical History

• Did your child meet their developmental milestones? (Provide examples as needed.) Please describe any delays.

• Do/does you/your child have any previous or current medical conditions or illnesses? If so, what? When were/was you/your child diagnosed?

• Have/has you/your child ever been hospitalized? If so, for what and how long?

• Have/has you/your child ever experienced a concussion, brain injury, or seizure(s)? If so, please describe.

• Are/is you/your child currently taking any medication? Have/has you/your child taken any medications in the past? If so, what medication(s) and what dose?

• What medical conditions or psychological disorders are present on both sides of your/your child’s family?

• Please describe your/your child’s sleep habits. (Onset, maintenance, the average length of sleep, etc.)

• Please describe your/your child’s eating habits/behaviors.

• You mentioned (insert items indicated in the paperwork) are ways you/your child maintain(s) a healthy lifestyle. Please describe those and the frequency you/your child engage(s) in those behaviors. (Assess other areas that may have been left out—diet, exercise, meditation, etc.)

Emotional Functioning

• How would you typically describe your/your child’s mood? (Any concerns of depression or anxiety? Assess in more depth, if necessary.)

• Have/has you/your child ever experienced suicidal ideation? (If so, ask the client to describe when that took place and what prevented further action. Also, assess current ideation, plan, intent, and protective factors.)

• You mentioned (insert person or thing from the intake paperwork) brings you/your child happiness and well-being. Please describe that person/thing. (Assess duration, frequency, intensity, triggers, etc.)

Social Functioning and Environmental Variables

• What concerns, if any, do you have about your/your child’s social relationships and social skills?

• Are you currently in a romantic relationship? If so, with whom? Tell me about your partner. (These questions will largely pertain to the adult and adolescent populations.)

• Are you sexually active? If so, what sexual behaviors are you engaging in, how often, and do you use protection? (These questions will largely pertain to the adolescent population unless there are concerns of sexual activity with the child client.)

• Who are the important people in your/your child’s life? What is your/your child’s relation to them?

• You also mentioned (insert name of people or things in the client’s environment from the intake form) are helpful or supportive. Please tell me about these people/things.

• Whom do/does you/your child currently live with? (If parents are separated/divorced, assess custody arrangement.)

• How many siblings does your child have? What are their ages?

• Where do/does you/your child work? What does your/your child’s job entail? (These questions will pertain to the adult and adolescent populations).

• Where does your child go to school? What grade are they in? Do they receive any special services/accommodations? If so, what do they receive and how often? When did they begin using these services?

• What areas in school does your child excel and struggle in?

• What do/does you/your child like to do for fun? What are your/your child’s hobbies? Are/is you/your child involved in any organizations, clubs, sports, or extracurricular activities?

Substance Use

• Do you currently use any substances (e.g., alcohol, tobacco, caffeine)? If so, what substance(s)? How often do you use each substance? (These questions will largely pertain to the adult and adolescent populations unless there are concerns of substance use with the child client.)

• Have you used or experimented with any other substances in the past? If so, what substance have you used? (These questions will largely pertain to the adult and adolescent populations unless there are concerns of substance use with the child client.)

• (If a previous substance use problem existed) What prevents you from continuing using (insert name of the substance)?

Trauma and Stressors

• Have/has you/your child ever experienced a traumatic event, including accidents? If so, please describe to your level of comfort.

• Have/has you/your child ever experienced sexual, emotional, or physical abuse? If so, please describe to your level of comfort. (If so, assess the details of the presence of the perpetrator and the form and frequency of the abuse.)

• Are you currently experiencing any significant stressors (e.g., death in the family, moved)? Have/has you/your child experienced any significant stressors in the past year or so? If so, please describe.

• What has helped you/your child cope with/overcome the trauma(s)/stressor(s) you/your child have/has experienced?

• Have/has you/your child ever been arrested/in trouble with the law? If so, for what? When did this occur?

Psychological Services

• You noted in the intake paperwork that you/your child have/has been in therapy before. What did you find helpful about that experience? What did you/your child not find helpful or what would you/your child change?

• You noted in the intake paperwork that you/your child have/has had an evaluation/testing before. What did you/your child find helpful about that experience? What did you/your child not find helpful or what would you/your child change?

• Have/has you/your child been diagnosed with anything? If so, do you recall what?

Goals/Hope

• You mentioned you/your child hope(s) to gain (insert client’s answer from intake) from therapy/this evaluation. What are ways you/your child can foresee yourself/themself achieving that/those goal(s)? (Assess the pathways for each goal.)

• On a scale from 1 to 10, with 1 being not at all and 10 being extremely, how motivated are/is you/your child to achieve your/their goal(s)? (Assess agency for each goal.)

Note. This is designed to be a semi-structured interview. Therefore, questions can be asked in any order, and additional questions may be necessary. Some questions may not apply to all individuals interviewed.

Appendix B slightly modified from Owens, R. L., Magyar-Moe, J. L., & Lopez, S. J. (2015). Finding balance via positive psychological assessment and conceptualization: Recommendations for practice. The Counseling Psychologist, 43(5), 634–670. doi: https://doi.org/10.1177/0011000015584956

Appendix C: Comprehensive Model of Positive Psychological Assessment Report Template

Name:

Date of Birth:

Date of Evaluation:

Referral:

Relevant History:

Presenting Concerns and Individual Strengths:

Cultural Identities: (including cultural assets and struggles)

Medical History and Physical Wellness:

Emotional Functioning and Well-being: (including positive emotions)

Social Functioning and Environmental Variables: (including environmental resources and deficits)

Substance Use:

Trauma, Stressors, and Coping Strategies:

Psychological Services:

Goals/Hope:

Tests Administered:

• List the names of the tests/measures administered, including positive psychological measures.

Behavioral Observations:

• Aim for equal space and focus on positive and negative behaviors observed.

Test Results:

• Report all test/measure results; include significant and personal strengths and weaknesses throughout.

Cognitive Abilities:

Adaptive Functioning:

Academic Achievement:

Language:

Attention:

Executive Functions:

Learning and Memory:

Visual-Motor/Motor:

Emotional and Social Functioning:

Personality:

Strengths:

Additional Positive Psychological Measures:

Summary and Balanced Diagnostic Impressions:

• Note the reason for referral.

• Identify client cultural identities.

• Summarize significant findings from background information, behavior observations, and test results, with equal space and focus on strengths and weaknesses.

• List each variable from the Balanced Diagnostic Impressions (DICE-PM) Model.

Diagnosis:

Individual strengths:

Individual weaknesses:

Cultural assets:

Cultural struggles:

Environmental resources:

Environmental deficits:

Physical wellness:

Physical health concerns:

Mental health category:

Recommendations:

• Include recommendations focusing on strengths and weaknesses. Note. Not all components/headings in the Relevant History and Test Results sections will apply. Include only those relevant to the client.

Appendix C from Owens, R. L., Magyar-Moe, J. L., & Lopez, S. J. (2015). Finding balance via positive psychological assessment and conceptualization: Recommendations for practice. The Counseling Psychologist, 43(5), 634–670. https://doi.org/10.1177/0011000015584956