Child-Centered Intervention for Homeless Youth

A Child-Centered Intervention for Homeless Youth Dorothy Reynoso 603 Abstract A family who is homeless not is the inability of affording a home but also basic needs like nutritional food, clean water, a safe shelter, clothing, and medical care. Other than just the mentioned needs, homeless families are not in the streets solely because of lack in money but possibly because it is an alternative to past living conditions. The type of play therapy that would be used to service children is child-centered play therapy (CCPT) so that the focus can remain on the children’s own expression of their unique circumstances and struggles as a homeless individual.

This intervention would use group activities and individual sessions focused on the adolescents’ issues through play therapy.

Homeless children will be able to have positive outcomes through child-centered pay therapy in an environment where they can direct their own play through their own same aged groups. Empathy is a key feature needed in a therapeutic relationship in order for the client to be comfortable and personally change.

When a clinician has empathy, they momentarily experience what the client experiences and can provide better therapeutic services (Clark, 2010). As human beings, it is not always easy for one to be able to understand where a client is coming from when we are unfamiliar to different situations that clients are facing like transgender people, children with a past of sexual abuse, or individuals who are lacking from multiple resources. An imposed lifestyle of a growing population is homeless individuals, specifically looking into children.

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Through the proposed intervention, homeless children’s needs are met in order to be open to positive opportunities for a better future. For a play therapist to be able to help this population that is affected by their socio-economic standing, a play therapist needs to understand their current situation and struggles to have empathy. A family who is homeless has no ability of affording a home but also basic needs like nutritional food, clean water, a safe shelter, clothing, and medical care. Other than just the mentioned needs, homeless families are not in the streets solely because of lack in money but possibly because it is an alternative to past living conditions.

Families have left past homes because of domestic violence (Baggerly, 2003), substance use (Cohen, Mulroy, Tull, White, & Crowley, 2004), suffering from mental illness (Cohen et al., 2004), sexual abuse (Buckner, Bassuk, Weinreb, & Brooks, 1999), natural disasters or other significant events. These events or circumstances not only force families out of their home but also create a negative effect on homeless families, especially children. Adults and children are affected psychologically creating internalized and/or externalized symptoms like anxiety, depression or problematic behaviors (Buckner et al, 1999). Through the use of child-centered play therapy, providing an opportunity for the children to direct their therapy and take advantage of the opportunity to express their feelings freely.

Recognizing that the children that will seek help will have a past that is affecting their present. Having a creative intervention suitable for children to be active in therapy is recommended. In order for a child to be interactive in the therapeutic process, the child needs to be in an environment that they are familiar with and comfortable to build a relationship with the therapist (Green, Myrick, & Crenshaw, 2013). The type of play therapy that would be used to service children is child-centered play therapy (CCPT) so that the focus can remain on the children’s own expression of their unique circumstances and struggles as a homeless individual.

By focusing on the child in therapy, the child will be able to be in a comfortable environment to express their current emotions and issues, making it possible for the therapist to work with the child. This intervention would use group activities and individual sessions that is focused on the adolescents’ issues. Another important factor that should be focused on in this intervention is adding a component that will take care of their physiological needs like food and hygiene. Additional to their physical needs, these children need an opportunity to receive career development.

Child-centered therapy and career development would be beneficial for this population especially adolescents, in order for future goals be motivation for self-improvement. The use of child-centered therapy has been shown to have positive effects to children. Kot, Landreth, and Giordano’s (19998) study involved children who have trauma from witnessing domestic violence. Twenty-two children participated in play therapy for two weeks as an intensive intervention (Kot, Landreth, Gordiano, 1998). Through the intervention of child-centered play therapy, the children had increased self-concept, a decrease in external and total behavior problems, and a significant increase in play behavior of nurturing and creative play themes (Kot, Landreth, Gordiano, 1998).

Important cooperation in this intervention would be the use of group activity. Ojiambo and Bratton (2014) conducted a study on 624 students who took part of a 10-week period of group play therapy in Uganda. The participants of this study experienced behavioral problems, which led them to be referred for treatment (Ojiambo & Bratton, 2014). The study showed that the use of child-centered group activity significantly decreased behavior problems compared to a group of children who were in a controlled group, re: reading mentoring (Ojiambo & Bratton, 2014). The major factor of this study is the past experiences of the clients as orphans who are exhibiting bad behavior in school.

