A STUDY OF THE EDUCATIONAL THERAPY SERVICE IN NEWFOUNDLAND AND LABRADOR
byValeria ElizabethAnderson -lane
Athe sis submittedin partial fulfillmentofthe requirements for the degreeof
Master of Education
Department of EducationalPsychology Me moria lUniversity ofNewfoundland
June,1990
St.John's Newfoundland
Theauthorhas grantedan irrevocablenon- exclusive licenceallowinglheNationalUbrary of Canada10reproduce.loan,distributeorsen cop ies of his/her thesisby anymeansandin anyform or format,makingthis thesisavailable 10 interested persons.
The autho r re tains ownershipofthe copyri ght inhis/her thesis. Neitherthe thesisnor substantialextrac tsfromitmaybe printed or otherwise reproducedwithouthis/herper- mission.
L'auteur aaccoroeunelicenceirrevocable01 non exclu sivepermettant
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ACKNOWLEDGEMENTS
I would liketo thankDr.GlenSheppard and Dr.Kofi Marfofor theirguidanceandsuggestions during thedevelopmentofthis study.
Thankyou, Kali, for your timeandpatience withtheanalys is of the data.
I wouldlike to givespecialthanksto my brother,Doug,whose support, encouragement, and direction enabled metocomplete this project. Iam indebtedto him for his expertise,patience,and devotion. Thank you,Doug,for yourlove and friendship.
Thank you,Paulette , foryour typing,long hours,and for all the little thingsyou doto makeour days brighter. Iwillmissyou.
Thanks, Momand Dad,for your consistent encouragementand understa nding.
Finally, Iwouldlike tothankmy family for their support, especiall y duringthefinal stages of thisproject. Thank. you, Jocelyne and Jodean,forshouldering someof thehousehold responsibilities and babysittingwhile Iwasaway. Thankyou,Kevin, foryourlove and most of all,for beinga wonderful father toourson.
Isincere ly appreciateyou for puttingup withme during the lasttwo years and for giving methe opportunitytctaketimefor myself during the completion of thisthesis .
last.butnot least.I would liketothank my littleboy, Jason, whohasbroughtgreat joy and laughter into mylife. Thankyou.
Jason,for givingMommyyour love.
ABSTR ACT
In1986, the DepartmentofEducation inNewfoundland and Labradordeveloped a policyconcerning itsservicesforbehavior disorderedstudents. Theteachingunitassignedto providethese services was entitledEducational Therapist.
Thepurpose ofthis studywasto examinethe educational therapist's servicesofferedto behaviordisorderedstudents.
Educational therapists throughout theProvincecompletedasurvey questionnaireregardingtheir ownbackground,characteristicsofthe children,and theinterventionsprovidedforthesestudents. Fifty~
nine therapistsresponded and provid ed informationabout themselvesand306 core behaviordisorderedchildren.
Theanalysisof responsesincluded the characteristicsand problems ofchildren labeledbehaviordisorderedintheseunits;the natureof servicesandtreatments being provided;thetraining and background ofthetherapists, aswell as their perception offurther training needs. Results indicate that educationaltherapistswork with a variety of behavior disorderedchildren.
The<rainingandbackground of therapists arevariedand there islittle consensusamongthosesurveyed related totherare and function ofthe educati onaltherapist. Results wouldindicate a strong needtofurther researchthe effectivenessofthesepositions alongwith their appropriate rolesin the schoolsystem.
iv
...1
ABSTRACT .l v
LISTOFTABLES vll l
CHAPTER INTRODUCTION.
Purpose. . 1
BackgroundTo theProblem 1
Ratio nale 3
ResearchQuestions 7
Definition ofTerms 8
Li mita t ions 10
II REVIEW OF THELITERATURE..•...•...•.•...12
Historical Overview ofServices 12
Definitional Issues 19
Newfoundland Deflnltio ns 24
TheNature ofStudents-AtRisk- 25
Prevalence 25
SexofBehavior DisorderedChildren 26
Classificati on Systems 28
UndersocializedAggressive ConductDisorder 30 Socialized AggressiveConductDisorder 31
AttentionDeficitDisorder 32
Anxiety-withdrawal-dysphoria 33
Schizoid-unresponsive 34
SocialIneptness 35
PsychoticDisorder 36
MotorOveractivity 37
ServicesProvided forBehaviourDisorderedChildrenin Canada••••.•...•...37
NewfoundlandPolicy 40
Sl1ecif ic Interventions , 43
BiophysicaVBiogenicModel.. 44
Psychodynamic 44
BehavioraL 45
PsychoeducationalApproach ..45
Eco logical Approach 46 PrevalenceofIntervention Approaches _ ..46 Counselli ngTherapies and Te;chniques __ _ _ _ .47
RealityTherap y_ _ _ _..__ __ 48
Person-ce ntered Thera py.•._ .49
GestaJt Therapy•.•...••...•..._...••...••.•...•...5 0
Rational-EnlOtiveTherapy 5 0
Cogn itiveBehaviorTherapy_ _ 51
Behavioral Counselling.._ _ _ 51
Psychotherapy•••••...••...••.•...••••..•...••...52
Transactional Analysis 53
AdlerianTherapy _ 54
Family Therapy 55
Group Counselling 56
WhoAre ServingBehaviorallyDisturbed Children? 58
Role 58
Training and Backgrou nd ... . 59 Teacher sPerception sofTrainingNeeds... . 63
TeacherCompetencies 6 3
Teachers'Perceptions of TrainingAdequacy 70 Categorical/Noncategorical Training 72 III MElKXlCl.03Y .._..__••..._..•...__ _••.•_ __ _..74
Sarrl>fingProcedure.•...••...••....••.•...••••....•.••.••.•....••••..•...•••...••••74
Methodof Data Collection _ _ 74
Descript ion of the Questionna ire__ _ _ _ _ 75
Scoringand Analysis ofData _ 77
8corln9 77
Analysis of theoata _ _ 78
IV RESUlTS AND DISCUSSION _ 79
TheChildren Served 79
Number ofChildrenServed 7 9
Age.•...•..•.•...•.•...••...••...•...•...•..•...•...80
Grade 80
Sex 82
Typ e of Disorder . 83
DegreeofSeverity 87
Behavior Disordered StudentswithLearning Di s abili ties... . 87
HowThe ChildrenAreServed 88
Intr od uc t ion _ _ _ 88
Scope of Duties .. 95 Availabilityof Support.PersonneL ... .. 97
Preferred Delivery Models: 9 9
Placement... .. 102
Interventio n Approaches 103
Intervention Focus 110
Length of Time inTherapy 111
SummarI... . 112
WHOAREPROVIDING THESERViCES? 11 6
Tra in ing 116
Background and ProfesslcnalExperience 120
Summary 124
V CONCLUSIONSANDRECOMMENDATIONS 126
BIBLIOGRAPHy ..
APPENDICES ..
.. 134
.. 146
AppendixA• Letter to School Board Superintendents RequestingPermissionto Use Their Board in Study 146 AppendixB- LettertoEd ucational Therapists Requesting
Cooperationin Study 149
AppendixC - Questionnaire 152
LIST OF TABLE S
TABLE
viii
Children'sAges... . 80
Students'Gradelevel... .. 81 StudentBehavioralCategories... .. 84
SchoolsServedByTherapists .. 96
Counselling Time InSchools 98
Intervention Approaches Received By Children 104 Intervention Approaches By Therapist . 10 7 GroupingsUsedByTherapists... ...108 Groupings By0hifdren... ...109 10 InterventionFocus... ..1 11 11 PerceptionsofTraining Adequacy... .. 120 12 Respondents
Age. ... ... .. ... .. .... ... ..
12113 Qualifications of Therapist , 125
Introduction
The purpose of thisstudy was 10 obtain a descriptionof educational therapy services in Newfoundland and Labrador.
This descriptionwillinclude:
1.The presenting problemsof children being served.
2.Services offered by therapists.
3.The interventionsbeing used to help these children.
