[NB All names have been changed]

Beatrice is a 40-year-old married mother of four children; she married young and over time she and her husband separated on three occasions. Her husband previously subjected her to both psychological and physical abuse. As a child she lost her mother to suicide leaving her to be raised by her father. Unable to raise his daughters and work at the same time, Beatrice was passed around to various extended family members to be cared for. Unfortunately this exposed her to ongoing physical abuse.

Joe is 43 years old and the father of the four children; he has left Beatrice on 3 occasions over a 20-year period. He was raised in very poor circumstances and was subjected to physical abuse by his parents. He became addicted to alcohol in his teen years and developed increasingly violent behaviour.

Both Beatrice and Joe were raised in tragic and violent circumstances. Beatrice had to develop coping skills to survive an environment dominated by feelings of abandonment, parental loss and physical violence; home was not a safe place for her and her sisters. She also suffered unresolved grief in relation to her mother’s death; consequently positive parental modelling was non existent.

Joe had to survive a home life filled with violence where his father’s aggressive behaviour was exacerbated by heavy bouts of drinking. Forced to leave home when only 15 to fend for himself, Joe turned to drinking and made poor choices in his friends. Family modelling for Joe was a negative experience and he suffered from strong feelings of rejection and abandonment.

Both Beatrice and Joe had no concept of how to provide a loving and nurturing environment for children. As a consequence their children witnessed their mother being physically abused over many years; they were neglected and felt abandoned during the times their parents were separated.

The dominant emotion they experienced in their home life was fear. As the children grew into adolescence Joe and Beatrice became Christians and their life changed. Both decided they wanted to restore their marriage and be better parents. They separated in order to sort out their individual issues and a positive change in the behaviour of both parents became apparent.

A complicating factor was the death of Joe’s Aunty who had over the years been a great supporter of the children, providing care and love. It was at this time that their 14-year-old daughter Ann started to display powerful aggressive behaviour towards her parents and others. She also began to drink excessive amounts of alcohol and participated in high-risk activities with friends. Her parents convinced Ann to attend a series of counselling sessions.

Background Information on Ann’s Difficulties and Proposed Approach

The Broad Principles

Ann’s situation needs to be considered in the context of three broad areas of her life: her family and home environment, her school situation and her friends. As a counsellor a number of questions would need to be asked when considering how to help Ann. These could include questions about her family history, what her home environment is like, what is happening at school and how she is getting on with her friends; problems in any of these areas could be affecting her behaviour, causing the recent aggression and rebellion.

The Family Situation and Environment

Firstly we might consider the difficult subject of the possibility of abuse occurring in the home environment. In this case the counsellor would need to first consider the two primary determinants of behaviour: inherited traits (personality needs) and social learning (learned attitudes). Ann may have inherited aggressive tendencies from her parents which when coupled with the parental modelling have made her vulnerable to feelings of anxiety and aggression; however it is important to remember that having aggressive parents does not automatically mean that a child will inherit the aggressive trait.

Thus the interaction between the influences of Ann’s genetic inheritance (i.e. her personality, represented by traits, needs and genetic predispositions) known as ‘personality needs’ or ‘behavioural tendencies’ and those of her learned attitudes, shaped by socialisation and modelling influences, will be the major determinant of her behaviour.

In the case of Ann’s parents, their behaviour could also be the result of genetic loadings pre-disposing them to aggressive tendencies, coupled with what they may have learned as children brought up in an abusive environment.

The counsellor would look at all areas of Ann’s life, her primary environments, considering the possibility of specific events having had a negative impact on her, the family modelling she has been exposed to and her own personality traits.

The lack of appropriate parental modelling in the parents’ childhoods has made them unable to provide a functional safe home environment for their own children. Their separations, drinking and abusive behaviours have all impacted on Ann’s overall wellbeing, including her physical, emotional and mental states.

The counsellor would consider a range of possible aspects when working with Ann:

  1. A possible genetic predisposition towards anxiety and aggression inherited from her parents; such a predisposition would be exacerbated in a violent environment.
  2. The behaviour being modelled by her parents will influence Ann’s behaviour, both at home and at school. Ann may perceive aggression as a normal and appropriate way of dealing with problems.
  3. Ann may not be able to satisfy her lower order needs (such as those for security, shelter, freedom from threat etc) to an acceptable degree; if this is the case then her middle and higher order needs for love, belongingness, acceptance, self-esteem and self-fulfilment will also be unfulfilled. If her basic needs are not being met Ann could well be left feeling vulnerable and hostile.
  4. Another area which needs to be considered is grief and loss related to the death of Aunty. Often if a close friend or a member of a family is severely injured, dies, or is forced to leave, the parents may be given comfort and counsel but the children can be forgotten. They may have to find their own way through their sense of loss and grief, leaving them vulnerable to anxiety. Grief which is not being managed has the potential to lead to behavioural changes, such as Ann’s aggression.
  5. At the age of fourteen Ann’s physical health may be a factor negatively affecting her life. It would be advisable to suggest that she has a check up with the family GP to rule out any physical problems.

