NEGATIVE PEER INFLUENCES

CLIENT PRESENTATION

Susceptibility to Negative Peer Influences (1)¹
1. The client's parents identified that he/she is easily susceptible to negative peer influences that contribute to problems with authority figures at home, school, and in the community.
2. The client described behaviors that indicate a strong susceptibility to negative peer influences.
3. The client's susceptibility to negative peer influences has contributed to problems with sexual promiscuity and substance abuse.
4. The client has acknowledged his/her easy susceptibility to negative peer influences.
5. The client has shown a decreased susceptibility to negative peer influences.
Seek Peers' Reaction to Disruption (2)
1. The client was described as engaging in disruptive, negative, attention-seeking behaviors at school to elicit attention, approval, or support from peers.
2. The client has acted out within the community in order to elicit attention, approval, or support from peers.
3. The client acknowledged that he/she is often disruptive or seeks attention in negative ways in order to get approval or support from his/her peers.
4. As treatment has progressed, the client has decreased his/her pattern of behaviors designed to elicit negative support, attention, or approval from his/her peers.
Excessive Willingness to Follow (3)
1. The client has often followed the lead of others in order to attain approval or acceptance from his/her peers.
2. The client's parents describe him/her as being excessively willing to seek approval or acceptance from others through following their lead into negative activity.
3. The client has often been manipulated into taking responsibility for the actions of others and has agreed to do so to obtain approval or acceptance.
4. The client described himself/herself as a follower.
5. The client has begun to think and act on his/her own, rather than simply following the lead of others.
Risky Behavior/Thrill-Seeking (4)
1. The client described a propensity for taking ill-advised risks in peer group settings.
2. The client has engaged in thrill-seeking behavior in peer group settings.
3. The client described himself/herself as being caught up in the behavior of the group.
4. The client has gained insight into his/her pattern of ill-advised risks and thrill-seeking behavior.
5. The client used appropriate judgment in peer group settings.
Identification for Acceptance (5)
1. The client has identified with the negative peer group as a means of gaining acceptance.
2. The client reports that he/she was often rejected by others and now has gained acceptance with the negative peer group.
3. The client has attempted to elevate his/her status and self-esteem through identification with the negative peer group.
4. The client has no insight into the long-range effects of identification with the negative peer group and is unwilling to give up the acceptance, status, and self-esteem that he/she derives from identifying with that group.
5. The client has disconnected himself/herself from the negative peer group and is attempting to gain acceptance, status, and self-esteem through more positive means.
Affiliation for Protection (6)
1. The client has affiliated with a negative peer group in order to protect himself/herself from harm, danger, or perceived threats in the environment.
2. The client has joined a gang in order to feel safer from perceived threats in the environment.
3. The client has experienced increased harm, danger, and threats in the environment due to his/her affiliation with a negative peer group or gang.
4. The client has been assisted in decreasing the harm, danger, or perceived threats in the environment and no longer needs to affiliate with negative peer groups or gangs.
5. The client reports a discontinuation of the affiliation with negative peer groups or gangs.
Low Self-Esteem/Insecurity (7)
1. The client's parents described him/her as gravitating toward negative peer groups because of underlying feelings of low self-esteem and insecurity.
2. The client displayed behaviors indicative of low self-esteem within the session (e.g., self-disparaging remarks, difficulty accepting compliments, insecurity, anxiousness, avoidance).
3. The client acknowledged his/her tendency to gravitate toward negative peer groups because of underlying feelings of low self-esteem and insecurity.
4. The client has dropped his/her pattern of affiliating with negative peer groups to increase his/her self-esteem and security feelings and has begun to work on accepting himself/herself.
Ostracism/Teasing by Peers (8)
1. The client identified being ostracized, teased, or mocked by peers at school or in the community.
2. The client's parents reported that he/she often comes home upset about being ostracized, teased, or mocked by peers.
3. As the client has gained social skills, his/her pattern of being ostracized, teased, or mocked by peers has decreased.
Rejection Experiences (9)
1. The client has experienced a history of rejection experiences.
2. The client identified having been rejected by his/her peer group.
3. The client identified feeling rejected by his/her family members.
4. Rejections from others have contributed to the client's desire to seek out negative peer groups for a sense of belonging.
