Being an Inclusive Counselor to Children and Adolescents

In this webinar replay, learn why inclusive therapy is critical for children and adolescents in this free webinar replay featuring Dr. Autumn Cabell, Ph.D., LPC, NCC, CCC, CCTP and Ani King, COO. This discussion covers tools that are missing in identifying and managing access to specialized services.

Dr. Autumn Cabell joined DePaul University as an Assistant Professor in Counseling in Fall 2020. She earned her BS in Psychology from Florida State University, MA in School Counseling from George Washington University, and PhD in Counselor Education and Supervision from Virginia Commonwealth University. Her research agenda centers on developing interventions that support the mental health and career development of underrepresented students and examining the career-related concerns of counselors of color. She has expertise in career development, depression, anxiety, and trauma. Dr. Cabell is a licensed counselor, Certified Career Counselor, Nationally Certified Counselor, and Certified Clinical Trauma Professional. Learn more at The Career and Wellness Doctor.

Transcript

Ani King 0:01
And it is I’m going to pause the recording.

Ani King 0:05
Hi folks, thanks for joining us for another allcounselors.com webinar. This is the first in our inclusive therapy series and I’m really excited today to be here with Dr. Autumn Cabell talking about how to be an inclusive therapist to children and adolescents. Dr Cabell joined DePaul University as an assistant professor just this past fall. In counselling, she earned her Bachelor of Science in psychology from Florida State University, her masters in school counselling from George Washington University, and her PhD in counsellor education and supervision from Virginia Commonwealth University.

Ani King 0:43
Dr. Cabell, would you mind telling us a little bit about you, and you know, the areas that you’re focused on?

Autumn Cabell 0:50
Yeah, so I am in the Chicago area. And as you mentioned, my masters in school counselling, so I started off working with high school students. And so my passion area has always been with adolescents and even young adults, but I really, really liked that adolescent period of life and working with with children and adolescents and helping them to

Autumn Cabell 1:17
transition to whatever they want to do. And part of how I’ve done that in the past is through not only career development work, but also mental health, and even trauma work as well. And so I really am passionate about helping youth through that career development lens, but then also recognising that mental health and career are often interconnected. And so how can we address the mental health needs that you have, and also pursue the interest that you have as well, too. And so with that, I’ve had opportunity to work in a variety of settings, high schools, residential,

Autumn Cabell 2:02
private practice, and currently I am on a federal contract, working with federal employees, but then also their dependence on career coaching and counselling.

Ani King 2:18
That’s awesome. So kind of not just looking at the what’s next after high school with teenagers, but the, you know, all of this is connected. And part of getting to where you want to go is more self understanding and support and so on. That makes a lot of sense.

Autumn Cabell 2:48
Yeah, well, I think first, we can’t talk about children and adolescence without talking about child and adolescent development. And I think a key aspect of that is child childhood trauma, that I think is oftentimes missing in part of the conversation around behaviours that children and adolescence might be exhibiting, but also, counsellors and clinicians being aware of some of the underlying traumas that are happening in in childhood and adolescence and how that ultimately impacts development in the present day, but then also that ongoing developmental process. And so in addition to that career lens that I have, I also work with any clients that I see from that trauma perspective and assessment, for trauma and even, in some cases, suicidal ideation too

Ani King 3:46
thanks for sharing that. We’ve had a couple of folks come in. So just again, want to mention that we’re talking with Dr. Autumn Cabell today about becoming an inclusive counsellor to adolescents and children. As a reminder, Dr. Cabell joined DePaul University as an assistant professor and fall of 2020. And we were just talking a bit about the lens that she worked through, including career development, overall mental health, understanding the trauma that can occur in childhood and how that impacts immediate development and things that come later.

Ani King 4:22
So one of the questions I have is, do you think there are a lack of providers for this kind of group, you know, children and adolescence?

Autumn Cabell 4:32
Yeah, um, I do. And that’s been partly and just like the literature and the numbers, but then also just in my own personal experiences of working with children and adolescents and needing referrals to psychiatry and being able to work with psychiatrists who have that specialization in children and adolescence because that’s really important and, and often as a counsellor, I won’t refer any child or adolescent to a psychiatrist who doesn’t have that clear specialization. But then also just even in my peers and colleagues and kind of being that go to person for them for consultations around like, Hey, I’m working with this team, I’m totally lost, I don’t know what to do. And so I think, you know, the literature and the client experiences and parents experiences and having trouble finding providers for their, their children and adolescents also just aligns with the personal experience that I’ve had as well.

