David Christensen, M.A.: My Approach to Child Therapy

My name is David Christensen and I’m the child and family specialist at South Davis Psychological. With my post today I want to give you a better idea about I approach counseling/therapy with children. Therapy with children is not like therapy with adults because children are not adults. Talking isn’t always the best method to get results when working with children, but helping the child find their own voice in a natural way, such as through play therapy, can be the secret to getting results and improving their life.  

My Model for Child Therapy

In my work with kids I often turn to a proven, effective approach known as Attachment, Regulation, and Competency (ARC). This approach focuses on improving relationships, managing emotions, and developing a more positive self-esteem.

ATTACHMENT

  Attachment is the term used to describe the bond between family members. In this stage, I work to support both parents and children. For the parents, I work on helping them recognize, understand, accept, and manage their own responses to the needs and issues of their children with the goal of deepening their understanding of the child’s behavior and building a stronger bond with their child. For the child, I work to help them develop greater trust in their parents and others who support them, leading to a greater sense of security and a corresponding decrease in behavioral issues. When children feel safe, secure, and loved, it puts them in a place where they can then work on the next two stages.

REGULATION

 Regulation is the ability to identify, understand, tolerate, and manage one's emotions. Many children and youth struggle to regulate their emotions which can lead to episodes of anxiety and depression. I work to help the child develop an awareness of their physical experiences (body state), mental (thoughts), emotional (feelings), and social (behaviors) experiences; as well as helping them develop an increased capacity to tolerate and manage those thoughts and feelings through the use of coping skills and improving relationship connections.

COMPETENCY

 Competency is the development of skills and abilities to feel empowered and recognize consequences of actions. The goal in this stage includes increasing the child’s ability to make good choices and improve decision-making processes as well as improving self-esteem and self-identity to build a well-rounded life.

The Case of Josh: The ARC Approach in Action

When Josh was 9-years-old, his parents noticed that his behavior seemed to have changed. He never seemed happy, he was aggressive at school and his grades began to decline. He was angry all the time and threw temper tantrums that included throwing and breaking items. His parents didn’t know how to help him, his teachers labeled him as a “troublemaker”, and none of his friends wanted to play with him.  

This family came to my office one day after Josh had gotten suspended from school. The parents were frustrated at not knowing how to help him, and Josh was mad at them for bringing him to talk to someone. His parents weren’t sure about therapy and stated that Josh didn’t talk to them about anything, so they didn’t think he would talk to me either, but they had to try.

Josh’s parents and I faced a challenge. As adults, we form relationships and solve problems by going to lunch with our friends and spending time talking with each other. Children find different ways of connecting and opening up. One of those ways is play. The last thing on earth Josh wanted was to talk. When Josh came into my office I knew that he was not going to open up immediately and start verbally sharing his deepest concerns, but I knew that if I formed a relationship with him through play, he would eventually be able to express what was happening to him that was causing such a change in his behavior.

Using a sand tray and assorted toys I played with Josh and looked for themes in his play that correlated with what his parents had told me was happening. Josh’s story that he played out in the therapy session included a person that was pushed into a volcano and was buried in lava, and nobody was there to help him. I explored this story with him and after a few sessions of acting out different stories in the play, I began to help Josh see connections between the person in his story and himself.

It came through the play that in real life his parents both worked late hours and Josh was left with a sitter most of the day. I talked to him about how it feels inside his body when he gets angry. “I feel hot like I’m inside a volcano and I’m burning up,” he stated, “and I’m all alone so it scares me”. Josh was finally opening up and sharing his feelings. We explored more of his feelings about his experiences in school, at home with his family, and with his friends. As Josh began to describe what he was feeling, we began working on coping skills for him begin to learn to manage those intense emotions he was feeling.

Teaching children to recognize their emotions is the first step in solving an issue. If the child doesn’t know how they are feeling, it is hard for them to talk about it and explain why they behave the way they do. With Josh, we were able to make a connection with his experiences and how he feels emotionally. “When I get home from school mom and dad aren’t there and I feel scared and then I feel really hot inside like I have lava inside of me that needs to come out,” Josh told me. He didn’t want to get in trouble anymore, but he didn’t know how to stop the “lava” from coming out as he threw a temper tantrum. I used a visualization technique to have him imagine that the lava was inside his stomach and that he was able to send it into his hands where he could take a deep breath and cool the hot lava by slowly blowing on each of his fingers as if they were on fire. Josh tried it a few times in the session and exclaimed, “I feel calm!” That week I had him practice blowing out the fire within him using that coping skill every day. I even had him teach it to his teacher so she could help him calm down when she noticed that he was getting upset.

Josh began to have fewer issues at school and his behavior improved at home as he developed other skills to help him recognize and manage his emotions and behaviors. In subsequent sessions, I met with mom, dad, and Josh all together to help them improve their relationship as parents and child. We explored ways that Josh could still feel connected to them even when they were both gone to work. This was helpful for Josh to recognize that he was still safe, secure, and loved even when away from his parents.

As Josh gave voice to his feelings through play, we were able to address the struggles in his attachment to his parents. We also found ways together of tolerating those feelings (Regulation) and developed the skills to manage and harness them (Competency).

Focusing on these three areas allows me to look at the child as a whole, not just at the symptoms. I understand it can be frustrating to have a child that misbehaves, doesn’t listen, or is doing poorly in school, and all that is wanted is for them to be more obedient and get their homework in on time. However, when I examine what the child experiences in every area of their life, I am able to help resolve the symptoms because the underlying issue has been addressed and resolved.