Assessing symptoms and determining a treatment plan for clients is never a simple or straightforward task. This can be especially the case when it comes to working with talented and doubly exceptional clients.
Imagine that a highly intelligent second grader comes to your advice center. The child has some intense interests, which is not uncommon in gifted individuals, and they struggle with the regulation of emotions that appears to be related to the child's perfectionism and low tolerance for frustration. You might assume that this client's struggles are just a natural result of talent.
Emily Kircher-Morris, a Licensed Professional Counselor (LPC) at the Unlimited Potential Counseling & Education Center in O'Fallon, Missouri, made this assumption. It was only when her client entered fourth grade that Kircher-Morris learned that talent alone could not "explain" the student's emotional struggles. After a major event, the client's problems increased so much that Kircher-Morris referred him to a psychologist for a full differential diagnosis. Upon receiving the results, she was shocked to find out that her client was not only gifted but also autistic.
"I had gotten into the [common] belief in talent: that the [emotional struggles] were just sensory intensity or perfectionism," says Kircher-Morris, a member of the American Counseling Association, which focuses on talent and high Skills has specialized individuals. "I missed how intense his breakdowns were and that his intense interests were related to autism, not talent."
It is true that gifted people have a strong interest, but they can communicate on other topics in addition to that passion, while someone with Autism Spectrum Disorder cannot simply talk on other topics, explains Kircher-Morris.
In order to make an accurate assessment of a talented client, professional clinical advisors must first know what “talent” actually means. The problem is that the precise determinants and measures of talent vary from state to state and even from school to school. According to the National Association for Gifted Children (NAGC), individuals who are considered gifted or talented have the ability to perform better than their peers and need to change their educational experience to learn and achieve their potential.
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Neither Kircher-Morris nor James Bishop, an LPC at Blank Slate Therapy in Frisco, Texas, make a distinction between "gifted" and "high-performance" because they say that some people need to be cognitively challenged, whether or not they are Meet the formal definition of being gifted. And sometimes gifted people have learning difficulties or mental health problems that they need help with – a concept that can be tricky for people who are used to things coming easily, says Kircher-Morris.
Identify (mis) talent
There is also a considerable amount of anecdotal information and misunderstandings about talent, and Bishop, executive director of the Passionate Mind Institute, warns that even psychiatrists can fall prey to pseudoscience in this area. For example, some counselors too easily accept hyperexcitability as a common trait of gifted people, though there isn't much current research to support the belief, he says.
People can mistakenly assume that someone cannot be gifted if they don't do well in school or gifted people never need help, Bishop continues. Some also believe gifted people are more prone to depression, but research shows they are just as well adjusted, if not better, than their peers in the general population, he adds.
Such misunderstandings, as well as concerns about clinical misdiagnosis, prompted Bishop, a member of the ACA, to conduct a study to test the ability of psychologists to recognize gifted characteristics in presenting clients by means of vignettes indicating common problems and characteristics illustrate to talent. Half of the 330 participants were asked that giftedness might be a factor, but regardless of that prompting, Bishop found that the majority of participants still stuck to a diagnosis of a disorder in order to assess giftedness. (See "The Potential of High-IQ Adolescents to be Misdiagnosed by Practicing Mental Health Professionals: A Mixed-Method Study" in the journal High Ability Studies.)
The Bishop's study suggests that even psychiatric professionals, not just educators, have difficulty incorporating talent into their clinical assessments. “If you are careful and read about the real struggles that gifted [individuals] face, you can be a better clinician at assessing gifted [client] and determining whether or not their problems are the result of a disorder simply part of it is her talent, ”says Bishop, chairman of the NAGC network for social and emotional development.
Finding training in this area can, however, be a challenge for consultants. Bishop says he must do a PhD in educational psychology to get formal training in the subject. He is not aware of any counseling program that offers a focus on talent.
