Term Paper On Counseling Middle To Late Childhood Children With Low Self Esteem
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Low self-esteem can become a major issue facing children during their middle years (ages 9-11) that can have significant consequences when they reach late childhood or adolescence (ages 12-18). Development through these ages is complex. The causes for low self-esteem are varied and can manifest as eating disorders and difficulty at school. One intervention that has proven successful in treating low self-esteem is cognitive behavioral therapy.
Middle to late childhood is a time of critical development for children. Erikson has proposed in his theory of development that children ages 5-12 are in the stage of industry-vs-inferiority. In this stage children are learning and developing competence. Children become aware of themselves as individuals. Emotionally, they begin to form their own relationships with adults and other children. They are forming morals and values and they become aware of other cultures and individual differences in others. Cognitively, they are learning and understanding more complex ideas such as time, writing and math. Their thoughts are becoming increasingly complex as are their emotions. They become industrious and finish tasks that they began. They recognize their skills and talents and will seek out ways to pursue these interests. If a child has difficulties in any of these domains, they may develop feelings of inferiority which is translated into low self-esteem. Physically children’s bodies are maturing, they are taller, stronger, and more dexterous. They also begin to show the first signs of puberty such as pubic hair, the development of breasts and sexual feelings (Karkouti 2014).
Late adolescence, ages 12-18 is when a child moves into Erikson’s stage of identity-vs-role confusion. At this stage, the child is passing into adulthood. The adolescent is making decisions as to what career to pursue and develops a sense of sexual identity. Concern for their appearance is very important to the adolescent and how others perceive them. Their role in society becomes a major issue for adolescents. This role includes career, social and familial relationships, religious convictions and politics. During this stage of identity crisis, youths are given some space by families and societies to settle into what they have come to see as their roles. Experimentation with ideas and affiliations occur during this period. Cognitively, adolescents are processing abstract ideas and questioning more of what they are taught. Adolescents are learning to synthesize their own ideas and interpret information they are given. Exploration of complex subject areas and showing interest in subjects that they are proficient at or interested in is very common. These subjects can include mechanics, science, literature or art. Physically, adolescents are experiencing puberty and entering into adulthood. They have reached their full height, their bodies have become harder, sexual maturation has occurred. At this stage, if there is difficulty in making a decision and finding one’s place in society is not accomplished confusion can occur. Again, self-esteem can be negatively affected. An adolescent who has carried low self-esteem with them from the previous stage can have much more difficulty in navigating this critical stage of development (Karkouti 2014).
According to McClure, Tanski, Kingsbury, Gerrard and Sargent (2010) describe self-esteem as an overall reflection of one’s self-worth. The beliefs we have about ourselves and the emotional response it evokes determines our self-esteem. Signs and behaviors that demonstrate positive self-esteem are: confidence; self-direction; awareness of strengths; optimism and independence. These characteristics result in the ability to cooperate with others and develop and maintain healthy relationships. Low self-esteem occurs when we have negative beliefs about ourselves which causes a negative emotional state. Low self-esteem is related to many psychological, social and physiological problems. Depression, anxiety, eating disorders, anger and aggression, early sexual activity and substance abuse are all outcomes of low self-esteem. Activities and problems that are also symptomatic of low self-esteem are excessive amounts of television viewing, drinking and taking drugs, risky sexual behavior and obesity (McClure, Tanski, Kingsbury, Gerrard, & Sargent 2010).
In recent years, cognitive behavioral therapy has emerged as a useful and powerful therapy for many psychological issues. Low self-esteem is not considered an issue in of itself but it is often an underlying cause or a symptom of deeper psychological problems. Cognitive-behavioral therapy can enhances self-control, perceptions of personal efficacy, rational problem-solving skills, social skills, and participation in activities and physical exercise that bring the adolescent a sense of pleasure or mastery. These skills and activities can increase self-esteem. Cognitive-behavior therapy encompasses an assessment of how the client views the world, solves interpersonal problems and handles social situations (Clabby 2006).
Cognitive-behavioral therapy is active and dynamic. In addition to sessions with a therapist a client often has homework or has active work to do independently. Therapy is a learning process. The theory behind cognitive-behavioral therapy is by examining and recognizing how a client thinks and perceives the world around them (cognitive). The other aspect is recognizing how the things the client does affects their thinking (behavioral). By helping a client become aware and training them to pay attention to these two concepts, change in thinking can be accomplished through changing behaviors (Clabby 2006).
Typically, a client will begin with a situation. The situation will evoke a thought, an emotion occurs as a result of this thought, emotions cause physical symptoms which culminates in an action. For the child or adolescent struggling with low self-esteem a session would address a situation they have faced or could face and move through the model. For example, the client will have to take a difficult math test on Friday. The thinking in response to this challenge is, “I’m going to fail.” Which in turn produces an emotion, anger which causes a clenching and tightening of the muscles in the body. These physical reactions cause an action such as smoking marijuana, eating a gallon of ice cream or crawling into bed for 12 hours. With cognitive-behavioral therapy, a client is taught and practices new ways of thinking which will change the reactions and the behavior. In the previous math test scenario, the client will change the thought to: math is difficult for me but I have been getting extra help, the emotion resulting in confidence, which results in relaxation of the body and the action of studying some more. Changing thoughts and behaviors eventually become inherent and no longer need to be thought of consciously.
Cognitive-behavioral therapy is not traditionally a long term therapy, usually ten to twenty sessions are sufficient. Factors that affect the length of therapy are familial support, severity of the condition and how long the client has been dealing with the situation. Clients who fully participate and practice the interventions they learn outside of therapy sessions will have better results (Clabby 2006).
Low self-esteem in middle and late childhood is a serious problem that can result in more serious psychological and behavioral problems. The longer feelings of low self-esteem the more difficult it becomes to overcome and development through adolescence can be adversely affected. As children approach adolescence they are becoming more independent and more socially aware. Young adults in adolescents are testing and developing their talents and looking for the place they will fit in society to be of maximum value. Positive self-esteem is critical for growing through these stages. Cognitive-behavioral therapy has been proven to be effective in treating adolescents with low self-esteem and help them to learn healthy strategies for navigating life in a healthy and productive manner.
Clabby, J. (2006). Helping depressed adolescents: A menu of cognitive-behavioral procedures
for primary care. The Primary Care Companion to the Journal of Clinical Psychiatry, 8(3),
131-141. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1540388/
Karkouti, I.M. (2014). Examining psychosocial identity development theories: A guideline for
professional practice. Education, 135(2), 257-263. Retrieved from: http://eds.b.ebscohost.
McClure, A., Tanski, S., Kingsbury, J., Gerrard, M., & Sargent, J. (2010). Characteristics
associated with low self-esteem among U.S. adolescents. Academic Pediatrics, 10(4), 238-
244. DOI: 10.1016/j.acap.2010.03.007
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