Getting Started
Bringing your child or adolescent for psychotherapy is a big step. It can be very painful to know your child is suffering or is unable to cope effectively with life’s stresses. Therapy facilitates change for kids and teens, much the same way as it does adults: in the context of a trusting therapeutic relationship, coping improves. Among other benefits, this may include improved self-awareness (how your thoughts, feelings and behaviors work together), self-esteem, impulse control and frustration tolerance, anxiety management, communication skills, and problem solving skills. Therapy also promotes secure relationships, being able to take multiple perspectives, and relating to others in more mature ways. During adolescence, therapy helps teens manage their growing independence and explore their sense of self. Finally, psychotherapy can facilitate acceptance of conditions with which the child, or perhaps a family member, must cope.
The assessment phase for child cases is between one and three visits. During these sessions, I will meet with the parent(s) and the child, alone and in combination. I may gather information from physicians, schools or previous evaluations of the child. In general, the younger the child, the more likely it is for the parents to come alone to the initial session. With older children and adolescents, attendance at the initial session depends on the circumstances of the case. After the assessment, we meet to discuss my findings and create a treatment plan.
Individual Therapy
Therapy for children and teens can range from goal oriented skill development to open- ended self-exploration for personal enhancement. I rely on talk therapy methods (for more information click here) for treating older children and teens. With less verbal and younger children, I may use play therapy techniques, family therapy or parenting therapy. Throughout treatment, as with adults, I am actively assessing the situation to guide interventions in a timely and effective manner.
A common concern parents have about bringing their children for individual therapy is that the child will be manipulative, trying to garner support from the therapist by presenting a distorted view of their issues and or their family problems. If this happens to be your concern, please keep in mind that while I may empathize with your child, I do not blindly believe their view of the ‘truth’. I understand there is a side of the story that I am not hearing. Remember that therapy is a journey your child and I are on to discover how they are experiencing their world and I am listening for what they may be thinking, feeling or doing that interferes with and promotes their emotional or relational development. As they come to see me as an interested and trustworthy adult who can understand and sympathize, I gain the privilege of being able to challenge perceptions and offer new ways of thinking, feeling and behavior. I am open to feedback from parents, including parent or family sessions where appropriate. Often, I can share insights and guidance with families which may further the child’s progress.
Family Therapy
Family therapy can be a main focus of treatment or an adjunct to a child’s or a teen’s individual therapy. Family therapy presents a unique experience in that there is less emphasis on an ‘identified’ patient. In this model, the family is viewed as a system in which everyone has a role and function (or several of them). These roles and functions help to create and maintain the problems in a family member(s). Understanding and changing patterns of interaction and helping family members understand each other are often the focus of family therapy. It is not always necessary to have all family members present to utilize this approach to treatment. The beauty in this model is that no one is to blame and everyone has a chance, at one point or another, to make a significant contribution to change.
Treating Children of Divorce
Treating children of divorce presents special issues. It is best therapeutic practice, wherever possible, to have both parents consent to treatment and to foster a working relationship with each parent. My role in your child’s therapy is to help enhance his or her coping ability. I cannot be in an evaluative position regarding custody decisions or either parent’s conduct and will not participate in any court involvement, which out of necessity would break my confidentiality agreement with the child. Outside of appointment times, I ask that the parent bringing the child for sessions keep the other parent apprised of treatment progress. When this isn’t possible, at either parent’s request, I am happy to schedule time to share the information that I can.
Confidentiality
The therapy relationship is a private and confidential one. As such, it allows a child to speak openly with a trusted adult without fear of reprisal or betrayal. To that end, it would be counterproductive for me to share the child’s thoughts and feelings and behaviors discussed in sessions. Where appropriate, I will share general information regarding the progress of therapy and will take phone calls and offer guidance to parents. I often work with child clients to prepare feedback about their treatment that I can share with parents. The treatment plan itself may also include family or parent visits that build in discussion of issues relevant to the child’s treatment. Children age 14 and older must consent to the release of their confidential information. If there is an imminent threat to self or others, I will break confidentiality in accordance with the law.
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