+ All Categories
Home > Documents > 66868708

66868708

Date post: 03-Jun-2018
Category:
Upload: melindaduciag
View: 218 times
Download: 0 times
Share this document with a friend

of 13

Transcript
  • 8/12/2019 66868708

    1/13

    Family-Focused Child Therapy

    in Marital SeparationShannon O GornnanPrivate Practitioner Brisbane Australia

    W he n marriages and lon g-term relationships break dov^n, parents may refer their

    children and adolescents to therapy for a variety of reasons. W hi le the systemictherapist s preference may be to w o rk w ith th e family system/s, high co nflictseparation may pro hib it such an app roach. This a rticle discusses family-focusedchild therapy that prioritises the needs of children while seeking to preserve asystemic ap proach. A t a practice level this may involve: (a) individual child the rapy(b) engaging with smaller subsystems including siblings, (c) joint therapeutic workinvolving child/ren plus parent/s, and (d) any of these combinations; all while contin-uing to maintain a systemic understanding o f t h e w ork . The article discusses thechallenges of work ing w ith children fro m separated families, wh ere th ere isrestricted or no possibility of eng ging w ith the broad er family system.

    K e y w o r d s : femily therapy child therapy separation divorce

    When marriages and long-term relationships break down, parents may referchildren and adolescents to therapy for a variety of reasons. While the systemicthetapist's preference may be to respond to a referral by simultaneously engagingwith multiple members ofthe family system/s,' the reality of high-conflict separa-tion may prohibit such an approach. This article focuses upon some challenges ofworking with children from separated families, where there is restricted or no possi-bility of simultaneous work with the broader family system. It presents a family-focused child therapy approach that prioritises the needs of the child/adolescentwhile endeavouring to hold a systemic perspective. In doing so it acknowledges asimilar term 'child-focused family therapy' that has been applied elsewhere(Hecker, 2010, p. 53).

    Marital Separation in Clinical Practice

    In 20 07 , 4 9 .3 of all divorces in Australia involved children (Australian Bureau of

    Statistics, 2008a). Yet not all sepatations involve the traditional nuclear family ormarried couples. For example, within Australia during 2006-2007 there were

  • 8/12/2019 66868708

    2/13

    Shannon O'Gorman

    '14,000 families in which the grandparents were guardians or main carers of co-resident children aged 0 to 17 years' and '27,000 same-sex couple families'^(Australian Bureau of Statistics, 2008b). For the purpose of this article, the term'marital separation' will be taken to describe the breakdown of the relationshipbetween the two adults including married/unmarried and heterosexual/same sexcouples heading the family system.

    Family-focused child therapy in the context of marital separation is accompa-nied by a range of challenges. First, working with children can itself presentchallenges. For example: 'Some children can be noisy and chaotic, making it hardfor the grownups to have an ordinary conversation. Other children are so silentthat the therapist may feel lost, frustrated and impotent because her main thera-peutic tool (words) proves to be useless' (Rober, 2008, p. 467). Working with thechild in isolation from the family can risk increasing a parent's feelings of inade-quacy or jealousy, which may result in the child being withdrawn from therapyand/or the family system being unprepared for changes in their child's behaviours(Johnson, 1995, p. 56). If the therapist is able to assist the child in a manner theparent cannot, this '... often raises sensitive issues of blame or competition in theparents' (Rober, 2008, p. 468). Conversely, in the event that the therapist isunable to assist the child, then parents may '... flnd proof that they themselvesare no t to blam e: Even this professional cou ld no t han dle my child ' (Rober,2008, p. 468). These issues can be helped where parents are engaged in paralleltherapy.

