Emphasising health and growth

The task for the therapist is to make the health and growth of the child and the normalising of their development the central focus of the time- limited work. Communicating the urgency of this to the parents is central as the child cannot wait. This may involve challenging the parents’ preferred medical patient label for the child. For example, in one such situation, parents had made a decision not to send their seven-year-old son to school once his incontinence had taken hold although this was not the recommendation of the medical professionals. By the time the therapist saw the child and parents he had missed a whole term of school and was understandably anxious about returning. He remained at home highly indulged by his parents and presented to the therapist as though he was in a kind of suspended animation, neither being part of the child world of school and peers, nor part of the adult world of his parents.

The therapist was emphatic that the child had to return to school at the earliest opportunity and much of the therapeutic work was concerned with the practical day-to-day arrangements of how the boy could be helped to manage his soiling if this occurred while at school. For the boy, this took the responsibility of managing his body away from the over-concerned control of his parents, and helped him to begin to develop some capacity instead, enhancing the beginning of his own body awareness.

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