Taking a therapeutic history of the child

The questions asked about the child’s history are concerned with exploring with the parents the circumstances of the pregnancy, the experience of the birth and how the child has negotiated the normal milestones of development. These milestones include, feeding, sleeping, toileting and socialising; how the child has managed separations from the parents, such as going to childcare, kindergarten and school; illnesses the child may have had; how the child performs academically; the child’s interests and activities. On occasion, parents may come to the first session in a defensive mode denying that there is a problem, because the concerns about their child have been raised elsewhere, such as by the school. Allowing the parents to take the time to respond to the questions about the child’s everyday life may bring home to them the realisation that all is not as they have wanted to assume.

Key points to keep in mind: Resisting being ‘blinded' by the symptom

We keep in mind that the presenting problem of the child and young person represents the entry point to the therapeutic service. We make an assumption that it is not the real problem in the sense of containing the total picture. By resisting the urge to become ‘blinded by the symptom’ we also exercise caution in attributing a label to the presenting problem. In summary, in taking a therapeutic history and hearing about the problem, we recognise the following:

  • • What you see is rarely what you get;
  • • We are concerned with the unravelling of meaning not pathology;
  • • We ask questions that open up communication rather than closing it down;
  • • We understand presenting problems not as existing in a concrete sense within the child and young person, but being more likely to be a manifestation of what is taking place between the child, the young person and their parents and the broader family;
  • • The presenting problem may therefore be perceived as personifying the struggle of the child or young person to make sense of their experience.
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