    Second, this is an area of clinical practice that is frequently characterised byhigh-conflict and acrimonious battles between parents. Relationship breakdownsare likely to cause distress for the family system as a whole, and the maritalpartners in particular. Emotional distress, changes in housing, restructuredfinances, and the need to distribute the care of child/ren are frequently brought tothe attention of the therapist. In instances where the therapist seeks to highlightthe impact of such conflict upon the child, they will encounter parents withvarying degrees of insight into their own behaviours and motivat ions. Forexample, adults described as being in the precon temp lative stage of chang e, ...take no personal responsibility for the problem, instead labelling the entireproblem as abo ut the difficult b ehaviou r of oth er family mem bers. (Lebow &Rekart, 2007, p. 83). In some instances parents will need to be informed of theimportance of ensuring that adequate boundaries are placed around parentalconflict such that the child/adolescent's exposure to it is minimised.

    Third, as therapy progresses both parents may attempt to communicate infor-mation to the therapist that relates predominantly to the parent's own experiencerather than the child's. In some instances it is apparent this sharing of material isorganised around the theme of communicating to the therapist that the otherparent is at fault for any distress or disturbance within the household. Frequently,the issue of blame emerges when there is a separation that contributed to the child's

  • 8/12/2019 66868708

    3/13

    Family Focused Child Therapy in Marital Separation

    parents). Again, the therapist may recommend the parent/s seek an alternativetherapeutic space to discuss their own concerns.

    Finally, as separation is ofi:en accompanied by legal processes, there is the possi-bility the therapist may be called (voluntarily or not) to be a part of this separateprocess. This shift: in context most likely involves a different way of viewing andevaluating conversations. While this is necessary for deflning the split from one totwo family systems, it does not necessarily fit well with the therapeutic process andcontent. For example, the legal context automatically defines previous partners inthe adversarial roles of 'applicant' and 'respondent', whereas they are either simply'parents ' or 'carers' to the child/ren in question.

    Prioritising the Needs of the Child

    In family-focused child therapy the needs of the child are given greater priority thanthe rest of the family. This might be seen as problematic for a systemic understandingthat sees the child as part of n evolving family system that is greater than the sum ofits parts (Becvar Becvar, 2003; von Bertalanfiy, 1968). However, a decision to avoidengaging with a larger family system is a response to situations where parents areunable to be in the same location due to previous abuse, ongoing safety concerns, orwhen parents are unable to interact without exposing the child to parental conflict. Adecision to see a child alone may come at the request of paren t/s who decline dierapyfor themselves but seek it for their child. This presents a potential conflict with tradi-tional systemic approaches as '... family systems therapists oft:en advocate seeing theentire family and may even believe that seeing a child or adolescent alone, dependingupon their theoretical orientation, is countertherapeutic' (Hecker, 2010, p. 53).

    Arguing in support of both a child-focused and systemic position, Kaslow andRacusin (1990) have suggested child therapy is indicated where there are inadequateparental resources and when the child lacks '...a reasonable degree of ego strength'(p . 285); whereas '... family therapy may prove most beneficial when parents haveminimal psychopathology' (pp. 281282). In instances of highly conflicted maritalseparation, family-focused child therapy prioritises the needs of the child/adoles-cent. At a practice level this may involve: (a) individual child therapy with the child

    alone and/or (b) engaging with smaller subsystems including siblings and/or (c)joint therapeutic work involving the child/ren plus parent/s and/or (d) any of thesecombinations, while continuing to maintain a systemic understanding of the workthat is unfolding.

    Family-focused child therapy offers the potential to apply various therapycombinations (i.e., child therapy, parentchild sessions involving alternatingparents) within a defined context (i.e., marital separation). While it prioritises thespecific needs of children, it recognises they live within multiple evolving systems.In dealing with marital separation it is likely to be brief or time-limited therapeutic

    work.

  • 8/12/2019 66868708

    4/13

    Shannon O Gorman

    Clarity Regarding a Range o f Possible gendas Fix my chi ld

    Where adults request assistance for a child, the therapist has to deal with multipleclients. A common referral is a parent who asks for assistance to help a child copewith changes in the family structure, or a more specific referral might involve aparent discovering an adolescent s use of illeg l drugs. In both instances the needs ofthe adult are somewhat identifiable in seeking to address some concern about theirchild. Upon interviewing the child, the therapist may find any number of previ-ously undisclosed yet meaningful pieces of information.

