Counseling the Contemporary Woman - Suzanne Degges-White

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still minors. Informed consent, confidentiality, reporting, and counselor competence are four issues of concern when counseling children and adolescents (Lawrence & Kurpius, 2011). Informed consent gives formal permission for treatment, and parents need to give consent for treatment. It is also recommended that counselors obtain adolescent verbal or written consent, but the parents enter into the contract by their consent. Juvenile court can order counseling for adolescents (e.g., give permission to treatment without parents’ or minor’s consent). At sixteen, adolescents are considered mature minors, and that gives them specific rights under special circumstances. Such circumstances or exceptions from parental consent include emancipation, birth control, pregnancy, sexually transmitted diseases, treatment for drug use, and alleged sexual assault of a minor over twelve. Confidentiality is limited, and parents or legal guardians have a right to be informed about treatment and any assessments that are being administered. Counselors working with young girls need to be aware of their responsibility, as highlighted in the ACA Code of Ethics (ACA, 2014) as they are ethically obligated to obtain adolescent permission to release information. Every clinician working with adolescents walks a fine line here to ensure that their clients do not lose trust in the counselor. Trust can be jeopardized when personal information is disclosed without informing the client beforehand. However, by informing the parent, the counselor is obeying the laws of the state in which they practice. Mandatory reporting is related to reporting child and adolescent abuse and neglect. Counselors are obligated to report any suspected negligence or abuse; otherwise, they fail to obey the law and follow ethical standards. Bean, Softas-Nall, and Mahoney (2011) reported that 27 percent of clients dropped out of therapy after their counselor broke confidentiality for mandatory reporting. Thus, it is important to ensure that adolescent clients are made aware of your intent to disclose and the ways this might influence the client’s life.

      Advocacy Opportunities

      Considering their age and developmental tasks, such as striving for more independence, competence, and exploring identities, adolescent girls should be first acknowledged and validated for their feelings and experiences, as it is challenging to navigate this period today. Social media and entertainment media can negatively influence their development. Messages of what is the “right look,” the “right weight,” and the “right outfit” surround them daily, creating constant pressure to conform to cultural standards. As they are creating their identities, it is important to highlight their uniqueness, celebrate their strengths and talents, and bring into their awareness the significant potential that every girl possesses. Further, counselors can advocate for egalitarian approaches to education, career, and personal success. Also, addressing double standard in sexuality is a crucial advocacy piece for everyone, including creating safe environments for members of the LGBT population. Counselors should also promote assertiveness and self-advocacy in their clients to help them navigate today’s sociopolitical climate.

      Case Vignette Wrap-Up: Sofia

       Sofia started to trust her counselor as the counselor demonstrated empathy and validation of Sofia’s feelings of being lost and out of place: “I don’t want to go to school, I am forcing myself to go every day. I don’t fit in. I wear the same clothes over and over again and other girls have new outfits every week. They go out together and I don’t get invited. Some boys made fun of me when I didn’t bring art supplies. I feel nervous before any presentation because I know kids are going to think that I am an outcast.” Anna looked at Sofia, whose eyes were watery and said, “It looks like you are going through a lot, and it must be very hard facing so many difficulties, especially when it comes to not having your own home and feeling out of place.” Sofia’s tears were running down her cheeks at this point, but she continued: “I don’t want to feel like this. . . . My mom tells me to get a job. . . . But I can’t. I don’t want to feel the same way while working. I know we need money, but I don’t care.” Anna maintained her eye contact, took some time to respond, and after some silence said, “It sounds like there is a conflict between you and your mom, and such conflict is not helping you at all. Am I right?” Sofia nodded and said, “I wish my mom could understand.” “You don’t feel supported by your mom,” Anna reflected. Anna then asked if there was anything else bothering her at the present time. Sophie shook her head to signify that there was not.

      Interventions: Strength-Based Approach

       Anna began, “I have heard a lot about your difficulties and how hard it is for you to manage all these sad feelings. I would like to pause that discussion for a bit and focus on your hobbies, likes, and strengths. Would that be okay?” Sofia nodded and said that she liked painting and that she especially enjoyed drawing and designing clothing. She also made some jewelry from “found” materials. After further encouragement to talk more about her skills and strengths, Sofia said she was helping at home and with her little brother. She could cook, shop, and do laundry. She considered herself good in math but did not want to show it. Anna stepped in and said, “I also heard you say that you don’t want to go to school, but you do go every day and that shows me that you are committed and responsible. And the things that you have been through, and that you are here talking to me, means that you are resilient and courageous. Could that be true?” Sofia wiped her eyes, looked at Anna and said, “I guess.” Anna encouraged Sofia to think about some small things she would like to change about her feelings and situations. As Sofia shared her wants. Anna wrote them down so that they could cocreate some basic goals and objectives for Sofia to accomplish. The list looked like this:

      1 Have a place to call home

      2 Have some friends to hang out with and enjoy their company

      3 Have some happy feelings and feel good about myself

      4 Have a better relationship with Mom

      Brief Conceptualization

       Before any further work, here is a current developmental understanding of Sofia as a sixteen-year-old, Hispanic, homeless adolescent with only one parent, a history of past physical abuse, and currently residing in a facility for adolescent girls.

       Sofia is in a unique position that many adolescent girls do not experience on a daily basis. Her reality is less than her ideal and is causing her significant distress. Everyone has a need to belong—especially teenagers. Sofia does not have a stable residence, only one parent present in her life, and no friends. Her identity is being shaped by rather tough circumstances over which she has little control. She does not want to be homeless and without friends. This is causing her to feel shame and embarrassment; therefore, she avoids any contact with classmates and does not want to present in front of the class. Such feelings undermine her self-esteem and feelings of competence. She partially satisfied the need for independence by leaving home and being placed in the independent living facility for teenage girls, but that was not as satisfying as she might have expected it to be. She wishes for a real home and an improved relationship with her mother. Further, her sense of self as a competent young woman was attacked by boys when they made fun of her for not having art supplies, something that is beyond her control due to her financial situation. As a result of multiple factors, she withdraws, refuses to participate, does not do her schoolwork, and has a very low sense of worth. Therefore, it will be crucial for her counselor to address developmental tasks such as identity, competence, and independence over the course of her counseling.

      Final Wrap-Up

       Anna and Sofia went into detailed discussion about each goal and described what success would look like. Since having a home is not really in her control, they discussed how to make her current room feel more like home for the present. For the long term, they would explore how to get her mom involved and explore referrals to agencies that can help and assist with housing. They talked about some strategies to make friends, but Anna wanted Sofia to understand that it is imperative that Sofia feels good about herself and improves her sense of worth before trying to make friends. In order to boost Sofia’s self-esteem, Anna encouraged Sofia to explore some of her negative and irrational thoughts about herself

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