5. As the client has processed his/her rejection experiences, he/she feels less driven to seek out negative peer groups for belonging.
6. The client has established himself/herself with a more positive peer group and developed healthy experiences of acceptance.
Immaturity/Social Skills Deficits (10)
1. The client presented in a socially immature manner.
2. The client has pronounced deficits in his/her social skills.
3. The client has gained an appropriate level of social maturity and social skills proficiency.
4. As the client has matured and gained social skills, he/she has become less susceptible to negative peer influences.
Substance Abuse (11)
1. The client has participated in substance abuse in order to gain group acceptance.
2. The client has displayed acting out behaviors in order to gain group acceptance.
3. As the client has affiliated with a more positive peer group, his/her pattern of substance abuse and other acting out behaviors has diminished.

INTERVENTIONS IMPLEMENTED

Explore Perceptions, Thoughts, and Feelings (1)²
1. The client's perceptions of how he/she relates to peers were explored.
2. The client was urged to elaborate on his/her areas of conflict within peer relationships.
3. Warm acceptance and active-listening techniques were used to help support the client as he/she expressed thoughts and feelings about peer relationships.
4. The client was reinforced for expressing his/her perceptions, thoughts, and feelings about peer relationships.
5. The client's degree of denial regarding peer relationship conflict was found to be high and he/she was reluctant to express thoughts and feelings in this area.
Gather Psychosocial History (2)
1. A detailed psychosocial history was gathered, including information regarding the client's development, family environment, and interpersonal relationships.
2. Insights were drawn and reflected back to the client regarding factors contributing to his/her desire to affiliate with negative peer groups.
3. Upon review of the client's detailed psychosocial history, many factors were identified that may contribute to his/her affiliation with negative peer groups.
4. Despite a detailed psychosocial history of the client's development, family environment, and interpersonal relationships, no specific factors were identified that may contribute to his/her affiliation with negative peer groups.
Refer/Conduct SubstanceAbuse Evaluation (3)
1. The client was referred for a substance abuse evaluation to assess the extent of his/her drug/alcohol usage and determine the need for treatment.
2. The findings from the substance abuse evaluation revealed the presence of a substance abuse problem and the need for treatment.
3. The findings from the substance abuse evaluation revealed the presence of a substance abuse problem that appears to be contributing to the client's behavior control problems.
4. The evaluation findings did not reveal the presence of a substance-abuse problem or the need for treatment in this area.
Assess Level of Insight (4)
1. The client's level of insight toward the presenting problems was assessed.
2. The client was assessed in regard to the syntonic versus dystonic nature of his/her insight about the presenting problems.
3. The client was noted to demonstrate good insight into the problematic nature of the behavior and symptoms.
4. The client was noted to be in agreement with others' concerns and is motivated to work on change.
5. The client was noted to be ambivalent regarding the problems described and is reluctant to address the issues as a concern.
6. The client was noted to be resistant regarding acknowledgment of the problem areas, is not concerned about them, and has no motivation to make changes.
Assess for Correlated Disorders (5)
1. The client was assessed for evidence of research-based correlated disorders.
2. The client was assessed in regard to his/her level of vulnerability to suicide.
3. The client was identified as having a comorbid disorder, and treatment was adjusted to account for these concerns.
4. The client has been assessed for any correlated disorders, but none were found.
Assess for Culturally Based Confounding Issues (6)
1. The client was assessed for age-related issues that could help to better understand his/her clinical presentation.
2. The client was assessed for gender-related issues that could help to better understand his/her clinical presentation.
3. The client was assessed for cultural syndromes, cultural idioms of distress, or culturally based perceived causes that could help to better understand his/her clinical presentation.
4. Alternative factors have been identified as contributing to the client's currently defined “problem behavior,” and these were taken into account in regard to his/her treatment.
5. Culturally based factors that could help to account for the client's currently defined “problem behavior” were investigated, but no significant factors were identified.
