Notably, anxiety disorders are among the most common diseases in childhood and adolescence. According to the National Institutes of Health, anxiety disorders affect roughly one-third of all teenagers aged 13 to 18 (American Academy of Pediatrics, 2019). Twenge et al. (2017) claim that between 2010 and 2015, adolescents’ depressive symptoms, suicide-related outcomes, and suicide rates increased, particularly among females, “in two national surveys of U.S. adolescents in grades 8 through 12 (N = 506,820) and official statistics on suicide deaths for those ages 13 to 18” (p. 1). Adolescents who spent more time on media, such as social media and electronic devices like smartphones, were more likely to experience psychological disorders (Twenge et al., 2017). In contrast, students who spent more time on non-screen activities, interpersonal interactions, sports, study time were less likely. Anxiety can result in significant mental health issues such as depression, drug abuse, and even suicide (Kreuze et al., 2018). The symptoms can also cause physical complications such as headaches, persistent discomfort, digestive issues, and, in the long run, cardiovascular disease (American Academy of Pediatrics, 2019). Additionally, anxiety can impair one’s capacity to focus and study, resulting in educational troubles that can last a lifetime.
Research-based Effective Interventions
Research-based effective interventions for treating anxiety are psychodrama and cognitive-behavioral therapy (CBT). Şimşek et al. (2020) emphasize that psychodrama is a therapy practice that seeks to generate understanding and awareness by offering alternate answers to individuals’ issues based on their feelings, ideas, and some upsetting experiences in their life. It is a psychotherapeutic and socio-therapeutic action approach that is usually used in groups, in which participants replay their life (Şimşek et al., 2020). According to Şimşek et al. (2020), when study participants were tested one by one after group treatment utilizing the psychodrama approach with teenagers, there was a substantial drop in their anxiety levels and an increase in their empathy ratings. In addition to the benefits of being in a peer group owing to age group features, psychodrama applications aid teenagers in expressing emotions, acquiring new social skills, and developing direct self-confrontation and empathy abilities.
Cognitive-behavioral therapy (CBT) is an effective treatment for anxiety problems in children and adolescents. Moreover, comorbid complaints, such as depressive and externalizing symptomatology, are likely to decrease with anxiety-focused CBT (Kreuze et al., 2018). Kazantzis et al. (2018) argue that Modern CBT is now a standard term for various empirically validated psychological interventions aimed at specific processes. The overarching aims of therapy are to reduce distress, increase functioning, and, eventually, promote well-being and life quality. CBT sessions include a specific session format, such as an agenda, assignments, summary, and feedback (Kazantzis et al., 2018). Parental engagement in therapy may be especially crucial in facilitating the transfer of new abilities to everyday life and may also help to generalize results to larger outcome domains (Kreuze et al., 2018). Additionally, Parental engagement in CBT for anxious children and adolescents may minimize barriers such as parental worry, parental displeasure with the adolescent, anxiogenic parenting practices, and parental modeling of an avoidant coping strategy.
Essentially, the CBT and psychodrama can be integrated and adapted to fit into a small group intervention format. Treadwell and Dartnell (2017) acknowledge that CBPGT combines cognitive-behavioral and psychodrama therapies, allowing group members to recognize and alter anxious thoughts, behavior, and interpersonal patterns while promoting participation in positive and success-based experiences. Students and clinical populations highly receive this technique; consequently, they can build an awareness of their problematic thinking patterns and attitudes, which play a significant part in emotional regulation (Treadwell & Dartnell, 2017). Therefore, the group counseling plan will be based on CBPGT to deal with anxiety in adolescents.
Small Group Counseling Plan
The four small group counseling sessions will include psychodrama and CBT based on the finding. Treadwell and Dartnell (2017) suggest that all participants of the CBPGT group should be first tested using several instruments to determine the type and severity of presenting concerns and unearth other pertinent information. The first one or two sessions will establish group norms, discuss CBT and schemas, and outline the session pattern. Each group member should sign an informed consent form and an audiovisual recording consent form (Treadwell & Dartnell, 2017). Additionally, the audiovisual recordings provide a running record of group activity and may be used to give feedback to group members as necessary.