    For example, a child may be prohibited from phoning a parent when in the careof the other parent; or an adolescent has moved cities due to the change in parentalfinancial and employment status. While this provides additional information andraises questions regarding possible points of change, it may not strike the parent asrelevant. If so, the therapy may not fit the parent s agenda, summ ed up as fix mychild and oft:en accompanied by: I am fine and if I am not, it is not up for discus-sion . Th ere is a poten tial for conflict between the paren t (i.e., in some practices apaying customer) and the interests of the child (i.e., in many respects an involun-tary or relatively uninformed client). Ultimately the capacity of the parent to alignwith the therapist s professional jud ge men t in atten din g to relevant issues will deter-mine the scope or outcom e of the ongoing work.

    Unknow n Agendas

    Parents may be unable to identify, unwilling to articulate, or be unaware of theoutcomes they seek from therapy. For example, a parent may engage well with thetherapist, not miss appointments, pay fees promptly and be grateful for servicesrendered. After six sessions the same parent states s/he is aware that therapeuticreports were not part of the agreed service but a lawyer has requested the presenceof the therapist in an upcoming court proceeding. The therapist declines the invita-tion (unless issued with a subpoena) and the parent starts cancelling scheduledappointments, eventually making no further contact.

    Alternatively, a parent may introduce the (accurate or otherwise) idea that the

    other parent has alternative agendas for bringing their children to therapy. This maybe to reduce guilt associated with having engaged in an affair; to defend a positionof refiising to discuss the separation with the child; to present a better description ofparenting capacity for the purposes of child custody assessment; and so on.Awareness that therapy may be serving multiple purposes is essential and explo-ration of unstated and perhaps unconscious agendas may well prove necessary.

    Shifting Agend as

    The priorities of family-focused child therapy are formulated in response to theneeds of the child identified not only by the referring individual but also by thetherapist. For example, an adolescent may be referred due to self-harm behaviourand the therapist allows space to explore their understanding of parental conflict.

  • 8/12/2019 66868708

    5/13

    Family Focused Child Therapy in Marital Sep aration

    Potential also exists for family members to knowingly or unknowingly seek tosbifi: tbe focus of tbe tberapy. For example, a parent may request martial tberapy toreduce tension and conflict witb tbe otber parent. Tbis may prove beneficial for tbecbild but is accompanied by real risks regarding tbe break down of tbe tberapeuticrelationsbip. In essence, clarity regarding a range of possible agendas (spoken andunspoken) reduces tbe likelibood of the tberapist detouring from tbe goals identi-fied as part of tbougbtful assessment.

    Respecting Roles Enforcing oundaries

    In separation and divorce tbe original family system evolves into multiple familysystems, wbicb requires tbe tberapist to form and maintain clear boundaries.

    Transference

    Transference was originally described witbin psychoanalytic psycbotberapy and isdescribed as: ... a transference of emotions to tbe person of tbe pbysician, becausewe do not believe tbat tbe situation of tbe cure justifies tbe genesis of sucb feelings.We ratber surmise tbat this readiness toward emotion originated elsewhere, that itwas prepared within the patient, and that tbe opportunity given by the analytictreatm ent caused it to be transferred to tbe person of tbe pbysician. (Freud, 1922,p. 382). Transference describes an unconscious process wbere tbe client transfersemotions from some significant life figure onto tbe tberapist.

    Tbis is relevant for family tberapy, particularly wbere conflict associated witbmarital separation is played out in tbe client/tberapist relationsbip. Tbis processmay expose tbe tberapist to tbe p are nt s insecu rities, suspicion s, or bostility. Iftberapy is not cbaracterised by tboughtful, flexible yet clear boundaries, tbe capacityof tbe tberapist to focus upon the goals of therapy may be dramatically reduced.