Ani King 5:32
That I want that lack of providers, I think, also kind of adds to just the overall struggle in finding not only a therapist, but a therapist that your child can connect to, you know, as much as it’s a pretty personal and pretty well vulnerable relationship for adults. Do you think that that’s even more so for children?

Autumn Cabell 5:53
Yes, definitely. And I think that there’s, um, there’s a variety of factors that lead to the lack of access to providers, or just even the quantity of providers. And I think, just even as a counselor educator and working with the students that I work with, there can be this perception that working with children or adolescents is harder than working with adults, and then how that kind of maybe those beliefs get started in a Master’s programme. And then, over time, you just decide, okay, well, I’m going to work with adults, because I think that’s easier, and then you never really lean into that additional training or, or being open to seeing children or adolescents. And I find that part of that perception is that is this kind of view that children or adolescents are maybe less capable of participating in the counselling and therapeutic process, when really, it’s just adjustments that we have to make as a, as a counsellor or clinician to meet the developmental needs of our clients. And that is across the age range. But I think for some reason, there’s a hesitancy in doing that, to meet the needs of children and adolescents. I also think that counsellors and clinicians are aware of the working relationship that you’re going to have to have with parents or guardians as well. And sometimes that can be complicated. And, again, you know, counsellor position saying, You know what, I love kids, but I don’t want to deal with parents. I’ve heard that a lot, as well. And then I think, to just the, our own countertransference, that comes up. So I’ve, I’ve kind of heard peers and colleagues talk about, like, I just can’t work with, with the younger children, because I just want to take them home with me. And, you know, save them, but but recognising that that’s countertransference, is something that we have to kind of work through ourselves. And so I think it’s that that fear of not being able to set clear boundaries with children in adolescence, personally and professionally. And then also, I think that there’s an added layer of countertransference that comes around fear of the mandated reporter role. And, and the potential of doing risk assessments with children and adolescents to and feeling afraid of that or not competent in those areas to that can lead to people not going into this specialty area.

Ani King 8:39
Makes a lot of sense. And real quick, we’ve had a few more folks come in so welcome, everybody. We’re talking with Dr. Autumn Cabell. This is an allcounselors.com inclusive, inclusive therapy series webinar also sponsored by ILC or integrativelifecenter.com. I think that it makes a lot of sense around some of those fears, both with countertransference. But also working with parents. You know, I think we heard that from teachers and a lot of folks who work with children that working with kids is a joy for the most part. But that there are real complications come in when it’s that parent, Guardian, other type of relationship. I’m curious if one of the things that can be difficult, you know, maybe not after it’s developed as a skill, but is those kind of observing those boundaries of confidentiality with children? Can you talk a little bit about what that’s like?

Autumn Cabell 9:38
Yeah, um,

Autumn Cabell 9:39
I think first and foremost is recognising that the child or adolescent is your client. And, yes, legally, there’s some things that our parents are obligated to. But if you’re always kind of acting in the benefit from the perspective of the client, the counsellor or the child is my client. Then it, it allows us to lean into the agency that children and adolescents have. And so often what I do is working with children or adolescents is, invite them into that process. Nothing is secretive about talking with your parents, or that confidentiality process, the limits to that process, but then also, you know, how can I share with your parents what you would like me to share? How can I maybe help to advocate for you or be that kind of middleman in the relationship between you and your parents, if that’s something that you want, and then also to inviting parents into the relationship as well. And that takes some preparation. And for again, that child or adolescent is your client. And so we’re working with them collaborate collaboratively to see, okay. If your parents come into the session today, you know, what would you like for me to talk about what would you not like for me to talk about, you know, at what point do you want to speak. And so being kind of pre emptive, about building that collaborative relationship, not only with the client, but also with the parents can be really impactful. And I think one of the benefits of, I know, with confidentiality, oftentimes counsellors and clinicians kind of view it as this this burden. But I think it’s a real opportunity to make systemic change. So we’re with a child or adolescent for maybe an hour, maybe a couple hours a week, and all that other time, they’re with their family, they’re with their friends, they’re at school. And so it’s not often that with even our adult clients, we have the opportunity to be a part of a family system that they that they go back to, but with children in adolescence, there’s a real opportunity to make change within that family system, we can more understanding and collaboration within that family system. And that can be through building those boundaries and those understandings of the confidentiality process as well. And so even just making that collaborative process as well,