4.The training and background of the therapist.
5.Perceptions of the therapistswith respect to the delivery model for servIng these children.
~rQynd to the p ~
Over the past five years the Department of Educationin Newfoundland and Labrador has developed a unique(teaching) unit to meet the needs of behavior disordered children.
Smerdon and Butt (198S) described the rationale forthe development ofthe model for this unit, entitled Educational Therapists. Their review of the literature pointed to the need for unbiased identification procedures. a resource person highlytrained in behavior change methods, and the use of
objectivemeasures to evaluatetheservicesoffered. The DepartmentofEducation (1986)adopted this modeland produced a policystatementfor school boards and educational therapists to serve as aframeworkfor the implementation of theseservices.
The DepartmentofEducation's policystatement identifies the aim ofservicestobe theretention of the behaviordisordered studentin the mainstreamof theregular class. It describes theeducationaltherapistsas•.. .resource personsappc'ntedforthebenefit of administrators. teachers.
and parentsas wellasthe students themselves: (p.1). It claimsthe titleeducationaltherapist isused todistinguish.
theirrolefromthatof teacherswho areresponsiblefor academic instruction andguidancecounsellorswhose roleis much more broadlybased.
The policystatementis essentially providedto school systemsthroughout Newfoundlandand LabradorP.5a guideline forthe development,implementationand evaluationof programs andservicesforbehaviorally disorderedstudents.
As such, the policy document provides informationand guidance onthe following:
• Definition ofbehaviorallydisordered students.
requi red.
Competenciesreq uiredof educationaltherapi sts.
Roles andfunctions recommendedfor educatio nal therapis ts.
Whilethe policy statementprovidesan exce llent outli ne for the establish mentandimplementationof educatio nal therapyunits,little has been donetodatstoassess these units in terms oftheiroriginalmandate. The success of such aprogram will clearly dependupon the abilityof school systems toputprogramsinplacethat are effective and efficientfor behaviorallydisorderedchildren. Successwill not only depend upon programdevelopment skills ofschool boardpersonnel,but will alsolargelydepend upon the ability of boardsto attract trainedpersonnel in thefield of behavioral disabilities.
Researchinthe fieldof behavioraldisorders has sufferedbecause ofproblems withreportingand inconsistent
definitions (Skiba & Casey,1985): Studiesinboth Canadaand theUnited Stateshavereported variatio nsindefinitio ns us ed byprovincia l andstate departmentsofEducationforthe identificatio n of behavior disorde red students (Cullina n, Epstein,&Mclinden,1986:Csapo, 1981:Epstein,Cullinan.&
Sabatino,1977). Studiesofprogramsfor the behavio r disordered havebeen hampered byincomplete program descriptions in theliteratur e (G rosenick&Huntze, 1983,as cited inSkiba&Casey,1985). An analysisof research reportinginterventions for behaviordisorderedstude ntssince 1977, indicatedthatanumber of important descriptorswere missing,suchas:the subjects'age and sex; theamountof special education services subjects are pres entlyreceiving ; anda specific descriptio n ofthe subjects' behaviors(Skibaand Casey,1985).
Withthe implementationofthe educationaltherapyunit.
itwould seem thatNewfou ndland and Labrador,atleast theoretically .wouldhave a solid foundation for providing services to behaviordisord ered students. However,whethe r or not actualeducational therapypracticesfollo w theguidelines recentlyprinted is anothe r question. Thisstudy was aimed at determining the actual services andspecific interve ntions being provided tobehav ior disorderedchildrenwho are
Education, the definit ionofbehaviordisordered students will followthe definitionoutlined in the DepartmentofEducation's PolicyManual. The services offeredto the studentsinthese unitsmay be affectedby anumber ofothervariables. Someof these variables,which wereconsideredin thepresent study, are rev iewed below.
Information concerning the specificchildrenbeing served by the educational therapist ts needed. Variablessuch as age,sex, andtype of problems can influence the interventions and servicesprovided. This informationis also valuable in terms of discussingtheprevalence ofproblemsin Newfoundland andlabrador.
In orderto planfor future programs,the Departmentof Education will need informationon the natureandtypes of servicescurrentlybeing provided. Identifyingthe services thatare beingprovided willbeto a large extent dictatedby the typeofplacement the childis assumingwithin the school.
Thisplacementis importantfroma philosophicalpointof view as well,since theaimof services is supposedtobe mainstreaming. The natureof the servicesofferedto the behaviordisorderedstudents,willalsodepend onthe
responsibilities therapists area'~sumingwithinthe sch ools.
Information concerningthe responsibilities is important from two perspectives: (1)it willallowone toget a morecomplete descriptionof the broaderservicesbeing offered,suchas groupcounselling, classroom guidance, etc.and; (2) itmay indicate areasofresponsibili ties that could interfere with providing servicesto thebehavior disorderedstudents. For example,if the therapistsareresponsible forteaching other classesorsupervisingdetention,theymay beless available for intervention.
The specifictype of treatment offeredto helpa childis also a critical variable. Depending upon thenatureandneeds of the child involved,the selectionand appropriate use of specific therapies willclearlyaffect the successof the therapy program,
Directly related to theuse oftherapies isthe training and background of theeducat ional therapist. Beareand Lynch (1983)found that themost seriousproblem for servingthe needs of behaviordisordered students was a lack of trained personnel. Training and theoreticalorientationof the therapistshave alsobeen found to affect the typeof interventionused (Kestenbaum, 1978 ascitedinAlgol zi ne&
Lee,1981), Thesefindings seemlogical:therapistswho
Similarly.if sometherapists'orientation s aretowards remedi ation of academic difficult ies,itisless likely that they willbe offering psyc hoanalysis. Ideally.interventions usedbytherapists shouldbedirectlyrelated to thenature of the chlldrens'difficulties. However,onecannotexpectan intervention technique thatispresently not in the therapists' repert oire. Therefore,it isimportanttofind outhow therapistsviewthe adequacy of theirpresenttraining and their desire forfurther training in speci ficareas,
Themainpurposeofthis studywas to providea comprehensive picture of the services being offered to behaviordisorderedchildreninNewfoundland and Labrador schools. It was envisagedthatby taking the abovevariables into account,patterns willemerge thatwill make a valuable contributionnolonlytotheresearchinthis field, but also to the Improvementof services.
Research Questions
This studySO~!ghttoaddress the followingquestions.
1,Whatare the presenting problemsof childrenbeing served?
2.What kind of services are beingprovidedlor children with behaviordisordersin Newfoundland and Labrador?
3.What specific types of treatments are being used tohelpthesestudents?
4.What isthe trainingandbackground of persons servingthese childrenin the educational therapy units?
5.What types oftraining isperceivedto beneededin orderto moreeffective ly help thesestudents?
Definition of Terms
Educational therapist: Aperson appointedtothe salary unitfora minimumoffour studentswho are deemed (under Revised Regulation 278/82)"emotionallydisturbed".
Behavio r disordered student: For thepurposeofthis study,abehaviordisorderedchild is a child who isbeing served in the educationaltherapy unit. Thedefinition of behavior disorderedchild employedby the Governmentof NewfoundlandandLabradoristhefollowing:
characteristicsover along periodof timeand toa marked degree, which advers elyaffecteducational perfor mance:
1.A marked inabilitytolearnwhichcannotbe adequately explainedby intellect ual,sensory,neurophysiological,or generalhealth factors.
2.A consistent inabili ty tobuild andmaintainsatisfactory inter-pe rsonal relationships withpeersand teachers.
3.High age and/orsexinappropriatebehaviors or feelings within normal situations.
4.A generalpervasive moodofacute unhappinessor depression.
5.A tendency to developsymptoms,suchas speech problems,pains orfears,associatedwith personalor schoolproblems."
•Assessment datafrom avarietyof scales andsources is used to identifya "problem" In one or more ofthe above areas. Consistencyin pointing a student's
inapp ropriate behaviorsbe tween atfeast three 01 Ihese sources istakenas sufficientevidenceof iderniiicatjon.