    Consent

    In tbe context of marital separation and divorce, two adult parties are likely to sbare avested interest in tbe emotional wellbeing of tbeir child. Especially where both parentsretain or bave been granted joint custody, tbe tberapist must consider tbe legal andetbical questions associated witb dual consent and information sbaring. Cbild tberapy isbest conducted in a context in whicb botb parents place tbeir trust in tbe capacity ofthe therapist to work towards tbe better interests of tbeir cbild and tbougb tbe twomay bold competing needs at times tbe broader family system/s. Wbile tbe tberapistmay seek to gain consent from botb parents, complex questions arise when only oneparent gives consent, or worse still, tbe question of wbetber to continue witb tberapy incases in wbicb one (of two consenting parents) witbdraws consent after several sessions.

    In tbe auth or s experience it is no t un co m m on for parents to refuse conse nt totbe tberapist selected by tbe otber parent and, as such, tbe selection of tberapistitself becomes a matter for conflict. Tbis dilemma may present at tbe outset, or especially in instances in wbicb one parent perceives a tberapeutic bias after

    several sessions. Tbe realities of non-consent from one parent can include: tbe cbildnot turning up to tberapy if scheduled on a day tbe cbild is spending witb tbe non-

  • 8/12/2019 66868708

    6/13

    Shannon O Gorman

    Confidentiality

    Once therapy has been agreed to by parents and/or guardians, the thetapist is taskedwith holding in mind differing degrees of loyalty towards both the child andparen ts. T he needs of bo th parties play out w ith respect to the therapist s p ositionregarding confidentiality. For example, to what extent does a younger child requireprivacy, when co mp ared with the paren t s interest in and capacity to support thechild longer term?

    According to Hecker (2010): There are six possible ways that confidentialitycan be defined (p. 57).^ W hen working with young er children, the therapist mayconsider applying a definition of lim ite d confidentiality , w hich includes .. .t h eminor knows ahead of time what the topics are that will be discussed with parents(Hecker, 2010, p. 57). Feedback may need to follow each session in otdet to enablethe parent to respond appropriately to their young child, who may return home andraise short no t always contextualised extracts from the session.

    Where one parent has less access to their children (e.g., work commitments otfinancial resources make them less able to initiate therapy ot attend), e-mailfeedback to both parents at agreed-upon intervals may be useful. This covets keythem es wi thin the session and increases the pa ren t s awareness of the therapist sneutrali ty, which reduces the l ikelihood of sudden termination. In order toma intain the bound aries of the therapeutic space, each patent is instructed to replyair with any feedback. Any subsequent response by the therapist to an e-mail replyis minimal (outside of the therapeutic space). If using this practice, the therapistwould do well to be alert to the possibility that emails have the potential to be usedin a legal context. This represents a complexity for the therapist seeking to structurethe communication of information within a therapeutic (rather than legal) contextand with a therapeutic (rather than legal) intent. Naturally, the child will need to beinformed of the feedback arrangements in place and (with careful regard to their ageand understanding) the limits of confidentiality.

    Responding to Practice Challenges

    eferr l

    Therapeutic work relating to marital separation is not always accompanied by aninitial presentation involving the separated parental subsystem. Indeed, at the pointof referral the relationship may be intact although highly conflicted andseparation may occur part way into the therapeutic work. In some instances parentswill deliberately engage with a thetapist prior to informing their child (and oftenthe therapist) of theit decision to separate, whereas for other paren t s this processwill be a less deliberate and/or strategic decision. The need for clarity with regardsto multiple or obscure agendas was discussed above.

    Referrals can be a direct response to concerns regarding the impact of separationupon the child, which is acknowledged from the outset. In other cases, the referral

  • 8/12/2019 66868708

    7/13

    Family Focused Child Therapy in Marital Sep aration

    therapy and the child should not be considered a voluntary attendee, as parents mayhave left the child with little real option of declining treatment.

