and family therapy

from SFT nr2 2023

Dalarna

takes the film home and analyses it. She later sits down with the parents, and they look at it together, discussing what they can learn from it. As it is seen as the parent’s responsibility to raise and support their child, it is their thinking and behaviour which are the first targets for change. If the parents change, and this change is experienced as positive by the child, she in turn may find her relationship with her parents as being more pleasant. A positive loop will hopefully be established.

In considering the first explanation as to why family therapists do not work with children - that it is difficult – there can be several factors to why it is so. One such factor could be that family therapy can easily become a hybrid mixture of voluntary and compulsory treatment – voluntary for the parents, compulsory for the child, which may place the therapist in an ethical and professional dilemma. For example, if the parents clearly define their child as the only source and cause of the family pain, they may be reluctant to reflect over their own behaviour, thus abdicating from the responsibility inherent in the moral idea referred to above. Attempting to juggle with such a commission, the therapist may inadvertently increase the pain of both parents and child as the commission may be somewhat paradoxical: the parents want the help of the therapist to regain their competence as parents which can only be achieved, according to them, if the child permits it by being as they wish her to be. Potentially very difficult.

Such difficulties highlight the importance of therapist and parents being in agreement concerning the commission - one of the basic elements necessary for creating a therapeutic alliance. Bruce Wampold suggests that perhaps we should discuss if compulsory treatment, whether for adults or children, should be called therapy at all . My own experience suggests that if the therapist senses potential difficulties of whatever kind concerning the nature of the commission, then these should be clarified before treatment begins, and if agreement cannot be reached, then therapy should not be initiated.

Finally, if we take the second explanation given by therapists seriously as to why they do not work with children – that they have not learnt how to – we need to examine what might be missing in their training. It may be preferable that children are not present in the therapy session if the therapist feels inadequately trained to work with them. However, it would be a shame if the child was excluded from the therapy in the cases when it might be beneficial for them to be present, for the reason that the therapist lacks the training.

The issue of whether children should or should not participate in therapy is an important one for the family therapist. Presumably, such a decision should be based upon informed and transparent principles. One such principle might be related to the question of whether or not we family therapists have methods that can help the child by helping the parents without the child being physically present. Such a possibility might serve to justify not asking the child to participate. Another principle might be related to the possibility that the child could be harmed by participation. This possibility was noted above, with the example of when the child is held responsible by the parents for the family’s suffering. Identifying such principles would surely benefit us all, helping in the making of such decisions.

Dalarnas familjeterapiförening

Behandlarens V Rld

Svensk Familjeterapikongress 2023

Alain

Topor

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