A good therapist helps a child establish goals
– Emphasis is on the child, not the therapist and not the child’s parents. During an initial interview with your child, watch to see whether and how the therapist identifies from your child’s perspective his or her problems and goals. “What are your goals? What do you want to learn, change or accomplish while you’re here?” the therapist might ask. Establishing these goals is important. Here are some reasons why:
– They increase the child’s engagement and motivation by giving him or her a sense of ownership.
– This exercise sends an important message to the child: “I value you and want to hear your ideas and opinions.” Child need validation because they typically feel inadequate and inept.
– Goals become a treatment contract of sorts. They are a tool that give transparency and accountability to the process of therapy.
– This exercise shows how the child and therapist can work together cooperatively, which sets the tone for honesty and reciprocity in their relationship.
– Goal-setting can provoke emotions as the child discloses perceived problems. The therapist’s empathic response provides comfort, encourages further disclosure and creates a climate conducive to a “secure base” for the child.
– Goal-setting between a therapist and child can serve as a model for parents, as they observe the interaction from another room (We use a closed-circuit TV during our Intensive Outpatient Psychotherapy program, but not during traditional, outpatient therapy. Consult with the therapist with whom you’re working about when and how this kind of observation might be appropriate.) The parents become more optimistic as they see their child interacting in an honest and cooperative manner.
A good therapist explains the rules of therapy
A therapist should explain to a child the rules of therapy during the initial interview. Each rule should be discussed. Rules become contracts for specific behavior on the part of the child and the therapist. Rules also provide structure that is necessary for helping the child develop feelings of safety and security. The rules of therapy are:
– Eye contact is encouraged in all therapist-child dialogue. Eye contact is a crucial component of secure attachment.
– “We will not work harder on your life than you.” The child is told that the treatment team will work hard to provide help but that it is the child’s responsibility also to work hard. A discussion ensues about personal responsibility and the desire to change.
– The Four Rs. We share our philosophy that all children are expected to be respectful, responsible, resourceful and reciprocal.
– “I don’t know” is not an acceptable answer. Children generally say, “I don’t know” as an avoidance technique. Two alternative responses are acceptable: The child can ask for help from the therapist, or the child can offer his or her best guess, which encourages introspection and resourcefulness.
– Verbal responses must be expressed in a timely fashion. A form of interpersonal control and passive aggression is making others wait for a response. Instead, we encourage a timely response.
– No physical violence Children are encouraged to express their anger verbally. A mutual contract is established between the therapist and child to protect both from harm.
