The Springer Series on Human Exceptionality DonaldH.Saklofske,Ph.D. DivisionofAppliedPsychology UniversityofCalgary,Canada MosheZeidner,Ph.D. CenterforInterdisciplinaryResearchonEmotions DepartmentofHumanDevelopmentandCounseling HaifaUniversity,Israel Forfurthervolumes,goto: www.springer.com/series/6450 Zipora Shechtman Treating Child and Adolescent Aggression Through Bibliotherapy 1 3 ZiporaShechtman UniversityofHaifa MountCarmel Israel ISSN:1572-5642 ISBN:978-0-387-09743-5 e-ISBN:978-0-387-09745-9 DOI10.1007/978-0-387-09745-9 LibraryofCongressControlNumber:2008938332 #SpringerScienceþBusinessMedia,LLC2009 Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewritten permissionofthepublisher(SpringerScience+BusinessMedia,LLC,233SpringStreet,NewYork, NY10013,USA),exceptforbriefexcerptsinconnectionwithreviewsorscholarlyanalysis.Usein connectionwithanyformofinformationstorageandretrieval,electronicadaptation,computer software,orbysimilarordissimilarmethodologynowknownorhereafterdevelopedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,evenifthey arenotidentifiedassuch,isnottobetakenasanexpressionofopinionastowhetherornottheyare subjecttoproprietaryrights. Printedonacid-freepaper springer.com To my dear family The source of my energy and support With love To the many students who applied the method of bibliotherapy The source of the case studies and illustrations With appreciation Preface Aggression among children and adolescents is a highly disturbing behavior, whether it takes place at home, in the school, on the playground, or in the community.Attemptshavebeenmadetopreventaggressionthroughdisciplin- aryaction(‘‘ZeroTolerance’’approach)andsocialenhancement(‘‘Well-Being’’ approach), but while they often do result in decreased aggression, they don’t work for everyone. Owing to various individual differences (temperament, family circumstances, developmental difficulties, etc.), some children remain aggressivedespitethoseefforts.Classroomandschool-basededucationalpro- grams to reduce aggression are often of a primary prevention type, targeted toward the normative population in the school. But the children and adoles- centswhoareathighriskforaggressivebehaviorneedasecondaryprevention treatment,onethataddressestheuniquedifficultiesofaggressiveyoungpeople. Take,forexample,therecentshooting atVirginiaTechnicalUniversity, in which a college student killed 32 peers and professors and then committed suicide. This was an act of one very angry and lonely young man, as were othermassshootingsinschoolsintheUnitedStates.Itisthisanger,loneliness, and sense of rejection that need to be addressed in the treatment of these children,startingatanearlyage. Ignoringtheneedsoftheaggressor istypicalofoursociety.Paradoxically, themorepreventionattemptsaremadethemoredifficultbecomesthesituation for such children and youth. Prevention programs enhance awareness of the norms, rules and regulations expected in a certain setting, and any deviation fromthemarousesantagonismandanger.Becauseaggressivechildrendemon- strate deviantbehavior thatdoesnotadheretogroup rules, and because they are a threat to others, they are rejected by their peers and by adults. Indeed, adults are often quite helpless in facing the challenges these youngsters pose. Teachers even feel unsafe in schools and often don’t know how to cope with highlyaggressivestudents.Asaresult,theypunishratherthantreatthem. Itmakessensetopunishthosewhoinflictharmonothers,whouseforceto achievetheirgoals,andwhotakeadvantageoftheirpoweragainstvictims.We canevenrationalizethepunishmentbyarguingthatweareprotectingtheweak. Butisthiseffectiveinreducingaggressionoftheperpetrators?TheargumentI make in this book is that rejecting and punishing aggressive children vii viii Preface perpetuatesthoseverylifeexperiencesthatmadethemaggressiveindividualsin thefirstplace.Ifwewanttobreakthecycleofaggression,weneedtohelpthem. Aggressionisthesymptom,notthecauseofthebehavior.Ratherthanpushing themawayfromthesocialmainstream,weneedtounderstandtheirdifficulties, trytoaddresstheirspecialneeds,andbringthembacktosociety. Think for a moment about driving on a wet road, when suddenly the car veerstotheright.Yourfirstinstinctistoturnthewheelinthesamedirection, butactuallyyoushouldturnittheotherway.So,too,withaggressiveyouth,we needtoactagainstourbasicinstincts,toloveratherthanhate,toacceptrather thanreject,tonurtureratherthanpunish,andtoreachoutratherthanavoid. Efforts to change aggressive behavior are commonly based on cognitive