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Find resources to address the psychological and emotional impact of the COVID 19 pandemic for children, families, and healthcare staff

Welcome to Health Care Toolbox, brought to you by the Center for Pediatric Traumatic Stress (CPTS), a multidisciplinary center co-located at the Children's Hospital of Philadelphia and Nemours A.I. duPont Hospital for Children. CPTS was created to address medical trauma in the lives of children and families.

Our goals for Health Care Toolbox are to increase awareness of medical traumatic stress in children, provide information and evidence-based recommendations for health care providers, and guide parents and families to resources to help them cope with a child's illness or injury.

We also offer online education for health care providers! Check out our online courses on Pediatric Medical Traumatic Stress and Trauma-Informed Care. These courses are free and offer CE credit for nurses.

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Find resources to address the psychological and emotional impact of the COVID 19 pandemic for children, families, and healthcare staff Welcome to Health Care Toolbox, brought to you by the Center for Pediatric Traumatic Stress (CPTS), a multidisciplinary center co-located at the Children's Hospital of Philadelphia and Nemours A.I.

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Talking to Children when Scary Things Happen

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Talking to Children when Scary Things Happen

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CRWS_How to talk to youth about scary events

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The National Child Traumatic Stress Network

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Provides information on how to talk to children about mass shootings. This tip sheet describes ways to talk to children about mass violence events that involve a shooting. It gives tips about how to start the conversation, common reactions children may have, and how to seek help if needed.

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Provides information on how to talk to children about mass shootings. This tip sheet describes ways to talk to children about mass violence events that involve a shooting. It gives tips about how to start the conversation, common reactions children may have, and how to seek help if needed.

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Substance Abuse Prevention: Snapshots from the Safe Schools/Healthy Students Initiative

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Substance Abuse Prevention: Snapshots from the Safe Schools/Healthy Students Initiative

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Module 7 & 8 Substance Abuse Group Project-Prewitt Copy

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Module 7 & 8 Substance Abuse Group Project-Prewitt Copy

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Module 7 & 8 Substance Abuse Group Project-Prewitt Copy

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Module 6: Group Curriculum, Follow Up, and Evaluation.docx

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Small-Group Action Plan: Social and Emotional Learning

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Small-Group Action Plan: Social and Emotional Learning

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Missouri Comprehensive Guidance & Counseling Program: Responsive Services -Small Group Counseling Guide

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Missouri Comprehensive Guidance & Counseling Program: Responsive Services -Small Group Counseling Guide

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TRUSTED BY LEADING SUICIDE PREVENTION EXPERTS

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Hope Squad | Youth Suicide Prevention for Schools

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Hope Squad is a student-led, peer-to-peer support program that harnesses school connectedness to reduce the risk of suicide in elementary and secondary schools. We train trusted adults on campus (Advisors) who then empower students (Members) to recognize warning signs and connect their peers to a trusted adult.

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School-Based Program to Stem Substance Abuse - NEA

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School-Based Program to Stem Substance Abuse - NEA

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Campaigns to warn people about the consequences of substance abuse have been around since before the 1980s. Remember the "Friends Don't Let Friends Drive Drunk" and "This is Your Brain on Drugs" television advertisements? These campaigns created awareness around addiction and helped to save lives.

The Ad Council, for example, reported that 68 percent of Americans exposed to the "Friends Don't Let Friends Drive Drunk" ad have tried to prevent someone from driving drunk. In 1998, reports showed there was a record-low number of alcohol-related fatalities nationwide since the U.S. Department of Transportation began keeping records.

Ads alone cannot curb substance abuse. It's going to take a concerted effort among several entities, including schools.

By the Numbers

In 2014, the death toll from drug overdoses in the U.S. hit a record number: 47,055. Sixty-one percent-or 28,647-of these deaths resulted from opioid overdoses. Substance abuse, however, is more than just opioids. The most recent data from the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2016:

An estimated 51.3 million people aged 12 or older were current cigarette smokers, including 29.7 million who were daily cigarette smokers and 12.2 million who smoked approximately a pack or more of cigarettes per day. Although about 1 in 5 people aged 12 or older were current cigarette smokers, cigarette use generally declined between 2002 and 2016 across all age groups.

About 1 in 5 underage individuals aged 12 to 20 were current alcohol users. About 7.3 million people aged 12 to 20 reported drinking alcohol in the past month before the survey, including 4.5 million who reported binge alcohol use and 1.1 million who reported heavy alcohol use. The percentage of underage drinkers in 2016 was lower than the percentages in 2002 through 2014 but was similar to the percentage in 2015. About 2 out of 5 young adults aged 18 to 25 in 2016 were binge alcohol users, and about 1 in 10 were heavy alcohol users.

An estimated 28.6 million people aged 12 or older used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans overall (10.6 percent) but ranges as high as 1 in 4 for young adults aged 18 to 25. Regardless of age, the illicit drug use estimate for 2016 (the most recent year we have data for) continues to be driven primarily by marijuana use and the misuse of prescription pain relievers. Among people aged 12 or older, 24.0 million were current marijuana users and 3.3 million were current misusers of prescription pain relievers.

With substance abuse starting at early ages, states are looking to public schools to help revamp their drug abuse education programs. Much of the focus is now on preparing elementary school students with the right tools to make healthy decisions.

In February, a panel formed by Ohio lawmakers recommended schools implement new drug educational programs that start in kindergarten. Other states have already taken similarly strong measures as educators believe prevention efforts that start early are key to fighting substance abuse.

"It only makes sense to start health education in the early grades. The students will build on the knowledge as they grow and learn," explained Beth Mattey, lead nurse of the Brandywine School District in Delaware and president of the National Association of School Nurses (NASN ), in a March interview with NEA Today.

Helping Students Make Healthy Choices

Many factors contribute to substance abuse, and there is no single solution that schools can do to prevent it. However, there are a number of things schools can do that can help to create the conditions for students to make healthy choices, and include:

Foster protective factors. The Center for Disease Control and Prevention (CDC) has found, based on a growing number of studies, that there are protective factors that can help young people avoid multiple behaviors (including substance use) that can place them at risk. One of the most important is school connectedness, which is the belief by students that adults and peers in their school care about their learning and about them as people.

Provide standards-based health education, which is classroom instruction aligned to the National Health Education Standards. These are the expectations for what students should know and be able to do to promote their personal, family, and community health. Proper substance use, as well as state and local laws about substance use, should be part of a health education program in developmentally appropriate ways. Among the skills that are the most important in promoting healthy choices are decision making, goal setting, self-management, and bystander intervention.

Use teaching resources created by reputable sources, such as SAMHSA and their partners. One example of this is Operation Prevention from Discovery Education and the Drug Enforcement Administration. It offers a full toolkit of teaching resources, including lessons at all grade levels, which are aligned to the Next Generation Science Standards and the National Health Education Standards.

Support educator professional development through partnerships with state and local health departments. It is important that educators have access to the latest and best information on the substances and risks about which they are teaching.

Offer programs that have evidence of effectiveness for the specific issues targeted. SAMHSA's National Registry of Evidence-based Programs and Practices offers a searchable database of programs that can be refined by age group or for other specific groups of young people.

Follow the lead of Maryland and require public schools to carry the overdose reversal drug naloxone.

Consider the community partnerships that can help to connect students and families to resources such as additional counseling or treatment.

Seeking Treatment

Seeking treatment for substance abuse can seem like a huge undertaking. SAMHSA offers a confidential treatment locator at 1-800-662-HELP (4357) or https://findtreatment.samhsa.gov .From this landing page, one can search by zip code or call the confidential and toll-free number
1-800-487-4889 (TTY). If you have insurance that covers substance abuse and/or behavioral health, that is also an important resource for finding appropriate treatment.

Additional Resources

Association of Recovery Schools, https://recoveryschools.org

Centers for Disease Control and Prevention information on school-based health education, https://www.cdc.gov/healthyyouth/data/shpps/pdf/2016factsheets/Overview-SHPPS2016.pdf

Educational Leadership (published by ASCD), issue on mental health in schools. http://www.ascd.org/publications/educational-leadership/current-issue.aspx
NEA articles/blogs
http://lilysblackboard.org/2016/09/talk-opioids-heroin-kids-dying/
http://neatoday.org/2017/03/01/opioid-crisis-schools/
The Newshour, What works on opioids and kids. https://www.pbs.org/newshour/education/what-works-to-educate-kids-about-the-dangers-of-opioid-use

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All Hands on Deck: School-Based Programs to Stem Substance Abuse | NEA

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Campaigns to warn people about the consequences of substance abuse have been around since before the 1980s. Remember the "Friends Don't Let Friends Drive Drunk" and "This is Your Brain on Drugs" television advertisements? These campaigns created awareness around addiction and helped to save lives.

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National Dropout Prevention Center - The mission of the National Dropout Prevention Center/Network is to increase graduation rates through research and evidence-based solutions.

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Home - National Dropout Prevention Center

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Tools, resources, & research-backed solutions for student success

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Join the movement empowering young people to recognize and face the influences around us, including the pressure to abuse drugs and alcohol.