The lack of adequate education is a problem because, like trauma, talent should be a specialty, according to Michelle Tolison, a licensed clinical mental health counselor in Charlotte, North Carolina. In fact, she believes that without adequate training, consultants can do a lot of damage when working with talented clients.
Bishop, author of an upcoming book on Fear and Talent for Parents, recommends counselors attend national and state talented and talented conferences to have the opportunity to “immerse themselves, meet people in the field, and get a feel for the subject getting for it as they [as counselors] may play a role. “In addition to resources provided by Supporting Emotional Needs of the Gifted (sengifted.org) and NAGC (nagc.org), Bishop and Tolison, owners and senior therapist at Dandelion Family Counseling recommend reading Giftedness 101 (by Linda Kreger Silverman) and misdiagnosis and double diagnosis of gifted children and adults (by James T. Webb et al.).
The gifted gap
Most gifted children are identified through tests or referrals from primary school teachers. The problem is that schools don't have a standard test to determine aptitude. Additionally, many school districts do not test every student. Instead, they rely on referrals from teachers who, as Renae Mayes, an associate professor in the counseling program of the Department of Disability and Psychoeducational Studies at the University of Arizona, points out, introduces bias.
To highlight this potential trend, Mayes, an ACA member whose research focuses on gifted education and special needs education for color students in urban settings, raises several insightful questions: How are teachers trained to recognize talent? How are they trained to see that talent exists in many different types of bodies? Will teachers see a black student who cannot sit still in their seat and have a lot of energy as someone who is gifted and enthusiastic about learning, or will they perceive the child negatively – as someone who has a behavior problem or wants to disrupt the learning environment ?
The sad reality is that the current method of identifying talent has resulted in an under-representation of people with marginalized backgrounds in talented programs. Researchers at the Thomas B. Fordham Institute recently found that in schools with gifted programs, only three states have more than 10% of their black and Hispanic students in such programs. in 22 states this figure is less than 5%.
Black and Hispanic students are also overrepresented in special education, stresses Mayes. When children receive special education it often becomes the only lens through which they are perceived and the likelihood that they will also be identified as gifted decreases dramatically. As Mayes notes, these children are typically viewed from a deficit perspective, which often involves a stereotypical understanding of culture and disability, rather than allowing children to be seen for their gifts and talents.
According to the article "Myths and Researches Concerning the Socio-Emotional Needs of the Gifted," published in the September issue of The Gifted Education Review (co-editor of which is Bishop), people from different cultures may be not as easy to identify as gifted. The article gives reasons, among other things, because the cultural norms of these people differ from those of the prevailing culture (e.g. what can be seen as positive assertiveness in one culture, in another is perceived as being too aggressive) or because they Talented in their culture are native languages, which is different from the English programs in their schools.
"There is a great effort in gifted education to change the way we identify students and adapt them to the academic needs of children," said Kircher-Morris, president and founder of Gifted Support Network, a non-profit organization dedicated to helping the families of gifted, high-performing learners. "And schools are getting better at identifying younger children and they are doing more universal screening," which is helping to solve problems that can arise with referrals from teachers and parents.
Twice exceptional
Gifted people can also have a special need or a disability. According to the NAGC, the term "twice exceptional" (also known as "2e") describes gifted children who have the potential for high achievement but who also have one or more disabilities, including learning disabilities, speech and language disorders, emotional / behavioral and physical disorders Disabilities, autism spectrum disorder, or other impairments such as attention deficit / hyperactivity disorder (ADHD).
"People don't often think that gifted people can have a disability," says Kircher-Morris. "It's not intuitive, so you have children who are exceptionally cognitive but may have ADHD or are autistic and need a 504 plan or maybe even an individual education program."
Kircher-Morris, elected chairman of the NAGC Social and Emotional Development Network, has found that teachers sometimes don't feel like they need to be placed in settings such as advanced internship classes. These teachers just expect that a student in such a class should be able to get the job done. She often reminds educators that not taking a challenging course is not accommodation. Twice exceptional students have yet to be challenged. You just need some help along the way.