Each CBPGT group session will be structured into three components common in psychodramatic interventions: warm-up, action or play stage, and sharing. Şimşek et al. (2020) claim that firstly, the warm-up portion of a psychodrama session is designed to prepare group members and the management for the role, theme, and present circumstances. Warm-up encourages members to boost their spontaneity and overcome the group’s resistance (Şimşek et al., 2020). Several CBT strategies are used in the warm-up, such as detecting distressing events, automatic negative thoughts, and provoked emotions, and writing balanced ideas to counter negative automatic thoughts (Treadwell & Dartnell, 2017). Consequently, the play stage is the action stage that includes putting the decision taken during the warm-up phase into action. The counselor employs fundamental psychodrama methods at this stage (Şimşek et al., 2020). The play stage incorporates psychodramatic tactics such as role acting, role reversal, and mirroring to investigate many contradictory situations that individuals encounter in a group setting (Treadwell & Dartnell, 2017). It allows group participants to understand better the nature of negative thoughts prompted by events and their consequences on emotions.
Ultimately, the group meeting is the stage at which the group members give feedback on their roles at the end of the psychodrama game (Şimşek et al., 2020). The last stage, sharing, allows auxiliary and group members to discuss their experiences (Treadwell & Dartnell, 2017). Significantly, the counselor’s feedback and suggestions are critical at this point. Essentially, the first session will be devoted to getting to know one another and introducing participants. Session 2 will aid in the exploration of thoughts and feelings. During session 3, participants will be questioned about their anxiety and how it manifests itself. Session 4 will assist with overcoming fear, building trust in communication relationships, and increasing empathetic communication and awareness among adolescents 13-14 years old.
In order to present information discovered in my research to stuff in an exciting and meaningful way, I will prepare a presentation. Essentially, it will include the statistical data on anxiety among adolescents aged 13-14. Moreover, I will highlight the importance of the problem by highlighting the consequences of anxiety, such as depression, drug abuse, and suicide. The information regarding effective interventions would be helpful to staff because they will learn more about methods, such as psychodrama and cognitive-behavioral therapy (CBT), that help reduce anxiety symptoms. I will emphasize that CBT and psychodrama can be integrated to achieve better results. When up a staff development activity in which the information is presented, I will invite the staff members for a one-hour educational meeting to demonstrate my findings, show the presentation, and ask for ideas and feedback. For instance, I will state that parental involvement in therapy may be critical in promoting new capabilities to everyday life. Afterward, I will ask for opinions on the possibilities of parental participation in group counseling sessions.
The Issue of Diversity
Integrating a diversity focus into the design of the session and the assessment of students is fundamental. Every counselor should understand the vital need of caring for non-majority persons’ specific needs and surroundings. Scheel et al. (2018) state that the Model Training Program (MTP) for counseling psychology was created to reflect current advancements in counseling psychology, the American Psychological Association, and the globe. An emphasis on diversity and social justice is one of the fundamental principles. Scheel et al. (2018) advocate creating session contexts that foster safety, trust, and respect for all participants. Furthermore, counselors and students should recognize bias and prejudice in themselves and society and seek to mitigate its repressive consequences via self-examination and critical reasoning about individual values and views. Without a doubt, diversity may impact the assessment of my small group objectives. According to Scheel et al. (2018), assessments should be based on scientific evidence, professional practice norms, and the fostering of mutual respect and collaboration. Age, disabilities, ethnicity, gender, gender identity, language, national origin, race, religion, culture, sexual orientation, and socioeconomic position are included in the broad definition of cultural and individual distinctions and diversity (Scheel et al., 2018). Therefore, because of the interconnectedness of these factors, I will appreciate individual and cultural uniqueness to ensure the best result for each student.
American Academy of Pediatrics. (2019). Anxiety in teens is rising: What’s going on? Healthy Children. Web.
Kazantzis, N., Luong, H. K., Usatoff, A. S., Impala, T., Yew, R. Y., & Hofmann, S. G. (2018). The processes of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 42(4), 349–357. Web.
Kreuze, L. J., Pijnenborg, G. H. M., de Jonge, Y. B., & Nauta, M. H. (2018). Cognitive-behavior therapy for children and adolescents with anxiety disorders: A meta-analysis of secondary outcomes. Journal of Anxiety Disorders, 60, 43-57. Web.
Scheel, M. J., Stabb, S. D., Cohn, T. J., Duan, C., & Sauer, E. M. (2018). Counseling psychology model training program. The Counseling Psychologist, 46(1), 6–49. Web.
Şimşek, G., Yalçınkaya, E. Y., Ardıç, E., & Yıldırım, E. A. (2020). The effect of psychodrama on the empathy and social anxiety level in adolescents. Turkish Journal of Child and Adolescent Mental Health, 27(2), 96-101. Web.
Treadwell, T., & Dartnell, D. (2017). Cognitive behavioral psychodrama group therapy. International Journal of Group Psychotherapy, 67(sup1), S182–S193. Web.
Twenge, J. M., Joiner, T. E., Rogers, M. L., & Martin, G. N. (2017). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 6(1), 3–17. Web.