Counselling & Psychotherapy for Children & Adolescents

A Guide for Parents or Carers

“Children are not a slate from which the past can be rubbed like a duster or a sponge, but human beings who carry their previous experiences with them and whose behaviour in the present is profoundly affected by what has gone before.” (Bowlby, 1951)

Aims

At the Northern Guild we understand that the commitment and support of parents/carers is crucial in the outcome of any work with children and adolescents. Our aim is to provide information about the Counselling & Psychotherapy for Children & Adolescents  that we provide. We believe it is important to talk with you about what support is available for you so that you can help your child to get the best out of what we offer .

Working Together for the Young Person

Your child may be experiencing difficulties at school, home or elsewhere. They may be in a situation which adversely affects their emotions, changes their behaviour, creates anxieties or causes other problems. As parents or carers you will be aware of their struggles, supporting them on a day-to-day basis and offering a supportive relationship. Despite this some of these issues are not easily resolvable in the home environment and can be more appropriately explored in a focused therapeutic setting. In this way we can work together with you to give your child the best opportunity for working through their problems.

Confidentiality

Confidentiality is considered to be of vital important to the building of a therapeutic relationship. Therapists at the Northern Guild follow the normal Child Protection policies and procedures laid down by Northern Guild and the Local Authority.

What are Child Psychotherapy and Counselling?

Counselling is child centred and usually only lasts for a short duration, normally a few weeks. It aims to address specific problems. There will be a contract made with the child and the parents or carers to identify the goal and the desired outcome.

Psychotherapy is usually longer term and is used to help address more deep seated or enduring problems.

Both Counselling and Psychotherapy involve a therapist working individually with a young person to explore and work through their experiences  and to enable them to live more fully. In therapy the young person will have the opportunity to express themselves in a variety of ways, including creative media, the therapeutic sand-tray, play therapy, drawing, painting and story-telling as well as through talking and being listened to. Choice usually depends on the age of the child.

Although the benefits of therapy have been well documented, progress sometimes may seem slow and rapid change does not always occur. Symptoms, however, such as headaches, anxiety and so forth are relieved quite quickly. Anxiety is also usually reduced in the initial stages. As issues emerge and the young person begins to deal with them, they may feel some distress and require extra support at home.

How Psychotherapy May Help

Many young people find therapy beneficial and some of the positive effects that parents or carers frequently report are:-

• A marked reduction in anxiety
• Increased concentration with a positive effect on schoolwork
• Improved sleep with fewer disturbing dreams
• More able to manage difficult feelings and to make sense of their experiences
• Improved behaviour in different environments
• Enhanced relationships and friendships
• The development of self-esteem and identity

Types of Therapy on Offer

• Play therapy
• Short term counselling
• Longer Term Psychotherapy
• Sand Tray Therapy
• Art Therapy
• CBT (Cognitive Behaviour Therapy)
• Parent/Carer & Child Therapy
• Relationship Therapy involving both parent and child together
• Parents or Carers Consultation
• Counselling/Support for Parents
• EMDR

The Initial Meeting

An initial meeting will be set up with parents (or those with parental responsibility) to discuss whether and what type of therapeutic help would benefit your child.

A decision will be made during this meeting as to whether or not therapy might be helpful. Sometimes it becomes clear that it is better to offer direct support and consultation to the parent/carer instead of or in addition to therapy for the young person.

When therapy is considered the best option an assessment period will be agreed. During this phase the young person will meet with the therapist on a weekly basis in order to find out whether a positive therapeutic relationship can be made in which the child can engage in the therapy. A review meeting will be agreed to discuss the outcomes and recommendations of the therapist.

The First Therapy Session

In this session, the therapist will explain how therapy works and outline some of the key things that it is helpful to know. You will have ample opportunity to ask any questions you may have or to discuss any concerns. By the end of the session, a therapy contract will be agreed and a set of appointment dates will be scheduled.

Consultation Meetings

Once therapy commences, review meetings can be arranged. The purpose of these meetings is to review the young person’s personal development in relation to the therapeutic work and to provide consultation and, if needed, guidance to parents. Most parents/carers find these meetings very helpful in providing information, insight and support.

Closure Meeting

When a decision is made to end the therapy for whatever reason, again a meeting will be held. The aim of this meeting is to help the child make a ending with their therapist and to make sure there are no ‘loose ends’.

