Counseling Strengths & Difficulties (SDQ) Assessments Share +

 













Highlights from Counseling Strengths and Difficulties (SDQ)

 Assessments 2019/2020

 

Overview of the Counseling Program

Coronado SAFE provides counseling to individuals and families. Staff members at SAFE are committed to supporting individuals and families through a difficult season or helping them conquer anxiety and depression. The staff is here to serve the needs of the Coronado community. With backgrounds in Marriage and Family Therapy and Social Work, SAFE therapists offer short-term, confidential, and low-cost counseling services. The aim of the counseling programs is to foster personal growth, self-awareness, and coping skills by utilizing several evidence-based modalities in 8-session increments such as Narrative Therapy, Interpersonal Therapy, CBT, and Art and Play Therapy techniques. SAFE provides:

  • Screenings/intakes:  Initial support, assess appropriateness, and provides referrals if needed. 
  • Individual and Family Counseling:  8 session module that provides solution focused and strength-based strategies to youth and families struggling with a variety of issues.
  • Counseling support groups:  Offered to youth and parents

 

Demographics of Clients

Counseling clients at SAFE complete an intake form to collect basic demographic and clinical information. This data is summarized as follows:

  • 52% of clients are referred by school counselors
  • 83% have never been in counseling before
  • 22% live in more than one household
  • 61% exhibit depression/anxiety as their primary presenting problem

 



 

Overview of SDQ

The Strengths and Difficulties Questionnaire (SDQ) is a validated instrument to measure “behavioral and emotional difficulties that can be used to assess mental health problems in children and young people aged 4–17 years”[1]. The SDQ is given to clients and their parents each time they are seen by a SAFE counselor. The SDQ is composed of 25 items that are divided into five scales[2]:

  • Emotional symptoms
  • Conduct problems
  • Hyperactivity/inattention
  • Peer relationship problems
  • Prosocial behavior

 

A total difficulties score is composed of the first four scales. There is also an impact scale which asks if the young person has a problem, and if so, follow up questions about chronicity, distress, social impairment and burden to others are given. Additionally, the first four scales can be combined to form scales for internalizing and externalizing problems[3]:

  • Internalizing problems (emotional + peer symptoms)
  • Externalizing problems (conduct + hyperactivity symptoms)

 

Those with internalizing problems keep these problems to themselves. Internalizing disorders include depression, withdrawal, and anxiety and can lead to low self-esteem and even suicide while those with externalizing problems tend to act-out and can be described as aggressive, impulsive, coercive, and noncompliant.

 

During the 2019/2020 school year, 57 SDQ assessments were completed at SAFE by 39 unique clients and their parents. The average age of youth respondents is 16 years, 69% of the respondents are female and 31% male. Thirteen clients completed more than one SDQ. These thirteen clients comprise the before and after results of the SDQ reported in this document.

 

Results of SDQ

Overall, SAFE counseling clients and their parents report positive results from counseling intervention. Youth responses to the five scales in the SDQ assessment tended to exhibit less negative perceptions than parent responses. Taken in aggregate, there was improvement in every scale measured by the SDQ. Figure 1 shows the before and after aggregate responses of both youth results and their parents. The first four measures (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems) show improvement by a decrease in their scores range from a possible 10 points (most severe) to 0 (no signs of problems). Conversely the prosocial scale shows improvement by an increase in scores from a possible 0 (no social skills) to 10 (excellent social skills). The total score is a sum of the first four measures (possible total of 0-40) showing improvement through a decrease in total score from pre- to post- assessment.

 

 

 

Individual scores were also examined for each of the 5 scales. Table 1 shows the results of the SDQ scores for the percent of clients who showed improvement or consistency in each of the 5 scales and the totals. Over half of all respondents reported improvement or consistency in all of the scales.

 

Table 1: Improvement or Consistency in SDQ Scales

Scale

Parent

Youth

Emotional Problems Scale

86%

89%

Conduct Problems Scale

100%

89%

Hyperactivity/Inattention Scale

71%

56%

Peer Relationship Scale

57%

76%

Prosocial Scale

71%

100%

Total

100%

89%

 

 

 

Internalizing and Externalizing Problems

As stated earlier, the five scales can be broken down into three to show the propensity to internalize and/or externalize behavioral and emotional issues. The third scale used in this instance is the prosocial scale. The emotional and peer relationship scales are added together to obtain the internalizing problems scale and the conduct and hyperactivity/inattention are added together to obtain the externalizing problems scale. These scales are used to describe a general population rather than as a tool for treatment. Table 2 shows the improvement scores from Table 1 broken down into the three-scale option: 1) Internalizing problems; 2) externalizing problems; and 3) prosocial behavior.

 

Table 2: Internalizing and Externalizing Problems

Scale

Parent

Youth

Internalizing Problems

71%

89%

Externalizing Problems

86%

78%

Prosocial Scale

71%

100%

 

Conclusion

Although many of the post SDQs were taken just a month after the initial intervention with a SAFE counselor, the majority of clients showed improvements in all of the assessment scales. The first four measures (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems) show improvement by a decrease in scores from pre- to post- surveys, with the largest decrease measured in youth exhibiting emotional problems. The youth appeared to rate their own symptoms as more severe than their parents did in the pre-assessments, and their improvement was more pronounced. This suggests the youth found the counseling to be very effective for themselves. Emotional symptoms are categorized as internalizing disorders which include depression, withdrawal, anxiety, can lead to low self-esteem and even suicide. Results suggest SAFE counseling intervention has had a positive impact on youth who present internalizing disorder symptoms. Additionally, 100% of parents show improvement in their child’s conduct problems scale, indicating progress externalized disorders. In overall ratings, youth rated highest improvement scores in internalizing problems (89%) and on the prosocial scale (100%), both of which underscore the aim of the counseling programs, to foster personal growth, self-awareness, and coping skills.

 

[1] Goodman A, Goodman R. Strengths and difficulties questionnaire as a dimensional measure of child mental health. J Am Acad Child Psychiatry. 2009; 48:400–3.

[2] http://sdqinfo.org/a0.html

[3] https://web.archive.org/web/20180331104522/https://www.education.com/reference/article/emotional-behavioral-disorders-defined/