    Structuring tbe irst Interview

    The author takes the position that initial interviews ideally include the child/adoles-cent, their parent/s and any siblings. Where it becomes apparent that it would notbe advisable to meet with both parents simultaneously, then a session is scheduledwith the child/adolescent and their referring parent, followed closely with a sessioninvolving the child/adolescent and the other parent. A decision to communicateand ideally meet with both parents early in the therapy reflects an understandingtha t: 'Fo rging satisfactory therapeu tic alliances with all parties is especially crucial inthese families' (Lebow Reka rt, 20 07 , p. 81 ). In particular, a position of neu tralityis highly signiflcant given that each parent will likely be seeking to ensure the thera-

    pist does not form a closer alliance with the other parent.Typically, an adolescent will be invited to attend the first interview with their

    parent. This is not so in the case of the pre-school aged child. This differencereflects the emphasis that an adolescent is likely to place on forming their ownrelationship with the therapist, independent of any previously disclosed parentalviews. Additionally, this difference reflects an understanding that parents are likelyto have shielded young children from adult themes and family secrets (that arelikely to be more readily apparent to an adolescent). Nonetheless, there is a need toprovide parents of adolescents with an opportunity be this a subsequent sessionor towards the conclusion of the initial session to speak alone with the therapist,so they can be provided with an opportunity to raise any themes not yet disclosedto the adolescent.

    A decision to include the referring parent (preferably accompanied by the otherparent) in the initial interview will help the child's capacity to interact with thetherapist, provide insight into the primary concern as well as assist with the compi-lation of a relevant history. It is usually the concerns of the parent that have initi-ated the referral and, accurate or not, they need to be heard to establish a workingrelationship with the family system. The initial interview assesses current concernsas represented by each family member, the child within multiple contexts (includ-ing family and school), current family structures (including any court orders) anddiscussion of possible treatment options (including the need for any additionalassessment sessions).

    Goals o Therapy

    Family-focused child therapy addresses marital themes only when they are directlyrelevant to the parenting of the child; it is separate from marital therapy and/ormediation though these interventions may occur in parallel. Its goals are individu-alised to suit each client and are based on family therapy and related literature to:

    assist children to ' .. . be tter und erstan d what it means to be in a divorced family,to talk about their feelings about the conflict between their parents, and to find

  • 8/12/2019 66868708

    8/13

    Shannon O Gorman

    assist children ' .. . in achieving healthy relationships with each pare nt' (Greenberg Go uld , 20 01 ,p . 475)

    help in '.. . assisting parents in more effectively sup po rting the child's needs'(Greenberg Gou ld, 20 01 , p. 475)

    l imit the extent that children are ' . . . used as pawns in parental conflict '(Keoughan, Joann ing, Sudak-Allison, 20 01 , p. 159)

    establish clear rules across multiple households (Keoug han, Joan ning , Sudak -Allison, 2001, p. 160) and/or clearly defined and described differences

    address any identified behavioural and /or mo od related conce rns.

    At a different level, therapy with individuals and/or several members of the overallfamily system may also serve to prepare the broader family system/s for familytherapy (Johnson, 1995 , p.6 8) . As such, the capacity to shift from family-focusedchild therapy to family therapy may represent one of the goals of treatment.

    Sequencing ttendance t Therapy

    When considering the sequencing of attendees in therapy, there is a need toconsider the preferences of the family (Donovan, 2003, p. 13 1; Kaslow Racusin,1990, p. 281). In particular, it has been suggested that the '... child should beprovided with the option to have some decisional influence in therapy, wheneverpossible' (Hecker, 201 0, p . 55). With regards to the sequencing of attendance, threedifferent structures will now be discussed.

    Alternating Parental Attendance

    In instances in which separated parents are unable to sit in the same room(routinely or indeed, even for one session), the therapist may consider alternatingsessions such that the child attends each appointment, accompanied by the alterna-tive parent at each subsequent appointment. This format holds the child to be themain client but acknowledges the importance of each parent in the life of the child.

    Where the therapist agrees to alternating parent-child combinations, eachindividual is informed that information will be shared among all parties; that is, no

    information is held in confidence. This position reflects the reality that the child hasbeen witness to each session and cannot be expected to deliberately withhold infor-mation from either parent. It reinforces the need for each parent to speak of theother parent in a respectful manner. This can be complicated where one parentraises material that might leave them feeling vulnerable if shared with the otherparent. However, the emphasis upon the child's needs means such material isunlikely to represent one of the key themes of the session. Rather, if these themesare signiflcant, the therapist may suggest the parent consider raising them in analternative therapeutic setting.