Assess Severity of Impairment (7)
1. The severity of the client's impairment was assessed to determine the appropriate level of care.
2. The client was assessed in regard to his/her impairment in social, relational, vocational, and occupational endeavors.
3. It was reflected to the client that his/her impairment appears to create mild to moderate effects on the client's functioning.
4. It was reflected to the client that his/her impairment appears to create severe to very severe effects on the client's functioning.
5. The client was continuously assessed for the severity of impairment, as well as the efficacy and appropriateness of treatment.
Assess for Pathogenic Care (8)
1. The home, school, and community of the client were assessed for pathogenic care and concerns.
2. The client's various environments were assessed for the persistent disregard of the child's needs, repeated changes in caregivers, limited opportunities for stable attachment, harsh discipline, or other grossly inept care.
3. Pathogenic care was identified and the treatment plan included strategies for managing or correcting these concerns and protecting the child.
4. No pathogenic care was identified and this was reflected to the client and caregivers.
Assign Journaling (9)
1. The client was instructed to keep a journal in which he/she records both positive and negative peer experiences that have evoked strong emotions.
2. As the client shared entries from his/her peer association journal, these were processed to uncover factors that contribute to his/her desire to affiliate with negative peer groups.
3. The peer association journal has been helpful in identifying strengths that can allow the client to build positive peer relationships.
4. The client has failed to keep a peer association journal; he/she was redirected to do this journaling.
Identify Social-Emotional Needs (10)
1. The client was taught about how social-emotional needs may be met through his/her involvement with negative peer groups.
2. The client was assigned the exercise “Reasons for Negative Peer Group Involvement” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
3. The client was supported as he/she identified his/her social-emotional needs the negative peer group meets (e.g., achieving a sense of belonging and acceptance, elevated status, obtaining material goods, seeking protection).
4. The client failed to identify the social-emotional needs he/she attempts to meet with his/her involvement with negative peer groups and was provided with tentative examples in this area.
Establish Parental Rules and Boundaries (11)
1. The parents were assisted in establishing clearly defined rules and boundaries as well as providing greater structure in an effort to deter the client from being highly susceptible to negative peer group influences.
2. A family therapy session was focused on helping establish clearly defined rules and appropriate parent-child boundaries.
3. The parents were directed to read portions of How to Keep Your Teenager Out of Trouble and What to Do If You Can't (Bernstein).
4. The parents identified the rules and expectations that the client is expected to follow at home and positive feedback was provided to them for these clear expectations.
5. The parents have had difficulty establishing clearly defined rules and identifying appropriate consequences for the client's misbehavior and were provided with remedial assistance in this area.
Promote Communication between Home and School (12)
1. The parents and teachers were encouraged to maintain regular communication with each other via phone calls or written notes regarding the client's relationship with peers.
2. The client's teachers were asked to send home daily or weekly progress notes informing the parents about the client's academic progress.
3. The client was informed of his/her responsibility to bring home daily or weekly progress notes from school, allowing for regular communication between parents and teachers.
4. The parents and teachers were encouraged to follow through with firm, consistent limits if the client engages in acting out, disruptive, or aggressive behavior at school.
5. The increased communication between teachers and parents via phone calls or regular progress notes has been identified as being a significant contributing factor to the client's improved peer relationships.
Establish Contingency Contract (13)
1. A contingency contract was designed specifying the consequences for the client if he/she engages in disruptive, acting out, or antisocial behavior with peers.
2. The client was assigned the exercise “Clear Rules, Positive Reinforcement, Appropriate Consequences” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
3. The client and parents signed a contingency contract specifying the consequences of the client acting out with peers.
4. The client was asked to repeat the terms of the contract to demonstrate his/her understanding.
Design Reward System (14)
1. The client and parents were assisted in identifying a list of rewards to reinforce the client for engaging in specific positive social behaviors.
2. A reward system was designed to reinforce the client's positive social behaviors and deter the need to affiliate with negative peer groups.
3. Specific behaviors were included in the reward system (e.g., introducing self to others in a positive peer group, displaying kindness, helping another peer with academic or social problems).
List Negative Consequences (15)
1. The client was directed to list 5 to 10 negative consequences that his/her participation with negative peer groups has had on himself/herself and others.