Core student: Astude ntforwhomfull documentationexists in schoolandboardoffice, andtherefor eonewho cou ldbe used tosubstantiate the unitunderregulation section2(3)(a)(iii) ofThe SchoolAct(Teach er's salaries)Regulation(1982 Amendment).
Referredstudent: A student referred to aneducational thera pistbyself,teacher,paren t,orother agenciesfor evaluation,behavioralpro gram planning,or crisisin tervention.
Limitatio ns
As wit hmostresear c h,somecautionmustbetaken when interpr eting theres ults of this study. Thefollowin g point s highlightthe primary rese arch conside rations when applying thedata herein:
1. The questionnaireallows for a combi ned me asure of facts,definitio ns, attitu desandperceptions.
2.The studyis descriptive innat ure.
rn
3.The trainingand background of respondents varied considerably,creatingthepossibility ofa greater variance on more technicalquestions .
4.Respo ndentsmay inadvertently biasresults in favor of answers that are perceived to support their positions.
CHAPT.ER2 Review of the Literature Historical Overv iew of SerVices A brief examinat ion ofthehistoryof services for behavior disorde red children,willgiveone abetter apprecia tionofservicesthat exist today . Prior to18 00,few, if any. systematicattemptsweremadeto teach anytype of handicap pedchildren. "Abuse,negl ect, cruel medical treatment (e.g.,bleeding),and excessivepunishment were common and often acceptedmatter-ot-factlyforchildrenas well as adults who showed undes ir ablebehavio r"(Ka uffman, 1981.p.33).
De spite poortreatmentand institutionalization,themid 18005brought anincr eased intere stinpossible explanations of mala daptivebehavior. Diagnos is and classification became the locusinthe latterpart of thecentury. knownas the
"descrip t iveera". Duringthis period,a legaldistinction was madebe tween feeblemindedness(mental retard ation) and insanity (emoti o naldisturbance)in England (St ainback&
Stainba ck .1980).
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Unfortun ately, inthelasthalf ofthe18005, attitudes towardsfatalismdevelopedand theprev ailingbeliefwasthat insanitywasirrever sible. As aresult, treatment was believed to be useless and asylums becameaplac e toisolatetheinsane trom therest of society.
Inthe early1900's, concern forchildren with disordered behaviorincrea sedtremendously. Communitychildguidance clinicsfor em otiona lly dist urbed childre n were established.
As well,public schoolsbegan offeringmentalhygienecourses as apreventat ivemeasure for emotional disturba nce. The beginning of educati onforthe emotionally disturb ed was undoubtedly influencedbytheNationalCommittee forMental Hygiene,establishedin 1909. Oneofitsmembers,Thomas Haines, statedthathe believed thepublicschoolsshouldbe concerned ab outthe welfare of allexcep tionalchildren includingthe "psychopathic"(seriously disturbed) as wellas those who exhibit more mildbehaviorproblems (Stainback&
Stainback, 19 80).
In the1920s,twoorganizationswerefoundedthat greatly influen cedtheeducationof disturb edchildreninthe United States:theCouncil forExceptionalChildr en (1922)and the AmericanOrthopsychiatric Association (ADA)(1924). The
Council for ExceptionalChildren'greatlyinfluencedthe passage of legislation concerning theeducationof all handicapped childrenwh ileADA didmuchtoencourag e resea rchand disseminationof info rmation regard ingtherapeu tic and educationalendeavorswith behaviordisor dered child ren (Kauffman,1981). Othernationalorganiza tionssuchasthe CouncilforChildre nwithBehavioral Disor ders (1964), National Society for AutisticChild ren(196 5),andthe AmericanAssociationfor the Education of the Severely/Profound lyHandicapped(1974), werefounded throughout the century.
An inc reasedinterestin theeduca tionof these children complemente dthe growingliterature on schizop hreniaand othercateg ories ofchildhooddisorders thatflou rished during the 1930s and40s. Mostof the programs setup for the severely dist urbed , at this time werere sidential innature.
Those child renwhowere considered mildly disturbedwere,for themostpa rt, enrolled inspecialschoolsor specialclasses.
This segrega tionof handicapped children,for thepurposes of education, beganto changedrastically in the 60sand70s. At that time, Wolfensb erger(1972),maintainedtha tplacementin environmentssegregatedfrom"normal" individualsdidnot foster positive gainsIn thebehavior ofthose peopleplacedin
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such environmen ts. Thisphilosophyhasbeen apowerful force inshapingthe services weprovidefor exc eptiona lchild ren today.
Inthe 19605 and70s,amove towards norm alizatio n began andmainstr eaming becamethe cent ralfocusof special educatio n. Es s entiall y, normalization refer s to the 'placement ofthe individua l into a situat ionthatis as much as possible like thesituationhewouldbe in if he werenot considere dto be disturbedor behavio r diso rdered" (Stai nback& Stainback, 1980,p,50). Mainstr eaming may be viewe dasthe educati onal counterpartof themovement towards norm alizat io n. It is linked to therigh t of all children toan appropriate education.
In the19605 and 70s, the UnitedStates re sp onded to the movement by placing mildlydisturb ed child renin regula r classesand the severely dist urbed in specialclasses within the public schoo ls. Mainstreaming didnothave a serious impact inCanada untilthe 19705,whentheCELDICRepo rt (Roberts &Lazu re, 1970)was released. TheCommissionof EmotionalandLearning Disorders inChildr e n, thro ughfield visits.examined conventio na l pattern s of services forchildren withemotionaland learningdisorders and made several recommendation s for changestowardsthe improvementof such services. At the basis of these recommenda tionsaretwo
mainideas: (1) the child'sneedsshould be met withinthe normal environmentand throughthe local community:and (2) ifthis need is to be met.the people responsiblefor the children 's care mustbe able to call upon and use adequate consultation and sup port fromstaff with highlyspecialized training and skills. The emphasisis placed on integrationof the childinthe regular classroomwith sp ecial education consultanthelp for the classroomteacher andsupportservices for the child's family.
The authorsofthis report recommendedthefollowing:
"that bec auseofthe negativeeffects of separate special educationfacilities, educationa l authorities minimize the isolation of childrenwith emotional and learningdisorders and plan programs for themthatas far as possible retainchildren withinthe regula r school curriculum and activitie s.~
(Roberts&Lazure,1970,p.146) Although oneoftenviews placement in theregular classroo msynonymo uslywithmainstreaming,Hammell , Bartel,&Bunch(1984),warnusthat suchplacementshould notbe misconstruedas "appropriate"educati on. Placement procedures may varydependingon theneeds of thechildand
II>
the support services available.: Mainstreaming willinvolve placementofthe child in the"least restrictive" environment thatwlllbestmeethisneeds. TheCouncil for Exceptional Childrenputforward the following definitionof main streamingat its197 6international conference:
-Mainstreamingis an educational placement
procedurefor exceptiona' childrenbasedonthe conviction thateach childshouldbe educated in the least restrictive environmentinwhich his or her educationaland relatedneeds canbe satisfactorily addressed.•
Inordertomeet theneeds ofexceptionalchildrenin a normalizedsettlnq, support services arecrucial. TheCEl DIC Reportrecommended thatsupportservices beavailableto the classroomteacher as well as tothe child'sfamily.
"Werecommend manywaysofsupportingfamilies;
day care, homemakerservices, counselling;andwe recommend thatthe classroom teacherhave consultation helpreadilyavailablebothin the school and fromthecommunitytoincrease his skill andstrengthenhisrolein workingwitha child with emotionaland learningdisorders.·
(Roberts! Lazure,1970,p.l0)
Oneofthe majorproblemsseen bythisreport wasthe lack of coordinationofservicesprovided forchildren with emotionalandlearning disorders. Child renwereoften being treated independentlyby the education,medical,correctional and socialservicesystems. Poor communication between thesedifferent helpingservices often resulted infragmented treatmentsthat did not considerthe wholechild. Becausethe schoolis responsibleforthe daytoday careof children,the CELDIC reportrecommendedthatthe school form thebase for organizing andcoordinatingall thenecessary community services. This wouldenablefrontlinepersonnel, the regular classroomteachers,to serve theneeds ofemotionaland learning disordered childrenwhilehavingaccess to special educationconsultantswho are communicating with theother helping professions.