    If either parent has re-partnered and seeks to involve new members within thetherapeutic process, the author takes the position that the definition of the familysystem lies with the parent and is largely unchallenged (i.e., in the absence of any

  • 8/12/2019 66868708

    9/13

    Family Focused Child Therapy in Marital Sep aration

    the evolving family system. For example, a mother may object to her ex-husbandinviting his partner to therapy. Yet, these very discussions regarding therapy partici-pation can provide the therapist with valuable insight into the nature of therelationship between any new partner/s and the child/ren in question. For example,

    the implications for the child are dramatically different when comparing a 'new'partner whom the child has rarely met versus a 'new' partner who has moved intothe child's home and has some input into the functioning of this household.

    While a child may make the potentially accurate assumption that a new partnershould not be attending therapy in a parental role, the therapist may elect tosupport the parent's invitation of the new partner. For example, if it appears thatthe new partner has a significant role in either directly caring for the child (i.e., thechild spends time in the new partner's care without the parent being also present)or heavily influences the parent's approach to interacting with their child (i.e., the

    parent appears heavily reliant upon the new partner to inform or enact parentingapproaches). As such, it may be appropriate to attempt '... to bring them [newpartners] into the solution process' (Lebow Rekart, 20 07 , p. 87).

    Child in Isolation From Parents

    In the second example, the therapist engages with the child/ren alone. When seekingto engage with children, the therapist may consider the use of age-appropriate inter-ventions, including carefully selected stories, providing access to art materials anddolls, facilitating role plays and specific games (e.g., the squiggle game describedby Winnicott) as a means to providing the child with alternative forms of self

    expression. When working with children there is a need to remain '... mindful ofthe potential effects of suggestibility, repeated or leading questioning, children'sexposure to adult information or their parents' emotional needs, and high-conflictdynamics as contributing factors in children's statements and behaviour' (Greenberg Go uld , 200 1 ,p . 477).

    Where younger children and the therapist meet alone, potential exists to inviteone or both parents (usually the parent who has driven the child to the appoint-ment) in for a brief discussion at the beginning of each session. This is particularlyuseful if the child struggles to recall events that elapsed since the last session. This

    approach must consider the risk that the parent may then set the agenda for thesession and/or that the parent's descriptions of a child's limitations or disappoint-ments may be confronting for the child to hear. Nonetheless, parents often raiseimportant material that may, or may not, be discussed with the child alone as thesession progresses. Opportunity also exists for the parent to be invited to join theend of the session. During this time the child is encouraged to inform the parent ofany meaningful items discussed during the session and/or the therapist may providefeedback arising from observations made d urin g this, or a series of previous sessions.

    Parental Meeting

    If regular family therapy is not possible, the therapist may elect to invite bothparents simultaneously to a carefully structured, on e-off'm eetin g'. Given the inten-

  • 8/12/2019 66868708

    10/13

    Shannon O Gorman

    presence of the child. The idea of the joint meeting is introduced at a point intherap y tha t allows the therap ist to gauge its likely usefulness a nd the pa ren t scapacity to use it. The decision to include/exclude the child from this meetingwould be made in accordance with the items to be discussed within the meeting.

    Prior to the meeting, each parent is invited to write down a list of child-focusedconcerns (e.g., concerns that a parent holds with respect to their child, or topicsthat they feel might be usefiil to discuss in front of/with the child), which the thera-pist then compiles into an agenda and circulates in advance. The aim here is toreduce the likelihood of deviating in the direction of l ss relevant concerns, therebystressing the focus upon child related concerns (content) and where indicated, thechild s presence (process). In essence, this me eting seeks to provide a brief opp or tu-nity for communication (Kaplan, 1977) and is particularly useful in seeking toensure consistency or define differences in rules across households, providing thechild with an opportunity to discuss their experiences of the separation andhighlighting the child s perceptions of the curren t parental relationship.