Ani King 12:09
that makes so much sense. I know that with one of my kids, having their therapist model some of that behaviour around being very open about here are the things that I legally can tell you, but I won’t unless they say it’s okay. Or Unless, you know, your your kid says it’s okay. And I think that that was helpful as a parent and saying, Okay, how do I support my child having more agency and, you know, being able to advocate for themselves in terms of privacy needs, and so on. So I can see that being a really, honestly, just healthy way to help show some behaviour in terms of respecting, you know, a child or adolescence boundary is and how do they establish those even with their family, especially with, you know, especially if there are issues going on there? Yeah, I

Autumn Cabell 12:58
think, you know, often it’s about setting those clear expectations and boundaries from the beginning. And so one of the things that I even talked about in like the screening process, or the initial process, where people, you know, are deciding what counsellor they want to go to, and, and what my style is, as I talked about, you know, with parents, I set up that expectation that I’ll do a check in with you, maybe every three to four to four weeks, and before that check in, I’m also going to check in with the client, the child or adolescent and, and get their perspective on what they would like to be shared, as part of that check in and sometimes those check ins might be in a group check in as well, too. But helping to relieve some of that anxiety from the parents perspective around, you know, I’m trusting this person, with my child to help with very sensitive and vulnerable topics or things going on. And so they want to know and understand what to expect. And so I think the more that you can do that on the front end of the relationship, the better off it is for both the child or adolescent, and then also for the parents or guardians.

Ani King 14:07
That makes a lot of sense. Do you think that there are kind of continuing in that vein, you know, more challenges with adolescents and children when it comes to self advocacy? And you know, if so, how do you kind of deal with that or help support them through that?

Autumn Cabell 14:25
Yeah, so I think, again, that agency piece that children or adolescents, regardless of age, have some agency over their, their, their lives. And so the more that we as counsellors can support it and lean into that, the more that we can also teach, about teach them about self advocacy, but also, in some cases, advocate for them in our role as a counsellor or clinician. And so, I think with that self advocacy piece, part of what can be really powerful about counselling That process in general is that clients of any age now have some language about the experience that they’re having, they have some context or more understanding of themselves of their triggers of their coping skills of why they do what they do, that they can then use to as part of that self advocacy piece of part of that explanation of asking for what they need. And also in the counselling relationship, you mentioned modelling, we can model what it’s like to for a child or adolescent to ask for what they need, and even roleplay what it might be like to advocate to parents advocate to the school system, you know, whatever kind of the stakeholder is that, that we’re doing the advocacy work with. And I just think to, even before all of that is teaching children or adolescents what advocacy means, what it looks like, and how they can play a role with that, you know, sometimes as, as adults, we throw around these terms and language that children and adolescents are unaware of. And so we need to find a way to kind of break that down in a developmentally appropriate way, whether it’s pictures, whether it’s drawing or playing games, in order to help them to, to see that you have power in this process, even though it might seem like you’re powerless, or sometimes you even forced to come to counselling by parents or guardians or other key stakeholders, you still have a choice in what you want to say, hear of how you want to use our time together? And how can even that the process of counselling be part of the advocacy piece as well.

Ani King 16:48
When, you know, having worked with, you know, school systems and in school counselling, kind of, you know, helping with those roles, do you find that, in addition to a lack of providers for this kind of group, but there are also missing tools when it comes to identifying and managing access to special services?

