Skills in Counselling and Psychotherapy with Children and Young People

Lorraine Sherman

• Publisher: SAGE Publications Ltd
• Year: 2014
• ISBN:
  9781473909489
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

As interest and training in counselling children and young people continues to grow, it is essential that counsellors are equipped with the skills to work with this client group. In this book, Lorraine Sherman draws on her years of experience in the field to provide a practical resource for qualified and trainee counsellors, providing them with the necessary skills to ensure best practice with children and young people.

Distinguishing between working with young children and with adolescents, skills covered include:

- establishing a therapeutic relationship

- assessing a young client

- contracting

- counselling practice

- understanding and maintaining confidentiality and disclosure

Using case studies and examples to help demonstrate skills in action, this is essential reading for anyone planning to become or already engaged in the helping professions with young people.

1 Preparing for the Journey

Introduction

In this chapter, we will consider what is needed to begin counselling children and young people. To be with a young person in the counselling room is both a privilege and a challenge – a privilege as there is the opportunity to know the intimate reality of a young human being's life and a challenge to make best use of the counselling and offer each young person the potential for growth and change.

At the heart of practice are the therapeutic processes and therapeutic alliance. On first meeting a young client, we need to consider how the therapeutic relationship is formed. What will be different in this relationship from being a parent, teacher or friend of the young person?

The creation of an alliance with young clients takes skill and practice.

Heart of Practice – the Therapeutic Alliance

Case Example: Making an Alliance with Jan

Jan, aged 13, comes to your counselling room and begins by telling you she is ‘fed up with do-gooders trying to help her’. How do you respond?

There are many possible responses to a statement like this one. What is the best approach to gain an alliance with Jan who has clearly had enough of the helping professions of which you are a member?

Three possible responses are:

1. ‘Oh yeah, they are useless those social workers/teachers/mentors’. (child-to-child response) COLLUSION
2. ‘Sounds like lots of people are trying to help you but you don't feel helped at all’. This response shows you have heard Jan and are giving her permission to express her dislike of what she perceives as ‘do-gooders’.
3. ‘Please don't speak like that here about people who want the best for you even if you are fed up with them’. (parent-to-child response) JUDGEMENT

Let us consider each of these responses in the light of establishing a therapeutic alliance. Would we feel tempted to offer the third or first response? What is wrong with doing so?

Response 1: here we are isolating ourselves from other professionals. When counselling children and young people, we may at times find ourselves blaming a teacher for shouting or a social worker for calling our client a ‘drama queen’. It is easy to believe the client has a right to have an adult on ‘their side’ and this validates statement 1. If you believe an adult is acting in an inappropriate way towards your young client, it is vital to act. This needs to be done with calm and clear empathetic responses and not by joining in with a client's anger or rejection of authority.

Response 3: challenging young people who behave in rude and sullen ways invites ‘critical parent’ responses. If we do respond in this way, it is probably the last time we will see Jan, having been written off by her as someone trying to reform her behaviour, rather than get to know her empathically.

Response 2: we need to get alongside Jan, finding in us the place where we can really connect with what it is like to be her. This is what the second response begins to do.

What comes next? Jan is still eyeing us with suspicion, waiting to be told off or for you to attempt to help her. How do you build the therapeutic alliance from this place?

A useful strategy is to stick to honest and clear facts, for the first few minutes, about the possibilities and limitations available in counselling. This helps to deal with the ‘bullshit detector’ that young people often have in abundance. Honesty includes explaining the counselling contract to Jan at this early stage. This is part of being empathic in that it shows the client you know what it is like to BE them. Jan will probably appreciate clarity and honesty, both of which are often in short supply in a young person's life.

Emotional Literacy

We have the potential to open a door to a whole new world for a young person. The ‘norms’ of the counselling room may be very distant from a young client's everyday life. Emotional literacy is still not very widespread. You may find that a minority of your clients are exceptionally well versed in the language of feelings. A child or young person who has grown up in a home that allows and encourages expressions of anger, sadness, happiness and joy will have developed emotional literacy. A young client who is emotionally literate can say, for example, if they feel envious of a sibling or sad at the death of a pet. More often, there has been selective permission to feel some feelings and not others. Sadness is acceptable, but anger is not or anger is expressed so unskilfully as to be linked to aggression. Sometimes substances are used in families as ways to suppress feelings, and these may be legal or illegal.

Some children and young people will have already learnt in their early years that the expression of how they feel about anything puts them in danger of punishment. These young people have become able to hide how they really feel and sometimes will have lost connection with what it means to genuinely express emotion. A safe survival response to the circumstances in which they have grown up could be to hide feelings, manipulate situations or close down emotional responses. Young clients may have learnt to try to give adults what they think is wanted by them rather than express their real needs or wants. Conversely, they may have decided that any attention is better than none and act in odd or defiant ways to be noticed.