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Parent Guardian Post Group Perception Form(1)

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TEACHER PRE/POST GROUP PERCEPTIONS Sample 2

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TEACHER PRE/POST GROUP PERCEPTIONS Sample 2

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Teacher Pre Post Group Perception Form 2(1)

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TEACHER PRE/POST GROUP PERCEPTION FORM sample 1

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TEACHER PRE/POST GROUP PERCEPTION FORM sample 1

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Teacher Pre Post Group Perception Form 1(1)

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Student Post Group Perception Form 2(1)(1)

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STUDENT POST-GROUP PERCEPTION FORM Sample 1

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STUDENT POST-GROUP PERCEPTION FORM Sample 1

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STUDENT POST-GROUP: FOLLOW UP INTERVIEW FORM

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STUDENT POST-GROUP: FOLLOW UP INTERVIEW FORM

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Student Post Group Follow Up Interview Form(1)

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Bibliotherapy: Using Books to Help and Heal

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Bibliotherapy: Using Books to Help and Heal

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As the word suggests, bibliotherapy combines two of our favorite topics - reading and psychology - so it seemed a particularly appropriate topic to highlight in this post.

The term itself was coined only about a century ago by Samuel Crothers, a Unitarian minister who wrote an article in the Atlantic Monthly describing how relevant books could be used as an effective adjunct to medical or psychological treatment. However, the idea of bibliotherapy has existed from ancient times. The library at Thebes in ancient Greece had written over its door, "Healing place of the soul," and people have always instinctively recognized the power of stories to not only entertain and inform but also to comfort and guide.
What Is Bibliotherapy?
Bibliotherapy is most easily defined as facilitating psychological growth and healing through reading. Most people in the field recognize two distinct branches of bibliotherapy, though the exact dividing line between them is not easily drawn.

Developmental bibliotherapy is used mainly in community or educational settings, to help children or adults address common life issues. For example, Gregory and Vessay explain how school nurses can help children address issues of bullying through bibliotherapy, while a 2006 study by Frieswijk et al. demonstrated how bibliotherapy can positively affect self-care behaviors in somewhat frail, community-living seniors, thus decreasing their probability of future institutionalization.

Clinical or therapeutic bibliotherapy is the use of books in a professional therapy context to treat a diagnosed emotional disorder or ameliorate the negative life impact of a diagnosed emotional, mental or physical disorder. Therapeutic bibliotherapy is most often used as an adjunct to more traditional medical or psychological therapies, as in a just-reported study that successfully used poetry therapy to reduce anxiety and PTSD in patients recovering from a heart attack.

But it can be used as a stand-alone therapy as well, as it was in a 2004 study that compared the effectiveness of self-administered bibliotherapy with traditional short-term (12-20 sessions) psychotherapy for 60 older adults diagnosed with depression, and found both were equally effective in reducing clinician's ratings of depression, both immediately post-treatment and at a three-month follow-up.
How Is It Done?
Bibliotherapy is more of a general concept than a single, rigorously defined therapeutic method. As in the final example cited above, bibliotherapy can sometimes be as simple as "prescribing books" - that is, telling a student, client, or patient to read a particular book that you believe will help them. More often, bibliotherapy is facilitated through interaction with a helper or guide, either one-on-one, as in a counseling situation, or in a group of people who are dealing with similar issues and reading and responding to a text together.

The pioneering work of Sadie Peterson Delaney with World War I veterans at the VA Hospital in Tuskegee is an excellent example of both types. Delaney was a librarian by training, but bibliotherapy can also be successfully facilitated by many other helping professionals, including doctors, psychologists, social workers, school counselors, teachers, and community workers.

One can even practice bibliotherapy on oneself, as we suspect many avid readers do, returning to favorite books that they know will lift their spirits when life looks generally grey, or, more urgently, seeking written advice or inspiration to help them face significant life challenges, such as a cancer diagnosis or the loss of a loved one. Indeed, therapeutic texts can be of many different types: Narrative fiction is the original and traditional genre used in bibliotherapy, with poetry a close second, but self-help books are now just as popular, while biographies and memoirs can also be very helpful if written by or about someone who struggled with or triumphed over circumstances similar to those readers face.

Of course, therapeutic texts need not be complete books; short stories have been found effective in bibliotherapy, especially with participants whose attention span may be limited by age or cognitive impairment, while several practitioners have written about using comic books, and both teachers and therapists often use picture books to help young children develop and cope with difficult circumstances.
How Does It Work?
There is much discussion in the theoretical literature on bibliotherapy about whether its beneficial effects derive from the actual reading of the text itself or from the interaction, discussion, and sharing around the text that typically accompanies that reading. It seems likely the answer is both.

But most people in the field agree that the process works through the familiar therapeutic stages of identification, catharsis, and insight. In the first stage, the reader forms an affiliation with a character or characters in the text, identifying with their problems and goals. Catharsis comes about as the reader follows the characters through the text, experiencing from a safer, once-removed position their emotions, struggles, and hopes as they work toward the eventual resolution. Insight is the conscious recognition of similarities between the characters or situations in the text and the reader's own characteristics and circumstances, and the subsequent decision to apply ideas or lessons from the text to the reader's own thoughts and actions.

Many scholars add a fourth stage, universalization, in which the text helps readers realize that they are not alone, but that many others share similar problems and concerns and have found ways to deal with them. In this respect, bibliotherapy, even if undertaken alone or one-on-one, offers an important benefit more often associated with group therapy.
Who Can It Help?
Professional articles about bibliotherapy have tended more toward the anecdotal, recounting individual case studies or describing how a particular program or practitioner makes use of bibliotherapy. But some studies using experimental and quasi-experimental methods have found statistically significant evidence of the effectiveness of bibliotherapy with such disparate populations as depressed adults, children with internalizing and externalizing disorders, and perfectionists.

The number of such rigorous studies is gradually growing, and 2019 looks to be the "year of bibliotherapy" - a number of studies have been published just this year on the use of bibliotherapy with refugee children who have suffered trauma, children with intellectual disabilities, victims of sexual abuse, adults with dementia, children with OCD, and pre-service teachers.

If you want to know more about this growing field, which combines traditional aspects of literature - character, theme, emotion, and plot - with therapeutic functions more often ascribed to clinical psychology, here are a few good places to start:

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Bibliotherapy: Using Books to Help and Heal

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As the word suggests, bibliotherapy combines two of our favorite topics - reading and psychology - so it seemed a particularly appropriate topic to highlight in this post. The term itself was coined only about a century ago by Samuel Crothers, a Unitarian minister who wrote an article in the Atlantic Monthly describing how relevant books could be used as an effective adjunct to medical or psychological treatment.

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Every Thanksgiving weekend, I make an effort to enjoy my own personal tradition--- immersing myself in a good book. As a young girl, the entrepreneurial shenanigans of the Baby-Sitters Club had me excusing myself from the dinner table and bypassing the pumpkin pie. In high school, Stephen King's eerie tales of proms gone awry were more my style than any of the best Black Friday deals. Regardless of if I was studying for a spelling test or for my comprehensive exam, stories have provided me with an unmatched sense of comfort as I meet new people, travel to exotic lands (and yes, small-town Maine counts), and indulge in someone else's drama. The last week of November has always been the ideal time for this self-care ritual, as the days grow shorter and the dates draw closer to the impending holiday frenzy.

While I can speak of literature's restorative effects from my own experience, what place does it have in the world of counseling? Can creative texts, such as fiction and poetry, be used as formal therapeutic tools? Bibliotherapy, like art, music, and movement therapies, is a form of creative arts counseling. While the term was coined in the early 20th century, ancient scholars regarded the curative value of reading so highly that the inscription "The Healing Place of the Soul" adorned early library doors. Reading, according to contemporary bibliotherapy researchers, can help clients gain self-awareness, increase empathy, and even develop problem solving skills. Most importantly, when readers identify with the characters at hand, they can deepen their insight and find a renewed sense of hope in the perceived shared experience.

Surveys conducted by Dr. Dale Pehrsson and her research team suggest that bibliotherapy, in its various forms, is widely practiced by ACA affiliated professionals. However, more than two thirds of respondents note that they use nonfiction (i.e. self-help books and workbooks) compared to one third, who report using fiction. While this may be a reflection of the theoretical orientation of respondents (cognitive-behavioral therapists tend to favor self-help books while psychodynamic counselors are more apt to utilize creative texts), it might imply that creative literature is a relatively untapped source of therapeutic potential.

In upcoming posts, I hope to share with you research findings, best practices, and implications for counselor educators, as they relate to bibliotherapy. For now, here are a few things to consider:

Do I currently recommend literature to my clients? Why or why not?

How do I gauge the appropriateness of literature?

What is my role in processing these works with my client, if any?

Do I believe I possess the knowledge to make suitable recommendations, especially from a multiculturally competent perspective?

How do ethical standards guide me in selecting literature and determining who might benefit from bibliotherapy?

And so, what was on tap for this year's Reading Ritual? An article on Relational-cultural Theory, shared with me by my mentor. And a few Black Friday shopping flyers...

References:

Pehrsson, Dale-Elizabeth, and Paula S. McMillen. (2010). A national survey of bibliotherapy preparation and practices of professional counselors. Journal of creativity in mental health, 5 (4).

Bruneau, L., & Pehrsson, D. (2014). The process of therapeutic reading: Opening doors for counselor development. Journal of creativity in mental health, 9(3
Christine Hennigan Paone is a counselor in training at Monmouth University as well as an aspiring counselor educator. Her research interests include creativity in counseling, multicultural career counseling, and pedagogy.

