Chapter 9BEGINNING THE RELATIONSHIP

Child is not directed Child can do nothing, be noisy, regress, make a mess,

be quiet

Objectives of the Relationship

Establish atmosphere of safety

Understand and accept child’s world

Encourage expression of emotional world – no judgment

Establish feeling of permissiveness

Facilitate decision making by the child

Provide child with opportunity to assume responsibility and feel a sense of control.

Making contact

Child may be resistant, feel that therapist wants to change him/her.

Consider how you want the child to view you. Be careful not to go too fast. Demonstrate caring and desire to get to know the child

Be sure room and waiting room are attractive and appealing to kids

Child may be thinking:

Will I be accepted? Am I safe? Can I cope?

In the Waiting room

If parent tries to ambush counseling, ask parent to arrange a time for a visit to discuss issues.

Get down on child’s level

Say “We can go the playroom now. Your mom will wait her and will be hee when we come back.” Don’t ask “ would you like to come to the playroom?”

Chit chat on way to room

If child is reluctant, say “I see you need more time to decide about going to the playroom. I’m going back to my office. You can choose to 1 more minute or three more minutes. Which do you choose?

If still reluctant, ask mom to come to see the room. Usually child will go in when the room is open. If not, ask mom to come in and sit for a few minutes. Say that you will respond to the child. Indicate when you would like mom to leave.

If child is still reluctant, can either allow mom to stay, or deal with child’s feelings while blocking the door.

As last resort, have parent carry child to playroom. Don’t carry child yourself.

Introduction to the playroom

Smile, be warm and friendly

Say, “ __________, this is a place where you can play with the toys in a lot of the ways you would like to”

Allow child to lead

Therapist sits down in chair (floor is child’s territory). If therapist is on the floor, the child may feel obligated to invite the therapist to play, too.

Nothing happens in the playroom that is not the child’s decision.

Maintain therapeutic role while participating in the child’s play.

Keep responses short (under 10 words), if possible

Be consistent

Listen with your eyes

Respect child’s space (allow child to go off on own).

Use open posture- lean forward, watch child, keep your body positioned towards the child.

Therapist’s nose should follow his/her toes.

Be “with the child” by using facial expression, body, tone of voice, etc.

If you need to move chair, explain why to child

Track what child is doing to communicate interest. EX: “You decided to play with that”

Reflecting content and feelings

Summarize or paraphrase verbal interaction.

Don’t push child to talk.

Relect feelings EX: “You are frustrated that the bullet doesn’t go into the gun easily” or “You worked hard on your picture and are proud of what you made”.

Handling the anxious child

If child is anxious and just stands there, track what child is doing (looking at the shelf of dolls), and say “I guess sometimes it is hard to decide what to do first. But this is a place where you can play with any of the toys you want to play with.”

If child asks, “what is this?”, respond “It can be anything you would like it to be”

Listen to concerns behind the question. Child says, “Did someone break this?”, the therapist might wonder if child is worried about what happens when something gets broken, and say, “sometimes accidents happen in here”.

Go through scenerios on pp. 199-204.

Ending Session

Give 5 minute warning. _______ we have 5 more minutes in the playroom, and then it will be time to go to the waiting room where your mom is.

Four Healing Messages

I am here.

I hear you.

I understand.

I care.