Autumn Cabell 17:12
Yes. When you say tools, one of the things that comes to mind is assessment. And I think along with the the lack of providers is a lack of understanding or competency, even around the assessment process with children and adolescents. There’s not a lot of assessment tools out there that are geared specifically for, you know, children or adolescents, but there are some, and so one being able to find those and and be trained in them, but also being able to use the things that are out there, and adapt and adapt them to fit children’s needs. And so for example, you know, I might find, like the Beck depression inventory, which is, you know, a Likert type instrument where clients will rate themselves on certain questions around depression symptoms, and maybe I’m working with someone as an adolescent, let’s say, who’s not at that cutoff age for the Beck depression inventory, but it’s maybe close, you know, and, you know, I’m thinking, How can I make this adapt this assessment for this child? Well, maybe part of it is, instead of drawing those are, instead of having them rated on numbers, you use emojis that signify those, those differences and how they might be experiencing that symptom. Or you kind of you do it side by side with them. So the Beck depression inventory, for example, something that a client can do on their own, but maybe depending on the age, you do it in the room with them. And we go question by question, and we make sure that there’s that just reading comprehension piece that’s not impacting those, those scores. And, and so I think that assessment can be a really important process, part of the counselling process. And oftentimes, I think for counsellors and clinicians, they’re more likely to see that for adults, but get a little bit nervous or scared about what that might look like for children or adolescents. One and just finding the tools that are geared specifically normed specifically on children or adolescents, but then also being able to be creative about how you would get, you know, common tools that we use to fit children or adolescents. And when you think about the assessment piece, that can also be an important part of advocacy, too. Like if I know what my symptoms are, if I know how depression or anxiety shows up for me, then I’m bettle better able to communicate that with with Others, or sometimes when we’re thinking about the school system to in the realm of accommodations or things like that, now I’m able to get just even those systemic accommodations that I need to engage re engage in the learning process.

Ani King 20:17
I know that, you know, with the last year of the pandemic, one of the things that has definitely suffered in most school systems has been access to services for kids who need them, either it’s not safe because they need to be accessed in person, or there’s not yet been a way to adapt some of those services so that they can be helpful and meaningful when you can’t have that in person time. So I think it’s, it’s interesting to consider, and I’m curious what you think about whether or not there will be some long term impact on ways that children and adolescent can access services that they need as a result of this very long, very difficult time? Because I think, you know, we’re seeing people talk more and more about how children are very much impacted by being at home all the time by not having time with their peers, or with certain family members, or just being kind of stuck in the same place. Yeah,

Autumn Cabell 21:15
yeah, there’s a lot to unpack there. And I think, firstly, we don’t know the the long term impacts of this pandemic yet, because we’re still very much in it and, and school systems adjusting and adapting and trying to go back and then that not working. And then just even that, that transition piece. And when we think about development, and Child and Adolescent Development, we know how important it is to set expectations around transitions and to help with the transition process, because that can be very difficult for for children and adolescents to grasp. And so just in that very space of not being able to transition or prepare for virtual learning, you know, what are the impacts of that? And we don’t, we don’t know yet. But then there’s that piece, like you mentioned about services. And so on one hand, I think the pandemic and everything that has been going on has offered or allowed people to lean into telehealth in a way that they weren’t before, not to say that telehealth wasn’t happening before the pandemic, but definitely not at the rate that it is now. And so that also that that telehealth aspect can widen the opportunities for access to providers. And considering those specialty specialty areas around children and adolescents that, okay, maybe I don’t have to stay in, you know, my five to 10 mile radius, I have options online for for screening and things like that. And at the same time, you know, that that could be a benefit. But on the other hand, there, we know that there are systemic inequities in just internet access in, in just even having a safe and secure home environment to engage in the telehealth process. And so we’re still even though there there might be more like just technical access access to providers, there’s still systemic and racial disparities in in that in children and adolescents being able to get what they need in that way. And then the other I think, added layer to is that assessment piece, that often we have, I know, in my master’s programme, which wasn’t that long ago. You know, I didn’t get trained in how to convert some of these assessment processes through, you know, zoom or whatever telehealth platform. I’m, I’m utilising. And so there’s a knowledge gap even for clinicians on how do I even if I do have opportunity to be a part of this assessment process for children and adolescents, you know, how do I convert some of those things in this virtual space, and so I think that there’s a lot of barriers that we just don’t know, the impacts of yet. And kind of along those same lines is that social peace, like we know, for children and adolescents, the importance of, of social networks of play for younger children, and how the pandemic has shifted that in their access to their peers, and that the isolation that comes from that. And so I think that as counsellors being aware of those barriers, and also transparent about those barriers and the ambiguity like hey, it’s not just you who doesn’t, who doesn’t know yet, but you’re not alone in this process. No, we’re all adjusting and adapting and that’s really unfair. It’s really hard. That’s really disappointing. And just validating that experience. I think, first and foremost is is so important for children and adolescents at this time.

