Therapy for Children of Primary School Age

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All children (all humans really!) will struggle from time to time. Seeking external support and sending your child to therapy can be an overwhelming experience, especially when we have no idea what to expect. Stumbling upon this article – you may be researching on the best ways to seek mental health support for your child and exploring what services are out there. So, you are here now, what’s next?

Many parents may wonder what their roles are or their involvement in the therapy process. You may wonder if your child’s psychologist would ask for your input, ask your child directly about their experiences or make their own deductions based on what they observe in sessions? In general, children’s therapy works best when all of the above are incorporated and when the psychologist and parents work hand-in-hand. In saying that, however, gathering information from the child directly also depends on their level of comprehension and verbal abilities. This discussion will walk you through the therapy process for your children at Share Resolve (there may be slight variations in the ways each psychologist approach their child clients) and explain the importance of each step through a case study.

Preparing your child

You may wonder, what do I tell or say to my child prior to speaking to a psychologist? There are many ways you can prepare them, here are some ways you may start the conversation:

  • “Mummy and daddy need some help to understand you better.”
  • “We are going to see someone that can help you with your thoughts and feelings.”
  • “We really want to help you with (.. briefly describe the problem they are facing). So we are going to speak to someone who will teach us the best way to help you.”

You may also choose to share your own expectations or experiences of therapy (if you have any) with your child. This may help paint your child a picture on what to expect walking into the psychologist’s office and help them understand that the psychologist is a safe person to talk to.

First Meet-up

            When you first meet the psychologist, they will likely meet you and your child together. The first session can be seen as “information gathering” as well as a “briefing” on how sessions will run and for you to get to know the person working with your child. It will generally commence with the psychologist explaining that everything will remain confidential unless we need to protect you or someone else from getting seriously hurt. Even then we would normally try to contact you first to inform you and discuss options.

The psychologist will check on your understanding and answer any queries you may have and once they obtain your acknowledgement, they will start by gathering information. Often times, the psychologist will obtain your consent to gather further information from other sources such as teachers and other caretakers (e.g., nannies, grandparents, etc.). You may bring any documents that may highlight your child’s progress or the issues they have been experiencing Depending on the level of comprehension of your child, the psychologist may suggest to speak to your child alone to gather further information – this allows the young person to share information in a comfortable manner. The psychologist will involve your child in the process most of the time, making them feel like they are as much part of the process as you are. Afterall, the willingness to engage in therapy is needed for it to be an impactful and positive experience for your child.

Example: 8 yr old BB's first meeting with a psychologist
BB is an 8-year-old boy, referred for behavioural issues by his parents after being withdrawn from school and awaiting the decision from the school board. The psychologist started the first session by discussing confidentiality and obtaining the parents’ acknowledgement. The session continued with the psychologist gathering information from both parents about BB’s behavioural issues at school and at home. The information gathered include (but are not limited to):
- What the behaviours in question are, e.g., hits others when angry
- History of such behaviours, e.g., when did such behaviours start, what happens before and after those behaviours, etc.
- Family background and history, e.g., how the behaviours were managed by family members and school, etc.
- Important events, e.g., parental separation, bullying, etc.
BB’s thoughts and opinions on parents’ sharing were encouraged by the psychologist as this would help build a trusting work relationship with him, increasing likelihood of BB’s engagement in future sessions. The psychologist also explored his strengths and resources such as ways he overcame similar obstacles in the past (e.g., speaking to friends for emotional support) – this allows the psychologist to assess his coping skills and determine which areas require more attention during sessions.
The psychologist also obtained parents’ consent to speak with other sources such as BB’s teachers and nanny – this is to determine if his behaviours were similar or different across settings, which helps the psychologist prescribe effective ways of managing the presented issues. The psychologist then requested to speak to BB alone, whilst the parents waited in the waiting area. Confidentiality and its limitations were revisited as means to continue building trust with BB.

Following Sessions

The psychologist may use a variety of tools and spend time during sessions to speak about the young person’s interests such as their favourite games (e.g., Minecraft!) to engage them – this helps further establish trust between them to enhance the psychologist’s ability to support the child through difficult times and encourage better decision-making skills.

Goal-Setting

This step may also be included in the first meeting with parents and the young person, depending on how much information is shared and the time taken to do so. Goals set could be as straightforward as the adults describing how they would like the child behave instead (e.g., ask nicely instead of throwing a tantrum). This, in turn, will reduce the number of tantrums a child throws at home and school.

Over time, the psychologist will refine these goals by specifying them into clear behavioural goals with you and your child – this is aimed to enhance your child’s strengths and address contributors to the issues faced.

Example: Setting goals for BB
The psychologist discussed with BB’s parents on their expectations towards therapy and set specific behavioural goals they hope that BB would achieve. An example of BB’s behavioural goal was for BB to start asking for things nicely (without hitting others or throwing tantrum). The psychologist explained his parents’ expectations of him and the advantages of behaving accordingly. In this case specifically, a behavioural contract was drawn up (after discussions with parents) to help BB see how he should behave in certain situations – his agreement to the contract would increase likelihood of adherence.

Feedback and Recommended Interventions

Parent involvement is often necessary in making the therapy more effective, especially for children in Primary/Elementary School or younger. Prior to any discussions with parents or guardians, the psychologist will obtain consent from the young person. This highlights to them that sessions are indeed a safe space to work through difficult experiences they may encounter.

In some cases, parents may be requested by the psychologist to attend several sessions without their children to learn ways they can support their child more effectively. The psychologist will likely discuss every step of the recommended interventions as well as summary of the content of each session with parents (after obtaining consent from the young person) – this is to ensure that skills taught in sessions are implemented outside of therapy.

Example: Feedback & working in partnership with BB's parents
After each session, the psychologist makes it a priority to sit down with BB’s parents for feedback and briefing. These sharing aim to help his parents gain perspective about his difficulties and strengths to overcome the issues. As progress is mostly maintained outside the four walls of the therapy room, helping parents understand the nature of the child’s problem may assist in effectively applying the psychologist’s recommendations at home.
In BB’s case, where feedback from parents (e.g., explaining consequences) regarding his behaviours are necessary to help him, the psychologist not only spent time in sessions explaining the behavioural plan for BB but also provided pointers and demonstrated skills to his parents. Based on parents’ feedback in following sessions after trying out certain skills, the psychologist then brainstormed ways to manage any obstacles/challenges. The psychologist placed emphasis on parents’ acknowledgement of BB’s efforts serving as a reinforcement of desired behaviours (i.e., increase likelihood of repeating the behaviour).

Documentations for Schools

Occasionally, children presenting with behavioural issues may be required by their schools to produce some form of documentation from a psychologist. It is important to clarify with the schools what their requirements are; e.g., a verification letter that the child is seeking therapy, a specific assessment report, etc. You may discuss this with your child’s psychologist during your meetings.

Example: Getting BB support & understanding at school
BB’s parents reported that his school requested his parents to seek therapeutic support for him and obtain a letter from the psychologist. The psychologist suggested his parents to meet with the school to determine the exact documentation required (as it may differ across schools); in BB’s case, they required a specific behavioural assessment report and a verification letter from the psychologist. The assessment was held separately from the therapy sessions.

Arrange a consultation with one of clinical psychologists

If you think your child may benefit from therapy please contact Kae to arrange an appointment with one of our clinical psychologists. You can call or send a WhatsApp message to 012 5089910. You can also email Kae at info@resolve.my.

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