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Every Thanksgiving weekend, I make an effort to enjoy my own personal tradition--- immersing myself in a good book. As a young girl, the entrepreneurial shenanigans of the Baby-Sitters Club had me excusing myself from the dinner table and bypassing the pumpkin pie.

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Using Bibliotherapy with Children by Leah Davies *One of Prof. Hargraves' favs.

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Using Bibliotherapy with Children by Leah Davies *One of Prof. Hargraves' favs.

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Using Bibliotherapy with Children

By Leah Davies, M.Ed.

Bibliotherapy can assist children in overcoming problems by having them read stories about characters who have successfully resolved a dilemma similar to their own. Identification with a literary model can foster thought and possible resolution to a problem such as dealing with a separation, illness, death, poverty, disability, alienation, disaster, war, etc. The underlying premise of bibliotherapy is that interpreting stories is an ever-changing process to which children bring their own needs and experiences. Since students often have difficulty identifying and communicating their feelings, stories can serve to facilitate open discussion and self-understanding. If children become emotionally involved with literary characters, they are more able to verbalize, act out, or draw pictures describing their innermost thoughts.

Use of bibliotherapy is not limited to crisis situations, nor is it a cure for severe psychological difficulties. It may not meet the needs of some children, especially those who are not ready to face their specific issue. Other students may be unable to transfer insights gained from reading into their own life, or may use literature as a form of escape. Yet, these experiences with literary characters have been shown to be beneficial to many children.

The goals of bibliotherapy are to help children:

identify and validate their feelings;

realize that other children have problems similar to their own;

stimulate discussion;

foster thought and self-awareness;

discover possible coping skills and solutions; and

decide on a constructive course of action.

How can counselors, librarians and teachers use bibliotherapy?

1. Identify the needs of individuals or groups of students.

2. Locate literature that deals with emotional and developmental difficulties or unfortunate situations your student or students may be experiencing. Read the material prior to using it or recommending it. If you choose to read aloud or to refer a child to a particular story or book, be sure it is appropriate for the child's age, gender, maturity and background. The characters and plot should be realistic and include honest problem-solving. If literature is not available on a particular subject, consider books on tape or videos to assist children in learning ways to cope with their problems. Seek administrator approval if you plan to use bibliotherapy on topics that may be controversial in your community.

3. Chose a method to involve a child or children with the literature. Read a story aloud to one child or to small or large groups of children. Also, students may read assigned stories or books on their own. Those children with similar concerns could meet in small groups.

4. Design follow-up activities such as asking open-ended questions, retelling the story, acting out roles, using puppets, writing reactions, tape recording thoughts, and/or using various art materials to help children discover that:

other children have similar feelings when confronted with comparable circumstances;

they are not the only ones who experience dilemmas; all children encounter some difficulties in their lives;

everyone has strengths and weaknesses and through self-appraisal children can learn to persevere;

facing a problem is the first step to solving it;

there are a variety of ways to deal with a dilemma and that they can decide on a course of action; and

it takes time to remedy a problem; if they are unsuccessful at first, they need to think of something else to try.

5. When deemed necessary, involve children's parents in the process. Offer suggestions for additional reading selections and/or activities to assist the students in dealing with their emotions and specific difficulties.

Used by permission of the author, Leah Davies, and selected from the Kelly Bear website [www.kellybear.com]. 5/03

Click Below for More.

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Using Bibliotherapy with Children by Leah Davies,

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By Leah Davies, M.Ed. Bibliotherapy can assist children in overcoming problems by having them read stories about characters who have successfully resolved a dilemma similar to their own. Identification with a literary model can foster thought and possible resolution to a problem such as dealing with a separation, illness, death, poverty, disability, alienation, disaster, war, etc.

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How Bibliotherapy Can Help Students Open Up About Their Mental Health | KQED

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How Bibliotherapy Can Help Students Open Up About Their Mental Health | KQED

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For adolescents struggling with depression, anxiety and grief, the use of books as a therapeutic tool can be invaluable. Tweens and teens often get stuck in their narratives, believing that the fictional stories they tell themselves are accurate. Because of the insecurities that adolescence can bring, it's easy for them to assume that being excluded from a peer's birthday party or being left out of a group text exchange is a personal affront. Social media often fuel these beliefs, which can take a toll on a youth's mental health. Shame and stigma often prevent students from speaking out and seeking the emotional support they need.

But reading about a fictional character's experiences can normalize those feelings and give adolescents the courage to open up about their own struggles. During each meeting, Cellucci leads a discussion about a book, inviting students to share their impressions. Group members can also reflect privately about the readings by writing in their journals.

"' Buddha's Brain' offers practical mindfulness tips centered around kindness, empathy, love, and self-care," says Cellucci. While it's a nonfiction book, Cellucci uses the core concepts of Buddhism to help the students share their personal stories, such as times when they needed love and care, as well as moments when they offered this support to others. "After reading 'Buddha's Brain,' the students discuss how they can relate to the readings," says Cellucci.

Along with "Buddha's Brain," Cellucci also uses fiction books with students individually. Stories like " Please Ignore Vera Dietz" by A.S. King and " All American Boys" by Jason Reynolds and Brendan Kiely help students talk about sensitive topics, like race, privilege and human angst.

"Many of the students who read 'Please Ignore Vera Dietz' relate to Vera, the main character. This character helps them grapple with whether or not our family history determines our destiny," says Cellucci.
Getting Together
At Westborough's bibliotherapy group, each meeting follows a structured format in order to create a safe forum for the participants. The group begins with an activity, like yoga or a mindful breathing exercise. Then, Parteleno teaches the students cognitive tools, like reality testing and perspective taking, which helps them to challenge and cope with any distressing and worrisome thoughts. For example, if a worried student believes her friend is ignoring her, Parteleno might gently challenge the belief, asking a question like, "What evidence do you have that this is true?" followed by "Is there any other reason that could explain your friend's behavior?"

Students also practice activities based on Dialectical-Behavior Therapy, which teaches kids how to manage intense emotions. During the group, Parteleno leads the students through mindfulness and cognitive role-play exercises, acting out challenging real-life scenarios that they've faced during the week. For example, teens in the loss group role-played how to talk with friends and family members about their grief and loss.

While studies show DBT is an effective form of psychotherapy, especially for young adults, bibliotherapy is a newer mental health intervention for youth. However, research suggests it can help reduce symptoms of anxiety and depression, especially among adolescents.

For some students, talking about their suffering can feel vulnerable. But hearing about the experience of loss from a trusted adult can help the students feel more secure about sharing. During one group meeting, Cellucci spoke about the death of her grandmother and how the loss affected her as a child. For many of the students, hearing these stories creates a sense of solace, which facilitates the healing process.

After enduring a family trauma, one student found the group especially helpful.

"The loss group was helpful because it allowed me to open up my feelings and share with people who were going through the same pain as me," says the student in Cellucci's group.

The student says that Cellucci and Parteleno helped her learn how to manage her stress and deal with intense emotions.

"In the group, I could feel compassion from others, and this gave me hope. I learned that we have to keep going with the belief that life will get better," she says.

Cellucci says the students look forward to the group because it's a time of quiet reflection and personal connection in a safe and trusted space. Students who experience the therapeutic benefits of bibliotherapy also begin to see the library as a haven where they can find books to help them understand their feelings.

For school librarians who wish to begin a bibliotherapy program, Cellucci offers these tips:

1. Create material displays that demonstrate awareness, cultural diversity and student voice (materials developed by students and/or with student input).

2. Facilitate schoolwide events that promote literacy through diversity, breaking mental health stigma and inviting students to share their voices.

3. Write grants to bring SEL-related programs that include poetry slams, reflective writing and community art.

4. Collaborate with the school's counseling department to design SEL and bibliotherapy programs.

5. Pursue training in youth mental health education through Youth Mental Health First Aid and National Alliance on Mental Illness (NAMI).

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How Bibliotherapy Can Help Students Open Up About Their Mental Health | KQED

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For adolescents struggling with depression, anxiety and grief, the use of books as a therapeutic tool can be invaluable. Tweens and teens often get stuck in their narratives, believing that the fictional stories they tell themselves are accurate.

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Bibliotherapy for Children in the Classroom

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Bibliotherapy for Children in the Classroom

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Incorporating Bibliotherapy in Your Classroom

Incorporating bibliotherapy for children involves four simple steps:

1. Determining which challenges or problems you will address.

2. Finding appropriate literature selections to use as bibliotherapy texts.

3. Planning bibliotherapy activities that will enable you to accomplish your objectives.

4. Implementing your bibliotherapy activities.

Here is an example of how bibliotherapy could be implemented in a classroom using Hands Are Not for Hitting by Dr. Martine Agassi:

1. The teacher decides to address the problem of children hitting each other in the classroom.

2. After researching and previewing a number of texts, the teacher decides to use Hands Are Not for Hitting.

3. The objective of this bibliotherapy activity is to help students understand that hitting is not appropriate behavior. Pre-, during and post-reading activities are planned to achieve this objective.

The following bibliotherapy activities are implemented:

1. The teacher asks students write down all of the things their hands can be used for.

2. The teacher asks students to share some of the things they've written down with classmates.

3. After each student has contributed one item from their list, the teacher introduces Hands Are Not for Hitting to the class.

