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CHAPTER 6

COUNSELING SKILLS FOR TEACHERS

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BULLYING

What is Bullying?

According to Republic Act (RA) 10627, otherwise known as the Anti-Bullying

Act of 2013, “Bullying” refers to any severe or repeated use by one or more
students of a written, verbal or electronic expression, or a physical act or gesture,
or any combination thereof, directed at another student that has the effect of
actually causing or placing the latter in reasonable fear of physical or emotional
harm or damage to his property; creating a hostile environment at school for the
other student; infringing on the rights of another student at school; or
materially or substantially disrupting the education process or the orderly
operation of a school.

PHYSICAL VERBAL

RELATIONAL/SOCIAL CYBER

What are the types of Bullying?

According to Berger (2014), there are four types of bullying:

1. Physical (hitting, punching, or kicking)

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2. Verbal (name-calling or taunting)

3. Relational (destroying peer acceptance and friendships)

4. Cyber-bullying (using electronic means to harm others)

What are the personality traits and behavior of frequently bullied students?

According to Cook (2010) a typical victim is likely to be aggressive, lack social

skills, think negative thoughts, experience difficulties in solving social problems,
come from a negative family, school and community environments and be
noticeably rejected and isolated by peers. Victims often have characteristics such
as being physically weak as well as being easily distraught emotionally. They
may also have physical characteristics that make them easier targets of bullies,
such as being overweight or having some type of physical deformity. Boys are
more likely to be victims of physical bullying while girls are more likely to be
bullied indirectly.

What are the warning signs that a child is being bullied?

Bullied children usually exhibit this behavior (Penetrante, 2009):

1. They are extensively cautious, sensitive, quiet, withdrawn and shy; would cry
easily and appear fearful; classified as having emotional and behavioral
maladjustment or disorders.

2. They are also anxious, insecure and unhappy; they have very low self-esteem.

3. Victims of bullying often lack interpersonal skills needed to develop

friendships with peers. They often do not have a single good friend, or may have
a few friends. They tend to relate better to adults than to peers.

4. They may not fit the “macho” social image since they perceive themselves to
be physically weaker than their male peers.

5. If they are girls, they tend to be less physically attractive than female peers.
Girls who develop early and who are seen as attractive are more likely to be
sexually harassed by boys.

How can you tell if a child is a bully?

It is common to view the perpetuators as unusually aggressive and antisocial

children and indeed, some are arrogant and narcissistic, according to Field
(2013). Bullies can also use bullying as a tool to conceal shame or anxiety or to
boost self-esteem by demeaning others, the abuser feels empowered (Syiasha,
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2013). Bullies may bully out of jealousy and personality bevause they themselves
are bullied (Levinson, 2004).

What are the effects of bullying?

Children who are victims of bullying by their peers are at greater risk for
psychological maladjustment, physical manifestations of stress, sleep disturbance
and poor school performance compared to other students who are not
victimized. They often respond to bullying by escaping or engaging in avoidant
behavior (not going to school, refuse to attend certain events, running away).
Victims of bullying have greater difficulty making friends and are withdrawn.

Long term consequences of repeated victimization may result to low self-

esteem, increased anxiety, depression, and even suicidal behavior. In order to
retaliate, some victims may become bullies in the end, and continuing the cycle
of violence. For the bystanders or students who witness bullying, they may
suffer behavioral consequences including feelings of anger and helplessness for
not knowing what to do during bullying incidences, nightmares or paranoia
about being the next target, guilt for not taking action and fear of certain areas in
school (Penetrante, 2009).

What is cyberbullying?

Berger (2014), stated that cyberbullying is arguably the most destructive and
common form of bullying today. Cyberbullying have been defined as a form of
bullying that takes place in the use of text messaging, websites, emails, instant
messaging and social networking sites to threaten, harass, hurt, abuse, embarrass
and degrade a person who is helpless, isolated and socially withdrawn.

