Being active in the therapeutic process

Time-limited psychotherapy makes a demand on the therapist to be active and communicative at all times. Communication, reflection and observation since they are all of a piece, require to be shared with the parents. In other words, without necessarily jumping to conclusions or offering advice, the therapist shares with parents how they have arrived at making a start in trying to understand the problem. This has two important functions: first, it helps to demystify the therapeutic process and second, it demonstrates how connections can be made between events that at first may appear not to be connected. This function of helping to make these connections is central to the therapeutic process and sets in train an entirely new perspective for many parents about how behaviour can be understood.

Establishing a partnership

The primary focus of being active and communicative with parents is to establish a partnership with them in the service of jointly helping the child and young person. Being able to speak directly and openly to the child and young person is also part of this process. Explaining to children why they have arrived to see the therapist is a critical part of being open and honest with them, and contributes to reducing their anxiety and helping them to engage with the therapeutic process. This is in contrast to a concern that children need to be protected from knowing about themselves and their problems. By being open, direct and communicative, the therapist does not prioritise uncertainty for its own sake or believe that they must wait and not risk making a comment in case it is incorrect. In fact in clinical practice one may at times hear from parents (and children) who have had previous contact with traditional child psychotherapeutic work, that they found it vague and unfocused and received little feedback about what was happening to their child. Part of being active and communicative from the outset involves explaining the time frame to the parents and to the child and young person. Within the time frame the question of who is seen, how often, and when, should be approached flexibly. However, the work with parents remains a constant, and there needs to be agreement about what will be addressed and what will be required from them in terms of their commitment to the process. Clarity in this respect is critical. For example, a practitioner may express disappointment that a father ceases to attend after the first session, but may never in fact have made it clear what their expectations were with respect to his attendance.

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