4. The teacher reads the book aloud to the class.

5. The class discusses the book. The focal point of the discussion is why hands should not be used for hitting.

6. The teacher passes out cut-outs of hands and markers to the class. Students are told to write their names on the cut-outs as well as something that hands can be used for.

7. The teacher asks students to write a paragraph about why hands should not be used for hitting.

8. The class uses the hand cut-outs and paragraphs to create a bulletin board display about why hands should not be used for hitting.

Bibliotherapy for children can be implemented with just about any book, story, or other piece of text that lends itself to the issue you intend to address. It can be used with large groups of students, as well as small groups or individual students, and can be an excellent strategy for teaching the skills necessary for working effectively with a partner or in a group.

Create a concise lesson plan for each bibliotherapy lesson you intend to implement. Choose appropriate bibliotherapy texts to help you use literature to help create a classroom community that values, respects, supports and celebrates all of your learners.

It would also be beneficial for you to make a list of books and other pieces of text that make good resources for teaching bibliotherapy lessons, and which lessons the pieces lend themselves to teaching effectively. These tools will help you build a positive classroom environment that promotes balance and supports healthy interactions for years to come.

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Bibliotherapy for Children in the Classroom

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Incorporating bibliotherapy for children involves four simple steps: Determining which challenges or problems you will address. Finding appropriate literature selections to use as bibliotherapy texts. Planning bibliotherapy activities that will enable you to accomplish your objectives. Implementing your bibliotherapy activities.

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Bibliotherapy, a therapeutic approach that uses literature to support good mental health, is a versatile and cost-effective treatment option often adapted or used to supplement other types of therapy. Proponents of the approach suggest mild to moderate symptoms of several mood-related conditions can be successfully treated with reading activities.

Both individual and group therapy may utilize this method, which is considered appropriate for children, adolescents, and adults. Mental health professionals may encourage those in therapy and those who are waiting for therapy to read for guidance or self-help, developmental purposes, to learn about mental health concerns, and for the therapeutic benefits of imaginative literature.

History and Development of Bibliotherapy

Storytelling, creative writing, and reading have long been recognized for their therapeutic potential. The use of literature as a healing method dates back to ancient Greece, when Grecian libraries were seen as sacred places with curative powers. In the early nineteenth century, physicians like Benjamin Rush and Minson Galt II began to use bibliotherapy as an intervention technique in rehabilitation and the treatment of mental health issues. During World Wars I and II, bibliotherapy was used to help returning soldiers deal with both physical and emotional concerns.

In a 1916 article published in The Atlantic Monthly, Samuel Carothers defined bibliotherapy as the process of using books to teach those receiving medical care about their conditions, and Dorland's Illustrated Medical Dictionary, published in 1941, officially recognized this modality as a form of mental health treatment. Bibliotherapy's use expanded further in the 1950s when Carolyn Shrodes developed a theoretical model based on the premise that people are greatly influenced by the characters they identify with in stories. The American Library Association issued an official definition in 1966, and in 1969, The Association of Poetry Therapy formed, establishing poetry therapy, a form of bibliotherapy, as a treatment modality. In the 1970s, librarian Rhea Rubin classified bibliotherapy into two categories: developmental (for educational settings) and therapeutic (for mental health settings). Her 1978 work, Using Bibliotherapy: A Guide to Theory and Practice, contributed greatly to developments in the field. In 1983, The International Federation for Biblio/Poetry Therapy was established.

This page contains at least one affiliate link for the Amazon Services LLC Associates Program, which means GoodTherapy.org receives financial compensation if you make a purchase using an Amazon link.

Today, bibliotherapy is employed by educators, helping professionals, librarians, and even parents. Its versatility and adaptability make it an excellent supplement to self-improvement of all kinds.

How Is Bibliotherapy Used?

Developmental bibliotherapy, primarily used in educational settings, addresses typical childhood and adolescent concerns such as puberty, bodily functions, or developmental milestones. Educators or medical professionals may often encourage parents to use this approach with their children.

Therapeutic bibliotherapy takes many forms and can be used in conjunction with many different therapeutic frameworks. Reading has been shown to be able to help people understand the issues they are experiencing, amplify the effects of other treatment, normalize experiences with mental health concerns and care, and offer hope for positive change. Bibliotherapy can also expedite and intensify the therapeutic process by providing one potential format for therapeutic work outside of session.

The approach may be incorporated in one or more of the following ways:

Prescriptive bibliotherapy, which is also referred to as self-help, involves the use of specific reading materials and workbooks to address a variety of mental health concerns. Self-help may be conducted with or without the guidance of a therapist. A cognitive behavioral therapist teaching someone deep breathing and emotion regulation techniques may provide that person with a practice workbook to use at home, for example.

Books on Prescription is a program where reading materials targeting specific mental health needs are "prescribed" by mental health professionals, who might use resources such as the Bibliotherapy Education Project to find the appropriate books. Most libraries in the United States carry a set of books from the approved list for this purpose, often providing as a book list on their website. The Carnegie Library of Pittsburg is one such library. Their website also lists books for children, which cover topics like adoption, self-esteem, grief, divorce, and more.

Creative bibliotherapy utilizes imaginative literature-novels, short stories, poetry, plays, and biographies-to improve psychological well-being. Through the incorporation of carefully selected literary works, therapists can often guide people in treatment on a journey of self-discovery. This method is most beneficial when people are able to identify with a character, experience an emotional catharsis as a result of this identification, and then gain insight about their own life experiences. A therapist might use Our Gracie Aunt by Jacqueline Woodson, a story about a brother and sister who live with their aunt due to their mother's neglect, with a child who has experienced abuse to build interactive discussions and activities around the child's experience of the story.

Issues Treated with Bibliotherapy

While this method is not typically recommended instead of a more conventional form of therapy, it is frequently used by individuals in therapy and those who are waiting to receive therapy. In the U.K., where individuals seeking professional mental health treatment may wait up to six months, bibliotherapy is considered a first step in treatment for those who do not need immediate help.

Reading can benefit individuals of any age by increasing self-awareness, improving self-esteem, and aiding in the ability to face developmental crises. Studies show reading as a form of therapy to be useful in the treatment of depression, mild alcohol abuse, anxiety, eating disorders, and communication issues.

People in therapy for issues such as family-related challenges, posttraumatic stress, or grief might also benefit from the incorporation of books and reading activities into the approach being used. Books can be incorporated easily into any number of modalities, such as family systems therapy, play therapy, and cognitive behavioral therapy, among others.

Who Offers Bibliotherapy?

While many therapists include elements of bibliotherapy in their work with people in treatment, The International Federation for Biblio/Poetry Therapy (IFBPT) has set official standards for the practice. Practitioners interested in becoming certified poetry therapists (an umbrella term encompassing the fields of bibliotherapy, poetry therapy, and journal therapy) can pursue training from the IFBPT to obtain credentials. Studies show reading as a form of therapy to be useful in the treatment of depression, mild alcohol abuse, anxiety, eating disorders, and communication issues.

Credentials offered include:

Certified Applied Poetry Facilitator (CAPF): These individuals typically have a bachelor's degree and some experience in psychology. They work primarily with individuals who are not experiencing mental health concerns, but they are trained to recognize when an individual is experiencing distress and may benefit from a referral to a mental health professional. They often work in schools or libraries but are often able to work in a mental health setting with the supervision of a qualified professional.

Certified Poetry Therapist (CPT), Registered Poetry Therapist (PTR): Individuals who wish to complete requirements for either of these certifications are required to have post-graduate mental health training. They are generally licensed to work on their own with people who are experiencing mental health concerns. They may also be medical doctors. A registered poetry therapist completes advanced coursework and study to obtain the "registered" credential.

​​Training involves workshops and courses, peer experience, and field work, which is completed under the guidance of a mentor/supervisor. It is not necessary for a poetry therapist to be proficient in creative writing. More information can be found on the IFBPT website.

Is Bibliotherapy Effective?

Most professionals agree reading is a productive activity that can promote good mental health, as reading has been shown to increase empathy, sharpen the mind, and impact behavior. One study found children who read the Harry Potter series were more accepting of certain minority groups, and psychologists from the New School for Social Research determined fiction improved a reader's overall ability to discern and interpret emotion in others.

Anecdotal research suggests bibliotherapy may offer significant benefit in the treatment of mental health issues, and its popularity among mental health professionals further implies positive results. Many therapists believe the inclusion of books in treatment increases participation in therapy and can decrease recovery time, providing more opportunity for insight and behavioral change while also allowing people to take more responsibility in their therapy work. Research on the efficacy of the method has shown it to be a helpful part of the treatment process for those experiencing depression, anxiety, and substance dependency.

