In Part 2 of a Parents’ Guide, I reflected on why parents call a child therapist. In this third post I offer three core principles that guide the work.
In the post’s title I chose the word touchstone for its meaning – “a standard or criterion by which something is judged or recognized.” So what then are the touchstone principles that guide the work of child therapy?
The Team. The first is that you as parents, your child, the therapist, the teachers, your pediatrician and others who may be involved are a team, joining together in figuring it out and working it through. Each person’s role is distinct and vitally necessary, and there must be ongoing communications as needed between team members. On the team, the therapist plays a central, guiding and partnering role in the psychological aspects of the work.
Layers. Presenting issues manifest themselves on the surface, covering and often disguising underlying influences/forces that mold what is most discernibly in sight. The challenge is to peel back the layers, often one by one, to explore what is going on beneath the visible, often turbulent surface.
One significant and seductive risk for parents and providers alike is getting stuck on the surface, focusing primarily, even exclusively, on problematic behaviors without exploring what lies beneath. From this perspective what is going on below the surface is not held as central to the therapeutic process.
This view is particularly a hazard in our culture, primarily because of the longstanding, often entrenched perspectives born of learning theory in psychology (operant conditioning , a la B. F. Skinner). In this view all behaviors can be shaped into their preferred forms using well-engineered reinforcement schedules (roughly defined as rewards and punishments). Whole schools of best parenting practices and treatment regimens have been built on the foundational principles of Skinnerian learning theory.
For me or anyone to assert that beneath-the-surface issues are all that matters would be naive and misguided. Problematic behaviors are problematic, and these must be engaged and addressed. There are times when techniques from learning theory can be applied usefully in child therapy. However, the sources of behavioral problems are almost always rooted in misfiring relational patterns that constrain and interfere in kids getting along with family members, peers and others. And these patterns while most often not immediately visible, nevertheless powerfully play out beneath the surface energizing problematic behavior.
Reflective Process. An optometrist tests vision with lenses, evaluating which lenses sharpen visual focus and clarity and which don’t. By analogy we as a team try out different understandings, brainstorming and considering possible ways of making sense of the difficulties, retaining some understandings, while discounting, even discarding others. Successful outcomes in therapy depend on this kind of ongoing reflective process.
The reflective process recognizes complexity, that understandings require multiple perspectives and no one explanation is sufficient. It resists simple explanations and snap categorizations that can constrain the process of developing deeper insights and that can interfere with understandings and working things through. And it acknowledges that influences outside of conscious awareness contribute to the difficulties.
The concepts of the team, layers and reflective process are three foundational pillars that support and structure the work of child psychotherapy.
In the next post I am going offers a view of what parents can expect of their relationship with their child’s therapist.
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