It can be easy for counselors and other mental health professionals to overlook a double exception diagnosis, says Kircher-Morris, who hosts the Mind Matters podcast, which focuses on high-level and double-skill development. extraordinary people over their entire lifespan. She is also the author of the upcoming book, Teaching Twice-Exceptional Learners in Today's Classroom.
Kircher-Morris had several clients receive psychological assessments and came back with a misdiagnosis. She recalls an example where one of her gifted elementary school-age clients had a breakdown in school, became emotionally dysregulated, and had trouble understanding non-verbal cues. Kircher-Morris knew the client was gifted, and she strongly suspected he was also autistic. The boy's parents were reluctant to accept this label because of the stigma associated with autism. They found it easier to just say, "He's quirky because he's gifted."
When Kircher-Morris finally convinced the parents to perform a psychological assessment for their son, she wrote a letter to the person performing the assessment, informing them that the child was gifted to ensure that this was done will be considered. But the person doing the assessment did not specialize in aptitude and ended up diagnosing the child as depressed because sometimes when he had a breakdown he would say, “I hate myself. I wish I could die "
Kircher-Morris knew that the client was not clinically depressed. Instead, he had great emotions and wasn't sure how to talk about it, she says. She adds that a day of testing and questionnaires is not enough to fully understand and diagnose a person.
Kircher-Morris is still working with this student and now that he's in high school his autism is more pronounced. When his schedule changed and he had to start showering in the morning instead of the evening, he didn't get along well at first. Kircher-Morris worked with him to regulate his emotions related to this change. The student also has some problems with friends at school, but other people in his life often see him through a lens of talent and assume he shouldn't have any communication problems, says Kircher-Morris. Little do they know that as a twice extraordinary teenager, he sometimes has certain challenges.
Trying to identify a customer as doubly exceptional is even more difficult because of the concept of masking. As Tolison notes, gifted individuals with a learning disability can fall into one of three categories:
1) The advanced intellect of the individual compensates for his learning difficulties.
2) The learning disability or the special need overshadow the talent of the person.
3) The talent and the learning disabilities mask each other so much that the individual seems to have an average intelligence.
Research shows that doubly exceptional children are often diagnosed later as their peers because their struggles are not so noticeable at first, says Kircher-Morris. The fifth edition of the Diagnostic and Statistical Manual for Mental Disorders says that, for example, people with autism may be able to make up for their comparatively minor lack of social skills until social expectations are beyond their abilities, she notes. A gifted child who is also autistic may not have speech lag when they are small, but by the time they reach middle or high school their emotional and social struggles and rigid thinking become more problematic.
"And we've lost all of the time now to be proactive and support them and help them build the skills they need to be successful, confident and happy," adds Kircher-Morris.
To avoid mislabeling clients, Tolison, a registered play therapist who works with children who are doubly exceptional (especially those with ADHD), advises counselors to always consider how the client's behavior communicates. Are they fidgeting in the classroom because they are under-simulated or is it a symptom of ADHD?
Therapists need to "recognize the mixture of symptomology between talent and diagnosis," continues Tolison. For example, psychiatrists shouldn't assume that a client is autistic just because the client is smart and has difficulty connecting with their peers, she says. Instead, she advises digging deeper and considering whether the symptoms will decrease or resolve when the client is in an ideal environment, such as a living room. B. in the vicinity of others who have interests similar to them.
Talent and special needs education are often seen as opposite ends of the continuum, Mayes says, but she claims they are separate continuums and could coexist. "Disability is the way you do something," she explains. Even if a person may have to perform a task or skill differently or need help, they may still have higher cognitive abilities, notes Mayes, who has published several articles on the subject, including “College and Career Readiness Groups for Gifted Blacks High Students with Disabilities ”in the Journal for Specialists in Group Work.
