Elements of psychotherapy with children, adolescents and families, how to make choices.

WHAT IS PSYCHOTHERAPY WITH CHILDREN, ADOLESCENTS, AND FAMILIES?

Parenting is a complex and often difficult job. Children differ emotionally, based on their biology and temperament, their place in the family, and the culture and experience to which they have to adapt. All of these affect a child's personality, moods, behaviors, and relationship patterns. Some children at some ages may seem especially difficult for a particular parent to handle. This may happen in part because something from the parent's own childhood is evoked by the child; the result can be stress in the parent-child relationship.

Sometimes children are caught in the middle of a parental conflict, or are highly sensitive to the stresses of family life, or may react strongly to other environments such as school. Contrary to the myth people often hear, children are not more adaptable and less affected by problems than adults. The opposite is true-children have fewer coping skills and less control over the environment. They are less able to verbally describe emotional problems and must therefore show their distress in indirect ways, such as irritability, sleeping or eating problems, personality changes, physical complaints, disregard for personal safety, school problems, problems getting along with others, acting younger or older than their ages, and so on. It is often useful to consult a child or family psychotherapist if your child is behaving in a way that concerns you. A consultation can help you to assess whether the behavior that worries you is within the wide range of "normal" or whether it signals a problem that needs attention.

WHAT IS SPECIAL ABOUT FAMILY, ADOLESCENT AND CHILD PSYCHOTHERAPY?

Psychotherapists approach this specialized area in different ways, depending on the child's problem and on their training. Some problems are worked out best when all members of the family (even the children who are seen as problem free) join in therapy sessions. Other children and other problems may respond better in individual therapy, where the child has the time and space, apart from the family, to work on issues that may be getting in the way of development.

When a family meets together in therapy, the therapist listens carefully, without judgment, to each person's point of view. The therapist is objective, and helps family members understand some of the difficult feelings that come up in close family relationships. The therapist insures that no one person is unduly singled out. The goal is to create a safe place in which family members can experience different and improved ways of connecting with one another.

While it may at first feel frightening or embarrassing to "air one's family linen" in front of a stranger, most families find that the opportunity to create greater trust and harmony among family members far outweighs the initial fears.

Individual psychotherapy with adolescents is similar to the therapy that adults engage in. Although they may be somewhat self-conscious at first, teens often come to enjoy therapy. It is a place where they can focus on themselves, on their experiences and relationships, on their problems with family or peers, and on their hopes, dreams and fears. In the psychotherapy session they have the full, respectful attention of an understanding adult.

With young children, the psychotherapist does not usually discuss problems. Problems are worked on in the context of play. Play, often called the work of the child, is far from conflict-free. To a trained eye, it is a powerful form of communication about the child’s ways of experiencing his or her world and a way of expressing difficulties the child may be experiencing. Play is also a form of healing. When a child "plays out" fears and difficult experiences in a context in which they can be understood, the child is able to move on. If parents are puzzled by a child’s description of fun in the therapist’s office, they should be aware that much more than play is taking place.

WILL THE THERAPIST KEEP SECRETS FROM ME ABOUT MY CHILD?

With both adolescents and younger children, parents should expect feedback from the psychotherapist about his or her evaluation of the child. The therapist should share concerns about the child and suggest ways to improve difficult parent-child relationships. With adolescents, the question of what information is shared with the parents and what information will be considered private is carefully worked out with all concerned.

"If there is anything we would wish to change in the child, we should first examine it and see whether it is something that could be better changed in ourselves." 

--Carl Jung