Ani King 25:10
Thank you. And yes, that was definitely a multi layered question. So I appreciate you walking through that. Just quick note, folks, if you have any questions, feel free to hit the raise hand or the q&a or chat buttons down at the bottom of your zoom screen. I’ll hold most of those questions for the last 15 minutes. But we’d love to know what you’re thinking what you’d like to learn what you’re curious about. I think one of my questions, too, is while we’re talking about assessments, what are some things that providers should think about assessing for an addition to our presenting issue, or our you know, the main reason that somebody has come in to see you?

Autumn Cabell 25:50
Yeah, yeah. And so I mentioned in the beginning, that kind of trauma lens that I hold in my work with clients. And so I think that very much holds true in when working with children or adolescents, that oftentimes, like when we’re thinking about childhood, oftentimes, we might get a referral because of things that are happening in school. So maybe acting out in the classroom or with peers. And so I think that being able to see children and adolescents as not just their behaviours, but that those behaviours are a form of communication, and that oftentimes, some of those things that we perceive as negative, maladaptive behaviours might also have a might also be related to trauma that they might be experiencing. And recognising that trauma isn’t, isn’t just, you know, an experience. It’s, it’s the, it’s a stress response. And so for children and adolescents, sometimes, you know, I remember in in the school setting, you know, a break up happening for a young girl that I was working with, and that being, you know, devastating to, to her at that time, and then grades slipping as a result of that, or then maybe fighting with, with your other friends as a result of that. But really working from that perspective of that breakup for you at this point in time is, is a trauma that you’ve experienced, and you’re having a very real stress response to that. And so I think just even having that trauma lens for some of our work with children and adolescents can be really helpful in the, in trying to address a client or child or adolescent as a whole being with agency and with experiences that, that we can support and validate and also educate them on to

Ani King 27:59
well, and I think that there can be a tendency for adults, sometimes in any space to kind of dismiss some of those, you know, breakups and loss of friendship, and so on, as Oh, you know, this is just some kid stuff. Because I think we forget that, you know, how impactful it was when we were adolescents, and how the loss of a friend or the changing of nature of relationship, you know, even into adulthood, we all still struggle with that it’s hard for us to break up, it’s hard for us to lose friends, it’s hard for us to change jobs. And so seeing how that paying attention for those kinds of thing as the things that we might not necessarily or parents might not necessarily think of a significant how that can be playing such a big part in whatever is going on at the moment. We have a question that talks about our asks, How do you go about building a rapport with children during the first counselling session?

Autumn Cabell 28:56
Yeah, um, well, I think first and foremost, that piece that I was talking about, and confidentiality and also my relationship and with their parent or guardian as well, that kind of sets the tone for I think building trust and also setting norms for how the counselling relationship is going to go. And then I also think that it’s important to remember the importance of play at the children adolescence, also for adults to play therapies, also for adults. And, you know, some of us might not be trained or certified in play therapy, but at the very least, doing activity based interventions for children and adolescents and being very intentional about what those interventions are. And so often, you know, after I explain the informed consent, the confidentiality process, you know, my philosophy as a counsellor, all of those things that helped to set expectations and the tone I We’ll engage them in an activity, even over zoom in the toilet or in the telehealth setting and engage them in activity just to get to know them outside of that presenting concern that might be on paper or on or all that we kind of suspect is happening or heard is happening from other people. Letting them know that like they are the centre of this time to get there. And doing that, and in a way that kind of enters their world. And so oftentimes, for that first session, I’m doing some kind of game, some kind of activity, some kind of play, in order to break the ice, get to know them outside, again, just that that behaviour that they’re there to address.

Ani King 30:47
Thank you for answering that. We have another question that I think ties into this, at what point and this comes from Amy, thank you for your question, Amy. At what point are counselors legally bound to share aspects of therapy sessions with the parents? And what if the child or adolescent doesn’t want their parents to know what’s discussed in the sessions?