What is the role of schools and other stakeholders in preventing or reducing

incidences of bullying?

Incidents of bullying happen in school and often spills over into the community.
That’s why effective interventions need active collaboration and coordination
among different stakeholders, rather than focus on the perpetrators and the
victims alone (Penetrante, 2009). Some strategies are: have school-wide bullying
policies: implement curricular measures; create effective classroom
management strategies; improve the safety and security measures of the entire
school; form a crisis management team specifically for bullying cases; set in
place preventive guidance programs, peer counseling, assertiveness training;
initiate active school-wide campaign for anti-bullying; and empower students
through conflict resolution and non-adversarial communication skills.
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Children can learn that by taking care of each other, speaking out against
bullies, and working together, they could tremendous power.

Teachers can model desired attitude and behaviors, apply classroom rules
fairly, and give proper praise and reward systems. They can teach students how
to ask for help and report cruelty. They can align instructional topics of courage,
reasoning, justice and responsibility with appropriate academic, elective or
extracurricular activities.

The School Head, in partnership with other school personnel and parents,
must execute a dynamic program that collaboratively creates a bully-free
campus. This should include:

● An information and awareness campaign on bullying policies and

complimenting school-wide activities.

● An early identification program on various symptoms and effects of

bullying, with accompanying intervention programs to address it.

● Dynamic training for professional staff and parents regarding bullying.

● Active parent involvement in the establishment of procedures on how to

combat bullying incidents.

Conduct Disorder

Conduct disorder is a repetitive and persistent pattern of behavior in children

and adolescents in which the rights of others or basic social rules are violated.
The child or adolescent usually exhibits these behavior patterns in a variety of
settings—at home, at school, and in social situations—and they cause significant
impairment in his or her social, academic, and family functioning.

Children or adolescents with conduct disorder may exhibit some of the following
behaviors:

● Aggression to people and animals

● Destruction of property
● Deceitfulness, lying, or stealing
● Serious violations of rules

Oppositional Defiant Disorder

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Oppositional Defiant Disorder is a pattern of disobedient, hostile, and defiant

behavior towards authority figures. Oppositional behavior is often a normal part
of development for two or three years old and early adolescents. In children
with ODD, there is an ongoing pattern that seriously interferes with the
youngster’s day to day functioning. Symptoms may include:

● frequent temper tantrums

● excessive arguing with adults
● active defiance and refusal to comply with adult requests and rules
● deliberate attempts to annoy or upset people
● blaming others for his or her mistakes or misbehavior
● often being touchy or easily annoyed by others
● frequent anger resentment
● mean and hateful talking when upset
● seeking revenge

Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder is a condition in which a person’s

inability to focus and concentrate on a task or purpose interferes with his or her
ability to be productive. Some children have more trouble paying attention in
class and completing academic assignments than others. The disorder is said to
be found present more often in boys than girls.

Actually, normal attention span seems to develop in three stages:

1. the child’s attention is said to be overly exclusive

2. a child’s attention develops to where it is overly inclusive
3. the child develops selective attention

Characteristics of children with ADHD

1. Inattention – children who are inattentive have a hard time keeping their
minds on any one thing and may get bored with a task after only a few
minutes.
2. Hyperactive - children always seem to be “on the go” or constantly in
motion.
3. Impulsive - children seem unable to curb their immediate reactions or
think before they act.
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What Causes ADHD?

● Environmental agents
● Neurological dysfunctions in the brain
● Genetics
● Brain injury
Tips for the Teacher

1. Consistency is the key to helping ADHD children. They are really poor at
dealing with change, even if it is positive change. They need to have a
sense of external structure, as they tend to lack a sense of internal
structure.
2. ADHD kids have two kinds of time…plenty and none. They are usually
poor at organizing their time and need you to help them break tasks down
into small components.
3. Placing ADHD kids at the front of the room.
4. Try to avoid placing them in loft classrooms or in situations with multiple
children at a single desk. This maximizes their distractibility.
5. Use colors and shapes to help them organize.
6. Try to provide a quiet study area, free from distraction.
7. Try to work within the child’s attention span, keep changing the type of
work frequently and the child can continue to work productively.