In responsetothisneed,the NewfoundlandGovernment have establishedEducational Therapy positions within Newfoundlandschools. Thesepositions are intendedto address theneeds of behaviorallydisorderedchildrenwhile also providi ngconsultingservices to regular classroom teachers.
One ofthefirstproblems facing the establishmentof these positions was comingto some consensusonthe definitionof behavioral disorders.
I H
Definitionsof deviant behaviorhavebeenproposed from avariety of perspectives and disciplines (Olarlzo and McCoy.
1983.) At the present time, there isno unive rsally accepted definition and this reality poses a number of problems tor researchin thisfield. Winze r(1987) captures thenature and extentof these problems:
Difficulties in theprecise definition of emotional dist urbance have created problems in estimating prevalence, iden tifying characteristics, assessment,etiology, treatments, and educational approaches. Professiona ls cannot even agreeon whether to call these children emotionally disturbed, behaviorally di sor d e red, socia lly maladjus ted, deviant, psychologically impaired, educationallyhandicapped,character disordered, or delinquent (p.375).
There are several re asons why defin ing behavio ra l disorders is adifficulttask. Inorder tobe ableto define and identify abehavior that isdeviant,disordered, or abnormal, onemust first have a cleardefinitionof normalor acceptable
behavior. Garber (1984) pcmte out that we must view
"ncrmalacy"from a developmentalperspective:
Whether childhood psychopathological disorders are referred to as deviations from age appropriate norms, exaggerations of normal developmental tasks. or interferences in the normal progress ion of development , it is clear that some notion of normalit,v in the context of the developmental process isessential.
(Garber, 1984, p.35) Children exhibita variety ofbehaviors and itis very difficultto labelanyof these behaviors"abnormal"or "normal"
per se. Usually, it is the amount ordegree of behavior exhibited in certain situations that differentiates disordered and normalbehavior. Unfortunately,agreeing on what amount or degree is abnormal is alsoa problem.
Another reason behaviordisorder is so difficultto define is that itcuts acrossmany otherdisablingconditions(Bower.
1982). Mentally handicapped, hearingimpaired, and learning disabledchildren oftenexhibit inappropriatebehaviors and/or emotionalproblems.
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Definitio nal problems also exist because of varying professionalperspectives. The field of behavioraldisorde rs hasinput from medicine ,psychiatry, education,socialwork, and psychology. It is very difficult . if not impossibl e, to create a definitio n that would encompass these theo retical orientatio ns.
Evenwithin the educationalfield thereis generally a lack of consensus regarding the definition of be havior al disorders. Epst ein, Cullinan. andSabatino (1977),surveyed departmentsof education in the UnitedStates regardingtheir definitions of behavior disorders. They found a wide discrepancy betweenthe states' defin itions, with onestate's definition actua lly contrad icti ng another's. Csapo (198 1) reports that in Canada only six of twelve jurisdictions repor ted the existence of an official def inition and the se definitionsallvariedto some extent.
A consistent defin ition within any field is ve ry important. Kauffman states:
The definition one accepts will ref/ect how one conceptualizesthe problem of disorderedbehavior and, therefore, will determine what intervention strategies one considers appropriate...Furthermore
a definition specifies the:populationto beserved and.thereby.hasaprofoundeffectonwho receives interventionaswellas howtheywillbeserved.
(Kauffman,1981.p.19)
Consistent and objecti ve guideline s for defining and identifying disordersare also necessary for making progress in the research of thisfield: "Inthe absence of clea rand objecti ve guidelines for identifying disorders, generalizations acrossstudies havebeen difficult"(Garber,1984.p. 30).
Alt hou gh numerous de fi niti o ns of emot iona lly disturbed/behaviorally disordered childrenhavebeen proposed in thelast twentyyears,one definitionin particularhashad a significa nt impact onpublic policy. Thisdefinition is theone proposedbyBower (1969). Hedefined emotionally handicapped childre n as those exh ib iting one or more of live characteristics to amarked extentandover aperiodof time:
1. Aninability tolearn whichcannot be explainedby intellectual, sensory, or healthfactors 2.An inabili ty to build or maint ain sati sfactor y
interp er son al rel atio nsh ip s wit h peer s and teach ers
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3.Inappropriate types of behavior or feelings under normalconditions
4.A general, pervasive mood of unhappiness or depre ssion .
5.Atendency to developphysical symptoms, pains,or fearsassociated withpersonalor school problems.
(Bower, 19S9.pp.22-23 as cited in Kauffman,1981. p.20)
The UnitedStates Federal Government,under PublicLaw 94-142, adoptedBower'sdefinition with somemodifications.
Insteadof usingthe label"emotionally disturbed",the U.S.
governmentadded"seriously emotionallydisturbed". Not only do childrenhaveto exhibitone ormore characteristicsto a markeddegreeover a long period of time; these characteristi cs must also"adversely affect educat ional performance". Inadd ition to the five characte ristics described by Bower, thefeder aldefinition includesthefo llowing :
The termincludes childrenwho areschizophrenic orautistic. The termdoesnot includechildrenwho aresociallymaladjusted, unlessit is deter-mined that they are seriously emotionally disturbed.
(Educallonof HandicappedChildren,FederalReglster,Q Seeto n121a.5,19nascuedin Bower,1982.p.55)
The modifications of Bower's definitionhave been severelycriticizedonthe groundsthat we should be serving emotionally handicappedchildren beforetheybecome
"seriously" disturbed,(Bower,1982) andthat adding termssuch as schizophrenicandautisticare unnecessary sincesuch children obviously wouldexhibitat leastoneof the five characteristicsto a marked extentand overalong period of time (Kauffman,1981).
Newfo u n dla n d Definiti o ns
The Department of Education for Newfoundland and Labrado rhavemade a sincere attempt to consistently define behaviorally disorderedchildren throughoutthe Province. In theirpolicy manualfo r the'Bervicesfor BehaviorallyDisturbed Children" (1986) , they use the definition proposed by Bower(1969). They alsospecify fairlydetailedproceduresfor assessing whether a child actually hasthese characteristic s.
These procedures include documented information from a variety of sources. To reduce the chance of subjecti ve identification of the child by one source, there must be consistency in pointing a student's inappropriate behavio rs between at least three sources. Documentation of children defined as behaviorally disturbed must be presentedto the
24
Departmentof Education inNewfound land and Labradorbefore aneducational therapyunitis allocated. A minimum offour child ren are needed to satisfy the requirements fora unit withina school.
Althoug h theprocedures outline d bythe Gove rnment of Newfoundland and Labrador are not without problems, they represent oneof thebest effortstodeal withthe problems of definition and identificatio n. A study of Newfoundl and and Labrador services lor behav io rall y disorde red children is therefo re likely to prov ide a valuab le contributio n to this broad er field ofresearc h.
The Nature of Students "At Risk"
preval ence
A reasonable estimateofthe percentageofbehavior disorderedstudents whoneed specialeducation,appears tobe intherange ofthreetosix percent of the student pc pulatlc n (Ka uffman, 1989).
A longit udinal study byRubin&Balow (1978) foundthat In any given year,abouttwentyto thirty percent ofthe childrenwereconsidered by at least one teacher tobe a problem. Inthis same study,eleven percentof the boys and
three and one-halfpercentofthfigirls(foran averageof 7.4 percent) were considereda problem by everyteacherwhorated them over a periodof threeyears.
Avariety of studies point to similarfindings. Most childrenandadolescents display seriously disturbing behavior at somepointduringtheir development. Also,morethan two percentof school-agechildrenexhibitdisordered behavior consistently,overaperiod ofyears.
