Helping Children Cope

A relatively new category in the field of informational literature for children is the book to help children deal with psychological problems. It is not surprising that these books are being written, given the enormous number of such works available to adults, and the generally high level of sophistication of our culture about the need to identify and deal with emotional problems. Three recent titles are What Happens in Therapy and Trouble at Home, both by Sara Gilbert, and The Kids' Book of Divorce, edited by Eric Rofes. Underlying the divergent approaches in these books is a common recognition that children need and should have help in seeking information and support for their problems and uncertainties.

In What Happens in Therapy (New York: Lothrop, Lee, and Shepard, 1981), Gilbert seeks to communicate to teenagers the nature of the therapeutic process. Since adolescence is a time of rapid changes—emotional and cognitive, as well as biological—even youngsters from the most stable families often feel confused, anxious, and, on occasion, like they are "going crazy." Gilbert provides teenage readers with an understanding of the nature of adolescence and includes a list of stress points and symptoms that can help readers decide whether to seek professional counseling. For example, changes in eating or sleeping patterns, or a drop in school performance indicate that the teen would benefit from therapy, and the presence of even one severe symptom—thoughts of suicide or hallucinations—suggests that the teenager should seek immediate psychological help.

Gilbert describes typically troubled youngsters to illuminate a variety of treatment approaches. Insight and behaviorial therapy, as well as family, hospital, and residential treatments are described. Gilbert's own bias is psychodynamic. That is, she posits unconscious thoughts and feelings as causes for behavior. Consequently, her discussion of such important psychodynamic concepts as the unconscious, transference, resistance, acting-out, and working through are concise and well-drawn. The chapter on insight therapy, the most factual, informative, and realistic of the therapy chapters, is very good. The psychodynamic bias, however, creates some difficulty when she attempts to describe other modes of treatment. Behavioral therapists, for example, are not concerned with unconscious motivation. In the behaviorist view, behavior is learned, and what is learned by the individual is determined by the reinforcements he or she received. But Gilbert appears to ignore this fundamental difference between psychodynamic and behaviorial orientations. In the chapter on behavior therapy, she describes a teen being treated by a behavior therapist, though the explanations for the teen's behavior and for her behavioral changes are stated in psychodynamic terms.

In gathering information for the book, Gilbert conducted interviews with many people in the adolescent-helping professions, but she did not interview teenagers to find out what they thought of the therapeutic process. The absence of the teenager's voice is a serious flaw, since the reader is often left wondering what impressions typical young people would have contributed. The tone of the book is too formal and pedagogical. Questions and comments from teens would have made it more readable and more appealing to a teenage audience in search of information.

The second book by Gilbert, Trouble at Home (New York: Lothrop, Lee, and Shepard, 1981), is a thoughtful and important work dealing with the vicissitudes of family life. It recounts for teens the broad range of family crises that can affect them. Gilbert discusses problems with parents and siblings, and those problems concerning family secrets, illness, and death.

She describes how escape from trouble at home takes many forms: in response to stress, for example, teenagers may develop physical ailments, become emotionally disoriented, turn to drugs, or even attempt suicide. Gilbert offers well-researched, carefully reasoned advice to teens about alternative ways to deal with trouble at home. She also provides a list of organizations and other sources of aid and information.

The section dealing with specific and "secret" family problems is the most effective and useful. She shows that alcoholism, child abuse, and mental disturbances can be treated if someone is willing to take the responsibility for making the problems public. Gilbert clearly and forthrightly addresses the teenager's...