The counsellor would also be looking for any major changes in her environment, such as moving house or changing school, which could involve the loss of social and/or family connections.

The School Environment

Ann’s school environment needs to be examined. A counsellor would ask whether there have been any changes at school which might affect Ann’s behaviour. Some of the areas to consider are:

Has a new teacher taken over her class? If so has this affected her in some negative way? Perhaps they have a mutual dislike for each other. She may have developed a very close relationship with her former teacher, which is now lost. She may believe the new teacher does not understand her or dislikes her. Perhaps their teaching style is very different and she is falling behind in her studies. She may be bored with her schoolwork. It may be useful for the counsellor to contact her teacher and discuss Ann’s situation, with permission from both Ann and her mother.

Has a close friend left the school recently? If this is the case she may feel very lonely and no longer want to go to school. Or has a new teenager come into the school environment who is a bully? She now may be ‘picked on’ where previously school (or the school bus) was a safe place for her. Her needs for security and acceptance are no longer being met at school so she doesn’t want to be there any more.

Her Friends

In relation to Ann’s friends, a counsellor would be examining whether some significant change had occurred recently. For example:

Ann has social needs, which relate to her desire for friendship and companionship; are these social needs being met? And by whom?

Has a close friend recently moved away or died? If this were the case she would be experiencing grief which triggers a number of emotional and physical reactions

Has her circle of friends suddenly rejected her? If she is no longer accepted by her normal group of friends, she may be feeling rejected and confused about what she must do to regain peer acceptance. She may not want to socialise any more in case she is rejected again; she may become angry or resentful and take it out on others.

She may have a boyfriend and the relationship is causing difficulties or has come to an end.

Factors to Consider When Counselling Adolescents

When counselling an adolescent it is important to remember that it differs from counselling either children or adults. Things to consider:

Adolescents can be strongly egocentric. This trait starts in early adolescence and carries most weight in mid- to late-adolescence. They may have the notion that everyone is watching them, at times parading in front of others to invite attention. They may make up success stories about themselves, which they start to believe. This can lead to the idea they are bullet proof or powerful and cannot be hurt.

A critical adolescent task is the formation of personal identity; failure to achieve a satisfying personal identity is very likely to have a negative psychological effect on them and on their development into adulthood.

Teenagers are often experimenting in making their own decisions apart from parental influence. Part of this learning curve is for them making “both helpful and unhelpful choices”. This is part of life and the counsellor must recognise this if they are going to be successful in forming a working alliance with a teenager.

Young people particularly need to feel they have some power/control in the counselling relationship. Often profound disempowerment is a fact of life for a teenager where they have lost control to others and their direction appears to have been predetermined.

Session Content

C met Ann in the waiting room, and using observation skills assessed her as being nervous and unhappy.

C introduced himself to Ann in a cheerful manner in an attempt to commence building a rapport with Ann. C tried to put Ann at ease, by using affirmation skills to send her a very positive message about the courage she showed in coming to see C.

C: Your mother contacted me concerning your situation on Wednesday and gave me some background information. (C is doing this to demonstrate his willingness to be honest in the relationship by disclosing to Ann that her mother had contacted him, again adding weight to rapport building).

Ann: I thought she had when she gave me your phone number.

C: How do you feel about being here today?

Ann: (with eyes downcast) Well, I feel very nervous. I’m not sure what is going to happen. Mum tells me I need help but I’m not sure anyone can help me. She says I’m out of control.

C: That’s what your mum tells you, but what I am really interested in is what you think, how you are feeling.

C is validating Ann’s right to an opinion and also aiming to empower Ann by emphasising Ann’s ideas rather than her mother’s.

Ann: That doesn’t happen very much to me you know, adults don’t think my opinion’s worth anything. I like the way you do.

C noticed that Ann was looking at her shoes while responding to C’s questions; sensing her discomfort C shifted the focus of his questioning.

C: Ann, I notice you’re looking at your shoes a lot when you’re talking to me. They’re very nice joggers, are they new? Have you started a new sport?

Ann: Yeah, I have actually. Just started doing athletics. The sports master told me I could be a good runner one day if I train hard.