Se x of BehaYiQr Djsordered Children
Mcintyre (1989)reports that five timesmoreboysthan girlsareidentifiedas having emotionallbehavio rial disorders.
Numerous studies haveindicated thatboys outnumber girls consistentlyacross many formsofbehavioral disorders (Campbell&Werry,1986;Prior & Werry,1986; Quay, 1986;
Schlosser&Algozzine,1979; Schultz,Salvia,&Feinn, 1974;).
Depending on the type of disorderandnatureofthe study, ratiosvaried fromaslow as1.7to1.0, to as highas 10.to1.
Boys generally outnumberedgirlsforactingoutandmore aggressive andimmature behavior(Cullinan,Epstein &
Kauffman,1984; Schultzetat,1974; ). Schultz, Salvia,&
26
Feinn (1974)foundthat 36ofthe55 behavior sonthe BehavioralProblem Checklistwere moreprevalent in boys.
Despitethisgeneralfindingitis helpful to lookatthe behaviors thatdonot differ between malesand females and thosefor which femalesoutnumber males.
Schultzat al. (1974) found thatboysandgirlsdidnot differon fourteen symptoms, in particularthoserelatedto anxietyandwithdrawal. More recentresearch supports these findings,that sex differencesare minimal for anxiety- withdrawal disorders (Kauffman, 1989; Quay&LaGreca,1986).
Girlswererated significantly morefrequentlythan boys on five symptoms,generally demonstrating moreneurotic formsof behavior(Salvia,atal..1974).
Overall,when behaviors are clustered into complete syndromes to formaspecific disorder, females outnumber males on only onedisorder, thatbeinganorexia nervosa (Kauffma n. 1989).
Although this study islimited to third andfourth grade students, other researchsupports the finding thatboys' behaviorsareviewed as more disturbing. Schlosser&
Algozzine(1979) foundthat classroom teachersrated prevalent behaviorsin boys as significantly moredisturbing.
Classifi c a tion Systems
Althoughonedoesnotwant to encourage the labellingof children,it is important to identify common features01their behavior for education,therapyand researchpurposes.
Research and interventio n in the area of behavior disordershas long beenhindered becauseno oneclassification system has been adoptedin the field. As a result.oneof the primaryproblemsassociatedwith the researchonbehaviorally disturbed chi ldren is the number of differing classification systems used. While many of the classification systems available havesimilarcharacteristics, itis generallyobserved that most "systems" reflect the setting and theoretical background of the individual classifying. Inan attemptto bring more objectivity to these classification systems, researchers such as Quay (1986) are using multiva riate statistical techniques to investigate the interrelations among deviant behaviors and to define and clarify thesebehaviors intodistinct categories.
Quay's (1983)approachtoclassification hasreceived a great deal of support in the last decade(Kauffman, 1981;
28
Clarizio and McCoy, 1983: Center, 1989;Epstein. Kauffman, Cullinan,1985). Itis areliabl e andempirica l approach based onthe analysis ofclustersof behavior sderivedfrom thedata of children seen in hospitals. clinics and schoo ls (Cente r, 1989; Quay andWerry,1986;Kauffman, 1989). Each cluste rof behaviors that occur together and form apatte rn isgiven a namedescriptiveofthe behavior disorder ide ntified.
Quay's clasification syste mhas been criticized because of its emphasison broad dimensions. Clarizioand McCoy (1983) note that this approachmakes it very diffi cult to concludewhich particular behaviors canbe modified by a part icular treatment. Another limitation ofQuay's system is that it does not diffe rentiate bet ween severe behavior disorderssuchas childhoodschizophreniaandinfantileautis m.
Otherdisorderssuch as anorexianervosa,donot seemto fit into Quay's system. Like other classifi catio n systems , this one relieson reportsof childrens' behavior by concerned adults and may tell usmore about theirperceptions thanabout the child 'sactual behavior.
While numerou sother systems can be fou nd in the liter atur e, Quay's analysis appears to be one of themost comprehe nsive and encompassing of those availab le. The
following pages outline the slxmost prevalent behavioral clustersand theircharacteristic behaviors.
Undersocialized Aggress ive Conduct DIsorder
The first dimension, undersoc ialized aggressive conduct diso rder, has emerged consistentlyand has well validated, easily observab le characte ristics.(Quay, 1986). The most frequentlyassociated behaviors are thosegenerallyconsidered as aggressive, disrupti ve and noncompliant. A complete description of the character istics associa ted with this disorderareoutlined below.
Charact eristic s
Fighti ng, hitt ing, assault ive Disobed ient,defiant Temper tantrums Destructive ness
Impertinent, "smart,"impudent
Uncooperative, resistant, inconsiderate,stubborn Attention seeking, "show-off"
Dominates,bullies,threatens Disruptive, interrupts,disturbs others Boisterous ,noisy
Irritability, "blows up"easily
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Nega tive, refuses direction Restl ess
Untru stworth y, dish onest , lies Hyperact iv i ty
Socialized Aggress ive Conduct DlsQrder
The second pattern of behavior lab eled socialize d agg ressiv e cond uct disorder is characterized by the involve ment of peers in illega l and norm-violating behavior.
Quay(1986) sugg ests thatitis mainlya phenomeno n of older child hoodandad olesce nce. Specific chara cteristic behavior s are outlined below.
Characteristics
Has"bad"co mpani o ns Truantfrom schoo l Truant from home Stealsin company with others Belongsto a gang Isloyal 10delinqu entfriends Staysout late at night Stealsat home Lies, cheats
Attention Deficit Disorder
Thethird syndrome , Attention Defic it Disorder, earlier labeled Immat urity by Quay (1979), isdefined byprobl ems in concentration and attentio n,impulsivity, lackof perseverance, clumsiness, and passivit y. It has also emerged fre quently throughoutstudies inthe literature. Quay (1986) notesthat although hyperacti vity appears on this dimen sion, it isnot central,and behaviorsassociatedwithmotorunderactivity are more freque ntl y evide nt. A comple t e cha ra c te rist ic desc ription ofthisdisorder is outlined bel ow.
Characteristics
Poor conce nt ration, short attention span, inatt entive, distr actable
Daydreaming Clumsy, poorcoordination Preoccupied,staresinto space Passive,lacks initiativ e,easily led Fidgety , restl ess
Failsto finish tasks,lack of perseverance Sluggish.lazy
Impulsive lacks interest, bored
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Hyperactive Drowsy
An x iet y • Wllhd:'!l:wa! - Dysphoria
The second most frequentlyappearingsyndromeisnow labeled Anx iety-Wit hdrawal- Dysph or ia. Intern a lizi ng beha viors such as anxie ty, fearfulness, shyness, social withdrawal, satr-con sctousness. and crying defi ne this disorder. Othersalient characteristics of thisdisorder are outlined asfollows:
Characteris tics
Anxious,fearfur,tense Shy. timid, bashf ul Depressed,sad,disturbe d Hypersensi tive.easily hurt Feels lnferlcr, worthless Self-conscio us.easily embarassed Lacks sett-contlde nce Easily flustered Cries frequently Aloof Worries
The fo ur syndromes described thus far are refined examples of the dimensions originally described by Quay (1979). These four well known categories are empirically sound and well documented. Recently, two additional dimensionshave emerged labeled Schizcld-Unresponslve and Social Ineptness. Because theyhave not emerged as frequently as the othersfour dimensions, thesetwo classif ications are not asfirm empirically.
Sch izo id • Unrespo nsive
Schizoid-unresponsive is characterized by general unresponsive behaviors. Quay (1986) sugg ests that the unresponsivenessevident inthis pattern isnot limitedto peer relations, and may representtheextremeof theintroversion personality. Onemay alsocompareit to SchizoidDisorderin the DSM III classificatio n system. The following outline indicates the behavior s clus tered within this dimension.