Autumn Cabell 31:10
Yeah, um, well, so anytime that we’re heading into the realm of risk, so that can be suicide risk risk of harming self or, or others, anytime that we’re venturing into the realm of abuse. And that might be, you know, sometimes with children or adolescents, it’s the parents that are abusive. And so that might mean that the parents aren’t necessarily involved in that communication. But we’re that mandated reporter role. And so and then there’s all these other things that could come up, that maybe aren’t within the realm of legal responsibility, but could be helpful for parents to know or be aware of. And that could be as simple as some of the triggers that their child or adolescent has, or some of maybe there’s risky behaviours happening. And those things that might not be within that legal realm of what you’re responsible for, for sharing, but could also be helpful for again, that systemic change. I think that’s where you lean into the relationship that you have developed with a child or adolescent. And like, Hey, you know, I’m really concerned about you. I, you know, based on what you’re, you’re telling me, I think that it could be really helpful if we let mom and dad no are let Guardian know what’s happening. What would you ideally like that conversation to look like? What aspects would you feel comfortable sharing at this point? And maybe that’s not now? Maybe it’s three, four or five weeks from now. But is this something that you’re even willing to continue to check in on? And see, you know, gauge that kind of readiness for having that conversation? Is that a conversation you want to have totally on your own? Or would you like me there, and so again, that peace around agency and creativity around? around, you know, what that can look like as far as what could be helpful to that systemic change, but then also, ultimately, what’s helpful for that client and, and helping them to develop that agency over their counselling experience, but then also just over their lives as a whole?

Ani King 33:35
Thank you for that. And a great question. Amy. I have a follow up question for that. Are there any differences in confidentially or sharing requirements when you’re working with kids who are you know, in, in the system, they’re in foster care, or they have been in group homes or, you know, just all of those various places, detention centres, all of that? Are there any differences in what can or what has to be shared because of the kind of legal implications of their status?

Autumn Cabell 34:04
Yeah, so typically, the the legal aspect from state to state is, is pretty consistent. But there could be like protocol changes for, you know, if you’re thinking about the school context versus a residential, so when when I think about my time and in residential, there were some things that if those, like, if there was destruction of property, or significant harm to like another resident, then it was part of that protocol for like insurance and liability purposes that we would have to get police involved versus in the school system. During suicide risk assessment, it was policy that you know, after we kind of assess risk, and we go through that that conversation that we do notify parents before that, that child returns back home. And so that time in case we was really important in the school system. And then in the present, and in the residential piece, there’s certain things that if this was happening, you know, we had to involve crisis team or we had to involve, in some cases, emergency services. And so those protocols, I think, can look different from, from setting to setting. But those overall, like we’re always going to, to do something, if there’s abuse of a child, we’re always going to be then that mandated reporter role. And those steps might look different from state to state. But ultimately, that mandated reporter role is something that’s pretty consistent.

Ani King 35:41
Thank you for answering that. Again, folks, just a reminder, if you’ve got any questions that you’d like Dr. Cabell to ask or answer, feel free to hit that q&a button or hit the chat button. We’d love to know what’s on your mind. I think one of the questions that I saw from some folks who signed up was, you know, if you’re interested in starting to work with children and adolescents, what are the first steps that you should take? Yeah, well,

Autumn Cabell 36:09
um, you know, it’s always interesting to meet you. I mentioned, I started off talking about the importance of knowing Child and Adolescent Development, also neuro development to, right that children and adolescents, that prefrontal cortex is still developing now we know that it’s still developing, you know, up until the age of 25. And we’ve changed, you know, to claim that to emerging adulthood, but in some ways you can think of like 21 year olds as as less sensitive. But just even that, that child development and neuro development piece, and I think is something that is usually, in some cases, not a requirement for our, our programmes, often it’s an elective course. And so if you’re still a student, I definitely recommend leaning into those classes that you have the opportunity to take them. I also think, you know, when I think about my own training, play therapy wasn’t, I didn’t really have the opportunity to have like a whole course on on Play therapy. And so I think if you’re interested in children and adolescents, one, if it’s in your master’s programme, that child and adolescent development course or if there’s course on neuro development to, and then if that’s not possible, in your master’s programme, thinking about post, graduate it graduation, professional development, that you can get those experiences in those areas, or, and that could be from conferences, webinars, books that you read, it could also be in supervisors that you choose. And so really being mentored by supervisors who specialise in this work can be helpful in getting your foot in the door around just the the knowledge base. And then I also think if you have the opportunity to at least read articles on Play therapy interventions, or activity based interventions. Again, same with conferences, or, or just extra readings that you can do, I think, you know, one thing if I was looking back, I would have really appreciated having more opportunities and experiences around play therapy and how I can be intentional about playing because it’s not about just doing an activity for the sake of doing an activity to break the ice so that you feel more comfortable. But it’s also about how is even through this activity, I’m learning more about this child or adolescent, I’m entering their world in a different way than when they first started the session with me. How am I using even this basketball game to ask questions that that are helpful in understanding the clinical aspects of the things that we’re working on together. And so I think those two pieces around development and around play activity based interventions can be really helpful, just professional development opportunities to look out for.

