As part of an ongoing series, the staff at Union Square Practice will be sharing their thoughts on an important question: “What makes therapy work?” This week, Dr. Laura Paret, a child and adolescent psychologist, shares her thoughts.
No two therapies are exactly the same, especially when kids at different ages and stages of development are involved. To start, a big dose of compassion and optimism are essential to getting the therapeutic journey started! An empathic stance is particularly important when starting therapy with parents and kids. All too often, parents feel guilty or somehow at fault for their child’s struggles, and youngsters frequently feel that something is “wrong” with them.
I am quick to convey that my expertise in child development and therapeutic practice, coupled with the insight that parents and children have into their own strengths and challenges, makes us an unstoppable therapy team. Fortunately, my clinical experience as well as the scientific literature support that a strong working relationship and shared goals between therapist and clients is a key factor that promotes growth and change over time.
Next, I acknowledge with families that recognizing the need for help is an important first step in their journey. I explain how biological, psychological and social factors that underlie each child and families’ unique set of circumstances will dictate the therapeutic approach that will be most helpful. On the road to figuring this out, the first part of my job, and a core component of setting up therapy to be effective, is starting the relationship with a comprehensive assessment.
During the initial assessment process, I meet with caregivers and youth separately in order to generate ideas on what might be contributing to the child’s difficulties. I am like a detective, collecting evidence to help solve the mystery! On an as-needed basis, I will request to gain more information either from the child’s school or other parties (e.g., learning specialists, pediatricians) to gain a complete understanding of the presenting issues and the goals to be met through therapy.
Finally, together with the help of the child, family, and others, a mutual understanding of factors that are keeping the child and/or family stuck in unhelpful ways of thinking, feeling, or acting are established. I use this vital information to explain to the youngster and his or her family how targeted therapeutic approaches shown by research to be the most effective (e.g., cognitive-behavioral therapy, mindfulness, and parent-coaching) will help them to shift current patterns keeping them stuck. Once the therapy plan is agreed upon, I use my creativity and passion to make therapeutic strategies accessible and usable in youth’s day-to-day life in order to foster change.
To be sure, one of my favorite parts of being a child and adolescent psychologist is coming to understand a family’s strengths, relationships, culture, goals and pressures in order to best create an individualized therapy plan that will work for that particular child and family. In short, a partnership with caregivers (and sometimes with schools too!), a creative, warm, and fun working relationship with children and teens, and a grounding of the work in sound therapeutic approaches combine to create a therapy that works.