C: That’s great — good luck with it.

C distracted Ann from her nervousness by focusing Ann on a topic that was neutral, showing a genuine interest in what Ann saw as important to her. This relaxed Ann and the session was able to move on.

C: How much do you know about counselling?

Ann: Not much. I thought it was for people who are sick in the head.

C: Well for most people it is to help them sort out every day problems and issues. It helps them work their way through stressful times or when they are having disagreements with other people. It helps them change behaviours they don’t like doing and choose new ones which are more useful to them. Does that make sense?

Ann: Yes it does, I can understand that.

C: Ann, before we go any further I need to give you some information and explain what happens to the information you give me. Is that OK with you?

Ann: Yes that’s OK.

The counsellor then explained issues and limitations of confidentiality to Ann, making sure that she understood that what she said to him would not be repeated to her parents.

C: Ann, how have things been for you at home or at school.

Ann: Mum keeps me from going out with my friends all the time; I can’t even invite them back to have some fun. She tells me I can’t be trusted, it’s not safe. At school there’s this gang of girls who bully me. It’s so hard I can’t even concentrate on what the teacher is saying.

C: The bullying at school must be very hard for you to cope with Ann. Have you tried to do anything about it?

Ann: I’ve been to the teacher and asked for help a few times, but nothing seems to get done. I’ve spoken to mum too, but she can’t help much either, she works all week. Dad lives somewhere else and works funny shifts.

C: Would it help if I were to become your advocate and spoke to the school principal about this?

Ann: I’ll have to think about that one, I’m not sure, it could help.

C: Well, have a think about it Ann, it’s your decision to make. Ann, you mentioned that you were not allowed to go out with your friends, can you tell me more about that?

Ann: Well, Mum’s had a hard life, when she was younger things were bad for her and she’s scared bad things will happen to me too. She won’t listen to me. I get so frustrated, I can’t have any fun!

C: Ann, what do you think would have to change for Mum to let you go out with your friends?

Ann: Well, that’s a good question, I don’t know.

C: Ann, have there been times in the past where your mum has let you go out with your friends?

Ann: Well, yes there have been. Mum let me go out months ago.

C: What was different then?

Ann: Well, Dad had to run me to my friends and I had to be home by 11.00 pm or else.

C: So, what’s changed then to stop you being allowed to go out now?

Ann: Oh, I got home one night about four in the morning. Mum was really cranky.

C: Ann, what do you think you could do to turn things around?

Ann: Maybe get Dad involved again and stick to my curfew of 11 o’clock.

C: That’s a great solution, Ann, well done! You mentioned earlier your Dad does not live at home, are your parents separated?

Ann: Yep, been like that on and off for years. I live with Dad one week and then Mum the next. Not sure where I will be from week to week. Often lived with my aunty until recently, but she died. Now it’s just Mum and Dad.

Ann then began to cry. C allowed Ann to weep for as long as she wanted to, letting her experience her grief and loss.

C: That was very brave of you, Ann — to cry in front of me. Ann, I want you to feel that this is a safe place where you can be yourself.

Ann: I really miss her, I loved her a lot. I didn’t get a chance to say good bye to her. She cared for me and was so gentle. She was the only one to treat me kindly. Mum and Dad have been so angry with each other for years they forget me and get very cranky with me. All this makes me really sad and angry at the same time!

Ann became emotional again unable to contain her anger she cried out, and using coarse language struck out at life, shaking and crying. C allowed Ann to release her emotions until she ended it by looking down at the ground. C remained silent until Ann spoke, respecting her right to be angry and frustrated.

Ann: I’m sorry I did that in front of you. But I’m not really a nice person, so I’m told. But I do feel a bit better after that.

C: Ann I mentioned a little while ago this is a safe place for you to be yourself. That hasn’t changed. Considering what has happened to you, you have a right to be upset and frustrated. Ann, can I ask you who tells you that you are not a very nice person?

Ann: Well, they use worse words than that, but that’s what they mean. People at school and at home. It hurts to hear it. I feel worthless at times.

Ann is revealing that she sees herself as a worthless and rejected person, a significant piece of information for C.

C then asked Ann a scaling question to measure anxiety levels she was feeling at the moment.

C: Ann, on a scale out of 10 where 0 is no anxiety and 10 is a great deal of anxiety, what are you feeling at the moment?

Ann: I am feeling quite anxious, about a 7, but it was 10 a couple of minutes ago.

