Person-Centred Therapy with Children and Young People

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David Smyth

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    About the Author

    David Smyth undertook his professional training as a person-centred therapist at the University of East Anglia under its director Professor Brian Thorne. This represented a significant career change that followed thirty years working in the UK's National Health Service and as a bursar at a Cambridge college. He decided to develop his interest in working with children and young people and undertook further training in the Republic of Ireland over the ensuing five years.

    Resident in Suffolk, David established an independent practice that has steadily grown to become a full time commitment. His varied practice includes children, young people, adults and couples, undertaking occasional legal work and providing a psychotherapy service to an independent school.

    David is married with two grown up children. Away from his professional work, he enjoys coastline walks and exploring the woods and heathland in his locality together with his wife and his English Setter, Hugo.

    Foreword by Michael Behr

    This is a book not only about working as but also about becoming a child and adolescent psychotherapist. In this, it is a unique work. David Smyth discloses his personal journey into his profession. As the reader, I witness his journey from being externally driven, feeling and doing what others subtly convey, towards becoming a therapist who gives himself as a congruent person into an authentic relationship. I was fascinated to read how his experiential mode of being lends an outstanding quality to the therapeutic processes he thus facilitates today. I envy his young clients and their parents/caregivers in how lucky they are to experience a therapist who has gone through so many of the personal distresses of everyday life which they now face – and who is so very aware of this. Childhood, adolescence, being adult: how life issues transfer through development and turn into constructive changes. There is a saying that the really great psychotherapists are unpretentious and humble people who are very much conscious of their personal limits. David Smyth's work is a great support for this claim, and his book offers a kaleidoscope view of how clients may feel deeply understood out of such a position, and distinctively facilitated in their development.

    As the book proceeds, it deals further with scholarly and very practical questions within child and adolescent psychotherapy, and the counselling of parents/caregivers. In this David Smyth proves to be a thorough reader and thinker who has taken a wide field of literature into account but also finds personal solutions to the issues in question. Again, this makes the book a very practical one: the reader can find valuable consideration of a huge range of issues that are of basic interest in therapeutic practice. These include: intake procedure, toys, playing, media, refreshments, motivation for change, parental divorce and separation, different disorders and problems, record keeping, supervision, boundaries, confidentiality, parents, legislative matters, gender, end of therapy, resilience, transference, non-directivity and many more.

    I was especially fascinated with the large number of practical examples offered; here is a therapist who first and foremost draws into his work what the young clients are teaching him. These examples let the text shift towards an even higher level of meaningfulness; they convey how David Smyth relates personally to his practice and his understanding of its processes. In addition, questions for reflection are inserted throughout the text. They often stop the flow of reading in an evocative way and encourage the reader to go the author's way: switching into an experiential mode and considering what previous messages mean for personal thinking and feeling.

    David Smyth feels himself rooted within a classical approach of person-centred work. He revisits the conditions model and offers an interpretation written from a child-centred perspective that remains true to the core principles. He conveys scepticism wherever multimodal orientations question the non-directive paradigm of Rogerian therapy. In this, he advocates the young people's non-manipulated growth, a growth that evolves out of a relationship and an experientially aware therapist, and not out of exercises, behavioural learning, training or tricky cognitive operations. It is a book very much about being in a therapy session rather than doing therapy. It may demystify the apparent complexity which scholarly papers sometimes convey. Within person-centred sub-orientations, working with children and adolescents will obtain an equal position and be valued equally to other fields of person-centred work.

    So – do not read this book if you think the being and feeling of the therapist should be separated from the process of therapy. Do not read it if you think your own personal history should be left aside when becoming a therapist. Read it if you may join David Smyth when passionately advocating for a non-manipulated growth of children, a non-intrusive fostering development and a sense of being young people that allows them wide space and choices within a secure attachment. Read it if you yourself would only choose a therapist who is clearly open and proficient to deeply experiencing him or herself.

    If you are not sure, read it too. The book will help you to decide either way.

