This article was written by Pauline Pearson and can be found here on the CCPAS website and has been copied with permission.
Why Counsel Children?
Erikson in his book, Childhood and Society, describes an 8-stage model proposing opportunities for success and failure at age-related crises throughout life. “Failure to successfully complete the task appropriate to the chronological age, impairs ability to proceed to the next task and thus all further emotional development”.
If this is so, then there are very many children who, because of physical, sexual and emotional abuse and neglect, confusion at family break-up, grief at the loss of loved ones or the difficulty of coping with fostering and adoption, are unlikely to reach full emotional development without help.
Grief and Loss
Children also need help to come to terms with grief and loss. It may be the death of a favourite pet mouse or a loved grandparent. It may be an older brother or sister leaving home, or the family moving house. It may be the break-up of the parents’ marriage. Normally “good-enough parenting” will provide help and comfort for the child, but if the parents are not coping well or are incapacitated by their own grief, then the child’s needs may be forgotten or inappropriately handled.
A recent edition of the Reader’s Digest carried an article on divorce. It said that nearly one in every two marriages in Britain ended in divorce and each year 160,000 children become the products of broken homes. One child said that at nine years of age her parents told her that they were separating. She thought it was “the most terrible thing that could happen”. Another girl was seven when her parents divorced. “It was so confusing – I began to feel it must be my fault, that it had happened because I have been naughty. It made me terribly unhappy. I couldn’t talk about it to anyone. Mum seemed so unhappy herself. I didn’t want to make it worse by reminding her”.
Other children have to cope with the confusion of moving to new families when being fostered or adopted. Not only are there new people to relate to, there are birth parents and other carers to say goodbye to. They may have ongoing contact which can be threatening and confusing. At these times social workers and foster carers can help children sort things out by making life-story books or through other direct work.
Signs and symptoms of distress
These could include chronic irritability, difficulty concentrating, poor sleeping, poor eating habits, restlessness, rapid heart rate, various aches and pains, irritating behaviour, lack of spontaneity, frequent mood shifts and nervous habits.
Children may be observed to be not coping with life-events by parents, health visitors, nursery workers, teachers and children’s workers, or, in the course of their duties, by doctors and social workers.
Most children will be referred to the school psychologist (if the school is concerned about under-achievement) or the Department of Child and Family Psychiatry, while others may be seen by voluntary organisations such as NSPCC.
Alternatively, some who show severe signs of disorder may be referred to a play therapist offering long-term non-directive work with children or to others providing more specialist therapeutic input. Social workers are also involved in counselling children, but generally their time is too limited to offer this to many clients
The Differences in Counseling Children
The ethical considerations of informing parents that their child is being counselled and/or the content of sessions needs to be thought through in supervision. The Gillick case highlights these concerns. Victoria Gillick brought a case against the West Norfolk Health Authority to establish her parental rights if one of her children was receiving treatment or advice about contraception. The hearing ruled that a young person who has sufficient understanding and intelligence can give a legally valid consent. This applies to counselling just as much as in medical matters.
Problems of confidentiality
A counsellor needs to assess the child’s understanding of the problem for which she is seeking help and talk through the issue of confidentiality with them. If a child discloses abuse or identifies an abuser, then confidentiality should be breached to alert the investigating authorities ie police and social services. This point is stressed by Ann Cattanach in Play Therapy with Abused Children as absolutely necessary in the interests of the child client and others who may be abused. Indeed, this may be a requirement of the agency for which a counsellor works.
A younger child may be happier to have their parent present, but there may be situations when this would not be advisable (eg parent abuser). An older child or young person would probably be seen alone. My own preference is to see older children on their own, explain the limits of confidentiality, but I say they are free to discuss the sessions with anyone. This approach is important as it helps children to differentiate between confidentiality and secrecy -which may be part of the abuse they have experienced. Any drawings or writings I ask permission to photocopy and they can take home the original plus copies (if requested!).
Alternatively they can keep their work at my office in their own folder. Another difference between counselling children and adults is that it may be combined with other help for the family eg family therapy or parental counselling.
Language needs to be age-appropriate and reflect the child’s own word-usage eg children may have their own words for body parts. The approach to counselling may be different depending on a child’s age and understanding. Older children may be happy to sit and chat. Others will be more comfortable using paints, crayons, playdoh, puppets, toy telephones, or whilst playing games, building with Duplo or Lego, looking at books or writing on a whiteboard. A child may not be able to concentrate for a full fifty-minute session, so those bringing the child need to be available earlier.
Children, like adults, can be nervous about counselling and it is advisable to show them where the toilet is. They may also appreciate some refreshments but in the case of younger children it would be advisable to check with parents of any food allergies before offering a drink.