2. Positive reinforcement was provided to the client for his/her list of consequences from his/her participation with negative peer groups.
3. The client has not listed negative consequences related to his/her negative peer group affiliation and was redirected to do so.
Confront Impact of Negative Peer Group Involvement (16)
1. The client was firmly and consistently confronted with how his/her involvement with negative peer groups impacts himself/herself and others.
2. The client was asked to list the negative consequences of his/her negative peer group interaction for himself/herself and others.
3. Role-reversal techniques were used to help the client realize how his/her negative peer group affiliation has affected others.
4. The client was praised for his/her increased understanding of how his/her negative peer group affiliation has affected himself/herself and others.
5. The client continues to be in denial about the impact of his/her involvement with negative peer groups and the effect on himself/herself and others and was provided with specific, tentative examples of these effects.
Challenge Minimization (17)
1. Statements by the client that minimize the impact of his/her involvement with negative peer groups were identified.
2. The client was confronted and challenged when he/she made statements that minimized the impact that his/her involvement with negative peer groups has on his/her behavior.
3. The client accepted the confrontation regarding minimizing the impact that his/her negative peer group involvement has on his/her behavior and was assisted in replacing these minimizations with statements of responsibility for negative social behavior.
4. The client consistently denied any minimization and was provided with examples of such minimization.
Confront Blaming (18)
1. Today's therapy session explored the underlying factors contributing to the client's pattern of blaming others for his/her acting out, disruptive, or antisocial behaviors.
2. The client was challenged to accept the consequences of his/her acting out, disruptive, or antisocial behaviors.
3. The client was supported as he/she identified how his/her pattern of blaming others is associated with underlying feelings of low self-esteem, inadequacy, and insecurity.
4. The client was assisted in identifying constructive ways to improve his/her self-esteem to help reduce the pattern of blaming others.
5. The client denied any pattern of blaming others and was provided with specific examples in this area.
Challenge Parents to Cease Blaming and Set Limits (19)
1. The client's parents were identified as often blaming the client's misbehavior on his/her peers.
2. The parents were challenged to cease blaming the client's misbehavior on his/her peers.
3. The client's parents were directed to change their focus from blaming the client's peers to setting limits for the client's negative social behaviors that occur while affiliating with peers.
4. Support and encouragement were provided as the parents identified the need to discontinue blaming the client's peers and set firmer limits for him/her.
5. The client's parents have failed to switch from blaming peers to setting limits on the client and were provided with specific examples of how they might make this change.
Teach Mediational and Self-Control Techniques (20)
1. The client was taught mediational and self-control techniques to help him/her successfully resist negative peer influences.
2. The client was taught the “stop, listen, think, and act” technique.
3. The client was taught to count to 10 or walk away in order to successfully resist negative peer influences.
4. The client was assigned the exercise “Action Minus thought Equals Painful Consequences” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
5. As the client has implemented effective coping strategies to resist negative peer influences, his/her involvement in negative peer groups has decreased.
6. The client has not used mediational and self-control techniques to resist negative peer influences and was redirected to do so.
Teach Resistance to Negative Peers and Establishment of Positive Relationships (21)
1. Role-playing, modeling, and behavioral rehearsal techniques were used to teach the client effective ways to resist negative peer influences.
2. Role-playing, modeling, and behavioral rehearsal techniques were used to teach the client more effective ways to meet his/her social needs.
3. The client was assisted in learning techniques to establish lasting, meaningful friendships.
4. The client was assigned the exercise “Becoming Assertive” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, and McInnis.
5. The client was taught specific techniques (e.g., walking away from negative peers, changing the subject to a more positive area, just saying “no,” initiating positive conversations with positive peers, demonstrating empathy) to resist peer influence.
6. Positive feedback was provided to the client for the use of more effective ways to resist negative peer influences and develop lasting, meaningful friendships.
7. The client has not used new techniques to establish lasting, meaningful friendships and was redirected to do so.
Assign Reading on Resisting Negative Peer Influences/Maintaining Friendships (22)
1. The client was provided with reading material about effective ways to resist negative peer influences, yet still maintain friendships.
