Saturday, June 07, 2008

Parent and Child Interview

Working with children often requires gathering as much information from the parent and child relationship as possible. Often the nature of the relationship between Mother and child 'contains' the information required for the child's treatment plan in counselling. How can a counsellor gather Parent and Child information while effecting therapeutic gain at the same time?





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 or daughter might achieve in counselling if he/she is ok about doing some work with me. Leaving the option whether the child continues counselling is helping to peel off Driver functions and the pressures for child adapting in counselling. It is also building my relationship with the child and allowing time to observe any adverse reactions in the child.


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 in terms of their own values. 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 mind. The child at seems 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 will 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 vocal, answering questions which are directed at the mother? All of these initial observations are very important signs to the child's attachment style and adaptations to 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 to speak up 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" (psychologically) 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 throw objects when angry but not breaking anything, the child may be throwing things which 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's behaviours may reflect backing away or standing his ground. The child may run out the front or back door when angry. These are the important pieces of information to understand how the child's process of resentment, repression, displacement, withdrawal are working. In many cases this information may help to locate particular developmental stages the child may be recycling in their attempts to handle their life. Perhaps self esteem work is required in combination 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 of".


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 paramountl. 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 where they can 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

19 comments:

roses said...

Silly question i suppose, but have you ever watched the horse whisperer. It was a wonderful movie. So lovely how he let the horse make the decisions - the relational. Eventually the horse trusted him and rather than him working with the horse, they ended up working together. He was the same with the girl too (the horses owner). Some people just have 'a way'. So lovely.

This was truly a lovely post Ken. Thank you... roses

Ken said...

I am not sure that I have seen that film Roses, however I value your comment and enjoyment of the post. As far as I can remember I have always been able to 'connect' quite well with children.

kenoath

mariamusic said...

Hi Ken,

I found your posting rather inspiring.

I always had this thought or perhaps belief that children would benefit more if their parents would get psychotherapy (also?)!

well be,
Maryam.

Ken said...

Yes, I think you are right M. Children enjoy seeing Mum get some counselling. In some cases I think defiant children actually choose to come to therapy because they see how it might be good for Mum.

Thanks for comment M

ken

mariamusic said...

Roses, and Ken,

There is a nice article on the horse whisperer written by some behaviorists.

http://seab.envmed.rochester.edu/jeab/articles/1999/jeab-72-01-0139.pdf

One of their focuses is about the "helplesness" that the horse-breaking brings while the horse whispering does not. The technique uses the human as a member of the herd and not a predator.

I always find it a good reading, so i thought why not to cite it here?

Mariam.

mariamusic said...

http://seab.envmed.rochester.edu/jeab/articles/1999/jeab-72-01-0139.pdf

hope this one comes out fine.

sorry K.

M.

roses said...

Oh thank you for that Maryam! I'll just copy the url and paste it into my address bar. I hope it works too.

It's a lovely movie! Cheers... roses

roses said...

Ohh, Maryam! That was wonderful! Thank you so much for posting it here in Ken's comments. Gosh that was good.

roses

Anonymous said...

That is a good article Maryam. I have saved it to file thanks.

kenoath

mariamusic said...

glad you liked the article.

Maryam.

mariamusic said...

Hi K,

I tagged you.

M.

Kahless said...

Hi Ken,
This was really interesting. It must be hard working with kids in some respects, but very rewarding I am guessing.

roses said...

Kahless, this is a beautiful post isn't it?

roses said...

Ken?
"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."

Looking forward to this. By the way... was there another post here before?

roses

Shruti said...

You write fantastically well!

Shruti

Ken said...

Thank you Shruti, I appreciate you saying that. I have been thinking about coming back to this blog and writing some more. I think I needed time away and to work on the other blog for a while.

kenoath

KazzaB said...

That was an interesting post Ken. I was thinking as I was reading it, how I would react to my parent being in the room with the initial counselling session and I know I wouldn't say much at all with one of them there. I probably wouldn't say much without them there either because of the fear of them finding out and my getting into trouble. How do you deal with very quiet, adapted children or very afraid children? It would take a long time to establish trust, wouldn't it?

Colin said...

Hi Ken

Hope you're well. After much fiddling and farting about, I've just managed to add your blog to my favourites on my new 'Shack' blog.

It was great meeting Madeleine - we had a good old laugh! Anyway, when you get a moment come over and check out my new Shack. It's taken me a couple of years to find a network where I feel I can settle into.

Cheers
~ Colin

Colin said...

Hi Ken

I couldn't find your other blog - the one with a twist of lime. Can you please give me directions at some point?

Cheers!