ABUSE

What is physical abuse?

Physical abuse, which is 19% of all substantiated cases of child abuse, is the most
visible form of abuse and may be defined as any act which results in a non-
accidental trauma or physical injury. Inflicted physical injury most often
represents unreasonable, severe corporal punishment or unjustifiable
punishment. This usually happens when a frustrated or angry parent strikes,
shakes or throws a child. Physical abuse injuries result from punching, beating,
kicking, biting, burning or otherwise harming a child. While any of these injuries
can occur accidentally when a child is at play, physical abuse should be
suspected if the explanations do not fit the injury or if a pattern of frequency is
apparent. The longer the abuse continues, the more serious the injuries to the
child and the more difficult it is to eliminate the abusive behavior.
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Emotional Abuse

Emotional abuse can be defined as any behavior that affects the psychology of an
individual by overpowering him/her. It involves verbal, as well as non-verbal
abuse that eventually undermines the self-respect of the sufferer. Though
emotional abuse can occur to anybody, it is more common among those with
least power in the society, for example, children and women. An individual
under prolonged emotional abuse loses his/her self confidence, self-concept, self-
motivation and self-worth.
Emotional abuse is most commonly associated with an abusive
relationship and child abuse. It always precedes or accompanies a physical abuse
in domestic violence. It is often observed that a person who is abused in a
relationship can be an abuser to another person. This way, the person blames his
feelings and/or problems on others. Emotional abuse or maltreatment in children
can affect their development in terms of cognitive, social and psychological
behavior. The effects of child abuse are detrimental and long-lasting.

Emotional Abuse: Signs and Symptoms

Some common types of emotional abuse are neglecting/rejecting, isolating,

abusive expectations (demands, criticism), ignoring, denying (refuse to listen or
understand the feelings), constant chaos, exploiting, aggression (blaming,
commanding, threatening), emotional blackmail (threatening), dominating,
verbal assaults (sarcasm, berating), invalidation and unpredictable behavior
(mood changes, emotional outbursts).

It is common that the abuser displays his/her abusive characters in order

to humiliate the sufferer, when they are in the company of others. It is very
difficult to identify and assess the sufferers of emotional abuse. Thus, it goes
unreported or unrecognized in most of the instances.

If the emotional abuse remains unchecked, it can worsen the symptoms

and may lead to serious emotional and psychological disorders. The best way to
prevent emotional abuse is personal awareness and understanding the rights and
duties.
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Sexual Abuse

Child sexual abuse - contact or

interaction between a child and an
adult when the child is being used
for sexual stimulation of the
perpetrator. It occurs, when sexual
activity such as exposure of the
genitalia, fondling, intercourse, oral
sex, or pornography (exposure to or
involvement in) is enacted with a
minor.

The child of five or older who knows and cares for the abuser becomes
trapped between affection or loyalty for the person, and the sense that the sexual
activities are terribly wrong. If the child tries to break away from the sexual
relationship, the abuser may threaten the child with violence or loss of love.

A child who is the victim of prolonged sexual abuse usually develops low
self-esteem, a feeling of worthlessness and an abnormal or distorted view of sex.
The child may become withdrawn and mistrustful of adults, and can become
suicidal.

Some children who have been sexually abused have difficulty relating to
others except on sexual terms. Some sexually abused children become child
abusers or prostitutes, or have other serious problems when they reached
adulthood.

What are the three forms of child sexual abuse?

1. Non-physical such as when the perpetrator exhibits his private parts to

the child, obscene telephone call, or voyeurism.
2. Physical like fondling the private parts of the victim or actual sexual
intercourse.
3. Violent like rape and body harm that can result in death.