Reasons for orphanage were because of HIV/AIDS epidemic, civil war and other reasons (Ojiambo & Bratton, 2014). Their behavioral problems can be due to their traumatic experiences and abandonment issues. Through child-centered therapy, these children were able to build safe relationships with their therapists. This study involves a great reflection for an intervention for homeless individuals. The same way that the orphans in Uganda suffered a great loss and are experiencing difficulties behaviorally and emotionally, homeless children can react the same way to their issues like abandonment of parents, constant struggle for survival, low self esteem and many more. Homeless children will be able to have positive outcomes through child-centered pay therapy in an environment where they can direct their own play.

Adolescents will be able to incorporate competitive activities or play activities that can be completed as a time effort. Through the play activities, individuals will be able to express each other’s emotions, acknowledge their feelings and support everyone different or similar struggles. These activities stresses for a safe environment were there is no judgment but genuineness and acceptance (Ojiambo & Bratton, 2014). Due to the urgency of children needing an intervention for their mental health, the intervention would not exclude adolescences, which are ages 12-17 years of age.

Admission to solely children would be beneficial because their counseling intervention would begin at a young age and lessen the risks of having a mental health issue and increase positive outcomes. Admission to adolescent homeless individuals would also benefit the same if they were admitted to the program. The only difference is that the adolescent stressors may be higher than younger children and enter the program more damaged due to having a longer life of intense experiences. Child-centered play therapy can involve techniques and activities that will be competent for older ages. Techniques can be narrative writing, use of aggressive items, and expressive arts.

Aggressive items would be: bobo doll, punching bag and competitive board games (Ray et al, 2013; Breen, & Daigneault, 1998). Techniques to express feelings and emotions can be by working with clay, drawing, playing games, putting puzzles together, and making collages (Breen, & Daigneault, 1998). Through these activities, the older population will be removed from play items in that are childish like dolls and action figures. Regardless they will be put into a play atmosphere in order to express their feelings while focusing on their activities to later reflect on their work. The proposed intervention would be a center where homeless children and adolescents will be provided with therapy, resources and other services. In order for the homeless youth can focus in their therapy, they should be provided with a snack and refreshment in order for the client to be able to focus and have work done in therapy.

The rooms for younger children will be fully equipped with toys to use from and other material reflecting on the list of recommended toys provided by recent research (Ray, 2013). Recognizing that homeless children will not be able to provide money for their participation and if budgeting is a problem, pay therapy items can be bought in yard sales, thrift shops, or donations. An important factor about selecting toys is to select toys that the population would be familiar with and culturally acceptable.

Clients with a Hispanic, African-American, or other background will be able to express their selves through familiar toys to their culture that was initially difficult with other toys. Other then having the playrooms equipped with materials to use, the environment is important to create a safe haven for these individuals who have been rejected and removed from comfortable areas.

Using Green and Myrick’s (2014) integrative play therapy approach, there would be three different domains in the treatment for adolescents. The first domain would be the stabilization of the patient in the center and creating a safe alliance with the therapist (Green & Myrick, 2014). A safe nonjudgmental therapeutic relationship can be created through the use of play therapy items and acknowledging those emotions without judgment (Baggerly, 2003). Second domain focuses on the intense experiences of being homeless with no stable housings or past traumatic experiences (Green & Myrick, 2014). In this stage, it is important to focus on attachment issues or creating secure bonds/relationships with positive individuals in the patient’s life (Green, Myrick, & Crenshaw, 2013).

Drawing a heart and naming individuals in important in their lives and/or the use of mandalas. Green, Drewes and Kominski (2013) provide support to the use of Mandalas in the therapeutic process in order to further develop symbolic images that represent issues or current circumstances. This provides the therapist an opportunity to go further with the patient’s concerns for an older age group to process their drawn images and its relation to the individual (Green, Drewes & Kominski, 2013). The final stage would focus on the patients’ empowerment in order to work towards their life goals.

Although the theory is not meant to be linear, the aim in the center would be to begin creating a safe support system for homeless youth within the counseling center along with significant others and then individuals outside the center. This would be done because of the social stigma associated with homelessness and possible lack of social skills that adolescents may experience (Buckner et al., 1999). Play therapy is a therapist will have unconditional positive regard and genuineness meanwhile empowering the client to work on their own progress and increase self-awareness (Ray, 2011, as cited on Ojiambo & Bratton, 2014).

