I have an ongoing awareness that many people who are trained to work therapeutically with children, aren’t necessarily fully prepared within their training to work with parents/adults too. (Luckily in the days when I did IATE training, we qualified to work with both adults and children – although obviously not as indepth a training for either). Even if not doing p-c work – this feels so essential – from the minimal working alliance with a parent of a child/yp client in private practice; through regular meetings with a parent in a school setting; to responding for advice and guidance from parents of clients; to know when and where to refer a parent for their own work to working with the network of a child,– teachers, referrer, social workers etc.
I therefore ran a course in Brighton to explore some of these elements and to help skill people up/develop our thinking around this.
I keep thinking about the relevance of – systemic thinking, couples work, dyadic work, filial therapy, theraplay – and that some of the work we are undertaking draws from all of these elements but is different too.
So important to me is ‘dual empathy’– which sometimes broadens to ‘system empathy’ or ‘network empathy’ – trying to ‘get alongside’ or see the viewpoints of/work well with others – eg referrer, social worker, head teacher – which is difficult but often most effective way to help the child – yet always keeping the child at the centre. It is a delicate balancing act - weaving the different strands of their needs and our experience to make an individual tapestry of support for each family.
The temptation can always be there to ‘side’ with the child which feels slightly different from keeping the child at the centre – because the former can include us ‘acting out’ towards others – blaming, distancing, criticising, demanding of – which may well be part of transferential invitations/projective identification from the child.
I love the simplicity and tangibility of Dan Hughes’ description of being ‘open and engaged’ – O&E – I can feel in myself when I am this way with the child, with the parents, with others – and can relate PACEfully – and it almost always facilitates better communication and working alliances – which ultimately is better for the child – than when I become ‘closed’, ‘defensive’ etc. My being O&E with others, is more likely to enable them to be O&E and from there all connection and working together flows. The more PACEful I am with adults, the more likely, I believe, they are to be PACEful with children.
So I’m passionate about my work with parents – psychoeducation, positive parenting skills, emotional support, gentle challenge, exploration from the secure base of feeling safe with me – all whilst keeping child’s needs as paramount.
My fantasy is the development of services – where any family is struggling – and the first response is W, L &A – welcome, listen, and assess. Looking at the family as a whole – and starting where it makes most sense to start. I have often been referred parents for ‘therapeutic parenting’ work when my observation and experience of the family functioning is that they are skilled and able parents – room for improvement of course (for us all as parents I imagine!) but it’s not the sticking point, the key issue. One parent I worked with in this capacity, we both pushed very hard for assessment (which was resisted as child was adopted so all was seen through the lens of attachment and trauma – and therefore she was seen as needing to be a better therapeutic parent) and her child was eventually diagnosed with pathological demand avoidance, autistic spectrum disorder, adhd, sensory integration issues and dyspraxia. So she still needed parenting support and guidance, of course, but she actually felt heard and met in this. Equally I’ve had children referred for ‘anxiety’ for individual therapy – and have morphed into working with the parent – to help them with their anxieties, skill them up as a parent, explore their fears – and it has seemed to be that this has been the most effective way to work with the family. It would be great to have a central referral where the most appropriate way to start with the family is skilfully identified and the practitioner decides if they are able to do it or an appropriate referral is made – eg to Occupational Therapist as early brainstem regulation work is needed before we can even think about helping parent and child to connect better (eg Theraplay) or child to recover from past trauma (eg individual therapy). The parent, also , may need some pre-therapy type work or prep – eg some therapeutic input to help them regulate their anxiety, process their grief – before we would invite them into some dyadic work to connect with their child, where we want them to be our co-therapist and be O&E towards the child and their needs.
In this way I believe the dyadic work isn’t like couples work – it isn’t giving an equal voice – the parent totally deserves a voice and a space to tell their story, but the DDP work would be focused on therapist and child working together to empathise with the child and help the child’s story to be told. Equally, with older young people, there may well be some productive ‘couple type’ mediation-like work to be productively done – where both perspectives are expressed, validated, communicated, guided into assertive expression, conflict refereed, and both helped to stay O&E towards each other supporting ongoing communication, problem solving, mentalising etc. Here solution focused therapy, family coaching skills, mediation skills may be very helpful.
I’ve been using mindmapping with some recent referrals to try and ‘map’ the family and the issues – where the potential areas are to explore/work with, and to try and work out to start and where the most leverage might be. Obviously this may be where the most effective leverage seems to be from my professional point of view, or may be where the parent is willing to start. Any part of a system one can support/improve, will ripple out.