Mayes tells a real-life case study of how these continuities can overlap in a client: A black student who was in a talented middle school program had an accident and suffered a traumatic brain injury. The injury gave the boy a bad headache when he sat for long periods of time and his vision became blurred. But his cognitive abilities remained unchanged. He just needed some shelter to help him at school. However, his teachers did not believe that he actually had a headache. They assumed he was just trying to get out of work. The boy internalized their disbelief and told his mother the teachers looked at him like he was a "lazy black boy," a stereotype that he knew prevailed in school. Soon after, the boy's grades began to suffer.
His mother became a great advocate for her son and pushed for special education and a gifted label for him. Nevertheless, the school refused. It was only when the boy entered high school and the school counselor joined the mother's fight that they finally got a place to stay for the student. When the boy turned his talent for STEM (science, technology, engineering and math) into a passion for the band, the band director stood up for him too.
This student had to reconfigure his identity not just as a gifted student but as a gifted student with a traumatic brain injury and he had to learn to represent himself, Mayes says.
Asynchronous development
The cognitive, emotional and physical development of gifted children is often asynchronous, which means that their intellectual development exceeds their maturity or emotional development. Although their intellectual abilities are advanced, their social and emotional abilities may lag behind.
"Cognitive talent is not necessarily the same as emotional maturity," says Kircher-Morris. Because gifted children are often very verbal and speak as if they were mini-adults, people mistakenly assume that their behavioral and emotional regulation skills will also improve, she explains. Counselors should therefore consider clients' emotional development along with their cognitive development.
According to Tolison, there can be a gap of more than 12 years between a child's intellectual age and their social / emotional age. [and] For example, a twice extraordinary child with ADHD could be 8 years old biologically, but with the intellectual abilities of a 12 year old and the social and emotional development of a 6 year old. And at times, the kid could have emotional outbursts on a par with a 4-year-old, adds Tolison.
Tolison often helps her clients understand emotional language first. She finds the Anger Iceberg exercise helpful in teaching the identification and awareness of emotions. Since some customers may be empathetic, this process is less about identifying emotions and more about learning how to express them, she adds. Tolison then helps clients focus on executive skills such as: B. Planning ahead, organizing your thoughts, thinking flexibly, and demonstrating self-control – all of these can be a challenge for people who are doubly exceptional. She can play chess or othello with clients, for example to help them with impulse control.
Kircher-Morris leverages clients' cognitive skills at a higher level by adapting their counseling approach. This can be as simple as using a more advanced technique on a younger client (similar to skipping classes in school), or it can involve adjusting a technique to make it more analytical and creative.
The Emotion Wheel, which describes eight basic emotions and their various degrees, is a great tool to help customers identify and name their emotions, says Kircher-Morris. But this tool may not stimulate gifted customers enough to keep them occupied, and they will modify it to make it more cognitively challenging. Your emotion wheel is mostly empty. She leaves a few emotional words in different places on the steering wheel and works with clients to fill in the blanks. Sometimes they search for words in the thesaurus or online to find the “just right” word, and then customers rate and determine which words should appear on the steering wheel. This activity builds on the high-level vocabulary that gifted clients often possess and gives them some autonomy in the session, she says.
Allow gifted customers direct (but not dictated) sessions
Kircher-Morris notes that gifted children often do not know that something is "wrong". They may be skeptical of the counseling at first, especially if their parents are the ones who initiated it. And because these children are gifted, they often want to know the “why” before fully trusting and participating in various counseling approaches.
It is for this reason that Kircher-Morris encourages these clients to ask questions and takes time to explain the psychology behind the interventions. It also enables clients to find out what works best for them and come up with their own ideas about what would be helpful.
When Kircher-Morris introduced the cognitive triangle exercise (which emphasizes the relationship between one's thoughts, feelings and behaviors), it goes beyond simply drawing the diagram on a dry-erase board. She also presents a hypothetical example to help customers better understand the underlying principle of the activity.
One example she uses frequently is a student who has an upcoming math test. She asks, "What uncomfortable feelings might you experience?" After she and the client have worked out some possible feelings, she asks, "If you are experiencing these uncomfortable emotions, what thoughts might you be having?" She draws speech bubbles on the board and fills them out with the customer.