In order to provide these clients with unconditional positive regard and genuineness is for the clinicians to consider their selves as part of the environment. Clinicians are an important part of making the center a comfortable and safe place for homeless children to be in and especially to express their selves. Counselor that will provide counseling services to a homeless child need to see homeless individuals as regular human beings who seek treatment. They need to be looked at as worthy of respect no matter what socioeconomic position that they are in (Baggerly, 2003). Any feelings of guilty, pity or disgust need to be checked and reflected on in order for those biases not intervene with the therapeutic process or therapeutic relationship (Baggerly, 2003).

Reflecting on the Intersectionality perspective, a individual can be affected my many different identities that they identify with involving culture, ethnicity, socioeconomic status, gender, sexual orientation, and faith practices (Ecklund, 2012). Each client can be affected by the mentioned identities in different ways. This provides a perspective for clinicians to recognize that all clients are unique and should have unique treatment plans in order to focus on the issues of the client as an individual client and not part of one population (Ecklund, 2012).

Clinicians would also have to experience with this population. A clinician can make friends with individuals with diverse backgrounds, self-explore directly into the diverse community or change communities (Sue & Sue, 1999, as cited on Baggerly, 2003). Being multiculturally competent is important in this factor because there are homeless individuals that identify with a different race and culture (Baggerly, 2003). Although there can be trainings about being multiculturally competent but it is urge for individuals to take part of other communities or go abroad to become more familiar with different cultures.

Trainings will need done on research of homelessness and their form of living, in order for clinicians to able to empathize a homeless child. An introspection of oneself can be questioning “What does it mean to me to be middle class?” and “What is it like to live in poverty?” (Baggerly, 2003). Ethical considerations that would be need looked upon in a center for homeless children would be to follow admission protocol and orientation. This involves for the clients to be assessed with the accompaniment of their parents and sign consents for participation and confidentiality. The parents would have to consent if any need for seeing the psychiatrist or nurse when they are onsite.

The parents also would be familiar of their participation in the program as parents because family therapy would be part of the child’s treatment plan. In regards to the children being in a safe environment, no aggression towards another child would be permitted. Respect is an important feature to allowing the children to express their emotions and feelings. If a child offends or attacks another child, it should be pointed out to not permit other misbehavior. If such behavior was allowed or ignored, children would continue the miss behavior therefore the center would no longer be a safe place for them to express themselves or be comfortable.

Clinicians should protect the children from each other, communicate their limits and provide a different manner to act out their aggression (Baggerly, 2003). A manner can be to write a narrative letter, use the bobo doll or punching bag. The center providing child-entered play therapy for homeless children should have counselors set a norm for the youth to also express acceptance and care for other youth in the center. In the initial assessment of the children to be admitted into the center, they will be assessed for symptomology, therapy expectations, history of abuse and any additional assessments if needed i.e.: showing symptoms of depression or anger issues.

The assessment instrument to be used would be a post-session questionnaire and the Hopkins Symptoms Checklist (HSCL). The questionnaire would be a quantitative Likert scale that measures the client’s current feelings, their relationship with the counselor, and the liking of the counselor. The HSCL would be a questionnaire that measures any distressing symptoms presented like depression, anxiety, anger issues, low self-esteem and behavioral problems.

As part of their career development, an additional assessment would be use to determine what kind of career or job orientation the adolescent would be part of. The assessment that would be used for assessing the interests of the children would be the Strong Interest Inventory Exam (SII). By determining what kind of theme the child has, their interests and preferred work activities can be identified. These interests will be introduced to the children as their primary work interest and be introduced to other interests after. The children who are younger would not be assessed for career development but be involved in play activities involved with different occupations like a card game that involves characters in different uniforms.

After 60 days of the client being admitted to the center, the client would then be asked to complete the same assessments they had completed in their initial admission with an additional questionnaire regarding their therapist. These questionnaires would be more suitable for adolescence with the parents’ consents.

Children who are younger would have to be assessed by their teachers, parents or supervisor including three qualitative questions:

1. ‘can you tell me what you enjoy at (Name of Site)’,
2. ‘What can you tell me about (therapist) and you’ and  ‘do you remember when you first started coming here?
3. How different is it now?’

Through the use of qualitative questions, a clinician can analyze the information given to determine the client’s outlook of the therapist and the counseling services at the center. The need to review the treatment plan is to determine if the therapist has been meeting his/her goals and if the client is making progress or not. When it is time to review the treatment plan, if the client hasn’t met any goals then the therapist would have to determine if the goals have to be adjusted, or be referred and discharged from the center. The new goals in the treatment plan would be consented by the client and worked with together in order for the client to be able to work towards their own goals.