Coaching Emotional Abilities in Fostered Adolescents through Rational Emotive and Cognitive-Behavioral Education: Efficacy and Mechanisms of Change of Using Therapeutic Stories

By Neamtu, Gina M.; David, Oana A. | Journal of Evidence-Based Psychotherapies, March 2016 | Go to article overview

Coaching Emotional Abilities in Fostered Adolescents through Rational Emotive and Cognitive-Behavioral Education: Efficacy and Mechanisms of Change of Using Therapeutic Stories


Neamtu, Gina M., David, Oana A., Journal of Evidence-Based Psychotherapies


The most prevalent disorders of children enrolled in mental health clinics are disruptive behavior disorders (Kazdin, 1997). Moreover, hyperkinetic disorders, oppositional-defiant, aggressive behavior and conduct problems are the most frequently diagnosed disorders in childhood and adolescence, influencing parents to seek out mental health services (Döpfner, Schurmann & Frolich, 2006; Döpfner, Schurmann & Lehmkuhl, 2000). Research shows a clear negative impact of institutionalization on behavior problems of youth (Juffer & van Ijzendoorn, 2005; Groza & Ryan, 2002; Kreppner, et al., 2001 Marcovitch, et el., 1997), and thus these children display high levels of behavior problems (Dimigen, Del Priore, Butler et al., 1999), compared with children who are not institutionalized (McCann, James, Wilson & Dunn, 1996). Estimates on psychopathology among children cared for in residential care vary between 17-89%, compared with the psychopathology of children from outside the foster care system, ranging from 3-18% (Blower et al, 2004; Costello, Egger & Arnold, 2005; Groza, Ryan & Cash, 2003; Dimigen, DelPriore, Butler et al., 1999).

Multiple reasons for increased concern arise for the residents of the shelters, among which are the number of conflicts recorded in the placement centers, the number of disruptive behaviors in society (aggressive behavior, thefts, breaking the rules) and school difficulties (failure authority, absent without leave etc.; Oosterman, Schuengela, Slota et al., 2006). Blatt and Simms (1997) describe that children in foster care present with three to seven times more chronic medical problems, emotional disorders, and school failure, compared to children living in low socioeconomic conditions but within families. Thus, it becomes essential to find effective treatments for addressing behavioral and emotional problems of children in residential care since these children/young people are among the most vulnerable and underprivileged members of community (Sempik, Ward & Darker, 2008), presenting an increased risk for unfavorable evolution in terms of mental health (Ford, Vostanis, Meltzer & Goodman, 2007a; Viner & Taylor, 2005), and disruptive behavior disorders may be an obstacle to social and professional reintegration.

Studies that followed Romanian adopted children reported both externalizing and internalizing problems as a result of institutionalization (Kadlec & Cermak, 2002; Nelson, Zeanah, Fox et al., 2007; Zeanah et al., 2009). Without treatment, internalizing and externalizing disorders can become chronic in this population, and become co-morbid in adolescence and adulthood (Nock, 2003). Disruptive behavior disorders can have long-term devastating consequences, such as antisocial behavior, high rates of withdrawal from school in youth, drug and alcohol abuse, hospitalization and mortality (Loeber, Burke, Lahey, Winters, & Zera, 2000).

Etiopathogenetic mechanisms of child and adolescent emotional and behavioral difficulties

Psychopathology and attitudes are determined by genetic and environmental factors throughout life (Belsky, Bakermans-Kranenburg, & van Ijezdoorn, 2007). Cognitive models of externalizing disorders focus on information processing deviations associated with perceived danger (Beck, 1976). As such, children processing the information in a distorted way can lead to emotional disorders (Kendall & MacDonald, 1993). Empirical studies (David, Schnur & Belloiu, 2002) support the impact of irrational beliefs/dysfunctional cognitions on emotional distress; thus the discrepancy between what people wish for themselves and what is happening was considered (David, 2006; Ellis, 1962; Beck, 1976) one of the root causes involved in psychopathology. For example, in adolescents, a significant relationship was found between irrational beliefs (frustration intolerance for rules, frustration intolerance for work) and anger, hostility and aggression (Christopher Kong, Fuller, & DiGiuseppe, 2011). …

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