Therapy: Establishing the Framework

'The most productive therapy is child-centred, which means that the child leads.  The therapist’s motivation is driven by the child’s needs.  For example, in cases where the child denies that a traumatic event has occurred, a therapist will stand by his own assessment of the child and avoid direct conflict or argument over the subject, working in a consensual way.  The emphasis on child-centred therapy should not be taken as meaning the therapist is passive or colludes with avoidance and denial.

 

The role of the therapist

Who is the therapist?

A therapist has several concurrent roles, which include being:

  • A witness to the child’s story
  • An advocate for the child in relation to other professionals
  • Someone who empathizes with the child and affirms the validity of her experiences

He needs to be compassionate and emotionally warm, the kind of person to whom children are drawn, with whom they want to spend time, and who is able to enter into the child’s experience and able to speak the language of the child.

Perhaps the most essential quality is for him to be able to contain the child’s experience.  The child must have confidence that the therapist will contain her intense feelings.  It may help to tell the child that he has worked with other children who have been hurt by adults in a similar way.

He is trained to hear appalling stories and witness the acting out of painful experiences in the child’s therapy sessions.  He is critical to the child’s recovery.  Each child will be assigned a therapist based on an assessment of the child’s needs.  The therapist’s relationship with the child can be a significant one.’

Rymaszewska, J and Philpot, T (2006) Reaching the Vulnerable Child, Therapy with Traumatized Children, Jessica Kingsley Publishers, pp: 57-58

 

Every child living at SACCS receives therapy as an integral part of their individual recovery plan. Our sites are equipped with specially designed therapy suites, where the child visits accompanied by their Key Carer.

A qualified team of in-house therapists provide a range of therapies including Play Therapy, Movement Therapy, Art Therapy and more cognitive approaches that can be employed as necessary. Within the first 12 weeks of a child’s placement, an initial therapeutic assessment will be carried out by one of the team. Following this assessment a final decision will be taken as to which team member is best suited to the needs of the child at that time. Normally this will be the same person who undertakes the initial assessment, but this final check just allows for a second review before deciding on the right person.

Each therapist receives regular clinical supervision from a suitably qualified person. They also have regular sessions with the team of psychiatrists/psychologists/psychoanalysts who meet the therapeutic teams, again to support their well-being.

Each child has an individual therapeutic plan, as part of their IRP and normally receives weekly therapy sessions. If a child is encountering a difficult period emotionally, the frequency will be altered to suit and either increased or decreased dependent on what other work is currently being undertaken.

The therapist works with the inner world of the child exploring both their symbolic and concrete worlds. Within the safety of the therapeutic relationship, the child can begin to feel comfortable enough to externalise their feelings and share parts of the experiences that initially created their unhealthy internalised state. Through this process, the therapist is able to understand how the child has been able to survive and cope with the trauma that they have suffered and how they have used their coping mechanisms, usually extreme and uncontained behaviour; to survive their experiences and associated loss of previous placements.

Beginning to understand these psychological defences of the inner world, the therapist is able to help the child to re-process their past traumatic experiences with their current cognitive ability and to help them put their past into perspective so that they are able to progress and develop healthily.