Further research may yield more details regarding efficacy and benefits. Presently, bibliotherapy is believed to be one cost-effective and versatile option for the treatment of several mental health issues.
References:

1. Afolayan, J. A. (1992). Documentary perspective of bibliotherapy in education. Reading Horizons, 33(2). Retrieved from http://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=1498&context=reading_horizons

2. Anderson, H. (2015, January 6). Bibliotherapy: can you read yourself happy? Retrieved from http://www.bbc.com/culture/story/20150106-can-you-read-yourself-happy

3. Bibliotherapy. (n.d.). Retrieved from http://www.ala.org/tools/bibliotherapy

4. Hasty, P. (n.d.). Dynamic duo: combining bibliotherapy with play therapy techniques. Retrieved from http://www.lianalowenstein.com/article_bibliotherapy_edited.pdf

5. Helliker, K. (2007, July 31). Bibliotherapy: reading your way to mental health. Wall Street Journal. Retrieved from http://www.wsj.com/articles/SB118583572352482728

6. History. (n.d.). Retrieved from http://www.poetrytherapy.org/history.html#the association for poetry therapy

7. Iaquinta, A., & Hipsky, S. (2006, July). Bibliotherapy for the inclusive classroom. Retrieved from http://education.jhu.edu/PD/newhorizons/Exceptional%20Learners/Inclusion/Teaching%20and%20Learning/hipsky_iaquinta.htm

8. Pehrsson, D. E. (2006, June). Benefits of utilizing bibliotherapy with play therapy. Play Therapy. Retrieved from http://bibliotherapy.ehs.cmich.edu/documents/APT%20bib%20Cover%20article.pdf

9. Shechtman, Z. (2009, June). Treating child and adolescent aggression through bibliotherapy. The Springer Series on Human Exceptionality, 21-37. doi:10.1007/978-0-387-09745-9_2

10. Summary of Training Requirements. (n.d.). Retrieved from http://ifbpt.org/obtaining-a-credential/getting-trained

11. McLaine, S. (n.d.). What is bibliotherapy? Retrieved from http://wordsthatheal.com.au/about

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Bibliotherapy, a therapeutic approach that uses literature to support good mental health, is a versatile and cost-effective treatment option often adapted or used to supplement other types of therapy. Proponents of the approach suggest mild to moderate symptoms of several mood-related conditions can be successfully treated with reading activities.

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Documentation Tips and Guidelines

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ASCA Student Standards for Mindset and Behaviors

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ASCA Student Standards for Mindset and Behaviors

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Research Guides: APA 7th ed. Style Guide: Legal Sources

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Adolescent Consent Form & Parent Agreement to Respect Privacy

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How has COVID-19 impacted Students and Schools?

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How has COVID-19 impacted Students and Schools?

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Emotional intelligence (EQ or EI) is the ability to perceive, express, and regulate emotions. Learn the role that emotional intelligence play in relationships and other areas.

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Adlerian Consultation ~ another short -term technique

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Adlerian Consultation ~ another short -term technique

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Although this resource discusses Aderlian Consultation and not SFBC, the approach is focused on short-term goals/solutions, so it aligns with the premise of SFBC and may be useful to you as you learn about SFBC and begin thinking about the types of individual counseling situations you may face in your role.

This resource was provided by Levi McClendon at Texas A&M Central Texas.

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Fast Track is a comprehensive intervention project designed to look at how children develop across their lives by providing academic tutoring and lessons in developing social skills and regulating their behaviors. Selection began when the participants entered kindergarten and children were placed…

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Linking the Interests of Families and Teachers (LIFT)

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Linking the Interests of Families and Teachers (LIFT)

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The program has three main components: 1) classroom-based child social skills training, 2) the playground Good Behavior Game (GBG), and 3) parent management training. It also focuses on systematic communication between teachers and parents. To facilitate communication, a "LIFT line" is implemented in each classroom. The LIFT line is a phone and an answering machine in each classroom that families are encouraged to use if they have any questions for the teachers or have concerns they wish to share. Teachers could also use the LIFT line to record daily messages about class activities, which could be accessed by parents.

Child social skills training sessions are held during the regular school day and are broken into distinct segments. The training is delivered in 20 one-hour sessions over a 10-week period. Each session includes 1) classroom instruction and discussion about specific social and problem-solving skills, 2) skills practice in small and large groups, 3) free play in the context of the GBG group cooperation game, and 4) review and presentation of daily rewards. Parts 1, 2, and 4 of the session take place in the classroom, and part 3 takes place on the playground. The curriculum is similar for all elementary school students; however, delivery format, group exercises, and content emphasis are modified depending on the grade level of the participants.

The playground GBG takes place during the free-play portion of the social skills training and is used to actively encourage positive peer relations on the playground. During the game, rewards are earned by individual children for demonstrating positive problem-solving skills and other prosocial behaviors with peers; these rewards accumulate over time so that the entire group or class can earn a reward. A point system is used to discourage negative behaviors.

The parent management training component of LIFT is conducted in groups of 10 to 15 parents, and consists of six weekly 2½-hour sessions. Sessions can provide training either shortly after school or in the evenings. Session content concentrates on positive reinforcement, discipline, monitoring, problem solving, and parent involvement in the school. Communication is fostered throughout the school year. LIFT was informed by research on the development of delinquency-specifically coercion theory (for more details, see Patterson 1982 or Patterson, Reid, and Dishion 1992). An important assumption underlying the program is that social agents respond coercively to children who are at risk for conduct problems. The intervention components were developed to decrease oppositional/antisocial child behaviors and the coercive response to such behaviors, as well as to increase prosocial behaviors and their support.

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Linking the Interests of Families and Teachers (LIFT)

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The program has three main components: 1) classroom-based child social skills training, 2) the playground Good Behavior Game (GBG), and 3) parent management training. It also focuses on systematic communication between teachers and parents. To facilitate communication, a "LIFT line" is implemented in each classroom.

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7th Edition Common Reference Examples Guide

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7th Edition Common Reference Examples Guide

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Prewitt: Module 3: Leadership Theory-Teach Your Peers.webm

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Prewitt: Module 3: Leadership Theory-Teach Your Peers.webm

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Hello, my name is Jonetta Prewitt. I am a graduate student at Angelo State University and this video is for the graduate course: Leadership. For this project, Leadership Theory and Perspectives, I will be educating my peers on two common Leadership Theories.

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Prewitt: Module 3: Leadership Theory-Teach Your Peers.webm

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Dr. Aaron Beck reviews cognitive restructuring with a depressed client during a recent Beck Institute Workshop. Dr. Beck describes how he helped the client evaluate evidence for and against his thoughts and his belief that he was a failure. He also explains how cognitive restructuring helps depressed clients access rational thinking that is typically blocked by their cognitive distortions.

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Beck Institute for Cognitive Behavior Therapy

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ASCA Ethical Standards for School Counselors

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ASCA Ethical Standards for School Counselors

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Texas Model for Comprehensive School Counseling Programs

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Texas Model for Comprehensive School Counseling Programs

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School Counseling Roles and Responsibilities Infographic

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School Counseling Roles and Responsibilities Infographic

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JPrewitt Infographic Module 1 EDSC6301-DF1.pdf

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Educational Record Keeping and Access to Records

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Educational Record Keeping and Access to Records

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Educational Record Keeping and Access to Records

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25 Ways to Ask a Child: How Was Your Day?

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25 Ways to Ask a Child: How Was Your Day?

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Professional School Counseling: BOY Presentation

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Professional School Counseling: BOY Presentation

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Prewitt: Module 4: Delivery Components Presentation

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MultiMedia Presentation: EDG 6323 Theories of Counseling Module 6 

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Note: Excerpted from Solution-Focused School Counseling: The Missing Manual
by Russ Sabella, Ph.D.

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Uncommon Sense: Moving from a Problem-Focused to Solution-Focused Mindset | Mel Gill | TEDxVarna

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Uncommon Sense: Moving from a Problem-Focused to Solution-Focused Mindset | Mel Gill | TEDxVarna

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Uncommon Sense: Moving from a Problem-Focused to Solution-Focused Mindset | Mel Gill | TEDxVarna

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These resources were shared during a presentation at the 14th Annual TCA Professional School Counselor Conference (February 2019).  The program info is below.

Solution Focused Counseling in Schools: Effective Counseling When You Have Limited Time

Time: 11:30am-1:00pm

Room: 303B

Topic(s): Secondary School Counseling Child & Adolescent Counseling

Presenter(s): Remona Clark

Do you feel like you have limited time to provide counseling services? Need a refresher in solution focused brief therapy? Tired of feeling helpless and overworked? SFBT can make your job easier by helping you interact effectively with teachers, students, parents and administrators. Come learn ways you can use SFBT in your current role.

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These are "sketches" to visually represent the "triangle" method and scaling when working through a SFBC session. The triangle “sketch” is just an example of how some counselors work with their students/clients to visually represent the steps in the SFBC process.  The top of the triangle represents the “preferred” future, while the “sides / bottom points” represent defining the problem in a solvable way and exploring the effects of the issue, what they’re doing now in the issue, etc.  The triangle and scaling visualizations are not required to work through the process, but they are options that some use to help them visually work through the steps.

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http://www.youtube.com/watch?v=T33j_ZETzUs

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What is Solution-Focused Therapy: 3 Essential Techniques

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What is Solution-Focused Therapy: 3 Essential Techniques

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Imagine this scenario: You work at a company that produces widgets. You're at an important business meeting, and you're there to discuss some problems your company is having with its production.

At the meeting, you explain what's causing the problems: The widget-producing machine your company uses is getting old and slowing down. The machine is made up of hundreds of small parts that work in concert, and it would be much more expensive to replace each of these old, worn-down parts than to buy a new widget-producing machine.

You are hoping to convey to the other meeting attendees the impact of the problem, and the importance of buying a new widget-producing machine. You give a comprehensive overview of the problem and how it is impacting production.