2. The client was assigned to read How to Say No and Keep Your Friends (Scott) to teach him/her effective ways to resist negative peer influences and maintain friendships.
3. The client was assigned to read The Complete Idiot's Guide to Surviving Peer Pressure for Teens (Cherniss and Sluket) to teach him/her effective ways to resist negative peer influences and maintain friendships.
4. The client has read the assigned material on resisting negative peer influences and it was processed within the session.
5. The client has not read the assigned material on resisting negative peer influences and was redirected to do so.
Identify Successful Negative Peer Resistance (23)
1. The client was asked to explore periods when he/she has demonstrated successful resistance to negative peer influences and did not engage in acting out, disruptive, or antisocial behaviors.
2. The experiences of resisting negative peer influences were processed and reinforced.
3. The client was encouraged to use similar coping mechanisms that he/she has used successfully in the past in order to control negative peer influences and not engage in acting out, disruptive, or antisocial behaviors.
4. The client shared the realization that use of the successful strategies has helped him/her stay out of trouble.
5. The session revealed that the client was better behaved during periods of time when he/she received strong family support and affiliated with positive peer groups.
Teach Assertiveness (24)
1. The client was taught effective communication and assertiveness skills to help him/her successfully resist negative peer pressure.
2. The client was assigned the exercise “Becoming Assertive” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
3. Examples of assertive, effective communication were provided (e.g., “I have to leave now,” “I can't afford to get into any more trouble”).
4. Positive feedback was provided to the client as he/she displayed a clear understanding of how to use effective communication and assertiveness skills.
5. The client was strongly praised as he/she identified situations in which he/she has effectively used assertive communication skills to resist negative peer pressure.
6. The client has not used effective, assertive communication skills to resist negative peer pressure and was assisted in identifying situations in which he/she might have been more effective in using these skills.
Refer for Group Therapy (25)
1. The client was referred to a group therapy program to improve his/her social skills and learn ways to successfully resist negative peer pressure.
2. The client was directed to self-disclose at least two times in each group therapy session about his/her peer relationships.
3. The client has attended the group therapy sessions, and the skills he/she learned there were reviewed and processed.
4. The client has not attended the group therapy sessions and was redirected to do so.
Refer to Behavioral Contracting Group (26)
1. The client was referred to a behavioral contracting group.
2. The client has attended the behavioral contracting group, where he/she and other group members developed contracts to increase the frequency of positive peer interactions.
3. The client's review of progress with his/her behavioral contract was processed.
4. The client was praised for achieving goals regarding peer interactions.
Teach Positive Social Skills (27)
1. The client was taught positive social skills (e.g., introducing self to others, active listening, verbalizing empathy and concern for others, ignoring teasing).
2. Skillstreaming: The Adolescent Kit (McGinnis and Goldstein) was used to help the client learn how to improve peer relationships and increase chances of developing meaningful friendships.
3. The client was positively reinforced for using social skills that will help improve peer relationships and establish friendships.
4. The client has rarely used positive social skills and was provided with remedial assistance in this area.
Assign Social Skills Practice (28)
1. The client was directed to practice newly learned positive social skills at least once each day between therapy sessions.
2. The client was assigned the exercise “Developing Conversational Skills” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
3. The client was assigned the exercise “Greeting Peers” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
4. The client was assigned the exercise “Observing Positive Social Behaviors” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
5. The client's practice of newly learned positive social skills was reviewed.
6. The client was reinforced for his/her successes at implementing newly learned positive social skills.
7. The client was redirected for his/her failures at implementing newly learned positive social skills.
Encourage Positive Peer Group/Community Activities (29)
1. The client was encouraged to become involved in positive peer group or community activities where he/she can gain acceptance and status.
2. The client was assisted in identifying positive peer groups and community activities where he/she can gain acceptance and status (e.g., church or synagogue youth groups, YWCA or YMCA functions, school clubs, boys' or girls' clubs).
3. The client was reinforced for becoming involved in positive peer groups and community activities.
4. The client has not become involved in positive peer group and community activities and was redirected to do so.
Consult about Positive Socialization Groups (30)
1. A consultation was held with school officials about ways to increase the client's socialization with positive peer groups at school.
