Children’s therapy: what it looks like by Gorana Arnaud

In general, treating children in therapy is more complicated then treating adults. When an adult is in therapy, there is only one person for the therapist to consider: the patient. With a child, there are at least two distinct entities: the child, and the parent. Should the father and mother be separated or in conflict, there might be three sides to take into account. However, this does not mean that the counsellor must play the role of mediator or 'referee' as can sometimes be the case in particularly difficult sessions of couples’ therapy. When a child is involved, the only thing that really matters is what is in his or her best interest.

Children s therapy

 

What makes treating children so moving and gratifying is that, in nearly all cases, the parent who brings their child to see a therapist does really want what is best for their kid, they simply don’t know how to go about it. They’ve tried following their intuition, tried following the advice of well-meaning people around them, and they simply feel stuck, whilst their little one’s troubles still persist.

 

Most theories in psychology and psychoanalysis describe the child as a "symptom" of the parent. This means that THE CHILD IS LIKE A SPONGE, ABSORBING ALL OF THE PARENT’S MOODS AND FEARS, as well as the general atmosphere within the home, without necessarily having the adult capacity to verbalise them. For example, when mum is down because dad is away a lot, the young child might develop bedwetting as a symptom, the somewhat older child might react with difficulties concentrating and thus a sudden sharp decline in school results. Therefore, it is absolutely essential that at least one parent receives consideration from the therapist who will take special care to implicate them in their child’s healing process. This is, despite changing family structures and gender roles, still by far the mother.

 

The mother-child bond is so unique, it is the surest and fastest way for a child to become serene, healthy and happy again. So, if the therapist considers solely the child, and keeps the parents at bay, because most therapists in practice are indeed female, it is the therapist that becomes in a way the "substitute mother". This, in my opinion, is completely counterproductive, not benefitting the child at all. And whilst it may be inevitable in extreme settings such as hospitals or orphanages where the real mother is absent due to unavoidable circumstances, in the private practice setting it is simply too much.

 

What is needed is not a "second" mother, what is needed is to strengthen the fragilized bond between mother and child, so the child can become secure and carefree once again. Once the child enjoys this feeling of security, the pathological symptoms that brought them into therapy tend to disappear very quickly of their own accord. This is why, during the very first session, in which at least one parent is present together with the child, I explain to them that when working with children, my role is that of "parental assistant" or "mum’s helper".

 

So, in the very first therapy session, the parent and child are present together, and the parent explainwhy they want their son or daughter to see a therapist. Then, the child is asked for their point of view, if they have anything they want to say or to add. At the end of this session, I will ask the child directly: "Would it be ok if you were dropped off at my officeIn general, treating children in therapy is more complicated then treating adults. When an adult is in therapy, there is only one person for the therapist to consider: the patient. With a child, there are at least two distinct entities: the child, and the parent. Should the father and mother be separated or in conflict, there might be three sides to take into account. However, this does not mean that the counsellor must play the role of mediator or 'referee' as can sometimes be the case in particularly difficult sessions of couples’ therapy. When a child is involved, the only thing that really matters is what is in his or her best interest.

What makes treating children so moving and gratifying is that, in nearly all cases, the parent who brings their child to see a therapist does really want what is best for their kid, they simply don’t know how to go about it. They’ve tried following their intuition, tried following the advice of well-meaning people around them, and they simply feel stuck, whilst their little one’s troubles still persist.

Most theories in psychology and psychoanalysis describe the child as a "symptom" of the parent. This means that THE CHILD IS LIKE A SPONGE, ABSORBING ALL OF THE PARENT’S MOODS AND FEARS, as well as the general atmosphere within the home, without necessarily having the adult capacity to verbalise them. For example, when mum is down because dad is away a lot, the young child might develop bedwetting as a symptom, the somewhat older child might react with difficulties concentrating and thus a sudden sharp decline in school results. Therefore, it is absolutely essential that at least one parent receives consideration from the therapist who will take special care to implicate them in their child’s healing process. This is, despite changing family structures and gender roles, still by far the mother.