One meeting attendee asks, "So which part of the machine, exactly, is getting worn down?" Another says, "Please explain in detail how our widget-producing machine works." Yet another asks, "How does the new machine improve upon each of the components of the machine?" A fourth attendee asks, "Why is it getting worn down? We should discuss how the machine was made in order to fully understand why it is wearing down now."

You are probably starting to feel frustrated that your colleagues' questions don't address the real issue. You might be thinking, "What does it matter how the machine got worn down when buying a new one would fix the problem?" In this scenario, it is much more important to buy a new widget-producing machine than it is to understand why machinery wears down over time.

When we're seeking solutions, it's not always helpful to get bogged down in the details. We want results, not a narrative about how or why things became the way they are.

This is the idea behind solution-focused therapy. For many people, it is often more important to find solutions than it is to analyze the problem in great detail. This article will cover what solution-focused therapy is, how it's applied, and what its limitations are.

What Is Solution-Focused Therapy?

Solution-focused therapy, also called solution-focused brief therapy (SFBT), is a type of therapy that places far more importance on discussing solutions than problems (Berg, n.d.). Of course, you must discuss the problem to find a solution, but beyond understanding what the problem is and deciding how to address it, solution-focused therapy will not dwell on every detail of the problem you are experiencing.

Solution-focused brief therapy doesn't require a deep dive into your childhood and the ways in which your past has influenced your present. Instead, it will root your sessions firmly in the present while working toward a future in which your current problems have less of an impact on your life (Psychology Today, n.d.).

This solution-centric form of therapy grew out of the field of family therapy in the 1980s. Creators Steve de Shazer and Insoo Kim Berg noticed that most therapy sessions were spent discussing symptoms, issues, and problems (Good Therapy, 2016).

De Shazer and Berg saw an opportunity for quicker relief from negative symptoms in a new form of therapy that emphasized quick, specific problem-solving rather than an ongoing discussion of the problem itself.

The word "brief" in solution-focused brief therapy is key. The goal of SFBT is to find and implement a solution to the problem or problems as soon as possible to minimize time spent in therapy and, more importantly, time spent struggling or suffering (Antin, 2016).

SFBT is committed to finding realistic, workable solutions for clients as quickly as possible, and the efficacy of this treatment has influenced its spread around the world and use in multiple contexts.

SFBT has been successfully applied in individual, couples, and family therapy. The problems it can address are wide-ranging, from the normal stressors of life to high-impact life events.

The only realm in which SFBT is generally not recommended is that of the more extreme mental health issues, such as schizophrenia or major depressive disorder (Antin, 2016).

Theory Behind the Solution-Focused Approach

The solution-focused approach of SFBT is founded in de Shazer and Berg's idea that the solutions to one's problems are typically found in the "exceptions" to the problem, meaning the times when the problem is not actively affecting the individual (Psychology Today, n.d.).

This approach is a logical one-to find a lasting solution to a problem, it is rational to look first at those times in which the problem lacks its usual potency.

For example, if a client is struggling with excruciating shyness, but typically has no trouble speaking to his or her coworkers, a solution-focused therapist would target the client's interactions at work as an exception to the client's usual shyness. Once the client and therapist have discovered an exception, they will work as a team to find out how the exception is different from the client's usual experiences with the problem.

The therapist will help the client formulate a solution based on what sets the exception scenario apart, and aid the client in setting goals and implementing the solution.

You may have noticed that this type of therapy relies heavily on the therapist and client working together. Indeed, SFBT works on the assumption that every individual has at least some level of motivation to address their problem or problems and to find solutions that improve their quality of life (Psychology Today, n.d.).

This motivation on the part of the client is an essential piece of the model that drives SFBT.

Solution-Focused Model

While there is no formalized "A leads to B, which leads to C" sort of model for SFBT, there is a general model that acts as the foundation for this type of therapy.

Solution-focused theorists and therapists believe that generally, people develop default problem patterns based on their experiences, as well as default solution patterns. These patterns dictate an individual's usual way of experiencing a problem and his or her usual way of coping with problems (Focus on Solutions, 2013).

The solution-focused model holds that focusing only on problems is not an effective way of solving them. Instead, SFBT targets clients' default solution patterns, evaluates them for efficacy, and modifies or replaces them with problem-solving approaches that work (Focus on Solutions, 2013).

In addition to this foundational belief, the SFBT model is based on the following assumptions:

Change is constant and certain;

Emphasis should be on what is changeable and possible;

Clients must want to change;

Clients are the experts in therapy and must develop their own goals;

Clients already have the resources and strengths to solve their problems;

Therapy is short-term;

The focus must be on the future-a client's history is not a key part of this type of therapy (Counselling Directory, 2017).

Based on these assumptions, the model instructs therapists to do the following in their sessions with clients:

Ask questions rather than "selling" answers;

Notice and reinforce evidence of the client's positive qualities, strengths, resources, and general competence to solve their own problems;

Work with what people can do rather than focusing on what they can't do;

Pinpoint the behaviors a client is already engaging in that are helpful and effective and find new ways to facilitate problem-solving through these behaviors;

Focus on the details of the solution instead of the problem;

Develop action plans that work for the client (Focus on Solutions, 2013).

SFBT therapists aim to bring out the skills, strengths, and abilities that clients already possess rather than attempting to build new competencies from scratch. This assumption of a client's competence is one of the reasons this therapy can be administered in a short timeframe-it is much

quicker to harness the resources clients already have than to create and nurture new resources.

Beyond these basic activities, there are many techniques and exercises used in SFBT to promote problem-solving and enhance clients' ability to work through their own problems.

Popular Techniques and Interventions

While some of these techniques are used specifically in SFBT, others have applicability to a wide range of therapies, or even to individuals working on solving their problems without the guidance of a therapist. Working with a therapist is generally recommended when you are facing overwhelming or particularly difficult problems, but not all problems require a licensed professional to solve.

For each technique listed below, it will be noted if it can be used as a standalone technique.

Questions

Asking good questions is vital in any form of therapy, but SFBT formalized this practice into a technique that specifies a certain set of questions intended to provoke thinking and discussion about goal-setting and problem-solving.

One such question is the "coping question." This question is intended to help clients recognize their own resiliency and identify some of the ways in which they already cope with their problems effectively.

There are many ways to phrase this sort of question, but generally, a coping question is worded something like, "How do you manage, in the face of such difficulty, to fulfill your daily obligations?" (Antin, 2016).

Another type of question common in SFBT is the "miracle question." The miracle question encourages clients to imagine a future in which their problems are no longer affecting their lives. Imagining this desired future will help clients see a path forward, both allowing them to believe in the possibility of this future and helping them to identify concrete steps they can take to make it happen.

This question is generally asked in the following manner: "Imagine that a miracle has occurred. This problem you are struggling with is suddenly absent from your life. What does your life look like without this problem?" (Antin, 2016).

If the miracle question is unlikely to work, or if the client is having trouble imagining this miracle future, the SFBT therapist can use "best hopes" questions instead. The client's answers to these questions will help establish what the client is hoping to achieve and help him or her set realistic and achievable goals.

The "best hopes" questions can include the following:

What are your best hopes for today's session?

What needs to happen in this session to enable you to leave thinking it was worthwhile?

How will you know things are "good enough" for our sessions to end?

What needs to happen in these sessions so that your relatives/friends/coworkers can say, "I'm really glad you went to see [the therapist]"? (Vinnicombe, n.d.).

To identify the exceptions to the problems plaguing clients, therapists will ask "exception questions." These are questions that ask about clients' experiences both with and without their problems. This helps to distinguish between circumstances in which the problems are most active and the circumstances in which the problems either hold no power or have diminished power over clients' moods or thoughts.

Exception questions can include:

Tell me about the times when you felt the happiest;

What was it about that day that made it a better day?

Can you think of times when the problem was not present in your life? (Counselling Directory, 2017).

Another question frequently used by SFBT practitioners is the "scaling question."

It asks clients to rate their experiences (such as how their problems are currently affecting them, how confident they are in their treatment, and how they think the treatment is progressing) on a scale from 0 (lowest) to 10 (highest). This helps the therapist to gauge progress and learn more about clients' motivation and confidence in finding a solution.

For example, an SFBT therapist may ask, "On a scale from 0 to 10, how would you rate your progress in finding and implementing a solution to your problem?" (Antin, 2016).

Do One Thing Different

This exercise can be completed individually, but the handout may need to be modified for adult or adolescent users.

This exercise is intended to help the client or individual to learn how to break his or her problem patterns and build strategies to simply make things go better.

The handout breaks the exercise into the following steps (Coffen, n.d.):

Step One

Think about the things you do in a problem situation. Change any part you can. Choose to change one thing, such as the timing, your body patterns (what you do with your body), what you say, the location, or the order in which you do things;

Think of a time that things did not go well for you. When does that happen? What part of that problem situation will you do differently now?

Step Two

Think of something done by somebody else does that makes the problem better. Try doing what they do the next time the problem comes up. Or, think of something that you have done in the past that made things go better. Try doing that the next time the problem comes up;

Think of something that somebody else does that works to make things go better. What is the person's name and what do they do that you will try?

Think of something that you have done in the past that helped make things go better. What did you do that you will do next time?