TIPS FOR PARENTS

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For parents, there is no way that they can completely protect their children from
sexual abuse but there are some ways where they can lessen the chance that it
could occur. Unfortunately, just teaching the children not to talk to strangers or
unusual people is not a deterrent to protect the child. In fact approximately 85%
of sexual offenders are known to the child and 50% are parent figures. ( Facts
About Child Sexual Abuse ) Here are some tips from various sources on how to
prevent child sexual abuse:

● Tell children that if someone tries to touch their bodies in a way that
makes them feel "funny" or "bad" to say no then go tell an adult they trust.

● Talk to children every day about their contacts with other people. Ask
them about their feelings. This helps to encourage your children to feel
comfortable talking to you about anything.

● Do not teach your children blind obedience to adults. Don't teach children
to do everything a baby-sitter or teacher tells them. Instead teach them
that most adults are good people to be respected but that they should
listen to their own hearts; tell them that it's OK to say no to an adult if they
want the child to do something, they know is wrong.

● Teach your children the correct names for their body parts, as well as any
nicknames you might use. Take away the embarrassment children have
about talking about "private parts".

● Teach children the difference between good touches and bad touches.
Explain to them that while it is OK for a doctor to touch their stomach to
see what's wrong, it is not OK for Mr. Jones to touch them in their pants.

● Teach your children not to keep secrets from you and don't encourage
secret keeping in your family. Tell your children that they can always tell
you anything no matter what anyone tells them.

● Play "what if " games with your children. Create frightening and
confusing situations and ask children what they would do in these
situations, for example ask, "What would you do if someone wanted you
to play undressing games?" Make sure you balance these games with
questions about good touches.

How to Tell If Your Child May have been Molested

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In most cases there are no blatant signs that a child has been molested, however
as a parent it is important to trust your instincts. If you think something is wrong
it probably is, and it is important to get children to talk to you about whatever
problems they have. The following are some indicators that something may have
happened:

Behavioral Indicators

● Unusual interest in and/or knowledge of sexual activity, inappropriate to

the child's age
● Promiscuity, seductive behavior
● Change in personal hygiene habits, excessive cleanliness or lack of
cleanliness.
● Weight gain or loss, change in appetite
● Sleep disturbances: bedwetting, nightmares
● Depression, anger, irritability
● Reluctance to go home or other places
● Avoidance of certain people and places
● Inappropriate dress, such as tight or revealing clothing or overdressing,
wearing many layers of clothing regardless of weather
● Sexual drawings or stories

Physical Indicators

● Pregnancy
● Venereal disease
● Trauma to the mouth or genitals
● Excessive masturbatory behavior
● Rectal bleeding
● Torn or blood-stained clothing
● Attempts to touch adult's, children's or animal's genitals
● Pain or discomfort in the genital area

Substance Abuse

People abuse substances such as drugs, alcohol, and tobacco for varied and
complicated reasons, but it is clear that our society pays a significant cost.
Abused substances produce some form of intoxication that alters judgment,
perception, attention, or physical control.
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People experiment with drugs for many different reasons. Many first try
drugs out of curiosity, to have a good time, because friends are doing it, or in an
effort to improve athletic performance or ease another problem, such as stress,
anxiety, or depression. Use does not automatically lead to abuse, and there is no
specific level at which drug use moves from casual to problematic. It varies by
individual. Drug abuse and addiction is less about the amount of substance
consumed or the frequency, and more to do with the consequences of drug use.
No matter how often or how little you are consuming, if your drug use is causing
problems in your life—at work, school, home, or in your relationships—you
likely have a drug abuse or addiction problem.

