Children and Adolescents
Building a strong bond with children and adolescents is essential for therapeutic progress. While also important for adults, adults tend to accept the therapists ‘expertise’. Children and adolescents often only really take things to heart and allow for deep change when they value the person offering advice and insights. It is the mutually caring therapeutic relationship that is the fulcrum of lasting growth.
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ASSESSMENT: The therapy process with children and adolescents begins with careful assessment of whom to meet with and what approaches to use. I may choose multiple therapeutic configurations (child alone, family, parent-child), and multiple therapeutic techniques.
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YOUNGER CHILDREN (approximately 4-10). Here careful evaluation of the child’s ability to verbally communicate their issues and the amenability of the problem to different therapeutic approaches is critical. Treatment options may include play therapy (See note below), problem-solving therapy, social skills training, cognitive restructuring, affect regulation work and Habits of Mind principles.
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PRE-TEENS AND ADOLESCENTS: Ongoing attention to the needs of older children and teens is required in two areas. Determining which therapeutic approaches are most helpful, such as problem solving,insight, cognitive restructuring, Habits of Mind principles or social skills training. We must also negotiate who is seen and how frequently. Some teens require integration of the parents into the treatment, while others need a safe place to talk that is felt to be their own.
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PARENTING: With many child cases work with parents is essential. I stress collaboration with myself and parents having different, but complimentary roles. I bring my experience in psychotherapy and child development, and parents bring their knowledge of their child. Our purpose is to determine what parenting techniques and approaches will maximize movement toward treatment goals. I try to build on habits and practices parents already find effective.
I also become very curious about parenting techniques that should be effective but are not. Understanding why something doesn’t work may reveal other layers of the child’s mental functioning that were not previously understood. This often yields greater insight and more effective parenting strategies.
PLAY THERAPY: I have extensive experience teaching play therapy with younger children. I believe that play therapy is perhaps the most difficult therapy to practice well, because of the seemingly elusive nature of its underlying therapeutic action. Play itself stands as an intermediate reality; real enough to be connected to self-experience, but unreal enough to feel safe. The safety of play allows children to express that which they find too difficult or emotionally overstimulating to put into words. Instead they act out, and inhabit the feelings, attitudes and conflicts that they need to address. Within the play, often a child will choose to assign troubling attributes to the therapist, while monitoring how the therapist handles their assigned “role”. Sometimes play leads to explicit discussion of the problems the child is playing out and sometimes the problem remains in the metaphor of play.