Children and Adolescents
You are considering psychotherapy for your child or adolescent or a child in your care. I hope the following notes will help you understand what to expect.
Pre-adolescents
If your child is pre-adolescent, I will offer one or more appointments for both parents (where possible) or carer to meet with me. Unless otherwise arranged, the appointment will be for 50 minutes. The purpose of this interview is to understand why you are seeking help at this time, to hear about the child's history and to learn something about the family. It will be important for you to let me know if your child is receiving treatment from your general practitioner or a medical specialist. Where your child is receiving treatment for a condition related to your present concerns, it is usually advisable for there to be contact with the practitioner concerned and this is something we can discuss.
If you decide you would like me to see your child, an appointment will be arranged. Very young children may need a parent to be present at the start of the interview but where this is not necessary, you can bring your child to the door and introduce us. At the end of the interview, please would you be waiting outside in your car and your child will come and join you.
I will then offer a further interview for both parents (where possible) or carer when we will reach a decision about whether ongoing therapy is to be arranged.
Adolescents
Most of the above also applies to seeing an adolescent. The difference is that I do not ordinarily meet the parents again after meeting the adolescent unless we all meet together.
Attending for Psychotherapy
I will give you a brochure on Psychoanalytic Psychotherapy which is published by the British Confederation of Psychotherapists (now called British Psychoanalytic Council). Although not written primarily with children in mind, it provides helpful information about the nature of psychotherapy.
Sessions are arranged one or more times weekly. Bringing a child every week or several times a week makes a considerable demand on parents or carers both in time and money. Although brief psychotherapy may be indicated on some occasions, usually it continues for a considerable time. It may not be possible to offer appointment times outside school hours and it is important to consider how the school will respond.
Everyone is individual and it is impossible to predict how your child will respond to having sessions. Nevertheless it may be helpful to consider the kinds of responses there may be. Some children take to it very easily, finding it a relief to have someone outside the family with whom to talk. Others find it more difficult. Sometimes there is a "honeymoon" period when children attend easily and then suddenly become resistant. Sometimes there is a fairly quick improvement in the behaviour which led to your concern. There may be a tendency to withdraw the child from therapy at this time, but this may be premature. With other children behaviour deteriorates either at home or at school. Where sacrifices are being made to make therapy possible, this can be discouraging for parents and carers.
It is usual for people attending psychotherapy to have mixed feelings as difficult areas are discussed. Adults in therapy recognise this and this helps carry them over times experienced as painful. Children may not have this perspective and they may need their parents' or carer's encouragement to persist.
Confidentiality
In order for therapy to be effective it is necessary to establish trust that what is said will be treated in confidence. Trust can only be established over time and in the light of experience. Parents and carers have an important role in conveying to their child that this is understood and accepted. (There may be exceptional circumstances, such as being a danger to oneself or to others, when it is necessary to inform the appropriate people.)
I am involved in teaching, in maintaining my own professional development, giving workshops and writing occasional papers for professional settings and this involves the use of clinical material. When this is the case, all references to individual's experiences are made anonymous and disguised to ensure confidentiality. If you wish to withhold your permission for this or to discuss it, please let me know and your wishes will be respected.
Contact with Parents or Carers
You are free to telephone when necessary. This may be about practical arrangements or it may be with particular concerns about your child. It is usual to for me to mention such calls to your child. Alternatively I may need to telephone you about arrangements. Parents sometimes find it helpful to have an appointment to review progress. This would be arranged at a time other than your child's appointment time. In the case of adolescents a review would ordinarily include them.
Ending
As everyone is an individual and as therapy is a process which develops over time, it is difficult to be prescriptive about how long therapy continues. The length can vary from many months to several years. It is desirable if endings are arranged by mutual agreement and a date to end is set some time ahead. (From the standpoint of my time commitment, a minimum of a month's notice is appreciated.) It is often best to try to avoid an ending which coincides with another ending, like the end of term or the beginning of a holiday.
Fees
We will agree a fee at the start of therapy and this is subject to annual review. It is usual to pay for all missed or cancelled sessions. I will give notice of periods when I am away. So that breaks are not too long, it is useful if the child's holidays roughly coincide though I realise this is not always possible. There is, of course, no charge when I am away.
Lawrence Brown, Professional Member and Training Analyst, Society of Analytical Psychology, Member and Training Therapist, Association of Child Psychotherapists