    A joint parental meeting also represents an ideal forum in which the therapistcan address any need for psychoeducation related to specific themes. As statedpreviously, parents will present with differing degrees of understanding the possiblerelationship between the primary concern and the breakdown in the maritalrelationship. In many instances psychoeducation represents an opportunity toprovide the evolving family systems with new information in the hope that this maybe the .. . difference that makes a difference (Bateson, 1979, p. 21 2) . According toLebow and Rekart (2007): What is often not understood by parents is that thereare few conditions that are likely to be traumatic for children as the maintenance ofthe ongoing paren tal conflict (p. 84 ). In the case of those parents engaged in significant conflict, the therapist may com m unic ate som ething like the following: .. .that at this vulnerable time, when parents are dealing with their own emotionalissues, children are grappling with the transitions and strains in family relationships.A central message of this discussion is how difficult, yet important, it is to listen tochildren s distress at a time w hen paren ts and children are bo th feeling upse t(Pedro-Carroll et al., 20 01 , p. 381 ).

    The relevance and extent of psychoeducation within family-focused childtherapy will ultimately be determ ined by the goals of treatme nt.

    Limitations of Family Focused Child TherapyBefore closing, there is a need to acknowledge instances in which family-focused childtherapy may be partictilarly inapprop riate. In the auth or s op inion , for preschool an dearly school-aged children, child therapy shou ld only be condu cted if both parents areable to listen to any material that the child may relay from therapy; and provide aresponse that is free from hostility towards and/or degradation of th other parent andthe therapeutic process. Essentially, the parent must provide the child with a sensitiveresponse so the therapeutic process remains accessible and safe to the child, especially

  • 8/12/2019 66868708

    11/13

    Family Focused Child Therapy in Marital Separation

    on a caring or parenting role. Also it needs to be stressed that child therapy cannotnegate the impact of continual exposure to parental conflict. Nor does therapyenab le a child to fulfil roles above their age or ability, such as discussing com plexadult themes with a parent. Parents may need to be informed that while the thera-pist is able to contain the child's emotional experience and assist them to under-stand their internal and external world, this process can be difficult and confrontingfor the child and may not be viable in the face of unchanging and insensitiveparental behaviours. In oth er words therapists should be concerned where therapy issought for the child an involuntary client where parent(s) maintain a limitedand uncha nging capacity to prioritise their child's emo tional needs.

    As highlighted above, therapists expose themselves and their child/adolescentclient to potential hostility if a decision is made to proceed with therapy in theabsence of joint parental consent. However, if a therapist requires joint parental

    consent, then it may well be that those children/adolescents most in need oftherapy, namely, those living in the context of very hostile parental separations aredenied assistance at least outside of any court ordered therapy given that itwould not be uncommon for parents to disagree on most matters (including theselection of therapist). In such instances, the therapist may elect to raise with bothparents the possibility that the issue of consent now mirrors established patterns ofconflict and the consequent impact that this will have upon the child's access totreatment, in accordance with the therapist's own position on this matter.

    ConclusionThis article has focused on therapeutic work with families affected by separationwhere the possibility of work with the broader family system is constrained, yet theemotional world of the child needs to be prioritised. Nonetheless, the child repre-sents a part of larger whole and an inability to adequately explore significant partsof this whole may limit treatment. Thus in some cases the child and family willrequire additional assistance for example, in working with a child/adolescent thetherapist cannot provide therapy for a depressed mother. Also therapists engagedwith the child/adolescent and/or alternating parents cannot adequately examine thespaces between the parental subsystem (that continues to exist once the maritalsubsystem has separated). It is hoped that family-focused child therapy addressessome of the family's presenting concerns and provides each member with a success-flil experience of therapy that may make way for the possibility of fiirther work.