Drugs that Influence Consciousness

DEPRESSANT STIMULANT HALLUCINOGENS

Depressants are drugs Stimulants are a class of Psychedelic drugs, or

that inhibit the function psychoactive drug that hallucinogens, are
of the central nervous tend to increase activity psychoactive drugs that
system and are among in the brain. These affect thinking, alter
the most widely used drugs can temporarily moods and distort
drugs in the world. elevate alertness, mood perceptions. Drugs that
Drugs that are classified and awareness. While are classed as
as depressants include some stimulant drugs psychedelics include
alcohol, barbiturates, are legal and widely marijuana, LSD,
and benzodiazepines. used, all can be psilocybin (derived from
addicting. Drugs that a type of mushroom)
are classified as and mescaline (found in
stimulants include the peyote cactus).
caffeine, nicotine,
cocaine, amphetamines
and some prescription
drugs.

Stage One: Experimentation

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The first stage, experimentation, is the voluntary use of alcohol or other drugs.
Quite frequently, the person experimenting is trying to erase another problem.
The substance seems to solve the problem. So the person takes more, and moves
from experimentation to regular use, the next stage.

Stage Two: Regular Use

Some people stay in the regular use stage indefinitely. They will not develop a
problem, and stop by themselves. Others start using substances in a manner that
is risky or hazardous to themselves or to others. Risky behaviors include:
smoking marijuana and driving; binge drinking (consuming more than the
recommended amount of alcohol at one occasion); and unexplained violence, to
one’s self or another.

Stage Three: Risky Use

When and how the transition from regular to risky use happens differs for every
individual. So, what constitutes “risky behavior” by another person can be
difficult to gauge. Just the same, if someone’s behavior concerns you, say so.
People can pass quickly from risky use to dependence.

Stage Four: Dependence

Characteristics of dependence include: Repeated use of alcohol or other drugs

that leads to failure to fulfill major responsibilities related to work, family, school
or other roles. Or, repeatedly drinking or using drugs in situations that are
physically hazardous, such as driving while intoxicated or using heavy
machinery when intoxicated. Or repeated legal problems. Or any combination of
these.

Many dependent people are able to work, maintain family relationships and
friendships, and limit their use of alcohol or other drugs to certain time periods,
such as evenings or weekends.

Stage Five: Addiction

The last phase of the spectrum of substance use problems is addiction. Addiction
is a medical condition involving serious psychological and physical changes
from repeated heavy use of alcohol, other drugs, or both.
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● Symptoms include uncontrollable alcohol or other drug craving, seeking,

and use, that persists even in the face of negative consequences.
● Addiction is a progressive illness. If left untreated, it gets worse. It is also
chronic, or long-standing (versus acute, or short-term).
● Addiction is a treatable illness. Recovery rates for people who go through
treatment are very similar to those who get treatment for other chronic
diseases such as diabetes and asthma. These approaches can be
customized to fit the needs of the individual and family.

Nicotine Abuse

Nicotine dependence ― also called tobacco dependence ― is an addiction to

tobacco products caused by the drug nicotine. Nicotine dependence means you
can't stop using the substance, even though it's causing you harm.

Nicotine produces physical and mood-altering effects in your brain that

are temporarily pleasing. These effects make you want to use tobacco and lead to
dependence. At the same time, stopping tobacco use causes withdrawal
symptoms, including irritability and anxiety.

Nicotine withdrawal is short-lived and symptoms pass in time, usually

less than a week. Withdrawal is the most uncomfortable part of quitting, but the
real challenge is beating long-term cravings and staying away from tobacco.

Counseling Substance Abusers

● Modeling of parents also seem to play a major role in the development of

addictions.
● If the home environment is unstable, the risk of developing some type of
addiction is enhanced.
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Eating Disorders

Anorexia Nervosa

Anorexia nervosa is an eating disorder where people starve themselves.

Anorexia usually begins in young people around the onset of puberty.
Individuals suffering from anorexia have extreme weight loss. Weight loss is
usually 15% below the person's normal body weight. People suffering from
anorexia are very skinny but are convinced that they are overweight. Weight loss
is obtained by many ways. Some of the common techniques used are excessive
exercise, intake of laxatives and not eating.