2. The client was provided with a variety of options of ways to increase socialization with positive peer groups at school (e.g., join school choir or newspaper staff, participate in student government, become involved with school fundraiser).
3. Positive feedback was provided to the client as he/she has become involved with positive peer groups at school.
4. The client has not become involved with positive peer groups at school and was redirected to do so.
Assign Social Contact with Positive Peers (31)
1. The client was assigned a task of initiating one social contact per day with other peers who are identified as being responsible, dependable, friendly, or well liked.
2. The client was assigned the exercise “Choice of Friends Survey” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
3. The client has regularly initiated social contact with other peers who are identified as being positive and was provided with positive feedback about this.
4. The client has not regularly initiated social contact with positive peers and was redirected to do so.
Assign Telephone Contacts (32)
1. The client was assigned to initiate three phone contacts per week to different individuals outside of the identified negative peer group.
2. The client has regularly initiated telephone contact with different individuals outside of the identified negative peer group; his/her experience with these positive interactions was reviewed.
3. The client has not initiated phone contacts outside of the identified negative peer group, and the reasons for his/her failure were reviewed and processed.
Assign Coordination of Overnight Visit (33)
1. The client was directed to invite a peer or friend (outside the negative peer group) for an overnight visit.
2. The client was directed to set up an overnight visit at a peer or friend's home.
3. The client has completed the overnight visit with a positive peer, and his/her experience was processed and reinforced.
4. The client has not coordinated an overnight visit with a friend (outside the negative peer group) and was redirected to do so.
Assign Altruistic Acts (34)
1. The client was given the homework assignment of engaging in three altruistic or benevolent acts with peers before the next therapy session.
2. The client was assigned the exercise “Headed in the Right Direction” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, and McInnis.
3. The client has engaged in altruistic or benevolent acts with peers and was provided with positive feedback.
4. Others' responses to the client's altruistic or benevolent acts were identified and processed.
5. The client has not completed the altruistic or benevolent acts and was redirected to do so.
Brainstorm Ways to Meet Needs (35)
1. The client was assisted in brainstorming more adaptive ways for him/her to meet needs for recognition, status, acceptance, material goods, and excitement (other than through his/her involvement with negative peer groups).
2. The client was praised for his/her use of creativity and willingness to identify ways to meet his/her needs other than through negative peer group activities or gang involvement.
3. The client did not identify ways to meet his/her needs outside of the negative peer group and was provided with tentative examples in this area (e.g., attend or participate in sporting events, secure employment, visit amusement park with youth group).
Assign Handling Peer Pressure and Gangs (36)
1. The client was assigned to view the video Handling Peer Pressure and Gangs (Wellness Reproductions and Publishing) to help him/her resist negative peer influences or pressure to join a gang.
2. The client has viewed the video on peer pressure and gangs, and the key ideas were processed.
3. The client has not viewed the video on peer pressure and gangs and was redirected to do so.
Identify Resource People (37)
1. The client was assisted in identifying a list of resource people to whom he/she can turn for comfort, support, and guidance when he/she experiences negative peer pressure and/or feels rejected by peers.
2. The client was reinforced for committing to contact a list of resource people, including both peers and adults, available both at school and in the community.
3. The client was given support for his/her use of resource people when he/she experienced negative peer pressure and/or feelings of rejection by peers.
4. The client has not developed a list of resource people to whom he/she can turn for comfort, support, or guidance, and was redirected to do so.
Explore Peer Relationship History (38)
1. The client's background of peer relationships was explored in order to assess whether he/she feels rejected, ostracized, or unaccepted by many peers.
2. Active-listening skills were used as the client expressed his/her feelings regarding his/her history of peer relationships.
3. The client was assisted in identifying possible causes of rejection or alienation (e.g., hypersensitivity to teasing, target of scapegoating, poor social skills).
4. The client tended to deny any history of rejection or alienation and was urged to be more open about his/her past experiences.
