- low self-esteem
- depressive states and mood swings
- body dysmorphia
- suicidal ideation and attempted suicide
- anxiety in general
- anxiety related to an issue
- Insecure Attachment
- separation anxiety
- loss and grief
- social phobia
- obsessions and compulsions
- excessive fear
- difficulties with concentrating
- gender issues
- dissociative states
- selective mutism
It may be that current circumstances have triggered any number of these issues. Hidden aspects also need to be considered, such as earlier experiences which have compromised the mental and emotional wellbeing of the child or adolescent.
Face-to-face sessions in the physical therapeutic space
The therapy room is a containing space which is safe and private. Up until start of Covid-19 and lockdown, this has been the most common way in which children, adolescents and adults have participated therapy. This shared physical space may also raise some thoughts about the value of how it is to be in the physical presence of the other. For example, the nuances of facial expression, and subtle movement that the felt-sense of that is alive in that particular space. I am raising these thoughts because the alternative online therapy I also offer provides the same therapy or counselling but in the physical or virtual space.
Some parents and/or children would prefer to be is to be in the physical space in the face-to-face therapy-counselling. The geographical distance will also need to be taken into account. For a young person who doesn’t talk, I would say that the physical face-to-face therapy is more suitable than online. As I work with the arts and play, I provide all of the materials. But changes in Health and safety means that I need to consider the implications of physical contact with the objects used in the room. I have thought about this and at this time I think that each client will need to have their own set of drawing or painting materials. I also use miniature symbolic figures to create stories and for these I can wash (and disinfect) them and organise how to implement this. So it is a time of adapting to what is and we shall see more clearly how this unfolds.
I would also suggest that for younger children it is would be better for them to be in the physically shared space rather than online. The exception might occur if I have seen them in person over at least a short period of time. So if circumstances where travel isn’t possible due to any number of reasons, then seeing them online may be a suitable alternative. But this alternative would need to be assessed. The building where I see my clients it is a safe and pleasant environment. The parent or guardian can wait a reception area which is shared by the concierge at the desk. All the staff on the premises are warm, friendly and accommodating.
The in-person sessions also have the advantage of my being able to sit side by side (though in a 2-metre distance) to the child or teenager to view a drawing or painting alongside the dialogue. And if puppets are used in role playing then the use of puppets is likely to be more effective than online, though not every child is interested in engaging with puppets. But since I work creatively and intuitively, there are many ways in which the therapy can develop.
I believe that the key to successful therapy and counselling is the therapeutic relationship, regardless of whether it’s within a physical or a virtual space. And all questions or concerns can be discussed beforehand. Much depends of the practicalities such as time schedule and most often, geographical distance as to what is workable under any given circumstances.
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Online therapy and counselling
Now that my experience of working online with the child, adolescent and parents has developed to considerably higher degree, I have found that the effectiveness of the work is no different to face-to-face sessions. And, as I have mentioned, I am also able to discern through my own experience that I do not think it suitable for a much younger child to work online. I believe that experience is the best judge and at least this is what I can say is true for me at this time.
Privacy & Ethical Points Related To Online Therapy
A clinical supervisor is a very experienced psychotherapist who works with the therapist and discusses client work in confidence. UKCP requires a ratio of six clients per clinical supervision session. The support of the clinical supervisor is crucial for the overall work when discussing cases and he or she provides an added layer of support, indirectly, to each client through what is informed and discussed in the supervision sessions. Such sessions ensures that the quality of the work and the capacity of the therapist is assessed throughout. In addition to my clinical supervision sessions, I am also involved in a parent-child supervision group, as well as engaging in peer supervision which is a valuable entry into developing supervision skills and exchanging creative ideas and issues. All of these communications are confidential.
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Culture, race and religion is hugely important as far as the therapist’s awareness and experience in working with children, adolescents and their families, in addition to understanding the communities and traditional values that are intrinsic to the client. The systemic family as a whole, with all of its conflicts and diversity including blended families, foster care and adoption must be taken into account. Since I have the experience of working with these diverse groups, my way of communicating is approachable, constructive and authentic. This is an important subject that requires awareness and genuine responses to every aspect of the therapy work. Issues may include marginalisation, racial tensions and social considerations within the various environments, and in general, which have impacted each of the individuals that make up the family, their cultural collective and their relations with those outside of it.
Collaborations with Family Mediation professionals
Deborah takes on referrals from Family Mediators clients when therapy and counselling is suggested, in cases where the child or adolescent experiences emotional difficulties as a consequence of a breakdown in the parental relationship. She works individually with the child and also with the parents in one-to-one sessions.
The benefits of this type of therapeutic involvement enables the parents to explore the issues and relationship with their child, which often places communication problems at the centre. Whilst the parental sessions may be seen as therapeutic, the essence of this work is focus-based and setting out aims and goals.
Suitable strategies are also put into place, such as Non-Violent Communication (NVC), psycho-education and CBT. If any of these approaches are applied, they are used alongside general discussion with the overall themes that help the child and the parents to access valuable tools and enhance self-awareness.
In some cases, the parents’ background history reveal patterns which continue to play out. And some of these circumstances, Deborah may refer one or both parents to a psychotherapist who specialises in working with adults.
Deborah’s role where divorce proceedings have been instigated, also involves writing Assessment Reports which take into consideration the therapeutic confidentiality of the child or adolescent. This process allows for the young client to be given a voice. The unfolding of the therapy greatly helps with gaining clarity from their perspective, and all parts of this process is handled with sensitivity, and adheres to all manner of codes of ethics as set out by UKCP where she is a fully registered member. The Assessment Reports are submitted to the referring mediating professional and are made accessible to the parents. Prior to submission these Assessments are discussed between Deborah and her private clinical supervisor who will be familiar with the case. This also ensures that impartiality and integrity as concerns the child or adolescent and the parents are respectfully and accurately represented.
Breathing Space is a Family Service that provides a neutral, confidential space where separating couples who want to create a fair and workable financial settlement, a sensible co-parenting plan or both. These services provide a safe and constructive professional environment, rather than taking matters through solicitors or in the courts. However, in situations where decisions have been made to implement divorce procedures, then these cases are moved to Family Mediation involving solicitors. The company was founded by Sara Collins; we both trained at the Institute for Arts in Therapy and Education.
Sara can be contacted on 07808 955060
Sara also works with William Hogg, an experienced collaborative Family Lawyer, an accredited Family Mediator, and a member of Resolution and the Family Mediation Council. He was a member of Resolution`s DR committee for many years and a past chair of Law Net. He is a member of Resolutions collaborative law working party and the European Collaborative Network.
William has a wealth of knowledge in dealing with complex financial and children’s matters, helping to ensure that the voice of the child is heard in mediation. He has worked with some of the top London family practices. In addition to his work with Breathing Space, he acts as a consultant for Belmont and Lowe in Farringdon. He creates a safe environment where complex matters can be untangled. William is known for his ability to safely manage high conflict cases. He has also trained dispute resolution practitioners both in England and internationally.
William can be contacted on 07780 446029
Belmont and Lowe, 33 Sekforde Street, Farringdon, London EC1R 0HH