    In conclusion, this article has described a family-focused child therapy approachto working with children in the context of marital separation. The author's positionis that being entrusted with the emotional needs of child during times of vulnera-bility is a privileged responsibility to be carefully traversed. This reflects a need toconsider both of the '... complementary sides of the systemic coin'. * (Keeney, 1983,

    p. 70). The role of the therapist is also one to be respected and at times of intenseconflict and hurt, adult clients can knowingly or unknowingly present challenges

  • 8/12/2019 66868708

    12/13

    Shannon O Gorman

    Endnotes

    1 In referring to the 'family system' there is an und ers tan din g that the original familysystem that included the marital partners and children has now divided and isevolving into two separate systems and as such, may be best described as 'family systems'.

    2 It was noted tha t 'Th e majority of these couples had no children' (Australian Bureau ofStatistics, 2008b).

    3 'These include: com plete confidentiality, limited confidentiality, informed forced consen t,no guarantee of confidentiality (Hendrix, 1991), mutual agreement regarding confidential-ity, and a best interests agreement (Sori & Hacker, 200 6). ' (Hecker, 20 10 , p. 57).

    4. Keeney (1983) described these as being the processes of stability and change (p. 70) .

    References

    Australian Bureau of Statistics. (2008a). Divorces, Australia, 2007 {Cit. no. 3307.0.55.001).Retrieved from http://www .abs.gov.aU/ausstats/[email protected]/mf/3307.0.55.001

    Australian Bureau of Statistics. (2008b). Family Characteristics and Transitions, Australia,2006-07 (Cat. no. 44 42 .0). Retrieved from http://www.abs.gov.au/ausstats/[email protected]/PrimaryMainFeatures/4442.0?OpenDocument

    Bateson, G. (1979). Mind and nature: A necessary unity. Cresskill, New Jersey: Ham pto n Press.Becvar, D.S., & Becvar, R.J. (2003). Fa mily therapy: A systemic integration (5th ed.). B oston:

    Allyn and Bacon.Do nov an, M . (200 3). Mind the gap: Th e need for a generic bridge between psych oanalytic

    and systemic sjprosches. Journal of Family Therapy, 25(2), 115135.Freud, S. (1922). A general introduction to psychoa nalysis. New York Boni and Liveright.Greenberg, L.R., & Gould, J.W. (2001). The treating expert: A hybrid role with firm

    boundaries. Professional Psychology: Research and Practice, 32(5) , 469 -478 .Hecker, L. (2010). Ethics and professional issues in couple and family therapy. Ethics in

    therapy with children in families (pp. 51- 70 ). New York: Routledge.Johnson, L. (1995). Filial therapy: A bridge between individual child therapy and family

    ier py. Journal of Family Psychotherapy, 6(3) , 55-70.Kaplan, S.L. (1977). Structural family therapy for children of divorce: Gase reports. Family

    Process, 16(1), 7 5 - 8 3 .

    Kaslow, N.J., & Racusin, G.R. (1990). Family therapy or child therapy: An open or shutcas. Journal of Family Psychology, 3(3) , 273-289.

    Keeney, B.P. (19 83) . esthetics of change. New York The Guildford Press.

    Keough an, P., Joann ing, H ., & Sudak-Allison, J. (2 001 ). Ch ild access and visitation follow-ing divorce: A growth area for marriage and family therapy. The American Journal ofFamily Therapy, 29(2), 155 -163 .

    Lebow, J., & Rekart, K.N. (2007). Integrative family therapy for high-confiict divorce withdisputes over child custody and v isitation. Family Process, 4^6(1), 7 9 - 9 1 .

    Pedro-GarroU, J., Nakhnikian, E., & Montes, G. (2001). Assisting children through transi-tion: Helping parents protect their children from the toxic effects of ongoing conflict inthe aftermath of divorce. Fam ily Court Review, 39{4), 377 -392 .

    Rober P (2008) Being there experiencing and creating space for dialogue: About working

  • 8/12/2019 66868708

    13/13

    Copyright of Australian & New Zealand Journal of Family Therapy is the property of Australian Academic

    Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright

    holder's express written permission. However, users may print, download, or email articles for individual use.