Use Empty-Chair Technique (39)
1. The empty-chair technique was used to help the client express his/her feelings of anger, hurt, and sadness toward individuals who have rejected him/her.
2. The client was supported as he/she used the empty-chair technique to express his/her feelings toward individuals who have rejected him/her.
3. The client was supported as he/she expressed feelings of hurt, anger, and sadness.
4. The client tended to block his/her emotions as he/she used the empty-chair technique and was encouraged to be more open about his/her feelings.
Connect Low Self-Esteem and Negative Peer Groups (40)
1. The client was assisted in making a connection between underlying feelings of low self-esteem and insecurity, and his/her gravitation toward negative peer groups to achieve a sense of belonging and acceptance.
2. Active-listening skills were used as the client identified his/her own experience of using negative peer groups to cover up feelings of low self-esteem and insecurity.
3. The client denied any connection between underlying feelings of low self-esteem and gravitation toward negative peer groups and was provided with tentative examples regarding how this may have occurred.
Identify Alternative Means to Building Self-Esteem (41)
1. The client was assisted in identifying more constructive ways to build self-esteem and gain approval, other than affiliating with negative peer groups.
2. The client was supported as he/she identified more constructive ways to build self-esteem and win approval and was also encouraged to attempt these techniques.
3. The client did not identify constructive ways to build self-esteem and was provided with tentative examples (e.g., try out for school play, attend a school dance, participate in sporting or recreational activities).
List Strengths/Interests (42)
1. The client was directed to identify 5 to 10 strengths or interests.
2. The client was assigned the “Show Your Strengths” exercise from the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, and McInnis).
3. The client's list of strengths and interests was reviewed, and he/she was encouraged to utilize his/her strengths to build self-esteem and increase positive peer interactions.
4. The client did not complete the “Show Your Strengths” exercise and was redirected to do so.
Identify Healthy Risks (43)
1. The client was asked to identify healthy risks that he/she can take in the near future to improve his/her self-esteem.
2. The client identified several healthy risks that he/she can take in the near future to improve his/her self-esteem and was challenged to take three healthy risks before the next therapy session.
3. The client was provided with tentative examples of healthy risks that he/she can take to improve his/her self-esteem (e.g., try out for sports team, attend new social functions or gatherings, initiate conversations with unfamiliar people outside of the negative peer group); he/she was challenged to attempt three healthy risks before the next therapy session.
4. The client has not engaged in healthy social risks to increase self-esteem and this resistance was processed.
Explore Parental Strictness (44)
1. The parents' establishment of rules and boundaries was explored.
2. The parents were provided with feedback about how their rules and boundaries may be so rigid and strict as to constrict the client's opportunity to socialize with peers.
3. It was interpreted that the client rebels from overly rigid or strict rules and boundaries by engaging in acting out behaviors with negative peer groups.
4. Positive feedback was provided as the parents identified their rules and boundaries as overly strict and they were encouraged to loosen these rules and boundaries.
5. The parents rejected the notion that their rules and boundaries are overly strict or rigid and were encouraged to monitor this dynamic.
Encourage Loosening of Boundaries (45)
1. The overly rigid parents were challenged to loosen rules and boundaries to allow the client increased opportunities to engage in socially appropriate and positive peer group activities.
2. The parents were encouraged for appropriately loosening rules and boundaries.
3. The parents have not reasonably loosened the rules and boundaries and were redirected to do so.
Explore Lack of Supervision (46)
1. A family therapy session was used to explore whether the lack of supervision of the client by the parents and their inability to establish appropriate parent-child boundaries has contributed to the client's gravitation to a negative peer group.
2. It was acknowledged that the lack of supervision of the client has enabled him/her to gravitate toward negative peer group influences.
3. The parents were urged to provide better supervision of the client in order to eliminate gravitation toward negative peer group influences.
Identify Role Model Traits (47)
1. The client was asked to identify the traits that he/she would like to have in a role model.
2. The client was assigned the exercise “I Want to Be Like . . .” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, and McInnis.
3. The client was assisted in identifying the positive characteristics of various people, including those whom he knows and characters from books, movies, or television.
4. The client was supported as he/she identified the reasons why he/she likes particular role models.