Usually when I see a new client under 17 years of age I will invite both child and parent to the first counselling session. While taking the contact details and asking routine client information details, the child and parent being to settle comfortably in the room. I often find that the parent is needing to launch into the problematic scenarios of their child and sometimes they might be holding a report from school. Taking the initial interview slowly is helpful and is a containing method in counselling. I will always ask the parent whether the child is receiving treatments for anything. I ask the child his or her age inviting them to engaging with me. Often the reply to treatments is in relation to ADHD medications or asthma etc. This is a good opportunity to ask the child whether they think the medications work for them. Some children say yes and others say no. I stroke the child's ability to respond by saying "I like the way you know that".
The next thing to do is inquire about the contract for counselling. I invite the parent to describe the things she hopes her son might achieve in counselling if he is ok about doing some work with me. Leaving that option for the child's is helping to peel off Driver functions and pressures of adapting by the child. It is also building my relationship with the child. I observe any adverse reactions in the child and the extent of any prevailing sensitivity for them.
It is also important (in some cases) to "hear" the Parent Contract from the parent directly. What I mean by this is to observe how the parent expresses their "hopes" for the child. Often the Mother will begin to describe negative behaviours, however I will stop her and invite her to think about the positive things she hopes her child will gain from counselling. This is not an easy question for some parents. The most common and easy option for a parent is to say "I want my son to be happy" or "I want him to control his anger". I will spend some time helping the parent to re frame her "hopes" and investigate the benefits for the child if he does achieve such things from counselling. The positive outcomes for the child might mean having more friends, better relations at home etc. The child is listening intently to the parent voice and aligning mothers hopes with the possibilities in their life. The child at this stage seems to have more time to acclimatize to the counselling process as I work with the parent.
I will engage with the child next by asking about siblings and their ages while I am drawing the genogram of the family unit. In many cases parents have split up, so by asking empathicly, "when did you see Dad last" is imperative. Checking how often the child engages with a separated parent is also very important information. If there are any signs of affective responses in the child's body language I note that.
Observing the body language between child and parent in the early stages of the interview is the best means of information gathering.
It may be that the child is sitting in the chair in some manner, or the child diverts their attention to some play toys near by. Perhaps the child is siting quietly or being more vocal by answering the questions directed at the mother? All of these initial observations are very important signs to attachment styles and adaptations with the parent. Perhaps I will ask the child in a straight way "do you think you have an anger issue" (like what mum is saying). I will always stroke their answer if they offer one.
The next part of the interview is to gain the permission from the child for me to ask the parent about behaviours. I describe that feelings are like snow flakes, everyone has unique ways to express feelings. "If I know about your special kind of feelings then I will know more about you". I invite the child to have a say if he or she disagrees with what the parent says. Usually the child says "yes ok". But it is not enough to leave this invitation just there, its best to formalise the contract with the child's ok-ness to disagree by asking "How will you let me know that you disagree with her"? It is a simple question however most children stumble around before saying "I will just say something". "Ok, good idea", I say. I need the child to be "in the room" and in this way to invite them into thinking about what is being said.
If the issue of anger has been raised initially I ask the parent to describe their observations of what the child "does" when he or she gets angry. I develop safety with the child by containing the parent from describing all manner of problems the child may have. "I am writing a small list" I say. The list will usually show the kind of anger that the child exhibits. The child may be throwing objects but not breaking anything, the child may be throwing things that are smashing. The anger might be verbal, or with clenched teeth or fists.The child might be using a threatening style of behaviour which may indicate concerns around control.
The child may back away or stand his ground. The child may run out the front or back door when angry. These are the important pieces of information to understand the child's process of repression, displacement, withdrawal, destructive anger. In many cases this information may help locate developmental stages the child is recycling in their attempts to handle their life. Perhaps there is more self esteem work required in contrast to anger work. Along the way I support the child's concerns by offering nurturing responses such as "that doesn't sound fair" or "that is a pretty common behaviour that I hear".
The best outcome for ongoing counselling with children requires the enlisting of both parent and child into committing to the process. Developing safety and building relationship with the child is paramount of all. The initial counselling interview with parent and child is not only about information gathering however developing all manner of contracts and establishing the counsellor-client relationship. I have so far described about one half of the initial assessment interview. I guess we are about half way through the hour session at this point.
My next installment will describe how to gain information about the child's own ability to deal with angry feelings, their ability to desensitise. I will describe how the child can identify patterns in their thinking feeling and behaviours. I will describe how I Invite the child into a contract for change and then participate in a simple activity to prove themselves that anger can be expressed without getting into trouble. I will also describe how feelings arise for the parent during the interview and the benefit for the Parent and Child relationship.
Kenoath