The Process of  Counselling & Psychotherapy

During the process of  counselling & psychotherapy the young person and the therapist meet at least weekly for a set time period, usually a six week assessment period, and through these regular sessions a therapeutic relationship begins to develop. If necessary this may lead onto longer term therapy.

Therapy sessions are arranged at the same time each week and last for 45 minutes. All therapists are careful to begin and end on time.

To ensure the potential success of therapy we rely on you, the parents, to ensure that you:

• Commit to attending all the sessions
• Arrive for sessions promptly
• Ensure that the young person is in a physical state to engage in the work (for example, not being hungry or over-full)
• As some sessions may involve physical activity or getting messy, you are encouraged to provide suitable clothing.

To provide a greater sense of security for the young person you will be asked to remain in the building during sessions. By doing these things you will ensure that our work together has the greatest chance of success.

LONG TERM PSYCHOTHERAPY

Stages of the Therapy Process

Long Term psychotherapy goes through several different stages and you may notice changes in the young person’s behaviour during this time.

Stage 1 – Forming the Therapeutic Alliance

During the first stage the therapists focus will be to form what we call a therapeutic alliance with the young person. The length of time this takes depends on their patterns of attachment. The young person may demonstrate several ways of relating to the therapist. For example, they may become attached very quickly demonstrating an overly positive attitude, this type of attachment is likely to be superficial and may be followed by withdrawal or some other form of avoidance. Alternatively, they may be ambivalent or want to avoid coming to the sessions. What we find in practice is that once a child is in the therapy room they settle and become engaged in the session. The therapist will use methods that help the child to become involved in the therapy process, build trust and a sense of security and predictability.

Stage 2 – Awareness Raising

Once the young person begins to trust the therapist they will begin to accept her/his interventions and the therapy will move into a new phase. The therapist will focus on raising the child’s awareness of what they are feeling and experiencing and how this might be linked to their behaviour. For example, role play might be utilised whilst empathy and feedback will be used to help the child make these links.

Most young people begin to demonstrate a marked reduction in anxiety during this stage.

Stage 3 – Working Through

This stage can be very active, the child often experiencing surges of emotion. If the child has had traumatic or very upsetting experiences you might notice that they become agitated, experience changes in their behaviour or a disruption in their relationship with you. In response to this, you and sometimes other family members, may find that your feelings toward the child begin to change. Negative feelings toward the young person might begin to emerge. We will help you to understand these feelings and to support you in making interventions with the child.

This is a crucial time in the therapy process as buried feelings and sometimes memories come to the surface. During this stage it is useful if therapist and parents/carers work together to support the child. This might be a challenging time for you and you can ask for support from the therapist who will usually be happy to offer consultancy. It is important you ask for this should any problems arise.

We describe this part of the process as the child being like a tide whilst the parents/carers need to be the solid shore. As this stage comes to an end the young person will become much calmer and more settled within home and school and demonstrate a greater sense of self-esteem.

Stage 4 – Closure and Endings

Making a good ending is a vital part of the therapeutic work. We need to allow a good ending which is therapeutic for the child and provides proper closure for parents/carers. This will mean that we will provide:

• The right amount of time
• Opportunities for the child to reflect on their relationship with the therapist
• Allow the child to express their feelings about the ending.
• A reparative experience of ending so that the child can draw on this and use it as a positive and effective template for their future life. This is especially important for children who have experienced loss and separations.

What You Can Expect

Occasionally, because of issues that may emerge, the young person may require further support outside of sessions. For example, after sessions they may experience emotions which may either cause them to withdraw or, alternatively, to express these feelings in their relationship with you. Parents are encouraged to respect the young person’s choice about whether or not to discuss the contents of sessions. Any concerns about the young person relating to therapy can be discussed with the Therapist or the Child Therapy Manager at the Northern Guild.

The Surroundings

All psychotherapy takes place in comfortable rooms designed and equipped for therapeutic work with young people. At the Northern Guild we aim to create a safe and protective environment for all our clients and those that support them. You will be invited to wait in the waiting room so that you are available for contact if needed during the session.

Confidentiality

As in all psychotherapeutic practice, privacy and a sense of security through the rule of confidentiality are considered vitally important to the building of a therapeutic relationship.