“You had stated that you see the parents and child together at the first session. I have been leery to do this because, when I have, the parents’ comments were hurtful for the child to hear. I thought that it was more harmful to the child than helpful. Please comment.”
On the contrary, I found it most helpful to do this. If the child thinks I don’t know about his parents’ complaints, then this interferes with the relationship. A division has been set up between us. Believe me, he already knows how his parents feel about his behavior.
It’s important that he knows that I know. If I smile at him, he doesn’t think, “If she only knew how bad I was, she wouldn’t smile at me!”
Here’s a sample:
An eight year old boy—I’ll call him Danny—is brought in to see me because the school people threatened to put him in a special class due to his aggressive, disruptive behavior. The parents were told that if they tried counseling, they would wait before doing this. The parents were extremely angry at Danny for forcing them to seek counseling, as well as his behavior. At the first session I generally do an “intake” asking the child various question from a form on my clip board. I told the parents they could add information after their son answered the questions, such as, “Do you sleep O.K.? How is your appetite? “Do you have your own room?” “Do you have a favorite TV show?” and so forth. If he is reluctant to answer anything, I then turn to the parents. Danny was willing to answer many questions for himself. As you can see, our relationship is beginning to form. Finally I asked the parents to tell me why they are here. Dad responded in a very angry voice describing Danny’s transgressions and talking about how much trouble he is, etc. I turn to Mom, and she agrees, albeit somewhat reluctantly, (probably because Danny is in the room.) She begins to cry. I notice that Danny is cringing as his Dad speaks and his Mom cries, and lowers his head. I turn to Danny and say, “This must be hard for you to hear all this!” He nods. I sometimes will ask the child if he or she agrees with what the parent is saying. I did not do this since I could see that Danny is pretty upset and turned into himself.
Finally I tell the parents that I will need to see Danny alone for about four sessions and that after that we will come together again. At that time I will let them know if I think we will need to continue, or I may want to just see the parents, or have family sessions. I explain how I work, and give them my handout called, “A Description of the Therapy Process.” (See our Resources page for a copy of this handout). This handout pretty much describes each phase of the therapeutic process along with a description of my use of projective, expressive techniques. I say to Danny, “You might not agree with me, but just hearing your parents today I would say that you are not too happy in life.” Then to the parents, “My job is to help him feel happier.” (I have never met a parent who doesn’t want their child to feel happy.) I say to Danny, “Again I don’t know if you agree with me or not, but I would say that you don’t feel too good about yourself.” To the parents, “My job is to help Danny feel better about himself.” Then I say that I imagine that Danny keeps a lot of his feelings to himself and I hope to help him express those feelings. We use many of the expressive techniques to help him do this. Sometimes the inappropriate behaviors drop away through all of this. ”You can be sure that if I decide to see Danny for individual sessions, we will be in close contact, and I would want you to come in at least every 4 to 6 weeks.”
Then I turn to Danny and say, “Will you be willing to come in next week?” In this case, Danny, who has been eyeing some of the equipment in my office, especially some jars of paint, I notice, vigorously nods. If he should say no, or not answer, I would then tell the parents they need to make this decision. I generally say something like, “If he needed to go to the dentist, you would decide for him!”
I saw Danny weekly for four months. He painted and drew pictures, did sand tray scenes, pounded clay, and generally was quite responsive. His father, who was in the military, was shipped out and I never saw him again. His mother dropped Danny off regularly, but was reluctant to see me. We did talk on the phone often. She was pretty depressed herself, and Danny became her somewhat therapist. When he talked about his loneliness, I asked him if his mother was lonely, so he went home and asked her and this prompted a wonderful discussion between them. He even asked her to do some of the drawings he liked, such as the “Safe Place.” One day his Mother said he was so busy with life (baseball particularly) that she thought he was finished with counseling. I called the school and the counselor almost didn’t remember who he was. She spoke to his teacher who said he was doing just fine, that he probably was going through a stage! I have had many experiences such as the above. This family (there was a younger sister) had moved many times and Danny had been in several schools before his present one. In fact he had never finished a school year in one school. There were many issues to deal with and we dealt with them one by one. “Draw a picture or make a sand scene about what it’s like to always be the new kid in school.”
“Make your family out of clay and say one thing to each that you like, and then what makes you mad.” (Working with anger was an important part of his therapy.) I think our first session set the stage for a successful relationship and productive work.