Step Three

Feelings tell you that you need to do something. Your brain tells you what to do. Understand what your feelings are but do not let them determine your actions. Let your brain determine the actions;

Feelings are great advisors but poor masters (advisors give information and help you know what you could do; masters don't give you choices);

Think of a feeling that used to get you into trouble. What feeling do you want to stop getting you into trouble?

Think of what information that feeling is telling you. What does the feeling suggest you should do that would help things go better?

Step Four

Change what you focus on. What you pay attention to will become bigger in your life and you will notice it more and more. To solve a problem, try changing your focus or your perspective.

Think of something that you are focusing on too much. What gets you into trouble when you focus on it?

Think of something that you will focus on instead. What will you focus on that will not get you into trouble?

Step Five

Imagine a time in the future when you aren't having the problem you are having right now. Work backward to figure out what you could do now to make that future come true;

Think of what will be different for you in the future when things are going better;

Think of one thing that you would be doing differently before things could go better in the future. What one thing will you do differently?

Step Six

Sometimes people with problems talk about how other people cause those problems and why it's impossible to do better. Change your story. Talk about times when the problem was not happening and what you were doing at that time. Control what you can control. You can't control other people, but you can change your actions, and that might change what other people do;

Think of a time when you were not having the problem that is bothering you. Talk about that time.

Step Seven

If you believe in a god or a higher power, focus on God to get things to go better. When you are focused on God or you are asking God to help you, things might go better for you.

Do you believe in a god or a higher power? Talk about how you will seek help from your god to make things go better.

Step Eight

Use action talk to get things to go better. Action talk sticks to the facts, addresses only the things you can see, and doesn't address what you believe another person was thinking or feeling-we have no way of knowing that for sure. When you make a complaint, talk about the action that you do not like. When you make a request, talk about what action you want the person to do. When you praise someone, talk about what action you liked;

Make a complaint about someone cheating at a game using action talk;

Make a request for someone to play fairly using action talk;

Thank someone for doing what you asked using action talk.

Following these eight steps and answering the questions thoughtfully will help people recognize their strengths and resources, identify ways in which they can overcome problems, plan and set goals to address problems, and practice useful skills.

While this handout can be extremely effective for SFBT, it can also be used in other therapies or circumstances.

To see this handout and download it for you or your clients, click here.

Presupposing Change

This is a handy technique for SFBT therapists and it doesn't really apply to individuals who are not working with a therapist.

The "presupposing change" technique has great potential in SFBT, in part because when people are experiencing problems, they have a tendency to focus on the problems and ignore the positive changes in their life. It can be difficult to recognize the good things happening in your life when you are struggling with a painful or particularly troublesome problem.

This technique is intended to help clients be attentive to the positive things in their lives, no matter how small or seemingly insignificant. Any positive change or tiny step of progress should be noted, so clients can both celebrate their wins and draw from past wins to facilitate future wins.

Presupposing change is a strikingly simple technique to use: Ask questions that assume positive changes. This can include questions like, "What's different or better since I saw you last time?"

If clients are struggling to come up with evidence of positive change or are convinced that there has been no positive change, the therapist can ask questions that encourage clients to think about their abilities to effectively cope with problems, like, How come things aren't worse for you? What stopped total disaster from occurring? How did you avoid falling apart? (Australian Institute of Professional Counsellors, 2009).

SFBT Treatment Plan: An Example

A typical treatment plan in SFBT will include several factors relevant to the treatment, including:

The reason for referral, or the problem the client is experiencing that brought him or her to treatment;

A diagnosis (if any);

List of medications taken (if any);

Current symptoms;

Support for the client (family, friends, other mental health professionals, etc.);

Modality or treatment type;

Frequency of treatment;

Measurement criteria for progress on goals;

Barriers to progress.

All of these are common and important components of a successful treatment plan. Some of these components (e.g., diagnosis and medications) may be unaddressed or acknowledged only as a formality in SFBT due to its usual focus on less severe mental health issues. Others are vital to treatment progress and potential success in SFBT, including goals, objectives, measurement criteria, and client strengths.

Limitations of SFBT Counseling

As with any form of therapy, SFBT has limitations and potential disadvantages.

Some of the potential disadvantages for therapists include (George, 2010):

The potential for clients to focus on problems that the therapist believes are secondary problems. For example, the client may focus on a current relationship problem rather than the underlying self-esteem problem that is causing the relationship woes. SFBT dictates that the client is the expert, and the therapist must take what the client says at face value;

The client may decide that the treatment is successful or complete before the therapist is ready to make the same decision. This focus on taking what the client says at face value may mean the therapist must end treatment before they are convinced that the client is truly ready;

The hard work of the therapist may be ignored. When conducted successfully, it may seem that clients solved their problems by themselves, and didn't need the help of a therapist at all. An SFBT therapist may rarely get credit for the work they do but must take all the blame when sessions end unsuccessfully.

Some of the potential limitations for clients include (Antin, 2016):

The focus on quick solutions may miss some important underlying issues;

The quick, goal-oriented nature of SFBT may not allow for an emotional, empathetic connection between therapist and client.

If the client wants to discuss factors outside of their immediate ability to effect change, SFBT may be frustrating in its assumption that clients are always able to fix or address their problems.

Generally, SFBT can be an excellent treatment for many of the common stressors people experience in their lives, but it may be inappropriate if clients want to concentrate more on their symptoms and how they got to where they are today. As noted earlier, it is also generally not appropriate for clients with major mental health disorders.

What Does SFBT Have to Do with Positive Psychology?

First, both SFBT and positive psychology share a focus on the positive-on what people already have going for them and on what actions they can take. While problems are discussed and considered in SFBT, most of the time and energy is spent on discussing, thinking about, and researching what is already good, effective, and successful.

Second, both SFBT and positive psychology consider the individual to be his or her own best advocate, the source of information on his or her problems and potential solutions, and the architect of his or her own treatment and life success. The individual is considered competent, able, and "enough" in both SFBT and positive psychology.

This assumption of the inherent competence of individuals has run both subfields into murky waters and provoked criticism, particularly when systemic and societal factors are considered. While no respectable psychologist would disagree that an individual is generally in control of his or her own actions and, therefore, future, there is considerable debate about what level of influence other factors have on an individual's life.

While many of these criticisms are valid and bring up important points for discussion, we won't dive too deep into them in this piece. Suffice it to say that both SFBT and positive psychology have important places in the field of psychology and, like any subfield, may not apply to everyone and to all circumstances.

However, when they do apply, they are both capable of producing positive, lasting, and life-changing results.

A Take-Home Message

Solution-focused therapy puts problem-solving at the forefront of the conversation and can be particularly useful for clients who aren't suffering from major mental health issues and need help solving a particular problem (or problems). Rather than spending years in therapy, SFBT allows such clients to find solutions and get results quickly.

Have you ever tried Solution-Focused Brief Therapy, as a therapist or as a client? What did you think of the focus on solutions? Do you think SFBT misses anything important by taking the spotlight off the client's problem(s)? Let us know in the comments section.

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What is Solution-Focused Therapy: 3 Essential Techniques

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Imagine this scenario: You work at a company that produces widgets. You're at an important business meeting, and you're there to discuss some problems your company is having with its production. At the meeting, you explain what's causing the problems: The widget-producing machine your company uses is getting old and slowing down.

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Solution-Focused Scaling

Excerpted from Sabella, R. A. (2020). Solution-focused school counseling: The missing manual. Sabella & Associates, LLC.

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Scaling

Scaling begins when we invite students to perceive their current situation along a continuum. In a nutshell, the process of scaling involves rating how students are currently doing on a scale from 1 (when things have been at their worst) to 10 (when their problems are resolved, and they are adequately back on track). After rating themselves, the student and counselor explore in-depth the progress that has already been made. Finally, when the time is right, the counselor then helps the student explore future progress when things are 10% better, more closely approaching their miracle.

Perhaps one of the most important advantages of solution-focused scaling is that it highlights fluctuations, helping students to more easily explore the details of their better days (or hours, or minutes). Other advantages of solution-focused scaling include that it:

Provides a baseline of how the student is doing;

Sets the stage for exploring progress already made (exceptions and solutions);

Can be an excellent way to initiate the counseling process when you, as the counselor, don't know what else to do. Scaling is especially useful to get students to open up when they are not thrilled to be in counseling, especially when you present it as a game or experiment;

Helps students "step outside" their experience for a while, getting a bird's-eye view of their status;

Is easy for students to follow. In fact, after doing it several times with the counselor, students often begin scaling on their own without any prompting;

Helps in establishing manageable, realistic, and achievable (small) steps in the counseling process; and

Coupled with play techniques, scaling can be grasped by younger children, students with developmental challenges, and others who need to be concrete or logical.

Now, let's look at solution-focused scaling in more detail, as a part of a three-step process.

Step 1: Present the scale and ask for a number. The counselor begins by describing a scale from 1-10, where each number represents a rating of the student's progress toward problem resolution. For this step, you can use different types of scaling tools. You can simply draw a line on a piece of paper and make hash marks indicating placeholders for each number. Or, you can be more creative and use ladders, yardsticks, thermometers, football gridirons, or bar charts, for example (refer to this website to download various SFBC scaling templates: http://schoolcounselor.com/handouts/ or directly at http://bit.ly/sfbc-scales).