restructuring, because aggressive children exhibit distorted social information processing.Theytendtoascribehostilemeaningtowardthemandreactaggres- sivelyindefensewithoutconsideringalternativebehavior.Althoughthedeficit ininformationprocessingisclear,treatmentthatfocuses solelyonthisdeficit maybe insufficient,becauseemotionalfactorsplayan important role in their aggressivebehavior.Aggressivechildrenarefrustrated,dissatisfied,angry,and lonely.Theyfeelthattheyneedtoprotectthemselvesfromfurtherdisrespect, intimidation,andattacks.Mostofthetime,theyareunawareoftheproblems their behavior is causing to others. They rather see themselves as victims of others’aggressionandtheirownbehaviorasan‘‘innocent’’attempttodefend themselves. Even when theydo havesome awarenessoftheir antisocial beha- vior, these vulnerable children will not easily abandon their aggression, as it provides them with a sense of power that they need for their survival. This is whyaggressionissoresistanttochange. Changingaggressivebehaviorisnotaneasytask.Itrequirespromotingthe developmentof self-awareness without frightening thechild. We must engage thechildinanempoweringprocessandenhancehis/hermotivationtomakea change. And we must offer an alternative to aggression. All these require an environmentofcare,recognition,respect,andsupport.Thesearethenecessary conditions for any successful therapy, but they are insufficient conditions for treatment of aggression. In addition, we need to apply special methods and techniques that help us capture the child’s attention, raise the motivation to change, increase cooperation with the therapist in the change process, and reduceself-defensiveness. I offer bibliotherapy as an adjunct to a therapeutic process based on an integrative theory of treatment. Telling stories that are relevant to aggressive behavior present an indirect treatment for the child, one that minimizes self- defensiveness.Itpermitschildrentounderstandtheirbehaviorwithoutfocus- ing directly on themselves. Through identification with the characters in the story, they can learn about the reasons for aggression and its consequences withouthavingtofeelashamed,guilty,orthreatened.Intheprocessofdiscuss- ingalternativebehaviorstoaggressionforthecharacter,theybecomeawareof theirownalternativestoaggression.Allthisisdoneinanindirectway,sothat the children are not quite aware of the pressure to change. Indeed, reducing Preface ix externalpressuretochangeisthekey;itisofutmostimportanceforaggressive childrenandyouthbecauseoftheoppositionalnatureoftheirdisturbance. Bibliotherapy entails the use of literature for therapeutic purposes and it includeslisteningtostoriesandpoems,watchingfilms,andlookingatpictures. Itisaplayful,engaging,andfunprocess.Inasafeclimate,childreneventually make theconnection to their ownfeelings and behavior and become readyto takechargeoftheirlives. The integrative theory that we apply entails the treatment of aggressive children in stages. First, we use humanistic principles to create the necessary conditionsforchange:bondingwiththetherapist(individualtherapy)orwith thetherapistandotherchildren(grouptherapy),andcreatingasafesocialand emotional climate in which self-disclosure is promoted. Next, in the working stage,throughtheuseofstories,poems,pictures,andfilms,weapplypsycho- dynamic principles to develop awareness of their unconscious behavior. Finally, we use cognitive-behavioral principles to develop processes in which the children consider the pros and cons of aggressive behavior, and make a commitmenttochangetheirbehavior. The method is most often used in the school, but it can equally be used at home, in private clinics, and in corrective facilities, among others. With some modifications and adjustments of the literature, it can be applied to specific types of aggression (relational, reactive, and proactive) and in unique areas (e.g.,sexualaggression,addictions,andanimalabuse). Over the past 10 years, my colleagues and I have worked successfully with thismethodwithhundredsofchildren,inbothindividualandgroupformats. Throughaseriesofempiricalstudies,wewereabletoshowthatthemethodis effectiveinreducingaggressionandincreasingempathy—theflipsideofaggres- sion.Wealsowereabletolearnagreatdealaboutthechangeprocessesthatthe childrenundergo. I would like to share this knowledge and understanding with professionals whostrugglewithaggressivebehavior.Theseincludeteachers,schoolcounse- lors,psychologists,socialworkers,andothermentalhealthemployees.Parents, whoarecurrentlyquitehelplessinconflictsituationsathome,mayalsofindthis approachamenabletotheirneeds. Contents 1 TheNatureofAggressiveChildren ........................... 