    Michael BehrSchwäbisch Gmünd, GermanyMarch 2012

    Acknowledgements

    I would like to acknowledge the many people who have helped me with this work: Alice Oven at Sage Publishing, who has been the most remarkable person, providing encouragement when I most needed it and for her unswerving belief; Kate Wharton and Rachel Burrows at Sage, for their advice and guidance on many different editorial matters; Michael Behr for his gentle kindness and support; and my professional supervisor, Louise Young, a thoughtful, patient and resourceful colleague who has seen in me things I am yet to see in myself. I am indebted to the Headmaster of Ipswich School and the Head of Ipswich Preparatory School, together with staff and pupils, for their support in providing illustrations completed during pupils' PHSE and Art lessons. Their kindness and encouragement has been greatly appreciated. Marjoke Henrichs has prepared some wonderful illustrations with amazing enthusiasm and interest. She has responded to my needs thoughtfully and with considerable patience. Her drawing of the Madonna statue in Parma Cathedral has been reproduced with the kind permission of the Marquis Pallavicini.

    I want to give special mention to Eileen Prendiville, founder of the Children's Therapy Centre in Ireland, a key inspiration in my child psychotherapy and play therapy training whose wisdom and experience finds its place in this book, and Brian Thorne who got me going in person-centred therapy in the first place. I want to thank all the children and young people who have allowed me to work with them – they are the stars of this book – and to the grounding afforded by my family in this venture – including my dear wife Gail, without whom I would be lost. I am worried I have left somebody out and I hope they can forgive me: it is not intentional but rather overwhelming.

    Author's Note

    I recognise that, while the term ‘person-centred’ approach is universally recognisable, ‘play therapy’ is open to interpretation, depending upon the reader's existing knowledge and viewpoint. Until I came to finalise the manuscript, I had not appreciated that my meaning of the term was anything other than universal. I therefore want to clarify my use of the word ‘play’ as conveyed in this book.

    My core practice is philosophically founded upon the conditions of person-centred therapy. It seems to me that, by past convention, this has been used to describe a form of therapy rooted in the principles developed by Carl Rogers as an approach to working with adults. These principles have not tended to relate to therapeutic work with children and young people. Axline (1947) wrote about play therapy as a way of working with children. She was a student then colleague of Rogers who, according to Cochran et al. was ‘the “mother” of the non-directive or client-centered approach to play therapy’ (2010: 71). The ensuing decades have seen a development of play therapy utilising a variety of therapeutic models. It is evident that some now regard play therapy almost as an autonomous approach. Moreover, West potentially adds to the terminology confusion with her book Child-Centred Play Therapy (1996). In quoting other authors I have therefore diminished the term play therapy where it appears, to therapy. I hope these authors will understand.

    I want to describe the context within which this book has been written: it is absolutely about the person-centred approach but for children and young people. I call this child-centred if only to define its relationship to people up to 18 years of age. Since, as I explain, play is often the preferred therapeutic means of communication of children of a certain age group, I now recognise that to describe this as play therapy could be misleading. This book is not about the person-centred approach and play therapy – implying two different therapeutic approaches. It is, as the title states: Person-Centred Therapy for Children and Young People in which the human individual grows and develops along a continuum of life experience travelling through childhood to adulthood.

    The case examples described in this book illustrate the concepts and aspects of my professional practice. Pseudonyms are used throughout and the gender changed where I felt this to be appropriate.

    Introduction

    When I first contemplated this book, I had little idea of the many twists and turns this process would entail. After all, I had not attempted anything like this before and I was therefore blissfully naïve as to the true extent of the endeavour. To say this has been a personal learning experience for me would be a significant understatement. While describing face-to-face client work as my primary purpose, I am acutely aware that I feel most grounded when I am professionally in relationship with a young person. This relationship enables me to express my feelings fluidly within the context of my client's being.

    To prepare this script was therefore a huge personal paradigm shift. A concept explored by Thomas Kuhn – a philosopher of science who wrote The Structure of Scientific Revolution (1962) – who argued that scientific advancement is not evolutionary but rather a ‘series of peaceful interludes punctuated by intellectually violent revolutions’. Mine is not a work of science, nor am I an academic in the accepted sense. Therefore ‘battling’ through the jungle that is my mind, towards a predetermined clearing at its furthest extent, has at times been intellectually violent and testing for me – almost physically so. In this context, arriving at my destination, where clarity becomes possible for others not just for myself, has been a monumental experience. Time will tell if I have been able to achieve this in any small measure.

