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At Edify Therapy, where I see clients full-time, I also supervise therapists who are working towards their licensure. I recently completed a supervision session with a therapist under my guidance, which brought to light some fascinating and complex dynamics of transitioning from working exclusively with adult clients to working with child and adolescent clients. This therapist is encountering a range of new challenges that highlight the distinct approaches required for these different populations.

The Unique Challenges of Working with Children

One fundamental belief I hold about working with children is that they represent one of the most oppressed groups globally. While structure is necessary for their safety and development, it can often suppress their true nature and individuality. This belief is a cornerstone of the Cultural Effectiveness Training Model I employ when conceptualizing cases involving children.

During our supervision session, we delved into the therapist’s approach to adult versus child clients. With adults, they start with a person-centered approach, focusing on building the relationship before defining the problem. However, when working with children, they also begin with a person-centered, attachment-focused approach but find themself “meandering” when trying to define the problem.

Understanding the “Meandering Phase”

We deconstructed this “meandering phase” in depth and uncovered that it involves differentiating the child’s true essence from the oppressive narrative often imposed by the parent. Parents frequently bring their children to therapy with a list of complaints, which can shape the therapist’s initial perspective and potentially hinder the development of a direct and authentic relationship with the child.

During this phase, the therapist focuses on building rapport with the child, engaging in their interests, and developing a securely attached relationship. This process is crucial for understanding the child’s needs and identifying how the family system can support those needs. It also involves evaluating what adjustments parents might need to make or what behaviors need to be reinforced to foster a supportive environment for the child.

From Rapport to Problem Definition and Intervention

After this crucial rapport-building phase, the therapist moves on to defining the problem, taking into account perspectives from the child, the parents, and their clinical judgment. This comprehensive understanding allows for a more accurate and empathetic problem definition, which is essential for effective intervention.

The interventions often involve restructuring the family system and reinforcing positive behaviors within both the parent and the child. These interventions are designed to mitigate the problematic behaviors that initially brought the child to therapy.

Working with the Family System

I firmly believe in working with the part of the family system that can make the most change, which is typically the parents due to the power dynamics inherent in the structure of a parent and child relationship. My interventions usually involve working with both the child and the parents, both together and individually. This dual approach helps parents overcome attachment wounds that might be projected onto the child and enhances the child’s ability to navigate the family system effectively.

The ultimate goal is to cultivate a secure attachment between the child and their parents. This involves helping the child build a bond they can share with their parents while also supporting parents in forming a secure attachment with their child. This might involve addressing the parents’ own attachment wounds within family therapy or referring them to individual therapy. Such secure attachments are crucial for the child’s emotional and psychological well-being, allowing them to thrive both within the family system and in their broader life.

Conclusion

Transitioning to working with child and adolescent clients from an adult client base is a challenging but deeply rewarding journey. It requires a shift in approach, focusing on building securely attached relationships and understanding the unique needs of children. By differentiating the child’s true essence from parental narratives and working closely with the family system, therapists can create a supportive environment that fosters healthy development and well-being for the child.

In my supervision sessions, I aim to guide therapists through this transition, helping them to navigate the complexities and nuances of working with children and adolescents. Together, we can create a therapeutic space that honors the child’s individuality and promotes their growth within a nurturing family system.