1 TheProblem ............................................ 1 TypesofAggression ...................................... 3 Bullying.............................................. 3 ReactiveandProactiveAggression......................... 5 CausesofAggression ..................................... 7 Genetic,Biological,andTemperamentalFactors.............. 7 FamilyFactors ........................................ 8 SocialInfluences ....................................... 11 LearningDisabilities.................................... 13 CharacteristicsofAggressiveChildren........................ 14 VerbalizationofEmotions ............................... 14 Empathy ............................................. 16 PerceptionProblems:TheEndorsementofPower............. 17 Self-control ........................................... 18 SummaryandImplicationsforTreatment..................... 18 2 BibliotherapyasaMethodofTreatment ....................... 21 Introduction ............................................ 21 CognitiveBibliotherapy ................................... 22 StudiesofCognitiveBibliotherapyTreatments ............... 23 DrawbacksofCognitiveBibliotherapy...................... 25 AffectiveBibliotherapy.................................... 26 BenefitsofAffectiveBibliotherapy......................... 26 TheNeedforaTherapist ................................ 28 LevelsofProjectionandFormsofBibliotherapyMaterials...... 30 ResearchSupportingtheContributionofAffective Bibliotherapy.......................................... 32 Summary............................................... 36 3 BibliotherapyandTreatmentofAggression..................... 39 TheRationaleforUsingBibliotherapywithAggressiveChildren... 39 TheTheoreticalFoundation................................ 42 xi xii Contents StudiesValidatingtheChangeProcess........................ 47 TherapistSkills .......................................... 48 TheContentofIntervention................................ 51 Anger................................................ 51 Empathy ............................................. 52 PowerUseandMisuse .................................. 54 LackofSelf-control .................................... 56 ResearchSupportingOutcomes ............................. 58 Summary............................................... 63 4 TheApplicationofAffectiveBibliotherapy ..................... 67 SelectingtheLiterature:LiteraryQuality...................... 67 ThemesforDiscussion .................................... 71 AngerandAngerManagement............................ 72 IncreasingEmpathy .................................... 73 TheMisuseofPower.................................... 75 Self-control ........................................... 77 AdjustingtheLiteraturetotheChangeProcess................. 78 TheInitialStage ....................................... 78 TheWorkingStage..................................... 80 TheActionStage....................................... 82 DevelopmentalConsiderations.............................. 83 TheBibliotherapySession:ProcessandFormat ................ 84 ARecommendedBibliotherapyFormat..................... 84 TheRoleandSkillsoftheTherapist........................ 88 Summary............................................... 90 5 GroupsforAggressiveChildren.............................. 93 Introduction ............................................ 93 AdvantagesoftheGroupSetting.......................... 94 Demonstration:AGroupofYoungChildren .................. 97 Introduction .......................................... 97 TheGroupProcess ..................................... 97 Evaluation............................................ 102 Demonstration:AGroupofAdolescents...................... 103 Introduction .......................................... 103 TheGroupProcess ..................................... 103 Evaluation............................................ 115 Summary............................................... 118 6 IndividualTreatment ...................................... 121 Introduction ............................................ 121 TreatmentofaYoungBoy................................. 121 Background........................................... 121 TreatmentProcess...................................... 122
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