C: Ann, I need to tell you something very important. I see in front of me a unique and pretty young lady who, despite all the hard things you have been through, you are still doing well at school, still caring for yourself and you want to do better in life. You have athletic skills and you were able to form a close relationship with your aunty. So you are a valuable person. (C is re-enforcing Ann’s strengths and uniqueness to start rebuilding her self-esteem).

Ann: It’s nice to hear someone tell me I am important. I don’t hear that very often.

C: Ann, you will find that during counselling sessions I will keep emphasising your strengths and achievements, this will help motivate you to make the changes you want to make. Are you happy with this approach?

Ann: Yeah, that sounds good to me. By the way I’m feeling much better now.

C: Ann, I’d like to change the direction we are taking and clarify some information you gave me about your family and school situation. Is that OK with you?

Ann: Yes I think so, but it is sad for me to think about my family at the moment.

C: Ann, if it’s too hard for you to speak about this you can stop at anytime.

Ann: OK.

C: Ann you mentioned you loved your Aunty a great deal and you miss her a lot, can I ask what is your happiest memory you have of your Aunty?

Ann: I think it was last year when I spent my holidays with her. We did everything together. I loved it. When I think about it, it makes me feel loved.

C: Ann our memories of people can be very powerful, can I suggest when you are missing her, fill your mind with the good memories of her, the special times you had with her. This will help with your sadness. Do you think this could help you?

Ann: You know, I think this will help. It just did a minute ago.

C: Ann, I would very much like to see a photo of your Aunty. Would it be OK with you if you brought one along the next time we meet? (C is attempting to further strengthen the working alliance with Ann by showing an interest in something very important to her).

Ann: Yes I would like to that. I will bring a photo of her next time.

C: You have also mentioned you have been feeling very angry lately. How has this affected your relationships with your parents and friends?

Ann: Well, I’ve been so upset and angry I keep yelling at my parents and my friends lately. I don’t know what to do about it.

C: Can I ask you to shut your eyes and imagine a recent time when you started to get angry; try and remember what was happening inside you at that moment.

Ann: OK I’ll try. I couldn’t think straight, and my face got hot. Then I started to shake.

C: You’re doing very well to remember it. Those feelings you just described can be used by you to help control your anger. Next session I will show you how to relax and to change what you are thinking about so you can stop yourself losing your temper. How does that sound?

Ann: That’d be good.

C: It would be useful if you could over the next week record on a note pad when you become angry, including information about what caused it, who was involved, what you were thinking and how it affected you.

C is helping Ann to become self aware of her body before she looses control of her anger and is also providing to her some practical steps she can take to help herself over time.

C: Do you think this could help you?

Ann: Well I’ll give it a try and see what happens.

C then suggested Ann to reward herself for keeping this record and asked her about something she liked doing. Ann said that she liked looking in clothes shops after school. C is helping Ann to place value on keeping these records by providing a reward for her, which also acts as an incentive for her to keep doing it.

C finished this session by again congratulating Ann on her courage in dealing with some really difficult issues in her life.

End of Session

In this session the counsellor demonstrated the following strategies:

  1. Creating conditions to help Ann bring some equilibrium back into her life; supporting her in what she is experiencing, providing information to her about her reactions and her mental state being affected by grief and loss.
  2. Normalising as much as possible her reactions to her difficult home and school life.
  3. Examining her current situation, what support networks she has available to her, identifying the major issues and her concerns.
  4. Using focused problem solving methodology C attempted to establish realistic, achievable and clear goals for her to improve her quality of life both at home and school, exploring possible options, and also checked her levels of comfort using scaling questions.
  5. Identifying what supporting actions needed to be taken ie. Self-help, counsellor support etc.
  6. Discussing how she could monitor her own emotional state and become self aware, as a prelude to using agreed counselling interventions.

Next Session

Ann’s risky behaviour will need to be challenged in the next counselling session as it appears she does not understand the concept of consequential thinking, (i.e. the consequences of her actions based on her choices).

Author: Grahame Smith


  1. Clarke. J (1998) Advanced Professional Counselling. Published by J&S Garrett Pty Ltd. Australia.
  2. Corey, Gerald (1996) Theory and Practice of Counselling and Psychotherapy — 5th edition. Pacific Grove USA.-Books/Cole Publishing Company.
  3. Geldard K&D (2004) Counselling Adolescence — 2nd edition, SAGE publications, London UK.
  4. Tunnecliffe.M. (2002). Key Elements of Crisis Counselling. A paper presented at the Convention of the Critical Incident Stress Foundation of Australia, Melbourne 2002.

Related Case Studies: Behaviour Modification with Children, A Case of Childhood Sexual Abuse, An Insight into the Solution