I believe it is important to make the counselling session as painless as possible. If a child feels that they have had some fun as well as dealing with pain, they are more likely to invest in the time spent with the counsellor. At the end of a session I ask if they would like me to pray for/with them – if they don’t want to do so, then I respect their wishes.
The Dangers of Counselling Children
Children are vulnerable and open to suggestions. In cases of child abuse, a counsellor may damage a child protection investigation by asking leading questions. Another point to remember is that there is an even greater inequality in the relationship between counsellor and child than between counsellor and adult. As far as the child is concerned it is big person and little person – who may have been told to always do what grown-ups tell him. In Christian counselling there may be heavy pressure on a child/young person if the counsellor prays very loudly or in a way which suggests demonic involvement. A problem which I have met is when children and young people have made real progress but their parent/significant other has not done so. The counsellor must be careful not to undermine these people -however hard that may be!
As with counseling adults, I feel it is important to have at least one other person in the building to guard against allegations of misconduct or to lend support if a child becomes uncontrollable or very distressed. It may be possible to obtain a police check on yourself, either through the organization for which you work or by a self-checking procedure available under the Data Protection Act, for which you pay. The police check may help to reassure parents that you are a person of good standing.
The Rewards of Counseling Children
Beginning to see a child make sense of his situation and fit the pieces together again is most satisfying. Virginia Axline in Dibs in search of self has expressed it so well as she paints the picture of an isolated child beginning to communicate his pain and work through issues until he reached a place of wholeness.
As a child begins to rebuild faith and trust in himself, in others and in God, so a work of healing can take place.
Methods of Counselling Children – a personal view
Building the relationship The helping relationship is a very important part of counseling. I have found that as I have counselled adults and children, that the relationship has become stronger over time and they are then willing to share some deeply personal and painful things.
Establishing the child’s concerns
Having established the importance of the relationship and acknowledged the uniqueness of each individual, it will become apparent, how a child operates. Using Lazarus’ method of assessment known as BASIC ID I have identified how differently triplets will approach problems. One 12 year old girl, “Charlene” used drawings to dramatically express her anger towards her father who had been physically violent to her sisters and herself. Her sister, “Rebecca”, wrote extensively and cognitively while the third triplet, “Elizabeth” seemed less able in interpersonal relationships. In fact her drawings indicated that she had a poor self-image also.
These children were confused about their feelings for their father and stepfather (also a violent man). They loved and wanted them, but feared them greatly. Did they really want stepdad to return to the family? Was it OK to be angry with the abusers and with a mum who found it hard to effectively parent them? Working out solutions and ways of coping
So often there cannot be a “happily-ever-after” solution to problems, however much the child desires it. Working with each triplet individually, I was able to allow them to express their grief and anger. “Charlene” used the Gestalt “empty chair” technique to tell her stepfather how angry she was about his drinking.
I sat close by her as she verbalised her feelings. Rebecca” had been used to dispensing discipline to her sisters and her five-year-old brother. Using behavioural techniques I encouraged her to write down in a notebook which I gave her, every time she was able to refrain from taking on mum’s role, by leaving the room, picking up a book or otherwise ignoring the situations.
“Elizabeth” was helped to understand the facts of the family break-up and that however much she wanted God to make it better, grown ups made their own decisions for good or bad. Whilst I was working with the children, a colleague was counselling their mother. Without breaking confidentiality issues that concerned the girls were worked through and we undertook joint sessions with the whole family, enabling the girls to be honest about their feelings for the first time. This piece of work was carried out with the support of their church leaders and children’s workers, and link-families were identified for each of them, to give mum some respite, but also give the children a more positive view of family life and care. I would like to see this level of co-operation repeated in other families and churches.
In an age where there has been an “explosion” of counselling for adults, it is tragic that the needs of children are being largely ignored. Perhaps this is because children live in a world controlled by adults. In contrast Jesus respected children and used them as a model of simple faith which adults should follow. One of the most helpful books I have read on the subject, Children and Counselling by Margaret Crompton, draws heavily on children’s books to help the counsellor understand the world of the child more clearly. If a counsellor cannot relate to that world, cannot remember what it was like to be a child or teenager, then he will find it hard to enter into the child’s experience. A child deserves the best help in order for him to manage his life effectively and to develop emotionally and spiritually into adulthood.
Ax, V. (1964) Dibs in search of Self, London, Penguin
Cattanach,A. (1992) Play Therapy with Abused Children, London Jessica Kingsley Publishers Ltd
Crompton M (1992) Children and Counselling, London, Edward Arnold
Erikson, E. (1965) Childhood and Society, London, Penguin
Lazarus, M (1981) The Practice of Multi-modal Therapy, Baltimore, The John Hopkins University Press
Helping Children Handle Stress Wright H. N. (1987) San Bernardino CA, Here’s Life Publishers Inc.
The Sunday Times (19.3.95)