on Counselling

161 Pages·2017·2.1 MB·English

NATIONAL COMMISSON FOR PROTECTION
OF CHILD RIGHTS (NCPCR)

A HANDBOOK
on
Counselling
For Training, and skill development of staff of Child Care Institutions

1 | P age
DISCLAIMER

This Handbook for has been developed to provide information about child rights, legislatives and
basics of counselling. This handbook is intended to cover broadly the ‘need’ or rationale for developing
the handbook, primarily for the counsellors and other staff (the stakeholders) who are working in various
Child Care Institutions (CCIs) including Children homes and District Child Protection Units (DCPUs)
addressing various concerns of children in difficult circumstances, and the process with which it will be
applicable.
One of the main components of this Handbook is to identify psychological issues in children
living in Child Care Institutions that require counselling.
This Handbook is recommended for use by counsellors and staff in all the Child Care Institutions
of the country after getting training. It needs to be understood that there might be circumstances that
require professional experience and technical knowledge of psychotherapies and it is advised that the
counsellors develop their own locally available referral networks for their assistance.
2 | P age
Advisory Group Members:

Advisory Group members as contributors for ‘Handbook on Counselling Essentials ‘for CCIs by
NCPCR.
1. Ms Rupa Kapoor, Member, Child Health, NCPCR-Chairperson of the Group
2. Prof. (Dr.) Nimesh G Desai, Director, IHBAS
3. Dr. Ajay Khera, Deputy Commissioner, MOH&FW, GOI
4. Dr. Deepak Kumar, Assoc Prof (Psychiatry) & Deputy Medical Superintendent, IHBAS
5. Dr. Jahanara M Gajendragad, Associate Prof, Dept of Psychiatric Social Work, IHBAS
6. Dr. Anju Dhawan, Professor, NDDTC, AIIMS
7. Dr. Rajesh Sagar, Professor, Dept of Psychiatry, AIIMS
8. Dr. Rachna Bhargawa, NDDTC, AIIMS
9. Dr Adarsh Kohli, Professor, Department of Clinical Psychology, PGIMER, Chandigarh
10. Dr. Amit Khanna, Asst Prof. Dept of Psychiatry, IHBAS
11. Dr. Nishant P Goyal, Assistant Professor of Psychiatry, Central Institute of Psychiatry (CIP), Ranchi
12. Dr. Kiran Modi, Managing Director, UDYAN Care
13. Ms. Radhika Alkazi, Artha Astha, An organization for Children with Disabilities
14. Ms Rita Sengupta, Consultant, NCPCR
15. Ms Shaista K Shah, Senior Technical Expert, NCPCR
Other Contributors to the Handbook
16. Dr Biswadip Chatterji, Assistant Professor, Department of Psychiatry, AIIMS
17. Dr Vijay Krishnan, Psychiatrist, Research Officer, Department of Psychiatry, AIIMS, New Delhi
18. Sh. Mohit Kumar, Senior Research Fellow, Department of Psychiatry, AIIMS, New Delhi
Editorial Group
1. Ms Rupa Kapoor, Member, NCPCR
2. Prof. (Dr.) Nimesh G Desai, Director, IHBAS
3. Dr. Deepak Kumar, , Assoc Prof (Psychiatry) & Deputy Medical Superintendent, IHBAS
4. Dr. Jahanara M Gajendragad, Associate Prof, Dept of Psychiatric Social Work, IHBAS
5. Dr. Amit Khanna, Asst Prof. Dept of Psychiatry, IHBAS
6. Ms Shaista K Shah, Senior Technical Expert, NCPCR

3 | P age
ABBREVIATIONS and ACRONYMS

CCI - Child Care Institution
NCPCR - National Commission for Protection of Child Rights
IHBAS - Institute of Human Behaviour and Allied Sciences
CPD- Continuing Professional Development
NIPCCD – National Institute of Public Cooperation and Child Development
AIIMS- All India Institute of Medical Sciences
NDDTC- National Drug Dependence and Treatment Centre
PGIMER- Post Graduate Institute of Medical Education & Research
MOH&FW- Ministry of Health & Family Welfare
GOI- Government of India
CIP- Central Institute of Psychiatry
CSA- Child Sexual Abuse
NGO- Non Government Organization
JJ Act- The Juvenile Justice (Care and Protection of Children) Act

POCSO - The Protection of Children from Sexual Offences

UNICEF- United Nations Children’s Emergency Fund

WHO- World Health Organization

4 | P age
5 | P age
6 | P age
Acknowledgements

The preparation of this Handbook has been an intense learning experience that enables us to go
into great depth into the child rights from a mental health perspective. National Commission for
Protection of Child Rights (NCPCR), acknowledges the support it received from the members of the
Advisory Group set up by the Commission. This Handbook would not have been possible without the
leadership of Ms. Stuti Kacker, Hon’ble Chairperson of NCPCR. NCPCR is grateful to the members of
the Advisory group constituted for promotion of positive mental health of children in CCIs for their
valuable inputs. Our special thanks to Prof (Dr) Nimesh Desai and his team members Dr. Deepak
Kumar, Dr. Amit Khanna, Dr. Jahanara from IHBAS for their valuable contribution in giving a final
shape to this document.
I would also like to thank Ministry of Health & Family Welfare for their contribution. Dedicated
support received from Dr. Anju Dhawan, and Dr. Rachna Bhargava, NDDTC, AIIMS and Dr. Rajesh
Sagar, Dept of Psychiatry, AIIMS.
Sincere thanks to Director, CIP, Ranchi, for his support, especially to Dr. Nishant from CIP, for
his valuable inputs and suggestions. My thanks also to Ms. Radhika Alkazi for her inputs.
We are also grateful to Dr. Adarsh, PGIMER for her valuable inputs and support. Contribution of
Dr. Kiran Modi, Udyan Care is very much appreciable, as she provided her inputs and shared experience
during the making of this Handbook.
Finally, I would like to specially thank Ms. Shaista K Shah, Senior Technical Expert, NCPCR,
for assisting the Commission throughout the entire exercise of making of this Handbook. Special thanks
to Ms. Rita Sen Gupta, working as a Consultant with NCPCR.

