Magazine article Family Therapy Networker

IN CONSULTATION; Seen and Heard: Sometimes It Makes Sense to Bend the Rules

Magazine article Family Therapy Networker

IN CONSULTATION; Seen and Heard: Sometimes It Makes Sense to Bend the Rules

Article excerpt

Q:Traditionally, family therapists have worked with children only in the context of conjoint family sessions. Under what circumstances is it appropriate to see children individually?

A: My assumption is that the real therapy occurs among the family members; my role is that of catalyst and coach, not parent. There are times, however, when seeing a child individually for part or all of a session, usually early in treatment, helps my evaluation of the child and family or establishes a stronger working relationship with the family.

I begin each new case with a family evaluation session, during which I learn all that I can about the functioning of each child in the family. If I notice, however, that a child has something to say that he or she is unable, or perhaps unwilling, to say in the presence of the rest of the family, I make it a rule to spend a few minutes with him or her alone.  Some of these individual sessions yield little new information. But others significantly influence the direction the therapy takes.  For instance, children have told me that they are afraid to talk about their sadness, anxiety or academic difficulties for fear of upsetting their parents, that they are worried about a parent's drinking or poor health or that they are so angry at a parent that they dare not discuss it.  Some children have talked about physical or sexual abuse.

During an initial interview with a family seeing me ostensibly because their son was unrelenting in his teasing of  his little sister, I sensed that the boy wanted to say something privately, although he was unresponsive to prompts from his parents. So, with agreement from him and his parents, we met alone and he immediately told me he was angry because his parents loved his sister more than him. He could tell, he said, because he had to earn straight A's and be a soccer star to get their approval, while all she did was go to kindergarten. Ten minutes alone with this child revealed an issue that might have taken weeks to emerge in a family session.

In some cases, the parents themselves want the therapist to see their child alone, for a variety of reasons. Even when I don't think it is necessary, I usually agree to use part of the family session to see the child alone, both because the parents may be right--the child may have secrets to discuss--and because they may lose confidence in my work if I refuse. …

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