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A step towards inner peace and personal development
The difficulties faced by children, and the issues faced by adolescents present themselves in many different ways and consequently the motivations behind seeking psychological support are varied. All aspects of the child’s life may be affected including their emotions, their body, education, the relationship with others and more generally with the world around them. In fact physiological, emotional, social and cognitive well-being are closely entwined.
Child anxiety can be identified through various signs and symptoms: sleep difficulties, unhealthy eating, digestive problems, agitation or hyperactivity, mood disturbances, recurrent anger, latent sadness, excessive shyness, difficulties concentrating or learning, bed wetting, soiling, stuttering etc….
The way in which anxiety presents itself indicates the type of difficulties experienced by the child and so is relevant matter to work on in psychotherapy.
These difficulties and the way in which they manifest themselves may have a profound and lasting impact on the child’s or adolescent’s development.
Certain more serious conditions may have a greater impact on the child’s life and in these cases psychotherapyiseven more important.
However, beyond relieving symptoms, psychological consultations aim to act on the long term by preventing difficulties and issues from evolving and becoming engrained. Psychotherapy can accompany the child during this very vulnerable stage in life that is so important to the forming of personality.
A consultation can be considered as soon as unhappiness, difficulties or struggling with emotions areidentified by the child/adolescent and/or their parents.
It is never too soon to seek help: the sooner we act the better chance there is of preventing symptoms from developing and worsening.
As Françoise Dolto (a French Pediatrician and Psychoanalyst) said, child psychotherapy is first and foremost preventative, not curative. However, only too often parents wait until the symptoms haveadvanced and are engrained and debilitating before consulting. In this context, the role of psychotherapy cannot be preventative but has to be curative and work on the symptoms and causes of an existing problem. This takes more time – treating a minor ailment is naturally less complex than treating a major one.
There are no specific rules as to the layout of the session but the psychologist usually meets the child/adolescent along with their parent(s) in order to best apprehend and expand upon the difficulties encountered. The psychologist may also meet with the child/adolescent and parents separately so as to gain an understanding of each one’s particular experience of the situation.
The first session initiates the client-therapist relationship. It is the opportunity to explore the meaning behind this step taken to start therapy, to better understand and apprehend it.
It aims to analyse the situation: each person can expand upon the difficulties encountered. It is about understanding these difficulties, hypothesising about their origins, the way they manifest themselves and the consequences they have on your child’s and your family’s functioning.
This enables a better understanding of your needs and those of your child in order to provide an adapted and tailored treatment plan. Often a second appointment is necessary to gain a fuller overview of the situation.
Following this first meeting, the psychologist can determine the most appropriate way in which to offer support and develop a treatment plan based on the information provided by the parents and child.
Children do not express themselves in the same way as adults.
For the youngest ones, the means of expression of their difficulties, suffering, and internal world may be through games, drawings or informal chat. The psychologist will engage with the child, observe them and may participate in their games and drawings with them.
Older children need less help finding the means to express their difficulties, however some will prefer to start by drawing out what they are thinking or feeling.
As the child or adolescent expresses themselves, the psychologist will guide them and make suggestions that may help them to identify and attribute words totheir difficulties. These words can help to bring things into the conscious awareness of the child or adolescent and so enable them to make progress when a real situation or one that has been internally constructed, has trapped them in a certain cycle of behaviour that has been a source of concern for those close to them.
Whilst the psychologist can give the parents feedback about the progress their child is making, they cannot break the therapist-client confidentiality by revealing what has been shared in the sessions.
Very much like adult psychotherapy, child or adolescent psychotherapy provides a safe space in which to think and speak freely. However, the child can only speak freely if he or she is sure that their words will not be repeated whether to their parents, their sibling or anyone else.
The confidentially surrounding these verbalisationsallows the child or adolescent to express themselves freely.
The psychologist is distant enough from them (as opposed to their parents, friends, and family members) and can provide a role of caring neutrality regarding their opinions and the behaviour demonstrated during the sessions.
This neutrality is what creates a space for feeling and externalising freely. The freedom to feel and speak also provides freedom of thought and hence opens up possibilities for reflection (rather than opposition) and new ways of relating to the world.
In such a way, Speech enables Thought. It is what allows for internal conflicts that agitate and trap a person, to enter into consciousness: putting something into words can make it that bit more real. The power of speech is in that once we have expressed our difficulties through words, once we have understood what is bothering us, we can start the process to make changes.
