Response to Child Psychotherapy

Ms Leong: “I see that working with Children and working with Adolescents as being
vastly different, and I certainly believe that it requires very different
skills, as well as specific knowledge to working with adult clients. I think
in any statements on this position we need to draw a clear distinction
between the two, and recognize them as linked, but slightly different
specialisms.

I feel that therapists working with these 2 groups must constantly use a
'mental check list' to see if we have sufficient skills and knowledge to do
the job competently. If in doubt we should seek supervision and get into
working support groups.

We should also encourage ourselves if we are working with children to invest
in books, conferences and workshops to strengthen ourselves with an
underpinning theoretical framework and that our therapy is also supported by
professional literature.”

A belated reflection after reading Toh Hwee Boon’s input :

In my practicum experience, I had only come across 3 children (aged 9 to 15). From the outset, I chose to abide by the formal training received from ECTA with regards to confidentiality and boundary. For both groups of children (in primary and secondary), I would assure that whatever they shared would be kept in confidence unless they had intent to self-harm or hurt others. (Informed Consent form applies.) As for the parents, I would make it clear that permission would be sought from their children before I divulge any info. As such, I didn't have an issue with enmeshing the two parties. I agree with Jessica’s subsequent comment in a later email that very often the parents themselves are overwhelmed by their own personal and interpersonal issues to be able to handle their kids. I believed the relational tensions experienced by the kids at home had caused the kids to play out their frustrations in school. In the cases above, therapy was extended to the parents concurrently so that with improved relationships they could role-model their kids better.

I agree with H Boon that children can be very 'lonely' in spite of intense care of their well-being by parents and school. Their 'facade' (fueled by their rackety feelings) seems to work for them for some time but you and I know we need to help them to address the repressed feelings when they find it difficult to cope any longer. In therapy, often than not children react well to 'friendly chats' which leads to deep sharing if the therapeutic alliance is well-established. For children who enjoy drawing, I used their drawings to find 'openings' to enter their inner worlds. Some stories are great materials to inculcate good values indirectly. In this IT age, an IT-enhanced therapy may be more appealing and meaningful (?) to the computer savvy ones who are more attuned with the technology. For older children, I find topics on hobbies, games, friendship etc good avenues to explore and venture into the young minds.

I have yet to meet any parent who is resistant to therapy. The parents in my contact are mostly concerned & overly concerned ones with a couple of spouses who prefer to pursue their own happiness than addressing the needs of a kid. By and large, they want to co-operate with the therapist to reach out to their children (away from the limelight in school). This may take on a different meaning and implication in a school setting as the school authoritative figures are also involved in the helping (open) process. Some times the parents who are called in to meet the school counselor have different sets of expectations to comply - the school’s expectation of the child, the counselor’s expectation of the parents and child, and the parents’ own expectation of the child. Whose value systems should prevail in this case?

I will be seeing a Primary 6 child next month. She is ‘misbehaving’ according to her mother. The negative behavior came about after being locked up in the house together with her mother and siblings by their father on two occasions. She became hysterical during one of the lock-ups and threatened to jump out of the window. Knowing her unique background information, I cannot think of a straightforward approach to addressing her as she may be 12 years of age, but having witnessed and experienced family violence growing up has developed in her the fighter’s spirit.

Every child and adolescent has their own unique encounter in life. I agree with Jessica in that our approaches towards children and adolescents may have to be creatively varied to meet the special needs of the young person willingly or unwillingly enter our therapeutic zone. 