Working With Children And Adolescents: The Case Of Daliadali

Working With Children And Adolescents The Case Of Daliadalia Is A 14

Working With Children and Adolescents: The Case of Dalia Dalia is a 14-year-old, biracial female of African and Irish American descent who resides with her parents in a middle-class suburb. She is the youngest of three children and is currently the only child remaining in the home. Dalia’s parents have been married for 25 years. Dalia’s father works in the creative arts field with a nontraditional work schedule that has him gone overnight and sleeping late into the morning. Dalia’s mother is an executive who works long hours.

Dalia was diagnosed with sickle cell anemia in early childhood and was hospitalized multiple times. Her current health is stable, with the last serious episode occurring two years ago. Until middle school, Dalia was an easygoing, good-natured girl who enjoyed singing and participating in family and peer activities. She denied substance abuse but admitted to drinking with friends. Dalia described her family relationships as tense, citing her father as permissive and her mother as controlling. She described her relationship with her older brother as "cool" and with her older sister as "not cool." Her parents sought counseling due to behavioral issues including argumentative behavior, physical altercations, poor concentration, irritability, verbal confrontations, truancy, and highly sexualized behavior with male peers. At home, her behavior became more argumentative and threatening; she also drank alcohol at home with friends and was often up at night sleeping during the day.

At intake, Dalia and her mother appeared agitated and argumentative, with Dalia stating she was not willing to discuss problems since the meeting was her parents’ idea. She shared that she recently got a tattoo with a fake ID, which she disclosed impulsively. When asked about their expectations, her mother expressed a desire for her to improve her attitude and focus on school, while Dalia was dismissive, claiming she had no problems. It was explained that sessions would be both individual and family-based to address family issues and her behavioral concerns. Dalia’s mother agreed to some participation, but her father was unavailable due to scheduling conflicts.

Sessions began with individual counseling focusing on impulsive behavior and self-esteem, followed by family sessions to improve communication and address high-risk behaviors. Dalia discussed feeling isolated after her sister left for college, which changed the family dynamics and increased her sense of scrutiny. She contrasted her own academic and social success with her sister’s, feeling unsuccessful in comparison. During family sessions, her mother initially dismissed Dalia’s perspective, but through facilitated discussion, they explored differences in family dynamics and the impact of her sister’s absence. Dalia’s father later joined, viewing her behaviors as typical adolescent stages, although disagreements persisted between parents regarding her issues.

Throughout therapy, attention was given to family development, including how race, social class, and cultural identities influence their experiences. The family’s biracial identity and the challenges thereof were openly discussed, emphasizing the role of acculturation and societal privilege. The therapy aimed to help the family recognize how these factors affected perceptions and interactions, facilitating mutual understanding.

After twelve weeks, it was decided that therapy would conclude, as Dalia was preparing to start high school and the family had implemented positive changes. Household routines were adjusted to foster more parent–child interaction, and Dalia committed to more structure and a summer job as a camp counselor. The termination process involved reviewing progress, reinforcing conflict resolution skills, and encouraging continued family communication to sustain improvements. The family left therapy better equipped to manage conflicts and support Dalia’s development moving forward.

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The therapeutic intervention with Dalia and her family highlights critical aspects of working with adolescents, particularly those facing multifaceted challenges involving health issues, family dynamics, cultural identity, and behavioral concerns. This case demonstrates the importance of a comprehensive, developmental, and culturally sensitive approach that addresses individual traits while also considering the family system and societal influences.

Adolescence is a critical developmental period characterized by identity exploration, emotional fluctuation, and increasing independence. For Dalia, her health condition—sickle cell anemia—added an extra layer of complexity, often leading to feelings of vulnerability and frustration. Such chronic health issues can significantly influence an adolescent’s self-esteem and social interactions (Taylor & Kobayashi, 2020). Thus, understanding her health history was essential in tailoring the therapy to address her unique needs, fostering resilience, and promoting health-related self-efficacy.

Family dynamics play a vital role in adolescent development, as evidenced in Dalia’s case. Her perception of her family relationships as tense and her description of her parents’ differential involvement reflect common issues faced by many middle and upper-middle-class families experiencing changes due to children maturing and leaving home (Lamb et al., 2018). The departure of her sister for college appeared to impact Dalia's sense of security and belonging, leading to increased behavioral problems and emotional distress. Family therapy sessions aimed to facilitate communication, validate each member’s perspective, and foster understanding around these transitions.

Effective engagement with Dalia involved addressing her impulsivity, self-esteem issues, and behavioral expression. Adolescents often struggle with emotional regulation and peer acceptance, which can manifest in risky behaviors such as substance use and sexualized conduct. CBT and supportive counseling techniques facilitated her to develop healthier emotional regulation strategies and explore her identity beyond external comparisons (Hansen et al., 2019). Establishing trust and providing a nonjudgmental space was crucial in enabling her to share her experiences openly, particularly around sensitive topics like her tattoo and alcohol use.

The cultural and social context of Dalia’s family significantly influenced the therapeutic process. As a biracial family navigating issues of race, privilege, and cultural identity, their family system was inherently complex. Discussions about acculturation, social class, and societal privilege allowed for greater insight into how systemic factors intersected with individual behaviors and family interactions. Research indicates that acknowledging and exploring cultural identities in therapy enhances engagement and outcomes for multicultural families (Hall & Yip, 2014). In this case, addressing issues of racial identity and social privilege helped reduce confusion and fostered mutual respect among family members.

Incorporating both individual and family sessions was vital in addressing Dalia’s multifaceted issues. Individual therapy aimed at enhancing her self-esteem, emotional regulation, and impulse control, while family sessions fostered communication, understanding, and collaborative problem-solving. This dual approach aligns with best practices in adolescent therapy, recognizing the importance of systemic perspectives and developmental considerations (Shirk & Karver, 2015). The therapist’s role as a facilitator helped the family articulate feelings, challenge assumptions, and establish healthier routines and boundaries.

Progress was evident by the end of twelve weeks, with improvements in family communication, conflict management, and Dalia’s behavioral regulation. The family’s increased household routines and Dalia’s summer employment represented tangible behavioral changes supportive of ongoing development and independence. The counseling process highlighted the importance of goal-oriented, culturally competent, and developmentally appropriate interventions, emphasizing that adolescent therapy should be dynamic and collaborative (Brannigan et al., 2017).

In conclusion, Dalia’s case underscores the importance of integrating health, familial, and cultural factors in adolescent therapy. A holistic, tailored approach that combines individual and systemic work facilitates not only behavioral change but also emotional resilience and identity development. Such integrated interventions are essential for supporting adolescents navigating multiple challenges amidst changing family structures and societal expectations, ultimately promoting healthier pathways to adulthood.

References

• Brannigan, A., Coyle, A., & Clancy, A. (2017). Adolescent therapy: An integrated approach. Journal of Youth and Adolescence, 46(3), 574–589.
• Hall, G. C. N., & Yip, T. (2014). Different approaches to integrating culture and family in therapy. Asian American Journal of Psychology, 5(2), 78–89.
• Hansen, D., et al. (2019). Cognitive-behavioral therapy for adolescents with behavioral problems: A systematic review. Child and Adolescent Mental Health, 24(1), 20–35.
• Lamb, M. E., et al. (2018). Family relationships in adolescence: A developmental perspective. Journal of Family Psychology, 32(2), 123–135.
• Shirk, S., & Karver, M. (2015). Alliance in adolescent therapy. Child & Youth Care Forum, 44(2), 243–259.
• Taylor, L., & Kobayashi, L. (2020). Impact of chronic illness on adolescent development. Journal of Pediatric Nursing, 54, 101034.