Then they discuss how these thoughts could influence the behavior of the hypothetical student, where the student could intervene and how this would change the result. Going through this hypothesis allows clients to better understand how the exercise works before applying it to their own situations, says Kircher-Morris.
The fact that gifted people have higher thinking skills also means that they are more likely to find flaws in the logic of others, says Kircher-Morris. Indeed, because these individuals are often brighter than their parents, teachers, and others with whom they interact, counselors could be trapped in a corner of logic when a gifted client pokes holes in their reasoning. In this case, Kircher-Morris advises the advisors not to engage in a power struggle.
"Do not try to claim your intelligence or the information you have as it will damage rapport," says Kircher-Morris. Instead, their approach is to acknowledge the valid point that the customer made. For example, she might say, "I hadn't thought about it like that. I've seen this counseling technique work for other clients, but maybe it doesn't work for you. Let's find out what will work. Think that part of this Activity could be relevant for you? "
Tolison agrees that gifted clients benefit from having some control over their therapy, but warns counselors against letting them determine the direction of treatment. She says she often has parents who come to her because they previously worked with another therapist who allowed her gifted child to take control until they stopped making progress.
Gifted clients are often excited to deal with a topic they are passionate about, but that can dominate the session. However, as Tolison points out, counselors can turn this passion into therapeutic intervention. She once had a client who wanted to talk about the dwarf planet Pluto for most of her sessions. She used this as an opportunity to teach the client about mindfulness and social awareness.
She used the phrase "I noticed" to keep him from talking about Pluto: "I noticed that you have been talking about Pluto for 20 minutes now. I think it's great that you share your passion with me share, but can we take a break because I'm a little tired learning this information? Let's talk about something new. "This statement set a limit for the client while also helping him track the passage of time and other people's feelings better to take into account, says Tolison.
Tolison also encourages clinicians to be humble when working with gifted clients. "Sometimes the most therapeutic thing you can do for a gifted child is to be excited about what they can teach you, because that's where they learn, too," she says.
Comprehensive neurodiversity
Kircher-Morris' aim is to normalize the fact that there are different types of brain wiring. People with this brain wiring may deviate from the norm, but that doesn't mean there is something "wrong" with them. Being gifted or twice extraordinary is simply part of the human condition. Normalizing neurodiversity will encourage people to realize they need help and give them the courage to ask for it, she says.
Counselors have a great understanding of the individual needs of clients, she continues, but if they do not take into account all factors, including a person's cognitive abilities, they can misinterpret the client's situation and real needs. For example, if a cognitively gifted child is having a hard time making friends, a counselor can simply focus on helping the child develop social skills and confidence. But then the counselor would miss the opportunity to consider other possible factors like bullying, the child's high level of stress, their sense of isolation, or what others expect of them – all of which could affect the child's ability to build authentic relationships, Kircher-Morris explained.
Therefore, she advises counselors who work with this population to ensure that they view their clients' struggles through a lens of talent. How does talent or double exception affect the experience and reality of these customers? Doctors also need to figure out how to use clients' strengths with their cognitive skills to solve problems they have, says Kircher-Morris.
Laut Mayes müssen Berater das Verständnis der Klienten ganzheitlicher gestalten und sie als mehr als ihre Kämpfe oder sogar ihre Begabung ansehen. "Wir müssen bei unserer beruflichen Entwicklung einen breiteren Ansatz verfolgen", sagt sie, "damit wir beginnen können, die Identität von Individuen über die Begabung hinaus besser zu verstehen, um Kultur, Klasse, Geschlechtsidentität, affektive Identität und vieles mehr einzubeziehen."
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Lindsey Phillips ist Autorin von Counseling Today und UX-Content-Strategin. Kontaktieren Sie sie unter [email protected] oder über ihre Website unter lindseynphillips.com.
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