Ani King 39:21
Fantastic. And we have another question. I think this is a good one, too. How do you approach talking about racial identity as well as racial inequity in a group therapy session with children?

Unknown Speaker 39:34
Yeah.

Autumn Cabell 39:37
Excuse me. So it It could also start before the group therapy session even starts and what your topic is for, for group therapy and explaining that and how, you know, these are the things that we’ll talk about and one of those things includes race, culture, gender, gender expression, you know, things like that. So it could start just even in that screening process initially telling parents about or guardians about the groups, and then explaining that those groups to the child or adolescent, and then it can also be through that modelling piece of, you know, if I share a little bit about my background and how that’s gonna play a role in our time together, then we can also facilitate an opportunity for the the child’s with the children, I guess, in a group setting children or adolescents to share that as well. And I think another layer of that is through that intentional play or activity based having an activity, just even that first group session that’s geared towards sharing more about your yourself and your identity. That could be through drawing, that could be through, you know, that, like that activity that I are that I do often where they have kind of like a blank outline of a person. And they write kind of on the front, what people see, and about them when they first meet them. And then on the backside of that same person, what people don’t see about them. So it’s just even intentional activities like that. But get them drawing, then interactive, they can colour it, however they want to colour it, but then also very intentional about bringing in discussion around social identities can be really impactful and important to the work of the group that you’re running. And I would say that that’s also similar feedback. And I would have a similar answer for working one on one with children as well.

Ani King 41:40
Thank you for your answer. I think that’s a that’s a good question. I think that it’s a timely one to you know, and especially resonates the speaking with the parent ahead of time, if you can, but I think maybe also understanding for some children and adolescents, their parents will not be open to that conversation. And that’s, that’s something to navigate as well. Folks, we have about 20 minutes left, so I just want to make sure if you have questions that we’re getting those in there. I’m also going to drop Dr. Cobos, Instagram and Twitter handle and website in the chat. So you all have that. So you can check out more about her work and what she does. And again, thank you so much for being here. I think this has been a really helpful and open conversation. One question that I have to kind of continue on is, you know, when you are dealing with challenging topics, you know, with children, whether they do or do not have parent and Guardian support, and in tackling those, when there are areas where you feel like the question is out of the scope of something that you can necessarily understand or assist with, or you think, you know, maybe somebody else is the right person to help, because that’ll happen sometimes, right? You know, what is your process for determining, okay, it’s time for me to refer either, you know, just this specific piece or in general to somebody else. How do you approach that with the child or adolescent? Just with that, you know, that it’s a vulnerable relationship, and that relationship transition can be such a big thing, too.

Autumn Cabell 43:27
Yeah, yeah. Just even as you were asking that question I can think of, you know, a recent example of recognising that, again, you know, psychiatry services are have been so rare in my experience with children, adolescents, where I felt like, you know, a referral was needed to a psychiatrist, but I was kind of getting that inclination, inclination that maybe, you know, that psychiatry referral was something that was going to be needed. And so I’m, also, again, I think it comes back to that transition piece. And so one of the things that I did is I just put it out there, like, Hey, you know, I’m, you know, as we’ve been talking, you know, we’ve kind of done this, this and that, in order to better support you. And it’s, it’s not that in this case, like, it wasn’t that that the adolescent wasn’t engaging or doing, like the interventions or the things like that, right. So also making sure that you’re articulating that it’s no fault of your own, because often children and adolescents, their their worldview is very skewed, and they think kind of that, that something must be wrong with me, I did something wrong, if, you know, maybe a referral is needed. And so recognising, like, Hey, this is all of the work that we’ve done together. These are the things that that you’ve been capable of doing and that have worked for you. And still we’re kind of struggling with this. And so one thing that might be really helpful for you is Thinking about this psychiatry referral. And first of all, it’s explaining what psychiatry is, again, that language piece is really important. And also thinking about that the child or adolescent is your client first. And so we’re always talking about how this could be helpful for you. And, and recognising, like, hey, this isn’t something that we have to do right now. But I just want to put it out there. And now we’re starting to transition, right? We were at least introducing the idea, you have some time to think about it, give me some feedback on it, you check in next week about it. We see if there’s any questions between now and the, or between the last session, answer any questions that you might have, and it might be a three or four week transition to that referral to a psychiatrist. And that was just kind of one example that that I can think of, but those, those kind of key key constructs that I was talking about with just establishing trust, you know, being aware of the language that you’re using, that it’s developmentally appropriate, and that transition process is, is important. And that might look different from child to child or adolescent, to adolescent. And so for this, you know, case, in particular, it was, it was helpful to kind of have that, you know, three weeks, we lean into this idea, and it was helpful in also getting that buy in and having that person say, Hey, you know what, that thing that you brought up last week and the week before, I actually would like to look into that, and, and I thought about it, and now we have that agency, nice, but it’s your your choice, even in that referral process.