Rupa Kapoor
Member, NCPCR
7 | P age
Table of Con tents

Introduction to the Handbook………………………………………………………… Page: 10-11
1.
1.1 Overview of mental health in Child Care Institutions

1.2 Background

2. Purpose and Scope of the Handbook…………………………………………………Page: 12

3. Child Rights: an overview………………………………………………………….....Page: 13-26
3.1 Role of Child Care Institutions under Juvenile Justice (Care and Protection of Children) Act 2015
3.2 Roles and Responsibilities of Superintendent, Counsellor, Probation Officer/CWO/Case Worker,
House Mother/House Father & Para Medical Staff
3.3 Salient Features of POCSO Act 2012

4. Identification of Mental Health needs of Children in CCI’s ……………………….Page: 27-31
5. Framework of Counselling/Basic Issues in Counselling……………………………..Page: 32-44
5.1 What is Psychological Counselling
5.2 Attributes of a Good Counselor
5.3 Basic Counselling Skills
5.4 Techniques of counselling
5.5 Ethical Issues in counselling
5.6 Knowledge, Attitude and Practice Paradigm
5.7 Self awareness of Counsellors: Impact on practice

6. Application of counselling skills in special situations………………………………..Page: 45-96
6.1 Children with Disabilities
6.2 Children with Substance use
6.3 Suicidal behavior in Children
8 | P age
6.4 Victims of Child Abuse
6.5 Victims of Disaster (Natural & man Made) and conflict
6.6 Convergence and Prioritization
7. Promotion of Positive Mental Health & Well-Being among Children and Adolescents in CCIs…Page: 97-115

7.1 Identification of Positive and protective factors in children
7.2 Strategies for prevention and promotion of Mental Health in children living in Child care institutions
8. Mental Health Wellbeing of Counsellors (Care for carers) ……………………….Page: 116-121

9. Child and Adolescent Mental Health Assessment Tools (Brief and simple screening tools))….Page: 122-130

10. Framework for developing an Individual Care Plan ……………………………..Page: 131-137

11. Framework for developing a locally available referral network for specialized centre/services &
Referral criteria …………………………………………………………………... Page: 138-144

12. a. Reference…………………………………………………………………... …....Page: 145-148

b. Bibliography…………………………………………………………………... Page: 149

13. Annexures…………………………………………………………………... …….Page: 149-166
a. Executive summary of the three series CPD Workshop July-August 2014
b. Psychological Test
c. Screening Tools
d. Individualized care plan
e. Resource /Directory of Mental Health services in the local context in each state

9 | P age
Section 1: Introduction to the Handbook

Overview of Mental Health of children in Child Care Institutions
Across the Indian states, there are around 5000 Child Care Institutions both registered and
unregistered that are involved in the care and protection of approximately 1,50,000 children and
adolescents at any given time; who as a result of their adverse psychosocial circumstances are residing
in these CCI’s. A large number of these CCI’s have a high turnover and most of these children for
obvious reasons require psychosocial intervention. Psychosocial care with a preventive and promotive
inclination is of utmost importance for these children who are in need of care and protection.
The children and adolescents living in the CCI’s, most of whom come from low socio-economic
families with fractured family ties require intensive psychosocial intervention in the absence of any
significant family member or presence of reluctantly involved parent or guardian. Children and
Adolescents living in CCI’s suffer from a spectrum of mental health issues ranging from transient
emotional disturbances to more severe psychological/psychiatric problems such as substance use
disorders, Conduct disorders and varying grades of suicidality in the background of common and severe
mental illnesses.
Institutionalized children and adolescents have higher rates of moderate to severe forms of
psychological /psychiatric disorders making them a vulnerable group. With the changing socio-political
scenario in India and across the globe with reforms in laws that govern the care and protection of
children and adolescents; it is imperative that as a nation we focus on the needs of these children living
in difficult circumstances. Perhaps, the single most important means to achieve this goal would be to
focus on capacity and skill building of the counsellors and support staff.
According to the NCPCR inspection report of 2012 submitted to the High Court of Delhi (WP
No 694/2012), more than 50% of the children living in Child care homes in Delhi had emotional and
behavioral problems with 10-15% children having a diagnosable psychiatric syndrome, whereas for the
majority the mental health needs were largely unmet. Further, the major mental health problems were
Mild Mental Retardation, Depressive Disorder, Seizure Disorders, Conduct Disorder, Slow Learning
and speech defects. Most researches report a similar and grim mental health scenario in institutionalized
setups for children and adolescents across developing countries and hence there is urgent need to
address the mental health needs of these children through multi-disciplinary teams and mental health
networking and delivering a spectrum of curative, rehabilitative and preventive treatment interventions
for this vulnerable group of children.
In an ideal scenario, the counsellor can not only implement individual components of the
spectrum of care but also promptly and effectively implement a management plan for the holistic
development of the child, but a realistic approach needs to be adopted wherein the counsellors can
identify and diagnose various psychological/psychiatric disorders in the overall realm of preventive care.
10 | P age