Time-limited psychotherapy with children and young people experiencing loss and trauma

Therapeutic work with children and young people who have experienced significant abuse, loss and trauma, poses a major challenge for all who are involved in their care. The challenges involved in trying to help these often very damaged children and young people, tend to evoke in professionals, an inclination towards either despair or omnipotence. In the case of the latter, it would be wise to carefully ‘read the labels’ of therapies and programmes that present their snappy euphemistic titles, claiming to be ‘evidence-based’ and promise to undo a lifetime of misery and trauma in a stroke (Schmidt Neven, 2010). We would also want to avoid the pitfalls of either trying to get rid of troublesome behaviour through cognitive behavioural therapy, or maintain a belief that only long-term psychotherapy will make any difference.

In this respect we have to keep in mind that many deprived and deeply troubled children and young people, do not easily fit into one to one therapy, nor do they necessarily find it beneficial. This is due at least in part to their profoundly disordered relationships that have been characterised by abuse and neglect. In this context, time-limited psychotherapy has a helpful role to play in two key areas: given the very nature of a time-limited approach, this may be perceived as less threatening by the child and young person; second, there is the emphasis on working with children and young people in the total field. The fact that therapeutic contact can be time-limited may give children and young people a sense of control where this has largely been removed from them. Moreover, it holds out the promise that the child and young person can always return later to continue the therapy or focus on a particular area. The incorporation of the total field is crucial in therapeutic work with children and young people whose very connections with family and the community may hang on a thread through disruptive and destructive experiences. Here, the focus on dissolving the boundaries between the clinical setting and the broader network, comes into its own and provides a much needed protective safety net. The technique of finding the leverage is also at work in this process, where the child and young person may find a helpful connection with another professional, such as a teacher, social worker, or community worker. In this context, there is a parallel process in finding capacity in the referred child and young person and finding capacity in the system that surrounds them. Taking an inclusive rather than an exclusive approach means that we include foster parents and others who act in a parenting capacity as part of the total field.