Providing A THERAPEUTIC SPACE FOR CHILDREN AND TEENS
What gets expressed and what tasks are carried out in child psychotherapy? How does that happen?
First and foremost, psychotherapy is intended to be a space where self-expression of the child can occur. In my experience, when there is good therapist-patient fit, children express themselves adaptively through both verbal and non-verbal means, and they tend to benefit from self-expression. What is expressed in therapy? Some children want to share light or heavy emotions in therapy. Some dare to dream – they share their aspirations and hopes. Some want to talk about class and friends. Some children express hopelessness and loneliness. They may require the psychotherapist to hold hope - someone to envision a hopeful future for them.
How do I help kids to express themselves? Patients and their families report that my demeanor makes it easy for children and teens to feel at-ease in my office and that they express themselves because they feel relatively comfortable with me. They report that I seem relaxed and empathic with children; that I don't "talk down" to children; and also that I am very down-to-earth, which creates comfort for many kids. Being able to build rapport with children is necessary, but not sufficient for the therapist to be effective.
For treatment to be effective, evidence-based therapeutic methods are carried out in the treatment. In Exposure with Response Prevention (ERP), for example, a child might face uncomfortable stimuli. ERP is behavioral treatment geared at addressing various fears, phobias, and anxieties. We determine stimuli for "exposures" carefully. ERP is the gold standard for anxiety and patients and their families often report gains from this form of treatment. It is very pragmatic and tends to increase frustration tolerance and courage in children who might be otherwise avoidant or perhaps timid. Stimuli used in ERP might be as simple as the smell, taste, and texture of broccoli or more complex such as an interoceptive exposure. Exposures vary.
ERP is just one of many therapeutic interventions I use. "Therapeutic space" is defined differently for different sorts of problems and concerns. Each treatment plan is unique. What we do in treatment differs on a case-by-case basis, and depends on the personality and psychotherapy needs of each child or teen. While treating your child, I hope to engage with you and your child in way that allows you to capitalize on my skill set and training in order to address psychological issues that have developed in your child.