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Clinical Supervisor to students and registered psychotherapists.
465 Davis Drive, Suite 302A
New Market, ON L3Y 7T9
Barrie Office Address:
83 Berczy St. Barrie L4M 3R1
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Tel: (905) 717-7035
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An In-Depth Look At Psychotherapy
How Therapy Works With Children And Adolescents
Past events cannot be undone nor is it helpful for us to dwell on the past. However, the past may never
leave us alone. Past events can affect us to repeat it, without us knowing; we may still continue to live in our past or
drag it along with us. Either way, therapists like myself, trained in modern psychodynamic/analytic thought, understand the
past to be an important factor of the current problem.
For change to occur, an experience at the emotional level is necessary. In contrast, merely
explaining to the patient what the causes or motivations might be producing his symptoms and a difficulty is
never sufficient. Intellectual explanations do not produce effective change, especially long-lasting change.
Our inner world is the subjective picture of ourselves, others and things we all carry around
within us, sometimes without even being aware of it- and which may or may not adequately correspond to outward reality.
It includes our:
- Feelings and Attitudes
- Thoughts and Worries
- Fears and Conflicts
- Ways of looking at life
- How we see ourselves
- How we see others
Children & Adolescents
A child psychotherapist uses their training in close observation to help make sense of a child's
difficulties as they communicate with them through play, drawing, words and behaviour, so that the child is more
able to put into words the thoughts and feelings that lie behind their troubling behaviour. The psychotherapist
tailors their approach to the individual child and works in an age-appropriate way, for example using play or
drawing with younger children but talking about feelings with teenagers.
The relationship between the child and the therapist is central to treatment.
The therapist seeks to maintain a neutral, non-directive attitude and is open and receptive and
attuned to whatever the child/adolescent has to communicate. This allows the child/adolescent to trust and understand
that he will not be punished, humiliated or rejected when expressing, in his unique way, his hopes, fears and expectations
which govern his perceptions of the world and motivate his behaviour.
The therapeutic relationship provides a containing 'internal mental space' for the child; allowing the
child to experience the treatment situation as one in which anxieties and uncertainties are held or contained by the
therapist. The child's experience of the 'containment' of their troubled feelings helps to modify the strength of
their worries making them more bearable to acknowledge and express.
This "working through" allows the child to begin to understand and make sense of their conflicts
and feelings and allow them to express their experiences words rather than through their behaviour. Over time, the child
will have progressively less need for the therapist, parents or others to do this for him.
Most often, children/teens attend individual therapy. There may be times when it is helpful if
one or both parents attend with the child. This is discussed in detail with both the child and the parents.
Regular parent consultations are an important part of the psychotherapy process. Parent meetings
focus on helping parents understand and make sense of their child's perplexing behaviour and importantly help parents
understand their own responses to the child. Different options in parenting are also explored.
Parent consultation with a therapist may also be helpful when significant life changes are eminent.
For example: separation, divorce, or change of residence or schools. In these cases, parents may find it helpful to
talk with a therapist in order to understand what their child maybe experiencing and look at new options in supporting
their child through a difficult period. The most important of all environmental influences on the infant and young child
is his/her relationship with his mother and father. The parents, together, mediate, organize and interpret the events and
circumstances of the outside world to their child.
The child's view of their own reality and the importance of the outer world are very important factors
to the psychological world of the child. The child therapist is directly concerned with the external factors that
affect the child's inner emotional experience, as a result, parental involvement is very important in the child's
treatment as it allows the child therapist to understand the child within his/her unique family unit.
Child therapists work with parents in order to the help the parents understand their child's
behaviour, understand their own responses to the child, resolve problems, and support the positive changes taking
place in the child's treatment.
"If a community values its children it must cherish its parents."
- John Bowlby, Maternal Care and Mental Health
"Self-control can be learned, and self-control leads to self esteem".
"It is in playing and only in playing that the individual child or adult is able to be creative and to use
the whole personality, and it is only in being creative that the individual discovers the self."
- D.W. Winnicott, Playing and Reality,
Play is the highest form of research.
- Albert Einstein
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If needed, consultation with schools, daycares, Children's Aid Societies, physicians, lawyers and
other professionals may also prove helpful for your child or adolescent.
My background is in Psychodynamic psychotherapy - a therapeutic approach that that embraces
the work of all psychoanalytic therapies: it draws from object relations, ego psychology and self-psychology.
In psychodynamic psychotherapy, individuals are encouraged to speak freely about their emotions, thoughts,
desires, fears and early life experiences in order to gain insight into their lives and their present day problems.
Together the therapist and client identify and evaluate emotional coping patterns the client has developed over time.
When one begins to recognize recurring patterns as a method of coping with emotions they can begin to take steps to
change those patterns.
The therapeutic relationship is central to psychodynamic therapy as it can demonstrate the manner
in which the client interacts with their friends and loved ones. In addition, transference in therapy
(the transferring of one's feelings for a parent, for example, onto the therapist) can help illuminate the
ways that early life relationships affect a person today. This intimate look at interpersonal relationships
can help a client to see their part in relationship patterns and empower them to transform that dynamic.
Psychodynamic therapy encourages exploration and discussion of the full range of a patient's emotions.
The therapist helps the patient describe and put words to feelings, including contradictory feelings, feelings
that are troubling or threatening, and feelings that the patient may not initially be able to recognize or
acknowledge (this stands in contrast to a cognitive focus, where the greater emphasis is on thoughts and beliefs).
There is also recognition that intellectual insight is not the same as emotional insight, which resonates at a deep
level and leads to change (this is one reason why many intelligent and psychologically minded people can explain the
reasons for their difficulties, yet their understanding does not help them overcome those difficulties).
- Excerpt from Shedler, J. (2010) "The Efficacy of Psychodynamic Psychotherapy", American Psychologist, 65 (2) 98-109.
Jonathan Shedler, PhD is a leading expert on personality and psychotherapy."