The counselor might say, " On a scale of 1 to 10, with 1 being the worst this problem has ever been, and 10 being the best things could be, what number would you give me that lets me know how you are doing right now?" Although I have emphasized the importance of being detailed when it comes to establishing goals, this time, we present the scale as a way to look at general progress. Notice that in the presenting question, we asked about " ... how are you doing right now?" We did not ask about rating specific behaviors, goals, or actions. In my experience, the student may want further clarification and ask questions like, " What do you mean, like, give you a number for how I'm getting into trouble?" Again, you can (and should) keep it general at this step and reiterate, " ... just a number that lets me know how things are going here at school (or at home). "

If you believe that the student's number is inaccurate, especially if it is too high for the current reality, simply accept it as if it were true. The number they give you is not too important. The number is really a placeholder that helps to provide a baseline, focus, and motivation to progress. Movement on the scale is more important than where they start on the scale. Even if they overestimated their place on the scale by a longshot, it's okay. If they can explain why they gave themselves a high number, they are more apt to move toward that high number in reality. So, allow them to "shoot for the stars and land on the moon." This is more effective than challenging the student about his or her skewed perceptions and alleged distortion of reality. Remember, this is their reality.

Step 2: Explore progress already made. This step, in my opinion, is the most essential step in the solution-focused scaling process. But many counselors tend to give this step only a nod or skip it altogether. Once the student gives you a number, let's say a 3, many counselors feel the urge to have the student explain the obvious-what is the nature of their problems and issues that must exist because they are only at a 3. Or, the counselor skips this step and wants to explore future progress at a four or higher immediately. By doing this, they rob the student of the considerable benefit derived from focusing, in detail, on the strengths, efforts, resources, and achievements already in play. Students usually report that they feel more hopeful and empowered during this time of inventorying "what is right" as compared to what is wrong. For example, if the student chooses a 3, the process is just beginning, and it is time for detailing, mind mapping, minefielding, cheerleading, amplifying, and reframing when necessary. After a student gives me their number, my favorite word to use is already (e.g., " Wow, so you are already at a 3! ") Remember, when a student reports that they are already at a 3, they are 30% on their way!

A frequent question I get is, "If you included the number zero in your scale and the student chooses it, how would you handle that?" Good question. Here are a few ideas:

Acknowledge and then solicit a number that describes a time when he or she was doing better and focus on that number. You can ask, "What number would you give yourself when you were better or at your best?"

Or, you can share your amazement about how they have been able to do so much already (e.g., comb their hair, get dressed, get out of bed, agree to go to school/work, meet with the counselor, etc.), all at a zero!

You can certainly challenge it. Let the student know that, although they believe that they are at a zero, you have noticed them achieving and succeeding. Of course, you'll need to be ready with specific examples which might be provided by their teachers or parents.

As a side note, you might consider not including zero in your scale and, instead, start at a 1. You'll have an easier time exploring some progress at a one and not have to deal with zero, a bit of hedging on your bet. Besides, starting at a 1 is fair as there are always exceptions to problems and issues.

Step 3: Explore future progress. After you have sufficiently explored what progress your student has made, you can begin to explore future growth. In the third step, ask, " What will you be doing better or different when you get to the next number (or 10% higher)?" The key to this step is to assume that the student will indeed be making future progress. We are not asking them, "What can you do if ....?" We are asking, "What will you do when ...?" You can remember this by reminding yourself that "Where there is a will, there is a way." Your job is to help them identify what that progress looks like, describing in detail their behavior at the next number. Remember, always emphasize behaviors, thoughts, and feelings that they can control and that we can observe. Reframe actions that they want to do less. Throughout scaling, " we aim for small changes that will represent progress in the direction of goals and preferred outcomes " (Bertolino & O'Hanlon, 2002, p. 4). Ask questions such as:

If I were to make a video recording of you when you are at a 4 (the next number on the scale), what will I see you doing that lets me know that I should start recording?

What will others (teachers, parents, friends) see you doing that lets them know you are now at a 4?

How will your life be better for you when you are at a 4?

What will others (teacher, parents, friends) say or do when they notice you getting better? How does that make a difference to you?

If the student decided that he is at a 10, although you believe further progress is needed, you can continue the process by simply asking, " What would you say you will be doing better or differently if the scale went to an 11? " Don't worry, it's your scale; you can change it if you want. To finish, decide together on 2 to 3 behaviors that the student will be doing more or differently when 10% progress is made. The behaviors may include already existing behaviors that the student will do more of, old behaviors not currently practiced, or new behaviors or skills developed in the course of counseling or classroom lessons. These will become the goals. As a reminder, make certain that each goal meets the criteria for well-established goals: in their control, in the presence of an action (positive), and very detailed and clear.

In addition to scaling with a young student, you may choose to simultaneously scale with an adult such as a teacher or parent. If the student agrees, ask the teacher, for instance, to provide a number that indicates their perception of how the child is doing. If the teacher's number is lower than the student's, ask the student, " What are you doing that, if your teacher were to better notice, she too would give you a higher number? How will you be doing this better so that your teacher will notice?" If the teacher's number is higher than the student's, ask, " What is the teacher noticing about you that you probably have not recognized for yourself? " The focus should always be on what the student wants more frequently, more intensely, or over a longer duration.

As you may have already noticed, solution-focused scaling is very different than other types of scales that we use in counseling. SF scaling is not based on normative standards, is not supposed to be interpreted, and is certainly not a valid or reliable measure of anything outside of the student's world. One student's 5 is probably not another student's 5. I'll say it one more time: SF scaling is only for facilitating the SF process, helping students (a) better focus on what is important, (b) establish direction; and (c) generate momentum. Solution-focused scales also allow both the counselor and student to use natural dialogue by developing an agreed upon point (i.e., 6) and a concept (i.e., on a scale where 10 stands for the solution and 1 for the starting point, 6 is clearly better than 5). Scaling questions allow both counselor and student to jointly construct a bridge, a way of talking about things that may be hard to describe-including progress toward the student's solutions (de Shazer, 1994).

References

Bertolino, B., & O'Hanlon, W. H. (2002). Collaborative, competency-based counseling and therapy. Prentice Hall.

de Shazer, S. (1994). Words were originally magic. W.W. Norton & Company.

Get your copy today!
https://schoolcounselor.com/professional-development/themissingmanual/

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Excerpted from Sabella, R. A. (2020). Solution-focused school counseling: The missing manual . Sabella & Associates, LLC. ____________________________________________ Scaling begins when we invite students to perceive their current situation along a continuum.

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School counselors offer services designed to increase student wellness, improve academic performance, and increase participation in postsecondary education. School counselors support students in their academic, career, and social-emotional development. They help students achieve success in school, pursue post-secondary opportunities, and lead healthy, fulfilling lives. As described in Texas Education Code (TEC) §33.005 and §33.006, a school counselor works with school faculty and staff, students, parents, and the community to plan, implement, and evaluate a comprehensive school counseling program (CSCP). The school's CSCP includes the following four components:

Guidance Curriculum

Through a guidance curriculum, a school counselor guides students in developing their full educational potential and serves as a critical Tier I support for all students. This curriculum helps students develop competencies that align with the knowledge, attitudes, and skills appropriate for their developmental level. The guidance curriculum is delivered systematically by school counselors in collaboration with other professional educators. The curriculum includes K-12 classroom lessons and group activities.

Individual Student Planning

Through Individual Student Planning, a school counselor guides each student in planning, monitoring, and managing their educational, career, personal, and social development. To achieve this, school counselors work with other educational professionals to implement systemic activities that guide students in creating future goals and plans.

Responsive Services

Through the responsive services component, school counselors intervene on behalf of any student whose immediate personal concerns or problems put the student's continued educational, career, personal, or social development at risk. This can include preventive, remedial, or crisis situations. Responsive services are implemented through individual or small-group counseling, as well as through crisis response.

System Support

System support is the foundation of the comprehensive school counseling program (CSCP). School counselors plan, organize, implement, manage, and evaluate their school counseling program to increase efficiency and efficacy. In addition, school counselors coordinate with providers in the broad network of interrelated services offered in the school, district, and community to ensure individual student needs are met.

American School Counselor Association: A professional development association dedicated to supporting school counselors' efforts to help students focus on academic, career, and social/emotional development so they achieve success in school and are prepared to lead fulfilling lives as responsible members of society.

Lone Star State School Counselor Association: A professional development association dedicated to providing services and resources to meet the needs of school counselors across our great state of Texas.

Texas School Counselor Association: A professional development association dedicated to serving professional school counselors by advocating for and advancing the role of the professional school counselor and the comprehensive school guidance and counseling program throughout Texas.

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School counselors offer services designed to increase student wellness, improve academic performance, and increase participation in postsecondary education. School counselors support students in their academic, career, and social-emotional development. They help students achieve success in school, pursue post-secondary opportunities, and lead healthy, fulfilling lives.

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List of handouts used in various workshops/presentations which are frequently updated:

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Following is a list of handouts used in various workshops/presentations which are frequently updated:

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The Solution Focused Brief Approach: From Problem Solver to Solution SeekerRussell A. Sabella, PhDFlorida Gulf Coast University

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The Solution Focused Brief Approach: From Problem Solver to Solution SeekerRussell A. Sabella, PhDFlorida Gulf Coast University

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PowerPoint of the Workshop Slides. Includes good graphic organizers/visuals and many helpful solution-focus questions

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These are great videos to watch to glean insight on how you might lead an SFBC session.