Empowering Parents to Make Informed Treatment Choices
For many of us, there is nothing more important in our lives than providing for our children’s well being. While that is a relatively easy concept to grasp and to endorse, putting an effective plan in place to achieve this goal is frequently far more complicated. This essay is intended to briefly highlight some important ideas about children and how to best meet their needs. I approach this topic as both a mental health professional and as a parent, and am contemplating these distinct roles as I share these impressions.
I have been practicing as a clinical social worker since the 1990′s, specializing in working with children and their families. My training and experience have taught me valuable lessons about children and I have learned a great deal from these kids about healthy and not so healthy childhood development. I spent ten years in my professional life working with children who were involved with the child welfare system. These children were wards of the state and were either temporarily or permanently separated from their family of origin, often as a result of abuse and/or neglect. The impact of the abuse, neglect, and separation from family was undeniable, as was the remarkable strength and resilience of the children. Although many of these children were labeled as “behavioral problems” or much worse, the vast majority of them engaged well with the treatment process and seemed to derive significant benefits from the clinical relationship. In many of these instances, the relationship with a consistent, caring therapist represented the most stable and nurturing relationship available to these children. I am truly proud of my contributions to these relationships, and I have tremendous respect for the healing power of a therapist-child relationship.
During this period, I occasionally had the opportunity to engage other family members in the treatment process to augment the clinical support offered to the children. This experience taught me that most children desperately wish to forge healthy relationships with parents, grandparents, siblings, and others, even though their behavior might suggest otherwise. Moreover, these family relationships often provided the best hope of reaching many of these troubled children, even when family dysfunction seemed to be the greatest source of difficulty. Consequently, while individual therapy was great for most of these children, there was no substitute for nurturing family relationships. Thoughtfully incorporating family members in the treatment process, when such an intervention was safe and appropriate, was an important aspect of the overall attempt to meet the often complicated needs of these children.
A few years ago, I established a private practice and have continued to address the needs of children and their families. As children rarely seek their own treatment, I typically engage parents who are concerned with some aspect of their child’s development and who are seeking the best way to effectively address their child’s problem. Most of these well meaning parents are very concerned about their child and genuinely want to do what is best to help their kid. However, many of these parents assume that the best option is to take their child to the “expert” and hope that this person will “fix” the problem. Sadly, many of these parents fail to fully appreciate their own expertise and underestimate their ability to positively influence their child.
As a father, I can understand this position, as personal experience has also taught me some difficult parenting lessons. No parent, including myself, is able to meet the needs of his/her child all of the time. There have been numerous times when I have regretfully concluded that my parenting approach to a specific situation was off the mark. It is the unavoidable truth; all parents make mistakes. Parental perfection is not an option. Nevertheless, parents remain responsible for seeking how to best help their children, even when they recognize their own failings and limitations.
Actively engaged parents are usually extremely valuable in the treatment process. Therefore, while individual therapy may be the best and most appropriate treatment option for a specific child, I believe that many children would derive even greater benefit from an approach that emphasizes the positive role of parents in supporting their children. In most situations, no one knows more about their child, no one cares more for their child, and no one is better positioned to assist their child in the long-term than are the parents. Consequently, it only makes sense that parents play a vital role in the treatment of their children.
While this seems fairly obvious to many, some traditional child therapies continue to focus almost exclusively on the child’s symptomatic presentation and pay insufficient attention to factors that have the greatest influence on their development. As I engage parents in an initial discussion regarding their concerns, we assess whether it makes more sense for me to meet individually with the child, conjointly with child and parents, or perhaps only with the parents. In fact, in a number of instances involving anxious, aggressive, or otherwise struggling children, parents and I concluded that the most effective way to assist their child involved my working primarily with the parents to support them in more effectively meeting the needs of their child. Sometimes parents opt for a combination of therapeutic interventions, integrating individual sessions with a child with sessions that focus more directly on parenting issues. Whatever decisions the parents make regarding treatment, it is helpful for them to examine a variety of potential options and make an informed choice regarding how to assist their child and family.
My clinical experience has taught me that some parents are reluctant to participate in treatment in such a manner, not because they want to deprive their child of the best possible care, but because they are concerned about their own competence and/or being blamed for their child’s problems. Nevertheless, most parents would agree that it is not appropriate to avoid a potentially effective treatment that addresses their child’s needs simply because it is uncomfortable for them as parents to do so. Regardless of any previous contribution a parent has made to the development of a problematic dynamic, most parents can learn about their child’s needs and work to more effectively meet these needs. By asserting their appropriate role of primary caregivers responsible for the well being of their child, and not inappropriately deferring to others who are not as well positioned to assist their child, parents who engage in the treatment process reclaim their primary role and often find that this step is an important aspect of providing the best possible care for their child.
When working with families in such instances, my clinical role is not to establish the type of bond and relationship with a child that establishes the child-therapist relationship as the primary nurturing, care giving relationship. Instead, my role is to a) facilitate having parents gain an enhanced understanding of their child’s needs, b) adapt parenting strategies that are consistent with their values, and c) pursue the goal of better meeting their child’s needs.
This process is designed to assist the child by helping parents become the type of parents that they would like to be. While this frequently involves discussion regarding healthy childhood development, treatment may also incorporate a significant amount of parental support and exploration of the issues that create stress. Exploring parents’ personal feelings about parenting often yields surprising results that can lead to significant changes. Perhaps most significantly, having parents reclaim primary responsibility for family issues empowers them to assert meaningful leadership and it reduces the potential message that the child is to blame for the family’s problems
Every situation is unique and every situation requires thoughtful assessment. As the figures most responsible for their children, parents face many difficult questions regarding how to best care for them. My clinical experience working with individuals and families has provided the opportunity to assist many children and their loving care givers. While I understand that sometimes a child’s best treatment option involves individual therapy, it is my strong belief that parents are a tremendously underutilized resource. Parents are often best positioned to meet the needs of their child and treatment should recognize their vital role in assisting their children. Clinical interventions that acknowledge this reality and encourage parents to assert appropriate leadership are very useful in addressing a variety of child and family needs. Treatment that facilitates better and more effective parenting is a tremendously valuable experience; likely producing positive outcomes for both parents and children.
Please Contact Me for further information and I will be happy to answer any questions you have.
Sincerely,
Bruce Gordon, LCSW