Adolescents, as well as children, are often grateful to their parents for providing them with a space for freedom of thought and speech. After psychotherapy, they may express the importance that this“secret garden” had in helping them to understand their thoughts, sadness, aggression, shame, overall their internal world.
Child psychotherapy is a team effort. As such the team work with the parents is essential and it is important that they meet regularly with the psychologist in the context of interactive parental guidance. During the sessions, the psychologist will help the parents to better support their child and to take a look at the parent-child relationship in order to promote happy and balanced families.
Adolescents are less comfortable with sharing the same space as their parents. They may find it intrusive and develop latent hostility towards their parents and the psychologist. This could cause resistance to the treatment. For this reason, in the case of adolescent psychotherapy, the parental guidance sessions should be less frequent. The subject of the parents meeting with the therapist should be discussed with the adolescent along with their potential resistance.
As with adult psychotherapy, child psychotherapy is a space for development.
Through seeking to understand what is happening in their internal and external worlds, the objective of psychotherapy is to help the child/adolescent to overcome their distress and reduce the related symptoms in order to evolve into the most well-balanced adult possible.
It enables the child to better adapt to the demands of the family, of school, of society as a whole. It could, for example, lead to improved social skills with pairs or a more fulfilled family relationship.
It can assist the child/adolescent in overcoming psychological trauma related to a bereavement, an illness, an accident…
In the case of more serious illnesses, it can help the child/adolescent to manage their condition and to adapt as well as possible on a social level. It can help them to recognise their differences, accept them and sometimes even use them to their advantage, turn them into strengths.
Every psychotherapy is different because it relates to a unique individual, each with their own issues and each progressing at their own pace. For this reason, it is impossible to determine how long the therapy will last. The psychotherapy will go at the speed of the child.
However, in general, the sooner psychotherapy starts, the less time it lasts. The length of time that psychotherapy takes is dependent on the severity of the problems and the extent to which they have become engrained. Untreated problems get worse with time. Children with more serious psychological conditions will generally need psychotherapy for a longer period of time.
But perhaps it is not such a strange thing that a child is given the opportunity to take a few minutes a week for dialogue and self-reflection.
It is advisable to choose a psychologist that you feel confident and comfortable with. An essential factor in the success rate of therapy is the quality of the psychologist- client relationship - the therapeutic alliance. It is important that the psychologist is approachable, ready to listen to the parents and their child, pleasant and caring. This will create the foundations for open exchange both with the parents and with the child.
If you feel comfortable with your child’s relationship with their psychologist, your child will be reassured and more likely to invest in the therapy. The commitment of the parents is paramount to that of the child and essential for the success of the therapy. The child’s desire is reliant on that of its parents: if the parents are experiencing resistance to the therapeutic process then most likely the child will experience a loyalty conflict and hence will have difficulty investing in the psychotherapy. Unconsciously aware of their parents’ resistance, the child may fear that if they engage in the psychotherapy then they may make their parents angry. This prevents their treatment from being very effective.
It is important to note that having a child see a psychologist is not always an easy thing for the parents. They may feel guilt and this guilt could be a source of resistance to the therapeutic process for the parents and consequently the child.
It is therefore necessary to address this resistance and this guilt in order to move past them and enable the therapeutic process to be productive. To do so, the parents must feel that they can freely express their hesitations to the psychologist.
The help and support of the parents are thus essential for successful therapy.
As opposed to adults, children in general have no preconceived ideas about psychology and psychologists. It is mainly the parents’ ideas that condition those of the child. A parental attitude that does not provoke anxiety allows the child to participate in the psychotherapy in a positive manner. In the case of adolescents, some (negative) stereotypes may exist already and it is important to work with these in order to move forward with the therapy.
Would you ask the same question to a doctor? Whilst it is of course important to listen to your child’s concerns regarding psychotherapy and allow them to ask questions, giving them the responsibility to decide whether or not they need treatment is perhaps imagining them to be more mature than they are.
In the case of resistance, it is important to address the problem and seek to understand the child. They may be manifesting signs of latent anxiety and unconscious issues. For example an inhibited child will initially be inhibited with their psychologist. Focussing on the resistance enables an untangling of the issues behind it.
Sometimes it is just a question of patience – allowing the time necessary for the therapeutic alliance to develop, to get to know each other and to build trust little by little throughout the sessions.