Char act er i sti c s
Won't talk Withdrawn Shy,timid,bashful Cold andunresponsive
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Lack ofinterest Sad Stares blankly Conf used Secretive likestobe alone
Socia! Ineptnes s
Social Ineptness is defin ed by poor peer relations without accompanyin g anxiety, depre ssion, or generali zed unresponsiveness. Quay(1986)suggests that thispattern in children may onlybe a reflection of a limitedrepertoire of socialskills and may notneed tobe considered abehavior disorder . The followingprovides the principle characteristics associatedwiththis disorder.
Characte ri s tics Poor peerrelations Likes to be alone Is teased, pickedon Prefersyounger co mpanio ns Shy,timid
Stayswith adults.ignored bypeers
Two other dimensions that have been found in a few studies are Psychotic Disorder and MotorOveractivity. Quay (1986) explains however, that the relatively low prevalence rate of childhood psychosis makes it difficult to clarify by statistical analysis.
psychotic Di s o r d er
Psychotic Disorderis characterizedby extreme deviation from normalpatterns of thinking,feeling and acting. Some researchers (Center, 1989) go on to divide the disorder into two groups, distinguishable mainly by age of onset: infantile autism (diagnosed prior to thirty months of age); childhood schizophrenia (diagnosed afterthirty months). Quay (1986) suggests there is some support statistically for the distinction of two separate syndromes. Specific characteristics of this disorder are outlined below.
Characteristics
Incoherent Repetitive speech Bizarre, odd, peculiar Visual hallucination s Auditory hallucinations
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Strang eideas,behav ior Motor Overactiyi1y
The Motor Overactlvlty dimension Ischaract erized by excessivemotor activity that isaccompaniedby attentionalor cond uct problems. The following describe s the princ ipl e characteristics of this disorder.
Characteristics Restle ss,overactive Excita bl e, impulsive, can't wait Squirm y , jitte ry
Overta lkative
Hums andmakesotherodd noises
Service s Provided for Behavior Disordered Children In
Over the pastfifteen years, educationandtreatment of behaviordisordere dchildrenhave underg onedramatic changes.
Agreatdealof conce rn has beenfocused on theunnec essary segregationof allhandicappedpupilS,includingthoselabeled behaviordisordered. Placement inaneducatio nalsetting that istheleastrestrictive environmen thasbeenone ofthe guiding principlesthathavedram atically change d the
educationa lservice deliver y system. Behav iordisordered students are presentlybeingserved ina"continuum" of placements includi ng specialschoo ls,specialclasses, resource ro oms,andregularclasses. (MacMillan& Kavale, 1986 ).
In the last threedecades, provi sionofservices for behaviordisorderedchildreninCanadahasrapidly unfolded.
Thisdevelopment is attributedto anumber of provincial and nationa lreportsstressing theneed for educationalservices (Csap o ,198 1; Winzer,1987). The CELOIC Report, Commission ofEmotional andleaningDisorders in Children,( Roberts&
Lazur e,1970)recommends that local educational authorities assumeresponsibili ty forthe educationof all childrenwithin theirjurisdiction. TheSEECC Report , StandardsforEducation of ExceptionalChildrenin Canada,(Hardy,McLeod,Minto, Perkins,& Quance,1971 )recommends governmentsupportfor the trainingof perso nnel, researc hdevelopment,andthe overa llimproveme ntoffacilities for childre nwithproblems.
There port alsorecommend sthat teachers ofexceptional childrenI 'iefollowing competencies:knOWledgeof children wl. wioraland social disorders; a mimimum standardofperforma nce indiagnosis and prescriptive teachi ng;the abilityto developandimplementappropriate
38
prog rams in dealing withtheproblem s ofbehaviordisord ered ch ild ren (Csapo ,1981).
Follow ingthesere ports, Csapo (1981 ) stud iedthe extent ofpublic school servicesfor emotio nally disturbed child renin Canada. This study involved a19-itemque stionna ire which was sent to the Director of Special Educatio n oritsequ ivalent intheDep artme nt s ofEducation ofthe ten provinces and two territories. The mostfrequentl y occ urring modeofservi ce delivery wa s fou nd tobe the specialclass,resourc eroom , and homeboun d instru ction. However,Csaposu ggests thatthis mod e 01service deliver yis changing withmany provinces aiming10maintain the behavior disordered childinthe regular class room with supportservices.
Alth etime of Csapo'sstudy, Newfoundland wasnot one of the six jurisdictionswhich reported the existenceof an offic ial de fi nition ofemotional disturbance. Interms of termi nolog yused , Newfoundla ndwas oneofsixjurisdict ions that favoredthe term"severely emotionally disturbed". The type s of servicesprovid ed byNewfoun dland forth ese ch ildren included: the specialclass,resource room, academic tuto ring, guidance counse lling,school social worker ,psych iatric consultatio n,and paymentforprivate schoo lprogram. At that time,themaximum num berof childre nin a specialclass was
six. When areso urceteacher was inv o lved acase loadof 1:4 wasrecomm ended. Newfoundlandwas repo rted tohave special education qualifi c ationrequir e ments forspeciall y trained teachers andthatthistraining wasavailabl e in the province.
Since this reportin 1981 , theDepartm ent of Education in Newfoundla ndand labra d orha sattemp tedtomake somemajor changesin itspo licy concerningthe servicingof emotionally disturbed children. Inthe follo wingsection,Newfoundland's policy for serving behaviordisordered childrenand the philosophy underly ing these policies.will be discussed.
Newfoundland PQ~
SpecialEducationsalaryunits for "behaviorally dist urbed" (nole th e ter minolo gychangesince1981)students inNewfoun dland andLa brador aredis tinguishedfromother specialed ucation units by theterm"e ducati onalth erapist ". A need todistinguis h educationa lthera pists' rolesfrom other personnel ro les suchas thoseofteachersandguidance counsellors, arisesfromthephilosoph y and aimsofthe serv icethetherap ist prov ides. Theprincipal aimfor these serv icesis toret ain thebeha v iorally disturbedstudentinthe mainstream ofthe regular program(Governm ent of Newfoundla ndand labra dor,De partmen t ofEducation. 1986).
4(l
Althoughproviding "least restrictive"se rvicesand mainstreamingmaybe said to be thego al of many special education progr ams,thefocusoftheir servicesismainlyon academicrem ediation . The focus oftheservices providedby educational therapist s is "behavioralcha nge",
Thephil osophy orrationale surrou nding theeducational therapist posi tionis foundin anarticle by Smerd on and Butt (1985). In this article,"A WorkingModelforStudents Who Don't",Smerdo nandButt describe asuccessfulpilot project ofthe Terra NovaIntegrated School Boarddesign ed to meetthe needs ofbe haviordisorderedchildren. They suggest thatif these childre nareto be servedbythe sc hool,school boards need teacher s who aretrained to cope with emotionally maladjusted childrenandthe 'resource personnel (educational therapists) who wo rk directlywith the identifi ed students also need specificanddetailed trainingin behavior change methodology"(Smerdon&Butt,1985.p.81).
Althoug h these childrenare not ac hieving academically, Smerdon andButt suggestthat they arecognitivelyable to achieve and thereforedonotneed"speci aleducation" inthe traditionalsense. They suggestthat the children need to participatein the reg ularschoolsetting andbetaughtwith theirpeers, whileatthe sametime,receiveco unsellingfrom
theed ucatio n al thera pist. Besides worki ngind ividuallywith thechild,the educational therapistwould alsoserve as a consultant in designin g classroom program swith teachers and administrators, to accomodatestudents.
Atthepresent time,the servicedel iverymodelproposed bytheGovern mentof Newfoundlandand Labradorisbasically thatof a resource person who provides therapyto the behavior disorderedchild wh ileatthe same time consults with teachers, ad mi nistration , family andany significantothersin the child's life. This type of servicedelivery modelhasnot alwaysbeenfavoredby professionals. In thepast,regular classroomtea c hers' altitudes towardmaln streaminqthese students havebeendecidedlynegative (Bea re, 1981). When regularand specialeducatorswereasked to ratethe acceptability oftrea tment alternatives for behavioral disordersthey ranke dself-containedspecialeducation classes thehighest andcoun sellingsecond(Epste in,Matson, Bepp, &
Helset,1986) . However, this studyfaile dtooffer variations of special ed ucationplacementsuch astheresource room. It willbe importantto findouthow behavio rdisorderedchildren are actually placedin the schools andwhat typeofservice delivery mod el ispre ferredby the thera pists.