Anorexics have an intense fear of becoming

fat. Their dieting habits develop from this fear.
Anorexia mainly affects adolescent girls.
People with anorexia continue to think they
are overweight even after they become extremely
thin, are very ill or near death. Often they will
develop strange eating habits such as refusing to eat
in front of other people. Sometimes the individuals
will prepare big meals for others while refusing to
eat any of it.

The disorder is thought to be most common among people of higher

socioeconomic classes and people involved in activities where thinness is
especially looked upon, such as dancing, theater, and distance running.

Bulimia Nervosa

Bulimia, also called bulimia

nervosa, is a psychological eating
disorder. Bulimia is characterized
by episodes of binge-eating
followed by inappropriate
methods of weight control
(purging).
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Inappropriate methods of weight control include vomiting, fasting, enemas,

excessive use of laxatives and diuretics, or compulsive exercising. Excessive
shape and weight concerns are also characteristics of bulimia. A binge is an
episode where an individual eats a much larger amount of food than most
people would in a similar situation. Binge eating is not a response to intense
hunger. It is usually a response to depression, stress, or self esteem issues.
During the binge episode, the individual experiences a loss of control. However,
the sense of a loss of control is also followed by a short-lived calmness. The
calmness is often followed by self-loathing. The cycle of overeating and purging
usually becomes an obsession and is repeated often.

People with bulimia can look perfectly normal. Most of them are of
normal weight, and some may be overweight. Women with bulimia tend to be
high achievers.

It is often difficult to determine whether a person is suffering from

Bulimia. This occurs because binging and purging is often done in secret. Also,
individuals suffering from Bulimia often deny their condition. Sufferers consume
huge quantities of food. Sometimes up to 20,000 calories at a time. The foods on
which they binge tend to be foods labeled as "comfort foods" -- sweet foods, high
in calories, or smooth, soft foods like ice cream, cake, and pastry. An individual
may binge anywhere from twice a day to several times daily.

Personalities

Most people with eating disorders share certain personality traits: low self-
esteem, feelings of helplessness, and a fear of becoming fat. In anorexia, bulimia,
and binge eating disorder, eating behaviors seem to develop as a way of
handling stress and anxieties.

People with anorexia tend to be "too good to be true." They rarely disobey,
keep their feelings to themselves, and tend to be perfectionists, good students,
and excellent athletes.

Some researchers believe that people with anorexia restrict food --

particularly carbohydrates -- to gain a sense of control in some area of their lives.
Having followed the wishes of others for the most part, they have not learned
how to cope with the problems typical of adolescence, growing up, and
becoming independent.
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Controlling their weight appears to offer two advantages, at least initially:

they can take control of their bodies and gain approval from others. However, it
eventually becomes clear to other that they are out-of-control and dangerously
thin.

People who develop bulimia and binge eating disorder typically consume
huge amounts of food -- often junk food -- to reduce stress and relieve anxiety.
With binge eating, however, comes guilt and depression. Purging can bring
relief, but it is only temporary. Individuals with bulimia are also impulsive and
more likely to engage in risky behavior such as abuse of alcohol and drugs.

Genetic and environmental factors

Eating disorders appear to run in families -- with female relatives most often
affected. This finding suggests that genetic factors may predispose some people
to eating disorders; however, other influences -- both behavioral and
environmental -- may also play a role. One recent study found that mothers who
are overly concerned about their daughters' weight and physical attractiveness
may put the girls at increased risk of developing an eating disorder. In addition,
girls with eating disorders often have father and brothers who are overly critical
of their weight. Although most victims of anorexia and bulimia are adolescent
and young adult women, these illnesses can also strike men and older women.

While eating disorders may begin with preoccupations with food and
weight, they are most often about much more than food.

Eating disorders are complex conditions that arise from a combination of

long-standing behavioral, emotional, psychological, interpersonal, and social
factors. Scientists and researchers are still learning about the underlying causes
of these emotionally and physically damaging conditions. We do know,
however, about some of the general issues that can contribute to the
development of eating disorders.