Suddenly, as the young client enters the counselling room for the first time, they enter a place where feelings have value, openness is encouraged and privacy respected. The newness and difference from everyday life should not be under-estimated.

Skills and Qualities

There are various skills and qualities that the young people's counsellor needs to bring to a first session to establish a relationship. An acronym for these is: H. E. A. R. O. S.:

Holding the Overview

Empathy

Age-appropriateness

Resilience

Openness to Difference

Self-care

Some of these skills will be familiar ones to all counsellors. They need to be practised in a new manner within the context of counselling children and young people.

Considering each in turn with examples can help to clarify and illuminate how to use these skills.

Holding the Overview

This is an area that illustrates that counselling with children and young people is clearly different from counselling adults. When we counsel adults, we allow them to make choices concerning who they live with and how they conduct their personal relationships. A young person has far less choice in these matters, often none at all.

Reluctance, nervousness and ambivalence about attending counselling can all be managed and often overcome. Ongoing coercion, threats or bribes to attend, however, are not a good basis for creating a therapeutic alliance.

During the first session:

• ♦ Establish the nature of counselling with the young client.
• ♦ Let new clients know that you are not going to try to ‘make’ them behave differently.
• ♦ Be prepared to listen, find out what it is like to be the young client and enable them to understand their situation and life choices.
• ♦ Be yourself – this is vital in these initial stages as is an open account of the limitations of the service you are offering.
• ♦ Explain clearly the limits to confidentiality and the time constraints. This is considered in detail later in this book (in Chapter 5).
• ♦ Ask your client if they have had counselling or therapy before.
• ♦ Offer a different approach – sometimes young people are referred to see professionals and they have very little idea about who that professional is and what is going to happen.
• ♦ Take the time to explain who you are and what it is you hope for in the counselling process.
• ♦ Offer a general explanation of what you will and will not be doing in counselling.
• ♦ Include the opportunity for young clients to ask any questions they would like to.

Remember that it may be the first time in the young person's life that they have had one-to-one time with an adult they do not know. Once trust is established, this can be a great opportunity, though initially it may seem strange. The environment in which you meet your young client needs to aid this first contact.

Reflective Activity: Finding the Overview

Remember a time in your childhood or youth when you held a differing view to your parents or teachers but were made to do what they told you to.

Can you recall how you felt? Note the feelings down.

Now as an adult, how do you perceive that same situation looking back?

If the two views differ, attempt to see both views simultaneously, as if from a third position, as a neutral observer. Hold a sense of valuing everyone in the situation.

This is the overview – a place of compassion and care for each person involved.

Empathy

The skill of being empathic with a young person is particularly important. We need to step into their world and gain comprehension of what it is like to be their age in their particular circumstances. Our own expectations and beliefs will be barriers to this, however open we are.

Being in the present with your young client is a good way to begin the empathic connection that you need to find in order to build the therapeutic alliance.

Child ‘Ego State’

The transactional analysis child ‘ego state’ is helpful in understanding how to do this (Stewart and Joines 2012). The child ego state is divided into ‘free’ and ‘adapted’ child. One useful aspect of TA is the explicit explanation of words, gestures and postures that identify the child state. A child-to-child transaction will help us to connect with the young client, though as young person's therapists we need to be vigilant that we don't over-identify and remain clearly as the counsellor or therapist, not trying to be friend, playmate or ‘partner in crime’!

Empathising with the young client involves allowing our own inner child to be present whilst always remembering we are no longer a child.

Age-Appropriateness

The age of the client will give many clues as to how to respond to them. The language used with a 6-year-old will be different to the language employed with a 16-year-old. Later in the chapter, counselling different age groups will be examined in depth. Age appropriate language and responses by young people's counsellors are an important aspect of the counselling.

A family divorce is a good example of this:

A young child aged...

Table of contents

• Cover
• Half Title
• Publisher Note
• Title Page
• Copyright Page
• Contents
• About the Author
• Acknowledgements
• Introduction
• 1 Preparing for the Journey
• 2 Assessing a Young Client
• 3 Deepening and Developing Counselling Skills
• 4 Extending Modalities to Counsel Children and Young People
• 5 Skills in Managing Professional Issues: Confidentiality and Disclosure, Agreements and Contracts
• 6 Skills for Resolving Ethical Dilemmas
• 7 Skilful Play for Counsellors
• 8 Using Supervision Skilfully
• Index