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Spec ific Interyentions
Thellteraturaon behavi ordisordersdiscuss es avariety of differentmethods of treatment. Despite thevarietyof treatmentsreviewed,itis commonlyagreed that;
~the decisionofwhichtherapyisbestfora particular patient(studen t)remainsa criticalissue inthefield of behavioraldisorders"
(Algozzine&Lee, 1981).
Mostresearchers alsoagreewithWinzer (19 87)who notes that ;
Methodsof interventionfor thesechild renhave beenlargely developedaccord ingtovarious theoretical perspectives. Noone method hasproven effectiveforsf! emotio nally disturbed children.
Indeed,a consensus oninterve ntionisaselusiveas auniversaldefinitionof theproblem.
(Winzer, 1987,p.398)
Although th e placementofbeh aviordisorder ed students isanimportantconsider ation, it is evenmo reimportantto understand what is beingdone forsuch childre n regardlessof the selting . There are several intervention approaches
designed to alte rprob lembehav'lor. Thetherapie s usually fall under five categoriesrepresented bythecorrespo nding conceptua lmode ls: (1) medical, biogenicor biop hysical, (2) psychoed ucation al,sociologicalapproaches, (3) psychody namic . (4) ecological, (5) behavioral (Kauffman, 1981;Mac Millan & Kavale,1986;Winzer,19 87). These categories aredescrib ed below.
BIophys ical/B iogen ic Model
Thismod e lassumesthatpsyc hopathology/b ehavior disorders are causedbyeNS dysfunctionorsomephysiological flaw withinthe individ ual. Geneticfactors, braindysfunction, food alle rgiesandbioc hemicalimbalanceareexamples. A furtherassumption of this modelis thatdis order ed behavior can bebrought undercontrolthroughphysiol ogical meanssuch as drugs anddiet (Kauffman,1989; MacMillan &Havate,1986).
psychodynam ic
The psycho dynamicmodelisbased10a largeextenton thetenet s of ps ychoan alytic theory. It assumes that disordered behav ioris a symptom ofunderly ing mental problems repres entingimbalan ces inthe child's personality (Kauffman , 1989). The se mentalproblemsare believed to be theresultsof difficulti es duri nga child'searly development.
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Agreat dealof importanc eisplacedon understa nding the unconsciousmotivatio nforbehavior. Itassumesthat interventi oncannot be successf uluntil thisunderlying unconscious conflictis understood. Individual psychothera py isthepreferred treatment.
The behavioralapproach hastwo major assumpt ions: it considersthebehavioritselftobethemajorissue.andit assumes that behavior hasbeenlearned. Disordered behavior is viewedas inappropriate learnedresponses. Interventions within thismodel relyonlearningprinciples to teachmore appropriate behavior. Themanipulation and change of environme ntalantecedentsor consequences areimporta nt componentsof this approach(Kauffman,1989;MacMillan&
Kavale,1986).
psYchoeducatlo naJ Ap pr o ach
Thepsychoeducati onalapproachis simila r tothe psychodynamic model in that itisalsoconcerned with unconscious motivations and underlying conflicts. However,it differ s inits approachto intervention. Thepsychoeducational approachdoes not view thenecessityof resolvingand
understandingunconsciousmotivationsdeveloped in thepast.
It dealswith whatishappeningwith theindividual inthe present. Emphasis is on the child gaininginsightinto their presentbehavior andchangingit to more appropriate behavior infutur e situations.
Ecological Approach
Theecologicalapproach emphasizes the
interrel ationshipsbetweenindividual s and their environments.
Disturbance isbelieved tobetheresult ofamismatch between the individualand the ecosystem in whichheresides. The emphasisisnotplaced onthe individual's behavior itselfbut on theentire ecosystemas a whole. Interventionisdirected at allofthe facetsofthe child'smilieuandemphasizes behavioral and social learningconcepts.
prevalence of Int erv ent io n Approaches
MacMillanand Kavale (1986) notethatintervention methodsusedwithbehaviordisordered studentsvary greatly.
Theypoint tothe difflcultyofobtaining reliableestimates regarding theprevalenceofapproachesbecause of themove towardseducating behaviordisordered children intheleast restrictiveenvironment. As a result."prevalenceestimatesof
46
the different interventionstrategiescanbe madereliable only fromspecialclasses for the behaviordisordered."
MacMillanand Kavale(1986),in theirreview of prevalencestudies,suggest thatthe trend in educational treatmentof behavior disordered studentsis towardsmore behavioralinterventions as opposedto those
psychodynamicallyoriented. At the sametime. they indicate that two otherclassifications, psychoeducational and eclectic interventions,have emerged as beingvery popular. Bothof these intervent ionsuse componentsof the othertheoretical models and arenot 'pure'in thatsense, They note:
"The largepercentage ofprogramsthat fall within an
eclectic (including psychoeducational) classification suggests that educational programsfor behavior disordered studentsmore often thannot do notfall clearly within the parametersdefinedby anysingle theoreticalmodel. The theoretically ~pure~program is represented in onlyaminorityof programs.~ (p.591).
CQunselllng Therapies and Techniques
Counsellinghas beendefined as a process"tohelp individualstoward overcomingobstaclestotheirpersonal growth,wherever these may be encountered and toward
achieving optimumdevelopment"of theirpersonalresources."
(American Psychological Association ,Division ofCounselling Psychology, Committee on Definition, 1956,p.283as citedin Thompson&Rudolph,198 8).
Thompson and Rudolph(1988)offeraworking definition of counselling:
"CounselHng isaprocessinvolvinga relationship betweentwo peoplewho are meeting sothat one person canhelp the other toresolveaproblem. One ofthesepeople,by virtue01hisorhertraining,is the counseJlor; theperson receiving thehelpis the client."(p.13)
Thompson and Rudolph (1988)notethat numerous therapiesand techniquesas wellas combinations therein are addressedin the counsellingliterature. The followingsection outlinesthemajor counselling therapieshighlightedin the literatureas wellas anoverviewof their methodological focus.
Realitv Therapv
William Glasser was thefounderofrealitytherapy. This therapy focuses ontheclient learningn-oraellectivebehavior
to meet his/her presentsocial arid emotionalneeds. The methodis well-defined and involves thefollowingsteps: (1) establishing arelationship withthe client; (2) examining the client'spresent behavior; (3) helpingthe clientevaluate presentbehaviorbydeterminingifitishelping themget what theywant out oflife; (4) developing plansforalternate behavior; (5) getting the clientto commit himselfto oneof the plans; (6) evaluating the results ofthe commitment; (7) providinglogicalconsequences for client'sbehavior; (8) continuato workwiththe clientthrough thepreceding steps.
Pe rSQn-C ent er e d Therapy
The founderofperson-centered therapywas CarlRogers.
Person-centeredtherapy isbased onthe assumption that clientshavethe potential,andthereforeshouldhave complete responsibility for theirown personalgrowth. It is anon- directiveapproachin whichcounsellorsuse thefollowing methods: (1) activeand passivelistening; (2) reflection of thoughtsand feelings; (3) clarification; (4) summarization;
(5) confrontationof contradictions;and (6) general or open leadsthathelpclientself-exploration(Thompson&Rudolph, 1988,p. 67).
Gestalt Therapy
The founderof gestalttherapywas FritzPerls. This therapy is experiential,stressingthe Individual'sawareness ofthe hereandnow and teaching themtoassume responsibilityfor themselves. An emphasisis placed on the integrationofthe person's innerstate and behavior so that theymay give fullattention to meetingtheirneeds appropriately. Itoffers arange of techniques andmethods to helpindividualsexperiencethe presentandbecome awareof theirfeelings(Corey,1986; Thompson & Rudolph,1988).
