When assessing Children and young people, the theories below, provide me with a indepth level of understanding to the specific needs, and vulnerabilities ,of the Children and young person, at the level of development they present.
For example Bowlby’s Attachment Theory provides me with an understanding of the child/young persons Attachment style, behaviours and beliefs, how they are formed, and the impact thereof.
Mahler’s theory informs me as to the Separation and Individuation and Rapprochement Issues, and the possibility of developmental delay.
Stern’s theory gives me insight and informs me as to the inter-subjective experience of the child/young person and hence, the creation of self, through their interpersonal experience.
I take into consideration transitions and how they are managed, as this may also impact development. I consider the impact of trauma and abuse and how this may also impede development.
As a Transactional Analysis Child and Adolescent Psychotherapist ,my guiding principals are people can be responsible for their choices and thoughts, people are OK, worthwhile, deserve to be treated with dignity and make positive decisions about their lives.
When I’m working with children and young people, I am aware that their view 0f the world is often distorted by the adults who are responsible for their welfare.
When assessing children and agreeing what work needs to be done to address this, I will endeavor to involve the parents or carers, who may have contributed to the child or young persons dysfunctional behaviour.
When working with Children and Adolescents, I value and place importance on developing an alliance with Parents and involving them in the work I do with their Children, when and if it is deemed necessary. This involvement is often key to the work and essential to facilitating change. I work with the parents contractually and with agreement from the child or young person.
Essential to the work, I also consider the importance of peer, community and cultural influences, and take into account how this may have an impact.
I uphold the view that in any therapeutic relationship it’s essential to consider the dynamics of power and the transference and counter transference issues. To this end I have regular therapy and supervision in order that I can look at my process and any barriers to communication, and develop my knowledge to enhance my practice.
When working with children and young people; I am aware that there is often an invisible third party in the room. For example, the parent or parents, school or an agency that the child or young person is involved with will more often than not refer the child or young person for therapy. It is often the case therefore; that the child or young person is attending therapy because another party or person has decided that it will be helpful for them to do so. It is not always the case that client themselves request or initiate the referral.
This could cause problems, as there may be a conflict of expectations between the referrers, and or the child/young person. Sometimes they may even feel coerced or even forced to be there. It is important therefore, for all parties concerned that there are clear identified roles from the outset, whereby I make clear what I am there for and what I’m prepared to do. I then check out what the others are there for and what they want and then agree what is feasible for us all to achieve.
I also talk about potential for sabotage, what form it may take and how this may be addressed. A three-cornered contract is essential to ensure all parties have a clear understanding of the work to be undertaken; boundaries are outlined and agreed from the onset regarding the work. I ensure to the best of my ability that I keep client confidentiality; I also make it clear and have an agreement from the onset within the three cornered relationship, when it is necessary for information to be shared. There are times for example, when keeping such confidences is not in keeping with the child’s best interests, which need to be kept as paramount.
As with all my clients, I keep any notes, either handwritten or electronically stored, or work produced by the clients themselves, confidentially locked in a cabinet or encrypted on a PC, in accordance with the Data Protection Act, (1998). These records are kept after the work has been completed for up to seven years, unless it is required by law to keep them longer, e.g. in child protection cases.
When commencing the work with children and young people, an initial meeting is convened with all parties concerned. In his meeting I usually contract with the child and young person and their carers for a 4-6 week Assessment, after which we will meet for a review and agree what work needs to be done and contracted for, and the continuation of the therapy.
In this meeting we discuss how this will be done, i.e. how long for, when and where, andhow often.
At all times, I include the child or young person in this agreement, with the optionfor them to choose at any time to stop the work and say no to me.
The age range that I work with are children and young people between the ages of eight to seventeen. I employ various techniques such as, role play, art therapy and creative play toys for the younger age range. These tools enable both myself and the child or young person to have a better awareness of themselves and experience of relationships and the world.
I work relationally and to this end, with the use of transference, my aim, is to gain a better understanding of their subjective experience and thus facilitate the client to co-create a more integrated sense of self. Throughout the therapeutic relationship, I take into account and work with the presenting age of the client, as this may not be commensurate to their chronological age.
This informs me as to their developmental deficits, attachment patterns, and at what level to pitch the work.
I also am very interested in neurobiology ,and the impact that early care has onthe developing brain, and how this may have a lasting affect.
To this end I have read work recently written regarding working with children and young people, by Sue Gerhart(Why love matters) and Margo Sunderland (What every parent needs to know)
and the work of Alan Schore. This informs my work and influences the way that I assess,diagnose and treatment plan.
S Cooke 2014