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Counselling Children with Psychological Problems Malavika Kapur Delhi • Chennai • Chandigarh Counselling Children with Psychological Problems The copyright for the Appendix entitled, Developmental Psychopathology Check List (DPCL) vests in the author. Copyright © 2011 Dorling Kindersley (India) Pvt. Ltd. Licensees of Pearson Education in South Asia No part of this eBook may be used or reproduced in any manner whatsoever without the publisher’s prior written consent. This eBook may or may not include all assets that were part of the print version. The publisher reserves the right to remove any material present in this eBook at any time. ISBN 9788131730447 eISBN 9789332500938 Head Office: A-8(A), Sector 62, Knowledge Boulevard, 7th Floor, NOIDA 201 309, India Registered Office: 11 Local Shopping Centre, Panchsheel Park, New Delhi 110 017, India About the Author Malavika Kapur is Visiting Professor, School of Humanities, National Institute of Advanced Studies (NIAS), Bangalore. She retired as the Head of the Department of Clinical Psychology at the National Institute of Mental Health and Neurosciences (NIMHANS) and has been an honorary professor for NIAS from 2003 to 2010. Besides being a fellow of the British Psychological Society and the Indian Association of Clinical Psychologists, Professor Kapur is also an honorary fellow and recipient of the Lifetime Achievement Award of the Indian Association of Child and Adolescent Mental Health and the National Academy of Psychology. She is also a consultant for organizations like WHO, UGC, ICSSR and has been twice awarded Scholar in Residency at the Rockefeller Foundation Study and Conference Center at Bellagio in Italy. Her research interests include developmental psychology, community mental health programmes for children and adolescents in urban and rural schools, primary health care and Anganawadi workers under the Integrated Child Development Services of the Government of India, and development of assessment tools and intervention packages for children and adolescents in the Indian context. Her main contribution is her work in developing integrated models of mental health service delivery for children and adolescents. Her work is deeply embedded in the Indian cultural context, as revealed in her study of child care in ancient India based on Ayurveda. She has authored four volumes dealing with the subject of Indian children, has edited and contributed to a number of books in collaboration with other scholars, and has over 100 academic publications. Professor Kapur has also published two books of children’s fiction, Adventures at Kudremukh (Bangalore: Hitha Publications, 2003), and Doogoo the Baby Elephant and Other Stories (Bangalore: Unisun, 2005). One of her most recent volumes, Learning from Children What to Teach Them, was published in 2007. In a similar vein, this volume also focuses on children, delving further into their psychology with characteristic sympathy and care. Contents About the Author v Preface ix Part I General Background 1 1. Introduction 3 2. International Classifications of Psychiatric Disorders 6 3. Child Psychology and Psychopathology from a Developmental Perspective 11 4. Abnormal Child Psychology from a Developmental Perspective 18 5. Psychological Assessment of the Child 25 6. Psychological Therapies, or Counselling with Children 34 Part II Psychological Disorders 47 7. Specific Developmental Delays and Disorders 49 8. Learning Disorders 62 9. Externalizing Disorders: Hyperkinesis and Other Disruptive Behaviours 74 10. Internalizing Disorders: Anxiety, Phobias, Social Withdrawal 86 11. Physical Symptoms of Psychological Origin and Chronic Physical Illness 96 12. Pervasive Developmental Disorders and Childhood Psychoses 107 13. Nature, Causes and Patterns of Disorders in Asian Countries 119 14. Developmental Psychopathology in the Indian Context 126 Part III Counselling Techniques 129 15. Play Therapy 131 16. Art Work 137 17. Psychodynamic Techniques 142 viii Contents 18. Behaviour Therapy and Cognitive Behaviour Therapy 146 19. Supportive Measures 151 20. Working with the Families 155 21. Working with Groups 162 22. Working in Schools 168 Part IV Matching Disorders and Counselling Techniques 179 23. Counselling in General and a Case Illustration of Specific Developmental (Multiple) Delays 181 24. Attention Deficit Disorders 189 25. Internalizing Disorders 202 26. Externalizing Disorders 212 27. Learning Disorders 216 28. Therapies for Somatization and Chronic Physical Illness in Children 225 29. Children at Risk and Resilience in Childhood 229 30. Special Issues of Counselling/Therapies in the Asian Context 237 Appendix 245 References 257 Index 275 Preface This book is an ambitious yet necessary effort. It is a product of the experience and thought that has gone into training professional mental health workers, teachers, lay volunteers and postgraduates in clinical psychology at the National Institute of Mental Health and Neuro Sciences in Bangalore, India, since 1976. In most of Africa and South Asia, children are a neglected population with regard to education and health, including mental health. While teachers focus on education and paediatricians and physicians deal with physical problems, the child as a whole is neglected. In a typical Indian scenario, graduates with or without a degree in psychology start counselling children after attending workshops of a few hours to a few days. This happens especially because none of the developing countries have a statutory body to regulate the practice of counselling. In addition, these practitioners often have no access to libraries, books and even the Internet. To enable counsellors to have easy access to knowledge and information related to the methodological and practical aspects of their work, I have tried to create a single sourcebook for counsellors who work with children. To state simply, this book provides the rudiments of the nature, assessment, causes and treatments for psychological problems in children. The idea that all these aspects, necessary for counselling, can be assessed in a similar way led to the development of a tool called the Developmental Psychopathology Check List (DPCL). In the past six years, this tool has been used for noting down the basic history of children at a child guidance centre in Bengaluru, where my colleagues, Akila and Geetha, and I have supervised the work. The DPCL requires some training but not a great deal. Counselling children is a joyful experience. But it requires some training, some supervision and a great deal of practical experience, leading to self-learning. In this book I hope to provide the background material for counsellors to work with children. But it is good to have some expert supervision, or in the absence of it some peer consultation, so that one gets some feedback when someone goes wrong. Keeping detailed case notes and reviewing them as the counselling progresses is one of the best methods of self-learning. The book covers four themes. Part I introduces the themes of classification of developmental psychology, psychopathology, assessment and therapies. Part II deals with commonly seen psychological disorders such as developmental problems, conduct, emotion and learning disorders. Psychosomatic disorders and psychoses are also dealt with, albeit briefly. Part III discusses methods