Relional-Emoti ve Therapy
AlbertEllis wasthefounder of rational-emotivetherapy.
The theory underlyingthis approachisbased on the assumption that anindividual's thinking and belief systemis at theroot of hispersonalproblems. The two maingoals of rational- emotive therapyare: (1) to showindividualshow their irrational beliefs and attitudes are creating problems for them,and (2) toteach them how torid themselvesof these beliefs and replacethemwith rational ones. Thismethodof counsellingisdirect, didactic,confrontational,and verbally active. Therapeuticstrategiesare typicallyeclectic.
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Cognltlye e"'haVio[ Therapv
The cognitive behavioralapproaches developedby Maultsby ,BeckandMeichenbaum share the underlying assumption of Ellis' originalwork,that a reorganization of one' sself-statemen tswillresultin a corresponding reorgani zationofone'sbehav ior(Corey,1986). These approachesaredistinguishable mainly by the techniques they usetohelpindividual s chang e theirthoughts.
Behavioral Counselling
Key figures associatedwith the development of behavioraltherapy includeIvan Pavlov,John B.Watson,Edward Thorndike.EdwardC. Tolman,Josephwcice,L. Krasner, and ArnoldLazarus. Theindividualmost noted fortranslating the theorie sof other behaviori stsinto an applied anduseful technol ogywas B.F. Skinner. (Corey, 1986 ;Thompson&
Rudolph ,1988).
Behavioral therapy isbased on learning princip lesand assumesthatall behavior is learned and can be relearned.
Bc.ucalty, effective behavioris reinforced while maladaptive behavior is extinguished . Behavioral therapy includesseveral techniques and is used with both covert processes, such as
cognitions and emotions, as we'llas traditional overt behavior problems. Methods include contingency contracting, shaping, biofeedback, modeling, token economies, systematic desensitization,hypnosis, flooding, counterconditioning and aversive conditioning (Thompson&Rudolph,1988).
psychotherapy
The key figure associated with psychotherapy was Sigmund Freud.The primary goal of psychotherapyis to make the unconscious,conscious. Severalmethods are used to unveil repressed material. The five basic techniques are (1) free association; (2) interpretation; (3) dream analysis; (4) analysis of resistance, and (5) analysisof transference (Corey, 1986).
Play therapy is a technique similar to free association.
It is used with children younger than twelve years because of their limited cognitivedevelopment and ability to verbalize their thoughts and feelings. Through nondirectivefree play, children revealthe types ofinteractions in their Jives;they are able to express feelings they are otherwise unable to verbalize; they can act out feelings of anger and hostility constructively; and it can be an effective method for teaching social skills (Thompson & Rudolph, 1988). Thompson and
52
Rudolphalsoincludebibli otherapyandstorytellingas psychotherapeutic techniquesforchildren.
Tr ans ac t ion al Analv s is
The founderof transactionalanalysiswasEricBerne.
Transactional analysisisbest describedby Corey(1986)as:
~...an interactionalpsychotherapy that can be used inindividual therapy but that isparticularly appropriate forgroups. This approachisset apart frommostother therapies in thatitisboth contractualanddecisional. It involves acontract developedby the client, that c/early states the goalsand directionof the therapyprocess. It a/50 focuses on early decisionsthaI each person makes, anditstresses the capacity tomake new decisions.
Transactional analysisemphasizes the cognitive, rational, and behavioral aspects of personality and is oriented towards increasingawareness so that the client wilfbe ableto makenewdecisions and alter the course of his orher life.- (Corey,1986, p.
14 9 ).
Transactionalanalysishas a vocabularyof its ownandis fullofterms,diagramsandmodels. Teaching techniques are
used to helpclients understand the principlesoftransactional analysissothatthey canusethem toimprovetheir own behavior. Concepts taughtthrough transactional analysis include: (1) definitionandexplanationof egostates; (2) analysisoftransactions between egostates; (3) positive and negative stroking; (4) I'mOK,You're OK; (5) games and rackets; (6) scripts (Thompson&Rudolph,1988,p.179).
Adlerian Therapy
Thekey figure associatedwithAdleriantherapy was AlfredAdler. One of the basic assumptionsunderlyingthis therapy isthat clientsare havingproblemsbecause oftheir faulty beliefsandgoals. Thetherapistlooksfor whatiswrong with the client's thinking or"private logic",andhelpsthem changehow theyfeel and behave.
The therapeutic process has four stages:
(1) establishing theproper therapeutic relationship ;
(2) exploringthe dynamics operatingin the client through analysisand assessment;
(3) encouraging thedevelopmentofself-understanding (insigh t);
(4) helping the client make new choices (reorientation), (Corey,1986).
Adleriantherapists choosea variety ofmethods to completethis process,
Fam il y The rapy
There areseveral different theorists associated with family therapyand thereare as many types of familytherapies as there are therapists,
A common assumption among the various family therapies is that families consistof interdependent parts and when one part has a problemthe entire systemis adversely affected. Itisnecessary to treatthewhole family lf change isgoing to be effectiveandlong lasting.
Family therapy is often divided into two schools:
structural family therapy and strategicfamily thorapy.
In structuralfamily therapy,the goal is to change the family'sorganizationalstructureas a way of resolving the identified problem.
Strategicfamilytherapy isbasedon the assumption that symptomsof disordered behavior aredevelopedandmaintained bythefamily's ineffectiveproblemsolving ability.
Virginia Satirbasedher family therapyonthe assumptionthatfamilieshaveproblemsbecauseofpoor communication. Her goalis to teach families better communicationskillsso thatthey mayresolve conflictsmore effectively.
Techniquesused byfamilytherapists areborrowed from other therapiespreviouslydiscussed.
Group Counselling
Thetheories andprinciplesofvarious individual therapies canbe appliedto groupcounselling. Grouptherapy is different from individualtherapy in thatit providesdirect opportunities for children to unlearninappropriatebehaviors andlearnnewwaysof relatingto othersthroughinteraction and feedback ina safe,practicesituationwiththeir peers (Thompson&Rudolph , 1988).
Four typesofgroupsdescribed byThompson and Rudolph (1988) include:
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(1) The common-problems group consisting of children workingonthe samedifficulty. Examples ofthis are weight problems, family divorce.
(2)The case-centeredgroupconsisting ofchildren worki ng on differentproblems. Each child hastheopportunity toreceive the group's full attentiontohis or her problem.
(3 ) The human-potential grou pprovides an opportunityfor children todeveloptheir positivetraitsand strengths.
It focuses on building strongerself-concepts in childre n.
(4) The skills-development groupis directedto specific behavior andskillssuchas assertivenessand communication. (adaptedfrom p.260).
Insummary,onewouldhopethat the servicesoffered by individual therapistswould dependon thenature of the child's problem. However, as Kestenbaumpoints out:
"Typeoftreatmenthas typically been shaped tothe theoretical orientationof the therapist; it ts not always based on methodologicalstudyof allthe
neurologicalandpsychological deficitsin a particular child.~
(Kestenbaum,1978 as cited InAlgozzine& Lee,1982p.359)
Who Are Serv ing Behav ior all y pisturb ed Children ?
Smerdon andButt (1985) provide a descriptionof the therapist's role as follows:
The work of theEducational therapistisvaried.
Because ofthe low studentratio,the Educational therapisthas ample time todevelop complete behaviorchangeprograms for maximum effectiveness: the Therapist seesthe students for individual andgroupcounselling,is able to provide long-termfamilycounsefling services andworks extensivelywith other agencies, such as Social Services,R.C.M.P.,medicalpersonnelandothers in the helping professions. Through efforts with other agencies,ahealthy andfunctioning"team approachphilosophy~to problem childrenprevails inthe area...~
(Smerdon&BUll,1985p.82)