Ani King 46:43
That’s, that’s a great method, I just kind of it’s not a surprise. And it’s not an it’s not a fault situation, this isn’t like you didn’t do anything wrong, this is about best supporting you. And, you know, helping them kind of arrive at the wanting that additional support. And we have about 1015 minutes left. So just a quick reminder to folks to get your questions in. Is there anything, you know, that you would tell folks who are? Okay, you know, we’ve talked about being nervous about working with children, adolescents, but what would you tell folks who are nervous about it, but are still thinking, you know, I think this is the direction that I want to head in. Yeah,

Autumn Cabell 47:27
I think, you know, when you think when you understand like neural plasticity and neural neural development more, you understand that there is such a large opportunity to, for children to grow, and for children to be resilient. And the earlier that that process starts for them, the better off those long term outcomes are. And so I think while it’s important to be aware of some of the things that I talked about assessment, you know, the impact of childhood trauma of thinking about or examining behaviour as a form of communication, also recognising that children are, you know, they have agency, they, they’re creative, they have all of this potential and, and prospects about them, and they’re not, you know, these kind of fragile little things that, that you have to always kind of second guess yourself about, but that there is a real true opportunity that can lean into the relationship that you have a child or adolescent. And that be the the one interaction that is changes a whole life trajectory for them. And so there’s this this really amazing and beautiful opportunity as a counsellor clinician to be a part of that. Some cases post traumatic growth process, that resiliency process, or even building those protective factors for children or adolescents, like you yourself, as a counsellor clinician could be a protective factor for for someone, and that, I think, is really powerful. And I think also, you know, to me, it’s like, why wouldn’t you want to have that kind of opportunity to to, to be a part of changing someone’s life?

Ani King 49:26
Awesome, thank you so much. It looks like we have answered all of the questions that folks have. So as we start to wrap up my final question for you, is there anything that we didn’t talk about either by answering questions or just in general that you would really want to convey to this audience about being an inclusive counselor to children and adolescence? Yeah.

Autumn Cabell 49:49
I always encourage people, you know, when we think about childhood trauma, and understanding neurodevelopment and things like that, to look into the research around adverse childhood experiences, but then also positive childhood experiences. And so it’s not that just that, you know, experiencing childhood trauma can be debilitating. And we add to all these negative outcomes in adulthood but that there can be real true opportunities to foster growth and resiliency. And so those positive childhood experiences of having social connectedness amongst peers of having at least one adult outside the home that children or adolescents can connect with. All of those things have been shown in the research to be really impactful for long term outcomes. And so just even in your own kind of research or exploration around working with children and adolescents, looking into both adverse childhood experiences and positive childhood experiences as well.

Ani King 51:00
Thank you so much. It has been a pleasure to speak with you today and you know, learn a little bit more about working with children and adolescence. For all of our folks who are attending. You can find Dr. Cabell’s, Instagram, Twitter and website information in the chat. I think that this has been incredibly, incredibly helpful. And if anyone thinks of questions after the fact you can feel free to email me at Ani at all counselors dot com I’d be happy to pass them on and get you some answers. And make sure that you sign up for the oncoming sessions for our inclusive therapies. Series. Tomorrow, we are talking about indigenous and Native American support. And then we’re also talking about working with the Jewish community on Friday. So I hope to see everybody at as many as you can attend. And we will have a replay of this up in the next couple of days. So you’re welcome to watch again or share as widely as you want. Dr. Bell, thank you so much again, I this has been a fantastic conversation. I really appreciate your time. Yes,

Autumn Cabell 52:04
thank you. And I just want to also just reiterate, feel free to reach out to me as well.

Ani King 52:09
Thank you so much, everyone.

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