    When initially invited to write a book on working with children and young people, I wanted it to be both readable and encourage readers to apply their own ‘stamp’. What do I mean by this? We possess a uniqueness that is ours: if we acknowledge this for our clients, it is also true for us as students or practitioners irrespective of our professional background. I communicate with clients in a manner that is personal to them irrespective of their age. Equally, I choose to communicate the person I am rather than someone who for many years focused on his perceived acceptability (or lack thereof) to others. There are occasions when I will challenge traditional boundaries that purport to be child-centred when their authenticity seems to me to be a superficial and abstract concept.

    As if to underline this, Chapter 13 describes aspects of the current law in relation to children that has been of central relevance to my developing therapeutic practice. The administration of the law can significantly bear upon the emotional well being of affected children. It reaches well beyond what some might regard as ‘welfare’ issues that, by convention, could be considered to lie beyond the scope of therapeutic practice. I recognise that I have elected to develop my child-centred practice in this particular way and that it is a path that may not be chosen by others. I consider the person-centred approach to be inherently holistic: I therefore believe it is reasonable to conclude that legal decisions directly affecting the emotional development or well-being of children and young people represents a legitimate area for the child-centred practitioner's practice.

    My book is not prescriptive: that individuals find a path or way of being that has meaning for them within a safe and effective therapeutic practice is central to person-centred values. The practitioner is a therapist who relies not upon tools and techniques with which to direct the client, but who intuitively believes that offering appropriate conditions for emotional growth within the experience of the therapeutic relationship will enable clients to find a way that has meaning for them as individuals.

    Psychotherapy texts addressing the needs of children and young people invariably draw a distinction between these two age groups. Policies and practices tend to support this approach by, for instance, separating the needs of children in primary school education from those engaged in secondary education. I have elected to write about children as a single group for two reasons. First, they are holistic beings who, while possessing broadly recognisable stages of emotional growth through which they may pass, are, within the definition described in this book, children until they reach 18 years of age. Secondly, they experience a series of transitions that may or may not follow a ‘normal’ sequence as defined by others. I appreciate I could have perhaps simplified matters for myself had I followed the broadly accepted pattern, but this would not have permitted me to describe, for example, the child of 9 years of age who uses speech as his or her preferred method of communication or the young person aged 14 who has a preference for any kind of communication so long as it does not involve talking.

    In time, I hope it may be possible for adult-based courses to introduce students to working with children since many adults seeking counselling therapy embody experiences from their childhood and adolescence that shape their lives and can directly influence their decision to seek therapy. My experience leads me to believe that children who encounter significant events during their major emotional development period (see Chapter 3) will find these ‘grow’ (albeit not exclusively) with them into adulthood, in proportion to the impact encountered as that child. Adult clients may often express surprise that an event occurring in their childhood can still influence them, preferring instead to believe that, with time, the recollections had (or should have) faded or contextualised within their adult frame of reference. They may not appreciate that the intensity of their childhood experience can at times be as if they were now that child.

    This book is for students of counselling and qualified practitioners in other helping professions wanting to extend their training and thereby contribute to their ongoing development. It is my hope that this volume will find its way to trainees and professionals in other fields, such as medicine, nursing and other allied health professions. Student teachers, trainee social workers, law officers (such as those working in the family courts) and others may find something here to enhance their professional and personal approach.

    Readers may use this text as a tool to assist them find or develop their personal child-centred approach to children and young people within their professional field. The book defines ‘child-centred’ within the person-centred context: however, space constraints have limited me to providing a broad description of the model developed by Carl Rogers. Those who would like to learn more about the person-centred modality regarding the overall approach will find reference to some helpful texts in this book.

    Those wanting to enhance their child-centred practice will find affirmation if they feel the need for it, but I trust readers will also be open to self-scrutiny and use this opportunity to ‘audit’ existing practices and methods of working as I continue to do.

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