The mother-child bond is so unique, it is the surest and fastest way for a child to become serene, healthy and happy again. So, if the therapist considers solely the child, and keeps the parents at bay, because most therapists in practice are indeed female, it is the therapist that becomes in a way the "substitute mother". This, in my opinion, is completely counterproductive, not benefitting the child at all. And whilst it may be inevitable in extreme settings such as hospitals or orphanages where the real mother is absent due to unavoidable circumstances, in the private practice setting it is simply too much.

What is needed is not a "second" mother, what is needed is to strengthen the fragilized bond between mother and child, so the child can become secure and carefree once again. Once the child enjoys this feeling of security, the pathological symptoms that brought them into therapy tend to disappear very quickly of their own accord. This is why, during the very first session, in which at least one parent is present together with the child, I explain to them that when working with children, my role is that of "parental assistant" or "mum’s helper".

So, in the very first therapy session, the parent and child are present together, and the parent explainwhy they want their son or daughter to see a therapist. Then, the child is asked for their point of view, if they have anything they want to say or to add. At the end of this session, I will ask the child directly: "Would it be ok if you were dropped off at my office alone next week?" which is usually followed by a staring at the shoes, prolonged silence, and then a barely perceptible nod, at best an "Umm, ok..." So, the following week, the parent drops their child off, and even though there is a very comfortable waiting room, I tell them to go and wait in the café across the road, or go window-shopping, and come back in an hour. The child must feel completely free, and this may be hindered if he knows the parent is just in the next room. I now explain to my patient, in age-appropriate language, that whatever they tell me is completely confidential, and that Mum and Dad will only know what I choose to share. The next few sessions are equally one- on one, and then the parent is asked to join us.

The subsequent sessions are spent together with the parents, where I can share my insights with them as to the root causes of their child’s suffering, and where we can work out together practical strategies to implement at home so that our young patient starts to have that precious feeling of security once again, THE SECURITY THAT IS THE FOUNDATION FOR SOUND MENTAL AND PHYSICAL HEALTH. Again, these "family" sessions must be conducted somewhat diplomatically, in age-appropriate language. The child must have utter trust in the therapist, and feel intuitively that his private world is safe, that the therapist will not reveal their secrets to the parents. Yet, at the same time, the parent must be made aware of what they can do, mostly on a practical day to-day basis, in order to best help their child.

Because children are so much more sensitive than adults, this also means that they are more 'malleable' and thus lasting change can come about in a quicker, easier, smoother way.

alone next week?" which is usually followed by a staring at the shoes, prolonged silence, and then a barely perceptible nod, at best an "Umm, ok..." So, the following week, the parent drops their child off, and even though there is a very comfortable waiting room, I tell them to go and wait in the café across the road, or go window-shopping, and come back in an hour. The child must feel completely free, and this may be hindered if he knows the parent is just in the next room. I now explain to my patient, in age-appropriate language, that whatever they tell me is completely confidential, and that Mum and Dad will only know what I choose to share. The next few sessions are equally one- on one, and then the parent is asked to join us.

 

The subsequent sessions are spent together with the parents, where I can share my insights with them as to the root causes of their child’s suffering, and where we can work out together practical strategies to implement at home so that our young patient starts to have that precious feeling of security once again, THE SECURITY THAT IS THE FOUNDATION FOR SOUND MENTAL AND PHYSICAL HEALTH. Again, these "family" sessions must be conducted somewhat diplomatically, in age-appropriate language. The child must have utter trust in the therapist, and feel intuitively that his private world is safe, that the therapist will not reveal their secrets to the parents. Yet, at the same time, the parent must be made aware of what they can do, mostly on a practical day to-day basis, in order to best help their child.

 

Because children are so much more sensitive than adults, this also means that they are more 'malleable' and thus lasting change can come about in a quicker, easier, smoother way.