People with eating disorders often use food and the control of food in an
attempt to compensate for feelings and emotions that may otherwise seem over-
whelming. For some, dieting, bingeing, and purging may begin as a way to cope
with painful emotions and to feel in control of one’s life, but ultimately, these
behaviors will damage a person’s physical and emotional health, self-esteem,
and sense of competence and control.

Psychological Factors that can Contribute to Eating Disorders:

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● Low self-esteem
● Feelings of inadequacy or lack of control in life
● Depression, anxiety, anger, or loneliness
● Interpersonal Factors that Can Contribute to Eating Disorders:
● Troubled family and personal relationships
● Difficulty expressing emotions and feelings
● History of being teased or ridiculed based on size or weight
● History of physical or sexual abuse

Social Factors that Can Contribute to Eating Disorders:

● Cultural pressures that glorify "thinness" and place value on obtaining the
"perfect body"
● Narrow definitions of beauty that include only women and men of
specific body weights and shapes
● Cultural norms that value people on the basis of physical appearance and
not inner qualities and strengths
● Other Factors that can Contribute to Eating Disorders:
● Scientists are still researching possible biochemical or biological causes of
eating disorders. In some individuals with eating disorders, certain
chemicals in the brain that control hunger, appetite, and digestion have
been found to be imbalanced. The exact meaning and implications of these
imbalances remains under investigation.
● Eating disorders often run in families. Current research indicates that
there are significant genetic contributions to eating disorders.

Homosexuality

Sexual orientation indicates whom an individual is sexually and emotionally

attracted to. This can mean males or females of the same or opposite sex. A
person's sexual orientation is not the same as a person's sexual actions because
not everyone expresses the way they are feeling in their actions. It is therefore the
feelings one has towards another.

Individuals with a heterosexual preference are attracted to people of the

opposite sex. Homosexuality refers to individuals who are interested in people of
the same sex; the terms gay and lesbian are also used to indicate this orientation.
People who are sexually and emotionally attracted to both males and females are
often referred to as bisexual.
Understanding your sexuality
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Many people find it extremely hard to recognize why they are attracted to
an individual of the same sex or both sexes when it is perceived as 'natural' to be
interested in the opposite sex. These feelings are extremely common and there
are millions of people all over the world experiencing these emotions. It is
normal for people to feel confused about their emotions and nervous about how
others will react. Men in particular frequently feel quite isolated because of peer
pressure that homosexuality is wrong. Homosexuality or being gay is not wrong,
it is part of human sexuality, and individuals cannot choose their sexual
orientation.

Ideology within society teaches us that

homosexuality is not the correct sexual path
to follow. Due to these values and pressures,
some homosexuals do not realize they are gay
until they are much older, or they refuse to
accept their sexuality.

'Coming out'

One of the biggest steps is accepting yourself for who you are which can be very
difficult for some people. Once you have accepted the circumstances and feel
more comfortable about it, you may want to tell people about it so they are able
to accept you too. This is known as 'coming out' and is usually the hardest part of
being gay. When a person chooses to come out it will depend on when they feel
it is the right time.

Understanding the Client

When working with gays and lesbians, it is often important to know where your
client is in terms of acceptance. If sexuality is a presenting issue, understanding
the stages is even more important. Cass (1979) lists six stages that many
homosexuals go through when dealing with their own sexual orientation. These
stages have been widely accepted by professionals and gay men and women
alike. They include:

1. Identity Awareness. The point when the child or adolescent begins to

realize he or she has feelings that are different from others and different
from what they have been taught.
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2. Identity Comparison. The individual begins to explore his or her feelings

alone and to compare them to the beliefs of society, parents, and peers.

3. Identity Tolerance. During this stage, the individual will often rebel
against his or her feelings and attempt to deny them. After all, nobody
wants to be gay in a straight world.

4. Identity Acceptance. After realizing that sexuality is a part of who they

are, they begin to embrace it, explore their feelings and desires, and start
to find a place in the world where they are accepted and belong.

