Treating seriously emotionally disturbed adolescents: The views and working practice of school psychologists.

Abstract

Over three hundred school psychologists were surveyed about their working practice and their views with regard to treating seriously emotionally disturbed adolescents. The survey questionnaire sought the following details: 1) Demographic information; 2) Professional opinions about serious emotional disturbance; 3) Personal working practice with seriously emotionally disturbed students & 4) Recommendations. Keywords: school psychology; adolescents; emotional disturbance; special education; professional practice, survey. ********** This paper presents the findings of a survey of a large sample of school psychologists. This survey measured the extent to which the existing practices of school psychologists were evidenced-based when working with seriously emotionally disturbed adolescents? This was the fundamental research question of the survey. The questionnaire used in the survey was designed so that the respondents would not be strongly directed towards particular conclusions. Behavior analysis was not the focus of the survey but it might be of interest to behavior analysts to see the indications of the importance and usefulness of behavioral interventions that emerged from the survey findings. Is the professional practice of school psychologists evidence-based--particularly when recommending interventions for seriously emotionally disturbed adolescents? Is the decision-making of school psychologists based on clinical experience and judgment that is strongly influenced by particular philosophies, policy, resource availability and theories, but not necessarily by evidence of past success? It might be argued that it is inevitable and unavoidable that school psychologists do base their decision making on information that is not evidence based if it is the case that there is little empirical research and a lack of scientific data on which to base strong conclusions. A survey of school psychologists was carried out to measure the extent to which their existing practices were evidence-based when working with seriously emotionally disturbed adolescents. Additionally, their recommendations for effective school-based interventions were sought. Theoretical Conceptualizations of Emotional Disturbance In the United States, there are two main conceptualizations of emotional disturbance that can influence school psychologists and other mental health professionals: psychoanalytic and behavioral. Definitions of emotional disturbance in the United States usually fall into one or other of these two broad categories. A minority of definitions of emotional disturbance may be eclectic and draw on both behavioral and psychodynamic perspectives. A summary of the main theoretical conceptualizations is provided: Psychoanalytic The first conceptualization of adolescence described is psychodynamic or psychoanalytical. This approach usually views serious emotional disturbance as an internally instigated disorder in the individual. An individual's behavior or environment can be changed to alleviate the condition but conflicts or forces within the personality of the individual must be resolved and brought into harmony before emotional health and appropriate behavioral control can be achieved. The origins of this approach lie in the work of Freud, Jung and other early psychoanalysts. The early psychoanalysts were heralds of a new way of looking at human personality. Instead of seeing behavior largely in moralistic terms, it was interpreted in terms of an individual's experience and development. McWilliams (1999) provides a succinct description of the psychoanalytic/Freudian approach to adolescence. Work by Bowlby (1969, 1973, 1980, 1988) related serious emotional disturbance primarily to attachment difficulties stemming from insufficient bonding and love in childhood. Research that have been published in the past few years may reflect theories developed from the personal experience of the psychotherapist and may be limited to particular types of client and difficulties, as well as the social settings. …