As a clinical child psychologist, a common query I encounter from parents is what should be expected from a therapist or psychologist during sessions with a child struggling with an anxiety disorder.
The answer to this is complex, as therapists are trained in various models, each placing different emphases on treatment aspects. However, irrespective of the theoretical orientation, certain universal features must be present in all therapeutic approaches.
A fundamental prerequisite is the establishment of a safe and secure therapeutic relationship with the young person. This foundation paves the way for any intervention work. It is essential for several reasons:
The child must feel secure enough to share personal thoughts and feelings, which might be difficult to express.
The therapist needs to accept, without judgment, the emotional state of the young person.
The child requires confidence in the therapist's capacity to provide support, especially when they exhibit varying emotional states.
The importance of the therapeutic alliance harks back to the work of early luminaries in psychology and psychotherapy, such as John Bowlby (1907–1990), Donald Winnicott (1896–1971), and Wilfred Bion (1897–1979). Though each theorist had unique views on what constitutes a strong therapeutic alliance, the common thread was the clinician's ability to empathetically bear the patient's emotional experiences and facilitate understanding in a nonjudgmental manner.
Beyond the therapeutic alliance, two core components are often central in addressing anxiety with young individuals:
Psychoeducation: It is imperative for children to understand anxiety—its manifestations, perpetuating factors, and protective measures. Delivery methods may vary; some therapists employ creative means like metaphors or visual aids, while others may opt for straightforward, scientific explanations.
Exposure Therapy: A critical element, regardless of the type of anxiety, involves controlled exposure to feared situations with the therapist’s guidance. This assists children in tolerating distress and contextualizing their experiences.
Parents are encouraged to communicate with their clinician about when and how these interventions will be implemented. It’s crucial to understand that while therapeutic progress can be challenging, and not every session will be smooth, the support of the parent is vital in navigating the therapeutic process.
To conclude, despite the diversity in therapeutic approaches to anxiety, there are common factors that should be consistently integrated into treatment. These include the therapeutic relationship, psychoeducation, and exposure. Parents should feel empowered to discuss these elements with their child’s therapist to ensure a comprehensive approach to managing anxiety.
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