CEFS 620 Week 8 DB Forum 4 Example

Discussion Board Forum 4: Thread and Two Replies

CEFS 620 Counseling Children, Adolescents, and Their Families, Discussion Board Forum 4 (thread and two replies)

Thread by [Student Name]

The prompt and the classmates' posts are composites standing in for the course's own forum; the textbooks, Scripture and published studies are real, and every journal source is from the last five years as the guide requires; the requirements follow Liberty's public course guide for CEFS 620.

Thread

Every counselor who works with children faces the same question in the first session: how much should the parents be involved? Recent research gives a clear answer, which is quite a lot, but in particular ways. The answer also depends on the problem, since the evidence for parent involvement is strongest for behavior problems in younger children and more modest for adolescent depression.

For children with ADHD, parent training is the standard of care, and Dekkers et al. (2022) asked which parts of it matter. Analyzing 29 randomized trials with 2,345 families, they found robust small-to-medium improvements in positive and negative parenting, parenting confidence, the parent-child relationship and parents' mental health. Techniques that change what happens before a behavior, such as clear instructions and predictable routines, were associated with better parental confidence and mental health, and techniques that reinforce desired behavior were associated with less harsh parenting. Higher doses of psychoeducation were associated with weaker results, which suggests that parents benefit more from practicing skills than from hearing about ADHD.

Family involvement also helps in treating depression, though modestly. Dippel et al. (2022), meta-analyzing 17 trials, found a small but significant added benefit when caregivers were involved in treatment for child and adolescent depression, compared with similar treatment without them.

The parent's own history matters too. Zhu et al. (2025) found that parents' and children's adversity scores rise together, a strong pattern across nearly five thousand family pairs. A parent who struggles to follow a behavior plan may be carrying unresolved adversity of their own. In that case, more instruction is unlikely to help; the counselor may need to acknowledge the parent's stress, refer the parent for their own care, or adjust the plan to what the family can manage. The research suggests treating caregivers as partners who need support as well as instruction, because a parent's well-being is part of the child's treatment. Cook-Cottone et al. (2015) describe the counselor's work with children as inseparable from work with the systems around them, and caregivers are the most important of those systems.

Scripture describes the instruction of children as something that happens through daily life together, when sitting at home and walking along the road (English Standard Version Bible, 2001/2016, Deuteronomy 6:6-7). Counselors help parents do that work, not replace them in it, and they honor parents by equipping them.

Classmates: how do you plan to respond when a parent expects you to fix the child without changing anything at home?

Reply to Natalie

Natalie, you wrote about counseling children who have lost a parent, and you argued that grief in children is often overlooked because they may play normally one minute and fall apart the next. The scale of the need is larger than many counselors realize. Hillis et al. (2021), in a modeling study published in The Lancet, estimated that from March 2020 to April 2021, more than 1.1 million children worldwide experienced the death of a primary caregiver, a parent or custodial grandparent, from COVID-19-associated causes, and more than 1.5 million lost a primary or secondary caregiver. The authors noted that such children often face poverty, abuse and institutional care as well as grief.

For counselors, this means grief work with children often requires attention to the surviving caregiver and to practical stability, not only to the child's feelings. A grandparent raising a grieving child, for instance, may need support, resources and guidance as much as the child does, including help with benefits, school enrollment and the grandparent's own grief. Coordinating with schools and community agencies may matter as much as the counseling session itself.

In your experience, do surviving caregivers seek help for themselves, or mainly for the child, and how might a counselor invite them to accept support too?

Reply to Joshua

Joshua, you described families in your community who cannot attend weekly counseling because parents work evening shifts and have no transportation, and you asked what counselors can offer them. One option with recent evidence is brief online intervention. Schleider et al. (2022) tested the idea at scale, assigning thousands of depressed young teenagers at random to one free online session or to a comparison session. Three months on, teenagers given either active session, whether on scheduling rewarding activities or on the idea that traits can change, had less depression and hopelessness than the comparison group, by small margins.

For families who cannot attend weekly sessions because of work or travel, a counselor could recommend such an intervention as a first step, follow up by phone, and offer a parent session at a time that fits the family's schedule. The approach does not replace ongoing treatment for a young person who needs it, but it extends care to families who would otherwise receive none. Pairing it with telehealth sessions in the evening, when parents are home, could also bring the family into the work without asking them to travel.

Do you think families in your community would use an online tool if the counselor introduced it personally and checked in afterward?

References

Cook-Cottone, C. P., Kane, L. S., & Anderson, L. M. (2015). The elements of counseling children and adolescents. Springer Publishing.

Dekkers, T. J., Hornstra, R., van der Oord, S., Luman, M., Hoekstra, P. J., Groenman, A. P., & van den Hoofdakker, B. J. (2022). Meta-analysis: Which components of parent training work for children with attention-deficit/hyperactivity disorder? Journal of the American Academy of Child & Adolescent Psychiatry, 61(4), 478-494. https://doi.org/10.1016/j.jaac.2021.06.015

Dippel, N., Szota, K., Cuijpers, P., Christiansen, H., & Brakemeier, E.-L. (2022). Family involvement in psychotherapy for depression in children and adolescents: Systematic review and meta-analysis. Psychology and Psychotherapy: Theory, Research and Practice, 95(3), 656-679. https://doi.org/10.1111/papt.12392

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Hillis, S. D., Unwin, H. J. T., Chen, Y., Cluver, L., Sherr, L., Goldman, P. S., Ratmann, O., Donnelly, C. A., Bhatt, S., Villaveces, A., Butchart, A., Bachman, G., Rawlings, L., Green, P., Nelson, C. A., & Flaxman, S. (2021). Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: A modelling study. The Lancet, 398(10298), 391-402. https://doi.org/10.1016/S0140-6736(21)01253-8

Schleider, J. L., Mullarkey, M. C., Fox, K. R., Dobias, M. L., Shroff, A., Hart, E. A., & Roulston, C. A. (2022). A randomized trial of online single-session interventions for adolescent depression during COVID-19. Nature Human Behaviour, 6(2), 258-268. https://doi.org/10.1038/s41562-021-01235-0

Zhu, J., Deneault, A.-A., Turgeon, J., & Madigan, S. (2025). Caregiver and child adverse childhood experiences: A meta-analysis. Pediatrics, 155(2), Article e2024068578. https://doi.org/10.1542/peds.2024-068578