5. Identity Pride. Often involves anger toward parents, society, religion, or

other aspects of the world that tells them that they are bad, wrong,
immoral, or mentally ill merely because their feelings are directed toward
the same sex. They embrace the ‘homosexual lifestyle’ and explore their
newfound sexuality. It is during this stage that the gay or lesbian may
start fighting against what society has taught them.

6. Identity Synthesis. The final stage in which homosexuality becomes a part

of who they are rather than the defining factor. Instead of being a gay man
or lesbian, they begin to see themselves as parents, employees, leaders,
teachers, supervisors, coaches, and volunteers who just happen to be gay.
In the final stage, they are able to accept themselves more wholly rather
than seeing their sexuality as separate from the rest of who they are.

Counseling Homosexuals

● Gay males and lesbians differ in attitudes about sex and relationships
● Lesbians, like heterosexual women, emphasize the romantic side of
relationships more than do gay men.

Counseling Problems of Gays and Lesbians

● Helping clients consider the amount, degree, and duration of their

homosexual and heterosexual impulses or experiences.
● Explore what pressures or ambivalence are causing clients’ confusion
about their sexual preference or contributing to their request to change.
● “COMING OUT” is a step that can cause anxiety to homosexuals/the
process of admitting that they are homosexuals.

Suicide Potential
21

The tragedy of a young person dying because of overwhelming hopelessness or

frustration is devastating to family, friends, and community. Parents, siblings,
classmates, teachers, and neighbors might be left wondering if they could have
done something to prevent that young person from turning to suicide.
The best way to minimize the risk of suicide is to know the risk factors
and to recognize the warning signs of suicide. Take these signs seriously. Know
how to respond to them. It could save someone’s life.

The reason behind a teen’s suicide or attempted suicide can be complex.

Although suicide is relatively rare among children, the rate of suicides and
suicide attempts increases tremendously during adolescence.

The SAD PERSONS scale is a tool used to evaluate the risk of patients
who may be suicidal. The name is a mnemonic to help practitioners remember
each risk factors. One point is assigned for each risk factor present, and there
are guidelines on what to do with a patient scoring in each score range.

Men are more likely to go through with suicide plans than females, so
they are given one point for sex, while females get zero. People who are younger
than 20 or older than 75 are at higher risk. Those who have an organized
detailed plan for committing suicide are considered much more likely to follow
through.

SAD PERSONS can be modified to “SAD PERSONAS” to remedy this

omission with the second ‘A’ representing “Availability of lethal means”. This
modification reminds the psychologist to ask about lethal means when assessing
suicidality. If lethal means are available, the psychologist can then take whatever
action is reasonably indicated to reduce the likelihood of a suicide.

Adolescence is also time of sexual identity and relationships and a need

for independence that often conflicts with the rules and expectations set by
others. Suicide among teens often occurs following a stressful life event, such as
problems at school, a breakup from a relationship, the death of a loved one,
separation of parents, or a major family conflict

SAD PERSONaS Scale

Sex
Age
Depression
Previous attempt
22

Ethanol abuse
Rational thinking loss
Social support lacking
Organized plan
No spouse
Availability of lethal means
Sickness
Retrieved from http://www.currentpsychiatry.com/the-publication/past-issue-single-view/revised-sad-persons-scale

Guidelines for action with the SAD PERSONAS Scale

Total points Proposed clinical action
0 to 2 Send home with follow-up
3 to 4 Close follow-up; consider hospitalization
5 to 6 Strongly consider hospitalization, depending on
confidence in the follow-up arrangement
7 to 10 Hospitalize or commit
Retrieved from: www.med.unc.edu./emergmed/files/sadpersons.doc

Some adults feel that kids who say they are going to hurt or kill
themselves are “just doing it for attention.” It is important to realize that if teens
are ignored when seeking attention, it may increase the chance of them harming
themselves (or worse).