This week of working with my young clients took my thoughts back several years to leave me reflecting on my first class in Counseling Theories. Early on, I identified myself as a Rogerian. In the years following this first class, I began to resonate with parts of other theories, and found myself practicing and using various techniques. It was almost as if I had begun to take the therapeutic relationship for granted and assume it’s necessity, but not look carefully at its’ extreme and important impact.
This week’s schedule brought me my usual 4-6 year old clients who deal with depression, or anxiety or PTSD symptoms on a daily basis. It was one client in particular, however, which caused me to recognize the importance of the therapeutic relationship. Suffice it to say that this 6 year old child has suffered various forms of abuse and neglect since birth, and is currently under great stress due to reminders of both past and recent traumas.
After this week’s session, I felt somewhat defeated as reminders of her most current losses never seem to end, and her behavior was regressing after what appeared as weeks of progress. Also, despite the adoptive parents’ understanding of trauma triggers, they are at their wit’s end over my client’s extreme tantrums, contributing to the stress throughout the family system.
Much to my surprise, I received a call from this child the day after her session. She had asked her adoptive parents if she could call me after her latest tantrum. I had left her one of my business cards several weeks before when I noticed she was having a difficult time ending each session. This has proven to be a great transitional object for the children to hang onto until the next week, with the reassuring words that “they can call me, if needed”. Within about 5 minutes of talking with the client, she had shared her sadness and feeling of being ‘little’ (which she had described to me the day before) as she drew a tiny version of herself. Also, she had become calm, received reassurance that she would be okay, and agreed to try the child friendly versions of some relaxation techniques we had practiced the day before. As I closed the phone call with a conversation with the adoptive mom, this mom recounted to me how she advocated for her daughter at her elementary school that day, and how she had recognized that her tantrums were directly connected to her recent reminders of loss…two small steps at first glance, but really two huge steps for this overwhelmed adoptive mom.
So, despite what initially appeared to be an unsuccessful attempt to talk to the adoptive parents, and my apparent insufficient time practicing breathing with my client…what was operating underneath and all around these ‘techniques’ was the therapeutic relationship. It was this relationship which caused the client to desire to reconnect with the calm voice she remembered the day before. It was this relationship which caused the adoptive parents to mull over my words, and sort out what did and did not make sense for them. And, further, it was this therapeutic relationship which caused me to take a risk in the first place, to offer to ‘be there’ for my client, and offer some difficult but necessary parenting information.
Later, I reviewed my other client’s sessions of the past week, some with what I considered a successful use of techniques and some with a lack of what I considered successful. But, underneath and covering all of this was the therapeutic relationship, which proved to each child that I was there today and going to be there in all the future weeks, as well as when they need extra support. My being there won’t depend on their progress, or their behavior or their lack of fear or level of depression, nor will it depend on these factors being present or absent in myself. That in itself is comforting to me…and appears to be comforting to them, as well!
Debbie Carter is a counselor-in-training who is interested in helping children and families heal from trauma, grief, and loss through play therapy; for more information http://www.linkedin.com/pub/debbie-carter/23/7a6/801.